Improving Parental Stress Levels Among Mothers Living with HIV: A Randomized Control Group Intervention Study

Abstract

Limited knowledge exists regarding parenting efficacy interventions for mothers living with HIV (MLH). This study evaluated the impact of a supportive group intervention on lowering parenting stress among MLH. Eighty MLH were randomized to a parenting (N=34) or health focused (control) (N=46) group intervention. Pre- and post-intervention stress levels were assessed using the Parental Stress Index-Short Form (PSI/SF). Differences in PSI/SF scores were examined using ANOVA, and predictors of PSI/SF scores were evaluated using multivariable linear regression. Findings indicate that both groups experienced significant decreases in parenting stress from baseline to post-intervention (p=0.0001), with no significant differences between interventions. At baseline, 41% of participants were identified as highly stressed and 30% as clinically stressed, with PSI/SF scores above the 85(th) and 90(th) percentile, respectively. Amongst the highly stressed subpopulation, significant improvements in PSI/SF scores for Parental Distress PSI/SF (p=0.039), Difficult Child PSI/SF (p=0.048), and total PSI/SF (p=0.036) were seen, with greater improvements in the parenting intervention. Among the clinically stressed subpopulation, significant improvements in total post-intervention PSI/SF scores were seen (p=0.049), with greater improvements in the parenting intervention. Results indicate that screening for high levels of stress should be considered in clinical practice to effectively implement stress-reducing interventions among MLH.

Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review

“…Table 1 includes a summary of the main characteristics of the thirteen studies included in this review. Ten interventions were implemented in the United States [14, 16–23, 25]. Two interventions were conducted in China [25, 24] and one intervention was conducted in South Africa [13].…”

“…Children of parents living with HIV included in the studies ranged from 4 to 20 years old at the time of intervention. Two studies explicitly focused on PLH and their young children, ages 4–12 [13, 14]. One study focused explicitly on PLH and their adolescent children, ages 11–18 [16].…”

“…Two studies randomized parent-child dyads as a unit of randomization [13, 16]. Two studies randomized mothers only [14, 17]. Four studies randomized mothers alone, but included their children as participants in the study [20–23].…”

“…Four studies randomized mothers alone, but included their children as participants in the study [20–23]. One study cluster randomized villages as the unit of randomization [14]. One study used urn randomization, a randomization strategy that reduces the risk of experimental bias in small studies [35] by assigning individual participants to one of three tested conditions [25].…”

Maternal Parenting Stress and Child Perception of Family Functioning Among Families Affected by HIV

“…A study by Murphy, Marelich, Armistead, Herbeck, and Payne (2010) found that MLWH reporting more stress in their parenting roles and personal health were less likely to engage their children in family routines and more likely to report poorer parent-child communication. Interventions targeting parenting stress and family interactions with MLWH and their children have demonstrated positive outcomes related to reduced stress (Johnson et al, 2015) and improved open communication (Murphy, Armistead, Marelich, Payne, & Herbeck, 2011). Although such behavioral interventions have shown promise in affecting change, little is known regarding the relationship between parenting stress and indicators of family functioning from the child’s perspective.…”