PREDICTORS OF SELF‐REPORTED GAINS IN A RELATIONSHIP‐BASED HOME‐VISITING PROJECT FOR MOTHERS AFTER CHILDBIRTH

We assessed mothers’ self‐reported gains from a postpartum home‐visiting (HV) project in which home visitors are volunteer mothers from the community. Hypotheses were that gains are positively related to (a) mothers’ felt‐closeness with their home visitor, (b) mothers’ level of sociodemographic risk, and (c) the home visitors’ preproject training in support services for families or children (Professionalism). One hundred sixty‐four clients returned written evaluations of the HV project. Items assessing gains were reduced to two factors: Improved Well‐Being (“Self”) and Improved Infant Care (“Infant”). Repeated measures general linear models, with Gains (Self, Infant) as the repeated measure, and multiple regression analyses evaluated the hypotheses. Across the sample, gains on both factors were moderate, although gain scores were higher regarding Self than for Infant. Results show that (a) Mothers’ felt‐closeness with their volunteer was strongly related to mothers’ gains; (b) high‐risk mothers gained more from the project than did mothers of lower risk, particularly regarding Infant Care; and (c) mothers visited by volunteers who were professionals reported more substantial gains than did mothers visited by volunteers who were not professionals. Findings can help explain variance in mothers’ gains from such projects and could be useful in improving their efficacy.     

Treatment of Maternal Depression With In-Home Cognitive Behavioral Therapy Augmented by a Parenting Enhancement: A Case Report

Depression is prevalent among mothers who participate in home visitation programs. This case study describes In-Home Cognitive Behavioral Therapy (IH-CBT), an empirically based treatment for depressed mothers that is strongly integrated with ongoing home visitation. The use of a Parenting Enhancement for Maternal Depression (PEMD) module was added to address parenting difficulties in a depressed mother. This case describes issues and challenges encountered in delivering treatment in the home with low-income, depressed mothers. Issues involving engagement, adaptation to the setting, responding to the unique needs of low-income mothers, and partnership with concurrent home visiting to optimize outcomes are considered. Long-term follow-up (18 months after the end of treatment) permits examination of sustainability of gains. Implications for treating this high-risk population are discussed.     

母亲负性情绪与儿童外化问题行为的关系：家庭嘈杂度的调节作用

摘 要 对251名学前儿童及母亲进行一年的追踪来考察母亲负性情绪与学前儿童外化问题之间的关系及这一关系是否受到家庭嘈杂度的影响。结果: (1) T1儿童外化问题能正向预测T2母亲负性情绪,而T1母亲负性情绪对T2儿童外化问题的预测不显著;(2)与低嘈杂家庭相比,高嘈杂家庭中儿童外化问题对母亲负性情绪的预测作用更强,且儿童外化问题也更为稳定。结论：母亲负性情绪与儿童外化问题的关系主要表现为儿童效应,且这一效应受到家庭环境的调节。     

Can Home Visitation Enhance Maternal Social Support?

This study investigates the impacts of Healthy Start, a statewide, home visitation program, on the social support systems of 212 disadvantaged mothers in Oahu, Hawaii. Maternal support was assessed at the time these mothers gave birth and 12 months later with the Maternal Social Support Index. Comparisons of mothers randomly assigned to visited (n = 108) or nonvisited (n = 104) conditions uncover few differences on structural or affiliational aspects of support after 12 months. Visited mothers, however, are significantly less likely to report a decline in satisfaction with a close adult than nonvisited mothers do. The discussion examines the challenges of fostering social support and the ability of home visitation efforts to achieve this outcome.     

Daily Behavior Report Cards with and without Home-Based Consequences: Improving Classroom Behavior in Low Income,African American Children with ADHD

Daily Behavior Report Cards (DBRC), which typically require teachers to evaluate students' daily behavior and parents to provide contingent consequences, are an effective and acceptable method for improving children's classroom behavior. The current study evaluated whether parent involvement is an essential treatment component or whether teacher feedback alone would be sufficient to produce children's behavior changes. The effectiveness of DBRC with teacher feedback to students and parent delivered consequences (PC) was compared to teacher feedback to students only (no parent delivered consequences, NPC) for increasing appropriate classroom behavior and academic productivity in African American, low income, elementary school children with Attention-Deficit/Hyperactivity Disorder (ADHD). Both treatments led to increased on-task behavior, although PC was superior to NPC. Academic productivity outcomes are less clear. Treatment implications and future directions for research on teacher feedback interventions are discussed.     

Relationship Between the Children's Assertiveness Inventory (CAI) and the Revised Behaviorial Assertiveness Test for Children (BAT-CR)

In this study, the relationship between a self-report measure of assertive behavior in children, the Children's Assertiveness Inventory, and a role-play measure of assertive behavior, the Revised Behavioral Assertiveness Test for Children, was examined in 69 elementary school children. Measures of assertive responding to positive (initiating interactions/giving and receiving compliments) and negative (standing up for one's own rights/refusing unreasonable requests) situations were obtained for both self-report and role-play measures. Results suggest that self-report of positive assertion is more closely related to role-play measures and expert ratings of assertiveness than is self-report of negative assertion. Results are discussed in terms of relationship between assertive behavior and aggressive behavior in children and the need to "unbind" these two notions in future studies. Developmental issues which limit the finings are also addressed.     

Reducing Child Whining Through Self-Instructional Parent Training Materials

Parents used self-instructional booklets to decrease their children's (age4-8) whining. In each of 9 families, a multiple-baseline design across three problems, whining and two other was used. Parent data indicate mean improvement of 26% of the maximum possible from baseline means, with 8 of 9 children showing improvement. All parent final consumer ratings were positive. All interobserver reliabilities exceeded 80% agreement weighted for occurrence and nonoccurrence. Correlations for two sets of data between frequencies of whining estimated by parents twice an hour and percent of intervals recorded for whining from observer interval data for the hour produced median correlations of .62 and .51. Percent agreement between observer and parent data, both using interval recording at the same time, produced a median coefficient of agreement weighted for occurrence and non-occurrence of 59%. Results suggest that parents using self-instructional materials alone could reduce children's whining from levels originally considered excessive to levels parents considered acceptable.     

A public health approach to preventing child abuse in low‐ and middle‐income countries: A call for action

Violence against children is prevalent across all countries and cultures, with the burden of child injury and violence heaviest in low‐ and middle‐income (LAMI) settings. There are several types of program to prevent child abuse, with family‐based approaches to prevention being the most comprehensively researched and successful interventions in high‐income settings. In LAMI countries, however, there is very little research evidence for the prevention of child abuse. We conducted a systematic search of relevant databases for studies published between 1995 and 2011 and the search revealed only one relevant study. There is thus a need for research into child maltreatment prevention in LAMI settings, taking account of local resources and contexts. In the light of the lack of evidence, we focus on two case studies that document the use of home visiting by community health workers perinatally to improve maternal and child outcomes. We propose four areas for action moving forward, including increased investment in early intervention and prevention programs, development of a research agenda that prioritizes prevention research, integration of implementation research into efforts to scale up interventions, and improving systematically collected information on child maltreatment.     

Educational Prefrences of Older Adults and Implications for Local Congregations

This research project studied the educational preferences of older adults in 22 churches in North Carolina. These older adults displayed a significant preference for "instrumental" activities over "expressive" activities. Level of education and occupation (or previous occupation) were significantly related to educational preference. Persons with fewer years of schooling indicated significant preference for instrumental activities, almost to the exclusion of expressive interests. As levels of education rose, there was a decrease in the ratio of instrumental preferences to expressive preferences. Persons in white collar jobs preferred expressive learning experiences more than blue collar individuals. Programming implications for local churches are discussed.     

养老机构冠心病患者服药依从性现状及影响因素

采用Morisky推荐的MAQ对锦州市养老机构中153名冠心痛患者的服药依从性进行测评,探讨冠心病患者的服药依从性现状及影响因素.结果显示,养老机构冠心病患者服药依从性差的比率为81.7％,影响服药依从性的因素为文化程度、服药种类、医疗背景、入住年限.养老机构的护理人员应对上述因素给予更多的关注,从而提高其服药依从性,进而提升其临床治疗效果.