Search Results (127)

Aboriginal and Torres Strait Islander adolescents living in rural communities do not have sufficient access to health promotion services. Community programs that respond to adolescent needs, highlight community strengths, and are locally tailored are needed. Set in Queensland (Australia), this study was cross-sectional and qualitative in design. Using implementation science and Aboriginal and Torres Strait Islander frameworks, this study aimed to identify community priorities for the co-design of a culturally appropriate, empowerment-focused nutrition program with rural Aboriginal and Torres Strait Islander adolescents. Through community yarning, the barriers, enablers, and opportunities for program implementation were explored within an Aboriginal and Torres Strait Islander community-controlled health organization. Ten adolescents, two parents/caregivers, eight healthcare staff, six community leaders, and four Elders participated. Thematic analysis identified six themes that outline community health priorities, contextualization to the local food environment, and the importance of cooking skills for empowerment and involving the family unit. Thematic analysis also explored community preferences for program evaluation. Themes were integrated with other knowledge sources to develop a program outline that is aligned with evidence-based practice and community voice. Implementation of the co-designed program is recommended and will be explored in partnership with the community through future research. Full article

Background/Objectives: The goal of the study was to identify the peculiarities of attention deficit hyperactivity disorder (ADHD) on the base of the behavioral characteristics and acoustic features of speech of children with ADHD and ADHD with comorbidity—ADHD and autism spectrum disorders (ASD) and ADHD and intellectual disabilities (ID)—within the framework of one test task. Behavioral characteristics were selected using DSM-V criteria; acoustic features of speech were considered by researchers as speech markers of ASD and ID detected for different languages. Methods: The study includes 92 children aged 5–13 years with ADHD, ADHD and ID, ADHD and ASD, and control groups of children diagnosed with ASD, ID and typically developing (TD) children. The children were tested using the test task “co-op play”. Video and audio recordings of children performing the test task were collected. We used a complex approach to study the peculiarities of children with ADHD through expert analysis of children’s behavior and play, acoustic spectrographic analysis of speech and questionnaires about early childhood development filled out by parents. Results: The characteristics of behavior, play, and acoustic features of speech of children with ADHD and ADHD and comorbidity were revealed. Children with ADHD had lower behavior scores in the play situation on the expert assessment than TD children, with the greatest differences for characteristics of play, “Playing for toy”, and of behavior “Displaced activity” and “Losing attention”. The speech of children with ADHD is characterized by low values of the third formant and the difference between the first two formants, compared to the corresponding speech features of children from other groups. The speech of children with ADHD+ASD is characterized by maximal pitch values (high voice), while that of children with ADHD+ID is characterized by low vowel articulation index values. Conclusions: Based on the analysis of behavior and speech of children with TD, ADHD, ADHD and comorbidity performing the “co-op play” test task, the set of characteristics specific to ADHD was identified. The obtained data expand our understanding of the specificity of children with ADHD and may contribute to the development of qualified support for families with children with ADHD. Full article

This practice-based implementation report describes the adoption of the My Abilities First (MAF) initiative for children with developmental delays in Taiwan. Grounded in the International Classification of Functioning, Disability and Health (ICF) framework, MAF emphasizes a strengths-based, participatory, and human rights-oriented approach to early childhood intervention. The purpose of this report is to describe the development of the MAF framework and the details of its innovative, culturally sensitive implementation in Taiwan, using implementation science principles to support the national adoption of My Abilities ID Cards (ABIDs). Central to the MAF initiative is the ABID, a tool that empowers children to express their abilities, preferences, and support needs using their own voice or preferred mode of communication. Guided by implementation science, the MAF team in Taiwan engaged stakeholders in urban and rural centers, developed training programs, and integrated ABID into early intervention and special education systems. Preliminary outcomes indicate that from 2021 to 2025, 140 training sessions reached a total attendance of 6961. Notably, satisfaction with training was high (>95%), and practitioner subjective competence adopting positive language improved. The number of children under age 12 creating ABIDs grew to approximately 700. Preliminary evidence suggests that ABIDs might increase systematic adoption of children’s opinions in assessments and interventions. Qualitative feedback from parents and professionals highlights the contribution of ABIDs, ensuring self-expression, motivation, and meaningful participation. The pioneering Taiwanese experience demonstrates the feasibility and impact of MAF and ABIDs in promoting children’s rights and participation, offering practical insights for global adaptation in diverse contexts. Full article

The Welsh Government commissioned research to develop a national model of support to improve wellbeing and educational outcomes for children when a parent goes to prison, with a particular interest in collaboration between prisons and schools. Central to this ASPIRE project (Actioning a Schools and Prisons Independent Research Evaluation) were children’s rights, listening to the voices of children and families, multi-agency collaboration, evidence-based practice, and solution-focused development. Numerous studies highlight the potentially devastating impact of a parent’s imprisonment on children, but the existing literature is limited regarding what works in improving outcomes for children. Further, a disconnect exists between prison-focused policies promoting family contact and policies relating to the needs and rights of children. Few national policies refer to the needs of children with a parent in prison, and the rhetoric remains focused on the prevention of reoffending or on ‘breaking the cycle’ of offending and imprisonment within families. Positive pockets of support were notable in prisons, schools, and communities, but more work is needed to build on existing practice, promote existing services/resources, and support collaboration. This article considers what a national, rights-based approach to support should look like, recognising a parent’s imprisonment as one of many elements in a child’s life. Full article

Background: Youth with disabilities remain among the most overlooked groups in global sexual and reproductive health and rights (SRHR) discourses, including in sub-Saharan Africa. Yet, their SRHR needs are often ignored. This reflexive article aims to illuminate and recenter the experiences and perspectives of youth with disabilities living in Gulu City and Gulu District, Northern Uganda, exploring what matters to them regarding SRHR and their broader life aspirations. Methods: We adopted a qualitative, reflexive and participatory approach. Data were collected among six Ugandan young co-researchers with different disabilities (physical, visual, hearing, and albinism), who interacted with two Ugandan research assistants and a Canadian researcher involved in a larger SRHR research project. They engaged in in-person and virtual WhatsApp and Microsoft Teams exchanges over weeks, with the support of three Ugandan Sign Language interpreters. We thematically analyzed data, informed by the Intersectionality-based Policy Analysis and Structural Health Vulnerabilities and Agency frameworks. Results: Our analysis revealed four main findings: (1) the persistent feeling of social discrimination, stigma, and exclusion, including from parents, (2) inaccessible SRHR information and services, and knowledge gaps, (3) gender- and disability-based violence, and (4) youth with disabilities’ aspirations for SRHR and in life. Conclusions: The voices of youth with disabilities in Gulu underscore the value of disability equity-focused research. They reminded us that they are intelligent, capable, and thoughtful citizens with agency whose SRHR and broader well-being must be acknowledged and respected. Their perspectives carry critical implications for SRHR programming, policy, and research. Full article

Background/Objectives: HPV vaccination is safe, effective, and recommended at ages 11–12, yet uptake remains suboptimal. Serious video games may offer an innovative strategy to deliver brief, engaging education during clinic visits. This qualitative paper, embedded within a mixed-methods study, examined adolescents’, parents’, and healthcare providers’ (HCPs’) perceptions of the acceptability, usability, and perceived clinical applicability of HPV Detective, a tablet-based digital game designed to provide HPV-related education to parent–child dyads during pediatric clinic wait times. Methods: Eight adolescent–parent dyads (N = 16) and three HCPs from university-affiliated pediatric clinics participated in 30–60-min semi-structured Zoom interviews. Interviews were audio-recorded, transcribed, and thematically analyzed by two coders, with discrepancies resolved by consensus and reviewed by a third researcher. Results: Participants identified five key dyadic themes and four HCP themes. Adolescents described the gameplay as intuitive and enjoyable, highlighting interactive challenges and realistic avatars. Parents valued the clarity of HPV information and noted that the game helped initiate health-related conversations. Both adolescents and parents suggested enhancements including voice narration and greater customization and agreed that the game was well suited for 10–15-min clinic wait times, with text messaging preferred for follow-up. HCPs emphasized challenges such as parental hesitancy and competing clinical demands and viewed the game as a feasible adjunct to support vaccine-related discussions. Conclusions: Findings suggest the acceptability, usability, and perceived clinical applicability of a brief, clinic-based digital game for HPV-related education and engagement among adolescents and their parents. Full article

Families affected by 22q11.2 deletion syndrome (22q) face complex health and mental health challenges, yet their lived experiences, particularly within the UK, remain underexplored. This study aimed to understand how families navigate care systems, mental health provision, and the transition to adulthood. Using a participatory action research (PAR) framework, five young adults with 22q and six parents were interviewed, with a steering group co-developing the research questions to ensure relevance and accessibility. Thematic analysis revealed five key themes: lack of professional awareness and diagnostic delays; fragmented and generic care pathways; emotional burden of parental advocacy; systemic gaps during transition to adulthood; and the enabling role of supportive relationships and environments. These experiences highlight a need for holistic, collaborative models of care, improved professional training, and inclusive support systems tailored to the unique needs of individuals with 22q. By centring family voices, this study offers critical insights into systemic barriers and facilitators in the UK, with implications for policy, practice, and future research. Full article

Out-of-school time (OST) STEM programs are well-positioned to strengthen family engagement, yet practical, theory-aligned tools remain limited. This early-stage mixed-methods study tests parent/caregiver (P/C) and staff (S) surveys based on Clover for Families developmental theory expressed through the CARE framework: Connect (welcoming climate, clear communication), Act (hands-on participation, at-home supports), Reflect (shared meaning-making, feedback), and Empower (family voice, decision-making). Nine OST STEM programs (eight U.S. states) co-designed/piloted CARE plans, activities, and surveys over six months. Quantitative data included baseline experiences (CARE practice frequency; n = 67 P/C, 42 S across nine programs), program-end reflection (retrospective perceptions of change; n = 26 P/C, 29 S), and forced-ranking (most/least important domains; n = 67 P/C, 42 S). Qualitative data from meetings, open responses, and interviews were analyzed to contextualize quantitative findings, which included strong internal consistency (P/C α = 0.83–0.95; S α = 0.77–0.95) and large retrospective gains in both groups across domains. Forced-ranking elevated Connect and Act over Reflect and Empower, highlighting a need to scaffold family involvement. Staff described CARE as useful and actionable. Findings show that CARE supports measurement and continuous improvement of STEM family engagement. Future work should test large-sample validity, link results to observed practice and youth outcomes, and refine Empowerment-related items for everyday agency. Full article

This article analyses a GloCal Service-Learning experience conducted by a student from the University of Padova, during a 5-month mobility period in Brazil. The experience involved conducting educational meetings for in-service teachers and parents of children in conditions of high social vulnerability in the city of Juazeiro, Bahia. The meetings aimed to raise awareness about the importance of fostering healthy and psychologically stimulating environments during early infancy development. As part of a case study, the research focuses on teachers’ and parents’ evaluations of the meetings and the learning outcomes of the student involved. Qualitative data were analyzed using descriptive coding. Data analysis revealed, on the one hand, that both teachers and parents evaluated the meetings very positively and, on the other hand, the need to give the community a greater voice. With respect to student learning, the research highlighted that contextual immersion, language, and contextualized education—dimensions of the GloCal framework—emerged as interconnected and indispensable to translating care into practice. Despite its limitations, this experience offers valuable insights into how International Service-Learning can evolve into a truly intercultural and ethical practice, bringing care and GloCal responsibility to the heart of education. Full article

People with Down Syndrome often experience more barriers to achieving a good quality of life compared to people without disabilities. A lot of the existing research has focused on the views of parents and professionals, rather than directly including the voices and perspectives of people with Down Syndrome themselves. We wanted to find out how this might be done. At the 2024 World Down Syndrome Conference, over 140 adults with Down Syndrome came together at a one-day Forum to talk about their lives—aspects that are going well and what could be better. The goal was to hear directly from them. This article explains how the Forum was run so that others with Down Syndrome can use a similar process. We describe how Artificial Intelligence (AI) was used to assist the authors in organising and sharing the information from participants, such as grouping what people said into different themes and helping to create plain language reports. This process worked. Eight key themes were found that could help people to have a good life, such as having good relationships with family and friends; having a job; making personal choices; and being respected and included. The list was longer than previously reported in other studies. The Forum gave valuable insights and helped us think of new ideas for supporting people with Down Syndrome to speak up for themselves. Used thoughtfully, AI (Artificial Intelligence) could be a helpful tool in the future to help these people share their experiences and needs. More research is needed to understand how people with Down Syndrome can be more involved in making changes through advocacy projects where they take an active role. Full article

Voice acoustics have been extensively investigated as potential non-invasive markers for Autism Spectrum Disorder (ASD). Although many studies report high accuracies, they typically rely on highly controlled clinical protocols that reduce linguistic variability. Their data is also recorded using specialized microphone arrays that ensure high-quality recordings. Such dependencies limit their applicability in real-world or in-home screening contexts. In this work, we explore an alternative approach designed to reflect the requirements of mobile-based applications that could assist parents in monitoring their children. We use an open-access dataset of naturalistic storytelling, extracting only the speech segments in which the child is speaking. We applied previously published ASD voice-analysis pipelines to this dataset, which yielded suboptimal performance under these less controlled conditions. We then introduce a deep learning-based method that learns discriminative representations directly from raw audio, eliminating the need for manual feature extraction while being more robust to environmental noise. This approach achieves an accuracy of up to 77% in classifying children with ASD, children with Attention Deficit Hyperactivity Disorder (ADHD), and neurotypical children. Frequency-band occlusion sensitivity analysis on the deep model revealed that ASD speech relied more heavily on the 2000–4000 Hz range, TD speech on both low (100–300 Hz) and high (4000–8000 Hz) bands, and ADHD speech on mid-frequency regions. These spectral patterns may help bring us closer to developing practical, accessible pre-screening tools for parents. Full article

Background/Objectives: Parents achieving recommended eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid intake can improve the health of parents and their children. Evidence links higher DHA intake to lower preterm birth (PTB) risk. With parental intake poorly defined, the objective is to characterize EPA and DHA intake by parents with children in households in a diverse, urban city. Methods: Parents with ≥1 child in the household completed a validated seven-question food frequency questionnaire to assess consumption of foods contributing most to EPA and DHA intake in American diets during the cross-sectional Voices of Child Health in Chicago Panel Survey (May–July 2022). Female respondents reported prior PTB. Home/residence information was linked to the Childhood Opportunity Index (COI). Multivariable linear regression and survey-weighted models evaluated parental characteristics associated with EPA+DHA intake. Pairwise comparisons estimated intake differences (mean (SE)) among groups. Results: Chicago parents (n = 1057) reported lower-than-recommended EPA+DHA intake and mothers consumed less compared to fathers (difference: 27.1 (11.4) mg/d; p = 0.02). Prior PTB was associated with lower EPA+DHA intake, yet DHA-containing supplement use, which occurred in ~25% of parents, was associated with higher intake (p < 0.05). Lower household income and a lower COI were associated with lower intake while parental race and ethnicity categories were also associated with intake (all p < 0.05); intake differed for mothers and fathers based on Black race and Hispanic ethnicity categories. Conclusions: The findings suggest that efforts aimed at improving parental EPA+DHA intake to improve the health of families should account for multidimensional influences on household food choices. Full article

Scholars have long shown that post-separation abuse continues through legal channels and that legal institutions often reinforce existing social relations. Nevertheless, little is known about how abused mothers’ legal experiences shape their understanding of legality and how this dynamic may function to perpetuate coercive control. Drawing on in-depth interviews with 32 Israeli mothers co-parenting with abusive ex-partners, this study offers a phenomenological account of how post-separation abused mothers experience family law proceedings, based on a feminist imperative to bring their voices to center stage. The analysis reveals a dialectical legal consciousness comprising three interconnected orientations—characterized by internal contradictions and tensions that paradoxically serve to maintain rather than disrupt existing power relations: Institutional Trust and Disillusionment in the law’s protective promise, Institutional Asymmetry as experienced from the abused mothers’ perspective, and Recognizing Entrapment—the realization that legal processes reproduce the very dynamics they sought to escape. Abused mothers thus describe a paradoxical relationship with the law of both needing and distrusting a system that mandates continued contact with their abusers. Caught in a second-order abusive relationship, they feel compelled to comply with processes they perceive as harmful. We term this Entrapped Legal Consciousness—a form of legal subjectivity shaped by institutional norms that reconfigure resistance and reinscribe coercive control. This study offers empirical and theoretical insight into how legality may become a mechanism for cultivating continued control. Full article

This study explores how parenting practices influence access to mental health and substance use (MHSU) care among African immigrant and refugee youth in Nova Scotia. Based on qualitative interviews and focus groups with youth aged 18–25 who had accessed or attempted to access MHSU services, this study centers youth narratives on parental roles in navigating culturally unfamiliar health systems. Data were analyzed thematically by the research team, with input from advisory committee members of African descent, using a collaborative and manual approach grounded in Afrocentric and Ubuntu principles of relationality, collective meaning-making, and respect for participant voice. Despite stigma, and acculturative stress, findings reveal that African parents often act as vigilant protectors, cultural anchors, and decisive actors in recognizing and responding to youth substance use. Participants described their parents as watchful, strict, and deeply invested in their well-being, sometimes even “saving” them by initiating care when peers or institutions failed to do so. Parental nudging, family-based intervention, and cultural values of collective responsibility were central to accessing MHSU services. This study emphasizes the need for culturally responsive and family-inclusive healthcare delivery by highlighting gaps in care systems where parental involvement was excluded or where African family dynamics that shape help-seeking and support were misunderstood. Full article

Background/Objectives: Hispanics living in the United States have higher rates of diagnosis and mortality from certain kinds of cancers, including human papillomavirus (HPV)-related cancers. HPV vaccines can prevent 90% of HPV-associated cancers. Methods: The purpose of this study was to recruit a sample of Hispanic parents to investigate trusted sources of HPV vaccine information. An online survey was used to collect data from Hispanic parents who reported having children between the ages of 11 and 17. Results: Parents of children 11–17 years of age (n = 203, M_age = (38, SD = 6.97; female 85.1%) were included. The top five trusted sources of HPV vaccine information were medical doctors (95.1%), registered nurses (54.2%), the CDC (47.8%), the WHO (45.3%), and pharmacists (25.6%). The two least trusted sources were the president of the U.S. (7.9%) and religious leaders (3%). Hierarchical linear regression models revealed that HPV vaccine acceptance was associated with trusting registered nurses (p < 0.001) and the CDC (p = 0.026) in recommending the HPV vaccine. Importantly, the family-held belief that vaccines cause autism was strongly correlated with personal beliefs that vaccines cause autism (r = 0.58; p < 0.001). Conclusions: Findings from this study have clinical implications for the development of interventions and health communication strategies that leverage trusted sources of information including medical doctors and registered nurses to encourage preventive health behaviors. Additionally, our findings support that pharmacists should be included in these interventions as they are often an underused resource and are trusted by their patients for vaccine information. Full article