Letourneau, NicoleAnis, Lubna2020-08-212020-08-212020-08Anis, L. (2020). Reflective function, maternal-child interaction and child development: impacts of intervention for high risk families, innovative methods, measurement and fidelity assessment (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.http://hdl.handle.net/1880/112417Parents 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.engUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.parental reflective functionmaternal-child interactionchild developmentinterventionrandomized control trialinnovativemethodsvalidityfidelityATTACH™Education--Early ChildhoodMental HealthPublic Healthdoctoral thesis10.11575/PRISM/38104