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Psychosocial Intervention Programs for Parents of Children with Cancer: A Systematic Review and Critical Comparison of Programs' Models and Development.
Ogez, D, Péloquin, K, Bertout, L, Bourque, CJ, Curnier, D, Drouin, S, Laverdière, C, Marcil, V, Ribeiro, R, Callaci, M, et al
Journal of clinical psychology in medical settings. 2019;(4):550-574
Abstract
Intervention programs have been developed to help parents cope with their child's cancer. Despite some studies reporting a high level of evidence, it is unclear how these programs build on each other. Appraising models of change is critical to advance scientific knowledge and provide evidence-based interventions. This review aims to identify existing programs, explicitly formulate their underlying models, evaluate how they translate into concrete activities, as well as identify and discuss their development process. Eleven programs based on models of change from cognitive-behavioral, systemic and counselling theories were identified. Many models included a sound theoretical framework, targeted outcomes, as well as implementation strategies. In most cases, preliminary development studies were conducted, but details were rarely provided on how development stages informed the redesign of intervention programs. Acceptability and treatment fidelity were not available for one-third of the programs. Future reports should document the development and design redesign stages prior to conducting efficacy trials, as this step would provide crucial details to critically appraise programs.
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Home-based vs inpatient education for children newly diagnosed with type 1 diabetes.
Clapin, H, Hop, L, Ritchie, E, Jayabalan, R, Evans, M, Browne-Cooper, K, Peter, S, Vine, J, Jones, TW, Davis, EA
Pediatric diabetes. 2017;(7):579-587
Abstract
BACKGROUND Initial management of children diagnosed with type 1 diabetes (T1D) varies worldwide with sparse high quality evidence regarding the impact of different models of care. AIM: To compare the inpatient model of care with a hybrid home-based alternative, examining metabolic and psychosocial outcomes, diabetes knowledge, length of stay, and patient satisfaction. SUBJECTS AND METHODS The study design was a randomized-controlled trial. Inclusion criteria were: newly diagnosed T1D, aged 3 to 16 years, living within approximately 1 hour of the hospital, English-speaking, access to transport, absence of significant medical or psychosocial comorbidity. Patients were randomized to standard care with a 5 to 6 day initial inpatient stay or discharge after 2 days for home-based management. All patients received practical skills training in the first 48 hours. The intervention group was visited twice/day by a nurse for 2 days to assist with injections, then a multi-disciplinary team made 3 home visits over 2 weeks to complete education. Patients were followed up for 12 months. Clinical outcomes included HbA1c, hypoglycemia, and diabetes-related readmissions. Surveys measured patient satisfaction, diabetes knowledge, family impact, and quality of life. RESULTS Fifty patients were recruited, 25 to each group. There were no differences in medical or psychosocial outcomes or diabetes knowledge. Average length of admission was 1.9 days shorter for the intervention group. Families indicated that with hindsight, most would choose home- over hospital-based management. CONCLUSIONS With adequate support, children newly diagnosed with T1D can be safely managed at home following practical skills training.
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Parent Involvement Intervention in Developing Weight Management Skills for both Parents and Overweight/Obese Children.
Kim, HS, Park, J, Park, KY, Lee, MN, Ham, OK
Asian nursing research. 2016;(1):11-7
Abstract
PURPOSE The purpose of the study was to evaluate a parent involvement intervention for childhood obesity intended to increase parents' skills in managing children's weight-related behavior and to improve child-parent relationships. Many studies reported on parental influence on childhood obesity, emphasizing parent involvement in prevention and management of childhood obesity. METHODS A randomized controlled trial was conducted. Forty-two parents of overweight/obese children were recruited from four cities and randomized to the experimental group or control group. The parental intervention was provided only to parents in the experimental group and consisted of weekly newsletters and text messages for a period of 5 weeks. Exercise classes and nutrition education were provided to all children. Lifestyle Behaviour Checklist and the Child-Parent Relationship Scale (CPRS) were used for measurement of parent outcome. For the child outcome, dietary self-efficacy, exercise frequency, and body mass index were measured. A mixed-design analysis of variance was performed with city location entered as a random effect. RESULTS After the intervention, CPRS of parents and dietary self-efficacy of children showed an increase in the experimental group (p < .05). Intervention effects differed significantly according to the city location regarding the control efficacy of parents and dietary self-efficacy of children (p < .05). CONCLUSIONS The results support the effectiveness of the parent involvement intervention in promoting child-parent relationship and dietary self-efficacy of children. However, a 5-week parent involvement intervention was not sufficient to produce significant changes in children's body mass index. Further research is needed to investigate effects of parent involvement intervention with long-term evaluation.
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Authoritative feeding behaviors to reduce child BMI through online interventions.
Frenn, M, Pruszynski, JE, Felzer, H, Zhang, J
Journal for specialists in pediatric nursing : JSPN. 2013;(1):65-77
Abstract
PURPOSE.: The purpose of the study was to examine the feasibility and initial efficacies of parent- and/or child-focused online interventions and variables correlated with child body mass index percentile change. DESIGN AND METHODS.: A feasibility and cluster randomized controlled pilot study was used. RESULTS.: Recruitment was more effective at parent-teacher conferences compared with when materials were sent home with fifth- to eighth-grade culturally diverse students. Retention was 90% for students and 62-74% for parents. Authoritative parent feeding behaviors were associated with lower child body mass index. A larger study is warranted. PRACTICE IMPLICATIONS.: Online approaches may provide a feasible option for childhood obesity prevention and amelioration.
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Obesity-related behaviors of US- and non-US-born parents and children in low-income households.
Cespedes, EM, McDonald, J, Haines, J, Bottino, CJ, Schmidt, ME, Taveras, EM
Journal of developmental and behavioral pediatrics : JDBP. 2013;(8):541-8
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Abstract
OBJECTIVE To examine differences in obesity-related behaviors by parental US-born status among low-income, minority families participating in Healthy Habits, Happy Homes, an intervention trial to improve household routines for childhood obesity prevention. Evidence suggests lower obesity risk among adult immigrants, but research is inconclusive regarding the influence of having a non-US-born parent on childhood obesity. METHOD We sampled 57 US-born and 64 non-US-born families of children aged 2 to 5.9 years living in the Boston area. At baseline, parents reported their own screen time, physical activity, diet, and sleep as well as their children's behaviors. We used linear and logistic regression to examine the association of parental US-born status with obesity-related behaviors. RESULTS Mean (SD) body mass index z score was 0.94 (1.16), and it did not differ between the groups. After adjusting for parental education and child race/ethnicity, children of non-US-born (vs US-born) parents had later bedtimes (0.81 hours later; 95% confidence interval [CI], 0.37-1.25) and wake-up times (0.56 hours later; 95% CI, 0.16-0.95) and engaged in less active play (0.15 fewer hr/d; 95% CI, -0.28 to -0.01). Non-US-born (vs US-born) parents had less screen exposure. CONCLUSION In this cross-section of low-income, urban families, having a parent born outside the United States was associated with a profile of risk and protective behavior; adjustment for education and race/ethnicity removed the protective associations of parental nativity with child behavior. Obesity-related differences in behaviors and home environments should be considered when designing interventions targeting low-income communities with a high proportion of non-US-born participants.
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Childhood feeding difficulties: a randomized controlled trial of a group-based parenting intervention.
Adamson, M, Morawska, A, Sanders, MR
Journal of developmental and behavioral pediatrics : JDBP. 2013;(5):293-302
Abstract
BACKGROUND Difficulty with feeding is common during early childhood. Behavioral techniques have shown considerable utility for difficult feeding, although large-scale studies of behavioral parenting interventions with typically developing young children, and in group formats, are limited. OBJECTIVE The current study aimed to evaluate the efficacy of a group-based, behavioral family intervention for typically developing healthy children with problem eating via a fully randomized 2-group design. METHODS : Ninety-six families of children aged 1.5 to 6 years with feeding difficulties participated in a trial of Hassle Free Mealtimes Triple P (A. Morawska and M.R. Sanders, unpublished data, 2008) in regional and metropolitan Queensland (Australia). RESULTS Results support the utility of a group-based behavioral parenting program for childhood feeding issues, with significant improvements to the mealtime and general behavior of target children, the mealtime and general practices of parents, parental confidence and cognitions, compared with a waitlist control. Six-month follow-up data and clinical and reliable change indices support the intervention's utility. Parents were also highly satisfied with the program. CONCLUSION The current study provides evidence of the efficacy of a group-based behavioral family intervention for mealtime difficulties, including observational and more extended outcome measures. Future directions and clinical implications of this research are discussed.
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Contrasting parental perspectives with those of teenagers and young adults with cancer: comparing the findings from two qualitative studies.
Grinyer, A
European journal of oncology nursing : the official journal of European Oncology Nursing Society. 2009;(3):200-6
Abstract
PURPOSE To compare and contrast the issues raised in narrative data gathered from parents of teenagers and young adults with cancer with interview data gathered from young adults being treated for cancer. METHODS A narrative correspondence method elicited contributions from the parents of 28 young adults with cancer. In-depth qualitative interviews were undertaken with 28 young adults in treatment for cancer or soon after their treatment. KEY RESULTS The secondary analysis of the two data sets illuminates contrasting familial perspectives. While some of the topics raised by parents are also addressed by young people, their perspectives differ thus offering a 'mirror image' of the same issue. The contrast in priorities can contribute to stress within the family and can increase the danger of conflict over key decisions that may impact upon the health of the young adult with cancer. CONCLUSIONS If the potential conflicts are anticipated and understood and as a consequence handled with skill by professionals in the setting of care, this can benefit family relationships which can be thrown into crisis by the illness. It is thus important that a model of care that incorporates such an understanding is widely implemented in order to mitigate the negative impact on family dynamics when cancer is diagnosed in young adulthood.
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Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling.
Kalavainen, MP, Korppi, MO, Nuutinen, OM
International journal of obesity (2005). 2007;(10):1500-8
Abstract
OBJECTIVE The aim of the study was to compare the efficacy of group treatment stressing a health-promoting lifestyle with routine counseling in the treatment of childhood obesity. DESIGN AND SUBJECTS Seventy obese children (weight for height 115-182%) aged 7-9 years were randomized either to routine counseling (two appointments for children) or to family-based group treatment (15 separate sessions for parents and children). These sessions included nutrition education, physical activity education and behavioral therapy. OUTCOME MEASURES Children's weights and heights were measured at baseline, after the 6-month intervention and after the 6-month follow-up. The change of weight for height based on Finnish growth charts was used as the primary, and changes in body mass index (BMI) and BMI standard deviation scores (BMI-SDS) as secondary outcome measures. RESULTS Children attending the group treatment lost more weight for height (6.8%) than children receiving routine counseling (1.8%) (P=0.001). The difference was significant when the data were analyzed in four groups by the cut-off limits of 0, -5 and -10% for the change in weight for height. The respective decreases in BMI were 0.8 vs 0.0 (P=0.003) and in BMI-SDS 0.3 vs 0.2 (P=0.022). The results remained similar in adjusted analyses. Both group and routine programs were feasible with a high, 87-99%, participation rate in sessions and appointments and very low, 3% or less, attrition rate from the programs. Six months after the intervention, beneficial effects were partly lost, but for changes in weight for height and BMI, the differences between the two treatment programs still were significant, and for BMI-SDS, there was a trend. CONCLUSIONS Family-based group treatment that stresses a health-promoting lifestyle and is given separately for parents and children, offers an effective mode of therapy to treat obese school-aged children.