Family Outreach Research Articles

Voices of Families of Color: Navigating White Spaces in Gifted Education

Even when achievement outcomes are equal, some students of color still do not participate in advanced academic or gifted education programs. To better understand this phenomenon, researchers engaged in a research-practice partnership within the local community to explore the experiences of families of color and assess their needs pertaining to advanced learning opportunities for their children. Data were collected during two family outreach events using a semi-structured interview protocol with focus groups. Focus-group interviews were independently coded and analyzed using thematic analysis. Findings revealed challenges and barriers related to accessing enrichment and advanced academic learning opportunities. Some families discussed their personal experiences of racism, bias, and deficit thinking. Overall, themes illustrated how families of color believed they were perceived by educational practitioners and their desire for a sense of belonging and equitable access to high-quality academic programming for their children.

Determinan Status Vaksinasi Covid 19 Masyarakat Di Wilayah Kerja Puskesmas Walantaka Kota Serang Provinsi Banteh Tahun 2023

The Covid 19 vaccination is still a matter of pros and cons in society, giving rise to doubts among them about being able to receive it. including the effectiveness of the vaccine itself. Education and support from the family greatly influences a person's ability to receive the Covid 19 vaccination. This research aims to determine the determinants of the Covid 19 vaccination status of the community in the Walantaka Health Center working area, Serang City, Banteh Province in 2023. The method uses quantitative research with a cross sectional approach. The sample in this study used a two-proportion difference hypothesis test formula with the minimum number of samples obtained being multiplied by two to 146. The research instrument was a questionnaire. Hypothesis testing used a multiple logistic regression test. The results of the bivariate analysis showed a significant relationship between education, knowledge, attitudes and family support and Covid 19 vaccination coverage. Meanwhile, those that were not related were the variables age and beliefs. Multivariate analysis shows that family support is the dominant variable in Covid 19 vaccination coverage. Conclusions and Suggestions. Most respondents took the vaccine twice, because they were of a non-vulnerable age, low education and knowledge, beliefs, negative attitudes and received family support for the Covid 19 vaccine. There is a significant relationship between knowledge, attitudes and family support and Covid 19 vaccination coverage. Family support is the most dominant and has a 6,781 times chance of successful Covid 19 vaccination coverage compared to those who do not receive support. It is hoped that the Community Health Center can provide education and understanding about Covid 19 vaccination, either through individual, family, group and community outreach, as well as encouraging the public to maintain health protocols not only to reduce the possibility of contracting Covid 19 but also other infectious diseases. Keywords: Vaccine coverage, Knowledge, Attitude, Family support.

Functional independence among a geriatric population in Karachi, Pakistan: A cross sectional study.

Objective: To find out the frequency and associated factors of impaired IADLs (instrumental activities of daily living) among the geriatric population of Pakistan. Study Design: Cross-sectional study. Setting: Department of Family Medicine and Outreach Centres, Liaquat National Hospital, Karachi. Period: Dec 2020 to Dec 2021. Material & Methods: A total of 200 participants of either gender aged above 60 years were included. At the time of data collection, demographic information was noted along with impairment in specific IADLs and associated factors. Results: Total 200 participants were included in the study. Median age and body mass index was 70 (IQR= 65-73) years and 24.8 (IQR= 21.8-27.8) Kg/m2. Majority of study participants considered that their health status is better (n=92, 46%) whereas some considered it as not as good (n=33, 16.5%) and good (n=55, 27.5%). Few had no idea about their health status (n=20, 10%). The enrolled participants had comorbidity of hypertension (n=78, 39%), diabetes (n=53, 26.5%), ischemic heart diseases (n=10, 5%) and hypothyroid (n=15, 7.5%). Overall 85 (42.5%) study participants were found to be dependent with median IADL score of 6 (IQR= 4-7). Conclusion: Quite a significant proportion of the study participants were found to be dependent. Advancing age, gender predisposition, perceived weight loss and psychological distress were found to be associated with impairment in instrumental activities of daily living.

EFEKTIVITAS KINERJA DINAS PEMBERDAYAAN PEREMPUAN, PERLINDUNGAN ANAK DAN KELUARGA BERENCANA DALAM PENCEGAHAN STUNTING DI KABUPATEN SIMEULUE

The aim of this study was to determine the effectiveness level of DP3AKB's performance in preventing stunting in Simeulue District. This research was carried out at the Office of Women's Empowerment, Child Protection and Family Planning in Simeulue District. This research is a descriptive qualitative research where the research is carried out directly aimed at the informants as research objects. Data collection techniques were carried out in a triangulation (combined) manner, data analysis was inductive in nature, and the results of qualitative research emphasized meaning rather than generalization. The results of the study show that aspects of the duties or functions of the DP3AKB institution in preventing stunting in Simeulue Regency have been carried out effectively and the implementers have been carried out properly. Based on research, the effectiveness of the implementation of the Acceleration of Stunting Reduction program is quite effective because there are already cadres such as Toddler Family Development and outreach to the community about the program so that parents understand how stunting is prevented

Extended Family Outreach in Hereditary Cancer Using Web-Based Genealogy, Direct-to-Consumer Ancestry Genetics, and Social Media: Mixed Methods Process Evaluation of the ConnectMyVariant Intervention

Cascade screening, defined as helping at-risk relatives get targeted genetic testing of familial variants for dominant hereditary cancer syndromes, is a proven component of cancer prevention; however, its uptake is low. We developed and conducted a pilot study of the ConnectMyVariant intervention, in which participants received support to contact at-risk relatives that extended beyond first-degree relatives and encourage relatives to obtain genetic testing and connect with others having the same variant through email and social media. The support that participants received included listening to participants' needs, assisting with documentary genealogy to find common ancestors, facilitating direct-to-consumer DNA testing and interpretation, and assisting with database searches. We aimed to assess intervention feasibility, motivations for participating, and engagement among ConnectMyVariant participants and their families. We used a mixed methods design including both quantitative and qualitative evaluation methods. First, we considered intervention feasibility by characterizing recruitment and retention using multiple recruitment mechanisms, including web-based advertising, dissemination of invitations with positive test results, provider recruitment, snowball sampling, and recruitment through web-based social networks and research studies. Second, we characterized participants' motivations, concerns, and engagement through project documentation of participant engagement in outreach activities and qualitative analysis of participant communications. We used an inductive qualitative data analysis approach to analyze emails, free-text notes, and other communications generated with participants as part of the ConnectMyVariant intervention. We identified 84 prospective participants using different recruitment mechanisms; 57 participants were ultimately enrolled in the study for varying lengths of time. With respect to motivations for engaging in the intervention, participants were most interested in activities relating to genealogy and communication with others who had their specific variants. Although there was a desire to find others with the same variant and prevent cancer, more participants expressed an interest in learning about their genealogy and family health history, with prevention in relatives considered a natural side effect of outreach. Concerns about participation included whether relatives would be open to communication, how to go about it, and whether others with a specific variant would be motivated to help find common ancestors. We observed that ConnectMyVariant participants engaged in 6 primary activities to identify and communicate with at-risk relatives: sharing family history, family member testing, direct-to-consumer genealogy genetic testing analysis, contacting (distant) relatives, documentary genealogy, and expanding variant groups or outreach. Participants who connected with others who had the same variant were more likely to engage with several extended family outreach activities. This study demonstrated that there is an interest in extended family outreach as a mechanism to improve cascade screening for hereditary cancer prevention. Additional research to systematically evaluate the outcomes of such outreach may be challenging but is warranted.

Home-Based Treatment of Multi-Problem Families (MPF): State of Research and New Results

This article summarizes four studies of process and outcome research on family outreach therapy (ATF) with multi-problem families (MPF). We examined the relationship between different "patterns of of collaboration" and outcome variables in the treatment of MPF. Furthermore, we examined the relationship between childhood adversity factors and protective factors for the development of child psychiatric symptoms, and evaluated catamnesis data (follow-up 3 years). The paper summarizes four naturalistic studies of pre and post values and follow-up data in children aged 4-18 years, participating in an integrative, structural family therapy with (X = 115 sessions in 28.8 months, SD = 19.2). The data n = 1,031 show large effect sizes (ES) (d) (thirteen parameters, mean = 1.04, range 0.34 - 2.18). The outcome values correlate most strongly with the pattern "Improving Alliance", i. e. the improvement of the working alliance in the pre-post comparison (d = 0.64). Empirical studies on childhood adversity and protective factors showed significantly higher stress factors and significantly fewer protective factors in children from MPF compared to the non-clinical sample (95.7 % of children from MPF had a psychopathological diagnosis). The follow-up data showed stable treatment effects (three years of follow-up).The empirical research on the treatment of MPF requires further empirical studies in the sense of the treatment aptitude research on the question "what works for whom?".

Design for a cluster randomized controlled trial to evaluate the effects of the CATCH Healthy Smiles school-based oral health promotion intervention among elementary school children

BackgroundThe top two oral diseases (tooth decay and gum disease) are preventable, yet dental caries is the most common childhood disease with 68% of children entering kindergarten having tooth decay. CATCH Healthy Smiles is a coordinated school health program to prevent cavities for students in kindergarten, 1st, and 2nd grade, and is based on the framework of Coordinated Approach to Child Health (CATCH), an evidence-based coordinated school health program. CATCH has undergone several cluster-randomized controlled trials (CRCT) demonstrating sustainable long-term effectiveness in incorporating the factors surrounding children, in improving eating and physical activity behaviors, and reductions in obesity prevalence among low-income, ethnically diverse children. The aim of this paper is to describe the design of the CATCH Healthy Smiles CRCT to determine the effectiveness of an oral health school-based behavioral intervention in reducing incidence of dental caries among children. MethodsIn this CRCT, 30 schools serving low-income, ethnically-diverse children in greater Houston area are recruited and randomized into intervention and comparison groups. From which, 1020 kindergarten children (n = 510 children from 15 schools for each group) will be recruited and followed through 2nd grade. The intervention consists of four components (classroom curriculum, toothbrushing routine, family outreach, and schoolwide coordinated activities) will be implemented for three years in the intervention schools, whereas the control schools will be offered free trainings and materials to implement a sun safety curriculum in the meantime. Outcome evaluation will be conducted at four time points throughout the study period, each consists of three components: dental assessment, child anthropometric measures, and parent survey. The dental assessment will use International Caries Detection and Assessment System (ICDAS) to measures the primary outcome of this study: incidence of dental caries in primary teeth as measured at the tooth surface level (dfs). The parent self-report survey measures secondary outcomes of this study, such as oral health related behavioral and psychosocial factors. A modified crude caries increment (mCCI) will be used to calculate the primary outcome of the CATCH Healthy Smiles CRCT, and a two-tailed test of the null hypothesis will be conducted to evaluate the intervention effect, while considering between- and within-cluster variances through computing the weighted-average of the mCCI ratios by cluster. ConclusionIf found to be effective, a platform for scalability, sustainability and dissemination of CATCH already exists, and opens a new line of research in school oral health. Clinical trials identifierAt ClinicalTrials.gov - NCT04632667.

Screening and eradication of Helicobacter pylori to prevent gastric cancer in indigenous Taiwanese communities: a population-based study and development of an index-case method

Gastric cancer is one of the leading causes of cancer death, particularly in Asia and South America. Screening and eradication of Helicobacter pylori is recognised as an advantageous solution to reduce the disparities in the incidence of this cancer. However, the deployment of such policies is not yet sufficiently advanced in high-incidence areas. Our study aimed to show the acceptability and feasibility of an index-case method to implement a screening and eradication policy in high-risk populations living in Taiwanese indigenous communities. We did a population-based study with residents aged 20-60 years from 454 tribes across 40 indigenous townships. H pylori infection was documented via the 13C-urea breath test (Hwang's Pharmaceutical, Yunlin, Taiwan). When a participant tested positive for H pylori infection (constituting an index case), family members were invited to attend the screening service. H pylori carriers were referred for a four-drug antibiotic treatment course (lansoprazole 30 mg plus amoxicillin 1 g for the first 7 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg for another 7 days; all drugs given orally twice daily). Those who did not respond to the initial course of antibiotics were retreated with a 10-day treatment that consisted of a bismuth-based four-drug treatment (lansoprazole 30 mg twice daily, bismuth(III) oxide 120 mg four times a day, amoxicillin 500 mg four times a day, and tetracycline 500 mg four times a day; all drugs given orally) or a levofloxacin-based three-drug treatment (lansoprazole 30 mg twice daily, amoxicillin 1 g twice daily, and levofloxacin 500 mg once daily; all drugs given orally). Primary outcomes were the acceptability and feasibility of this screening method, which were evaluated according to the participation rate, test positivity rate, referral-to-treatment rate, and the eradication rate. Analyses were done in the intention-to-treat and per-protocol analyses. The adverse effect during treatment and the reinfection rate two years after treatment were also evaluated. This study is registered with ClinicalTrials.gov, NCT03900910, and is enrolling. Participants were enrolled between Sept 24, 2018, and Dec 31, 2021. The participation rate was 15 057 (80·0%) of 18 821 invitees. 9600 (63·8%) of 15 057 participants were women and 5457 (36·2%) were men, with a median age of 44·5 years (IQR 35·7-53·0). The test positivity rate was 6643 (44·1%) of 15 057 (95% CI 43·3-44·9%). 8852 (58·8%) participants were indigenous Taiwanese and had a positivity rate of 5055 (57·1%). 6205 (41·2%) of 15 057 were non-indigenous and had a positivity rate of 1588 (25·6%). Family members of participants who tested positive (positive index cases) had a 1·98 times (95% CI 1·03-3·80) higher prevalence of H pyloriinfection than the family members of those who tested negative (negative index cases), adjusted for the age, sex, and the social habits. 5493 (82·6%) of 6643 participants who tested positive received antibiotic treatments. The reinfection rate was estimated at 1·79 (95% CI 1·04-3·08) per 100 person-years. According to the intention-to-treat and per-protocol analyses, the eradication rates were 78·5% (95% CI 76·3-80·3%) and 79·5% (77·2-81·7%), respectively, after one course of antibiotic treatment, and 91·7% (CI 89·1-94·3%) and 92·1% (89·2-95·0%), respectively, after two courses of antibiotic treatment. The rate of adverse effects leading to treatment discontinuation was low (66 [1·2%] of 5493 patients [95% CI 0·9-1·5%]). Mass screening and eradication of H pyloriis acceptable and feasible for populations with a high prevalence of H pylori infection and a high incidence rate of gastric cancer, such as people living in the indigenous communities in Taiwan. Expanded programmes based on the index-case method and family outreach can accelerate progress toward the elimination of the health disparities around H pylori-related diseases. Health Promotion Administration, Ministry of Health and Welfare, Taiwan (grant number A1101008).

Individual and community-level factors associated with non-institutional delivery of women of childbearing-age in Nigeria

Maternal health is a major concern in Africa especially due to high level of maternal mortality in the region. A significant cause of high mortality is the unavailability of health facilities and preference for home-based delivery often carried out by unskilled health attendants. Reports reveal that 69% of young women in Nigeria opt for home-based delivery in Nigeria and some of these mothers lose their lives as a result of childbirth complications that are not properly attended to. This trend calls for urgent concern in the nation’s health system. Against this backdrop, this study examined the determinants of non-institutional delivery among women of reproductive age in Nigeria using the country’s National Demographic Health Survey [NDHS] (2018. Demographic health survey data. NPC and ICF, Abuja, Nigeria and Rockville. MD, USA) The data for this study include 12,567 of women of childbearing-age contained in the NDHS data. To analyse the data, the multilevel binary logistic regression was used to examine the determinants of non-institutional delivery among the women of childbearing-age. The results were presented using adjusted odds ratios (AOR) with 95% confidence interval. The result revealed that 56.8% of women preferred to have their children outside health institutions. The findings further revealed that educated women including urban dwellers, women with some level of formal education, high exposure to news media, high level of income and women with significant level of autonomy were less likely to deliver their babies outside health institutions. Based on the findings of the study, that there is the need to expand educational opportunities for Nigerian women, enhance and strengthen advocacy, and utilise focused group discussions, family outreach programmes and peer education to educate mothers on the benefits of using healthcare facilities during childbirth.

Barriers and Facilitators to Pediatric Sickle Cell Specialty Care: An Application of Conceptual Framework of Access to Care Model

Introduction: Routine comprehensive hematological care is critical for children with sickle cell disease (SCD) to prevent or mitigate complications and ensure optimal quality of life. Estimates of children with SCD with missed appointments or lost to care (no visit >1 year) range from 40-65%. Previously identified barriers to care include obstacles framed at the patient and provider levels including: forgetting appointments, competing demands, logistical challenges, health status, dissatisfaction with patient-provider relationships, and adverse clinic experiences. The Conceptual Framework of Access to Care Model proposes that access and engagement in health care involves a complex interaction of health care/systemic and patient/community factors. The purpose of this study was to apply this model to identify barriers and facilitators to SCD specialty care as part of the Dissemination and Implementation of Stroke Prevention Looking at the Care Environment (DISPLACE) project.Methods: Key informant interviews were conducted with a national sample of patient/caregivers as part of the DISPLACE study. DISPLACE is a large, multi-site study designed to examine stroke prevention practices and identify interventions to improve guideline-informed care. Due to the inclusion criteria for DISPLACE, all participants had sickle cell anemia (SCA) or a child with SCA. Participants were identified using purposive sampling with the goal of data saturation. Interviews included questions pertaining to barriers and facilitators to SCD specialty care, were audio recorded, and transcribed. Qualitative data were analyzed using a deductive-inductive approach with the Conceptual Framework of Access to Care Model as an initial coding framework. Themes were developed according to the theoretical model.Results: Themes and frequencies are in tables 1 and 2. Participants were 26 caregivers of children/adolescents with SCA (mean age = 39; 21 mothers, 4 fathers, 1 aunt) and one young adult (age 18, female). At the health care/systems level, participants reported a range of facilitators to care, with most factors focused on positive qualities of care provided by hematologists, clinic staff, and the overall health care system (appropriateness of care). The ability of the health care system to be available and accommodate patient needs (availability and accommodation) with supports to schedule, remember, and attend the visit in a convenient and timely way were also noted. At the patient/community level, family experiences with care impacted their ability to perceive a health care need and seek services (ability to perceive and seek). In addition, community supports, such as transportation and social support, helped families obtain care (ability to reach). Additional facilitators included insurance and work supports (ability to pay) and family engagement with SCD-specific education (ability to engage). Fewer barriers were reported by participants. At the health care/systems level, barriers included negative health care experiences (appropriateness) and complex health care processes and clinic location (availability and accommodation). At the patient/community level, participants reported difficulties reaching care due to transportation problems or competing demands (ability to reach) and insurance challenges (ability to pay).Conclusions: Health care access and engagement is complex and involves multi-level factors. As illustrated by patient perspectives in this study, a range of facilitators at the health care/systems level can promote access and engagement in care. Notably, participants predominantly focused on qualities of the provider and system that positively engaged them in care. At the patient/community level, clinics can provide support to mitigate complex health care processes and social determinants of health that impact care, such as through family navigators, psychosocial supports, transportation resources, and outreach clinics. Limitations included the focus on caregivers, the pediatric setting, and the lack of participants with other subtypes of SCD. In addition, while we attempted to reach participants with a range of health care experiences, our sample likely reflected families who were more adherent. Future work with families lost to care would contribute additional factors that can be targeted to promote consistent specialty care. [Display omitted] DisclosuresAdams: Global Blood Therapeutics: Consultancy, Honoraria. Kanter: Fulcrum Therapeutics, Inc.: Consultancy; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Forma: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Agios: Honoraria, Membership on an entity's Board of Directors or advisory committees; Beam: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees; Graphite Bio: Consultancy; GuidePoint Global: Honoraria; Fulcrum Tx: Consultancy.

Kebutuhan layanan pendidikan khusus di sekolah dasar

There is no real data on students who need special service education in elementary schools for the DKI Jakarta area. This study is interested in identifying and analyzing elementary school students who need special service education. This study will determine the real condition of the prevalence of the number of students in elementary schools who need special education services. The research method used is a quantitative approach. The instrument in this study used questions derived from the variable characteristics and characteristics of children with special needs. We collaborated with 14 elementary schools in the Thousand Islands, DKI Jakarta and the number of respondents in this study was 70 teachers. The data analysis technique was carried out by statistical analysis for quantitative. Therefore, the results obtained from a number of questions were asked to respondents and then transferred to the frequency distribution table. The results showed that the special needs most needed by students with special needs are slow learning, learning difficulties and intellectual disorders. The demand for educational services can increase family outreach efforts with schools through communication according to the types of needs of students. Inclusive school environments are ready to change and adapt and consider the needs of all people. The future research is required for an IQ test to ascertain special needs for intellectual disabilities and learning disabilities.

Concurrent Brainstorming Sessions

Background: Individuals with bipolar disorders (BD) are 5x more likely to be arrested, jailed, or convicted of a criminal offense than those in the general population. BD, in turn, increases risk for adverse outcomes for prisoners post-release, including mood instability, suicide attempts, substance use relapse, and repeat incarceration. Despite these negative sequelae, up to 70% of prisoners with BD do not receive mental health treatment following re-entry. Methods: To address this critical need, we have been piloting the CARE (Community treatment Adherence at Re-Entry) Program, a hybrid in-person/ telephone-based intervention that combines cognitive-behavioral, family, and telephone outreach strategies to promote treatment engagement for prisoners with BD following community re-entry. Results: Prior to the COVID-19 pandemic, we successfully completed an open feasibility trial (N = 12). At the time of the prison lockdown, 11 (out of 40) individuals had been enrolled in the ongoing pilot RCT of CARE vs. TAU, necessitating adjustments to the study protocol so as to safely and ethically retain participants during the pandemic. Other adjustments were made to recruitment and assessment of new participants, given the unique ethical and practical considerations regarding use of telehealth services in the prison setting. Discussion: We will compare and contrast our clinical, operational, and regulatory experiences prior to and during the pandemic, with respect to implementation of this clinical trial to support prisoners with BD around community re-entry.

Development and evaluation of an online, patient-driven, family outreach intervention to facilitate sharing of genetic risk information in families with Lynch syndrome

BackgroundIdentifying at-risk relatives of individuals with genetic conditions facilitates ‘cascade’ genetic testing and cancer prevention. Although current standards of care give mutation-positive (index) patients the responsibility of sharing genetic risk...

SAFER Care: Improving Caregiver Comprehension of Discharge Instructions.

One in five pediatric patients suffers from adverse events related to hospital discharge. Current literature lacks evidence on effective interventions to improve caregiver comprehension (CC) of discharge instructions. We examined if a standardized framework for written and verbal discharge counseling was associated with increased CC of key discharge instructions after discharge from a general pediatric inpatient unit. An interprofessional team created the SAFER Care framework to encourage standard, comprehensive discharge counseling. Plan-do-study-act cycles included electronic health record smartphrases, educational initiatives, data feedback, visual aids, and family outreach. Caregivers were surveyed by phone within 4 days of discharge. Our primary outcome was the proportion of caregivers correctly responding to all questions related to discharge care, comparing pre- and postintervention periods. Data were plotted on a statistical process control chart to assess the effectiveness of interventions. A total of 171 surveys were analyzed in the preintervention period, and 262 surveys were analyzed in the postintervention period. A total of 37% of caregivers correctly responded to all questions in the preintervention period, compared with 62% of caregivers in the postintervention period, meeting rules for special cause variation. Development of the SAFER Care framework and its use in written and verbal discharge counseling was associated with significantly improved CC of discharge instructions in a general pediatric inpatient unit. Further studies should be focused on expanding this to other populations, particularly limited-English-proficiency families.

Conceptual framework for telehealth strategies to increase family involvement in treatment and recovery for youth opioid use disorder.

With opioid use at crisis levels, it is imperative to support youth ages with opioid use disorders (OUD) in taking medication and accessing behavioral services over long periods. This article presents a conceptual framework for telehealth strategies that can be adopted to increase family involvement across a four-stage continuum of youth OUD treatment and recovery: Treatment Preparation, Treatment Initiation, Treatment Stabilization, OUD Recovery. It first identifies provider-delivered tele-interventions that can enhance OUD services in each of the four stages, including family outreach, family engagement, family-focused intervention, and family-focused recovery maintenance. It then introduces several types of direct-to-family tele-supports that can be used to supplement provider-delivered interventions. These include both synchronous tele-supports (remote interactions that occur in real time) such as helplines, peer-to-peer coaching, and online support groups; and asynchronous tele-supports (communications that occur without participants being simultaneously present) such as automated text messaging, self-directed internet-based courses, and digital web support.

Abstract PS8-28: Outreach to families with known BRCA mutation through the reach (research, education, and awareness of cancer family history) registry

Abstract Background: Women with germline mutations in the BRCA1 or BRCA2 (BRCA1/2) genes have a significantly increased lifetime risk of developing breast and ovarian cancers. Since approximately 5-10% of breast and ovarian cancer is due to a hereditary predisposition, identification of a BRCA1/2 mutation has significant implications for early cancer detection, prevention, and cancer treatment options. Additionally, identifying women with a BRCA1/2 mutation allows for targeted, family-based cancer screening and prevention in their at- risk relatives. Any first degree relative (parents, siblings, and children) of an individual identified to carry a BRCA1/2 mutation has a 50% chance of carrying the same mutation. However, little is known if and how genetic test results are conveyed to family members and what they do with this information. UT MD Anderson Cancer Center initiated a project REACH (Research, Education and Awareness of Cancer Family History) that aims to maximize the identification of hereditary breast and ovarian cancer in at-risk family members of individuals identified to have a BRCA1/2 mutation (pathogenic variant or variant of uncertain significance). Here we present the infrastructure and initial feasibility of this prospective initiative. Methods: This study is conducted through the University of Texas MD Anderson Cancer Center’s Women Cancer Moonshot and Clinical Cancer Genetics program at MD Anderson. The probands consists of BRCA1/2 positive triple negative breast cancer (TNBC) patients that underwent universal BRCA testing between 2014-2019 on a preceding Universal BRCA Testing registry (published elsewhere) and BRCA1/2 positive patients that presented to the breast center clinic. Probands are consented for a prospective family outreach protocol (REACH registry) where they give us permission to contact their relatives. The REACH registry includes questionnaires (related to family communication, genetic testing, cancer risk reduction, and surgical choices), optional yearly follow ups, and active outreach to at-risk family members using an innovative information-technology platform and a variety of web-based patient education tools. Results: Since 2014 a total of 122 probands with TNBC and a BRCA germline mutation were enrolled into the REACH registry and of those 92 (75.4%) completed the baseline questionnaire. Of the 62 second year follow up questionnaires sent, 42 (67.8%) were completed. Before pausing study activities in 2017 (due to funding), of the 18 third year follow up questionnaires sent, 5 (27%) were completed. We were able to enroll 38 at-risk family members of TNBC probands into the registry. 31 (81%) of the family members completed the baseline questionnaire. Of the 26 second year follow up questionnaires sent to family members, 17 (65.4%) were completed. Before a pause in study, of the 10 year three questionnaires sent, 7 (70%) were completed. The study restarted in 2019, recruitment, questionnaires and web-based education are on-going. Conclusion: We have shown that it is feasible to develop a practical infrastructure that allows us to continue communication with our proband and to connect with their at-risk relatives to further communicate with them issues related to genetic testing, interpretation, implications and screening. The next phase will include to offer virtual genetic counseling and testing family members. Citation Format: Sierra Green, Meagan Kaulfus, Angelica Gutierrez Barrera, Karen Lu, Banu Arun. Outreach to families with known BRCA mutation through the reach (research, education, and awareness of cancer family history) registry [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-28.

Youth OUD treatment during and after COVID: Increasing family involvement across the services continuum

Telehealth innovations in substance use treatment necessitated by the COVID-19 pandemic present a generational opportunity to increase family involvement in medication for opioid use disorders (MOUD) among youth. This commentary describes a conceptual framework for engaging and retaining youth and families across four stages of MOUD services: Preparation, Initiation, Stabilization, Remission & Recovery. Case vignettes illustrate provider-delivered and direct-to-family tele-interventions for augmenting family involvement in each MOUD stage: Family Outreach, Family Engagement, Family Training, Family Recovery Maintenance.

Supporting family engagement with child and adolescent mental health services: A scoping review

A key challenge facing the mental health field is connecting children and families to services when symptoms first appear. Multiple barriers inhibit timely access to treatment, and interventions to resolve barriers to care are not common among health and social care organisations. To address this research-to-practice gap this study undertook a scoping review of the empirical literature aimed at identifying key factors in the social ecology of families which influence family engagement with child and adolescent mental health services, then identifying and describing models of intervention designed to help facilitate access to care. Forty studies published between 1 January 2000 and 28 February 2019 were reviewed. Key factors associated with child and adolescent mental health service engagement included family attitudes towards mental illness and help seeking, the flexibility and availability of needed services, community attitudes and stigma surrounding mental illness and mental health treatment, and the degree of coordination and integration across systems of health and social care. Models of intervention to facilitate engagement with mental health services included family outreach, telephone and digital health strategies, and integrated care approaches. Empirical support is strongest for family outreach and integrated care, although telephone and digital health strategies are underexplored with children and families and a potentially promising avenue for future research. To support family engagement with child and adolescent mental health services health and social care organisations should be prepared to identify barriers in their local practice settings and integrate efficacious engagement approaches into their continuum of available services.

The Case of Museum in Boxed Egyptian Museum Family and School Outreach Cultural

The Case of Museum in Boxed Egyptian Museum Family and School Outreach Cultural

Family outreach and empowerment program: Health promotion model for medical students.

INTRODUCTION:Providing health promotion and communication learning opportunities for medical students practising their theoretical information into action, addressing the health problems, and trying to find suitable and feasible interventions is very much neededto learn and experience directly about healthrelated behavior in the community. Health promotion practice of PRECEDE-PROCEED model, is used as the foundation of this Family Outreach and Empowerment Program (FOEP). This study aims to implement and evaluate FOEP as an effective health promotion learning model for undergraduate medical students.METHODS:Two hundred and forty-four medical students joined the program for the whole weeks. The reports were evaluated to assess their activities throughout the process. Evaluation was done using the assessment checklists based on PRECEDE-PROCEED framework. Data collected from the assessment will be processed and analyzed using the IBM SPSS Statistics 22 program.RESULTS:Two hundred and forty-four report's has been evaluated, the report's scores in the category very good is 136, good 64, enough 26, bad 12 and very bad 6. The main problem in FOEP is behavior (37,6%) and the most alternate intervention choosen is education (232).DISCUSSION:The most intervention used by students for FOEP was education because it has been proven that can demonstrate feasibility, effectivity, increase knowledge control, and self-efficacy among disease.CONCLUSION:Student's reports was already satisfied.