Search Results (33)

Background/Objectives: This study examined how different types of language activities in educational settings predict language ability in preschoolers with cochlear implants (CIs) versus normal-hearing (NH) peers. Predictor variables included two dimensions of language activities (language learning activities: shared reading, word games, and story retelling; daily communication activities: routine conversations and free play talk), as well as auditory utilization status (awareness of sounds, perception of speech sounds, and attentive listening to teachers/peers), learning attentional state, and family socioeconomic status (SERS). The outcome variable was language ability, measured with the Mandarin Clinical Evaluation of Language for Preschoolers’ Core Scale (MCELP-CS), and control variables included age and, for the CI group only, age of implantation. Methods: Participants included 189 CI (mean age = 4.53 years, SD = 0.83) and 210 NH preschoolers (mean age = 4.64 years, SD = 0.83). All predictor and control variables were collected via teacher-reported questionnaires (self-compiled by the research team). Statistical analyses used hierarchical regression with separate models for each group. Results: For the CI group, after controlling for age and age of implantation, engagement in language learning activities emerged as the most stable and independent predictor of language ability. Auditory utilization status was another significant predictor, and its inclusion substantially increased the model’s R². For the NH group, language ability was primarily predicted by age-related maturation, with language learning activities showing additional predictive value, while daily communication activities and learning attentional state contributed very little. Conclusions: Findings suggest that for educational rehabilitation of CI preschoolers: increasing engagement in language learning activities in classrooms may be more beneficial than relying on daily conversation or merely improving attention alone; meanwhile, auditory utilization skills should also be fostered synergistically. Importantly, language intervention models designed for NH preschoolers cannot be directly transferred to CI preschoolers. Full article

Background: The psychosocial needs of families involving a child with a life-limiting or life-threatening condition are well recognized. However, evidence-based interventions that address the needs of the entire family remain scarce, even though family health can be maintained and supported if interventions encompass each individual family member, as well as the family as a unit. The aim was to evaluate the family talk intervention (FTI), regarding family communication, and psychosocial health, for families involving a child with a life-limiting or life-threatening condition. Methods: This pre-post study without a control group involved families of children with a life-limiting or life-threatening condition receiving FTI at a pediatric hospital and a hospice in Sweden. The study is registered at clinicaltrials.gov (ID NCT05020158, date of registration: 23 August 2021). FTI is a family-based intervention with the goal of facilitating family communication about illness-related topics, e.g., prognosis, support parenting, and making all children’s needs visible. In total, 105 participants from 29 families were included. Surveys measuring self-assessed family communication and satisfaction, anxiety, resilience, parenting skills, and children’s mental problems were answered at three time points: baseline (before intervention), at the end of the intervention, and six months later. Changes over time were analyzed using linear mixed-effects models. Results: Significant improvements were reported in family communication, family satisfaction, parenting skills, and levels of anxiety over time. Children’s mental health problems were reduced over time regarding emotional symptoms, conduct problems, peer relationship difficulties, and hyperactivity. No changes were found regarding resilience. Conclusion: The results suggest that FTI contributes to improved family communication and psychosocial health for families involving a child with a life-limiting or life-threatening condition. This highlights the value of a systemic approach that actively involves all family members. Full article

Objective: From a family perspective, this study aimed to examine the effects of a 12-week digital platform-based parent–child exercise intervention on children’s behavioral level (physical activity), psychological level (physical exercise attitude), and mental health. Methods: This study included 218 students aged 10–11 years who underwent a 12-week standardized parent–child exercise intervention. The intervention group completed two structured parent–child tasks per week through a digital platform (Ding Talk App) while maintaining regular physical education classes; the control group only maintained their regular physical education classes. Assessments were conducted using the Physical Activity Rating Scale, Exercise Attitude Scale, and mental health scales (The Spence Children’s Anxiety Scale (SCAS) and The Patient Health Questionnaire-9 (PHQ-9)) at four stages: pre-intervention (T1), mid-intervention (T2), post-intervention (T3), and a 2-month follow-up period (T4). The intervention effects and effect sizes (ηp²) were examined using Repeated Measures Analysis of Variance. Results: At the behavioral level, a significant group × time interaction was found for physical activity volume (F = 17.651, p = 0.04, ηp² = 0.138), indicating the presence of a moderate effect. At the psychological level, significant interactions were observed across exercise attitude dimensions (behavioral attitude: F = 3.699, p = 0.002, ηp² = 0.033; perceived behavioral control: F = 4.189, p = 0.006, ηp² = 0.037; subjective norm: F = 4.616, p < 0.001, ηp² = 0.040) and mental health measures (depression: F = 4.009, p = 0.026, ηp² = 0.044; anxiety: F = 3.1, p = 0.016, ηp² = 0.020), though no significant effect was found for behavioral intention (F = 1.346, p = 0.259, ηp² = 0.012), with all significant effects being relatively weak. Conclusions: The home–school collaborative, digital platform-based parent–child exercise intervention demonstrated positive effects on children’s physical activity volume, exercise attitudes, and mental health, offering a feasible and promising strategy to support more integrated child health promotion initiatives. Full article

Gendered social protection interventions such as Let’s Talk are now appreciated as a significant component of family-based HIV prevention services. The intervention deliberately focuses on bridging the caregiver–adolescent relational and communication divides in the context of HIV prevention. This qualitative study used interviews to explore the caregivers’ parenting experiences after attending the Let’s Talk programme in Soweto, South Africa. Simple random sampling was used to select four Community-Based Organisations (CBOs). Twelve caregivers were purposively sampled from the four CBOs. Data analysis was accomplished through thematic analysis. The findings indicate that Let’s Talk had positive transformative effects on the caregivers’ parenting experiences and relational dynamics with adolescents. The improved parenting experiences were characterised by better communication, mutual respect and observed behaviour improvements by adolescents. In conclusion, caregivers’ reports of improved parenting experiences provide empirical evidence of acceptability to participants, effective implementation, and Let’s Talk’s efficacy in facilitating desired outcomes. Full article

This study investigates the impact of family engagement on student reading achievement in the United Arab Emirates (UAE) using counterfactual explainable artificial intelligence (CXAI) analysis. Drawing data from 24,600 students in the UAE PISA dataset, the analysis employed Gradient Boosting, SHAP (SHapley Additive exPlanations), and counterfactual simulations to model and interpret the influence of ten parental involvement variables. The results identified time spent talking with parents, frequency of family meals, and encouragement to achieve good marks as the strongest predictors of reading performance. Counterfactual analysis revealed that increasing the time spent talking with parents and frequency of family meals from their minimum (1) to maximum (5) levels, while holding other variables constant at their medians, could increase the predicted reading score from the baseline of 358.93 to as high as 448.68, marking an improvement of nearly 90 points. These findings emphasize the educational value of culturally compatible parental behaviors. The study also contributes to methodological advancement by integrating interpretable machine learning with prescriptive insights, demonstrating the potential of XAI for educational policy and intervention design. Implications for educators, policymakers, and families highlight the importance of promoting high-impact family practices to support literacy development. The approach offers a replicable model for leveraging AI to understand and enhance student learning outcomes across diverse contexts. Full article

Background: Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers, yet vaccination rates remain suboptimal, particularly in Florida. Social influence, including family and peer support, may shape parental decisions to vaccinate their children. In this study, we examined the role of social networks (online and offline) in parental intention to vaccinate their 11- to 12-year-old children against HPV. Methods: We conducted a cross-sectional survey among 746 parents in Florida as part of the Text & Talk trial (2022–2023). Among other questions, parents reported on their intention to vaccinate, perceived social norms, and support received from up to three reported confidants. We performed logistic regression and multivariable analyses to assess the relationship between network support, social norms, and vaccination intent. Results: Seventy percent of parents intended to vaccinate their children. Greater support from the first reported confidant was significantly associated with higher vaccination intention (OR = 1.30, p < 0.0001). Perceived norms among friends (p = 0.01) and higher overall network support (p < 0.0001) were also predictive of intent. The higher the percentage of reported family members, the higher the support received for the vaccine (p = 0.04). Conclusions: Social support, particularly from close confidants and peers, plays a critical role in shaping parental HPV vaccination decisions while accounting for perceived social norms. Public health interventions can leverage peer networks alongside family support to enhance HPV vaccine uptake. Full article

Objective: This study aimed to explore the association between adolescents’ health risk behaviours (excessive use of alcohol, (e)cigarette smoking, cannabis use) and familial factors. A special objective of this study was to compare findings between Bulgarian and Lithuanian adolescents aged 15 years. Material and Methods: National samples from the WHO Health Behaviour in School-aged Children (HBSC) survey in 2021/2022 were analysed. The focus was on adolescents aged 15 (n = 64,349), including those from Bulgaria (n = 793) and Lithuania (n = 1137). The set of outcome variables included drunkenness, smoked cigarettes, e-cigarettes, and used cannabis (all variables were measured during the last 30 days); their indicators were child’s talking separately to their father and separately to their mother, as well as the four-item family support scale. All variables were dichotomised and their associations were analysed using Structural Equation Modelling with a WLSMV estimator. Results: In the total sample, the prevalence of drunkenness was 14.9%, cigarette smoking at 12.6%, e-cigarette smoking at 18.4%, and cannabis use at 5.9%; while in Bulgaria, in contrast to Lithuania, these behaviours were much more prevalent, at 27.0%, 29.9%, 29.8%, and 11.1%, respectively. The use of substances was significantly associated with selected familial factors, which were more pronounced among girls than boys in most subsamples. Low family support showed the strongest association with increased substance use (in the total sample, regression weight B varied from 0.231 to 0.382). Adolescents’ difficulty in talking to mother was more pronounced (B = 0.123 to 0.204) than difficulty in talking to their father (B = 0.058 to 0.140). Comparison of data samples from Bulgaria and Lithuania showed stronger relationships in Bulgarian adolescents compared to other countries, which are more pronounced among boys. In addition, among Bulgarian adolescents, easy communication with their father had an inverse association (increasing prevalence) with cannabis use. Conclusions: Adolescent health risk behaviours, such as use of substances, are associated with familial factors, including parent–teen communication and family support. Generally, these associations are more pronounced among girls than boys, and more evident among Bulgarian adolescents than their Lithuanian counterparts. Identifying environmental factors in families helps to plan interventions to prevent development of multiple health risk behaviours in adolescents. Full article

Cyberbullying can be prevalent across different life stages, with lasting traces on mental health across the lifespan. This study aims to (a) explore how cyberbullying is emotionally experienced across three distinct age groups and (b) analyze the influence of cyberbullying on mental health across the lifespan. This study included 883 participants divided into three age groups: 18–39, 40–59, and 60+. In-depth semi-structured interviews were conducted to gather participants’ experiences and perspectives. The data were then subjected to content analysis, which revealed a number of themes. The first objective revealed the following themes: For ages 18–39: (a) feeling ashamed or humiliated (92.4%), (b) withdrawing from friends and family, and (c) experiencing harassment as positive and difficulties with rules. For ages 40–59: (a) losing interest in hobbies (89.5%), (b) questioning about things they did or did not do, and (c) experiencing a sense of missing out. For ages 60+: (a) negative thoughts and self-talk (91.3%), (b) feeling judged negatively, and (c) feeling financially vulnerable. The second objective showed: For 18–39: (a) depressive symptoms (79.7%), (b) easy anger, and (c) suicidal behavior. For 40–59: (a) anxiety (93.2%), (b) low self-esteem, and (c) the use of substances. For 60+: (a) frustration (78.1%), (b) isolation, and (c) disturbances in sleep and eating patterns. This study highlights the significant psychological and emotional impact of cyberbullying across age groups, emphasizing the need for targeted interventions that address the unique challenges faced by individuals at different life stages. The findings underscore the importance of developing age-specific strategies to mitigate the effects of cyberbullying and to have perpetrators take responsibility for their reckless disregard for others, and ultimately, themselves. Full article

Background: Children in pediatric oncology report unmet needs related to communication and information about the illness, care involvement, and psychosocial support. Supporting the whole family involves challenges, with a risk that children’s voices are not heard above those of the adults. Article 12 of the UNCRC has been a catalyst in supporting children’s voices and their right to participate in processes that affect them. The aim of this study was to explore how children with cancer and their siblings experienced participation in a family-centered psychosocial support intervention, the Family Talk Intervention (FTI). Methods: Interviews were held with 35 children (ill and siblings) from 26 families in pediatric oncology after having completed the FTI. A combined deductive and inductive qualitative content analysis was undertaken, guided by the Lundy model of child participation. Results: Children’s experiences of being able to express their views, being listened to, and being involved during FTI were mainly positive. This was related to their participation in individual meetings where they could raise their concerns and views, undertake small activities while talking, and have their voices and needs mediated to relevant adults, such as parents and professionals. Conclusions: The findings of this study showed that the FTI for families in pediatric oncology created opportunities to promote child participation. These findings indicate that, by offering children an individual space where they can express themselves freely and supporting them in various ways to do so, the children’s voices and involvement are strengthened. Full article

Background and Objectives: The aim of this study was to determine the role of physicians in the intensive intervention and education regarding the smoking cessation of patients undergoing elective surgery under general anaesthesia. Materials and Methods: A randomised prospective study was conducted in family physicians’ clinics in which smokers of both sexes, aged 21–65 years, without cognitive impairments, and who were not addicted to psychoactive substances voluntarily participated. Four weeks preoperatively, 120 smokers were randomised into two equal groups; the intervention group (IG) underwent an intervention for the purpose of smoking cessation and the control group (CG) underwent no intervention. Biochemical tests were performed in order to determine the smoking status of the participants in the phase of randomisation, one week preoperatively, as well as 40, 120, and 180 days and 12 months postoperatively. The examinees of the IG talked to the physician five times and received 140 telephone messages, leaflets, and motivational letters along with the pharmacotherapy, while the participants in the CG received little or no advice on smoking cessation. Results: The results of this study confirmed a significant influence of the intervention and education on the smoking abstinence in the IG compared to the CG (p < 0.001). The smokers in the IG had 7.31 (95% CI: 2.32–23.04) times greater odds of abstinence upon the 12-month follow-up than the smokers in the CG. The smokers in the IG who did not stop smoking had a lower degree of dependence and smoked fewer cigarettes (p < 0.0001) compared to those in the CG, as well as a multiple times higher prevalence of short- and long-term abstinence. Conclusions: It can be concluded that the intensive intervention and education can motivate patients preparing for elective surgery to stop smoking in the short- and long term. Full article

Background: Childhood cancer impacts the family system and has psychosocial consequences for all family members. For the parents, the ill child, and the siblings to be able to adjust to this challenging situation, the whole family needs access to psychosocial support. However, only a few such family interventions in pediatric oncology have been evaluated. The aim of this study was to explore the potential effects of a family-centered intervention, the Family Talk Intervention (FTI), in pediatric oncology from the parents’ perspectives. Methods: A concurrent mixed methods design was used for this study. Data were derived from a pilot study of 26 families recruited from one pediatric oncology center in Sweden. This study focused on questionnaire and interview data from 52 parents. Results: After participation in FTI, the parents felt more satisfied with the conversations within the family about the illness. FTI also contributed to strengthened family togetherness, including more open communication and improved family relations, as described by the parents. Parents further expressed that they felt more empowered in their parenting role following FTI. Conclusions: The findings regarding FTI’s ability to improve family communication and family relations, thus strengthening family togetherness in families with childhood cancer, are promising. This provides motivation for a large-scale study of FTIs in pediatric oncology. Full article

HIV diagnosis and management have often caused disruption to the everyday life and imagined futures of people living with HIV, both at individual and social levels. This disruption has been conceptualised, in a rather dystopian way, as ‘biographical disruption’. This paper explores whether or not biographical disruption of living with HIV encourages men living with HIV (MLHIV; n = 40) in Yogyakarta and Belu, Indonesia, to reinvent their sense of self and future over time using internal and external assets. Our analysis uses the concepts of additive and subtractive resilience strategies, and we show how, rather than having a purely disrupted biography, participants talked about their experiences of ‘biographical reinvention’. Study participants were recruited using the snowball sampling technique, beginning with two HIV clinics as the settings. Data were collected using one-on-one in-depth interviews, and a qualitative framework analysis was used to guide step-by-step data analysis. The findings showed that, despite the disruptions in their everyday lives (i.e., mental health condition, work, activities, social relationships, etc.) following the HIV diagnosis and management, MLHIV in our study managed to utilise their internal assets or traits (i.e., hope, optimism, resilience) and mobilised external resources (i.e., support from families, friends and healthcare professionals) to cope with the disruptions. An interweaving of these internal assets and external resources enabled them to take on new activities and roles (additive resilience strategies) and give up health compromising behaviours (subtractive resilience strategies). These were effective for most MLHIV in our study, not only to cope with the HIV repercussions and improve their physical and mental health conditions, but to think or work on a ‘reinvented’ biography which encompassed resilience, hope and optimism for better health, life and future. The findings indicate the need for HIV interventions and healthcare systems that provide appropriate support for the development and maintenance of internal assets of PLHIV to enable them to cope with the repercussions of HIV and work on a ‘reinvented’ biography. Full article

For many diagnosed mothers and their daughters, breast cancer is a shared experience. However, they struggle to talk about cancer. This is particularly true when the daughter is in adolescence or young adulthood, as they tend to be more avoidant, which is associated with poorer biopsychosocial outcomes. When daughters are their mother’s caregivers, daughters’ burden and distress are heightened. Young adult caregiving daughters (YACDs) are the second most common family caregiver and encounter more distress and burden than other caregiver types. Yet, YACDs and their diagnosed mothers receive no guidance on how to talk about cancer. Thirty-nine mother/YACD pairs participated in an online survey to identify challenging topics and strategies for talking about cancer, and to explore associations between openness/avoidance and psychosocial outcomes. YACDs and mothers reported the same challenging topics (death, treatment-related issues, negative emotions, relational challenges, YACDs’ disease risk) but differed on why they avoided the topic. YACDs and mothers identified the same helpful approaches to navigate conversations (openness, staying positive, third-party involvement, avoidance). Avoidance was correlated with more distress whereas openness was correlated with better psychosocial outcomes. These results provide a psychosocial map for a mother-YACD communication skills intervention, which is key to promoting healthy outcomes. Full article

Diabetes can be prevented through lifestyle modification in the prediabetic phase. A group-based lifestyle intervention called ‘Diabetes Prevention Education Program’ (DiPEP) was tested recently in Nepal. The present study aimed to explore experiences of making lifestyle changes among people with prediabetes participating in the DiPEP. This qualitative study, with semi-structured interviews of 20 participants, was conducted 4–7 months following DiPEP intervention. Data analysis was performed by thematic analysis. The results included four themes, understanding that diabetes could be prevented, lifestyle changes made, hurdles to overcome, and experiencing benefits leading to sustained change. Some participants said they felt relieved to know that they had a chance to prevent diabetes. The participants talked mostly about making changes in diet (reducing carbohydrate intake) and physical activity (starting exercises). Obstacles mentioned included a lack of motivation and a lack of family support to implement changes. Experiencing benefits such as weight loss and reduced blood sugar levels were reported to lead them to maintain the changes they had made. Understanding that diabetes could be prevented was a key motivator for implementing changes. The benefits and hurdles experienced by the participants of the present study can be taken into consideration while designing lifestyle intervention programs in similar settings. Full article

Little is known about the effects of parental depression on offspring as they transition to adulthood—a challenging time developmentally, when late adolescents must separate from home, achieve intimate relationships, and develop a sense of identity. We present long-term quantitative and qualitative data from early adolescents with a depressed parent who were randomized to one of two family-based preventive interventions and followed over time, across the transition to young adulthood. Specifically, we present clinical measures of psychopathology and Likert-scale questionnaire data from young adults and their parents regarding the transition to adulthood and perceptions of the interventions. We also report in-depth qualitative interview data from young adults about the effects of parental depression on their transition to adulthood. Findings suggest that leaving home, establishing relationships, and coping with stressors may be challenging for emerging adults. Furthermore, the interviews highlight the importance of siblings, the burden of parental depression, and the development of self-understanding and empathy in young adults who grew up with a depressed parent. Data suggest that clinicians, policy makers, educators, and employers must address the preventive and clinical needs of young people and their families as they transition to young adulthood after growing up with depressed parents. Full article