Family Leave and Parents of Newborn Infants or CSHCN

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DESCRIPTION (provided by applicant): As 2-parent families have become increasingly 2-income, and as single-parent families have become more common, resolving conflicts between work and family has become critical for child health. Family leave policies allow parents to bond with a newborn infant or to care for an ill child. In July 2004, California implemented the Paid Family Leave Insurance (PFLI) program - the first major new family leave policy in the U.S. in over a decade - becoming the first state to guarantee paid family leave to most employees. What effects PFLI will have remain unclear, because how parents weigh the costs and benefits of employment and leave against the needs of their children has not been characterized. The goals in this application are to elucidate the work-family decision-making processes of parents of newborn infants and children with special health care needs (CSHCN) and to prepare for a career studying the clinical ramifications of social determinants of child health (including work-family policies). The specific aims are to examine: (1) what factors influence decisions about leave-taking and employment among parents of newborn infants or of CSHCN; (2) how taking leave (or seeking, changing, reducing, or quitting work) affects child's health and health care, parents' emotional wellbeing, and family's financial health; and (3) whether an intervention among physicians, nurses, and social workers can affect parents' knowledge and use of leave options, help parents address work-family conflicts, and improve child's health and health care, parents' emotional wellbeing, and family's financial health. Phase I will include parent focus groups, Phase II will be interviews and longitudinal follow-ups of parents with newborn or hospitalized children, and Phase III will be a hospital- based randomized controlled intervention for parents. Career development activities will include coursework in economics, sociology, and research methods. Long-term career goals include crafting studies evaluating the health effects of public work-family policies and developing effective clinical responses to these policies.