Search Results (19)

Parents of children with special educational needs (SEN) experience elevated stress, anxiety, and depression, a challenge compounded by insufficient emotional support services. This study developed and evaluated a culturally adapted online counselling programme for Hong Kong Chinese parents of adolescents with SEN, integrating Solution-Focused Brief Therapy (SFBT) and Mindfulness Training. The 8-week programme aimed to reduce parental distress and improve family dynamics by emphasising strengths, fostering self-compassion, and enhancing empathetic interactions. A mixed-methods approach was used, combining standardised self-report measures such as the Parental Stress Scale (PSS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Child Behaviour Checklist (CBCL), with qualitative interviews and behavioural observations. Quantitative analysis of pre–post data via paired samples t-tests indicated significant within-group reductions in anxiety across all groups and in depression for the active control group. However, between-group comparisons of post-test scores did not show clear superiority of the experimental intervention. Qualitative findings highlighted perceived benefits, including increased emotional regulation, a shift towards a strengths-based perspective, and enhanced self-compassion, with the programme’s cultural adaptation deemed crucial for engagement. The study addresses a significant service gap and provides preliminary evidence for the acceptability and potential mechanisms of an integrative online model, while highlighting the need for further research with larger samples. Full article

Background: Attention Deficit Hyperactivity Disorder (ADHD) is associated with executive function deficits—such as planning, organization, and prospective memory—that impair autonomy and daily functioning, increase family stress, and create challenges in educational contexts. These consequences underscore the need for accessible and ecologically valid interventions addressing the cognitive, familial, and educational dimensions. Traditional approaches often lack ecological validity, and pharmacological treatment shows a limited impact on functional cognition. Objectives: This protocol outlines a feasibility study of DiverAcción, a web-based telerehabilitation system designed to enhance functional cognition through interactive and gamified tasks integrated into a comprehensive healthcare programme. Methods: A quasi-experimental feasibility study before and after the study will recruit 30 participants aged 9 to 17 years with ADHD. The study comprises an initial face-to-face session for instructions and baseline assessment (T0), followed by twelve supervised online sessions over six weeks. Therapeutic support is provided via integrated chat, email, and two scheduled videoconference check-ins. Feasibility Outcomes: include recruitment, adherence, retention, usability (SUS), acceptability (TAM), satisfaction, user-friendly design, therapeutic alliance (WAI-I), and professionals’ attitudes toward technology (e-TAP-T). Exploratory Measures: include parental self-efficacy (BPSES), parenting stress (PSI-4-SF), ADHD symptomatology (SNAP-IV), executive functioning (BRIEF-2), time management (Time-S), emotional regulation (ERQ-CA), prospective memory (PRMQ-C), and health-related quality of life (KIDSCREEN-52). Analyses emphasize descriptive statistics for feasibility metrics (recruitment, adherence, retention, dropout and fidelity). Assessments are conducted post-intervention (T1) and at three-month follow-up (T2) and analyzed relative to baseline using repeated-measures ANOVA or Friedman tests, depending on data distribution. Conclusions: This feasibility protocol will provide preliminary evidence on the usability, acceptability, and implementation of DiverAcción. Findings will guide refinements and inform the design of a subsequent randomized controlled trial. Full article

It is well known that early education and care lay the foundation for learning and wellbeing; however, resources available to support children with different life experiences can vary. For example, resources available to support early childhood educators working with young children from military families are particularly lacking. This is of concern, given that these children face a range of stressors in their daily lives. To address this gap, our interdisciplinary team used a co-creation framework to build a suite of free, online, psychosocial resources for the children and their parents, educators and support workers. To test the usability of the resources, we conducted an online survey with 83 Australian participants (parents, educators, and support workers) about their knowledge, skills and confidence in supporting these children and the children’s wellbeing. After the study, the participants were given access to the psychosocial resources for 6 to 12 months. Following this, an adapted survey was administered online (post-intervention) with 15 participants who had remained in the study during the COVID-19 pandemic. Quantitative data was analysed using cross-tabulation and descriptive statistics. Qualitative data was analysed using inductive thematic analysis. In our pre-intervention studies, 61% of parents and almost 26% of educators were only partially confident in understanding children’s responses to military-specific stressors. In contrast, in the current study, this number had fallen to under 7% (combined participant group), with perceived improvements noted in their views on the children’s wellbeing. These exploratory findings with a small sample size highlight the potential benefit of targeted programmes, professional development, and accessible resources for parents, educators, and support workers who assist children from military families. Full article

This study presents and analyses the effectiveness of the programme “Intelligent Families” aimed at promoting the development of parenting skills in parents within the framework of positive parenting. The popularity of attachment- and emotion-based interventions seems to have grown among clinicians, researchers and parents. However, in Spain, these programmes are practically non-existent or do not provide evidence of their effectiveness. A randomised experimental study with two groups (experimental and control) and a longitudinal design (pre, post and follow-up) was conducted to test the programme’s impact on parenting skills. The sample comprised 637 Spanish parents. Two moderating variables were considered: the modality (face-to-face or online) and the length of the intervention (2 or 4 sessions). The experimental group significantly increased their empathic authority, established rules with confidence and sensitivity, and could negotiate in everyday family conflicts. There were no differences according to the parent’s gender, the children’s age, or the intervention’s modality or duration. This study verified the effectiveness of the “Intelligent Families” intervention programme. The importance of developing and studying the effectiveness of preventive actions to promote families’ emotional well-being is discussed. Full article

Understanding the factors that influence teacher well-being is crucial as it significantly affects students, teachers, schools, and the sustainability of the education system, especially during prolonged emergencies. This study contributes to the field by empirically testing a conceptual model of teacher well-being in emergency contexts, specifically addressing the COVID-19 school closures with a sample of over 19,600 teachers from Kazakhstan through an online survey design. Utilising a multidimensional socio-ecological framework that considers individual, school and home, community, and national factors, this study identifies key predictors of teacher self-reported well-being. Individual-level predictors explained 9.3% of the variation in physical well-being (F = 118, p < 0.001, R² = 0.093) and 4.5% in psychological well-being (F = 72.2, p < 0.001, R² = 0.045). In contrast, school- and home-level predictors demonstrated significantly greater explanatory power, accounting for 21.9% (F = 128, p < 0.001, R² = 0.219) and 15.5% (F = 89.5, p < 0.001, R² = 0.155) of the variation in physical and psychological well-being, respectively. Community-level predictors explained 12.8% of the variation in physical well-being (F = 191, p < 0.001, R² = 0.128) and 10.2% in psychological well-being (F = 324, p < 0.001, R² = 0.102), while national-level predictors accounted for much smaller proportions: 0.67% for physical well-being (F = 21.8, p < 0.001, R² = 0.0067) and 1.4% for psychological well-being (F = 83.589, p < 0.001, R² = 0.014). These findings highlight the significant influence of home and school, as well as community-level predictors, on teacher well-being during emergency contexts, suggesting that interventions targeting these areas may be particularly effective in supporting teacher well-being. The findings reveal that while Kazakhstani teachers reported poor physical well-being, they generally had a more positive assessment of their psychological well-being. Vulnerable groups included women, older teachers, non-Kazakh teachers, and those with higher education levels, as well as teachers in Russian medium and mixed-medium schools, all of whom reported lower physical and psychological well-being. Additional risk factors identified were a lack of student engagement, difficult relationships with parents, a directive leadership style, family conflicts, and inadequate resources at home and school. Conversely, protective factors such as teacher autonomy, collegiality, networking opportunities, and self-efficacy emerged as significant contributors to well-being. These findings reveal a complex interplay between cultural factors and subjective perceptions of well-being. This study emphasises the critical role of these predictors in both emergency and non-emergency contexts, underscoring the urgent need for targeted policies and programmes that sustainably support and enhance teacher well-being holistically. This approach will promote Sustainable Development Goal (SDG) 3 (well-being) and ensure access to equitable quality education (SDG 4) for all learners, ultimately contributing to the overall resilience of educational systems. Full article

Background/Objectives: The field of paediatric bioethics addresses ethical issues in paediatric care, where parental authority often guides medical decisions, but children’s preferences should also be considered. Promoting ethical awareness among minors can help them understand complex issues. This study aimed to analyse how sociodemographic, educational, and experiential factors shape adult perspectives on paediatric bioethical issues, particularly concerning pain and death. Methods: A questionnaire was developed to collect adult views of bioethical issues. The online questionnaire was disseminated via e-mail or WhatsApp. It started with an initial group of known individuals and then expanded hierarchically to include contacts of friends. Participants completed an online questionnaire, and data were analysed using SPSS version 22.0 for Windows. Clustering analysis identified two distinct groups. Results: This research focused on Italian adults (N = 889) aged 18 and over. Cluster 1, predominantly female (78.3%) and more highly educated (38.6% with postgraduate degrees), exhibited greater experience with paediatric bioethical issues (81.1%). This group favoured a collaborative approach, supporting shared training among adults (92.3%) and advocating for gradually addressing bioethical issues during childhood (84.3%). Cluster 2, with a higher proportion of males (31.5%) and parents (75.1%), showed lower educational levels (3.0% with middle school education) and less experience with bioethical concerns (93.5%). This group preferred a reactive, situation-specific approach to these issues. Conclusions: This study showed two distinct adult profiles regarding how they approach paediatric bioethics. The first group adopts a preventive and collaborative strategy, while the second group is more reactive and situation-driven. These findings can guide the development of tailored educational programmes to improve discussions about sensitive topics such as pain, incurability, and death in paediatric care. Full article

Background: Community champions have been employed across various settings to disseminate evidence-based public health information. The Building Babies’ Brains programme trains champions to work with parents in communities, equipping them with child development knowledge and parental engagement strategies. We explored what makes community champions effective in distributing information to parents, including how the champion–parent relationship and champions’ personal characteristics affect information dissemination. Methods: Champions included both peers and professionals working with parents in target communities. We administered an online survey (n = 53) and follow-up interviews (n = 14) with champions, with representation from across all training cohorts. We conducted a realist-informed reflexive thematic analysis to generate themes in the data and highlight the contexts, mechanisms, and outcome patterns identified. Results: We observed 15 Context–Mechanism–Outcome configurations across five themes: information sharing opportunities, information relevance, the nature of the champion–parent relationship, interaction expectations, and champion confidence. Our programme theory for how the community champion approach works identified that peer champions focused more on building rapport, modelling behaviours, and being a trusted community resource than direct information transfer. Professional champions, in contrast, showed greater expertise and confidence in discussing parenting practices directly. For both groups, traits such as friendliness and the ability to establish a trusting relationship enhanced effectiveness. Conclusions: This research identifies the impacts of champion role, characteristics, and the champion–parent relationship on the effectiveness of knowledge mobilisation in this context, with implications for training and recruitment of champions. Those using a champion model in comparable settings should ensure that champions have the necessary knowledge, skills, and confidence to engage parents and share information effectively. Full article

This systematic literature review examines the evidence base on the effectiveness of online programmes on the mental health and well-being of family carers of people with intellectual disabilities. Databases (ERIC, Medline, PsycINFO and CINAHL) were searched for intervention studies that considered online interventions for family carers of people with intellectual disabilities. Data were extracted using standardised data extraction tools. Bias was assessed using the Cochrane risk of bias tool for randomised trials (RoB 2). Screening, extraction and assessment of bias were completed independently by two members of the research team. Given the low number of included studies and different outcomes assessed within them, it was not possible to conduct a meta-analysis; therefore, data are presented narratively. Two studies met the criteria to be included in the review. Both studies utilised a feasibility randomised controlled trial methodology. One study found a significant decrease in parental stress, while the other found a significant increase in psychological well-being. Caution must be taken in drawing firm conclusions, given the small sample sizes and low retention rates in both studies. Online programmes seem to offer potential benefits to family carers of people with intellectual disabilities. However, further investigation is needed to examine these programmes, adopting a collaborative approach with family carers. Full article

Child abuse is a global problem. Shaken baby syndrome (SBS) is a result of child abuse, with shaking being the most common form of maltreatment, causing mortality or severe brain damage in infants. A lack of awareness of SBS among current and future healthcare professionals can have serious consequences. To date, no studies have been conducted in Saudi Arabia to examine student nurses’ awareness of SBS, so we sought to assess this issue in an academic institution in Riyadh, Saudi Arabia. For this questionnaire-based study, we employed a cross-sectional, descriptive design. The target population was nursing students from every year of study in the institution’s five-year undergraduate nursing programme, who received an online questionnaire during the 2022–2023 academic year. The data were analysed using descriptive and inferential statistical analysis. Of the 293 respondents, 100.0% confirmed that they were not aware of SBS through their nursing curricula, and 62.1% reported not being made aware of SBS at all during their academic journey. The majority of participants were unaware of the negative consequences of shaking a baby. Most were not aware that shaking a baby vigorously can cause permanent blindness (73.4%), postural impairments (56.7%), sleep disorders (61.1%), or convulsions (60.1%). The results of our study revealed a statistically significant relationship between nursing students’ awareness of SBS and both their year of study and marital status. Those at higher academic levels and those who were married were more aware of SBS. To improve nursing students’ knowledge of SBS and help them to better inform the public of this syndrome, particularly parents, child maltreatment topics should be added to nursing curricula in Saudi Arabia, and their importance should be emphasised. This will help reduce the prevalence and burden of SBS nationally. Full article

The global COVID-19 pandemic presented not only challenges for services but also opportunities for reflection and change. This study aimed to understand young people, parents/carers, and professionals’ experiences of remote provision across a voluntary sector organization to inform the nature of future delivery. Reflections from professionals (n = 7), young people (n = 7), and parents/carers (n = 2) were collected through semi-structured interviews and focus groups. Data were thematically analysed. Five overarching themes were identified: ‘Accessibility’, ‘Remote therapeutic experiences’, ‘Translating to online’, ‘Spaces of comfort/discomfort’, and ‘Moving towards hybrid provision’. The COVID-19 pandemic changed service provision, notably with accelerated digitalisation. Although the service became more accessible, the digitalisation of services impacted the relational experiences for young people. Nevertheless, online provision was described as a ‘steppingstone’, allowing young people to engage in online therapy or group programmes before transferring to in-person provision. Although remote provision can lead to improvements in young people’s mental health, this format was not suitable for all. When considering future models of provision, assessing needs, preferences, and access to private space and hardware are all important considerations when deciding which format to use to achieve the best possible outcomes. Full article

(1) Background: surveillance data from the Saudi Ministry of Health shows that the Kingdom’s large-scale immunisation programme has significantly reduced the mortality and morbidity of the target diseases among children. In this study, we review relevant literature and test a number of hypotheses related to the association between demographic, socio-economic, clinic-related, and parents-related variables and completion of childhood immunisation. In doing so, this study identifies critical factors associated with completion of childhood immunisation and presents important implications to healthcare practitioners, particularly in Saudi Arabia; (2) Literature review: a systematic literature review was conducted to understand what is currently published concerning parents’ immunisation compliance in Saudi Arabia and the factors associated with immunisation compliance. (3) Methods: from March to May 2022, an online survey was administered to parents attending one of the 27 primary health care (PHC) centres in Qatif. Data from parents (n = 353) were analysed using exploratory factor analysis, correlation, and a series of OLS and logistic regression models; (4) Results: parental (child) age was negatively (positively) associated with the completion status of childhood immunisation (both p < 0.05). Parents with positive attitudes, social norms, perceptions towards immunisation, and those working in private companies were more likely to immunise their children (all p < 0.05). Conversely, living in an apartment building, walking to PHCs, waiting longer at PHCs, and having higher knowledge of immunisation were negatively associated with the completion of childhood immunisation (all p < 0.05); (5) Conclusions: several factors that positively or negatively influence the completion of childhood immunisation have been identified. Future studies may investigate the causal link between these factors and parental decision-making regarding childhood immunisation. Full article

Introduction: The COVID-19 pandemic and the lockdowns have affected many aspects of university students’ daily lives, including their dietary habits. This study aimed to evaluate the change of diet quality of university students before and during the COVID-19 period, and the factors associated with unfavorable changes in diet quality. Methods: An online cross-sectional study was performed in May 2021 among Rouen (France) university students. Socio-demographic characteristics, body mass index, depression, academic stress, risk of eating disorders and food security were collected. The French “Programme National Nutrition Santé-Guidelines Score 2” (PNNS-GS2) was used to access diet quality. Results: A total of 3508 students were included, 74.4% were female, the mean age was 20.7 (SD = 2.3), and 7.0% were in a situation of food insecurity. The PNNS-GS2 score decreased between the pre- and the COVID-19 pandemic period for 33.1% of university students. The associated factors with the decrease in the PNNS-GS2 score were food insecurity, financial insecurity, not living with parents, depression, academic stress, eating disorders, being in the two first years of study and having been infected by COVID-19. Conclusions: Diets with healthy components decreased for one-third of university students since the COVID-19 pandemic, and this was shown to be associated with food insecurity, poor mental health and eating disorder. This study provides important information to help public health authorities and universities give better support to student health feeding programs during pandemics and lockdowns. Full article

(1) Background: Vaccine hesitancy remains a major public health concern. The reasons behind this attitude are complex and warrant careful consideration, especially in the context of the COVID-19 era. The purpose of this study was to estimate vaccine hesitancy towards the established childhood immunization programmes in a non-random sample of Greek parents and explore possible links with important drivers of this phenomenon. (2) Methods: An online self-administered questionnaire was used from October 2020 to April 2021 to collect socio-demographic, lifestyle, and health status data and evaluate knowledge, views, and attitudes of the Greek population on COVID-19 pandemic-related issues. Parents were further asked to complete the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. (3) Results: A total of 1095 parents participated in the study with a mean age of 50 years (SD 9.5 years). The hesitancy against the established childhood vaccinations was estimated at 8.9% (95% CI, 7.3–10.8%). Married status and higher education and income were negatively correlated with hesitancy, whereas positive correlations were found for stress and depressive symptoms and current smoking. Variables related to proper awareness, sound knowledge, and trust toward authorities regarding the COVID-19 pandemic were strongly associated with being less hesitant against the established childhood vaccination programmes. (4) Conclusion: The estimated parental hesitancy against the established childhood vaccination programmes is worrisome. Variables related to good awareness and knowledge of the COVID-19 pandemic were strongly associated with being less hesitant against childhood vaccinations. Since controversy surrounding COVID-19 vaccinations may decrease parents’ confidence in routine childhood vaccinations, appreciating the complex reasons behind vaccine hesitancy may inform public health policies to overcome barriers and increase vaccine acceptance. Full article

The COVID-19 pandemic has forced schools and universities to shift their activities online, influencing the adoption of health-related behaviours such as physical activity and healthy dietary habits. The present study investigates the changes in adherence to a healthy diet and regular physical activity in university students in Italy before and during the COVID-19 pandemic and understands the role of sociodemographic variables in creating the changes above. We conducted a repeated cross-sectional survey performing the same sampling strategy at the first data collection (T0) and second data collection (T1) with a combination of convenience and snowball sampling approaches. The sample is composed of a total of 2001 students, 60.2% women and 39.8% men, with an average age of 22.7 (±5.5 SD). At T1, 39.9% of the students reported regular physical activity. During the pandemic, however, many, especially male students, abandoned or reduced physical activity practice (T1 40%), with an increase in social media use (T0 52.1%; T1 90%). A direct association between very low frequency of physical activity and increased sedentary time (r = 0.2, p = 0.001) and between change in dietary style and increased Body Mass Index (BMI) value (r = 0.3, p = 0.002) was found. The multivariate analysis for the total sample showed that some sociodemographic variables such as gender, age, parents’ level of education, area of study, household type, and perception of one’s body influence eating behaviours and physical activity. Our findings suggest that universities should invest in the protection and promotion of the health of their students with specific awareness programmes, and further research should repeat the survey in the post-lockdown period to investigate the long-term effects on health-related behaviours. Full article

Nutritional education is a recent, mandatory inclusion within the quality standards framework for the Holiday Activities and Food (HAF) programme in England; funded by the Department for Education (DfE). Whilst research has been conducted regarding nutritional education in other contexts, such as schools and community organisations, to the authors’ knowledge, no published research has yet explored nutritional education within HAF. The current study therefore aimed to explore the implementation, delivery, and perceived facilitators, barriers and impacts of nutritional education across a number of Local Authorities delivering HAF in England. Purposive sampling (n = 11) was used to recruit HAF leads involved in nutritional education, to participate in semi-structured interviews. Thematic analysis showed that nutritional education is currently delivered through a variety of modes including face-to-face, online, and take-home methods, all of which require a range of considerations in terms of implementation, delivery, and associated impacts, with some holiday clubs offering no nutritional education. According to participating HAF leads, nutritional education was used as a mechanism to enhance children’s and parents’ cooking confidence and competence, to improve dietary intake, and to increase understanding of issues such as food sustainability, environmental impacts, and food provenance. Although there are many examples of innovative practice, the findings suggested that COVID guidelines proved challenging for providers to include nutritional education within HAF delivery during 2021. Further, whilst the quality standards framework for nutritional education provides flexibility in terms of implementation and delivery, specific guidance, and monitoring of provision is required to ensure quality assurance and consistency across the HAF programme. Full article