Family correlates of fruit and vegetable consumption in children and adolescents : a systematic review

Objectives To review associations between the family environment and young people’s fruit and vegetable consumption.

Design A systematic review. Published English-language (n 60) papers were identified using electronic databases and manual searches of personal files and reference lists. Observational research reporting a measure of fruit/vegetable intake for children (aged 6–11 years) and/or adolescents (aged 12–18 years) and at least one potential family correlate of dietary intake was included.

Results Parental modelling and parental intake were consistently and positively associated with children’s fruit and fruit, juice and vegetable (FJV) consumption. There were also positive associations between home availability, family rules and parental encouragement and children’s fruit and vegetable consumption. Parental intake was positively associated with adolescents’ fruit and vegetable consumption. There were also positive associations between parental occupational status and adolescent fruit consumption and between parental education and adolescents’ FJV consumption.

Conclusions Our findings highlight the importance of targeting the family environment for the promotion of healthy eating behaviours among children and adolescents. Future interventions should encourage parents to be positive role models by targeting parental intake and to create a supportive home environment through increased encouragement and availability of fruits and vegetables and employing rules to govern eating behaviours. For adolescents, indicators of family circumstances (e.g. parental education) should be used to identify target groups for interventions aimed at promoting healthy eating.

Parental influences upon their children's body image concerns and behaviours

An examination of the influence of parents revealed that sons' and daughters' perceptions of the direct and indirect pressures exerted by both mothers and fathers were more predictive of their body image concerns and body change strategies than the messages reported by parents. The professional portfolio presents four case studies of children referred to a Child and Adolescent Mental Health Service with depressive symptomatology in relation to attachment theory.

Child-focused and child-inclusive divorce mediation : comparatice outcomes from a prospective study of postseparation adjustment

This study compared outcomes over 1 year for two groups of separated parents, who attended two different forms of brief therapeutic mediation for entrenched parenting disputes. The two interventions each targeted psychological resolution of parental conflict, enhanced parental reflective function, and associated reduction of distress for their children. The child-focused (CF) intervention actively supported parents to consider the needs of their children, but without any direct involvement of the children, while the child-inclusive (CI) intervention incorporated separate consultation by a specialist with the children in each family, and consideration of their concerns with parents in the mediation forum. Repeated measures at baseline, 3 months, and 1 year postintervention explored changes over time and across treatments in conflict management, subjective distress, and relationship quality for all family members. Enduring reduction in levels of conflict and improved management of disputes, as reported by parents and children, occurred for both treatment groups in the year after mediation. The CI intervention had several impacts not evident in the other treatment group, related to relationship improvements and psychological well-being. These effects were strongest for fathers and children. Agreements reached by the CI group were significantly more durable, and the parents in this group were half as likely to instigate new litigation over parenting matters in the year after mediation as were the CF parents. The article explores the potential of CI divorce mediation to not only safely include many children in family law matters related to them, but also to promote their developmental recovery from high-conflict separation, through enhanced emotional availability of their parents.

Cruelty to animals and psychosocial adjustment among Chinese children

Childhood cruelty to animals is associated with interpersonal violence in later life. The study for this thesis investigated risk factors for childhood cruelty to animals in China. For both boys and girls externalising problems, poor communication within families, and harsh parental discipline predicted animal cruelty, providing targets for intervention to prevent later violence. The portfolio presents four clinical case studies which demonstrate the complex and varied impact that intimate partner violence has on women, and the importance of psychological intervention in assisting women to manage their physical and mental health and well-being.

Dual audiences, double pedagogies : representing family literacy as parental work in picture books

Narrative for a dual audience of children and adults is a field of expanding interest among children’s literature scholars. A great deal of the extant research is implicitly or explicitly informed by longstanding anxieties about the status of children’s fiction, a context that shifts the parameters of the analysis to questions of literary sophistication. Whilst some attention is paid to the readersubject position of the child reader, rather less is given to the positioning of the adult reader in relation to the pedagogical agendas of such texts. This article examines picture books featuring parents reading to preschool children. In the context of family literacy, it is an instance in which the pedagogical address to the adult reader is as significant as the address to the child. Drawing on distinctions between double and dual address, the article examines the ways in which representations of parents.

Family functioning, parental psychological distress and child behaviours : evidence from the Victorian child health and wellbeing study

We examined, using data from the 2006 Victorian Child Health and Wellbeing Study (VCHWS), whether family functioning is associated with parental psychological distress and children’s behavioural difficulties. The VCHWS was a statewide cross-sectional telephone survey to 5,000 randomly selected primary caregivers of 0- to 12-year-old children between October 2005 and March 2006. Only parents or guardians of children aged 4–12 years (n = 3,370) were included in this study. After adjusting for sociodemographic variables and ethnicity, parents or guardians scoring higher on the family functioning scale (i.e., from poorly functioning households) were at greater risk of psychological distress and had children with lower levels of prosocial behaviour and higher levels of behavioural difficulties relative to those from healthily functioning households. Mental health prevention programmes addressing child mental and conduct problems should consider the family environment and target those families functioning poorly.

A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3-5 year old children

Objective : To examine the potential efficacy of a brief telephone-based parental intervention in increasing fruit and vegetable consumption in children aged 3–5 years and to examine the feasibility of intervention delivery and acceptability to parents.

Design : A pre–post study design with no comparison group. Telephone surveys were conducted approximately 1 week before and following intervention delivery.
Setting Participants were recruited through pre-schools in the Hunter region, New South Wales, Australia.

Subjects : Thirty-four parents of 3–5-year-olds received four 30-min interventional telephone calls over 4 weeks administered by trained telephone interviewers. The scripted support calls focused on fruit and vegetable availability and accessibility within the home, parental role modelling of fruit and vegetable consumption and on implementing supportive family eating routines.

Results : Following the intervention, the frequency and variety of fruit and vegetable consumption increased (P = 0·027), as measured by a subscale of the children's dietary questionnaire. The intervention was feasible to be delivered to parents, as all participants who started the intervention completed all four calls, and all aspects of the interventional calls, including the number, length, content, format and relevance, were considered acceptable by more than 90 % of parents.

Conclusions : A brief telephone-based parental intervention to encourage fruit and vegetable consumption in pre-school-aged children may be effective, feasible and acceptable. Further investigation is warranted in a randomised controlled trial.

The association between parental personality patterns and internalising and externalising behaviour problems in children and adolescents

Background:  This study investigated the relationship between parental personality patterns and internalising and externalising behaviour problems in a clinically referred sample of children (aged 4–8) and adolescents (aged 12–18).

Methods:  Data from families involved in two clinical trials in Victoria, Australia were analysed (n = 59). Families were administered the Millons Clinical Multiaxial Inventory—III (MCMI-III) which reports personality patterns consistent with Axis II disorder and an Achenbach measure of mental health as appropriate to child's age (Child Behavior Checklist (CBCL), Youth Self-Report (YSR), or Adult Self-Report (ASR)). Relationships between internalising and externalising behaviour problems, and parental personality patterns were examined via correlation and regression analyses.

Results:  The study found a positive correlation between parental borderline, paranoid, and avoidant personality patterns, and child and adolescent externalising behaviour problems. The relationships were generally stronger for adolescents than for children. However, no relationship was observed between parental personality patterns and internalising behaviour problems.

Conclusions:  These findings underline the importance of clinical assessment of the family ecology as a whole—including the interaction between parental personality patterns and child and adolescent behaviour and emotional problems. These findings contribute to the understanding of developmental risk factors for child and adolescent mental health and the transmission of psychopathology across generations.

Childhood cruelty to animals in China: the relationship with psychological adjustment and family functioning

Background
The current study broadened the general scope of research conducted on childhood cruelty to animals by examining the association between psychological adjustment, family functioning and animal cruelty in an Eastern context, China.

Method
The mothers and fathers of 729 children attending primary school in Chengdu, China participated in this study. Each parent completed the Strengths and Difficulties Questionnaire, the Chinese Family Assessment Instrument, and the Children's Attitudes and Behaviours towards Animals questionnaire.

Results
Findings from an actor partner interdependence model demonstrated that parents' ratings of family functioning and of their child's externalizing coping style predicted only modest amounts of variance in animal cruelty. In particular, parents' ratings of their child's externalizing coping style most consistently predicted animal cruelty. Family functioning, fathers' ratings in particular, played a minor role, more so for boys compared with girls.

Conclusion
This study provided the first insight into childhood animal cruelty in China, and suggests that further research may enhance our understanding of these phenomena.

"These are our children" : polyamorous parenting

Some LGBT individuals are polyamorous—that is, they have relationships with multiple partners of the same and/or the other gender. This chapter discusses the findings from an Australian focus group of 13 polyfamily participants, and also presents an overview of previous research on polyparenting. Issues of being “out” to their children, relations with extended families and friendship networks, and navigating broader societal systems and structures are the greatest concerns for polyparents. The duality of lack of visibility and fear of disclosure is examined in the context of formal societal structures such as education, health, and the law; less formal networks such as family, friends, neighbors, and social groups; and the mass media and popular culture. Another theme we discuss is how polyfamilies can be supportive environments. Shared child rearing is creating new forms of kinship structures that are beneficial to both children and adults in polyfamilies, although attachment to transient members of the family is raised as a concern. The chapter concludes with a call for more research into all facets of polyfamilies as well as the need for legitimization and resource development in social, health, educational, media, and legal institutions.

Reducing parental anxiety using a family based intervention for youth mental health : a randomized controlled trial

This paper presents findings on parent anxiety and attachment relationship style from the Deakin Family Options (DFO) pilot study, a randomized controlled pilot study comparing a family-based treatment (BEST Plus), versus a youth only treatment (CBT) versus a group who received both of these treatments (COMBINED). Eligible participants were families with a young person (aged 12 - 25 years) with a high prevalence mental health problem. Youth from participating families scored in the clinical or subclinical range for depression, anxiety and/or substance misuse symptoms on standardized measures during the initial assessment. The collected sample was drawn from regional and urban centers in Victoria, Australia and allocated to treatment condition using a simple randomization procedure (parallel design). It was hypothesized that families receiving the BEST Plus would experience greater reductions in youth and parent mental health symptoms, and improved parent-child relationships, compared with those in the CBT condition. This paper describes and discusses changes in parent anxiety and parent attachment, according to whether the parent participated in a treatment (BEST Plus) or did not (NONBEST Plus). Participants were blind to the study hypotheses. In total 71 parent participants returned pre data and were allocated to a treatment group. In this paper, data from parent participants who completed pre and post measures (n = 48) and pre, post, and 6-month follow-up measures (n = 28) on anxiety and attachment were analyzed by group (BEST Plus versus NONBEST Plus). The results of this study suggest that parent anxiety decreased significantly more following parent involvement in a group treatment, than for parents that did not receive treatment. Unexpectedly, avoidant attachment increased in the no treatment group, but remained relatively stable following the BEST Plus group. There were no significant findings in relation to compulsive traits and anxious attachment. These findings are discussed in light of the study limitations.

Neighborhood perceptions moderate the association between the family environment and children's objectively assessed physical activity

This study aimed to investigate whether parents' perceptions of the neighborhood environment moderate associations between the family environment and children's moderate- to vigorous-intensity physical activity (MVPA) outside of school hours. In total, 929 parents of 10-12 year-old children completed a questionnaire concerning the family environment, MVPA levels, and the neighborhood environment. Children wore an Actigraph (AM7164-2.2C) accelerometer. Compared with neighborhood environment factors, the family environment was more frequently associated with children's MVPA. Parental MVPA was positively associated with children's MVPA, but only among children whose parents reported a high presence of sporting venues. Having more restrictive physical activity rules was negatively associated with children's weekday MVPA in neighborhoods with high perceived stranger danger.

Parental factors associated with obesity in children with disability: a systematic review

The current literature on obesity in typically developing children shows that the family context, and specifically the way parents parent their children are major determinants of childhood obesity. The influence of these factors on obesity in children with disability, however, remains unclear. A systematic review of the literature was undertaken to identify the parental and parenting risk factors associated with obesity in children and adolescents with disability. Articles were identified through Medline, Academic Search Complete, PsycINFO, ProQuest, ISI, CINAHL, Cochrane and Scopus databases. There was no restriction on publication dates. The inclusion criteria were empirical papers that tested associations between parental and parenting risk factors and obesity in children and adolescents with intellectual and other developmental disabilities. Only 11 studies met the selection criteria and subsequently included in this review. Results suggest that obesity in children and adolescents with disability may be associated with socioeconomic status; parents' body mass index, perception and attitude towards their children's weight and physical activity; and levels of activity in both parents and children. Firm conclusions about these associations cannot be reached, however, due to mixed findings and methodological limitations of the studies. Recommendations for future research are provided.

Family food involvement and frequency of famiy dinner meals among Australian children aged 10-12 years. Cross-sectional and longitudinal associations with dietary patterns

Involvement in meal preparation and eating meals with the family are associated with better dietary patterns in adolescents, however little research has included older children or longitudinal study designs. This 3-year longitudinal study examines cross-sectional and longitudinal associations between family food involvement, family dinner meal frequency and dietary patterns during late childhood. Questionnaires were completed by parents of 188 children from Greater Melbourne, Australia at baseline in 2002 (mean age = 11.25 years) and at follow-up in 2006 (mean age = 14.16 years). Principal components analysis (PCA) was used to identify dietary patterns. Factor analysis (FA) was used to determine the principal factors from six indicators of family food involvement. Multiple linear regression models were used to predict the dietary patterns of children and adolescents at baseline and at follow-up, 3 years later, from baseline indicators of family food involvement and frequency of family dinner meals. PCA revealed two dietary patterns, labeled a healthful pattern and an energy-dense pattern. FA revealed one factor for family food involvement. Cross-sectionally among boys, family food involvement score (β = 0.55, 95% CI: 0.02, 1.07) and eating family dinner meals daily (β = 1.11, 95% CI: 0.27, 1.96) during late childhood were positively associated with the healthful pattern. Eating family dinner meals daily was inversely associated with the energy-dense pattern, cross-sectionally among boys (β = −0.56, 95% CI: −1.06, −0.06). No significant cross-sectional associations were found among girls and no significant longitudinal associations were found for either gender. Involvement in family food and eating dinner with the family during late childhood may have a positive influence on dietary patterns of boys. No evidence was found to suggest the effects on dietary patterns persist into adolescence.

Reducing electronic media use in 2-3 year-old children: feasibility and efficacy of the Family@play pilot randomised controlled trial

BACKGROUND: Participation in electronic media use among 2-3 year olds is high and associated with adverse health and developmental outcomes. This study sought to test the feasibility and potential efficacy of a family-based program to decrease electronic media (EM) use in 2-3-year-old children. METHODS: Family@play was a six-session pilot randomised controlled trial delivered to parents of 2-3 year-old children from August to September 2012 in a community environment in the Illawarra region of New South Wales, Australia. Development of program content was guided by Social Cognitive and Family Systems Theories. The primary outcome was children's electronic media use. Secondary outcomes included children's time in sitting, standing and stepping. Data collectors were blinded to group allocation. Parents completed comprehensive process evaluation measures and participated in focus group discussions following completion of the program. Regression analyses were undertaken and effect sizes calculated using principles of intention to treat. RESULTS: Twenty-two participants (n = 12 intervention; n = 10 control) provided complete baseline data; complete data from 16 participants (n = 6 intervention; n = 10 control) were available post-intervention. Process evaluation results were high, showing the acceptability of the program. Compared with children in the control group, there were greater decreases in total EM use among children in the intervention group (adjusted difference [95 % CI] = -31.2 mins/day [-71.0-8.6] Cohen's d = 0.70). Differences for other outcomes were in the hypothesised direction and ranged from small for postural (sitting, standing, stepping) outcomes to moderate to large for individual electronic media (e.g. TV viewing, DVD/video viewing). CONCLUSIONS: This is the first family-based study to engage families of 2-3 year old children outside the United States and target multiple EM behaviours. Family@play was shown to be a feasible and acceptable intervention to deliver to families of 2-3 year old children. Potential efficacy is evident from moderate to large effect sizes. A larger trial is warranted to test the efficacy of the program. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ( ACTRN12612000470897 ).