The agreement between parent-reported and directly measured child language and parenting behaviors

Parenting behaviors are commonly targeted in early interventions to improve children\u27s language development. Accurate measurement of both parenting behaviors and children\u27s language outcomes is thus crucial for sensitive assessment of intervention outcomes. To date, only a small number of studies have compared parent-reported and directly measured behaviors, and these have been hampered by small sample sizes and inaccurate statistical techniques, such as correlations. The Bland-Altman Method and Reduced Major Axis regression represent more reliable alternatives because they allow us to quantify fixed and proportional bias between measures. In this study, we draw on data from two Australian early childhood cohorts (N = 201 parents and slow-to-talk toddlers aged 24 months; and N = 218 parents and children aged 6-36 months experiencing social adversity) to (1) examine agreement and quantify bias between parent-reported and direct measures, and (2) to determine socio-demographic predictors of the differences between parent-reported and direct measures. Measures of child language and parenting behaviors were collected from parents and their children. Our findings support the utility of the Bland-Altman Method and Reduced Major Axis regression in comparing measurement methods. Results indicated stronger agreement between parent-reported and directly measured child language, and poorer agreement between measures of parenting behaviors. Child age was associated with difference scores for child language; however, the direction varied for each cohort. Parents who rated their child\u27s temperament as more difficult tended to report lower language scores on the parent questionnaire, compared to the directly measured scores. Older parents tended to report lower parenting responsiveness on the parent questionnaire, compared to directly measured scores. Finally, speaking a language other than English was associated with less responsive parenting behaviors on the videotaped observation compared to the parent questionnaire. Variation in patterns of agreement across the distribution of scores highlighted the importance of assessing agreement comprehensively, providing strong evidence that simple correlations are grossly insufficient for method comparisons. We discuss implications for researchers and clinicians, including guidance for measurement selection, and the potential to reduce financial and time-related expenses and improve data quality. Further research is required to determine whether findings described here are reflected in more representative populations

What influences parental engagement in early intervention? Parent, program and community predictors of enrolment, retention and involvement

Poor participant engagement undermines individual and public health benefits of early intervention programs. This study assessed the extent to which three types of engagement (participant enrolment, retention and involvement) were influenced by individual, program and contextual factors. Data were from a cluster randomised controlled trial (N = 1447) of a community-based parenting program, delivered at two levels of intensity (group sessions with and without individualised home coaching) conducted in Victoria, Australia. Individual (parent and family) factors and program factors were assessed by parent report and administrative records, and contextual factors by area-level population statistics. Data were analysed using multilevel logistic or linear regression models. Individual and contextual factors predicted enrolment, while family and program factors were more influential on program retention and parents’ active involvement. Provision of individualised support was important to all forms of engagement, particularly for families experiencing the greatest barriers to participation. These findings indicate that different strategies are required to effectively support families in the processes of enrolling, continuing to attend and actively participating in early intervention program

EHLS at school: school-age follow-up of the early home learning study cluster randomized controlled trial

BACKGROUND: Targeted interventions during early childhood can assist families in providing strong foundations that promote children\u27s health and wellbeing across the life course. There is growing recognition that longer follow-up times are necessary to assess intervention outcomes, as effects may change as children develop. The Early Home Learning Study, or \u27EHLS\u27, comprised two cluster randomized controlled superiority trials of a brief parenting intervention, smalltalk, aimed at supporting parents to strengthen the early childhood home learning environment of infants (6-12 months) or toddlers (12-36 months). Results showed sustained improvements in parent-child interactions and the home environment at the 32 week follow-up for the toddler but not the infant trial. The current study will therefore follow up the EHLS toddler cohort to primary school age, with the aim of addressing a gap in literature concerning long-term effects of early childhood interventions focused on improving school readiness and later developmental outcomes. METHODS: \u27EHLS at School\u27 is a school-aged follow-up study of the toddler cluster randomized controlled trial (n = 1226). Data will be collected by parent-, child- and teacher-report questionnaires, recorded observations of parent-child interactions, and direct child assessment when children are aged 7.5 years old. Data linkage will provide additional data on child health and academic functioning at ages 5, 8 and 10 years. Child outcomes will be compared for families allocated to standard/usual care (control) versus those allocated to the smalltalk program (group program only or group program with additional home coaching). DISCUSSION: Findings from The Early Home Learning Study provided evidence of the benefits of the smalltalk intervention delivered via facilitated playgroups for parents of toddlers. The EHLS at School Study aims to examine the long-term outcomes of this initiative to determine whether improvements in the quality of the parent-child relationship persist over time and translate into benefits for children\u27s social, academic and behavioral skills that last into the school years

International journal of Zizek studies : IJZS

BACKGROUND: Adolescents with Type 1 diabetes (T1D) show less effective metabolic control than other age groups, partly because of biological changes beyond their control and partly because in this period of developmental transition, psychosocial factors can militate against young people upholding their lifestyle and medical regimens. Parents have an important role to play in supporting adolescents to self-manage their disease, but resultant family tensions can be high. In this study, we aimed to assess family functioning and adolescent behaviour/ adjustment and examine the relationships between these parent-reported variables and adolescent metabolic control (HbA1c), self-reported health and diabetes self-care. METHOD: A sample of 76 parents of Australian adolescents with T1D completed the Child Health Questionnaire -Parent form. Their adolescent child with T1D provided their HbA1c level from their most recent clinic visit, their self-reported general health, and completed a measure of diabetes self-care. RESULTS: Parent-reported family conflict was high, as was disease impact on family dynamics and parental stress. Higher HbA1c (poorer metabolic control) and less adequate adolescent self-care were associated with lower levels of family functioning, more adolescent behavioural difficulties and poorer adolescent mental health. CONCLUSIONS: The implication of these findings was discussed in relation to needs for information and support among Australian families with an adolescent with T1D, acknowledging the important dimension of family functioning and relationships in adolescent chronic disease management

Does place matter in the implementation of an evidence-based program policy in an Australian place-based initiative for children?

Policy-mandated requirements for use of evidence-based programs (EBP) in place-based initiatives are becoming more common. Little attention has been paid to the geographic aspects of uneven market development and urbanicity in implementing EBPs in large place-based initiatives. The aim of this study was to explore geographic variation in knowledge, attitudes, and experiences of service providers who implemented an EBP policy in Australia's largest place-based initiative for children, Communities for Children. A cross-sectional online survey of Communities for Children service providers was conducted in 2018–2019, yielding 197 participants from all of Australia's eight states and territories. Relationships between two measures of ‘place’ (thick and thin market states; urbanicity: urban, regional and remote) and study-designed measures of knowledge, attitudes, and implementation experiences were analyzed using adjusted logistic and multinomial regressions. Participants from thin market states (outside the Eastern Seaboard) were more resistant to the policy and experienced greater implementation challenges than those from thick market states (Eastern Seaboard). Regional participants reported greater knowledge about EBPs but experienced greater dissatisfaction and implementation challenges with the policy than both urban and remote participants. Our study found that place does matter when implementing EBPs in a place-based initiative.</p

Place-based approaches to improve health and development outcomes in young children: A scoping review

This scoping review examines the strength of evidence for the effectiveness of public policy led place-based initiatives designed to improve outcomes for disadvantaged children, their families and the communities in which they live. Study designs and methods for evaluating such place-based initiatives were assessed, along with the contexts in which initiatives were implemented and evaluated. Thirty-two reports relating to 12 initiatives were included. Eleven initiatives used a quasi-experimental evaluation to assess impact, although there were considerable design variations within this. The remaining initiative used a pre- and post- evaluation design. Place-based initiatives by definition aim to improve multiple and interrelated outcomes. We examined initiatives to determine what outcomes were measured and coded them within the five domains of pregnancy and birth, child, parent, family and community. Across the 83 outcomes reported in the 11 studies with a comparison group, 30 (36.4%) demonstrated a positive outcome, and all but one initiative demonstrated a positive outcome in at least one outcome measure. Of the six studies that examined outcomes more than once post baseline, 10 from 38 outcomes (26.3%) demonstrated positive sustained results. Many initiatives were affected by external factors such as policy and funding changes, with unknown impact on their effectiveness. Despite the growth of place-based initiatives to improve outcomes for disadvantaged children, the evidence for their effectiveness remains inconclusive.</p

Can the onset of Type 2 diabetes be delayed by a group-based lifestyle intervention? A randomised control trial

This study was a randomised control trial with a waiting control group. It was designed to evaluate the effectiveness of a 6-month, group-based diabetes prevention programme, The Healthy Living Course and assess whether participation in the programme led to changes in modifiable risk factors for type 2 diabetes among an already at-risk pre-diabetic population. Individuals designated at risk for diabetes by their general practitioners (GPs) were screened using an Oral Glucose Tolerance Test. Volunteers (N¼307) with pre-diabetes were assigned to an intervention or wait-control group in the ratio of approximately 2 : 1. The sample was pre-tested on biochemical, anthropometric and self-report behavioural, cognitive and mood variables and post-tested either at the end of the educational/support-based lifestyle programme or the end of the wait period. The intervention group significantly improved their diabetes knowledge, motivation to change, positive affect, healthy eating and activity levels and showed significantly greater reductions in weight, body mass index, waist circumference, diastolic blood pressure and fasting plasma glucose in comparison with controls. The intervention group also changed their diagnostic status from pre-diabetes to non-diabetes at a greater rate than the wait group (43% vs. 26%) who received standard care from their GPs

Predictors of diabetes self-care, metabolic control, and mental health in youth with type 1 diabetes

The purpose of this study was to explore the psychosocial predictors of diabetes self-care (adherence to care regimes), metabolic control (glycated haemoglobin), and mental health among rural- and urban-dwelling youth with type 1 diabetes. One hundred and twenty three adolescents/young adults (aged 13-25 years, mean=16 years, standard deviation=3.8 years) with type 1 diabetes, 50 males and 73 females, completed questionnaires reporting on diabetes self-care, metabolic control, mental health (negative affect, quality of life), risk-taking behaviours and attitudes, diabetes self-efficacy, community engagement, and perceived social support. No rural/urban differences were detected on key predictors or outcome variables. Structural equation modelling revealed that high diabetes self-efficacy, lower risk behaviour, and more conservative attitudes to risk taking predicted better diabetes self-care, which in turn predicted better metabolic control and mental health. Social support and engagement in community activities did not influence diabetes self-care. The study has significance because both diabetes self-efficacy and propensity towards risk behaviour are potential targets for educational and counselling interventions designed to improve diabetes self-care regimes and resultant metabolic and mental health outcomes

Mothers’ experiences of parent-reported and video-recorded observational assessments

Rigorous evaluation of early childhood interventions requires accurate and efficient measurement. Researchers commonly use parent-reported surveys or direct observations; both of which have inherent strengths and limitations. Existing attempts to understand the correspondence between these methods have been primarily quantitative in design. Little is known about parents’ unique, subjective experiences of parent-reported surveys and direct parent-child observations. In this paper, we describe the experiences of ten mothers of children aged 24 months, recruited from a randomised controlled trial of a nurse home visiting program for mothers at risk of experiencing social adversity. After completing both a survey and video-recorded parent-child observation, mothers participated in in-depth semi-structured interviews which were analysed thematically. Mothers voiced concerns about how researchers may view their parenting skills, and their child’s behaviour and development. Contrary to previous quantitative evidence, mothers reported parent and child behavioural change, which they attributed to the researcher’s presence. Mothers described how the structured requirements of the observation contributed to forced and unnatural interactions. The survey was viewed as a welcome opportunity to reflect on parenting skills, the parent-child relationship and the child’s development. Mothers identified practical strategies for minimising parent-child discomfort during video-recorded observations, such as the researcher averting their gaze or stepping out of the room. We highlight opportunities for enhanced data validity in research and clinical settings, strengthened participant engagement, and minimisation of participant discomfort. Given the exploratory nature of this study, we do not claim that results are necessarily generalisable to other parent or general populations. Further research is warranted to build the evidence regarding parent participation in early childhood research.No Full Tex

Establishing agreement between parent-reported and directly-measured behaviours

The quality and accuracy of research findings relies on the use of appropriate and sensitive research methods. To date, few studies have directly compared quantitative measurement methods in the early childhood field and the extent to which parent-reported and directly-measured behaviours agree is unclear. Existing studies are hampered by small sample sizes and the use of statistical techniques which quantify the magnitude of association between measures (e.g. correlations), but not agreement. Here we review the limitations of existing method comparisons and suggest how alternative statistical approaches such as the Bland-Altman Method and ordinary least products regression can be readily applied in the early childhood context. Understanding agreement (and disagreement) between measurement methods has potential to reduce research costs and improve data quality, with important implications for researchers, clinicians and policy-makers.Full Tex