Helping families improve: an evaluation of two primary care approaches to parenting support in the Netherlands

The present study evaluated two primary care parenting interventions. First, we evaluated the most widely used Dutch practices for primary care parenting support. Second, we assessed the applicability of the Primary Care Triple P approach, which is now being utilized in a wide variety of primary care settings. Both interventions target parents of children with mild to moderate behavioural and/or emotional problems, with the aim of improving parenting skills and thereby decreasing child problems. We examined the interventions in pre‐, post‐ and follow‐up assessment, and compared the results. Both interventions produced significant reductions in reported child emotional and behaviour problems, that also remained after 3 months. For both groups, parenting styles were also found to have improved at both post‐test and follow‐up measurement. When compared with the regular Dutch parenting consultation practices, however, the Primary Care Triple P approach produced greater reductions in parental laxness and total parenting dysfunction, and greater improvement in total parenting competence at both post‐test and follow‐up. Primary Care Triple P may even—in light of the greater improvements in parenting skills and total parental competences in the Triple P group than in the regular Dutch parenting consultation group—produce better results in the long run concerning child behaviour and emotional problems. Copyright © 2009 John Wiley & Sons, Ltd.     

Circle of Security parenting program efficacy for improving parental self-efficacy in a South African setting: Preliminary evidence

This pilot study examined the cross-cultural transportability of a western Circle of Security (COS) parenting program to improve on levels of parental self-efficacy in a South African setting. Participants (n = 9) were sampled from a fishing community on the West Coast of South Africa. The participants completed the COS with pre-test and post-test measures of their parenting self-efficacy. Furthermore, they completed an open-ended measure of their satisfaction with the parenting program. The data were analysed using the Wilcoxon sign-rank test and the Sign test to determine the significance in differences between pre-to-post-test change scores. In addition, a thematic analysis was conducted on participant’s satisfaction with the parenting program. Results indicated significant and possible change scores for the efficacy scores: ability to handle parenting pressures, control, and learning. The participants considered the COS program appropriate to their context and situation. These preliminary findings support the need for further study of the COS parenting program within the broader context of South Africa.     

A structural modeling approach to the understanding of parenting stress

Tested and cross-validated a multidimensional model of predictors of parenting stress on data from a population-based sample of Swedish mothers (N = 1,081) with children ages 6 months to 3 years. The study was a cross-sectional questionnaire study, focusing on the explanation of variance in parenting stress. Structural equation modeling procedures permitted disentanglement of total, direct, and indirect effects. A Swedish instrument based on parts of the Parent Domain in the Parenting Stress Index was used as a measure of stress. The results provided general support for the proposed model. High workload, low social support, perception of the child as fussy-difficult, negative life events, child caretaking hassles, more children in the family, and high maternal age related directly to more stress. Child irregularity contributed indirectly to mother's experienced stress. No buffering effects of social support were found. Forty-eight percent of the variance in the parenting stress measure was explained by the model. Implications for interventions were discussed.     

Neighborhood social disorder as a determinant of drug injection behaviors: a structural equation modeling approach.

Neighborhood environments are increasingly recognized as a contextual determinant of health, behaviors, and disease; however, the pathways through which neighborhood characteristics impact health behaviors are poorly understood. This article examines pathways to elucidate how neighborhood social disorder may lead to HIV transmission. Data are from a baseline survey of 701 injection drug users from the Self-Help in Eliminating Lethal Diseases Study, an HIV prevention intervention in Baltimore. Structural equation modeling was used to examine the pathways among social disorder, psychological distress, and drug injection behaviors. The relationship between disorder and injection behaviors in the models tested suggests that psychological distress is higher in more socially disordered neighborhoods, that distress leads to greater injection frequency and equipment sharing, and that injection frequency predicts equipment sharing.     

Clarifying the role of impulsivity in dietary restraint: A structural equation modeling approach

This study was designed to clarify the relationship between the four dimensions of impulsivity in Whiteside and Lynam’s (2001) model and the two aspects of dietary restraint (Concern for Dieting and Weight Fluctuation) in a non-clinical sample. Data were collected from a volunteer community sample (N = 216) of women who responded to two self-report instruments related to impulsivity (UPPS Impulsive Behavior Scale, Whiteside & Lynam, 2001) and dietary restraint (Restraint Scale, Polivy, Herman, & Warsh, 1978). A structural equation model was tested. The model provided a good fit to the data (χ²/df = 1.64, p < .0001, RMSEA = 0.054, 90% CI = 0.050–0.058, p-value for test of close fit (RMSEA > 0.05) = .035) and revealed that Concern for Dieting was positively related to Urgency (standardized β = 0.25, p < .01). Weight Fluctuation was related to lack of Perseverance (standardized β = 0.25, p < .01) and tended to relate to Sensation Seeking (standardized β = 0.17, p = .056). Urgency and lack of Perseverance were found to play a significant role in predicting Concern for Dieting and Weight Fluctuation.     

Networks of meaning and the bicultural mind: A structural equation modeling approach

The paper examines cultural frame-switching among bicultural participants at the level of associated meanings. Bicultural participants of Greek descent who live in the Netherlands were randomly primed with either Greek or Dutch cultural symbols and language. A monocultural Dutch group in the Netherlands and a monocultural Greek group in Greece, were involved as control groups. Structural equation modeling indicated that the Greek participants in Greece and the bicultural participants primed with Greek culture had a similar pattern of associations. This pattern differed from that of the Dutch participants and the participants primed with Dutch culture. Thus, the two different monocultural association patterns were replicated among bicultural individuals. The findings show that meanings are affected by cultural frame-switching, and provide further support for the dynamic constructivist approach.     

Resilience and coping in trauma spectrum symptoms prediction: A structural equation modeling approach

Resilience is increasingly recognized as a relevant factor in shaping psychological response to natural disasters. Aim of the study is to examine in the context of a natural disaster the potential effects of resilience on the relation between coping and trauma spectrum symptoms, using structural equation modeling.A sample of 371 students who survived the earthquake in L’Aquila (Italy) were cross-sectionally evaluated using Resilience Scale for Adolescents, Brief Cope and Trauma and Loss Spectrum scale.The model shows a direct path of positive and emotional coping styles on resilience. Emotional coping shows also a direct impact on the outcome; positive and emotional coping results to be positively correlated as well as emotional and disengagement coping styles. Resilience directly affects the PTSD symptoms, partially mediating the impact of the coping styles. The model explains 30% of the variance in the outcome, i.e. the Post-Traumatic Stress Disorder (PTSD) symptoms, with very good fit indexes.Resilience operates as a protective factor from stress symptom development. It is likely that emotional and disengagement coping skills are rapidly involved after a traumatic exposure but when problem focused coping intervenes, resilience allows it to buffer the stressors or even guides toward a more successful outcome.     

Comparing standardized coefficients in structural equation modeling: a model reparameterization approach

We propose a two-stage method for comparing standardized coefficients in structural equation modeling (SEM). At stage 1, we transform the original model of interest into the standardized model by model reparameterization, so that the model parameters appearing in the standardized model are equivalent to the standardized parameters of the original model. At stage 2, we impose appropriate linear equality constraints on the standardized model and use a likelihood ratio test to make statistical inferences about the equality of standardized coefficients. Unlike other existing methods for comparing standardized coefficients, the proposed method does not require specific modeling features (e.g., specification of nonlinear constraints), which are available only in certain SEM software programs. Moreover, this method allows researchers to compare two or more standardized coefficients simultaneously in a standard and convenient way. Three real examples are given to illustrate the proposed method, using EQS, a popular SEM software program. Results show that the proposed method performs satisfactorily for testing the equality of standardized coefficients.     

The Role of Parenting Programmes in the Prevention of Child Maltreatment

Child maltreatment is a major worldwide concern and continuing high rates of abuse demand action. This article examines the role of parenting programmes as a strategy to prevent child maltreatment in the population as a whole and also as a targeted intervention for parents who have abused, or are at risk of abusing, their children. We argue that a blend of universal and targeted interventions is needed to reduce the prevalence of child maltreatment. Parenting interventions that concurrently target positive parenting and effective child management skills, dysfunctional parental attributions, and increasing parents' capacity to regulate their emotions are particularly useful. A variant of the Triple P—Positive Parenting Program, known as Pathways Triple P, is discussed to illustrate the value of this approach. Contextual factors that need to be addressed in working with child protection cases are also discussed. The role of training and supervision is discussed in the context of disseminating evidence‐based parenting programmes, and future directions for research are presented.     

Perceptions of ambiguously unpleasant interracial interactions: a structural equation modeling approach

Despite a general consensus in the United States that overtly racist acts are unacceptable, many ambiguous situations in everyday life raise questions of whether racism has influenced a person's behavior in an interracial encounter. The authors of the present study sought to (a) examine simultaneously an array of variables thought to be related to perceived racism and (b) investigate how the contribution of these variables may differ with respect to the asymmetry hypothesis, which suggests that acts of discrimination from a dominant person toward a subordinate person will be viewed as more biased than if the situation were reversed. The authors used a dual structural equation modeling approach. Results indicated that ethnic identity significantly predicted perceived racism. In addition, the extent to which cognitive interpretation style significantly predicted perceived racism depended on the ethnicity of participants involved in the interaction.     

A review of attachment-based parenting interventions: Recent advances and future considerations

Research evidence has shown that in childhood, a secure attachment to a reliable caregiver is important for future mental health and well-being. The theoretical and research basis for attachment theory continues to grow. As attachment theory has become more widely adopted there are challenges and opportunities both theoretically and in terms of its clinical use. Disordered attachment has been linked to psychopathology including internalising and externalising disorders. However, there are ongoing implications for researchers and clinicians as only the most extreme forms of attachment disorders are included in the current diagnostic systems. A wide range of reliable and validated observational assessments to classify attachment are available. Owing to the growing popularity of attachment-based interventions there is a need to develop assessments which are practical for use in clinical settings. The use of attachment-based parenting interventions in clinical settings is increasing as they have been found to be effective and relevant. This growth presents opportunities to further refine these interventions, so they are easy to deliver in clinical practice and tailored to different populations. Attachment-based interventions are being widely used in Australia, and this has led to a need to understand and adapt the theory, assessments, and interventions to this context. Attachment-based interventions demonstrate the importance of relationships and provide an important tool to support children and families. For psychologists here in Australia there are many opportunities to develop measures and interventions based on attachment theory that fit into the Australia context.     

Training of interventionists and cultural adaptation procedures: A systematic review of culturally adapted evidence-based parenting programs in Africa

There has been an increase in the implementation of evidence-based parenting programs from high-income countries to several African countries. In this review, we systematically evaluated intervention studies of culturally adapted parenting programs in nine African countries with the objective of examining the quality of training for interventionists and cultural adaptation procedures. A total of 18 studies, obtained from an electronic search of 6 databases, met the inclusion criteria and were evaluated following PRISMA guidelines. The Ecological Validity Model was adopted to organize data on cultural adaptation procedures. Sixteen of the 18 studies reported information regarding the clinical training of interventionists and the cultural adaptations undertaken. Live and interactive workshops were the most common format used to train interventionists in the focal intervention. Overall, cultural adaptations in most studies included translation of intervention protocols into the local language. However, studies varied in the way cultural adaptation procedures were reported with some studies failing to report on cultural adaptation procedures. Concurring with previous literature, attending to issues of culture, power, privilege, access, sustainability, and other relevant concepts to increase the cultural relevance is highly encouraged in parent intervention studies in Africa. This review provides a baseline upon which future training and adaptation procedures can be built.     

The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach

A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.     

Neighborhood structure,parenting processes,and the development of youths' externalizing behaviors: a multilevel analysis

Associations among neighborhood structure, parenting processes, and the development of externalizing behavior problems were investigated in a longitudinal sample of early adolescents (from age 11 to 13). Mothers' reports of parental monitoring (at age 11), mothers' and youths' reports of the amount of youths' unsupervised time (at age 11), and youths' reports of positive parental involvement (at age 12) were used to predict initial levels (at age 11) and growth rates in youths' externalizing behavior as reported by teachers. Census-based measures of neighborhood structural disadvantage, residential instability, and concentrated affluence were expected to moderate the effects of parenting processes (e.g., parental monitoring) on externalizing behavior. Hierarchical linear modeling results revealed that less parental monitoring was associated with more externalizing behavior problems at age 11, and more unsupervised time spent out in the community (vs. unsupervised time in any context) and less positive parental involvement were associated with increases in externalizing behavior across time. Furthermore, the decrease in externalizing levels associated with more parental monitoring was significantly more pronounced when youths lived in neighborhoods with more residential instability.     

Prem Baby Triple P a new parenting intervention for parents of infants born very preterm: acceptability and barriers

Over 10% of preterm infants develop major disabilities, 50% develop behavioural problems and 40% need special education ( [Huddy et al., 2001] and [0185] ). Prem Baby Triple P is a new variant of the Positive Parenting Program (Triple P) adapted specifically for parents of very preterm infants. The aim of this study is to assess the acceptability of Prem Baby Triple P to parents of infants born preterm and to test whether parental attributions and parental perception of infant health/developmental status are barriers to intervention acceptability. One hundred and twenty-three parents of preterm infants participated, 83 parents of very preterm infants and 40 parents of preterm infants. In addition, 32 parents of term infants participated as a comparison group. The acceptability of Prem Baby Triple P was moderately high and did not differ significantly across the three groups. Parental attributions were not found to be barriers to intervention acceptability and parental perceptions that their infant is less healthy/developmentally delayed facilitated Prem Baby Triple P acceptance in parents of infants born very preterm. This suggests that the planned Prem Baby Triple P content is acceptable to parents of infants born very preterm and sensitised to medical and developmental issues. These findings, as social validation data, will contribute towards the further development of Prem Baby Triple P and a future randomised controlled trial.     

The Efficacy of a Group Triple P (Positive Parenting Program) for Chinese Parents with a Child Diagnosed with ADHD in Hong Kong: A Pilot Randomised Controlled Study

The present pilot study evaluated the efficacy of the Level 4 Group Positive Parenting Program (Triple P) with Hong Kong Chinese parents who had a child with attention deficit/hyperactivity disorder (ADHD), using a randomised controlled trial design. It was a mixed research method involving quantitative measurement and semi‐structured focus group. Participants were randomly assigned to Triple P (n = 8) or control group (n = 9) and completed measures on child disruptive behaviours, sense of parenting efficacy and satisfaction, family stress and service needs. Outcomes were assessed at pre‐, post‐, and 3‐month follow‐up. A focus group was also conducted with the participants in the intervention group upon the programme completion. Compared with the control group, the intervention group reported a significant reduction in intensity of child behaviour problems and a significant increase in parenting efficacy at post‐intervention. The gain in reducing intensity of child disruptive behaviours maintained to 3 months after the completion of programme. Qualitative data suggested the three key elements to help both parents and children get positive changes: understanding and empathy, emotional control, and persistence in applying positive parenting strategies. The results partially provided preliminary evidence supporting the efficacy of Triple P in reducing child behaviour problems for ADHD in Chinese society.     

Bayesian structural equation modeling: A more flexible representation of substantive theory

This article proposes a new approach to factor analysis and structural equation modeling using Bayesian analysis. The new approach replaces parameter specifications of exact zeros with approximate zeros based on informative, small-variance priors. It is argued that this produces an analysis that better reflects substantive theories. The proposed Bayesian approach is particularly beneficial in applications where parameters are added to a conventional model such that a nonidentified model is obtained if maximum-likelihood estimation is applied. This approach is useful for measurement aspects of latent variable modeling, such as with confirmatory factor analysis, and the measurement part of structural equation modeling. Two application areas are studied, cross-loadings and residual correlations in confirmatory factor analysis. An example using a full structural equation model is also presented, showing an efficient way to find model misspecification. The approach encompasses 3 elements: model testing using posterior predictive checking, model estimation, and model modification. Monte Carlo simulations and real data are analyzed using Mplus. The real-data analyses use data from Holzinger and Swineford's (1939) classic mental abilities study, Big Five personality factor data from a British survey, and science achievement data from the National Educational Longitudinal Study of 1988. (PsycINFO Database Record (c) 2012 APA, all rights reserved).