The Effects of a Community-Based, Multicomponent, Depression Prevention Intervention in Mothers At-Risk

The purpose of this study was to develop a 12-week multicomponent, depression prevention pilot intervention and evaluate its feasibility and preliminary effects on improving levels and correlates of depressive symptoms, including anger, self-esteem perceived stress, social support, and racism. A quasi-experimental, mixed-methods design and a community-based participatory research (CBPR) approach was employed. University faculty, students and community residents collaborated at a low-income housing complex in a low-resourced, urban community. Fifteen low-income, ethnic minority mothers ages 23-46 years completed the intervention and evaluation surveys. Eight mothers participated in a focus group. The intervention included social group-dance, health education, and socialization. t-Tests, sign-tests, and thematic analysis was employed. Mothers identified barriers and facilitators of program engagement. Depressive symptoms were significantly reduced (t(14) = 2.41, p = .030). Self-esteem (t(14) = 2.28, p = .039) and social support levels (M = 4.5, p = .035) were significantly increased. This multicomponent intervention is feasible. Preliminary efficacy evidence was mixed.

[THE ROLE OF THE FAMILY IN SHAPING ATTITUDES TO YOUTH HEALTH IN THE CONTEXT OF THE PANDEMIC]

The family plays an important role both in the life of each individual and in society as a whole. In conditions of instability, risks, and increased epidemiological burden, the level of intra-family trust has increased, including in matters of health care. The article analyzes the sociological studies conducted during the first and second waves of the pandemic, on the basis of which it is determined that the family forms an attitude to health, which can be manifested from the standpoint of rational and irrational health-oriented behavior.

'Improving Health through Reducing Stress': Parents' Priorities in the Participatory Development of a Multilevel Family Health Programme in a Low-Income Neighbourhood in The Netherlands

In order to reduce health inequities, a socio-ecological approach and community engagement are needed to develop sustained interventions with a positive effect on the health of disadvantaged groups. This qualitative study was part of the development phase of a community health promotion programme. The study aimed to provide insight into the perceptions of parents in a disadvantaged neighbourhood about health, and their priorities for the community health programme. It also described the process of integrating these perceptions in the development of a multilevel plan for this programme. Participatory methods were applied to enable the engagement of all groups involved. Ten parents from a low-income neighbourhood in the Netherlands participated in five panel sessions. Parents’ priorities for improving family health were reducing chronic stress and not so much healthy eating and physical activity. They prioritised solutions to reduce their financial stress, to provide a safe place for their children to meet and play and to establish good quality communication with authorities. The programme development process resulted in objectives in which both parents and professionals were willing to invest, such as a safe playground for children. This study shows that target population engagement in health programme development is possible and valuable.

Family Health Behavior: Preventive Measures against Acute Respiratory Infections in Under-5 Children

BACKGROUND

The under-5 mortality rate in Indonesia is 32 per 1,000 live births, still higher than the SDG target. Acute respiratory infections (ARIs), as one of the leading causes of death, must be prevented. Arguments emerge concerning the association of home crowding, health behavior, and the incidence of ARI.

METHODS

A cross-section analysis with the Indonesia Demographic and Health Survey (IDHS) 2017 dataset is performed. Samples are restricted to 16,555 children aged 0-59 months who lived with their mother (eligible women interviewed) during the survey. For each of the variables observed during this study, missing data must be omitted as exclusion criteria. A 100 per cent answer rate was achieved. Logistic regression was used to determine ARI-associated factors, by examining the effect of each explanatory factor (independent variables) on the odds ratio of ARI (one dependent binary variable).

RESULTS

The prevalence of ARI was more common among children living in the poorest households (AOR 1.66; 95% CI, 1.20 - 2.28) and those exposed to indoor tobacco smoke pollution (AOR 1.27; 95% CI, 1.04-1.56). On the other hand, those aged 0-5 months (AOR 0.59; 95% CI, 0.43-0.82), living at home with improved sanitation (AOR 0.74; 95% CI, 0.61-0.89), and exclusively breastfed (AOR 0.85; 95% CI, 0.73-0.99) were less likely to have ARI.

CONCLUSIONS

Home crowding is not associated with ARI. Efforts should be focused on preserving family health behavior. The family functioned as a health-support system for their under-5 children by establishing an indoor tobacco smoking-free zone, practicing exclusive breastfeeding, and enhancing hygiene facilities.

Quality of life of Family Health Strategy professionals: a systematic review

BACKGROUND

Individuals' quality of working life and motivation are directly related to their satisfaction and wellbeing. Although studies on the quality of life of family health workers have been conducted, there are none correlating these professionals' wellbeing with this work model.

OBJECTIVE

To review the scientific literature in order to identify the levels of quality of life, in their dimensions, of Family Health Strategy workers.

DESIGN AND SETTING

Systematic review of observational studies developed through a partnership between two postgraduate schools (Piracicaba and Uberlândia).

METHODS

The review followed the PRISMA recommendations and was registered in the PROSPERO database. Ten databases were used, including the "grey literature". Two evaluators selected the eligible studies, collected the data and assessed the risk of biases, independently. The JBI tool was used to assess the risk of bias. A complementary statistical analysis was conducted on the means and standard deviations of the results from the WHOQOL-100 and WHOQOL-bref questionnaires.

RESULTS

The initial search presented 1,744 results, from which eight were included in the qualitative analysis. The studies were published between 2007 and 2018. The total sample included 1,358 answered questionnaires. All the studies presented low risk of bias. The complementary analysis showed that the environmental factor (mean score 56.12 ± 2.33) had the most influence on the quality of life of community health workers, while physical health (mean score 14.29 ± 0.21) had the most influence on graduate professionals.

CONCLUSION

Professionals working within the Family Health Strategy had dimensions of quality of life that varied according to their professional category.

Health professionals' views and experiences of discussing weight with children and their families: A systematic review of qualitative research

BACKGROUND

Healthcare professionals are ideally placed to discuss weight management with children and families to treat and prevent childhood obesity. The aim of this review was to collect and synthesize primary research evidence relating to health professional's views and experiences of discussing weight with children and their families.

METHODS

Systematic searches were conducted using the following databases: MEDLINE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE (OVID), PsycINFO (OVID) and Healthcare Management Information Consortium (HMIC). Twenty-six full text qualitative studies published in English Language journals since inception to October 2019 were included. Papers were quality assessed and synthesized using an inductive thematic analysis approach.

RESULTS

Data analysis generated five themes: sensitivity of the issue, family-professional relationships, whole systems approach, professional competency and sociocultural context.

CONCLUSION

Supporting behaviour change through discussion of healthy weight with children and families is an important part of the health professional's role. Tailored information for professionals, including resources and training, facilitates them to confidently talk to children and families about weight prioritized within interventions. The success of such interventions requires commitment from a range of professionals to ensure healthy weight is tackled through a whole system approach.

Multiprofessional family health residency as a setting for education and interprofessional practices

OBJECTIVE

to know the experiences lived during the residency by graduates of a Multiprofessional Residency Program in Family Health that could contribute to the development of Interprofessional Education and/or Collaborative Practice.

METHOD

a qualitative study with residents who entered a Multiprofessional Residency Program of a Brazilian public university in 2017, a period in which the theme of interprofessionality was implemented in the activities of the residency. Data was collected using an electronic form built from the theoretical framework of interprofessional education. Content analysis was used to process the data.

RESULTS

nine residents participated, distributed among the professions of Physical Education, Nursing, Nutrition, Dentistry, Psychology and Social Work, five of whom were female and with a mean age of 28.4. Two categories emerged: the Residency as a setting for learning from the other, and the Residency as a setting for understanding the role of the other. Interprofessional education and practice provided opportunities for the development of collaborative skills, enhancing teamwork and interprofessional work.

CONCLUSION

the multiprofessional logic was evidenced in the resident's practice; and the gradual insertion of activities such as case discussions, shared services and inter-sectoral actions aligned with the theoretical-methodological framework of interprofessionality favored an approach to interprofessional work.

Family and Social Variables Associated with Family Health

The current study examined the interrelationships among potentially relevant family and social factors associated with family health. A cross-sectional study was conducted by collecting demographic information from 432 families, including family typology, family life cycle (FLC), and social status as well as social support and stressful life events (SLEs), with self-perception of family health being measured as a dependent variable. Descriptive analysis of the sample and univariate and multivariate linear regression analyses were performed. Multivariate analyses showed that the FLC stage of families as launching centers, lower educational level of household heads, and impact of SLEs were negatively associated with family health, whereas adequate perceived social support and the number of close friends and relatives were positively associated with family health. Therefore, these factors must be considered by family nurses to promote family health and prevent family dysfunction.

Impact of parental injury on adolescent sleep

STUDY OBJECTIVES

The aim of this study was to determine the impact of serious parental injury on adolescent sleep disorder diagnoses, outpatient care, and medication use.

METHODS

U.S. military personnel who sustained a serious injury and were parents of adolescents aged 10-18 years were identified. Included adolescents were enrolled in the Military Health System for 2 years before their parent's injury and 2 years after the injury. We used logistic regression clustered by adolescents to compare the odds of having a sleep diagnosis and negative binomial regression analysis clustered by adolescents to compare outpatient sleep disorder visits and sleep medication days before and after parental injury.

RESULTS

There were 96,318 parents seriously injured during 2004-2014 who had 117,577 children aged 10-18 years in 2002-2016. Approximately 2% of adolescents had a sleep disorder diagnosis, both before and after their parent's injury or illness. Outpatient sleep disorder visits increased 36% after a parent's injury (incidence rate ratio 1.36 [1.24-1.50]), with a twofold increase in insomnia visits (incidence rate ratio 2.35 [2.08-2.64]). Increases in sleep visits were most pronounced in adolescents of parents with traumatic brain injury, comorbid traumatic brain injury and posttraumatic stress disorder, battle injury, and those who were medically discharged from the military. The number of adolescents using sleep medications increased, but sleep medication days did not increase.

CONCLUSIONS

Adolescents in our study used more outpatient medical care for sleep disorders; sleep medication use increased after parental injury. Sleep disorders should be considered in the care of adolescents with injured parents.

Immunization Catch-Up for Newly Arrived Migrants in France: A Cross-Sectional Study among French General Practitioners

Background: Migrants often undergo an incomplete vaccination program in regards to the French recommendations. The aim of this study was to evaluate the practices of French General Practitioners’ (GPs) in terms of catch-up vaccination. Methods: A cross-sectional study was carried-out in 2017–2018 in France. An online questionnaire was disseminated by email through scholarly societies to GPs involved in the care and the vaccination of migrants. Analyses included univariate and multivariate analysis with a logistic regression model. Results: A total of 216 GPs completed the survey. A majority identified themselves with an average level regarding the prevention of infectious diseases among migrant populations (56.7%) and confirmed this is part of their daily practice (83.3%). The majority of respondents do not perform more than two injections on the same day. When compared to GPs working in health centres, those with a private practice are more likely to report returning to a full primary vaccination schedule (adjusted OR = 2.90, 95% CI [1.29–6.53]). Aside from the serology for hepatitis B and to a lesser extent for measles, other pre-vaccination serologies were not frequently used by GPs. When a migrant declares to be up-to-date with his immunisations, only 56.5% of doctors consider this information reliable. Conclusions: This study clarified the vaccination practices of GPs receiving migrant patients in consultation and showed its heterogeneity. An important need for benchmarks has been identified and these results were used for the elaboration of the French guidelines on vaccines catch-up.

An Early Collaborative Intervention Focusing on Parent-Infant Interaction in the Neonatal Period. A Descriptive Study of the Developmental Framework

Moderate to late preterm infants are at risk of developing problems later in life. To support attachment and infants’ development, high quality parent-infant interaction is important. Parent-infant interaction is known to improve through intervention programs but since no such intervention program is addressed directly to moderate to late preterm infants, a tailor-made intervention was developed. The aim was to describe the rationale, development, framework and practical provision of a new early collaborative intervention program. This study has a descriptive design and the intervention is described using the Template for Intervention Description and Replication. During an intervention-session, the preterm infant’s cues are made visible to the parents as they perform an everyday care-taking procedure. Instant feedback is delivered to give the parents the opportunity to notice, interpret and respond to cues immediately. The infant’s response to the parent’s action is discussed in a dialogue to instantly guide parents´ awareness of the preterm infant’s subtle cues. This study describes a new early collaborative intervention, developed to support interaction between parents and their moderate to late preterm infants starting in the neonatal intensive care unit. Clinical studies evaluating parental experiences as well as the effects of the early intervention are ongoing, ClinicalTrials.gov NCT02034617.

Systematic Review of the Relationship between Couple Dyadic Adjustment and Family Health

The importance of family functioning in the development of child and adult psychopathology has been widely studied. However, the relationship between partners’ adjustment and family health is less studied. This paper aims to describe and summarize research that analyzes the relationship between partners’ adjustment and family health. A systematic review was conducted in the PubMed, PsycINFO, Scopus, Lilacs, Psicodoc, Cinahl, and Jstor databases. Inclusion criteria were as follows: articles published from 2012 to 2019 in English, Spanish, or Portuguese. Data were extracted and organized according to the family health model: family climate, integrity, functioning, and coping. Initially, 835 references were identified, and 24 articles were assessed for quality appraisal. Finally, 20 publications were selected. Results showed that couple adjustment was an important factor that triggered the emotional climate of the family, was positively intercorrelated to parenting alliance or coparenting, and contributed to family efficacy and help when facing stressful life events. Findings revealed a consensus about the relationship between couple dyadic adjustment and family health. The results could orientate interventions to promote well-being and to increase quality of life and family strength. Health professionals should thoroughly study couple relationships to identify risk factors, assess family skills, and promote family health.

Sexually transmitted infection laboratory testing and education trends in US outpatient physician offices, 2009-2016

OBJECTIVE

To describe national rates of sexually transmitted infection (STI) testing and education overall and among patient subgroups in US outpatient physician offices from 2009 to 2016.

DESIGN

This was a cross-sectional study of the Centers for Disease Control and Prevention's National Ambulatory Medical Care Survey from 2009 to 2016. Data weights were applied to extrapolate to national estimates.

SETTING

Data were collected from a systematic random sample of outpatient physician office visits throughout USA. Physician office types include free standing clinics, private or group setting practices, centres offering community and mental health services, family planning clinics and health maintenance organisations/other prepaid clinics.

PARTICIPANTS

All sampled patient visits were eligible for inclusion and were assessed for the provision of STI prevention education and STI testing for chlamydia, gonorrhoea, hepatitis, human papillomavirus (HPV) and HIV.

RESULTS

Of 7.6 billion total visits, 123 million included an STI test. Hepatitis was the most commonly tested STI (9.12 per 1000), followed by chlamydia (6.67 per 1000), gonorrhoea (6.00 per 1000), HIV (5.40 per 1000) and HPV (5.03 per 1000). Testing rates for the three STIs measured for the entire 8-year period increased over time and peaked in 2015 compared with 2009: chlamydia (R2=0.36), HPV (R2=0.28) and HIV (R2=0.51). Testing was highest among women (21.93 per 1000), 15-24-year olds (46.04 per 1000), non-Hispanic blacks (37.33 per 1000) and those seen by obstetrics/gynaecology specialists (103.75 per 1000). STI prevention education was provided to 4.89 per 1000 patients and remained relatively unchanged from 2013 to 2016.

CONCLUSION

STI testing in outpatient physician offices increased over the study period but varied by patient characteristics and site of care. Few patients received STI prevention education, highlighting a potential gap in resource utilisation in these settings.

Grieves and struggles of family caregivers providing care for bedridden elderly patients affected by chronic degenerative diseases

OBJECTIVES

To understand grieves and struggles of family caregivers providing care for bedridden elderly patients affected by chronic degenerative diseases.

METHODS

This cross-sectional study was developed following the guidelines of the clinical-qualitative method. The sample was composed of 10 female family caregivers of bedridden elderly patients affected by chronic degenerative diseases in a city in the interior of Minas Gerais, Brazil. The sample size was determined by data saturation. The instruments used included semi-structured interviews and a field diary. The audio-recorded interviews were transcribed verbatim and submitted to content analysis. The field diary provided contributions to the organization of categories, conferring a more accurate context.

RESULTS

The participants experienced two types of grief, one for the loss of a "healthy family member" and the other for the "announced death" of this person. Additionally, the participants faced two main struggles: overcoming (objective and subjective) fatigue and becoming fully capable of performing their roles.

CONCLUSIONS

The family caregivers of bedridden elderly patients affected by chronic degenerative diseases experience grieves and struggles that should be taken into account from the beginning of the care process through mental health actions intended to meet their needs.

Family Functioning Assessment Instruments in Adults with a Non-Psychiatric Chronic Disease: A Systematic Review

There is little information on the evaluation of family functioning in adult patients with chronic non-psychiatric illness. The objective of this systematic review was to identify family functioning assessment instruments of known validity and reliability that have been used in health research on patients with a chronic non-psychiatric illness. We conducted a search in three biomedical databases (PubMed, Science Direct, and Web of Science), for original articles available in English or Spanish published between 2000 and 2019. The review was conducted in accordance with PRISMA guidelines. Fourteen articles were included in the review. The instruments Family Assessment Device, Family Adaptability and Cohesion Evaluation Scales, Family Functioning Health and Social Support, Family APGAR, Assessment of Strategies in Families-Effectiveness, Iceland Expressive Family Functioning, Brief Family Assessment Measure-III, and Family Relationship Index were identified. All of them are reliable instruments to evaluate family functioning in chronic patients and could be very valuable to help nurses identify families in need of a psychosocial intervention. The availability and clinical application of these instruments will allow nurses to generate knowledge on family health and care for non-psychiatric chronic conditions, and will eventually contribute to the health and wellbeing of adults with a non-psychiatric chronic disease and their families.

Impact of the COVID-19 pandemic on the well-being of children with neurodevelopmental disabilities and their parents

AIMS

To examine the impact of COVID-19 pandemic on child mental health and socio-emotional and physical well-being (including sleep, diet, exercise, use of electronic media; care giver perceptions of symptoms of child neurodevelopmental disability [NDD] and comorbidities), and care giver mental health and well-being, social support and service use.

METHODS

An online cross-sectional self-report survey was distributed via disability service providers and support groups. Care givers of children aged 2-17 years with a NDD were invited to respond to questions on child symptom severity and well-being, parent well-being and service access and satisfaction.

RESULTS

Overall, 302 care givers (94.7% female) completed the survey. Average child age was 9.7 years and 66.9% were male. Worsening of any child NDD or comorbid mental health symptom was reported by 64.5% of respondents and 76.9% reported child health and well-being was impacted by COVID-19. Children were viewing more television and digital media (81.6%), exercising less (68.0%), experiencing reduced sleep quality (43.6%) and had a poorer diet (32.4%). Almost one fifth (18.8%) of families reported an increase in the dosage of medication administered to their child. Parents reported COVID-19 had impacted their own well-being (76.1%). Over half of respondents were not satisfied with services received during COVID-19 (54.8%) and just 30% reported that telehealth works well for their child.

CONCLUSION

Targeted interventions are required to address worsening child neurodevelopmental disability, mental health symptoms and poor diet, sleep and exercise patterns. Improved access to telehealth services is indicated, as is further research on barriers and enablers of effective telehealth services.

Protection Motivation During COVID-19: A Cross-Sectional Study of Family Health, Media, and Economic Influences

BACKGROUND

Protection motivation to practice preventive behaviors is necessary for sustained mitigation during coronavirus disease 2019 (COVID-19); however, limited research exists on the ecological sources of influence for COVID-19 protection motivation.

AIM

To explore sources of influence (family health, media consumption, and loss of work hours) on COVID-19 protection motivation.

METHOD

An online quantitative survey of U.S. adults (N = 501) aged 18 years or older was administered using Qualtrics with participants recruited through Amazon Mechanical Turk. Data were collected on constructs related to the protection motivation theory and theory of planned behavior as well as sources of influence and intention to socially distance and socially isolate during COVID-19. Constructs were further defined through exploratory and confirmatory factor analyses. Structural equation modeling was used to determine relationships between constructs.

RESULTS

A two-factor model was identified with threat appraisal as one factor and subjective norms appraisal, coping appraisal, and behavioral intention loading as another factor. Higher news media consumption and loss of work hours due to COVID-19 were both significant predictors of increased threat appraisal. Family healthy lifestyle and family health resources were significantly related to increases in the subjective norms, coping appraisal, and behavioral intention appraisal factor.

CONCLUSIONS

Family health, news media consumption, and loss of work hours are associated with COVID-19 protection motivation. COVID-19 protection motivation might be enhanced through policies and messaging that can affect ecological sources of influence.

Healthier together: a pilot study on the implementation of a novel family centered pediatric obesity prevention program

CONTEXT

With pediatric obesity rates reaching epidemic scales across the United States, innovative research to identify key factors for successful implementation of obesity intervention programs is increasingly paramount. Project Healthy Attitudes Produces Positive Youth (HAPPY) is a family centered pediatric obesity prevention program targeting elementary age children and their families.

OBJECTIVES

To determine whether Project HAPPY interventions emphasizing social networks were successful.

METHODS

This was a small scale evaluation of the Project HAPPY pilot program, conducted after school at a public elementary campus in Solano County, California. From April 2018 to May 2018, first year medical students from Touro University California College of Osteopathic Medicine served as "family navigators," guiding participants through a 5 week curriculum of didactic lessons, cooking demonstrations, and physical exercises. Eligibility requirements for Project HAPPY included basic English proficiency, confirmed enrollment of at least one child at the elementary school, and willingness to attend all study sessions. The primary outcome evaluated was a shift in attitude toward individual health. Changes in body mass index (BMI) and health behaviors were assessed as secondary outcomes. Outcomes were assessed through surveys and measurements of BMI completed during Session 1, Session 10, and 4, 6, and 8 month follow up sessions.

RESULTS

Initial study participants included seven families, consisting of elementary school students with their siblings and parents (n=27). Only four families (n=13) completed the entire 5 week intervention. Over the course of the study, survey results of participants' attitudes regarding health suggested a positive trend toward self efficacy, while BMI appeared stable or increased. Participants demonstrated retention of successful health behaviors up to 8 months after the end of the intervention through qualitative reports of being "more conscious of meals and what (they) are eating," "valu[ing their] nutrition on a daily basis," "play[ing] a lot outside and inside on the weekends," "carry[ing] a water bottle," and "cook(ing) a lot." A higher percentage of respondents in the final session compared selected the option "strongly agree" to each of the following statements: "I can be healthier if my family works together" (87.5% final session vs. 84.6% first session), "Drinking water makes me healthy" (87.5% final session vs. 84.6% first session), "Moving my body makes me healthy" (87.5% final session vs. 76.9% first session), "I reach my goals even when things get in my way" (62.5% final session vs. 46.2% first session), "Eating fruits and veggies make me healthy" (100% final session vs. 92.3% first session), "I can be healthy and enjoy my favorite foods" (87.5% final session vs. 66.7% first session), and "I can create a healthy balanced meal" (87.0% final session vs. 75.0% first session). Concrete data analysis was severely complicated by loss of study participants to follow up and incomplete data collection.

CONCLUSIONS

Project HAPPY showed promising indications that should be further evaluated in studies of larger scale and longer duration.

Factors associated with family functioning in patients with heart failure and their family members: An international cross-sectional study

AIMS

To describe and compare family functioning, family health, and perceived social support from nurses and to identify the variables that are associated with family functioning in patients with heart failure (HF) and their family members in Denmark, Iran, and Iceland.

DESIGN

An international multi-centre cross-sectional study.

METHODS

A sample of 1382 participants (692 patients and 690 family members) from Denmark, Iceland, and Iran were included from January 2015 to May 2020. Data were collected using the Family Functioning, Health, and Social Support questionnaire.

RESULTS

The significant factors associated with family functioning in patients were country, New York Heart Association classification (NYHA), education level, age, family health, social support, and there was a significant interaction effect between NYHA class and gender. The significant factors associated with family functioning in family members were country, education level, work status, family health, and there was a significant interaction effect between education and work status.

CONCLUSION

This study indicated that the strongest factor associated with higher family functioning was family health for both patients and family members. Women in NYHA class I and younger patients and those with an academic education had a lower level of family functioning. Moreover, unemployed family members with an elementary education and family members with elementary and high school educations who were self-employed or employees had a lower level of family functioning.

IMPACT

This is the first international study to investigate family functioning, family health, and social support and adds to the literature on the factors associated with family functioning in patients with HF and their family members. Our findings may help nurses to identify the most vulnerable families living with HF, thereby being able to provide special support to enhance their family functioning to promote self-management strategies.

Lay health worker as interventionist training: reflective writing in US family health promotion practice

Lay health worker-led health promotion interventions are well received within racial and ethnic minority communities. Increasing numbers of trained lay health workers will be needed to meet global health goals. The purpose of this process evaluation was to gain insights about how lay health worker as interventionists used theory-based approaches within a nutrition and physical activity health behavior change intervention in a clinical trial enrolling immigrant and refugee families. Data were comprised of ongoing reflective writing statements from four health workers about their implementation of the intervention. Using content analysis three themes emerged: (i) encouraging setting of small, family focused and relevant goals, (ii) being flexible in content delivery and (iii) being personally transformed (i.e. gained a sense of meaning from their experience). Lay health worker interventionist reflections on practice revealed they delivered the intervention within the primacy of the family partnering relationship by attending to unique family needs, and adjusting educational content and goal setting accordingly. Our results provide guidance for training and process evaluation of lay health worker intervention delivery in ethnically and racially diverse populations. Incorporating real-time reflection upon what was learned about skills of facilitating family motivation and family confidence enhanced affective learning and may be useful in future research studies and health promotion practice. The processes identified including setting small goals, flexibility and personal transformation could be considered in future lay health worker-delivered health promotion interventions.

The Role of Family Caregiver's Sense of Coherence and Family Adaptation Determinants in Predicting Distress and Caregiver Burden in Families of Cancer Patients

Background:

Most cancer patients' families suffer from maladaptation which increases family distress and caregiving burden. This study was conducted to explore the relationship between these maladaptation indicators, and the sense of coherence (SOC) of family caregivers alongside other family resilience determines among family caregivers of cancer patients.

Methods:

A total of 104 family caregivers of cancer patients were included in this cross-sectional study. They answered three questionnaires to assess family resilience factors: Family Inventory of Resources for Management (FIRM), Family Crisis Oriented Personal Evaluation Scales (F-COPES), and SOC scale. In addition, family maladaptation factors were determined by two instruments, including Family Distress Index (FDI) and Caregiver Burden Inventory (CBI).

Results:

The results of this study showed that the FIRM and the SOC together were responsible for 35% and 43% of the variances in FDI and CBI scores, respectively (P < 0.001). “Reframing”, the subscale of the F-COPES, significantly predicted the variances of FDI (β = −0.26, P = 0.01) and CBI scores (β = −0.21, P = 0.04). Moreover, “Mastery and health”, the subscale of the FIRM, significantly predicted the variances of FDI (β = −0.38, P < 0.01) and CBI scores (β = −0.21, P = 0.02).

Conclusions:

Family caregiver's SOC alongside other family resilience determinants plays a significant role in alleviating family distress and caregiver burden. It is suggested that palliative care providers consider family caregivers' SOC in developing a psychological intervention plan to improve family resilience in families of cancer patients.

Parental consumption of ultra-processed, high-fat products has no association with childhood overweight/obesity: an epidemiological study among 10-12-years-old children in Greece

BACKGROUND

Overweight and obesity during childhood consist two of the most important public health issues in the 21st century. Consumption of high-fat processed food has been increased alarmingly.

OBJECTIVE

To examine the association between parental ultra-processed, high-fat products' consumption and childhood overweight/obesity.

METHODS

A cross-sectional survey, conducted among 422 children, aged 10-12 years, and their parents, during school years 2014-16. Parental and child data were collected through self-administered, anonymous and validated questionnaires. Among others, high-fat ultra-processed food consumption was also recorded. Children's weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index (BMI) cut-offs.

RESULTS

The prevalence of obesity in the reference population was 2.9%, whereas the prevalence of overweight was 19.3%. A strong correlation was observed between children's and their parents' BMI status (P < 0.001). Multi-adjusted data analysis revealed no association between parental intake of ultra-processed, high-fat products and children overweight/obesity. Similarly, when the data analysis accounted for family income and physical activity status of the children, the aforementioned results remained insignificant.

CONCLUSION

Despite the fact that parents' specific dietary habits seem not to affect their children's weight status, public health programs should consider parental nutrition education and mobilization as a preventive measure for childhood overweight/obesity.

Exploring the health of families with a child with autism

LAY ABSTRACT

Families are important for the overall growth and development of a child. The health of a family is foundational to the everyday life in which a child and family can blossom. Families with a child with autism have a family life that has challenges for many reasons including that parents can be stressed from trying to figure out how to be a good parent for their child with autism. We wanted to know two things: (1) what is family health for families of a child with autism and (2) what affects families trying to be their healthiest. We wanted to know the answers to these questions from families themselves, including parents (not just moms), children, and children with autism, because they are the best experts. We talked to 16 families including 16 mothers, 8 fathers, and 32 children (18 with autism). Families shared that being a healthy family was a journey with ups and downs and that families were not always perfect. It helped when families knew about themselves as a family such as knowing what they liked and did not like to do, and knowing what the different people in the family needed. Families said that what helped and influenced their family's health was being together, keeping their days not too busy, stress, autism itself, having helpers like friends, grandparents, therapists, and having money to pay for services. We hope that knowing these answers will guide service providers of people with autism to think about healthy families from a holistic perspective.

The Family Health Scale: Reliability and Validity of a Short- and Long-Form

Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.