Parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: Instrument reliability and validity

BACKGROUND: Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. OBJECTIVES: To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. METHODS: The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. SETTING AND PARTICIPANTS: A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. RESULTS: Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. CONCLUSIONS: Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

The relationship between the quality of parent-child interactions and positive child developmental trajectories is well established (Guralnick, 2006; Shonkoff & Meissels, 2000; Zubrick et al., 2008). However, a range of parental, family, and socio-economic factors can pose risks to parents’ capacity to participate in quality interactions with their children. In particular, families with a child with a disability have been found to have higher levels of parenting stress, and are more likely to experience economic disadvantage, as well as social isolation. The importance of early interventions to promote positive parenting and child development for these families is widely recognised (Shonkoff & Meissels, 2000). However, to date, there is a lack of evidence about the effectiveness of early parenting programs for families who have a young child with a disability. This thesis investigates the impact of a music therapy parenting program, Sing & Grow, on 201 parent-child dyads who attended programs specifically targeted to parents who had a young child with a disability. Sing & Grow is an Australian national early parenting intervention funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs and delivered by Playgroup Queensland. It is designed and delivered by Registered Music Therapists for families with children aged from birth to three years. It aims to improve parenting skills and confidence, improve family functioning (positive parent-child interactions), enhance child development, and provide social networking opportunities to socially isolated families. The intervention targets a range of families in circumstances that have the potential to impact negatively on family functioning. This thesis uses data from the National Evaluation Study of Sing & Grow from programs which were targeted at families who had a young child with a disability. Three studies were conducted to address the objectives of this thesis. Study 1 examines the effects of the Sing & Grow intervention on parent reported pre and post parent mental health, parenting confidence, parenting skills, and child development, and other parent reported outcomes including social support, use of intervention resources, satisfaction with the intervention and perceived benefits of and barriers to participation. Significant improvements from pre to post were found for parent mental health and parent reported child communication and social skills, along with evidence that parents were very satisfied with the program and that it brought social benefits to families. Study 2 explored the pre to post effects of the intervention on children’s developmental skills and parent-child interactions using observational ratings made by clinicians. Significant pre to post improvements were found for parenting sensitivity, parental engagement with child and acceptance of child as well as for child responsiveness to parent, interest, and participation in the intervention, and social skills. Study 3 examined the nature of child and family characteristics that predicted better outcomes for families while taking account of the level of participation in the program. An overall outcome index was calculated and served as the dependent variable in a logistic regression analysis. Families who attended six or more sessions and mothers who had not completed high school were more likely to have higher outcome scores at post intervention than those who attended fewer sessions and those with more educated mothers respectively. The findings of this research indicate that the intervention had a positive impact on participants’ mental health, parenting behaviours and child development and that level of attendance was associated with better outcomes. There was also evidence that the program reached its target of high risk families (i.e., families in which mothers had lower educational levels) and that for these families better outcomes were achieved. There were also indications that the program was accessible and highly regarded by families and that it promoted social connections for participants. A theoretical model of how the intervention is currently working for families is proposed to explain the connections between early parenting, child development and maternal wellbeing. However, more research is required to further elucidate the mechanisms by which the intervention creates change for families. This research presents promising evidence that a short term group music therapy program can elicit important therapeutic benefits for families who have a child with a disability.

Parents as coteachers of science and technology in a middle-school classroom

This study explores coteaching/cogenerative dialoguing with parents to investigate how it may be employed to engage parents more meaningfully in schools. The cogens provided a space where participants became aware of resources available for coteaching, made decisions about planning and enacting coteaching, as well as interstitial culture that facilitated positive parent-teacher relationships.

Identifying parents' perceptions about physical activity : a qualitative exploration of salient behavioural, normative and control beliefs among mothers and fathers of young children

Drawing on the belief-based framework of the Theory of Planned Behaviour, this study employs qualitative methodology involving individual and group interviews to examine the beliefs associated with regular physical activity performance among parents of young children (N = 40). The data were analysed using thematic content analysis. A range of advantages (e.g. improves parenting practices), disadvantages (e.g. interferes with commitments), barriers (e.g. time), and facilitators (e.g. social support) to performing physical activity are identified. Normative pressures are also identified as affecting parents’ activity behaviour. These identified beliefs can be used to inform interventions to challenge inactivity among this at-risk group.

Pondering policy and parental perspectives : how parents view their role in shaping early childhood public policy

The focus of this paper is the role of Australian parents in early childhood education and care (ECEC), in particular, their role in shaping ECEC public policy. The paper reports the findings of a study investigating the different ways in which a group of parents viewed and experienced this role. Set against a policy backdrop where parents are positioned as 'consumers' and 'participants' in ECEC, the study employed a phenomenographic research approach to describe this role as viewed and experienced by parents. The study identified four logically related, qualitatively different ways of constituting this role among this group of parents, ranging from 'no role in shaping public policy' (the no role conception) to 'participating in policy decision-making, particularly where policy was likely to affect their child and family (the participating in policy decision-making conception). The study provides an insider-perspective on the role of parents in shaping policy and highlights variation in how this role is constituted by parents. The study also identifies factors perceived by parents as influencing their participation and discusses their implications for both policy and practice.

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

Background The relationship between positive parent-child interactions and optimal child development is well established. Families with a child with a disability may face additional challenges to establishing positive parent-child relationships. There are limited studies addressing the effectiveness of interventions which seek to address these issues with parents and young children with a disability. In particular, prior studies of music therapy with this group have been limited by small sample sizes and the use of measures of limited reliability and validity. Objective This study investigates the effectiveness of a short-term group music therapy intervention for parents who have a child with a disability and explores the factors associated with higher outcomes for participating families. Methods The participants were 201 mother-child dyads, where the child had a disability. Pre and post intervention parental questionnaires and clinician observation measures were taken on a range of parental wellbeing, parenting behaviours and child developmental factors. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. Results Significant improvements pre to post were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence that parents were very satisfied with the program and that it brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. Conclusions This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas. Whilst several limitations are discussed, the study does address some of the gaps in the music therapy evidence base in this area.

Parents’ risky choices around the IB Diploma

In recent years there has been a rapid growth in the International Baccalaureate Diploma(IBD), a secondary curriculum administered by the International Baccalaureate Organisation(IBO), as an alternative to the local curriculum in Australian schools in some schools. This growth is indicative of an increasing demand from Australian families for new educational structures, practices and processes. With more curriculum options and pathways such as the IBD available in the secondary education system, parents are faced with a more complex high stakes decision when it comes to choosing the optimal education path for their offspring, one which requires a careful assessment of potential outcomes and risks. This paper reports on the responses of 184 parents to an online survey conducted in 26 Australian schools that offer the IBD as a curricular alternative. It examines which parents either chose, or chose not to, enrol their children in the program, why, and what risks they perceived to be associated with that choice. The paper will compare the choice behaviour of the two groups of parents from a sociological perspective, framing the enquiry with reference to globalisation and neo-liberal education policy and its effect on parental choice of schooling. This paper will make evident how parental choice of educational alternatives has become a more complicated process for Australian families.

A study of parents’ conceptions of their roles as home educators of their children

Home education is a growing phenomenon in Australia. It is the practice whereby parents engage in the full time education of their children at home. This study used a phenomenographic approach to identify and analyse how home educating parents conceive of their roles as home educators. Data analysis presented an outcome space of the parents‘ qualitatively different conceptions of their roles as home educators. This outcome space exemplifies the phenomenon of the roles of parent home educators. This thesis reports on the qualitatively different ways in which a group of 27 home educating parents viewed their roles in the education of their children. Four categories of description of parent home educator roles emerged from the analysis. These parents saw themselves in the role of a (1) learner, as they needed to gain knowledge and skills in order to both commence and to continue home education. Further, they perceived of themselves as (2) partners, usually with their spouse, in an educational partnership, which provided the family‘s educational infrastructure. They also saw themselves in the role of (3) teachers of their children, facilitating their education and development. Finally, they conceived of themselves as (4) educational pioneers in their communities. These four categories were linked and differentiated from each other by three key themes or dimensions of variation. These were the themes of (1) educational influence; (2) educational example; and (3) spirituality, which impacted both their families and the wider community. The findings of the study indicate that home educators experience their roles in four critically different ways, each of which contributes to their family educational enterprise. The findings suggest that home educators, are bona fide educators and that they access parental qualities that provide a form of education which differs from the educational practices characteristic of the majority of Australians. The study has the potential to generate further understandings of home education for home educators and for the wider community. It may also inform policy makers in the fields of education, social welfare, and the law, where there is a vested interest in the education and welfare of children and families.

Parents resourcing children’s early development and learning

Parents deal with a complex web of choices when seeking and using knowledge and resources related to their young children’s literacy development. Information about children’s learning and development comes in many forms and is produced by an increasingly diverse range of players including governments, nongovernment organisations and commercial businesses. This study used a survey, interview and artefact collection to investigate mothers’ and fathers’ reported activities in seeking, accessing, producing and circulating information and resources related to children’s learning and development. Differences were found relating to parent gender and level of education. Parents’ resourcing activities are also shaped by their particular goals for their children.

Teachers’ and parents’ perspectives of digital technology in the lives of young children

The pervasiveness of technology in the 21st Century has meant that adults and children live in a society where digital devices are integral to their everyday lives and participation in society. How we communicate, learn, work, entertain ourselves, and even shop is influenced by technology. Therefore, before children begin school they are potentially exposed to a range of learning opportunities mediated by digital devices. These devices include microwaves, mobile phones, computers, and console games such as Playstations® and iPods®. In Queensland preparatory classrooms and in the homes of these children, teachers and parents support and scaffold young children’s experiences, providing them with access to a range of tools that promote learning and provide entertainment. This paper examines teachers’ and parents’ perspectives and considers whether they are techno-optimists who advocate for and promote the inclusion of digital technology, or whether they are they techno-pessimists, who prefer to exclude digital devices from young children’s everyday experiences. An exploratory, single case study design was utilised to gather data from three teachers and ten parents of children in the preparatory year. Teacher data was collected through interviews and email correspondence. Parent data was collected from questionnaires and focus groups. All parents who responded to the research invitation were mothers. The results of data analysis identified a misalignment among adults’ perspectives. Teachers were identified as techno-optimists and parents were identified as techno-pessimists with further emergent themes particular to each category being established. This is concerning because both teachers and mothers influence young children’s experiences and numeracy knowledge, thus, a shared understanding and a common commitment to supporting young children’s use of technology would be beneficial. Further research must investigate fathers’ perspectives of digital devices and the beneficial and detrimental roles that a range of digital devices, tools, and entertainment gadgets play in 21st Century children’s lives.

Parents’ views about child sexual abuse prevention education : a systematic review

This paper presents the results of a systematic review of literature on the topic of parents’ views about child sexual abuse prevention education. It describes: i) what parents know about child sexual abuse prevention education; ii) what child sexual abuse prevention messages parents provide to their children and what topics they discuss; iii) what parents’ attitudes are towards child sexual abuse prevention education in schools; and iv) their preferences for content. Electronic database searches were conducted to identify relevant literature published in English relating to child sexual abuse prevention programs and parent’s views. A total of 429 papers were evaluated with 13 studies identified as meeting the study’s inclusion criteria. Worldwide, empirical research on parents’ views about child sexual abuse prevention programs is limited and more research is needed in Australia. Implications for future research and practice are outlined.

Psychometric properties of the parents' fever management scale in a Turkish population

Aim: This paper reports a study designed to assess the psychometric properties (validity and reliability) of a Turkish version of the Australian Parents’ Fever Management Scale (PFMS). Background: Little is known about childhood fever management among Turkish parents. No scales to measure parents’ fever management practices in Turkey are available. Design: This is a methodological study. Methods: Eighty parents, of febrile children aged six months to five years, were randomly selected from the paedaitric hospital and two community family health centers in Sakarya, Turkey. The PFMS was back translated; language equivalence and content validity were validated. PFMS and socio-demographic data were collected in 2009. Means and standard deviations were calculated for interval level data and p values greater than 0.05 were considered statistically significant. Unrotated principal component analysis was used to determine construct validity and Cronbach’s coefficient alpha determined the internal consistency reliability. Results: The PFMS was psychometrically sound in this population. Construct validity, confirmed by confirmatory factor analysis [KMO 0.812, Bartlett’s Specificity (χ² = 182.799, df=28, P < 0·001)] revealed the Turkish version to be comprised of the eight original PFMS items. Internal consistency reliability coefficient was 0.80 and the scale’s total-item correlation coefficients ranged from 0.15 to 0.66 and were significant (p<0.001). Interestingly parents reported high scores on the PFMS 34.52±4.60 (range 8-40 with 40 indicating a high burden of care for febrile children). Conclusion: The PFMS was as psychometrically robust in a Turkish population as in an Australian population and is, therefore, a useful tool for health professionals to identify parents’ practices, provide targeted education thereby in reducing the unnecessary burden of care they place on themselves when caring for a febrile child. Relevance to clinical practice. Testing in different populations, cultures and healthcare systems will further assist in reporting the PFMS usefulness in clinical practice and research.