Families Systems & Health最新文献

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).

Background: There is a causal relationship between parental incarceration (PI) and childhood food insecurity (FI). This is a pressing policy issue given that public assistance designed to curb hunger (i.e., Supplemental Nutrition Assistance Program) is often revoked due to incarceration which, on top of the removal of a household income source, can significantly alter children's food access. Yet questions remain regarding the prevalence of FI among youth with incarcerated parents, as well as the interplay of parent-child coresidence, race/ethnicity, and geographic region.

Method: Data come from the 2019 Minnesota Student Survey, a statewide sample of adolescents (N = 112,554). Youth self-reported experiences of PI, parent-child coresidence at the time of incarceration, past-month FI, and race/ethnicity. Based on school districts, regions were classified as city, suburb, town, or rural.

Results: Youth with currently and formerly incarcerated parents reported significantly higher rates of FI (18.11% and 10.41%, respectively) compared to peers who never experienced PI (2.84%; ORs = 7.56 and 3.97, respectively). Among youth with currently incarcerated parents, rates of FI were highest among those who lived with the parent at the time of incarceration (21.79%) compared to those who did not (13.98%). Youth of color and city youth were more likely to experience FI in contexts of PI.

Conclusions: Findings extend the link between PI and child FI. The evidence is concerning given FI's heightened risk for chronic health conditions, which may be compounded by trauma and systemic injustice. This work has implications for policies that expand, rather than reduce, food access and financial assistance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Exacerbated by a global pandemic, healthcare organizations have become increasingly isolated spaces and healthcare professionals suffer from threats to psychological safety, occupational burnout, and attrition. Restorative justice (RJ) is a human- and community-centered framework used to foster connections and promote healing among groups and has recently been implemented in healthcare settings. It may serve as a novel approach to promote the well-being of healthcare professionals.

Method: In this article, we describe the conceptual underpinnings of RJ, briefly reviewing the existing literature supporting restorative approaches and exploring its early applications within healthcare. We provide a case example of our own efforts to implement an RJ program to support healthcare professionals.

Results: Using our own program as reference, we describe how we have monitored engagement to guide program improvement and utilized participant feedback to understand impact.

Discussion: RJ offers unique potential for promoting a safe workplace for healthcare professionals and advancing inclusion in medicine. With regularly implemented restorative practices, we hope to effect lasting change within our institution (i.e., improved retention), which should be explored with future studies. In order to improve the health of diverse communities we serve, we must also prioritize the well-being of our own healthcare communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In this poem, the author is a hospitalized patient who had been struck by a car while she was walking on a moonless night. In the emergency room, scalpels, scissors, and stars aligned, assembled by her frightened brain. Name your fears and you banish them. The author never knew the stars had names, nor that sharp edges could soften, could suture as deftly as sever, could stitch a path out of her darkness, and light her from broken to whole. (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: Young adulthood is a time when persons with Type 1 diabetes (T1D) become more fully responsible for diabetes management. Establishing healthy diabetes routines during this period is foundational for successful management across adulthood. Although partner support is generally considered helpful in T1D management, less is known about specific partner behaviors that could benefit glucose levels. The aim of this study was to explore associations between communal coping behaviors and T1D glucose management.

Method: During 2018-2020, 23 young married opposite-sex couples (M_age = 25.7 years), wherein one spouse had T1D, completed daily measures of communal coping for 9 consecutive days. Daily average glucose and time-in-range were computed from the person with T1D's glucose meter or continuous glucose monitor.

Results: Multilevel model results suggested that higher time-in-range on a given day was predicted by reports of lower daily spousal instrumental support, lower overprotective and controlling behaviors, and by higher emotional support. Controlling spousal behavior on one day was associated with higher time-in-range the next day. At the same time, patient reports of higher average spousal controlling behavior (across all days) were associated with lower time-in-range and higher average glucose. Average glucose was also predicted by communal coping behaviors (especially within-person higher instrumental support), yet results were less robust after covariates were considered.

Discussion: Some young romantic partners may engage in behaviors that are associated with higher average blood glucose and lower time-in-range for the person with T1D. Persons with T1D could communicate to their partners types of support that are helpful versus not. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: In Japan, approximately 90% of kidney transplantations involve living donors who are relatives. Selection of a living donor from potential family member donors could affect the entire family. However, reports focusing on preliving-related kidney transplant (LRKT) family functioning are lacking. Family functioning comprises ways that family members communicate and cooperate with each other. The Family Assessment Device (FAD) was used to measure family functioning from the perspective of donors and recipients just prior to LRKT.

Method: A total of 122 donor-recipient pairs (244 participants in total) who planned to have LRKT were recruited consecutively from July 2020 to July 2021 and included in the analysis.

Results: There was no significant difference in FAD scores between donors and recipients, with approximately 20% of both groups reporting poor family functioning. Differences in family functioning according to types of relatives were shown in recipients. The rate of poor family functioning was significantly lower in the spouse group than in the parent-to-child group (recipient: 6.6%, 29.3%; donor: 8.2%, 34.1%, respectively). However, agreement regarding good or poor family functioning assessment was high in the parent-to-child pairs and low in the spouse pairs.

Discussion: Most LRKT donors and recipients reported good family functioning; however, some perceived poor family functioning. Evaluations by donors did not always align with that of recipients, especially among spouse pairs. It is important to treat them as independent entities. Preoperative assessment to connect them with appropriate support can enhance recovery after LRKT. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: The purpose of our research was to explore how parents and their adolescent children make decisions about the human papillomavirus (HPV) vaccine, and to inform future interventions that aim to facilitate inclusive decision-making processes.

Method: Purposive and snowball sampling strategies targeted parents and their adolescent children (ages = 11-13) in a large city in Australia. We conducted separate and joint semistructured interviews in 2013 with six mother-adolescent dyads (50% female adolescents and 50% male). Interviews were analyzed using a grounded theory approach.

Results: Factors that both facilitate and impede decision making emerged, including: background knowledge, values, historical experiences, parenting style, and opinion weights.

Discussion: New interventions, strategies, and tools that are informed by these decision-making factors can be used to aid productive, mutual decision making between parents and adolescents and support adolescent autonomy and self-sufficiency in health decision making. (PsycInfo Database Record (c) 2024 APA, all rights reserved).