Josiah King’s research while affiliated with University of Edinburgh and other places

Background: Parental stress occurs when parenting demands are greater than the resources available to cope with parenting. Previous research has identified household wealth, educational level, marital status, age, and number of dependent children as predictors of parental stress. However, limited evidence exists from sub-Saharan Africa (SSA). This study investigated the sociodemographic predictors of parenting stress among mothers in Kenya and Zambia. Methods: Data were obtained from longitudinal nurturing care evaluation studies conducted in rural and urban study sites in Kenya and Zambia. Mean parental stress scores (PSS) were compared across study sites, and multiple regression modelling was used to examine associations between sociodemographic predictors (household income, educational level, marital status, maternal age, child age, number of children aged <5 years) and PSS, adjusting for clustering and other predictors. Results: The mean PSS was lower in rural study sites and higher in urban sites (Kenya rural: 37.6 [SD=11.8], Kenya urban: 48.8 [SD=4.2], and Zambia rural: 43.0 [SD=9.1]). In addition, mothers’ income and educational level were associated with PSS (income: Kenya rural, β = -0.43; 95% CI[-16.07, -5.74]; P =.003**; Kenya urban, β = -0.33; 95% CI[-6.69, -0.80]; P =.01*; education: Kenya rural, β = -0.24; 95% CI[-8.97, -1.68]; P=.005**). Conclusion: Measures to increase education levels, alleviate poverty, and improve household incomes, such as subsidising childcare, improving parental stress levels, and positive parenting practices, lead to better growth and development of their children. Trial registration: PACTR201905787868050 and PACTR20180774832663

Background Previous research has linked prenatal maternal infections to later childhood developmental outcomes and socioemotional difficulties. However, existing studies have relied on retrospectively self-reported survey data, or data on hospital-recorded infections only, resulting in gaps in data collection. Methods This study used a large linked administrative health dataset, bringing together data from birth records, hospital records, prescriptions and routine child health reviews for 55,856 children born in Greater Glasgow & Clyde, Scotland, in 2011-2015, and their mothers. Logistic regression models examined associations between prenatal infections, measured as both hospital-diagnosed prenatal infections and receipt of infection-related prescription(s) during pregnancy, and childhood developmental concern(s) identified by health visitors during 6-8 weeks or 27-30 months health reviews. Secondary analyses examined whether results varied by (a) specific developmental outcome types (gross-motor-skills, hearing-communication, vision-social-awareness, personal-social, emotional-behavioural-attention, and speech-language-communication), and (b) the trimester(s) in which infections occurred. Results After confounder/covariate adjustment, hospital-diagnosed infections were associated with increased odds of having at least one developmental concern (OR: 1.30; 95% CI: 1.19-1.42). This was consistent across almost all developmental outcome types, and appeared to be specifically linked to infections occurring in pregnancy trimesters 2 (OR: 1.34; 95% CI: 1.07-1.67) and 3 (OR: 1.33; 95% CI: 1.21-1.47), i.e. the trimesters in which fetal brain myelination occurs. Infection-related prescriptions were not associated with a significant increase in odds of having at least one developmental concern after confounders/covariate adjustment (OR: 1.03; 95% CI: 0.98-1.08), but were associated with slightly increased odds of concerns specifically related to personal-social (OR: 1.12; 95% CI: 1.03-1.22) and emotional-behavioural-attention (OR: 1.15; 95% CI: 1.08-1.22) development. Conclusions Prenatal infections, particularly those which are hospital-diagnosed (and likely more severe) are associated with early childhood developmental outcomes. Prevention of prenatal infections, and monitoring of support needs of affected children, may improve childhood development, but causality remains to be established. Key Points Previous studies suggest that prenatal infections, and the maternal immune activation that comes with them, are associated with child developmental outcomes. However, research to date has been based on infections data that is either self-reported or included infections diagnosed in hospital only. This study examined associations between prenatal infections, measured by both hospital-diagnosed infections and receipt of infection-related prescriptions, and child developmental concerns identified by health visitors at ages 6-8 weeks and 27-30 months. Hospital-diagnosed prenatal infections were consistently associated with developmental concerns. Maternal receipt of infection-related prescriptions during pregnancy were also associated with developmental concerns, but only those related to personal-social and emotional-behavioural-attention development. This suggests that prenatal infections, particularly severe infections, are associated with early childhood developmental outcomes.

Objectives Previous research suggests that prenatal maternal infections may be linked to later childhood neurodevelopmental outcomes and socioemotional difficulties. We exploited a large linked administrative health dataset to examine relationships between prenatal infections and early childhood development outcomes in Greater Glasgow & Clyde (GGC), Scotland. Methods We used population data from birth records, hospital records, prescriptions and routine child health reviews for 55,856 children born in GGC, 2011-2015, and their mothers. Logistic regression models were used to examine the relationship between prenatal infections, measured as both hospital-diagnosed prenatal infections and receipt of infection-related prescription(s) during pregnancy, and having adverse childhood development outcomes identified by health visitors during 6-8 weeks/27-30 months routine child health reviews. Secondary analysis examined whether results varied by (a) specific development outcome types (i.e. gross-motor-skills, hearing-communication, vision-social-awareness, personal-social, emotional-behavioural-attention, and speech-language-communication development), and (b) the trimester(s) in which infections occurred. ResultsAfter adjusting for confounders/covariates, hospital-diagnosed infections were associated with increased odds of having at least one adverse development outcome identified during child health reviews (OR: 1.30; 95% CI: 1.19-1.42). This relationship was consistent across almost all development outcome types, and appeared to be specifically linked to infections occurring in trimesters 2 (OR: 1.34; 95% CI: 1.07-1.67) and 3 (OR: 1.33; 95% CI: 1.21-1.47), i.e. the trimesters in which fetal brain myelination occurs. Infection-related prescriptions were not associated with a significant increase in odds of having at least one adverse development outcome after adjusting for confounders/covariates (OR: 1.03; 95% CI: 0.98-1.08), but were associated with slightly increased odds of adverse outcomes specifically related to personal-social (OR: 1.12; 95% CI: 1.03-1.22) and emotional-behavioural-attention (OR: 1.15; 95% CI: 1.08-1.22) development. Conclusion Prenatal infections, particularly those which are hospital-diagnosed and therefore likely to be more severe, are associated with early childhood development outcomes. Our study highlights the usefulness of Scotland’s administrative health data in measuring childhood development. Future research will examine the impact of COVID-19 prenatal infections and lockdown measures.

Background Parental stress often arises when parenting demands exceed the expected and actual resources available for the parents to succeed in the parenting role. Parental stress is an important contributor to parent-child relationships. This in turn affects opportunities to engage their children in stimulating activities which could improve children’s development outcomes. However, limited evidence exists from sub-Saharan Africa (SSA) on the association between parental stress, caregiving practices and child developmental outcomes. Methods The findings reported in this paper were derived from data collected through previously conducted longitudinal nurturing care evaluation studies in Kisumu and Nairobi Counties in Kenya, and Chisamba District in Zambia. A total of 341 caregivers and their children who participated in the three rounds of data collection were included in this study. A Random Intercept Cross-Lagged Panel model (RI-CLPM) was used to determine the association between caregivers’ parenting stress, child stimulation practices, and child developmental outcomes. Results The findings showed that caregiver stimulation practices were positively associated with children’s developmental outcomes. The findings on the associations between parental stress and caregiver’s stimulation practices and children’s developmental outcomes were not universally supported. Conclusion The findings show that improved caregiver stimulation practices are likely to improve children’s developmental outcomes. The policy implications of the findings from this study focus on improving parenting practices by addressing predictors of parental stress. This includes creating awareness and subsidising childcare services to alleviate the costs related to childcare. Trial registration PACTR20180774832663

Traditionally attention deficit hyperactivity disorder (ADHD) has been conceptualised as a childhood condition; however, there is growing recognition that ADHD symptoms also commonly impact adults. Research has also highlighted considerable individual differences in ADHD symptom trajectories from childhood to adulthood. To better illuminate the lifespan development of ADHD symptoms, psychometric measures of ADHD symptoms are needed that can capture symptoms reliably, validly, and comparably from childhood to adulthood in research studies. Few such measures exist; however, the items of the ADHD subscale of the Social Behavior Questionnaire (SBQ-ADHD) provide strong candidates for an existing measure that can meet this need. In this study we evaluate the psychometric properties of the self-report version of the SBQ-ADHD as administered in adulthood (ages 20 and 24) to a large normative sample. We also examine the cross-informant (parent-teacher-self- reports) and developmental (age 7-24) measurement invariance of a core SBQ-ADHD item set. Results suggest that support for the SBQ-ADHD scores as a measure of adult ADHD symptoms in terms of internal consistency reliability, gender measurement invariance, and convergent validity. Items from the core set showed evidence of non-invariance for specific ages and informants, providing insights into how ADHD symptoms may manifest and/or be perceived differently by different informants and at different ages. Overall, however, results suggest that a partial invariance measurement model using the core item set could support longitudinal/cross-informant ADHD research spanning childhood to adulthood. Taken together, our findings support the use of the SBQ-ADHD items for developmental studies of ADHD symptoms from childhood to adulthood.

Introduction: Parental stress occurs when parenting demands are greater than the resources available to cope with parenting. Factors including household wealth, educational level, marital status, age and the number of children under the care of a parent have been indicated as predictors of parental stress. However, there is limited evidence from sub-Saharan Africa (SSA) on these associations. This work provides an understanding of parental stress in SSA and improves the conceptualization and implementation of maternal mental health-related interventions. Methods: Data was derived from longitudinal nurturing care evaluation studies conducted in Kisumu and Nairobi Counties in Kenya, and Chisamba District in Zambia. A linear regression model adjusting for clustering and covariates was used to determine the association between caregivers’ parenting stress and their socio-demographic characteristics. Results: The mean parental stress scores were slightly below the average in the rural study sites and slightly above the average in the urban study site (Kenya rural; 37.6 (11.8), Kenya urban; 48.8 (4.2) and Zambia rural; 43.0 (9.1). In addition, parental stress was associated with at least four factors; caregivers’ income, their age, their level of education and the age of their child (income: Kenya rural; β = -0.285, P < .01**, Kenya urban; β = -0.179, P = .02* and education: Kenya rural; β = -0.192, P < .01**, Kenya urban; β = -0.148, P = .01*). Conclusion: The policy implications of the findings from this study include improving maternal mental health through poverty alleviation-related interventions, improving caregivers parenting knowledge and improving the provision of childcare services in poor urban and rural settings. Trial registration: PACTR201905787868050 and PACTR20180774832663

Background: Parental stress occurs when parenting demands are greater than the resources available to cope with parenting. Previous research has identified household wealth, educational level, marital status, age, and number of dependent children as predictors of parental stress. However, limited evidence exists from sub-Saharan Africa (SSA). This study investigated the sociodemographic predictors of parenting stress among mothers in Kenya and Zambia. Methods: Data were obtained from longitudinal nurturing care evaluation studies conducted in rural and urban study sites in Kenya and Zambia. Mean parental stress scores (PSS) were compared across study sites, and multiple regression modelling was used to examine associations between sociodemographic predictors (household income, educational level, marital status, maternal age, child age, number of children aged <5 years) and PSS, adjusting for clustering and other predictors. Results: The mean PSS was lower in rural study sites and higher in urban sites (Kenya rural: 37.6 [SD=11.8], Kenya urban: 48.8 [SD=4.2], and Zambia rural: 43.0 [SD=9.1]). In addition, mothers’ income and educational level were associated with PSS (income: Kenya rural, β = -0.43; 95% CI[-16.07, -5.74]; P =.003**; Kenya urban, β = -0.33; 95% CI[-6.69, -0.80]; P =.01*; education: Kenya rural, β = -0.24; 95% CI[-8.97, -1.68]; P=.005**). Conclusion: Measures to increase education levels, alleviate poverty, and improve household incomes, such as subsidising childcare, improving parental stress levels, and positive parenting practices, lead to better growth and development of their children. Trial registration: PACTR201905787868050 and PACTR20180774832663