Research projects in Parental Health and Support | PRIME Health

Research projects in the area parental health and support conducted by the PRIME Health research group.

The universal parental support program “all children in focus” – ABC

Parents have earlier been involved in programs that aim to improve parenting and reduce child behaviour problems. Research has shown that these interventions usually have a positive influence on both parents and children. There is however a gap in the literature when it comes to randomized controlled studies of short, manual-based programs which focus on promoting health.

We have therefore developed a four-session health promotion parent group program named All Children in Focus - ABC. The aim is to promote parental self-efficacy and children’s well-being with the parent-child relationship as the target.

A pilot study and a prospective multicentre randomized wait-list controlled trial were conducted with parents having children ranging in age from 3-12 years. The parents have been recruited in municipalities and city districts in the County of Stockholm, Sweden. Parents in the RCT were randomized at baseline to an intervention group, which received the program directly, or to a waiting-list control group, which participated in the program six months later. Changes in parental self-efficacy and child well-being were assessed with measures immediately post-intervention and six months after the baseline.

Observations of a minor group of parents and children were conducted to explore possible relations between parental reports and observed behaviours. Data collected within the evaluation were also used to evaluate the possible cost-effectiveness of the program.

Trial registration: Current Controlled Trials ISRCTN70202532

Funding from The Swedish National Institute of Public Health

Collaborators

  • Pia Enebrink, Department of Clinical Neuroscience, KI
  • Camilla Jalling, Department of Clinical Neuroscience, KI
  • Maria Lalouni, Department of Medicine, KI
  • Lene Lindberg, Department of Public Health Sciences, KI
  • Anna Månsdotter, Department of Public Health Sciences, KI
  • Eva Skärstrand, Stockholm Prevents Alcohol and Drug Problems, Stockholm County Council
  • Malin Ulfsdotter, Department of Clinical Neuroscience, KI
  • Kajsa Lönn Rhodin, Family and Social Welfare, Stockholm County Council

Publications

The effects and costs of the universal parent group program - all children in focus: a study protocol for a randomized wait-list controlled trial.
Lindberg L, Ulfsdotter M, Jalling C, Skärstrand E, Lalouni M, Lönn Rhodin K, et al
BMC Public Health 2013 Jul;13():688

Enebrink P, Danneman M, Benvestito V, Ulfsdotter M, Jalling C, Lindberg L. ABC for parents: pilot study of a universal 4-session program shows increased parenting skills, self-efficacy and child well-being. J Child Fam Stud, 2014; DOI: 10.1007/s10826-014-9992-6.

Effectiveness of a universal health-promoting parenting program: a randomized waitlist-controlled trial of All Children in Focus.
Ulfsdotter M, Enebrink P, Lindberg L
BMC Public Health 2014 Oct;14():1083

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus.
Ulfsdotter M, Lindberg L, Månsdotter A
PLoS ONE 2015 ;10(12):e0145201

Contact

Adjunct senior lecturer

Lene Lindberg

Organizational unit: Social Medicin
E-mail: Lene.Lindberg@ki.se

A community-based intervention: Implementing new clinical visits for fathers at the Stockholm County child health centers

This is a community-based intervention, with the aim of evaluating the implementation and outcomes derived from a series of new clinical visits at the Stockholm County child health centers, to better support fathers. 

Around half of the Stockholm County child health nurses completed a half-day training to implement a series of father visits in 2017. Within this program, fathers are invited, along with their partner, to the initial nurse-parent meeting (e.g. home visit), as well as to a 3-5 week visit. Fathers, but not mothers, are then invited to a 3-5 month visit. During these visits, child health nurses should form a relationship with the father, independent of the mother, and provide parenting support to fathers. 

Material and method

Nurses have completed questionnaires at three time points:

  1. baseline questionnaire, where they provided information on their attitudes of fathers of infants compared to mothers;
  2. training questionnaire (1-2 months post training), where they provided information on their thoughts of the half-day training and initial implementation of these father visits; and
  3. adherence questionnaire (8-12 months post-training), where questions focus on how well nurses deliver the program as advertised, as well as any strengths and barriers to implementation. 

Fathers will complete a questionnaire after their 3-5 month visits. This questionnaire consists of adherence questions related to the home, 3-5 week, and 3-5 month visits, as well as uses validated questionnaires regarding the parent-infant relationship, coparenting relationship, and fathers' mental health. 

Funding from Stockholm Läns Landsting 

Collaborators

Public Engagement

Contact

Postdoc

Michael Wells

Organizational unit: Social Medicin
E-mail: michael.wells@ki.se

Domestic violence – identification and intervention

Research indicates that between 6 and 11% of children are exposed to intimate partner violence (IPV) in Sweden. The Child Health Care (CHC) has a unique opportunity to identify and prevent IPV as CHC is universal for all children in the ages of 0-6 years. Recent reports from the CHC in Stockholm County indicate however that very few children are identified and reported to the child protection services.

The aim with the present study is to study the feasibility for CHC nurses to work with identification of IPV and to compare different methods that can be used to identify IPV. In the pilot study a model was developed and tested in collaboration with six CHC nurses. The nurses participating in the pilot study documented how the different conditions were implemented and the reactions from the parents.

The parents were interviewed about the information they had received about IPV and mothers receiving questions about IPV were interviewed.

In the next step nurses within the CHC will be randomized to three different conditions:

  1. to inform at a home visit and systematically question when the infant is 6-8 weeks old
  2. to question on indication
  3. or treatment as usual.

The two groups of nurses that will question systematically or on indication will receive training and supervision during the study period. The results will be analysed and presented both quantitatively and qualitatively. Our findings can contribute with further knowledge about how to identify and prevent IPV within the health care.

Funding from the Foundation Allmänna Barnhuset, Stockholm County Council and Karolinska Institutet, ALF

Collaborators

  • Bo Burström, Department of Public Health Sciences, KI
  • Maigun Edhborg, Department of Neurobiology, Care Sciences and Society (NVS), KI 
  • Lene Lindberg, Department of Public Health Sciences, KI
  • Helena Martin, Department of Women's and Children's Health, KI
  • Steven Lucas, Uppsala University

Contact

Adjunct senior lecturer

Lene Lindberg

Organizational unit: Social Medicin
E-mail: Lene.Lindberg@ki.se

Postnatal depression – development of methods in the view of equality

Mental health problems among new parents are important to identify because they may have implications for children’s development and health. Extensive research regarding the prevalence and effective interventions has been reported for mothers, but not for fathers.

The overall aim for this project is to identify and support all parents with postnatal depression, both mothers and fathers. Within this frame the project has the following subordinate aims: to validate the questionnaires Edinburgh Postnatal Depression Scale - EPDS and Gotland Male Depression Scale GMDS against each other. To obtain new knowledge about family relations (to the child and the partner) and life situation in families where one or both of the parents have postnatal depression.

An epidemiological study was carried out in 2011 in Stockholm County, Sweden, with questionnaires sent to 8,000 new fathers to measure depressive symptoms with a follow-up when the child was a year old. In the study, the questionnaires were used to measure symptoms, and fathers with symptoms were offered a self-help book or counselling after randomization.

A smaller group of fathers with depressive symptoms were interviewed about the impact of their symptoms on family and parenting. In a second step, in 2014, questionnaires measuring depressive symptoms were sent to approximately 4,000 new parents to study how depressive symptoms manifest for mothers and fathers. These parents were also invited to participate in clinical interviews. Interventions offered to parents with symptoms were self-help books, Internet-based therapy or individual or family counselling. Analyses are ongoing regarding, among others, psychometrics, frequencies and possible risk factors.

Funding from Stockholm County Council and Public Health Grant

Collaborators

  • Gerhard Andersson, Linköping University and Karolinska Institutet
  • Magdalena Carlberg, Stockholm County Council
  • Maigun Edhborg, Department of Neurobiology, Care Sciences and Society (NVS), KI 
  • Lene Lindberg, Department of Public Health Sciences, KI
  • Kimmo Sorjonen, Department of Clinical Neuroscience, KI

Public Engagement

”Stoppa övergreppen mot funktionsnedsatta föräldrar”, DN debatt, June 8 2016.

Granqvist, P., Forslund, T., Fransson, M., Springer, L., & Lindberg, L. (2014). Anknytning hos barn till mödrar med intellektuella funktionshinder: Om vanvård i dubbla bemärkelser, del II. Psykisk Hälsa, 55, 68-73.

Publications

"Waiting for Better Times": Experiences in the First Postpartum Year by Swedish Fathers With Depressive Symptoms.
Edhborg M, Carlberg M, Simon F, Lindberg L
Am J Mens Health 2016 09;10(5):428-39

Contact

Adjunct senior lecturer

Lene Lindberg

Organizational unit: Social Medicin
E-mail: Lene.Lindberg@ki.se