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Mallory KD, Al-Hakeem H, Alam S, Brassel S, Isaacs T, Basarke S, Hooper M, Hickling A, Scratch SE. Evaluating iSibWorks: A virtual cognitive-behavioural intervention for siblings of children with disabilities. PEC INNOVATION 2024; 5:100326. [PMID: 39157712 PMCID: PMC11326925 DOI: 10.1016/j.pecinn.2024.100326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 08/20/2024]
Abstract
Objectives 1) Examine if participation in iSibWorks, a group-based virtual intervention for siblings of children with disabilities, impacted siblings' perception of quality of life (QoL) and social support; and 2) Explore siblings' feedback on iSibWorks. Methods Thirty-eight children participated in iSibWorks and completed questionnaires (Pediatric Quality of Life [PedsQL™], Social Support Scale for Children [SSSC]) one week pre- and post-intervention. Conventional content analysis was used to explore siblings' open-ended responses on a post-participation feedback form. Results No significant differences in PedsQL™ and SSSC scores were observed after participating in iSibWorks. Despite this, siblings had positive feedback about iSibWorks and discussed: 1) Engaging in group learning and activities, 2) Meeting other siblings, and 3) Applying iSibWorks content to their daily life. Conclusion Factors related to the COVID-19 pandemic such as family stress, school closures, virtual learning, and social distancing likely impacted study results. Although there were no significant changes in QoL and social support, siblings found iSibWorks to be fun, meaningful, and engaging. Innovation Siblings of children with disabilities can experience psychosocial challenges and there are few virtual interventions designed for this population. iSibWorks was adapted to address this gap and increase access and support for siblings of children with disabilities.
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Affiliation(s)
- Kylie D. Mallory
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada
| | - Hiba Al-Hakeem
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada
| | - Shazeen Alam
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 60-500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Sandy Brassel
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 60-500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Tamiko Isaacs
- Department of Psychology, York University, 4700 Keele Street, Behavioural Science Building, Room 297, Toronto, ON M3J 1P3, Canada
| | - Sonya Basarke
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada
| | - Marie Hooper
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada
- Department of Psychology, York University, 4700 Keele Street, Behavioural Science Building, Room 297, Toronto, ON M3J 1P3, Canada
| | - Andrea Hickling
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 60-500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Shannon E. Scratch
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON M5G 1X8, Canada
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Santamaría Torres A, Rozo Guzmán AN, Trujillo Naranjo MC, Carreño Moreno SP. El hermano del niño con cáncer merece ser visible. REVISTA LATINOAMERICANA DE BIOÉTICA 2022. [DOI: 10.18359/rlbi.5436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
El hermano sano en situaciones de cáncer infantil es con frecuencia un sujeto invisible para su familia, los profesionales de la salud y las instituciones. El objetivo de este trabajo fue mapear e integrar la literatura científica acerca de la experiencia del hermano del niño diagnosticado con cáncer. Se desarrolló una Scoping Review de 28 artículos publicados entre 2016 y 2020, en los idiomas español, inglés y portugués. Se incluyeron 12 estudios cualitativos, 15 cuantitativos y un estudio mixto. Frente a los hallazgos, se identificó que hay cambios en las relaciones entre hermanos, parentales y sociales, además de cambios personales y una oferta limitada de apoyo a los hermanos del niño con cáncer. Se concluye que el cáncer infantil afecta directamente a los miembros de la familia, incluido al hermano sano, quien enfrenta cambios drásticos en su vida que implican nuevas necesidades, sentimientos y conductas de riesgo. Se requiere una mayor investigación y abordaje acerca del impacto del cáncer infantil en hermanos sanos, así como el diseño de intervenciones que pongan de manifiesto la necesidad de hacer visible a este sujeto que sufre el daño colateral del cáncer infantil y que ha sido descuidado por su familia y por los profesionales en salud.
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Uber A, Ebelhar JS, Lanzel AF, Roche A, Vidal-Anaya V, Brock KE. Palliative Care in Pediatric Oncology and Hematopoietic Stem Cell Transplantation. Curr Oncol Rep 2022; 24:161-174. [DOI: 10.1007/s11912-021-01174-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
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Multifaceted Support Interventions for Siblings of Children With Cancer: A Systematic Review. Cancer Nurs 2021; 44:E609-E635. [PMID: 34406189 DOI: 10.1097/ncc.0000000000000966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND When a child is given a diagnosis of cancer, the impact reverberates through the family unit. Siblings, in particular, experience an accumulation of distress. Siblings of children with cancer can experience both short- and long-term difficulties in psychosocial and physical functioning, and professional bodies have called for interventions targeted at their needs. OBJECTIVE The aim of this study was to describe outcomes, core components, and general characteristics of effective interventions intended to support sibling well-being and psychosocial health in pediatric oncology. METHODS MEDLINE (Ovid), EMBASE, CINAHL, PsycINFO, and Cochrane CENTRAL databases were searched in September 2019 and July 2020. Studies were included if they focused on interventions for siblings or family in pediatric cancer, had quantitative data to describe the effect or impact of the intervention, and were published in English. Included studies underwent quality appraisal, data extraction, and data synthesis. RESULTS Twenty articles fit inclusion criteria. Most interventions focused on 6- to 18-year-old siblings within a group setting. Most were theory based. Group format with multiple sessions was the most common approach. The most frequently assessed outcomes were depression, anxiety, posttraumatic stress symptoms, and health-related quality of life. CONCLUSIONS Understanding outcomes, core components, and characteristics of effective interventions is important to translate sibling-support interventions into standard practice. Such considerations are important in delivering equitable family-centered care to siblings of children with cancer. IMPLICATIONS FOR PRACTICE As institutions create mechanisms to support siblings, it may be important to target high-risk siblings initially, partner with community resources, attend to underrecognized populations of siblings, and more fully incorporate family into sibling support.
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Turchi GP, Dalla Riva MS, Orrù L, Pinto E. How to Intervene in the Health Management of the Oncological Patient and of Their Caregiver? A Narrative Review in the Psycho-Oncology Field. Behav Sci (Basel) 2021; 11:99. [PMID: 34356716 PMCID: PMC8301046 DOI: 10.3390/bs11070099] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/22/2023] Open
Abstract
Starting from statistical data derived from the oncological field, some articles have highlighted the importance of communication in the patient-caregiver dyad and have considered the various roles involved in a cancer diagnosis situation. Thus, the question of how to intervene in terms of "quality of life" from the time of diagnosis to the recovery or death of a cancer patient, beyond the sanitary and physical dimensions, has become relevant. Therefore, the present narrative review aims to offer an overview of the state of the art in terms of the psychological treatment modalities of cancer patients, from the diagnosis to the post-surgery period. A total of 67 articles were collected and analyzed, in relation to (1) psychological constructs employed in the oncological field, (2) intervention models and (3) quality of life and well-being measurement and evaluation tools. We described these articles, differentiating between those focusing on the role of (1) the patient, (2) the caregiver, (3) the patient-caregiver dyad and (4) healthcare professional roles. The oncological diagnosis and its repercussions in the lives of the patient and caregiver were explored and critical aspects that emerged from the literature were highlighted. In conclusion, the analysis allowed some considerations about the need to define research protocols and useful management strategies for increasing the overall health of patients with cancer diagnoses and the people who surround them.
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Affiliation(s)
- Gian Piero Turchi
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy; (G.P.T.); (M.S.D.R.); (L.O.)
| | - Marta Silvia Dalla Riva
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy; (G.P.T.); (M.S.D.R.); (L.O.)
| | - Luisa Orrù
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy; (G.P.T.); (M.S.D.R.); (L.O.)
| | - Eleonora Pinto
- Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology, 35128 Padua, Italy
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Guan T, Chapman MV, Qan'ir Y, Song L. Psychosocial interventions for siblings of children with cancer: A mixed methods systematic review. Psychooncology 2021; 30:818-831. [PMID: 33848391 DOI: 10.1002/pon.5684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/22/2021] [Accepted: 03/22/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This review systematically (1) describes the characteristics of psychosocial interventions for siblings of children with cancer (SCC); (2) assesses the effect of the psychosocial interventions on SCCs' outcomes, and (3) describes SCCs' experiences and perceptions of these interventions. METHODS Seven databases were systematically searched for relevant literature. We included both quantitative and qualitative studies of psychological interventions designed to improve the adjustment of SCCs. RESULTS Our database searches yielded 19 publications. We found a range of psychosocial interventions being used among SCCs, with group interventions being the most common. The primary outcomes focused on the SCCs' depression, anxiety, and quality of life. Quantitative studies provided insufficient evidence to draw definitive conclusions about the interventions' effects, whereas the qualitative studies indicated that SCCs can derive benefits from these interventions, including an enhanced sense of belonging and bonding, improved family relationships, increased self-awareness and confidence, increased cancer knowledge, and decreased somatic symptoms. CONCLUSIONS Although a growing number of psychosocial interventions have been developed to improve the adjustment of SCCs, research evidence of the effects of these interventions on SCCs' adjustment remains limited. Future research needs to rigorously evaluate the effects of these interventions.
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Affiliation(s)
- Ting Guan
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mimi V Chapman
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yousef Qan'ir
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lixin Song
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Buchbinder D, Sidhu S, Alderfer MA, Lown A, Kolarik RC, Wang T. Pediatric resident knowledge, experience, comfort, and perceived competency in providing sibling psychosocial support. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:73-75. [PMID: 32199019 PMCID: PMC7246124 DOI: 10.5116/ijme.5e63.6a46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/07/2020] [Indexed: 06/10/2023]
Affiliation(s)
- David Buchbinder
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
| | - Sonam Sidhu
- Department of Pediatrics, University of California at Los Angeles, Los Angeles, CA, USA
| | - Melissa A. Alderfer
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Anne Lown
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Russ C. Kolarik
- Department of Internal Medicine-Pediatrics, University of South Carolina, Greenville, SC, USA
| | - Tommy Wang
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
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Law E, Fisher E, Eccleston C, Palermo TM. Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev 2019; 3:CD009660. [PMID: 30883665 PMCID: PMC6450193 DOI: 10.1002/14651858.cd009660.pub4] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Psychological therapies for parents of children and adolescents with chronic illness aim to improve parenting behavior and mental health, child functioning (behavior/disability, mental health, and medical symptoms), and family functioning.This is an updated version of the original Cochrane Review (2012) which was first updated in 2015. OBJECTIVES To evaluate the efficacy and adverse events of psychological therapies for parents of children and adolescents with a chronic illness. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and trials registries for studies published up to July 2018. SELECTION CRITERIA Included studies were randomized controlled trials (RCTs) of psychological interventions for parents of children and adolescents with a chronic illness. In this update we included studies with more than 20 participants per arm. In this update, we included interventions that combined psychological and pharmacological treatments. We included comparison groups that received either non-psychological treatment (e.g. psychoeducation), treatment as usual (e.g. standard medical care without added psychological therapy), or wait-list. DATA COLLECTION AND ANALYSIS We extracted study characteristics and outcomes post-treatment and at first available follow-up. Primary outcomes were parenting behavior and parent mental health. Secondary outcomes were child behavior/disability, child mental health, child medical symptoms, and family functioning. We pooled data using the standardized mean difference (SMD) and a random-effects model, and evaluated outcomes by medical condition and by therapy type. We assessed risk of bias per Cochrane guidance and quality of evidence using GRADE. MAIN RESULTS We added 21 new studies. We removed 23 studies from the previous update that no longer met our inclusion criteria. There are now 44 RCTs, including 4697 participants post-treatment. Studies included children with asthma (4), cancer (7), chronic pain (13), diabetes (15), inflammatory bowel disease (2), skin diseases (1), and traumatic brain injury (3). Therapy types included cognitive-behavioural therapy (CBT; 21), family therapy (4), motivational interviewing (3), multisystemic therapy (4), and problem-solving therapy (PST; 12). We rated risk of bias as low or unclear for most domains, except selective reporting bias, which we rated high for 19 studies due to incomplete outcome reporting. Evidence quality ranged from very low to moderate. We downgraded evidence due to high heterogeneity, imprecision, and publication bias.Evaluation of parent outcomes by medical conditionPsychological therapies may improve parenting behavior (e.g. maladaptive or solicitous behaviors; lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.28, 95% confidence interval (CI) -0.43 to -0.13; participants = 664; studies = 3; SMD -0.21, 95% CI -0.37 to -0.05; participants = 625; studies = 3; I2 = 0%, respectively, low-quality evidence), chronic pain post-treatment and follow-up (SMD -0.29, 95% CI -0.47 to -0.10; participants = 755; studies = 6; SMD -0.35, 95% CI -0.50 to -0.20; participants = 678; studies = 5, respectively, moderate-quality evidence), diabetes post-treatment (SMD -1.39, 95% CI -2.41 to -0.38; participants = 338; studies = 5, very low-quality evidence), and traumatic brain injury post-treatment (SMD -0.74, 95% CI -1.25 to -0.22; participants = 254; studies = 3, very low-quality evidence). For the remaining analyses data were insufficient to evaluate the effect of treatment.Psychological therapies may improve parent mental health (e.g. depression, anxiety, lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.21, 95% CI -0.35 to -0.08; participants = 836, studies = 6, high-quality evidence; SMD -0.23, 95% CI -0.39 to -0.08; participants = 667; studies = 4, moderate-quality evidence, respectively), and chronic pain post-treatment and follow-up (SMD -0.24, 95% CI -0.42 to -0.06; participants = 490; studies = 3; SMD -0.20, 95% CI -0.38 to -0.02; participants = 482; studies = 3, respectively, low-quality evidence). Parent mental health did not improve in studies of children with diabetes post-treatment (SMD -0.24, 95% CI -0.90 to 0.42; participants = 211; studies = 3, very low-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent mental health.Evaluation of parent outcomes by psychological therapy typeCBT may improve parenting behavior post-treatment (SMD -0.45, 95% CI -0.68 to -0.21; participants = 1040; studies = 9, low-quality evidence), and follow-up (SMD -0.26, 95% CI -0.42 to -0.11; participants = 743; studies = 6, moderate-quality evidence). We did not find evidence for a beneficial effect for CBT on parent mental health at post-treatment or follow-up (SMD -0.19, 95% CI -0.41 to 0.03; participants = 811; studies = 8; SMD -0.07, 95% CI -0.34 to 0.20; participants = 592; studies = 5; respectively, very low-quality evidence). PST may improve parenting behavior post-treatment and follow-up (SMD -0.39, 95% CI -0.64 to -0.13; participants = 947; studies = 7, low-quality evidence; SMD -0.54, 95% CI -0.94 to -0.14; participants = 852; studies = 6, very low-quality evidence, respectively), and parent mental health post-treatment and follow-up (SMD -0.30, 95% CI -0.45 to -0.15; participants = 891; studies = 6; SMD -0.21, 95% CI -0.35 to -0.07; participants = 800; studies = 5, respectively, moderate-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent outcomes.Adverse eventsWe could not evaluate treatment safety because most studies (32) did not report on whether adverse events occurred during the study period. In six studies, the authors reported that no adverse events occurred. The remaining six studies reported adverse events and none were attributed to psychological therapy. We rated the quality of evidence for adverse events as moderate. AUTHORS' CONCLUSIONS Psychological therapy may improve parenting behavior among parents of children with cancer, chronic pain, diabetes, and traumatic brain injury. We also found beneficial effects of psychological therapy may also improve parent mental health among parents of children with cancer and chronic pain. CBT and PST may improve parenting behavior. PST may also improve parent mental health. However, the quality of evidence is generally low and there are insufficient data to evaluate most outcomes. Our findings could change as new studies are conducted.
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Affiliation(s)
- Emily Law
- Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
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Washington KT, Demiris G, Parker Oliver D, Albright DL, Craig KW, Tatum P. Delivering problem-solving therapy to family caregivers of people with cancer: A feasibility study in outpatient palliative care. Psychooncology 2018; 27:2494-2499. [PMID: 30107070 DOI: 10.1002/pon.4859] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE In response to the well-documented need for evidence-based cancer caregiver support, we examined the feasibility of problem-solving therapy for family caregivers of cancer patients receiving outpatient palliative care and investigated the impact of problem-solving therapy on family caregivers' anxiety, depression, and quality of life. METHODS We conducted a feasibility study of a structured problem-solving therapy intervention delivered to family caregivers of cancer patients receiving outpatient palliative care from an academic health center in the Midwestern United States. Participants (N = 83) were randomly assigned to receive usual care or usual care plus a problem-solving therapy intervention, which was delivered over three sessions via web-based videoconferencing or telephone. Descriptive statistics were used to determine feasibility relative to recruitment, retention, and fidelity to core intervention components. Outcome data were analyzed using ordinary least squares multiple regression. RESULTS Problem-solving therapy for family caregivers of patients with cancer was found to be highly feasible in the outpatient palliative care setting. Caregivers who received problem-solving therapy reported less anxiety than those who received only usual care (P = 0.03). No statistically significant differences were observed for caregiver depression (P = 0.07) or quality of life (P = 0.06). CONCLUSIONS Problem-solving therapy is a feasible and promising approach to reducing cancer family caregivers' anxiety in the outpatient palliative care setting. Further testing in multiple sites is recommended.
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Affiliation(s)
- Karla T Washington
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri
| | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Debra Parker Oliver
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri
| | - David L Albright
- School of Social Work, University of Alabama, Tuscaloosa, Alabama
| | - Kevin W Craig
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri
| | - Paul Tatum
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri
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