Child Care Health and Development最新文献

{"title":"‘COVID-19 Evokes Positive and Negative Memories’: The Experiences of Children in Ghana: A Qualitative Inquiry","authors":"Sylvester Kyei-Gyamfi,&nbsp;Zita Kyei-Gyamfi","doi":"10.1111/cch.70104","DOIUrl":"https://doi.org/10.1111/cch.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic significantly altered everyday life for children globally, particularly in regions with high infection rates. In Ghana, limited research has documented the lived experiences of children during this public health crisis, especially in hotspot areas like Accra and Tema.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim was to highlight children's experiences of the pandemic as they recount their positive and negative moments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative research design was utilised for this study. In-depth telephone interviews were conducted with 59 children aged 8 to 17 years from Accra and Tema, two of Ghana's COVID-19 hotspots. The interviews were transcribed and thematically analysed to identify key patterns and insights.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children reported mixed experiences during the pandemic. On the positive side, many appreciated spending more time with parents and siblings, which helped strengthen family bonds. However, they also faced challenges such as food insecurity, overcrowding in their homes, the loss of family members to COVID-19, and instances of domestic abuse, as highlighted in the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Strong family support and psychosocial interventions are recommended to reduce the likelihood of children experiencing harsh punishment. The Ministry of Gender, Children, and Social Protection should take the lead on this initiative, with support from other government agencies and non-governmental organisations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manager Perspectives on Services Addressing Mental Health Needs of Youth in Physical Rehabilitation","authors":"Stephanie M. Tremblay,&nbsp;Shalini Lal,&nbsp;Mark A. Ferro,&nbsp;Dana Anaby","doi":"10.1111/cch.70102","DOIUrl":"https://doi.org/10.1111/cch.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Youth mental health is becoming a priority, but models for organizing services in physical rehabilitation centres to meet the growing needs of youth with chronic physical disabilities and mental health problems are scarce. Initial research revealed barriers faced by youth, families and rehabilitation specialists when accessing or providing mental health services for this population. This study explores managers' perspectives on challenges, strengths and opportunities for mental health service delivery and integration in physical rehabilitation at the organizational level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two semistructured focus groups were conducted with nine managers across five organizations offering rehabilitation services in a large Canadian city. Data were analysed using inductive and deductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Barriers and facilitators expressed by managers fell into three categories: (1) available clinical resources for mental health (access to mental health specialists within internal team and internal organizational structures and mandates), (2) clinician workforce capacity (internal mental health knowledge and professional development for staff in physical rehabilitation and external mental health professionals' knowledge in physical disability) and (3) links and partnerships with key players (working in silos, external organizational structures and procedures and actions to improve pathways to access mental health services across external programs and organizations).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Managers' insights can guide the development of policies and advocacy for change at the organizational level to support mental health service delivery within physical rehabilitation. This can be done by building capacity on mental health knowledge and skills of rehabilitation teams and establishing collaborative partnerships and well-coordinated procedures within and outside of their organizations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of SAFE Early Intervention Approach in the First Months of Life in Infants at Risk: A Randomized Controlled Study","authors":"Ayse Yildiz,&nbsp;Ramazan Yildiz,&nbsp;Umut Apaydin,&nbsp;Pelin Atalan Efkere,&nbsp;Kivilcim Gücüyener,&nbsp;Ibrahim Murat Hirfanoglu,&nbsp;Bulent Elbasan","doi":"10.1111/cch.70107","DOIUrl":"https://doi.org/10.1111/cch.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to examine the effects of the SAFE early intervention approach (Sensory strategies, Activity-based motor training, Family collaboration, and Environmental Enrichment), developed for at-risk infants, on motor, cognitive, language development, and sensory processing skills in the first 3 months of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-six infants with a corrected age of 42 weeks were included in the study, and the infants were randomly distributed to the treatment and control groups. The SAFE early intervention approach was applied to 14 infants in the treatment group, and the Neurodevelopmental Treatment-based home programme was applied to 12 infants in the control group. All infants included in the study were evaluated at the corrected 42nd week before the intervention and at the corrected 12th week after the intervention by an evaluator blinded to the treatment. Bayley Scales of Infant and Toddler Development III (Bayley-III) to evaluate cognitive and motor development; Test of Infant Motor Performance (TIMP) to evaluate neuromotor development; Infant/Toddler Sensory Profile 2 (ITSP 2) to assess sensory processing t was used. The Infant/Toddler HOME Inventory was used to evaluate the home environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The interaction effects (time × group) revealed significant advantages for the SAFE early intervention group, evidenced by higher scores in the Bayley-III motor composite, TIMP elicited and HOME total assessments (<i>p</i> &lt; 0.05). However, the interaction effects (time × group) showed no differences between the groups in the Bayley-III cognitive and language composite scores, as well as the TIMP observed and TIMP total scores (<i>p</i> &gt; 0.05). The main effect for time was significant in all parameters (<i>p</i> &lt; 0.05). Similarly, the main impact for groups was substantial in all evaluation parameters except the Bayley-III language composite score and TIMP observed score (<i>p</i> &lt; 0.05). The interaction effects (time × group) demonstrated significant differences in favour of the SAFE early intervention group for the general processing score, auditory processing score, tactile processing score and total score of the ITSP 2 (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SAFE early intervention approach enhanced motor and sensory outcomes and provided a more enriched home environment than the NDT-based home programme. It was concluded that neurodevelopmental improvement will be achieved ","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Developmental Status of Children Aged 0–5 Years and Its Association With Child Gender, Family Background and Geographic Locations in Australian Community-Based Early Learning Centres","authors":"Huahua Yin,&nbsp;Matthew Ankers,&nbsp;Alicia Bell,&nbsp;Yvonne Karen Parry,&nbsp;Eileen Willis","doi":"10.1111/cch.70097","DOIUrl":"https://doi.org/10.1111/cch.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early childhood plays a vital role in long-term outcomes such as health, learning, behaviour and wellbeing. Evidence shows that developmental screening of children aged 0–5 years is currently inadequate and understanding of key factors influencing child development in the years before school remain limited. This study aimed to examine the associations between a child's age, gender, family background, remoteness of residence, community socio-economic level and developmental status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analysed data from a Paediatric Nurse Practitioners and Registered Nurses-led initiative, which offered Child Health Development Checks and referral support, for children attending Australian early learning centres from August 2022 to August 2023. The Brigance Screen III packages were used to do the child development screening, which assessed three domains for children aged 0–2 and five domains for those aged 2–5. Data from 1002 children (convenience sampling with children who attended the early learning centres) were included; univariable and multivariable logistic regression models and chi-square tests were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After controlling for other explanatory variables, children aged 2–3, were approximately six times more likely to have developmental concerns in language and self-help domains (<i>p</i> &lt; 0.05, <i>p</i> &lt; 0.001), when compared to children aged 5. Boys were around twice as likely to have developmental concern in academic and self-help domains (<i>p</i> &lt; 0.01). Children from culturally and linguistically diverse backgrounds were approximately two to three times more likely to have developmental concerns in language and social–emotional domains (<i>p</i> &lt; 0.01, <i>p</i> &lt; 0.001). Children living in mid-level socio-economic communities were more than twice as likely to have developmental concerns in academic domains, when compared to children living in most advantaged areas (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that male children, those from culturally and linguistically diverse backgrounds, or children from mid-level socio-economic communities may be at higher risk of experiencing developmental concerns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between 24-h Movement Behaviours and Health in 3- and 4-Year-Old Children From a Low-Income Country: The SUNRISE Ethiopia Study","authors":"Chalchisa Abdeta,&nbsp;Dylan Cliff,&nbsp;Katharina Kariippanon,&nbsp;Alem Deksisa,&nbsp;Sileshi Garoma,&nbsp;Debrework Tesfaye,&nbsp;Anthony D. Okely","doi":"10.1111/cch.70096","DOIUrl":"https://doi.org/10.1111/cch.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is little evidence on the associations between 24-h movement behaviours and health in children from low-income countries. We examined the associations of physical activity, sedentary behaviour, screen time and sleep with adiposity, motor skills and executive functions among 3- and 4-year-old children in Ethiopia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study conducted in Adama city and Lume Woreda, Oromia region, Ethiopia. We recruited children from kindergartens and rural Kebeles or villages. Children's time spent in physical activity, sedentary behaviour and sleep were measured using hip worn ActiGraph accelerometers. Children's screen time was parent-reported. Linear mixed models tested associations of 24-h movement behaviours with adiposity (BMI <i>z</i>-score), motor skills (NIH Toolbox) and executive functions (Early Years Toolbox). All models accounted for child sex, age and dietary diversity as fixed effects and clustering of children within kindergarten/villages as a random effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 430 children participated (4.2 ± 0.6 years). Children who slept longer had lower adiposity (−0.12, 95% CI: −0.19, −0.06). Those who had higher levels of total physical activity (TPA) (0.06, 95% CI 0.01, 0.13) and moderate to vigorous-intensity physical activity (MVPA) (0.03, 95% CI 0.01, 0.06) had higher scores on handgrip strength. Children who spent more time in sedentary behaviour had lower handgrip strength (−0.08, 95% CI −0.16, −0.01). There were no significant associations with executive functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Strategies to improve adiposity and motor skills should focus on promoting healthy levels of 24-h movement behaviours, especially adequate sleep and time spent in physical activity in Ethiopian children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Comparison of Adaptive Behaviour Between British and Brazilian Clinical Samples With Neurodevelopmental Disorders","authors":"Tally Lichtensztejn Tafla,&nbsp;Kate Anne Woodcock,&nbsp;Tatiana Pontrelli Mecca,&nbsp;Maria Cristina Triguero Veloz Teixeira","doi":"10.1111/cch.70098","DOIUrl":"https://doi.org/10.1111/cch.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Adaptive behaviour deficits are limitations in executing daily activities and difficulties in responding to environmental changes, which impact social participation and independence across contexts. Adaptive behaviour measures can be used to guide interventions for individuals with neurodevelopmental disorders. Cross-cultural studies can contribute to the understanding of adaptive functioning of neurodivergence across countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study is to evaluate and compare the adaptive behaviour profiles of children and adolescents with neurodevelopmental condition from different countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-eight children with an autism spectrum diagnosis were equally separated into country groups (Brazil and the United Kingdom) and ages (5–10 and 11–17 years old) and were evaluated with the Adaptive Behavior Assessment System, 3rd Edition (ABAS-3), the Parent Form (Ages 5–21), using the raw scores of the questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The only scale in which a difference between nationality groups was identified was the self-direction scale, which evaluates skills needed for independence, responsibility and self-control, with older Brazilians scoring higher than their British peers in the same age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Similar profiles of adaptive functioning in individuals with ASD were found across cultures, with a singular difference in the self-direction scale. The study's findings shed light on the need for interventions to increase adaptive functioning skills acquisition, regardless of the culture or country in which the individual is.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child Care and Development in the Migration Context of Brazil: A Convergent Parallel Mixed Methods Study at an International Border","authors":"Gabriela D. M. Casacio,&nbsp;Rosane M. M. Silva,&nbsp;Ana L. Penna,&nbsp;Gabrielle Oliveira,&nbsp;Aisha K. Yousafzai,&nbsp;Débora F. Mello","doi":"10.1111/cch.70094","DOIUrl":"https://doi.org/10.1111/cch.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immigrant families in Brazil face challenges such as socio-economic vulnerability, and limited access to essential services like health and education. These stressors may compromise the capacity of families to provide adequate nurturing care for their young children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study used a convergent parallel mixed methods design to address how the experience of parenting and accessing support among immigrant and refugee caregivers of young children explains their parenting related practices and perceived parenting stress. The study objectives were to (1) describe parental beliefs, care practices and stressors among caregivers of young children living in a migratory context; (2) explore how the environment and social context influence parents' nurturing care for young children; and (3) examine how parents, nurses and educators promote young children's development in a migratory context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy caregivers participated in the quantitative study, and a subset of 21 caregivers along with 12 nurses and 13 teachers took part in the qualitative study. Quantitative findings revealed that caregivers were not engaging in stimulating activities with their children and perceived their parenting demands to exceed their ability to provide care. These findings were elucidated by the qualitative data, which found that the challenges of migration contributed to parental stress and negative caregiving practices, reduced caregiver–child interaction and was perceived to impact children's health and development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Understanding these factors may inform interventions to mitigate challenges and offer adequate support for children to thrive in a migratory context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Psychological Distress in Children With Physical Illness and Their Parents During the COVID-19 Pandemic","authors":"Melissa Elgie,&nbsp;Christy K. Y. Chan,&nbsp;Chloe Bedard,&nbsp;Mark A. Ferro","doi":"10.1111/cch.70082","DOIUrl":"https://doi.org/10.1111/cch.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parents and their children with chronic physical illness (CPI) are often predisposed to experiencing psychopathology, a phenomenon, which may be exacerbated during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study modelled trajectories of psychological distress experienced by children with CPI and their parents before and during COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, 134 parent–child dyads enrolled in an ongoing cohort study, Multimorbidity in Children and Youth across the Life-course study, participated in this COVID-19 substudy. Data were collected at three time-points: pre-pandemic (Dec 19–Mar 20) and two intrapandemic periods (Dec 20–Mar 21 and Jun 22–Oct 22) in Ontario, Canada. Parents reported on symptoms psychological distress they and their children experienced, using the Kessler-6. Linear mixed-effects modelling was used to estimate trajectories of psychological distress over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Parents of children with CPI experienced increased psychological distress from pre-pandemic to intrapandemic 2021, which declined slightly by intrapandemic 2022 (B_linear = 4.64, <i>p</i> &lt; 0.001; B_quadratic = −1.79, <i>p</i> &lt; 0.001), and this rate of change over time was influenced by parent stress. Psychological distress was lower among parents of older children. Children experienced increasing psychological distress from pre-pandemic to intrapandemic 2022 (B_linear = 1.20, <i>p</i> &lt; 0.001). Elevated child psychological distress was associated with the presence of mental illness, older age, greater disability, younger parent age, and higher household income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children with CPI and their parents experienced elevated psychological distress during COVID-19. Understanding the course of psychological distress for vulnerable children and their families is crucial to informing healthcare strategies that foster mental well-being and preparedness for future global crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex Care Needs a Team Approach: How Implementation of a Nurse Key-Worker Can Improve Care for Children With Medical Complexity and Their Families","authors":"Tessa Diaczun,&nbsp;Mimi T. Y. Kuan,&nbsp;Tamara Crozier,&nbsp;Amie Nowak,&nbsp;Cynthia Vallance,&nbsp;Esther Lee","doi":"10.1111/cch.70093","DOIUrl":"https://doi.org/10.1111/cch.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Children with medical complexity (CMC) have complex, chronic conditions and require specialized care and extensive support across multiple sectors. Children's Healthcare Canada guidelines highlight the importance of care coordination for this population. The BC Children's Hospital Complex Care programme introduced a Nurse Key Worker (NKW) to perform care coordination in conjunction with the expertise of physicians and nurse practitioner (NP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the feasibility of the NKW role in coordinating care for families of CMC. To evaluate the activities performed to meet care coordination needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-one caregivers of CMC (0–19 years old) were invited to work with the NKW. Electronic health records were utilized to determine the number of patient appointments before and after NKW implementation. Caregivers completed the Family Experience with Care Coordination Measure and Patient-Reported Outcomes Measurement Information System Self-Efficacy tools at baseline and 9 months post-implementation. The physician, NP and NKW completed the Care Coordination Measurement Tool for a duration of 2 weeks to assess and quantify care coordination needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was an average of 45% increase in the number of patient appointments after NKW implementation. Caregivers of CMC recognized their NKW as a reliable, skilled, single point of contact. More caregivers reported feeling “very confident” in their ability to care for their CMC. The NKW addressed 168 care coordination needs and performed 576 activities, whereas the NP and physician addressed 115 care coordination needs and performed 282 activities. The care coordination activities prevented unnecessary emergency and clinic visits and reduced family stress and burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The NKW effectively addressed the care coordination needs of CMC and their families without requiring additional physician or NP resources. The NKW, NP and physician performed different activities to meet care coordination needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Parents of Children With Cerebral Palsy Participating in an Online Parenting Course Grounded in Acceptance and Commitment Therapy","authors":"Koa Whittingham,&nbsp;Tara Crandon,&nbsp;Catherine Mak,&nbsp;Jeanie Sheffield,&nbsp;Ashleigh Wright,&nbsp;Grace Kirby,&nbsp;Roslyn N. Boyd","doi":"10.1111/cch.70075","DOIUrl":"https://doi.org/10.1111/cch.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To understand the experiences of parents of children with cerebral palsy (CP) participating in an online parenting course grounded in acceptance and commitment therapy (PACT) from an implementation perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Fifty-five parents from 50 families of children with CP (GMFCS I = 21, II = 15, III = 8, IV = 8, V = 3) participated in this mixed methods study. Families were drawn from 67 families participating in an RCT of PACT. Parents participated in a qualitative interview and gave additional feedback on 10-point Likert scales and open-ended questions via the course platform. The implementation analysis consisted of a thematic analysis as well as descriptive statistics, <i>t</i>-tests and ANOVAs to examine the impact of child age and motor functioning as potential barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Parents reported that they liked both the ACT content and the online format, and the modules were rated highly in the course feedback (7–9 on 10-point Likert scales). Parents reported positive changes for both them and their child. Parents of younger (2–5 years) children rated the videos from Module One Living a Meaningful Life more highly than parents of older (6–10 years) children. There were no other effects of child age or motor functioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, parental response to PACT was positive, and child age and motor functioning level were not barriers. The online format of the programme and ACT content were well suited to the needs of this population. In particular, the ACT components of values and mindfulness were found to be particularly relevant. Implementation should focus on understanding that ACT can be psychologically challenging, ensuring that parents who need individualised support for intervention adaptation receive it, providing good support to address technological difficulties and building effective reminders into the intervention protocol.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry: ACTRN12616000351415</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}