Family Leave and Parents of Newborn Infants or CSHCN

描述(申请人提供)：随着双亲家庭越来越多地成为双亲家庭，随着单亲家庭变得越来越普遍，解决工作和家庭之间的冲突对儿童健康变得至关重要。家庭假政策允许父母与新生儿建立联系或照顾生病的孩子。2004年7月，加利福尼亚州实施了带薪探亲假保险计划(Pfli)，这是十多年来美国第一个重大的新探亲假政策，成为第一个保障大多数员工带薪探亲假的州。Pfli将产生什么影响尚不清楚，因为父母如何权衡就业和休假的成本和好处与孩子的需求还没有确定的特征。本申请的目标是阐明新生儿和有特殊卫生保健需要的儿童(CSHCN)的父母的工作-家庭决策过程，并为研究儿童健康的社会决定因素(包括工作-家庭政策)的临床影响做好职业准备。具体目的是考察：(1)哪些因素影响新生儿或CSHCN的父母关于休假和就业的决定；(2)休假(或寻求、改变、减少或退出工作)如何影响儿童的健康和保健、父母的情绪健康和家庭的经济健康；以及(3)医生、护士和社会工作者的干预是否可以影响父母对休假选项的了解和使用，帮助父母解决工作与家庭冲突，并改善儿童的健康和保健、父母的情绪健康和家庭的经济健康。第一阶段将包括家长焦点小组，第二阶段将是对有新生儿或住院儿童的父母的访谈和纵向随访，第三阶段将是以医院为基础的父母随机对照干预。职业发展活动将包括经济学、社会学和研究方法的课程。长期的职业目标包括精心设计研究，评估公共工作-家庭政策的健康影响，并开发对这些政策的有效临床反应。

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.