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Research suggests that children in Hong Kong are at an elevated risk of emotional problems. Authoritarian parenting, a common parenting style in Hong Kong, is a critical factor associated with childhood mental health problems. The purpose of this paper is to evaluate the effectiveness of the 6As Positive Parenting Program (6As) in modifying parenting attitudes, reduction of parenting stress and increasing self-efficacy in positive parenting, among a sample of 82 Hong Kong parents. 6As focuses on prevention by instilling positive parenting beliefs and principles, thereby reducing reliance on authoritarian and related parenting styles.

The program was evaluated using a controlled pre-post-treatment design. Outcome measures were the Chinese Child-rearing Beliefs Questionnaire, Parental Stress Scale, Parenting Self-efficacy Scale and participant feedback. ANOVA and correlation were utilized to detect treatment effects and relationships between the degree of change among measures and subscales.

Relative to the control group, the 6As Positive Parenting Program significantly changed parents’ parenting attitudes, reduced parenting stress and increased self-efficacy in positive parenting. In sum, 97.6 percent of the participants agreed that the program is a good fit for the Hong Kong culture.

A larger sample would have been desirable for this study. One factor that limited analyzable data was that some of the participating organizations enrolled participants into the program who did not meet research inclusion criteria. Furthermore, the size of groups varied from 5 to 16 participants, which may have produced different group dynamics that added variability to outcomes. Future 6As parenting program research should attempt to standardize group size or to directly compare the effectiveness of smaller vs larger groups. Furthermore, as noted earlier, the research was conducted during the primary school application period, which may have heightened the parenting stress for parents of younger children.

The results suggest that an enhanced belief in authoritative, autonomy and training strategies could reduce parental stress and shift parents’ attitude toward a more positive approach in child-rearing.

There is considerable need for a holistically designed parenting training that is culturally credible and sensitive.

Findings suggest that positive parenting can enhance the parent–child relationship and reduce parental stress. The results support governmental, non-governmental organizational and community focus on positive practices for parenting training in Hong Kong.

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

Involvement of parents/carers may increase effectiveness of primary school-based alcohol-misuse prevention projects through strengthening family-based protective factors, but rates of parental engagement are typically low. This paper reports findings from an exploratory trial of a school-based prevention intervention – Kids, Adults Together (KAT), based on the Social Development Model, which aimed to promote pro-social family communication in order to prevent alcohol misuse, and incorporated strategies to engage parents/carers. The purpose of this paper is to assess the feasibility and value of conducting an effectiveness trial of KAT.

The study was a parallel-group cluster randomised exploratory trial with an embedded process evaluation. The study took place in south Wales, UK, and involved nine primary schools, 367 pupils in Years 5/6 (aged 9-11 years) and their parents/carers and teachers. Questionnaires were completed by pupils at baseline and four month follow-up, and by parents at six month follow-up.

Overall KAT was delivered with good fidelity, but two of five intervention schools withdrew from the study without completing implementation. In total, 50 per cent of eligible parents participated in the intervention, and KAT had good acceptability among pupils, parents and teachers. However, a number of “progression to effectiveness trial” criteria were not met. Intermediate outcomes on family communication (hypothesised to prevent alcohol misuse) showed insufficient evidence of an intervention effect. Difficulties were encountered in identifying age appropriate outcome measures for primary school-age children, particularly in relation to family communication processes. The study was unable to find comprehensive methodological guidance on exploratory trials.

It would not be appropriate to conduct an effectiveness trial as key progression criteria relating to intervention and trial feasibility were not met. There is a need for new measures of family communication which are suitable for primary school-age children, and more guidance on the design and conduct of exploratory/feasibility trials.

KAT achieved high rates of parental involvement, and its theoretical framework and processes could be adapted by other interventions which experience difficulties with recruitment of parents/carers.

Equine-assisted therapy (EAT) uses the horse and its environment to achieve therapeutic goals as designed by an allied health professional (Taylor, 2010). The benefits of these interventions affect areas such as motor skills (Bass et al., 2009; Silkwood-Sherer et al., 2012), sensory processing (Ward et al., 2013), learning, social interaction and socioemotional development (Bracher, 2000). It was felt that occupational therapists could offer valuable input in this area. This paper aims to investigate the impact of a specific six-week EAT programme on six participants’ occupational performance.

Mixed methods were used in this pilot study, consisting of a pre- and post-design with two follow-up periods. Participants were aged between 5 and10 years with a diagnosis of a visual impairment, and some had additional diagnoses. The Canadian Occupational Performance Measure (COPM) was administered to parents pre-programme, post-programme and approximately six week after the programme ceased. Additional information from notes that contained children’s and parents’ reports was analysed thematically.

Five of the six children were rated as having clinically significant changes in their occupational performance. Analysis of parents’ and children’s reports on their experience of the programme showed the main themes to be: peer interaction, taking on new challenges, feelings towards EAT and change.

Although there are many practitioners of EAT in Ireland, there is little research, and none was found in relation to the role of occupational therapists within this context. These results indicate that EAT may be effective in assisting some children to reach a variety of goals. This pilot study not only suggests that EAT is worth further research but also begins to explore the role of occupational therapy in this form of intervention.

At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of introducing AA as a potential intervention to the OT community, this study aims to investigate the extent to which participation in a two-day AA training could contribute to increasing confidence and inspire changes in practice for Irish occupational therapists (OTs) supporting autistic children.

A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of a two-day AA training on six OTs. The OTs support autistic children throughout Ireland across public, private and voluntary sectors. They completed brief, non-standardised questionnaires 2 weeks before the training (Time 1) and again 12 weeks post (Time 2) training session. At Time 2, additional exploratory questions were answered by OTs regarding their use of AA in practice.

This explorative study’s quantitative findings presented percentage change increases within three areas of confidence for all OTs. These include establishing attention, motivating and developing functional skill goals with autistic children. One of the participants did not score any change in confidence in a fourth area, building rapport, however, the five other participants scored percentage change increases. Qualitative data provided by participants showed that they were implementing AA in practice since attending the training. Five of the participants reported positive experiences of using AA and one participant reported the programme was not suitable for her caseload because of their level of understanding and need.

This was a small, exploratory, practice-based study. As this is the first study exploring this area of practice for OTs, to the best of the authors’ knowledge, there were no standardised methods of assessment available, therefore a self-designed survey was used by the author which had a limited number of open-ended questions and four Likert scale questions. This study was also limited in that there was one main researcher who also delivered the two-day AA training. The sample data set was small which resulted in the limitation of the choice of methods used to analyse the quantitative data. Percentage changes were used as the only available and reliable method for a small data set.

Findings of this study, despite their preliminary nature, indicate that AA training may be a useful professional development consideration for OTs who provide a service for autistic children. Further AA research in OT is required including larger and more rigorous studies. An alternative training option of The Curiosity Programme may be considered for OTs supporting children who may not yet be ready to participate in AA.

Policy for women's entrepreneurship is designed to promote economic growth, not least in depleted rural areas, but very little is known about the contributions of rural women entrepreneurs, their needs or how the existing policy is received by them. Using a theoretical framework developed by Korsgaard et al. (2015), the authors analyse how rural women entrepreneurs contribute to rural development and discuss the implications for entrepreneurship policy. This paper aims to focus on the aforementioned objectives.

The authors interviewed 32 women entrepreneurs in rural Sweden representing the variety of businesses in which rural Swedish women are engaged. The authors analysed their contributions to rural development by analysing their motives, strategies and outcomes using Korsgaard et al.’s framework of “entrepreneurship in the rural” and “rural entrepreneurship” as a heuristic, interpretative device.

Irrespective of industry, the respondents were deeply embedded in family and local social structures. Their contributions were substantial, multidimensional and indispensable for rural viability, but the policy tended to bypass most women-owned businesses. Support in terms of business training, counselling and financing are important, but programmes especially for women tend to miss the mark, and so does rural development policy. More important for rural women entrepreneurs in Sweden is the provision of good public services, including for example, schools and social care, that make rural life possible.

Theoretically, the findings question the individualist and a-contextual focus of much entrepreneurship research, as well as the taken-for-granted work–family divide. How gender and how the public and the private are configured varies greatly between contexts and needs contextual assessment. Moreover, the results call for theorising place as an entrepreneurial actor.

Based on the findings, the authors advise future policymakers to gender mainstream entrepreneurship policy and to integrate entrepreneurship and rural development policy with family and welfare state policy.

The paper highlights how rural women respond to policy, and the results are contextualised, making it possible to compare them to other contexts. The authors widen the discussion on contributions beyond economic growth, and the authors show that policy for public and commercial services and infrastructure is indeed also policy for entrepreneurship.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

This chapter discusses how ‘hidden’ populations of women who use drugs (WWUD) in coastal Kenya became ‘visible’ through accessing health, harm reduction and rights services. This effort was facilitated by the Muslim Education and Welfare Association (MEWA) and their work with community leaders. Mapping undertaken by MEWA outreach workers identified women who use opioids and other substances in isolated drug use settings. MEWA introduced daily meals in identified sites, needle and syringe services and residential rehabilitation services for opioid withdrawal. The introduction of residential adherence services for HIV and tuberculosis and the provision of methadone enabled compliance with the 90-90-90 UN HIV cascade. These services achieved sustained HIV viral load suppression at 83% and a 100% cure rate for tuberculosis among WWUD. In addition, disclosure and partner risk tracing was established in the ‘drug dens’ for women who test positive for STIs. The introduction of women-only hours once per week at the drop-in centre contributed to a better understanding of drug dependency among outreach workers and clinicians. Policies on gender-based violence were also refined, leading to an increase in reported cases. Programmes targeting families were introduced to promote effective communication and improve parenting skills. Access barriers to social security programmes were tackled by a network of paralegal officers in partnership with Kenyan authorities. Finally, entrepreneurship training and mentorship programmes were implemented to build resilience among WWUD.

The topic of parent migration and its effects on the family environment has become a focus of moral dilemmas in East Europe for the last three decades. Children have been portrayed as social orphans and parents working abroad as neglectful parents. Today, with more evidence from research and experience, the impact of parental migration is much more comprehensive and nuanced, recognising its noxious or even harmful but also possibly empowering effects. This chapter reflects on the involvement of left-behind adolescents as co-researchers in a study of transnational families. It acknowledges the agentic role of children (often automatically labelled as victims of neglect), amplifies their voices to inform existing data on the impact of parents' departure to work abroad and identifies directions for intervention that might strengthen families.

The research is an integral part of CASTLE – Children Left Behind by Labour Migration, an ongoing project (June 2021–December 2023). ¹ This chapter presents the research collaboration experience with 12 co-researcher adolescents with previous left-behind experiences, originating from Moldova and currently residing in Romania. The co-researchers participated in all stages of the research process: training, design of data collection, recruitment of research participants, data analysis and dissemination of results. Taking co-researcher roles had an empowering effect on adolescents, who learnt how to express their views on the topic, voiced their experiences about the emotional costs of being left behind by their parents and reflected on sensitive issues like separation of family members and violence in the family.

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.