Melissa A. Faith

Relationship Quality and the Mentoring of Aggressive, High-Risk Children

We used data from a randomized clinical trial to examine the degree to which relationship quality predicted outcomes for aggressive children in two different mentoring programs. Data were available for 145 aggressive children in Grades 2 and 3. Children were blocked by school and randomly assigned to PrimeTime (n = 75) or Lunch Buddy (n = 70) programs. PrimeTime combined community-based mentoring with child-focused skills training and consultation for parents and teachers, and mentors were extensively trained and supervised. Lunch Buddy was a stand-alone, school-based mentoring program that involved lunchtime visits and a different mentor each semester. PrimeTime children rated their mentors as more supportive than did Lunch Buddy children. Relationship conflict predicted changes in teacher-rated externalizing problems. Ratings of relationship quality interacted with treatment in predicting changes in parent-rated externalizing behavior for PrimeTime children only.

Mentoring Highly Aggressive Children: Pre–Post Changes in Mentors’ Attitudes, Personality, and Attachment Tendencies

This study examined the degree to which mentoring highly aggressive children was associated with changes in mentors’ attitudes, personality, and attachment tendencies. Participants were 102 college students who each mentored an aggressive, high-risk child across three academic semesters (spring, fall, spring). We examined pre- to post-mentoring changes in attitudes about mentoring efficacy and future parenting, Big Five personality characteristics, and attachment tendencies. Mentors also rated the impact of the mentoring relationship in their lives, and both mentors and mentees rated support of the mentoring relationship. Results indicated a statistically significant decrease over time in mentors’ ratings of self-efficacy, openness, conscientiousness, extraversion, and agreeableness. These findings held even when controlling for ratings of relationship impact. However, mentors who rated the mentoring relationship as supportive tended to experience increased openness, conscientiousness, and agreeableness and less attachment-related avoidance over time. Child-rated support negatively predicted mentors’ post-mentoring attitudes toward future parenting. Discussed are the potential costs of mentoring highly aggressive children and strategies that could help increase benefits to mentors.

Bullying in medically fragile youth: a review of risks, protective factors, and recommendations for medical providers

ABSTRACT: Bullying is a common child and adolescent phenomenon that has concurrent and long-term implications for victims psychological, psychosomatic, social, and academic functioning. Youth with chronic illnesses are at increased risk for being bullied, but few studies have evaluated specific risk and protective factors for medically fragile youth. Despite recommendations by the American Academy of Pediatrics and the Society for Adolescent Medicine that pediatric health care providers should contribute to bullying prevention and intervention efforts, researchers also have yet to identify the best ways for providers to intervene with medically fragile youth. In this article, the authors review risk and protective factors for bullying among healthy samples. Then, the authors specifically address the ways in which these risk and protective factors are likely to apply to children with fragile medical conditions, and they provide summaries of extant bullying research for selected examples of medically fragile pediatric populations. Finally, the authors present recommendations for intervening with medically fragile youth and suggest several areas in which additional research is needed.

Exploring change processes in school-based mentoring for bullied children

We examined change processes associated with the school-based, lunchtime mentoring of bullied children. We used data from a one-semester open trial of Lunch Buddy (LB) mentoring (Nxa0=xa024) to examine changes in bullied children’s lunchtime peer relationships. We also tested whether these changes predicted key outcomes (i.e., peer victimization, social preference) post-mentoring. Results provided partial support that bullied children paired with LB mentors experienced improved lunchtime peer relationships and that gains in lunchtime relationships predicted post-mentoring levels of social preference and peer victimization. Neither child nor mentors’ ratings of the mentoring relationship predicted post-mentoring outcomes; however, child-rated mentor support and conflict predicted improvements in lunchtime peer relationships. We discuss implications for future research on school-based mentoring as a form of selective intervention for bullied children.

Risk for Psychosocial Problems in Pediatric Cancer: Impact of Socioeconomics

The aim of this study was to investigate demographic and socioeconomic variables associated with risk for patient and family problems over the course of 1 year in a largely low-income and rural pediatric oncology population. Caregivers (nu2009=u2009163) completed the Psychosocial Assessment Tool 2.0 up to 4 times during regular clinic visits. Multilevel modeling examined change over time, as well as demographic and socioeconomic variables associated with psychosocial risk. Results suggest that pediatric oncology patients with caregivers of lower educational attainment and financial difficulties are at significantly greater risk for psychosocial problems, and should be offered early psychological intervention.

Development of the family symptom inventory: a psychosocial screener for children with hematology/oncology conditions.

A growing body of literature has begun to underscore the importance of integrating family-based comprehensive psychological screening into standard medical care for children with oncology and hematology conditions. There are no known family-based measures designed to screen for clinically significant emotional and behavioral concerns in pediatric oncology and hematology patients. The aim of this study was to develop and evaluate the Family Symptom Inventory (FSI), a brief screener of patient and family member psychological symptoms. The FSI also screens for common comorbid physical symptoms (pain and sleep disturbance) and is designed for use at any point during treatment and follow-up. A total of 488 caregivers completed the FSI during regular hematology/oncology visits for 193 cancer, 219 sickle cell disease, and 76 hematology pediatric patients. Exploratory factor analysis, confirmatory factor analysis, and tests of reliability and preliminary validity were conducted. Exploratory factor analysis suggested a 34-item, 4-factor solution, which was confirmed in an independent sample using confirmatory factor analysis (factor loadings=0.49 to 0.88). The FSI demonstrated good internal reliability (&agr;’s=0.86 to 0.92) and good preliminary validity. Regular psychosocial screening throughout the course of treatment and follow-up may lead to improved quality of care for children with oncology and hematology conditions.

Diabetes symptoms predictors of health-related quality of life in adolescents and young adults with type 1 or type 2 diabetes

ObjectivesThe objective was to investigate the patient-reported diabetes symptoms predictors of generic health-related quality of life (HRQOL) in adolescents and young adults (AYA) with type 1 or type 2 diabetes.MethodsThe 15-item PedsQL™ 3.2 Diabetes Module Diabetes Symptoms Summary Score and PedsQL™ 4.0 Generic Core Scales were completed in a 10-site national field test study by 513 AYA ages 13–25xa0years with type 1 (nu2009=u2009424) or type 2 (nu2009=u200989) diabetes. Diabetes symptoms were tested for bivariate and multivariate linear associations with generic HRQOL.ResultsDiabetes symptoms were associated with decreased HRQOL in bivariate analyses. In predictive analytics models utilizing hierarchical multiple regression analyses controlling for relevant demographic and clinical covariates, diabetes symptoms accounted for 38 and 39% of the variance in patient-reported generic HRQOL for type 1 and type 2 diabetes, respectively, reflecting large effect sizes. The diabetes symptoms facets hyperglycemia symptoms, hypoglycemia symptoms, and nonspecific diabetes symptoms individually accounted for a significant percentage of the variance in separate exploratory predictive analytics models after controlling for demographic and clinical covariates, with small-to-large effect sizes.ConclusionsDiabetes symptoms are potentially modifiable predictors of generic HRQOL in AYA with diabetes. Identifying specific diabetes symptoms or symptoms facets that are the most important predictors from the patient perspective facilitates a patient-centered approach in clinical research, clinical trials, and practice designed to enhance overall generic HRQOL in AYA with diabetes.

Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes

The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health‐related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model.

PedsQL 3.2 Diabetes Module for Children, Adolescents, and Young Adults: Reliability and Validity in Type 1 Diabetes

OBJECTIVE The objective of the study was to report on the measurement properties of the revised and updated Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module for children, adolescents, and young adults with type 1 diabetes. RESEARCH DESIGN AND METHODS The 33-item PedsQL 3.2 Diabetes Module and PedsQL Generic Core Scales were completed in a 10-site national field test study by 656 families of patients ages 2–25 years with type 1 diabetes. RESULTS The 15-item Diabetes Symptoms Summary Score and 18-item Diabetes Management Summary Score were derived from the factor analysis of the items. The Diabetes Symptoms and Diabetes Management Summary Scores evidenced excellent reliability (patient self-report α = 0.88–0.90; parent proxy report α = 0.89–0.90). The Diabetes Symptoms and Diabetes Management Summary Scores demonstrated construct validity through medium to large effect size correlations with the Generic Core Scales Total Scale Score (r = 0.43–0.67, P < 0.001). HbA1c was significantly correlated with the Diabetes Symptoms and Diabetes Management Summary Scores (r = −0.21 to −0.29, P < 0.001). Minimal clinically important difference scores ranged from 5.05 to 5.55. CONCLUSIONS The PedsQL 3.2 Diabetes Module Diabetes Symptoms and Diabetes Management Summary Scores demonstrated excellent measurement properties and may be useful as standardized patient-reported outcomes of diabetes symptoms and diabetes management in clinical research, clinical trials, and practice in children, adolescents, and young adults with type 1 diabetes.

Measuring emotion socialization in families affected by pediatric cancer: Refinement and reduction of the Parents’ Beliefs about Children’s Emotions questionnaire:

The aim of this study is to conduct a multimethod psychometric reduction in the Parents’ Beliefs about Children’s Emotions (PBCE) questionnaire using an item response theory framework with a pediatric oncology sample. Participants were 216 pediatric oncology caregivers who completed the PBCE. The PBCE contains 105 items (11 subscales) rated on a 6-point Likert-type scale. We evaluated the PBCE subscale performance by applying a partial credit model in WINSTEPS. Sixty-six statistically weak items were removed, creating a 44-item PBCE questionnaire with 10 subscales and 3 response options per item. The refined scale displayed good psychometric properties and correlated .910 with the original PBCE. Additional analyses examined dimensionality, item-level (e.g. difficulty), and person-level (e.g. ethnicity) characteristics. The refined PBCE questionnaire provides better test information, improves instrument reliability, and reduces burden on families, providers, and researchers. With this improved measure, providers can more easily identify families who may benefit from psychosocial interventions targeting emotion socialization. The results of the multistep approach presented should be considered preliminary, given the limited sample size.