Poster #101 - Purposeful Parenting and Child Health in the US: A Population-Based Study of Children 0-5 Years

• In Event: 2-002 - Special Poster Session 05 with Continental Breakfast Reception
  In Poster Session: PS 05 - Interdisciplinary Section

Integrative Statement

BACKGROUND: Parenting education traditionally occurs within the mental health setting; however, studies suggest that integrating parenting education in primary health care presents a unique opportunity for anticipatory guidance with potential to improve child health and development (Perrin et al., 2014). Purposeful parenting (PP) is a framework for health care providers to educate parents on strategies to foster positive childhood social-emotional and linguistic skills (American Academy of Pediatrics, Ohio Chapter, 2012). Few studies have examined the relationship between PP and childhood health outcomes. We examined the associations between PP and positive health status in a large population-based sample of children. METHODS: Data for this study were from the 2016 National Survey of Children’s Health (NSCH) (N=52,000), a nationally representative survey of U.S. children aged 0- 17 years. Funded and directed since 2001 by the Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA/MCHB), the NSCH provides key parent-reported measures of child health, health care access, quality, and utilization and related familial and community factors (Ghandour et al., 2018). NSCH parenting variables related to the six PP domains were independently identified through thematic analysis. In-depth discussions were used to resolve thematic discrepancies until consensus was achieved. The following six PPs domains were selected for this study: Protective [P1a-b]; Progressive [P2]; Personal [P3]; Positive [P4]; Playful [P5]; and Purposeful [P6]. Chi-square tests of independence and logistic regressions were used to test the associations between overall child health status and six PP domains controlling for sociodemographic and family characteristics in a sample of children aged 0-5 (N=12,670). STATA svy command was used to account for complex survey design at a p level of 0.05 significance. RESULTS: In the unadjusted analyses, children who experienced the six PP domains were significantly more likely to have positive overall health than those who did not experience PP. After adjustment for covariates, positive child health remained significantly associated with only three of the six PP domains: protective, progressive, and purposeful. Specifically, children who reside in protective homes with financial security (OR=1.82, SE=0.32) and safe neighborhoods (OR=1.47, SE=0.27), have a progressive outlook (OR=2.47, SE=0.71), and whose parents are purposeful in partnering with their healthcare provider (OR=2.47, SE=0.70) were more likely to have positive overall health status compared to their counterparts. The associations were similar across racial/ethnic groups. Children of two-parent (biological/adopted) homes (OR=2.18, SE=0.58), who did not have first generation parents (OR=0.15, SE=0.08), and without special healthcare needs (OR=10.45, SE=1.93) were more likely to have positive overall health status compared to their counterparts. IMPLICATIONS FOR POLICY AND PRACTICE: This study provides evidence that positive child health status is associated with some, but not all positive parenting domains regardless of racial/ethnic status. While recognizing that these are cross-sectional data, findings support the need to integrate parenting/caregiver education during pediatric encounters to support parents and enable children to reach their full potential. Further studies are needed to elucidate the preventive benefits of positive parenting for improving child health and development when implemented in primary care settings.

Authors

• Romuladus E. Azuine, Health Resources and Services Administration/Maternal and Child Health Bureau
  Non-Presenting Author

• Deborah E. Linares, Health Resources and Services Administration/Maternal and Child Health Bureau
  Presenting Author

• Jessica N. DiBari, Health Resources and Services Administration/Maternal and Child Health Bureau
  Non-Presenting Author