The reflective component of the Mellow Bumps parenting intervention: Implementation, engagement and mechanisms of change

Understanding why parenting programmes work or do not work, and for whom, is crucial for development of more effective parenting interventions. In this paper we focus on a specific component of Mellow Bumps: reflection on one’s own childhood/past/life. We explore how this component was implemented, how participants engaged with it, the facilitating and constraining factors shaping this, whether and how it appeared to work, or not, and for whom. The paper analyses data from the Process Evaluation of the Trial of Healthy Relationships Initiatives for the Very Early years, which is evaluating two antenatal interventions delivered to vulnerable women, one of which is Mellow Bumps. Data were collected from January 2014 to June 2018 for 28 groups, 108 participants and 24 facilitators in a comprehensive and rigorous Process Evaluation designed to complement the Outcome Evaluation. Data were gathered at various time points using multiple methods, and were synthesised to triangulate findings. The reflective component was implemented with fidelity and participants engaged with it to varying degrees, dependent largely on the coherence of the group. Patchy attendance compromised the coherence of some groups, with the development of rapport, which is key to delivering reflective exercises, more difficult when group composition varied from week to week. Where there was a coherent group, powerful mechanisms of change, leading to stress reduction, included: relief through unburdening, empowerment through support given and received, reduced isolation through sharing anxieties, and control through self-care advice. A minority of highly vulnerable mothers seemed not to benefit from the reflective exercises and were marginalised within their groups. In order to minimise potential harmful effects of such exercises, allocation of participants to groups should strive to maximise group homogeneity. More research is needed to explore how very vulnerable parents can be supported in attending parenting interventions from start to finish

A realist process evaluation of Enhanced Triple P for Baby and Mellow Bumps, within a Trial of Healthy Relationship Initiatives for the Very Early years (THRIVE): study protocol for a randomized controlled trial

Background: THRIVE is a three-arm randomised controlled trial (RCT) that aims to evaluate whether antenatal and early postnatal interventions, Enhanced Triple B for Baby (ETPB) plus care as usual (CAU) or Mellow Bumps (MB) plus CAU (versus CAU alone), can: 1) improve the mental health and well-being of pregnant women with complex health and social care needs; 2) improve mother-infant bonding and interaction; 3) reduce child maltreatment; and 4) improve child language acquisition. This paper focuses on THRIVE’s realist process evaluation, which is carefully monitoring what is happening in the RCT. Methods: Realistic evaluation provides the theoretical rationale for the process evaluation. We question: 1) how faithfully are MB and ETPB implemented? 2) What are the mechanisms by which they work, if they do, and who do they work for and how? 3) What contextual factors are necessary for the programmes to function, or might prevent them functioning? The mixed-methods design includes quantitative measures, which are pre- and post-training/intervention questionnaires for facilitators and mothers-to-be, and post-session evaluation forms. Qualitative data collection methods include participant observation of facilitator training and the delivery of a series of antenatal sessions in selected intervention groups (n = 3 for ETPB and n = 3 for MB), semi-structured interviews with facilitators, pregnant women, partners, and referring facilitators, and telephone interviews examining the content of the postnatal components of ETPB and MB. Discussion: The findings of this process evaluation will help researchers and decision makers interpret the outcomes of THRIVE. It will provide a greater understanding of: how the interventions work (if they do); the extent and quality of their implementation; contextual factors facilitating and constraining intervention functioning; variations in response within and between subgroups of vulnerable parents; and benefits or unintended consequences of either intervention. Few studies to date have published detailed research protocols illustrating how realist process evaluation is designed and conducted as an integral part of a randomised controlled trial

The use of case studies in OR teaching

This article investigates the current use of case studies in the teaching of Operational Research (OR) in the UK: how and where they are used; how they are developed; and whether there is an interest in training this area. It is aimed at lecturers teaching OR who are using or planning to use case studies in their teaching. It may also be of interest to policy-makers who wish to know what is being done in OR. The article focuses on the results of a survey sent to lecturers of OR in higher education in the UK. These are combined with an examination of the literature on using case studies in teaching in general and a small number of specific examples of how case studies are used in OR teaching. Case studies are included in OR teaching in a variety of ways and to develop a range of skills; particularly the ability to transfer academic knowledge to real-life contexts. The article identifies that the most significant barrier to the use of case studies in OR teaching is the development of new case studies; suggestions are made to address this, including providing training and collaboration opportunities. Overall this article provides an assessment of the ways in which case studies are used in OR; the advantages and limitationsof using them; and specific examples of their use which will provide ideas to assist in improving OR teaching

Parenting and the decline of physical activity from age 9 to 15

Background: There is a rapid decline in moderate-to-vigorous physical activity (MVPA) during middle childhood and adolescence. Information on the environmental factors implicated in this decline is limited. This study focuses on family factors associated with the rate of decline in objectively measured physical activity during middle childhood and adolescence. Methods: Longitudinal analysis of 801 participants from 10 US sites in the NICHD Study of Early Child Care and Youth Development whose data included accelerometer-determined levels of moderate-to-vigorous physical activity (MVPA) between ages 9 and 15 years, as well as family process, BMI and demographic information. The sample included an even split of boys (49%) and girls (51%), was predominantly white (77%), and contained about 26% low income and 19% single parent families. The outcome measure was mean MVPA. It was based on 4 to 7 days of monitored physical activity. Results: Boys with lower parental monitoring scores and more days of parental encouragement had significantly more minutes of MVPA at age 9 years. The effect of parental monitoring, however, was moderated by early puberty. High parental monitoring was associated with decreased activity levels for boys experiencing later puberty and increased activity for boy experiencing early puberty. Minutes of MVPA for boys living in the Midwest decreased at significantly faster rates than boys living in any other region; and boys in the South declined faster than boys in the West. Girls in the Midwest and South declined faster than girls in the West and Northeast. Among girls, more days of parental exercise and transportation to activities were associated with more MVPA per day at age 9. However, more parental transportation to activities and less monitoring was associated with faster linear declines in daughters' MVPA between the ages of 9 and 15 years. For girls who experienced puberty early, parental encouragement was associated with more MVPA. Conclusions: Parenting processes, such as monitoring and encouragement, as well as the parents' own level of physical activity, showed significant, but small, gender-specific associations with MVPA levels at age nine and the linear rate of decline in MVPA between ages 9 and 15

The Relationship of Body Mass Index and Behavior in Children

Objectives- To examine reciprocal relations between body mass index (BMI), internalizing problems and externalizing problems from infancy through middle childhood with a focus on sex and history of overweight. Study design- Data from 1254 children in the NICHD Study of Early Child Care and Youth Development were used to conduct longitudinal analyses of relations between BMI and scores on the Child Behavior Checklist from age two through 6th grade. Results- BMI and behavior problems showed stability across the 7 measurement occasions. No consistent relation between BMI and behavior problems was evident prior to school entry; but being heavier was associated with later internalizing problems beginning in 1st grade for boys and girls. Higher BMI was not associated with increased conduct problems. Conclusions- As children move into middle childhood, higher BMI is associated with increased likelihood of developing internalizing problems. Health care providers should monitor BMI as children enter school and to provide guidance to parents regarding emerging symptoms of anxiety and depression

Differentiating Maternal Sensitivity to Infant Distress and Non-Distress

Drawing from a domain specificity perspective, we assert that maternal sensitivity to infant distress cues is distinct from maternal sensitivity to non-distress cues. We review evidence from prior research demonstrating that the two constructs have more unshared than shared variance and that sensitivity to infant distress is a unique predictor of infants' early emotional well-being when both types of sensitivity are examined as simultaneous predictors. In addition, we present new evidence to test the hypothesis that maternal sensitivity to infant distress and non-distress have different origins. We draw on data from a subset of mothers and infants who participated in Phase I of the National Institute of Child Health and Human Development Study of Early Child Care (Study 1) and from 101 mother–infant dyads who participated in a longitudinal study of the origins of maternal sensitivity (Study 2). In both studies, maternal sensitivity to distress and non-distress were rated when infants were six months old. In both studies, socio-demographic risk (i.e., young, unmarried, low income mothers) was a stronger predictor of sensitivity to non-distress than of sensitivity to distress. In Study 2, mothers' emotional and cognitive responses to videotapes of crying infants during the prenatal period predicted maternal sensitivity during tasks designed to elicit infant fear and frustration but were unrelated to maternal sensitivity in a non-arousing free play context. Maternal sensitivity during infancy can be further divided into specific sub-types that have unique origins and unique effects on subsequent child well-being. Methodological, theoretical, and applied implications of such an approach are discussed

Identifying mother-child interaction styles using a person-centered approach

Parent–child conflict in the context of a supportive relationship has been discussed as a potentially constructive interaction pattern; the current study is the first to test this using a holistic analytic approach. Interaction styles, defined as mother–child conflict in the context of maternal sensitivity, were identified and described with demographic and stress-related characteristics of families. Longitudinal associations were tested between interaction styles and children's later social competence. Participants included 814 partnered mothers with a first-grade child. Latent profile analysis identified agreeable, dynamic, and disconnected interaction styles. Mothers' intimacy with a partner, depressive symptoms, and authoritarian childrearing beliefs, along with children's later conflict with a best friend and externalizing problems, were associated with group membership. Notably, the dynamic style, characterized by high sensitivity and high conflict, included families who experienced psychological and relational stressors. Findings are discussed with regard to how family stressors shape parent–child interaction patterns

Differential Effects of Maternal Sensitivity to Infant Distress and Nondistress on Social-Emotional Functioning

Associations between maternal sensitivity to infant distress and nondistress and infant social-emotional adjustment were examined in a subset of dyads from the NICHD Study of Early Child Care (N = 376). Mothers reported on infant temperament at 1 and 6 months postpartum, and maternal sensitivity to distress and nondistress were observed at 6 months. Child behavior problems, social competence, and affect dysregulation were measured at 24 and 36 months. Maternal sensitivity to distress but not to nondistress was related to fewer behavioral problems and higher social competence. In addition, for temperamentally reactive infants, maternal sensitivity to distress was associated with less affect dysregulation. Sensitivity to nondistress only prevented affect dysregulation if sensitivity to distress was also high

Los Deseos y la Expresión de la Gratitud en los Jóvenes

Poucos estudos examinaram o desenvolvimento da gratidão em jovens, e nenhum estabeleceu relações entre sua gratidão e seus desejos. Assim, solicitamos a 358 participantes norte-americanos entre 7 e 14 anos de idade (56% meninas; 55% brancos) que escrevessem qual seria o seu maior desejo e o que eles fariam a seu benfeitor. Utilizando qui quadrado e estimativa de curva linear, encontramos que os mais jovens (de 7 a 10 anos de idade) foram significativamente mais propensos a expressar desejos hedonistas (desejo por ganho imediato) e gratidão concreta (não considerando os desejos do benfeitor); os jovens mais velhos (de 11 a 14 anos de idade) foram significativamente mais propensos a desejar seja algo envolvendo bem-estar futuro para si mesmos seja o bem-estar de outros e gratidão conectiva (levando em conta os desejos do benfeitor).Em ambos os grupos etários, houve uma relação inversa significativa entre desejos hedonistas e gratidão conectiva.Esta pesquisa tem implicações para encorajar o sentimento e a expressão de gratidão conectiva.Little research has examined the development of gratitude in youth, and none has related their gratitude to their wishes. We therefore asked 358 7- to 14-year-old North American participants (56% female; 55% White) to write their greatest wish and what they would do for their benefactor. Using chi-square and linear curve estimation, we found that younger youth (aged 7 to 10) were significantly more likely to express hedonistic wishes (desire for immediate gain) and concrete gratitude (not taking the benefactor's wishes into account); older youth (aged 11 to 14) were significantly more likely to wish either for something involving future well-being for themselves or the well-being of others and connective gratitude (taking into account the benefactor's wishes). Within both age groups, there was a significant inverse relation between hedonistic wishes and connective gratitude. This research has implications for encouraging the feeling and expression of connective gratitude.Pocos estudios han examinado el desarrollo de gratitud en los jóvenes, y ninguno ha relacionado su gratitud a sus deseos. Por lo tanto, pedimos a 358 participantes de América del Norte de 7 a 14 años de edad (55% femenino, 55% blanco) a escribir su mayor deseo y lo que harían por su benefactor. Utilizando un distribución ji-cuadrado y estimación curva lineal, encontramos que los más jóvenes (de 7 a 10 años de edad) fueron significativamente más propensos a expresar los deseos hedonistas (deseo de ganancia inmediata) y la gratitud de concreto (no tomar los deseos del benefactor en cuenta); los jóvenes mayores (de 11 a 14 años de edad) fueron significativamente más propensos a desear sea para algo relacionado con el bienestar futuro para sí mismos o para el bienestar de los demás y gratitud conectivo (tomando en cuenta los deseos del benefactor). Dentro de ambos grupos de edad, existe una relación inversa significativa entre los deseos hedonistas y gratitud conectivo. Esta investigación tiene implicaciones para fomentar el sentimiento y la expresión de gratitud conectivo

Contributions of Child’s Physiology and Maternal Behavior to Children’s Trajectories of Temperamental Reactivity

Trajectories of children’s temperamental reactivity (negative affectivity and surgency) were examined in a community sample of 370 children across the ages of 4 to 7 using Hierarchical Linear Modeling. Children’s physiological reactivity (respiratory sinus arrhythmia, RSA), physiological regulation (?RSA), and maternal parenting behavior were included as predictors of children’s trajectories of temperamental reactivity. Results indicated that negative affectivity and surgency decreased from 4 to 7 years of age, however within-person changes in negative affectivity were dependent on levels of baseline RSA and not age. Increases in negative affectivity were also predicted by higher levels of earlier maternal controlling behavior. Decreases in surgency were predicted by higher levels of ?RSA during mother-child interaction tasks and positive parenting behavior. Baseline RSA and maternal controlling parenting also accounted for interindividual differences in children’s negative affectivity at age 7, while gender and children’s baseline RSA accounted for interindividual differences in children’s surgency at age 7. Overall, these results provide further evidence that parenting behavior and children’s RSA influence the changes that occur in children’s temperamental reactivity