Examining Long‐Term Effects Of An Infant Mental Health Home‐Based Early Head Start Program On Family Strengths And Resilience

Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home‐based Early Head Start (IMH‐HB EHS) program on family functioning. The sample includes 152 low‐income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH‐HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH‐HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH‐HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH‐HB EHS services are maintained after services cease.RESUMENLa meta de las intervenciones con base en la salud mental infantil es promover el desarrollo sano de infantes y bebés por medio de promover un funcionamiento familiar sano para adoptar relaciones de apoyo entre el pequeño niño y sus importantes cuidadores. Este estudio examinó el impacto que sobre el funcionamiento familiar tiene un programa “Early Head Start” de salud mental infantil con base en casa (IMH‐HB EHS). El grupo muestra lo componen 152 familias de bajos recursos del Medio Oeste de Estados Unidos, en espera de o ya criando a un niño menor de un año de edad, que fueron asignadas al azar para recibir los servicios de IMH‐HB EHS (n=75) o a una condición comparativa (n=77). Las madres que recibieron los servicios de IMH‐HB EHS reportaron un funcionamiento sicológico y familiar más saludable, resultados que son consistentes con el enfoque de IMH, cuando sus niños tenían entre 3 y 7 años de edad. Específicamente, las madres en el grupo IMH‐HB EHS reportaron un funcionamiento y relaciones familiares más saludables, mejores habilidades para arreglárselas que eran necesarias para abogar por sus familias, así como menos estrés en el papel de crianza al ser comparadas con aquellas madres en la condición comparativa. El estudio también examinó la manera de arreglárselas buscando apoyo, algunas de las cuales cambiaron diferentemente a través del tiempo con base en las asignaciones de grupo del programa. En general, los resultados sugieren que los aspectos positivos que las familias alcanzan como resultado de participar en los servicios de IMH‐HB EHS se mantienen después que los servicios terminan.RÉSUMÉLes interventions fondées sur la santé mentale ont pour but de promouvoir le développement sain des nourrissons et des jeunes enfants en promouvant le fonctionnement saind'une famille afin de favoriser des relations de soutien entre le jeune enfant et ceux qui s'occupent d'elle ou de lui. Cette étude a examiné les impacts d'un programme américain de Early Head Start focalisé sur la santé mentale du nourrisson (abrégé IMH‐HB EHS) sur le fonctionnement de la famille. L’échantillon a compris 152 familles de milieu défavorisé de la région centre des Etats‐Unis, attendant un enfant ou s'occupant d'un enfant de moins d'un an, a qui on a assigné au hasard les services IMH‐HB EHS (n=75) ou une condition de comparaison (n=77). Les mères ayant reçu les services IMH‐HB EHS ont fait état d'un meilleur fonctionnement psychologique et familial, des résultats qui correspondent à l'objectif de santé mentale du nourrisson, lorsque leurs enfants avaient entre 3 et 7 ans. Plus spécifiquement, les mères du groupe IMH‐HB EHS ont fait état d'un meilleur fonctionnement familial et de meilleurs relations familiales, de meilleures capacités à s'adapter nécessaires afin de se porter les avocates de leurs familles, et de moins de stress de parentage comparé à celles du groupe de comparaison. L’étude a aussi examiné l'adaptation liée à la quête de soutien, qui a en partie changé différemment au fil du temps, en fonction du groupe de placement. Au bout du compte les résultats suggèrent que les gains obtenus par les familles comme résultat de la participation aux services du IMH‐HB EHS se maintiennent après que les services cessent.ZUSAMMENFASSUNGInterventionen, die auf der mentalen Gesundheit von Säuglingen basieren, zielen darauf ab, die gesunde Entwicklung von Säuglingen und Kleinkindern zu verbessern, indem ein gesundes familiäres Funktionieren gefördert wird, um unterstützende Beziehungen zwischen dem Kleinkind und ihren/seinen wichtigsten Bezugspersonen zu begünstigen. Diese Studie untersuchte die Effekte eines Early Head Start‐Hausbesuchs‐Programms (IMH‐HB EHS) auf das familiäre Funktionieren. Die Stichprobe umfasst 152 Familien mit niedrigem Einkommen aus dem Mittleren Westen der USA. Es handelt sich bei der Stichprobe um werdende Eltern oder Eltern mit einem Kind unter einem Jahr, die randomisiert einer Dienstleistung zugewiesen wurden: zum IMH‐HB EHS‐Programm (n = 75) oder zu einer Vergleichsbedingung (n = 77). Mütter, die das IMH‐HB EHS‐Programm erhielten, berichteten von gesünderem psychologischem und familiärem Funktionieren, wenn ihre Kinder im Alter zwischen 3 und 7 Jahren waren. Dies sind Ergebnisse, die mit dem IMH Fokus übereinstimmen. Im Speziellen berichteten Mütter, die in der IMH‐HB EHS‐Gruppe waren, von gesünderem familiären Funktionieren und familiären Beziehungen, besseren Bewältigungsstrategien, um für ihre Familien einzustehen und von weniger Stress in der Elternrolle verglichen mit den Müttern der Vergleichsbedingung. Die Studie untersuchte auch unterstützungssuchende Bewältigungsstrategien, von denen sich einige basierend auf der Gruppenzugehörigkeit im Laufe der Zeit in unterschiedlicher Weise veränderten. Insgesamt deuten die Ergebnisse darauf hin, dass die Gewinne, die die Familien infolge der Teilnahme am IMH‐HB EHS‐Programm erzielten, nach Ende des Programms aufrechterhalten werden.抄録乳幼児精神保健に基づく介入は、幼い子どもとその重要な養育者との間の支持的な関係性を育てるという健康な家族機能の促進を通して、乳幼児の健康な発達を促進することを目的としている。この研究は、乳幼児精神保健在宅早期ヘッドスタートInfant Mental Health home‐based Early Head Start (IMH‐HB EHS)プログラムが、家族機能に与える影響を調査した。対象はアメリカ合衆国中西部の妊娠中か1歳以下の子どもを育てている152の低所得家族で、IMH‐HB EHSサービスを受ける(n=75)か、比較の条件か(n=77)に、ランダムに割り当てられた。IMH‐HB EHSサービスを受けた母親は、子どもが3歳から7歳の間に、より健康的な心理機能および家族機能を報告した。これはIMHの焦点と一致している結果だった。特に、IMH‐HB EHS群の母親は、比較条件の母親と比べ、より健康な家族機能と関係性、家族を擁護するのに必要なよりよい対処機能、そして親役割にストレスが少ないことを報告した。研究はまた、支援を求める対処についても調査した。その一部はプログラム群への割り当てに基づいて時間経過により異なって変化していた。全体として、IMH‐HB EHSサービスに参加した結果として家族が達成し獲得したものは、サービスが終了した後も、維持されている。摘要以幼兒心理健康為基礎的介入旨在通過健康的家庭運作去培養小童與其重要看護者間的支持性關係, 以此促進幼兒和學步兒的健康發展。本文探討一個幼兒心理健康家訪早期搶步計畫 (IMH‐HB‐EHS) 對家庭運作的影響。樣本包括一百五十二個在美國中西部低入息的家庭。這些家庭正待產或在養育一個少於一歲的小孩。參與家庭被隨機分派到接受IMH‐HB‐EHS服務 (n=75) 或一個比較環境 (n=77)。有接受IMH‐HB‐EHS服務的母親報告在孩兒三至七歲間有較健康的心理和家庭運作, 這結果與IMH的焦點相附合。具體來說, 在IMH‐HB‐EHS組的母親較在比較環境組的母親報告有健康些的家庭運作和關係, 有好些的因應技巧為家庭作鼓吹, 及在親職角色中有少些壓力。本文亦探討尋求支持的因應, 發現這會根據組別分派而有不同的隨時間改變。總體而言, 探討結果顯示家庭從參與IMH‐HB‐EHS服務所得的收益在服務停止後仍會維持。Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112230/1/imhj21518.pd

Sustaining entrepreneurial business: a complexity perspective on processes that produce emergent practice

This article examines the management practices in an entrepreneurial small firm which sustain the business. Using a longitudinal qualitative case study, four general processes are identified (experimentation, reflexivity, organising and sensing), that together provide a mechanism to sustain the enterprise. The analysis draws on concepts from entrepreneurship and complexity science. We suggest that an entrepreneur’s awareness of the role of these parallel processes will facilitate their approaches to sustaining and developing enterprises. We also suggest that these processes operate in parallel at multiple levels, including the self, the business and inter-firm networks. This finding contributes to a general theory of entrepreneurship. A number of areas for further research are discussed arising from this result

‘What are you going to do, confiscate their passports?’ Professional perspectives on cross-border reproductive travel

Objective: This article reports findings from a UK-based study which explored the phenomenon of overseas travel for fertility treatment. The first phase of this project aimed to explore how infertility clinicians and others professionally involved in fertility treatment understand the nature and consequences of cross-border reproductive travel. Background: There are indications that, for a variety of reasons, people from the UK are increasingly travelling across national borders to access assisted reproductive technologies. While research with patients is growing, little is known about how ‘fertility tourism’ is perceived by health professionals and others with a close association with infertility patients. Methods: Using an interpretivist approach, this exploratory research included focussed discussions with 20 people professionally knowledgeable about patients who had either been abroad or were considering having treatment outside the UK. Semi-structured interviews were recorded, transcribed verbatim and subjected to a thematic analysis. Results: Three conceptual categories are developed from the data: ‘the autonomous patient’; ‘cross-border travel as risk’, and ‘professional responsibilities in harm minimisation’. Professionals construct nuanced, complex and sometimes contradictory narratives of the ‘fertility traveller’, as vulnerable and knowledgeable; as engaged in risky behaviour and in its active minimisation. Conclusions: There is little support for the suggestion that states should seek to prevent cross-border treatment. Rather, an argument is made for less direct strategies to safeguard patient interests. Further research is required to assess the impact of professional views and actions on patient choices and patient experiences of treatment, before, during and after travelling abroad

Effects of COVID-19 on home visiting services for vulnerable families: A cross-state analysis of enrollment, engagement, and attrition patterns

Introduction: COVID-19 has resulted in massive health and economic consequences, with effects felt most acutely by populations that were disadvantaged prior to the pandemic. For families with young children, the effects have been compounded by service interruptions, though there is a lack of empirical evidence that demonstrates how COVID-19 has affected home visiting programs. This cross-state study is the first to examine the effects of the pandemic on home visiting enrollment, engagement, and retention patterns. Method: Program implementation records gathered from 2017–2020 in Arkansas and Wisconsin were analyzed. Both states operate a large network of home visiting programs that serve predominantly low-income families and that are supported by the federal Maternal, Infant, and Early Childhood Home Visiting program. Trends prior to COVID were compared to post-COVID trends (March 12 to December 31, 2020) in program enrollments, service capacity, visitation frequency, service modalities, attrition rates, and service duration. Results: Compared to average pre-pandemic enrollments from 2017–2019, post-COVID enrollments decreased by 33–36%. Total visits fell by 15–24%; the percentage of completed visits relative to expected visits declined more modestly. However, the average duration of services increased post-COVID while rates of early program dropout decreased. Discussion: The findings suggest that enrollment and engagement in home visiting decreased during the COVID-19 pandemic, which is unfortunate given the large number of vulnerable families served nationwide. Further research is needed to examine how COVID affected both consumer and program behaviors

Engaging Families and Addressing Adverse Childhood Experiences in Early Head Start

Supporting parenting and home environments for children through collaborations with families is a critical function of Early Head Start (EHS)/Head Start (HS) providers. Building a strong partnership with caregivers allows educators to identify family strengths and identifying areas of concern in parenting and home environments, such as those linked to adverse childhood experiences (ACEs). Family Map Inventory (FMI) is a tool used to screen for ACEs among children birth to 5 years-of-age while respecting the family needs. The effectiveness of FMI in its original paper format (p-FMI) has been validated. This study examined the validity of a new, web-based Family Map Inventory (e-FMI) by (1) comparing the distribution of ACEs risks captured in e-FMI with the traditional p-FMI, and (2) investigating the association of ACEs captured through e-FMI and parental warmth. Further, this study documented decreases in ACEs risks after center-based EHS services