Parental Competence, Parenting Stress, Family Harmony, and Perceived Available Support among Mothers with Children Aged 3-6 Years

Abstract

There is a growing body of research focused on examining family dynamics. This article reports on two studies. Study 1 aimed to develop a parental competence scale and examine its psychometric qualities. Data was gathered from 915 Turkish mothers with children aged 3-6 years. In order to evaluate the instrument’s internal structure, exploratory (EFA) and confirmatory factor analyses (CFA) were performed. EFA revealed that there is a single factor structure consisting of 13 items. CFA confirmed that all items in the one-dimensional scale are compatible with the model and goodness of fit values are acceptable. Reliability analyses showed that the scale’s internal consistency was high. Study 2 aimed to investigate the direct and indirect effects of parenting stress on parental competence and family harmony through the perceived available support. Data was obtained from 261 mothers with children ages 3-6 years. The results of the study revealed that the perceived available support not only mediated the relationship between parenting stress and parental competence, but also the relationship between parenting stress and family harmony. Findings were discussed in light of family dynamics literature.

Keywords

• Parental competence
• Family harmony
• Parenting stress
• Perceived available support
• Mothers

References

1. Abidin, R. R. (1990). Parenting Stress Index-Short Form. Pediatric Psychology Press.
2. Abidin, R. R., & Brunner, J. F. (1995). Development of a Parenting Alliance Inventory. Journal of Clinical Child Psychology, 24(1), 31–40. https://doi.org/10.1207/s15374424jccp2401_4
3. Albanese, A., M., Russo, G. R., & Geller, P. A. (2019). The role of parental self-efficacy in parent and child well-being: A systematic review of associated outcomes. Child Care, Health and Development, 45(3), 333–363. https://doi.org/10.1111/cch.12661
4. Anthony, L. G., Anthony, B. J., Glanville, D. N., Naiman, D. Q., Waanders, C., & Shaffer, S. (2005). The relationships between parenting stress, parenting behaviour and preschoolers’ social competence and behaviour problems in the classroom. Infant and Child Development, 14(2), 133–154. https://doi.org/10.1002/icd.385
5. Bandura, A. (2009). Self-efficacy in changing societies. Cambridge University Press.
6. Bandura, A. (1997). Self-efficacy: The exercise of control. W H Freeman/Times Books/ Henry Holt & Co.
7. Bandura, A. (1994). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4) (pp. 71–81). Academic Press.
8. Barrera, M., Jr. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14, 413–445. https://doi.org/10.1007/BF00922627

9. Berryhill, M. B. (2016) Mothers’ parenting stress and engagement: Mediating role of parental competence. Marriage & Family Review, 52(5), 461–480. https://doi.org/10.1080/01494929.2015.1113600
10. Baumrind, D. (2005). Patterns of parental authority and adolescent autonomy. New Directions for Child and Adolescent Development, 108, 61–69. https://doi.org/10.1002/cd.128
11. Belsky, J., Robins, E., & Gamble, W. (1984). The determinants of parental competence: Toward a contextual theory. In M. Lewis (Ed.), Beyond the dyad (pp. 251–280). Springer Science+Business Media, LLC.
12. Bowlby, J. (1982). Attachment and loss (Vol. I) (2nd edition). Basic Books.
13. Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32(7), 513–531. https://doi.org/10.1037/0003-066X.32.7.513
14. Büyüköztürk, Ş. (2010). Sosyal bilimler için veri analizi el kitabı. Pegem Akademi.
15. Carter, B., Arnott, J., Simons, J., & Bray, L. (2017). Developing a sense of knowing and acquiring the skills to manage pain in children with profound cognitive impairments: Mothers’ perspectives. Pain Research & Management, 2514920, 1–11. https://doi.org/10.1155/2017/2514920
16. Cheung, F., Lun, V. M. C., Ngo, H. Y., & Fong, E. (2020). Seeking harmony in Chinese families: A dyadic analysis on Chinese parent‒child relations. Asian Journal of Scoial Psychology, 23(1), 81–90. https://doi.org/10.1111/ajsp.12393
17. Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38(5), 300–314. http://dx.doi.org/10.1097/00006842-197609000-00003
18. Cochran, M., & Brassard, J. (1979). Child development and personal social networks. Child Development, 50(3), 601–616. https://doi.org/10.2307/1128926
19. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310
20. Cokamay Yılmaz, G. (2018). Cognitive behavioural therapy based parent trainings: A theoretical review. Journal of Cognitive Behavioral Psychotherapy and Research, 7(3), 133–143. https://doi.org/10.5455/JCBPR.300581
21. Çokluk, Ö., Şekercioğlu, G., & Büyüköztürk, Ş. (2012). Sosyal bilimler için çok değişkenli istatistik: SPSS ve LISREL uygulamaları. Pegem Akademi.
22. Costello, A.B., & Osborne, J.W. (2005). Best practices in exploratory factor analysis: Four recommendations forgetting the most from your analysis. Practical Assessment Research and Evaluation, 10(7), 1–9. https://doi.org/10.7275/jyj1-4868
23. Deater-Deckard, K., Scarr, S., McCartney, K., & Eisenberg, M. (1994). Paternal separation anxiety: Relationships with parenting stress, child-rearing attitudes, and maternal anxieties. Psychological Science, 5(6), 341–346. https://doi.org/10.1111/j.1467-9280.1994.tb00283.x
24. Deater-Deckard, K. (1998). Parenting stress and child adjustment: Some old hypotheses and new questions. Clinical Psychology: Science and Practice, 5(3), 314–332. https://doi.org/10.1111/j.1468-2850.1998.tb00152.x
25. Demirci, İ. (2022). Family harmony and flourishing in Turkey: The roles of interdependent happiness and harmony in life. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being, 23, 985–1005. https://doi.org/10.1007/s10902-021-00437-7
26. Dittman, C.K., Farruggia, S.P., Keown, L.J., & Sanders, M.R. (2016). Dealing with disobedience: An evaluation of a brief parenting intervention for young children showing noncompliant behavior problems. Child Psychiatry and Human Development, 47(1), 102–112. https://doi.org/10.1007/s10578-015-0548-9.
27. Duman Kula, M., Eksi, H., & Demirci, I. (2018). The psychometric properties of the Turkish form of Family Harmony Scale. Eskişehir Osmangazi University Journal of Social Sciences, 19(1), 97–106. https://doi.org/10.17494/ogusbd.457082
28. Ecevit, Y. (2010). İş ve aile yaşamının uzlaştırılması bağlamında Türkiye’de erken çocukluk bakımı ve eğitimi. In I. Ilkkaracan (Ed.), Emek piyasasında toplumsal cinsiyet eşitliğine doğru: İş ve aile yaşamını uzlaştırma politikaları (pp. 87–114). ITU BMTKAUM & KIH-YÇ.
29. Erikson, E. (1977). Childhood and society. Paladin Grafton Books
30. Erkuş, A. (2012). Psikolojide ölçme ve ölçek geliştirme - I. Pegem Akademi Yayınları.
31. Evans, G. W., Boxhill, L., & Pinkava, M. (2008). Poverty and maternal responsiveness: The role of maternal stress and social resources. International Journal of Behavioural Development, 32(3), 232–237. https://doi.org/10.1177/0165025408089272
32. Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4(3), 272–299. https://doi.org/10.1037/1082-989X.4.3.272
33. Freeman, P., Coffee, P., & Rees, T. (2011). Social support moderates the relationship between stressors and task performance through self-efficacy. Journal of Sport & Exercise Psychology, 33, 54–74.
34. Gibaud-Wallston, J., & Wandersman, L. P. (1978). Parenting Sense of Competence Scale (PSOC) [Database record]. APA PsycTests. https://doi.org/10.1037/t01311-000
35. Gilmore, L. & Cuskelly, M. (2008). Factor structure of the Parenting Sense of Competence Scale using a normative sample. Child: Care, Health and Development, 35(1), 48–55. https://doi.org/10.1111/j.1365-2214.2008.00867.x
36. Gladding, S. T. (2015). Family therapy: History, theory, and practice (Sixth edition). Pearson.
37. Gondoli, D. M., & Silverberg, S. B. (1997). Maternal emotional distress and diminished responsiveness: The mediating role of parenting efficacy and parental perspective taking. Developmental Psychology, 33(5), 861–868. https://doi.org/10.1037/0012-1649.33.5.861
38. Gülerce, A. (1996). Türkiye’de ailelerin psikolojik örüntüleri. Bogazici University Press.
39. Hayes, A. F. (2018). Partial, conditional, and moderated moderated mediation: Quantification, inference, and interpretation. Communication Monographs, 85(1), 4–40. https://doi.org/10.1080/03637751.2017.1352100
40. Hess, C. R., Teti, D. M., & Hussey-Gardner, B. (2004). Self-efficacy and parenting of high-risk infants: The moderating role of parent knowledge of infant development. Journal of Applied Developmental Psychology, 25(4), 423–437. https://doi.org/10.1016/j.appdev.2004.06.002
41. Hildingsson, I., & Thomas, J. (2014). Parental stress in mothers and fathers one year after birth. Journal of Reproductive and Infant Psychology, 32(1), 41–56. https://doi.org/10.1080/02646838.2013.840882
42. Hsiao, Y. J. (2018). Autism spectrum disorders: Family demographics, parental stress, and family quality of life. Journal of Policy and Practice in Intellectual Disabilities, 15(1), 70–79. https://doi.org/10.1111/jppi.12232
43. Ho, M. Y., & Liang, S. (2021). Emotion-oriented coping and parental competency: An evidence-based parenting intervention for parents of children with special educational needs. Child & Family Social Work, 26(4), 518–529. https://doi.org/10.1111/cfs.12834
44. Hofstede, G. (2001). Culture’s consequences: Comparing values, behaviors, institutions, organizations across nations. Sage.
45. Hong, X., & Liu, Q. (2021). Parenting stress, social support and parenting self-efficacy in Chinese families : does the number of children matter? Early Child Development and Care, 191(14), 2269–2280, https://doi.org/10.1080/03004430.2019.1702036
46. Hoover-Dempsey, K., Walker, J. M., Sandler, H. M., Whtesel, D., Green, C. L., Wilkins, A., & Closson, K. (2005). Why do parents become ınvolved? Research findings and ımplications. The Elementary School Journal, 106(2), 105-130. http://dx.doi.org/10.1086/499194
47. Hu, L. T., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424
48. Hu, L. T., & Bentler, P. M. (1999). Cut-off criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
49. Huang, C. Y., Costeines, J., Ayala, C., & Kaufman, J. S. (2014). Parenting stress, social support, and depression for ethnic minority adolescent mothers: Impact on child development. Journal of Child and Family Studies, 23(2), 255–262. https://doi.org/10.1007/s10826-013-9807-1
50. Huey M. J., Laursen B., Kaniušonytė G., Malinauskienė O., & Žukauskienė R. (2020). Self-esteem mediates over-time associations from parenting to adolescent adjustment. Journal of Abnormal Child Psychology, 48(3), 331–341. https://doi.org/10.1007/s10802-019-00599-2
51. Ip, P. K. (2014). Harmony as happiness? Social harmony in two Chinese societies. Social Indicators Research, 117(3), 719–741. https://doi.org/10.1007/s11205-013-0395-7.
52. Jackson, A. P., & Huang, C. C. (2000). Parenting stress and behavior among single mothers of preschoolers: The mediating role of self-efficacy. Journal of Social Service Research, 26(4), 29–42. https://doi.org/10.1300/J079v26n04_02.
53. Jackson, C.B., & Moreland, A.D. Parental competency as a mediator in the PACE parenting program’s short and long-term effects on parenting stress. Journal of Child and Family Studies, 27, 211–217 (2018). https://doi.org/10.1007/s10826-017-0859-5
54. Johnston, C., & Mash, E. J. (1989). A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18(2), 167–175. https://doi.org/10.1207/s15374424jccp1802_8
55. Jones, T. L., & Prinz, R. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: a review. Clinical Psychology Review, 25(3), 341–63. https://doi.org/10.1016/j.cpr.2004.12.004.
56. Jöreskog, K. G., & Sörbom, D. (2001). Lisrel 8: User’s reference guide. Scientific Software International.
57. Kagitcibasi, Ç. (2005). Autonomy and relatedness in cultural context: Implications for self and family. Journal of Cross-Cultural Psychology, 36(4), 403–422. https://doi.org/10.1177/0022022105275959
58. Kagitcibasi, C. (2017). Family, self, and human development across cultures: theory and applications. Psychology Press / Routledge Classic Editions.
59. Kapkiran, S., & Acun Kapkiran, N. (2010). The validity and reliability of the Perceived Available Support Scale. Ankara University Journal of Faculty of Educational Sciences, 43(2), 51-73. https://doi.org/10.1501/Egifak_0000001202
60. Kavikondala, S., Stewart, S. M., Ni, M. Y., Chan, B. H., Lee, P. H., Li, K. K., McDowell, I., Johnston, J. M., Chan, S. S., Lam, T. H., Lam, W. W. T., Fielding, R., & Lam, W. W. (2016). Structure and validity of Family Harmony Scale: An instrument for measuring harmony. Psychological assessment, 28(3), 307-318.
61. Kaymak Ozmen, S. & Ozmen, A. (2012). Parent Stress Scale development. Mili Eğitim, 196, 20-35
62. Keller, D., & Honig, A. S. (2004). Maternal and paternal stress in families with school-aged children with disabilities. American Journal of Orthopsychiatry, 74(3), 337–348. https://doi.org/10.1037/0002-9432.74.3.337.
63. Kjell, O. N. E., Daukantaitė, D., Hefferon, K., & Sikström, S. (2016). The harmony in life scale complements the satisfaction with life scale: Expanding the conceptualization of the cognitive component of subjective well-being. Social Indicators Research, 126(2), 893–919. https://doi.org/10.1007/s11205-015-0903-z
64. Kline, R.B. (2011). Principles and practice of structural equation modeling. The Guilford Press.
65. Lamb, M. (1996). The role of the father in child development. Wiley.
66. Lam, W. W. T., Fielding, R., McDowell, I., Johnston, J., Chan, S., Leung, G. M., & Lam, T. H. (2012). Perspectives on family health, happiness and harmony (3H) among Hong Kong Chinese people: a qualitative study. Health Education Research, 27(5), 767–779. https://doi.org/10.1093/her/cys087
67. Lau, S., Lew, W. J. F., Hau, K. T., Cheung, P. C., & Berndt, T. J. (1990). Relations among perceived parental control, warmth, indulgence, and family harmony of Chinese in mainland China. Developmental Psychology, 26(4), 674–677. https://doi.org/10.1037/0012-1649.26.4.674
68. Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: Exploring the question, weighing the merits. Structural Equation Modeling, 9(2),151–173.
69. Maccoby, E. E., & Martin, J. A. (1983). Socialization in the context of the family: Parent-child interaction. In P. H. Mussen, & E. M. Hetherington (Eds.), Handbook of child psychology: Socialization, personality, and social development (Vol. 4) (pp. 1–101). Wiley.
70. MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7(1), 83–104. https://doi.org/10.1037/1082-989X.7.1.83
71. Manuel, J. I., Martinson, M. L., Bledsoe-Mansori, S. E., & Bellamy, J. L. (2012). The influence of stress and social support on depressive symptoms in mothers with young children. Social Science & Medicine, 75(11), 2013–2020. https://doi.org/10.1016/j.socscimed.2012.07.034
72. Martínez-González, R.-A., Rodríguez-Ruiz, B., Álvarez-Blanco, L., and Becedóniz- Vázquez, C. (2016). Evidence in promoting positive parenting through the program-guide to develop emotional competences. Psychosocial Intervention, 25(2), 111–117. https://doi.org/10.1016/j.psi.2016.04.001
73. McQuillan, M. E., Bates, J. E., Staples, A. D., & Deater-Deckard, K. (2019). Maternal stress, sleep, and parenting. Journal of Family Psychology, 33(3), 349–359. https://doi.org/10.1037/fam0000516
74. Montigny, F., & Lacharité, C. (2005). Perceived parental efficacy: concept analysis. Journal of Advanced Nursing, 49(4), 387–396. https://doi.org/10.1111/j.1365-2648.2004.03302.x
75. Oddi, K. B., Murdock, K. W., Vadnais, S., Bridgett, D. J., & Gartstein, M. A. (2013). Maternal and infant temperament characteristics as contributors to parenting stress in the first year postpartum. Infant and Child Development, 22(6), 553–579. https://doi.org/10.1002/icd.1813.
76. Osman, F., Salari, R., Klingberg-Allvin, M., Schon, U., & Flacking, R. (2017). Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting: A randomised controlled trial. BMJ Open, 7( e071600), 1–9. https://doi.org/10.1136/bmjopen-2017-017600
77. Ostberg, M., & Hagekull, B. (2000). A structural modeling approach to the understanding of parenting stress. Journal of Clinical Child Psychology, 29(4), 615–25. https://doi.org/10.1207/S15374424JCCP2904_13
78. Oyserman, D., Coon, H. M., & Kemmelmeier, M. (2002). Rethinking individualism and collectivism: Evaluation of theoretical assumptions and meta-analyses. Psychological Bulletin, 128(1), 3–72. https://doi.org/10.1037/0033-2909.128.1.3
79. Pearlin, L. I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30(3), 241–256. https://doi.org/10.2307/2136956
80. Perez, E. H. & Rubio, J. A. R. (2023). Parental stress in families with children with early intervention needs linked to socio-environmental vulnerability. Ansiedad y Estrés, 29(2), 71–77. https://doi.org/10.5093/anyes2023a8
81. Raikes, H. A., & Thompson, R. A. (2005). Links between risk and attachment security: Models of influence. Journal of Applied Developmental Psychology, 26(4), 440–455. https://doi.org/10.1016/j.appdev.2005.04.003
82. Reparaz, C., Rivas, S., Osorio, A., & Garcia-Zavala, G. (2021). A Parental Competence Scale: Dimensions and their association with adolescent outcomes. Frontiers Psychology, 12:652884, 1–14. https://doi.org/10.3389/fpsyg.2021.652884
83. Rodgers, A. Y. (1993). The assessment of variables related to the parenting behavior of mothers with young children. Children and Youth Services Review, 15(5), 385–402. https://doi.org/10.1016/0190-7409(93)90011-W
84. Roggman, L. A., Moe, S. T., Hart, A. D., & Forthun, L. F. (1994). Family leisure and social support: Relations with parenting stress and psychological well-being in Head Start parents. Early Childhood Research Quarterly, 9(3-4), 463–480. https://doi.org/10.1016/0885-2006(94)90020-5
85. Ruiz-Zalibdar, C., Serrano-Monzó, I., & Mujika, A. (2018). Parental competence programs to promote positive parenting and healthy lifestyles in children: a systematic review. Journal de Pediatria, 94(3), 238–250. https://doi.org/0.1016/j.jped.2017.07.019
86. Sabatelli, R. M., & Waldron, R. J. (1995). Measurement issues in the assessment of the experiences of parenthood. Journal of Marriage and the Family, 57(4), 969–980. https://doi.org/10.2307/353416
87. Sharda, E. A., Sutherby, C. G., Cavanaugh, D. L., Hughes, A. K., & Woodward, A. T. (2019). Parenting stress, well-being, and social support among kinship caregivers. Children and Youth Services Review, 99, 74–80. https://doi.org/10.1016/j.childyouth.2019.01.025
88. Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7(4), 422–445. https://doi.org/10.1037/1082-989X.7.4.422
89. Schulz, U., & Schwarzer, R. (2003). Soziale Unterstützung bei der Krankheitsbewältigung: Die Berliner Social Support Skalen (BSSS) [Social Support in Coping with Illness: The Berlin Social Support Scales (BSSS)]. Diagnostica, 49(2), 73–82. https://doi.org/10.1026/0012-1924.49.2.73
90. Skreden, M., Skari, H., Malt, U. F., Pripp, A. H., Björk, M. D., Faugli, A., & Emblem, R. (2012). Parenting stress and emotional wellbeing in mothers and fathers of preschool children. Scandinavian Journal of Public Health, 40(7), 596–604. https://doi.org/10.1177/1403494812460347.
91. Steele, K. R., Townsend, M. L., & Grenyer, B. F.S. (2020). Parenting stress and competence in borderline personality disorder is associated with mental health, trauma history, attachment and reflective capacity. Borderline Personality Disorder and Emotion Dysregulation, 7(8), 1–14. https://doi.org/10.1186/s40479-020-00124-8
92. Şimşek, Ö. F. (2007). Yapısal eşitlik modellemesine giriş: Temel ilkeler ve LISREL uygulamaları. Ekinoks Yayınevi.
93. Tabachnick, B.G., & Fidell, L.S. (2007). Using multivariate statistics. Allyn and Bacon Publishing.
94. Teti, D. M. & Candelaria, 2002). Parenting competence. In M. H. Bornstein (Ed.), Handbook of parenting (Vol 4: Social conditions and applied parenting) (pp. 149–180). Lawrence Erbaum Associates.
95. Teti, D. M., Nakagawa, M., Das, R., & Wirth, O. (1991). Security of attachment between preschoolers and their mothers: Relations among social interaction, parenting stress, and mother's sorts of the Attachment Q-Set. Developmental Psychology, 27(3), 440–447. https://doi.org/10.1037/0012-1649.27.3.440
96. Thompson, B. (2004). Exploratory and confirmatory factor analysis. American Psychological Association.
97. Townshend, K., Jordan, Z., Stephenson, M., & Tsey, K. (2016). The effectiveness of mindful parenting programs in promoting parents’ and children’s wellbeing: a systematic review. JBI Database of Systematic Reviews & Implementation Reports, 14(3), 139–80. https://doi.org/10.11124/JBISRIR-2016-2314
98. Uchino, B. N. (2009). Understanding the links between social support and physical health. Perspectives on Psychological Science, 4(3), 236–255. https://doi.org/10.1111/j.1745-6924.2009.01122.x
99. Vance, A. J., & Brandon, D.H. (2017). Delineating among parenting confidence, parenting self-efficacy, and competence. Advances in Nursing Science, 40 (4), E18–E37. https://doi.org/ 10.1097/ANS.0000000000000179
100. Wang, S., Charissa, S. L. C., Xiaoli, Z., & Huiguang, R. (2023). Parental stress and chinese american preschoolers’ adjustment: The mediating role of parenting. Behavioral Sciences, 13(7), 562: 1–16. https://doi.org/10.3390/bs13070562
101. Webster-Stratton, C. (1998). Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66(5), 715–730. https://doi.org/10.1037/0022-006X.66.5.715
102. Wethington, E., & Kessler, R. C. (1986). Perceived support, received support, and adjustment to stressful life events. Journal of Health and Social Behavior, 27(1), 78–89. https://doi.org/10.2307/2136504
103. Wills, T. A., & Shinar, O. (2000). Measuring perceived and received social support. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 86–135). Oxford University Press.
104. Windhorst, D. A., Fang, Y., Fierloos, I. N., Crone, M. R., Van Mourik, K., Jonkman, H., Hosman, C. M. H., Jansen, W., & Raat, H. (2019). Evaluation of effectiveness of (elements of) parenting support in daily practice of preventive youth health care; design of a naturalistic effect evaluation in ‘CIKEO’ (consortium integration knowledge promotion effectiveness of parenting interventions). BMC Public Health, 19(1), 1–9. https://doi.org/10.1186/s12889-019-7785-y