Family Support Services Research Articles

Participation in the Missouri Parents as Teachers Parent Education Program and third grade math and English language arts proficiency

The Missouri Parents as Teachers (PAT) Parent Education Program is a voluntary and universal home visiting program available to all Missouri families who are expecting a child or who have a child ages birth to kindergarten entry. Families participating in the Missouri PAT Parent Education Program receive a variety of family support services, including family personal visits with trained parent educators to develop parent practices and child school readiness. Research indicates that home visiting components of parent education programs support child academic outcomes. However, studies have not extensively examined how variation in participation, including the developmental period of exposure—the child's age upon entry and duration of participation—and number and frequency of home/family visits, is associated with child outcomes. In this study, we used linear probability regression to examine associations between variation in participation in the Missouri PAT Parent Education Program and child third grade proficiency in math and English language arts (ELA) (n = 9777), while controlling for relevant child, parent, family, and school-level factors. We also tested the potential moderating role of family low-income status at enrollment into the program. We found that the number of family personal visits was positively associated with third-grade math and ELA proficiency, whereas no significant findings emerged for developmental period of program exposure. Our findings indicate that increased exposure to the Missouri PAT Parent Education Program was positively associated with third-grade academic achievement for all children, including those from low-income families.

Barriers and facilitators of transition of adolescents living with HIV into adult care in under-resourced settings of Southern Ethiopia: a qualitative study

BackgroundAdolescence is commonly perceived as a distinct and typically healthy stage of life. However, in regions with a high prevalence of HIV, like Ethiopia, numerous adolescents are contracting the virus. Upon testing and diagnosis, they encounter care-related issues, particularly barriers and facilitators of the healthcare transition from adolescent to adult clinics. Hence, the study aimed to investigate the barriers and facilitators influencing the transition of adolescents living with HIV (ALWHs) in the resource-limited settings of Southern Ethiopia.MethodsThe research employed a phenomenological study design with a qualitative methodology. Purposive sampling was used to gather data through in-depth interviews (IDIs) and focus group discussions (FDGs) involving ALWHs and their parents. The data analysis followed Van Manen’s principles.ResultsFollowing Van Manen’s guidelines, the data analysis revealed a conceptual framework with two major themes: “Barriers” and “Facilitators”. The theme barrier was derived from three sub-themes including behavioral barriers, social barriers, and system barriers in the transition. The theme facilitator was derived from four sub-themes including self-acceptance as an adult, a desire to experience new things, a supportive family, and friendly healthcare services. The study identified three levels of factors influencing the transition into adult clinics: individual, family/peer, and healthcare-related factors. The barriers to transition included lack of knowledge, being in a romantic relationship, psychosocial struggles, perceiving us as immature, stigma, negative peer pressure, lack of timely disclosure, absence of transition guidelines, disrespectful treatment, and absence of separate clinics. On the other hand, facilitators such as self-acceptance as an adult, desire for new experiences, family support, informed support and promising outcomes, flexible appointment scheduling, and psycho-social support groups were found to improve the transition process and enhance the overall well-being of adolescents living with HIV.ConclusionThe study highlights the complex transition process for ALWHs into adult healthcare. Barriers such as lack of knowledge, stigma, and disrespectful treatment pose challenges during this critical period. Conversely, facilitators like self-acceptance, family support, and youth-friendly healthcare services can enhance the transition experience and well-being of ALWHs. Collaborative efforts among ALWHs, families, and healthcare providers are crucial for successful transitions and improved health outcomes. Separated clinics catering to the unique needs of ALWHs are recommended to address privacy concerns.

A scoping review of early childhood support for Aboriginal and Torres Strait Islander children living with a disability in regional, rural and remote settings.

Many experts and communities have concerns about how National Disability Insurance Scheme services are provided to Aboriginal and Torres Strait children. This study was undertaken at the request of the NPY Women's Council in partnership with the researchers, to explore supports for Aboriginal and Torres Strait Islander children living with a disability in their remote areas. This scoping review aims to (a) explore the barriers and enablers to accessing disability support services for families of young Aboriginal and Torres Strait Islander children (0-8 years) living in regional, rural and remote settings, and (b) summarise best practice approaches for accessing support for young children in these settings. The search was run in three electronic databases, as well as grey literature sources. We assessed the quality of included publications using the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. A narrative synthesis was supported by thematic analysis. From an initial search (557 citations), we identified 13 eligible documents. Most documents were peer-reviewed articles of qualitative studies. Key themes identified included the following: (1) Holistic approach, (2) Understanding disability, (3) Consistent relationships, (4), Flexibility, (5) Simplify system and (6) Enhance communication. This scoping review has revealed gaps in the provision of quality, culturally responsive disability services for families of Aboriginal and Torres Strait Islander children living in regional, rural and remote areas of Australia. A family-centred, flexible approach will help address their needs. Future research is required to design and evaluate models of care for Aboriginal and Torres Strait Islander children.

Exploring the Experiences of Children in Kinship Care in Scotland: A Sequence Analysis of Care Journeys, Characteristics and Outcomes

Objective and ApproachAn increasing proportion of children in care in Scotland are formally living with extended family or friends – known as kinship care. To gain an enhanced understanding of experiences within kinship care, sequence analysis methods were applied to determine distinct patterns in care journeys throughout their first 5 years in care. Through linkage to education and health data, associations between these distinct types of care journey and children’s characteristics and outcomes were assessed. ResultsUsing a sample of 2987 children born between 2008 and 2014 who had experienced kinship care, we identified four ‘typical’ care journeys which best describe their experiences in terms of the type, number and duration of care placements. Our analysis found that children who entered care as infants were more likely to experience short-term kinship care, while those with a disability were more likely to spend extended periods in foster care than kinship care. Those living mainly in kinship care had poorer educational outcomes than those living mainly in foster care. ConclusionsSequence analysis can provide a more holistic view of children’s experiences over time than annual ‘snapshot’ data. The approach enabled us to identify different types of care journey, the characteristics of children who may be likely to have these experiences, and what their outcomes may be. ImplicationsThese findings have implications for the commissioning and design of support services for families who experience kinship care, and highlight the importance of consistent, long-term data collection to facilitate longitudinal analysis.

Measuring accumulation: Constructing a tool for evaluating cumulative harm in children engaged with an intensive family support service

AbstractThere is a significant body of research that attests to the deleterious impact of an accumulation of adverse childhood experience across the lifespan, which provides a strong rationale for the development of a means for evaluating this accumulation in a high‐risk population. We developed a theory‐driven measure, the Cumulative Experiences Index, and conducted a pilot study to test its utility. The Cumulative Experiences Index derives a cumulative harm score that can be used to inform intervention and prevention strategies, programmes and initiatives across all tiers of public health prevention intervention. The Cumulative Experiences Index was piloted with 50 participants aged 8–17 years old who were actively engaged with an Intensive Family Support service. The study explores whether cases rated as low, medium or high severity on the Cumulative Experiences Index corresponded with severity ratings on the three measures of concurrent validity: the Strengths and Difficulties Questionnaire, Kessler‐10 and Children's Revised Impact of Events Scale. The Index provides a valid and accurate means of reflecting the interconnectedness and complexity of exposure to different forms of harm that accumulates over time. Practitioners and researchers will benefit from using the Cumulative Experiences Index—a new valid and reliable measure of cumulative harm.

Effects of an Inclusive Childcare Capacity Building Program on In-service Teachers’ Teaching Efficacy and Attitudes towards Inclusion

An inclusive childcare capacity building program was designed to enhance teacher efficacy and attitudes toward the inclusion of childcare teachers. A total of 36 teachers working in childcare facilities in Gyeonggi-do participated in this study. Nineteen teachers were assigned to the treatment condition and 17 teachers were assigned to the control condition. The program explicitly addressed 15 topics, including screening and diagnosis, early development, characteristics of disability, family support and related services, IEP, and online site observation. The program was primarily delivered by field professionals using adult learning techniques such as small group activities, reflective journal writings, and online consultation. Teachers in the treatment group outperformed teachers in the control group on three measures of teacher efficacy, teacher play efficacy, and attitudes toward inclusion. The results were statistically significant. The increase in teacher efficacy, play efficacy, and attitudes toward inclusion of teachers was attributed to the well-designed program, encompassing early development, disability characteristics, small group discussions, and online support. The results highlight the importance of providing and disseminating a capacity building program for in-service teachers.

Linkage of administrative family court care proceedings and hospital records for mothers in England: linkage accuracy and cumulative incidence of family court care proceedings after a first live birth

IntroductionLinkage of public law family court care proceedings (CP) data to all women giving birth in NHS hospitals in England allows calculation of the cumulative incidence of CP involvement for mothers with first children born. ObjectivesTo assess linkage accuracy and determine the 10-year cumulative incidence of CP after a first live birth (FLB) for population subgroups. MethodNHS England linked records for mothers in Cafcass (Children and Family Court Advisory and Support Service) involved in CP (2007-2021) to all mothers with a delivery in England using Hospital Episode Statistics (HES: 1997-21). We calculated match rates and assessed indirect evidence of potential false positive and missed links. We used survival analyses to estimate cumulative incidence of CP within 10 years overall and for five-year maternal age groups at first live birth. ResultsOf 120,937 mothers involved in CP, 6.6% (n = 8,010) were excluded due to missing postcode or date of birth, or age < 15 or > 50. Of the remaining 112,927 mothers, 92,891 (82.8%) were linked to a HES delivery record. Match rates were lowest for mothers with an ethnic minority background, older at first case, or residing in Greater London, but improved over time. Of 3,572,737 mothers with a FLB, 38,462 had CP involvement. The cumulative incidence of CP at 10 years from FLB was 1.31% (95% Confidence Interval [CI]; 1.29-1.32) overall and highest in mothers aged 15--19 years (6.79%, 95% CI: 6.69-6.89) and those living in the most deprived areas (2.47%, 95% CI: 2.43-2.51). ConclusionOne in 77 of all mothers and one in 15 aged less than 20 at first live birth were involved in CP within 10 years. Linkage error may underestimate the incidence of CP for mothers in London or with an ethnic minority background.

Addressing gaps and enhancing experiences in support services for families of pediatric cancer survivors.

Childhood cancer's enduring challenges extend beyond primary therapy. Diverse medical and psychosocial services are available to assist families in follow-up care. This interview study sought to gain a thorough understanding of family motives, satisfaction levels, and barriers to utilization. The design of this cross-sectional study involves a qualitative content analysis of semi-structured interviews. We interviewed parents of minor cancer survivors within the first 5 years after primary treatment. Survivors readily accessed medical support services when necessary. While parents expressed overall satisfaction with the available services, there was a notable gap in their knowledge regarding appropriate psychosocial and family-orientated services. Barriers to access included geographical distances, time constraints, and the absence of childcare options. There are familial challenges and burdens that fall outside the scope of conventional care services. Tailoring services to family-centered needs, providing more information and easier access to interventions might help to reduce barriers. Existing need notwithstanding, families did not frequently utilize psychosocial services as they did medical ones. Identified barriers included lack of awareness, limited availability, long distances, and scheduling conflicts. While many studies primarily focus on adult patients or young adults, the present study examines the gaps and strengths in follow-up care for pediatric cancer survivors and their families. By acknowledging and addressing the unique challenges and strengths of families with pediatric cancer survivors, we can lead to a more tailored and effective follow-up approach that can enhance their overall well-being by minimizing barriers and providing targeted support.

가족이 경험하는 어려움에 대한 가족의 대처방법과 가족서비스 인식

This study delved into coping mechanisms individuals employ to navigate familial difficulties, their perspectives on the need for family support services from local communities and public institutions, and the factors hindering their utilization. The study surveyed a sample of 1,500 adults aged 20-69 years and residing in South Korea. Descriptive statistics, cross-tabulation, t-tests, and one-way ANOVA were conducted using SPSS 26. The results indicated that individuals primarily relied on personal coping mechanisms when dealing with difficulties. Second, there was widespread recognition of the need for support in areas such as childcare and family care. Third, ‘lack of awareness of family services’ was identified as the primary obstacle to accessing such services. Understanding the demographics and needs of potential users could aid the development of promotional and programmatic strategies to enhance the accessibility of family services.

Demographic Factors and Perceived Social Support as Predictors of Burden of Care among Family Caregivers of Children Living With HIV in Akwa Ibom State

The burden of care among caregivers has emerged as a significant public health concern. This study investigated demographic factors and perceived social support as predictors of the burden of care among family caregivers of children living with HIV (CLHIV) in Akwa Ibom State. Fifty-seven participants, comprising 6 males (10.53%) and 51 females (89.47%), were purposively selected from rural family caregivers receiving family support services from selected Non-Governmental Organisations (NGOs) in Akwa Ibom State. A cross-sectional survey design was employed, utilizing the Perceived Social Support Scale and the Burden of Care Scale for data collection. Descriptive statistics and multiple regression were used for data analysis. Results indicated that age significantly predicted the burden of care among family caregivers of CLHIV (β = .322; t = 2.50, P < .05). However, caregivers' education (β = .031; t = .235; P > .05) and relationship with the care recipient (β = -.077; t = -0.58; P > .05) did not predict the burden of care. Notably, perceived social support independently predicted the burden of care (β = .292; t = 2.29; P < .05). Furthermore, a significant joint prediction of demographic factors and perceived social support on the burden of care of family caregivers of CLHIV was found (F = (6,56) = 2.82; P < .05). The findings highlight the need for targeted interventions and support programs that address caregivers' needs, particularly in terms of social support networks, to alleviate the burden associated with caring for children living with HIV.

Psychosocial Experiences of Spanish-Speaking Parents of Children With Craniofacial Microsomia.

Craniofacial microsomia (CFM) and microtia psychosocial research in the US is primarily with English-speaking participants. Given that 19% of the US is Latino, and there is a higher prevalence of CFM in Latino populations, this study aims to describe psychosocial experiences related to CFM among Spanish-speaking Latino caregivers to better inform health care. Narrative interviews (mean 73±17min) were completed in Spanish with parents of children with CFM aged 3 to 17 (mean age 10.8±4.8years). Transcripts were analyzed using quantitative linguistic analyses and reflexive thematic analysis. Participants (N=12) were mostly mothers (83%) who had immigrated to the US and had low socioeconomic status. Based upon analysis of grouped word counts, participants spent approximately half of their narratives discussing the first two years of their child's life. Themes selected based on US Latino sociodemographics and cultural values included the Impact of Language, Healthcare Challenges, Supportive Healthcare Experiences, Caregiver Coping with CFM, Family Roles, and Addressing Social Implications of CFM. Results highlighted that the first years of care are of critical importance to parents and suggest this is an optimal time to focus on education and support services for families. Additional treatment suggestions include providing interpretation and informational materials in Spanish, addressing care barriers, supporting familial and child coping, accounting for the role of extended family, and helping address social concerns. Ongoing research with Latino families can further assist in guiding culturally sensitive CFM health care.

Mapping key actors in family support. A European perspective

Research has proven that family is the context for the development and well-being of the new generation, and parents need support in order to fulfill children and young people’s physical, cognitive, emotional, and social needs. Most EU policy relating to children and young people is mediated through family even if this is not explicitly named. At a national level, European countries have been encouraged to offer family support initiatives through local authorities that promote positive parenting and guarantee children’s rights. The current challenge in the family support landscape consists of engaging the European level with the local and national structures, in order to support the delivery of quality family support systems and services across Europe. This article reports on the progress in this area by the European Family Support Network (EurofamNet). EurofamNet was created with the purpose of establishing a pan-European family support network to inform family support policies and practices in order to contribute with global actions to face current challenges in family support agenda at European level. This paper introduces the mapping exercise performed by the network to identify key family support actors for research, policy, and practice at the European, local and national level. For this purpose, an expert-targeted approach was followed. Two experts identified 83 key family support actors at the European level, and a panel of 22 experts jointly identified 326 key actors and organizations in 17 European countries. The analysis of this mapping exercise offers an interesting mosaic of family support provision in different European countries that reflect both intra- and inter-network diversity in nature, scope, and sectors of family support actors and organizations. At the same time, this mapping exercise contributes to creating social fabric with the potential to facilitate knowledge mobilization of quality standards to be implemented for the guarantee of quality provision in family support in Europe. Practical implications for the development of the family support and wider services fields of this novel initiative of connecting the efforts of key actors in family support throughout Europe are discussed.

Health service use of infants involved in family justice care and supervision proceedings in Wales: a data linkage study

IntroductionWhen a child has suffered, or is at risk of suffering, significant harm from parents or caregivers, the local authority may issue Section 31 (s.31) Care and Supervision proceedings under the Children Act (1989). ObjectivesWe compared the healthcare use of infants less than one year old subject to s.31 proceedings in Wales (n = 1,332),to that of a comparison group of infants not subject to s.31 proceedings (n = 204,417), between January 2011 and February 2020. MethodsPopulation-based e-cohort study utilising data held in the Secure Anonymised Information Linkage (SAIL) Databank. Infants in s.31 proceedings were identified using the Children and Family Court Advisory and Support Service dataset. This was linked to demographic and healthcare datasets, to identify General Practice (GP) visits, emergency department (ED) attendances, and hospital admissions (emergency and elective); before the study end date or the child's first birthday for the comparison group, orbefore the s.31 application date.Regression analysis calculated event rate ratios [RR] and incidence rate ratios [IRR] for healthcare events, adjusting for widerdeterminants of health (e.g. perinatal factors, maternal mental health, deprivation), and investigated reasons for healthcare use. ResultsInfants in s.31 proceedings had ahigher number and incidence of healthcare events compared with the comparison group, across all healthcare settings. Differences were greatest for emergency hospital admissions (IRR = 4.03, 95% confidence interval [CI] = 3.53 - 4.59; RR = 4.60, CI = 3.90 - 5.41). "Injury and poisoning" was the main reason for emergency admissions amongst infants in s.31 proceedings. For ED presentations, emergency hospital admissions, and GP visits, there were proportionally more events for these infants across all top ten reasons for healthcare. ConclusionsFindings highlight greater healthcare utilisation for infants involved in s.31 proceedings in Wales, helping to build a better understanding of their needs and vulnerabilities.

The Associations among Perceived Courtesy Stigma, Health and Social Behaviours in Family Members and Friends of People Who Use Substances: An Ecological Momentary Assessment Study

Background: The stigma and discrimination experienced by individuals with an alcohol/substance use disorder often extends to the family members and friends who provide care, which is known as courtesy stigma. This courtesy stigma can lead to isolation, poor mental health and might impact the quality-of-care these individuals provide. The aim of this study was to examine the frequency of experienced courtesy stigma/discrimination in individuals in a family support service for a loved one’s substance use, and to examine any cross-sectional associations with changes in mood, health- and social-related outcomes. Methods: Thirty-six individuals (25 female) with a mean age of 51.91 years took part in an ecological momentary assessment study in which the experience of courtesy stigma/discrimination and measures of mood, health (e.g. alcohol use, nicotine use, healthy eating, sleep, physical activity) and social connections were taken 3 times per day for fourteen days. Results: Across 1029 competed assessments (compliance ∼68%), there were 122 (∼11%) reports of courtesy stigma/discrimination. The most common sources of stigma/discrimination were from family members (∼43% of occurrences) and friends (∼31% of occurrences). Experiencing this stigma/discrimination was associated with increases in alcohol and nicotine use, as well as reductions in healthy eating, physical activity, sleep, social connections, and mood. Conclusions: The experience of courtesy stigma/discrimination was common in a sample of individual’s who support a loved one with alcohol or substance use disorder. These experiences are associated with changes in health and social behaviors and may lead to a poorer quality of care.

Examining the effect of family-based intervention programs used in psychosis on the disease: a systematic review

IntroductionPsychosis is a complex mental health condition that can have a significant impact on individuals and their families. Family-based intervention programs have been developed to provide support and education to both individuals with psychosis and their families. These programs aim to improve clinical and family outcomes, reduce relapse rates, and enhance the overall well-being of individuals and their families . This study examined the effect of family-based intervention programs used in psychosis on the disease by synthesizing evidence from a systematic review of relevant studies.Family interventions have shown promising results in improving clinical and family outcomes in long-standing psychosis (Sadath et al., 2015). These interventions focus on improving relationships through problem-solving and enhancing the understanding of the illness and its treatment (Kuipers et al., 2010).ObjectivesThe aim of this study was to evaluate the effect of intervention programs implemented for the families of individuals diagnosed with psychosis on the course of the disease.MethodsThe study was conducted between August and September 2023 in 3 databases (PubMed, Cochrane Library, Science Direct) using the keywords “psychosis”, “family interventions”, “family in psychosis”. These databases were preferred because they contain a significant amount of evidence-based literature in the field of biomedical sciences and psychology. Studies conducted between 2013 and 2023, whose full texts were accessed and written in Turkish and English were included in the study.ResultsAs of September 2023, 16 national and international research articles on the subject have been reached and the literature review continues. When the literature review is finalized, all study results will be presented together.ConclusionsThis review provides an overview of the effects of intervention programs implemented for the families of individuals diagnosed with psychosis on the course of the disease and solution suggestions. Family-based intervention programs have shown promise in improving clinical and family outcomes in psychosis. These programs focus on enhancing relationships, providing education, and reducing relapse rates. However, the implementation of family interventions in routine clinical services can be challenging due to various barriers. Peer support programs have emerged as a valuable addition to family interventions, providing a supportive environment for families to share their experiences and support one another. Future research should focus on addressing barriers to implementation and further exploring the benefits of peer-driven family support services in early intervention programs for psychosis.Disclosure of InterestNone Declared

Macro-level predictors of child removals: Do social welfare benefits and services reduce demand for children’s out of home placements?

The purpose of this macro-level study is to examine the effects of social welfare benefits and services on the demand for child removals. The study is based on the panel data of Finnish municipalities (N = 293) and their social welfare indicators for the period 2010–2021. Linear regression analysis was conducted to analyze the associations between the dependent variable (child removals) and the main predictors (child welfare notifications, family support services, social assistance). The community-level social risk factors were controlled for. It was found that child welfare notifications and family support services were associated with child removals. The more cases there are of children accessing the child protection system, the more cases there also are of child removals in a municipality. On balance, additional income support seems to reduce the demand for child removals. Furthermore, it is noteworthy that community-level social risk factors (drop-out youth, unemployment, low education level) were in a negative relationship with child removals, which would tentatively suggest that the threshold for child welfare notifications is actually higher in the deprived communities than in the prosperous areas. Relatively, it is more difficult for children to access child protection services in the communities with a high unemployment rate and low education level and also if there is a high proportion of youths out of education, employment, and training. The present study underlines the significance of a macro-level approach to child protection.

Transformation of child welfare Institutions in Bandung, West Java: A case of deinstitutionalization in Indonesia

The enactment of the National Standard of Care for Child Welfare Institutions in 2011 signifies Indonesia's commitment to deinstitutionalization by guiding the transformation of the country’s Child Welfare Institutions, from facility-based childcare homes or orphanages, to centers of community-based children and family services. Yet, evidence of this transformation of Child Welfare Institutions is scarce. This study aimed to investigate the state of transformation of the child welfare service providers for neglected children in the City of Bandung as a parameter to understand the progress of the deinstitutionalization process in Indonesia.Fifty child welfare service providers (Child Welfare Institutions and government child protection services) operating in Bandung participated in an online survey. Cluster analysis of organizational data combined with an analysis of responses to hypothetical scenarios of children at risk of family separation, grouped service providers into; (i) medium to large, faith-based, non-government Child Welfare Institutions that primarily provide privately funded institutional care services at the Bandung level (50%), (ii) small, secular, non-government Child Welfare Institutions and government child protection services that primarily deliver family support services at the Bandung level (26%) and (iii) medium to large, secular, non-government Child Welfare Institutions that deliver privately funded institutional care and other family support services at the provincial level (24%). While there is evidence of deinstitutionalization activity in Bandung, the large number and relative size of privately operated Child Welfare Institutions suggests a high dependency on institutional care to meet children's general welfare needs.The cluster analysis also indicates limited government funding and the missions of religious organizations as possible constraints on system transformation. Further research is needed to understand the enablers and barriers to transforming the system from predominantly institutional care to a continuum of services in the context of deinstitutionalization in Bandung.

Realizing an Evidence-Based Framework for the Management and Delivery of Family Support Services

ABSTRACT Purpose This paper reports on how service providers and academic researchers partnered to support the journey of a primary prevention organization in western Canada as they reviewed their programming against an evidence-based practice (EBP) framework. The process allows the organization to increase their EBP culture by encouraging staff understanding and uptake of their nine family support programs. It also informs service users and other stakeholders of the evidentiary status of different kinds of support services. In this way, the families become more informed and engaged partners who might easily evaluate the respective risks and benefits of the various applications. Method As part of the process, an evidence-based framework used a common language to assess the efficacy of the respective nine programs. Results All nine programs are now mapped into the EBP framework. Conclusions This review allows staff to become more intentional and informed about the EBPs they employ to support vulnerable families and to use this knowledge to better inform the families with whom they work. This paper and the process the agency followed can be a model for other organizations who serve families experiencing short-term housing crisis, provide infant nursery care, and other support services for families with young children.

The effects of multicultural family support services on the longitudinal changes of acculturative stress, peer relations, and school adjustment.

This study investigated the long-term trends of acculturative stress, peer relationship, and school adjustment among adolescents from multicultural families in South Korea, and examined the concurrent and lagged effects of multicultural family support services (MFSS) on the longitudinal changes in the variables of interest. Concurrent and lagged models as well as developmental trajectories via latent growth modeling (LGM) were employed on a sample of 1,443 middle school students (706 boys, 737 girls) from the Multicultural Youth Panel Survey (MAPS). The results revealed that peer relationships and school adjustment perceived by adolescents demonstrated consistent, gradual declines across 3-year time points while there was a lack of significant change in acculturative stress during the same period. The absence of significant change in acculturative stress could be attributed to floor effects, stemming from its initial low mean level. Nevertheless, the LGM modeling also exhibited significant concurrent and lagged effects of MFSS at the first and third time points of investigation. The intermittent significant effects of MFSS and the direction of its improvement were discussed. More educational interventions guiding students from multicultural families would be needed as they navigate the complexities of adolescence.

DIFFICULTIES EXPERIENCED BY FAMILY CAREGIVERS IN THE DAILY CARE OF THE ELDERLY

Introduction: care for the elderly requires family caregivers to reorganize family roles, in addition to constant and holistic support, when there are failures in this process, significant negative outcomes may occur for the caregiver. Objective: to know the difficulties experienced by family caregivers in the daily care of the elderly. Methodology: descriptive study of qualitative approach conducted with family caregivers registered in a Basic Health Unit. A questionnaire was used for sociodemographic characterization and a semi-structured interview with a guide question. Content analysis was used for data analysis. Results: the conditions to which caregivers are exposed entail important challenges that require family support and health services. The study revealed constant episodes of conflicts, resulting in the absence of division of responsibilities by family members. Conclusion: the difficulties experienced by the caregiver were questions related to sleep quality, overload, family relationships and feelings of ambivalence.