Robin Gaines Lanzi

Variations in Latino Parenting Practices and Their Effects on Child Cognitive Developmental Outcomes.

This research examines variations in parenting and its effects on child cognitive outcomes across Latino subgroups from a national sampling that utilized a subset of 995 former Head Start Latino parents and children. Comparisons of the Parenting Dimension Inventory scaled scores revealed Latino subgroup differences on nurturance and consistency. Puerto Rican parental caregivers scored higher on nurturance and consistency than Mexican Americans and El Salvadorans. Pearson’s product-moment correlation revealed a positive relationship between responsiveness to child inputs and higher academic achievement scores for each Latino subgroup. Examination of the Woodcock-Johnson Test of Achievement also revealed a main effect of Latino subgroup differences. Findings suggest that there exist intracultural variations in parenting and academic achievement within the Latino population and confirm previous findings that parenting is related to positive child cognitive outcomes.

Family Factors Associated With High Academic Competence in Former Head Start Children at Third Grade

Most studies of gifted students have looked at already identified groups, often convenience samples. This study takes a more epidemiological approach. Of the 5,400 children in the National Head Start/Public School Early Childhood Transition Demonstration group Project tested at the end of third grade, the highest achieving 3% (N = 162) were selected by conducting a principal components analysis on their scores on the vocabulary and achievement measures. Compared with the remaining children, the high-achieving children were thriving both socially and academically, and, although as a group they were not enamoured of school, fewer were strongly disaffected. On the whole, the families of these children had somewhat more resources on which to call and somewhat fewer stresses with which to deal than the families of the remaining children, although their mean income was only 1.26 times the Poverty Index. Compared to caretakers of the remaining children, caretakers of high achievers ascribed to more positive parenting attitudes and were seen by teachers as more strongly encouraging their childrens progress. Of the 113 third-grade high achievers with test scores at grades 1, 2, and 3, 52 had met the 3% criterion in at least 2 grades, and 37 had done so in all 3. Years of high achievement correlated with family resources. These findings demonstrate that even families sorely stressed by life circumstances can support very positive intellectual and social competence in their children.

The Preconception Stress and Resiliency Pathways Model: A Multi-Level Framework on Maternal, Paternal, and Child Health Disparities Derived by Community-Based Participatory Research

Abstract Emerging evidence supports the theoretical and clinical importance of the preconception period in influencing pregnancy outcomes and child health. Collectively, this evidence affirms the need for a novel, integrative theoretical framework to design future investigations, integrate new findings, and identify promising, evidence-informed interventions to improve intergenerational health and reduce disparities. This article presents a transdisciplinary framework developed by the NIH Community Child Health Network (CCHN) through community-based participatory research processes. CCHN developed a Preconception Stress and Resiliency Pathways (PSRP) model by building local and multi-site community-academic participatory partnerships that established guidelines for research planning and decision-making; reviewed relevant findings diverse disciplinary and community perspectives; and identified the major themes of stress and resilience within the context of families and communities. The PSRP model focuses on inter-relating the multiple, complex, and dynamic biosocial influences theoretically linked to family health disparities. The PSRP model borrowed from and then added original constructs relating to developmental origins of lifelong health, epigenetics, and neighborhood and community influences on pregnancy outcome and family functioning (cf. MCHJ 2014). Novel elements include centrality of the preconception/inter-conception period, role of fathers and the parental relationship, maternal allostatic load (a composite biomarker index of cumulative wear-and-tear of stress), resilience resources of parents, and local neighborhood and community level influences (e.g., employment, housing, education, health care, and stability of basic necessities). CCHN’s integrative framework embraces new ways of thinking about how to improve outcomes for future generations, by starting before conception, by including all family members, and by engaging the community vigorously at multiple levels to promote resiliency, reduce chronic and acute stressors, and expand individualized health care that integrates promotive and prevention strategies. If widely adopted, the PSRP model may help realize the goal of sustaining engagement of communities, health and social services providers, and scientists to overcome the siloes, inefficiencies, and lack of innovation in efforts to reduce family health disparities. Model limitations include tremendous breadth and difficulty measuring all elements with precision and sensitivity.

Shedding Light on the Mechanisms Underlying Health Disparities Through Community Participatory Methods: The Stress Pathway

Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative—the Community Child Health Network—to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions.

Cell Phones and the Measurement of Child Neglect The Validity of the Parent-Child Activities Interview

Two multisite studies were conducted to assess the feasibility of using cell phone interviews (the Parent-Child Activities Interview) to learn more about the quality of daily parenting among high-risk mothers, including child neglect. In Study 1, 45 primiparous teenage mothers with 3- to 9-month-old infants were recruited and randomly assigned to two groups: one received frequent cell phone interviews and the other group less frequent interviews over their home telephone. Relationships among paper-and-pencil surveys of parenting (gathered in person) and a Parenting Essentials score (coded from the phone interviews) were significantly correlated. In Study 2, adolescent and adult mothers and their first-born children ( n = 544) completed 2 observations of parenting in their home as well as a series of 3 PCA calls at ages 4 and 8 months. Parenting Essentials coded from the interviews were significantly related to observed measures of parenting at both time points. The Parent-Child Activities Interview shows promise as a reliable and valid measure of parenting, capturing frequent and detailed information about daily parenting practices. Cell phones may prove useful in intervening with mothers at risk of suboptimal parenting and child neglect.

Spiritual and Religious Resources in African American Women Protection From Depressive Symptoms After Childbirth

Many women experience depressive symptoms after childbirth, and rates among African Americans are as high as 40%. Spirituality and religiosity are valued in African American communities, but their relevance to new mothers has not been empirically tested. We examined effects of religiosity and spirituality on trajectories of depressive symptoms during the year after childbirth. Data were collected by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Community Child Health Network, which focuses on maternal-child health disparities. The sample consisted of 702 low-socioeconomic-status African American predominantly Christian women. Participants were interviewed in their homes throughout the year after a birth. Spirituality and religiosity each independently predicted changes in depressive symptoms, and low levels predicted increases over time. Effects of religiosity were mediated by a woman’s spirituality. Religiosity and spirituality functioned as significant, interrelated protective factors in this study, which provides novel insight about lower-income African American women after childbirth.

Cell Phone Methodology for Research and Service with High Risk Mothers and Children.

Cell phones afford a set of distinctive advantages for gathering information on daily patterns of behavior, establishing relationships, maintaining contact, and providing professional expertise to participants in a wide array of programs, including intervention, treatment, and service. This paper presents new findings about innovative applications of cell phone technology in research on daily patterns of behavior with adolescent mothers, findings relative to feasibility and utility, and presents recommendations for the applicability of its use in early care and education.

Pregnancy Intentions, Long-Acting Contraceptive Use, and Rapid Subsequent Pregnancies Among Adolescent and Adult First-Time Mothers

PROBLEM Greater understanding is needed related to qualitatively assess pregnancy intentions and rapid subsequent pregnancies among adolescent and adult mothers. METHODS Four-site prospective study of 227 adolescent and adult mothers. Data were analyzed to understand the relationship between pregnancy intentions, adolescent status, and use of long-acting contraceptives and rapid subsequent pregnancy. FINDINGS The findings from this study provide evidence of the importance of goal-oriented pregnancy intentions, long-acting contraceptive use, and older age in delaying a second pregnancy. CONCLUSION Findings reveal the need for clinician awareness of the qualitative pregnancy intentions of young women and potential desired use of long-acting contraceptives.

The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research

ABSTRACT Background and Objectives: Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Design and Methods: Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Results: Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. Conclusions: This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.

Maternal depression and rapid subsequent pregnancy among first time mothers.

Purpose:To examine differences in prenatal depression among first-time mothers who had a subsequent pregnancy within 6 months of first birth and those who did not. Mothers with depression symptoms were expected to have a greater likelihood of rapid subsequent pregnancy. Study Design:The Parenting for the First Time study is a longitudinal multisite prospective descriptive study designed to identify and understand the dynamics of subthreshold neglectful parenting behaviors among first-time mothers. Data were collected from the prenatal period through the childs first 3 years of life. The Parenting for the First Time sample consisted of 684 first-time mothers between 15 and 36 years. Data were available on prenatal depression and subsequent pregnancy at 6 months for 279 participants (n = 279). Methods:Multiple logistic regression analysis was conducted to determine the odds of subsequent pregnancy within 6 months of first birth. Results:Twelve mothers (5.9%) became pregnant within 6 months of first birth. The odds of subsequent pregnancy were 7.24 greater (95% confidence interval [CI]: 2.18-24.04) among mothers with moderate-to-severe depression. White versus non-White race did not influence subsequent pregnancy (0.91, 95% CI: 0.18-4.49). Pregnancy was not significantly different between teen and adult mothers (odds ratio: 0.92, 95% CI: 0.24-3.68). Clinical Implications:In this sample of first time mothers, moderate-to-severe depression symptoms were associated with subsequent pregnancy within 6 months of first birth. Routine depression screening by nurses during the prenatal period offers opportunities for intensive contraceptive counseling and may help mothers achieve optimal birth spacing.