Families Systems & Health最新文献

Introduction: The transition to telehealth as a result of the COVID-19 pandemic brought the potential to ameliorate or exacerbate disparities in access to behavioral health care. This study examined patient-specific sociodemographic predictors of integrated behavioral health (IBH) utilization prior to and during COVID to identify variations in care access.

Method: Data from three primary care clinics across two medical centers (N = 819 patients), and multivariate general linear modeling, were used to test direct associations between age, sex, primary language, and race/ethnicity and use of IBH services pre-COVID (March 2019-February 2020) versus peri-COVID (March 2020-February 2021). Moderated effects due to health care system-specific telehealth modalities were also tested.

Results: Findings suggest patients completing peri-COVID IBH visits were significantly younger than pre-COVID, specifically among patients seen in academic medical center settings with primarily video-based IBH care. Results also indicate patients engaging in peri-COVID IBH were significantly more likely to identify as Hispanic/Latino than non-Hispanic White, specifically among county-funded clinic patients receiving phone-based IBH.

Discussion: The transition to telehealth-delivered IBH care may have reduced behavioral health care access for aging patients, who are least likely to be comfortable with video-based care. The use of phone visits may have improved access for underserved Hispanic/Latino patients, who may experience barriers to in-person care. Aligning telemental health care with primary care patients' preferences and access to telehealth-ready devices may amplify IBH-related improvements to mental health care access. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The family systems emphasis area of Families, Systems, & Health (FSH) is representative of one of the longest standing foci emphasized in the journal. We highlight how patients navigate health challenges within relational and social contexts (e.g., marriages, committed partnerships, friendships, and communities). By co-owning problems and coconstructing solutions, we recognize how patients fare better in couple, family, and social groups compared to when they function alone. Systemic interventions, community-based participatory research, and other means of pursuing health collectively are recognized and embraced in this emphasis area. As associate editors, we are highly committed to publishing innovative work aligned with these tenets. In this article, we discuss (1) current knowledge: what do we know? and; (2) what is next? identified needs, suggestions, and invitations for future submissions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Reviews the book, Play and Health in Childhood: A Rights-Based Approach by Julia Whitaker and Alison Tonkin (2023). This book addresses a critical issue: the increasing constraints on children's opportunities for play in contemporary society. By adopting a rights-based approach, the authors highlight the ethical and legal responsibilities involved in advocating for children's right to play. The book skillfully weaves together theoretical discussions and practical case studies, illustrating the interconnectedness of children's rights to play and their rights to health. Although primarily targeted at scholars and practitioners in child development, education, health care, and social work, this work also offers significant insights for policymakers, educators, health care providers, and community leaders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Prolonged activation of the body's stress response from chronic exposure to adverse stressors may have a significant impact on lifelong psychosocial functioning. Screening for the impact of prolonged adversity in childhood has become an integral component of pediatric care. While past research has separately explored the impact of caregiver chronic illness and caregiver toxic stress on children, the relationship between caregiver chronic illness disability burden, caregiver parental toxic stress, and their child's psychosocial functioning is not well understood. This study aimed to investigate how caregiver chronic illness disability burden and caregiver toxic stress impact childhood psychosocial dysfunction (CPD).

Method: This pilot study was conducted at two free family medicine clinics in Inland Southern California between August and December 2022. It surveyed caregivers with chronic illness of any age or functional capacity who are full-time caretakers of children aged 4-17 years old. Validated screening tools assessed caregiver disability burden (World Health Organization Disability Assessment Schedule 2.0-12), parental toxic stress (Functional Impact of Toxic Stress for Parents), and pediatric psychosocial functioning (Pediatric Symptom Checklist-17). Regression analysis tested if caregiver scores on these measures predicted CPD. Twenty-nine participants completed the survey.

Results: High caregiver chronic illness disability burden and toxic stress together significantly predicted CPD. Caregiver toxic stress alone predicted CPD, whereas chronic illness disability burden alone did not.

Discussion: This study highlights the relationship between caregiver chronic illness disability burden, caregiver toxic stress, and childhood psychosocial dysfunction, and may contribute to providing holistic care to children and their caregivers. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: There is a critical need for new approaches to prevent opioid overdose; one is to expand the use of naloxone. Primary supporters of patients with opioid prescriptions are key in this role, though many hesitate to carry and administer naloxone. An insufficient understanding of supporters' experiences limits the ability to develop resources that will engage and promote naloxone use in this group. Web applications (apps) are accessible and can address concerns, though the preferences and needs of the supporters are poorly understood. This study was designed to identify (a) barriers and facilitators to naloxone use among supporters, and (b) preferences for a web app to provide relevant resources (e.g., content, design elements).

Method: Participants (N = 16, M_age = 43, 50% racial/ethnic minority identification) identified as a patient's family member (87.5%) or friend (12.5%) and completed a semistructured interview.

Results: Thematic analysis identified patterns in supporters' responses: a wide range of experiences (including ambivalence), anxiety for themselves and the patient, lack of knowledge about naloxone, and desire for clear communication from providers. They expressed interest in a web app for supporters and preferred an interface that guides them through its use. Responses also conveyed appreciation for validating their challenges, a preference for a mature tone to app content, and high acceptability of the app prototype.

Discussion: Findings show that user-centered design informed a digital tool that is responsive to the unique needs of those who could help to prevent deaths from opioid overdose; this tool warrants testing in large, diverse groups of supporters. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The purpose of this qualitative study was to understand the needs of family caregivers (FCGs) from the perspectives of health care professionals delivering cancer care to American Indian and rural populations.

Method: A descriptive content analysis of 18 interviews with multidisciplinary health care professionals delivering cancer care at a rural cancer institute in the Great Plains region was conducted.

Results: We identified three themes: access, support, and awareness with six subthemes. Consideration of these core needs, coupled with the individual cultural circumstance, is critical in addressing disparities faced by American Indian/Alaska Native and rural FCGs.

Conclusions: The availability of specialized health care services, like palliative care, can positively impact the experience of FCGs providing care. However, access is limited. The needs and challenges faced by American Indian/Alaska Native and rural FCGs described in this study can inform the development of a culturally responsive palliative care intervention. Nurses are well positioned to develop and lead this intervention, which will be the first of its kind. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: The prevalence of type 2 diabetes (T2D) is increasing globally, especially among South Asian (SA) adults, and requires innovative solutions. Traditional T2D prevention and management programs focus on lifestyle change but this is often challenging for caregivers with competing priorities and may not fit a family's needs. Utilizing social support has been promising for supporting diabetes prevention and management. We aim to explore how the social networks of SA caregivers with diabetes can influence their health and inform interpersonal and community-level health interventions for this community.

Method: Participants lived in Peel Region, Ontario were diagnosed with T2D, prediabetes, or gestational diabetes and were SA caregivers of children under 24 years old. Caregivers completed a semistructured interview to discuss (a) their experiences, perceptions, and beliefs about T2D, (b) their caregiving roles in their diabetes management, (c) how the social determinants of health impact diabetes management, and (d) the individuals and resources influencing their diabetes management. We used network analysis to explore network size and composition in relation to social supports.

Results: Twenty-one caregivers completed interviews. We identified three network typologies for caregivers, including (a) healthcare and community program focused, (b) isolated, and (c) family and diverse social support and explored how caregivers describe the network actors as supporting or not supporting their diabetes management.

Conclusion: This study advances our understanding of the social networks and supports that SA caregivers use to support diabetes management and further emphasizes the importance of leveraging existing community supports. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: The appropriate assessment and treatment of depression in older adults is critical to promoting the quality of life as well as reducing the risk for physical conditions such as frailty. Medical and mental health care clinicians working in integrated care settings are distinctly positioned to provide depression care for older adults; yet, there is a lack of sufficient training at the intersection of depression and frailty among older adults.

Method: To address this gap in training, we developed a four-module, 60-min multidisciplinary, web-based training entitled, "Assessing and Treating Depressed and Frail Older Adults in Integrated Primary Care." The feasibility, participant reaction (acceptability and utility), and learning outcomes of the training were assessed with a sample (N = 25 completers) of clinical psychology graduate students and medical residents during the 2022-2023 academic year.

Results: Overall, participants were receptive to the training, and the training resulted in improved knowledge as measured by pre- and postcontent questions.

Discussion: The findings suggest that, despite certain barriers to implementation, cross-disciplinary training on geriatric mental health has promising feasibility and can result in enhanced learning for medical and clinical psychology trainees. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Studies have evaluated the receipt of preventive care among children with Down syndrome, but barriers surrounding access to screenings and health care in general have not been well described among this population across the United States. This study describes parental perspectives on barriers to screenings and health care.

Method: Twenty-four semistructured interviews with parents of children with Down syndrome were administered to families across South Carolina in 2022. Thematic analysis was used to identify salient themes related to barriers to care.

Results: Barriers to preventive care identified by families included ineffective care coordination, insurance-related concerns, health care provider access shortages, and language barriers.

Discussion: Findings can be used to address problems with major aspects of medical care and to make care more family-centered and accessible for children with Down syndrome. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Integrated health care (IHC) has evolved since the 1990s, and the journal's mission has sought to align with and adjust to changes in the broader health care and societal contexts. We are expanding upon the journal's long tradition of providing a robust shared space for interdisciplinary thinkers, practitioners, and researchers. We aim to push further toward achieving the goals of Peek and others who have challenged the field to clarify and reinforce the definitions, areas of focus, and strategies needed for IHC to effectively expand the reach and support of population health improvements. The journal will continue to evolve as the editorial processes and decisions change with the journal's changing priorities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).