Violence against women is a human rights violation with grave health consequences and crippling effects on women’s abilities to contribute to societal development. Furthermore, violence against women is a global phenomenon, but women in low-income countries suffer a disproportionate burden. Factors such as economic crisis, political instability and civil unrest amplifies the burden. This is the case in Nepal, where the second phase of the ADVANCE project (Addressing Domestic Violence in Pregnancy 2) is based. 

The ADVANCE project addresses one of the most common types of violence against women, domestic violence, which poses significant health risks to women and their unborn infants in pregnancy. Antenatal care presents an opportunity for women to access adequate assistance that may prevent pregnancy-related complications caused by violence and that can have long-standing effects on maternal and child health.

Antenatal care (ANC) presents a ‘window of opportunity’ to reduce the harmful health consequences of domestic violence as most women use ANC services in their lifetimes (Photo: iStock)

However, to date, evidence of the effectiveness of  interventions to address domestic violence in antenatal care contexts is limited and mainly obtained from studies conducted in high-income countries. Considerable knowledge gaps exist to inform antenatal care providers in identifying and assisting pregnant women living with domestic violence in low-income country settings.

The original phase of the ADVANCE project (Addressing Domestic Violence in Antenatal Care Environments) was funded by the Research Council of Norway from 2013-2018 to fill some of these gaps, in Nepal and Sri Lanka. The ADVANCE project team has now been awarded 11 million Norwegian kroner from the FRIPRO research programme of The Research Council of Norway for a second phase of the project (2020-2025) focused on research activities in Nepal. ADVANCE 2 builds on findings from the first ADVANCE studies, now with the aim of ensuring sustainable and evidence-based changes can be made to antenatal care in Nepal.

How can knowledge from high-income countries be contextually adapted to be relevant and useful in other settings? How can effective low-cost interventions be set in place? How will such interventions reach women in the most remote areas where all types of health services are limited? In contexts where few women living with domestic violence are able to leave the relationship, how can health providers assist in mitigating potential harms to women’s health during pregnancy? These are some of the research questions we will answer in the continuation of the ADVANCE project.

To date, the ADVANCE team has completed a pioneering assessment of the burden of domestic violence in pregnancy in Nepal. We found a substantial proportion (21%) of pregnant women reported the experience of domestic violence, as published in the Scandinavian Journal of Public Health in August 2017. Young age and low socioeconomic status were particular risk factors for experiencing domestic violence. Women who reported having their own income and the autonomy to use it were at significantly lower risk of domestic violence compared to women with no income. The study also found that few women had ever disclosed their experience of domestic violence to a health care provider or been asked about domestic violence by a health provider. This underlines the importance of integrating culturally-sensitive and systematic assessment of domestic violence into antenatal care in the future in Nepal.

Project leaders, Research Fellow Jennifer Infanti and Professor Berit Schei

With ADVANCE 2, our team is planning to improve the assessment instrument we developed for the prevalence study, and formally validate it. The assessment instrument is an adapted version of the Abuse Assessment Screen (AAS), a widely-used five-item instrument originally developed in the USA to detect violence against pregnant women. We have translated the instrument to Nepali language and developed an electronic method of data capture for it called a Colour-Coded Audio Computer-Assisted Self-Interview (C-ACASI). Women wear headphones connected to a tablet computer, listen to the questions read to them by a recorded voice through the headphones, and respond to the answers by pressing colour-coded options (for example, in our study, red = yes and green = no). This technology allows women to answer sensitive questions about domestic violence in privacy in otherwise busy antenatal care settings. Importantly, it also allows for the inclusion of participants with limited or no literacy. In Nepal, the female literacy rate is approximately 67%.

We have also carried out an extensive qualitative study with 41 men and 76 women in 12 focus group discussions in community settings to explore perceptions of domestic violence in pregnancy. This was published in Global Health Action in 2016. In this work, we learned that other events than those covered in the AAS could be classified as domestic violence in Nepal and have the potential for harmful effects on a woman’s pregnancy. The community members identified culturally-specific forms of DV such as mothers-in-law restricting or denying food to pregnant women; being forced to perform long days of heavy manual labour into late pregnancy; bullying, belittling, threats and psychological stress related to dowries; and psychological stress related to cultural preference, familial pressure and taunting to give birth to a son.

Again, ADVANCE 2 builds on this prior knowledge. In the new study, we will modify the AAS to ensure it captures culturally-relevant examples of domestic violence, particularly types of emotional abuse. Our aim is therefore to create the Nepalese Abuse Assessment Screen (N-AAS), which will then be formally validated in our two partner hospitals (Dhulikhel Hospital and Kathmandu Medical College).

Example of illustrations made by a Nepalese artist to explain possible safety measures to practice during pregnancy.

It is critical not only to identify pregnant women living with domestic violence but also to provide them with assistance. In our prior work, we assessed the impact of a safety-promoting intervention delivered on an antenatal care ward at Kathmandu Medical College, in a cohort study. Pregnant women between 12-28 weeks gestation were recruited to the study at their regular antenatal care appointments at the hospital. They were educated about safety measures by a nurse or researcher using a pictorial flipchart that we developed in a teaching session lasting for a maximum of 30 minutes. The flipchart was based on a standardised safety behaviour checklist, originally created in a high-income country setting. We adapted the checklist to ensure the relevance of the safety behaviours for women in Nepal. The figure above is an example of the safety behaviours.

The findings of our study were promising, as published in the International Journal of Environmental Research and Public Health in 2020. We observed that the range of safety measures used by women increased from baseline to follow-up. However, the main weakness was the follow-up cohort study design as we were unable to compare the use of safety measures with other types of intervention. Therefore, in ADVANCE 2, we plan to test the intervention in a randomised controlled trial compared to standard care in both of our partner hospitals. This will expand the evidence-base on health sector interventions to address domestic violence in low-income country settings. The long-term goal is to integrate safety planning into standard antenatal care in Nepal.

The ADVANCE 2 study is led by Research Fellow Jennifer Infanti and Professor Berit Schei (Principal Investigator) at Department of Public Health and Nursing, NTNU. Our former PhD candidates from the original ADVANCE study, now NTNU graduates, will continue in key roles in the project’s second phase. Poonam Rishal is postdoctoral researcher for ADVANCE 2, based at Kathmandu Medical College and Teaching Hospital (KMC). Kunta Devi Pun is co-local Principal Investigator for ADVANCE 2, based at Dhulikhel Hospital-Kathmandu University School of Medical Sciences (KUSMS). Our other local Principal Investigators in Nepal are Sunil Kumar Joshi (KMC) and Rajendra Koju (DH-KUSMS). In Scandinavia, our partner institutions and/or supervisors for the ADVANCE 2 project include Katarina Swahnberg at Linnaeus University (Sweden), Mirjam Lukasse at University of South-Eastern Norway, and Lena Henriksen at Oslo Metropolitan University. Jacquelyn C. Campbell at Johns Hopkins School of Nursing (USA) is international advisor to the project team.

 Blogger: Ekaterina Zotcheva, PhD Candidate, Department of Public Health and Nursing

Ekaterina Zotcheva, Stpendiat, CERG employee

In 2015, approximately 47 million people worldwide were living with dementia. As populations across the globe age, this number is predicted to almost triple by 2050 [1]. Dementia is one of the most burdensome conditions among older people worldwide, and has a large impact both on the societal and individual level. The World Alzheimer Report on the global impact of dementia states that the total estimated global cost of dementia in 2015 was an astonishing US$818 billion, where almost 85% of the costs were related to family and social care [1]. Thus, new knowledge about prevention and treatment of dementia is of great value.

In July, the Lancet Commission on Dementia Prevention and Care published an article presenting an extensive review of risk and protective factors for dementia. Theoretically, approximately one third of dementia cases can be avoided by eliminating a number of risk factors, according to the authors. Based on the literature review, a striking 9.1% of dementia cases are attributable to hearing loss in midlife, whereas 7.5% can be attributed to low education. Other important risk factors are smoking, depression, physical inactivity, social isolation, hypertension, diabetes, and obesity [2].

Prevention is better than cure

So, I can just start exercising, stop smoking, and live a healthier life, right? The authors recommend that efforts must be made on both the individual and the societal level to reduce the prevalence of these risk factors. “Prevention is better than cure”, and while reducing or even eliminating the mentioned risk factors may not get rid of a whole third of dementia cases, it may delay the onset of many cases by several years [2]. Researchers have estimated that the prevalence of dementia could be halved if we could delay its onset by 5 years [3]!

The road ahead

Hearing loss, smoking, depression, social isolation and obisity are some of the risk factors for dementia [2]

The Health Study in Nord-Trøndelag (HUNT), one of the world’s largest and most successful population studies, started collecting data from the population in Nord-Trøndelag County in Norway in 1984. HUNT provides unique data on health and lifestyle factors, as well as on the prevalence of mental and somatic diseases. The fourth wave of the study (HUNT4) starts this fall. In the sub-study HUNT4 70+, researchers will gather valuable information on cognitive function, dementia, physical activity and function, nutrition, and oral health, in addition to the standard surveys included in HUNT4, from inhabitants aged 70 and up. Of approximately 20 000 inhabitants in this age group, 18 700 have previously participated in at least one of the three earlier waves of HUNT. Geir Selbæk, one of the authors of the aforementioned Lancet Commission article and research director at the Norwegian National Advisory Unit on Ageing and Health, is responsible for the part of HUNT4 70+ regarding cognitive function and dementia. The results from the HUNT and HUNT4 70+ studies will provide a substantial database for studying risk factors for dementia, hopefully helping us further disentangle and understand the complex relationship between lifestyle, cognitive function, and dementia.

Sources

1. Prince M, Wimo A, Guerchet M, Ali G-C, Wu Y-T, Prina M. World Alzheimer Report 2015. The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. Alzheimer’s Disease International, 2015.
2. Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. The Lancet. 2017. doi: 10.1016/S0140-6736(17)31363-6.
3. Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand. 1987;76(5):465-79.
4. Cherbuin N, Kim S, Anstey KJ. Dementia risk estimates associated with measures of depression: a systematic review and meta-analysis. BMJ open. 2015;5(12):e008853. doi: 10.1136/bmjopen-2015-008853.
5. Snowden MB, Atkins DC, Steinman LE, Bell JF, Bryant LL, Copeland C, et al. Longitudinal Association of Dementia and Depression. Am J Geriatr Psychiatry. 2015;23(9):897-905. doi: 10.1016/j.jagp.2014.09.002.

The seminar will take place on 21 October in Øya helsehus (Aud. 1), and focus on:

• Health care systems in low income countries
• Violence against women

 Speakers

Professor Staffan Bergström, Karolinska Institute. Specialist in Obstetrics and Gynecology.
Staffan Bergström has experiences from several African countries on how to save mothers and newborns in places where there is a shortage of doctors. He points to the importance of health workers without medical training. It is they who are the backbone of health care system in low income countries.

“On the African continent only 5,000 doctors are educated annually. African countries are thus forced use health workers without medical training. They do a tremendous job, without having spent even a day at medical school. Simply training midwives in life saving skills can make a big difference” says Professor Bergström. He has had great influence internationally on the task-shifting debate. The last three years Bergström has worked in Tanzania with “Maternal Health Initiative”

Dean Sylvia Kaaya, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania.
Silvia Kaaya is professor of psychiatry. Her research interest is children and mental health. Professor Kaaya’s publications trades extensively to detect and treat mental illness and depression in different groups e.g pregnant women, children, youths and how HIV positivity affects mental health. Recently NTNU and MUHAS signed a MoU in research and student exchange.

Professor Charlotte Watts, London School of Hygiene and Tropical Medicine, UK.
In the mid-90s Charlotte Watts did her fieldwork in Zimbabwe. The findings from her study illustrates not only the extent to which violence against women is widespread throughout the world, but also that there is considerable variation in the levels of violence – both within the country as well as between countries. Although the causes of violence are complex, this suggests local variation and that there may be local conditions that affect the extent to which women are subjected to violence. A better understanding of the causes of this variation can be used to identify how to prevent future violence.

Programme and registration

Programme for Global Health Day 2014 (pdf)

The seminar, lunch and pizza are free. Please register for the seminar before 10 October 2014.

Target audience

The target group are persons engaged in research, teaching or clinical activities targeted towards developing countries as well as students in health sciences or medicine.

About the seminar

Global health research embodies research on health problems related to challenges that particularly affect people in low- and middle income countries. The Faculty of Medicine, NTNU, has increased its investment in global health, in close cooperation with St. Olavs University Hospital, Sør-Trøndelag University College (HiST), as well as partner institutions in low- and middle income countries. The seminar aims to increase cooperation, networking and further research activity while providing professional input and inspiration. The Research Council of Norway has given financial support to this seminar.

If you have any questions about the seminar, please contact Elin Yli Dvergsdal

This is what we are doing there: http://scienceinthecity.dk/en/event/6-can-u-hear-u-sound

On Saturday at 17:00 our researcher Garrett Newton Andersen will demonstrate a hand-held ultrasound machine (Vscan) on stage: http://scienceinthecity.dk/en/event/103-scan-your-heart-stage-can-u-hear-u-sound

Blogger: Vibeke Videm

Twice as many of those who got rheumatoid arthritis between the HUNT2 population-based health survey in 1995-1997 and the next survey (HUNT3) in 2006-2008, reported previous cardiovascular disease at HUNT2. They either had angina or had suffered a myocardial infarction or stroke. The data indicate that there may be a causative link.

(…) chronic inflammation in one part of the body intensifies chronic inflammatory processes in other parts

Atherosclerosis, the most common cause of cardiovascular disease, is caused by chronic inflammation in the vessel walls. Rheumatoid arthritis is due to a gradual process with increasing dysregulation of the immune system that finally leads to inflammation in the joints. The inflammation due to atherosclerosis probably intensifies the process leading to rheumatoid arthritis. The study was recently published in the scientific journal  Arthritis Research and Therapy.

The findings are especially interesting because we already know that persons with established rheumatoid arthritis have an increased risk of cardiovascular disease. Our data indicate that the relationship between rheumatoid arthritis and cardiovascular disease may go both ways: if a person has one of these conditions, the risk of the other increases.

In other words: chronic inflammation in one part of the body intensifies chronic inflammatory processes in other parts. The joints and vessel walls are not independent sites, but influence each other.

In the HUNT surveys, the entire adult population in the county of North Trøndelag in Norway was invited to participate. In HUNT2, 70 % of those invited participated, and in HUNT2, 54 %. We studied 786 participants who reported having rheumatoid arthritis in HUNT3, but not in HUNT2. They were compared to more than 32,000 other HUNT participants. We found that 6.6 % of those who later got rheumatoid arthritis had previous cardiovascular disease, compared to 3.1 % of the other participants.

The risk was now 90 % larger for future rheumatoid arthritis in the participants who had cardiovascular disease at HUNT2.

The diagnosis of rheumatoid arthritis in HUNT is self-reported. This introduces some uncertainty because some of those who answer that they have rheumatoid arthritis may actually have another condition. We therefore repeated the analysis after investigating whether the participants reporting rheumatoid arthritis also had a diagnosis from one of the three hospitals in Trøndelag. When comparing these 201 persons with the remaining HUNT participants the connection became stronger: The risk was now 90 % larger for future rheumatoid arthritis in the participants who had cardiovascular disease at HUNT2.

Approximately 1 % of the population suffers from rheumatoid arthritis. Without treatment, the condition causes pain and gradual joint destruction, resulting in decreased function. To a large extent, this may be prevented by modern treatment. The most important risk factor is a genetic predisposition, and rheumatoid arthritis is more common in women. The risk also increases with advancing age. These are factors the individual cannot influence.

(…) our study confirms that lifestyle-related factors have an important impact on whether a person with a genetic predisposition actually develops rheumatoid arthritis

However, our study confirms that lifestyle-related factors have an important impact on whether a person with a genetic predisposition actually develops rheumatoid arthritis. Smoking, overweight, high blood pressure, too little physical activity and increased blood cholesterol are important risk factors for cardiovascular disease, which in turn is associated with increased risk of rheumatoid arthritis. Several of these factors also directly influence the risk of rheumatoid arthritis, without the “detour” via cardiovascular disease. It is well established that smoking at least doubles the risk of rheumatoid arthritis and that this effect remains for many years following cessation. In our study, the effect from previous cardiovascular disease was additive to the direct effect of smoking.

Which practical conclusions may be drawn from the study?

First, that a person with relatives having rheumatoid arthritis has very strong reasons to try to adopt a lifestyle that reduces the risk of cardiovascular disease: avoid smoking, eat a healthy diet and get enough exercise, and have his or her blood pressure and cholesterol checked from time to time. It is certainly a positive thing that it is possible to do something that reduces the risk of developing disease even if one has had back luck with respect to the genetic predisposition.

(…) a person with relatives having rheumatoid arthritis has very strong reasons to try to adopt a lifestyle that reduces the risk of cardiovascular disease

Second, that someone with cardiovascular disease who develops joint problems may actually have an early form of rheumatoid arthritis, and that the doctor needs to keep this diagnosis in mind during the diagnostic work-up. Joint problems have many causes. But if they turn out to be due to rheumatoid arthritis, it is important to start treatment as early as possible.

International collaboration

The study results from collaboration between researchers at the Medical Faculty at the Norwegian University of Science and Technology in Trondheim, Norway, and researchers at the University of Queensland in Brisbane, Australia. The HUNT study is very well suited for this kind of studies: There are a large number of participants, they represent the general population and not selected subgroups, and follow-up time is long.

We are grateful to the people in North Trøndelag who were willing to participate in several of the HUNT surveys. If not, the study would not have been feasible because it was based on comparison between responses in HUNT2 and HUNT3. The research group is now planning new studies on rheumatoid arthritis in a future HUNT4, where we hope that the inhabitants of North Trøndelag will once again contribute to helping us getting further knowledge about the causes and possible strategies to reduce the risk.

Blogger: Boukje Ehlen

Working as an EU-advisor for the Faculty of Medicine at NTNU, I read this article in Universitetsavisa with great interest.

(…) last week The Faculty of Medicine submitted a record-breaking 14 EU-proposals, so it can’t be all bad.

Unfortunately, this article builds on the negative experience of researchers with the previous (seventh) framework programme. Though it provides valuable input on how these were perceived, I think it is also important to broadcast that the system is now easier to access:

• budgeting and reporting of projects has been simplified
• information on research topics, which documents are needed etc., has become better to find and read
• it is easy to scan if your topic fits, by applying with a first stage proposal that is only six pages on goals, ambition and impact

Within the Faculty of Medicine, we have put in collaborative effort to explain researchers that Horizon 2020 is different, easier and participating has more value than just money.

I met a researcher that said he once tried to apply for a project back in 1995, and was not keen on applying again. I tried to encourage him by telling him that much has changed since 1995. And not just my looks, but the European project and proposal organisation has changed as well!

Within the Faculty of Medicine, we have put in collaborative effort to explain researchers that Horizon 2020 is different, easier and participating has more value than just money. It can give you (global) visibility, collaboration with different fields, influence on European policy and contacts that last forever.

I meet researcher who express that applying for a EU-projects is a learning process: They learn much more about their research topic, how to phrase it, and to place their research in a European context.

In order to address the perceived challenges with EU-proposals and project, the Faculty of Medicine provides a hands-on, customized and service-oriented support in all stages of the process. We give tailored advice to researchers, which topics and programmes might be relevant, and whether or not to apply.

We give tailored advice to researchers, which topics and programmes might be relevant, and whether or not to apply.

And we explain to researchers, that experiences with EU-proposals of the past can be quite out-dated: the evaluation process has changed, reporting schemes have changed and funding rates have changed.

I hope that with our faculty’s encouragement and support, many researchers will feel confident to embark on a very special journey, that’s called EU-projects!

In the article in Universitetsavisa almost four out of five researchers who did get funding from EU would try again. And last week The Faculty of Medicine submitted a record-breaking 14 EU-proposals, so it can’t be all bad.

By participating in this study you will help us on our way to understand the difference between active and inactive people and how they respond to a meal, and if there is a difference in appetite regulation between the two groups. We are interested in examining the daily variation in insulin response and appetite regulation after the same test meal and how mood and physical activity level can affect it.

You have to be available on three occasions. There will be weighing, measuring, exercise testing (VO2max) and measures of body composition (BODPOD). Two occasions will consist of milkshake and blood samples (approximately 3 hours both times). It will be possible to bring your laptop, books, etc.

If you want more information about this study, please contact master student Linn Bøhler (in English or Norwegian, linnbo@stud.ntnu.no).

The study will run at the Faculty of Medicine, NTNU and is without commercial interests.

*BMI is calculated as: weight (kg) / (height (m) x height (m)).

Research from several different countries has shown that spending time in child daycare institutions may cause increased levels of stress in small children. In Norway 80 percent of 1-year-olds attend daycare. We know nothing about their stress levels.

In the international studies the children’s stress levels have been measured through analysing the levels of cortisol, also called “the stress hormone”, in spit samples taken at different times in the cause of a day. Our levels of the hormone cortisol increase in situations involving danger and make our bodies prepared for situations perceived as difficult or threatening.

Illustration: Photos.com

Normally, our levels of cortisol are highest in the morning, decrease during the day and are at their lowest in the evening. Research in other countries has shown that many of the smallest children attending daycare institutions have cortisol levels that remain high throughout the day. When the children spend a day at home their cortisol levels act normally again, falling during the day. This finding indicates that some small children are constantly alert in order to tackle challenges and difficulties when they are in daycare. Perhaps they are spending too much time on their own without support from grown-ups they feel secure with.

Small children need attentive and available adults around them that can help them when they need it. This is not always the practice during busy days in a daycare institution, not in Norway either. Some small children are assumed to be more exposed for experiencing daycare as stressful, because they for instance have a more vulnerable temperament. It is also assumed that a large number of activities controlled by grown-ups and plenty of time spent in a big group can cause higher stress levels in small children.

Negative stress over time can cause a weakened immune system and reduced memory, capability to regulate own behaviour and handle future stress situations. At present, there is not enough knowledge to say if stress caused in child care institutions has these effects.

This autumn we start collecting data for the study “Small in daycare” (“Liten i barnehagen”), where around 400 parents from Trondheim and Oslo will be invited to participate with their children. We will be measuring the children’s levels of cortisol both in daycare and at home as part of the research. Further, we will observe the interaction between the children and the personnel to see if there is a connection between positive interplay and reduced stress levels in the children. We will also investigate factors such as physical buildings, the size of the group of children and number of children per grown-up.

The research project is collaboration between the Regional Centre for Child and Youth Mental health and Child Welfare at NTNU and the Regional Center for Child and Adolescent Mental Health – Region East and South. In addition international researchers on child care will take part in the research.

Data about the participants has been collected already from pregnancy, a fact that makes the project unique, also on an international level. By controlling other factors that also may cause stress we can be sure that it actually is stress related to the child care institution we are examining. We can also investigate if some children are more vulnerable than others when it comes to kindergarten-related stress. So far, little research has been conducted on this topic internationally.

Our research project will show if the youngest children in daycare in Norway are less stressed than small children in other countries. Perhaps Norwegian daycare institutions are of such a quality that this is the case, but so far we do not know.

References:

Badanes, L.S., Dmitrieva, J. & Watamura, S.E. (2012). Understanding cortisol reactivity across the day at child care: The potential buffering role of secure attachment to caregivers. Early Childhood Research Quarterly, 27, 156-165.

Bratterud, Å., Sandseter, E.B. & Seland, M. (2012). Barns trivsel og medvirkning i barnehagen. Trondheim: Barnevernets Utviklingssenter, Rapport 21/12.

Gunnar, M.R., Kryzer, E., van Ryzin, M.J. & Phillips, D.A. (2010). The rise in cortisol in family day care: Associations with aspects of care quality, child behavior, and child sex. Child Development, 81, 853-870.

Phillips, D.A., Fox, N.A. & Gunnar, M.R. (2011). Same place, different experiences: Bringing individual differences to reserach in child care. Child Development Perspectives, 5, 44-49.

Sajaniemi, N., Suhonon, E., Kontu, E., Rantanen, P., Lindholm, H., Hyttinen, S. & Hirvonen, A. (2011). Children’s cortisolpatterns and the quality of early learning environment. European Early Childhood Education Research Journal, 19, 45-62.

Vermeer, H.J. & IJzendoorn, M.H. (2006). Children’s elevated cortisol levels at daycare: A review and meta-analysis. Early Childhood Research Quarterly, 21, 390-401.

Parental involvement in their children’s education is one of the strongest predictors of children’s school success and has a powerful influence on the children’s achievement and adjustment.

As part of my PhD project at the Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) I have examined parent involvement in relation to children’s behavioural problems and social competence in school. For children with behavioural problems, parent involvement is especially important for how the children cope in school.

Illustration: Photos.com

Parental involvement in school involves behaviour by parents in school settings and at home that is intended to support their children’s educational development. These are behaviour like getting involved with school/ teacher, attending parent-teacher conferences and school meetings and encourage the child’s positive attitude towards education, e.g.; helping the child with its homework, playing games to teach the child new things, taking the child to the library, reading to child and so on.

Positive involvement between parents and school/teachers has been shown to improve the children’s academic accomplishment on all levels as well as their social functioning in school. For children in general, parental involvement in school is reported to lead to improved behaviour, attitudes and attendance at school, as well as better emotional adjustment and greater well-being.

For the youngest children in school, parental involvement is associated with early school success, this including academic and language skills and social competence. Further; parent’s expectations and involvement in school seem to have a stronger influence on the youngest children’s achievement compared to children in the later years of elementary school.

For children with behavioural problems, parent involvement is especially important for how the children cope in school.

In general, children with behaviour problems often have learning difficulties and lack social competence and therefore tend to be rejected by prosocial children. For these children parent involvement in school and co-operation between parents and school/ teacher is in particular important.Young children with high levels of behaviour problems are considered less academically competent, they have poorer reading and verbal skills, they perform worse in school and they receive more negative feedback from teachers than their more behaviourally competent peers.

Positive parent–school involvement for children with behaviour problems is a predictor of later social and academic success and the lack of parental involvement may contribute to extend the child’s behavioural problems.

Maintaining a good working relationship between parents and school is a mutual responsibility. Good communication between home and school, as well as mutual respect is decisive for good cooperation.

Reference:

Kirkhaug, B., Drugli, M.B., Klöckner, C.A., & Mørch, W-T. (2013). Association between parental involvement in school and child conduct, social, and internalizing problems: teacher report. Educational Research and Evaluation, 1-16.

Illustration: Photos.com

In August, Norwegian children start kindergarten and school after the summer holiday. This is an exciting time for many families. Some have a toddler in the family going to kindergarten for the first time, while others may have a kid starting in a new class with new classmates.

“Back to school and kindergarten” is the main theme for this blog in August.  Experts within a range of fields, from physical and psychological health to educational science and social science will write about themes related to kindergarten and school. Perhaps we can share some new insights and tips?