BackgroundSelf-control in childhood has been linked to long-term and cascading effects on health, academic, criminality, wealth and parenting outcomes. Hence it is important to target self-control deficits early in life. Self-control deficits are a hallmark of Attention Deficit/Hyperactivity Disorder (ADHD). Even after receiving care-as-usual (CAU) for ADHD, impaired self-control often remains. Pharmacotherapy can be hampered by side-effects, low adherence and short-term effectiveness. Other limitations of CAU are decreased effectiveness when parents have ADHD and little effect on parental well-being. Mindfulness-Based Interventions (MBIs) are an emerging non-pharmacological approach with potential to improve self-control and well-being in both children and parents. However, there is a lack of sufficiently powered randomised controlled trials (RCTs) to establish their effects in families with ADHD. This study protocol describes an RCT to investigate the effectiveness of a family MBI as an add-on to CAU in treatment of youth with ADHD, and is described in accordance with Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT).Methods/designAn RCT will be conducted in N = 100 children (aged 8–16 years) with ADHD and their parents. The experimental condition will consist of a family MBI (MYmind): 8-week group-based MBI for youth combined with parallel group-based Mindful Parenting for their parents, as an add-on to CAU. The control condition will consist of CAU-only. Assessments will take place at baseline, end of treatment (3 months later), 2 and 6 months’ follow-up. Primary outcome measure will be an ecologically valid assessment of child self-control with the parent-rated Behaviour Rating Inventory of Executive Function (BRIEF). Secondary child outcome measures will be teacher-rated BRIEF, computerised self-control tasks and questionnaires on psychological symptoms (e.g. ADHD, symptoms of autism), well-being and mindfulness. For parental outcomes, secondary measures will be self-rated BRIEF, computerised self-control tasks and questionnaires on psychological symptoms, well-being and mindful parenting.DiscussionThe proposed RCT will take account of methodological limitations of previous studies on MBIs in child ADHD populations. The current study will provide valuable information on family MBI as a potential effective intervention in targeting self-control deficits for youth with ADHD and their parents.Trial registrationClinicalTrials.gov NCT03220308. Retrospectively registered 18 July 2017.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1811-y) contains supplementary material, which is available to authorized users.
Objective: the transition period in which men become fathers might provide an important window of opportunity for parenting interventions that may produce long-term positive effects on paternal care and, consequently, child development. Existing prenatal programs traditionally focus on maternal and infant health and seldom involve the father. Study design: This paper describes an interaction-based prenatal parenting intervention program for first-time fathers using ultrasound images, the Prenatal video Feedback Intervention to promote Positive Parenting (VIPP-PRE). We randomised a group of expectant fathers (N = 73) to either the VIPP-PRE or a control condition. Results: Expectant fathers thought the VIPP-PRE was more helpful and influenced their insights into their babies to a greater extent than the control condition. Expectant fathers receiving the VIPP-PRE reported that they particularly liked seeing and interacting with their unborn children as well as receiving feedback on these interactions. The intervention was well received and was considered feasible by both expectant fathers and sonographers and midwives. Discussion: We discuss the VIPP-PRE based on the experiences and perspectives of fathers, interveners, and sonographers and midwives.
Background The aim of this study was to evaluate an interaction-based prenatal parenting intervention program aimed at promoting parental sensitivity and involvement in expectant fathers using ultrasound images: Prenatal Video-Feedback Intervention to Promote Positive Parenting (VIPP-PRE). Methods In this randomized controlled trial, 73 first-time, healthy expectant fathers were enrolled. Participants were randomly assigned to the VIPP-PRE intervention (n = 39) or a dummy intervention (n = 34). Parental sensitivity was coded from video-recorded 10-min interactions with an infant simulator at a prenatal pretest and with fathers’ own infant at a postnatal posttest. Prenatal and postnatal involvement was assessed via an application on participants’ smartphones. Results Fathers receiving VIPP-PRE demonstrated increased sensitivity across the perinatal period, relative to fathers receiving a dummy intervention. Fathers’ involvement with the infant increased significantly from the prenatal to postnatal period, regardless of the intervention. Conclusions Prenatal video-feedback using ultrasound imaging of the unborn child has the potential to promote the quality of parenting in an important, but understudied, population and period: men in the transition to fatherhood. Future research should examine the long-term effectiveness of VIPP-PRE and its effectiveness in increasing parenting quality in at-risk families. Impact This study identifies a brief and focused prenatal intervention using assisted interactions between the father and his baby by means of ultrasound imaging as a promising strategy to improve sensitive fathering in the early postnatal phase. Our study shows that pregnancy provides a window of opportunity for promoting prenatal involvement and bonding in expectant fathers, with potential long-term benefits for the future father–child relationship. Ultrasound measures are currently used to monitor fetal growth and development, but our results suggest that they may also create an opportunity for stimulating father–infant interaction to promote postnatal caregiving quality.
Although parenting interventions including expectant fathers are scarce, they yield promising results. The Prenatal Video-feedback Intervention to promote Positive Parenting (VIPP-PRE) is a recently developed intervention, that is both manualized and personalized, aiming to enhance paternal sensitivity and involvement before the birth of the baby. Illustrating the intervention process, the current study presents two case studies of expectant fathers receiving VIPP-PRE (clinical trial registration NL62696.058.17). The VIPP-PRE program is described along with the individual dyads' prenatal video fragments and feedback specific for each father-fetus dyad. In addition, changes in paternal sensitivity and involvement levels are presented, as well as fathers' and intervener's evaluation of the intervention. VIPP-PRE promises to be a feasible short-term and potentially effective parenting intervention for expectant fathers. Currently, a randomized controlled trial (RCT) is under review that systematically investigates the efficacy of the VIPP-PRE. Here we aim to provide further information on the intervention process, as well as fathers' and intervener's evaluations of this process, and the benefits of using ultrasound imaging in a parenting intervention.
Objectives During the perinatal period, women are exposed to major changes, holding possible adverse effects on psychological well-being and child development. An effective way of coping with these challenges and adjustments could be mindfulness. The current study examined associations of mindfulness facets during pregnancy with toddler’s social-emotional development and behavior problems, as well as potentially mediating effects of maternal mental health. Method A total of 167 women completed questionnaires during pregnancy, the postpartum period, and 2 and 3 years after childbirth, assessing dispositional mindfulness, pregnancy distress, symptoms of anxiety and depression, child social-emotional development, and child behavior problems. Results There was a positive association between maternal non-reacting mindfulness skills and child social-emotional development at 2 years of age, regardless of mothers’ perinatal mental health, whereas other mindfulness facets were unrelated. Pregnancy distress mediated the association between maternal non-judging skills during pregnancy and child externalizing problem behavior, but no other mediating effects were found. Conclusions Non-reacting skills in mothers during pregnancy may have favorable implications for child social-emotional development. Due to the relatively high number of tests that were conducted, the mediating effect of pregnancy distress must be interpreted with caution.
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