Publications (8) View all
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Article: Infant-mother interaction as a predictor of child's chronic health problems.
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ABSTRACT: Psychological stress is associated with physical illnesses like asthma or infections. For an infant, situations perceived as stressful are highly dependent on the relationship with the caregiver. Constantly poor mother-infant interaction increases the child's vulnerability to stressful conditions and experiences. The aim of the study was to investigate the impact of the quality of early mother-infant interaction on the subsequent physical health of the child. Poor mother-infant interaction was hypothesized to be associated with chronic or recurrent health problems in the child. Fifty-seven mother-infant dyads from families at risk of psychosocial problems and 63 from non-risk families, altogether 120 dyads, participated in the study. Families were drawn from normal population, from well-baby clinics in the city of Tampere, Finland. Infants were full-term and healthy, families with severe risks like psychotic illnesses of the parents or a history of child protection concerns were excluded from the study. After the initial interview with the mother, the mother-infant interaction was videotaped when the infants were 8-11 weeks of age and the interaction was assessed using the Global Rating Scale for Mother-Infant Interaction (Murray et al. 1996a). After the 2-year follow-up mothers were interviewed again and the health problems of the child were elicited. Poor dyadic mother-infant interaction and infant's poor interactive behaviour assessed at two months were separately associated with the physical health of the child during the two-year follow-up. After adjusting for other factors in the logistic regression analysis infant's poor interactive behaviour remained as a significant predictor of chronic or recurrent health problems in the child. Infant's health problems at the time of the initial interview and day care centre attendance were also significant predictors. The results suggest that interactional issues between a mother and her infant are related to the child's subsequent physical health. Children with recurrent or chronic health problems may have relationship difficulties with which they need help. Also, early avoidant behaviour of the infant should be regarded as an indicator of the infant's distress with possibly adverse outcomes in the child's physical health, among other consequences.Child Care Health and Development 06/2003; 29(3):181-91. · 1.20 Impact Factor -
Article: The European Early Promotion Project: Description of the Service and Evaluation Study
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ABSTRACT: This chapter describes an innovative cross-cultural method of working with families to promote the psychosocial well-being of children and to prevent the development of psychological and social problems. It also presents a study designed to evaluate the effects of the service. Primary health care workers in five countries from Northern, Central and Southern Europe were trained to conduct promotional interviews with all prospective mothers in their area one month before and one month after birth. They were also taught to work with mothers identified as in need of support as a parent, by using a specific counselling model to try to prevent the onset of child mental health difficulties. Effects of the intervention on children's psychological development and family adaptation were evaluated at two years of age in comparison with matched groups not receiving the intervention, using a set of questionnaires, interviews and observation methods. The total sample of the study at the initial assessment was 824 families, of which 705 (85.6%) were retained for the outcome assessment.The International Journal of Mental Health Promotion. 01/2005; 7(1):17-31. -
Article: Primary Prevention of Child Mental Health Problems using Primary Health Care Professionals: Cost Comparisons
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ABSTRACT: The importance of an economic dimension in the planning, delivery and evaluation of care and support for children and families is widely recognised. We report a cost analysis of a primary prevention programme using primary health care professionals trained to promote the psychosocial adaptation of children from birth. The programme was established in five European centres. We estimated the cost of the intervention in training and supervision for each country, and measured the impact of the intervention on service use and cost two years after the birth of the index child. Total costs incurred by families at comparison sites where no such training was provided were also calculated, and were compared with total costs at intervention sites. Cost differences between countries were also explored. Differences in total costs between the Intervention and Comparison treatment groups were small and did not reach statistical significance. However, total costs varied substantially between countries. Training primary health care professionals in the primary prevention of child mental health problems is found to be inexpensive, and does not appear to affect total costs in the years immediately following the intervention. Given the outcome findings from the study (see other chapters in this special issue), the cost evaluation provides encouragement for the wider establishment and examination of this preventative intervention.The International Journal of Mental Health Promotion. 01/2005; 7(1):95-102. -
Article: Training for Primary Health Care Practitioners
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ABSTRACT: This chapter describes in detail the training course for primary health care practitioners (PHCPs) designed for the needs of the EEP project, aiming to promote parent-infant interaction and to ensure that resources are targeted to those families in need of more support. The course is based on the principles of adult learning models and uses a partnership approach to the helping process, combining the Parent Adviser model, promotional interviewing from the EU/WHO project and the theory and skills of assessing and supporting early parent-infant interaction and the psychosocial development of infants. This chapter provides a step-by-step exposition of how to train PHCPs, stressing the importance of the helper-parent relationship and ways of facilitating parent-child communication. It gives an analytic description of the course content (see also Appendix) and the methods of training. It describes in detail the supervision which followed the training and accompanied the PHCPs throughout the implementation phase, elaborating on the supervisory relationship and the alliance necessary for the supervision to be effective. It finishes with some concluding remarks about the training and the supervision, and their role in the project.The International Journal of Mental Health Promotion. 01/2005; 7(1):41-53. -
Article: Child and Family Outcomes of the European Early Promotion Project
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ABSTRACT: This chapter concerns the outcomes for the families involved in the European Early Promotion Project and presents data collected when the children were between six and eight weeks old and when they were 24 months old. A total of 824 families were recruited from the five countries involved. At baseline, differences were found between country samples in the extent and type of need (Finnish families having the lowest risk factor rates and Serbia the highest, for example), but recruitment was generally successful in including families from the whole range of need, excluding those with the most severe physical and psychiatric problems. Although not randomised, Intervention families (receiving the EEPP service) were reasonably matched with Comparison families (receiving usual services) on most variables initially, except in Greece, where Intervention families were somewhat more at risk. At 24 months, in spite of low intensity of service provision and methodological difficulties likely to reduce effects, there was evidence, particularly in Greece, of differences in outcome favouring the Intervention group, who also showed significantly higher levels of satisfaction with the intervention they had received. It was concluded that the service merits further exploration to assist in understanding promotional and preventative processes.The International Journal of Mental Health Promotion. 01/2005; 7(1):63-81.
