Search Results (654)

Background/Objectives: Depression and anxiety in children pose a significant public health concern, with long-term implications for well-being. Over 10% of children and adolescents are affected by emotional disorders such as depression and anxiety. African American youth face disproportionate exposure to mental health risk factors, including poverty, adverse childhood events, community violence, and racial discrimination, which elevate their vulnerability to these disorders. A particularly at-risk subgroup includes African American children in kinship care arrangements (e.g., grandparents raising grandchildren), who may face additional factors such as family disruption and separation from birth parents. Methods: This mixed-methods sequential study examined how caregiver stress and birth mother–child relationship quality relate to depression and anxiety symptoms in African American children in kinship care. Phase I included survey data from 58 caregivers of children aged 5 to 12; Phase II involved interviews with 16 of these caregivers. Results: Results indicated that lower caregiver stress was associated with reduced child depression and anxiety symptoms. Furthermore, findings suggest that a high quality of the birth mother–child relationship serves as a promotive factor, particularly for depressive symptoms. Qualitative findings highlighted two themes: (1) the weight of kinship care, marked by factors such as ongoing grief and financial strain; and (2) birth parent relationships, defined by a mix of connection, conflict, and loss that affects children’s mental health. Conclusions: These findings underscore the need for greater understanding of the strengths and resources within kinship families that support positive mental health outcomes and highlight the importance of targeted interventions to reduce caregiver stress and foster supportive parent–child relationships. Full article

This study investigated how county- and state-level socioeconomic factors influence racial differences in placement stability outcomes for children in foster care. Using a sample drawn from the Adoption and Foster Care Analysis and Reporting System (AFCARS) covering 2012–2020, we employed linear mixed modeling (LMMs) to nest individual- and case-level data within counties and states. Our analysis focused on Black and White children, examining how variables such as poverty, unemployment, public welfare expenditures, residential mobility, and family structure affect the number of placement moves experienced by children. The findings indicated that Black children experience higher rates of placement instability compared to White children, although the gap narrows over time. Key factors associated with improved stability included county-administered child welfare systems and higher rates of multigenerational households and owner-occupied housing, particularly benefiting Black children. In contrast, higher levels of Supplemental Nutrition Assistance Program (SNAP) participation and increased residential mobility were linked to greater instability. The implementation of program improvement plans (PIPs) during the third round of the Child and Family Services Reviews (CFSR-3) produced mixed outcomes, with PIPs contributing to a reduction in the racial gap primarily by increasing placement moves for White children. These findings underscore the importance of analyzing data by race and incorporating broader socioeconomic contexts into child welfare improvement strategies, while also emphasizing the need for localized, context-sensitive approaches to improve placement stability. Full article

Background/Objectives: Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants, often resulting in prolonged neonatal intensive care unit (NICU) stays and significant parental stress. The experiences of parents navigating their preterm infant’s early NICU journey are important to support clinical trials to improve infant outcomes. Aim: The aim of this study was to explore parental perceptions of their infant’s health progression during the first 10 days of life through personal diary entries and their correlation with the echo scans assessments, as part of the Exploring Right vEntricular function applicability in a Prediction mOdel to identify pReterm infanTs with early BronchoPulmonary Dysplasia (REPORT-BPD) feasibility study. Methods: An embedded qualitative design was employed, utilising thematic analysis of 17 parent diaries. Parents of preterm infants (<32 weeks of gestation) admitted to a NICU documented their daily experiences. Thematic analysis was applied to ensure a rigorous, inductive examination of emerging themes. Findings: Four main themes were identified: (1) developing parent–infant relationships, highlighting the emotional impact of separation and the significance of bonding; (2) health and well-being of premature infants and family, reflecting parental vigilance, cautious optimism, and emotional distress; (3) parents navigating support and the NICU environment, describing challenges related to medical procedures, communication with staff, and adapting to a highly technical setting; and (4) emotions and protective gestures, illustrating parental resilience, coping mechanisms, and the innate drive to protect their child. Conclusions: Parental experiences in the NICU were shaped by emotional turmoil, uncertainty, and the need for support in navigating their infant’s care. Diaries provided an effective means for parents to express their experiences; they could serve as a communication tool in clinical trials to provide a deeper understanding of the development of the recruited preterm infants. Full article

Introduction: Post-Intensive Care Syndrome in Pediatrics (PICS-P) for families is a growing concern as receiving care in the Pediatric Intensive Care Unit (PICU) improves child survival. PICU parental stress may cause post-discharge psychiatric symptoms. Understanding personality-related distress is key for early intervention. This study examined whether parental personality traits correlate with such symptoms for PICS-P prevention. Methods: A cohort pilot study was conducted at a Japanese university hospital PICU (eight beds, 200–300 annual admissions, mandatory critical care consultation) between January and September 2022. Participants were parents of children admitted for longer than 1 week. Personality traits were investigated using the Big-Five-based test, and psychiatric symptoms were investigated using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the PTSD Checklist-5 (PCL-5). The correlation between personality traits and psychiatric symptoms was investigated. Results: Among the 53 subjects who met the inclusion criteria, 25 gave consent to participate in this study. The correlation analysis revealed distinct patterns. Agreeableness demonstrated negative correlations: a moderately significant negative correlation with PTSD symptoms (ρ = −0.612, p < 0.05) and non-significant negative correlations with anxiety (ρ = −0.238) and depression (ρ = −0.060). Conversely, neuroticism exhibited positive correlations: a moderately significant positive correlation with anxiety symptoms (ρ = 0.539, p < 0.05), alongside non-significant positive correlations with depression (ρ = 0.318) and PTSD symptoms (ρ = 0.327). Regarding other personality traits, extraversion showed negative correlations with anxiety (ρ = −0.282), depression (ρ = −0.399), and PTSD (ρ = −0.438), conscientiousness displayed positive correlations with anxiety (ρ = 0.318), depression (ρ = 0.127), and PTSD (ρ = 0.467), while openness exhibited negative correlations with anxiety (ρ = −0.333), depression (ρ = −0.312), and PTSD (ρ = −0.309), although none of these associations were statistically significant. Conclusions: Lower levels of agreeableness and higher levels of neuroticism in parents are significantly associated with increased PTSD and anxiety symptoms, respectively, in the PICU setting. These personality traits may serve as predictors of parental psychological distress, suggesting their utility in informing targeted PICS-P interventions and preventative strategies. Full article

Background/Objectives: School-age children with food allergies (FAs) face substantial psychosocial challenges. Herein, we aimed to synthesize the experiences of such children. Methods: A systematic review of qualitative studies was conducted using the Joanna Briggs Institute methodology. The protocol was registered in PROSPERO (CRD42022359854). A systematic search was conducted of eight databases. Thirteen studies met the inclusion criteria. The data were synthesized through meta-aggregation, and the confidence in the findings was assessed using the ConQual approach. Results: Seventy-three unequivocal findings were extracted and synthesized into three integrated findings. (1) Children with FAs live with daily fear, social restrictions, and emotional stress. To ensure their safety and foster self-management skills, the trusted adults in their lives must be well-informed about allergy management. (2) Children with FAs experience isolation, teasing, and exclusion from peers, whereas peer communication can foster understanding and acceptance. To address this, schools must promote peer empathy, provide allergy education, and build inclusive environments that empower children to express their needs safely. (3) Motivated by curiosity and personal goals, some children engage in oral immunotherapy or allergen reintroduction, leading to meaningful outcomes, such as increased food choices, social inclusion, and reduced anxiety. At the same time, they face emotional and physical burdens, highlighting the need for safety-focused, informed, supported care that considers both the benefits and burdens. Conclusions: This review highlights the need for child-centered, emotionally supportive, and inclusive care involving families, schools, and healthcare providers. However, the moderate ConQual score of the synthesized findings indicates that the recommendations should be considered with caution. Full article

Background: Early language development, a key predictor of later academic achievement, arises out of social interactions and communication. High-quality social and emotional interactions in early child care and education (ECCE) programs may therefore promote language-rich environments for young children. While culturally and linguistically minoritized communities face systemic barriers that limit equitable access to high-quality ECCE including social and emotional learning (SEL) programs, access to evidence-based SEL programs remains inequitable, disproportionately benefiting White, English-speaking, and higher-income ECCE providers. The current study aims to examine how I-T CHILD, a program designed to foster a climate that supports mental health and SEL in ECCE, improves the quality of the language environment using LENA technology. Methods: Implemented at the height of the COVID-19 pandemic, 38 family child care providers located in an urban setting (63.2% Hispanic/Latine; 40% living in poverty) were randomly assigned to the 12-week I-T CHILD program or to the waitlist-control group. Data were analyzed using hierarchical linear modeling procedures. Results: Infants and toddlers cared for by I-T CHILD providers produced significantly more vocalizations (p = 0.002; ES = 1.50) and were exposed to significantly less media and electronic sounds (p = 0.032; ES = −0.97) than infants and toddlers in the waitlist-control condition. Conclusions: Our findings reinforce the importance of the mental health climate in ECCE and its circular effect on early language development. We offer key insights into how mental health climate interventions in ECCE settings can enhance language interactions, center the child, and foster foundational skills linked to long-term academic success for historically underserved populations. Full article

Background: Maternal and newborn health disparities remain a challenge in Puerto Rico, especially in underserved communities. Comienzo Saludable Puerto Rico, sponsored by the U.S. Department of Health and Human Services’ Healthy Start Initiative (HRSA), addresses these gaps through an integrated Networks of Care model known as Cuidado Compartido. Comienzo Saludable Puerto Rico is a maternal, paternal, and child health program aimed at improving the health and well-being of pregnant women, mothers, fathers, newborns, and children in Puerto Rico, particularly those from disadvantaged communities. Methods: This paper presents the Comienzo Saludable Puerto Rico program’s Cuidado Compartido model to integrate a network of healthcare providers and services across hospitals, community organizations, and families. This model aims to improve maternal and newborn/child health outcomes by focusing on the importance of integrated, hospital-community-based care networks. Results: Participants experienced significant improvements in key birth outcomes: low birth weight prevalence declined by 27.2% compared to the community baseline, premature birth rates decreased by 30.9%, and infant mortality dropped by 75%, reaching 0% by 2021 and remaining there through 2023. These results were complemented by increases in maternal mental health screening, paternal involvement, and breastfeeding practices. Conclusions: The Cuidado Compartido model demonstrates a scalable, culturally responsive strategy to improve maternal, newborn, and child health outcomes. It offers critical insights for implementation in other high-need contexts. Full article

Background/Objectives: Despite the importance of parent mental health for child health, there are no global prevalence data on parental mental health symptoms when children are hospitalized. We aimed to describe depression and anxiety symptom prevalence and associated factors among parents of hospitalized children. Methods: We conducted this 14-country prospective cohort survey with parents/primary caregivers staying at a nearby Ronald McDonald House^® during their child’s hospital treatment. We used the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms and validated scales and theory-based questions to measure parent, family, and child covariates. We calculated the prevalence of clinically significant or concerning symptoms of depression and anxiety, and used multivariable regression analyses to examine associations between covariates and outcomes. Results: Among 3350 participants, 1789 (49.7%) reported depression symptoms and 2286 (69.0%) reported anxiety symptoms. Worry about housing and poorer ratings of their child’s health were associated with increased risk of depression symptoms. Poorer rating of the child’s health, living with a partner, and discrimination in daily life were associated with increased risk of anxiety symptoms. Higher levels of self-care, hospital family-centered care, and social support were associated with reduced risk of depression symptoms. Higher levels of self-care and social support were associated with reduced risk of anxiety symptoms. Conclusions: Clinically significant or concerning depression and anxiety symptoms are common among parents of hospitalized children globally. Hospitals should consider offering routine mental health symptom screening and preventative mental health and support services to all parents. Full article

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

Bring them home, keep them home is research based in New South Wales (NSW) Australia, that aims to understand successful and sustainable reunification for Aboriginal families who have children in out-of-home care (OOHC). This research is led by Aboriginal researchers, and partners with Aboriginal organisations. It is informed by the experiences of 20 Aboriginal parents and family members, and more than 200 practitioners and professionals working in child protection and reunification. This paper traces the evolution of Bring them home, keep them home which is now at the forefront of influence for NSW child protection reforms. Using specific examples, it highlights the role of research advocacy and resistance in challenging and disrupting systems in ways that amplify the voices of Aboriginal families and communities and embeds these voices as the foundation for radical innovation for child reunification approaches. The paper shares lessons being learned and insights for Aboriginal-led research with communities in the pursuit of restorative justice, system change, and self-determination. Providing a framework for liberating Aboriginal families from child abduction systems, this paper seeks to offer a truth-telling and practical contribution to the international efforts of Indigenous resistance to child abduction systems. Full article

Background/Objectives: Communication disorders in childhood, including expressive, receptive, pragmatic, and fluency impairments, have been consistently linked to mental health challenges such as anxiety, depression, and behavioural difficulties. However, existing research remains fragmented across diagnostic categories and developmental stages. This scoping review aimed to synthesise empirical evidence on the relationship between communication disorders and mental health outcomes in children and adolescents and to identify key patterns and implications for practice and policy. Methods: Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O’Malley’s framework, this review included empirical studies published in English between 2000 and 2024. Five databases were searched, and ten studies met the inclusion criteria. Data were charted and thematically analysed to explore associations across communication profiles and emotional–behavioural outcomes. Results: Four interconnected themes were identified: (1) emotional and behavioural manifestations of communication disorders; (2) social burden linked to pragmatic and expressive difficulties; (3) family and environmental stressors exacerbating child-level challenges; and (4) a lack of integrated care models addressing both communication and mental health needs. The findings highlight that communication disorders frequently co-occur with emotional difficulties, often embedded within broader social and systemic contexts. Conclusions: This review underscores the need for developmentally informed, culturally responsive, and interdisciplinary service models that address both communication and mental health in children. Early identification, family-centred care, and policy reforms are critical to reducing inequities and improving outcomes for this underserved population. Full article

Background and Objectives: The transition from pediatric to adult-oriented healthcare is challenging and data on parental involvement and perception regarding the transition of children with chronic digestive diseases are scarce. Materials and Methods: Legal guardians of adolescents with chronic digestive diseases receiving care at a North-Eastern Romanian tertiary center and private offices were administered a 30-item survey. Results: There were 124 responders; 73.4% lived in rural areas; 81.5% were patients’ mothers. Positive correlations were found between parents’ perception of the child’s readiness for health-related decisions and appreciation of the children’s preparedness for transition (0.544; p = 0.000), between parents encouraging their children to maintain healthcare records and their perception of the children’s knowledge about their disease (0.67; p = 0.000), between parents’ fear of therapeutic breaks during transition and their perception of the need for transition training (0.704; p = 0.000), between fears for children’s impropriate health-related choices, fears of therapeutic breaks (0.573; p = 0.00) and parental perception that the adult physicians would be more patient-oriented and less family-centered (0.453; p < 0.000) and between parents’ trust in their children’s self-management skills and encouraging them to make decisions on their own (0.673; p < 0.000). Conclusions: The results of our study highlight the importance of addressing parental fears during special parent–children counseling sessions and promoting a child’s independence, chronic disease knowledge, records and alone consultations. Full article

Introduction: It is widely acknowledged that good quality relationships between social workers and children are essential to children’s non-formal inclusion in child protection processes. However, research exploring the perspective of children has shown this relationship to be highly complex, particularly when children are taken into care. Methods: This paper combines insights from two qualitative participatory studies conducted in Italy, both developed out of a collaboration between university, professional social work associations, and the Italian association of care leavers. The two projects explored, respectively, the perspectives of social workers on the one hand and of children in care and care leavers on the other regarding their relationship. Outcomes: The data reveal the complexity of the relationship between children and social workers, showing how both share a mirrored perception of it. Social workers recognise children’s negative feelings toward them and see them as inevitable, especially in cases of tense family dynamics. A relationship marked by hostile attitudes, anger, and distrust not only fuels social workers’ emotional struggles but also makes it harder to engage children effectively. While hostile attitudes and mistrust are often seen as obstacles to positive engagement, we advocate for recognising them not as barriers to be overcome but as realities to be acknowledged and addressed openly. This approach can create space for both children and practitioners to explore alternative forms of agency, fostering more meaningful participation. Full article

Objective: To explore the experiences and self-efficacy of parent-caregivers providing care for a child with a tracheostomy tube. Study Design: Parent-caregivers completed surveys and participated in semi-structured interviews about their experiences learning to care for their child with a tracheostomy tube. Survey data were analyzed using descriptive statistics. Interviews were transcribed verbatim and analyzed thematically through coding. Results: Fifteen parent-caregivers participated in the survey, 13 of whom completed an interview. After receiving a tracheostomy, children were hospitalized a median of 6 months prior to discharge home. At the time of our study, children had been home for a median of 3.5 years. Parent-caregivers felt more prepared to perform routine daily care compared to triaging a change in medical status. Parent-caregiver self-efficacy in performing tracheostomy care skills improved with experience at home. Four themes were identified from interviews: new identity formation, enduring education, child and family biopsychosocial support, and establishing normalcy. Parent-caregivers shared that education was more than just acquiring skills; it also involved discovering diverse ways of learning and building confidence in one’s own abilities to fulfill the many types of roles they serve to successfully care for and keep their child safe while supporting their social and emotional needs as parent-caregivers. Conclusions: Parent-caregivers’ reflections on their experiences provide critical insight into their psychosocial needs and challenges in providing care to children with tracheostomies. Further investigation of lived experiences is vital to shaping a community that can support families of medically complex children. Full article

The “Baby Ubuntu” programme is a well-established, low-cost, community-based intervention to support caregivers of children with complex neurodisability, like cerebral palsy, in low- and middle-income country (LMIC) contexts. This process-focused paper describes our utilisation of the ADAPT guidance to adapt “Baby Ubuntu” for use in ethnically and linguistically diverse, and economically deprived urban boroughs in the United Kingdom (UK). The process was guided by an adaptation team, including parents with lived experience, who explored the rationale for the intervention from local perspectives and its fit for this UK community. Through qualitative interviews and co-creation strategies, the perspectives of caregivers and healthcare professionals substantially contributed to the “Encompass” programme theory, drafting the content, and planning the delivery. Ten modules were co-produced with various topics, based on the “Baby Ubuntu” modules, to be co-facilitated by a parent with lived experience and a healthcare professional. The programme is participatory, allowing caregivers to share information, problem solve, and form supportive peer networks. The “Encompass” programme is an example of a “decolonised healthcare innovation”, as it aims to transfer knowledge and solutions developed in low- and middle-income countries to a high-income context like the UK. Piloting of the new programme is underway. Full article