Top

15-02-2024 | ORIGINAL PAPER

Evaluation of a Mindfulness-Based Early-Childhood Behavioral Parenting Program that Promotes Parent and Child Well-Being in High-Risk Contexts

Auteurs: Liliana J. Lengua, Michele R. Smith, Autumn Eo, Ana Funes Gonzalez, Erika Ruberry

Gepubliceerd in: Mindfulness

Abstract

Objectives

Two studies were conducted to evaluate the effectiveness of a brief (6-week) mindfulness-based behavioral parenting program offered in community settings to parents of preschool-age children living in low-income or high-adversity contexts.

Method

Study 1 was a quasi-experimental, waitlist control study conducted with 53 parents whose children were enrolled in Head-Start or similar early childhood program. Study 2 evaluated the program when it was delivered synchronously online with 28 parents living in transitional housing or who were unhoused and whose children attended an early learning program. Assessments included parent-reported mindfulness problems, mental health symptoms, parenting and child social competence, and internalizing and externalizing problems. Study 1 also included observational ratings of parenting behaviors.

Results

Study 1 treatment group (n = 27) showed significant improvements or positive trends in mindfulness, parental warmth, scaffolding, acceptance, anxiety symptoms, parent-reported rejection, and child internalizing and externalizing problems when compared to waitlist participants (n = 26). Study 2 participants (n = 28) reported increases in consistent limit setting, child social competence, decreases in internalizing, and a tendency toward reduced parental anxiety symptoms from pretest to post-test, and treatment effects were maintained at follow-up. Parents’ satisfaction with the program was high, and attendance improved when the program was delivered online.

Conclusions

Preliminary results suggest that this brief mindfulness-based behavioral parenting program may improve parental anxiety and parenting behaviors, as well as children’s adjustment. The program is acceptable to parents who participated and feasibly implemented both in person and online in community settings with parents living in low-income contexts.

Preregistration

This study is not preregistered.

Albanese, A. M., Russo, G. R., & Geller, P. A. (2019). The role of parental self-efficacy in parent and child well-being: a systematic review of associated outcomes. Child: Care, Health Development, 45(3), 333–363. https://doi.org/10.1111/cch.12661CrossRefPubMed

Bank, L., Forgatch, M. S., Patterson, G. R., & Fetrow, R. A. (1993). Parenting practices of single mothers: Mediators of negative contextual factors. Journal of Marriage and the Family, 55(2), 371–384. https://doi.org/10.2307/352808CrossRef

Barker, E. D., Jaffee, S. R., Uher, R., & Maughan, B. (2011). The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depression and Anxiety, 28(8), 696–702. https://doi.org/10.1002/da.20856CrossRefPubMed

Baumel, A., Pawar, A., Kane, J. M., & Correll, C. U. (2016). Digital parent training for children with disruptive behaviors: Systematic review and meta-analysis of randomized trials. Journal of Child and Adolescent Psychopharmacology, 26(8), 740–749. https://doi.org/10.1089/cap.2016.0048CrossRefPubMed

Bolger, K. E., Patterson, C. J., Thompson, W. W., & Kupersmidt, J. B. (1995). Psychosocial adjustment among children experiencing persistent and intermittent family economic hardship. Child Development, 66(4), 1107–1129. https://doi.org/10.2307/1131802CrossRef

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848. https://doi.org/10.1037/0022-3514.84.4.822CrossRefPubMed

Buchanan-Pascall, S., Gray, K. M., Gordon, M., & Melvin, G. A. (2018). Systematic review and meta-analysis of parent group interventions for primary school children aged 4–12 years with externalizing and/or internalizing problems. Child Psychiatry & Human Development, 49(2), 244–267. https://doi.org/10.1007/s10578-017-0745-9CrossRef

Burgdorf, V., Szabó, M., & Abbott, M. J. (2019). The effect of mindfulness interventions for parents on parenting stress and youth psychological outcomes: A systematic review and meta-analysis. Frontiers in Psychology, 10, 1336. https://doi.org/10.3389/fpsyg.2019.01336CrossRefPubMedPubMedCentral

Cameron, E. E., Joyce, K. M., Delaquis, C. P., Reynolds, K., Protudjer, J. L., & Roos, L. E. (2020). Maternal psychological distress & mental health service use during the COVID-19 pandemic. Journal of Affective Disorders, 276, 765–774. https://doi.org/10.1016/j.jad.2020.07.081CrossRefPubMedPubMedCentral

Chen, M., & Chan, K. L. (2016). Effects of parenting programs on child maltreatment prevention: A meta-analysis. Trauma, Violence, & Abuse, 17(1), 88–104. https://doi.org/10.1177/1524838014566718CrossRef

Chin, G., Anyanso, V., & Greeson, J. (2009). Addressing diversity in mindfulness research on health: a narrative review using the ADDRESSING framework. Cooper Rowan Medical Journal, 1(1), 2. https://doi.org/10.31986/issn.2578-3343_vol1iss1.1.2CrossRef

Conger, K. J., Rueter, M. A., & Conger, R. D. (2000). The role of economic pressure in the lives of parents and their adolescents: The Family Stress Model. In L. J. Crockett & R. K. Silbereisen (Eds.), Negotiating Adolescence in Times of Social Change (pp. 201–223). Cambridge University Press.

Conger, R., Wallace, L., Sun, Y., Simons, R., McLoyd, V., & Brody, G. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179–193. https://doi.org/10.1037/0012-1649.38.2.179CrossRefPubMed

Cowan, P., & Cowan, C. (1992). Parenting style ratings: School children and their families project. University of California.

Doran, E., Aikens, N., Malone, L., Harrington, J., & Cannon, J. (2021). Economic conditions of head start families: connections with social supports and child and family well-being. Research Brief. OPRE Report 2021–84. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation

Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A model of mindful parenting: Implications for parent–child relationships and prevention research. Clinical Child and Family Psychology Review, 12, 255–270. https://doi.org/10.1007/s10567-009-0046-3CrossRefPubMedPubMedCentral

Duncan, G. J., Morris, P. A., & Rodrigues, C. (2011). Does money really matter? Estimating impacts of family income on young children’s achievement with data from random-assignment experiments. Developmental Psychology, 47(5), 1263–1279. https://doi.org/10.1037/a0023875CrossRefPubMedPubMedCentral

Emerson, L. M., Aktar, E., de Bruin, E., Potharst, E., & Bögels, S. (2021). Mindful parenting in secondary child mental health: Key parenting predictors of treatment effects. Mindfulness, 12(2), 532–542. https://doi.org/10.1007/s12671-019-01176-wCrossRef

Ettekal, I., Eiden, R., Nickerson, A., Molnar, D., & Schuetze, P. (2020). Developmental cascades to children’s conduct problems: the role of prenatal substance use, socioeconomic adversity, maternal depression and sensitivity, and children’s conscience. Development and Psychopathology, 32(1), 85–103. https://doi.org/10.1017/S095457941800144XCrossRefPubMed

Gach, E. J., Ip, K. I., Sameroff, A. J., & Olson, S. L. (2018). Early cumulative risk predicts externalizing behavior at age 10: The mediating role of adverse parenting. Journal of Family Psychology, 32(1), 92–102. https://doi.org/10.1037/fam0000360CrossRefPubMed

Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27. https://doi.org/10.1007/s10567-010-0080-1CrossRefPubMed

Gresham, F. M., & Elliot, S. N. (1990). Social skills rating system. American Guidance Service.

Hoeft, T. J., Fortney, J. C., Patel, V., & Unützer, J. (2018). Task sharing approaches to improve mental health care in rural and other low resource settings: A systematic review. Journal of Rural Health, 34(1), 48–62. https://doi.org/10.1111/jrh.12229CrossRef

Jansen, P. W., Raat, H., Mackenbach, J. P., Hofman, A., Jaddoe, V. W. V., Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., Verhulst, F. C., & Tiemeier, H. (2012). Early determinants of maternal and paternal harsh discipline: the Generation R study. Family Relations, 61(2), 253–270. https://doi.org/10.1111/j.1741-3729.2011.00691.xCrossRef

Kerns, C. E., Elkins, R. M., Carpenter, A. L., Chou, T., Green, J. G., & Comer, J. S. (2014). Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing. Journal of Affective Disorders, 167, 50–55. https://doi.org/10.1016/j.jad.2014.05.040CrossRefPubMedPubMedCentral

Kiliç, C., Kiliç, E. Z., & Aydin, I. O. (2011). Effect of relocation and parental psychopathology on earthquake survivor-children’s mental health. The Journal of Nervous and Mental Disease, 199(5), 335–341. https://doi.org/10.1097/NMD.0b013e3182174ffaCrossRefPubMed

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.xCrossRefPubMedPubMedCentral

Leijten, P., Gardner, F., Melendez-Torres, G. J., Van Aar, J., Hutchings, J., Schulz, S., Knerr, W., & Overbeek, G. (2019). Meta-analyses: key parenting program components for disruptive child behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 58(2), 180–190. https://doi.org/10.1016/j.jaac.2018.07.900CrossRef

Lengua, L. J., Honorado, E., & Bush, N. R. (2007). Contextual risk and parenting as predictors of effortful control and social competence in preschool children. Journal of Applied Developmental Psychology, 28(1), 40–55. https://doi.org/10.1016/j.appdev.2006.10.001CrossRefPubMedPubMedCentral

Lengua, L. J., Kiff, C., Moran, L. R., Zalewski, M., Thompson, S. F., Cortes, R., & Ruberry, E. (2014). Parenting mediates the effects of income and cumulative risk on the development of effortful control. Social Development, 23, 631–649. https://doi.org/10.1111/sode.12071CrossRef

Lengua, L. J., Ruberry, E. J., McEntire, C., Klein, M., & Jones, B. (2018). Preliminary evaluation of an innovative, brief parenting program designed to promote self-regulation in parents and children. Mindfulness, 12(2), 438–449. https://doi.org/10.1007/s12671-018-1016-yCrossRef

Lengua, L. J., Thompson, S. F., Kim, S. G., Rosen, M. L., Rodman, A., Kasparek, S., Mayes, M., Zalewski, M., Meltzoff, A., & McLaughlin, K. A. (2022). Maternal mental health mediates the effects of pandemic-related stressors on adolescent psychopathology during COVID-19. Journal of Child Psychology and Psychiatry, 63(12), 1544–1552. https://doi.org/10.1111/jcpp.13610CrossRefPubMed

Lengua, L. J. (2015). SEACAP Program Manual: social, emotional and academic competence for children and parents. Unpublished manual.

Lindahl, K., & Malik, N. (2000). System for coding interactions and family functioning (SCIFF): a coding system for family problem discussions. Unpublished Manuscript, University of Miami.

McLeod, J. D., & Shanahan, M. J. (1993). Poverty, parenting, and children’s mental health. American Sociological Review, 58(3), 351–366. https://doi.org/10.2307/2095905CrossRef

McLoyd, V. C. (1998). Socioeconomic disadvantage and child development. American Psychologist, 53(2), 185–204. https://doi.org/10.1037/0003-066X.53.2.185CrossRefPubMed

Mejia, A., Calam, R., & Sanders, M. R. (2015). A pilot randomized controlled trial of a brief parenting intervention in low-resource settings in Panama. Prevention Science, 16(5), 707–717. https://doi.org/10.1007/s11121-015-0551-1CrossRefPubMed

Mistry, R. S., Vandewater, E. A., Huston, A. C., & McLoyd, V. C. (2002). Economic well-being and children’s social adjustment: The role of family process in an ethnically diverse low-income sample. Child Development, 73(3), 935–951. https://doi.org/10.1111/1467-8624.00448CrossRefPubMed

National Academies of Sciences, Engineering, and Medicine. (2016). Parenting matters: Supporting parents of children Ages 0–8. The National Academies Press. https://doi.org/10.17226/21868CrossRef

National Center for Parent, Family and Community Engagement. (2015). Compendium of parenting interventions. National Center on Parent, Family, and Community Engagement, Office of Head Start, U.S. Department of Health & Human Services.

Newby, J. M., O’Moore, K., Tang, S., Christensen, H., & Faasse, K. (2020). Acute mental health responses during the COVID-19 pandemic in Australia. PLoS ONE, 15(7), e0236562. https://doi.org/10.1371/journal.pone.0236562CrossRefPubMedPubMedCentral

Parent, J., McKee, L. G., Rough, N. J., & Forehand, R. (2016). The association of parent mindfulness with parenting and youth psychopathology across three developmental stages. Journal of Abnormal Child Psychology, 44, 191–202. https://doi.org/10.1007/s10802-015-9978-xCrossRefPubMedPubMedCentral

Park, C. L., Russell, B. S., Fendrich, M., Finkelstein-Fox, L., Hutchison, M., & Becker, J. (2020). Americans’ COVID-19 stress, coping, and adherence to CDC guidelines. Journal of General Internal Medicine, 35, 2296–2303. https://doi.org/10.1007/s11606-020-05898-9CrossRefPubMedPubMedCentral

Parker, K., Minkin, R., & Bennett, J. (2020). Economic fallout from COVID-19 continues to hit lower-income americans the hardest. Pew Research Center. https://www.pewresearch.org/social-trends/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/#:~:text=A%20new%20Pew%20Research%20Center,food%20from%20a%20food%20bank

Pereira, M., Negrão, M., Soares, I., & Mesman, J. (2013). Predicting harsh discipline in at-risk mothers: The moderating effect of socioeconomic deprivation severity. Journal of Child and Family Studies, 24(3), 725–733. https://doi.org/10.1007/s10826-013-9883-2CrossRef

Potharst, E. S., Boekhorst, M. G., Cuijlits, I., Van Broekhoven, K. E., Jacobs, A., Spek, V., Nyklicek, I., Bogels, S. M., & Pop, V. J. (2019). A randomized control trial evaluating an online mindful parenting training for mothers with elevated parental stress. Frontiers in Psychology, 10, 1550. https://doi.org/10.3389/fpsyg.2019.01550CrossRefPubMedPubMedCentral

Potharst, E. S., Kuijl, M., Wind, D., & Bögels, S. M. (2022). Do improvements in maternal mental health predict improvements in parenting? Mechanisms of the mindful with your baby training. International Journal of Environmental Research and Public Health, 19(13), 7571. https://doi.org/10.3390/ijerph19137571CrossRefPubMedPubMedCentral

Racine, N., Eirich, R., Cookee, J., Zhu, J., Pador, P., Dunnewold, N., & Madigan, S. (2021). When the bough breaks: a systematic review and meta-analysis of mental health symptoms in mothers of young children during the COVID-19 pandemic. PsyArXiv. https://doi.org/10.31234/osf.io/u8pnhCrossRef

Reising, M. M., Watson, K. H., Hardcastle, E. J., Merchant, M. J., Roberts, L., Forehand, R., & Compas, B. (2013). Parental depression and economic disadvantage: the role of parenting in associations with internalizing and externalizing symptoms in children and adolescents. Journal of Child and Family Studies, 22, 335–343. https://doi.org/10.1007/s10826-012-9582-4CrossRef

Ricketts, H., & Anderson, P. (2008). The impact of poverty and stress on the interaction of Jamaican caregivers with young children. International Journal of Early Years Education, 16(1), 61–74. https://doi.org/10.1080/09669760801892276CrossRef

Roth, R. M., Isquith, P. K., & Gioia, G. A. (2013). Assessment of executive functioning using the Behavior Rating Inventory of Executive Function (BRIEF). Handbook of executive functioning (pp. 301–331). Springer.

Rubin, K. H., & Cheah, C. S. L. (2000). Parental warmth and control scale—revised. University of Maryland.

Russell, B. S., Hutchison, M., Tambling, R., Tomkunas, A. J., & Horton, A. L. (2020). Initial challenges of caregiving during COVID-19: Caregiver burden, mental health, and the parent–child relationship. Child Psychiatry & Human Development, 51(5), 671–682. https://doi.org/10.1007/s10578-020-01037-xCrossRef

Santiago, C. D., Wadsworth, M. E., & Stump, J. (2011). Socioeconomic status, neighborhood disadvantage, and poverty-related stress: Prospective effects on psychological syndromes among diverse low-income families. Journal of Economic Psychology, 32(2), 218–230. https://doi.org/10.1016/j.joep.2009.10.008CrossRef

Shih, E. W., Ahmad, S. I., Bush, N. R., Roubinov, D., Tylavsky, F., Graff, C., Karr, S. S., & LeWinn, K. Z. (2023). A path model examination: maternal anxiety and parenting mediate the association between maternal adverse childhood experiences and children’s internalizing behaviors. Psychological Medicine, 53(1), 112–122. https://doi.org/10.1017/S0033291721001203CrossRefPubMed

Shorey, S., & Ng, E. D. (2021). The efficacy of mindful parenting interventions: A systematic review and meta-analysis. International Journal of Nursing Studies, 121, 103996. https://doi.org/10.1016/j.ijnurstu.2021.103996CrossRefPubMed

Singh, N. N., Lancioni, G. E., Medvedev, O. N., Hwang, Y. S., & Myers, R. E. (2021). A component analysis of the mindfulness-based positive behavior support (MBPBS) program for mindful parenting by mothers of children with autism spectrum disorder. Mindfulness, 12(2), 463–475. https://doi.org/10.1007/s12671-020-01376-9CrossRefPubMed

Smith, M. R., King, K. M., & Lengua, L. J. (under review). The impact of neighborhood safety, maternal depression, and parenting on adjustment in early childhood and preadolescence.

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092CrossRefPubMed

Teleki, J. K., Powell, J. A., & Dodder, R. A. (1982). Factor analysis of reports of parental behavior by children living in divorced and married families. The Journal of Psychology, 112(2), 295–302. https://doi.org/10.1080/00223980.1982.9915387CrossRefPubMed

Thompson, S. F., Shimomaeda, L., Calhoun, R., Moini, N., Smith, M. R., & Lengua, L. J. (2022). Maternal mental health and child adjustment problems in response to the COVID-19 pandemic in families experiencing economic disadvantage. Research on Child and Adolescent Psychopathology, 50(6), 695–708. https://doi.org/10.1007/s10802-021-00888-9CrossRefPubMedPubMedCentral

Trentacosta, C. J., Hyde, L. W., Shaw, D. S., Dishion, T. J., Gardner, F., & Wilson, M. (2008). The relations among cumulative risk, parenting, and behavior problems during early childhood. Journal of Child Psychology and Psychiatry, 49(11), 1211–1219. https://doi.org/10.1111/j.1469-7610.2008.01941.xCrossRefPubMed

Turney, K. (2012). Pathways of disadvantage: Explaining the relationship between maternal depression and children’s problem behaviors. Social Science Research, 41(6), 1546–1564. https://doi.org/10.1016/j.ssresearch.2012.06.003CrossRefPubMed

van Agteren, J., Iasiello, M., Lo, L., Bartholomaeus, J., Kopsaftis, Z., Carey, M., & Kyrios, M. (2021). A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nature Human Behaviour, 5(5), 631–652. https://doi.org/10.1038/s41562-021-01093-wCrossRefPubMed

Waldrop, J., Baker, M., Salomon, R., & Moreton, E. (2021). Parenting interventions and secondary outcomes related to maternal mental health: a systematic review. Maternal and Child Health Journal, 25, 870–880. https://doi.org/10.1007/s10995-021-03130-6CrossRefPubMed

World Health Organization. (2020). Listings of WHO’s response to COVID-19. https://www.who.int/news/item/29-06-2020-covidtimeline

Zhu, X. (2014). Comparison of four methods for handing missing data in longitudinal data analysis through a simulation study. Open Journal of Statistics, 4(11), 933–944. https://doi.org/10.4236/ojs.2014.411088CrossRef

Titel: Evaluation of a Mindfulness-Based Early-Childhood Behavioral Parenting Program that Promotes Parent and Child Well-Being in High-Risk Contexts
Auteurs: Liliana J. Lengua
Michele R. Smith
Autumn Eo
Ana Funes Gonzalez
Erika Ruberry
Publicatiedatum: 15-02-2024
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-024-02307-8