Browsing by Author "Anis, Lubna"
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- ItemOpen AccessMaternal sensitivity and social support protect against childhood atopic dermatitis(Springer Nature, 2017-05-26) Letourneau, Nicole Lyn; Kozyrskyj, Anita L.; Cosic, Nela; Ntanda, Henry N.; Anis, Lubna; Hart, Martha J.; Campbell, Tavis S.; Giesbrecht, G. F.; APrON Study TeamBackground: Many studies have identified associations between qualities of maternal–child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal–infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. Methods: We conducted a secondary analysis of data collected on a sub-sample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrolment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. Results: Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. Conclusions: Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal–infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.
- ItemOpen AccessMaternal sensitivity and social support protect against childhood atopic dermatitis(2017-05-26) Letourneau, Nicole L; Kozyrskyj, Anita L; Cosic, Nela; Ntanda, Henry N; Anis, Lubna; Hart, Martha J; Campbell, Tavis S; Giesbrecht, Gerald FAbstract Background Many studies have identified associations between qualities of maternal–child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal–infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. Methods We conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. Results Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. Conclusions Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal–infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.
- ItemOpen AccessReflective Function, Maternal-Child Interaction and Child Development: Impacts of Intervention for High Risk Families, Innovative Methods, Measurement and Fidelity Assessment(2020-08) Anis, Lubna; Letourneau, Nicole; Benzies, Karen Marie; Ewashen, Carol J.Parents suffering from toxic stressors (depression, addictions, family violence) are often unable to respond sensitively to their infants. Such early, persistent stress is understood to interfere with infant brain development, placing infants at risk for health and developmental problems over their lifespan. Parental sensitivity is also influenced by parental Reflective Function (RF), the ability to envision mental states in oneself and one’s child. While many modern parenting programs aim to improve parental sensitivity to their infants to promote healthy child development, parental RF is a commonly missing component. Parental RF is modifiable by intervention and predicts improvements in maternal sensitivity and responsiveness and infant attachment security, thus clearly beneficial. However, the link between an intervention aimed at improving parental RF and child development is unexplored. Given the importance of the early years for children’s development, improved interventions for vulnerable children and families have become public health imperatives. My doctoral research sought to examine the effectiveness of an innovative parenting program called Attachment and Child Health (ATTACHTM) on parent-child interaction and child development. In this manuscript-based dissertation, the first manuscript presents the results from the ATTACHTM pilot studies, demonstrating that ATTACHTM improved outcomes. The ATTACHTM pilots employed new accelerated methods to combat time- and cost-related challenges associated with traditional randomized controlled trials. Therefore, in my second manuscript, I undertook a realist review comparing innovative methods for intervention evaluation with traditional randomized controlled trial (RCT) methods in their ability to test, mobilize knowledge and provide recommendations for best approaches to promote child health. In my third manuscript, I compared the validity of different tools to measure RF, given the increasing need for effective, efficient rapid assessment in wide-ranging settings. Finally, I prepared a manuscript on the need to deliver evidence-based programs to promote early childhood development with fidelity. I developed and assessed an intervention fidelity tool for community nursing research by using the ATTACHTM intervention as an exemplar. My dissertation concludes with a summary of the research findings, and recommendation for nursing research, policy and practice.
- ItemOpen AccessStudy protocol for Attachment & Child Health (ATTACHTM) program: promoting vulnerable Children’s health at scale(2022-08-19) Anis, Lubna; Letourneau, Nicole; Ross, Kharah M.; Hart, Martha; Graham, Ian; Lalonde, Simone; Varro, Suzanna; Baldwin, Alanna; Soulsby, Angela; Majnemer, Annette; Donnelly, Carlene; Piotrowski, Caroline; Collier, Carrie; Lindeman, Cliff; Goldowitz, Dan; Isaac, Dawn; Thomson, Denise; Serré, Diane; Citro, Elisabeth; Zimmermann, Gabrielle; Pliszka, Harold; Mann, Jackie; Baumann, Janine; Piekarski, Joanna; Dalton, Jo-Anne; Johnson-Green, Joy; Wood, Karen; Bruce, Marcia; Santana, Maria; Mayer, Matt; Gould, Meghan; Kobor, Michael; Flowers, Michelle; Haywood, Michelle; Koerner, Michelle; Parker, Nancy; Muhajarine, Nazeem; Fairie, Paul; Chrishti, Rabea; Perry, Robert; Merrill, Sarah; Pociuk, Shellie; StephanieTaylor; Cole, Steve; Murphy, Tim; Marchment, Tmira; Xavier, Virginia; Shajani, Zahra; West, ZoeAbstract Background Children’s exposure to toxic stress (e.g., parental depression, violence, poverty) predicts developmental and physical health problems resulting in health care system burden. Supporting parents to develop parenting skills can buffer the effects of toxic stress, leading to healthier outcomes for those children. Parenting interventions that focus on promoting parental reflective function (RF), i.e., parents’ capacity for insight into their child’s and their own thoughts, feelings, and mental states, may understand help reduce societal health inequities stemming from childhood stress exposures. The Attachment and Child Health (ATTACHTM) program has been implemented and tested in seven rapid-cycling pilot studies (n = 64) and found to significantly improve parents’ RF in the domains of attachment, parenting quality, immune function, and children’s cognitive and motor development. The purpose of the study is to conduct an effectiveness-implementation hybrid (EIH) Type II study of ATTACHTM to assess its impacts in naturalistic, real-world settings delivered by community agencies rather than researchers under more controlled conditions. Methods The study is comprised of a quantitative pre/post-test quasi-experimental evaluation of the ATTACHTM program, and a qualitative examination of implementation feasibility using thematic analysis via Normalization Process Theory (NPT). We will work with 100 families and their children (birth to 36-months-old). Study outcomes include: the Parent Child Interaction Teaching Scale to assess parent-child interaction; the Parental Reflective Function and Reflective Function Questionnaires to assess RF; and the Ages and Stages Questionnaire – 3rd edition to examine child development, all administered pre-, post-, and 3-month-delayed post-assessment. Blood samples will be collected pre- and post- assessment to assess immune biomarkers. Further, we will conduct one-on-one interviews with study participants, health and social service providers, and administrators (total n = 60) from each collaborating agency, using NPT to explore perceptions and experiences of intervention uptake, the fidelity assessment tool and e-learning training as well as the benefits, barriers, and challenges to ATTACHTM implementation. Discussion The proposed study will assess effectiveness and implementation to help understand the delivery of ATTACHTM in community agencies. Trial registration Name of registry: https://clinicaltrials.gov/. Registration number: NCT04853888 . Date of registration: April 22, 2021.