Families Systems & Health最新文献

In this article, the authors assert that a potential solution to mitigate the mental health care workforce shortage is to embed psychiatric nurses in primary care. Nurse practitioners (NPs) are nurses who have advanced education (master's or doctoral degree) and advanced clinical training to diagnose and treat illness, manage chronic disease, and contribute to population health. Although there are not yet large-scale studies of psychiatric NP integration in primary care, emerging evidence suggests that such models can improve mental health care referrals, increase uptake of mental health referrals, decrease child behavioral symptoms, and decrease repeat primary care visits for unmet behavioral health needs. The ongoing shortage of specialty mental health care providers has created a significant opportunity for physician-nurse collaborative models of care to fill this gap. An innovative and practical solution to the nation's child mental health crisis is expanding, incentivizing, and sustaining the role of psychiatric NPs in pediatric primary care models. Such models may yield distinct health benefits in underserved and low-resource communities with mental health provider shortages. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Integrated primary care (IPC) settings serve as primary access points for mental health care, particularly for underserved populations that face barriers to traditional care. This brief report investigates the feasibility and practical implementation of two mobile health (mHealth) applications, MindLAMP and BounceBackNow, deployed in IPC settings. MindLAMP was selected for its evidence-based design tailored to support patients with depression, offering tools for mood tracking, cognitive behavioral strategies, and personalized feedback. BounceBackNow was chosen due to its focus on trauma-related symptoms, providing psychoeducational resources, symptom monitoring, and coping strategies specifically designed for individuals experiencing posttraumatic stress. Both apps were selected for their user-centered design, accessibility, and alignment with IPC goals of improving mental health access for underserved populations.

Method: The apps were deployed to support patients with depression and trauma-related symptoms, offering a digital tool to complement in-person therapy sessions. Both patient outcome measures and individual interview data from behavioral health providers and other clinical staff members were collected and analyzed.

Results: Despite the promising potential of these apps, the studies faced significant challenges, including low patient recruitment, technical barriers, and time constraints for health care providers.

Discussion: The findings highlight the need for comprehensive strategies to integrate digital health tools into existing health care systems. Future directions and lessons learned include addressing organizational barriers, enhancing provider training, and exploring community-based engagement strategies to improve patient adoption and sustained use of mHealth apps. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this essay, the narrator reflects on her experience of taking medical leave from her work in academic health sciences during a complicated twin pregnancy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Milbank query assumes that there is evidence that integrated behavioral health works and saves money (Nguyen et al., 2025). If so, we need to define the statement more clearly. The core question has been asked for quite a while. Miller and Kessler asked 20 years ago: "What behavioral health intervention in primary care delivered by what type of organization, personnel, and duration, generates what outcomes, clinically and financially, for which patients?" (Miller et al., 2011). Since that time, there have been multiple innovators and practices who have moved the field ahead. We suggest that while these early adopters have made great progress, the field has not generally progressed to the point where the elements of the question have been satisfactorily adopted or answered, and, as Butler et al. (2008) suggested almost 20 years ago, orthodoxy about the utility of behavioral health integration was premature. We maintain that this was true then, and much of it remains true now. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this brief article, the author recounts how her mother experienced pain-induced delusions and bodily dysfunctions as cancer wracked her body. This new phase in palliative care was challenging her mental health training and her dad's infinite patience, but they knew it was not her fighting them. It was the cancer. For the mother's remaining months before her mother died, the author and her dad would whisper-sing "Kill the wabbit!" as their code for (a) everything would be okay, (b) it may be time to switch strategies, (c) you are not alone, or (d) make each other laugh when there was no time for tears. This grew more important as her mother's body and mind withered before their eyes. Despite the support of the palliative care team and the flexibility of the author's doctoral committee and her bosses, who allowed her to defend and work remotely, it could be isolating. As someone who trains others to seek help, being a caregiver for a loved one with cancer provided the author a unique insight into how challenging it could be to reach out for support. In the past two and a half years, she and her dad have worked to develop an adapted relationship reflecting their respective "new normal," and they have become close again. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: There is a paucity of information about the quality of life in mothers during their adolescent-young adult's transition to adulthood. To ensure family-centered care throughout the lifespan, this research seeks to gain a better understanding of the influence of Type 1 diabetes on the mother's quality of life during their adolescent-young adult's transition to adulthood.

Method: In this convergent parallel mixed methods study using the Family Management Style Framework, a sample of 72 mothers of adolescent-young adults (15-25 years) completed measures of social support, diabetes distress, and Type 1 diabetes health-related quality of life. From this sample, 12 mothers participated in interviews to further characterize the influences of Type 1 diabetes on mothers during the transition to adulthood.

Results: Mothers reported continued Type 1 diabetes-related distress related to lack of control of diabetes management, disrupted sleep patterns, and lack of support. Type 1 diabetes health-related quality of life was positively associated with perceived social support (τb = .194, p < .024) and negatively associated with diabetes distress (τb = -.629, p < .001).

Discussion: Despite the significance of their role during the adolescent-young adult transition to adulthood, the needs of mothers during this time have been largely ignored in extant research. Isolation, lack of control, and disrupted sleep led to increased Type 1 diabetes distress and diminished quality of life for mothers during this time. This study highlights the long-term consequences of Type 1 diabetes on mothers and emphasizes the need for continued professional support for mothers during the transition to adulthood. (PsycInfo Database Record (c) 2025 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) 2025 APA, all rights reserved).

Introduction: Familism varies across cultures, with some societies placing greater emphasis on family ties and obligations than others. Despite its variability, the precise impact of familism on psychosocial functioning remains inconclusive and requires further exploration to clarify its effects in different cultural contexts. Understanding the role of familism in a cross-cultural context can help health care providers enhance patient care by considering familial influences on mental health and well-being.

Method: This study used World Values Survey data (Wave 7) to investigate familism's effects on psychological well-being, physical well-being, and life satisfaction across 48 countries. Hierarchical linear models were employed to analyze data from 69,578 adult participants (52.4% female, M_age = 42.59, SD = 16.28). The study examined the relationship between familism and well-being outcomes, with consideration of urbanization and individualism as moderators.

Results: Findings revealed a positive association between familism and well-being outcomes, indicating potential universality in this relationship across cultures. Urbanization and individualism did not significantly influence the relationship between familism and well-being, suggesting its stability across different societal contexts.

Discussion: These results suggest that familism may have universal benefits for well-being, as it fosters connections within families, providing individuals with a sense of purpose and meaning in life. This is particularly significant in the contemporary context of shrinking household sizes, epidemic of loneliness, and increasing social isolation. Integrating insights on familism can help health care providers better support patients and improve mental health and well-being. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Black women in the United States experience higher rates of adverse maternal and birth outcomes (e.g., depressive symptoms and preterm birth), influenced by social and psychosocial factors including mother-father relationship quality. Existing measures of relationship quality often overlook the unique dynamics within Black families, requiring a more nuanced approach.

Objective: This study aims to contextualize the multidimensional nature of relationship quality between pregnant Black women and the fathers of their babies.

Method: Using a cross-sectional design, we analyzed data from 405 women enrolled in the Biosocial Impacts on Black Births study. Participants completed questionnaires at 19-29 weeks gestation on six indicators of relationship quality: frequency of contact, frequency of father's involvement during pregnancy, relationship before and during pregnancy, support, and conflict. Latent class analysis was used to identify a construct of relationship quality.

Results: Three distinct classes of relationship quality were identified: "no relationship," "conflictual relationship," and "good relationship." Sensitivity analyses showed that while marital or cohabitation status was highly correlated with both the relationship indicators and identified classes, its inclusion as an additional indicator did not alter classification in the latent class model. These classes highlight the intricacies of relationship dynamics, which may be specific to Black families.

Conclusion: This study underscores the importance of considering the multifaceted context of relationship quality, which is essential for designing culturally informed public health strategies or interventions. The implications of our findings are significant for both research and clinical interventions aimed at improving birth outcomes for diverse populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Integrated care teams require both collaboration and the ability to navigate conflict. When teams lack the needed tools to repair ruptures, cohesion and care can begin to erode. In his work, the first author of this President's Column (Jason Herndon) has found the relational frameworks of Nonviolent Communication and Crucial Conversations invaluable. In this column, the two authors provide a roadmap to managing conflict through the spirit of integrated care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).