Families Systems & Health最新文献

Background: The benefits of utilizing virtual simulation in substance use disorder (SUD) training are emerging in the literature. However, a clear understanding of how behavioral health graduate trainees experience virtual simulation as part of an interprofessional SUD training is still needed.

Method: Graduate-level health professions students (N = 69) from four different behavioral health disciplines completed an interprofessional training program, including completion of two virtual simulations, that addressed SUD screening, brief intervention, and referral to treatment (SBIRT) and teamwork topics using an interprofessional lens. Participants completed a baseline and posttraining survey, pre- and postsimulation surveys, and a recorded debrief meeting postsimulation completion.

Results: Quantitative results indicated statistically significant changes for drug perceptions (p < .001), interprofessional competency (p < .001), and preparedness and confidence implementing the SBIRT model between baseline and posttraining. Two overarching themes were identified as part of the qualitative analysis, including (a) the benefits and limitations of utilizing a structured virtual simulation within the context of interprofessional SUD training and (b) the benefits of utilizing interprofessional knowledge and teamwork when completing the simulation.

Conclusions: Completing an interprofessional training for SUD and SBIRT using simulation may help better prepare behavioral health trainees in applying both SBIRT and interprofessional teamwork principles in their clinical work, thereby addressing the needs of their future patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aim: Attitude is a response to certain events and phenomena based on past knowledge and experience. This study aimed to improve the attitudes of family members toward diabetes after the implementation of the program.

Method: The study was a one-group quasi-experimental design conducted with family members of patients with diabetes in a city in northern Turkey. There were a total of 38 family members of people with diabetes in the study group. The participants completed the personal information form and the Diabetes Attitude Scale as a pretest. They then took part in a diabetes education program based on the health belief model. After the education program, family members received an education booklet, health belief model-based text messages (twice per week for 3 months/total of 24), and phone calls (once per month/total of three). The family members completed the posttests at the end of the 3 months.

Results: Of the family members, 55.3% were female, 42.1% were primary school graduates, 52.6% were spouses of patients with diabetes, and the mean age was 45.32 ± 13.99 years. The Diabetes Attitude Scale total score was 3.2 ± 0.2 on the pretest and 4.0 ± 0.0 on the posttest (p < .001). There was a significant increase in all subscale scores after the intervention.

Conclusion: There was a significant improvement in the attitudes of family members who participated in the diabetes education program. Having family members with positive attitudes toward diabetes can be beneficial in the management and care of the patient's diabetes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Strong support for family-based interventions in child and adolescent weight management exists. However, family-based interventions have not been as well documented in adult populations. Given that many adults operate within family systems that could influence their weight management behaviors, research is needed to establish possible family-level variables as intervention targets for adult weight loss programs.

Method: This study tested the relationship between family functioning (defined as support and bonding), chaos (defined as disorder in the home), and weight loss in adults with overweight or obesity participating in a behavioral weight-loss program. Participants (N = 118; baseline mean body mass index 33.8 ± 3.7; 69.5% female; 97.5% White; 67.8% with a combined annual income of $75k or above; 90.7% completed some college or above) were from a randomized controlled trial examining weight loss ripple effects (Gorin et al., 2018) in individuals assigned to either 6 months of WW (formerly Weight Watchers) or a self-guided approach.

Results: Higher family support and bonding at baseline were associated with greater percent weight loss at 6 months. Family support and bonding at baseline were associated with lower chaos in the home at 6 months. However, this was moderated by condition such that this association was significant in the WW but not the self-guided group.

Discussion: Results provide theoretical support that targeting family dynamics may improve weight loss outcomes in behavioral weight loss programs for adults. Future research should test whether family support, bonding, chaos, or other related variables such as family cohesion and adaptability-focused interventions improve weight loss outcomes for adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Collaborative care (CoCM) has been utilized as one strategy for improving access to behavioral health treatment through the primary care setting. However, despite the increased prevalence rates, need for services, and expansion of behavioral health into primary care, there are patients who initiate treatment but disengage for unknown reasons and without communication with their care team. This study analyzes treatment factors by comparing patients who disengage from CoCM for known versus unknown reasons to identify factors that may enhance the ability of providers to implement strategies for retaining those who have initiated care. The analysis utilizes clinical data from Concert Health, a national behavioral health medical group providing CoCM across 19 states.

Method: The full patient disengagement data set contains 3,317 patient-level observations. A backward stepwise logistic regression was used to analyze how patient characteristics and level of care impacted patient disengagement for unknown reasons relative to known reasons.

Results: The number of clinical touchpoints a patient receives has a significant association with disengagement for unknown reasons. Specifically, more touchpoints and touchpoints early in treatment appear to be important in preventing unknown disengagement. Other significant variables associated with disengagement for unknown reasons include age, primary diagnosis and comorbidities, and improvement as measured by Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scores.

Discussion: This analysis sheds light on factors that impact patient disengagement from care for unknown reasons. The article concludes with a series of implications for enhancing care and patient retention based on these findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: System-level initiatives are key to promoting health and well-being among young families, yet agencies and organizations who support those families often do not coordinate their delivery of supportive services and resources. We describe the South Carolina (SC) two-generation (2Gen) community of practice (CoP) and its early efforts to foster statewide adoption of "whole family" centered approaches.

Method: This mixed-methods study evaluated the impact of the CoP. Quantitative data were gathered from CoP participants to assess its impact on their increased knowledge and use of the 2Gen approach, as well as on new peer connections and individual professional development. Qualitative data were gathered on the perceived value of the CoP, as well as opportunities for growth.

Results: Data indicate that SC 2Gen CoP meetings have been well received by participants. Data from meeting evaluations demonstrate that the information increased participants' knowledge on the 2Gen approach and that it contributed to their growth and professional development. Meetings have also been effective in promoting connections between like-minded professionals, as well as in providing useful information to integrate 2Gen approaches into their work.

Discussion: These early findings demonstrate the continued need for the SC 2Gen CoP and its potential to grow into a robust outlet to support family-serving professionals in SC. More efforts are needed to promote systems coordination and integration among family-serving professionals. CoPs are one way to integrate system-level strategies, such as the 2Gen approach, to support family-serving professionals and enhance the integration of resources provided to families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: In 2022, Families, Systems, & Health (FSH) issued a statement of purpose to equity, diversity, and inclusion (EDI) and developed a strategic plan for promoting EDI in scientific communication and publishing. The purpose of this review was to evaluate a decade of research published in FSH prior to the journal's initiatives to improve EDI.

Method: We utilized a scoping review to broadly review literature published in FSH that focused on topics of race, ethnicity, racism, and/or BIPOC (Black, Indigenous, and people of color) groups. All research studies published in FSH between 2012 and 2021 were independently assessed by two reviewers for inclusion. Charting of data from each study was based on a diversity accountability index.

Results: Of the 360 research studies identified, 41 were included in the review. Characteristics and frequencies of keywords, research designs, and samples among the included studies were examined, alongside the reporting of results that focused on the differences between racial/ethnic groups and within BIPOC groups.

Discussion: Research focused on race, ethnicity, racism, and diversity science is not well represented among published studies in FSH prior to the implementation of the above-described EDI efforts. Among articles that did focus on these topics, comparisons largely were of a racial/ethnic minority sample to a White sample. Action steps for FSH and other journals wishing to promote EDI include a thorough examination of current journal review procedures paired with the establishment of procedures for combatting bias and racism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: While studies have described the benefits of integrating behavioral health (BH) into primary care (PC), few have examined patients' perspectives, especially in large, urban health systems. In 2015, the University of Chicago Medicine launched the Primary Care Behavioral Health Integration Program, located in a mental health professional shortage area.

Method: In 2021, semistructured interviews were conducted with adult patients who had discussed their depression symptoms with their primary care clinician (PCC). Participants were asked about their experiences of being screened for depression, discussing BH, and being referred to behavioral health clinicians (BHCs). Interviews were analyzed using thematic analysis and constant comparison, and they were conducted until theme saturation was achieved.

Results: Fifteen participants were interviewed, the majority of whom were women and African American/Black, with an average age of 52. Participants expressed that PC-BH integration helps patients recognize BH problems and navigate the BH care system, emphasizes the connection between physical and mental health, and eases conversations through familiar setting and established trust. Patients enumerated barriers to integration, including barriers to BH care in the PC setting, barriers to BH conversations with PCCs/BHCs, and barriers to referrals to psychiatry/external therapy. Patients highlighted facilitators of integration, including trust with their PCC, collaboration between PCCs and BHCs, and population-level screening.

Discussion: These perspectives affirm the core strength of PC-BH integration: making BH more accessible and destigmatizing, especially for underserved communities. They also emphasize the importance of collaboration between PCCs and BHCs, shared identities, and actively involving patients in program design and quality improvement interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This article discusses the life of a Type 1 diabetic. Everything is a danger. Stress, flu, infection, or a common cold could all lead to a hospital stay. There are many negative long-term effects: blindness, loss of a limb, heart attacks, etc. Every day is an effort to keep on top of things. The diabetes cannot be forgotten or ignored. The cost of living with diabetes is atrocious, between the devices, insulin, and other needed supplies. It is expensive to be sick. On top of the insulin pump, there are numerous supplies, such as reservoirs to hold the insulin, the infusion sets to put the plastic needle into the body, along with tubing to carry the insulin from the pump to the insertion point on the abdomen. There are also continuous glucose monitors (CGM), which include a transmitter, as well as sensors that have to be changed weekly. These items are much needed for people like the author, who after having diabetes for 24 years, find it difficult to feel low blood sugars. This difficulty feeling low blood sugars is quite dangerous, and may lead to seizures, brain damage, or even death if unnoticed and untreated. With CGM technology, the transmitter and sensors have saved the author on multiple occasions from seizures, or worse. They are a necessity, and the author needs the CGMs to protect her life. The author highlights a promise of hope in the Canadian Government's plan to financially cover "diabetic medications and supplies." And while it would not cover the expensive drugs not currently covered by the author's insurance, it does mean insulin and oral medications for Type 2 diabetes will no longer be paid out of pocket. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Minimal research on integrated primary care (IPC) or integrated behavioral health (IBH) has examined clinics in rural communities. The relationships between provider burnout, job satisfaction, and IBH/IPC practices remain understudied, particularly in rural settings.

Method: We employed an online survey of 147 medical and behavioral health care providers in primary care settings throughout Montana. Respondents self-identified as predominantly White/European American (89.4%) and female (76.7%). We tested whether degree of adherence to IBH/IPC practices concurrently predicted providers' reports of emotional exhaustion (EE), a dimension of burnout, and job satisfaction. Data were collected during the COVID-19 pandemic, in 2020.

Results: In multiple linear regression analyses, providers' reports of IBH/IPC practices significantly predicted EE (B = -0.036, p < .01) and job satisfaction (B = 0.123, p < .05), suggesting that higher levels of integration were linked to less EE and greater job satisfaction.

Discussion: Our findings contribute to the evidence base regarding the potential usefulness of IBH/IPC models. Specifically, because existing research links provider burnout and low job satisfaction with provider retention difficulties and diminished health, poor patient satisfaction and outcomes, and cost inefficiencies, our findings have potential to inform policy-level discussions regarding the use of IBH/IPC models in rural states like Montana. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Diabetes-specific family conflict is a risk factor for diabetes indicators (e.g., higher hemoglobin A1c (HbA1c), lower adherence), but little longitudinal data are available to understand associations across time. To better inform targets and timing of interventions, we examined (a) whether fluctuations in conflict covary with diabetes indicators within adolescents across time; (b) whether reciprocal associations exist; and (c) whether aspects of the parent-adolescent relationship (e.g., parental acceptance) buffer associations across time.

Method: Adolescents (N = 235, ages 11.5-15.5 at baseline, 53.6% female) completed measures of diabetes-related conflict with mothers and with fathers (separately), parental acceptance, and adherence every 6 months across 1 year (three time points). HbA1c was obtained from medical records. Data were collected in 2009.

Results: Bivariate between-person correlations indicated that at each time point, adolescents who reported more conflict with mothers and fathers also had higher HbA1c and lower adherence. Within-person correlations (fluctuations across three time points) indicated that fluctuations in conflict with mothers were associated with fluctuations in HbA1c but not adherence. Actor-partner multilevel models indicated that fluctuations in family conflict at each time point were not associated with future diabetes indicators. Parental acceptance did not moderate associations of family conflict and diabetes indicators.

Discussion: While findings corroborate extant literature noting that adolescents with high average diabetes-specific family conflict may benefit from interventions designed to reduce conflict, conflict at one time point may not be predictive of future diabetes indicators. (PsycInfo Database Record (c) 2024 APA, all rights reserved).