Peer-Reviewed Publications from the Family Life Project

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1.Barnett, M.A. & The Family Life Project Key Investigators (2008). Mother and grandmother parenting in low-income three-generation rural households. Journal of Marriage and Family, 70(5), 1241-1257.

This study draws data from the Family Life Project to examine parenting behaviors observed for 105 mothers and grandmothers raising an infant in rural low- income multigenerational households. Multilevel models are used to examine the relationships between maternal age and psychological distress and parenting of the infant by both generations. The findings indicate that young maternal age is a risk factor for less sensitive parenting in the presence of other risks, including psychological distress. Further, young maternal age is associated with negative parenting behaviors by grandmothers only. Grandmothers and mothers displayed similar levels of negative intrusive parenting, but different factors were linked to the observed parenting of each generation. These findings contribute to understanding the benefits and risks of three-generation households.

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2.Blair, C., Granger, D., Willoughby, M., Kivlighan, K., & Family Life Project Key Investigators. (2006). Maternal sensitivity is related to hypothalamic-pituitary-adrenal axis stress reactivity and regulation in response to emotion challenge in 6-month-old infants. Annals of New York Academy of Sciences, 1094, 263-267.

This study examined relations between maternal sensitivity as observed in a free play interaction and changes in levels of the glucocorticoid hormone cortisol in response to procedures designed to elicit negative affect in 6-month old infants. The sample included 1,292 families in predominantly rural and low-income communities in Pennsylvania and North Carolina. Results indicated that infants of more sensitive mothers had lower levels of cortisol at baseline and increased cortisol reactivity and regulation in response to the emotion procedures. Maternal negativity was unrelated to infant cortisol. Findings highlight the need for further research on variation in early caregiving and the development of the stress response in young children.

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3. Blair, C., Granger, D., Kivlighan, K.T., Mills-Koonce, W.R., Willoughy, M., Greenberg, M.T., Hibel, L.C., Fortunato, C. & Family Life Project Key Investigators. (2008). Maternal and child contributions to cortisol response to emotional arousal in young children from low income rural communities. Developmental Psychology, 44(4), 1095-1109.

Relations of maternal and child characteristics to child cortisol reactivity to and recovery from emotional arousal were examined prospectively at approximately 7 months of age (infancy) and then again at approximately 15 months of age (toddlerhood). The sample was diverse and population based (N = 1,292 mother–infant dyads) and included families from predominantly low-income, rural communities. Maternal behavior, family income-to-need ratio and social advantage, and child temperament, attention, and mental development were assessed, and children’s saliva was sampled before and after standardized procedures designed to elicit emotional arousal. Maternal engagement in infancy was associated with greater cortisol reactivity at the infancy assessment and with reduced overall cortisol level at the toddler assessment. Also at the toddler assessment, child attention, mental development, and temperamental distress to novelty were associated with increased cortisol reactivity and regulation, whereas temperamental distress to limitations and African American ethnicity were associated with reduced cortisol reactivity. Findings are consistent with prior work linking early caregiving to the development of the hypothalamic–pituitary–adrenal axis stress response system and with a conceptual model in which developing temperament is characterized by the interplay of emotional reactivity and the emergence of the ability to effortfully regulate this reactivity using attention.

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4. Burchinal, M. R., Vernon-Feagans, L., Cox., M., & The Family Life Project Key Investigators (2008). Cumulative social risk, parenting, and infant development in rural low-income communities. Parenting: Science and Practice, 8, 41-69.

Objective. The extent to which the severity of exposure to social risk is related to parenting and cognitive development in the first 15 months of an infant’s life was studied in a representative diverse sample of families in two rural poor regions in the United States. Design. One thousand two hundred ninety-two families were followed for the first 15 months of the infant’s life. Results. Evidence supported a pathway from risk severity through maternal sensitivity and warmth, language and learning acitivites, and maternal language to child outcomes, with language and learning activities providing the most consistent independent prediction. Race, age, and geographic isolation moderated associations between risk and different aspects of parenting. Both level and change in maternal engagement, maternal language input, and overall learning environment were related to early cognitive development. Cummulative risk measured as the mean of risk variables was a stronger predictor of parenting and infant development than when measured as the count of risk factors. Conclusion. Severity of risk exposure is negatively related to parenting and to child development for infants as young as 15 months of age. This study provides evidence supporting a pathway from risk severity through parenting to child outcomes and suggests that both initial parenting skills and change in parenting skillls during infancy predict infants’ cognitive skills.

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5. Burton, L. (2007). Childhood adultification in economically disadvantaged families: A conceptual model. Family Relations. 56, 329-345.

This article presents an emergent conceptual model of childhood adultification and economic disadvantage derived from 5 longitudinal ethnographies of children and adolescents growing up in low-income families. Childhood adultification involves contextual, social, and developmental processes in which youth are prematurely, and often inappropriately, exposed to adult knowledge and assume extensive adult roles and responsibilities within their family networks. Exemplar cases from the ethnographies are integrated in the discussion to illustrate components of the model. Four successive levels of adultification are described: precocious knowledge, mentored-adultification, peerification/spousification, and parentification. The developmental assets and liabilities children incur also are discussed. Recommendations for school, health care, and social service practitioners working with low-income families and children are provided.

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6. Crouter, A.C., Lanza, S., Pirretti, A.E., Goodman, W.B., Neebe, E., & The Family Life Project Key Investigators. (2006). The O*Net jobs classification system: A primer for family researchers. Family Relations, 55(4), 461-472.

We introduce family researchers to the Occupational Information Network, or O*Net, an electronic database on the work characteristics of over 950 occupations. The paper here is a practical primer that covers data collection, selecting occupational characteristics, coding occupations, scale creation, and construct validity, with empirical illustrations from the Family Life Project, a study of almost 1,300 families with infants born in 6 lowincome, nonmetro counties in North Carolina and Pennsylvania. We factor analyzed parents’ occupations on 35 O*Net characteristics and identified 5 factors: occupational self-direction, physical hazards, physical activity, care work, and automation/repetition, variables that supplement data collected from parents directly. Applied researchers can use the O*Net to expand their knowledge of participants’ work circumstances with objective data.

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7. De Marco, A., Crouter, A. C., & Vernon-Feagans, L.  (2009).The relationship between     maternal work characteristics and child care selection and quality.  Community, Work, & Family, 12(4), 369-387

Drawing on data from the Family Life Project collected in North Carolina and Pennsylvania, this paper examines the relationship between maternal work characteristics and childcare type and quality in rural communities. Research is limited on the childcare experiences of rural families. Rural areas have less access to formal childcare and families often commute long distances for work, restricting childcare options. Employed mothers using childcare were selected (n=441). Logistic and OLS regression was used to examine which characteristics, including workplace support, objective occupational measures, hours, wage, and shift, predicted care type and quality. Results indicated that most families were using informal care. Those with more hazardous work conditions and working night shifts were less likely to use centers. Higher quality care was related to more workplace support, center use, and higher wages. Implications for social policy and practice are discussed

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8. Flower, K., Willoughby, M., Cadigan, R.J., Perrin, E.M., Randolph, G., & The Family Life Project Key Investigators. (2007). Understanding breastfeeding initiation and continuation in rural communities: A combined qualitative/quantitative approach. Maternal and Child Health Journal, 12(3), 402-414.

Objective To determine factors associated with breastfeeding in rural communities. Methods We combined qualitative and quantitative data from the Family Life Project, consisting of: (1) a longitudinal cohort study (N = 1292) of infants born September 2003–2004 and (2) a parallel ethnographic study (N = 30 families). Demographic characteristics, maternal and infant health factors, and health services were used to predict breastfeeding initiation and discontinuation using logistic and Cox regression models, respectively. Ethnographic interviews identified additional reasons for not initiating or continuing breastfeeding. Results Fifty-five percent of women initiated breastfeeding and 18% continued for at least 6 months. Maternal employment at 2 months and receiving WIC were associated with decreased breastfeeding initiation and continuation. Ethnographic data suggested that many women had never even considered breastfeeding and often discontinued breastfeeding due to discomfort, embarrassment, and lack of assistance. Conclusions Breastfeeding rates in these rural communities lag behind national averages. Opportunities for increasing breastfeeding in rural communities include enhancing workplace support, maximizing the role of WIC, increasing hospital breastfeeding assistance, and creating a social environment in which breastfeeding is normative.

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9. Garrett-Peters, P., Mills-Koonce, W.R., Adkins, D., Vernon-Feagans, L., Cox, M., & The Family Life Project Key Investigators. (2008) Early environmental correlates of maternal emotion talk. Parenting: Science and Practice, 8, 1-36.

Objective: The primary goal of this study was to examine contextual, child, and maternal factors that are associated with mothers' early emotion talk in an ethnically diverse, low-income sample. Design: Emotion talk (positive and negative labels) was coded for 1111 mothers while engaged with their 7-month-olds in viewing an emotion-faces picture book. Infant attention during the interaction was also coded. Mothers' parenting style (positive engagement and negative intrusiveness) was coded during a dyadic free-play interaction. Demographic information was obtained, as well as maternal ratings of child temperament and mother's knowledge of infant development. Results: Hierarchical regression analyses revealed that social context and maternal qualities are significant predictors of mothers' early positive and negative emotion talk. In particular, mothers who were African American, had higher income, and who showed more positive engagement when interacting with their infants demonstrated increased rates of positive and negative emotion talk with their infants. For negative emotion talk, social context variables moderated other predictors. Specifically, infant attention was positively associated with negative emotion talk only for African American mothers, and knowledge of infant development was positively associated with negative emotion talk only for non-African American mothers. The positive association between maternal positive engagement and negative emotion talk was greater for lower-income families than for higher-income families. Conclusions: Mothers' emotion language with infants is not sensitive to child factors but is associated with social contextual factors and characteristics of the mothers themselves.

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10.Goodman, W. B., Crouter, A. C., Lanza, S. T., Cox, M. J., & The Family Life Project Key Investigators (2008). Paternal work characteristics and father-infant interactions in low-income, rural families. Journal of Marriage and Family, 70, 640-653.

To examine the implications of paternal occupational conditions for the quality of father-infant interactions, home visits, including interviews and videotaped observations of father-infant interactions, were conducted with 446 fathers living in six low-income, nonmetropolitan counties in North Carolina and Pennsylvania. When a variety of individual and demographic characteristics were controlled for, a less supportive work environment was associated with lower levels of fathers' engaged and sensitive parenting. Significant interactions pointed to the importance of understanding combinations of risk factors. Experiencing high levels of workplace stressors, including low levels of self-direction and high levels of care work, in the presence of other individual or demographic risk factors was associated with lower levels of father parenting quality.

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11. Goodman, W. B., Crouter, A. C., & The Family Life Project Key Investigators (2009).  Longitudinal associations between maternal work stress, negative work-family spillover, and depressive symptoms. Family Relations, 58, 245-258.

The current study examined associations over an 18-month period between maternal work stressors, negative work-family spillover, and depressive symptoms in a sample of 414 employed mothers with young children living in six predominantly nonmetropolitan counties in the Eastern United States. Results from a one-group mediation model showed that a less flexible work environment and greater work pressure predicted higher levels of depressive symptoms and, further, that these associations were mediated by perceptions of negative work-family spillover. Additionally, results from a two-group mediation model suggested that work pressure predicted greater perceptions of spillover only for mothers employed full-time. Findings suggest the need for policies that reduce levels of work stress and help mothers manage their work and family responsibilities.

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12. Granger, D., Blair, C., Willoughby M., Kivlighan, K.T., Hibel, L.C., Fortunato, C.K., Wiegand, L.E., & Family Life Project Key Investigators. (2007) Individual differences in salivary cortisol and alpha-amylase in mothers and their infants: Relation to tobacco and smoke exposure. Developmental Psychobiology, 49(7), 692-701.

Tobacco smoke exposure affects the activity of both the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). Statistics reveal 41 million children in the U.S. are regularly exposed to tobacco smoke, but we know little about the effects of environmental tobacco smoke exposure on HPA and SNS activity in early childhood. This study assayed cotinine (a metabolite of nicotine), cortisol, and alpha-amylase (sAA) in the saliva of mother-infant dyads from 197 low income and ethnically diverse families. The dyads were identified as tobacco smoke exposed (N = 82) or nonexposed (N = 115) based on maternal self-reports of smoking and salivary cotinine levels greater or less than 10 ng/ml. As expected, higher rates of maternal smoking behavior were associated with higher levels of cotinine in mothers' and their infants' saliva. On average, smoking mothers' salivary cotinine levels were 281 times higher compared to their nonsmoking counterparts, and 23 times higher compared to their own infant's salivary cotinine levels. Infants of smoking mothers had salivary cotinine levels that were four times higher than infants with nonsmoking mothers. Mothers who smoked had higher salivary cortisol levels and lower sAA activity compared to nonsmoking mothers. There were no associations between maternal smoking behavior, infant's salivary cotinine levels, or tobacco exposure group, and cortisol or sAA measured in infant's saliva. The findings are discussed in relation to the influence of smoking tobacco on the validity of salivary biomarkers of stress.

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13. Hibel, L. C., Granger, D. A., Kivlighan, K. T., Blair, C. & The Family Life Project Key Investigators (2006). Individual differences in salivary cortisol: Association with common over the counter and prescription medications in infants and their mothers. Hormones and Behavior 50, 293-300.

The purpose of the present study was to describe associations between the use of common over-the-counter (OTC) and prescription medications with individual differences in salivary cortisol in infants and their mothers. Participants were 1020 mothers and 852 infants (52.5% boys; ages 5.03–13.44 months) from economically disadvantaged and ethnically diverse families (38.4% African American) who donated saliva samples before, 20 and 40 min after infants participated in a series of challenging tasks. Samples (N = 5616) were later assayed for cortisol. Medication information was content analyzed separately for infants (e.g., teething gels, nonsteroidal anti-inflammatory drugs, acetaminophen, decongestants) and mothers (e.g., narcotics, antidepressants, antipsychotics, contraceptives, glucocorticoids). A large percentage of infants (44%) and the majority of mothers (57.5%) had used at least one medication (range 0–4) in the previous 48 h. Most frequent were acetaminophen (e.g., Tylenol®) and cold medications (e.g., decongestants) for infants and contraceptives and acetaminophen for mothers. Compared to infants not taking any medications, cortisol reactivity to the challenge tasks was less pronounced for infants taking acetaminophen. Cortisol levels were higher for mothers taking oral or transdermal contraceptives and acetylsalicylic acid (e.g., Aspirin®) but lower for mothers taking pure agonist opioids (e.g., Oxycontin®) compared to mothers not taking any medications. These medication-related differences remained significant after controlling for sampling time, fever, maternal anxiety and depression, infant temperament, ethnicity, SES, and health status. Recommendations are provided to steer investigators clear of these potential sources of unsystematic error variance in salivary cortisol.

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14. Hibel, L. C., Granger, D. A., Blair, C. Cox, M. J., & The Family Life Project Key  Investigators (2009). Intimate partner violence moderates the association between mother-infant adrenocortical activity across an emotional challenge. The Journal of Family Psychology, 23(5), 615-625.

This study examined the relationship between mother and infant adrenocortical levels and reactivity to an emotion eliciting task. The impact of intimate partner violence (IPV) on these relationships was assessed as a moderator. The sample (n = 702 mother-infant dyads) was racially diverse and from predominantly low-income, rural communities. During a home visit, the dyad's saliva was sampled before, 20 min, and 40 min after standardized tasks designed to elicit the infant's emotional arousal and later assayed for cortisol. Mothers completed self-report measures of their partner's violence, and parenting behaviors were assessed via structured interview and mother-child interactions. In response to the task, infants had positive, and mothers had negative, cortisol slopes. Contrary to expectations, there were no IPV-related differences in mean pretask cortisol levels or reactivity in the mothers or infants. Mother-infant dyads from households characterized by either (1) violence or (2) restrictive and punitive parenting behaviors exhibited correlated cortisol reactivity measured in response to the infant challenge task. The findings suggest that social contextual features of the early caregiving environment may influence individual differences in the coordination between maternal and infant adrenocortical reactivity.

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15. Odom E.C., Vernon-Feagans, L., & The Family Life Project Key Investigators (2010). Buffers of racial discrimination: Links with depression among rural African   American mothers. Journal of Marriage and Family, 72, 346-359.

The current study examines racial discrimination as a predictor of depression in a sample of 414 rural, low-income African American mothers of young children. The potential moderating role of optimism and church-based social support was also examined. Mothers completed questionnaires when their child was 24 months old. Hierarchical regression revealed that mothers’ perception of racism was a significant predictor of depression even after controlling for a variety of distal demographic characteristics and environmental stressors. Significant interactions suggested the importance of psychological and social characteristics in understanding maternal depression. Specifically, high levels of optimism and church-based social support buffered mothers from increased depressive symptomology attributable to perceived racism.

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16. Pancsofar, N., & Vernon-Feagans, L. (2006). Mother and father language input to young children: Contributions to later language development. Journal of Applied Developmental Psychology, 27(6), 571-587.

There has been little research comparing the nature and contributions of language input of mothers and fathers to their young children. This study examined differences in mother and father talk to their 24 month-old children. This study also considered contributions of parent education, child care quality and mother and father language (output, vocabulary, complexity, questions, and pragmatics) to children's expressive language development at 36 months. It was found that fathers' language input was less than mothers' language input on the following: verbal output, turn length, different word roots, and wh-questions. Mothers and fathers did not differ on type-token ratio, mean length of utterance, or the proportion of questions. At age 36 months, parent level of education, the total quality of child care and paternal different words were significant predictors of child language. Mothers' language was not a significant predictor of child language.

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17. Pancsofar, N., Vernon-Feagans, L., Odom, E., & Roe, J. R. (2008).  Family relationships during infancy and later mother and father vocabulary use with young children. Early Childhood Research Quarterly, 23(4), 493-503.

Very little previous research has considered the contributions of family relationships and interactions on the language input ofmothers and fathers to their young children. This study examined the contributions of marital love and conflict, and broader family-level conflict, cohesion, and expressiveness to mother and father vocabulary in triadic interactions with their young children in 70 dual-earner families. Itwas found that after controlling for parent sensitivity and parent directive behavior, marital love and family conflict when children were 12 months of age were significant predictors of both father vocabulary and mother vocabulary to children at 24 months of age. In families with higher levels of marital love when childrenwere 12 months of age, mothers and fathers used a more diverse vocabulary with their 24-month-old children. In families with lower levels of family conflict when children were 12 months of age, mothers and fathers used a more diverse vocabulary with their 24-month-old children.

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18. Stifter, C. A., Willoughby, M. T., Towe-Goodman, N. R., & The Family Life Project Key Investigators (2008). Agree or agree to disagree? Assessing the convergence between parents and observers on infant temperament. Infant and Child Development, 17, 407-426.

The assessment of infant temperament has been typically accomplished with parent questionnaires. When compared with temperament behaviours observed in the laboratory, parents and observers generally do not agree, leading some researchers to question the validity of parent report. This paper reports on a representative sample of infants whose families resided in nonmetropolitan counties and whose temperament was measured in three ways: (1) standard parent report (Infant Behavior Questionnaire);(2) observer ratings across two lengthy home visits; and (3) observer coding of second-by-second reactions to specific emotion-eliciting tasks. In order to account for both trait and method variance, structural equation modelling was applied to a sample of 955 infants (M age57.3 months) using variables from the three methods that reflected the dimensions of positivity and negativity. Although models based solely on method factors and trait factors fit the data well, results indicated that a model that included method and trait factors provided the best fit. Results also indicated that parents and observers (either across the home visit or to specific tasks) converge, to a degree, on ratings of the positivity dimension but diverge on the negativity dimension.

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19. Vernon-Feagans, L., Pancsofar, N., Willoughby, M., Odom, E., Quade, A., Cox, M., & Family Life Project Key Investigators. (2008). Predictors of maternal language input to infants during a picture book task in the home: Family, SES, child characteristics and the parenting environment. Journal of Applied Developmental Psychology, 29, 213-226.

This study investigated the contribution of child characteristics and parenting environment to the relationship between family SES/demographic characteristics and maternal language to infants. 1157 children were drawn from a representative sample of 1292 infants born to mothers in rural Appalachian counties and rural counties in southern minority U.S. communities. Mothers and their 6-8 month old babies were videotaped at home while talking about a wordless picture book. Mothers' language output and complexity were analyzed. Child temperament, age, and parenting environment (knowledge of child development and observed mother-child engagement) were predictors of maternal language. Furthermore, their inclusion reduced the magnitude of the association between demographic characteristics and maternal language. Tests of mediation suggested that the parenting environment partially mediates the relationship between SES/demographic characteristics and maternal language. Findings are discussed with respect to identifying proximal processes that explain how SES may exert its influence on the language of young children.

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20. Vernon-Feagans, L. & Blair, C. (2006). Measurement of school readiness: Introduction to a special issue of Early Education and Development. Early Education and Development, 17, 1-5.

This issue of Early Education and Development is devoted to the topic of the measurement of school readiness. In the fall of 2005, the Center for Developmental Science, and the Frank Porter Graham Child Development Institute and the School of Education at the University of North Carolina at Chapel Hill sponsored a day-long conference on the measurement of school readiness. This conference brought together scholars from a variety of different disciplines who have grappled with the issue of the measurement of school readiness. These scholars not only discussed the challenges of defining readiness and developing good school readiness measures, but also suggested the best measurement tools available to measure readiness. These articles represent the state of the art in defining and measuring school readiness, based on an almost 16-year recent history of controversy over what readiness is and how to measure it. To introduce these articles, we first give a short history of the need to measure readiness and then briefly describe each article's contribution to our understanding of how to measure school readiness.

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21. Willoughby, M., Blair, C., Greenberg, M., Stifter, C. (2007). Neurobehavioral consequences of prenatal exposure to smoking at 6 to 8 months of age. Infancy, 12(3), 273-301.

Between 400,000 and 800,000 infants are born in the United States each year to women who smoked cigarettes during their pregnancy. Whereas the physical health consequences to infants of prenatal exposure to smoking are well established, the early neurobehavioral consequences are less well understood. This study investigated the neurobehavioral consequences of prenatal exposure to smoking using an epidemiologically derived sample of 454 infants who were drawn from a larger sample of 1,292 infants whose families were recruited at birth. Results indicated that, on average, infants who were exposed to higher levels of prenatal smoking exhibited less positive affect and greater irritability. Moreover, among male infants, elevated levels of prenatal exposure to smoking were associated with lower levels of approach, gross motor movement, reactivity, and attention. There was no evidence that the effects of prenatal exposure to smoking on infant neurobehavioral functioning were mediated by physical growth parameters (infant weight and head circumference) that are also known to be affected by prenatal exposure to smoking.

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22. Willoughby, M., Cadigan, J., Burchinal, M, & Skinner, D. (2008). An Evaluation of the psychometric properties and criterion validity of the religious social support scale. Journal for the Scientific Study of Religion. 47(1), 147-159.

This study evaluates the psychometric properties and criterion validity of the Religious Social Support (RSS) Scale in a diverse, representative community sample of new mothers (N = 1,156). Results indicated that two factors best represented the RSS. Criterion validity was established by demonstrating that the RSS was associated with relational and health outcomes. However, these associations were reduced to statistical insignificance once a general measure of social support was included as a covariate. There were no indications that race moderated either the psychometric properties of the RSS or the relationships between social support and outcomes. Qualitative analyses indicated that religious social support is a salient construct in the lives of women that we studied and suggested ways to improve future developments of RSS scales.

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23. Willoughby, M. T., Kollins, S. H., & McClernon, F. J., & The Family Life Project Key Investigators. (2009). Association between smoking and retrospectively reported ADHD symptoms in a large sample of new mothers. Nicotine and Tobacco Research,  11(3), 313-322

Introduction : This study investigated the association between retrospectively reported attention-defi cit/hyperactivity disorder (ADHD) symptoms experienced during childhood and five cigarette smoking – related outcomes in adulthood. Methods : A large sample ( N = 1,117) of new mothers participating in an ongoing longitudinal study completed retrospective reports of their childhood ADHD symptomatology, as well as concurrent and retrospective reports of their smoking behavior. Linear regression models tested the association between ADHD symptomatology and smoking outcomes. Results : Childhood ADHD symptomatology was predictive of the number of cigarettes smoked per day currently and during pregnancy, as well as the age at onset of smoking. We found nonlinear associations between hyperactive – impulsive symptoms and the number of cigarettes smoked per day in pregnancy, as well as between inattentive symptoms and the number of cigarettes smoked per day currently. Women who retrospectively reported intermediate levels of ADHD symptoms during their childhood reported smoking more cigarettes per day than women who reported low or high levels of ADHD symptoms during childhood. We also found multiplicative relationship between inattentive and hyperactive – impulsive symptoms, such that inattentive symptoms were predictive of an earlier age at smoking onset only when hyperactive – impulsive symptoms were low; moreover, the magnitude of this association was stronger for Black relative to White women. Discussion : These findings demonstrate the importance of considering differential effects of ADHD symptoms and smoking outcomes as a function of sex and race. They also represent a potentially indirect means through which women who have even a moderate childhood history of ADHD symptomatology may create a set of circumstances that compromise the health and well-being of their own children.

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24. Willoughby, M., Vandergrift, N., Blair, C., & Granger, D.A. (2007). A Structural equation modeling approach for the analysis of cortisol data collected using pre-post-post designs. Structural Equation Modeling. 14(1), 125-145.

This study introduces a novel application of structural equation modeling (SEM) for the analysis of cortisol data that are collected using a pre–post–post design. By way of an extended example, an SEM model is developed that permits an examination of both the overall level of cortisol, as well as changes in cortisol (reactivity and regulation), as predictors of cognitive (executive) and behavioral functioning in 3- to 5-year-old children (N = 171) attending Head Start. The SEM model makes use of the parameterization of latent curve models. Throughout the extended example, the strengths of using an SEM approach for the analysis of cortisol data that are collected using pre–post–post designs is highlighted.

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25. Zolotor, A., Burchinal, M., Skinner, D., Rosenthal, M. & The Family Life Project Key Investigators. (2008). Maternal psychological adjustment and knowledge of infant development as predictors of home safety practices in Rural low-income communities. Pediatrics, 121(6), 1668 - 1675.

Background. Unintentional injury is the leading cause of death among toddlers in the United States. Toddlers spend the majority of time at home, and the use of recommended safety practices can prevent many injuries. Objective. Maternal psychological adjustment and understanding of child development are thought to influence the implementation of safety practices; however, the extent to which either factor is related has been examined with small samples and without attention to potential confounding. We hypothesize that mothers' use of safety practices will be higher when mothers have more knowledge of development and better psychological adjustment. Methods. This study is part of the Family Life Project, a longitudinal birth cohort of children from poor rural communities (n = 1161) and an ethnographic sample (n = 36). Mothers in the birth cohort completed scales to measure knowledge of development, psychological adjustment, and home safety practices. Factor analysis of the safety scale resulted in 4 subscales. Each subscale was predicted from maternal knowledge and adjustment in multivariable regression. Mothers in the ethnographic study described sources of information about home safety, current practices, and barriers. Results. Analyses indicated that mothers with better psychological adjustment were more likely to implement all of the safety practices, and mothers with more knowledge about development were more likely to minimize subtle hazards and install safety devices. An interaction between maternal adjustment and knowledge suggested that mothers with psychological distress were more likely to install safety devices if they had greater knowledge of development. Mothers reported that health care providers were the primary source of safety information, and barriers to implementation included poverty and lack of stable housing. Conclusions Knowledge of development and better psychological adjustment are associated with improved home safety. Knowledge about development is especially important for mothers with poor mental health. Pediatricians and designers of injury-prevention programs should consider the role of maternal mental health in child safety.

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