| 1. |
- Al Adhami, Maissa, Doctoral candidate, 1972-, et al.
(författare)
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A cross-sectional study of health and well-being among newly settled refugee migrants in Sweden–The role of health literacy, social support and self-efficacy
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:12
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Tidskriftsartikel (refereegranskat)abstract
- Structural barriers such as inadequate housing, lack of employment opportunities, and discrimination are known to adversely affect the health of newly settled refugee migrants. However, these barriers remain largely unresolved and unaddressed. Thus, there is a need to better understand how other factors, such as individual-level health resources, may influence health and mitigate ill health in the early post-migration phase. In this study, we aimed to explore the relationship between health outcomes and individual health resources including health literacy, social support, and self-efficacy in newly settled refugee migrants. Survey data was collected from 787 refugee migrants in Sweden. Logistical regression analysis showed that limited health literacy, lack of emotional support, and low self-efficacy were consistently associated with poor health outcomes. Demographic variables such as gender, education, and type of residence permit were not as imperative. Individual-level health resources may play an important role in the general and psychological well-being of newly settled migrants. Promoting health literacy and facilitating the attainment of social support may buffer for structural challenges in the establishment phase and enhance the prospects of later health and social integration.
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| 2. |
- Al-Adhami, Maissa, 1972-, et al.
(författare)
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Can an extended civic orientation course improve newly settled migrants’ health literacy and social capital? : A quasi-experimental study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Structural and contextual factors such as limited work opportunities, restrictive integration policies and discrimination negatively affect the health and well-being of newly settled refugee migrants in receiving high-income countries. Health promotion initiatives aiming to facilitate access to work and integration by enhancing individual-level health resources have been tried out within the Swedish Civic Orientation. However, longitudinal evaluations of these interventions are rare. The aim of the current study was to compare the effectiveness of a regular and an extended civic orientation course with added health communication and examine whether the latter would improve self-rated health and psychological well-being, health literacy, and social capital among newly settled refugee migrants in Sweden. Pre-and post-assessment questionnaires were collected from the intervention group receiving the extended course (n=143) and a control group receiving the regular course (n=173). Linear mixed models and Chi-square analyses showed a significant increase with a small effect size (0.21) in health literacy in the intervention group. However, there were no significant changes in emotional and practical support, general self-rated health, or psychological well-being. The findings indicate that added health communication provided within the Swedish civic orientation can increase health literacy. However, further longitudinal studies are needed to confirm the sustainability of the observed effect and examine whether these short-term improvements in health literacy translate to long-term benefits in other outcomes such as health and integration of newly settled refugee migrants.
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| 3. |
- Al Adhami, Maissa, Doctoral candidate, 1972-, et al.
(författare)
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Can extended health communication improve newly settled refugees’ health literacy? A quasi-experimental study from Sweden
- 2024
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Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 39:2
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Tidskriftsartikel (refereegranskat)abstract
- Structural and contextual factors such as limited work and housing opportunities negatively affect the health and well-being of newly settled refugee migrants in receiving high-income countries. Health promotion initiatives aiming at strengthening health and integration have been tried out within the Swedish Introduction program for refugee migrants. However, longitudinal evaluations of these interventions are rare. The aim of the current study was to compare the effectiveness of a regular and an extended civic orientation course with added health communication and examine whether the latter would improve self-rated health and psychological well-being, health literacy and social capital among newly settled refugee migrants in Sweden. Pre- and post-assessment questionnaires were collected from the intervention group receiving the extended course (n = 143) and a control group receiving the regular course (n = 173). Linear mixed models and chi-square analyses showed a significant increase with a small effect size (0.21) in health literacy in the intervention group. However, there were no significant changes in emotional and practical support, general self-rated health or psychological well-being. The findings indicate that added health communication provided embedded in the civic orientation course can increase health literacy. However, further longitudinal studies are needed to confirm the sustainability of the observed effect and examine whether these short-term improvements in health literacy translate to long-term advances in health and integration.
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| 4. |
- Al Adhami, Maissa, Doctoral candidate, 1972-, et al.
(författare)
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Can extended health communication improve newly settled refugees' health literacy? A quasi-experimental study from Sweden
- 2024
-
Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 39:2
-
Tidskriftsartikel (refereegranskat)abstract
- Structural and contextual factors such as limited work and housing opportunities negatively affect the health and well-being of newly settled refugee migrants in receiving high-income countries. Health promotion initiatives aiming at strengthening health and integration have been tried out within the Swedish Introduction program for refugee migrants. However, longitudinal evaluations of these interventions are rare. The aim of the current study was to compare the effectiveness of a regular and an extended civic orientation course with added health communication and examine whether the latter would improve self-rated health and psychological well-being, health literacy and social capital among newly settled refugee migrants in Sweden. Pre- and post-assessment questionnaires were collected from the intervention group receiving the extended course (n = 143) and a control group receiving the regular course (n = 173). Linear mixed models and chi-square analyses showed a significant increase with a small effect size (0.21) in health literacy in the intervention group. However, there were no significant changes in emotional and practical support, general self-rated health or psychological well-being. The findings indicate that added health communication provided embedded in the civic orientation course can increase health literacy. However, further longitudinal studies are needed to confirm the sustainability of the observed effect and examine whether these short-term improvements in health literacy translate to long-term advances in health and integration.
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| 5. |
- Al-Adhami, Maissa, 1972-
(författare)
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Health of refugee migrants in the early post-migration phase in Sweden : The role of health resources and health promotion
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the early post-migration phase, the health and well-being of newly settled refugee migrants is negatively affected by structural factors such as restrictive immigration policies, hostile political discourse and limited housing and work opportunities. There is a need for a better understanding of how individual health resources and health promotion can mitigate the impact of these ongoing stressors. The thesis aimed to explore, assess, and further the understanding of the role of health promotion and individual health resources for health and well-being of newly settled refugee migrants in Sweden.In Study I, six focus group discussions were conducted with 32 newly settled refugees, exploring their perceptions of a Swedish Civic Orientation (CO) course with added health communication. The results showed that the course inspired them to focus on their health, promoted independence and empowerment, and gave new social contacts. However, the course is needed earlier in the post-migration phase and should be adjusted to better fit refugee migrants’ varying pre-existing knowledge. Study II was a cross-sectional study, exploring how individual resources of newly settled refugee migrants (n=787) were associated with self-rated health and psychological well-being. Logistical regression analysis showed that limited health literacy, lack of emotional support, and low self-efficacy were consistently associated with poor health outcomes. In Study III, interviews with 10 civic communicators were performed to explore their perceptions of an in-depth training course on mental health in relation to observed psychological needs among newly settled refugee migrants. The overall result was that the attainment of new knowledge and new tools enabled them to lead reflective conversations about mental health with participants. Mental health needs were perceived to be related to pre- and post-migration experiences. Barriers included stigma and lack of arenas to address mental health needs of refugee migrants.In Study IV, the effectiveness of a regular and an extended CO course was compared in a quasi-experimental study design among newly settled refugee migrants (n=173 and 143 respectively). Linear mixed models and Chi-square analyses showed that the extended course led to a small, but significant increase in health literacy. No significant differences were observed regarding other outcomes (emotional and practical support, general self-rated health, or psychological well-being).The thesis illustrates the potential of early health promotion initiatives focusing on individual health resources to enhance health. However, overarching structural barriers related to living conditions, work opportunities and inclusion must also be addressed.
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| 6. |
- Al Adhami, Maissa, Doctoral candidate, 1972-, et al.
(författare)
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”Putting words to their feelings” : civic communicators’ perceptions and experiences of an in-depth course on mental health for newly settled refugee migrants in Sweden
- 2023
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Ingår i: BMC Health Services Research. - : Springer Nature. - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Newly settled refugee migrants face psychological stressors stemming from pre-, during- and post-migration experiences. In Sweden, mental health promotion is part of the health module in the civic orientation classes for newly settled refugee migrants. Training courses are offered to civic communicators to facilitate communication about mental health; however, the training is seldom evaluated. In the current study, we aim to explore civic communicators’ perceptions and experiences of an in-depth mental health training course in relation to observed needs among newly settled refugee migrants. Method: We interviewed ten civic communicators that had partaken in the in-depth training course on mental health. All respondents had prior migratory experience and worked as civic communicators in their native languages. The interviews were semi-structured and data were analyzed using thematic analysis.Results: Three themes were identified: (1) Intertwined mental health needs related to migration, (2) Multi-layered barriers to addressing mental health, and (3) Becoming aware of the mental health journey. One overarching theme was arrived at through synthesizing the three themes ‘Acquired new tools to lead reflective conversations about mental health and well-being’. Conclusion: The in-depth mental health training course led to the attainment of new knowledge and new tools enabling civic communicators to lead reflective conversations about mental health and well-being with newly settled refugee migrants. Mental health needs were related to pre- and post-migration experiences. Barriers to talking about mental health included stigma and a lack of arenas to promote the mental health of refugee migrants. Increasing knowledge among communicators can facilitate the promotion of mental self-help capacity and resilience among newly settled refugee migrants.
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| 7. |
- Bergström, Malin, et al.
(författare)
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Importance of living arrangements and coparenting quality for young children's mental health after parental divorce : a cross-sectional parental survey
- 2021
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Ingår i: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Parental separation has been associated with adverse child mental health outcomes in the literature. For school-aged children, joint physical custody (JPC), that is, spending equal time in both parents’ homes after a divorce, has been associated with better health and well-being than single care arrangements. Preschool children’s well-being in JPC is less studied. The aim of this study was to investigate the association of living arrangements and coparenting quality with mental health in preschool children after parental separation.Methods This cross-sectional population-based study includes 12 845 three-year-old children in Sweden. Mental health was measured by parental reports of the Strength and Difficulties Questionnaire and coparenting quality with a four-item scale. The living arrangements of the 642 children in non-intact families were categorised into JPC, living mostly with one parent and living only with one parent.Results Linear regression models, adjusted for sociodemographic confounders, showed an association between increased mental health problems and living mostly and only with one parent (B=1.18; 95% CI 0.37 to 2.00, and B=1.20; 95% CI 0.40 to 2.00, respectively), while children in intact families vs JPC did not differ significantly (B=−0.11; 95% CI −0.58 to 0.36). After adjusting the analyses for coparenting quality, differences in child mental health between the post divorce living arrangements were, however, minimal while children in intact families had more mental health problems compared with JPC (B=0.70; 95% CI 0.24 to 1.15). Factorial analysis of covariance revealed that low coparenting quality was more strongly related to mental health problems for children in intact families and JPC compared with children living mostly or only with one parent.Conclusions This study suggests that coparenting quality is a key determinant of mental health in preschool children and thus should be targeted in preventive interventions.
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| 8. |
- Bergström, Malin, et al.
(författare)
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Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 107:2, s. 294-300
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Joint physical custody (JPC), where children spend about equal time in both parent's homes after parental separation, is increasing. The suitability of this practice for preschool children, with a need for predictability and continuity, has been questioned.METHODS: In this cross-sectional study, we used data on 3656 Swedish children aged three to five years living in intact families, JPC, mostly with one parent or single care. Linear regression analyses were conducted with the Strengths and Difficulties Questionnaire, completed by parents and preschool teachers, as the outcome measure.RESULTS: Children in JPC showed less psychological problems than those living mostly (adjusted B 1.81; 95% CI [0.66 to 2.95]) or only with one parent (adjusted B 1.94; 95% CI [0.75 to 3.13]), in parental reports. In preschool teacher reports, the adjusted Betas were 1.27, 95% CI [0.14 to 2.40] and 1.41, 95% CI [0.24 to 2.58], respectively. In parental reports, children in JPC and those in intact families had similar outcomes, while teachers reported lower unadjusted symptom scores for children in intact families.CONCLUSION: Joint physical custody arrangements were not associated with more psychological symptoms in children aged 3-5, but longitudinal studies are needed to account for potential preseparation differences.
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| 9. |
- Dahlberg, Anton
(författare)
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Capturing and addressing preschool children’s emotional and behavioural problems : Using parents’, teachers’ and children’s perspectives
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Emotional and behavioural problems (EBP) are among the most common mental health problems in preschool children. EBP are also associated with poor parent mental health. Untreated, EBP can persist or worsen over time. In order to capture and address preschool children’s EBP, we need scientifically valid instruments that can access the perspectives of informants from different contexts of the child. We also need cut-off values for questionnaires assessing EBP that are representative of the population. Parenting support is a recommended intervention for addressing EBP in preschool children. Most parenting support programmes have a solid evidence-base and show positive effects on child EBP and parent wellbeing. However, we need a better understanding of the children’s emotional and relational experiences, especially in relation to their parents. Further, although the implementation of evidence-based interventions is a complex matter with substantial impact on intervention success, few studies assess the implementation process of parenting programmes. The studies constituting this thesis focused on preschool children. The Strengths and Difficulties Questionnaire (SDQ) was assessed for capturing EBP. Study I assessed the construct validity of the SDQ and its five subscales, when rated by fathers and preschool teachers. Confirmatory factor analysis was applied to evaluate construct validity. Results indicated that the SDQ can be used as an instrument to measure EBP in preschool children, rated by parents and preschool teachers. In study II, we established Swedish norms for the SDQ for preschool children. Results suggested lower SDQ cut-offs for Swedish preschool children compared with other countries, and higher cut-offs for boys compared with girls. In study III, preschool children whose parents participated in a parenting programme were interviewed regarding their emotional and relational experiences at home. Data were analysed using qualitative content analysis. The children provided accounts of negative and positive interactions with their parents, elaborately describing a coercive cycle with escalating conflicts and lack of problem resolution. In study IV, the implementation of the parenting programme Triple P in a preschool setting was assessed using the RE-AIM framework. Results indicated a successful implementation that relied on customisation of the programme; assessment of the process from parent, staff, and organisation levels; interdisciplinary collaboration; and continuous work on securing maintenance over time. This thesis provides pieces to a complex puzzle of understanding and addressing child mental health problems, particularly EBP. Assessing EBP from different perspectives and promoting children’s voices are essential, as well as actively working with the implementation of evidence-based programmes.
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| 10. |
- Dahlberg, Anton, et al.
(författare)
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SDQ in the Hands of Fathers and Preschool Teachers : Psychometric Properties in a Non-clinical Sample of 3-5-Year-Olds
- 2019
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Ingår i: Child Psychiatry and Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327. ; 50:1, s. 132-141
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Tidskriftsartikel (refereegranskat)abstract
- The Strengths and Difficulties Questionnaire (SDQ) is a well-established instrument for measuring social and behavioural problems among children, with good psychometric properties for older children, but less validity reports on pre-schoolers. In addition, there is a knowledge gap concerning fathers as informants. The present work is one of the few validity studies to include preschool teachers and the first on preschool children where fathers are included as separate informants. In this study, SDQs were collected from a large community sample (n = 17,752) of children aged 3-5, rated by mothers, fathers, and preschool teachers and analysed using confirmatory factor analysis. Our results revealed acceptable fit for all informant groups and measurement invariance across child gender, child age, and parental education level. Our findings suggest good construct validity of the SDQ for a non-clinical preschool population and imply that it may be used for assessing child behaviour problems from different informant perspectives.
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| 11. |
- Dahlberg, Anton, et al.
(författare)
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Successful implementation of parenting support at preschool : An evaluation of Triple P in Sweden
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:4
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Tidskriftsartikel (refereegranskat)abstract
- Although emotional and behavioural problems among young children are common and, if unaddressed, can lead to multi-facetted problems later in life, there is little research investigating the implementation of parenting programs that target these problems. In this study, the RE-AIM framework was used to evaluate the implementation of the Triple P parenting program in a preschool setting at a medium-sized municipality in Sweden. Reach increased over time, showing an overall increase in participating fathers and parents with lower education. Effectiveness outcomes showed an improvement in emotional and behavioural problems in children and less mental health-related symptoms and higher self-efficacy in parents. Adoption rate was 93.3%. To ensure staff "buy-in", designated coordinators made changes in recruitment procedures, and provided supervision and training to all Triple P practitioners. Implementation adaptations were made, such as minor revisions of parenting strategies and other program content, as well as providing child care during seminars and groups, and setting up weekend-groups. Maintenance assessed through 12 month follow-up data suggested that several child and parent outcomes were maintained over time. Uppsala municipality continues to offer Triple P to parents. The reach, effectiveness, adoption, implementation and maintenance of the program were all satisfactory and demonstrated the suitability of delivering evidence-based parenting support using preschools as an arena.
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| 12. |
- Dahlberg, Anton, et al.
(författare)
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Swedish norms for the Strengths and Difficulties Questionnaire for children 3-5 years rated by parents and preschool teachers
- 2020
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 61:2, s. 253-261
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Tidskriftsartikel (refereegranskat)abstract
- The Strengths and Difficulties Questionnaire (SDQ) is a widespread tool for assessing behavior problems in children and adolescents. Despite being investigated thoroughly concerning both validity and reliability, peer reviewed studies that provide norms, especially for preschool children, are lacking. This paper provides Swedish norms using data from a large community sample of children aged 3-5, based on mothers', fathers', and preschool teacher's ratings. Preschool teachers' ratings were generally lower than parents' ratings, which contradicts some previous studies. Differences between girls and boys were found, suggesting that boys display higher levels of behavior problems. Lower parental education and country of origin outside of Sweden were also associated with more difficulties. Cut-offs are presented for each age group, gender and rater category. Population-specific norms and percentile cut-offs provided in this study facilitate identifying children in need of interventions in paediatric care and enable cross-country comparisons of children's mental health problems.
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| 13. |
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| 14. |
- Durbeej, Natalie, et al.
(författare)
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Outside the norm : Mental health, school adjustment and community engagement in non-binary youth
- 2019
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 49:5, s. 529-538
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to explore the role of self-reported non-binary gender identity in mental health problems, school adjustment, and wish to exert influence on municipal issues in a community sample of adolescents.Methods: In a cross-sectional design, data were collected through an anonymous survey in Uppsala County, Sweden, among 8385 students (response rate 58.2%) in grades 7, 9, and 11, aged 13-17 years. The Strengths and Difficulties Questionnaire (SDQ) self-report was used to assess mental health problems. Gender identity was measured with one item and youth were categorized into those who identified as male or female (i.e. binary youth), and those who did or could not identify with either gender (i.e. non-binary youth). Logistic regressions and qualitative content analysis were used to analyse data.Results: Youth with non-binary gender identity (n = 137; 1.6%) had higher odds of having mental problems according to the SDQ total score (OR=3.05; 1.77-5.25). The association between non-binary gender identity and mental health problems remained significant after adjusting for confounders. Additionally, compared to their binary peers, the non-binary youth reported more truancy (36.5% vs 49.6%), more often failed a subject (21.5% vs 36.5%), and were more interested in exerting influence on municipal issues such as sociopolitical development, education, municipal services, and drug and alcohol policies (25.3% vs 38.0%).Conclusions: Youth with non-binary gender identity constitute a vulnerable population regarding mental health problems and school adjustment. The willingness to exert influence on municipal issues suggests a possible pathway to engagement.
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| 15. |
- Edvinsson Sollander, Sofia, et al.
(författare)
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Asthma and allergies correlate to mental health problems in preschool children
- 2021
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:5, s. 1601-1609
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore the relations between asthma, allergies and mental health problems in preschool children, aged 3-5-years.METHODS: In this cross-sectional Swedish study, we used data on 4649 children in Uppsala municipality whose parents and preschool teachers had responded to questions measuring asthma and allergies, and the Strengths and Difficulties Questionnaire (SDQ) for assessment of mental health problems. Logistic regression models were used to explore the relations between asthma and allergies and mental health problems.RESULTS: Children with asthma (8.5%) had elevated odds of having emotional symptoms as rated by parents (OR: 1.34; 1.02-1.76) and teachers (OR: 1.44; 1.09-1.91). According to parents' ratings, these children also had elevated odds of showing mental health problems in general according to the SDQ total score (OR: 1.42; 1.05-1.94). Children with food allergies or intolerance (4.4%) only had elevated odds of having emotional symptoms (OR: 1.64; 1.16-2.33), as reported by parents. These results remained significant after adjustment for parental background factors.CONCLUSION: Preschool children with asthma and food allergies or intolerance are at risk of having concurrent mental health problems. Mental health problems should be assessed in children with these disorders. Adequate support and/or referral to specialised services should be offered when needed.
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| 16. |
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| 17. |
- Fält, Elisabet, et al.
(författare)
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Agreement between mothers', fathers', and teachers' ratings of behavioural and emotional problems in 3-5-year-old children
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:11
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Strengths and Difficulties Questionnaire (SDQ), a valid and reliable instrument for measuring children's mental health, is available in parent- and teacher versions, making it an ideal tool for assessing behavioural and emotional problems in young children. However, few studies have evaluated inter-parent agreement on the SDQ, and in most studies on SDQ agreement, parent scores are either provided by only one parent or have been combined into one parent score. Furthermore, studies on SDQ inter-rater agreement usually only reflect degree of correlation, leaving the agreement between measurements unknown. The aim of the present study was therefore to examine both degree of correlation and agreement between parent and teacher SDQ reports, in a community sample of preschool-aged children in Sweden.Methods: Data were obtained from the Children and Parents in Focus trial. The sample comprised 4,46 children 3-5-years-old. Mothers, fathers and preschool teachers completed the SDQ as part of the routine health check-ups at Child Health Centres. Inter-rater agreement was measured using Pearson correlation coefficient and intraclass correlation (ICC).Results: Results revealed poor/fair agreement between parent and teacher ratings (ICC 0.25-0.54) and good/excellent agreement between mother and father ratings (ICC 0.66-0.76). The highest level of agreement between parents and teachers was found for the hyperactivity and peer problem subscales, whereas the strongest agreement between parents was found for the hyperactivity and conduct subscales.Conclusions: Low inter-rater agreement between parent and teacher ratings suggests that information from both teachers and parents is important when using the SDQ as a method to identify mental health problems in preschool children. Although mothers and fathers each provide unique information about their child's behaviour, good inter-parent agreement indicates that a single parent informant may be sufficient and simplify data collection.
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| 18. |
- Fält, Elisabet, et al.
(författare)
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Facilitating implementation of an evidence-based method to assess the mental health of 3–5-year-old children at Child Health Clinics: a mixed-methods process evaluation
- 2020
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; :6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: A number of instruments for identifying mental health problems in children are available, but there is limited knowledge about how to successfully implement their use in routine practice. The Strengths and Difficulties Questionnaire (SDQ) is an instrument with sound psychometric properties. Because using multi-informant SDQs when assessing young children has been emphasized, parent- and preschool teacher reports on the SDQ were introduced at Child Health Clinics in a Swedish municipality. This paper aimed to describe a facilitation programme developed to support the introduction of SDQ in clinical practice and evaluate how nurses perceived the facilitation strategies used. Moreover, the dose (delivery) and reach (response rate and population coverage) of the questionnaires were assessed. Methods: The mixed-methods process evaluation was guided by Moore et al.'s framework. Process data were excerpted from monitoring data, the trial database, research group documents, study materials, group interviews with nurses, and a survey on nurses' opinions and experiences of the screening method and the implementation process. Data were analysed using descriptive statistics and qualitative content analysis. Results: Facilitation strategies used included: educational meetings, educational outreach visits, newsletters, facilitative administrative support, and adaptations made in procedures and materials when required. Although nurses described a variety of barriers at the organisational and individual level, they were in favour of using the SDQ in clinical practice and emphasised the importance of the facilitation strategies used for its implementation. While dose levels (77-91%) indicated that nurses essentially delivered the intervention as intended, parental response rates remained between 54 and 63% and population coverage at around 50%, throughout the intervention period. Conclusion: The facilitation program was perceived to support the implementation of the SDQ at the yearly check-ups in the child healthcare setting, but further efforts are required to reach all families.
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| 19. |
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| 20. |
- Fängström, Karin, et al.
(författare)
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Is the Strengths and Difficulties Questionnaire with a Trauma Supplement a Valuable Tool in Screening Refugee Children for Mental Health Problems?
- 2019
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Ingår i: The Journal of Refugee Studies. - : Oxford University Press (OUP). - 0951-6328 .- 1471-6925. ; 32:Special issue 1, s. 122-140
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Tidskriftsartikel (refereegranskat)abstract
- The high number of asylum seekers in Sweden has highlighted the need to develop and evaluate structured assessment tools for children. In this study, we aimed to explore the utility of the Strengths and Difficulties Questionnaire (SDQ) with a trauma supplement of six items for preschool children in routine care. Parents of two- to six-year-olds (N = 61) were asked to complete the questionnaire during the routine health check-up offered to all refugees upon their arrival to Sweden. Focus-group interviews were conducted with the nurses who used the SDQ. The nurses found the SDQ valuable once they established a routine and felt that the SDQ contributed to a more structured and informative conversation about the child’s mental health. The SDQ total difficulties showed good internal consistency (alpha = 0.82). A significant proportion of children scored above the clinical cut-off and SDQ scores correlated significantly with the number of post-traumatic stress disorder symptoms measured using the supplement (rho = 0.29). The findings suggest that the SDQ with the trauma supplement is a useful tool in this clinical setting.
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| 21. |
- Fängström, Karin, et al.
(författare)
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The computer-assisted interview In My Shoes can benefit shy preschool children's communication
- 2017
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:8
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Tidskriftsartikel (refereegranskat)abstract
- Interviewing children is a cognitively, socially, and emotionally challenging situation, especially for young and shy children. Thus, finding methods that aid rapport and increase these children's communication is important. The present study investigated whether children's verbal and non-verbal communicative behavior developed differently during the rapport phase, depending on whether children were situationally shy or not, and whether the interview was conducted using the computer-assisted interview In My Shoes (IMS) or a Standard verbal interview. The sample consisted of 60 children aged 4 to 5-years-old. The results showed that for the shy children in the IMS group their talkativeness increased and their answer latency decreased including the amount of encouragement the child needed to talk, while no changes were observed for the shy children in the Standard verbal interview group. There were no significant differences in the non-verbal behavior for the shy children regardless of the interview method used. For the non-shy children, overall, the interview method did not affect either the verbal or the non-verbal outcomes. Our findings indicate that IMS can be a useful tool during the rapport-building phase with shy children as it helps these children to improve their verbal communication.
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| 22. |
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| 23. |
- Kristen, Anna, et al.
(författare)
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Attachment and trauma-informed programme to support forcibly displaced parents of youth in Sweden : feasibility and preliminary outcomes of the eConnect Online programme
- 2023
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess the feasibility, acceptability and the impact of an online parenting programme for forcibly displaced parents of adolescents.Design: The study was a single-arm feasibility study using pre-intervention post-intervention and follow-up assessments.Setting: Participants were recruited from municipality-based activities for refugee parents in a small city in the south of Sweden.Participants: Participants were forcibly displaced parents (n=23; 47.8% maternal figures) of youth (n=23; 8-17 years old; 26.1% female) from Syria, Afghanistan and Somalia participating in an online parenting programme (eConnect).Intervention: eConnect is an attachment-based and trauma-informed parenting intervention and was delivered over the course of 10 weekly sessions.Primary and secondary outcome measures: Feasibility was assessed by programme enrolment, attendance, completion and acceptability of the online platform and cultural fit of the programme. Primary outcome measures were programme impact on youth mental health problems. Secondary outcome measures were programme impact on family functioning and parent-child attachment insecurity.Results: The eConnect programme was highly feasible in terms of overall enrolment (100%), attendance (89.6%) and retention rates (100%). The online platform was acceptable, with mixed feedback primarily related to the access and usage of technology. Cultural fit of the programme was acceptable. Youth mental health problems (& eta;(2)=0.29) and family functioning significantly improved (& eta;(2)=0.18) over the course of the programme. Unexpectedly, parent reports of youth attachment insecurity significantly worsened (& eta;(2)=0.16).Conclusions: The findings suggest that the online delivery of Connect was a promising way to reduce barriers to service access and improve mental health problems and family functioning among forcibly displaced parents and their children during COVID-19. Future research is needed to explore the acceptability and impact of this programme post-COVID-19, and to develop culturally tailored and psychometrically sound measures for parent and youth reports of attachment.
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| 24. |
- Osman, Fatumo, 1973-, et al.
(författare)
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Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting : a randomised controlled trial
- 2017
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 7:12
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the effectiveness of a culturally tailored parenting support programme on Somali-born parents' mental health and sense of competence in parenting.DESIGN: Randomised controlled trial.SETTING: A city in the middle of Sweden.PARTICIPANTS: Somali-born parents (n=120) with children aged 11-16 years and self-perceived stress in their parenting were randomised to an intervention group (n=60) or a waiting-list control group (n=60).INTERVENTION: Parents in the intervention group received culturally tailored societal information combined with the Connect parenting programme during 12 weeks for 1-2 hours per week. The intervention consisted of a standardised training programme delivered by nine group leaders of Somali background.OUTCOME: The General Health Questionnaire 12 was used to measure parents' mental health and the Parenting Sense of Competence scale to measure parent satisfaction and efficacy in the parent role. Analysis was conducted using intention-to-treat principles.RESULTS: The results indicated that parents in the intervention group showed significant improvement in mental health compared with the parents in the control group at a 2-month follow-up: B=3.62, 95% CI 2.01 to 5.18, p<0.001. Further, significant improvement was found for efficacy (B=-6.72, 95% CI -8.15 to -5.28, p<0.001) and satisfaction (B=-4.48, 95% CI -6.27 to -2.69, p<0.001) for parents in the intervention group. Parents' satisfaction mediated the intervention effect on parental mental health (β=-0.88, 95% CI -1.84 to -0.16, p=0.047).CONCLUSION: The culturally tailored parenting support programme led to improved mental health of Somali-born parents and their sense of competence in parenting 2 months after the intervention. The study underlines the importance of acknowledging immigrant parents' need for societal information in parent support programmes and the importance of delivering these programmes in a culturally sensitive manner.CLINICAL TRIAL REGISTRATION: NCT02114593.
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| 25. |
- Osman, Fatumo, 1973-, et al.
(författare)
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Impact of a culturally tailored parenting programme on the mental health of Somali parents and children living in Sweden : a longitudinal cohort study
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:8
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aimed to evaluate the long-term impact (3-year follow-up) of a culturally tailored parenting support programme (Ladnaan) on the mental health of Somali-born parents and their children living in Sweden.Methods In this longitudinal cohort study, Somali-born parents with children aged 11-16 were followed up 3 years after they had participated in the Ladnaan intervention. The Ladnaan intervention comprises two main components: societal information and the Connect parenting programme delivered using a culturally sensitive approach. It consists of 12 weekly group-based sessions each lasting 1-2 hours. The primary outcome was improved mental health in children, as measured by the Child Behaviour Checklist (CBCL). The secondary outcome was improved mental health in parents, as measured by the General Health Questionnaire-12. Data were collected from the parent's perspective.Results Of the 60 parents who were originally offered the intervention, 51 were included in this long-term follow-up. The one-way repeated measures (baseline to the 3-year follow-up) analysis of variance for the CBCL confirmed maintenance of all the treatment gains for children: total problem scores (95% CI 11.49 to 18.00, d=1.57), and externalising problems (95% CI 2.48 to 5.83, d=0.86). Similar results were observed for the parents' mental health (95% CI 0.40 to 3.11, d=0.46).Conclusion Positive changes in the mental health of Somali-born parents and their children were maintained 3 years after they had participated in a parenting support programme that was culturally tailored and specifically designed to address their needs. Our findings highlight the long-term potential benefits of these programmes in tackling mental health issues in immigrant families.
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| 26. |
- Persson, Christine, et al.
(författare)
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NICU parents' mental health : A comparative study with parents of term and healthy infants
- 2023
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 112:5, s. 954-966
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare mental health in parents of preterm/ill infants and parents of term and healthy infants before birth and 1 month after hospital discharge.METHODS: A comparative cohort design was used. In total 439 parents from six neonatal intensive care units (NICUs) and 484 parents from four maternity units (MUs) in Sweden answered a survey 1 month after discharge.RESULTS: Parents in neonatal units experienced significantly more psychologically traumatic births and rated their health and the health of their infants less favourably the first week after delivery than parents in MUs. In the neonatal units, both parents had better possibilities to stay together with the infant during hospital stay. There was no difference between the NICU and MU groups in postpartum depressive symptoms 1 month after discharge. Experiencing a traumatic birth was not related to an increased risk of perinatal depressive symptoms (Edinburgh Postnatal Depression Scale ≥13) for mothers in NICUs. In contrast, the risk of depression increased for mothers in MUs.CONCLUSION: Family togetherness, parent-infant closeness and emotional support at NICUs may contribute to the positive outcome. Further studies are needed to assess the long-term effects of how family togetherness and closeness influence families long-term.
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| 27. |
- Persson, Christine, et al.
(författare)
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NICU parents’ mental health : A comparative study with parents of term and healthy infants, 1 month after discharge
- 2023
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Konferensbidrag (refereegranskat)abstract
- Background: Parents who have been at neonatal units (NICUs) with their infants have increased risks for exhibit symptoms of depression or psychological trauma. Key risk factors for the onset of depression, symptoms of psychological trauma, or parental anxiety during the time in NICU are; a stressful birth experience, early and prolonged separation and unclear responsibilities for the infant (de Paula Eduardo et al., 2019; R. Flacking et al., 2012). Maternal depression levels in NICU mothers could decrease if parents' have [ME1] unlimited access to their infants, a trustworthy staff-parent partnership, substantial emotional support (Axelin et al., 2021), and a single-family room (Tandberg et al., 2019). In Sweden most parents can stay at the unit day and night and therefore staff has good opportunities to give support (Flacking et al., 2019).Aim: To compare mental health in parents of preterm/ill infants and parents of term and healthy infants before birth and 1 month after hospital discharge.Method: A comparative cohort design where parents from six NICUs (n=439) and four maternal units (MUs) (n=484) in Sweden answered a survey one month after discharge.Results:Parents from NICUs experienced significantly more traumatic births and rated their health worse the first week after giving birth, compared to MU parents. NICU parents also rated their infant’s health worse the first week after birth and they had longer hospital stay. One month after discharge there was no difference between NICU and MU parents regarding symptoms of postnatal depression (EPDS). However, an association between traumatic birth and depression was only observed in mothers from MUs. Both parents at all NICUs had access to their infant 24/7 and they were significantly more often staying together as a family at the NICU. In total 80% of NICU parents were satisfied with the emotional support given by staff and significantly more NICU fathers were satisfied compared to MU fathers.Conclusion: ‘Family togetherness’, parent-infant closeness, and emotional support at the NICU could be protective factors for developing depression in NICU parents in the short term because it strengthens parenthood, attachment, and resilience. [ME1]had?
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| 28. |
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| 29. |
- Salari, Raziye, et al.
(författare)
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An efficacy trial: Positive Parenting Program for parents of teenagers
- 2014
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Ingår i: Behaviour change. - : Cambridge University Press (CUP). - 0813-4839 .- 2049-7768. ; 31:1, s. 34-52
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Tidskriftsartikel (refereegranskat)abstract
- Studies on the efficacy of parent training programs have mostly been conducted with preadolescents, with only a few studies investigating family treatment models in adolescents. In this article, a study is described that evaluates Standard Teen Triple P (Positive Parenting Program), a behavioural family intervention for parents of 11- to 16-year-old teenagers. Participants were 46 families with a teenager who was experiencing detectable behavioural and emotional problems. Compared to parents in the waitlist control condition, parents participating in the intervention condition reported decreased levels of teen disruptive behaviours and parent adolescent conflict, as well as a reduction in the use of ineffective parenting strategies and conflict over child-rearing issues. These positive changes were maintained at the 3-month follow-up. Results suggest that Standard Teen Triple P is a promising parenting intervention for tackling adolescent externalising problems.
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| 30. |
- Salari, Raziye, et al.
(författare)
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Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:7, s. 547-553
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Tidskriftsartikel (refereegranskat)abstract
- Aims: We aim to examine the relationship between child behavioural problems and several parental factors, particularly parental behaviours as reported by both mothers and fathers in a sample of preschool children in Sweden. Methods: Participants were mothers and fathers of 504 3- to 5-year-olds that were recruited through preschools. They completed a set of questionnaires including the Eyberg Child Behavior Inventory, Parenting Sense of Competence Scale, Parenting Scale, Parent Problem Checklist, Dyadic Adjustment Scale and Depression Anxiety Stress Scale. Results: Correlational analyses showed that parent-reported child behaviour problems were positively associated with ineffective parenting practices and interparental conflicts and negatively related to parental competence. Regression analyses showed that, for both mothers and fathers, higher levels of parental over-reactivity and interparental conflict over child-rearing issues and lower levels of parental satisfaction were the most salient factors in predicting their reports of disruptive child behaviour. Conclusions: This study revealed that Swedish parents' perceptions of their parenting is related to their ratings of child behaviour problems which therefore implies that parent training programs can be useful in addressing behavioural problems in Swedish children.
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| 31. |
- Salari, Raziye, et al.
(författare)
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Direct marketing of parenting programs : comparing a promotion-focused and a prevention-focused strategy
- 2017
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 27:3, s. 489-494
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Tidskriftsartikel (refereegranskat)abstract
- Background: For parenting programs to achieve a public health impact, it is necessary to develop more effective marketing strategies to increase public awareness of these programs and promote parental participation. In this article, we compared a promotion-focused and a prevention-focused strategy via two studies. Method: We designed two ads inviting parents to participate in a universal parenting program; one ad focused on the program increasing the likelihood of positive outcomes for children (promotion-focused) and the other on the program reducing the likelihood of negative outcomes (prevention-focused). In study I, the two ads were run online simultaneously. Those who clicked on an ad were directed to a website where they could read about and sign up for the program. In study II, a community sample of 706 parents answered a questionnaire about the ads. Results: In study I, over 85 days, the prevention ad generated more clicks. There was no difference in the number of pages visited on the website nor in the number of parents who signed up for the program. In study II, parents showed a preference for the promotion ad, perceiving it as more relevant and rating it as more effective in getting them interested in the program. Conclusion: A prevention strategy may be more effective in drawing public attention, in general. However, a promotion strategy is more likely to reach parents, in particular, and inspire them to consider participating in parenting programs. These strategies should be developed further and tested in both general and clinical populations.
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| 32. |
- Salari, Raziye, et al.
(författare)
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Neuropsychological functioning and attachment representations in early school age as predictors of ADHD symptoms in late adolescence
- 2017
-
Ingår i: Child Psychiatry and Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327. ; 48:3, s. 370-384
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to examine relations between parent and child attachment representations and neuropsychological functions at age 8, as well as relations between these constructs and ADHD symptoms over a 10-year period. A community-based sample of 105 children (52 boys) participated. Measures of attachment representations and a range of neuropsychological functions were collected at age 8. Parents rated emotion dysregulation and ADHD symptoms at age 8 and ADHD symptoms again at age 18. Significant, although modest, relations were found between disorganized attachment and some aspects of neuropsychological functioning in childhood. When studying outcomes in late adolescence and controlling for early ADHD symptom levels, spatial working memory and disorganized attachment remained significant in relation to both ADHD symptom domains, and one measure of inhibition remained significant for hyperactivity/impulsivity. When examining independent effects, spatial working memory and disorganized attachment were related to inattention, whereas spatial working memory and dysregulation of happiness/exuberance were related to hyperactivity/impulsivity. Our findings showing that disorganized attachment is longitudinally related to ADHD symptoms over and above the influence of both neuropsychological functioning and early ADHD symptom levels highlights the importance of including measures of attachment representations when trying to understand the development of ADHD symptoms. If replicated in more “at-risk” samples, these findings could also suggest that parent–child attachment should be taken into consideration when children are referred for assessment and treatment of ADHD.
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| 33. |
- Salari, Raziye, et al.
(författare)
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Parental monitoring in late adolescence : Relations to ADHD symptoms and longitudinal predictors
- 2015
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Ingår i: Journal of Adolescence. - : Wiley. - 0140-1971 .- 1095-9254. ; 40, s. 24-33
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we aimed to replicate Stattin and Kerr's (2000) study on parental monitoring and adolescents' deviant behavior, to extend their findings to ADHD symptoms, and to examine the longitudinal predictors (8-18 years) of parental knowledge and child disclosure. Results showed that conduct problems were primarily associated with parental knowledge and child disclosure, but not with parental solicitation and control. A similar pattern was observed for ADHD symptoms. However, while the relations for conduct problems were generally independent of ADHD symptoms, the relations for ADHD symptoms were primarily non-significant after controlling for conduct problems. Moreover, early behavior problems, but not insecure/disorganized attachment, were associated with parental knowledge and child disclosure in adolescence. In conclusion, child disclosure is primarily associated with deviant behavior rather than ADHD, and early child problem behavior is a more important predictor of child disclosure (implicating reciprocal relations between these two constructs) than is insecure/disorganized attachment.
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| 34. |
- Salari, Raziye, et al.
(författare)
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Parenting Scale : Which version should we use?
- 2012
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Ingår i: Journal of Psychopathology and Behavioral Assessment. - : Springer Science and Business Media LLC. - 0882-2689 .- 1573-3505. ; 34:2, s. 268-281
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Tidskriftsartikel (refereegranskat)abstract
- Factor analytic studies of one of the widely used measurements of parental discipline, the Parenting Scale (PS), have yielded ambiguous results. The purpose of this study was to compare various forms of the PS in terms of factor structure and other psychometric properties. The sample consisted of 617 mothers and 430 fathers of 2 to 5-year-olds. Confirmatory factor analysis indicated that shorter structural models provided a better fit compared to the original model; however, none led to an optimal fit. Other psychometric properties such as internal consistency, test-retest reliability, concurrent and predictive validity were slightly higher for the original Laxness and Overreactivity subscales. The findings from this study and previous studies suggest that the inter-item relationship in the scale might be too sensitive to sample characteristics, implying that factor analysis might not be the best way to measure the scale's validity. Nevertheless, other psychometric properties support the use of the Parenting Scale in the assessment of dysfunctional parenting practices. We recommend using the original Laxness and Overreactivity subscales rather than the later models, especially for research purposes.
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| 35. |
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| 36. |
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| 37. |
- Salari, Raziye, et al.
(författare)
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Screening for PTSD symptoms in unaccompanied refugee minors : a test of the CRIES-8 questionnaire in routine care
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 45:6, s. 605-611
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The dramatic increase in the number of refugees in Europe presents a major public health challenge. The limited existing evidence indicates that the mental health needs of refugees are significant; unaccompanied refugee minors (URMs) constitute a particularly vulnerable group. In this study, we aimed to investigate whether a short questionnaire (Children's Revised Impact of Event Scale; CRIES-8) could be used as a screening tool for PTSD symptoms in URMs, 8-18 years old, during their routine health check-up.Methods: Data were collected at the healthcare centre for asylum-seekers in Uppsala, Sweden. In total, 208 URMs completed the CRIES-8 during their health assessment.Results: The CRIES-8 was feasible to use, showed good internal consistency and its factor structure was confirmed. Children with less than four years of education often had difficulties completing the questionnaire by themselves and needed help reading the questions. Almost all the respondents were male (98%), aged 9-18 years. The majority (81%) came from Afghanistan. About 76% scored above the cut-off and therefore were considered to be at risk of PTSD. The proportion of children who screened positive did not differ based on age, country of origin or current living arrangements.Conclusions: The CRIES-8 is a useful tool in clinical settings, however, children should be provided with reading support and instructions about how to complete the questionnaire. The high number of children who screened positive for PTSD symptoms indicates the need for a more thorough mental health assessment, and early prevention/intervention programmes to address URMs' mental health issues.
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| 38. |
- Salari, Raziye, et al.
(författare)
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The Children and Parents in Focus project : a population-based cluster-randomised controlled trial to prevent behavioural and emotional problems in children.
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context.METHODS/DESIGN: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013--2017). Outcomes will be measured annually. The primary outcome will be children's behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents' behaviour and parents' general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children's mental health, parent's mental health and health-related quality of life.DISCUSSION: This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden.Trial registration: ISRCTN: ISRCTN16513449.
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| 39. |
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| 40. |
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| 41. |
- Salari, Raziye, et al.
(författare)
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Using the Health Belief Model to Explain Mothers’ and Fathers’ Intention to Participate in Universal Parenting Programs
- 2017
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Ingår i: Prevention Science. - : Springer Science and Business Media LLC. - 1389-4986 .- 1573-6695. ; 18:1, s. 83-94
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Tidskriftsartikel (refereegranskat)abstract
- Using the Health Belief Model (HBM) as a theoretical framework, we studied factors related to parental intention to participate in parenting programs and examined the moderating effects of parent gender on these factors. Participants were a community sample of 290 mothers and 290 fathers of 5- to 10-year-old children. Parents completed a set of questionnaires assessing child emotional and behavioral difficulties and the HBM constructs concerning perceived program benefits and barriers, perceived child problem susceptibility and severity, and perceived self-efficacy. The hypothesized model was evaluated using structural equation modeling. The results showed that, for both mothers and fathers, perceived program benefits were associated with higher intention to participate in parenting programs. In addition, higher intention to participate was associated with lower perceived barriers only in the sample of mothers and with higher perceived self-efficacy only in the sample of fathers. No significant relations were found between intention to participate and perceived child problem susceptibility and severity. Mediation analyses indicated that, for both mothers and fathers, child emotional and behavioral problems had an indirect effect on parents’ intention to participate by increasing the level of perceived benefits of the program. As a whole, the proposed model explained about 45 % of the variance in parental intention to participate. The current study suggests that mothers and fathers may be motivated by different factors when making their decision to participate in a parenting program. This finding can inform future parent engagement strategies intended to increase both mothers’ and fathers’ participation rates in parenting programs.
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| 42. |
- Sampaio, Filipa, et al.
(författare)
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Cost and effects of a universal parenting programme delivered to parents of preschoolers
- 2015
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 25:6, s. 1035-1042
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Parenting programmes are effective in improving child behaviour and parental well-being, but long follow-up studies of universally offered programmes are scarce.METHODS:A cluster randomized controlled trial was conducted to assess the costs and effects of Triple P levels 2-3 on child externalizing behaviours and parental mental health. The programme was offered universally to parents of preschoolers (self-selection allowed). Preschools were randomized to Triple P or a waitlist control. Health outcomes were reduction in externalizing behaviours measured on the Eyberg Child Behaviour Inventory-22 and improvement in parental mental health measured on the Depression Anxiety Stress Scales collected at baseline, 6-, 12- and 18-month follow-up. Child outcomes were based on 355 children aged 3-5 years (child sample) and parental outcomes on 759 parents (parental sample) with baseline data. Costs were collected from a municipality perspective, including 312 children and 488 parents with baseline data in the intervention preschools.RESULTS:Sixty-seven (29%) parents attended the intervention. Triple P showed no significant improvement in child externalizing behaviours or parental mental health at either of the follow-up points. Triple P had an average yearly total cost of 3007 Swedish Krona (SEK) (€323) per child or 1922 SEK (€207) per parent. Running Triple P cost 227 SEK (€24) per child or 145 SEK (€16) per parent yearly.CONCLUSION:Offering low intensity levels of Triple P with 29% attendance may not be a reasonable use of public resources, as no evidence of improvement in child externalizing behaviours or parental mental health was found.
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| 43. |
- Sampaio, Filipa, 1985-
(författare)
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Prevention and Treatment of Externalizing Behaviour Problems in Children through Parenting Interventions : An Application of Health Economic Methods
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The early onset of externalizing behaviour problems (EBP) is associated with negative outcomes later in life, such as poor mental health, substance use, crime, and unemployment. Some children also develop conduct disorder (CD), entailing a high disease and economic burden for both individuals and society.Most studies on the effectiveness and cost-effectiveness of parenting interventions targeting EBP among children have evaluated selective or indicated preventive interventions, or treatment strategies. Evidence on the effectiveness of universally delivered parenting programmes is controversial, partly due to methodological difficulties.The overall aim of this thesis was to 1) address the methodological challenges of evaluating universal parenting programmes, and to 2) employ different health economic methods to evaluate parenting interventions for EBP and CD in children.Study I indicated that offering low intensity levels of Triple P universally, with limited intervention attendance, does not result in improved outcomes, and may not be a worthwhile use of public resources. Study II showed that using the distribution of an outcome variable makes it possible to estimate the impact of public health interventions at the population level. Study III supports offering bibliotherapy to initially target CP in children, whereas Comet could be offered to achieve greater effects based on decision-makers’ willingness to make larger investments. Cope could be offered when targeting symptom improvement, rather than clinical caseness. The economic decision model in Study IV demonstrated that Triple P for the treatment of CD appears to represent good value for money, when delivered in a Group format, but less likely, when delivered in an Individual format.To reduce the burden of mental health problems in childhood, cost-effective and evidence-based interventions should be provided on a continuum from prevention through early intervention to treatment. We believe our results can assist decision-makers in resource allocation to this field.
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| 44. |
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| 45. |
- Sarkadi, Anna, Professor, 1974-, et al.
(författare)
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Evaluation of the Teaching Recovery Techniques community-based intervention for unaccompanied refugee youth experiencing post-traumatic stress symptoms (Swedish UnaccomPanied yOuth Refugee Trial; SUPpORT) : study protocol for a randomised controlled trial
- 2020
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Ingår i: Trials. - : NLM (Medline). - 1745-6215. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs). Refugee children, especially URMs, have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue years after resettlement. The Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT) aims to evaluate a community-based intervention, called Teaching Recovery Techniques (TRT), for refugee youth experiencing PTSD symptoms.METHODS/DESIGN: A randomised controlled trial will be conducted in which participants will be randomly allocated to one of two possible arms: the intervention arm (n = 109) will be offered the TRT programme, and the waitlist-control arm (n = 109) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; about 8 weeks after randomisation) and follow-up (T3; about 20 weeks after randomisation).DISCUSSION: This study will provide knowledge about the effect and efficiency of a group intervention for URMs reporting symptoms of PTSD in Sweden. TRIAL REGISTRATION: ISRCTN, ISRCTN47820795. Prospectively registered on 20 December 2018.
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| 46. |
- Sarkadi, Anna, Professor, 1974-, et al.
(författare)
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Is the refugee health screener a useful tool when screening 14-18 year old refugee adolescents for emotional distress?
- 2019
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Ingår i: The Journal of Refugee Studies. - Oxford, UK : Oxford Academic. - 0951-6328 .- 1471-6925. ; 32:Special_Issue_1, s. i141-i150
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Tidskriftsartikel (refereegranskat)abstract
- The high number of asylum seekers in Sweden has highlighted the need for structured assessment tools to screen for refugee mental health problems in clinical services. We examined the utility of the Refugee Health Screener (RHS) in refugee adolescents, aged 14-18, attending routine clinical examinations or staying in group homes/refugee centres (N=29). Participants completed a survey, including the RHS, administered through iPads in their native language. The RHS showed excellent internal consistency (α = .96) and correlated moderately with symptoms of PTSD (r=0.41, p=.025). Mean scores and prevalence rates were comparable to a study of adult refugees in Sweden. Unaccompanied refugee minors (URM) scored significantly higher (M=32.0, SD=12.9) compared to youth staying with their families (M=7.5, SD=8.2, p<.001, d=2.27). Our findings confirm that the RHS can be used in the adolescent population in Sweden. These findings moreover suggest that URMs are a particularly vulnerable group with a large burden of mental health problems.
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| 47. |
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| 48. |
- Sarkadi, Anna, Professor, 1974-, et al.
(författare)
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Teaching Recovery Techniques : evaluation of a group intervention for unaccompanied refugee minors with symptoms of PTSD in Sweden
- 2018
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Ingår i: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 27:4, s. 467-479
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Tidskriftsartikel (refereegranskat)abstract
- In 2015, a total of 35,369 unaccompanied refugee minors (URMs) sought asylum in Sweden. In a previous study of 208 URMs, we found that 76% screened positive for PTSD. This study aimed to (1) evaluate the indicated prevention program Teaching Recovery Techniques (TRT) in a community setting and describe the program's effects on symptoms of PTSD and depression in URMs; and (2) examine participants' experiences of the program. The study included 10 groups. Methods for evaluation included the Children's Revised Impact of Event Scale (CRIES-8) and the Montgomery–Åsberg Depression Rating Scale Self-report (MADRS-S) at baseline and at post-intervention. Qualitative interviews were conducted with 22 participating URMs to elicit their experiences. Pre- and post-measures were available for 46 participants. At baseline, 83% of the participants reported moderate or severe depression and 48% suicidal ideation or plans. Although more than half (62%) of the participants reported negative life events during the study period, both PTSD (CRIES-8) and depression (MADRS-S) symptoms decreased significantly after the intervention (p = 0.017, 95% CI − 5.55; − 0.58; and p < 0.001, 95% CI − 8.94; − 2.88, respectively). The qualitative content analysis resulted in six overall categories: social support, normalisation, valuable tools, comprehensibility, manageability, and meaningfulness when the youth described their experiences of the program, well reflecting TRT's program theory. Overall, results indicate that TRT, delivered in a community setting, is a promising indicated preventive intervention for URMs with PTSD symptoms. This successful evaluation should be followed up with a controlled study.
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- Warner, Georgina, et al.
(författare)
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Evaluation of the teaching recovery techniques community-based intervention for accompanied refugee children experiencing post-traumatic stress symptoms (Accompanied refugeeS In Sweden Trial; ASsIST) : study protocol for a cluster randomised controlled trial
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Refugee children have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue for years after resettlement. The Accompanied refugeeS In Sweden Trial (ASsIST) aims to evaluate a community-based intervention, called 'Teaching Recovery Techniques' (TRT), for accompanied refugee minors experiencing PTSD symptoms. METHODS/DESIGN: A cluster randomised controlled trial will be conducted in which participants will be randomly allocated to one of the two possible arms: the intervention arm (n=113) will be offered the TRT programme and the waitlist-control arm (n=113) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; c.8 weeks after randomisation) and follow-up (T3; c.20 weeks after randomisation). ETHICS AND DISSEMINATION: Ethical approval was granted by the Regional Ethical Review Board in Uppsala (Ref. 2018/382) (24th February 2019). Results will be published in scientific journals. TRIAL REGISTRATION DETAILS: ISRCTN17754931. Prospectively registered on 4th June 2019.
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