Concerned Family Members Research Articles

Developing a smartphone web app to help DWI offenders and their families

IntroductionDriving while intoxicated (DWI) results in significant morbidity and mortality. Ignition interlock devices (IID) decrease the risk of drinking and driving while installed, but DWI rates increase after the IID is removed. Efforts are needed to maintain change after the IID is removed; engaging concerned family members (CFMs) is an untested strategy. Smartphones may provide a promising platform to support DWI offenders with IIDs and their CFMs; the purpose of the present study was to develop such a smartphone-web app. MethodsFormative work occurred in two sequential phases. Phase 1 included key informant interviews with DWI offenders and CFMs, development of one app module, and usability testing. Phase 2 included focus groups with DWI offenders and CFMs, development of three more app modules, and usability testing. The Bangor System Usability Scale was used to rate app usability and navigability. ResultsResults of key informants and focus groups indicated that offenders and CFMs lacked information and were frustrated by the IID, experienced financial burden from the DWI and IID, viewed supportive communication and positive shared activities as important, and were positive about the app. Four modules were developed, Life with Interlock, Supporting Changes in Drinking, Doing Things Together, and Effective Communication. Usability testing indicated that the B-SMART modules were easy to use and informative. ConclusionsCareful formative work resulted in an app responsive to the concerns of DWI offenders with IIDs and their CFMs. Controlled research is needed to evaluate the efficacy of the app.

Internet of Things-based care monitoring for the elderly and those with special needs

As a society, we should provide support and care for individuals who are advanced in age or have special needs. We must offer them the opportunity to lead a safe and comfortable life. Sometimes, addressing simple things can mitigate critical problems. For instance, an improperly functioning heating system can put the users’ lives at risk, and a gas leak can prove fatal if not detected in time. Hence, this study aims to identify solutions that can help prevent accidents in such vulnerable populations. To achieve this, a safety device equipped with essential sensors continuously monitors the living environment of people with special needs. If there are any anomalies, the system will immediately alert the concerned family members and competent security authorities, ensuring a quick and efficient response to potential emergencies. The proposed safety device aims to provide extra protection and peace of mind for special care individuals. By implementing such safety measures, we can make significant strides in promoting the well-being and safety of vulnerable populations.

Abstract PO-245: Perspectives of Hispanic/Latino patients with non-alcoholic fatty liver disease

Abstract Introduction. Hispanic/Latino (heretofore Hispanic) adults have twice the incidence of liver cancer as Non-Hispanic Whites adults. Non-alcoholic fatty liver disease (NAFLD) is a major contributor to the upward trend in liver cancer incidence and other adverse outcomes, especially among Hispanic adults. The cornerstone of treatment for NAFLD includes weight loss through regular physical activity and healthy eating. There is little current research on the perspectives of Hispanic patients with NAFLD as it relates to their condition and behavior change. Research in this area is needed to inform the design of culturally appropriate and disease-specific interventions for this population. The purpose of this study was to explore the perspectives of Hispanic patients with NAFLD on their diagnosis and management of the condition. Methods. We conducted in-depth qualitative interviews using a semi-structured interview guide with a sample of 12 Hispanic women diagnosed with NAFLD to understand their knowledge, perceptions, and experiences with NAFLD. Interviews were conducted via phone in Spanish and consent was obtained to record the interviews. The interviews were then transcribed and translated to English for analysis. We conducted thematic analysis, using Atlas.ti 8 to support qualitative analyses. Results. Participants were from the greater Houston, TX area with an average of 47 years and median time of diagnosis was 3 years prior to the interview. Women were diagnosed with NAFLD by their primary care physicians who referred them for imaging and/or consultation with liver specialists to confirm the diagnosis. Most women neither disclosed nor discussed their NAFLD diagnosis with others, because they were uncomfortable doing so or were concerned family members would worry about them. Even though doctors were the main source of information for NAFLD background and management, some participants sought additional knowledge on their own from the Internet. Women had a general understanding that NAFLD is associated with lifestyle, although some attributed it to genetics and family history. Most participants tried eating healthy but struggled to balance that with their own and their families' dietary and taste preferences, noting especially the difficulty of avoiding foods pervasive in their cuisine (e.g. rice, tortillas) and exposure to readily-available junk food less. They also tried to participate in physical activity, but encountered various barriers, such as tiredness and lack of motivation. Participants also conveyed that psychological factors such as stress and depression impacted their management of NAFLD. Conclusions. Our results suggest that Hispanic women struggle with barriers to NAFLD management and desire more information about and support for NAFLD management. Strategies to address psychological and emotional factors associated with NAFLD should also be incorporated into future programs. These findings provide culturally relevant insights that will be key to adapting an evidence-based intervention for Hispanic adults with NAFLD. Citation Format: Natalia I. Heredia, Sylvia Ayieko, Lorna H. McNeill, Jessica P. Hwang, Amelia Averyt, Maria E. Fernandez. Perspectives of Hispanic/Latino patients with non-alcoholic fatty liver disease [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-245.

For Better or Worse: A Gendered Outlook of the films The Leisure Seeker and Alaska

ABSTRACT Although much has been written to date on gender equality, on personal liberty within the family, and on the burden of family caregivers of spouses, the manner in which these different aspects intersect and impact each other has gone largely unexamined. How do relationships of power and dependency interact? How do they affect the pursuit of happiness and the ability to maintain personal liberty within the family in times of sickness and poor health? Our analysis is based on a qualitative and comparative effort of two films: The first is Paolo Virzi’s The Leisure Seeker (USA, 2017). The second Zepel Yeshurun’s Alaska (Israel, 2018). The findings allow to identify a model of liberty within the family at old age that consists of three aspects: first, women’s freedom within an oppressive system: the ability of women in unequal conjugal relationships to retain agency, to act, to decide, and to struggle for their beliefs. Second, negative freedom: the struggle of old age couples to fend off over-involvement by concerned family members and caregiving institutions, and to assert their independence. Third, positive freedom: the desire of older couples to pursue happiness despite illness and old age.

A Family Systems Perspective of Elder Family Financial Exploitation: Examining Family Context Profiles.

Informed by Family Systems Theory, this study examines the interwoven nature of intergenerational family structures and roles in which elder family financial exploitation (EFFE) takes place. Data from a mixed-methods study were utilized to examine patterns of family structures and roles within and across 23 family systems. Participants were non-perpetrator/non-victim concerned family members (CFMs) who had experienced EFFE. Four family context profiles were identified, organized by the number and roles of victim(s) and perpetrator(s) in each family system, including: Single victim, Single perpetrator; Single victim, Multiple perpetrators; Two victims, Single perpetrator; and Two victims, Multiple perpetrators. It is possible for multiple perpetrators to be involved, with up to five perpetrators across three generations in our sample. Findings offer insight into the range of intergenerational family structures and roles affected by EFFE. Practitioners are encouraged to understand and address family contexts to improve EFFE intervention outcomes.

The Role of the Family in Alcohol Use Disorder Recovery for Adults.

Alcohol use disorder (AUD) and family functioning are inextricably bound, and families are impacted negatively by AUD, but families show substantial improvements with AUD recovery. Family members can successfully motivate a person with AUD to initiate changes in drinking or to seek AUD treatment. During recovery, family members can provide active support for recovery. Several couple- or family-involved treatments for AUD have been developed and tested in rigorous efficacy trials. Efficacious treatments based in family systems theory or cognitive behavioral approaches focus on the concerned family member alone, or they engage the couple or family as a unit in the treatment. However, most treatments have been studied in fairly homogeneous, heterosexual, White, non-Hispanic populations, limiting the potential generalizability of these treatments. Substantial gaps remain in our understanding of family processes associated with the initiation and maintenance of AUD recovery among adults. This review outlines the existing literature and describes opportunities for future research to address knowledge gaps in understanding the mechanisms by which these treatments are efficacious, use of family-based treatments with diverse populations, integration of pharmacotherapies with family-involved treatment, role of families in recovery-oriented systems of care, and how to improve treatment development and dissemination.

When Concerned Family Members Intervene in Elder Family Financial Exploitation: Goals and Outcomes

The role and experience of non-abusing concerned family members (CFMs) in elder family financial exploitation (EFFE) is largely unexplored. This paper examines the experience of “trying to do the right thing,” focusing on what CFM’s were trying to accomplish (motivating goals), and resulting outcomes utilizing data from a qualitative study of 28 CFMs (primarily female adult children of an older victim, and siblings of primary perpetrator). Five common goals appear to be motivating CFM involvement, driven by a priority to ensuring the victim’s quality of life, as well as the desire to honor and respect the victim’s wishes, protect the victim’s financial well-being, preserve family relationships, and deal with the perpetrator(s). CFM help-seeking resulted in a wide range of outcomes, from making a difference by connecting victims to supportive services and interrupting the financial exploitation, to mixed results, and in other cases frustration with no desirable outcomes.

Concerned Family Members’ Help-Seeking in Elder Family Financial Exploitation

This paper examines non-perpetrator family members’ experience of trying to help when faced with elder family financial exploitation. Utilizing data from a qualitative study of 28 Concerned Family Members (CFMs) who were primarily adult children of older victims, findings provide evidence of the critical role CFMs play in helping the victims. Six help-seeking tasks are identified, including gathering evidence, learning new systems, and taking on money management roles. CFMs often put the victim’s health and well-being before their own, becoming secondary victims in the process. CFMs experienced a wide range of costs to their individual health and well-being, including physical, emotional, psychological, social and financial dimensions (e.g. stress, depression, inability to sleep, isolation, harassment, threats to personal safety, physical abuse, attorney and court costs, time off work). Findings have implications for supporting CFMs and addressing practical and health-related needs as secondary victims.

The Critical Help-Seeking Role of Family, Friends, and Neighbors in the Lives of Elder Abuse Victims

Elder abuse prevention and intervention is a complex puzzle. We focus on examining the typically invisible role, experience, and impact of nonabusing family, friends, and neighbors, or “concerned persons” in stopping elder abuse. Given the reality that most elder abuse goes unreported and unaddressed, it seems essential to understand if and how concerned persons can play a role in help-seeking for older victims, and to also understand the needs and issues faced by concerned persons as a consequence. First. Breckman presents evidence of the significant distress concerned person’s experience from knowing about elder abuse and trying to assist victims, and shares experience developing and implementing the first Elder Abuse Helpline for Concerned Persons in the U.S. Second, Fraga Dominguez et.al. present an important international perspective highlighting findings about concerned persons as users of a UK elder abuse helpline, their profile, the impact of helping, and variables relating to help-seeking. Third, Stum shares findings from a qualitative study of elder family financial exploitation related to what concerned family members were trying to accomplish by getting involved (motivating goals) and the resulting continuum of outcomes. Fourth, Kilaberia also explores the help-seeking experiences of concerned family members in elder family financial exploitation situations, specifically the range of tasks involved, and the impacts on the concerned family member’s individual health and well- The discussion led by Burnes will focus on understanding contributions of the research presented given the current state of the field, and offer suggestions for future research and intervention directions.

Elder Family Financial Exploitation: The Complexity of Roles and Family Context

Despite elder family financial exploitation (EFFE) being recognized as the most prevalent type of elder abuse, little is known about the family context in which it occurs. To-date most EFFE research has focused on understanding the profiles of one victim and one perpetrator in reported cases. Informed by Family Systems Theory, this study offers new insight into the range and complexity of EFFE victim and perpetrator roles, family structures (relationship types across generations) and living arrangements. A mixed-methods dataset from a sample of non-perpetrator/non-victim concerned family members who experienced EFFE (most unreported to authorities) was utilized to map and analyze 23 family system genograms. The findings reflect four overall profiles when organized by the number of victim(s) and perpetrator(s) in each involved family system including: Single victim, single perpetrator (n=7), Single victim, multiple perpetrators (n=12), Two victims, single perpetrator (n=1), and Two victims, multiple perpetrators (n=3). Across the 4 profiles, most primary perpetrators moved in to live with the elder victims. For Single victim, single perpetrator cases, remarried spouses, as well as parent/adult child relationships in nuclear families with 2-3 adult children emerged. For Single victim, multiple perpetrators, up to five family perpetrators from 3 different nuclear families were involved, including adult children, their in-laws, and grandchildren as a common combination of perpetrators. The findings suggest EFFE is more complex than often assumed, involving multiple perpetrators and victims, and family relationship types beyond older parent/adult child. Implications for reframing risk profiles, assessment tools, and family-focused intervention strategies are discussed.

Successful Informal Help-Seeking and Resolution of Elder Family Financial Exploitation: A Case Study

Effective interventions are needed to address elder family financial exploitation (EFFE), one of the most prevalent types of elder abuse globally. This poster examines the unique and critical help-seeking role informal family support can play when faced with EFFE. We present a holistic case study that offers an understanding of one family’s successful help-seeking and resolution of the EFFE situation. The family drew on internal family and community supports and did not seek formal elder abuse services. The case stood out as unique relative to 23 family’s help-seeking attempts in a larger study of the meaning and experience of EFFE from the perspective of concerned family members (non-abusing/non-victims). The case summary and analysis are based on an in-depth interview narrative reflecting the subjective experience of a concerned family member who was directly involved in the EFFE situation (in-law relative to both the older victim and the perpetrator). Study findings reveal 5 interwoven themes related to help-seeking processes and outcomes: 1) honoring the victim’s wishes, 2) providing support and accountability for perpetrator, 3) restoring family relationships and functioning, 4) maintaining internal (family-based) control, and 5) engaging in family problem solving processes. The family’s help-seeking demonstrated three distinctive features: a) embracing their informal social support role, b) the interdependence of family members, and c) restorative justice principles. The findings raise questions about broadening the scope and continuum of EFFE intervention research and practices to recognize and support informal social intervention.

Coaching Into Care: Veterans Affairs Telephone-Based Service for Concerned Family Members of Military Veterans.

Many veterans who need mental health treatment are reluctant to seek care, and their family members often do not know how to encourage them to do so. In 2011, a telephone-based service called Coaching Into Care (CIC) was developed to address this concern. Callers are provided with educational resources and referrals; in more complicated cases, callers are provided with up to 6 months of telephone-based coaching. This coaching of family members has been associated with an increase in veterans accessing mental health care. This program may serve as a model for community efforts to engage individuals in needed mental health care.

Treatment algorithm for the use of psychopharmacological agents in individuals prenatally exposed to alcohol and/or with diagnosis of fetal alcohol spectrum disorder (FASD).

Psychotropic medication treatment of individuals who have experienced prenatal alcohol exposure (PAE) has lagged behind psychosocial interventions. Multiple psychotropic medications are often prescribed for those diagnosed with a range of neurodevelopmental disabilities and impairments of PAE (neurodevelopmental disorder associated with prenatal alcohol exposure and/or fetal alcohol spectrum disorder [ND-PAE/FASD]). Despite the diverse comorbid mental disorders, there are no specific guidelines for psychotropic medications for individuals with ND-PAE/FASD. When prescribed, concerned family members and caregivers of individuals with ND-PAE/FASD reported that polypharmacy, which was typical and adverse effects render the psychotropic medications ineffective. The objective of this work was to generate a treatment algorithm for the use of psychopharmacological agents specifically for individuals with ND-PAE/FASD. The development of decision tree for use to prescribe psychotropic medications incorporated findings from previous research and the collective clinical experience of a multidisciplinary and international panel of experts who work with individuals with ND-PAE/FASD, including an algorithm specialist. After multiple meetings and discussions, the experts reached consensus on how best to streamline prescribing along neurodevelopmental clusters. These were subdivided into four ligand-specific, receptor-acting medication targets (hyperarousal, emotional dysregulation, hyperactive/neurocognitive, and cognitive inflexibility). Each cluster is represented by a list of common symptoms. The experts recommended that prescribers first ensure adequate psychosocial and environmental, including sufficient dietary, exercise, and sleep support before prescribing psychotropic medications. Treatment then progresses through three steps of psychotropic medications for each cluster. To support established treatment goals, the most function impairing clusters are targeted first.

YouTube: Searching for answers about breast cancer.

Breast cancer is the most common cancer in women, affecting approximately 1 in 8 women worldwide. Additionally, it is either the most or second-most lethal cancer depending on ethnicity. Many women and concerned family members turn to the internet for information regarding the signs, symptoms, diagnosis and treatment of this life-altering condition. We sought to objectively evaluate the quality of the information available on YouTube concerning breast cancer. We searched YouTube for videos relating to breast cancer. We included videos that were less than 20 minutes in length, were in the top 200 for most views and were available in English, either subtitled or narrated. Videos were independently and blindly scored using a standardized scoring form. Possible scores ranged from negative infinity to 25.5 with one point being deducted for each misleading statement or claim. After exclusions, 133 videos in our sample were evaluated. Out of a possible 25.5 points, the true mean was 3.90 with a standard deviation of 1.38. There were only 30 videos (22.5%) that scored more than 7 points. 12 (9.0%) videos scored 0 points or fewer. 12 (9.0%) of the videos in our sample contained at least one misleading statement with 9 of those contained multiple misleading statements with some videos having up to 10 such statements. While YouTube is an important source of information regarding breast cancer, few videos contain a significant amount of quality information and many of the videos contain false or misleading statements. In an area where patients are often scared and searching for answers, there is a significant need for more high-quality videos to educate patients and dispel myths and pseudoscience.

Role of Gated SPECT MPI in Follow-up of Patients afterCoronary Revascularization

Objective: Gated SPECT myocardial perfusion imaging (GSMPI) is a preferred modality for non invasive assessment following coronary revascularization (CR) of both symptomatic and asymptomatic patients. This study was conducted to observe the impact of GSMPI results on further management of patients who after CR had underwent GSMPI at National Institute of Nuclear Medicine and Allied Sciences (NINMAS).
 Patients and methods: Record files of GSMPI of all patients who underwent GSMPI over a period of 31 months from June 2011 to December 2013 at NINMAS for assessment of perfusion after CR were selected from the Nuclear Cardiology Divisional archive of patient studies in order to retrieve their clinical and demographic data including the contact numbers. The results of GSMPI scan were categorized as normal scan (NS) and perfusion defect (PD) which included reversible and/or fixed PD. All the contact numbers were called up by a nuclear medicine physician who conducted a semi-structured telephonic interview either with the patients or with a concerned family member. Management strategies adopted after GSMPI were categorized as conservative (CM) and interventional (IM).Cramer’s V (φc) test were done to find strength of relation among patients’ symptoms, scan findings and management strategies.
 Results: Follow up data of 55 patients (54M, 1F) among 68 (66M, 2F) were available who underwent MPI for the purpose of post CR assessment. MPI was performed in between six months to 13 years after CR (mean 43.8 ± 48.2 months). Categorically 33 patients had percutaneous transluminal coronary angioplasty (PTCA) with stent, 16 patients had coronary artery by-pass grafting (CABG) and 6 patients had both CABG & PTCA. There were 38PD (27symptomatic) and 17NS(12 symptomatic).Since all patients (n=12) who had fixed PD were symptomatic, a strong relation was found between being symptomatic and fixed perfusion defect (φc> 0.3). Symptoms were found to be weakly related with reversible PD i.e. ischemia (φc< 0.2). Management strategies were conservative in 44 (30 symptomatic and 28 PD) and interventional in 11 (nine symptomatic and 10 PD). Management strategies were found to be weakly related with symptoms (φc< 0.2) but moderately related with perfusion status (φc = 0.24).
 Conclusions: While symptoms were observed to be poorly related with perfusion status following CR, GSMPI guided to choose further interventional management strategies with rationality in lower proportion of patients.
 Bangladesh J. Nuclear Med. 22(1): 30-35, Jan 2019

A Novel Simulation to Assess Residents' Utilization of a Medical Interpreter.

Physicians must be facile in working with a medical interpreter (MI) given the large population of patients with limited English proficiency. To facilitate residents' assessment of their ability to interact with non-English-speaking patients, we developed a simulation case involving one such patient. The case involved a 31-year-old Spanish-speaking postpartum female who presented with eclamptic seizures. The learner needed to request an MI to assist with obtaining the patient's medical history once her concerned family member (also Spanish speaking) arrived. The major critical actions included appropriate use of MI services, recognition of the risk for eclamptic seizures, proper evaluation and treatment, and appropriate disposition to an obstetrician. The case required a high-fidelity mannequin and simulation operator, nurse simulated participant, Spanish-speaking actor (to play the husband or family member), certified Spanish MI, and faculty evaluator. We implemented this case with 60 emergency medicine residents, ranging from PGY 1 to 3. The learner was assessed by both the faculty observer and MI. Checklists for assessment and debriefing materials were provided. Two of 60 residents did not request an MI. When compared to a prior version of this case that did not include the language barrier, median scores dropped from 12 to 10 out of 24, suggesting that the language barrier created a more challenging case. The use of MIs is an integral part of health care practice in the United States, and we present a simulation case that can assess learners' use of MIs.

ELDER FAMILY FINANCIAL EXPLOITATION: EXPERIENCES WITH SOCIAL SERVICES

Elder family financial exploitation (EFFE) has attracted the attention of scholars and professionals across disciplines. This qualitative study examines the experiences of help seeking by non-perpetrator family members with a focus on the role of social services. 15 in-depth interviews were examined in which social services were mentioned as being involved. Findings provide insight into the role and involvement of social services, whether wishes expressed by victims to participants made a difference in help-seeking, and gaps experienced. Participants described social services professionals as those who (1) received reports of exploitation; (2) provided education and served as a liaison with families; (3) conducted assessments, including cognitive assessment of elders; and (4) acted as connectors to other systems. In some cases, when elders were assertive about their wishes, they had results such as reporting exploitation or transferring power of attorney to non-perpetrator family members. In other cases, elders were prevented from taking such action because of undue influence by perpetrators, disregard of their wishes, due to being uninformed, or opposing helpful family members. Participants explained experienced gaps in two ways: by attributing responsibility to social services in terms of failure to believe victims, do meaningful cognitive assessments, and navigate family dynamics. On the other hand, participants were not able to clearly ascribe responsibility, and questioned whose fault it was, suggesting opportunities for improved systems functioning. Recommendations for improving the role of social services in addressing the help-seeking needs of concerned family members coping with EFFE follow.

1521 Case Series of 5 Patients Detected With Gut Fermentation Syndrome

INTRODUCTION: Gut fermentation syndrome (GFS) is a rare medical phenomenon in which ingestion of carbohydrate meals results in alcohol production through different biochemical pathways. These patients are presumed to have intestinal yeast fermenting carbohydrate to alcohol. This is due to fungi overgrowth in the digestive tract. This can often result in alcohol toxicity without any exogenous alcohol intake. The aim of this study was confirmation and treatment of GFS using a standardized carbohydrate challenge test followed by upper and lower endoscopy to obtain intestinal secretions to detect fungal growth. CASE DESCRIPTION/METHODS: This presents five patients who presented with implications of alcoholism while denying use any exogenous alcoholic beverages. A long detailed history and physical examination was conducted in order to screen these patients whose symptoms were unlikely due to exogenous drinking. All other possible primary causes were ruled out. There are currently no established diagnostic criteria to confirm GFS or treat this condition. We therefore propose the following protocol for this. It was important to make certain that patients with suspected GFS who have elevated blood or breath alcohol levels were not surreptitiously drinking. In our provocative carbohydrate challenge test, we gave the patients 200 g of glucose by mouth after an overnight fast with blood drawn at timed intervals of 0, 1/2, 1, 2, 4, 8, 16, and 24 hours for glucose and blood alcohol levels. This test was aborted early if alcohol levels become elevated in the first few hours. This used algorithm, carbohydrate challenge results and a comparison of all five patients is shown in the Table 1 format. If any elevated serum alcohol was detected without any drinking then these patients were recommended to participate for further testing. Routine laboratory testing and stool microbiome were sent for specification. Upper and lower endoscopy were performed during which secretions were collected for bacterial and fungal cultures along with biopsies to further study. DISCUSSION: Any patient denying alcohol ingestion but who has elevated alcohol levels should be investigated. The earliest symptoms of GFS may be mood changes. Some of the patients were bought to us by a concerned family member. This condition was treated with dietary modifications, antifungal therapy, and probiotic use in our patients. We are only starting to recognize the complexity of this condition and are currently studying more patients using the proposed protocol.

Employee Turnover in the Long-Term Care Industry using Herzberg’s Motivation-Hygiene Theory

Employee turnover costs long-term care facilities billions of dollars on an annual basis. The purpose of this correlational study was to examine the relationships between employee turnover intention of certified nursing assistants (CNAs) in the long-term care industry and employee compensation, engagement, job satisfaction, motivation, and work environment. The predictor variables were employee compensation, engagement, job satisfaction, motivation, and work environment. The criterion variable was employee turnover intention. The population of interest consisted of CNAs who were residents of Florida, over the age of 18 years, and employed in the long-term care industry. The theoretical framework that grounded this study was the motivational-hygiene theory. For this study, a sample of 157 participants completed an electronic survey. Multiple linear regression analyses predicted the dependent variables, R² = .34, F(5, 151) = 15.22, p < .0001. The multiple regression model with 4 of the 5 predictors accounted for significantly more variance in turnover intention than would be expected by chance. Correlation tests resulted in statistically significant inverse relationships between employee turnover intention and employee compensation, engagement, job satisfaction, and work environment. The negative correlation observed between motivation and turnover intention was not statistically significant. The findings in this study may contribute to positive social change by reducing turnover intention while improving the quality of care and reducing costs of care that affect the lives of the long-term care residents, concerned family members, and significant others.

Skill sets for family members and friends to help motivate a smoker to seek treatment: research to practice

Background: Translation of effective behavioral interventions is a key challenge for the addictions treatment field. With the goal of disseminating an effective behavioral intervention to practice, this narrative study describes tobacco cessation coaches’ skills sets and provides an illustrative case study of a 1-session phone intervention between a coach and a concerned family member who wants to help their smoker quit. Methods: Delivered through a quitline by quitline coaches, the intervention consisted of a 15–30 minute phone session and written materials. The goal of the intervention was for family members and friends (support persons) to encourage their smoker to use a quitline. Data were collected from transcripts of 193 audiotapes of the one session phone intervention from a previous trial (Patten et al., 2017). Using content analysis, major themes regarding barriers and challenges within the sessions and coaches’ solutions assisted in selecting case study illustrating the dialog between a coach and a support person, as well as demonstrating the coaches’ skill sets used to deliver the session. Results: The barriers and challenges among support persons (i.e. uncertainty about how to approach the smoke, the smoker is not ready to quit) and the coaches’ responses and suggestions are illustrated. Conclusions: These types of data could be useful to clinicians, providers and others interested in implementing a behavioral intervention for nonsmokers who want to support a smoker to quit.