Factors associated with the identification of child mental health problems in primary care—a systematic review

Background Child mental health problems are now recognised as a key public health concern. Parenting programs have been developed as one solution to reduce children’s risk of developing mental health problems. However, their potential for widespread dissemination is hindered by low parental engagement, which includes intent to enrol, enrolment, and attendance. To increase parental engagement in preventive parenting programs, we need a better understanding of the predictors of engagement, and the strategies that can be used to enhance engagement. Method Employing a PRISMA method, we conducted a systematic review of the predictors of parent engagement and engagement enhancement strategies in preventive parenting programs. Key inclusion criteria included: (1) the intervention is directed primarily at the parent, (2) parent age >18 years, the article is (3) written in English and (4) published between 2004–2016. Stouffer’s method of combining p-values was used to determine whether associations between variables were reliable. Results Twenty-three articles reported a variety of predictors of parental engagement and engagement enhancement strategies. Only one of eleven predictors (child mental health symptoms) demonstrated a reliable association with enrolment (Stouffer’s p < .01). Discussion There was a lack of consistent evidence for predictors of parental engagement. Nonetheless, preliminary evidence suggests that engagement enhancement strategies modelled on theories, such as the Health Belief Model and Theory of Planned Behaviour, may increase parents’ engagement. Systematic review registration PROSPERO CRD42014013664.

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Parenting stress during infancy is a risk factor for mental health problems in 3-year-old children

BMC Public Health ◽

10.1186/s12889-020-09861-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Nayantara Hattangadi ◽

Katherine T. Cost ◽

Catherine S. Birken ◽

Cornelia M. Borkhoff ◽

Jonathon L. Maguire ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Parenting Stress ◽

Child Mental Health ◽

Mental Health Problems ◽

Health Problems ◽

Research Network ◽

Care Practice ◽

The Impact ◽

Preschool Aged Children

Abstract Background Although research on the relationship between parent and child mental health is growing, the impact of early parenting stress on preschool-aged children’s mental health remains unclear. The objective was to evaluate the association between parenting stress during infancy and mental health problems in 3-year-old children. Methods A prospective cohort study of healthy preschool-aged children recruited from 9 primary care practices in Toronto, Canada was conducted through the TARGet Kids! primary care practice-based research network. Parenting stress was measured when children were between 0 to 16 months of age, using the Parent Stress Index Short Form, PSI-SF. Parent-reported child mental health problems were measured at 36 to 47 months using the preschool Strengths and Difficulties Questionnaire, total difficulties score (TDS). Hierarchical linear regression analysis was used to investigate the association between standardized PSI-SF and TDS, adjusted for child age, sex, temperament, sleep duration and household income. To strengthen clinical interpretation, analysis was repeated using adjusted multivariable logistic regression (TDS dichotomized at top 20%). Results A total of 148 children (mean ± SD age, 37.2 ± 1.7 months, 49% male) were included in the analysis. Parenting stress during infancy (11.4 ± 3.1 months of age) was significantly associated with mental health problems in 3-year-old children (β = 0.35; 95% CI = 0.20–0.49, p < 0.001). Higher parenting stress was also associated with increased odds of higher TDS (OR = 2.26, 95% CI = 1.69–2.83, p < 0.01). Conclusion Healthy preschool-aged children with parents reporting parenting stress during infancy had a 2 times higher odds of mental health problems at 3 years.

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