Family-centered Approach Research Articles

A manual-based family intervention for families living with acquired brain or spinal cord injury: a qualitative study of families’ experiences

Purpose To explore families’ experiences of participating in a family intervention, targeting families living with the consequences of acquired brain injury (ABI) or spinal cord injury (SCI). Materials and methods Individuals with ABI or SCI and their family members were recruited from a randomised controlled trial investigating the effectiveness of the manual-based family intervention, which consisted of eight weekly sessions. Semi-structured interviews were conducted with 16 families (n = 33). The data were analyzed through reflexive thematic analysis. Results One central theme was developed “A sense of belonging together again”, describing the value of the reciprocal format of the family intervention, where individuals with ABI or SCI and their family members gained new insights into each other while building up their relationship. The central theme was supported by three additional themes: “Strengthened communication and emotional control”, “Acknowledging the changed life situation” and “Being seen as a whole person”. Conclusions The family intervention supported the families to strengthen family cohesion and to be capable to manage the changed life situation. The findings emphasize the importance of a family-centered approach in neurorehabilitation, and how healthcare professionals play a significant role in facilitating families to achieve a balanced level of family cohesion.

Construction of a Shared Decision-Making Model Between Doctor and Patient in China Based on Selection Preferences

Influenced by Confucian values, China’s medical decision-making emphasizes a family-centric and harmonious approach, contrasting with Western practices that highlight individual autonomy. However, there’s a global shift towards “patient-centered” care, promoting shared decision-making (SDM) between healthcare practitioners and patients. This study aims to advance the SDM model in China by analyzing the alignment in decision-making between doctors and patients. The focus is on addressing the absence of quantitative tools for SDM coordination. An SDM coupling coordination model was developed, and the coordination level was assessed using data from questionnaires filled by 210 doctors and 248 patients from three prominent Chinese hospitals. Doctors’ and patients’ preferences were categorized into four areas: treatment efficacy, cost considerations, potential side effects, and overall treatment experience. The coordination degrees, represented by “D values,” for these areas were 0.6375, 0.5299, 0.5704, and 0.4586, respectively. A higher “D value” signifies better alignment between doctors and patients. Treatment efficacy showed the strongest alignment, followed by costs and side effects, while treatment experience had the least alignment. In conclusion, the alignment in doctor–patient SDM in China is currently not optimal. Improvements necessitate a foundational “patient-first” approach in SDM, an emphasis on optimization in collaborative strategies, and the establishment of a comprehensive platform for collaboration and coordination in SDM.

Community Networks with a Family Focus: Success Factors in Implementing a TANF Funded Housing Support Program

Although the US safety net includes housing supports, finding and securing affordable housing remains a challenge for many low-income families. As a block grant to states, Temporary Assistance for Needy Families (TANF) is a potential mechanism for creating additional supports for housing, which some states such as New Jersey pursue. This qualitative study focuses on three New Jersey counties with positive track records of implementing those additional supports. Research questions concern what factors contributed to successful implementation of the housing supportive Emergency Assistance Program on a county level and how these factors interacted to impact program effectiveness. From thematic coding of interviews with government and nonprofit staff at the state and county levels (N = 17), document reviews, and meeting observations, this study found that the program was incorporated as one piece of a family-centered approach to social service provision. Having a tight network between service providers with strong commitment to the program, vital in previous social service research as well as the current study, fed into that family-centered approach and successful implementation. Future research should examine how to build staff buy-in and mission-driven approaches with a family focus as well as center the voices of participants in these programs.

The Lived Experience of Pediatric Gene Therapy: A Scoping Review.

Little is known about patients' and families' lived experiences of participating in pediatric gene therapy (GT) clinical trials. Currently, pediatric GT research targets a broad range of indications--including rare and ultra-rare diseases--which vary in severity and in the availability of alternative therapies. Pediatric GT differs meaningfully from adult GT because the decision to participate involves a dyad of both the child and parent or caregiver/s. It is critical to understand patients' and caregivers' perceptions and experiences of social, emotional, physical, and logistical burdens or benefits of participating in such trials, and how they weigh and prioritize these factors when deciding whether to participate. We conducted a scoping review of the current literature in this subject area with objectives to (1) provide an overview of existing literature, (2) identify gaps and areas for further research, and (3) better understand the lived impact of pediatric GT research on patients and their parents/caregivers. Four themes emerged, including (1) weighing risks and benefits (2) timing of GT trial participation, (3) value of clear communication, and (4) potential impact on quality of life. Notably, our sample surfaced articles about how patients/parents/caregivers were thinking about GT-their understanding of its safety, efficacy, and risks-rather than accounts of their experiences, which was our initial intention. Nevertheless, our findings offer useful insights to improve the informed consent process and promote a more patient- and family-centered approach. Moreover, our findings can contribute to patient advocacy organizations' efforts to develop educational materials tailored to patients' and families' expressed informational needs and perspectives, and can inform more patient- and family-centered policies from GT clinical trial sponsors.

“What should I do? We still have to go to work”: Latino immigrant perceptions of the COVID-19 pandemic and vaccine

PurposeThe COVID-19 pandemic disproportionately impacted Latinos across the United States though data on emerging immigrant communities is lacking. The purpose of this study is to better understand how Latino immigrants were impacted by the COVID-19 pandemic, allowing a community health clinic in Charlotte, North Carolina to quickly respond to their needs.Design/methodology/approachA mixed method, rapid appraisal using community-based participatory research approaches conducted in February to April 2021 by a team of bilingual researchers. Project consisted of a Spanish, electronic survey distributed through community leaders and in-person interviews conducted in Spanish at COVID-19 vaccine clinics. SPSS Version 26 was used for quantitative analysis. Ordinal and binary logistic regression tests were performed to assess the associations among several outcome and four predictor variables: documentation status, status of health insurance, level of trust in the vaccine and place of birth. Qualitative analysis used rapid appraisal and grounded theory approaches.FindingsLatino immigrants experienced job and income loss, resulting in difficulty paying for food, housing and health care. Participants experienced emotional and financial stress and isolation from family. Undocumented immigrants were more likely to experience detrimental impacts than documented immigrants. Most wanted the vaccine but felt barriers like trust and insurance may prevent them.Research limitations/implicationsFindings from this study are locally relevant to Latino immigrants living in the Charlotte area of North Carolina and findings may not be generalizable to other Latinos. Participants were recruited through faith networks and those who are not connected may not be represented. In addition, interview participants were sampled during vaccination clinics and likely had positive views of the vaccine.Practical implicationsAs a direct result of this project, community health clinic (CHC) held vaccination clinics to instill more confidence in the vaccination process. Spanish-speaking staff were available to assist with paperwork and answer questions onsite. The importance of familismo in decision-making and the reported presence of misinformation about the vaccine prompted CHC to continue providing accurate information about the vaccine in Spanish, and to strategize marketing materials to reflect a family-centric approach to better appeal to Latinos. Findings were used to obtain funding for expansion of clinical and behavioral health services in the community through mobile units, increasing accessibility for Latino immigrants.Originality/valueTo the best of the authors’ knowledge, this was the first study to examine the effects of the pandemic on a growing and disproportionately underrepresented group in an emerging immigrant state. Findings informed culturally competent COVID-19 vaccine clinics, marketing strategies and the expansion of medical and behavioral health services for a local community clinic.

Parents' and nurses' perceptions and behaviours of family-centred care during periods of busyness.

Busyness as a construct within modern healthcare is complex and multidimensional. To date, few studies have sought to explore how busyness influences family-centred care. This study explored the influence of busyness on the delivery of family-centred care for nurses and parents. Ethnography was selected as the research design. The study site was a metropolitan tertiary hospital inpatient paediatric unit in Sydney, Australia. Semi-structured interview and non-participant observation techniques were used for data collection. Ten paediatric nurses and 10 parents were interviewed and 40 h of non-participant observations were undertaken. The COREQ was used to report the study. The findings are presented as three key themes: (i) 'Supporting family-centred care' in which participants detail beliefs about the nurse-parent relationships and how despite busyness nurses sought out moments to engage with parents; (ii) 'Being present at the bedside' identified the challenges in optimising safety and how parents adapted their way of being and interacting on the unit; and (iii) 'The emotional cost of busyness' and how this influenced nurse-parent interactions, care delivery and family-centred care. The ethnography has given shape to social understandings of busyness, the complexities of paediatric nursing and family-centred care. The culture of care changed in moments of busyness and transformed parent and nursing roles, expectations and collaborative care that at time generated internal emotional conflict and tension. Given the increasing work demands across health systems, new agile ways of working need to ensure maintenance of a family-centred approach. Strategies need to be developed during periods of busyness to better support collaborative connections and the well-being of paediatric nurses and parents. At an organisational level, fostering a positive workplace culture that shares a vision for family-centred care and collaboration is essential. Parents of sick children admitted to an acute paediatric inpatient ward were invited to be a participant in a single interview. Parents were aware of the study through ward advertisement and informal discussions with the researchers or senior clinical staff. Engagement with parents was important as healthcare delivery in paediatrics is focused on the delivery of family-centred care. To minimise the risk of child distress and separation anxiety, children were present during the parent interview. Whist children and young people voices were not silenced during the interview process, for this study the parent's voice remained the focus. While important, due to limited resources, parents were not involved in the design analysis or interpretation of the data or in the preparation of this manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Feeding after congenital heart surgery: a mixed-methods study of the caregiver experience.

Feeding difficulties after congenital heart surgery are a common concern for caregivers of children with CHD. Insight into the intricacies of their experience is lacking. With a better understanding, healthcare providers can continue to optimize the approach and support mechanisms for these families. This study will explore the psychosocial impacts on caregivers, define barriers to care, and identify areas to improve their care. This mixed-methods study combined semi-structured interviews with surveys. Purposive sampling targeted caregivers of a child who underwent heart surgery and was discharged with alternative enteral feeding access. A hybrid inductive-deductive methodology was used to analyse interview transcripts. Survey scores were compared to interview content for concordance. Fifteen interviews were conducted with socio-demographically diverse caregivers. Feeding difficulties were often identified as their greatest challenge, with the laborious feeding schedule, sleep deprivation, and tube management being common contributors. Most caregivers described feeling overwhelmed and worried. Time-intensive feeding schedules and lack of appropriate childcare options precluded caregivers' ability to work. Barriers to care included imperfect feeding education, proximity of specialist clinics, and issues with medical supply companies. Caregiver proposals for improved care addressed easing the transition home, improving emotional support mechanisms, and intensifying feeding therapy for expedited tube removal. This study describes the psychosocial toll on the caregiver, typical barriers to care, and ideas for improved provision of care. These themes and ideas can be used to advance the family-centered approach to feeding difficulties after heart surgery.

An Integrative Review of Grandparents' Experiences in Childhood Cancer.

Background: While it is generally accepted that childhood cancer has a profound impact on the family unit, there has been little focus on the experiences of grandparents who are affected by the diagnosis. Grandparents play an integral role throughout the child's illness trajectory as they are called upon to provide support physically, spiritually, emotionally, and at times financially. This integrative review examines the current research specific to grandparents' experiences of childhood cancer. Method: CINAHL, PubMed, and Web of Science were searched using the key terms "grandparent*" AND "experience*" AND "child*" AND "cancer." Inclusion criteria used for this review were as follows: electronic full text, peer-reviewed, and published in English between 2012 and 2022. Results: Grandparents of children with cancer experience an emotional whirlwind, a double-whammy effect, the giving and receiving of support, a balancing act, and attempt to find meaning throughout the diagnosis. They feel unacknowledged and unsupported by the health care team. Discussion: It is difficult to deny the emotional and familial impact the child's cancer diagnosis has not only on the child and immediate family but also on grandparents. While the reports of grandparents are consistent across studies, there have been lackluster attempts to mitigate the suffering experienced by this group. Pediatric oncology nurses, with their family-centered care approach, are in a unique position to uncover and meet the specific needs of grandparents of children diagnosed with cancer.

Early Childhood Care in Spain before the Lockdown

It is widely assumed that every action in Early Childhood Care (ECC) must be conducted taking into consideration the well-being of the family and relying on their active involvement. It becomes essential to implement an intervention strategy that encompasses not only the children but also their immediate environment and the entire family unit. In this context, the Family-Centred Approach (FCA) has emerged as a prominent methodology. This approach can be defined as a collaborative connection between professionals and families, characterised by mutual respect and acknowledgment of their values and choices. Moreover, it entails extending assistance when required, all aimed at fostering optimal functioning of the familial core. This article aims to understand perceptions of families and professionals concerning Early Intervention in Spain before the lockdown. For this, a scoping review was conducted by mapping articles related to Spain in Scopus or Dialnet (CIRC A+, A, B, or C) before the COVID-19 lockdown. After reviewing thirty-five chosen articles, the identified topics were categorised into emotions, diagnoses, and requirements. Many of the publications fulfilled the CIRC B criterion, with a minority of articles meeting this criterion in the latter portion of the present decade. This subject matter warrants further research. There is a need for effective Early Childhood Care (ECC), characterised by early detection and diagnosis, involving well-trained professionals, and which recognises the importance of families in interventions and children development.

Parental practices and children's lifestyle correlates of childhood overweight/obesity in Europe: The Feel4Diabetes study.

Parental influences on children's eating and physical activity (PA) and consequently on their weight are fundamental. The present study aimed to identify the predominant correlates of childhood overweight/obesity among a variety of parental practices and children's lifestyle indices in a large sample of children in Europe. Families from low socio-economic status regions were recruited through schools, located in six European countries (Belgium, Finland, Greece, Spain, Bulgaria and Hungary). Seven thousand three hundred ninety-seven children 4-12 years old and their parents were selected using the FINDRISC-questionnaire. Parental practices assessed included parental role modelling, permissiveness and reward. Children's dietary intake and lifestyle behaviours were assessed through parent-reported questionnaires. Regarding parental practices, it was revealed that being sometimes (odds ratio [OR] = 1.26; 95% confidence interval [CI] = 1.10-1.43) or rarely (OR = 1.43; 95% CI = 1.21-1.69) physically active with the child was associated with greater overweight/obesity risk, whereas rare permission of computer/mobile/tablet (OR = 0.81; 95% CI = 0.67-0.98) and sometimes (OR = 0.77; 95% CI = 0.68-0.88) or rare (OR = 0.77; 95% CI = 0.66-0.91) reward with PA were associated with lower risk. Regarding children's lifestyle factors, consuming > 3 cups/week fresh fruit juices (OR = 1.28; 95% CI = 1.13-1.45), skipping breakfast (OR = 1.37; 95% CI = 1.17-1.61), absence of 1 h of daily PA (OR = 1.40; 95% CI = 1.24-1.58) and increased daily screen time (ST) (OR = 1.23; 95% CI = 1.09-1.39) were associated with greater overweight/obesity risk. All the variables were adjusted for maternal education, child's sex and age. These findings emphasize the necessity of family-centered approaches in health promotion and obesity prevention programs for children. Such programs should focus on parents as the primary role models in exerting positive influence and encouraging healthy eating habits, PA, and ST behaviors in their children, which in turn, may have a substantial impact on children's overall weight status.

First and final farewells, disrupted family connections and loss: A collective case study exploring the impact of COVID-19 visitor restrictions in critical care

BackgroundPatient and family-centred care is considered best practice. Such an approach is associated with high quality and positive experiences of care, and family presence at the bedside is encouraged and enabled. The COVID-19 pandemic, however, resulted in strictly enforced restrictions on hospital visitation, which threatened health professionals’ ability to provide family-centred care. AimTo explore the impact of COVID-19 visitor restrictions on family relationships during critical illness at the end of life in the intensive care unit. DesignA retrospective collective case study approach was taken, using semi-structured interviews, conducted via telephone or Zoom, in accordance with COVID-19 restrictions. Setting/participantsTwo participant groups, bereaved next-of-kin of patients who died in the intensive care unit (n = 6) and critical care nurses (n = 3) from a major metropolitan hospital were included. FindingsInterviews with bereaved next-of-kin lasted 25–59 (mean = 41) minutes, and critical care nurse interviews lasted 31–52 (mean = 43) minutes. Inductive content analysis revealed five themes: (i) the first farewell, the significance not realised at the time; (ii) confusing rules and restrictions, which emphasised physical and created emotional barriers to family connections; (iii) inadequate communication, which further impacted next-of-kin; (iv) final farewells, which were rushed, emotional and afforded no privacy; and (v) reflecting back. ConclusionsThis collective case study demonstrates the profound impact visitor restrictions have had on bereaved next-of-kin and the wider family. A family-centred approach to care, protecting and prioritising family connection, and recognising the patient as a person who is part of a larger family unit must be emphasised. Implications for clinical practiceCritical care teams must consider their own approach to end-of-life care during times of visitor restrictions, finding new, flexible and innovative ways to improve communication, promote family-centred care, maintain the patient-family connection and facilitate end-of-life cultural customs, and rituals imperative to next-of-kin and the wider family unit.

Surveying Early Intervention Providers to Identify Opportunities for Workforce Support to Strengthen Family-Centered Care.

Traditional provider-to-child models of early intervention (EI) service provision have been increasingly replaced by service guidelines that promote a broader family-centered approach to support improvement in the child's primary area of delay. These guidelines include working directly with caregivers and addressing needs of the family that might impact a caregivers' capacity to engage in developmentally supportive interactions with children (e.g., caregiver distress). Knowledge of provider skills, practices, and attitudes would inform efforts to broaden and enhance practice in line with these guidelines. Within an academic-community partnership to support EI, we surveyed 88 providers in Miami and Boston about their usual practice, perceptions of their skills, general attitudes towards evidence-based practices, and interest in specific training opportunities. Findings indicated that providers spent more time working directly with children than caregivers. Providers reported high interest in training to manage caregiver distress, support preschool readiness, and align work with family culture. Negative overall attitudes towards using evidence-based interventions and provider exhaustion were related to less interest in obtaining training in culturally-responsive practice. Exhaustion also related to less interest in training on other topics that represent a broadened scope of care, including building warm parent-child relationships. Findings are informing efforts to design EI training opportunities to improve parent-provider relations, enhance parent-child interactions, and reduce caregiver stress.

“I Don’t Think There’s a Cookie-Cutter Way of Working With People With Autism”: Mothers of Children With Autism and Their Experiences With Counseling Services

Clinical mental health counselors can play a critical role in treating children diagnosed with autism spectrum disorder (ASD) as they age toward adulthood. While best practice for treatment of children with ASD should be individualized and include a family-centered approach, the experience of the mother receiving mental health services has not been previously explored in counseling research. For this study, we utilized interpretative phenomenological inquiry to examine the lived experiences of mothers (n = 8) who navigated the complexities of the counseling services for their child(ren) with ASD. Implications for clinical mental health counselors and counselor educators were presented to better serve this ever-increasing client population.

Parent and healthcare provider views of live varicella vaccination of pediatric solid organ transplant recipients.

Live attenuated varicella vaccine (LAVV) has historically been contraindicated in children who are immunocompromised due to solid organ transplant (SOT) because of safety concerns. Recently, clinical guidelines were developed that support post-transplant varicella vaccination in selected SOT recipients based on emerging evidence of LAVV safety. This qualitative study sought to explore barriers and facilitators to implementing the new guidelines, as well as acceptability of LAVV among healthcare providers (HCPs) and parents. HCPs and parents of transplant recipients were recruited from four sites using purposive sampling. Data from semi-structured interviews were analyzed using an Interpretive Description approach that incorporated data from the interviews, academic knowledge and clinical experience, and drew from Grounded Theory and Thematic Analysis. The theoretical framework used was Adaptive Leadership. Thirty-four participants (16 HCPs and 18 parents) were included in the analysis. Parents developed skills in adaptive leadership that included strategies to protect their child against infectious diseases. Foundational information that live vaccines were absolutely contraindicated post-transplant "stuck" with parents and led them to develop strategies other than vaccination to keep their child safe. Some parents struggled to understand that information previously presented as a certainty (contraindication of LAVV) could change. Their approach to adaptive leadership informed their appraisal of the new vaccination guidelines and willingness to accept vaccination. HCPs should adopt a family-centered approach to communicating changing guidelines that considers parents' approach to adaptive leadership and discusses the changing nature of medical evidence. Trust between HCPs and parents can facilitate these conversations.

75 Factors that Influence Parental Decision-making Regarding Analgesia for their Children with Musculoskeletal Injury-related Pain: A Qualitative Study

Abstract Background Parents/caregivers are often the gatekeepers for the pharmacologic management of their children’s pain. Parents’ unique expertise in assessing their children’s pain reactions, alongside a deep emotional drive to protect their children, make them invaluable advocates and partners. Parents are highly invested in optimizing pain management outcomes for children. Concerns and preferences regarding medications, including opioids, influence their choices. An improved understanding of caregiver decision-making should encourage a family-centred approach to communication with parents when deciding analgesic plans for children with acute pain, facilitate shared clinical decision-making, and optimize paediatric pain management outcomes in the clinical setting. Objectives Our primary objective was to explore and understand caregiver decision-making as it relates to acute pain management for children presenting to the emergency department, with particular focus on opioids. Design/Methods This qualitative study was embedded within an ongoing paediatric clinical trial (‘The No OUCH Trials’, NCT03767933), which aims to evaluate the clinical efficacy of a combination of oral opioid (hydromorphone) and non-opioid (ibuprofen and acetaminophen) analgesics to manage paediatric musculoskeletal injury-related pain. This study employed one-on-one semi-structured interviews. Parents of children with acute musculoskeletal injuries were recruited from three Canadian paediatric emergency departments (Stollery Children’s Hospital [Edmonton, Alta.], CHU Sainte-Justine [Montreal, Qué.], and Winnipeg Children’s Hospital [Winnipeg, Man.]). Interviews were conducted via telephone from June 2019 to March 2021. Verbatim transcription and thematic analyses occurred concurrently with data collection, supporting data saturation and theory development considerations. Results Twenty-seven interviews were completed. Five major themes regarding pain assessment and treatment emerged: a) My child’s comfort is a priority; b) Every situation is unique; c) Opioids only if necessary; d) Considerations when choosing opioids; and e) Pain research is important. Overall, parents were highly comfortable with their assessment of their child’s pain. Participants’ willingness to use opioid analgesia for their children was primarily dependent on perceptions of injury and pain severity. Although considerations for opioid use were similar between opioid-averse and opioid-willing families, the trade-offs between maximizing pain relief and minimizing risks were weighed differently. Conclusion Our study revealed that parents assess their child’s pain and distress as a global entity, with great confidence in their own assessment and decision-making. For most parents, the desire to relieve their children’s pain outweighed concerns of addiction, misuse, and adverse events when making decisions about opioid analgesia for short-term use. These results can inform evidence-based family-centred approaches to co-decision-making of analgesic plans for children with acute pain.

Clinicians' perspectives on barriers and facilitators to sperm banking in adolescent males with cancer: a mixed-methods study.

To examine processes, barriers, and facilitators to sperm banking counseling and decision-making for adolescent males newly diagnosed with cancer from the perspective of clinicians who completed Oncofertility communication training. We also identify opportunities for improvement to inform future interventions and implementation. A survey (N=104) and subsequent focus groups (N=15) were conducted with non-physician clinicians practicing in pediatric oncology who completed Oncofertility communication training. Most survey participants were confident in communicating about the impact of cancer on fertility (n=87, 83.7%) and fertility preservation options (n=80, 76.9%). Most participants reported never/rarely using a sperm banking decision tool (n=70, 67.3%), although 98.1% (n=102) said a decision tool with a family-centered approach would be beneficial. Primary themes in the subsequent focus groups included variable processes/workflows (inconsistent approaches to consult initiation; involvement of adolescents, caregivers, and various clinician types; assessment of puberty/sexual experience), structural and psychosocial barriers (cost and logistics, developmental, cultural, clinical acuity/prognosis), and facilitators (educational materials, alternative options for banking). Opportunities and strategies for improvement (including fertility preservation in existing research protocols; additional staffing/resources; oncologist education and buy-in; and development of decision tools) were informed by challenges identified in the other themes. Barriers to adolescent sperm banking remain, even among clinicians who have completed Oncofertility training. Although training is one factor necessary to facilitate banking, structural and psychosocial barriers persist. Given the complexities of offering sperm banking to pediatric populations, continued efforts are needed to mitigate structural barriers and develop strategies to facilitate decision-making before childhood cancer treatment.

UPAYA EDUKASI RISIKO OBESITAS “RETAS” PADA KELUARGA DI WILAYAH KOTA SURABAYA

Introduction & Aim: While the issue of malnutrition hasn't been completely overcome, the issue of overweight and obesity seems to be becoming worse. Obesity is a phenomenon similar to an iceberg that appears straightforward on the surface. If not treated right once, it would endanger the sustainability of future generations. Families and their members will have more access to complete health care. The aim of this activity is to carry out extensive community service projects that educate about the risks of obesity using a family-centered approach. Method of Activity: Educational Activities "RETAS" or Risk of Obesity is one of the health promotion activities with a family approach. The educational activity "RETAS" was carried out in Gubeng District, Surabaya, in December 2022. The implementation of community service activities included filling out pre-tests, giving materials, filling out food diaries, food diary, demonstration of physical activity, and post-tests. Activity. The "RETAS" activity was filled with the provision of comprehensive education, including obesity prevention, a community movement program for healthy living, balanced nutrition guidelines followed by filling out a food diary according to WHO guidelines, demonstration of physical activity, also distribution of media leaflets and booklets. Results: Participants' understanding increased by 72% after delivering education and materials. Discussion: Leaflets and booklets have been proven to increase participants' knowledge of the risk of obesity in families. Prevention of the risk of obesity with a comprehensive family approach through "RETAS" Education is hoped to be adopted as one of the health promotion efforts in urban and rural areas.

Implementing depression care in under-resourced communities: a school-based family resilience skill-building pilot randomized controlled trial in the United States.

Youth in under-resourced communities are more likely to have greater social risk factors for mental health needs yet have less access to needed care. School-based mental health services are effective in treating common disorders such as adolescent depression; however, few have a family-centered approach, which may especially benefit specific populations. Utilizing a community-partnered approach, we adapted an established, trauma-informed, resilience skill-building family intervention for adolescents with depression. We conducted a small randomized controlled feasibility pilot of an adapted intervention in a large school district that serves predominately low-income, Latinx students in the Southwest United States between 2014-2017. Youth between the ages of 12-18 years old with a Patient Health Questionnaire (PHQ-8) score of 10 or higher, who spoke English or Spanish, were recruited from 12 school mental health clinics. Twenty-five eligible adolescents with depression and their participating caregivers were enrolled and randomly assigned to receive either the adapted intervention, Families OverComing Under Stress for Families with Adolescent Depression (FOCUS-AD), or usual care, Cognitive Behavioral Therapy (CBT) only. Most of the sample was Latinx and female. We evaluated feasibility, acceptability, and preliminary effectiveness. Among participants who completed standardized assessments administered at baseline and approximately five months post-randomization (n = 10 FOCUS-AD, n = 11 CBT only), effectiveness was explored by identifying significant changes over time in adolescent mental health within the FOCUS-AD and CBT only groups and comparing the magnitude of these changes between groups. Nonparametric statistical tests were used. We found the FOCUS-AD intervention to be feasible and acceptable; participant retention was high. Adolescent symptoms of depression (measured by the PHQ-8) improved significantly from baseline to follow-up for youth in both FOCUS-AD (median decrease [MD] = 10, p = 0.02) and control (MD = 6, p = 0.01) groups, with no significant difference across the two groups. Results were similar for symptoms of PTSD (measured by the Child PTSD Symptom Scale; FOCUS-AD MD = 12.5, p = 0.01; CBT only MD = 7, p = 0.04; no significant difference between groups). Family-centered approaches to depression treatment among adolescents living in under-resourced communities may lead to improved mental health, although further research is warranted.

Service Climate and Nurses' Collaboration with Families of Older Patients in the Care Process during Hospitalization.

This study focuses on the concrete role of the presence of a ward's service climate in cultivating nurses' collaboration with family members. Accordingly, this study examined the moderating role of the service climate in the link between nurses' attitudes toward the family and their collaboration with family members in the care process. This is the second article of a series of studies we conducted among health staff in Israeli public hospitals. Relying on the patient- and family-centered care approach and using a cross-sectional study of 179 nurses from 13 internal medicine, surgical and geriatric wards at a large public hospital in Israel, we conducted a multiple regression analysis to test the contribution of all relationship variables to predicting nurses' collaborative behavior with the family in the care process during elderly hospitalization. The findings indicate that service climate had a conditional moderating effect on the relationship between nurses' perception of the family as a burden and their collaboration with the family in nursing care. Namely, in the absence of a targeted service climate, nurses form perceptions about the families as a burden, which in turn affects their distinct non-collaboration, and vice versa.

Perspectives and Experiences of Eight Latina Mothers of Young Children With Augmentative and Alternative Communication Needs

Purpose: The purpose of this study was to examine the perceptions of eight Latina mothers on early augmentative and alternative communication (AAC) services for their young children, including their decision-making process, and knowledge of AAC. The ultimate goal is to help professionals develop culturally responsive and family-centered education and training programs to facilitate AAC intervention for Latinx parents with young children who benefit from AAC. Method: The method involved in-person semistructured interviews conducted in Spanish at the mothers' homes or preferred locations, which were then video-recorded, transcribed verbatim, and translated to English. Transcripts were analyzed through a process consisting of coding, identifying themes, constructing thematic networks, summarizing thematic networks, and interpreting patterns. Results: Mothers' perceptions of early intervention services revealed a lack of knowledge about AAC, unquestioned acceptance of early intervention services, and gratitude for receiving these services. They also reported having received minimal training in AAC and expressed a desire to receive additional training. The decision-making process was matriarchal with professionals serving as the primary informants of services to be received. Discussion: This investigation adds to the existing literature by providing insight into Latinx parental perceptions of AAC, their decision-making process, and the types of training they prefer. The study highlights the importance of providing Latina mothers with meaningful opportunities to participate in the early intervention process related to the communication and language needs of their children. To establish trust, professionals should communicate clearly, accurately, and straightforwardly. Additionally, a family-centered approach rooted in the language and culture is crucial. Professionals can achieve this by providing culturally and linguistically accessible training, learning about the family's specific values and beliefs regarding AAC, and facilitating their learning so that AAC is achievable and practical. Supplemental Material: https://doi.org/10.23641/asha.24059043