| Author: | Xiao, Xiao |
| Title: | The feasibility of an online intergenerational co-parenting programme for father-mother-grandmother triad on the intergenerational co-parenting relationship in the perinatal period |
| Advisors: | Loke, Yuen Alice (SN) Ngai, Vivian (SN) Leung, Y. P. Doris (SN) Molasiotis, Alex (SN) |
| Degree: | Ph.D. |
| Year: | 2023 |
| Subject: | Parenting Grandparenting Internet -- Social aspects Hong Kong Polytechnic University -- Dissertations |
| Department: | School of Nursing |
| Pages: | 466 pages : color illustrations |
| Language: | English |
| Abstract: | Brief Description: Background: In families where grandparents assist with childrearing during the perinatal period, the intergenerational co-parenting relationship could influence the psychological health of young parents and grandparents, the co-parenting relationship between couples, and a postpartum mother's parenting self-efficacy. However, limited studies were identified to support intergenerational co-parenting during this critical period. Aims: To assess the feasibility of an online intergenerational co-parenting programme and to examine the preliminary effects of such a programme on mother reported intergenerational co-parenting relationship with grandmothers (primary outcome), and on the secondary outcomes: the perceived stress and depressive symptoms of parents and grandmothers, the co-parenting relationship between parents, parenting stress, and parenting self-efficacy of parents at 6 weeks postpartum (T1) and 3 months postpartum (T2) were assessed. Method: The Medical Research Council (MRC) framework was adopted to guide the development and evaluation of an online intergenerational co-parenting intervention programme. A conceptual framework for intergenerational co-parenting families was proposed based on the Ecological Model of Co-parenting, series of literature reviews and two inter-related qualitative studies. There are four domains in the proposed model for intergenerational co-parenting, including division of labor, infant care and postpartum care agreement, joint family management and support/undermining. The consequences of intergenerational co-parenting included the depressive symptoms and perceived stress of co-parenting members, co-parenting relationship between parents, parenting self-efficacy and parenting stress of parents. The consequences of intergenerational co-parenting might relate and interact with each other. An intergenerational co-parenting programme was developed based on the the conceptual framework proposed in this study, with the contents of which focused on the four domains of the conceptual framework. The feasibility and preliminary effects of the developed intergenerational co-parenting programme was tested by a pilot randomised controlled trial. A convenience sample of 60 intergenerational co-parenting family units, including 60 first-time parents (60 mothers and 60 fathers) and 60 grandmothers (mother-in-law of mothers) was recruited from the obstetric clinic in the outpatient department of the study hospital. The recruited families were randomly assigned to the intervention (n=30) or control group (n=30). Participants in the control group received usual care. Participants in the intervention group received the online intergenerational co-parenting programme in addition to usual care, including three weekly antenatal sessions (starting from 33-35 weeks gestation) and two weekly postnatal sessions (starting from the first week after discharge from hospital). Results: Sixteen mother-father-grandmother triads had completed all the five sessions of the intervention. More than 75% of the included families had completed the outcome assessment at T1 and T2. Mothers, fathers and grandmothers in the intervention group reported higher score in the Client Satisfaction Questionnaire than those in the control group. The intervention did not find significant differences on the total scores of the observed outcomes between the two groups. However, the intervention reported some positive effects on the Co-parenting Relationship Scale (CRS) domains of "endorse partner parenting" (Cohen's d=0.14), and "exposure to conflict" (Vargha-Delaney's A (VDA)=0.65). It could significantly reduce the co-parenting undermining domain in CRS between mothers and grandmothers (Cohen's d=0.55, p=0.04). In addition, some positive effects were also found on the perceived stress of mothers at T1 (VDA=0.60), the depressive symptoms of grandmothers at T1 (VDA=0.61). It could also protect the decline of co-parenting relationship both reported by mothers (Cohen's d=0.12) and fathers (VDA=0.38). It was also helpful to reduce the total score of mothers' parenting stress (Cohen's d=0.14), the domain of "parent-child dysfunctional interaction" (Cohen's d=0.29) and "difficult child" (VDA=0.63) reported by mothers in Parenting Stress Index (PSI). The intervention could also improve the parenting self-efficacy of mothers with a moderate effect size (Cohen's d=0.36) and fathers parenting satisfaction (Cohen's d=0.25). However, the intervention found some negative effects on the total score of intergenerational co-parenting relationship with a small effect size (Cohen's d=0.17, p=0.53), and total score of parenting sense of competence reported both by mothers and fathers with a medium effect size (VDA=0.63, p=0.14). In addition, the intervention may reduce the parenting satisfaction of mothers (Cohen's d=0.66, p=0.01) and parenting self-efficacy of fathers (Cohen's d=0.62, p=0.03) significantly compared to the usual care. Conclusion: The online intergenerational co-parenting programme was feasible and acceptable for the intergenerational co-parenting families during the perinatal period. The programme found some negative effects on the total score of intergenerational co-parenting relationship between mothers and grandmothers, but reported some positive effects on the domain of "co-parenting undermining" and "exposure to conflicts" in CRS, co-parenting relationship between couples, and parenting stress of mothers. Interestingly, the intervention may benefit the parenting self-efficacy of mothers and parenting satisfaction of fathers, but may potentially reduce mothers' parenting satisfaction and fathers' parenting self-efficacy. Further study with larger sample size and longer follow up are recommended to verify the effectiveness of the intergenerational co-parenting programme. |
| Rights: | All rights reserved |
| Access: | open access |
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