centering parenting: meeting the needs of parents j. cyne johnston, phd and cheryl macleod, rn med
TRANSCRIPT
Centering Parenting: Meeting the needs of parents
J. Cyne Johnston, PhD and Cheryl MacLeod, RN MEd
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Outline
• Group Parenting Programs• Centering Parenting• Centering Parenting within AHS
– Development– Implementation– Evaluation
• Future Plans
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Transitions
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Traditional One-to-One Support
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Group Care
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Key Concepts for Group Care
Client and Provider
Satisfaction
Family Centered
Care
Facilitative
EmpowermentPeer Support
Capacity Building
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Group Parenting Interventions
• Short-term improvement in parental depression, stress, confidence and anxiety (Barlow, et al. 2012)
• Early support for improvement of child emotional and behavioural adjustment (Barlow et al. 2012)
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Other Supporting Work
• Peer Support for improving breastfeeding duration
(Jolly et al. 2012, Renfrew et al. 2012)
• Early evaluation work from other Centering Parenting programs shows some signs of improved maternal BMI
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Centering Parenting
A model of group care for well-woman and well-baby
» Health assessment» Education» Peer and Professional Support» Immunization
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Each 2 hour session
30- 45 minutes Check-in and individual assessments with the provider
45-60 minutes Formal “circle-up” or facilitated discussion time
30-45 minutes Vaccinations and informal socialization
Closing and follow-up as needed
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Maternal and Infant Self-Assessment
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Provider Assessment
• Each dyad has an individual assessment with the health provider
• Normal triage done
• Questions are saved for the group session
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Group Session
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• 8 parent/infant dyads and 2 PHN facilitators• All activities occur within the group space• The group is conducted in a circle• Each session has an overall plan with core content;
emphasis may vary depending upon the needs of the group
• Group members are involved in self-care activities, weighing, examining, assessing infants and selves.
• Opportunity for socializing within the group is provided• There is on-going evaluation of outcomes
Key Elements of Centering Parenting
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Paradigm Shift
Traditional Care Group Care• Directive• Expert-led• Education random
and provider dependent
• Few opportunities for socialization with others
• Facilitative• Shared ownership of health• More time for education,
shared with all• Opportunity for
socialization, peer-to-peer support
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Centering Parenting in Calgary Public Health Clinics
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Centering Parenting Project within AHS
Stage 1– Received a $10K grant from the Alberta Centre for
Child, Family, and Community Research– Development of the universal program and content
– Focus groups with parents, PHNs, parenting experts
– Adaptation and integration of U.S. Centering Parenting curriculum
– Development of research proposal
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Adapting to local context
• Curriculum• Vaccination delivery system• Public health nursing led• Visit time points: 1,2,4,6,9,12
months
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What have we learned so far…
Parents:
“I didn’t have a support network: other mothers who were feeling the same things I was feeling.”
“The most valuable component is connecting with other parents.”
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What have we learned so far…
PHNs were excited about a new model of providing care and having additional opportunities for professional growth.
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Parenting Experts
There was considerable support from local parenting and child development experts
“[The program] has really good adult learning principles and parenting education practices as well… It’s fabulous.”
“I really think that it’s only getting them there once. Once you get them to [the group] they’re hooked. I truly believe that.”
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Centering Parenting Calgary Zone
Stage 2- Current Work– Received grant from the Alberta
Centre for Child, Family, and Community Research
– Funding for: Staff training and a feasibility study of Centering Parenting for 32 parent/infants in 2 locations
– Recruiting now!!! Intervention to begin November 2013
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Research Questions for the Feasibility Study
Is it feasible to implement a Centering Parenting group intervention In the Alberta context?
How do the pilot results compare to pre-intervention measures, available local data, and/or established
norms?
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Centering Parenting Calgary Zone
Research Methodology– 2 communities selected for pilot – 1 urban (East
Community Health Centre) and 1 suburban/rural (Airdrie)
– Two groups will be run concurrently at each site – 7-8 mother/infant dyads recruited in each group (28-
32 in total)– Families will attend 6 X 2 hour sessions
(@1,2,4,6,9,12 months)
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Centering Parenting Calgary Zone
Data Collection Tools, Measures, Health Indicators
Maternal BMI Program costs
Child growth Qualitative interviews
Social support
Postpartum depression
Parenting moral index
Parent and clinician satisfaction
Parenting stress
Breastfeeding initiation/duration
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Centering Parenting Calgary Zone
Stage 3 – Future Work– Randomized Trial– Additional external
funding will be sought if the pilot is acceptable to PHNs, parents, AHS.
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Challenges
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Shift in Practice
• Moving from directive to facilitative
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Logistical Issues
• Physical space for a group that’s appropriate for groups of parents and infants
• Scheduling and shift changes
• Recruitment of parents
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Stakeholder Support
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Provincial and International Interest
Considerable interest from:• Alberta Health• Centering Healthcare Institute• Other Alberta Health Services Zones• Primary Care Networks
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Key Points
• Early parenthood is a time of great transitions • Group parenting programs have the potential to provide
an effective intervention to improve the health of children, parents, and families
• There is demand for a group well-child visit among parents, PHNs, and parenting experts
• Centering Parenting Pilot is ready for implementation in 2 Calgary-area sites
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Special Thanks to Project Team
• Cheryl MacLeod• Donna Wallace• Shelly Philly• Deborah A. McNeil• Germaeline van der Lee• Kaitlyn Hill• Joanne Coldham• Sandy Phillips • Lynn Headley
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Special Thanks
• Alberta Centre for Child, Family and Community Research
• Alberta Health Services• University of Calgary
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Contact Information
Cyne Johnston
Cheryl MacLeod