The increasing incidence of emotional and behavioral disorders in children and the challenges associated with them and their families stress the need to address the quality of family interactions, particularly those between mothers and their children. The purpose of this study was to investigate the effectiveness of mother-child interaction training, which draws upon the principles of the Precede model, on the meta-emotional philosophy of mothers and their children's emotional-behavioral problems. This research project was designed as a semi-experimental study adopting a pre-test and post-test format with a control group. The participants in this study consisted of mothers of children with emotional-behavioral disorders, and the study sample was selected from a total population of 30 individuals. Fifteen participants were randomly assigned to the experimental group, while 15 others were assigned to the control group. For the experimental group, participants attended 6 sessions of mother-child interaction training based on the Precede model, while the control group received no intervention. Both groups were assessed using the following research instruments: Evelyne kehe’s (2006) meta-emotional philosophy questionnaire and Achenbach's (1992) child behavior checklist-parent form, which were administered both prior to and following the intervention. Data analysis in the study was performed using two methods: univariate and multivariate (multivariate) ANCOVA tests executed in the SPSS software (version 26.00). The results revealed a significant difference in both variable values in the experimental and control groups, with a significance level of less than 0.05. The findings suggest that this intervention had a positive and significant impact in improving both metam-emotion philosophy (F = 201.568, P = 0.0001) and emotional-behavioral problems (F = 36.588, P = 0.0001). These effects were significant at the α = 0.05 significance level. The findings demonstrate that mother-child interaction training based on the Precede model was effective in significantly improving mothers’ meta-emotional philosophies and reducing emotional-behavioral problems in adolescents aged 11-14 years. Considering the pivotal role of the mother's role in their children, it is recommended that providing educational interventions to mothers, to strengthen their relationship with their children, would be effective in reducing and managing children's emotional-behavioral problems.
Keywords: Mother-Child Interaction; Precede Model; Meta-Emotion Philosophy; Emotional Behavioral Problems.
 
 
 
Extended Abstract

Introduction

The presence of emotional and behavioral problems among children is a significant issue within the field of clinical psychology and the psychology of children with special needs. Notably, a considerable number of children in the pre-primary school age bracket are affected by such problems. The importance of this issue is further magnified due to the high number of students with mental health problems who are also grappling with emotional and behavioral challenges. According to Zupard et al. (2023), family factors are significant contributors to children's behavioral problems. Specifically, supportive maternal interactions are associated with positive social and emotional outcomes, while controlling interactions predict negative outcomes for children. Bell (2020) supports this notion, asserting that supportive maternal interactions can foster healthy socio-emotional development in children. Effectively, effective mother-child communication contributes to several beneficial outcomes for children, including improved social skills (Rezapour, Kohestani, & Erfan, 1401), enhanced self-regulation and emotional-social consequences (Bell, 2020), and ultimately, enhanced psychological and social abilities (Thompson, 2008).
Mother-child interaction constitutes an emotional and psychological bond between the two, and it hinges on the child's past experience of the dynamics of their relationship with the mother (Lindsey, 2021). Research indicates that positive interactions between mothers and children help reduce instances of behavioral problems (Hashemi & eini, 1400). Moreover, high-quality interactions exhibit an inverse correlation with both externalized and internalized behavioral issues (Dubois et al., 2015). Overall, enhancing the quality of mother-child interaction emerges as a vital factor in minimizing or ameliorating the challenges associated with children experiencing emotional-behavioral issues. Conversely, the concept of meta-emotional philosophy is intricately linked to the relationship between mother and child. According to Nunes et al. (2022), strong meta-emotion is observed in mothers who foster positive relationships with their children, with a clear indication that children of mothers exhibiting high levels of meta emotion philosophy exhibit a secure attachment to their mothers (Chen et al., 2012). In light of this connection, enhancing the quality of mother-child interaction can effectively institutionalize meta-emotional strategies within the parent-child relationship. The notion of meta-emotion signifies second-order emotions—that is, emotions experienced in relation to one's own emotions or those of others (Miceli & Castelfrani, 2019). Similarly, the meta-emotional philosophy of parents pertains to their emotional response to their child's emotions. Children struggling with emotional and behavioral disorders encounter numerous challenges related to emotion regulation and control of negative emotions (Najati-Far et al., 2019).
Studies conducted in recent years indicate that greater emotional development in mothers is associated with reduced levels of both internalized and externalized problems in children. Furthermore, research suggests that mothers' emotional dysfunction can serve as a predictor for increased instances of internalized and externalized issues (He, et al., 2020). Given the heightened prevalence of emotional and behavioral problems among these mothers, it is plausible that their meta-emotional philosophies are relatively weak. Consequently, it becomes imperative to implement a program that bolsters the meta-emotional philosophy in parents whose children are grappling with emotional and behavioral issues. A thorough review of the effectiveness of interventions based on mother-child interaction in children grappling with emotional-behavioral issues reveals that these difficulties tend to resurface following treatment (Levi et al., 2021) and can persist into adulthood (Fan et. al., 2024). Supporting this claim, research has found correlations between elevated levels of maltreatment in childhood and interpersonal issues in adulthood (Mayer et al., 2019). The research conducted by Arslan et al. (2020) established a correlation between the presence of externalized behavioral problems in children and the emergence of maladaptive behaviors during adulthood. Furthermore, it was observed that these problems can persist until adolescence and even extend into adulthood (Agnafors, 2021). This prolonged persistence of behavioral problems often proves challenging to treat effectively, thereby increasing the risk of developing mental health issues during adulthood.
In recent years, methods that aim to promote health-related desirable behaviors and have demonstrated lasting effects have become increasingly popular, with interventions rooted in the Precede model being among them. The Precede model, developed by Green et al. in 1974, serves as an effective theoretical framework for identifying health and health education needs, comprising two components: educational diagnosis (precede) and ecological diagnosis (proceed). The Precede model's intervention focuses on altering the context of the family by strengthening positive factors, thereby reinforcing a healthy mother-child interaction as a social norm within this small society. Furthermore, by introducing and highlighting the support resources available to mothers, the intervention can have a more profound impact and leave a lasting impression on these parents. Based on the characteristics of the intervention rooted in the Precede model, which encompasses stages and components, it is anticipated that mothers of children with emotional-behavioral issues will achieve skills that are persistent and become an integrated part of their daily lives through this intervention. This transformation presents a significant challenge and appears unattainable for these mothers, as highlighted by Rubino et al. (2023).
Inspired by the aforementioned research findings, the researchers of this study devised an intervention based on the Precede model to achieve impactful and enduring outcomes in reducing the severity of emotional-behavioral problems. The meticulous research conducted by the research team in both local and international sources has highlighted a significant research gap concerning interventions grounded in the Precede model within the psychological field when compared to studies in the medical and health domains. In light of this gap, a notable absence of interventions targeting mother-child interaction, particularly for children grappling with emotional-behavioral challenges, becomes particularly manifest. The necessity to improve the quality of mother-child interaction in children grappling with emotional-behavioral challenges is unequivocally recognized, especially given the potential long-term impact of the asked model in cultivating positive interactions between mothers and their children. Consequently, the central focus of this research endeavor is to investigate the effectiveness of an educational intervention grounded in the Precede model on both mothers' meta-emotional philosophies and children's emotional-behavioral issues.
Research Questions
This study pursues the following research questions:

Is mother-child interaction training based on the Precede model effective on the meta-emotional philosophy of mothers?
Is the teaching of mother-child interaction based on the Precede model effective on children's emotional-behavioral problems?


Literature Review

Recent studies indicate that positive mother-child interactions can reduce children's behavioral problems (Hashemi and eini, 1400). Consistent findings indicate that interventions grounded in the Precede model have demonstrated efficacy in addressing diverse objectives, including: (1) enhancing psychological well-being in women (Meshki et al., 2022), (2) fostering self-care practices among high blood pressure patients (a study by Abadi et al., 2019), (3) fostering the mental health of middle-aged women (Shiani Jalili, 2014), and (4) promoting healthy lifestyles for hypertensive patients (Hosseini et al., 2013). Research conducted both within and outside of Iran reveals a significant research gap concerning the employment of interventions based on the Precede model in the field of psychology compared to research conducted in the medicine and health domains. This research gap is particularly evident given the absence of any intervention focusing specifically on mother-child interaction with children experiencing emotional-behavioral difficulties.

Methodology

This research project was conducted as a semi-experimental study, comprised of pre-test, post-test, and follow-up assessments. The study population included all mothers with children displaying external behavioral issues enrolled in regular schools in Isfahan during the academic year 2019-2020. Diagnosing children's behavioral problems utilized the Achenbach Behavior Problems Questionnaire. For the purpose of selecting the sample, a convenience and purposive sampling method was employed. Firstly, the mothers of students with identified emotional and behavioral difficulties were invited to participate in the research, from which a sample of 30 individuals who met the inclusion criteria were chosen. Data collection commenced with the assessment of dependent variables in the pre-test phase. Following this, an intervention based on the Precede model was executed in six, 60-minute sessions (one session per week) for the experimental group. Subsequently, in the follow-up phase, after the intervention's conclusion, both the experimental and control groups were assessed on dependent variables. The difference between pre-test and follow-up scores for the experimental and control groups was then statistically analyzed to establish the effect of the independent variable.

Results

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Table 1. Descriptive statistics of meta emotional philosophy and emotional behavioral problems




control


experimental


 




standard deviation


Mean


standard deviation


Mean


N


tese


 






42/7


63/25


04/9


47/23


15


Pre test


Sufficiency and competence




35/7


47/26


85/7


20/35


15


Post test


 




76/13


27/48


87/13


46/45


15


Pre test


Emotional coaching




04/14


66/48


79/14


60/65


15


Post test


 




34/19


20/74


79/21


93/68


15


Pre test


Meta emotional philsophy




25/19


13/75


10/21


108


15


Post test


 




91/13


60/37


16/13


20/27


15


Pre test


Internlaized problems




35/14


27/38


69/10


80/20


15


Post test


 




55/13


06/41


52/21


87/34


15


Pre test


externlaized problems




04/15


53/42


38/16


40/26


15


Post test


 




06/16


66/78


85/15


06/62


15


Pre test


Behavioral problems




42/17


80/80


60/12


20/47


15


Post test


 




Table 2. results of univariate analysis of covariance mean post-test scores on meta-emotional philosophy and behavioral problems




Test power


Effect size


Sig


F


Mean of square


df


Sum of square


Stage


 






000/1


919/0


0001/0


566/306


099/10503


1


099/10503


Pre test


Post test


Meta emotional philsophy




000/1


882/0


0001/0


568/201


824/6905


1


824/6905


Group


 




 


 


 


 


261/34


27


034/925


Error


 




 


 


 


 


 


30


000/248513


Total


 




000/1


733/0


0001/0


229/74


820/4747


1


820/4747


Pre test


Pott test


Behavioral problem




000/1


575/0


0001/0


588/36


265/2340


1


265/2340


Group


 




 


 


 


 


 


27


980/1726


Error


 




 


 


 


 


 


30


000/137822


Total


 





Discussion

In line with previous research findings showing a significant relationship between parenting styles and meta-emotional philosophy (Basaknejad, Younesi, & Janadele, 2018), as well as the inclusion of parenting style education within the Precede model-based intervention, these findings were anticipated. Additionally, during the training sessions based on the Precede model, the concept of "mindful parenting" was introduced to the mothers. Given the proven effectiveness of mindful parenting in improving "mothers' emotion regulation" (Badiei et al., 2020), it is logical that mothers, upon completing the training, would have improved their capability to appropriately manage their children's emotions. Studies indicate that children with emotional and behavioral issues struggle with recognizing their inner feelings, as well as understanding their emotional experiences (Persan & Jandari, 2018). Moreover, addressing these challenges relies heavily on enhancing mothers' meta-emotional philosophy, which subsequently strengthens their emotion regulation skills. Research has demonstrated the effectiveness of this method in improving externalized behavioral issues among kids (Nejatifar, Abedi & Ghamrani, 2019).

Conclusion

The research findings indicate that mother-child interaction training grounded in the Precede model significantly elevates mothers' meta-emotional philosophy and concurrently reduces their children's emotional and behavioral issues.
Acknowledgments
We express our profound gratitude to all the mothers who actively participated in our intervention sessions. We also extend our sincere appreciation to all individuals who contributed to the successful completion of this research venture.