Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda
Residing in poverty-impacted Ugandan communities and raising children with disruptive behavior disorders (DBDs) is associated with above heightened parenting stress. An evidence-based intervention designed to help parents tailor their parenting style to effectively manage children with DBDs was impl...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | SSM - Mental Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666560324000434 |
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| author | Rachel Brathwaite Massy Mutumba Fred M. Ssewamala Ozge Sensoy Bahar Torsten B. Neilands Phionah Namatovu Mary M. McKay Kimberly Hoagwood |
| author_facet | Rachel Brathwaite Massy Mutumba Fred M. Ssewamala Ozge Sensoy Bahar Torsten B. Neilands Phionah Namatovu Mary M. McKay Kimberly Hoagwood |
| author_sort | Rachel Brathwaite |
| collection | DOAJ |
| description | Residing in poverty-impacted Ugandan communities and raising children with disruptive behavior disorders (DBDs) is associated with above heightened parenting stress. An evidence-based intervention designed to help parents tailor their parenting style to effectively manage children with DBDs was implemented in Uganda between 2017 and 2023. At the end of the intervention, caregivers displayed lower levels of parenting stress than controls, however the mechanisms by which stress reduction occurred is unknown. We investigated whether the intervention's effect on parenting stress was mediated by parenting practices, family cohesion, or mental health.Mediation was assessed using Mitchell and Maxwell's cross-lagged auto-regressive approach. Each mediation model regressed the outcome parenting stress score at each time point onto intervention group assignment (0 = Control; 1 = Multiple Family Group (MFG) intervention) and parenting stress score at the preceding time point. Each mediator was investigated one at a time and regressed onto intervention group assignment and the mediator score at the preceding time point. Parenting stress score was also regressed onto the preceding time point mediator score. The residuals for mediators and parenting stress were allowed to correlate at each time point. We included regression pathways from each covariate to the mediators and outcomes at subsequent waves and were included in the model as random variables.The findings show that the intervention had a significant direct effect on parenting stress at 16 weeks post intervention initiation and was partially mediated by parenting practices, caregiver mental health, and parenting stress at 8 weeks, but we found no evidence it was mediated by family cohesion, supporting two of our hypotheses.Equipping caregivers with parenting skills and strategies to improve mental health can go a long way in reducing overall parenting stress among caregivers with DBDs. Our findings could be leveraged to enhance stress reduction among caregivers of children with DBDs in the long-term. |
| format | Article |
| id | doaj-art-aa69a58fc8bc4460907b4705478d58b0 |
| institution | Kabale University |
| issn | 2666-5603 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Mental Health |
| spelling | doaj-art-aa69a58fc8bc4460907b4705478d58b02024-12-13T11:05:08ZengElsevierSSM - Mental Health2666-56032024-12-016100338Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in UgandaRachel Brathwaite0Massy Mutumba1Fred M. Ssewamala2Ozge Sensoy Bahar3Torsten B. Neilands4Phionah Namatovu5Mary M. McKay6Kimberly Hoagwood7International Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, USADepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USAInternational Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, USA; Corresponding author. Brown School, Washington University in St. Louis, MO, 63130, USA.International Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, USADivision of Prevention Science, University of California, San Francisco, CA, 94143, USAInternational Center for Child Health and Development, Masaka, UgandaBrown School, Washington University in St. Louis, MO, 63130, USADepartment of Child and Adolescent Psychiatry at the School of Medicine, New York University, 1 Park Avenue, Seventh Floor, New York, NY, 10016, USAResiding in poverty-impacted Ugandan communities and raising children with disruptive behavior disorders (DBDs) is associated with above heightened parenting stress. An evidence-based intervention designed to help parents tailor their parenting style to effectively manage children with DBDs was implemented in Uganda between 2017 and 2023. At the end of the intervention, caregivers displayed lower levels of parenting stress than controls, however the mechanisms by which stress reduction occurred is unknown. We investigated whether the intervention's effect on parenting stress was mediated by parenting practices, family cohesion, or mental health.Mediation was assessed using Mitchell and Maxwell's cross-lagged auto-regressive approach. Each mediation model regressed the outcome parenting stress score at each time point onto intervention group assignment (0 = Control; 1 = Multiple Family Group (MFG) intervention) and parenting stress score at the preceding time point. Each mediator was investigated one at a time and regressed onto intervention group assignment and the mediator score at the preceding time point. Parenting stress score was also regressed onto the preceding time point mediator score. The residuals for mediators and parenting stress were allowed to correlate at each time point. We included regression pathways from each covariate to the mediators and outcomes at subsequent waves and were included in the model as random variables.The findings show that the intervention had a significant direct effect on parenting stress at 16 weeks post intervention initiation and was partially mediated by parenting practices, caregiver mental health, and parenting stress at 8 weeks, but we found no evidence it was mediated by family cohesion, supporting two of our hypotheses.Equipping caregivers with parenting skills and strategies to improve mental health can go a long way in reducing overall parenting stress among caregivers with DBDs. Our findings could be leveraged to enhance stress reduction among caregivers of children with DBDs in the long-term.http://www.sciencedirect.com/science/article/pii/S2666560324000434Parenting stressDisruptive behavior disordersMediation effectsCaregiversLow resource settings |
| spellingShingle | Rachel Brathwaite Massy Mutumba Fred M. Ssewamala Ozge Sensoy Bahar Torsten B. Neilands Phionah Namatovu Mary M. McKay Kimberly Hoagwood Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda SSM - Mental Health Parenting stress Disruptive behavior disorders Mediation effects Caregivers Low resource settings |
| title | Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda |
| title_full | Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda |
| title_fullStr | Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda |
| title_full_unstemmed | Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda |
| title_short | Exploring mediators of the Amaka Amasanyufu Multiple Family Group Intervention (2016–2022) on parenting stress reduction among caregivers of children with disruptive behavior disorders in Uganda |
| title_sort | exploring mediators of the amaka amasanyufu multiple family group intervention 2016 2022 on parenting stress reduction among caregivers of children with disruptive behavior disorders in uganda |
| topic | Parenting stress Disruptive behavior disorders Mediation effects Caregivers Low resource settings |
| url | http://www.sciencedirect.com/science/article/pii/S2666560324000434 |
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