Parental support in a changing society

Abstract: In today's Swedish society there is increasing emphasis on health-promotive work among children, adolescents, and their parents. Knowledge is needed about why certain activities work better than others. It is important to study the parents' motives and experiences of participating in parental supporting programmes.

In child health care, mostly among the nurses, there is a contrast between what they wish to do and what they have to do according to policy guidelines. By revealing the main lines in the development of Swedish child health care (Paper I), we hoped to obtain a better understanding of this discrepancy between policy and practice. It is difficult to translate policy recommendation into practice. One reason is the increasing focus on psychosocial problems. Another reason is the transition from unambiguously described measures in terms of paternalistic regulation to a more participatory and expansive definition of roles and responsibilities.

In an interview study (Paper II), both parents and child health care staff emphasized support and medical check-ups as particularly important. There was a clash between the parents' need for support and their need for integrity. The parents viewed parental education as an opportunity to exchange experience with other adults, while the staff mainly regarded the education as a way to inform parents and strengthen them in their parental role. Fathers participate to a lesser degree in parental supporting activities in Sweden today .

To increase knowledge about fathers´ perception of and involvement in their childrens health, we interviewed 237 fathers of small children in Skåne by telephone (Paper III). The fathers were involved in their children to a large extent, and they performed just as many caring as playing activities. They had a good idea of the childs health and just over half of them had at some time contacted a doctor. Although 97% felt that they were good fathers, slightly more than half of them (54%) thought that they spent enough time with their children. Most parental supporting programmes are initiated centrally. In Paper IV a process whereby parents of teenage children developed and implemented their own "parents school" is described. Parents took part in planning meetings and lecture evenings including group discussions. The majority reported that they were satisfied with the activity and had acquired knowledge and insight about the teenage period. The parents own ambitions for the activity seemed to be visionary and long-term. This thesis indicates that is not possible to propose one specific model for parental support.

In future activities one should include the parents right from the planning and implementation stage. Long-term work is more important than many different short projects to obtain good evaluations. There is a need to clarify the conditions for developing methods of parental support in child health care. New forms of family support that includes the father on equal terms could be designed and researched