Families Systems & Health最新文献

The author presents a poem about forgiveness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: The primary care behavioral health (PCBH) model is one of the most widely implemented integrated care approaches. However, research on the model has been limited by inconsistent measurement and reporting of model fidelity. One way of making measurement of PCBH model fidelity more routine is to incorporate fidelity indicators into the electronic medical record (EMR), though research regarding the accuracy of EMR data is mixed. In this study, we aimed to assess the reliability of EMR data as a PCBH fidelity measurement tool by comparing key EMR indicators of PCBH fidelity to those recorded by an observational coder.

Method: Over an 8-month period (October 2021-May 2022), 12 behavioral health consultants (BHCs; 92% White, 75% female) across five primary care clinics recorded indicators of PCBH fidelity in the EMR as part of their routine charting of behavioral health visits. During that same period, one observational coder completed seven 4-hr visits per clinic to obtain multiple samples of data from each over time and recorded the same variables (i.e., percentage of visits prompted by warm handoffs, number of warm handoffs, and number of patient visits). We used bivariate correlations to test the associations between the EMR variables and the observer-coded variables.

Results: Correlations between EMR and observer-coded variables were moderate to strong, ranging from r = .46 to r = .97.

Discussion: Leveraging EMR data appears to be a fairly reliable approach to capturing indicators of PCBH model fidelity in the key domains of accessibility and high productivity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

It started with a simple question on social media, "How is everybody doing?" (Elmo [@elmo], 2024). With this basic check-in from one of our most beloved Sesame Street characters, Elmo was able to reach millions of people and elicit responses that gave words to the feelings that the authors have been personally experiencing and noticing within my behavioral health (BH) colleagues and patients for some time now. Quite simply, we are struggling. Responses to Elmo's collective check-in demonstrated the depths of the current human experience, ranging from individual sadness, trauma, existential crises, despondence, mere survival, disbelief, and societal despair. Resilience for BH providers is possible if we return to the basics, what we are foundationally trained to do, and what Elmo reminded us works so well: facilitate human connection within ourselves, with our colleagues, with our patients, and to continue to advocate for this connection at a systemic level. Exploring fundamental questions about our well-being, showing empathy for each other's pain, and openly acknowledging our shared struggles allows for a way through this, together. As we practice these efforts at the individual level, broader policies to support the BH system must follow to offer an effective, resilient, and enduring BH system necessary for the world we live in. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This poem was inspired by a patient I followed during my third year of medical school. It invites the reader to ponder the dangers of implicit and explicit bias toward patients who suffer from chronic pain, and who often simply want to be understood in the context of their lived experience and identity separate from their illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The author presents a haiku about being queer and their experiences with bigotry and unjust healthcare. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The author presents a poem about the element lead. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Whereas parents play an important role in shaping the home environment, it is unknown whether health-related parent-adolescent conversations may be associated with different health-promoting parenting practices, such as limiting adolescent mealtime media use in Hispanic families.

Method: For this cross-sectional analysis, Hispanic parents (n = 344; 40.4 ± 6.6 years; 89.2% female) of sixth- to eighth-grade adolescents self-reported the frequency of having health- or weight-related conversations with their adolescent child, and the frequency of adolescent mealtime media device use. Spearman's rank correlations were used to assess whether parent-adolescent health-related conversations are associated with mealtime media device use by adolescents.

Results: Over 75% of parents reported having conversations about healthy eating and being physically active at least a few times per week. Fewer parents reported having frequent weight-related conversations. Frequency of mealtime media use was low, except for television/movie watching (only 30% of parents reported their child rarely/never watching television during family meals). Having conversations related to the adolescent weighing too much was correlated with the mealtime use of television (r = .207; p < .001), cellphones (r = .134; p = .018), and headphones for music listening (r = .145; p = .010). Conversations about exercising to lose weight were correlated with television/movie watching during mealtimes (r = .129; p = .035).

Discussion: Findings suggest the co-occurrence of less health-promoting parenting behaviors, such as focusing on weight-related conversations and allowing the use of media devices during mealtimes. Focusing on health- rather than weight-related parent-adolescent conversations and implementing mealtime media use rules may have the potential to shape a home food environment which ultimately could improve an adolescent's overall health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Based on an ecological model of resilience, this study aimed to identify common and differential ecological risk and protective factors influencing the psychological health of general adult population (aged 18-60) and older adults (older than 60) in Hong Kong during the COVID-19 pandemic.

Method: A population-based random telephone survey was conducted in 2020, and 877 respondents in Hong Kong (308 older adults, i.e., older than 60; 569 adults, i.e., aged 18-60) were interviewed. Multiple group structural equation modeling was used to examine the proposed model.

Results: Chinese older adults in Hong Kong reported significantly lower levels of psychological distress than adults, and no difference in levels of family functioning was evident between the two groups. Community resources and family functioning served as important protectors for both groups. Parent-child conflicts were a significant mediator between COVID-19 stressors and psychological distress for adults only, while a decreasing level of outdoor family leisure served as a significant mediator for older adults only.

Discussion: The findings highlighted the importance of providing family- and community-based mental health services for Chinese people facing a public health crisis such as COVID-19 in Hong Kong. Mental health services designed for adult and older adult family members should emphasize different components. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Despite high rates of pain-related concerns among primary care patients and associated increases in health care costs (Gore et al., 2012; Mills et al., 2016), psychological or behavioral treatments that are well suited for use in integrated primary care (IPC) settings remain sparsely implemented. Psychological treatment for chronic pain has been recommended for many years (Darnall, 2021; Institute of Medicine (US) Committee on Advancing Pain Research, Care and Education, 2011; Kligler et al., 2018), and the emphasis on the application of nonpharmacological treatment has intensified following concerns about opioid safety. There is abundant empirical support for the use of psychological treatment for chronic pain, such as cognitive behavioral therapy (CBT) in specialty settings (Williams et al., 2021). The evidence to support the use of "brief treatments" in IPC is in a comparatively early stage. The limited state of the research might suggest that brief behavioral intervention for chronic pain is years away from being ready for translation to everyday clinical practice. But why wait? We therefore conducted a focused narrative review of peer-reviewed research on brief psychotherapy for chronic pain in adults that could be feasibly employed in IPC settings through more widely adopted models, such as primary care behavioral health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The authors want to invite the integrated care community to reflect with us on an evolutionary shift in how we approach matters of justice and equity: from a diversity, equity, and inclusion (DEI) framework to a perspective that centers the relational concepts of belonging, dignity, and justice (BDJ) for a more just world (Davis, 2021). Our desire to reflect, question, and pivot is inspired by the Ecocycle Planning Model-which I (Deepu George) used to critically frame the Collaborative Family Healthcare Association's (CFHA) history in Part I of the article (George, 2023a) and creatively anticipate our future in Part II (George & Khatri, 2024). In this article, the authors want to focus on the nodes of maturity and creative destruction, as well as the idea of the rigidity trap-to examine our collective energies around the idea of DEI. With CFHA's 30th anniversary upon us, we pause and reflect on not only the benefits of DEI efforts heretofore, but also the pitfalls, to avoid the rigidity trap, which is likely to occur when we embrace tenets of an idea that may no longer serve the values we once aspired to or fail to evolve in favor of the familiar. Considering critiques of the limitations of DEI work in practice and literature, the authors believe a BDJ approach will better inform our growth moving forward. Therefore, the authors want to reflect, honor, and build upon the impact and gains from DEI and adapt them to better serve the needs of all-especially the historically marginalized and underrepresented voices. (PsycInfo Database Record (c) 2024 APA, all rights reserved).