Families Systems & Health最新文献

Introduction: Youth decision-making involvement (DMI) regarding growth hormone (GH) may be beneficial. Identification of correlates of DMI may inform the development of strategies to encourage youth involvement and enhance self-efficacy. The goal of this study was to examine the associations of DMI regarding GH treatment with youth and parent characteristics.

Method: Youth, aged 8-14 years (34% female), undergoing GH stimulation testing and a parent (94% mothers) completed surveys at the time of testing (Visit 1; 2019-2023); the Decision-Making Involvement Scale was completed 3 months later. Surveys collected demographics; decision-making involvement; youth coping skills, parent social support; parent autonomy support; parental perceived worry, scarcity, and instability regarding the child's current/future environments; and parents' achievement goals for their child. Correlations and multivariable linear regressions were used to identify factors significantly associated with Decision-Making Involvement Scale subscales.

Results: The analysis included 44 parents who indicated that a decision about GH was made and that they discussed the decision with the youth, as well as 30 youth who remembered having such a discussion. On multivariable modeling, youth who had more engaged coping skills and parents who perceived resources in the world as scarce reported higher youth DMI. Parents with older children, less worry about their children being out in the world, and less desire for the child to avoid activities that he/she might not do well in reported higher youth DMI.

Discussion: Parental worry and youth coping may be important targets of intervention when seeking to facilitate youth involvement in GH-related decision making. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Health care organizations have recognized the necessity of addressing diversity, equity, and inclusion (DEI)-related issues to promote anti-racism and improve workplace culture. Little is known about the short- and long-term impacts on staff perceptions of inclusion, psychological safety, and belongingness, or what aspects of DEI initiatives hold meaning and value for team members. In particular, the perspective of clinical staff identifying as racial-ethnic minorities/persons of color (POC), who disproportionately occupy support staff roles with less power on the team, has been unclear and understudied. The purpose of this study was to investigate what makes organizational DEI efforts meaningful and impactful in creating a sense of inclusion for POC clinic team members and identifies perceived barriers to inclusion efforts.

Method: A qualitative study was conducted across 13 community health clinics within a safety-net health care system in Colorado. Semi-structured interviews were conducted with 40 participants (77.5% female; M_age 41; 77.5% POC). Participants' clinic roles included support staff team members (75%), medical providers (15%), and clinic leadership (10%).

Results: Findings illustrated elements of existing DEI initiatives, ranging from the most beneficial to the most detrimental, including some common across all participant groups and some unique to specific races and/or role groups.

Discussion: All participants endorsed common beneficial elements of DEI initiatives. Participants identifying as POC and in roles with less power in the clinic (i.e., support staff members) shared elements with the potential to cause harm. Avoiding detrimental elements and incorporating beneficial elements will allow teams to engage in meaningful DEI initiatives. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Some individuals over their life course will experience significant health-related events, such as a physical or mental illness, that can alter their life pathways or trajectories, known as "turning-point" events. This systematic review aimed to synthesize the evidence from population-based data collections for: (a) parent health-related turning point events and the impact of these events on offspring health and social outcomes; and (b) offspring health-related turning point events and the impact of these events on parent health and social outcomes.

Method: A review of four databases (MEDLINE, CINAHL, PsycINFO, and Scopus) from January 1, 2010 to February 23, 2023 was conducted. Abstracts and full-text articles were screened by four reviewers and critically appraised.

Results: Of 114 articles, 98 (86%) examined the effect of a parental health-related turning point on offspring, 11 (10%) examined the effect of an offspring turning point on parents, and five (4%) investigated bidirectional impacts of a turning point event. For parents and offspring, mental health disorders (50%), physical health (26%), and death (24%) were common turning point events examined. For parents and offspring, common health outcomes included mental disorders (n = 50), physical health (n = 11), substance use (n = 9), and death (n = 7), and common social outcomes included educational performance (n = 14), employment or income level (n = 7), and involvement of child protective services (n = 5).

Discussion: The ability to disentangle relationships between turning point events and adverse health and social outcomes is required, as is the development of strategies to disrupt intergenerational disadvantage. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: The prevalence of mental and behavioral health disorders (MBHDs) in children is rising, along with the use of emergency departments (EDs) for care. School-based health centers (SBHCs) are accessible clinics that can provide integrated primary care and behavioral health services and are associated with decreased acute health care utilization. However, little is known about the relationship between SBHC enrollment and ED utilization for MBHD. We sought to describe ED utilization for MBHD among children enrolled in a comprehensive SBHC.

Method: Descriptive, cross-sectional analysis of Medicaid data for SBHC-enrolled students (SBHC users and nonusers) in Grades K-8, September 2015-August 2019, compared to propensity score-matched children not enrolled in the school. We calculated ED visit rates using 10th revision of the International Classification of Diseases codes for MBHD and ranked MBHD codes by percentage of encounters.

Results: A total of 1,173 SBHC-enrolled students (SBHC users: n = 816; SBHC nonusers: n = 357) and 2,594 controls were included. SBHC-enrolled students and controls were well matched (mean age = 10.7 years, SD = 3.5, 51% female, and 82.7% Black, non-Hispanic). ED visit rates with any code for MBHD differed between the subset of SBHC users (49.9 visits/1,000) and the controls (72.5/1,000). Depression was the top reason for primary presentations for MBHD among SBHC users versus attention-deficit/hyperactivity disorder for controls.

Discussion: ED visit rates for MBHD were lower among SBHC users compared to controls. SBHCs may prevent low-acuity ED visits for MBHD by leveraging an integrated approach to behavioral health in the education setting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this narrative, a mother with an unexpected medical setback creates a board game with her children to talk with them about what happened and share their emotions about the experience. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Hazardous drinking by fathers poses a significant risk for negative family interactions and child outcomes. The transition to parenthood may be a time when expectant parents are potentially motivated for health behavior change, suggesting that implementing preventive interventions during this period may be particularly effective. This article provides an overview of the rationale for an innovative prevention strategy incorporating alcohol-use intervention with a family-focused program.

Method: We describe the process of integration and adaptation of two evidence-based interventions beginning in pregnancy: (a) Family Foundations, a universal transition-to-parenthood intervention for couples to enhance coparenting and couple dyadic functioning, and (b) brief intervention to address alcohol use delivered using a couples-focused motivational interviewing style.

Results: Lessons learned from pilot testing (conducted October 2020-March 2021) included the importance of softened framing of the discussions and language used around alcohol use given that parents were not specifically seeking treatment for alcohol use and the program was described as a parenting program that included discussion of health behaviors, including drinking. In addition, we found that evoking discussion and communication within dyads and supporting autonomy in decision making regarding alcohol use also facilitated engagement.

Conclusion: Pilot testing demonstrated the acceptability and feasibility of an adapted, integrated intervention program designed to strengthen coparenting skills and dyadic functioning and promote lower risk levels of alcohol use among couples during the transition to parenthood. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: China's recent policy initiatives and dedication of resources to heighten the public's awareness of cancer risks have led to increased cervical cancer screening and testing for human papillomavirus (HPV) which has resulted in a greater number of people diagnosed with HPV. The psychological stress experienced by women of childbearing age who are infected with HPV is also felt by their spouses, as the close relationship between spouses results in intertwined psychological distress and health statuses. Therefore, this study aimed to explore the dyadic coping experience of HPV-infected patients of childbearing age and their spouses in China and to provide a research basis for marital interventions for the disease.

Method: From July 2022 to January 2023, we used a purposive sampling method to select 11 pairs of HPV-infected patients of childbearing age and their spouses from a tertiary hospital. We conducted in-depth interviews with the patients and their spouses and analyzed the data using Colaizzi's seven-step method.

Results: We identified three main themes and eight subthemes: (a) stress perception (including negative psychological reactions, emotional relationship deterioration, and family social role imbalance), (b) stress communication (including enhancing communication awareness and changing communication methods), and (c) stress adjustment (including supporting each other emotionally, facing the disease together, and seeking social support).

Conclusion: Health care professionals should assess the stress experienced by patients and their spouses. Moreover, they should encourage them to better cope with the disease as a team. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Targeting cardiovascular disease (CVD) and its associated risk factors is important not only in the general population, but also among those served by the military health care system. The primary care behavioral health model of integrating behavioral health consultants (BHCs) into a primary care setting is one method for enhancing how these modifiable risk factors are addressed; however, it is unknown how often BHCs are used to target those with biopsychosocial factors contributing to CVD and those with diagnosed CVD.

Method: The present study evaluated what percentage of primary care patients with diagnosed CVD risk factors (i.e., tobacco use, obesity, and depression) or diagnosed CVD were referred to BHCs. Data were drawn from electronic health records of U.S. military primary care clinics over the 3-year period from January 2017 to December 2019.

Results: A total of 1,321,072 unique individuals were included. Among the sample, 37.1% were active duty, 40.6% were married, 43.8% were female, and 30.9% were between 45 and 64 years old. The study revealed penetration rates of 1.5% (8,577 of 583,659 patients) for patients diagnosed with CVD, 5.3% (10,286 of 192,566 patients) of those demonstrating tobacco use, 3.4% (8,765 of 256,852 patients) of those demonstrating obesity, and 20.0% (31,125 of 155,656 patients) of those diagnosed with depression.

Discussion: These findings suggest that BHCs are underutilized for targeting CVD and some associated risk factors in military primary care clinics. Research should explore whether these findings replicate in other health care systems and implement methods to improve BHC utilization. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The author describes his first day on the obstetrics unit of a rural hospital in New Mexico. As a fourth-year medical student, he was excited to show all that he knew about pregnancy and delivery. He recounts the delivery of a fetus via c-section that was stillborn. There was a post-mortem one hour later with the surgeons, nurses, and residents. The patient spoke only Spanish, which put an enormous strain on the interpreter who the author noticed sitting near the center of the room. The team of nurses, doctors, and surgeons argued around her, obviously upset about how the case was handled. The author watched the translator for a moment and noticed a tear rolling down her left cheek. The bickering stopped abruptly when the translator's quiet tears suddenly turned into heavy sobs. The room turned silent, and everyone's attention shifted toward the translator. For a moment, the events of the morning were forgotten, and everyone's anger turned into empathy. The author learned all he could about the medical aspects of this pregnancy and why it went so wrong. But the interpreter taught him something that can't be found in any medical textbooks; she taught him about the pain of loss. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In George and Herndon (2024), the authors encouraged an evolution from a diversity, equity, and inclusion framework to dignity, belonging, and justice framework-dignity, belonging, and justice. In the current article, the authors emphasize the principles of belonging. They share frameworks relevant to the practice of belonging and its implementation in systems of integrated care. They review strategies for identifying groups who are often left out of belonging efforts and encourage individual reflection as a strategy to overcome barriers to support belonging. (PsycInfo Database Record (c) 2025 APA, all rights reserved).