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in elementary occupations (35%) and the service and shop/sales categories (31%),2 indicating that they are socio-economically relatively disadvantaged.

Although there were local studies on PMR families, different criteria were used to define new arrivals in different studies. Only a few focused on pre-primary schoolchildren and few compared them with local families. Most used questionnaires with unknown psychometric properties.

On the subject of physical health, a survey revealed the immunisation cover for mainland-born preschool children was comparable to that of their local-born counterparts.3 A study on new arrival children under 18 years found that 18.1% and 2.6% had blood lead levels of above 0.48 and 0.71 µmol/L respectivel , when measured within 14 days of arrival in Hong Kong, but information on local children was unavailable for comparison.4 The oral health of mainland-born preschool children was found to be poorer than that of the local-born.5,6

Regarding education, 27.2% of newly arrived preschool students were over-aged for their classes. About 50% were considered weak in English by their teachers, and around 10% were weak in either Chinese or Mathematics.7

As for social and emotional aspects explored using a locally developed questionnaire, PMR parents rated their preschool children more positively in personal and social competence than local parents, with no difference in common behaviour problems.8 In another study using validated questionnaires, among participants in a programme for parents of preschool children, PMR parents reported higher pre-intervention child behaviour problem scores, but more child behaviour changes post-intervention than local parents.9 However, the programme completion rate of PMR parents was lower than that of local parents.

The aim of the present study was to understand the specific parenting needs of PMR parents of preschool children in comparison to those of local parents, in terms of parenting stress, child behaviour problems, and marital satisfaction, using questionnaires with known psychometric properties. These variables were chosen because it was well- documented that parent-child interactions and the quality of parenting are affected by parents’ life events. Moving to a new society is recognised as a stressful life event.10 High levels of family stress can interfere with effective caregiving and exacerbate

ineffective parenting,11,12

which may in turn lead to

child behaviour problems.13 It is argued that stress encountered by couples in a new environment can adversely affect their marital relationship,14 and that parental marital relationships also affect child behaviour.15 We hypothesised that PMR status was associated with parenting stress, child behaviour

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    Newly arrived parents and parenting #

problem, and marital relationships.

Methods Participants and procedures

The target population was families with at least one PMR parent with at least one child aged 3 to 6 years, living in Hong Kong. Participants were recruited through social service centres, preschools, and Maternal and Child Health Centres (MCHCs) between January and June 2004. Random sampling was not conducted, as there was no sampling frame; none of these agencies had a complete list of children from PMR families. Upon consent, parents were asked to complete a self-administered questionnaire in small groups, supervised by research assistants. A small sample of parents was also invited to participate in individual interviews, which were tape-recorded and transcribed verbatim. The Ethics Committee of the Department of Health approved this study.

Data on non-PMR parents from a previous community survey on parents of 4-year-old children attending MCHCs conducted in 200216 were used for comparison.

Measurement tools

Participants in both studies had to complete a questionnaire with the following sections:


Eyberg Child Behaviour Inventory (ECBI17)— this was a 36-item multidimensional measure of parental perception of disruptive behaviour in children and incorporated two scores, the intensity score (problem severity) and the

Hong Kong Med J Vol 13 No 5 # October 2007 # www.hkmj.org


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