Scaling Up Parenting Interventions is Critical for Attaining the Sustainable Development Goals

Sanders, Matthew R.; Divan, Gauri; Singhal, Meghna; Turner, Karen; Velleman, Richard; Michelson, Daniel; Patel, Vikram

doi:10.1007/s10578-021-01171-0

Cited by 44 publications

(25 citation statements)

References 56 publications

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“…Beyond community-based interventions that focus on providing more supports to parents and caregivers in higher-risk settings, national policies that increase resources for pregnant women and other caregivers—such as expansion of perinatal Medicaid coverage, increased parental leave, and perinatal cash transfer programs—can uplift our capacity to break intergenerational cycles of risk for child psychopathology and poor health ( 101 – 103 ). A growing body of literature highlights the importance and benefits of offering universal access to evidence-based parenting support and training programs—especially early in child development ( 104 ). In addition to improving child functioning, such intervention programs have also been shown to improve women's mental health ( 105 ).…”

Section: Discussionmentioning

confidence: 99%

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

et al. 2022

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ObjectiveExperiences of stress and adversity, such as intimate partner violence, confer risk for psychiatric problems across the life span. The effects of these risks are disproportionately borne by women and their offspring—particularly those from communities of color. The prenatal period is an especially vulnerable period of fetal development, during which time women's experiences of stress can have long-lasting implications for offspring mental health. Importantly, there is a lack of focus on women's capacity for resilience and potential postnatal protective factors that might mitigate these intergenerational risks and inform intervention efforts. The present study examined intergenerational associations between women's prenatal stressors and child executive functioning and externalizing problems, testing maternal parenting quality and child sex as moderators, using a large, prospective, sociodemographically diverse cohort.MethodsWe used data from 1,034 mother-child dyads (64% Black, 30% White) from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) pregnancy cohort within the ECHO PATHWAYS consortium. Women's prenatal stressors included stressful life events (pSLE) and intimate partner violence (pIPV). Measures of child psychopathology at age 4–6 included executive functioning and externalizing problems. Parenting behaviors were assessed by trained observers, averaged across two sessions of mother-child interactions. Linear regression models were used to estimate associations between women's prenatal stressors and child psychopathology, adjusting for confounders and assessing moderation effects by maternal parenting quality and child sex.ResultsWomen's exposures to pSLE and pIPV were independently associated with child executive functioning problems and externalizing problems in fully-adjusted models. Maternal parenting quality moderated associations between pSLE and both outcomes, such that higher parenting quality was protective for the associations between women's pSLE and child executive functioning and externalizing problems. No moderation by child sex was found.DiscussionFindings from this large, sociodemographically diverse cohort suggest women's exposures to interpersonal violence and major stressful events—common for women during pregnancy—may prenatally program her child's executive functioning and externalizing problems. Women's capacity to provide high quality parenting can buffer this intergenerational risk. Implications for universal and targeted prevention and early intervention efforts to support women's and children's wellbeing are discussed.

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Section: Discussionmentioning

confidence: 99%

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

et al. 2022

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“…There is also evidence from systematic reviews and meta-analyses that EBPSs work in both HICs and LMICs, with findings suggesting that EBPSs are at least as effective when transported to countries with different cultures and service provisions than those in which the EBPSs were developed [ 16 , 54 ]. EBPSs also provide a mechanism through which the United Nations Sustainable Development Goals may be attained, as positive parenting practices can promote diverse prosocial outcomes in children and parents [ 36 , 55 ].…”

Section: Outlining the Evidence That Ebpss Improve Child And Parent Outcomesmentioning

confidence: 99%

“…Despite all of this evidence, policies do not seem to support the broad implementation and population-level reach of EBPSs in most countries, and certainly not in any LMIC [ 36 ]. The majority of the world’s children who might benefit from their caregivers participating in EBPSs live in countries where accessing such programs is not a policy priority [ 36 ]. It therefore appears that there is a gap between what is known in the literature and what policymakers know.…”

mentioning

confidence: 99%

Policies are Needed to Increase the Reach and Impact of Evidence-Based Parenting Supports: A Call for a Population-Based Approach to Supporting Parents, Children, and Families

Doyle

Morawska

Higgins

et al. 2022

Child Psychiatry Hum Dev

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Parents can be essential change-agents in their children’s lives. To support parents in their parenting role, a range of programs have been developed and evaluated. In this paper, we provide an overview of the evidence for the effectiveness of parenting interventions for parents and children across a range of outcomes, including child and adolescent mental and physical health, child and adolescent competencies and academic outcomes, parental skills and competencies, parental wellbeing and mental health, and prevention of child maltreatment and family violence. Although there is extensive research showing the effectiveness of evidence-based parenting programs, these are not yet widely available at a population level and many parents are unable to access support. We outline how to achieve increased reach of evidence-based parenting supports, highlighting the policy imperative to adequately support the use of these supports as a way to address high priority mental health, physical health, and social problems.

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“…There are currently a few parent management training (PMT) programs that focus on improving parent-child interactions, which are being implemented worldwide [ 13 ]. Importantly, parenting is fundamentally linked to children developing life skills, and worldwide research into parenting programs has shown that developmental, emotional, behavioral, and health outcomes for both parents and children can improve as a result [ 14 ]. Within PMT programs, research has shown that programs based on the social learning theory are the most effective [ 12 ], of which Parent-Child Interaction Therapy (PCIT) is one [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation of Virtual Reality to Parent-Child Interaction Therapy for Enhancement of Positive Parenting Skills: Study Protocol for Single-Case Experimental Design With Multiple Baselines

Scherpbier¹,

Abrahamse²,

Belleman³

et al. 2022

JMIR Res Protoc

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Background Disruptive behavior is a common reason for young children to be referred to mental health care services worldwide. Research indicates that treatments for child disruptive behavior where parents are the primary agents of change are most impactful. Parent-Child Interaction Therapy (PCIT) is an effective parent management training program currently implemented in therapeutic settings within the Netherlands. Ongoing research into improving the effectiveness of PCIT is being done within these settings. To further promote the key elements of PCIT, this study focuses on creating the opportunity for parents to practice positive parenting skills more outside of the clinical setting by adding virtual reality (VR) as an additional homework element. PCIT has shown to make impactful long-term improvements in parental warmth, responsiveness, and the parent-child relationship. Through VR, parents practice the taught parenting skills out loud in the comfort of their own homes in VR scenarios. We expect that VR addition will innovatively increase the effectiveness of PCIT. Objective This study aimed to evaluate the added value of VR to PCIT by using a multiple baseline single-case experimental design (SCED). We expect to find that PCIT-VR will ameliorate positive parenting skills. By implementing the VR element, we secondarily expected that meeting the skill criteria will be achieved sooner, treatment completion rates will increase, and the parent-child relationship will be better, whereas parental stress and child disruptive behavior will decrease. Methods A total of 15 children (aged 2-7 years) with disruptive behavior and their parents will be followed throughout the PCIT-VR treatment. Using a multiple baseline SCED with 3 phases, 15 families will fill out questionnaires weekly, in addition to having pre- and posttreatment and follow-up measurements to monitor their positive parenting skills, child disruptive behavior, parenting stress, and VR progress. Moreover, quantitative information and qualitative interviews will be analyzed visually and statistically and summarized to provide a complete picture of experiences. Results As of February 2021, 6 families have been enrolled in the study at the moment of submission. Data collection is projected to be completed in 2023. Quantitative and qualitative results are planned to be published in peer-reviewed journals, as well as being presented at national and international conferences. Conclusions The SCED—with its phased design, randomization, and the opportunity to replicate and assess both individual and group treatment effects—and adaptability of the VR technology are the strengths of the study. The risks of increased type I errors, maturation effects, or technological failure will be mitigated with the right statistical support. This study aims to magnify the scope of the treatment through additional skill training, ultimately in support of routinely implementing VR within PCIT. International Registered Report Identifier (IRRID) DERR1-10.2196/34120

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Scaling Up Parenting Interventions is Critical for Attaining the Sustainable Development Goals

Cited by 44 publications

References 56 publications

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

Policies are Needed to Increase the Reach and Impact of Evidence-Based Parenting Supports: A Call for a Population-Based Approach to Supporting Parents, Children, and Families

Implementation of Virtual Reality to Parent-Child Interaction Therapy for Enhancement of Positive Parenting Skills: Study Protocol for Single-Case Experimental Design With Multiple Baselines

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