Enhance Family Communication Research Articles

Healthy identity development in adolescent and young adult (AYA) oncology: Enhancing family communication to reduce AYAs’ identity distress.

371 Background: Identity development is the process that informs how an individual views oneself and develops a sense of self. A cancer diagnosis during adolescence and young adulthood (AYA; ages 15-39) disrupts AYAs’ identity development and creates identity distress. Identity development is a key developmental task during AYA. It is a recognized psychosocial concern and need for diagnosed AYAs but remains an understudied psychosocial need in AYA oncology care. Identity development can be promoted (or inhibited) in AYAs’ social interactions. AYAs’ communication with parents (often their primary source of support) may function adaptively or maladaptively for AYAs’ identity development. A communication skills intervention for diagnosed AYAs and parents could address communication strategies that promote AYAs’ healthy identity development while buffering identity distress. To capture knowledge that will contribute to a communication skill intervention, this study aimed to identify parent – AYA communication that promotes or inhibits identity formation. Methods: We recruited 14 AYAs to participate in audio-recorded, semi-structured, in-depth interviews. Eligibility criteria for AYAs included: 1) must be diagnosed with any type of cancer during adolescence (aged 15-18) or emerging adulthood (aged 19-29) and 2) be in active treatment or up to 32 months since the end of treatment. Interviews were thematically analyzed using constant comparative method. Results: AYAs’ age ranged from 19-29 ( M =24 years old), and their age of diagnosis ranged from 15-27 years ( M =21 years old). Diagnosed AYAs shared four types of identity disruptions that involved communication with their parents: independence, friendships, sexual orientation/behavior, and long-term goals. They also shared how parents’ communication either promoted identity development or contributed to identity distress. Results indicated that parents’ using parental psychological control in communication contributed to AYAs’ identity distress. AYAs shared parents prioritizing the AYA’s voice and engaging in emotionally supportive communication fostered their identity development. Conclusions: This study captures specific communication approaches and behaviors in parent-AYA communication and its promotion of AYAs’ identity development or contribution to identity distress. Findings demonstrate the importance of developing communication skills training and conversation tools to helps both AYAs and parents learn how to communicate to promote AYAs’ identity development and better overall psychological well-being.

THE POWER OF OPEN COMMUNICATION: EXAMINING THE RELATIONSHIP BETWEEN PARENT-ADOLESCENT COMMUNICATION AND PROBLEM EXTENT AND THE MODERATING ROLE OF SIBLING INFLUENCE

Adolescence is the period of extensive physical, emotional, and social transformation. This article focuses on the primary role of effective communication within the family, especially parents and siblings influence, in shaping adolescence development. It considers how open, supportive, and sincere interactions help in identity formation, peer relationships, cognitive development, and affect regulation during this critical stage. The article draws both on Eastern and Western psychological paradigms, showing how academic psychology has evolved over the years and the main theoretical frameworks which inform our understanding of adolescent development. It is in this regard that the current study will explore the importance of effective family communication in developing a positive identity, building self-esteem, and supplying a sense of belonging. Emphasized herein is the role of parents in guiding adolescents through open discussions that will help them think critically, solve problems, and make independent decisions. Attention falls onto sibling influence in that they are in a special position to offer emotional support, companionship, and modeling behaviors. It draws from quantitative studies how family dynamics impact adolescent results. Construction and standardization processes of psychological measures are described to explain why reliable and valid instruments are needed when studying adolescent behavior and family interaction. This article concludes with the practical recommendations to enhance family communication strategies in supporting adolescent development. This integration of theoretical perspectives and empirical findings thus provides critical insights for educators, practitioners, and families seeking to promote healthy developmental trajectories among adolescents through effective communication and supportive sibling relationships.

Family Communication With Children and Adolescents Post Parental Loss in Road Traffic Accidents: A Qualitative Study

Background: Traumatic parental loss during childhood and adolescence can have long-lasting effects on the developmental trajectory of youngsters. While there is some literature on the advantages of positive family communication fostering better adjustment in bereaved children and adolescents, patterns of family communication post parental loss have not received much attention. An understanding of these patterns can pave the way for more holistic interventions in this vulnerable group. Aim: The aim of the study was to explore parental loss-related communication in families of children and adolescents who have lost a parent to a road traffic accident. Method: The study was carried out in a tertiary hospital setting in Bengaluru. The sample comprised of 24 children and 17 surviving parents. The study employed a qualitative research design. Semi-structured in-depth interviews were conducted with surviving parents/caregivers and the children/adolescents. The interviews were analysed by using inductive thematic analysis. Results: The themes generated from the semi-structured interviews highlighted patterns of communication in parentally bereaved families. Four major themes emerged from the semi-structured interviews – mode of getting to know about the death, disclosure regarding the death, discussion regarding the death and individual needs related to communication. Conclusions: Communication regarding parental loss as a result of road traffic accidents in the family context seems to be desirable and may enable healthy grieving in youngsters. Short-term interventions aimed at enhancing family communication patterns following traumatic parental loss need to be developed in the Indian context.

Sports Practice for Children and Its Role in Enhancing Family Communication and Academic Achievement in the Point of View of the Parents

The study aimed to identify children’s sports practice and its role in enhancing family communication and academic achievement from the parents’ point of view. The descriptive approach was used, in addition to using the questionnaire as a tool for the study, which was applied to a sample of (57) parents of children who practice sports; The study concluded that children's sports practice would open areas of discussion and dialogue between members of the same family in various fields, which paves the way for communication within the family; In addition, regular sports practice plays an effective role in creating a positive family atmosphere, and paves the way for dialogues and discussions between children and parents. It also concluded that practicing sports in the right ways is a helpful factor in increasing the level of academic achievement. In addition, the practice of systematic sports activities helps in psychological compatibility and modifies and refines the behavior of children who practice sports.

Family communication patterns, individual's overall conflict resolution style, and cognitive flexibility among young adults

The dissertation delves into the intricate dynamics of Family Communication Patterns and its profound relationship on an individual's Conflict Resolution Style and Cognitive Flexibility. The three variables together can form the futuristic contours of an individual’s life. Understanding the intricate interplay of these factors becomes paramount, for they are not merely aspects of academic curiosity, rather they are the very heartbeats of our life. The study encompasses a sample size of 207 young adults, and meticulously employs The Family Adaptability and Cohesion Scale (FACES-IV), the Conflict Resolution Styles Inventory (CRSI) by Kurdek, and the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010) as its research tools. The primary objective was to unravel the multifaceted relationship between Family Communication Patterns, Conflict Resolution Styles, and Cognitive Flexibility among adults, with a specific focus on understanding the impact of Family Communication Patterns on an individual's Conflict Resolution Style and Cognitive Flexibility. The findings of the study revealed compelling insights into the interconnectedness of these variables. The implications of these findings are far-reaching, with potential applications in the realms of psychology, family therapy, and interpersonal communication. The study underscores the need for further exploration into the development of interventions tailored to enhance Family Communication Patterns, thereby fostering more adaptive Conflict Resolution Styles and greater Cognitive Flexibility among young adults. Additionally, the longitudinal impact of these variables together warrants comprehensive investigation, offering a rich avenue for future research endeavors.

Acceptability and Usability of the Family Gene Toolkit for Swiss and Korean Families Harboring BRCA1/BRAC2 Pathogenic Variants: A Web-Based Platform for Cascade Genetic Testing.

The study adapted the Family Gene Toolkit and developed a customized web application for Swiss and Korean families harboring BRCA1 or BRCA2 pathogenic variants to support family communication of genetic testing results and promote cascade genetic testing among at-risk relatives. In the first step, narrative data from 68 women with BRCA1/BRCA2 pathogenic variants and clinician feedback informed a culturally sensitive adaptation of the content consistent with current risk management guidelines. In the second step, the Information Technology team developed the functions and the interface of the web application that will host the intervention. In the third step, a new sample of 18 women from families harboring BRCA1/BRCA2 pathogenic variants tested the acceptability and usability of the intervention using "think-aloud" interviews and a questionnaire. Participants expressed high levels of satisfaction with the intervention. They provided positive feedback for the information regarding active coping, strategies to enhance family communication, interactive elements, and illustrative stories. They reported that the information was useful and the web application was easy to navigate. Findings suggest that the Family Gene Toolkit is well-designed and can increase rates of cascade testing among at-risk relatives. Its efficacy will be tested in a subsequent randomized trial.

Investigating the factors affecting adolescents’ test anxiety in Greece during the COVID-19 pandemic

ABSTRACT The most prevalent mental health challenges in teenagers are generalized anxiety disorder and depression. The (COVID-19) pandemic has added an extra negative effect on children’s mental health.1 This study focuses on the investigation of a specific form of adolescent anxiety, i.e. test anxiety (TA). TA in adolescents is associated with mental and behavioral comorbidities and may have adverse effects on students’ academic performance as well as their physiological and psychological well-being. Therefore, this study examines the impact of family communication and body image dissatisfaction on adolescents’ test anxiety in Greece. According to the results of the Structural Equation Model that was examined, family communication presented a minimal negative effect on students’ TA. However, the main finding of this study was that body image dissatisfaction had an important direct and minimal indirect effect on students’ TA. The indirect effect was via the physical activity hours that acted as a mediator between body image dissatisfaction and TA. As a result, examining body image concerns and enhancing family communication may be crucial in assisting adolescents at risk for severe TA symptoms. Implications of the findings are discussed. 1

Using a Tailored Digital Health Intervention for Family Communication and Cascade Genetic Testing in Swiss and Korean Families With Hereditary Breast and Ovarian Cancer: Protocol for the DIALOGUE Study.

BackgroundIn hereditary breast and ovarian cancer (HBOC), family communication of genetic test results is essential for cascade genetic screening, that is, identifying and testing blood relatives of known mutation carriers to determine whether they also carry the pathogenic variant, and to propose preventive and clinical management options. However, up to 50% of blood relatives are unaware of relevant genetic information, suggesting that potential benefits of genetic testing are not communicated effectively within family networks. Technology can facilitate communication and genetic education within HBOC families.ObjectiveThe aims of this study are to develop the K-CASCADE (Korean–Cancer Predisposition Cascade Genetic Testing) cohort in Korea by expanding an infrastructure developed by the CASCADE (Cancer Predisposition Cascade Genetic Testing) Consortium in Switzerland; develop a digital health intervention to support the communication of cancer predisposition for Swiss and Korean HBOC families, based on linguistic and cultural adaptation of the Family Gene Toolkit; evaluate its efficacy on primary (family communication of genetic results and cascade testing) and secondary (psychological distress, genetic literacy, active coping, and decision making) outcomes; and explore its translatability using the reach, effectiveness, adoption, implementation, and maintenance framework.MethodsThe digital health intervention will be available in French, German, Italian, Korean, and English and can be accessed via the web, mobile phone, or tablet (ie, device-agnostic). K-CASCADE cohort of Korean HBOC mutation carriers and relatives will be based on the CASCADE infrastructure. Narrative data collected through individual interviews or mini focus groups from 20 to 24 HBOC family members per linguistic region and 6-10 health care providers involved in genetic services will identify the local cultures and context, and inform the content of the tailored messages. The efficacy of the digital health intervention against a comparison website will be assessed in a randomized trial with 104 HBOC mutation carriers (52 in each study arm). The translatability of the digital health intervention will be assessed using survey data collected from HBOC families and health care providers.ResultsFunding was received in October 2019. It is projected that data collection will be completed by January 2023 and results will be published in fall 2023.ConclusionsThis study addresses the continuum of translational research, from developing an international research infrastructure and adapting an existing digital health intervention to testing its efficacy in a randomized controlled trial and exploring its translatability using an established framework. Adapting existing interventions, rather than developing new ones, takes advantage of previous valid experiences without duplicating efforts. Culturally sensitive web-based interventions that enhance family communication and understanding of genetic cancer risk are timely. This collaboration creates a research infrastructure between Switzerland and Korea that can be scaled up to cover other hereditary cancer syndromes.Trial RegistrationClinicalTrials.gov NCT04214210; https://clinicaltrials.gov/ct2/show/NCT04214210 and CRiS KCT0005643; https://cris.nih.go.kr/cris/International Registered Report Identifier (IRRID)PRR1-10.2196/26264

Parent of Origin Effects on Family Communication of Risk in BRCA+ Women: A Qualitative Investigation of Human Factors in Cascade Screening.

Pathogenic germline variants in Breast Cancer 1/2 (BRCA) genes confer increased cancer risk. Understanding BRCA status/risk can enable family cascade screening and improve cancer outcomes. However, more than half of the families do not communicate family cancer history/BRCA status, and cancer outcomes differ according to parent of origin (i.e., maternally vs. paternally inherited pathogenic variant). We aimed to explore communication patterns around family cancer history/BRCA risk according to parent of origin. We analyzed qualitative interviews (n = 97) using template analysis and employed the Theory of Planned Behavior (TPB) to identify interventions to improve communication. Interviews revealed sub-codes of ‘male stoicism and ‘paternal guilt’ that impede family communication (template code: gender scripting). Conversely, ‘fatherly protection’ and ‘female camaraderie’ promote communication of risk. The template code ‘dysfunctional family communication’ was contextualized by several sub-codes (‘harmful negligence’, ‘intra-family ignorance’ and ‘active withdrawal of support’) emerging from interview data. Sub-codes ‘medical misconceptions’ and ‘medical minimizing’ deepened our understanding of the template code ‘medical biases’. Importantly, sub-codes of ‘informed physicians’ and ‘trust in healthcare’ mitigated bias. Mapping findings to the TPB identified variables to tailor interventions aimed at enhancing family communication of risk and promoting cascade screening. In conclusion, these data provide empirical evidence of the human factors impeding communication of family BRCA risk. Tailored, theory-informed interventions merit consideration for overcoming blocked communication and improving cascade screening uptake.

Intra-household cooperation and inter-generational communication in the extended family: a field experiment in a poor urban community in Africa

There is a dearth of studies on cooperation within the extended inter-generational family, a common living arrangement in Africa. This study employs a communication treatment and a 10-item Family Communication Scale (FCS) of the Family Adaptability and Cohesion Evaluation Scales (FACES IV) to explain cooperation in a Voluntary Contribution Mechanism (VCM) beyond the laboratory. The study applies the Random Effect regression analysis. The results show that inter-generational cooperation is heterogeneous, limited and subject to decay, with stronger cooperation up the generational hierarchy. The framed field experiment presents evidence of the positive impact on cooperation of face-to-face communication and of positive perceptions of family communication. More specifically, communication mitigates contribution decay and enhances cooperation, especially between parents and grandparents and their children and grandchildren. Inter-generational transfers and the associated investment in family-type public goods can be augmented by social developmental policies such as parenting skills training that enhance family communication and in turn, intra-household cooperation.

Test-retest reliability and validity of a single-item Self-reported Family Happiness Scale in Hong Kong Chinese: findings from Hong Kong Jockey Club FAMILY Project.

Family happiness is one major theme of family well-being in Chinese culture. We investigated the reliability and validity of the single-item Self-reported Family Happiness Scale (SFHS-1) with the score of 0-10, based on two studies in Hong Kong Chinese. Study 1 was a territory-wide population-based telephone survey (n = 4038) conducted in 2016. Study 2 was a community-based family intervention program conducted during 2012-2013 (n = 1261) to enhance family communication and well-being. Test-retest reliability of the SFHS-1 was assessed over 1month in Study 2. Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale, Family Communication Scale, Subjective Happiness Scale, 12-item Short Form Health Survey Version 2, and 2-item Patient Health Questionnaire were used to assess the convergent and discriminant validities of the SFHS-1 in both studies. Multiple regression analysis was used to assess the incremental validity by identifying the additional contribution of the SFHS-1 score in predicting subjective happiness. The 1-month test-retest reliability assessed by intraclass correlation was 0.76. Family happiness was moderately to strongly correlated with family function, family communication, subjective happiness, mental health-related quality of life and depression, but weakly correlated with physical health-related quality of life. Furthermore, the score of the SFHS-1 added predictive power to mental health-related quality of life and depression in assessing subjective happiness. Our results have shown the SFHS-1 as a reliable and valid measurement of family happiness in Hong Kong Chinese, suggesting SFHS-1 is highly practicable for future large epidemiological and community-based intervention studies.

How Can We Reach At-Risk Relatives? Efforts to Enhance Communication and Cascade Testing Uptake: a Mini-Review

Cascade testing, or screening, is the process of stepwise, systematic genetic testing of at-risk relatives for a genetic variant originally identified in a proband. Cascade testing effectively identifies at-risk relatives who would benefit from early screening and/or medical intervention, and can potentially lead to early diagnoses and disease prevention. However, recent studies highlight the need for additional resources to enhance family communication and improve the cascade testing process. In this mini-review of cascade testing, we discuss various factors that influence the effectiveness of communicating genetic risk information among families, including barriers, provision of additional resources, direct contact, and the role of technology and healthcare providers. Patients desire and value involvement of healthcare providers in the cascade testing process. Uptake of cascade testing increases when patients are provided with educational materials and technological resources, and when healthcare providers assist with communicating risk to their at-risk relatives. Through achievable adjustments in patient care, healthcare providers can facilitate family communication and uptake of cascade testing. This can be done by asserting the importance of genetic testing results to at-risk family members when reviewing results with patients and leveraging technological tools and other options for direct contact to maximize the benefits of earlier diagnosis and prevention.

Enhancing Family Communication in Families Where a Parent has a Mental Illness

In this brief we will discuss the <strong>Think Family-Whole Family Programme</strong>, which differs from other interventions by putting a central focus on fostering effective communication within families. This can enhance families’ understanding of parental mental illness (PMI) and how it affects behavior and relationships, help families jointly set goals for recovery, and enable more supportive interactions among family members. A Spanish translation of this publication is available to download under "Additional Files".

A Community-Based Intervention Program to Enhance Family Communication and Family Well-being: The Learning Families Project in Hong Kong.

Family communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based "Learning Families Project," based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems. This quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South) Estate] and control (Shun Tin Estate) estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1), immediately after the intervention (T2), and 6 weeks after the intervention (T3). Control group participants were assessed at baseline (March to April 2011) and follow-up (December 2011 to March 2012). Assessments of family communication (time and perceived adequacy) and family well-being (harmony, happiness, and health) at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention. Family communication time and perceived communication adequacy increased significantly in the intervention group (n = 515) with a small effect size (Cohen effect d: 0.10 and 0.24, respectively). Compared with the control group (n = 476), the improvements in family communication time and perceived communication adequacy (Cohen effect d: 0.13 and 0.14, respectively), and perceived family harmony and happiness (Cohen effect d: 0.12 and 0.12, respectively) were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving family communication and family well-being. Mediation analysis showed that perceived communication adequacy mediated the effects of the intervention on family harmony [β = 0.10, 95% confidence interval (CI) 0.03, 0.18], happiness (β = 0.12, 95% CI 0.04, 0.20), and health (β = 0.10, 95% CI 0.02, 0.17), adjusting for age and education. This community intervention based on the social ecological model improved family well-being through improving family communication, which could be an effective target to promote family well-being in other communities. This study was registered under ClinicalTrials.gov, identifier NCT02851667. URL: https://clinicaltrials.gov/ct2/show/NCT02851667?term=02851667&rank=1.

QLIF-10. FAMILY CAMP: A MULTI-DISCIPLINARY, HOLISTIC INTERVENTION FOR BRAIN TUMOR PATIENTS AND THEIR FAMILIES

A brain tumor diagnosis is a devastating and life-altering event that impacts the entire family. Families experience radical change of roles due to cognitive, physical, and emotional changes resulting from the illness. “Family Camp” was a targeted psychosocial intervention to create a safe environment that would provide families with children respite from daily burdens and connect them with similar others. In 2014, a multi-disciplinary team established a weekend camp. Staff included artists, body workers, psychologists, “camp counselors”, doctors, nurses, social workers, who are members of their healthcare team, and community volunteers. Interventions included counseling, community building, and educational sessions. Communication strategies were suggested to enhance family communication. Opportunities for art, singing, games, and rest were provided. Anxiety, stress, depression, coping, and values-based living were measured pre and post camp using DASS21, CES-D, Brief Cope Inventory, Values Based Living, and surveys. 11 families (22 adults) attended camp; 15 adults remained the entire duration. A paired sample t-test was conducted to compare scores before and after camp on a variety of outcomes. On the DASS21 patients (n=7) reported statistically significant decreases in the axes of depression and stress; p= 0.038 and 0.0077 and caregivers (n=8) reported statistically significant decreases in depression and anxiety; p=0.02 and 0.017. This was also reflected on the CES-D; p=0.021. Subjective assessments were consistent with these observations, and most felt that the experience made them closer as a family. A multi-disciplinary program focused on patients’ families improves psycho-social stressors. Data suggest that support programs designed for entire families may be an important intervention that improves quality-of-life and perception of the “illness” experience. Sustainability of observed benefits are unknown, but serial interventions are likely important in this patient population with variable disease trajectories.

Happy Family Kitchen: A community-based research for enhancing family communication and well-being in Hong Kong.

Urban families worldwide are often characterized by busy working lives which leave little time for family gatherings and communication. The Happy Family Kitchen project, which emphasized cooking and dining with family members, was conducted in a deprived district in Hong Kong. We hypothesized that the community-based family intervention, derived from a positive psychology framework, can improve family communication, family well-being, and subjective happiness. Twenty-three social service units organized and delivered the intervention programs for 1,419 individuals from 612 families. The core intervention was developed with emphasis on 1 of 5 positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at preintervention, immediate postintervention, and 6 weeks and 12 weeks postintervention. Results showed that family communication, family well-being, and subjective happiness improved with small effect sizes which were sustained up to 12 weeks. The gratitude intervention improved all of the outcome measures. Qualitative data provided additional evidence for effectiveness with in-depth insights into family dynamics. We concluded that this brief intervention was a low-cost and simple approach to improve family communication and well-being. (PsycINFO Database Record

Use of Relational Agents to Improve Family Communication in Type 1 Diabetes: Methods.

BackgroundPhysiological and environmental risk factors interact to undermine blood glucose control during early adolescence. This has been documented to be associated with family conflict and poor adherence to diabetes management tasks. Family Teamwork is an efficacious program demonstrated to enhance family communication and reduce conflict during this vulnerable period. It was designed to be delivered to families in-person, which limited reach and potential impact.ObjectiveThe purpose of this paper is to present the protocol for adapting Family Teamwork for Web-based delivery.MethodsFormative research with health care providers, parents, and adolescents will help modify Family Teamwork for Web-based delivery by a relational agent (ie, a computerized character with human-like features and actions). Sessions will be interactive, requiring both parent and adolescent participation, with the relational agent serving as a health coach. After programming, usability testing will be conducted to help ensure the program is easy to use. Video and instructional materials will be developed to facilitate use, and a small pilot study will be conducted to assess feasibility. Families will provide written informed consent prior to participation in any phase of the study. The Institutional Review Board at Baylor College of Medicine reviewed and approved the protocol (H-37245).ResultsFormative research is underway. No results are available at this time.ConclusionsThis research has the potential to make an important contribution to diabetes management by using technology to enhance the reach of an efficacious program.

Happy Family Kitchen II: A Cluster Randomized Controlled Trial of a Community-Based Family Intervention for Enhancing Family Communication and Well-being in Hong Kong.

Long working hours and stressful urban lifestyles pose major challenges to family communication and well-being in Hong Kong. A community-based family intervention derived from a positive psychology framework, by using cooking and dining as a platform, was developed for improving family communication and well-being. Social workers and teachers from 31 social service units and schools in collaboration with an academic partner organized and conducted the intervention programs for 2,070 individuals from 973 families in a deprived district in Hong Kong. The participants were randomly assigned into the intervention or control group in a cluster randomized controlled trial (cRCT). The core intervention covered one of five positive psychology themes: joy, gratitude, flow, savoring, and listening. Assessments at pre-intervention, immediate post-intervention, and 4 and 12 weeks post-intervention showed improved family communication and well-being with sustainable effects up to 12 weeks. Positive changes in family happiness and family health were greater in the intervention group than in the control group. The savoring intervention had the most improved outcomes among the five themes. We concluded that this large-scale brief cRCT developed and conducted in real-world settings provided evidence for the feasibility and effectiveness of a community-based family intervention. This study was registered under ClinicalTrials.gov (NCT01796275).

Exploring ambivalence in motivational interviewing with obese African American adolescents and their caregivers: A mixed methods analysis

ObjectiveWe conducted an exploratory mixed methods study to describe the ambivalence African-American adolescents and their caregivers expressed during motivational interviewing sessions targeting weight loss. MethodsWe extracted ambivalence statements from 37 previously coded counseling sessions. We used directed content analysis to categorize ambivalence related to the target behaviors of nutrition, activity, or weight. We compared adolescent-caregiver dyads’ ambivalence using the paired sample t-test and Wilcoxon signed-rank test. We then used conventional content analysis to compare the specific content of adolescents’ and caregivers’ ambivalence statements. ResultsAdolescents and caregivers expressed the same number of ambivalence statements overall, related to activity and weight, but caregivers expressed more statements about nutrition. Content analysis revealed convergences and divergences in caregivers’ and adolescents’ ambivalence about weight loss. ConclusionUnderstanding divergences in adolescent-caregiver ambivalence about the specific behaviors to target may partially explain the limited success of family-based weight loss interventions targeting African American families and provides a unique opportunity for providers to enhance family communication, foster teamwork, and build self-efficacy to promote behavior change. Practice implicationsClinicians working in family contexts should explore how adolescents and caregivers converge and diverge in their ambivalence in order to recommend weight loss strategies that best meet families’ needs.

Enhancing Family Communication: Examining the Impact of a Therapeutic Wilderness Program for Struggling Teens and Parents

Every year approximately 130 families participate in Intercept, a program for struggling teens and their families at the Voyageur Outward Bound School, because they are concerned about the loss of trust, poor communication, and/or other high-risk behaviors they are experiencing with their children. Though families hope for improvements in family functioning, little research has been done on the impact of this type of program on the parent/child relationship or how families function once they leave the program. This phenomenological study collected qualitative data from nine families to determine what positive relationship outcomes emerged between parent(s) and their adolescent child post-program, as well as what aspects of the program curriculum were helpful in improving the parent/child relationship. Results showed that communication among family members improved as a result of participation in the Outward Bound program, and families reported utilizing new skills they had learned, including the use of time-outs, improved listening, and other assertive communication tools. Families reported that the parent/child conference at the end of the program was the most helpful aspect of the Intercept curriculum for improving the parent/child relationship. Implications for family therapy include support for therapeutic wilderness programs as a viable intervention for families of high-risk teens struggling with communication.