Family Dyads Research Articles

A Community-Based Mindfulness Intervention Among Latino Adolescents and Their Parents: A Qualitative Feasibility and Acceptability Study.

Few studies have evaluated the effectiveness of mindfulness-based meditation interventions (MBMIs) among Latino youth. Furthermore, joint parent-child participation in such programs is rare. Utilizing a community-based participatory research approach, this study evaluated the feasibility of a pilot bilingual MBMI among Latino adolescents and their parents in Los Angeles. Qualitative interviews were conducted to assess the practicality, implementation, and acceptability of the program. Challenges to attendance included health issues or conflicts with work. Several adolescents struggled with distractions from peers. However, overall responses suggest that parents and children found the program convenient and enjoyable, and perceived benefits from the curriculum. This study supports the feasibility of a MBMI among Latino family dyads.

Understanding the family care dyad: A comparison of two multilevel models.

Although there has been increasing attention on a dyadic perspective of illness, contemporary dyadic research methods are still rarely utilized in cardiovascular disease. The focus of this paper is to describe the advantages of two types of multilevel dyadic models (the matched pairs model and the lesser known incongruence model). Data exemplars in a sample of heart failure family dyads are used to illustrate the distinct advantages of these two related multilevel dyadic models with particular emphasis on alignment with research questions. The more commonly known matched pairs model examines separate outcomes for each member of the dyad, controlling for the interdependent nature of the data. By re-parameterizing this model into a univariate dyadic outcomes model, researchers can address distinct, and sometimes more appropriate, research questions (e.g. incongruent appraisals of the illness experience). This paper promotes greater application of these methods in cardiovascular research to further understanding of the dyadic experience and more appropriately target interventions.

The development of a family participatory dignity therapy programme for patients with haematologic neoplasms and their family caregivers in China: A feasibility study.

To develop a communication prompt based on dignity therapy to facilitate effective conversations between patients with haematologic neoplasms and their family caregivers and to improve the programme and preliminarily explore the benefits and challenges of family participatory dignity therapy (FPDT). A mixed-methods approach was applied to develop and revise the programme. The FPDT was developed and validated using the Delphi survey, and its further improvement was explored with a simple one-group pre- and post-trial and semi-structured in-depth interviews. Most of the FPDT items were endorsed by experts and patient-family dyads. The Content Validity Index was 93.6% in the first round of the Delphi survey and 100% in the second round. The "hope level," "spiritual well-being" and "general health" scores of pre- and post-testing increased from 33.60±4.30 to 37.70±5.10 (t=3.99, p=.003); from 30.30±3.65 to 38.80±7.29(t=4.13, p=.003); and from 41.67±8.78 to 53.33±8.05 (t=3.50, p=.007) respectively. The qualitative data also indicated that the project was meaningful and well received. We showed that FPDT was a valuable and feasible means of improving communication between patients with haematologic neoplasms and their family caregivers in China by raising the hope level and spiritual well-being and promoting general health.

Family storytelling about hereditary cancer: Framing shared understandings of risk.

Family communication about the family's health history (FHH) is an important step in alerting individuals to their hereditary disease risks and facilitating prevention. Individuals often communicate about the FHH of hereditary cancer as a story, which highlights the importance of analyzing family narratives of hereditary cancer to better understand their relation to psychological and physical well-being. This study investigates the content of family stories by examining how narrative tone and framing relate to coping, perceptions of risk, and medical decision-making. The current study recruited 42 family dyads with a prevalent FHH of hereditary cancer to participate in dyadic phone interviews to jointly tell their family narrative of hereditary cancer. Using an iterative analysis, findings examine how families create a shared understanding of FHH and hereditary risk. Narrative tone reflects participants' psychological well-being and contributed to the way families framed their experiences. Common frames to family narratives of hereditary cancer included empowerment, adversity, laissez faire, and discrepant. Each frame gave insight into how families were coping, their perceptions of risk, and how they make medical decisions to manage those risks. Developing a better understanding of how families communicate about their hereditary cancer risks can aid in designing clinical interventions to help families re-frame their stories to promote improved health outcomes.

Exploring Cultural Identity in a Multicultural Context—the Special Case of Luxembourg

In light of globalization and increased cultural diversity, the question of cultural identity becomes particularly salient in many societies today. Whereas most studies have concentrated on cultural identity of immigrants, less is known about the identity constructions of non-immigrants and receiving country nationals living in a multicultural setting. The Grand Duchy of Luxembourg with a foreign population of 48% provides an excellent example case here. The present study examined the cultural identity of two generations of native Luxembourgers, drawing on a content analysis of qualitative interviews with N = 18 participants belonging to nine family dyads, each composed of one (young) adult child and one parent. As Luxembourg’s cultural diversity has increased continuously in the last decades, we focussed here on similarities and differences between (young) adults and their parents in order to find out in how far age (i.e., different points in the individual life span) or generation (i.e., growing up in different times and historical contexts) might be highlighted in their cultural identity constructions. Five main domains pertaining to Luxembourger’s cultural identity were found through qualitative content analysis: ‘the Luxembourgish language’, ‘Belongingness to Luxembourg and the love for Luxembourg as a homeland’, ‘Europeanization and multiculturalism in Luxembourg’, ‘Representing Luxembourg as a native in international contexts’ and ‘Luxembourgish traditions and history’. While the older generation focused more on the feeling of belongingness to their home country, the younger generation made more specific links to Europe and multiculturalism. Practical and theoretical implications are discussed.

PHYSICAL ACTIVITY INTERVENTION IN HOME CARE: COMPARING FAMILY AND NON-FAMILY CAREGIVING DYADS

An increasing number of states pay family members who care for older adults in Medicaid-funded home care. Previous research documented pros and cons of hiring family members as home care providers. However, little is known about whether family and non-family caregiving dyads function differently when they participate in health promotion interventions in home care. Using data collected in a pilot study of a gentle physical activity program delivered by home care workers in a Medicare home care program, this study compared 18 family and 32 non-family caregiving dyads in client outcomes (self-reported and performance-based function) and process outcomes (exercise-related social support provided by home care aides) before and after the intervention. Linear mixed models indicated that client outcomes improved after the 4-month intervention (p<0.05), controlling for clients’ age, gender, and number of chronic conditions. Compared to family caregiving dyads, greater improvement in exercise-related support was observed in non-family caregiving dyads (p<0.05), where care providers offered less exercise-related support at baseline. The intervention program was received well by both family and non-family dyads, as expressed by one of the caregivers: “It makes my client feel good about herself. I also feel good for my client.” Results suggest that empowering caregivers with health promotion skills is a promising strategy, especially in non-family caregiving dyads. Further research is warranted to produce evidence-based health promotion programs for family and non-family caregiving dyads in home care.

Health communication roles in Latino, Pacific Islander, and Caucasian Families: A qualitative investigation.

Family communication about health is critical for the dissemination of information that may improve health management of all family members. Communication about health issues, attitudes, and behaviors in families is associated with life expectancy as well as quality of life for family members. This study addresses family communication about health by examining individual roles for family health communication and factors related to these roles, among families of three different racial/ethnic groups: Caucasians, Latinos, and Pacific Islanders. Data were collected from 60 participants recruited as 30 family dyads, 10 from each group, through qualitative semistructured interviews. Interviews were conducted with each participant separately and then together in a dyadic interview. Two coders independently coded interview transcripts using NVivo 11. Results identified the family health communication roles of collector, disseminator, health educator, and researcher. We also identified several factors related to these roles using the lens of family systems theory-the presence of chronic conditions in the family, previous experience, medical education, and family hierarchy. Findings demonstrate many similarities and relatively few differences in the family health communication roles and the related factors among the families of different race/ethnicity. Conclusions highlight implications for future research and intervention development.

Role Expectations and Role Evaluations in Daughtering: Constructing the Good Daughter

ABSTRACTThe relationship between mother and daughter is unlike other family dyads and important to both parties over a lifespan. One underexplored area of this relationship is how adult daughters construct and perform the daughtering role. The present study explores how daughters talk about the ways they enact daughtering and evaluate their role in a social world. The findings reveal how daughters position themselves within a family system and, more broadly, in society. This paper includes interview data with 33 adult daughters about their mothers. We illuminate more about how daughters, as role players, conceive of the expectations for their roles and evaluate their role performance in light of role expectations. Analysis revealed four role expectations tied to good daughtering: showing respect, providing protection, eliciting mothering, and making time for connection. Our analysis supports that daughters assess themselves based on their understanding of these role expectations. We present a matrix to illustrate these findings.

Dignity of the patient-–family unit: further understanding in hospice palliative care

ObjectivesThis study aimed to explore the construct of dignity of the patient–family dyad in hospice palliative care, as well as its influencing factors from the perspective of hospice palliative care...

Gentle Physical Activity Intervention Led by Caregivers in a Medicaid Home Care Program: Do Outcomes Differ Between Family and Nonfamily Caregiving Dyads?

Background and ObjectivesCaregiving dyads are fertile contexts for health promotion such as physical activity. However, previous physical activity interventions in caregiving dyads paid limited attention to care recipients’ outcomes and rarely involved paid caregivers. Home care aides (HCAs) provide nonmedical care for older family members or nonfamily clients in publicly funded home care programs in the United States. This study examined whether family and nonfamily HCA–client dyads differed in the outcomes of a 4-month gentle physical activity pilot program led by HCAs in a Medicaid home care program.Design and MethodsA single-group prepost design was used to assess changes in clients’ function (self-reported and performance-based) and process outcomes (exercise-related social support provided by HCAs) in 18 family and 32 nonfamily HCA–client dyads. Repeated measures analysis controlled for clients’ demographic and health characteristics. Clients’ and HCAs’ motivation to continue the program beyond the intervention period was examined using quantitative and qualitative data.ResultsClient outcomes and exercise-related social support provided by HCAs improved, especially in nonfamily dyads. Both family and nonfamily dyads had high levels of motivation to continue the program, supporting the program’s sustainability for both clients and HCAs.Discussion and ImplicationsEmpowering HCAs to engage in health promoting activities with their clients is a promising strategy to improve the lives of caregiving dyads.

Savouring and psychological well-being in family dyads coping with cancer: An actor-partner interdependence model.

Previous studies have investigated interdependence of the associations between predictors and negative psychological outcomes in dyads of cancer patients and family caregivers. This study examined the dyadic effects of perceived capability of savouring the moment on psychological well-being. A total of 152 dyads of cancer patients and caregivers reported their perceived capability of savouring the moment (Savoring Beliefs Inventory), state positive affect (Chinese Affect Scale) and life satisfaction (Satisfaction With Life Scale) within 6months following diagnosis. Actor-Partner Interdependence Model (APIM) demonstrated that patients' and caregivers' savouring the moment was positively associated with their own positive affect and life satisfaction (actor effects: βs=0.309-0.603, 95% CIs=0.171-0.502, 0.446-0.703, ps<0.001). Patients' savouring the moment was positively associated with caregivers' positive affect (β=0.158, 95% CI=0.018, 0.299, p=0.028), whereas caregivers' savouring the moment was positively associated with patients' life satisfaction (β=0.158, 95% CI=0.026, 0.289, p=0.020). Partner effects between caregivers' savouring the moment and patients' positive affect and between patients' savouring the moment and caregivers' life satisfaction were not significant. The findings suggest the role of savouring in psychological well-being within patient-caregiver dyads, highlighting the importance of investigating positive psychological pathways in their joint adaptation.

How can mindful parenting be related to emotional eating and overeating in childhood and adolescence? The mediating role of parenting stress and parental child-feeding practices

To explore whether the association between mindful parenting and children/adolescents’ disordered eating behaviors (i.e., emotional eating and overeating) may be mediated by parenting stress and parental child-feeding practices.The sample comprised 726 family dyads composed of a mother (79.8%) or a father (20.2%) and their child (7–18 years old), of which 362 children/adolescents had normal weight (BMI = 5–85th percentile) and 364 had overweight or obesity (BMI ≥ 85th percentile) according to the WHO Child Growth Standards. Parents completed self-report measures of mindful parenting, parenting stress, and child-feeding practices, and children/adolescents completed measures of emotional eating and overeating. The path model was estimated in AMOS.Mindful parenting was negatively associated with children's emotional eating through lower levels of parenting stress followed by less frequent use of food as a reward and through less frequent use of food as a reward only. Mindful parenting was linked to children's overeating through lower levels of parenting stress. Moreover, mindful parenting was associated with less frequent use of food as a reward, pressuring to eat and monitoring through lower levels of parenting stress, among parents of girls, mostly from the early stage of adolescence. Additionally, higher levels of parenting stress were associated with using food as a reward and, consequently, with higher levels of emotional eating among girls, and with more restriction and, consequently, with more overeating among early-stage adolescents.A comprehensive model suggesting that mindful parenting can help children/adolescents engage less in disordered eating behaviors through lower levels of parenting stress and the adoption of more adaptive child-feeding practices is proposed. Parental practices, particularly mindful parenting, may have an important role in promoting healthier eating behaviors among children/adolescents.

Family Health History Tools as Communication Resources: Perspectives from Caucasian, Hispanic, and Pacific Islander Families

ABSTRACT Many tools facilitate gathering family health history (FHH) information. Public health initiatives have focused on improving FHH communication. Research indicates that tools remain largely unused in non-clinical settings and people tend to refrain from engaging in FHH communication. Research also indicates that cultural and family relationship factors influence FHH communication and tool use. This study investigated FHH tools as resources for FHH communication within Caucasian, Hispanic, and Pacific Islander families. Interviews with 10 family dyads from each racial/ethnic group included opportunities for participants to evaluate two FHH tools. Using structurating activity theory, the qualitative analysis revealed that participants viewed the tools as a structure for FHH information, a guide for how to communicate about FHH, and a source for stories about family health. Results are discussed in terms of how family system elements and social structures shape perceptions and use of FHH tools. Conclusions include implications for research and practice.

Family, Work, and Spatial Mobility: The Influence of Commuting on the Subjective Well-Being of Couples

Previous research shows that commuting is often accompanied by increased stress, exhaustion and less time for partners and children. On the basis of the life course approach and work-life balance theory, we argue that these negative outcomes also influence the dynamics of the social relationships of individuals who live together in the same household. Most research has focused on the commuter, whereas less is known regarding how commuting affects the subjective well-being of other household members, in this case, the partner. Our paper contributes to this research gap by analysing the interdependencies of parents who commute in regard to their overall and domain-specific well-being. We use pooled data from three waves of the German Family Panel, which includes standardised information related to working conditions and job-related mobility as well as family dynamics from both parents’ perspectives. The resulting subsample has N = 2443 dyads in families. Our dyadic analysis shows negative spillover effects of commuting times on all included measures of subjective well-being, but only for mothers. Moreover, there are two crossover effects: a negative crossover effect from mothers commuting on fathers’ satisfaction with family life and a positive crossover effect of fathers commuting on mothers’ satisfaction with social contacts outside the family (i.e. friends). Overall, the findings indicate that mothers own commuting works as a more general burden, whereas fathers seem to suffer more from their partner’s commuting time than vice versa.

Utilizing a Board Game to Measure Family/Parenting Factors and Childhood Obesity Risk

ObjectiveTo describe a direct observational approach (ie, interactive family board game) to measure familyfunctioning and parenting behaviors of relevance to child weight and weight-related behaviors and to examine family functioning and parenting factors from multiple family dyads (eg, siblings, parent–child) and their associations with child weight and weight-related behaviors. DesignCross-sectional, mixed-methods study. SettingTwo home visits were conducted with families 10days apart with a 7-day observational period between home visits. ParticipantsChildren (n = 150) aged 5–7years and their families from 1 of 6 racial and ethnic or immigrant and refugee groups, including African American, Hispanic, Hmong, Native American, Somali, and white, participated in the Family Matters study between 2014 and 2016. Main Outcome MeasureChild weight status and weight-related behaviors (ie, diet quality, physical activity). AnalysisAdjusted logistic and linear regression models with robust SEs were used in analysis. ResultsHigher family functioning scores across the majority of family dyads were significantly associated with lower child weight status (P < .05). In addition, some family functioning scores were associated with child diet and physical activity, but not consistently. Parenting behavior scores were inconsistently associated with child weight and weight-related outcomes. Conclusions and ImplicationsResults suggest that the interactive family board game task is a direct observational approach that researchers can use with family members to measure family functioning and parenting behaviors related to childhood obesity. Future interventions may want to consider including multiple family members in both measurement and intervention development to target childhood obesity.

Unpacking the 'black box' of lay health worker processes in a US-based intervention.

Prior studies have supported the effectiveness of the use of Lay Health Workers (LHWs) as an intervention model for managing chronic health conditions, yet few have documented the mechanisms that underlie the effectiveness of the interventions. This study provides a first look into how LHWs delivered a family-based intervention and the challenges encountered. We utilize observation data from LHW-led educational sessions delivered as part of a randomized controlled trial (RCT) designed to test a LHW outreach family-based intervention to promote smoking cessation among Vietnamese American smokers. The RCT included experimental (smoking cessation) and control (healthy living) arms. Vietnamese LHWs were trained to provide health information in Vietnamese to groups of family dyads (smoker and family member). Bilingual, bicultural research team members conducted unobtrusive observations in a subset of LHW educational sessions and described the setting, process and activities in structured fieldnotes. Two team members coded each fieldnote following a grounded theory approach. We utilized Atlas.ti qualitative software to organize coding and facilitate combined analysis. Findings offer a detailed look at the 'black box' of how LHWs work with their participants to deliver health messages. LHWs utilized multiple relational strategies, including preparing an environment that enables relationship building, using recognized teaching methods to engage learners and co-learners as well as using humor and employing culturally specific strategies such as hierarchical forms of address to create trust. Future research will assess the effectiveness of LHW techniques, thus enhancing the potential of LHW interventions to promote health among underserved populations.

Epistemic Activities, Schooling and Parenting Styles: A Case Study in French Guiana Rural Contexts

Based on an eco-systemic approach, this article presents the results of an experimental survey among parents and children of four ethnic and cultural French Guiana minorities. Moving from questioning the existence of a correlation between interactive parenting styles and the schooling achievements of young children in French Guiana, we propose two hypotheses: (1) family interactions are visible manifestations of parents’ educational ideologies; a large gap between family and school interactions could influence the child’s school adaptation; (2) parenting interactive styles may vary depending on the nature of the interactions: daily versus learning interactions. Our sample concerned 16 family dyads belonging to four distinct groups: the Teko, Aluku, Laotians and Haitians of French Guiana. Data collection was performed by in-situ observations (to explore the first hypothesis) and video recordings (for the second hypothesis). We used coding and data analysis tools belonging to both conversational pragmatics and the anthropological methodological tradition. The results, based on the interactive styles model proposed by Ailincai & Weil-Barais (2007), suggest that parents’ educational styles are influenced by the socio-cultural ecosystem and that parental behavior, especially when it is related to school success, is profoundly influenced by “globalized” logics, strategies and educational ideologies. The interactional context influences the interactive parental style: as such, the daily interactive styles appear as very mixed between the observed communities, whereas the interactive epistemic styles (related to the learning situations) seem to mobilize the same behavioral categories in all the groups we studied.

Unpacking the 'black box' of lay health worker processes in a US-based intervention.

Prior studies have supported the effectiveness of the use of Lay Health Workers (LHWs) as an intervention model for managing chronic health conditions, yet few have documented the mechanisms that underlie the effectiveness of the interventions. This study provides a first look into how LHWs delivered a family-based intervention and the challenges encountered. We utilize observation data from LHW-led educational sessions delivered as part of a randomized controlled trial (RCT) designed to test a LHW outreach family-based intervention to promote smoking cessation among Vietnamese American smokers. The RCT included experimental (smoking cessation) and control (healthy living) arms. Vietnamese LHWs were trained to provide health information in Vietnamese to groups of family dyads (smoker and family member). Bilingual, bicultural research team members conducted unobtrusive observations in a subset of LHW educational sessions and described the setting, process and activities in structured fieldnotes. Two team members coded each fieldnote following a grounded theory approach. We utilized Atlas.ti qualitative software to organize coding and facilitate combined analysis. Findings offer a detailed look at the 'black box' of how LHWs work with their participants to deliver health messages. LHWs utilized multiple relational strategies, including preparing an environment that enables relationship building, using recognized teaching methods to engage learners and co-learners as well as using humor and employing culturally specific strategies such as hierarchical forms of address to create trust. Future research will assess the effectiveness of LHW techniques, thus enhancing the potential of LHW interventions to promote health among underserved populations.

Unpacking the 'black box' of lay health worker processes in a US-based intervention.

Prior studies have supported the effectiveness of the use of Lay Health Workers (LHWs) as an intervention model for managing chronic health conditions, yet few have documented the mechanisms that underlie the effectiveness of the interventions. This study provides a first look into how LHWs delivered a family-based intervention and the challenges encountered. We utilize observation data from LHW-led educational sessions delivered as part of a randomized controlled trial (RCT) designed to test a LHW outreach family-based intervention to promote smoking cessation among Vietnamese American smokers. The RCT included experimental (smoking cessation) and control (healthy living) arms. Vietnamese LHWs were trained to provide health information in Vietnamese to groups of family dyads (smoker and family member). Bilingual, bicultural research team members conducted unobtrusive observations in a subset of LHW educational sessions and described the setting, process and activities in structured fieldnotes. Two team members coded each fieldnote following a grounded theory approach. We utilized Atlas.ti qualitative software to organize coding and facilitate combined analysis. Findings offer a detailed look at the 'black box' of how LHWs work with their participants to deliver health messages. LHWs utilized multiple relational strategies, including preparing an environment that enables relationship building, using recognized teaching methods to engage learners and co-learners as well as using humor and employing culturally specific strategies such as hierarchical forms of address to create trust. Future research will assess the effectiveness of LHW techniques, thus enhancing the potential of LHW interventions to promote health among underserved populations.

Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents

BackgroundTo investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families.MethodsForty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress.ResultsFrom pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p < .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups.ConclusionsThe adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group.Trial registrationThis study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593–31/5).