Objective: To determine the effectiveness of exercise as an intervention in the management of depression. Design: Systematic review and meta-regression analysis of randomised controlled trials obtained from five electronic databases (Medline, Embase, Sports Discus, PsycLIT, Cochrane Library) and through contact with experts in the field, bibliographic searches, and hand searches of recent copies of relevant journals. Main outcome measures: Standardised mean difference in effect size and weighted mean difference in Beck depression inventory score between exercise and no treatment and between exercise and cognitive therapy. Results: All of the 14 studies analysed had important methodological weaknesses; randomisation was adequately concealed in only three studies, intention to treat analysis was undertaken in only two, and assessment of outcome was blinded in only one. The participants in most studies were community volunteers, and diagnosis was determined by their score on the Beck depression inventory. When compared with no treatment, exercise reduced symptoms of depression (standardised mean difference in effect size −1.1 (95% confidence interval −1.5 to −0.6); weighted mean difference in Beck depression inventory −7.3 (−10.0 to −4.6)). The effect size was significantly greater in those trials with shorter follow up and in two trials reported only as conference abstracts. The effect of exercise was similar to that of cognitive therapy (standardised mean difference −0.3 (95% confidence interval −0.7 to 0.1)). Conclusions: The effectiveness of exercise in reducing symptoms of depression cannot be determined because of a lack of good quality research on clinical populations with adequate follow up. What is already known on this topic Depression is common Management is often inadequate and many patients do not comply with antidepressant medication The effect of exercise on depression has been a subject of interest for many years What this study adds Most studies of the effect of exercise on depression are of poor quality, have brief follow up, and are undertaken on non-clinical volunteers Exercise may be efficacious in reducing symptoms of depression in the short term but its effectiveness in clinical populations is unknown A well designed, randomised controlled trial with long term follow up is needed

https://www.bmj.com/content/bmj/322/7289/763.full.pdf

The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials

Parents are confronted with a fundamental but often difficult task: teaching children the values and regulations necessary to function effectively in society while also nurturing children’s drive to express themselves and to pursue their unique interests and capacities. The central socialization goal is internalization, wherein children “take in” social regulations, make them their own, and eventually self-regulate autonomously (e.g., Lepper, 1983; Schafer, 1968). When it functions optimally, internalization is beneficial for children’s learning, well-being, and psychosocial adjustment. However, because activities that need to be internalised are often not enjoyable (e.g., clean-up, homework), adults wonder how to encourage children’s engagement in such tasks without negatively affecting their selfdetermination.

https://selfdeterminationtheory.org/SDT/documents/2008_JoussemetLandryKoestner_CanPsych.pdf

A self-determination theory perspective on parenting.

Objective: A meta-analysis was conducted to evaluate the ability of parent training programs to reduce parents’ risk of abusing a child. Method: A total of 23 studies were submitted to a meta-analy...

Preventing Child Abuse: A Meta-Analysis of Parent Training Programs.

Background Mental health problems are common and there is evidence to suggest that the origins of such problems lie in infancy and childhood. In particular, there is evidence from a range of studies to suggest that maternal psychosocial health can have a significant effect on the mother-infant relationship, and that this in turn can have consequences for both the short and long-term psychological health of the child. The use of parenting programmes is increasing in the UK and elsewhere and evidence of their effectiveness in improving outcomes for children has been provided. Evidence is now required of their effectiveness in improving outcomes for mothers. Objectives The objective of this review is to address whether group-based parenting programmes are effective in improving maternal psychosocial health including anxiety, depression, and self-esteem. Search strategy A range of biomedical, social science, educational and general reference electronic databases were searched including MEDLINE, EMBASE CINAHL, PsychLIT, ERIC, ASSIA, Sociofile and the Social Science Citation Index. Other sources of information included the Cochrane Library (SPECTR, CENTRAL), and the National Research Register (NRR). Selection criteria Only randomised controlled trials were included in which participants had been randomly allocated to an experimental and a control group, the latter being a waiting-list, no-treatment or a placebo control group. Studies had to include at least one group-based parenting programme, and one standardised instrument measuring maternal psychosocial health. Data collection and analysis A systematic critical appraisal of all included studies was undertaken using a modified version of the Journal of the American Medical Association (JAMA) published criteria. The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group, by the pooled standard deviation, to produce an effect size. Where appropriate the results were then combined in a meta-analysis using a fixed-effect model, and 95% confidence intervals were used to assess the significance of the findings. Main results A total of 23 studies were included in the original review which was increased to 26 at the first udate (2003). Of these 20 provided sufficient data to calculate effect sizes. The 20 studies provided a total of 64 assessments of outcome on a range of aspects of psychosocial functioning including depression, anxiety, stress, self-esteem, social competence, social support, guilt, mood, automatic thoughts, dyadic adjustment, psychiatric morbidity, irrationality, anger and aggression, mood, attitude, personality, and beliefs. Data sufficient to combine in a meta-analysis existed for only five outcomes (depression; anxiety/stress; self-esteem; social support; and relationship with spouse/marital adjustment). The results of the meta-analyses show statistically significant results favouring the intervention group for depression; anxiety/stress; self-esteem; and relationship with spouse/marital adjustment. The meta-analysis of the social support data showed no evidence of effectiveness. Of the remaining data that it was not possible to combine in a meta-analysis, approximately 22% of the outcomes measured, showed significant differences between the intervention group and the control group. A further 40% showed non-significant differences favouring the intervention group. Approximately one-third of outcomes showed no evidence of effectiveness.A meta-analysis of the follow-up data on three outcomes was also conducted - depression, self-esteem and relationship with spouse/marital adjustment. The results show that there was a continued improvement in self-esteem, depression, and marital adjustment at follow-up, although the latter two findings were not statistically significant. This review has been updated (2003) with the addition of 3 new included studies. A number of additional excluded studies have also been added. There is one additional study awaiting 03) with the addition of 3 new included studies. A number of additional excluded studies have also been added. There is one additional study awaiting assessment and 2 ongoing studies listed for inclusion at a future update of this review. The size of effect for the main outcomes has not been substantially altered by this update. Additional sensitivity analyses to assess the impact of quasi randomised studies on the result have also been added. Where the quasi randomised studies are excluded from the analysis, the result was found to be slightly more conservative. Reviewer's conclusions It is suggested that parenting programmes can make a significant contribution to the short-term psychosocial health of mothers. However, there is currently a paucity of evidence concerning whether these results are maintained over time, and the limited follow-up data which are available show equivocal results. This points to the need for further evidence concerning the long-term effectiveness of parenting programmes on maternal mental health. Whilst the results of this review are positive overall, some studies showed no effect. Further research is needed to assess which factors contribute to successful outcomes in these programmes with particular attention being paid to the quality of delivery.These results suggest that parenting programmes have a potential role to play in the promotion of mental health.

Parent-training programmes for improving maternal psychosocial health.

Parenting practices play a significant role in the development of emotional and behavioural problems in children, and parenting programmes which are aimed at the parents of infants and toddlers thereby have the potential to prevent the occurrence of such problems. The findings of this review provide some support for the use of group-based parenting programmes to improve theemotional and behavioural adjustment of children under the age of 3 years. The limited evidence available concerning the extent to which these results are maintained over time, however, is equivocal, and it may be that during this period of rapid change in the infant's development, further input at a later date is required. More research is needed before questions of this nature can be answered.

/pdf/group-based-parent-training-programmes-for-improving-4xe7e1xhmk.pdf

Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.

Balancing Work and Family in Cooperative Extension: History, Effective Programs, and Future Directions.

A preliminary evaluation of the Colorado RETHINK Parenting and Anger Management program.

The self-esteem of children in small towns was assessed. Comparing these children’s self-rated competencies to extant norms suggests that rural children’s self-perceptions are not distinctly different from suburban and urban children. Rural children’s feelings of self-worth and self-assessments of scholastic competence are comparable to or higher than metropolitan norms. Rural children display the same decrement in self-ratings of physical appearance as they grow older —girls more so than boys—as do urban children. Rural and urban boys rate themselves higher in athletic competence than girls. The impact of rural/urban differences on children may be less marked than suspected.

The Self-Esteem of Rural Children

Extension agents and specialists have experienced increased pressure for greater program effectiveness and accountability and especially for evidence-based programs. This article builds on previously published evidence-based programming articles. It provides ideas that address three problems that Extension staff face with EBPs and that Extension agents and specialists can use either to test or enhance an

Evidence-Based Programming: What Is a Process an Extension Agent Can Use to Evaluate a Program's Effectiveness?

There are many parent education programs available for Extension professionals. How does a busy Extension professional decide which is best for his/her clients? This article provides a practical review and critique of 16 major parenting educational programs using three review criteria—program readiness, strength of scientific base, and empirical evidence of program effectiveness. Best programs included STAR Parenting, Strengthening Families Program for Parents and Youth 10-14, Systematic Training for Effective Parenting, and Triple P-Positive Parenting Program. The parent education field utilizes a multitude of curricula, making it difficult for Extension professionals, Certified Family Life Educators (CFLE's), parent educators, and parents to choose a series of effective, research-based activities that will meet specific clientele needs for their parenting program. How does a busy Extension professional decide which parenting program is best for his/her clientele who may include incarcerated parents, churches, military, kinship caregivers such as grandparents, mandated parent education for divorcing parents, children who end up in juvenile courts, etc. A review and critique of many of the major parenting curricula and available programs could potentially assist parents and professionals in implementing a program with confidence. Methodology We begin with Extension's mission—in this case to provide research-based information and empirically effective parenting education programs. Three criteria were used to evaluate each curriculum, and each program's ratings are included in Table 1. Knowing how busy our Extension agents are and how pulled they are to address the spectrum of clientele needs, the first criterion was a very practical one—the readiness of the curriculum to be used in the field. Ratings ranged from 0 (A parent educator would have to spend a great amount of time creating program materials prior to teaching the curriculum) to 5 (After studying and becoming familiar with the curriculum, an educator could teach the curriculum without having to prepare additional teaching materials). The second criterion was evidence/science-based. We live and work in an era of information overload and in an era where we experience increased pressure from federal, state, and local

Robert J. Fetsch

Papers

Balancing Work and Family in Cooperative Extension: History, Effective Programs, and Future Directions.

A preliminary evaluation of the Colorado RETHINK Parenting and Anger Management program.

The Self-Esteem of Rural Children

Evidence-Based Programming: What Is a Process an Extension Agent Can Use to Evaluate a Program's Effectiveness?

A Review and Critique of 16 Major Parent Education Programs