Deborah a Gross

• Johns Hopkins University

Background Social, emotional and behavioural (SEB) problems are among the most common chronic disabilities affecting children growing up in poverty. They also have implications for children’s school success as they affect essential social-emotional learning skills such as the ability to comply with rules, regulate emotions and get along with others...

Cervical cancer is the leading cause of cancer-related deaths among women in Sub-Saharan Africa, especially in rural areas with limited access to screening. This study examined factors influencing rural Kenyan women's willingness to self-collect samples for HPV-DNA testing. Data were drawn from a mixed-methods study in two Kenyan rural Couties, inc...

Parenting programs may mitigate adverse childhood experiences (ACEs) and promote positive childhood experiences (PCEs), yet they can be stigmatizing and difficult to access in under‐resourced communities. We explored whether a trauma‐informed, evidence‐based parenting program (Chicago Parent Program; CPP) offered universally in public schools in hi...

Background Globally, 10% of children and adolescents live with mental health problems and often lack high-quality care. Over 80% of people facing mental health issues reside in low- and middle-income countries (LMICs). Failing to address children's mental health may prolong these challenges into adulthood, impeding their chances for a healthy life....

Background: Research on adverse childhood experiences (ACEs) often reports lower prevalence among Asian Americans compared to other racial and ethnic groups. However, most studies fail to account for the socioeconomic inequality and cultural heterogeneity in Asian

A better understanding of factors influencing who receives disability support services through an Individualized Education Program (IEP) or a Section 504 Accommodation Plan from the Rehabilitation Act of 1973 (504 plan) and when is needed. This study used administrative data from11,405 students enrolled in 121 Baltimore City Schools (51% male; 85%...

Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental...

Postpartum depression (PPD) is a common mental health issue in resource‐limited settings that negatively affects the well‐being of mothers and children. However, PPD often remains untreated, leading to long‐term consequences for families. Therefore, we examined the prevalence and determinants of PPD among adolescent and adult mothers in northwest E...

BACKGROUND Parent training (PT) interventions support and strengthen parenting practices and parent-child relationships and improve child behavior. Between 2017 and February 2020, a community-based parenting program conducted 38 in-person groups Chicago Parent Program (CPP) groups. In response to the COVID-19 pandemic, we modified the delivery of t...

Background Parent training interventions support and strengthen parenting practices and parent-child relationships and improve child behavior. Between March 2018 and February 2020, a community-based parenting program conducted 38 in-person Chicago Parent Program (CPP) groups. In response to the COVID-19 pandemic, we modified the delivery of the in-...

Group-based parent training (PT) is an evidence-based approach for strengthening parenting skills and reducing child behavior problems. However, there has been little research on the social connectedness (SC) formed among PT participants, particularly in low-income communities where parents may be more socially isolated. This study describes SC for...

Background Little is known about the cost-effectiveness of parent training programs when offered universally in U.S. elementary schools in disadvantaged urban communities. Objective To estimate the cost-effectiveness of a universal school-based implementation study of the Chicago Parent Program (CPP). Methods CPP was offered universally from 2014...

Group‐based parent‐training (PT) is one of the most common and well‐established approaches for strengthening parenting skills and reducing child behavior problems. When offered in school settings, the social connections formed among participants may generate additional benefits for parents, schools, and children. However, to date there has been lim...

Adverse childhood experiences (ACEs) are prevalent, costly, and associated with poor health outcomes in adults. Little is known about ACE prevalence rates or strategies for measuring ACEs among young adults in Mainland China. The aims of this study were to (a) translate the ACE-International Questionnaire (ACE-IQ) into Simplified Chinese, (b) asses...

This study evaluated the validity of the Parent Engagement in Early Childhood Education (PEECE) Survey as an equitable measure of parent engagement in early childhood education that would address limitations of existing parent-report measures for use in urban schools in high poverty neighborhoods. We examined the PEECE Survey factor structure; item...

Social isolation has been linked to numerous health risks, including depression and mortality. Parents raising children in low-income and under-resourced communities are at an increased risk for experiencing social isolation and its negative effects. Social connectedness (SC), one's sense of belongingness and connection to other people, or a commun...

Aim: The aims of this study were to examine the prevalence of adverse childhood experiences (ACEs) among health science students in China; associations between the number of ACE exposures and severity of depressive and anxiety symptoms; and the extent to which resilience moderates the effect of ACEs on mental health outcomes. Design: This descripti...

This scoping review summarizes and consolidates the parenting goals for young children captured in existing parent-report measures, and the characteristics of studies that employed them. Five electronic databases were systematically searched to identify original studies that used a self-report measure for parenting goals during the child's first 5...

This study examined associations between four indicators of social determinants of health (SDOH; parent education, poverty, material hardships, and child health problems), chronic school absence, and teachers' ratings of parents' engagement in their children's education. Surveys were collected from 304 parents and 26 teachers from eight Baltimore C...

The purpose of this study was to identify indicators of parent engagement in early learning that would be relevant for children's academic success; equitable for all families regardless of social, educational, or economic backgrounds; and actionable for urban school districts seeking to promote parent engagement with limited resources. Using a Delp...

Despite the evidence and investment in evidence-based federally funded maternal, infant, and early childhood home visiting, substantial challenges persist with parent involvement: enrolling, engaging, and retaining participants. We present an integrative review and synthesis of recent evidence regarding the influence of multi-level factors on paren...

Objectives Parent engagement in early learning has historically been defined quite broadly and it is unclear whether those designing, implementing, evaluating, or participating in parent engagement initiatives conceptualize parent engagement in the same way. Lack of consensus could contribute to poor quality of parent-school partnerships and relian...

Objectives Children of teen parents are at increased risk for developmental delays which impact a host of social outcomes. Maternal executive function (EF) has previously been identified as an essential contributor to quality parenting directly and child development indirectly. Further, evidence of intergenerational transmission of EF combined with...

Background Parent training is a method for strengthening parenting skill, reducing child behavior problems, and promoting positive parent-child relationships. However, few parents have access to these evidence-based programs. The ezParent program, a tablet-based delivery adaptation of the group-based Chicago Parent Program (CPP), is a parent traini...

Background Approximately 8% to 10% of children younger than 5 years of age experience emotional, behavioral, and social relationship problems. These children are more likely to exhibit poor social interactions, problematic parent–child relationships, and school related setbacks, thus reinforcing the need for early interventions such as parent train...

BACKGROUND: Parent training is a method for strengthening parenting skills, reducing child behavior problems, and promoting positive parent–child relationships. However, few parents have access to these evidence-based programs. The ezParent program, a tablet-based delivery adaptation of the group-based Chicago Parent Program, is a parent training p...

Although financial incentives are a well-accepted strategy for raising parent participation rates in prevention studies, they are rarely employed in practice due to concerns about their ethics, sustainability, and public acceptability. We sought to address these common concerns in the context of a larger prevention study using financial incentives...

Objective: This pragmatic, randomized, non-inferiority trial compared the effectiveness and cost of group-based parent management training with mastery-based individual coaching parent management training in a low-income, predominantly African American sample. Method: Parents seeking treatment for their 2- to 5-year-old children's behavior probl...

Social determinants of health (SDOH) refer to the social, economic, and physical conditions in which people live that may affect their health. Poverty, which affects nearly 15 million children in the United States, has far-reaching effects on children's physical and mental health. Although it is difficult to change a family's economic circumstances...

Over 2 million children in the US have uncontrolled asthma. African American children are disproportionately affected with a risk of dying from asthma that is 7.6 times higher than non‐Hispanic White children. Racial disparities in childhood asthma are partially attributed to differential exposures to poverty; unsafe and stressful neighborhoods; an...

Young children first develop the social–behavioral skills needed to succeed in school from parents. However, most school-based interventions designed to bolster children’s social–behavioral skills have focused on strengthening teachers’ skills. This study examined the extent to which a 12-session group-based program for strengthening parenting skil...

OBJECTIVES/SPECIFIC AIMS: This case-control study aims to determine the relationships among childhood adversity, attachment style, and the likelihood of accepting or declining a referral for HV. The study will serve as a pilot to inform the power analysis of a subsequently proposed full-scale study. METHODS/STUDY POPULATION: Using a case-control st...

Purpose: To examine perceptions of what mothers of young children (birth to 5 years old) need to be a "good parent" while their military spouse is deployed. Design: Q methodology was used to uncover different views on military spouses' parenting needs. Methods: In Phase 1, 18 statements related to military spouses' parenting needs were elicite...

We examined whether parent engagement in parent training (PT) differed based on PT format (parent group-based with video versus mastery-based individual coaching with child) in an economically disadvantaged sample of families seeking behavioral treatment for their preschool children in an urban mental health clinic. Parents (N = 159; 76.1% mothers,...

In 2010, the Institute of Medicine released a landmark report, “The Future of Nursing: Leading Change, Advancing Health,” calling for a transformation of the nursing profession in education, leadership, and practice (Institute of Medicine [IOM], 2010). Consistent with the call to transform nursing and its role in health and health care, the America...

Background: Parents' involvement in their children's education is integral to academic success. Several education-based organizations have identified recommendations for how parents can best support their children's learning. However, executive functioning (EF), a high-ordered cognitive skill set, contributes to the extent to which parents can fol...

Social, emotional, and behavioral skills are foundational to learning and long-term success. However, poverty and exposure to adverse childhood experiences reduce the chances of children entering kindergarten socially-behaviorally ready to learn. This study examined the unique impact of 5-year-old children (N = 11,412) entering kindergarten not soc...

Children born to teen mothers may experience less responsive and supportive parenting and are at heightened risk for a range of social, developmental, and health issues. There is literature to support the positive impact of grandmothers on teen parents and their children. However, what if the teen's mother is also limited in her parenting capacitie...

Entry into the child protection system in the US begins with a child maltreatment report. Some evidence suggests that report source and child age are related to report outcomes, but there has been no national study of these relationships. The purpose of this secondary data analysis was to describe the distribution of report sources for child physic...

OBJECTIVES/SPECIFIC AIMS: The purpose of this study is to understand factors that are associated with identifying which eligible pregnant women in Baltimore City accept a referral for HV services. Taking into account demographic and obstetrical variables, we will examine the extent to which 13 medical and 14 psychosocial risk factors differentiate...

Objectives: To examine the relationships between universal mandatory reporting (UMR), child physical abuse reporting, and the moderating effect of UMR on physical abuse report outcomes by report source. Methods: We used a national data set of 204 414 children reported for physical abuse in 2013 to compare rates of total and confirmed reports by...

This mixed method study examined factors associated with parents not attending their child’s mental health treatment after initially seeking help for their 2–5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents wh...

Background Parenting programs integrating general parenting and health behaviour messaging may be an effective childhood obesity prevention strategy. The current study explored workplaces as an alternate setting to deliver parenting programs. Methods This study involved two phases. The objective of the first phase was to explore interest in and pre...

Purpose: African American (AA) fathers who live apart from their children face multiple obstacles to consistent and positive involvement with their children. Consequently, significant numbers of children are bereft of their father's positive involvement. Intervention research that is explicitly focused on promoting the positive involvement of non-...

Background: Parent training programs are traditionally delivered in face-to-face formats and require trained facilitators and weekly parent attendance. Implementing face-to-face sessions is challenging in busy primary care settings and many barriers exist for parents to attend these sessions. Tablet-based delivery of parent training offers an alte...

Objective: To test the feasibility, acceptability and preliminary impact of Parents and Tots Together (PTT), a family-based obesity prevention intervention, in Canada. Participants: Canadian parents of preschoolers (aged 2-5 years). Setting: Ontario Early Years centres in southwestern Ontario. Intervention: A pilot randomized controlled tria...

Dating violence is a serious and prevalent public health problem that is associated with numerous negative physical and psychological health outcomes, and yet there has been limited evaluation of prevention programs on college campuses. A recent innovation in campus prevention focuses on mobilizing bystanders to take action. To date, bystander prog...

Objective: To assess the extent to which an obesity prevention intervention that embeds obesity-related messages within a parenting program, compared with controls who received weekly mailings, resulted in a smaller increase in children's BMI (primary outcome) and improvements in weight-related behaviors from baseline to 9-month follow-up. Method...

Parents' use of praise and criticism are common indicators of parent-child interaction quality and are intervention targets for mental health treatment. Clinicians and researchers often rely on parents' self-reports of parenting behavior, although studies about the correlation of parents' self-reports and actual behavior are rare. We examined the c...

More than 40% of children in military families are <6 years old, a period when children are most dependent on their parents' physical and emotional availability. This systematic review describes the impact of deployment since 9/11 on the mental health of military families with young children, evaluates evidence-based interventions for military pare...

To explore the association of experiencing death, trauma, and abuse during childhood with depressive symptoms and quality of life at mid-life among incarcerated men and to understand how current social support and coping strategies mediate the impact of childhood trauma histories on mental health. Study participants were 192 male inmates in a maxim...

The perception and use of physical discipline (PD) is culture-based, and the differentiation between PD and abuse is subjective and complex. The purpose of this study was to understand how Chinese American mothers and one group of mandated reporters of child abuse (i.e. pediatric nurses) differentiate PD from abuse. Using Q-methodology, 3 viewpoint...

Nurses are mandated to report suspected cases of child maltreatment. However, it is unclear how nurses decide what constitutes child abuse or evidence for reporting. It is crucial to examine how nurses define various forms of child maltreatment, including child abuse and its differentiation from physical discipline, to enhance our services to famil...

Developing innovative delivery methods is needed to overcome time and logistic barriers to in-person participation in evidence-based parent training (PT) programs. The purpose of this paper is to (a) describe the systematic process for adapting an evidence-based group PT program (the Chicago Parent Program) to a tablet-based delivery format, (b) pr...

Nearly 25% of young children in the United States are living in poverty, and a disproportionate number of those children are African American or Latino (Children’s Defense Fund, 2011). Living in poverty is stressful and it increases the likelihood that children will have more developmental, academic, and mental health problems than their more econo...

Background: Extant research has demonstrated that compared to adults with insecure attachment styles, more securely attached parents tend to be more responsive, sensitive, and involved parents resulting in improved behavioral outcomes for their children. Whereas there is an extensive research literature on the role of maternal attachment style in e...

Introduction: There is a gap between the theoretical potential of evidence-based programs (EBPs) designed to prevent emotional and behavioral problems of children, and the actual impact these EBPs have in society. One reason for this gap are issues related to delivery platforms, the ability to reach families, and sustain and maintain intervention f...

Background Alternative delivery methods to implement evidence-based parent training programs are emerging to address barriers related to parent attendance in face-to-face administration. The purpose of this systematic review is to summarize and critically evaluate the research on the use of technology and digital delivery methods for parenting trai...

Untreated behavioral and mental health problems beginning in early childhood are costly problems affecting the long-term health and wellbeing of children, their families, and society. Although parent training (PT) programs have been demonstrated to be a cost-effective intervention modality for treating childhood behavior problems, they have been le...

The purpose of this study was to describe clinician-observed, naturally occurring temper tantrums in preschoolers ages 2 to 5.5 diagnosed with severe behavior problems. Participants were 24 mother-child dyads enrolled in an intensive outpatient treatment program. Clinicians timed and observed 330 temper tantrums, rated their intensity, and recorded...

Extant research has demonstrated that compared to adults with insecure attachment styles, more securely attached parents tend to be more responsive, sensitive, and involved parents, resulting in improved outcomes for their children. Less studied is the influence of a mother's attachment style on her attachment to her unborn child during pregnancy a...

Introduction: Considerable evidence shows that behavioral parent training (PT) interventions are effective in preventing child behavior problems. However, program efficacy – when delivered in face-to-face formats – is reduced due to low enrollment and group attendance. Developing innovative approaches to service delivery are needed to overcome time...

Low enrollment and participation are common in face-to-face parenting interventions. Developing innovative delivery methods is one way to address participation barriers. The purpose of this study was to test the feasibility of a Web-based delivery model for an evidence-based behavioral parent training program. Parents (n = 9) completed two Web-base...

Data were merged from two prevention randomized trials testing 1-year outcomes of a parenting skills program, the Chicago Parent Program (CPP) and comparing its effects for African-American (n = 291) versus Latino (n = 213) parents and their preschool children. Compared to controls, intervention parents had improved self-efficacy, used less corpora...

In this article, we describe the development and feasibility evaluation of Parents and Tots Together (PTT), a family-based obesity prevention intervention that embeds weight-related messages within a general parenting programme. To inform the development of PTT, we conducted 5 focus groups with 19 racially/ethnically diverse parents to examine pare...

To examine and describe the influence of maternal depressive symptoms on maternal-fetal attachment (MFA) in predominantly low-income women. Mixed method. Three urban obstetric/gynecologic (OB/GYN) clinics serving predominantly low-income women. A convenience sample of 166 women participated in the quantitative component and a purposeful subsample o...

This descriptive, retrospective study examined patient and event characteristics associated with multiple seclusion and restraint (SR). The goal was to identify patient characteristics of multiple seclusion and restraint users to improve patient care and decrease the need for seclusion or restraint. Medical charts were reviewed for 63 patients hosp...

Maternal-fetal attachment (MFA) has been associated with health practices during pregnancy, but less is known about this relationship in low-income women, and no identified studies have examined this relationship to neonatal outcomes. This longitudinal descriptive study was conducted to examine the relationships among MFA, health practices during p...

The purpose of this study was to investigate combat-related post-traumatic stress symptoms (PTSS) and couple relationships in Army couples. US Army combat veteran couples (N = 66 couples) completed self-report questionnaires on couple functioning, coercion, resilience, and PTSS. In 23% of the couples (n = 15), both members had PTSS above the clinic...

The Food and Drug Administration has approved the use of antipsychotic medications in some children and adolescents with severe emotional and behavioral disorders. However, recent national data show a dramatic rise in off-label and Food and Drug Administration-approved uses of these medications. Of particular note is a twofold to fivefold increase...

We tested the cost-effectiveness of giving low-income parents childcare discounts contingent on their participation in the Chicago Parent Program, a 12-session preventive parent training (PT) program offered at their child's daycare center. Eight centers were matched and randomized to an experimental condition in which parents received a discount o...

Background: IPV during pregnancy affects .9% to 17% of U.S. women and significantly impacts maternal mental health and neonatal health with higher rates of low birth weight and preterm birth. Gaps in the literature remain concerning relationships between maternal mental health, IPV, and adverse neonatal outcomes. This mixed-methods study is one of...

Aims: Preventive parent training (PT) can be highly effective for improving parenting and reducing child behavior problems. However, enrollment and attendance rates in prevention studies tend to be very low, particularly among ethnic minority families from economically disadvantaged communities. This study tested the effect of using childcare disco...

Establishing the feasibility and validity of implementation fidelity monitoring strategies is an important methodological step in implementing evidence-based interventions on a large scale. The objective of the study was to examine the reliability and validity of the Fidelity Checklist, a measure designed to assess group leader adherence and compet...

Implementation fidelity is the degree to which an intervention is delivered as intended and is critical to successful translation of evidence-based interventions into practice. Diminished fidelity may be why interventions that work well in highly controlled trials may fail to yield the same outcomes when applied in real life contexts. The purpose o...

Depression among Mexican immigrant women and children exceeds national prevalence rates. Given the influence of maternal depression on children, a clinical trial testing the effects of the Mexican American Problem Solving (MAPS) program was designed to address depression symptoms of Mexican immigrant women and their fourth and fifth grade children...

This study tested the efficacy of a 12-session parent training program, the Chicago Parent Program (CPP), which was developed in collaboration with African American and Latino parents. Using growth curve modeling, data were analyzed from 253 parents (58.9% African American, 32.8% Latino) of 2-4 year old children enrolled in seven day care centers s...

Disruptive behavior problems in young children are the number one reason for referral to mental health agencies. However, owing to difficulties differentiating clinically significant disruptive behaviors from typical development, a significant proportion of young children with disruptive behavior problems go unidentified and untreated. Research sup...

This article highlights issues and presents strategies for conducting intervention research in highly unstable environments such as schools, critical care units, and long-term care facilities. The authors draw on their own experiences to discuss the challenges that may be encountered in highly unstable settings. The concept of validity provides a f...

While a growing number of researchers are addressing the high rates of depression and suicidal ideation among Latinos in epidemiological studies and clinical trials, there remains an issue regarding screening for mental health problems and subsequent follow-up. The purpose of this presentation is to describe the referral practices, follow-up comple...

This study examined how parents from different racial/ethnic, income, and language groups viewed two widely used parent-report measures of child behavior problems, the Child Behavior Checklist and the Eyberg Child Behavior Inventory. Seventy African American, Latino, and non-Latino Caucasian parents of preschoolers stratified by income met in 1 of...

Many social and economic policies have been developed to increase fathers' involvement with their children. Yet, we know little about the meaning of involvement for African-American non-resident fathers. The purpose of this study was to obtain African-American non-resident fathers' perspectives on involvement and perceptions of their involvement. S...

Although the majority of young children growing up in low-income communities will not experience mental health problems, a proportion of children will develop problems that can be painful for families and costly to society. There is growing consensus that preventive interventions in the first 5 years of life are the most cost-effective strategy for...

This study evaluated the reliability, equivalence, and convergent validity of the Eyberg Child Behavior Inventory (ECBI) in 682, 2- to 4-year-old children. For analysis, parent informants' data were blocked by race/ethnicity (African-American, Latino, non-Latino White), family income (low versus middle/upper), child's gender, and ECBI language vers...