Centering Parenting: Meeting the needs of parents J. Cyne Johnston, PhD and Cheryl MacLeod, RN MEd
Feb 23, 2016
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 ShiftTraditional 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 ExpertsThere 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 costsChild growth Qualitative interviewsSocial support Postpartum depressionParenting moral indexParent and clinician satisfactionParenting stressBreastfeeding 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