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Abstract Background Parents of individuals with rare neurodevelopmental conditions and intellectual disabilities (ID) are vulnerable to mental health difficulties, which vary between parents and within parents over time. The underlying cause of a child’s condition can influence parents’ mental health, via uncertain pathways and within unknown time-windows. Results We analysed baseline data from the IMAGINE-ID cohort, comprising 2655 parents of children and young people with ID of known genetic origin. First, we conducted a factor analysis of the SDQ Impact scale to isolate specific pathways from genetic aetiology to parents’ mental health. This suggested a two-factor structure for the SDQ Impact scale, with a “home & distress” dimension and a “participation” dimension. Second, we tested via structural equation modelling (SEM) whether genetic diagnosis affects Impact and mental health directly, or indirectly via children’s characteristics. This analysis identified an indirect pathway linking genetic aetiology to parents’ mental health, serially through child characteristics (physical disabilities, emotional and behavioural difficulties) and Impact: home & distress. Third, we conducted moderation analysis to explore the influence of time elapsed since genetic diagnosis. This showed that the serial mediation model was moderated by time since diagnosis, with strongest mediating effects among recently diagnosed cases. Conclusions There are multiple steps on the pathway from ID-associated genetic diagnoses to parents’ mental health. Pathway links are strongest within 5 years of receiving a genetic diagnosis, highlighting opportunities for better post-diagnostic support. Recognition and enhanced support for children’s physical and behavioural needs might reduce impact on family life, ameliorating parents’ vulnerabilities to mental health difficulties.

Abstract Public and Patient Involvement in research is becoming a requirement on most research funding applications; this includes both healthcare and lab-based research. Whilst case studies and practical guides have been developed and are well documented for PPI in healthcare research, there is very little guidance available for PPI in lab-based research. In this piece we discuss our experience of how we have successfully involved patients in our translational cancer research, which is focused on developing personalised treatment for high-grade serous ovarian cancer. We discuss the benefits it has made to both our research and to us as researchers. The patients involved write about their experience, what they enjoyed, and the benefits they felt. Although PPI is quite topical and is being widely discussed, there is hesitancy among researchers, especially those in lab-based research about getting started because of a lack of practical guidance about how to implement it. Here, we have shared our experience, hopefully providing a practical example of how PPI can be incorporated into a lab-based research project.

IntroductionDelayed puberty (DP) is a frequent concern for adolescents. The most common underlying aetiology is self-limited DP (SLDP). However, this can be difficult to differentiate from the more severe condition congenital hypogonadotrophic hypogonadism (HH), especially on first presentation of an adolescent patient with DP. This study sought to elucidate phenotypic differences between the two diagnoses, in order to optimise patient management and pubertal development.MethodsThis was a study of a UK DP cohort managed 2015-2023, identified through the NIHR clinical research network. Patients were followed longitudinally until adulthood, with a definite diagnosis made: SLDP if they had spontaneously completed puberty by age 18 years; HH if they had not commenced (complete, cHH), or had commenced but not completed puberty (partial, pHH), by this stage. Phenotypic data pertaining to auxology, Tanner staging, biochemistry, bone age and hormonal treatment at presentation and during puberty were retrospectively analysed.Results78 patients were included. 52 (66.7%) patients had SLDP and 26 (33.3%) patients had HH, comprising 17 (65.4%) pHH and 9 (34.6%) cHH patients. Probands were predominantly male (90.4%). Male SLDP patients presented with significantly lower height and weight standard deviation scores than HH patients (height p=0.004, weight p=0.021). 15.4% of SLDP compared to 38.5% of HH patients had classical associated features of HH (micropenis, cryptorchidism, anosmia, etc. p=0.023). 73.1% of patients with SLDP and 43.3% with HH had a family history of DP (p=0.007). Mean first recorded luteinizing hormone (LH) and inhibin B were lower in male patients with HH, particularly in cHH patients, but not discriminatory. There were no significant differences identified in blood concentrations of FSH, testosterone or AMH at presentation, or in bone age delay.DiscussionKey clinical markers of auxology, associated signs including micropenis, and serum inhibin B may help distinguish between SLDP and HH in patients presenting with pubertal delay, and can be incorporated into clinical assessment to improve diagnostic accuracy for adolescents. However, the distinction between HH, particularly partial HH, and SLDP remains problematic. Further research into an integrated framework or scoring system would be useful in aiding clinician decision-making and optimization of treatment.

Abstract Background This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). Methods A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed. Results Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes. Conclusion Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.

Abstract Objectives The Strengths and Difficulties Questionnaire (SDQ) has been shown to be invariant across informants, developmental stage and settings, but tests of cross‐cultural equivalence are limited to adolescents' self‐reports. The COVID‐19 pandemic makes this gap particularly pertinent, given the need to understand whether distinct government approaches (e.g., school closures) are uniquely associated with variability in children's psychosocial outcomes and the reliance on parents' ratings for young children. Methods Within a Confirmatory Factor Analysis framework, we tested the cross‐cultural measurement invariance of the SDQ across six countries: Australia, China, Italy, Sweden, the United Kingdom and USA, using a sample of 1761 parents of 3‐ to 8‐year‐olds (M = 5.76, SD = 1.09). Results A five‐factors model showed good fit to the data and partial cross‐cultural scalar invariance. In this sample, Swedish parents reported the fewest peer problems (Cohen's d = 0.950) and the highest prosocial scores (Cohen's d = 0.547), whilst British parents reported the greatest child emotional (Cohen's d = 0.412) and hyperactivity problems (Cohen's d = 0.535). Conclusions The present results indicate that the parent‐version of the SDQ is appropriate for use and comparison across different contexts during the pandemic.

Abstract While psychological connection to nature is known to be associated with both pro‐environmental behaviours and well‐being, there is an urgent need to extend this research to consider impacts from the COVID‐19 lockdown period. Examining whether children's connection to nature changed during this period, identifying the drivers of these changes and determining the links between connection to nature and child well‐being can each serve to guide post‐lockdown initiatives to promote children's connection to nature. Three findings emerged from this UK sample of 376 families with young children. First, nearly two thirds of parents reported a change (most typically, an increase) in their child's connection to nature. Explanations for this increase included having more time, increased enjoyment of nature and increased awareness or interest in nature. Second, a third of children whose connection to nature decreased during the pandemic displayed increased problems of well‐being—manifest as either ‘acting out’ (externalising problems) or sadness/anxiety (internalising problems). Third, an increase in connection to nature during the pandemic was more evident for children from affluent families than for their less affluent peers. While connecting to nature may be an effective means of addressing child problems of well‐being, the divergent findings for children from different family backgrounds indicate that efforts to enhance connection to nature should focus on the barriers experienced by children from less affluent families. A free Plain Language Summary can be found within the Supporting Information of this article.

Research shows that children’s block construction skills are positively associated with their concurrent and later mathematics performance. Furthermore, there is evidence that block construction training is particularly beneficial for improving early mathematics skills in children from low-Socio Economic Status (SES) groups who are known to have lower maths performance than their peers. The current study investigates (a) the association between block construction and mathematics in children just before the start of formal schooling (4 years-of-age in the UK) and (b) whether the association between block construction and mathematics differs between children from more compared to less affluent families. Participants in this study included 116 children (M = 3 years 11 months, SD = 3 months) who all completed numeracy, block construction, and receptive vocabulary tasks. Socio-economic status and demographic information (child age, gender, ethnicity) were also obtained from parents. Findings show a strong positive association between block construction and early numeracy skills. Block construction skills explained approximately 5% of the variation in numeracy, even after controlling for age in months, household income, and child receptive vocabulary. When separated by SES group, for children from less affluent families, block construction explained a significant amount of variability (14.5%) in numeracy performance after covariates. For children from more affluent families, block construction did not explain a significant amount of variation in numeracy. These findings suggest that, interventions involving block construction skills may help to reduce SES-based attainment gaps in UK children’s mathematics achievement.

Abstract Introduction This study assessed the feasibility and acceptability of FRESH (Families Reporting Every Step to Health), a theory-based child-led family physical activity (PA) intervention delivered online. We also assessed the preliminary effectiveness of the intervention on outcomes of interest and whether pre-specified criteria were met to progress to a full-scale definitive trial. Methods In a three-armed randomised pilot trial, 41 families (with a 7–11-year-old index child) were allocated to a: ‘family’ (FAM), ‘pedometer-only’ (PED), or a no-treatment control (CON) arm. The FAM arm received access to the FRESH website, allowing participants to select step challenges to ‘travel’ to target cities around the world, log their steps, and track progress as families virtually globetrot. FAM and PED arms also received family sets of pedometers. All family members could participate in the evaluation. Physical (e.g., fitness, blood pressure), psychosocial (e.g., social support), behavioural (e.g., objectively-measured PA), and economic (e.g., expenditure for PA) data were collected at baseline, 8- and 52-weeks. Results At 8- and 52-weeks, 98 and 88% of families were retained, respectively. Most children liked participating in the study (> 90%) and thought it was fun (> 80%). Compared to the PED (45%) and CON (39%) arms, a higher percentage of children in the FAM (81%) arm reported doing more activities with their family. Adults agreed that FRESH encouraged their family do more PA and made their family more aware of the amount of PA they do. No notable between-group differences were found for childrens’ minutes in moderate-to-vigorous PA. Sizeable changes of 9.4 (95%CI: 0.4, 18.4) and 15.3 (95%CI: 6.0, 24.5) minutes in moderate-to-vigorous PA was found for adults in the FAM group compared to those in the PED or CON groups, respectively. No other notable differences were found. Conclusion This study demonstrates feasibility and acceptability of the FRESH intervention. All progression criteria were at least partially satisfied. However, we failed to recruit the target sample size and did not find a signal of effectiveness on PA particularly long-term or in children. Further refinements are required to progress to a full-scale trial. Trial registration This study was prospectively registered ( ISRCTN12789422 ) on 16/03/2016.

This paper outlines climate emergencies facing universities and, by drawing on research on system transition, provides insights about how change to overcome the challenges might be stewarded. Climate change brings three interconnected and urgent emergencies for universities: (1) Manifest emergencies such as risks to operations and business models; (2) Conceptual emergencies that arise because assumptions, ideologies, systems, and structures cannot match the scale of the manifest challenges; and (3) Existential emergencies where current identities and sense of purpose are incapable of supporting the changes needed to overcome the conceptual challenges. To be viable leaders in the world, universities will need to renew their commitments to serving the public good, be dedicated to an unwavering challenge-orientation, create post-disciplinary structures, and be the change one seeks to see in the world. Importantly, universities will need to overcome the emergencies on the inside if they are to help society address the scale of the challenges on the outside, to which both universities and human capacity are seriously cognitively and emotionally ill-prepared. Fortunately, new insights from research on system transition provide helpful advice on how to steward transformational change. This work highlights that successful transformation requires strong adherence to transformational intent and, in the case of universities, working with all three emergencies simultaneously. Successful transformation will also require harnessing opportunities to disrupt the status quo; supporting an interplay of different forms of management and orientations to the future; developing appropriate infrastructure to support transformation; and rapidly accelerating the development of capacities for transformational change. By actively developing capacities for transformation on the inside universities will then be in a much better position to help and lead others beyond the halls of the academy.

Background: Family-based physical activity promotion presents a promising avenue for promoting whole-family physical activity, but high-quality research is lacking. Objectives: To assess the feasibility, acceptability and preliminary effectiveness of FRESH (Families Reporting Every Step to Health), a child-led online family-based physical activity intervention; and to identify effective and resource-efficient family recruitment strategies. Design: The project consisted of (1) a randomised feasibility trial, (2) a randomised controlled pilot trial and (3) a systematic review and Delphi study. Setting: Norfolk/Suffolk counties, UK. Participants: Families, recruited from schools, workplaces and community settings, were eligible to participate if one child aged 7–11 years and one adult responsible for their care provided written consent; all family members could participate. Interventions: The FRESH intervention, guided by self-determination theory, targeted whole families and was delivered via an online platform. All family members received pedometers and were given website access to select family step challenges to ‘travel’ to target cities around the world, log steps, and track progress as they virtually globetrotted. Families were randomised to FRESH intervention, pedometer-only or control arm. Main outcome measures: Physical (e.g. blood pressure), psychosocial (e.g. family functioning) and behavioural (e.g. device-measured family physical activity) measures were collected at baseline and at 8- and 52-week follow-up. A mixed-methods process evaluation assessed the acceptability of the intervention and evaluation. Data sources review: Systematic search of four databases (Cochrane Library, PubMed, PsycINFO and SCOPUS). Review methods: Articles were screened in duplicate, and data extraction was fully checked. Academic experts participated in the three-round Delphi study. Data were combined to identify effective and resource-efficient family recruitment strategies. Inclusion criteria: Included generally healthy school-aged children and at least one adult; intervention attempted to change physical activity, sedentary behaviour, screen use, diet, or prevent overweight/obesity in multiple family members; presented relevant measure of effect in children and adults. Results: The feasibility study (12 families, 32 participants; 100% retention at 8 weeks) demonstrated the feasibility and acceptability of FRESH, but highlighted that adaptations were required. Of 41 families recruited in the pilot study (149 participants), 98% and 88% were retained at the 8-week and 52-week follow-up, respectively. More children in the FRESH arm self-reported doing more family physical activity, and they thought that FRESH was fun. There were no notable between-group differences in children’s outcomes. Change in moderate to vigorous physical activity at 8 weeks favoured FRESH intervention adults [vs. control: 9.4 minutes/week (95% confidence interval 0.4 to 18.4) vs. pedometer only: 15.3 (95% confidence interval 6.0 to 24.5)], and was stronger in fathers, but this was not maintained. In 49 included studies, apart from recruitment settings and strategies used (reported in 84% and 73% of the studies, respectively), recruitment details were scarce. School-based recruitment was predominant. The Delphi study identified a wide range of recruitment settings and strategies. Limitations: Recruitment was the main limitation of the FRESH studies; generalisability of the proposed recruitment strategies may be limited. Conclusions: This study has demonstrated the feasibility and acceptability of the FRESH intervention. However, we failed to recruit the target sample size and were unable to demonstrate a signal of effectiveness. Future research should employ a multifaceted recruitment approach. Future work: Further refinements to intervention delivery and recruitment methods should be investigated. Study registration: Current Controlled Trials ISRCTN12789422 and PROSPERO CRD42019140042. Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 9. See the NIHR Journals Library website for further project information.

Background: Well-being is a key aspect of children's education, yet measurement issues have limited studies in early primary school. Aims: The current 12-month longitudinal study assesses the temporal stability of child- and parent-reported school well-being and examines developmental links with academic self-concept and parent-rated prosocial behaviour. Sample(s): We tracked a sample of 206 children across the transition from the first (T1) to the second (T2) year of primary school (T1 child M[subscript age] = 5.3, SD = 0.46, 54.3% girls) and gathered ratings of well-being, prosocial behaviour and academic self-concept at both timepoints. Methods: We used cross-lagged analyses to investigate developmental links between these three constructs. Results: Parent and child reports of children's well-being showed similar temporal stability and converged over time, such that informants' reports showed a modest but significant correlation at T2. Girls reported greater well-being than boys at both timepoints and received higher parental ratings of well-being than boys at T2. For both girls and boys, associations between the constructs were asymmetric: early well-being predicted later self-concept and prosocial behaviour, but the reciprocal associations were not significant. Conclusions: These findings support the validity of young children's self-reported well-being, highlight the early onset of gender differences in school well-being and demonstrate that early well-being heralds later prosocial behaviour and positive academic self-concepts.

Abstract Background There is a need for high-quality research aiming to increase physical activity in families. This study assessed the feasibility and acceptability of FRESH (Families Reporting Every Step to Health), a child-led family-based physical activity intervention delivered online. Methods In a two-armed randomised feasibility study, 12 families (with an 8–10-year-old index child) were allocated to a ‘child-only’ (CO) or ‘family’ arm (FAM) of the theory-based FRESH intervention. Both received access to the FRESH website, allowing participants to select step challenges to ‘travel’ to target cities around the world, log their steps, and track their progress as they virtually globetrot. Only index children wore pedometers in CO; in FAM, all family members wore pedometers and worked towards collective goals. All family members were eligible to participate in the evaluation. Mixed-methods process evaluation (questionnaires and family focus groups) at 6-week follow-up consisted of completing questionnaires assessing acceptability of the intervention and accompanying effectiveness evaluation, focussed on physical (e.g. fitness, blood pressure), psychosocial (e.g. social support), and behavioural (e.g. objectively-measured family physical activity) measures. Results All families were retained (32 participants). Parents enjoyed FRESH and all children found it fun. More FAM children wanted to continue with FRESH, found the website easy to use, and enjoyed wearing pedometers. FAM children also found it easier to reach goals. Most CO families would have preferred whole family participation. Compared to CO, FAM exhibited greater website engagement as they travelled to more cities (36 ± 11 vs. 13 ± 8) and failed fewer challenges (1.5 ± 1 vs. 3 ± 1). Focus groups also revealed that most families wanted elements of competition. All children enjoyed being part of the evaluation, and adults disagreed that there were too many intervention measures (overall, 2.4 ± 1.3) or that data collection took too long (overall, 2.2 ± 1.1). Conclusion FRESH was feasible and acceptable to participating families; however, findings favoured the FAM group. Recruitment, intervention fidelity and delivery and some measurement procedures are particular areas that require further attention for optimisation. Testing the preliminary effectiveness of FRESH on family physical activity is a necessary next step. Trial registration This study was registered and given an International Standard Randomised Controlled Trials Number (ISRCTN12789422). Registered 16 March 2016. http://www.isrctn.com/ISRCTN12789422

Problems of depression and anxiety are common in early parenthood and adversely affect parenting quality (1). Rumination is closely linked to poor wellbeing (2), suggesting that self-focus may be one mediator of the association between wellbeing and caregiving [e.g., (3)]. Framed within an international study of first-time mothers and fathers (4), the current study included 396 British mothers and fathers (in 198 heterosexual cohabiting couple relationships) of first-born 4-month-old infants. Parents reported on their symptoms of depression, anxiety and satisfaction in their couple relationship. Five-minute speech samples were transcribed and coded for parents' pronoun use (i.e., “I” and either infant- or partner-inclusive use of “We”), whilst observations in the Still-Face paradigm were coded for parental sensitivity to infants' cues. Our first goal was to test whether new parents' self-focus was associated with wellbeing and couple relationship quality. We also examined whether (i) self-focus mediated the expected association between wellbeing and caregiving sensitivity and (ii) couple relationship quality moderated the expected association between self-focus and caregiver sensitivity. Finally, we compared results for mothers and fathers. Our results illustrate gender-specific associations. First, although mean levels of self-focus and partner-inclusive talk were similar for mothers and fathers, infant-inclusive use of the “we” pronoun was higher in mothers than fathers. Second, self-focus was unrelated to either mothers' or fathers' wellbeing, but was associated with fathers' report of reduced couple relationship quality. In addition, poor perinatal wellbeing was associated with reduced partner-inclusive talk for fathers, but with reduced use of infant-inclusive talk for mothers. Third, mediation models suggest that reduced infant-inclusive talk underpins the association between poor wellbeing and reduced sensitivity in mothers, but not fathers. Fourth, in the context of good couple relationship quality, mothers' elevated partner-inclusive talk was associated with reduced caregiving sensitivity. These findings are discussed in terms of their implications for interventions to support new mothers and fathers, who may benefit from distinct strategies to foster attention to their developing infant.

Introduction Violence against children is a health, human rights and social problem affecting approximately half of the world’s children. Its effects begin at prenatal stages with long-lasting impacts on later health and well-being. The Evidence for Better Lives Study (EBLS) aims to produce high-quality longitudinal data from cities in eight low- and middle-income countries—Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam—to support effective intervention to reduce violence against children. EBLS-Foundational Research (EBLS-FR) tests critical aspects of the planned EBLS, including participant recruitment and retention, data collection and analysis. Alongside epidemiological estimates of levels and predictors of exposure to violence and adversity during pregnancy, we plan to explore mechanisms that may link exposure to violence to mothers’ biological stress markers and subjective well-being.Methods and analyses EBLS-FR is a short longitudinal study with a sample of 1200 pregnant women. Data are collected during the last trimester of pregnancy and 2 to 6 months after birth. The questionnaire for participating women has been translated into nine languages. Measures obtained from mothers will include, among others, mental and physical health, attitudes to corporal punishment, adverse childhood experiences, prenatal intimate partner violence, substance use and social/community support. Hair and dry blood spot samples are collected from the pregnant women to measure stress markers. To explore research participation among fathers, EBLS-FR is recruiting 300 fathers in the Philippines and Sri Lanka.Ethics and dissemination The study received ethical approvals at all recruiting sites and universities in the project. Results will be disseminated through journal publications, conferences and seminar presentations involving local communities, health services and other stakeholders. Findings from this work will help to adjust the subsequent stages of the EBLS project.

Technology is pervasive in homes with young children. Emerging evidence that electronic screen-based media use has adverse effects on executive functions may help explain negative relations between media use and early academic skills. However, longitudinal investigations are needed to test this idea. In a sample of 193 British toddlers tracked from age 2 to 3 years, we test concurrent and predictive relations between screen use and children’s executive function. We find no concurrent association between screen use and executive function; however, screen time at age 2 is negatively associated with the development of executive functions in toddlerhood from age 2 to 3, controlling for a range of covariates including verbal ability. Implications for parenting, education, and pediatric recommendations are discussed.

In Hawai’i, Native Hawaiian men (kāne) have the highest death rate from colon cancer among all ethnic groups. While screening can prevent 90% of these cancers, data show that >58% of kāne over age 50 have never been screened. Prior research has demonstrated that community-based social networks may help kāne adopt healthy behaviors such as cancer screening, however, few studies have activated such an approach. A cross-sectional study entitled No Ke Ola Pono o Nā Kāne (for the good health of men) was conducted statewide in Hawai’i from 2014 to 2018. The study strived to perpetuate the Native Hawaiian traditional practice of “hale mua” (men’s house) to promote healthy behaviors among kāne including the adoption of colon cancer prevention strategies such as fecal immunochemical testing (FIT). The study applied a peer-led intervention model using kāne volunteers to deliver the program’s educational components, including standardized materials to help the volunteers confidently conduct the sessions. Of the 378 kāne who were recruited into the study, 232 participated in the colorectal session of which 64% ( n = 149) were over age 50. Survey data from the 149 kāne indicated that 31% had not discussed colon health or screening with their doctors but 92% had improved their knowledge about colon health from the session. In addition, 76% ( n = 113) agreed to complete a FIT. Session evaluations indicated that >91% of kāne liked the hale mua approach and benefited from talking with other kāne about their health.

Abstract Background There are marked disparities between pre-school children in key skills affecting school readiness, disparities that commonly persist and influence children’s later academic achievements, employment, and adjustment. Much of this disparity is linked to socio-economic disadvantage and its impact on the home learning environment. Children’s Centres are an ideal context in which to implement and evaluate programmes to address this problem. They principally serve the 30% worst areas on the Indices of Deprivation Affecting Children, providing for families from the antenatal period up to age 5 years, aiming to promote parenting skills and provide care for children. Methods We are conducting a randomised controlled trial, based in Children Centres, to evaluate a parenting intervention for caregivers of children between 28 and 45 months of age. The intervention provides training to parents in dialogic book-sharing. The training is run by a facilitator who sees parents in small groups, on a weekly basis over 7 weeks. The study is a cluster randomised controlled trial. Twelve of the Children’s Centres in the town of Reading in the UK have been randomly assigned to an index or control condition. The primary outcome is child cognition (language, attention, and executive function); and secondary outcomes are child social development, behaviour problems, and emotion regulation, parenting during book-sharing and problem solving and parental child behaviour management strategies. Data are collected at baseline, post-intervention and 4–6 months post-intervention. Discussion The Impact of Early-years Provision in Children’s Centres trial (EPICC) aims to evaluate the impact of an early parenting intervention on several key risk factors for compromised child development, including aspects of parenting and child cognition, social development, behaviour problems and emotion regulation. The study is being carried out in Children’s Centres, which largely serve the most disadvantaged families in the UK. Since the intervention is brief and, with modest levels of training, readily deliverable within Children’s Centres and similar early childcare provision centres, demonstration that it is of benefit to child cognition, socio-emotional development and behaviour would be important. Trial registration ISRCTN Registry, ISRCTN28513611. Registered on 28 March 2017. This is version 1 of the protocol for the EPICC trial.

Spending time in nature has benefits for wellbeing in children, but relatively little is known about how autistic children experience nature. Framed by self-determination theory, this case study addresses this gap by exploring the experiences of 25 autistic children participating in a Forest School at their specialist school in the East of England. We used deductive reflexive thematic analysis to analyse participant observation and parent and child interview data. Our results indicated that Forest School benefited these autistic children through opportunities to play, exercise autonomy, and develop practical, motor, and social skills. However, challenges were also evident, including children absconding and conflict between peers. The success of sessions seemed contingent on adherence to routines and the influence of the adults present. Our findings supported the application of self-determination theory to Forest School to promote psychological wellbeing through autonomy, competence, and relatedness in autistic children. We discuss implications for training and practice.

Transition to school research has largely overlooked parents' experiences, particularly fathers. Addressing this gap, we gathered speech samples from UK parents (93 mothers, Mean age = 37.1 years; SD = 4.6 years; and 70 fathers, Mean age = 38.0 years; SD = 3.59 years) that captured their experiences of the school transition. This study (a) compared mothers' and fathers' experiences; and (b) examined experiences alongside parental self-reported psychological distress and household disorder. Parents' experiences differed in valence: Emotional Reaction (mixed), Experiences with the School (positive), Support and Relationships (mixed), and Routines and Responsibilities (negative). Relationships and Support elicited heightened emotions from mothers than fathers. Only maternal experiences were associated with psychological distress and household disorder. Within couples (n = 64), only negative talk about Routines and Responsibilities was shared; all other experiences were individual. Findings show significant, mixed, and independent parental effects and recommend greater policy and practice consideration of the family context during the school transition.

The past decade has witnessed a growth of interest in parental influences on individual differences in children’s executive function (EF) on the one hand and in the academic consequences of variation in children’s EF on the other hand. The primary aim of this longitudinal study was to examine whether children’s EF mediated the relation between three distinct aspects of parental behavior (i.e., parental scaffolding, negative parent-child interactions and the provision of informal learning opportunities) and children’s academic ability (as measured by standard tests of literacy and numeracy skills). Data were collected from 117 parent-child dyads (60 boys) at two time points approximately 1 year apart (M Age at Time 1 = 3.94 years, SD = 0.53; M Age at Time 2 = 5.11 years, SD = 0.54). At both time points children completed a battery of tasks designed to measure general cognitive ability (e.g., non-verbal reasoning) and EF (e.g., inhibition, cognitive flexibility, working memory). Our models revealed that children’s EF (but not general cognitive ability) mediated the relations between parental scaffolding and negative parent-child interactions and children’s early academic ability. In contrast, parental provision of opportunities for learning in the home environment was directly related to children’s academic abilities. These results suggest that parental scaffolding and negative parent-child interactions influence children’s academic ability by shaping children’s emerging EF.

Native Hawaiians and other Pacific Islanders (NH/PI; e.g., Samoan and Chuukese) have higher type 2 diabetes prevalence compared to other groups in Hawai‘i. Partners in Care (PIC), a culturally tailored, community-based, diabetes self-management education intervention (DSME), is effective at improving participants’ glycemic control and self-care behaviors. Maintenance of improvements is challenging. Diabetes-related social support groups (SSG) are a promising maintenance component for DSME. This study examined the effects of a diabetes-specific SSG component relative to a control group, after the receipt of the 3-month PIC intervention, which was delivered to 47 adult NH/PI with type 2 diabetes. Participants were then randomized to either a 3-month, 6-session SSG or a control group. Hemoglobin A1c (HbA1c), blood pressure, triglycerides, cholesterol, and diabetes self-management knowledge and behaviors were assessed at baseline, 3 months, and 6 months. Results indicated significant improvements in HbA1c, diabetes-related self-management knowledge, and behaviors from baseline to 3-month assessment. However, no differences between the SSG and control group from 3-month to 6-month assessment suggest that all participants were able to maintain initial improvements. The SSG group had a significant decrease in systolic blood pressure from 3-month to 6-month assessment while the control group did not. Study limitations and future directions are discussed.