title: Positive Parenting Practices, Health Disparities, and Developmental Progress.
abstract: OBJECTIVE
  To describe interactive activities between parents and young children in a nationally representative sample. We hypothesized that the frequency of participation in interactive activities would be different across economic strata and would be associated with developmental delay.
  
  
  METHODS
  Children 4 to 36 months of age were identified by using The National Survey of Children's Health 2011-2012. Interactive caregiving practices were reported by poverty status. Developmental concerns were derived from caregiver responses and scoring of the Parents Evaluation of Developmental Status. Multivariable logistic regressions with weighting were used to explore the effect of interactive practices on risk for developmental delay across poverty levels. Covariates including age, gender, insurance type, maternal education, parenting stress, and ethnicity were adjusted in the models.
  
  
  RESULTS
  In our sample (n = 12,642), caregivers with the lowest income versus highest income reported lower participation in reading (33% vs 64%; P < .0001), singing or telling stories (52% vs 77%, P < .0001), and taking their child on an outing (13% vs 22%, P < .0001). Less frequent participation in interactive activities during the week were associated with increased risk of developmental delay among low-income families (Reading odds ratio [OR] 1.57, 95% confidence interval [CI] 1.15-2.13; Singing songs/Telling Stories OR 1.66, 95% CI 1.15-2.40; Outings OR 1.48, 95% CI 1.11-1.97).
  
  
  CONCLUSIONS
  Despite evidence emphasizing the protective effects of supportive parenting practices on early child development, our work demonstrates significant disparities in parenting practices that promote early child development between economically advantaged and disadvantaged parents. Innovative population-level strategies that enrich parenting practices for vulnerable children in early childhood are needed.
authors.affiliation: Department of Pediatrics, College of Medicine, and reshmamd@uic.edu.
authors.forename: Reshma
authors.initials: R
authors.lastname: Shah
authors.affiliation: Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Developmental Disabilities, The University of Chicago, Comer Children's Hospital and Pritzker School of Medicine, Chicago, Illinois.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Sobotka
authors.affiliation: Center for Clinical and Translational Science, The University of Illinois at Chicago, Chicago, Illinois; and.
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Developmental Disabilities, The University of Chicago, Comer Children's Hospital and Pritzker School of Medicine, Chicago, Illinois.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Msall
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting; D011203:Poverty