Family Priorities Research Articles

Changes in value priorities due to the COVID-19 pandemic-A 4-year cross-sectional study with German students.

In March 2020, the WHO declared the coronavirus a pandemic. Since then, the German government has tried to control the spread of the virus with various restrictions. These restrictions had a direct impact on the life of German students. In this study, we investigate to what extent the restrictions led to a change of value priorities of German students. From January 2019 to January 2022, we conducted a cross-sectional study with four measurement points and, in total, 1,328 participants. Two measurement points were before the first outbreak of COVID-19 in Germany, one in the second lockdown phase and the third after two years in the pandemic. In this study, the students were asked to indicate their value priorities while solving a real-world decision problem important to them. Results suggest increased value priorities of the values Intellectual Fulfillment and Environment and Nature and a decrease of Family and Partner value priority as a direct effect of the second lockdown phase. We also found small differences regarding value priorities between the male and female subjects. The data show bounce-back effects as the pandemic became more normal to the students. In the long run, value priorities seem to be stable, with the exception of a longer-lasting increase in Freedom and Independence.

Comparing the autism service needs and priorities of Indigenous and newcomer families in Canada: Qualitative insights

BackgroundIndigenous Peoples and newcomers are two of the largest and fastest growing populations in Canada (Statistics Canada, 2022; Zimonjic, 2022). Yet despite this, little is known about their experiences navigating and accessing autism services for their children. MethodTo address this gap, the current study sought to explore the autism service needs and priorities of Indigenous and newcomer families in Canada. A total of 19 participants (9 Indigenous and 10 newcomer caregivers) were selected using purposive sampling to participate in a semi-structured interview. ResultsThe findings revealed that Indigenous families prioritized the need for services in rural and remote areas, tailored information to their needs, and support preserving their cultural heritage. On the other hand, newcomer families emphasized the importance of peer support, quality standards for services and therapies, and support during transition periods. Similarities across both groups indicated the need for addressing the lengthy waitlists for services, which have also been reported in the general population in Canada, having services and professionals place a greater emphasis on the child’s strengths, and culturally safe services and practice. ConclusionThe present findings have important implications for the design and implementation of services and supports which reflect the needs and priorities of underserved communities.

Aligning Professional Development With Service Coordinator Knowledge and Skills

Service coordinators under Part C of the Individuals With Disabilities Education Act (IDEA, 2004) help families navigate the early intervention (EI) system and ensure regular communication among team members so services are aligned with family priorities and recommended EI practices. To meet the demands of service coordination, personnel entering the EI field who will serve as service coordinators must receive high-quality professional development to orient them to their unique roles and responsibilities. The purpose of this program evaluation was to examine the effectiveness of one state's service coordination training program and its alignment with the Knowledge and Skills for Service Coordinators (KSSC), a resource document in the Division for Early Childhood and IDEA Infant Toddler Coordinators Association (DEC & ITCA) Joint Position Statement: Service Coordination in Early Intervention (2020). Survey results suggested that the training program was associated with increased knowledge and skills for service coordinator participants in many of the KSSC areas. Participants also reported using what they learned in their work with families. The rubric used to evaluate this training program could be a resource for state-level professional development providers to evaluate alignment of current and future training for service coordinators with the KSSC.

Extending Our Understanding of the Social Determinants of Physical Activity and Sedentary Behaviors in Families: A Systems Mapping Approach.

The social environment is important to consider for effective promotion of movement behaviors like increased physical activity (PA) and reduced sedentary behavior (SB); yet, it is less often considered than individual and built environments. One way to advance social environment research is to develop system maps, an innovative, participatory, action-oriented research process that actively engages stakeholders to visualize system structures and explore how systems "work." The purpose of this research was to develop PA and SB system maps of the social environment embedded within the core/nuclear family system. The development process began with a 2-day multicountry, 16-researcher, in-person participatory workshop in August 2023, followed by multiple online follow-up consultations. Attendees contributed to the creation of the maps through shared development of critical determinants and their causal pathways. The structure of the final maps was analyzed using network analysis methods to identify indicators of centrality, and key feedback loops and areas for potential intervention were explored. Key central determinants that were likely critical targets for systems intervention to produce changes in PA and SB and featured prominently in most of the reinforcing and balancing feedback loops included shared family interests, values and priorities, family logistical support, family cohesion/organization, and shared experiences. The maps also highlighted key determinants of the broader social environment external to the family. These system maps support current evidence on movement behaviors in family systems and socioecological theories and have the utility to galvanize future research and policy to promote PA and reduce SB.

"You Just Want to Be Able to Communicate With Your Child": Parents' Perspectives on Communication and AAC Use for Beginning Communicators on the Autism Spectrum.

For young children on the autism spectrum who are beginning communicators, augmentative and alternative communication (AAC) can support language development and participation in meaningful interactions. AAC is more likely to be effective when services align with the needs and priorities of the child's family. To better understand family perspectives, this study investigated the communication and AAC experiences of parents of young beginning communicators on the autism spectrum. The study used a phenomenological qualitative design. Eight caregivers of seven children on the autism spectrum participated in semistructured interviews, and thematic analysis was used to identify themes within the data. Five main themes and 15 subthemes emerged from the data. Parents situated communication and AAC experiences within the context of complex, busy lives. They discussed the value of communication and benefits of AAC, but described numerous challenges related to obtaining, learning, and implementing AAC that evolved over time as needs and skills changed. Parents discussed their children's individuality and the need for AAC systems and services to fit the unique needs of their child and their family. They also emphasized ways in which communication outcomes were affected by factors external to the child and the family, including factors related to professional services and the U.S. health care and educational systems. The results affirm the need to consider the family and the broader social system when providing AAC services to young children on the autism spectrum. Provision of family-centered services is critical to successful AAC. https://doi.org/10.23641/asha.24881562.

EXPERIENCES AND SUPPORTIVE CARE NEEDS OF LATINX MILLENNIAL CAREGIVERS

Abstract Latinx millennial caregivers are the largest ethnic minority subgroup within the millennial caregiving cohort. Due to age and life stage, members of this understudied group must often manage the competing priorities of career, family, and caregiving. Layered with these challenges are the experiences of being part of a minority group in the United States, with systemic barriers impacting access to healthcare, insurance, a safe built environment, and educational opportunities. The purpose of this qualitative descriptive study was to explore the experiences and needs of Latinx millennial caregivers. Participants were recruited locally and nationally using recruitment flyers and social media advertising. Data were collected from 29 participants using five focus group interviews and one individual interview. Data analysis using interpretive thematic analysis and inductive coding occurred. Twenty female and nine male Latinx millennial caregivers participated in the focus groups. Two meta-themes threaded throughout the analysis included the Latinx experience (immigrant background, Latinx culture, and navigating barriers as a minoritized individual) and being a super-caregiver. Main themes were identified: family well-being, occupational and financial well-being, social support dynamics, challenges and rewards of family caregiving, and coping strategies. Family and community were emphasized in all main themes. In this study, the importance of family and community relationships motivated caregiving and were areas where support was needed for Latinx millennial caregivers. Interventions and clinical support for these caregivers is needed that addresses their cultural background, the value of family and community, and the barriers they experience to accessing care and support.

Nurses' beliefs and perceptions regarding family-centered care services in acute pediatric healthcare settings

ObjectivesTo describe pediatrics nurses' beliefs about family-centered services (FCS) as a model of providing healthcare to children in acute care settings in Jordan. Design and methodsThis is a cross-sectional descriptive study. Nurses who provide direct acute care to children (n = 246) completed the ‘Measure of Beliefs about Participation in Family-Centered Service’ questionnaire. Descriptive statistics were used to describe nurses' beliefs about participation, practical feasibility, implementation self-efficacy, principles, and potential adverse outcomes of FCS. ResultsMany nurses feel confident (70%) about their ability to work with others in providing FCS and perceive having the ability to operate according to family-centered care (FCC) principles (68%). Many (75%) nurses believed parents should be encouraged to decide how much they want to be involved in the child's care. However, only 46% of the nurses valued attending to family priorities if the health decisions made by the family differed from the healthcare providers' priorities. Many nurses (70%) believed that healthcare professionals' competencies and capacities to work utilizing FCC are more important than their personal preferences and opinion. ConclusionsThe findings of this study clearly indicate that nurses positively viewed providing children's care within a FCS. This supports the efforts to reasonably integrate FCC as an operating model in the pediatric healthcare settings in Jordan. Practice implicationsFCS is a complex task requiring integrating multidisciplinary effort and healthcare providers' positive attitudes toward families as care partners. Steps should help maximize the organizational resources to facilitate family presence and create opportunities for professional-families partnerships for children's care.

Centering family voice during a public health crisis: Challenge and opportunity for health collaborations and community systems of care.

Evidence is lacking about how to integrate family and community voice into systems of care. This is particularly relevant in public health crises when reducing barriers to health care and resources is critical for everyone, but especially community members who typically experience more barriers to care. Addressing this gap, this study investigated the voice strategies used by systems of care to respond to the COVID-19 pandemic. We conducted semi-structured interviews in three U.S. counties with agency leaders representing healthcare, public health, and early childhood partners in local systems of care (n = 15) and resource navigators who worked with families (n = 4). We found that systems of care were better able to identify and respond to family priorities when they used diverse voice strategies, implemented among multiple agencies involved and at multiple time points. Family and community voice helped uncover blind spots in the crisis response, facilitating reaching more individuals in need. Flexibility in safety net service policies and protocols was critical to each organization in the system of care. Systems of care that develop a multi-dimensional approach to voice strategies that can be readily mobilized in a public health crisis will be more apt to meet emerging needs. Questions remain about whether power sharing that occurred in the context of crisis translates into reform that builds out from family priorities. Common issues to meeting family needs that could be addressed prior to a crisis included outdated resource lists, confusing application processes, poorly translated materials, and insufficient broadband access. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Safe, Social, and Engaged: Clinician perspectives on good institution‐free days for people with dementia

AbstractBackgroundComposite measures of survival and residence, such as institution‐free days (IFDs), encompass many patient and family priorities and are readily measured using payer claims or electronic health record data. However, knowledge gaps limit their application to studies of people with dementia (PWD). First, PWD, family care partners, and clinician perspectives on survival‐residence composite outcomes are unknown. Second, approaches to measuring IFDs consider all institution days equally poor and all home days equally well, which may be inconsistent with stakeholder assessments.MethodWe conducted a qualitative study to explore stakeholders’ perspectives on what makes a “good day” for a PWD. This included semi‐structured interviews with clinicians who provide care to PWD. Clinicians were also asked for their opinions regarding the use of survival‐residence composite outcomes in dementia research. Interviews were audio‐recorded and professionally transcribed. De‐identified transcripts were reviewed by the research team independently and during weekly consensus meetings to identify relevant themes.ResultThematic saturation was reached after 24 interviews. Nearly half of clinicians also had personal experience as a care partner of a PWD. Participant characteristics are summarized in Table 1. Salient themes were identified and grouped into 2 major categories: (1) attributes of quality of days for PWD, and (2) impressions of survival‐residence composite outcomes (Table 2). Key attributes of quality of days were safety, socialization and engagement, and neuropsychiatric distress. These qualities were more important in defining “home” than type of residence (Figure). Clinicians appreciated that a survival‐residence composite outcome, such as IFDs, could capture the important aspects of “aging in place” and avoiding burdensome hospitalizations. They also noted a desire for such a measure to capture the quality of those days. Concerns were raised over how differential access to home‐based services due to socioeconomic factors would influence patient accrual of IFDs and whether such a measure might also increase existing stigma around institutions.ConclusionFuture work will integrate these findings with the perspectives of PWD and their family care partners as well as further explore the relative values of these attributes of a survival‐residence composite outcome for studies of patients with ADRD.

Innovative postures in a family business: Family priorities driving resource (re)configuration

Innovative postures in a family business: Family priorities driving resource (re)configuration

Building the Bridge From Pediatric to Adult Neurological Care.

In this brief communication, we discuss the current landscape and unmet needs of pediatric to adult transition care in neurology. Optimizing transition care is a priority for patients, families, and providers with growing discussion in neurology. We also introduce the activities of the University of Toronto Pediatric-Adult Transition Working Group - a collaborative interdivisional and inter-subspeciality group of faculty, advanced-practice providers, trainees, and patient-family advisors pursuing collaboration with patients, families, and universities from across Canada. We envision that these efforts will result in a national neurology transition strategy that will inform designation of health authority attention and funding.

Unraveling Virtual Threads: The Impact of Social Media Engagement on Family Dynamics and Real-Life Relationships

Virtual communication through social networking sites: Instagram, Facebook, Twitter, WhatsApp, Snapchat, LinkedIn, Pinterest, Gaming Sites, and YouTube is the key characteristic of contemporary lifestyles, relationships, and interactions of young adults with friends and family (Bhowmick & Madhu,2020). Its spread has raised concerns in Pakistan, a multi-lingual and multi-ethnic Muslim country, with conventional, family-orientated social frameworks based mostly on joint and extended systems. Online over-engagement though is increasing awareness, it is reducing real communication between parents and their (young) adults in urban Pakistan that the society considers essential for propagation of family norms, traditions, and values (Woodward, 2020). It has compromised real family time and inter-family social networking by involving individuals in the virtual world. They are physically present with their families but they are mentally engaged with their mobile phones (Kanwal, Pitafi, Akhtar, and Irfan, 2019). This research explores the multifaceted impact of virtual engagement with social networking sites on patterns of open communication within families. The study aims to investigate the influence of virtual engagement on real-life priorities and connections, proposing hypotheses that posit significant correlations between online identity maintenance and decreases in family social interaction and bonding. Utilizing a quantitative approach, the research employs a survey method with standardized questions to collect data from 800 participants. The data is analyzed using the Statistical Package for Social Sciences (SPSS) version 26, revealing key demographic information and social media usage patterns. Linear regression analyses support the hypotheses, demonstrating a significant relationship between time spent on social media and reduced family interaction and bonding, as well as its impact on family relations and priorities. The findings suggest that excessive engagement in sustaining online identities negatively influences real-life relationships, emphasizing the need to address the growing trend of social media dependency in familial contexts. The findings serve as a guide for the strategists who may plan to sustain social values and good relations between parents and their (young) adults in what they are perceiving as digital Pakistan of the future.

54 Preterm Parents Identified Meaningful Outcomes: Involving Parents in Implementing Change

Abstract Background The Canadian Neonatal Follow-Up Network (CNFUN) reports on neurodevelopmental impairments (NDI) in the very preterm population but has never asked parents which outcomes and definitions are meaningful to them. The Parent Voices group conducted four studies which showed differences between parents and CNFUN perspectives on definitions, severity, composite outcomes, which outcomes, and the need to report positive as well as adverse outcomes. Disseminating and implementing change based on these results is the next essential step. Objectives To create consensus statements to guide evidence-based change. Design/Methods Using a modified Delphi method, Parent Voices results were reviewed and discussed with parents, clinicians and researchers in a virtual workshop in Oct 2021. The discussion was analyzed qualitatively to create statements, circulated for feedback, and 80% consensus statements identified by electronic polling. Priority items requiring further work were identified, working groups created, and results presented at a Sept 2022 workshop. Results In the 2021 workshop, 17 consensus statements were identified (7 from the Parent Voices results, 5 from the discussion, and 5 were out of scope). Actionable statements (n=11, Table 1) and items needing further work (n=6, Table 2) were identified and progress was made (Tables 1 and 2). To identify how to measure 7 outcomes which parents and stakeholders identified as important (child well-being, quality of life, socioemotional and behavioural, respiratory, feeding, sleeping, and caregiver well-being), working groups reviewed literature and made recommendations for minimal dataset and funded research at a virtual presentation with parent, clinicians, and researchers in Sept 2022. In the summer of 2022, the Canadian Premature Babies Foundation (CPBF), Parent-EPIQ team members and summer students disseminated the Parent Voices results to lay stakeholder groups via CPBF blogs and webinars. They also pursued a project identified in the 2021 workshop to educate parents about the role of Neonatal Follow-Up Programs using infographics and information sheets. Conclusion We have successfully collaborated with parent partners to implement the actionable results from our Parent Voices Project, and have a process to implement change when further work is required. Involving parents in research, knowledge dissemination and implementation can lead to changes that accurately represent the priorities of families.

Comparing Pediatric Surgeons' and Palliative Care Pediatricians’ Palliative Care Practices and Perspectives in Pediatric Surgical Patients

PurposeThe nature of interactions between surgical and pediatric palliative care (PPC) teams caring for seriously ill children is unknown. This study compares pediatric surgeons' and PPC physicians’ perspectives and practices regarding PPC in surgical patients. MethodsA survey was administered to members of the American Pediatric Surgical Association and Pediatric Interest Group of the American Academy of Hospice and Palliative Medicine. ResultsOne hundred twenty-four pediatric surgeons (31% female, 17.2 mean years of experience) and 71 PPC physicians (69% female, 10.1 mean years of experience) participated. Forty-three percent of surgeons reported consulting PPC often for children with serious illnesses. However, most PPC physicians (67%), said they are rarely/never consulted by surgeons (p = 0.002). PPC physicians were more likely to report that PPC involvement was too late (43% vs 21%, p = 0.005). More surgeons than PPC physicians felt that an appropriate time for PPC consultation was during serious illness deterioration (30% vs 7%, p = 0.05), whereas PPC physicians preferred consultation at diagnosis (54% vs 34%, p = 0.05). More PPC physicians (67%) than surgeons (17%) agreed that invasive interventions could be considered a form of PPC (p = 0.002). The most reported barrier to PPC consultation by surgeons (29%) was concern that parents would think the surgical team was giving up. PPC physicians were more likely to perceive barriers to consultation by surgeons than surgeons themselves (p < 0.001). ConclusionWhile pediatric surgeons value PPC involvement, surgical culture and misperception of parental resistance to PPC involvement lead to palliative care consultation only when illness acuity and severity are high, the possibility of curability is low, and death seems imminent. Seeking to understand patient and family priorities in care, managing patient and parental psychological distress, and treating non-surgical symptoms are areas where PPC can improve patient care. Barriers to PPC use and self-reported knowledge gaps in PPC provision may be mitigated by formalized PPC training for surgeons and intentional collaboration between the two groups. Type of StudySurvey. Level of EvidenceN/A.

Collaborative working in speech and language therapy for children with DLD-What are parents' needs?

Collaborative practice between therapists and parents is a key element of family-centred care and is essential if we want to address family priorities and needs in interventions. However, collaborative practice is challenging for speech and language therapists (SLTs) and parents. To facilitate collaboration, collaborative practices need to be implemented into speech and language therapy for young children with developmental language disorders (DLD) and their families. Actual change and implementation of collaboration in practice will be successful only when it corresponds with patients' needs, in our case the needs of parents of young children with DLD. To explore parents' needs in their collaboration with SLTs during therapy for their young child with DLD. Parents of children with (a risk of) DLD in the age of 2-6 years were eligible for participation. We recruited parents via SLTs. Twelve parents of children with DLD participated in semi-structured interviews about their needs in collaboration with SLTs. We used a phenomenological approach focusing on parents' lived experiences. We transcribed the interviews verbatim. All interviews were read/listened to and discussed by our parent panel, multiple researchers and the interviewer. Two researchers independently analysed the data using the reflective thematic analysis of Braun and Clarke. The analysis of the interviews resulted in six themes: (1) knowing what to expect, (2) knowing how to contribute, (3) feeling capable of supporting the child, (4) trusting the therapist, (5) alignment with parents and children's needs, preferences and priorities and (6) time and space for asking questions and sharing information. Parents want SLTs to invest time in collaborating with them. Parents need SLTs to empower them to become a collaborative partner and enable them to support their child in daily life. Parents need knowledge about the therapy process and diagnosis and skills in how to support their child's language development. Also, they need emotional support to feel secure enough to support their child, to ask questions to therapists and to bring up their own thoughts and opinions in therapy. Parents' needs are in line with collaborative working as described in literature, which underlines the importance of implementing collaborative working in speech and language therapy for young children with DLD. What is already known on the subject Several reviews have explored parents' perspectives on speech and language therapy. Results reveal parents' experiences with speech and language therapy in general, and parents' perspectives on specific topics such as shared decision-making and parents/therapists roles in therapy. What this study adds This study adds insights into parents' needs to ensure collaboration with speech and language therapists (SLTs). Parents of young children with developmental language disorders (DLD) need SLTs to invest time to create optimal collaboration. It is important for parents to have enough knowledge about DLD and the SLT process, skills and confidence in how to support their child and opportunities to share thoughts and questions with SLTs. Our results underline the importance of parents being empowered by SLTs to become a collaborative partner. What are the clinical implications of this work? When children are referred to speech and language therapy, parents often venture into an unknown journey. They need support from SLTs to become a collaborative partner in speech and language therapy. Parents need SLTs to invest time in sharing knowledge, skills and power and align therapy to parents' and child's needs, preferences, priorities and expectations.

Understanding priorities of care: An assessment of FAMCARE-2 satisfaction surveys and thematic analysis in community palliative care

Background The palliative care sector currently faces cumulative challenges and finite resources to meet population needs. To optimise the effectiveness and efficiency of palliative care services, it is necessary to understand care needs and aspects prioritised by patients and families. Deepening our understanding of their experience and preferences will direct the sector’s limited resources toward achieving optimal care in the place of choice. Aim To assesses patient and carer satisfaction of a community palliative care service and to identify common themes that impact the experience of care, and the aspects of care that are important to them. Method A single-centre, prospective study exploring patient and carer satisfaction of two cohorts (patients receiving standard palliative care, or additional and intensive care support) via the Bupa Palliative Care Choices (BPCC) programme. A tool specifically designed to measure satisfaction with palliative care was utilised. Survey comments in the BPCC cohort were analysed thematically. Results Survey response rate was 35% and satisfaction results across all domains were high in both cohorts (very satisfied/satisfied >90%). Thematic analysis of comments identified priorities of care being emotional support for the patient and family, availability of the palliative care team, a focus on patient dignity, and provision of information relating to the patient’s condition and illness trajectory. Conclusion This study provides insights into patient and family priorities of care and identifies areas of need as emotional support, availability of and access to 24-hour care, respecting patient’s dignity, and transparent discussions regarding the patient’s condition and illness trajectory.

Diversified caregiver input to upgrade the Young Children’s Participation and Environment Measure for equitable pediatric re/habilitation practice

BackgroundPractitioner and family experiences of pediatric re/habilitation can be inequitable. The Young Children’s Participation and Environment Measure (YC-PEM) is an evidence-based and promising electronic patient-reported outcome measure that was designed with and for caregivers for research and practice. This study examined historically minoritized caregivers’ responses to revised YC-PEM content modifications and their perspectives on core intelligent virtual agent functionality needed to improve its reach for equitable service design.MethodsCaregivers were recruited during a routine early intervention (EI) service visit and met five inclusion criteria: (1) were 18 + years old; (2) identified as the parent or legal guardian of a child 0–3 years old enrolled in EI services for 3 + months; (3) read, wrote, and spoke English; (4) had Internet and telephone access; and (5) identified as a parent or legal guardian of a Black, non-Hispanic child or as publicly insured. Three rounds of semi-structured cognitive interviews (55–90 min each) used videoconferencing to gather caregiver feedback on their responses to select content modifications while completing YC-PEM, and their ideas for core intelligent virtual agent functionality. Interviews were transcribed verbatim, cross-checked for accuracy, and deductively and inductively content analyzed by multiple staff in three rounds.ResultsEight Black, non-Hispanic caregivers from a single urban EI catchment and with diverse income levels (Mdn = $15,001–20,000) were enrolled, with children (M = 21.2 months, SD = 7.73) enrolled in EI. Caregivers proposed three ways to improve comprehension (clarify item wording, remove or simplify terms, add item examples). Environmental item edits prompted caregivers to share how they relate and respond to experiences with interpersonal and institutional discrimination impacting participation. Caregivers characterized three core functions of a virtual agent to strengthen YC-PEM navigation (read question aloud, visual and verbal prompts, more examples and/or definitions).ConclusionsResults indicate four ways that YC-PEM content will be modified to strengthen how providers screen for unmet participation needs and determinants to design pediatric re/habilitation services that are responsive to family priorities. Results also motivate the need for user-centered design of an intelligent virtual agent to strengthen user navigation, prior to undertaking a community-based pragmatic trial of its implementation for equitable practice.

The Triple P System of Evidence-Based Parenting Support: Past, Present, and Future Directions

Triple P is an integrated, multi-level system of evidence-based parenting support designed to promote the well-being of children and families to reduce prevalence rates of social, emotional, and behavioral problems in children and adolescents and to prevent child maltreatment. The system developed gradually over four decades to address the complex needs of parents and children from diverse family, socioeconomic and cultural backgrounds. It blends universal and targeted programs, a focus on developing parental self-regulation capabilities, and adopts a life span perspective with a population health framework. The Triple P system is used as a case example to discuss the past, present and future challenges, and opportunities involved in developing, evaluating, adapting, scaling and maintaining a sustainable system of evidence-based parenting intervention. Seven stages of program development are outlined from initial theory building and development of the core parenting program through to the sustained deployment of the intervention system delivered at scale. The importance of ongoing research and evaluation is highlighted so that different programs within the system evolve and adapt to address the contemporary concerns and priorities of families in diverse cultural contexts. A well-trained workforce is essential to deliver evidence-based programs, in a need-responsive manner that blends both fidelity of delivery and flexibility and is tailored to respond to the needs of individual families and local context. Programs need to be gender-sensitive, culturally informed, and attuned to the local context including relevant policies, resources, cultural factors, funding, workforce availability and their capacity to implement programs.

The Effect of Career- Family Priorities on Life Stress and Job Involvement Service

This study aimed to investigate how career-family objectives affect life stress, job engagement, service efficacy, and career prospects. This study used Quantitative Exploratory Research method. Using self-administrative survey - as the main method of data gathering - was used to gather data from employees currently serving in private sector organizations in Pakistan. The findings determined that Career-Family priorities are essential for accomplishing strategic objectives. To reduce stress in the workplace by ensuring that employees are happy with their employment and have a pleasant atmosphere to work in. To keep employees, the company should offer those benefits and compensation that are competitive. Additionally, the Supervisor's upbeat demeanour is crucial. The majority of the time, irrelevant job duties create barriers for priorities related to career and family. Designing appropriate and pertinent job involvement is the main task of HRM. Organizations that have healthy internal politics are better able to retain employees over the long run.

Navigating STEM Major and Transfer Destination Choices: Community College Student Experiences through the Lens of Practice Theory

Objective/Research Question: This research explores how community college students, who are underrepresented in science, technology, engineering, and mathematics (STEM) fields and aspire to vertical transfer in STEM make choices about majors and transfer destinations. The question is important to advancing equity in STEM, which continues to perpetuate disparities in attainment for minoritized, first-generation, and financially disadvantaged students, who disproportionately enter higher education in community colleges. Methods: Using a longitudinal, qualitative research design, the study relied on semi-structured interviewing to generate in-depth evidence about student experiences. Results: Findings showed that career goals were uniformly influential to students, yet career information was unevenly available or comprehensible during community college. Students’ choices about what to major in and where to transfer were iterative and intertwined, with these choices deeply connected to students’ families and lifetime priorities. Delays in student decision-making tended to have less to do with uncertain individual preferences than to lack of information about a specific STEM major and its alignment with possible future degrees, transfer destinations, and career pathways, as well as contingencies associated with the transfer admission process. Conclusions/Contributions: This research demonstrated STEM-specific nuance in how underrepresented community college students navigate major, career, and transfer destination decision-making as well as the influence of family and location-based priorities in student choices. Future research should investigate how to best provide directional support for students’ major and transfer destination decisions, including major-to-career awareness and the academic and personal dimensions of transfer.