Family Survey Research Articles

Family Experience of Caregiver Burden and Health Care Usage in a Statewide Medical Home Program

ObjectiveTo evaluate family-reported caregiver experiences and health care utilization of patients enrolled in the Pennsylvania Medical Home Program (PA-MHP) statewide practice network and compare results to PA-MHP practices’ Medical Home Index (MHI) scores. We hypothesized families enrolled in higher-scoring patient-and-family-centered medical homes (PCMH) on completed MHIs would report decreased caregiver burden and improved health care utilization. MethodsWe analyzed surveys completed by families receiving care coordination services in PA-MHP's network and each practice's mean MHI score. A total of 3221 caregivers completed surveys evaluating hours spent coordinating care/week, missed school/workdays, sick visits, and emergency department (ED) visits. A total of 222 providers from 54 participating PA-MHP practices completed the nationally recognized MHI. Family/practice demographics were collected. We developed multivariate logistic regression models assessing independent associations among family survey outcomes and corresponding practices’ MHI scores. ResultsFamilies enrolled in high-scoring PCMHs had decreased odds of spending >1 h/wk coordinating care (odds ratio [OR] 0.82, adjusted OR [aOR]: 0.70, 95% confidence interval [CI] 0.55–0.90), missing workdays in the past 6 months (OR 0.82, aOR: 0.72, 95% CI 0.69–0.97), and ED visits in the past 12 months (OR 0.83, aOR: 0.81, 95% CI 0.65–0.99) in comparison to families enrolled in lower-scoring PCMHs. Families enrolled in higher-scoring PCMHs did not report fewer sick visits despite fewer ED visits, indicating more appropriate health care utilization. High-scoring PCMHs had lower percentages of publicly insured and low-income children. ConclusionsHigher-scoring PCMHs are associated with decreased caregiver burden and improved health care utilization across diverse PA practices. Future studies should evaluate interventions uniformly improving PCMH quality and equity.

Impact of health educational intervention among pregnant and lactating mothers in a rural field practice area of Bagalkot: A non randomized interventional trial without control

: Anemia is very common in Indian subcontinent. In India, according to National Health and Family Survey (NHFS-4), the prevalence of anaemia in India among adolescent girls, 15-19 years is 54.1%. Women during pregnancy are more vulnerable for anemia not only because of the synergistic effects of physiological increase in plasma volume (hemodilution) but also because of increased demand and poor bioavailability of iron in the food.To find out the impact of health educational intervention on anaemia among pregnant and lactating women.A non-randomized interventional trial without control study was conducted in the Rural field practice area of Department of Community Medicine, S.N. Medical college, Bagalkot with the Sample size for pregnant and lactating women is 153, for the period of one year (March 2018- June 2019).: There is increase in level of knowledge among pregnant and lactating women regarding anemia after health education intervention and was found to be statistically significant by paired t-test. Health education is one of the cost-effective method in improving the knowledge among pregnant and lactating mothers.

Associations Between Ambient Particulate Air Pollution and Cognitive Function in Indonesian Children Living in Forest Fire-Prone Provinces.

Smoke from forest fires can reach hazardous levels for extended periods of time. We aimed to determine if there is an association between particulate matter ≤2.5 µm in aerodynamic diameter (PM2.5) and living in a forest fire-prone province and cognitive function. We used data from the Indonesian Family and Life Survey. Cognitive function was assessed by the Ravens Colored Progressive Matrices (RCPM). We used regression models to estimate associations between PM2.5 and living in a forest fire-prone province and cognitive function. In multivariable models, we found very small positive relationships between PM2.5 levels and RCPM scores (PM2.5 level at year of survey: β = 0.1%; 95% confidence interval (CI) [0.01, 0.19%]). There were no differences in RCPM scores for children living in forest fire-prone provinces compared with children living in non-forest fire-prone provinces (mean difference = -1.16%, 95% CI [-2.53, 0.21]). RCPM scores were lower for children who had lived in a forest fire-prone province all their lives compared with children who lived in a non-forest fire-prone province all their life (β = -1.50%; 95% CI [-2.94, -0.07]). Living in a forest fire-prone province for a prolonged period of time negatively affected cognitive scores after adjusting for individual factors.

Are National Family Surveys Biased toward the Happy Family? A Multiactor Analysis of Selective Survey Nonresponse

Virtually, all large-scale family surveys in the United States and Europe have yielded a positive view of family ties in contemporary societies. The present study examines whether surveys like these are affected by selective nonresponse. Are people with negative family ties less likely to participate in surveys, and if so, to what extent does this yield a biased descriptive view of family solidarity? Using a novel multiactor design with matched register data, we examine the determinants of nonresponse of the parents of adult children aged 25–45 in the Netherlands. Our analysis reveals significant effects of the strength of parent–child ties on parental nonresponse, especially for fathers. Moreover, we find negative effects of divorce on father’s participation and this effect is stronger when family ties are weak. While these findings support the hypothesis of selective nonresponse, the magnitude of the effects is small and descriptive findings on family ties change only modestly when correcting for selective nonresponse.

Storage of Medications: A Survey of Families in the Pediatric Emergency Department.

To evaluate caregivers' practice of prescription medication storage, particularly of opioid medications, as well as to provide educational materials to families about the opioid crisis. Caregivers of patients in a pediatric emergency department were asked to participate in a survey about medication storage practices and beliefs, focusing on opioid medications. Data were collected through a survey documenting demographic data along with knowledge and behaviors of medication storage. Brief education about the US opioid crisis and safe storage was provided. In total, 233 families participated; 3 families declined; 11.5% of caregivers reported storing prescribed medications in a locked or latched place, although most store them "out of reach." Most believed their child or children's friends could not easily access their medications (81.8%). Families who did not keep their medications in locked or latched places had never thought about it (39.7%). In total, 33% of respondents were unaware of the opioid crisis; 87.4% of caregivers said they would use a medication lock box if given one. Many caregivers are not aware of the opioid crisis and do not keep opioid medications locked up. Half of the caregivers surveyed stated they "never thought about" locking up medications. Most parents would use a lock box if given to them. This opens the door to further study, education, and interventions.

Covid-19 Pandemic and its relation to the Unemployment situation in Malaysia: A Case Study from Sabah

Covid-19 not only exposed the vulnerability of most industries especially industries that relies on air travel and tourism but resulted in the exponential increase of unemployment in Malaysia. At the same time, online business or trade and ‘GIG’ economy increased exponentially. The sudden and unexpected loss of jobs had dire consequences for many people. This paper examines how policies enacted during the Covid-19 pandemic affected unemployment in Malaysia by focussing on the situation in Sabah, one of the three remaining partners in the formation of Malaysia. It draws on data from the Family, Women and Youth Survey conducted online towards the end of 2020, as well as secondary data. The study shows that hardship has been faced by many people, especially those previously in professional roles, and those who are younger. The widespread damage to the economy, and to social cohesion, will require significant collaboration between business and industry, the government and the people.

Социально-экономическое самочувствие российских семей с детьми в условиях пандемии коронавирусной инфекции

 The article is devoted to the essence of the social well-being of the family. The author points out that it largely depends on the socio-economic processes taking place in the modern society, and is associated with social guarantees of the state in the specific period. The author analyzes the statistical data of the survey of Russian families with children on their social status and well-being in 2019–2020 and points out an increase in the level of anxiety of the population about their financial situation and the ability to provide their family with everything they needed. The article pays particular attention to the analysis of government support measures to this category of the population.

유자녀 취업여성의 일-가족 전이 유형과 유형별 특성 및 심리적 복지감 비교: 잠재프로파일분석

The purpose of this study was to identify the types of work-family spillover for employed women with children. We analyzed factors that affect the typology of work-family spillover and compared the differences in the psychological well-being of women based on the types. The data used in the study were from wave seven of the Korean Longitudinal Survey of Women and Families (KLoWF). The subsample included 1,950 employed women who lived with their husbands and had more than one child. Using latent profile analysis, three types of work-family spillover were classified including high conflict-high enrichment, middle conflict-high enrichment, and low conflict-high enrichment type. Logistic regression analysis showed that the women’s attitudes toward their family roles, children’s age, satisfaction with the division of housework, job satisfaction, and working hours were related to the type of work-family spillover. Regarding the psychological well-being of the women, women in the low conflict-high enrichment type were the happiest and had the lowest depression compared to the high conflict-high enrichment type. The present study suggests that changing working women’s attitudes about their family roles, increasing the husband’s support, and support for childcare are important factors in order to reduce working women’s work-family conflict.

Shifting neighborhoods, shifting health: A longitudinal analysis of gentrification and health in Los Angeles County

Gentrification is characterized by an influx of capital, built environment upgrades, and physical and social displacement of residents and institutions. The numerous, relatively rapid transitions that occur during gentrification make accounting for duration of exposure to gentrification particularly important when exploring its relationship to health. Though a large literature explores how timing and duration of exposure to relatively stable neighborhood conditions are linked to health, little is known about how exposure to gentrification is linked to the health of longtime residents. Using restricted, longitudinal data from the Los Angeles Family and Neighborhood Survey, I ask (1) how is duration of exposure to gentrification linked to the self-reported health of those who remain in the neighborhood? (2) How does this relationship vary for members of different racial and ethnic groups? Results indicate that the longer an individual lives in a gentrifying neighborhood, the better their self-reported health. The results do not vary by race or ethnicity. The results of this study are not an endorsement of the use of gentrification as a public health intervention, as previous work finds that gentrification can also be associated with social, physical, and institutional displacement. Instead, findings reiterate the importance of neighborhood investments for the health and well-being of their residents over time.

Prevalence of diarrhoea among under five children in India and its contextual determinants: A geo-spatial analysis

BackgroundDiarrheal diseases which is one of the leading reason behind global mortality and morbidity is more threatening for infants and young children. Childhood diarrhoea is becoming increasingly prevalent disease in developing countries like India. Moreover, it is a major cause of malnutrition that contributes towards third major cause of under 5 mortalities. This has raised a serious concern in the domain of public health. ObjectivesThe present study attempts to identify the spatial prevalence and clustering of diarrhoea in India based on National Family and Heath Survey (NFHS-4, 2015–16) and also tries to identify the association of prevalence of diarrheal disease among under 5 children with socio-economic factors. MethodsThe study applies spatial analysis software i.e ArcGIS 10.8 and GeoDa 1.18 including Moran's index and logistics regression to show the spatial prevalence and auto-correlation of diarrhoea among neighbourhood districts and their contextual determinants. FindingsThe study finds a total of 71 districts belong to the hot spot area are mostly from central and eastern costal part of India. Analysis of socio-economic determinants show prevalence of diarrhoea among under 5 children is higher in rural areas, among children not staying in Pacca house, living with unimproved sanitation facilities, belonging to under privileged community (highest among OBC followed by SC/STs), children of younger mothers (<25 years) and “poor’ households considering the wealth index. ConclusionThe study recommends to target hot-spot districts with high prevalence of diarrhoea and policy level interventions like improved sanitation to reduce the risk of childhood diarrhoea.

Public Participation and Governance Performance in Gender-Imbalanced Central Rural China: The Roles of Trust and Risk Perception

The study investigates the impact of public participation on governance performance in a risk society. A trust-based participatory paradigm is proposed as a viable framework. Using data from a 2018 survey of family planning services in Hubei, China, this study develops hypotheses drawn from causal mechanisms of participatory governance. A structural equation modeling (SEM) approach is employed to disentangle the direct effect of public participation on governance performance from its indirect effect through trust. Moderated multiple regressions (MMR) are conducted to identify the moderating effect of risk perception. The results indicate that public participation is associated with higher perceived quality of family planning services and decreases son preference through the serial mediation effects of trust and perceived quality. Risk perception of gender imbalance magnifies the positive effect of civic autonomy on perceived quality. This paper extends previous research on the governance of gender imbalance and contributes to the literature on the relationship between public participation, trust, risk perception, and governance performance in authoritarian countries.

Gender Role Ideology, Work–Family Conflict, Family–Work Conflict, and Marital Satisfaction Among Korean Dual-Earner Couples

The purpose of this study was to examine the effect of the gender role ideology of Korean dual-earner couples on marital satisfaction through work-to-family conflict and family-to-work conflict. The subjects of the study were 4059 participants (2434 men and 1625 women) in South Korea selected from the 2015 Fact-Finding Survey in Families. Results of the study revealed that women scored higher on gender role ideology and family-to-work conflict, but men scored higher on work-to-family conflict and marital satisfaction. Gender role ideology had a significant indirect relationship on marital satisfaction through family-to-work conflict for men in the study, but there was no significant indirect relationship found for the women studied. Gender differences existed between marital satisfaction and its predicting variables. Based on the results of this study, the discussion in this article addresses implications and future research directions.

The impact of the selective two-child policy on residents’ fertility intentions in China

ABSTRACT The research uses CGSS, a family survey data, to study the impact of the second phase of the selective two-child policy (STCP II) on residents’ fertility intentions in China. It finds that the policy does improve residents’ two-child fertility intentions, which is more significant in the younger groups. The research results suggest that relaxing the family planning policies does increase the residents’ willingness to have more children in the short term.

The influence of time, resource, and gender ideology on the division of domestic work in Korea

AbstractThe paper examines how time availability, relative monetary contribution, and gender ideology are related to a couple's contribution to domestic work in South Korea, using data from the Korean Longitudinal Survey of Women and Families. OLS regressions with fixed effects indicate that couples' hours worked were significantly associated with their own and their spouse's time spent on domestic work. The wife's relative wage was another essential determinant in the division of domestic work between wife and husband. Although the wife's gender ideology was not a significant factor for her domestic work time, a husband whose wife had more gender‐equitable attitudes was more likely to devote time to domestic work. Going beyond earlier studies, we also present new evidence for gender display: the wife's relative wage had a curvilinear relationship with the couple's time spent on domestic work. The broader implications of the main findings are also discussed.

Intersectional Typologies of Children with Cultural Minority Backgrounds: Relation to School Readiness in Head Start

ABSTRACT Research Findings: A constellation of social positions of difference can contribute to substantial variation among children from culturally and linguistically diverse (CLD) backgrounds. Using data from the Head Start Family and Child Experiences Survey 2009 cohort, the present study identified intersectional typologies of cultural minority backgrounds and examined their associations with school readiness among CLD children in Head Start. Latent class analysis was used to identify intersectional CLD typologies that were inferred from five cultural minority indicators, including child’s racial minority status, maternal and paternal nativity status, non-English speaking primary parent, and non-English speaking families. Four latent typologies were identified: a) CLD-Race, b) CLD-Race/immigrant, c) CLD-Race/multilingualism, and d) CLD-Race/immigrant/non-English dominant. Multilevel models revealed differences in school readiness at the start and end of Head Start by typology. Practice or Policy: Our findings shed light on the importance of looking at the intersections of cultural minority characteristics to understand different strengths and needs across CLD children. Incorporating intersectionality theory into early education research and federally-funded early intervention programs may be useful to more precisely identify the diverse needs of CLD subgroups and assist early educators in tailoring and differentiating instruction accordingly.

Premature adult mortality in India: what is the size of the matter?

BackgroundReducing adult mortality by 2030 is a key component of the United Nations Sustainable Development Goals (UNSDGs). Monitoring progress towards these goals requires timely and reliable information on deaths by...

Inequality across Three Generations under Pressure from Sovietization Policies

Abstract This article explores the multigenerational impact of Sovietization policies on the reproduction of educational inequalities in Estonia. Estonia provides an opportunity to assess the multigenerational effect under conditions of regime changes after transitioning from the independent Estonian Republic to Soviet Estonia and thence to the newly independent post-Soviet Estonia. During Sovietization, a wide range of measures involving repressions and positive discrimination were applied to abruptly hinder intergenerational continuity. Analysis based on retrospective data from the Estonian Family and Fertility Survey 2004 indicates grandparents’ social positions are associated with grandchildren’s attainment of higher education. Their influence is only partially mediated through the parental generation. Overall, the Sovietization policies have not reduced either the two or three-generational reproduction of inequality. Moreover, these policies produced unintended consequences, facilitating the transmission of advantage in three generational perspectives. Our findings argue in favour of the importance of contextual sensitivity and a multigenerational perspective in research of social stratification.

Time Availability: Assessing Causal Ordering in the Performance of Paid Labor and Unpaid Housework

Key to understanding gender inequality in families, the time availability hypothesis implies that one’s time in paid work negatively affects one’s time in unpaid housework. Although dozens of studies have demonstrated an association between husbands’ and wives’ time in the paid labor force and their performance of housework, most suffer from numerous limitations, especially the use of unidirectional modeling and cross-sectional data. This is problematic since these methods cannot assess causal directionality and since human capital theory suggests that housework responsibilities affect time in paid work. Using structural equation modeling and two stage least squares regression—two methods that can help parse causal ordering—and data from the 1987–88 and 1992–94 waves of the U.S. National Survey of Families and Households (NSFH) this study finds no support for the time availability hypothesis regarding the association between paid work hours and unpaid housework. Consistent with human capital theory, husbands’ housework time affects their own time in paid work. No association is found among wives.

Consumption of Breast Milk Is Associated With Decreased Prevalence of Autism in Fragile X Syndrome

ObjectivesBreastfeeding is associated with numerous health benefits in infants, but early life nutrition has not been specifically studied in the neurodevelopmental disorder fragile X syndrome (FXS). Herein, we evaluate associations between the consumption of breast milk during infancy and the prevalence of autism, allergies, diabetes, gastrointestinal (GI) problems and seizures in participants with FXS. MethodsThe study design was a retrospective survey of families enrolled in the Fragile X Online Registry and Accessible Research Database (FORWARD). ResultsThere was a 73% rate of breastfeeding in the enrolled participants with an 81% rate for at least 3 months, 73% for 6 months and 41% for 12 months of age or longer. There was a 1.7-fold reduction in the prevalence of autism in participants with FXS who were fed breast milk for 12 months or longer and a 1.9-fold decrease in autism in participants reporting no use of any infant formula (P < 0.05). The most common reasons for cessation of breastfeeding were reduced milk production and age of the child. There were strong negative correlations between increased time the infant with FXS was fed breast milk and the prevalence of autism and seizures and moderate negative correlations with the prevalence of GI problems and allergies. However, participants reporting GI problems or allergies commenced these comorbidities significantly earlier than participants that were not fed breast milk. Parsing the data by sex indicated that males exclusively fed breast milk exhibited decreased prevalence of GI problems and allergies. ConclusionsThese data suggest that long-term or exclusive use of breast milk is associated with reduced prevalence of key comorbidities in FXS including autism, GI problems and allergies, although breast milk is associated with the earlier development of GI problems and allergies. Funding SourcesNICHD.

Psychological Adaptation among Marriage Migrant Women in South Korea: Stress and Coping, Culture Learning, and Social Cognition Approaches

This study is an examination of determinants of psychological adaptation among marriage migrant women in South Korea within three main theories: stress and coping, culture learning, and social cognition. Generalized ordinary logistic regression is applied to the 2015 National Multicultural Family Survey. The results reveal that loneliness and family conflicts have negative effects on psychological adaptation while social supports result in positive effects. Participation in gatherings with Koreans and Korean language proficiency work positively for psychological adaptation, while residence period and cultural differences have negative effects. Discrimination is also negatively associated with psychological adaptation.