Feasibility, acceptability, and preliminary outcomes of the Fortalezas Familiares intervention for Latino families facing maternal depression

PubMed Central

Valdez, Carmen R.; Padilla, Brian; Moore, Sarah; Magaña, Sandra

2014-01-01

This pilot study examined the feasibility, acceptability, and preliminary outcomes of a linguistically- and culturally-adapted intervention for immigrant Latina mothers with depression and their families. Fortalezas Familiares (Family Strengths) is a community-based, 12-week, multi-family group intervention that aims to increase communication about family processes leading up to and affected by the mother’s depression, build child coping and efficacy, enhance parenting competence and skills, and promote cultural and social assets within the family. In terms of feasibility, of 16 families who enrolled and participated in the intervention, 13 families attended more than 90% of meetings and completed the intervention. Post-tests reported positive changes following the intervention, including improved psychological functioning, increased family and marital support, and enhanced family functioning, as reported by mothers and other caregivers. Mothers also reported decreased conduct and hyperactivity problems among their children. Children reported positive changes in their psychological functioning and coping, peer relations, parenting warmth and acceptance, and overall family functioning. Post-intervention focus groups and surveys measuring acceptability revealed families’ satisfaction with the intervention and suggested areas of improvement. We discuss similarities and differences in outcomes between the adapted intervention, Fortalezas Familiares, and the original intervention, Keeping Families Strong, and propose future areas of intervention adaptation and development. PMID:24033238

eHealth Familias Unidas: Efficacy Trial of an Evidence-Based Intervention Adapted for Use on the Internet with Hispanic Families.

PubMed

Estrada, Yannine; Lee, Tae Kyoung; Wagstaff, Rachel; M Rojas, Lourdes; Tapia, Maria I; Velázquez, Maria Rosa; Sardinas, Krystal; Pantin, Hilda; Sutton, Madeline Y; Prado, Guillermo

2018-05-10

While substance use and sexual risk behaviors among Hispanic youth continue to be public health concerns, few evidence-based preventive interventions are developed for and implemented with Hispanic/Latino youth. The objective of this study was to evaluate the efficacy of eHealth Familias Unidas, an Internet adaptation of an evidence-based family intervention for Hispanics. A randomized controlled trial design (n = 230) was used to evaluate intervention effects on substance use and condomless sex among a sample of Hispanic eighth graders with behavioral problems. Participants were randomized to eHealth Familias Unidas (n = 113) or prevention as usual (n = 117) and assessed at baseline and 3 and 12 months post baseline. We trained mental health school personnel and community mental health professionals to recruit and deliver the Internet-based intervention with Hispanic families. It was hypothesized that, over time, eHealth Familias Unidas would be more efficacious than prevention as usual in reducing drug use (marijuana, cocaine, inhalants, and other drugs), prescription drug use, cigarette use, alcohol use, and condomless sex and that these changes would be mediated by family functioning. Significant intervention effects were found across time for drug use, prescription drug use, and cigarette use. While eHealth Familias Unidas positively affected family functioning, mediation effects were not found. This study demonstrated that family-based eHealth interventions can be efficacious among Hispanic populations when delivered in community settings.

Cultural adaptation process for international dissemination of the strengthening families program.

PubMed

Kumpfer, Karol L; Pinyuchon, Methinin; Teixeira de Melo, Ana; Whiteside, Henry O

2008-06-01

The Strengthening Families Program (SFP) is an evidence-based family skills training intervention developed and found efficacious for substance abuse prevention by U.S researchers in the 1980s. In the 1990s, a cultural adaptation process was developed to transport SFP for effectiveness trials with diverse populations (African, Hispanic, Asian, Pacific Islander, and Native American). Since 2003, SFP has been culturally adapted for use in 17 countries. This article reviews the SFP theory and research and a recommended cultural adaptation process. Challenges in international dissemination of evidence-based programs (EBPs) are discussed based on the results of U.N. and U.S. governmental initiatives to transport EBP family interventions to developing countries. The technology transfer and quality assurance system are described, including the language translation and cultural adaptation process for materials development, staff training, and on-site and online Web-based supervision and technical assistance and evaluation services to assure quality implementation and process evaluation feedback for improvements.

Cultural Adaptation of a Neurobiologically Informed Intervention in Local and International Contexts.

PubMed

Pakulak, Eric; Hampton Wray, Amanda; Longoria, Zayra; Garcia Isaza, Alejandra; Stevens, Courtney; Bell, Theodore; Burlingame, Sarah; Klein, Scott; Berlinski, Samuel; Attanasio, Orazio; Neville, Helen

2017-12-01

The relationship between early adversity and numerous negative outcomes across the lifespan is evident in a wide range of societies and cultures (e.g., Pakulak, Stevens, & Neville, 2018). Among the most affected neural systems are those supporting attention, self-regulation, and stress regulation. As such, these systems represent targets for neurobiologically informed interventions addressing early adversity. In prior work with monolingual native English-speaking families, we showed that a two-generation intervention targeting these systems in families improves outcomes across multiple domains including child brain function for selective attention (for detail, see Neville et al., 2013). Here, we discuss the translation and cultural adaptation (CA) of this intervention in local and international contexts, which required systematic consideration of cultural differences that could affect program acceptability. First, we conducted a translation and CA of our program to serve Latino families in the United States using the Cultural Adaptation Process (CAP), a model that works closely with stakeholders in a systematic, iterative process. Second, to implement the adapted program in Medellín, Colombia, we conducted a subsequent adaptation for Colombian culture using the same CAP. Our experience underscores the importance of consideration of cultural differences and a systematic approach to adaptation before assessing the efficacy of neurobiologically informed interventions in different cultural contexts. © 2017 Wiley Periodicals, Inc.

Effectiveness of a Culturally Adapted Strengthening Families Program 12-16-Years for High-Risk Irish Families

ERIC Educational Resources Information Center

Kumpfer, Karol L.; Xie, Jing; O'Driscoll, Robert

2012-01-01

Background: Evidence-based programs (EBPs) targeting effective family skills are the most cost effective for improving adolescent behavioural health. Cochrane Reviews have found the "Strengthening Families Program" (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaptation processes resulted…

Family functioning mediates adaptation in caregivers of individuals with Rett syndrome.

PubMed

Lamb, Amanda E; Biesecker, Barbara B; Umstead, Kendall L; Muratori, Michelle; Biesecker, Leslie G; Erby, Lori H

2016-11-01

The objective of this study was to investigate factors related to family functioning and adaptation in caregivers of individuals with Rett syndrome (RS). A cross-sectional quantitative survey explored the relationships between demographics, parental self-efficacy, coping methods, family functioning and adaptation. A forward-backward, step-wise model selection procedure was used to evaluate variables associated with both family functioning and adaptation. Analyses also explored family functioning as a mediator of the relationship between other variables and adaptation. Bivariate analyses (N=400) revealed that greater parental self-efficacy, a greater proportion of problem-focused coping, and a lesser proportion of emotion-focused coping were associated with more effective family functioning. In addition, these key variables were significantly associated with greater adaptation, as was family functioning, while controlling for confounders. Finally, regression analyses suggest family functioning as a mediator of the relationships between three variables (parental self-efficacy, problem-focused coping, and emotion-focused coping) with adaptation. This study demonstrates the potentially predictive roles of expectations and coping methods and the mediator role of family functioning in adaptation among caregivers of individuals with RS, a chronic developmental disorder. A potential target for intervention is strengthening of caregiver competence in the parenting role to enhance caregiver adaptation. Published by Elsevier Ireland Ltd.

Examining the impact of differential cultural adaptation with Latina/o immigrants exposed to adapted parent training interventions

PubMed Central

Parra-Cardona, J. Rubén; Bybee, Deborah; Sullivan, Cris M.; Domenech Rodríguez, Melanie M.; Dates, Brian; Tams, Lisa; Bernal, Guillermo

2016-01-01

Objective There is a dearth of empirical studies aimed at examining the impact of differential cultural adaptation of evidence-based clinical and prevention interventions. This prevention study consisted of a randomized controlled trial aimed at comparing the impact of two differentially culturally adapted versions of the evidence-based parenting intervention known as Parent Management Training, the Oregon Model (PMTOR). Method The sample consisted of 103 Latina/o immigrant families (190 individual parents). Each family was allocated to one of three conditions: (a) a culturally adapted PMTO (CA), (b) culturally adapted and enhanced PMTO (CE), and (c) a wait-list control. Measurements were implemented at baseline (T1), treatment completion (T2) and 6-month follow up (T3). Results Multi-level growth modeling analyses indicated statistically significant improvements on parenting skills for fathers and mothers (main effect) at 6-month follow-up in both adapted interventions, when compared to the control condition. With regards to parent-reported child behaviors, child internalizing behaviors were significantly lower for both parents in the CE intervention (main effect), compared with control at 6-month follow-up. No main effect was found for child externalizing behaviors. However, a Parent x Condition effect was found indicating a significant reduction of child externalizing behaviors for CE fathers compared to CA and control fathers at posttest and 6-month follow-up. Conclusion Present findings indicate the value of differential cultural adaptation research designs and the importance of examining effects for both mothers and fathers, particularly when culturally-focused and gender variables are considered for intervention design and implementation. PMID:28045288

Adapting, piloting and evaluating complex public health interventions: lessons learned from the Nurse–Family Partnership in Canadian public health settings

PubMed Central

Jack, S. M.; Catherine, N.; Gonzalez, A.; MacMillan, H. L.; Sheehan, D.; Waddell, C.

2015-01-01

Abstract Introduction: The Nurse–Family Partnership (NFP) is a home-visit program for young and first-time, socially and economically disadvantaged mothers. Evidence from three United States randomized controlled trials (RCTs) on the effectiveness of this intervention at improving pregnancy outcomes, improving child health and development, and increasing maternal economic self-sufficiency is robust. However, the effectiveness of the NFP in Canada, with its different health and social care context, needs to be determined. The purpose of this article is to describe the complex process for moving the NFP from the research arena to full implementation in Canada. Methods: This process of evaluation in Canada includes (1) adapting the intervention; (2) piloting the intervention in small-scale feasibility and acceptability studies; and (3) conducting an RCT and process evaluation through a study called the British Columbia Healthy Connections Project (BCHCP). This large-scale evaluation also creates an opportunity to expand the NFP evidence base by conducting an additional study to examine potential biological mechanisms linking intervention and behavioural outcomes in children. Results: Adaptation of the NFP home-visit materials is a continuous process. A pilot project determined that it was feasible to enrol eligible women into the NFP. This pilot also determined that, in Canada, it was most appropriate for public health agencies to implement the NFP and for public health nurses to deliver the intervention. Finally, the pilot showed that this intensive home-visit program was acceptable to clients, their family members and health care providers. Through the BCHCP, the next steps—the RCT and process evaluation—are currently underway. The BCHCP will also set the foundation for long-term evaluation of key public health outcomes in a highly vulnerable population of families. PMID:26605564

Adapting, piloting and evaluating complex public health interventions: lessons learned from the Nurse-Family Partnership in Canadian public health settings.

PubMed

Jack, S M; Catherine, N; Gonzalez, A; MacMillan, H L; Sheehan, D; Waddell, D

2015-01-01

The Nurse-Family Partnership (NFP) is a home-visit program for young and first-time, socially and economically disadvantaged mothers. Evidence from three United States randomized controlled trials (RCTs) on the effectiveness of this intervention at improving pregnancy outcomes, improving child health and development, and increasing maternal economic self-sufficiency is robust. However, the effectiveness of the NFP in Canada, with its different health and social care context, needs to be determined. The purpose of this article is to describe the complex process for moving the NFP from the research arena to full implementation in Canada. This process of evaluation in Canada includes (1) adapting the intervention; (2) piloting the intervention in small-scale feasibility and acceptability studies; and (3) conducting an RCT and process evaluation through a study called the British Columbia Healthy Connections Project (BCHCP). This large-scale evaluation also creates an opportunity to expand the NFP evidence base by conducting an additional study to examine potential biological mechanisms linking intervention and behavioural outcomes in children. Adaptation of the NFP home-visit materials is a continuous process. A pilot project determined that it was feasible to enrol eligible women into the NFP. This pilot also determined that, in Canada, it was most appropriate for public health agencies to implement the NFP and for public health nurses to deliver the intervention. Finally, the pilot showed that this intensive home-visit program was acceptable to clients, their family members and health care providers. Through the BCHCP, the next steps - the RCT and process evaluation - are currently underway. The BCHCP will also set the foundation for long-term evaluation of key public health outcomes in a highly vulnerable population of families.

Exploring the potential of a family-based prevention intervention to reduce alcohol use and violence within HIV-affected families in Rwanda.

PubMed

Chaudhury, Sumona; Brown, Felicity L; Kirk, Catherine M; Mukunzi, Sylvere; Nyirandagijimana, Beatha; Mukandanga, Josee; Ukundineza, Christian; Godfrey, Kalisa; Ng, Lauren C; Brennan, Robert T; Betancourt, Theresa S

2016-03-01

HIV-affected families report higher rates of harmful alcohol use, intimate partner violence (IPV) and family conflict, which can have detrimental effects on children. Few evidence-based interventions exist to address these complex issues in Sub-Saharan Africa. This mixed methods study explores the potential of a family-based intervention to reduce IPV, family conflict and problems related to alcohol use to promote child mental health and family functioning within HIV-affected families in post-genocide Rwanda. A family home-visiting, evidence-based intervention designed to identify and enhance resilience and communication in families to promote mental health in children was adapted and developed for use in this context for families affected by caregiver HIV in Rwanda. The intervention was adapted and developed through a series of pilot study phases prior to being tested in open and randomized controlled trials (RCTs) in Rwanda for families affected by caregiver HIV. Quantitative and qualitative data from the RCT are explored here using a mixed methods approach to integrate findings. Reductions in alcohol use and IPV among caregivers are supported by qualitative reports of improved family functioning, lower levels of violence and problem drinking as well as improved child mental health, among the intervention group. This mixed methods analysis supports the potential of family-based interventions to reduce adverse caregiver behaviors as a major mechanism for improving child well-being. Further studies to examine these mechanisms in well-powered trials are needed to extend the evidence-base on the promise of family-based intervention for use in low- and middle-income countries.

Examining the impact of differential cultural adaptation with Latina/o immigrants exposed to adapted parent training interventions.

PubMed

Parra-Cardona, J Rubén; Bybee, Deborah; Sullivan, Cris M; Rodríguez, Melanie M Domenech; Dates, Brian; Tams, Lisa; Bernal, Guillermo

2017-01-01

There is a dearth of empirical studies aimed at examining the impact of differential cultural adaptation of evidence-based clinical and prevention interventions. This prevention study consisted of a randomized controlled trial aimed at comparing the impact of 2 differentially culturally adapted versions of the evidence-based parenting intervention known as Parent Management Training, the Oregon Model (PMTOR). The sample consisted of 103 Latina/o immigrant families (190 individual parents). Each family was allocated to 1 of 3 conditions: (a) a culturally adapted PMTO (CA), (b) culturally adapted and enhanced PMTO (CE), and (c) a wait-list control. Measurements were implemented at baseline (T1), treatment completion (T2) and 6-month follow up (T3). Multilevel growth modeling analyses indicated statistically significant improvements on parenting skills for fathers and mothers (main effect) at 6-month follow-up in both adapted interventions, when compared with the control condition. With regard to parent-reported child behaviors, child internalizing behaviors were significantly lower for both parents in the CE intervention (main effect), compared with control at 6-month follow-up. No main effect was found for child externalizing behaviors. However, a Parent × Condition effect was found indicating a significant reduction of child externalizing behaviors for CE fathers compared with CA and control fathers at posttest and 6-month follow-up. Present findings indicate the value of differential cultural adaptation research designs and the importance of examining effects for both mothers and fathers, particularly when culturally focused and gender variables are considered for intervention design and implementation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Adapting the Unique Minds Program: Exploring the Feasibility of a Multiple Family Intervention for Children with Learning Disabilities in the Context of Spain.

PubMed

López-Larrosa, Silvia; González-Seijas, Rosa M; Carpenter, John S W

2017-06-01

The Unique Minds Program (Stern, Unique Minds Program, 1999) addresses the socio-emotional needs of children with learning disabilities (LD) and their families. Children and their parents work together in a multiple family group to learn more about LD and themselves as people with the capacity to solve problems in a collaborative way, including problems in family school relationships. This article reports the cultural adaptation of the program for use in Spain and findings from a feasibility study involving three multiple family groups and a total of 15 children and 15 mothers, using a pre-post design. This Spanish adaptation of the program is called "Mentes Únicas". Standardized outcome measures indicated an overall statistically significant decrease in children's self-rated maladjustment and relationship difficulties by the end of the program. Improvements were endorsed by most mothers, although they were not always recognized by the children's teachers. The program had a high level of acceptability: Mothers and children felt safe, understood, and helped throughout the sessions. The efficacy of the adapted intervention for the context of Spain remains to be tested in a more rigorous study. © 2016 Family Process Institute.

eHealth Familias Unidas: Pilot Study of an Internet Adaptation of an Evidence-Based Family Intervention to Reduce Drug Use and Sexual Risk Behaviors Among Hispanic Adolescents

PubMed Central

Estrada, Yannine; Molleda, Lourdes; Murray, Ashley; Drumhiller, Kathryn; Tapia, Maria; Sardinas, Krystal; Rosen, Alexa; Pantin, Hilda; Perrino, Tatiana; Sutton, Madeline; Cano, Miguel Ángel; Dorcius, Daphney; Wendorf Muhamad, Jessica; Prado, Guillermo

2017-01-01

This paper describes the Internet adaptation of an evidenced-based intervention for Hispanic families, eHealth Familias Unidas, and explores whether an Internet-based format is feasible and acceptable to Hispanic families. Core intervention components from the evidence-based intervention, Familias Unidas, were transposed into a video format and edited for content. Additionally, interactive exercises and a soap opera series were incorporated to reinforce intervention content and optimize participant engagement and retention. To understand the feasibility and acceptability of eHealth Familias Unidas, we conducted a pilot study and examined findings from: (1) session completion rates for both e-parent group sessions and family sessions (n = 23 families); and (2) qualitative data collected from Hispanic parents (n = 29) that received the eHealth intervention. Engagement and attendance in the intervention showed that 83% of families engaged in the intervention and that there was an overall session completion rate of 78%. Qualitative interviews were conducted mid and post intervention with a combined total of 29 participants. A general inductive approach was used to derive themes from the collected data. Overall, parents expressed positive feedback in regards to the intervention and stated that there were multiple lessons learned from participating in eHealth Familias Unidas. Findings indicate that an Internet-based family intervention is not only feasible and acceptable for Hispanic families, but also offers a viable option to ameliorate barriers to participation and implementation of preventive interventions. PMID:28273862

Adapting hypertension self-management interventions to enhance their sustained effectiveness among urban African Americans.

PubMed

Ameling, Jessica M; Ephraim, Patti L; Bone, Lee R; Levine, David M; Roter, Debra L; Wolff, Jennifer L; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L; Noronha, Gary J; Fagan, Peter J; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A; Aboumatar, Hanan J; Albert, Michael C; Flynn, Sarah J; Boulware, L Ebony

2014-01-01

African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions' cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial.

Family behavior, adaptation, and treatment adherence of pediatric nephrology patients.

PubMed

Davis, M C; Tucker, C M; Fennell, R S

1996-04-01

In this exploratory study we investigated the relationships among family behavior variables (e.g., family expressiveness), adaptive functioning skills, maladaptive behavior, and adherence to treatment in pediatric renal failure patients. The study included 22 pediatric outpatients with renal failure who had not yet received dialysis or transplantation (RF) and their parents, and 12 pediatric outpatients with kidney transplants (TX) and their parents. For the RF patients, significant correlations were found between some of their adaptive functioning skills and measures of their medication adherence, diet adherence, and clinic appointment adherence; however, for the TX patients significant correlations were found only between some of their adaptive functioning skills and measures of their medication adherence. For the RF patients only, some measures of their family behavior were significantly correlated with measures of their medication adherence and diet adherence. Additionally, some measures of the RF patients' family behavior were significantly related to their communication skills, socialization skills, overall adaptive functioning skills, and maladaptive behavior. For the TX patients, only their socialization skill level was significantly correlated with one measure of their family behavior. It is concluded that facilitation of adaptive and physical functioning among renal pediatric patients likely requires multidimensional training and/or counselling interventions with the children and their families, and that some of the content and/or emphasis of this training likely needs to differ for RF patients versus TX patients.

Developing preventive mental health interventions for refugee families in resettlement.

PubMed

Weine, Stevan Merrill

2011-09-01

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. 2011 © FPI, Inc.

Developing Preventive Mental Health Interventions for Refugee Families in Resettlement

PubMed Central

WEINE, STEVAN MERRILL

2014-01-01

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. PMID:21884078

The effect of peer support groups on family adaptation from the perspective of wives of war veterans with posttraumatic stress disorder.

PubMed

Vagharseyyedin, Seyyed Abolfazl; Gholami, Mojtaba; Hajihoseini, Morteza; Esmaeili, Aliakbar

2017-11-01

The aim of this study was to examine the effect of peer group support on family adaptation of wives of war veterans suffering from post-traumatic stress disorder (PTSD). In this randomized controlled trial, 80 wives of war veterans with PTSD were incorporated, and selected participants were randomly assigned into intervention and control groups (n = 40 per group). The intervention group was divided into four subgroups, with each participating in eight weekly based 1.5-hr peer support group sessions and the control group received no intervention. Demographics form and Family Adaptation Scale (FAS) developed by Antonovsky and Sourani (1988) were applied. The total mean scores of family adaptation increased significantly more in the intervention group than in the control group (p = .033). Furthermore, the time × group interaction effects were significant for internal family fit (p = .013) and a combination of both family fit and family community fit (p = .020) dimensions. Nonetheless family fit dimensions mean scores had no significant increase in the intervention group than the control group over time (p = .948). Peer support group can be a useful tool for health care professionals to enhance family adaptation in spouses of war veterans with PTSD. © 2017 Wiley Periodicals, Inc.

Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China.

PubMed

Williams, Ann B; Wang, Honghong; Burgess, Jane; Li, Xianhong; Danvers, Karina

2013-04-01

Adapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. This paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SITE: The intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. The adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. The adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. The primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include (1) involve stakeholders from the beginning; (2) assess the population, need, and context; (3) evaluate the intervention to be adapted with attention to

An Adapted Brief Strategic Family Therapy for Gang-Affiliated Mexican American Adolescents

ERIC Educational Resources Information Center

Valdez, Avelardo; Cepeda, Alice; Parrish, Danielle; Horowitz, Rosalind; Kaplan, Charles

2013-01-01

Objective: This study assessed the effectiveness of an adapted Brief Strategic Family Therapy (BSFT) intervention for gang-affiliated Mexican American adolescents and their parents. Methods: A total of 200 adolescents and their family caregivers were randomized to either a treatment or a control condition. Outcomes included adolescent substance…

Adapting Hypertension Self-Management Interventions to Enhance their Sustained Effectiveness among Urban African Americans

PubMed Central

Ameling, Jessica M.; Ephraim, Patti L.; Bone, Lee R.; Levine, David M.; Roter, Debra L.; Wolff, Jennifer L.; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L.; Noronha, Gary J.; Fagan, Peter J.; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A.; Aboumatar, Hanan J.; Albert, Michael C.; Flynn, Sarah J.; Boulware, L. Ebony

2014-01-01

African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions’ cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial. PMID:24569158

Family adaptation to cerebral palsy in adolescents: A European multicenter study.

PubMed

Guyard, Audrey; Michelsen, Susan I; Arnaud, Catherine; Fauconnier, Jerome

2017-02-01

Factors promoting family adaptation to child's disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model. 286 families of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations. 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed. Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child's family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main stressors, family functioning as the largest protecting factors, and equipment and

Pilot Study to Gauge Acceptability of a Mindfulness-Based, Family-Focused Preventive Intervention

ERIC Educational Resources Information Center

Duncan, Larissa G.; Coatsworth, J. Douglas; Greenberg, Mark T.

2009-01-01

The purpose of the present study was to conduct a test of acceptability of a new model for family-focused drug prevention programs for families of early adolescents. An existing evidence-based behavioral intervention, the Strengthening Families Program: For Parents and Youth 10-14 (SFP), was adapted to include concepts and activities related to…

Religious Involvement and Adaptation in Female Family Caregivers.

PubMed

Koenig, Harold G; Nelson, Bruce; Shaw, Sally F; Saxena, Salil; Cohen, Harvey Jay

2016-03-01

To examine the relationship between religious involvement (RI) and adaptation of women caring for family members with severe physical or neurological disability. Two-site cross-sectional study. Community. A convenience sample of 251 caregivers was recruited. RI and caregiver adaptation (assessed by perceived stress, caregiver burden, and depressive symptoms) were measured using standard scales, along with caregiver characteristics, social support, and health behaviors. Bivariate and multivariate analyses were conducted to identify relationships and mediating and moderating factors. Religious involvement (RI) was associated with better caregiver adaptation independent of age, race, education, caregiver health, care recipient's health, social support, and health behaviors (B = -0.09, standard error = 0.04, t = -2.08, P = .04). This association was strongest in caregivers aged 58-75 and spouses and for perceived stress in blacks. Religious involvement (RI) in female caregivers is associated with better caregiver adaptation, especially for those who are older, spouses of the care recipients, and blacks. These results are relevant to the development of future interventions that provide support to family caregivers. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Maternal perceptions of sibling adaptation in Korean families of children with Down syndrome.

PubMed

Choi, H; Van Riper, M

2014-10-01

It is estimated that more than 500 infants with Down syndrome (DS) are born each year in Korea. DS affects not only these individuals, but family members as well. Some siblings deal successfully with the challenges of living with a child with DS and adapt well while others struggle or fail to adapt. The aims of this descriptive study were to explore how Korean mothers of children with DS perceive the adaptation of their typically developing (TD) children aged 4 to 19 and how family variables contribute to sibling adaptation. This descriptive, cross-sectional study was conducted with 105 Korean mothers. Most mothers indicated that their TD children were not experiencing psychological or behavioural problems; however, many described problems in the sibling relationship. It was found that family factors (i.e. condition management effort, condition management ability, child's daily life, parental mutuality, family hardiness and social support) were strong predictors of sibling psychological, behavioural and relational adaptation. Demographic characteristics of the child with DS, the mother and the family appeared to significantly influence sibling adaptation. These findings highlight the importance of familial contexts in understanding sibling adaptation. Knowledge of family factors associated with better adaptation in Korean siblings of child with DS will facilitate the development of culturally appropriate interventions for these children and their families. In addition, an awareness of demographic characteristics associated with sibling adaptation will help health care professionals identify siblings who are at increased risk of experiencing difficulties in adapting. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Family intervention for schizophrenia

PubMed Central

Pharoah, Fiona; Mari, Jair; Rathbone, John; Wong, Winson

2014-01-01

Background People with schizophrenia from families that express high levels of criticism, hostility, or over involvement, have more frequent relapses than people with similar problems from families that tend to be less expressive of emotions. Forms of psychosocial intervention, designed to reduce these levels of expressed emotions within families, are now widely used. Objectives To estimate the effects of family psychosocial interventions in community settings for people with schizophrenia or schizophrenia-like conditions compared with standard care. Search strategy We updated previous searches by searching the Cochrane Schizophrenia Group Trials Register (September 2008). Selection criteria We selected randomised or quasi-randomised studies focusing primarily on families of people with schizophrenia or schizoaffective disorder that compared community-orientated family-based psychosocial intervention with standard care. Data collection and analysis We independently extracted data and calculated fixed-effect relative risk (RR), the 95% confidence intervals (CI) for binary data, and, where appropriate, the number needed to treat (NNT) on an intention-to-treat basis. For continuous data, we calculated mean differences (MD). Main results This 2009-10 update adds 21 additional studies, with a total of 53 randomised controlled trials included. Family intervention may decrease the frequency of relapse (n = 2981, 32 RCTs, RR 0.55 CI 0.5 to 0.6, NNT 7 CI 6 to 8), although some small but negative studies might not have been identified by the search. Family intervention may also reduce hospital admission (n = 481, 8 RCTs, RR 0.78 CI 0.6 to 1.0, NNT 8 CI 6 to 13) and encourage compliance with medication (n = 695, 10 RCTs, RR 0.60 CI 0.5 to 0.7, NNT 6 CI 5 to 9) but it does not obviously affect the tendency of individuals/families to leave care (n = 733, 10 RCTs, RR 0.74 CI 0.5 to 1.0). Family intervention also seems to improve general social impairment and the levels of

The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change

PubMed Central

Dishion, Thomas; Forgatch, Marion; Chamberlain, Patricia; Pelham, William E.

2017-01-01

This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children’s adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training–Oregon model), and family attenuation and dissolution (Treatment Foster Care–Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements. PMID:27993335

Perceptions of communication, family adaptability and cohesion: a comparison of adolescents newly diagnosed with cancer and their parents.

PubMed

Phillips-Salimi, Celeste R; Robb, Sheri L; Monahan, Patrick O; Dossey, Amy; Haase, Joan E

2014-01-01

To describe and compare adolescent and parent perspectives on communication, family adaptability and cohesion, as well as relationships among these variables, during the first month of an adolescent's cancer diagnosis. Seventy adolescent-parent dyads were enrolled as part of a larger multi-site study. The adolescents ranged in age from 11 to 19, and 61% were males. Parents were predominately mothers (83%). Dyads were predominately non-Hispanic Caucasian (63%). Measures included the Parent-Adolescent Communication Scale and the Family Adaptability and Cohesion Evaluation Scale (FACES II). Paired t-tests, Pearson correlations, intra-class correlation coefficients and multiple linear regression analyses were completed. Adolescent scores on communication, family adaptability and cohesion were significantly lower than parent scores. The inter-dyadic agreement between adolescents and parents was low. Communication, family adaptability and cohesion were examined separately for adolescents and for parents, and significant relationships were found. Both adolescent- and parent-perceived communication was significantly associated with family adaptability and cohesion outcomes. Differences were found in adolescent and parent perceptions of communication, family adaptability and cohesion. When both adolescents and parents had better perceived communication, this was associated with better perceived family adaptability and cohesion. Results suggest that the development of interventions to enhance adolescent-parent communication could help foster better family adaptability and cohesion, which may ultimately impact their psychological adjustment. In addition, understanding the degree to which adolescents and parents disagree on their perceptions, including the results that parents generally have more favorable perceptions, may be a useful starting point when developing interventions.

Perceptions of Communication, Family Adaptability, and Cohesion: A Comparison of Adolescents Newly Diagnosed with Cancer and their Parents

PubMed Central

Phillips-Salimi, Celeste R.; Robb, Sheri L.; Monahan, Patrick O.; Dossey, Amy; Haase, Joan E.

2017-01-01

Purpose Describe and compare adolescent and parent perspectives on communication, family adaptability and cohesion, as well as relationships among these variables, during the first month of the adolescent’s cancer diagnosis. Methods Seventy 70 adolescent-parent dyads were enrolled as part of a larger multi-site study. Adolescents ranged in age from 11–19 and 61% were males. Parents were predominately mothers (83%). Dyads were predominately non-Hispanic Caucasian (63%). Measures included the Parent-Adolescent Communication Scale and the Family Adaptability and Cohesion Evaluation Scale (FACES II). Paired t tests, Pearson correlations, intra-class correlation coefficients, and multiple linear regression analyses were completed. Results Adolescent scores on communication, family adaptability, and cohesion were significantly lower than parent scores. The inter-dyadic agreement between adolescents and parents was low. Communication, family adaptability, and cohesion were examined separately for adolescents and for parents, significant relationships were found. Both adolescent- and parent-perceived communication was significantly associated with family adaptability and cohesion outcomes. Conclusions Differences were found in adolescent and parent perceptions of communication, family adaptability, and cohesion. When both adolescents and parents had better perceived communication, it was associated with better perceived family adaptability and cohesion. Results suggest the development of interventions to enhance adolescent-parent communication could help foster better family adaptability and cohesion which may ultimately impact their psychological adjustment. In addition, understanding the degree to which adolescents and parents disagree on their perceptions, including the results that parents generally have more favorable perceptions, may be a useful starting point when developing interventions. PMID:24501152

Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. a systematic review.

PubMed

Nierkens, Vera; Hartman, Marieke A; Nicolaou, Mary; Vissenberg, Charlotte; Beune, Erik J A J; Hosper, Karen; van Valkengoed, Irene G; Stronks, Karien

2013-01-01

The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997-2009). a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity. Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the intervention. More systematic experiments are needed in which

Effectiveness of Cultural Adaptations of Interventions Aimed at Smoking Cessation, Diet, and/or Physical Activity in Ethnic Minorities. A Systematic Review

PubMed Central

Nierkens, Vera; Hartman, Marieke A.; Nicolaou, Mary; Vissenberg, Charlotte; Beune, Erik J. A. J.; Hosper, Karen; van Valkengoed, Irene G.; Stronks, Karien

2013-01-01

Background The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. Aim To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. Methods Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997–2009). Inclusion criteria: a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity. Results Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. Conclusion This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the

Family-Based Interventions for the Prevention of Substance Abuse and Other Impulse Control Disorders in Girls

PubMed Central

Kumpfer, K. L.

2014-01-01

Standardized family-based interventions are the most effective way of preventing or treating adolescent substance abuse and delinquency. This paper first reviews the incidence of adolescent substance abuse worldwide emphasizing gender and causes by etiological risk and protective factors. New epigenetic research is included suggesting that nurturing parenting significantly prevents the phenotypic expression of inherited genetic diseases including substance abuse. Evidence-based family interventions are reviewed including family change theories behind their success, principles and types of family-based interventions, research results, cultural adaptation steps for ethnic and international translation, and dissemination issues. The author's Strengthening Family Program is used as an example of how these principles of effective prevention and cultural adaptation can result in highly effective prevention programs not only for substance abuse, but for other impulse control disorders as well. The conclusions include recommendations for more use of computer technologies to cut the high cost of family interventions relative to youth-only prevention programs and increase the public health impact of evidence-based prevention programs. The paper recommends that to reduce health care costs these family-based approaches should be applied to the prevention and treatment of other impulse control disorders such as obesity and type 2 diabetes, sexually transmitted diseases, and delinquency. PMID:25938121

The impact of a family skills training intervention among Burmese migrant families in Thailand: A randomized controlled trial.

PubMed

Puffer, Eve S; Annan, Jeannie; Sim, Amanda L; Salhi, Carmel; Betancourt, Theresa S

2017-01-01

To conduct a randomized controlled trial assessing the impact of a family-based intervention delivered to Burmese migrant families displaced in Thailand on parenting and family functioning. Participants included 479 Burmese migrant families from 20 communities in Thailand. Families, including 513 caregivers and 479 children aged 7 to 15 years, were randomized to treatment and waitlist control groups. The treatment group received a 12-session family-based intervention delivered to groups of families by lay facilitators. Adapted standardized and locally derived measures were administered before and after the intervention to assess parent-child relationship quality, discipline practices, and family functioning. Compared with controls, intervention families demonstrated improved quality of parent-child interactions on scales of parental warmth and affection (Effect size (ES) = 0.25 caregivers; 0.26 children, both p < 0.05) and negative relationship quality (ES = -0.37, p < 0.001 caregivers; -0.22 children, p < 0.05). Both children and caregivers also reported an effect on relationship quality based on a locally derived measure (ES = 0.40 caregivers, p < .001; 0.43 children, p < .05). Family functioning was improved, including family cohesion (ES = 0.46 caregivers; 0.36 children; both p < 0.001) and decreased negative interactions (ES = -0.30 caregivers, p < 0.01; -0.24 children, p < 0.05). Family communication also improved according to children only (ES = 0.29, p < 0.01). Caregivers, but not children, reported decreased harsh discipline (ES = -0.39, p < 0.001), and no effects were observed on use of positive discipline strategies. Treatment attendance was high, with participants attending a mean of 9.7 out of 12 sessions. The intervention increased protective aspects of family well-being for migrant children and caregivers in a middle-income country. The strongest effects were on parent-child relationship quality and family functioning, while results were mixed on

Family Interventions for Schizophrenia and the Psychoses: A Review.

PubMed

McFarlane, William R

2016-09-01

Family psychoeducation as a treatment for schizophrenia was developed 40 years ago almost simultaneously and independently by investigators who at the time were not family therapists. Although the original goal was to decrease high expressed emotion as a means of preventing relapse, later variations have gone beyond to focus on social and role functioning and family well-being. Explicitly disavowing the earlier assumptions that family pathology caused relapse and deterioration, family psychoeducation seeks to engage family members as more sophisticated partners, complementing interventions by clinicians with specialized interactions and coping skills that counter the neurologic deficits inherent to the disorder. It has proved to be one of the most consistently effective treatments available. Reports on outcome studies now number more than 100, while meta-analyses put relapse rate reduction at 50-60% over treatment as usual. The most recent application in first episode and prodromal psychosis, combined with other evidence-based interventions, is yielding perhaps the most promising results yet achieved-substantial return of functioning and avoidance of psychosis altogether. Reviewed here are its scientific, theoretical, and clinical sources, a description of the most commonly applied version-the multifamily group format, selected clinical trials spanning those four decades, international and ethnic adaptations, and studies on mechanisms of efficacy. © 2016 Family Process Institute.

Lessons learned: Engaging culturally diverse families in neurodevelopmental disorders intervention research

PubMed Central

Ratto, Allison B; Anthony, Bruno J; Pugliese, Cara; Mendez, Rocio; Safer-Lichtenstein, Jonathan; Dudley, Katerina M; Kahn, Nicole F; Kenworthy, Lauren; Biel, Matthew; Martucci, Jillian L; Anthony, Laura G

2016-01-01

Low-income and ethnic minority families continue to face critical disparities in access to diagnostic and treatment services for neurodevelopmental conditions, such as autism spectrum disorder and attention deficit hyperactivity disorder. Despite the growing cultural diversity of the United States, ethnic minority children and families continue to be substantially underrepresented across research on neurodevelopmental disorders, and there is a particularly concerning lack of research on the treatment of these conditions in low-income and ethnic minority communities. Of note, there are currently no published studies on adapting autism spectrum disorder treatment for low-income Latino communities and relatively few studies documenting adapted treatments for children with attention deficit hyperactivity disorder in these communities. This article describes methodological considerations and adaptations made to research procedures using a Diffusion of Innovation framework in order to effectively recruit and engage low-income, ethnic minority, particularly Latino, families of children with neurodevelopmental disorders, in a comparative effectiveness trial of two school-based interventions for executive dysfunction. PMID:27313190

Adapting Evidence-Based Interventions to Meet the Needs of Adolescents Growing Up with HIV in South Africa: The VUKA Case Example

PubMed Central

Nestadt, Danielle; Bhana, Arvin; Petersen, Inge; Abrams, Elaine J.; Alicea, Stacey; Holst, Helga; Myeza, Nonhlahla; John, Sally; Small, Latoya; McKay, Mary

2015-01-01

The VUKA family program is one of the only evidence-based interventions to promote positive psychosocial outcomes in South African HIV-infected pre- and early adolescents and their families. In this paper, we discuss the collaborative process by which a multidisciplinary team of clinicians, researchers, counselors, and artists/educators and families adapted and developed VUKA for this population using community-based participatory research methods. We describe the intervention and explore lessons learned that may be applicable across contexts related to international collaboration and adapting evidence-based interventions so that they are likely to be acceptable, feasible, and effective in a given setting and country context. PMID:25984440

Children with Elevated Psychosocial Risk Load Benefit Most from a Family-Based Preventive Intervention: Exploratory Differential Analyses from the German "Strengthening Families Program 10-14" Adaptation Trial.

PubMed

Bröning, Sonja; Baldus, Christiane; Thomsen, Monika; Sack, Peter-Michael; Arnaud, Nicolas; Thomasius, Rainer

2017-11-01

While the effectiveness of substance use prevention programs such as the Strengthening Families Program 10-14 (SFP) has been demonstrated in the USA, European SFP adaptations have not replicated these sizable effects. Following the rationale of the risk moderation hypothesis positing that elevated risk groups may benefit more from a preventive intervention than lower-risk groups, we reanalyzed evaluation data from a randomized controlled trial testing the adapted German version of SFP (SFP-D). We hypothesized a differential impact of risk status on intervention results. The study employed a minimal control condition. Of the N = 292 participating children, 73.5% qualified as at-risk because they lived in a deprived urban district, and 26.5% qualified as high risk because they additionally scored as "difficult" in the German Strengths and Difficulty Questionnaire (parents' reports using gender- and age-specific German norms). Outcomes were children's self-reports on substance use, mental health, family functioning, and quality of life. Data were analyzed with repeated measures linear mixed models and relative risk analyses. The high-risk group in the SFP-D condition achieved the best results compared with all other groups, especially in mental health and quality of life. Relative risk analyses on tobacco [alcohol] abstinence showed that an additional percentage of 29.8% [16.0%] of high-risk children in nonabstinent controls would have remained abstinent if they had participated in SFP-D. We conclude that risk load influences the impact of substance use prevention programs and discuss to what extent differential analyses can add value to prevention research.

Early intervention for vulnerable infants and their families: an emerging agenda.

PubMed

Kruskal, M O; Thomasgard, M C; Shonkoff, J P

1989-12-01

Early childhood development is a complex dynamic process that begins at birth and unfolds in a transactional manner as infants interact with their environment. Children are highly adaptive organisms with powerful homeostatic mechanisms; consequently, most high-risk infants do well. Environmental factors are powerful mediators in this process, and a supportive and responsive environment may alleviate many early developmental insults, while a deficient environment can exacerbate developmental weaknesses. Available data suggest that appropriately designed early intervention services can be effective in facilitating both child and family adaptation for a variety of target groups. However, many important questions remain unanswered. For example, although interventions have been shown to improve cognitive function, effects in other important areas such as social and emotional functioning and family coping have not been well studied. Information about the impact of family variables is also incomplete as is our knowledge about which services work best for which children and families. Finally, the influence of protective factors in the child and in the environment requires further exploration. The perinatologist can make several critical contributions to the comprehensive care of high risk infants beyond their medical management. He or she can play a pivotal role in identifying those neonates who need early intervention on the basis of their biologic vulnerability, their environmental risk factors, or both. Perinatologists are also in the best position to facilitate early entry into an appropriate service system and can be important collaborators in providing comprehensive services and long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Exploring the functional impact of adaptive seating on the lives of individual children and their families: a collective case study.

PubMed

Stier, Carly D; Chieu, Ivan B; Howell, Lori; Ryan, Stephen E

2017-07-01

This study examined parent-reported change in the functional performance of four school-aged children with wheeled mobility needs who had used a new adaptive seating system for 6 weeks. The collective case study involved four mothers whose children, ages 6-9 years, received a new adaptive seating system for a manual wheelchair or stroller. Mothers completed the Family Impact of Assistive Technology Scale for Adaptive Seating (FIATS-AS) at the time their child received a new seating system, and then after 6 weeks of daily use. Other questionnaires, health records, and semi-structured interviews provided additional data about the seating interventions and their functional effects on individual children and their families. The FIATS-AS detected overall functional gain in one family, and both gains and losses in 2-7 dimensions for all families. Functional status and change scores showed consistency with measures of seating intervention satisfaction, global functional change, and home participation. Interview themes also suggested consistency with change scores, but provided a deeper understanding of important factors that influenced adaptive seating outcomes. This study supports the need to explore further the complexity, temporality and meaningfulness of adaptive seating outcomes in individual children and their families. Implications for Rehabilitation Assistive technology practitioners need to adopt practical measurement strategies that consider the complexity, temporality, and meaningfulness of outcomes to make evidence-informed decisions about how to improve adaptive seating services and interventions. Health measurement scales that measure adaptive seating outcomes for service applications must have adequate levels of reliability and validity, as well as demonstrate responsive to important change over time for individual children and their families. Needs-specific measurement scales provide a promising avenue for understanding functional outcomes for

Adapting pediatric psychology interventions: lessons learned in treating families from the Middle East.

PubMed

Hilliard, Marisa E; Ernst, Michelle M; Gray, Wendy N; Saeed, Shehzad A; Cortina, Sandra

2012-09-01

Pediatric psychologists are increasingly called upon to treat children from non-Western countries, whose cultures may contrast with a Western medical setting. Research on cultural adaptations of evidence-based treatments (EBTs), particularly for individuals from the Middle East, is sparse. To address this need, we discuss clinical issues encountered when working with patients from the Middle East. Synthesis of the literature regarding culturally adapted EBTs and common themes in Middle Eastern culture. Case vignettes illustrate possible EBT adaptations. Integrating cultural values in treatment is an opportunity to join with patients and families to optimize care. Expectations for medical and psychological treatment vary, and collaborations with cultural liaisons are beneficial. Critical next steps include systematic development, testing, and training in culturally adapting EBTs in pediatric medical settings. Increased dialogue between clinicians, researchers, and cultural liaisons is needed to share knowledge and experiences to enhance patient care.

Findings from the Families on Track Intervention Pilot Trial for Children with Fetal Alcohol Spectrum Disorders and Their Families.

PubMed

Petrenko, Christie L M; Pandolfino, Mary E; Robinson, Luther K

2017-07-01

Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multicomponent intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled. Families were randomized to either the Families on Track Integrated Preventive Intervention or an active control of neuropsychological assessment and personalized community referrals. The 30-week intervention integrates scientifically validated bimonthly, in-home parent behavioral consultation, and weekly child skills groups. Outcomes measured at baseline and follow-up postintervention included intervention satisfaction, child emotional and behavioral functioning, child self-esteem, caregiver knowledge of FASD and advocacy, caregiver attitudes, use of targeted parenting practices, perceived family needs met, social support, and self-care. Data analysis emphasized calculation of effect sizes and was supplemented with analysis of variance techniques. Analyses indicated that families participating in the intervention reported high program satisfaction. Relative to comparison group outcomes, the intervention was associated with medium-to-large effects for child emotion regulation, self-esteem, and anxiety. Medium-sized improvements in disruptive behavior were observed for both groups. Medium and large effects were seen for important caregiver outcomes: knowledge of FASD and advocacy, attributions of behavior, use of antecedent strategies, parenting efficacy, family needs met, social support, and self-care. This pilot study yielded promising findings from the multicomponent Families on Track Integrated Preventive Intervention for child and caregiver outcomes. An important next step is to

The impact of a family skills training intervention among Burmese migrant families in Thailand: A randomized controlled trial

PubMed Central

2017-01-01

Objective To conduct a randomized controlled trial assessing the impact of a family-based intervention delivered to Burmese migrant families displaced in Thailand on parenting and family functioning. Participants and procedures Participants included 479 Burmese migrant families from 20 communities in Thailand. Families, including 513 caregivers and 479 children aged 7 to 15 years, were randomized to treatment and waitlist control groups. The treatment group received a 12-session family-based intervention delivered to groups of families by lay facilitators. Adapted standardized and locally derived measures were administered before and after the intervention to assess parent-child relationship quality, discipline practices, and family functioning. Results Compared with controls, intervention families demonstrated improved quality of parent-child interactions on scales of parental warmth and affection (Effect size (ES) = 0.25 caregivers; 0.26 children, both p < 0.05) and negative relationship quality (ES = -0.37, p < 0.001 caregivers; -0.22 children, p < 0.05). Both children and caregivers also reported an effect on relationship quality based on a locally derived measure (ES = 0.40 caregivers, p < .001; 0.43 children, p < .05). Family functioning was improved, including family cohesion (ES = 0.46 caregivers; 0.36 children; both p < 0.001) and decreased negative interactions (ES = -0.30 caregivers, p < 0.01; -0.24 children, p < 0.05). Family communication also improved according to children only (ES = 0.29, p < 0.01). Caregivers, but not children, reported decreased harsh discipline (ES = -0.39, p < 0.001), and no effects were observed on use of positive discipline strategies. Treatment attendance was high, with participants attending a mean of 9.7 out of 12 sessions. Conclusion The intervention increased protective aspects of family well-being for migrant children and caregivers in a middle-income country. The strongest effects were on parent-child relationship

“Queremos Aprender”: Latino Immigrants’ Call to Integrate Cultural Adaptation with Best Practice Knowledge in a Parenting Intervention

PubMed Central

Parra Cardona, José; Holtrop, Kendal; Córdova, David; Escobar-Chew, Ana Rocio; Horsford, Sheena; Tams, Lisa; Villarruel, Francisco A.; Villalobos, Graciela; Dates, Brian; Anthony, James C.; Fitzgerald, Hiram E.

2015-01-01

Despite the unique and challenging circumstances confronting Latino immigrant families, debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Following the grounded theory approach, the current qualitative investigation utilized focus group interviews with 83 Latino immigrant parents to explore the relevance of culturally adapting an evidence-based parenting intervention to be disseminated within this population. Findings from this study indicate that Latino immigrant parents want to participate in a culturally adapted parenting intervention as long as it is culturally relevant, respectful, and responsive to their life experiences. Research results also suggest that the parenting skills participants seek to enhance are among those commonly targeted by evidence-based parenting interventions. This study contributes to the cultural adaptation/fidelity balance debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance, as well as high fidelity to the core components that have established efficacy for evidence-based parenting interventions. PMID:19579906

Engaging Families in In-Home Family Intervention

ERIC Educational Resources Information Center

Thompson, Ronald W.; Koley, Sarah

2014-01-01

Boys Town has created a program called In-Home Family Services to deliver help to families in stress. In-home family intervention programs have become widely used to help more families who are at risk and experiencing difficulties with a wide range of problems including domestic violence, child behavior problems, parent-child and family…

Experiences of family members of patients with colostomies and expectations about professional intervention

PubMed Central

Ferreira-Umpiérrez, Augusto; Fort-Fort, Zoraida

2014-01-01

Objective the objective was to understand the experience of a group of family members of patients with colostomies, revealing their expectations regarding the intervention of health professionals. Method qualitative research, with the social phenomenological approach of Alfred Schütz, conducted in Montevideo in 2012; twelve family members of patients with colostomies participated, from an ostomy service of a health institution. Results the following categories were identified: family ties, trust in the health care team, the nurse as the articulator of the process, the desire to humanize care, and adaptation to new family life. Conclusions knowing the experience and expectations of the families of colostomy patients was achieved, emphasizing the previous family relationships to build upon them, and the trust in the health team, emphasizing the nurse as articulator of the process. Expectations focused on the desire for humanized care, enhancing adaptation of the nuclear family to the new way of life, restoring and enhancing its strengths, and collaborating in overcoming its weaknesses. PMID:26107831

Adaptation and resiliency in Swedish families.

PubMed

Kiehl, Ermalynn M; Carson, David K; Dykes, Anna-Karin

2007-09-01

A longitudinal research project began in 1993 of Norwegian, Swedish and American mothers' perception of her family's dynamics and adaptation during childbearing and childrearing. Results indicated that Swedish mothers adapted better than other mothers. In 2003, a mixed design study was conducted with original Swedish mothers that aimed to describe the experience of motherhood, the meaning mothers attached to events in their lives that made adaptation necessary, and ways in which they achieved adaptation. Fourteen mothers completed quantitative instruments and 13 of those mothers were interviewed. Audiotaped interviews were transcribed and analysed for themes using a protocol based on a model of family resiliency. Quantitative findings revealed statistically significant findings in areas of children, mother's work outside the home and families in which a major illness had occurred. Qualitative findings revealed that protective factors far outweighed vulnerability and risk factors. Mothers' satisfaction with life manifested itself in love of home, contentment with employment, fulfillment from an active and healthy life and support from a society that provides a wide range of social benefits for the family. Vulnerability occurred primarily when mothers were tired, lacked personal time or someone in the family was experiencing a serious illness. Results of this study enhance the scholarly scientific knowledge about the uniqueness of Swedish mothers, and increased understanding of family dynamics and adaptation. Many of the findings relate in some way to overall social benefits and supports available for families.

A Pilot Study Promoting Participation of Families with Limited Resources in Early Autism Intervention

PubMed Central

Carr, Themba; Lord, Catherine

2016-01-01

Background Relatively little research about autism early intervention has occurred in families of low socioeconomic status. Barriers to participation for under-resourced families (i.e., families with low incomes or limited education), pose a significant problem. The purpose of this pilot study was to apply empirically supported methods promoting participation of families with low-income and low-education levels to an established intervention for children with autism spectrum disorder (ASD). Method Participant recruitment specifically targeted families whose income was equal to or below two times the federal poverty line and whose caregiver(s) had no more than two years of college attendance. An evidence-based intervention was modified to be more accessible to participating families. Adaptations focused on decreasing access barriers, decreasing attrition, and promoting positive change within families. Success of the program was measured quantitatively and qualitatively. Results Twenty-seven families were referred to the project, 13 of which did not meet eligibility requirements. Eight families enrolled, maintained participation for the majority of the project and provided positive qualitative feedback of their experiences. Project and treatment attrition were calculated at 62% and 12.5%, respectively. Treatment attendance was high, but length of time to complete treatment was greatly influenced by the number of session cancellations. Conclusions The exploratory project demonstrated that practical modifications to standard early intervention protocols can promote engagement in families with limited resources. Recommendations for programs seeking to implement interventions in under-resourced communities are discussed. PMID:27019670

The drug-user husband and his wife: attachment styles, family cohesion, and adaptability.

PubMed

Finzi-Dottan, Ricky; Cohen, Orna; Iwaniec, Dorota; Sapir, Yaffa; Weizman, Abraham

2003-01-01

This study which assesses the association between the attachment styles of drug-user husbands (n = 56) and their wives (n = 56) and their perceptions of family dynamics was conducted in 1998. The population study included heroin (52.9%) and multidrug detoxified outpatients. All subjects completed the Adult Attachment Style Scale and the FACES III. Results indicated that the perceptions of family adaptability and cohesion among the drug-user husbands and their wives did not differ from the Israeli norm. Most of the drug users (60.7%) were characterized by the avoidant attachment style, followed by the secure style (26.8%), and the anxious/ambivalent style (12.5%). Half the wives (53.6%) were characterized by the secure style, followed by the avoidant style (42.9%) and the anxious/ambivalent style (3.6%). A secure style in husband and wife was associated with higher levels of family cohesion and adaptability, and the anxious/ambivalent style with a lower perception of family cohesion and adaptability. These findings have important implications for rehabilitation prospects and for planning intervention programs.

Adaptation in families of children with Down syndrome in East Asian countries: an integrative review.

PubMed

Choi, Hyunkyung; Van Riper, Marcia

2017-08-01

The purpose of this integrative literature review was to understand the experiences of East Asian families of children with Down syndrome and identify factors affecting their adaptation in the Resiliency Model of Family Stress, Adjustment and Adaptation. Socio-cultural factors influence how well families adapt following the birth of a child with Down syndrome. Existing literature in this area has focused primarily on families from Western cultures. This is problematic because nurses care for families from all over the world. Therefore, the focus of this review is on families of children with Down syndrome living in East Asia, where Confucianism is dominant. Integrative literature review. Online databases (i.e. PubMed, CINAHL and PsycINFO) and a public search engine (i.e. Google Scholar) were used along with manual searches of reference lists and major journals. Studies were limited to original publications written in English and published between 1990-2014. Two authors independently performed integrative review processes proposed by Whittemore and Knafl and a quality assessment using the Mixed Methods Appraisal Tool. Like families in Western cultures, some East Asian families of children with Down syndrome adapted well and even thrived while others struggled. Various socio-cultural factors, including some associated with Confucianism, played a role in how individuals, dyads and families adapted. An understanding of socio-cultural influences can help nurses implement culturally sensitive family-centred interventions with families of children with Down syndrome. It may also facilitate policy changes concerning resources for these families. © 2016 John Wiley & Sons Ltd.

A discussion of HIV/AIDS family interventions: implications for family-focused nursing practice.

PubMed

Eustace, Rosemary W

2013-07-01

This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care. Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual-level HIV prevention, HIV/AIDS family-focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention. The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were 'nurse', or 'nursing', 'HIV/AIDS', 'family interventions', 'family support' and 'family education', and/or 'family subsystems'. The process of theorizing about 'family interventions' and 'HIV/AIDS-family interventions' is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective. Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS-FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family-focused approaches. © 2012 Blackwell Publishing Ltd.

The Family in Us: Family History, Family Identity and Self-Reproductive Adaptive Behavior.

PubMed

Ferring, Dieter

2017-06-01

This contribution is an essay about the notion of family identity reflecting shared significant experiences within a family system originating a set of signs used in social communication within and between families. Significant experiences are considered as experiences of events that have an immediate impact on the adaptation of the family in a given socio-ecological and cultural context at a given historical time. It is assumed that family history is stored in a shared "family memory" holding both implicit and explicit knowledge and exerting an influence on the behavior of each family member. This is described as transgenerational family memory being constituted of a system of meaningful signs. The crucial dimension underlying the logic of this essay are the ideas of adaptation as well as self-reproduction of systems.

Family interventions to improve diabetes outcomes for adults

PubMed Central

Baig, Arshiya A.; Benitez, Amanda; Quinn, Michael T.; Burnet, Deborah L.

2015-01-01

Diabetes self-care is a critical aspect of disease management for adults with diabetes. Since family members can play a vital role in a patient’s disease management, involving them in self-care interventions may positively influence patients’ diabetes outcomes. We systematically reviewed family-based interventions for adults with diabetes published from 1994 to 2014 and assessed their impact on patients’ diabetes outcomes and the extent of family involvement. We found 26 studies describing family-based diabetes interventions for adults. Interventions were conducted across a range of patient populations and settings. The degree of family involvement varied across studies. We found evidence for improvement in patients’ self-efficacy, perceived social support, diabetes knowledge, and diabetes self-care across the studies. Owing to the heterogeneity of the study designs, types of interventions, reporting of outcomes, and family involvement, it is difficult to determine how family participation in diabetes interventions may affect patients’ clinical outcomes. Future studies should clearly describe the role of family in the intervention, assess quality and extent of family participation, and compare patient outcomes with and without family involvement. PMID:26250784

Family-focused physical activity, diet and obesity interventions in African-American girls: a systematic review.

PubMed

Barr-Anderson, D J; Adams-Wynn, A W; DiSantis, K I; Kumanyika, S

2013-01-01

Obesity interventions that involve family members may be effective with racial/ethnic minority youth. This review assessed the nature and effectiveness of family involvement in obesity interventions among African-American girls aged 5-18 years, a population group with high rates of obesity. Twenty-six databases were searched between January 2011 and March 2012, yielding 27 obesity pilot or full-length prevention or treatment studies with some degree of family involvement and data specific to African-American girls. Interventions varied in type and level of family involvement, cultural adaptation, delivery format and behaviour change intervention strategies; most targeted parent-child dyads. Some similarities in approach based on family involvement were identified. The use of theoretical perspectives specific to African-American family dynamics was absent. Across all studies, effects on weight-related behaviours were generally promising but often non-significant. Similar conclusions were drawn for weight-related outcomes among the full-length randomized controlled trials. Many strategies appeared promising on face value, but available data did not permit inferences about whether or how best to involve family members in obesity prevention and treatment interventions with African-American girls. Study designs that directly compare different types and levels of family involvement and incorporate relevant theoretical elements may be an important next step. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

Families living with parental mental illness and their experiences of family interventions.

PubMed

Afzelius, M; Plantin, L; Östman, M

2018-03-01

WHAT IS KNOWN ON THE SUBJECT?: Coping with parental mental illness in families can be challenging for both children and parents. Providing evidence-based family interventions to families where a parent has a mental illness can enhance the relationships in the family. Although psychiatric research has shown that evidence-based family interventions may improve the communication and understanding of parental mental illness, there is a lack in this area of research from an everyday clinical context. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Our study reinforces the fact that parents with mental illnesses are searching for support from psychiatric services in order to talk to their children about their illness. The finding that under-age children comply when they are told by their parents to join an intervention in psychiatric services supporting the family is something not observed earlier in research. This study once more illuminates the fact that partners of a person with parental mental illness are seldom, in an obvious way, included in family support interventions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric services, and especially mental health nurses, have an important task in providing families with parental mental illness with support concerning communication with their children and in including the "healthy" partner in family support interventions. Introduction Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method Five families with children aged 10-12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both

Longitudinal Effects of Adaptability on Behavior Problems and Maternal Depression in Families of Adolescents with Autism

PubMed Central

Baker, Jason K.; Seltzer, Marsha Mailick; Greenberg, Jan S.

2014-01-01

Research on families of individuals with autism has tended to focus on child-driven effects utilizing models of stress and coping. The current study used a family-systems perspective to examine whether family-level adaptability promoted beneficial outcomes for mothers and their adolescents with autism over time. Participants were 149 families of children diagnosed with autism who were between the ages of 10 and 22 years during the three-year period examined. Mothers reported on family adaptability, the mother-child relationship, their own depressive symptoms, and the behavior problems of their children at Wave 1, and these factors were used to predict maternal depression and child behavior problems three years later. Family-level adaptability predicted change in both maternal depression and child behavior problems over the study period, above and beyond the contribution of the dyadic mother-child relationship. These associations did not appear to depend upon the intellectual disability status of the individual with autism. Implications for autism, parent mental health, family systems theory, and for intervention with this population are discussed. PMID:21668120

A Methodological Study of Family Cohesion and Adaptability.

ERIC Educational Resources Information Center

Russell, Candyce S.

1980-01-01

Assessed the validity of four separate instruments: SIMFAM; an adaptation of the Bowerman and Bahr Identification Scale; the Moos Family Environment Scale; and the Kvebaek Family Sculpture Test. Data support the Family Sculpture Test as a useful tool for measuring family cohesion but not adaptability. (Author)

Longitudinal Impact of a Family Critical Time Intervention on Children in High-Risk Families Experiencing Homelessness: A Randomized Trial.

PubMed

Shinn, Marybeth; Samuels, Judith; Fischer, Sean N; Thompkins, Amanda; Fowler, Patrick J

2015-12-01

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence-based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time-limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children-99 ages 1.5-5 years, 113 ages 6-10 years, and 99 ages 11-16 years-included mother-, teacher-, and child-reports of mental health, school experiences, and psychosocial well-being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool-aged children and externalizing for adolescents 11-16. The intervention led to declines in self-reported school troubles for children 6-10 and 11-16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness.

Feasibility study of a family-focused intervention to improve outcomes for children with FASD.

PubMed

Reid, Natasha; Dawe, Sharon; Harnett, Paul; Shelton, Doug; Hutton, Lauren; O'Callaghan, Frances

2017-08-01

Growing evidence shows that children with fetal alcohol spectrum disorder (FASD) can benefit from interventions, and specifically interventions focused on improving self-regulation. However, novel ways of improving outcomes for children with FASD need further investigation so that programs target not only the individual child but also the family context, which includes the parent-child relationship. The current study aimed to evaluate the feasibility of an adapted version of the Parents under Pressure (PuP) program that addresses self-regulatory processes, through improving the parent-child relationship and the use of mindfulness-based strategies for both children and parents. This was a mixed methods study. Feasibility was examined by evaluating recruitment, data collection/outcome measures, and intervention procedures. The study used a phenomenological approach to obtain qualitative information from caregivers and a single-case experimental design to evaluate the preliminary participant responses to the intervention. Two out of three families completed treatment. The recruitment and intervention procedures were found to be suitable for and acceptable to the families involved. Some concerns were identified regarding the outcome measures that would need to be addressed in future research. Quantitative and qualitative outcomes were positive. The results provide preliminary support for the feasibility of an adapted version of the PuP program. Thus, offering a potential multi-component option, that aims to improve self-regulatory skills for children with FASD, through focusing on improving the parent-child relationship and incorporating mindfulness-based techniques for both parents and children. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cultural Adaptation of a U.S. Evidence-Based Parenting Intervention for Rural Western Kenya: From Parents Matter! to Families Matter!

ERIC Educational Resources Information Center

Poulsen, Melissa N.; Vandenhoudt, Hilde; Wyckoff, Sarah C.; Obong'o, Christopher O.; Ochura, Juliet; Njika, Gillian; Otwoma, Nelson Juma; Miller, Kim S.

2010-01-01

Evidence-based interventions (EBIs) are critical for effective HIV prevention, but time and resources required to develop and evaluate new interventions are limited. Alternatively, existing EBIs can be adapted for new settings if core elements remain intact. We describe the process of adapting the Parents Matter! Program, an EBI originally…

Family quality of life and ASD: the role of child adaptive functioning and behavior problems.

PubMed

Emily, Gardiner; Grace, Iarocci

2015-04-01

The family is the key support network for children with autism spectrum disorder (ASD), in many cases into adulthood. The Family Quality of Life (FQOL) construct encompasses family satisfaction with both internal and external dynamics, as well as support availability. Therefore, although these families face considerable risk in raising a child with a disability, the FQOL outcome is conceptualized as representative of a continuum of family adaptation. This study examined the role of child characteristics, including adaptive functioning and behaviour problems, in relation to FQOL. Eighty-four caregivers of children and adolescents (range = 6-18 years) with ASD participated, completing questionnaires online and by telephone. Adaptive functioning, and specifically daily living skills, emerged as a significant predictor of FQOL satisfaction, after accounting for behavioural and demographic characteristics, including child age, gender, perceived disability severity, and behavioural problems, as well as family income. Furthermore, there were significant differences across each domain of FQOL when groups were separated by daily living skill functioning level ('low,' 'moderately low,' and 'adequate'). The results suggest that intervention strategies targeting daily living skills will likely have beneficial effects for both individual and family well-being, and may reduce family support demands. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Use of family management styles in family intervention research.

PubMed

Alderfer, Melissa A

2006-01-01

Family management styles (FMSs) explain some of the complexities embedded in a family with a child who has chronic illness. The FMS typologies provide descriptions of family adjustment and management of care. These 5 distinct patterns may be valuable in tailoring and evaluating family interventions in research.

A Family-Based Diabetes Intervention for Hispanic Adults and Their Family Members

PubMed Central

Wallace, Debra; McCoy, Thomas; Amirehsani, Karen

2014-01-01

Aims The purpose of this quasi-experimental one group longitudinal study is to examine the effects of a family-based intervention program on diabetes self-management behaviors, HbA1c, other biomarkers, psychosocial factors and health-related quality of life in Hispanics with diabetes. Methods Adult patients with diabetes (n = 36) and family members (n = 37) were recruited from a community clinic in rural central North Carolina. Patients and family members attended an 8-week culturally tailored diabetes educational program taught in Spanish. Data was collected pre and post intervention for both patients and family members, with an additional data collection for patients 1 month post intervention. Results Most patients and family members were female and almost all were immigrants. HbA1c dropped by 0.41% on average among patients from pre-intervention to 1 month post intervention. Patients showed significant improvements in systolic blood pressure, diabetes self-efficacy diabetes knowledge, and physical and mental components of health-related quality of life. Higher levels of intake of healthy foods and performance of blood sugar tests and foot inspections were reported. Family members significantly lowered BMI and improved diabetes knowledge from pre- to immediate post-intervention. No significant changes in levels of physical activity were found among patients with diabetes or family members. Conclusions Findings suggest that including family members in educational interventions may provide emotional and psychological support to patients with diabetes, help to develop healthy family behaviors, and promote diabetes self-management. PMID:24248832

Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.

PubMed

Lin, Pao-Hwa; Intille, Stephen; Bennett, Gary; Bosworth, Hayden B; Corsino, Leonor; Voils, Corrine; Grambow, Steven; Lazenka, Tony; Batch, Bryan C; Tyson, Crystal; Svetkey, Laura P

2015-12-01

The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this article is to describe the design and development of the intervention tested in the Cell Phone Intervention for You study and to highlight the importance of adaptive intervention design that made it possible. The Cell Phone Intervention for You study was a National Heart, Lung, and Blood Institute-sponsored, controlled, 24-month randomized clinical trial comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (body mass index≥25 kg/m2) young adults. Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, adaptive intervention design, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The adaptive intervention design strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. Adaptive intervention design was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. The cell phone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive-providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools

Clarifying Work-Family Intervention Processes: The Roles of Work-Family Conflict and Family Supportive Supervisor Behaviors

PubMed Central

Hammer, Leslie B.; Kossek, Ellen E.; Anger, W. Kent; Bodner, Todd; Zimmerman, Kristi L.

2010-01-01

Drawing on a conceptual model integrating research on training, work-family interventions, and social support, we conducted a quasi-experimental field study to assess the impact of a supervisory training and self-monitoring intervention designed to increase supervisors' use of family supportive supervisor behaviors. Pre- and post-intervention surveys were completed, nine months apart, by 239 employees at six intervention (N = 117) and six control (N = 122) grocery store sites. Thirty-nine supervisors in the six intervention sites received the training consisting of one hour of self-paced computer-based training, one hour of face-to-face group training, followed by instructions for behavioral self-monitoring (recording the frequency of supportive behaviors) to support on-the-job transfer. Results demonstrated a disordinal interaction for the effect of training and family-to-work conflict on employee job satisfaction, turnover intentions and physical health. In particular, for these outcomes, positive training effects were observed for employees with high family-to-work conflict, while negative training effects were observed for employees with low family-to-work conflict. These moderation effects were mediated by the interactive effect of training and family-to-work conflict on employee perceptions of family-supportive supervisor behaviors. Implications of our findings for future work-family intervention development and evaluation are discussed. PMID:20853943

Experimental Design and Primary Data Analysis Methods for Comparing Adaptive Interventions

PubMed Central

Nahum-Shani, Inbal; Qian, Min; Almirall, Daniel; Pelham, William E.; Gnagy, Beth; Fabiano, Greg; Waxmonsky, Jim; Yu, Jihnhee; Murphy, Susan

2013-01-01

In recent years, research in the area of intervention development is shifting from the traditional fixed-intervention approach to adaptive interventions, which allow greater individualization and adaptation of intervention options (i.e., intervention type and/or dosage) over time. Adaptive interventions are operationalized via a sequence of decision rules that specify how intervention options should be adapted to an individual’s characteristics and changing needs, with the general aim to optimize the long-term effectiveness of the intervention. Here, we review adaptive interventions, discussing the potential contribution of this concept to research in the behavioral and social sciences. We then propose the sequential multiple assignment randomized trial (SMART), an experimental design useful for addressing research questions that inform the construction of high-quality adaptive interventions. To clarify the SMART approach and its advantages, we compare SMART with other experimental approaches. We also provide methods for analyzing data from SMART to address primary research questions that inform the construction of a high-quality adaptive intervention. PMID:23025433

Longitudinal Impact of a Family Critical Time Intervention on Children in High-Risk Families Experiencing Homelessness: A Randomized Trial

PubMed Central

Samuels, Judith; Fischer, Sean N.; Thompkins, Amanda; Fowler, Patrick J.

2016-01-01

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence-based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time-limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children—99 ages 1.5–5 years, 113 ages 6–10 years, and 99 ages 11–16 years—included mother-, teacher-, and child-reports of mental health, school experiences, and psychosocial well-being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool-aged children and externalizing for adolescents 11–16. The intervention led to declines in self-reported school troubles for children 6–10 and 11–16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness. PMID:26238278

[Problems in the process of adapting to change among the family caregivers of elderly people with dementia].

PubMed

Moreno-Cámara, Sara; Palomino-Moral, Pedro Ángel; Moral-Fernández, Lourdes; Frías-Osuna, Antonio; Del-Pino-Casado, Rafael

2016-01-01

To identify and analyse problems in adapting to change among the family caregivers of relatives with dementia. Qualitative study based on the methodology of Charmaz's Constructivist Grounded Theory. Seven focus groups were conducted in different primary health care centres in the province of Jaen (Spain). Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Triangulation analysis was carried out to increase internal validity. We obtained three main categories: 'Changing Care', 'Problems in the process of adapting to change' and 'Facilitators of the process of adapting to change'. Family caregivers perform their role in a context characterized by personal change, both in the person receiving the care and in the social and cultural context. The challenge of adaptation lies in the balance between the problems that hamper adaptation of the caregiver to new situations of care and the factors that facilitate the caregiver role. The adaptation of family caregivers to caring for a person with dementia is hindered by the lack of formal support and under-diagnosis of dementia. The adaptation process could be improved by strengthening formal support in the early stages of care to reduce the stress of family caregivers who must teach themselves about their task and by interventions adapted to each phase in the development of the caregiver role. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

PubMed Central

Copenhaver, Michael M.; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A.; Kamarulzaman, Adeeba; Altice, Frederick L.

2011-01-01

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated. PMID:21860786

Cultural Adaptations of Behavioral Health Interventions: A Progress Report

PubMed Central

Barrera, Manuel

2014-01-01

Objective To reduce health disparities, behavioral health interventions must reach subcultural groups and demonstrate effectiveness in improving their health behaviors and outcomes. One approach to developing such health interventions is to culturally adapt original evidence-based interventions. The goals of the paper are to (a) describe consensus on the stages involved in developing cultural adaptations, (b) identify common elements in cultural adaptations, (c) examine evidence on the effectiveness of culturally enhanced interventions for various health conditions, and (d) pose questions for future research. Method Influential literature from the past decade was examined to identify points of consensus. Results There is agreement that cultural adaptation can be organized into five stages: information gathering, preliminary design, preliminary testing, refinement, and final trial. With few exceptions, reviews of several health conditions (e.g., AIDS, asthma, diabetes) concluded that culturally enhanced interventions are more effective in improving health outcomes than usual care or other control conditions. Conclusion Progress has been made in establishing methods for conducting cultural adaptations and providing evidence of their effectiveness. Future research should include evaluations of cultural adaptations developed in stages, tests to determine the effectiveness of cultural adaptations relative to the original versions, and studies that advance our understanding of cultural constructs’ contributions to intervention engagement and efficacy. PMID:22289132

Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors Among Overweight/Obese Latino Smokers

PubMed Central

Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Robles, Eden Hernandez; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

2015-01-01

More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers. PMID:25527143

Parent Management Training-Oregon Model: Adapting Intervention with Rigorous Research.

PubMed

Forgatch, Marion S; Kjøbli, John

2016-09-01

Parent Management Training-Oregon Model (PMTO(®) ) is a set of theory-based parenting programs with status as evidence-based treatments. PMTO has been rigorously tested in efficacy and effectiveness trials in different contexts, cultures, and formats. Parents, the presumed agents of change, learn core parenting practices, specifically skill encouragement, limit setting, monitoring/supervision, interpersonal problem solving, and positive involvement. The intervention effectively prevents and ameliorates children's behavior problems by replacing coercive interactions with positive parenting practices. Delivery format includes sessions with individual families in agencies or families' homes, parent groups, and web-based and telehealth communication. Mediational models have tested parenting practices as mechanisms of change for children's behavior and found support for the theory underlying PMTO programs. Moderating effects include children's age, maternal depression, and social disadvantage. The Norwegian PMTO implementation is presented as an example of how PMTO has been tailored to reach diverse populations as delivered by multiple systems of care throughout the nation. An implementation and research center in Oslo provides infrastructure and promotes collaboration between practitioners and researchers to conduct rigorous intervention research. Although evidence-based and tested within a wide array of contexts and populations, PMTO must continue to adapt to an ever-changing world. © 2016 Family Process Institute.

Linking Anger Trait with Somatization in Low-Grade College Students: Moderating Roles of Family Cohesion and Adaptability

PubMed Central

LIU, Liang; LIU, Cuilian; ZHAO, Xudong

2017-01-01

of current depression, family adaptability to some degree exempted individuals with anger proneness from developing somatic complaints. Interventions that integrate family cohesion cultivation, family flexibility fostering and depression treatment might be more effective for somatic patients high in anger trait. PMID:28769543

Linking Anger Trait with Somatization in Low-Grade College Students: Moderating Roles of Family Cohesion and Adaptability.

PubMed

Liu, Liang; Liu, Cuilian; Zhao, Xudong

2017-02-25

adaptability to some degree exempted individuals with anger proneness from developing somatic complaints. Interventions that integrate family cohesion cultivation, family flexibility fostering and depression treatment might be more effective for somatic patients high in anger trait.

The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence.

PubMed

Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

2013-05-01

China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence-favorably evaluated in the West-for Chinese HIV-positive patients. The adaptation process was theory-driven and covered several key issues of cultural adaptation. We considered the importance of interpersonal relationships and family in China and cultural notions of health. Using an evidence-based treatment protocol originally designed for Western HIV-positive patients, we developed an 11-step Chinese Life-Steps program with an additional culture-specific intervention option. We describe in detail how the cultural elements were incorporated into the intervention and put into practice at each stage. Clinical considerations are also outlined and followed by two case examples that are provided to illustrate our application of the intervention. Finally, we discuss practical and research issues and limitations emerging from our field experiments in a HIV clinic in Beijing. The intervention was tailored to address both universal and culturally specific barriers to adherence and is readily applicable to generalized clinical settings. This evidence-based intervention provides a case example of the process of adapting behavioral interventions to culturally diverse communities with limited resources.

Going Global: A Model for Evaluating Empirically Supported Family-Based Interventions in New Contexts.

PubMed

Sundell, Knut; Ferrer-Wreder, Laura; Fraser, Mark W

2014-06-01

The spread of evidence-based practice throughout the world has resulted in the wide adoption of empirically supported interventions (ESIs) and a growing number of controlled trials of imported and culturally adapted ESIs. This article is informed by outcome research on family-based interventions including programs listed in the American Blueprints Model and Promising Programs. Evidence from these controlled trials is mixed and, because it is comprised of both successful and unsuccessful replications of ESIs, it provides clues for the translation of promising programs in the future. At least four explanations appear plausible for the mixed results in replication trials. One has to do with methodological differences across trials. A second deals with ambiguities in the cultural adaptation process. A third explanation is that ESIs in failed replications have not been adequately implemented. A fourth source of variation derives from unanticipated contextual influences that might affect the effects of ESIs when transported to other cultures and countries. This article describes a model that allows for the differential examination of adaptations of interventions in new cultural contexts. © The Author(s) 2012.

Strategic family therapy interventions with deaf member families.

PubMed

Sloman, L; Springer, S

1987-10-01

A deviance based model of deafness is compared with one based on ethnicity. The function of inadequate communication in deaf member families is explored. Techniques of intervention are examined with a focus on three strategic interventions namely: 1) circular interviewing; 2) positive connotation; and, 3) use of rituals. Case histories are provided.

Cultural Adaptation of Interventions in Real Practice Settings

ERIC Educational Resources Information Center

Marsiglia, Flavio F.; Booth, Jamie M.

2015-01-01

This article provides an overview of some common challenges and opportunities related to cultural adaptation of behavioral interventions. Cultural adaptation is presented as a necessary action to ponder when considering the adoption of an evidence-based intervention with ethnic and other minority groups. It proposes a roadmap to choose existing…

A Community-Based Intervention Program to Enhance Family Communication and Family Well-being: The Learning Families Project in Hong Kong.

PubMed

Shen, Chen; Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M; Lam, Tai Hing; Chan, Sophia Siu Chee

2017-01-01

Family communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based "Learning Families Project," based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems. This quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South) Estate] and control (Shun Tin Estate) estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1), immediately after the intervention (T2), and 6 weeks after the intervention (T3). Control group participants were assessed at baseline (March to April 2011) and follow-up (December 2011 to March 2012). Assessments of family communication (time and perceived adequacy) and family well-being (harmony, happiness, and health) at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention. Family communication time and perceived communication adequacy increased significantly in the intervention group ( n  = 515) with a small effect size (Cohen effect d : 0.10 and 0.24, respectively). Compared with the control group ( n  = 476), the improvements in family communication time and perceived communication adequacy (Cohen effect d : 0.13 and 0.14, respectively), and perceived family harmony and happiness (Cohen effect d : 0.12 and 0.12, respectively) were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving family communication and

Family Crisis Intervention in War Contexts: A Case Study of a Traumatised Palestinian Family

ERIC Educational Resources Information Center

Veronese, Guido; Said, Mahmud S.; Castiglioni, Marco

2014-01-01

The aim of this study was to analyse the phases of an innovative in vivo exposure intervention in which all family members were present at the scene of a traumatic incident. Clinical practice has borne out the efficacy of family intervention and its benefits for traumatised individuals and family groups. The intervention discussed here was…

Couple and Family Interventions in Health Problems

ERIC Educational Resources Information Center

Shields, Cleveland G.; Finley, Michelle A.; Chawla, Neelu

2012-01-01

Intervention research for couples and families managing chronic health problems is in an early developmental stage. We reviewed randomized clinical trials of family interventions for common neurological diseases, cardiovascular diseases, cancer, and diabetes, which is similar to the content of previous reviews discussed later. One overriding theme…

A brief anti-stigma intervention for Chinese immigrant caregivers of individuals with psychosis: adaptation and initial findings.

PubMed

Yang, Lawrence H; Lai, Grace Y; Tu, Ming; Luo, Maggie; Wonpat-Borja, Ahtoy; Jackson, Valerie W; Lewis-Fernández, Roberto; Dixon, Lisa

2014-04-01

Mental illness stigma has adverse effects on both the caregivers' psychological well-being and the effectiveness of care that consumers receive. While anti-stigma interventions for family caregivers from Western settings have recently shown efficacy, these interventions may not be equally applicable across culturally diverse groups. Specifically, Chinese immigrant caregivers experience heightened internalized stigma, which predisposes the adoption of harmful coping strategies and reduced quality of social networks. We present an anti-stigma intervention based on a peer-family group format, co-led by a clinician and a trained family caregiver, to counter stigma among Chinese immigrants. Data are presented from a brief intervention administered to a pilot sample of 11 Chinese immigrant caregivers that provides: psychoeducation, strategies to counter experienced discrimination, and techniques to resist internalized stigma. Case vignettes illustrate implementation of this intervention, and how the peer-family format via interactive contact counteracts internalized stereotypes, encourages adaptive coping strategies, and reinvigorates social networks. Quantitative results further suggest preliminary efficacy in reducing internalized stigma for caregivers who evidenced at least some prior internalized stigma. This study constitutes an initial but important step towards reducing mental illness stigma among Asian Americans, for whom stigma has played a powerful role in the delay and underuse of treatment.

The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

PubMed Central

Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

2013-01-01

China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence—favorably evaluated in the West—for Chinese HIV-positive patients. The adaptation process was theory-driven and covered several key issues of cultural adaptation. We considered the importance of interpersonal relationships and family in China and cultural notions of health. Using an evidence-based treatment protocol originally designed for Western HIV-positive patients, we developed an 11-step Chinese Life-Steps program with an additional culture-specific intervention option. We describe in detail how the cultural elements were incorporated into the intervention and put into practice at each stage. Clinical considerations are also outlined and followed by two case examples that are provided to illustrate our application of the intervention. Finally, we discuss practical and research issues and limitations emerging from our field experiments in a HIV clinic in Beijing. The intervention was tailored to address both universal and culturally specific barriers to adherence and is readily applicable to generalized clinical settings. This evidence-based intervention provides a case example of the process of adapting behavioral interventions to culturally diverse communities with limited resources. PMID:23667305

Family intervention in Indigenous communities: emergent issues in conducting outcome research.

PubMed

Turner, Karen; Sanders, Matthew

2007-01-01

Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P---Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.

A family nursing educational intervention supports nurses and families in an adult intensive care unit.

PubMed

Eggenberger, Sandra K; Sanders, Marita

2016-11-01

The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses' attitudes towards and confidence in providing family care, as well as families' perceptions of support from nurses in an adult critical care setting. An academic-clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members' experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic-clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in

Culturally Adaptive Walking Intervention for Korean-Chinese Female Migrant Workers.

PubMed

Cho, Sunghye; Lee, Hyeonkyeong; Kim, Jung Hee; Lee, Meenhye; Lee, Young-Me

2017-05-01

Although the literature has commonly cited that development of culturally adaptive interventions is key to improving the health outcomes of culturally and linguistically diverse populations, there have been limited culturally adaptive walking interventions specific to Korean-Chinese (KC) migrants. The objective of this study is to describe the process in development of culturally adaptive walking interventions for KC female migrant workers, using the intervention mapping (IM) method. The culturally adaptive walking intervention was developed using the IM method, which is a stepwise theory and evidence-based approach for planning interventions. The IM method process has six steps, including needs assessment, formulation of change objectives, selection of theory-based methods and practical strategies, development of an intervention program, development of an adoption and implementation plan, and development of an evaluation design. The determinants of walking behavior, including knowledge, self-efficacy, social support, and acculturation, were identified through an extensive literature review, community leader interviews, and a survey of female KC migrant workers. Appropriate intervention methods and strategies were identified based on relevant theories. Acculturation was a determinant of exercise behavior, and various methods to improve cultural adaptation were identified in the context of the lifestyles and working environments of the target population. The IM method provided a foundation for creating a health intervention for KC female migrant workers. This method could easily be useful for health care providers working with other groups.

FAMily-Oriented Support (FAMOS): development and feasibility of a psychosocial intervention for families of childhood cancer survivors.

PubMed

Salem, Hanin; Johansen, Christoffer; Schmiegelow, Kjeld; Winther, Jeanette Falck; Wehner, Peder Skov; Hasle, Henrik; Rosthøj, Steen; Kazak, Anne E; E Bidstrup, Pernille

2017-02-01

We developed and tested the feasibility of a manualized psychosocial intervention, FAMily-Oriented Support (FAMOS), a home-based psychosocial intervention for families of childhood cancer survivors. The aim of the intervention is to support families in adopting healthy strategies to cope with the psychological consequences of childhood cancer. The intervention is now being evaluated in a nationwide randomized controlled trial (RCT). FAMOS is based on principles of family systems therapy and cognitive behavioral therapy, and is delivered in six sessions at home. Families were recruited from all four pediatric oncology departments in Denmark after the end of intensive cancer treatment. We evaluated the feasibility of the intervention and of a RCT design for comparing the intervention with usual care. The evaluation was conducted among families enrolled in the study by tracking procedures and parents' evaluations. A total of 68 families (68 mothers, 60 fathers, 68 children with cancer and 73 siblings) were enrolled, with a participation rate of 62% of families. Fathers were highly represented (88% of families); also families with single parents (12%) and parents with basic education (7-12 years of primary, secondary, and grammar school education) were represented (12%). The dropout rate was 12% of families (all in the control group), and two families did not complete the intervention because of relapse. Evaluation by parents in the intervention group showed overall satisfaction with the format, timing, and content of the intervention. The results indicate that the FAMOS intervention is feasible in terms of recruitment, retention, and acceptability. The effects of the intervention on post-traumatic stress, depression, anxiety, family functioning, and quality of life will be reported after the nationwide RCT has been completed.

Family-based behavioural intervention for obese children.

PubMed

Epstein, L H

1996-02-01

The family environment can contribute to the development of obesity. Parenting styles may influence the development of food preferences and the ability of a child to regulate intake. Parents and other family members arrange a common, shared environment that may be conducive to overeating or a sedentary lifestyle. Family members serve as models, and reinforce and support the acquisition and maintenance of eating and exercise behaviours. Family-based interventions are needed to modify these variables in treating obese children. We have made significant progress in developing interventions that target obese 8-12 year-old children, completing four 10-year follow-up studies that provide support for two factors that are useful in childhood obesity treatment. First, our research suggests that the direct involvement of at least one parent as an active participant in the weight loss process improves short- and long-term weight regulation. Second, our research suggests that increasing activity is important for maintenance of long-term weight control. Correlational analyses on the 10-year database suggest that family and friend support for behaviour change are related to long-term outcome. Family-based obesity treatment provides interventions for both children and their parents, but children benefit more from treatment than their parents. These positive results provide an encouraging basis for optimism that further development of interventions, based on newer research on family processes and behaviour changes, can be useful in treating childhood obesity.

A family systems nursing intervention model for paediatric health crisis.

PubMed

Tomlinson, Patricia Short; Peden-McAlpine, Cynthia; Sherman, Suzan

2012-03-01

This article discusses the development of a family systems nursing intervention for clinical use in health crisis. Although studies in paediatric critical care provide evidence that family stress is an important clinical phenomenon, studies have demonstrated that few nurses have the requisite family intervention skills to provide family members with adequate support during crisis. In addition, few intervention studies that focus on provider-family relationships with the goal of reducing stress have been reported. This article contributes to the literature by redressing this lack. Data sources.  The literature search supporting this project spanned from 1980 to 2009 and included searches from classic nursing theory, family theory and relevant nursing research specific to the design of the intervention reported. The goal of the intervention is to provide a theoretical and practical foundation for explicit action that enhances relationships with caregivers thereby supporting the integrity of the family and enhancing their coping abilities. The intervention, based on the Family Systems Model and the family's understandings of the situation, defines specific goals and desired outcomes to guide strategic actions. Discussion of the conceptual foundation, procedural development and an example of the protocol is provided. Implications for nursing.  The intervention is designed for nurses with limited knowledge in family theory to aid them to better help families dealing with stress. The proposed intervention can be used to increase nurses' skills in family centred nursing care. Although designed for use in paediatric critical care, it can, with modifications, be used in other nursing specialty areas. © 2011 Blackwell Publishing Ltd.

Defining Family-Friendly Early Intervention.

ERIC Educational Resources Information Center

Wadsworth, Donna E. Dugger; Wartelle, Noah L.

Prior to the 1986 passage of PL 99-457, an extension of the special services coverage under the Education for All Handicapped Children Act, early intervention programs were primarily interventionist directed and child focused. The new legislation provided incentives for providing programs that were family-centered and family-driven. The goal of…

Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women

PubMed Central

Highfield, Linda; Hartman, Marieke A.; Mullen, Patricia Dolan; Fernandez, Maria E.; Bartholomew, L. Kay

2015-01-01

This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI. PMID:26587531

Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women.

PubMed

Highfield, Linda; Hartman, Marieke A; Mullen, Patricia Dolan; Rodriguez, Serena A; Fernandez, Maria E; Bartholomew, L Kay

2015-01-01

This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI.

The Family Navigator: A Pilot Intervention to Support Intensive Care Unit Family Surrogates.

PubMed

Torke, Alexia M; Wocial, Lucia D; Johns, Shelley A; Sachs, Greg A; Callahan, Christopher M; Bosslet, Gabriel T; Slaven, James E; Perkins, Susan M; Hickman, Susan E; Montz, Kianna; Burke, Emily S

2016-11-01

Communication problems between family surrogates and intensive care unit (ICU) clinicians have been documented, but few interventions are effective. Nurses have the potential to play an expanded role in ICU communication and decision making. To conduct a pilot randomized controlled trial of the family navigator (FN), a distinct nursing role to address family members' unmet communication needs early in an ICU stay. An interprofessional team developed the FN protocol. A randomized controlled pilot intervention trial of the FN was performed in a tertiary referral hospital's ICU to test the feasibility and acceptability of the intervention. The intervention addressed informational and emotional communication needs through daily contact by using structured clinical updates, emotional and informational support modules, family meeting support, and follow-up phone calls. Twenty-six surrogate/patient pairs (13 per study arm) were enrolled. Surrogates randomized to the intervention had contact with the FN on 90% or more of eligible patient days. All surrogates agreed that they would recom mend the FN to other families. Open-ended comments from both surrogates and clinicians were uniformly positive. Having a fully integrated nurse empowered to facilitate decision making is a feasible intervention in an ICU and is well-received by ICU families and staff. A larger randomized controlled trial is needed to demonstrate impact on important outcomes, such as surrogates' well-being and decision quality. ©2016 American Association of Critical-Care Nurses.

Toward Dynamic Adaptation of Psychological Interventions for Child and Adolescent Development and Mental Health.

PubMed

Malti, Tina; Noam, Gil G; Beelmann, Andreas; Sommer, Simon

2016-01-01

Children's and adolescents' mental health needs emphasize the necessity of a new era of translational research to enhance development and yield better lives for children, families, and communities. Developmental, clinical, and translational research serves as a powerful tool for managing the inevitable complexities in pursuit of these goals. This article proposes key ideas that will strengthen current evidence-based intervention practices by creating stronger links between research, practice, and complex systems contexts, with the potential of extending applicability, replicability, and impact. As exemplified in some of the articles throughout this special issue, new research and innovative implementation models will likely contribute to better ways of assessing and dynamically adapting structure and intervention practice within mental health systems. We contend that future models for effective interventions with children and adolescents will involve increased attention to (a) the connection of research on the developmental needs of children and adolescents to practice models; (b) consideration of informed contextual and cultural adaptation in implementation; and (c) a rational model of evidence-based planning, using a dynamic, inclusive approach with high support for adaptation, flexibility, and implementation fidelity. We discuss future directions for translational research for researchers, practitioners, and administrators in the field to continue and transform these ideas and their illustrations.

Clarifying Work-Family Intervention Processes: The Roles of Work-Family Conflict and Family-Supportive Supervisor Behaviors

ERIC Educational Resources Information Center

Hammer, Leslie B.; Kossek, Ellen Ernst; Anger, W. Kent; Bodner, Todd; Zimmerman, Kristi L.

2011-01-01

Drawing on a conceptual model integrating research on training, work-family interventions, and social support, we conducted a quasi-experimental field study to assess the impact of a supervisor training and self-monitoring intervention designed to increase supervisors' use of family-supportive supervisor behaviors. Pre- and postintervention…

Family interventions in traumatized immigrants and refugees: A systematic review.

PubMed

Slobodin, Ortal; de Jong, Joop T V M

2015-12-01

The importance of the family as a unit in the aftermath of trauma necessitates the use of family interventions among immigrants and refugees. While abundant clinical material suggests that family-based trauma interventions are applicable across cultures, very little is known about the extent to which family treatment modalities are effective for immigrants and refugees. We conducted a systematic review of intervention studies that have been designed or modified specifically for traumatized immigrant and refugee families. The terms "trauma," "family," and "immigrants/refugees/culture" were used along with different terms for "intervention." Studies with no research methodology were excluded. Only 6 experimental studies met our inclusion criteria; 4 of them describe school-based interventions and 2 present multifamily support groups. The shortage of research in this area does not allow clear conclusions about the effectiveness of family interventions for traumatized immigrants or refugees. The complexity of employing methodologically rigorous research in small communities is discussed. Future trials should go beyond the individualistic approach and focus on posttraumatic stress disorder to address family-level processes, such as family relationship, communication, and resilience. © The Author(s) 2015.

The Family Adaptation Model: A Life Course Perspective. Technical Report 880.

ERIC Educational Resources Information Center

Bowen, Gary L.

This conceptual model for explaining the factors and processes that underlie family adaptation in the Army relies heavily upon two traditions: the "Double ABCX" model of family stress and adaptation and the "Person-Environment Fit" model. The new model has three major parts: the environmental system, the personal system, and family adaptation.…

Predictors of adaptation in Icelandic and American families of young children with chronic asthma.

PubMed

Svavarsdottir, Erla Kolbrun; Rayens, Mary Kay; McCubbin, Marilyn

2005-01-01

The purposes of this international study were to determine the predictors of adaptation and to assess potential moderating effects of parents' sense of coherence and family hardiness on the relationship of severity of illness of a child with asthma and family and caregiving demands as predictors of family adaptation. For both parents, sense of coherence and family hardiness predicted family adaptation. Icelandic mothers perceived their family's adaptation more favorably than did their American counterparts. For the fathers, family demands predicted adaptation. Sense of coherence moderated the effect of family demands on adaptation for both parents. These findings underscore the importance of strengthening individual and family resiliency as a mechanism for improving family adaptation.

Modeling Family Adaptation to Fragile X Syndrome

ERIC Educational Resources Information Center

Raspa, Melissa; Bailey, Donald, Jr.; Bann, Carla; Bishop, Ellen

2014-01-01

Using data from a survey of 1,099 families who have a child with Fragile X syndrome, we examined adaptation across 7 dimensions of family life: parenting knowledge, social support, social life, financial impact, well-being, quality of life, and overall impact. Results illustrate that although families report a high quality of life, they struggle…

Ten adaptive strategies for family and work balance: advice from successful families.

PubMed

Haddock, S A; Zimmerman, T S; Ziemba, S J; Current, L R

2001-10-01

Despite negative media images and social dynamics insensitive to the lives of many dual-career couples, research shows that these families are largely healthy and thriving. In this study, we investigated the adaptive strategies of middle-class, dual-earner couples (N = 47) with children that are successfully managing family and work. Guided by grounded-theory methodology, analysis of interview data revealed that these successful couples structured their lives around 10 major strategies: Valuing family, striving for partnership, deriving meaning from work, maintaining work boundaries, focusing and producing at work, taking pride in dual earning, prioritizing family fun, living simply, making decisions proactively, and valuing time. Each adaptive strategy is defined and illustrated through the participants' own words. Clinical applications for therapists working with dual-earner couples are offered.

Systematic, Multimethod Assessment of Adaptations Across Four Diverse Health Systems Interventions.

PubMed

Rabin, Borsika A; McCreight, Marina; Battaglia, Catherine; Ayele, Roman; Burke, Robert E; Hess, Paul L; Frank, Joseph W; Glasgow, Russell E

2018-01-01

Many health outcomes and implementation science studies have demonstrated the importance of tailoring evidence-based care interventions to local context to improve fit. By adapting to local culture, history, resources, characteristics, and priorities, interventions are more likely to lead to improved outcomes. However, it is unclear how best to adapt evidence-based programs and promising innovations. There are few guides or examples of how to best categorize or assess health-care adaptations, and even fewer that are brief and practical for use by non-researchers. This study describes the importance and potential of assessing adaptations before, during, and after the implementation of health systems interventions. We present a promising multilevel and multimethod approach developed and being applied across four different health systems interventions. Finally, we discuss implications and opportunities for future research. The four case studies are diverse in the conditions addressed, interventions, and implementation strategies. They include two nurse coordinator-based transition of care interventions, a data and training-driven multimodal pain management project, and a cardiovascular patient-reported outcomes project, all of which are using audit and feedback. We used the same modified adaptation framework to document changes made to the interventions and implementation strategies. To create the modified framework, we started with the adaptation and modification model developed by Stirman and colleagues and expanded it by adding concepts from the RE-AIM framework. Our assessments address the intuitive domains of Who, How, When, What, and Why to classify and organize adaptations. For each case study, we discuss how the modified framework was operationalized, the multiple methods used to collect data, results to date and approaches utilized for data analysis. These methods include a real-time tracking system and structured interviews at key times during the

Role adaptation of family caregivers for ventilator-dependent patients: transition from respiratory care ward to home.

PubMed

Huang, Tzu-Ting; Peng, Ji-Ming

2010-06-01

To explore the underlying theoretical framework for the role adaptation of family caregivers for ventilator-dependent patients after transferring from respiratory care ward to home. The number of ventilator-dependent patients has been increasing worldwide. Under Taiwan's National Health Insurance policy, if ventilator-dependent patients are stable, they should be transferred from an acute care hospital to a subacute unit or home. A qualitative design based on grounded theory was adopted for this study. One-on-one, in-depth interviews were conducted with a purposive sample of 15 family caregivers who were caretaking ventilator-dependent patients at their home two months after hospital discharge. Theoretical sampling was used until concepts emerging in data analysis were saturated. Analysis of audio-taped interview transcripts generated a process of role adaptation for family caregivers of a ventilator-dependent patient. The caregiver's transition to the care-giving role is a dynamic process with consequences that are impacted by level of support from the family, affective rewards from the patient, patient's health condition and a balanced life schedule for the caregiver. The results of this study can provide respiratory care professionals with skills to assess the needs of caregivers for ventilator-dependent patients and individualise interventions to caregivers' specific needs. The findings of this study contribute to nurses' understanding and promotion of role adaptation for family caregivers among ventilator-dependent patients.

The Nature of Family Engagement in Interventions for Children With Chronic Conditions.

PubMed

Knafl, Kathleen A; Havill, Nancy L; Leeman, Jennifer; Fleming, Louise; Crandell, Jamie L; Sandelowski, Margarete

2017-05-01

Recognizing the bi-directional relationship between family functioning and child well-being in the context of childhood chronic conditions, researchers have tested family-focused interventions aimed at promoting both child and family well-being through improving the family's condition management capacity. Based on a sample of 70 interventions for families in which there was a child with a chronic physical condition, this analysis examined the nature of family engagement in the interventions. Data were extracted from the intervention reports using a standardized template; conventional content analysis was used to describe family engagement. Interventions varied in focus, structure, and level of family engagement. Investigators most often sought to improve condition control or management, with parent engagement focused on improving capacity to manage the treatment regimen. Few investigators addressed capacity building in the context of family functioning. Recommendations are made for reporting standards for family-focused interventions and for enhancing the family systems grounding of interventions.

How does family intervention improve the outcome of people with schizophrenia?

PubMed

Girón, Manuel; Nova-Fernández, Francisco; Mañá-Alvarenga, Sonia; Nolasco, Andreu; Molina-Habas, Antonia; Fernández-Yañez, Antonio; Tabarés-Seisdedos, Rafael; Gómez-Beneyto, Manuel

2015-03-01

There is strong evidence of the efficacy of family psychosocial interventions for schizophrenia, but evidence of the role played by the attitudes of relatives in the therapeutic process is lacking. To study the effect of a family intervention on family attitudes and to analyse their mediating role in the therapeutic process 50 patients with schizophrenia and their key relatives undergoing a trial on the efficacy of a family psychosocial intervention were studied by means of the Affective Style Coding System, the Scale of Empathy, and the Relational Control Coding System. Specific statistical methods were used to determine the nature of the relationship of the relatives' attitudes to the outcome of family intervention. Family psychosocial intervention was associated with a reduction in relatives' guilt induction and dominance and an improvement in empathy. Empathy and lack of dominance were identified as independent mediators of the effect of family psychosocial intervention. The change in empathy and dominance during the first 9 months of the intervention predicted the outcome in the following 15 months. Relatives' empathy and lack of dominance are mediators of the beneficial effect of family psychosocial intervention on patient's outcome.

Designing for Productive Adaptations of Curriculum Interventions

ERIC Educational Resources Information Center

Debarger, Angela Haydel; Choppin, Jeffrey; Beauvineau, Yves; Moorthy, Savitha

2013-01-01

Productive adaptations at the classroom level are evidence-based curriculum adaptations that are responsive to the demands of a particular classroom context and still consistent with the core design principles and intentions of a curriculum intervention. The model of design-based implementation research (DBIR) offers insights into complexities and…

The Family-centered Action Model of Intervention Layout and Implementation (FAMILI): the example of childhood obesity.

PubMed

Davison, Kirsten K; Lawson, Hal A; Coatsworth, J Douglas

2012-07-01

Parents play a fundamental role in shaping children's development, including their dietary and physical activity behaviors. Yet family-centered interventions are rarely used in obesity prevention research. Less than half of childhood obesity prevention programs include parents, and those that do include parents or a family component seldom focus on sustainable change at the level of the family. The general absence of a family-centered approach may be explained by persistent challenges in engaging parents and families and the absence of an intervention framework explicitly designed to foster family-centered programs. The Family-centered Action Model of Intervention Layout and Implementation, or FAMILI, was developed to address these needs. FAMILI draws on theories of family development to frame research and intervention design, uses a mixed-methods approach to conduct ecologically valid research, and positions family members as active participants in the development, implementation, and evaluation of family-centered obesity prevention programs. FAMILI is intended to facilitate the development of culturally responsive and sustainable prevention programs with the potential to improve outcomes. Although childhood obesity was used to illustrate the application of FAMILI, this model can be used to address a range of child health problems.

Intra-Familial Stigmatization: An Adverse Outcome of a Family-Based Health Education Intervention to Reduce Childhood Obesity

ERIC Educational Resources Information Center

Hoeeg, Didde; Grabowski, Dan; Christensen, Ulla

2018-01-01

Purpose: To treat childhood obesity, health education interventions are often aimed at the whole family. However, such interventions seem to have a relatively limited effect on weight loss. The purpose of this paper is to examine how families enrolled in a family-based health education intervention manage the intervention in their daily lives and…

Children facing a family member's acute illness: a review of intervention studies.

PubMed

Spath, Mary L

2007-07-01

A review of psycho-educational intervention studies to benefit children adapting to a close (parent, sibling, or grandparent) family member's serious illness was conducted. To review the literature on studies addressing this topic, critique research methods, describe clinical outcomes, and make recommendations for future research efforts. Research citations from 1990 to 2005 from Medline, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, and PsycINFO databases were identified. Citations were reviewed and evaluated for sample, design, theoretical framework, intervention, threats to validity, and outcomes. Reviewed studies were limited to those that included statistical analysis to evaluate interventions and outcomes. Six studies were reviewed. Positive outcomes were reported for all of the interventional strategies used in the studies. Reviewed studies generally lacked a theoretical framework and a control group, were generally composed of small convenience samples, and primarily used non-tested investigator instruments. They were diverse in terms of intervention length and intensity, and measured short-term outcomes related to participant program satisfaction, rather than participant cognitive and behavioral change. The paucity of interventional studies and lack of systematic empirical precision to evaluate intervention effectiveness necessitates future studies that are methodologically rigorous.

Adapting the Structural Family Systems Rating to Assess the Patterns of Interaction in Families of Dementia Caregivers

ERIC Educational Resources Information Center

Mitrani, Victoria B.; Feaster, Daniel J.; McCabe, Brian E.; Czaja, Sara J.; Szapocznik, Jose

2005-01-01

Purpose: This study adapted the Structural Family Systems Ratings (SFSR), an observational measure of family interactions, for dementia caregivers. This article presents the development of the SFSR-Dementia Caregiver adaptation (SFSR-DC) and examines relationships between specific family-interaction patterns and caregiver distress. Design and…

Early Intervention for Families and Children Experiencing Homelessness

ERIC Educational Resources Information Center

Hurley, Jennifer J.; Looby, Winnie; Goodrum, Ashley R.; Campbell, Elizabeth M.; Bonti, Gregg K.; Raymon, Becca A.; Condon, Rebecca; Schwaeber, Sami E.; Mauceri, Melina E.; Bourne, Erin M.; Callahan, Elizabeth D.; Hardy, Danielle L.; Mathews, Pamela

2018-01-01

Early intervention (EI) services are provided for families and children at risk for or with developmental delays. Early intervention includes services that are provided in the natural environment as mandated by the Individuals with Disabilities Education Act (IDEA; 2004). The natural environment is where children and families would naturally spend…

[Effects of family cohesion and adaptability on behavioral problems in preschool children].

PubMed

Wang, Yan-Ni; Xue, Hong-Li; Chen, Qian

2016-05-01

To investigate the effects of family cohesion and adaptability on behavioral problems in preschool children. The stratified cluster multistage sampling method was used to perform a questionnaire survey in the parents of 1 284 children aged 3-6 years in the urban area of Lanzhou, China. The general status questionnaire, Conners Child Behavior Checklist (Parent Symptom Question), and Family Adaptability and Cohesion Scale, Second edition, Chinese version (FACESII-CV) were used to investigate behavioral problems and family cohesion and adaptability. The overall detection rate of behavioral problems in preschool children was 17.13%. The children with different types of family cohesion had different detection rates of behavioral problems, and those with free-type family cohesion showed the highest detection rate of behavioral problems (40.2%). The children with different types of family adaptability also had different detection rates of behavioral problems, and those with stiffness type showed the highest detection rate of behavioral problems (25.1%). The behavioral problems in preschool children were negatively correlated with family cohesion and adaptability. During the growth of preschool children, family cohesion and adaptability have certain effects on the mental development of preschool children.

A Family-Centered Preventive Intervention within Pediatric Oncology: Adapting the FOCUS Intervention for Latino Youth and Their Families

ERIC Educational Resources Information Center

Garcia, Ediza; Wijesekera, Kanchana; Lester, Patricia

2017-01-01

Pediatric cancer can disrupt the behavioral and emotional well-being of youth and their families, representing a potential psychological health risk for the entire family. Among ethnic minority families, cultural factors such as acculturation and language competency may affect the experience of this illness, which can, in turn, affect overall…

Strengthening family coping resources: the feasibility of a multifamily group intervention for families exposed to trauma.

PubMed

Kiser, Laurel J; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M

2010-12-01

Families exposed to urban poverty face a disproportionate risk of exposure to repeated trauma. Repeated exposures can lead to severe and chronic reactions in multiple family members with effects that ripple throughout the family system. Interventions for distressed families residing in traumatic contexts, such as low-income, urban settings are desperately needed. This report presents preliminary data in support of Strengthening Family Coping Resources, a trauma-focused, multifamily, skill-building intervention. Strengthening Family Coping Resources is designed for families living in traumatic contexts with the goal of reducing symptoms of posttraumatic stress disorder and other trauma-related disorders in children and caregivers. Results from open trials suggest Strengthening Family Coping Resources is a feasible intervention with positive effects on children's symptoms of trauma-related distress.

Youth social behaviour and network therapy (Y-SBNT): adaptation of a family and social network intervention for young people who misuse alcohol and drugs - a randomised controlled feasibility trial.

PubMed

Watson, Judith; Toner, Paul; Day, Ed; Back, Donna; Brady, Louca-Mai; Fairhurst, Caroline; Renwick, Charlotte; Templeton, Lorna; Akhtar, Shabana; Lloyd, Charlie; Li, Jinshuo; Cocks, Kim; Ambegaokar, Sangeeta; Parrott, Steve; McArdle, Paul; Gilvarry, Eilish; Copello, Alex

2017-03-01

Family interventions appear to be effective at treating young people's substance misuse. However, implementation of family approaches in UK services is low. This study aimed to demonstrate the feasibility of recruiting young people to an intervention based on an adaptation of adult social behaviour and network therapy. It also sought to involve young people with experience of using substance misuse services in the research process. To demonstrate the feasibility of recruiting young people to family and social network therapy and to explore ways in which young people with experience of using substance misuse services could be involved in a study of this nature. A pragmatic, two-armed, randomised controlled open feasibility trial. Two UK-based treatment services for young people with substance use problems, with recruitment taking place from May to November 2014. Young people aged 12-18 years, newly referred and accepted for structured interventions for drug and/or alcohol problems. A remote, web-based computer randomisation system allocated young people to adapted youth social behaviour and network therapy (Y-SBNT) or treatment as usual (TAU). Y-SBNT participants were intended to receive up to six 50-minute sessions over a maximum of 12 weeks. TAU participants continued to receive usual care delivered by their service. Feasibility was measured by recruitment rates, retention in treatment and follow-up completion rates. The main clinical outcome was the proportion of days on which the main problem substance was used in the preceding 90-day period as captured by the Timeline Follow-Back interview at 3 and 12 months. In total, 53 young people were randomised (Y-SBNT, n  = 26; TAU, n  = 27) against a target of 60 (88.3%). Forty-two young people attended at least one treatment session [Y-SBNT 22/26 (84.6%); TAU 20/27 (74.1%)]; follow-up rates were 77.4% at month 3 and 73.6% at month 12. Data for nine young people were missing at both months 3 and 12, so the main

Intervention outcomes among HIV-affected families over 18 months.

PubMed

Rotheram-Borus, Mary Jane; Rice, Eric; Comulada, W Scott; Best, Karin; Elia, Carla; Peters, Katherine; Li, Li; Green, Sara; Valladares, Ena

2012-07-01

We evaluate the efficacy of a family-based intervention over time among HIV-affected families. Mothers living with HIV (MLH; n = 339) in Los Angeles and their school-aged children were randomized to either an intervention or control condition and followed for 18 months. MLH and their children in the intervention received 16 cognitive-behavioral, small-group sessions designed to help them maintain physical and mental health, parent while ill, address HIV-related stressors, and reduce HIV-transmission behaviors. At recruitment, MLH reported few problem behaviors related to physical health, mental health, or sexual or drug transmission acts. Compared to MLH in the control condition, intervention MLH were significantly more likely to monitor their own CD4 cell counts and their children were more likely to decrease alcohol and drug use. Most MLH and their children had relatively healthy family relationships. Family-based HIV interventions should be limited to MLH who are experiencing substantial problems.

Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU.

PubMed

Curtis, J Randall; Ciechanowski, Paul S; Downey, Lois; Gold, Julia; Nielsen, Elizabeth L; Shannon, Sarah E; Treece, Patsy D; Young, Jessica P; Engelberg, Ruth A

2012-11-01

The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies suggest that the current quality of ICU communication is often poor and is associated with psychological distress among family members of critically ill patients. This paper describes the development and evaluation of an intervention designed to improve the quality of care in the ICU by improving communication among the ICU team and with family members of critically ill patients. We developed a multi-faceted, interprofessional intervention based on self-efficacy theory. The intervention involves a "communication facilitator" - a nurse or social worker - trained to facilitate communication among the interprofessional ICU team and with the critically ill patient's family. The facilitators are trained using three specific content areas: a) evidence-based approaches to improving clinician-family communication in the ICU, b) attachment theory allowing clinicians to adapt communication to meet individual family member's communication needs, and c) mediation to facilitate identification and resolution of conflict including clinician-family, clinician-clinician, and intra-family conflict. The outcomes assessed in this randomized trial focus on psychological distress among family members including anxiety, depression, and post-traumatic stress disorder at 3 and 6 months after the ICU stay. This manuscript also reports some of the lessons that we have learned early in this study. Copyright © 2012 Elsevier Inc. All rights reserved.

A modified theoretical framework to assess implementation fidelity of adaptive public health interventions.

PubMed

Pérez, Dennis; Van der Stuyft, Patrick; Zabala, Maríadel Carmen; Castro, Marta; Lefèvre, Pierre

2016-07-08

One of the major debates in implementation research turns around fidelity and adaptation. Fidelity is the degree to which an intervention is implemented as intended by its developers. It is meant to ensure that the intervention maintains its intended effects. Adaptation is the process of implementers or users bringing changes to the original design of an intervention. Depending on the nature of the modifications brought, adaptation could either be potentially positive or could carry the risk of threatening the theoretical basis of the intervention, resulting in a negative effect on expected outcomes. Adaptive interventions are those for which adaptation is allowed or even encouraged. Classical fidelity dimensions and conceptual frameworks do not address the issue of how to adapt an intervention while still maintaining its effectiveness. We support the idea that fidelity and adaptation co-exist and that adaptations can impact either positively or negatively on the intervention's effectiveness. For adaptive interventions, research should answer the question how an adequate fidelity-adaptation balance can be reached. One way to address this issue is by looking systematically at the aspects of an intervention that are being adapted. We conducted fidelity research on the implementation of an empowerment strategy for dengue prevention in Cuba. In view of the adaptive nature of the strategy, we anticipated that the classical fidelity dimensions would be of limited use for assessing adaptations. The typology we used in the assessment-implemented, not-implemented, modified, or added components of the strategy-also had limitations. It did not allow us to answer the question which of the modifications introduced in the strategy contributed to or distracted from outcomes. We confronted our empirical research with existing literature on fidelity, and as a result, considered that the framework for implementation fidelity proposed by Carroll et al. in 2007 could potentially meet

Psychological interventions for individuals with cystic fibrosis and their families.

PubMed

Goldbeck, Lutz; Fidika, Astrid; Herle, Marion; Quittner, Alexandra L

2014-06-18

With increasing survival estimates for individuals with cystic fibrosis, long-term management has become an important focus. Psychological interventions are largely concerned with adherence to treatment, emotional and social adaptation and health-related quality of life. We are unaware of any relevant systematic reviews. To determine whether psychological interventions for people with cystic fibrosis provide significant psychosocial and physical benefits in addition to standard medical care. Studies were identified from two Cochrane trials registers (Cystic Fibrosis and Genetic Disorders Group; Depression, Anxiety and Neurosis Group), Ovid MEDLINE and PsychINFO; unpublished trials were located through professional networks and Listserves. Most recent search of the Cystic Fibrosis and Genetic Disorders Group's register: 19 December 2013.Most recent search of the Depression, Anxiety and Neurosis Group's register: 12 November 2013. Randomised controlled studies of a broad range of psychological interventions evaluating subjective and objective health outcomes, such as quality of life or pulmonary function, in individuals of all ages with cystic fibrosis and their immediate family. We were interested in psychological interventions, including psychological methods within the scope of psychotherapeutic or psychosomatic mechanism of action (e.g. cognitive behavioural, cognitive, family systems or systemic, psycho-dynamic, or other, e.g. supportive, relaxation, or biofeedback), which were aimed at improving psychological and psychosocial outcomes (e.g. quality of life, levels of stress or distress, psychopathology, etc.), adaptation to disease management and physiological outcomes. Three authors were involved in selecting the eligible studies and two of these authors assessed their risk of bias. The review includes 16 studies (eight new studies included in this update) representing data from 556 participants. Studies are diverse in their design and their methods. They

Project power: Adapting an evidence-based HIV/STI prevention intervention for incarcerated women.

PubMed

Fasula, Amy M; Fogel, Catherine I; Gelaude, Deborah; Carry, Monique; Gaiter, Juarlyn; Parker, Sharon

2013-06-01

Incarcerated women are a critical population for targeted HIV/STI prevention programming; however, there is a dearth of evidence-based, genderspecific behavioral interventions for this population. Systematically adapting existing evidence-based interventions (EBIs) can help fill this gap. We illustrate the adaptation of the HIV/STI prevention EBI, Project Safe, for use among incarcerated women and delivery in prisons. Project POWER, the final adapted intervention, was developed using formative research with prison staff and administration, incarcerated and previously incarcerated women, and input of community advisory boards. Intervention delivery adaptations included: shorter, more frequent intervention sessions; booster sessions prior to and just after release; facilitator experience in prisons and counseling; and new videos. Intervention content adaptations addressed issues of empowerment, substance use, gender and power inequity in relationships, interpersonal violence, mental health, reentry, and social support. This illustration of the adaption process provides information to inform additional efforts to adapt EBIs for this underserved population.

Influence and adaptability in families with deaf parents and hearing children.

PubMed

Rienzi, B M

1990-12-01

This study assessed the influence of individual family members in functional families, primarily to determine whether hearing children of deaf parents have more influence than do hearing children of hearing parents. Eight families with deaf parents and a hearing child and eight all hearing families were videotaped while planning a family meal together. It was found that deaf-parented families share many traits with hearing families. However, there were some differences. The hearing children of deaf parents had a greater number and percentage of their ideas accepted than did the hearing children of hearing parents. Differences were also noted between the deaf fathers and the hearing fathers. The deaf-parented families were more adaptable, as measured by the Family Adaptability and Cohesion Evaluation Scale. The observed difference in child influence, in and of itself, is neither good nor bad. Deafness of one family member, in an auditory dependent environment, may require a more flexible family power structure. Professionals assessing deaf-parented families should be sensitive to the special adaptive needs required for healthy functioning of the family.

Special Issue: Troubled Family Interactions and Group Intervention.

ERIC Educational Resources Information Center

West, John D.; Kirby, Jonell, Eds.

1981-01-01

Examines the view that individual pathologies and problems are manifestations of family dysfunctions. The interdependence of family members is the critical element in the family group therapy process. Intervention involves the disruption of the dynamic balance maintained by the family system. (RC)

A randomised controlled feasibility trial of family and social network intervention for young people who misuse alcohol and drugs: study protocol (Y-SBNT).

PubMed

Watson, Judith; Back, Donna; Toner, Paul; Lloyd, Charlie; Day, Ed; Brady, Louca-Mai; Templeton, Lorna; Ambegaokar, Sangeeta; Parrott, Steve; Torgerson, David; Cocks, Kim; Gilvarry, Eilish; McArdle, Paul; Copello, Alex

2015-01-01

A growing body of research has identified family interventions to be effective in treating young people's substance use problems. However, despite this evidence, take-up of family-based approaches in the UK has been low. Key factors for this appear to include the resource-intensive nature of most family interventions which challenges implementation and delivery in many service settings and the cultural adaptation of approaches developed in the USA to a UK setting. This study aims to demonstrate the feasibility of recruiting young people to a specifically developed family- and wider social network-based intervention by testing an adapted version of adult social behaviour and network therapy (SBNT). A pragmatic, randomised controlled, open feasibility trial delivered in two services for young people in the UK. Potential participants are aged 12-18 years referred for drug or alcohol problems to either service. The main purpose of this study is to demonstrate the feasibility of recruiting young people to a specifically developed family and social network-based intervention. The feasibility and acceptability of this intervention will be measured by recruitment rates, treatment retention, follow-up rates and qualitative interviews. The feasibility of training staff from existing services to deliver this intervention will be explored. Using this opportunity to compare the effectiveness of the intervention against treatment as usual, Timeline Follow-Back interviews will document the proportion of days on which the main problem substance was used in the preceding 90-day period at each assessment point. The economic component will examine the feasibility of conducting a full incremental cost-effectiveness analysis of the two treatments. The study will also explore and develop models of patient and public involvement which support the involvement of young people in a study of this nature. An earlier phase of work adapted social behaviour and network therapy (adult approach

Strengthening Family Coping Resources: The Feasibility of a Multifamily Group Intervention for Families Exposed to Trauma*

PubMed Central

Kiser, Laurel J.; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M.

2010-01-01

Families exposed to urban poverty face a disproportionate risk of exposure to repeated trauma. Repeated exposures can lead to severe and chronic reactions in multiple family members with effects that ripple throughout the family system. Interventions for distressed families residing in traumatic contexts, such as low-income, urban settings are desperately needed. This report presents preliminary data in support of Strengthening Family Coping Resources, a trauma-focused, multifamily, skill-building intervention. Strengthening Family Coping Resources is designed for families living in traumatic contexts with the goal of reducing symptoms of posttraumatic stress disorder and other trauma-related disorders in children and caregivers. Results from open trials suggest Strengthening Family Coping Resources is a feasible intervention with positive effects on children’s symptoms of trauma-related distress. PMID:21105068

Religious adaptation of a parenting programme: process evaluation of the Family Links Islamic Values course for Muslim fathers.

PubMed

Scourfield, J; Nasiruddin, Q

2015-09-01

Amid concern about the reach and inclusivity of parenting interventions, attempts have been made to culturally adapt programmes for specific ethnic or linguistic groups. This paper describes a novel approach of the religious adaptation of a parenting programme, namely the Family Links Islamic Values course. A small-scale qualitative process evaluation was conducted on one Family Links Islamic Values course for Muslim fathers in the South of England in order to describe the intervention as implemented and its theory of change, as well as the acceptability of the programme to the participants. The data consisted of 13 semi-structured interviews (10 with parents and three with staff), 25 h of observation and reading of programme manuals. A logic model is presented to describe the theoretical basis of the intervention. The programme was highly acceptable to fathers who valued the integration of religious teachings and were generally very positive about their experience of attending the course. Post-course interviews with both fathers and mothers mentioned some positive changes in fathers as a result of their attendance. It is important to be responsive to the needs of some British Muslims for religiously credible interventions. This small-scale process evaluation needs to be followed by a robust evaluation of programme outcomes for parents and children. © 2015 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.

Religious adaptation of a parenting programme: process evaluation of the Family Links Islamic Values course for Muslim fathers

PubMed Central

Nasiruddin, Q.

2015-01-01

Abstract Background Amid concern about the reach and inclusivity of parenting interventions, attempts have been made to culturally adapt programmes for specific ethnic or linguistic groups. This paper describes a novel approach of the religious adaptation of a parenting programme, namely the Family Links Islamic Values course. Methods A small‐scale qualitative process evaluation was conducted on one Family Links Islamic Values course for Muslim fathers in the South of England in order to describe the intervention as implemented and its theory of change, as well as the acceptability of the programme to the participants. The data consisted of 13 semi‐structured interviews (10 with parents and three with staff), 25 h of observation and reading of programme manuals. Results A logic model is presented to describe the theoretical basis of the intervention. The programme was highly acceptable to fathers who valued the integration of religious teachings and were generally very positive about their experience of attending the course. Post‐course interviews with both fathers and mothers mentioned some positive changes in fathers as a result of their attendance. Conclusions It is important to be responsive to the needs of some British Muslims for religiously credible interventions. This small‐scale process evaluation needs to be followed by a robust evaluation of programme outcomes for parents and children. PMID:25649634

Attachment-based family therapy interventions.

PubMed

Diamond, Gary M

2014-03-01

Attachment-Based Family Therapy is a treatment model designed specifically for depressed and suicidal adolescents. The primary goal of the treatment is to promote developmentally appropriate adolescent-parent attachment. Three core interventions are discussed: relational reframes; focusing on primary emotions and unmet attachment needs; and facilitating corrective attachment episodes. For each intervention, the theoretical/clinical rationale is presented followed by a brief illustration and relevant research findings. (c) 2014 APA, all rights reserved.

Cross-cultural adaptation of the instrument 'Family Needs Questionnaire'.

PubMed

Hora, Edilene Curvelo; de Sousa, Regina Márcia Cardoso

2009-01-01

This is a quantitative methodological development study on the cross-cultural adaptation of the 'Family Needs Questionnaire' (FNQ), which is a structured instrument developed in the United States to measure the perceived needs of family members after the Traumatic Brain Injury (TBI) of a relative. This instrument aims to identify important needs presented by family members, whether met or not. The FNQ translation and adaptation followed a particular method, which permitted to achieve semantic, idiomatic, cultural and conceptual equivalence of the instrument version labeled in Portuguese as 'Questionário de Necessidades da Família'. The results of the questionnaire application to 161 family members showed that the instrument content is valid to measure the needs of families of patients with TBI in the Brazilian context.

PSYCHOSOCIAL INTERVENTION EFFECTS ON ADAPTATION, DISEASE COURSE AND BIOBEHAVIORAL PROCESSES IN CANCER

PubMed Central

Antoni, Michael H.

2012-01-01

A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation changes (negative affect). Changes in adaptation may alter tumor growth-promoting processes (increased angiogenesis, migration and invasion, and inflammation) and tumor defense processes (decreased cellular immunity) relevant for cancer progression and the quality of life of cancer patients. Some evidence suggests that psychosocial intervention can improve psychological and physiological adaptation indicators in cancer patients. However, less is known about whether these interventions can influence tumor activity and tumor growth-promoting processes and whether changes in these processes could explain the psychosocial intervention effects on recurrence and survival documented to date. Documenting that psychosocial interventions can modulate molecular activities (e.g., transcriptional indicators of cell signaling) that govern tumor promoting and tumor defense processes on the one hand, and clinical disease course on the other is a key challenge for biobehavioral oncology research. This mini-review will summarize current knowledge on psychological and physiological adaptation processes affected throughout the stress of the cancer experience, and the effects of psychosocial interventions on psychological adaptation, cancer disease progression, and changes in stress-related biobehavioral processes that may mediate intervention effects on clinical cancer outcomes. Very recent intervention work in breast cancer will be used to illuminate emerging trends in molecular probes of

Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer.

PubMed

Antoni, Michael H

2013-03-01

A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation changes (negative affect). Changes in adaptation may alter tumor growth-promoting processes (increased angiogenesis, migration and invasion, and inflammation) and tumor defense processes (decreased cellular immunity) relevant for cancer progression and the quality of life of cancer patients. Some evidence suggests that psychosocial intervention can improve psychological and physiological adaptation indicators in cancer patients. However, less is known about whether these interventions can influence tumor activity and tumor growth-promoting processes and whether changes in these processes could explain the psychosocial intervention effects on recurrence and survival documented to date. Documenting that psychosocial interventions can modulate molecular activities (e.g., transcriptional indicators of cell signaling) that govern tumor promoting and tumor defense processes on the one hand, and clinical disease course on the other is a key challenge for biobehavioral oncology research. This mini-review will summarize current knowledge on psychological and physiological adaptation processes affected throughout the stress of the cancer experience, and the effects of psychosocial interventions on psychological adaptation, cancer disease progression, and changes in stress-related biobehavioral processes that may mediate intervention effects on clinical cancer outcomes. Very recent intervention work in breast cancer will be used to illuminate emerging trends in molecular probes of

Families Matter! Presexual Risk Prevention Intervention

PubMed Central

Lasswell, Sarah M.; Riley, Drewallyn B.; Poulsen, Melissa N.

2013-01-01

Parent-based HIV prevention programming may play an important role in reaching youths early to help establish lifelong patterns of safe and healthy sexual behaviors. Families Matter! is a 5-session, evidence-based behavioral intervention designed for primary caregivers of children aged 9 to 12 years to promote positive parenting and effective parent–child communication about sexuality and sexual risk reduction. The program’s 5-step capacity-building model was implemented with local government, community, and faith-based partners in 8 sub-Saharan African countries with good intervention fidelity and high levels of participant retention. Families Matter! may be useful in other resource-constrained settings. PMID:24028229

Cultivating Resilience in Families Who Foster: Understanding How Families Cope and Adapt Over Time.

PubMed

Lietz, Cynthia A; Julien-Chinn, Francie J; Geiger, Jennifer M; Hayes Piel, Megan

2016-12-01

Families who foster offer essential care for children and youth when their own parents are unable to provide for their safety and well-being. Foster caregivers face many challenges including increased workload, emotional distress, and the difficulties associated with health and mental health problems that are more common in children in foster care. Despite these stressors, many families are able to sustain fostering while maintaining or enhancing functioning of their unit. This qualitative study applied an adaptational process model of family resilience that emerged in previous studies to examine narratives of persistent, long-term, and multiple fostering experiences. Data corroborated previous research in two ways. Family resilience was again described as a transactional process of coping and adaptation that evolves over time. This process was cultivated through the activation of 10 family strengths that are important in different ways, during varied phases. © 2016 Family Process Institute.

Adapting an evidence-based survivorship intervention for Latina breast cancer survivors

PubMed Central

Meneses, Karen; Gisiger-Camata, Silvia; Schoenberger, Yu-Mei; Weech-Maldonado, Robert; McNees, Patrick

2015-01-01

Aim About 120,000 Latina breast cancer survivors (LBCS) live in the USA with the numbers expected to increase. LBCS experience survivorship disparities and report poor quality of life outcomes. Despite poor outcomes, few survivorship interventions for LBCS are available. Adapting evidence-based interventions for Latinas may be one strategy to reduce disparities. Materials & Methods An evidence-based intervention called the Breast Cancer Education Intervention was adapted for Latinas. First, certified translation and cognitive interview to assess cultural relevance were conducted. Next, a pilot sample of 40 Latinas who participated in the intervention were asked to provide follow-up evaluation of their satisfaction with and usefulness of the translated education manual and intervention. Results Thirty LBCS completed the intervention, and 14 LBCS submitted an evaluation summary expressing satisfaction with usefulness, readability and relevance. Conclusion The process by which translation and cultural adaptation of an evidence-based intervention provides beginning foundation to support and reduce disparities among LBCS. PMID:25776285

Are family-oriented interventions in Portuguese genetics services a remote possibility? Professionals' views on a multifamily intervention for cancer susceptibility families.

PubMed

Mendes, Alvaro; Paneque, Milena; Sousa, Liliana

2012-10-01

This article examines genetics healthcare professionals' opinions about a multifamily psychoeducational programme for hereditary cancer susceptibility families, implemented at a Portuguese genetics service. Their views on how a family-oriented approach is envisioned to be incorporated in Portuguese genetic counselling services are also reported. Six focus groups and three individual interviews were undertaken comprising 30 professionals working in the provision of genetic counselling and genetic counsellor trainees. Participants were given a page-summary describing the intervention and asked to comment the strengths and limitations of the multifamily intervention. All interviews were fully transcribed and analysed using the constant comparison method. The qualitative analysis generated data comprising four thematic categories in relation to the professionals' views: (a) usefulness of the programme; (b) programme's methodological and practical obstacles; (c) genetics services constraints; and (d) suggestions for improving the programme and further family-oriented interventions. We reflect on the reported views examining the intervention, and on how current constraints of genetic services limit the provision of psychosocial support for cancer susceptibility families. The implications of these findings regarding the purpose of genetic counselling are discussed. Results may sensitise stakeholders and policy makers for the need to deliver family-based services in cancer genetic counselling, with adequate planning and collaborative involvement of different professionals.

A family systems-based model of organizational intervention.

PubMed

Shumway, Sterling T; Kimball, Thomas G; Korinek, Alan W; Arredondo, Rudy

2007-04-01

Employee assistance professionals are expected to be proficient at intervening in organizations and creating meaningful behavioral change in interpersonal functioning. Because of their training in family systems theories and concepts, marriage and family therapists (MFTs) are well suited to serve organizations as "systems consultants." Unfortunately, the authors were unable to identify any family systems-based models for organizational intervention that have been empirically tested and supported. In this article, the authors present a family systems-based model of intervention that they developed while working in an employee assistance program (EAP). They also present research that was used to refine the model and to provide initial support for its effectiveness.

Adapting evidence-based interventions using a common theory, practices, and principles.

PubMed

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D

2014-01-01

Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families' well-being; however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families' everyday lives with a prevention framework. At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, Zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework that taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Successes and challenges are discussed for (a) engaging parents and communities; (b) identifying and training Family Mentors to promote children and families' well-being; and (c) gathering data for supervision, outcome evaluation, and continuous quality improvement. To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers' past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.

Mapping the Paths from Styles of Anger Experience and Expression to Obsessive-Compulsive Symptoms: The Moderating Roles of Family Cohesion and Adaptability.

PubMed

Liu, Liang; Liu, Cuilian; Zhao, Xudong

2017-01-01

Previous research has shown strong connections of anger experience and expression with obsessive-compulsive (OC) symptoms. Additionally, studies have demonstrated links between family environment variables and obsessive-compulsive disorder (OCD). Our study aims to integrate the perspectives from these two literatures by exploring the moderating roles of family cohesion and family adaptability in the relationship between anger proneness and suppression and OCD symptoms. A total of 2008 college students were recruited from a comprehensive university in Shanghai, China between February and May 2016. The subjects completed self-report inventories, including the Symptom Check List-90, State-Trait Anger Expression Inventory 2 (Chinese version), and Family Adaptability and Cohesion Scale, second edition (Chinese Version). Controlling for age, one-child family status, ethnicity, family income, current depression, and anxiety, our analyses showed that the association between anger proneness and OC symptoms was moderated by family cohesion among men and that family adaptability moderated the connection between anger suppression and OC complaints among women. The findings imply that a more cohesive and empathic family environment may protect male students with high levels of anger proneness from developing OC behaviors or thoughts. The results suggest that for female subjects who are accustomed to suppressing angry feelings, flexible family coping strategies and communication atmospheres would reduce their vulnerability to OC symptoms. The findings are somewhat consistent with those of previous studies on psychotherapy outcomes that showed that OCD patients benefitted from psychotherapeutic interventions that cultivated the clients' family cohesion and adaptability.

Psychosocial interventions for addiction-affected families in Low and Middle Income Countries: A systematic review.

PubMed

Rane, Anil; Church, Sydney; Bhatia, Urvita; Orford, Jim; Velleman, Richard; Nadkarni, Abhijit

2017-11-01

To review the literature on psychosocial interventions for addiction affected family members in Low and Middle Income Countries (LMIC). A systematic review with a detailed search strategy focussing on psychosocial interventions directed towards people affected by addiction without any gender, year or language specifications was conducted. Identified titles and abstracts were screened; where needed full papers retrieved, and then independently reviewed. Data was extracted based on the aims of the study, to describe the modalities, acceptability, feasibility and effectiveness of the interventions. Four papers met our selection criteria. They were published between 2003 and 2014; the total sample size was 137 participants, and two studies were from Mexico and one each from Vietnam and Malaysia. The predominantly female participants comprised of parents, spouses and siblings. The common components of all the interventions included providing information regarding addiction, teaching coping skills, and providing support. Though preliminary these small studies suggests a positive effect on affected family members (AFM). There was lowering of psychological and physical distress, along with a better understanding of addictive behaviour. The interventions led to better coping; with improvements in self-esteem and assertive behaviour. The interventions, mostly delivered in group settings, were largely acceptable. The limited evidence does suggest positive benefits to AFMs. The scope of research needs to be extended to other addictions, and family members other than spouse and female relatives. Indigenous and locally adapted interventions are needed to address this issue keeping in mind the limited resources of LMIC. This is a field indeed in its infancy and this under recognised and under-served group needs urgent attention of researchers and policy makers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Childhood Epilepsy and Asthma: Family Strengths Associated with Child Adaptation.

ERIC Educational Resources Information Center

Austin, Joan Kessner

This study aimed to describe demographic, seizure, and family characteristics associated with good and poor adaptation to childhood epilepsy and contrast them with demographic, asthma, and family characteristics associated with good and poor adaptation to childhood asthma. Children with asthma were selected as a comparison sample because epilepsy…

Helping military families through the deployment process: Strategies to support parenting

PubMed Central

Gewirtz, Abigail H.; Erbes, Christopher R.; Polusny, Melissa A.; Forgatch, Marion S.; DeGarmo, David S.

2011-01-01

Recent studies have highlighted the impact of deployment on military families and children and the corresponding need for interventions to support them. Historically, however, little emphasis has been placed on family-based interventions in general, and parenting interventions in particular, with returning service members. This paper provides an overview of research on the associations between combat deployment, parental adjustment of service members and spouses, parenting impairments, and children’s adjustment problems, and provides a social interaction learning framework for research and practice to support parenting among military families affected by a parent’s deployment. We then describe the Parent Management Training-Oregon model (PMTO™), a family of interventions that improves parenting practices and child adjustment in highly stressed families, and briefly present work on an adaptation of PMTO for use in military families (After Deployment: Adaptive Parenting Tools, or ADAPT). The article concludes with PMTO-based recommendations for clinicians providing parenting support to military families. PMID:21841889

Family Quality of Life: Adaptation to Spanish Population of Several Family Support Questionnaires

ERIC Educational Resources Information Center

Balcells-Balcells, A.; Gine, C.; Guardia-Olmos, J.; Summers, J. A.

2011-01-01

Background: The concept of family quality of life has emerged as a decisive construct in the last decades to improve the capabilities of families and to assess the outcomes of the services and supports they get. The goal of this research is to adapt three instruments to the Spanish population: the "Beach Center Family Quality of Life…

Cognitive-Behavioral Coping, Illness Perception, and Family Adaptability in Oncological Patients with a Family History of Cancer.

PubMed

Postolica, Roxana; Iorga, Magdalena; Petrariu, Florin Dumitru; Azoicai, Doina

2017-01-01

Aim . The study investigated the differences between patients with and without a family history of cancer regarding coping strategies, illness perception, and family adaptability to the disease. Material and Methods . A total of 124 patients diagnosed with cancer were included in the research (55 of them with a family history of cancer). The Cognitive Emotion Regulation Questionnaire , the Strategic Approach to Coping Scale , the Family Adaptability and Cohesion Scale , and the Illness Perception Questionnaire were applied. The data were processed using the SPSS 21 software. Results . Patients with previous records of cancer in the family get significantly higher scores for the illness coherence factor. Family satisfaction is significantly higher for patients with a genetic risk, compared to the one reported by patients who suffer from the disease but have no genetic risk. Cognitive-behavioral coping strategies and family cohesion are factors that correlate with an adaptive perception of the illness in the case of patients with a family history of cancer. Conclusion . Results are important for the construction of strategies used for patients with a family history of cancer.

Cognitive-Behavioral Coping, Illness Perception, and Family Adaptability in Oncological Patients with a Family History of Cancer

PubMed Central

Petrariu, Florin Dumitru; Azoicai, Doina

2017-01-01

Aim. The study investigated the differences between patients with and without a family history of cancer regarding coping strategies, illness perception, and family adaptability to the disease. Material and Methods. A total of 124 patients diagnosed with cancer were included in the research (55 of them with a family history of cancer). The Cognitive Emotion Regulation Questionnaire, the Strategic Approach to Coping Scale, the Family Adaptability and Cohesion Scale, and the Illness Perception Questionnaire were applied. The data were processed using the SPSS 21 software. Results. Patients with previous records of cancer in the family get significantly higher scores for the illness coherence factor. Family satisfaction is significantly higher for patients with a genetic risk, compared to the one reported by patients who suffer from the disease but have no genetic risk. Cognitive-behavioral coping strategies and family cohesion are factors that correlate with an adaptive perception of the illness in the case of patients with a family history of cancer. Conclusion. Results are important for the construction of strategies used for patients with a family history of cancer. PMID:28424789

Evaluation of a family camp intervention for children with a heart transplant and their families.

PubMed

Nicholas, David B; Dodd, Bernadette; Urschel, Simon; Young, Amber; West, Lori J

2016-10-01

Given the arduous course of heart transplantation and follow-up care, recipients and their families face complex challenges and stressors warranting supportive interventions. This study explored the impact of a family camp as an intervention of education and social support for pediatric transplant recipients and their families. A total of 49 individuals participated in this evaluation, including eight children and nine youth with heart transplants, five siblings, 19 parents, and 13 health care providers. Participants ranked and described the 3-day family camp experience. Analysis of pre/post intervention measures on knowledge, social support, and coping revealed statistically significant improvements in knowledge, social support, self-esteem, and psychological stability. Satisfaction surveys revealed the camp to be an important resource for education, family fun, and peer support among transplant recipients, their families, and the health care team. Implications and recommendations are offered for clinical and community practice.

Effects of a father-based in-home intervention on perceived stress and family dynamics in parents of children with autism.

PubMed

Bendixen, Roxanna M; Elder, Jennifer H; Donaldson, Susan; Kairalla, John A; Valcante, Greg; Ferdig, Richard E

2011-01-01

Parents of children with autism report high rates of stress. Parental differences in stress are inconsistent, with most research indicating that mothers report higher levels of stress than fathers. We explored parental differences before and after an in-home training program. Fathers were taught an intervention designed to improve their child's social reciprocity and communication; they then trained mothers. Stress was assessed with the Parenting Stress Index-Short Form, and family dynamics was assessed with the Family Adaptability and Cohesion Evaluation Scales II. Both mothers and fathers reported high preintervention levels of stress. After intervention, fathers' stress was reduced, but not significantly, possibly because of the variability in fathers' scores; mothers' stress scores were significantly reduced. Parenting styles were significantly different before and after intervention. Interdisciplinary teams, including occupational therapists, nurses, and special educators, can work.together to have a positive impact on the lives of families of children with autism.

Barriers to healthy eating among Norwegian-Pakistani women participating in a culturally adapted intervention.

PubMed

Råberg Kjøllesdal, Marte K; Telle Hjellset, Victoria; Bjørge, Benedikte; Holmboe-Ottesen, Gerd; Wandel, Margareta

2010-11-01

To explore barriers to healthy dietary changes experienced by Pakistani immigrant women participating in a culturally adapted intervention, and whether these barriers were associated with intentions to change dietary behaviours. Participants were randomly assigned to control and intervention group. The 7-month intervention consisted of six educational group sessions on diet and physical activity, based on knowledge about Pakistani lifestyle and focusing on blood glucose control. Data on barriers for and intentions to healthy dietary changes were collected through an interview with help of a questionnaire. The article is based on data from follow-up assessments in the intervention group, comprising 82 women, aged 28-62 years, without a history of type 2 diabetes. The most important barriers to healthy dietary changes were preferences of children and other family members and perceived expectations during social gatherings. The perceived pressure from other family members was especially strong when the women were trying to change to more vegetables, lentils, and fish and to use less oil in food preparation. The barriers were inversely related to intentions to change. The women encountered various types of barriers when trying to change to healthier food habits, the most prominent being those related to the social dimensions of food consumption, as well as to awareness of the amount of oil used for cooking.

Replicating an Intervention: The Tension between Fidelity and Adaptation

ERIC Educational Resources Information Center

Morrison, Diane M.; Hoppe, Marilyn J.; Gillmore, Mary Rogers; Kluver, Carisa; Higa, Darrel; Wells, Elizabeth A.

2009-01-01

Increased awareness of the importance of tailoring interventions to participants' cultures has focused attention on the limited generalizability of a single test of an intervention to determine efficacy. Adaptation is often necessary to replicate interventions across cultures. This produces a tension between fidelity to the original intervention…

Lessons learned while developing, adapting and implementing a pilot parent-mediated behavioural intervention for children with autism spectrum disorder in rural Bangladesh.

PubMed

Blake, Jasmine M; Rubenstein, Eric; Tsai, Peng-Chou; Rahman, Hafizur; Rieth, Sarah R; Ali, Hasmot; Lee, Li-Ching

2017-07-01

Low- and middle-income countries often have limited resources, underdeveloped health systems and scarce knowledge of autism spectrum disorder. The objectives of this preliminary study were to develop and adapt intervention materials and to train a native clinician to implement a community-based parent-mediated behavioural intervention in rural Gaibandha, Bangladesh. Intervention materials to support parents' use of behavioural strategies were developed and refined by US behavioural intervention experts and Bangladesh field experts. Study investigators trained a native child psychologist in developmental milestones and behavioural intervention techniques. The native clinician delivered a 1-day group education session attended by 10 families of children aged 7-9 years with autism spectrum disorder, followed by two one-on-one training sessions with each family to train and practice individualized strategies for targeted challenging behaviours. Preliminary qualitative results indicate the importance of materials that are culturally appropriate and at an adequate literacy level. All families expressed strong desires to have learned the behavioural strategies when their child was younger and vocalized their need for further support and tools to help their children. This study is a preliminary step to creating sustainable and low-cost autism spectrum disorder interventions in rural Bangladesh, and possibly for families in regions with similar cultural and socioeconomic status backgrounds.

Families and the Juvenile Justice System: Considerations for Family-Based Interventions.

PubMed

Amani, Bita; Milburn, Norweeta G; Lopez, Susana; Young-Brinn, Angela; Castro, Lourdes; Lee, Alex; Bath, Eraka

We conducted focus groups with defense lawyers, clinicians, and education advocates to gather their perspectives on families' experiences with the juvenile justice system. Our quantitative descriptive analysis identified a range of themes such as discussions about the poor treatment of families as well as recommendations for a shifting of power to families. These perspectives may provide insights about the context in which families are expected to participate in interventions, meet probationary demands, and provide for their youth's well-being. The results support evidence gathered from families about the impact of youth incarceration on their lives and has implications for practitioners and researchers working with families whose youth have been incarcerated.

Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia

PubMed Central

Barrio, Concepción; Yamada, Ann-Marie

2011-01-01

Objectives This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. Results Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. Conclusions This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations. PMID:22121328

Effectiveness of resource-enhancing family-oriented intervention.

PubMed

Häggman-Laitila, Arja; Tanninen, Hanna-Mari; Pietilä, Anna-Maija

2010-09-01

The purpose of the study was to assess the effectiveness of a resource-enhancing family-oriented intervention. There is very little empirical knowledge of how nurses working in a home context develop relationships with families, what methods they use to enhance families' resources and how such relationships affect the families' health outcomes. The study was designed as a descriptive service evaluation. A total of 129 family members from 30 families with small children participated in the study. Data were collected with family care plans and client reports in 2004-2005. Data were analysed by qualitative content analysis and by descriptive statistical methods. Resource-enhancing discussions were carried out in all family meetings. Other methods were video guidance, creation of a family tree and parents' role map, network collaboration, observation and parent-child group activity. The families needed support mostly in parents' health and well-being, coping with parenthood, upbringing and child care, parents' relationships, social relations and children's health and growth. The families had an average of five support needs at the beginning of the intervention and 1·8 needs at the completion. The families set on average 3·6 and achieved 4·5 goals during the family nursing process. The resource-enhancing family nursing can be used for supporting parenthood, the raising of and caring for the children, strengthening of social support networks, decreasing the need for support from the authorities and enhancing the parents' resources to manage the duties related to their work and studies. The study resulted in empirically based concepts that can be used in the future to construct instruments to evaluate the effectiveness of resource-enhancing family nursing from the perspective of families and family health. The findings add to our professional understanding of resource-enhancing family nursing. © 2010 Blackwell Publishing Ltd.

Happy Family Kitchen II: A Cluster Randomized Controlled Trial of a Community-Based Family Intervention for Enhancing Family Communication and Well-being in Hong Kong

PubMed Central

Ho, Henry C. Y.; Mui, Moses; Wan, Alice; Ng, Yin-Lam; Stewart, Sunita M.; Yew, Carol; Lam, Tai Hing; Chan, Sophia S.

2016-01-01

Long working hours and stressful urban lifestyles pose major challenges to family communication and well-being in Hong Kong. A community-based family intervention derived from a positive psychology framework, by using cooking and dining as a platform, was developed for improving family communication and well-being. Social workers and teachers from 31 social service units and schools in collaboration with an academic partner organized and conducted the intervention programs for 2,070 individuals from 973 families in a deprived district in Hong Kong. The participants were randomly assigned into the intervention or control group in a cluster randomized controlled trial (cRCT). The core intervention covered one of five positive psychology themes: joy, gratitude, flow, savoring, and listening. Assessments at pre-intervention, immediate post-intervention, and 4 and 12 weeks post-intervention showed improved family communication and well-being with sustainable effects up to 12 weeks. Positive changes in family happiness and family health were greater in the intervention group than in the control group. The savoring intervention had the most improved outcomes among the five themes. We concluded that this large-scale brief cRCT developed and conducted in real-world settings provided evidence for the feasibility and effectiveness of a community-based family intervention. This study was registered under ClinicalTrials.gov (NCT01796275). PMID:27199864

A control systems engineering approach for adaptive behavioral interventions: illustration with a fibromyalgia intervention.

PubMed

Deshpande, Sunil; Rivera, Daniel E; Younger, Jarred W; Nandola, Naresh N

2014-09-01

The term adaptive intervention has been used in behavioral medicine to describe operationalized and individually tailored strategies for prevention and treatment of chronic, relapsing disorders. Control systems engineering offers an attractive means for designing and implementing adaptive behavioral interventions that feature intensive measurement and frequent decision-making over time. This is illustrated in this paper for the case of a low-dose naltrexone treatment intervention for fibromyalgia. System identification methods from engineering are used to estimate dynamical models from daily diary reports completed by participants. These dynamical models then form part of a model predictive control algorithm which systematically decides on treatment dosages based on measurements obtained under real-life conditions involving noise, disturbances, and uncertainty. The effectiveness and implications of this approach for behavioral interventions (in general) and pain treatment (in particular) are demonstrated using informative simulations.

Mapping the Paths from Styles of Anger Experience and Expression to Obsessive–Compulsive Symptoms: The Moderating Roles of Family Cohesion and Adaptability

PubMed Central

Liu, Liang; Liu, Cuilian; Zhao, Xudong

2017-01-01

Previous research has shown strong connections of anger experience and expression with obsessive–compulsive (OC) symptoms. Additionally, studies have demonstrated links between family environment variables and obsessive–compulsive disorder (OCD). Our study aims to integrate the perspectives from these two literatures by exploring the moderating roles of family cohesion and family adaptability in the relationship between anger proneness and suppression and OCD symptoms. A total of 2008 college students were recruited from a comprehensive university in Shanghai, China between February and May 2016. The subjects completed self-report inventories, including the Symptom Check List-90, State-Trait Anger Expression Inventory 2 (Chinese version), and Family Adaptability and Cohesion Scale, second edition (Chinese Version). Controlling for age, one-child family status, ethnicity, family income, current depression, and anxiety, our analyses showed that the association between anger proneness and OC symptoms was moderated by family cohesion among men and that family adaptability moderated the connection between anger suppression and OC complaints among women. The findings imply that a more cohesive and empathic family environment may protect male students with high levels of anger proneness from developing OC behaviors or thoughts. The results suggest that for female subjects who are accustomed to suppressing angry feelings, flexible family coping strategies and communication atmospheres would reduce their vulnerability to OC symptoms. The findings are somewhat consistent with those of previous studies on psychotherapy outcomes that showed that OCD patients benefitted from psychotherapeutic interventions that cultivated the clients’ family cohesion and adaptability. PMID:28512441

Chinese family adaptation during the postpartum period and its influencing factors: A questionnaire survey.

PubMed

Lu, Hong; Zhu, Xiu; Hou, Rui; Wang, De-hui; Zhang, Hai-juan; While, Alison

2012-04-01

this study aimed to explore new parents' views and experiences during their transition to parenthood. in China the one-child birth policy may bring more stress and challenges for the new parents due to the lack of experience and greater expectations of their new role. China is also at a stage of rapid economic and social development which creates new conditions for parenthood. a cross-sectional survey was conducted from February to September 2009 among 232 mothers and fathers, yielding a 83.6% response rate (n=194 couples). The questionnaire included: the Family Assessment Device-General Function Scale, the Family Resources Scale, the Family Adaptation Scale, and the Chinese Perceived Stress Scale. there were no significant differences between mothers' adaptation and fathers' adaptation during the postpartum period, as well as their perceived stress, family function and family resources (p>0.05). Method of childbirth was not related to adaptation. About 29% of variance in mothers' adaptation could be explained by satisfaction with the infant's gender (B=0.295, p<0.001), fathers' adaptation (B=0.236, p<0.001), and family resources (B=0.179, p=0.016). About 42% of variance in fathers' adaptation could be explained by mothers' adaptation (B=0.268, p<0.001), satisfaction with marriage (B=0.248, p=0.002), satisfaction with the infant's gender (B=0.209, p<0.007), and family resources (B=0.206, p=0.002). this study highlights the importance of family resources to family adaptation and antenatal and postnatal education programmes as part of family-centred care. The possible influences of culture and policies need to be considered by health-care professionals developing strategies to facilitate family adaptation to the early parenthood. Copyright © 2011 Elsevier Ltd. All rights reserved.

Family Quality of Life for Families in Early Intervention in Spain

ERIC Educational Resources Information Center

Mas, Joana M.; Baqués, Natasha; Balcells-Balcells, Anna; Dalmau, Mariona; Giné, Climent; Gràcia, Marta; Vilaseca, Rosa

2016-01-01

Early intervention (EI) has been shown to be an essential resource for meeting the needs and priorities of children with intellectual and developmental disability and their families. The objective of this study was to examine (a) the perceived quality of life of families attending EI centers in Spain and (b) its relationship with characteristics…

Interventions for Family Members of Adolescents with Disruptive Behavior Disorders

PubMed Central

Draucker, Claire; Alkhattab, Halima; Knopf, Amy; Mazurcyk, Jill

2014-01-01

PROBLEM The family members of adolescents diagnosed with Disruptive Behavior Disorders (DBD) experience profound stress and burden. Despite the need for empirically supported interventions that address the challenges faced by these family members, few such interventions are available. METHODS In this qualitative descriptive study, we conducted in-depth interviews with 15 families of adolescents diagnosed with DBD. We asked the family members to identify what types of mental health services they needed and to describe the ‘ideal” program that would best address their concerns. FINDINGS Family members identified several intervention modalities that would fit their needs including multi-family groups, family therapy, individual therapy, and community-based hotlines. They indicated that programs should address the following topics: family communication, conflict resolution, education about DBD, and strategies to improve interactions with child service agencies. CONCLUSIONS Clinicians should recognize that all family members may need support to manage the stressors associated with caring for or living with adolescents with DBD. When working with families, clinicians should provide information about the etiology and management of DBD, help navigate interactions with child service agencies, and employ strategies to improve family communication and functioning. PMID:24934181

Family intervention to control type 2 diabetes: a controlled clinical trial.

PubMed

García-Huidobro, Diego; Bittner, Marcela; Brahm, Paulina; Puschel, Klaus

2011-02-01

Chilean patients with type 2 diabetes mellitus (T2DM) have a low rate of blood sugar control. We studied the effectiveness of a culturally sensitive family oriented intervention designed to improve metabolic control in primary care patients with uncontrolled T2DM. Patients with T2DM from three primary care clinics in Santiago, Chile were randomly selected for inclusion if they had a recent HbA1c ≥7%, were between 18 and 70 years old and lived with a family member. Patients from one clinic received the family oriented intervention; patients from the other two (control) clinics received standard care. The intervention involved family members in care and included family counselling during clinic visits, family meetings and home visits. The primary outcome was HbA1c, measured at 6 and 12 months. A total of 243 patients were enrolled and 209 (86%) completed the study. The intervention was fully administered to only 34% of patients in the intervention clinic. The reduction in the HbA1c from baseline to 12 months was not significantly different between clinics. During the second 6-month period, when the intervention was more intensive, the patients in the intervention clinic significantly improved their HbA1c (P < 0.001) compared to the control patients. A family intervention for the control of T2DM was associated with a significant reduction in HbA1c when the intervention was provided. Incomplete implementation, low statistical power and potential confounding variables between groups could be some of the main factors that explain the lack of difference between clinics in the 12-month period.

Adapting an in-person patient-caregiver communication intervention to a tailored web-based format.

PubMed

Zulman, Donna M; Schafenacker, Ann; Barr, Kathryn L C; Moore, Ian T; Fisher, Jake; McCurdy, Kathryn; Derry, Holly A; Saunders, Edward W; An, Lawrence C; Northouse, Laurel

2012-03-01

Interventions that target cancer patients and their caregivers have been shown to improve patient-caregiver communication, support, and emotional well-being. To adapt an in-person communication intervention for cancer patients and caregivers to a web-based format, and to examine the usability and acceptability of the web-based program among representative users. A tailored, interactive web-based communication program for cancer patients and their family caregivers was developed based on an existing in-person, nurse-delivered intervention. The development process involved: (1) building a multidisciplinary team of content and web design experts, (2) combining key components of the in-person intervention with the unique tailoring and interactive features of a web-based platform, and (3) conducting focus groups and usability testing to obtain feedback from representative program users at multiple time points. Four focus groups with 2-3 patient-caregiver pairs per group (n = 22 total participants) and two iterations of usability testing with four patient-caregiver pairs per session (n = 16 total participants) were conducted. Response to the program's structure, design, and content was favorable, even among users who were older or had limited computer and Internet experience. The program received high ratings for ease of use and overall usability (mean System Usability Score of 89.5 out of 100). Many elements of a nurse-delivered patient-caregiver intervention can be successfully adapted to a web-based format. A multidisciplinary design team and an iterative evaluation process with representative users were instrumental in the development of a usable and well-received web-based program. Copyright © 2011 John Wiley & Sons, Ltd.

Promoting family meals: a review of existing interventions and opportunities for future research

PubMed Central

Dwyer, Laura; Oh, April; Patrick, Heather; Hennessy, Erin

2015-01-01

Evidence suggests that regular family meals protect against unhealthy eating and obesity during childhood and adolescence. However, there is limited information on ways to promote family meals as part of health promotion and obesity prevention efforts. The primary aim of this review was to synthesize the literature on strategies to promote family meals among families with school-aged children and adolescents. First, we reviewed interventions that assess family meals as an outcome and summarized strategies that have been used in these interventions. Second, we reviewed correlates and barriers to family meals to identify focal populations and target constructs for consideration in new interventions. During May 26–27, 2014, PubMed and PsycInfo databases were searched to identify literature on family meals published between January 1, 2000 and May 27, 2014. Two reviewers coded 2,115 titles/abstracts, yielding a sample of 139 articles for full-text review. Six interventions and 43 other studies presenting data on correlates of or barriers to family meals were included in the review. Four interventions resulted in greater family meal frequency. Although there were a small number of interventions, intervention settings were diverse and included the home, community, medical settings, the workplace, and the Internet. Common strategies were goal setting and interactive group activities, and intervention targets included cooking and food preparation, cost, shopping, and adolescent influence. Although methodological nuances may contribute to mixed findings, key correlates of family meals were employment, socioeconomic and demographic factors, family structure, and psychosocial constructs. Barriers to consider in future interventions include time and scheduling challenges, cost, and food preferences. Increasing youth involvement in mealtime, tailoring interventions to family characteristics, and providing support for families experiencing time-related barriers are suggested

Promoting family meals: a review of existing interventions and opportunities for future research.

PubMed

Dwyer, Laura; Oh, April; Patrick, Heather; Hennessy, Erin

2015-01-01

Evidence suggests that regular family meals protect against unhealthy eating and obesity during childhood and adolescence. However, there is limited information on ways to promote family meals as part of health promotion and obesity prevention efforts. The primary aim of this review was to synthesize the literature on strategies to promote family meals among families with school-aged children and adolescents. First, we reviewed interventions that assess family meals as an outcome and summarized strategies that have been used in these interventions. Second, we reviewed correlates and barriers to family meals to identify focal populations and target constructs for consideration in new interventions. During May 26-27, 2014, PubMed and PsycInfo databases were searched to identify literature on family meals published between January 1, 2000 and May 27, 2014. Two reviewers coded 2,115 titles/abstracts, yielding a sample of 139 articles for full-text review. Six interventions and 43 other studies presenting data on correlates of or barriers to family meals were included in the review. Four interventions resulted in greater family meal frequency. Although there were a small number of interventions, intervention settings were diverse and included the home, community, medical settings, the workplace, and the Internet. Common strategies were goal setting and interactive group activities, and intervention targets included cooking and food preparation, cost, shopping, and adolescent influence. Although methodological nuances may contribute to mixed findings, key correlates of family meals were employment, socioeconomic and demographic factors, family structure, and psychosocial constructs. Barriers to consider in future interventions include time and scheduling challenges, cost, and food preferences. Increasing youth involvement in mealtime, tailoring interventions to family characteristics, and providing support for families experiencing time-related barriers are suggested

Adapting HIV prevention evidence-based interventions in practice settings: an interview study

PubMed Central

2009-01-01

Background Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Methods Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73). Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Results Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Conclusion Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to ensure that reinventions are

Military-Induced Family Separation: A Stress Reduction Intervention.

ERIC Educational Resources Information Center

Black, William G., Jr.

1993-01-01

Notes that Persian Gulf War focused public attention on the problems military families face in coping with military-induced family separation. Highlights some of the unique stressors faced by active-duty, national guard, and reserve military families. Presents practical guidelines to assist social workers in designing interventions to help these…

Intergenerational Benefits of Family-Based HIV Interventions

ERIC Educational Resources Information Center

Rotheram-Borus, Mary Jane; Lester, Patricia; Song, Juwon; Lin, Ying-Ying; Leonard, Noelle R.; Beckwith, Leila; Ward, Mary J.; Sigman, Marian; Lord,Lynwood

2006-01-01

The longitudinal impact of a family-based intervention on grandchildren of parents with HIV (PWH) is evaluated. Because PWH and their daughters demonstrated gains over 6 years when randomized to a coping skills intervention compared with a control condition, the adjustment of the PWH's grandchildren was also compared across conditions.…

Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU☆, ☆☆

PubMed Central

Curtis, J. Randall; Ciechanowski, Paul S.; Downey, Lois; Gold, Julia; Nielsen, Elizabeth L.; Shannon, Sarah E.; Treece, Patsy D.; Young, Jessica P.; Engelberg, Ruth A.

2013-01-01

The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies suggest that the current quality of ICU communication is often poor and is associated with psychological distress among family members of critically ill patients. This paper describes the development and evaluation of an intervention designed to improve the quality of care in the ICU by improving communication among the ICU team and with family members of critically ill patients. We developed a multi-faceted, interprofessional intervention based on self-efficacy theory. The intervention involves a “communication facilitator” – a nurse or social worker – trained to facilitate communication among the interprofessional ICU team and with the critically ill patient’s family. The facilitators are trained using three specific content areas: a) evidence-based approaches to improving clinician–family communication in the ICU, b) attachment theory allowing clinicians to adapt communication to meet individual family member’s communication needs, and c) mediation to facilitate identification and resolution of conflict including clinician–family, clinician–clinician, and intra-family conflict. The outcomes assessed in this randomized trial focus on psychological distress among family members including anxiety, depression, and post-traumatic stress disorder at 3 and 6 months after the ICU stay. This manuscript also reports some of the lessons that we have learned early in this study. PMID:22772089

Family and home in cognitive rehabilitation after brain injury: The importance of family oriented interventions.

PubMed

Wulf-Andersen, Camilla; Mogensen, Jesper

2017-01-01

Acquired brain injury (ABI) severely affects both the injured patient and her/his family. This fact alone calls for a therapeutic approach addressing not only the individual victim of ABI but also her/his family. Additionally, the optimal outcome of posttraumatic cognitive rehabilitation may be best obtained by supplementing the institution-based cognitive training with home-based training. Moving cognitive training and other therapeutic interventions into the home environment does, however, constitute an additional challenge to the family structure and psychological wellbeing of all family members. We presently argue in favour of an increased utilization of family-based intervention programs for the families of brain injured patients - in general and especially in case of utilization of home-based rehabilitative training.

Using engineering control principles to inform the design of adaptive interventions: a conceptual introduction.

PubMed

Rivera, Daniel E; Pew, Michael D; Collins, Linda M

2007-05-01

The goal of this paper is to describe the role that control engineering principles can play in developing and improving the efficacy of adaptive, time-varying interventions. It is demonstrated that adaptive interventions constitute a form of feedback control system in the context of behavioral health. Consequently, drawing from ideas in control engineering has the potential to significantly inform the analysis, design, and implementation of adaptive interventions, leading to improved adherence, better management of limited resources, a reduction of negative effects, and overall more effective interventions. This article illustrates how to express an adaptive intervention in control engineering terms, and how to use this framework in a computer simulation to investigate the anticipated impact of intervention design choices on efficacy. The potential benefits of operationalizing decision rules based on control engineering principles are particularly significant for adaptive interventions that involve multiple components or address co-morbidities, situations that pose significant challenges to conventional clinical practice.

Using Engineering Control Principles to Inform the Design of Adaptive Interventions: A Conceptual Introduction

PubMed Central

Rivera, Daniel E.; Pew, Michael D.; Collins, Linda M.

2007-01-01

The goal of this paper is to describe the role that control engineering principles can play in developing and improving the efficacy of adaptive, time-varying interventions. It is demonstrated that adaptive interventions constitute a form of feedback control system in the context of behavioral health. Consequently, drawing from ideas in control engineering has the potential to significantly inform the analysis, design, and implementation of adaptive interventions, leading to improved adherence, better management of limited resources, a reduction of negative effects, and overall more effective interventions. This article illustrates how to express an adaptive intervention in control engineering terms, and how to use this framework in a computer simulation to investigate the anticipated impact of intervention design choices on efficacy. The potential benefits of operationalizing decision rules based on control engineering principles are particularly significant for adaptive interventions that involve multiple components or address co-morbidities, situations that pose significant challenges to conventional clinical practice. PMID:17169503

A Review of Technology-Based Youth and Family-Focused Interventions

PubMed Central

Prinz, Ronald J.

2017-01-01

In the past 10 years, mental and behavioral health has seen a proliferation of technology-based interventions in the form of online and other computer-delivered programs. This paper focuses on technology-based treatment and preventive interventions aimed at benefitting children and adolescents via either involving the parents and families, or only the youth. The review considered only technology-based interventions that had at least one published study with a randomized controlled trial design. Questions being addressed included: (1) What are the technology-based interventions in the mental/behavioral health area that have been systematically evaluated in published studies? (2) What are the common and unique characteristics of these interventions and their application with respect to sample characteristics, target problems, and technology characteristics (platforms, structures, elements, and communication formats)? and (3) Which intervention approaches and strategies have accrued the greatest evidence? The review identified 30 technology-based psychosocial interventions for children and families, 19 of which were parent or family-focused (32 studies) and 11 of which were youth-focused (in 13 studies). For the parent/family-focused interventions, greatest promise was found in those that addressed either youth behavioral problems or depressive/anxious symptoms, as well as more general bolstering of parenting efficacy. The youth-focused interventions showed some promise in reducing depressive/ anxious symptoms. Advantages and disadvantages of the technology-based approaches were considered, and areas for future research and development were discussed. PMID:27787701

A Review of Technology-Based Youth and Family-Focused Interventions.

PubMed

MacDonell, Kathleen Watson; Prinz, Ronald J

2017-06-01

In the past 10 years, mental and behavioral health has seen a proliferation of technology-based interventions in the form of online and other computer-delivered programs. This paper focuses on technology-based treatment and preventive interventions aimed at benefitting children and adolescents via either involving the parents and families, or only the youth. The review considered only technology-based interventions that had at least one published study with a randomized controlled trial design. Questions being addressed included: (1) What are the technology-based interventions in the mental/behavioral health area that have been systematically evaluated in published studies? (2) What are the common and unique characteristics of these interventions and their application with respect to sample characteristics, target problems, and technology characteristics (platforms, structures, elements, and communication formats)? and (3) Which intervention approaches and strategies have accrued the greatest evidence? The review identified 30 technology-based psychosocial interventions for children and families, 19 of which were parent or family-focused (32 studies) and 11 of which were youth-focused (in 13 studies). For the parent/family-focused interventions, greatest promise was found in those that addressed either youth behavioral problems or depressive/anxious symptoms, as well as more general bolstering of parenting efficacy. The youth-focused interventions showed some promise in reducing depressive/anxious symptoms. Advantages and disadvantages of the technology-based approaches were considered, and areas for future research and development were discussed.

Early Intervention in Portugal: Family Support and Benefits

ERIC Educational Resources Information Center

Correia Leite, Carina Sofia; Da Silva Pereira, Ana Paula

2013-01-01

This study investigated the support and benefits of early intervention (EI) in families with children with special needs. Data were gathered through a written questionnaire, "Family Benefits Inventory," completed by 126 families with children with special needs supported by EI teams, with ages from six months to six years in Portugal.…

Engaging Mexican Origin Families in a School-Based Preventive Intervention

PubMed Central

Mauricio, Anne M.; Gonzales, Nancy A.; Millsap, Roger E.; Meza, Connie M.; Dumka, Larry E.; Germán, Miguelina; Genalo, M. Toni

2009-01-01

This study describes a culturally sensitive approach to engage Mexican origin families in a school-based, family-focused preventive intervention trial. The approach was evaluated via assessing study enrollment and intervention program participation, as well as examining predictors of engagement at each stage. Incorporating traditional cultural values into all aspects of engagement resulted in participation rates higher than reported rates of minority-focused trials not emphasizing cultural sensitivity. Family preferred language (English or Spanish) or acculturation status predicted engagement at all levels, with less acculturated families participating at higher rates. Spanish-language families with less acculturated adolescents participated at higher rates than Spanish-language families with more acculturated adolescents. Other findings included two-way interactions between family language and the target child’s familism values, family single- vs. dual-parent status, and number of hours the primary parent worked in predicting intervention participation. Editors’ Strategic Implications: The authors present a promising approach—which requires replication—to engaging and retaining Mexican American families in a school-based prevention program. The research also highlights the importance of considering acculturation status when implementing and studying culturally tailored aspects of prevention models. PMID:18004659

Information and support needs of young women regarding breast cancer risk and genetic testing: adapting effective interventions for a novel population.

PubMed

O'Neill, Suzanne C; Evans, Chalanda; Hamilton, Rebekah J; Peshkin, Beth N; Isaacs, Claudine; Friedman, Sue; Tercyak, Kenneth P

2017-11-09

Young women from hereditary breast and ovarian cancer (HBOC) families face a unique set of challenges in managing their HBOC risk, where obtaining essential information to inform decision making is key. Previous work suggests that this need for specific health information also comes at a time of heightened distress and greater individuation from family. In this report, we describe our adaptation of a previously-studied behavioral intervention for this population, utilizing a systematic approach outlined by the Centers for Disease Control and Prevention. First, we assessed the information needs and levels of distress in this population and correlates of this distress. These data then were used to inform the adaptation and piloting of a three-session telephone-based peer coaching intervention. One hundred young women (M age = 25 years) who were first or second degree relatives of BRCA1/2 mutation carriers participated. Sixty-three percent of the sample endorsed unmet HBOC information needs and they, on average, reported moderate levels of cancer-related distress (M = 21.9, SD = 14.6). Greater familial disruption was associated with greater cancer-related distress in multivariable models (p < .05). Ten women who participated in the survey completed the intervention pilot. They reported lower distress from pre- to post- (15.8 vs. 12.0), as well as significantly lower decisional conflict (p < .05) and greater endorsement of an array of healthy coping strategies (i.e., active coping, instrumental coping, positive reframing, planning, p's < .05). Our survey results suggest that young adult women from HBOC families have unmet cancer genetic information and support needs. Our pilot intervention was able to reduce levels of decisional conflict and promote the use of effective coping strategies. This approach needs to be further tested in a larger randomized trial.

Strengthening Family Practices for Latino Families.

PubMed

Chartier, Karen G; Negroni, Lirio K; Hesselbrock, Michie N

2010-01-01

The study examined the effectiveness of a culturally-adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9-12 year old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto Rican families.

Pilot Study of a Newly Developed Intervention for Families Facing Serious Injury

PubMed Central

Stevens, Lillian Flores; Lehan, Tara; Durán, María Angélica Segura; Plaza, Silvia Leonor Olivera

2016-01-01

Background: There is a need to develop interventions that address the entire family after spinal cord injury (SCI), especially in Latin America, where rehabilitation resources are limited and little is known about family adjustment to SCI. Objective: To evaluate the short-term (post-intervention) and longer term (6-month) effectiveness of the newly developed, 8-session manualized family intervention for individuals with SCI and their family members compared to a control group. Methods: In this clinical demonstration project, longitudinal self-report data were collected from 8 individuals with SCI and their family members in Colombia, South America. The 8 families were randomly assigned to either the SCI intervention group or the waitlist control group. The intervention group included 10 individuals from 4 different families, with a mean age of 41.40 years (SD = 14.18). The control group was composed of 13 individuals from 4 different families with a mean age of 44.38 years (SD = 14.76). All participants completed Spanish versions of instruments that assessed depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), burden (Zarit Burden Interview), and perceived problem-solving skills (Problem-Solving Inventory). Results: Results provide preliminary evidence that symptoms of depression, anxiety, and burden as well as problem-solving appraisals improved significantly for individuals who participated in the intervention, whereas no change in symptoms was observed among those in the waitlist control group. Conclusions: Findings suggest that this newly developed intervention for families facing SCI can be beneficial; however, this pilot study represents only the first step in the examination of the efficacy and effectiveness of this intervention. PMID:29398893

Developing family interventions for adolescent HIV prevention in South Africa.

PubMed

Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K Brown, Larry

2016-01-01

Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent-adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352).

An eHealth Intervention to Promote Physical Activity and Social Network of Single, Chronically Impaired Older Adults: Adaptation of an Existing Intervention Using Intervention Mapping

PubMed Central

Peels, Denise A; Berendsen, Brenda AJ; Bolman, Catherine AW; Lechner, Lilian

2017-01-01

Background Especially for single older adults with chronic diseases, physical inactivity and a poor social network are regarded as serious threats to their health and independence. The Active Plus intervention is an automated computer-tailored eHealth intervention that has been proven effective to promote physical activity (PA) in the general population of adults older than 50 years. Objective The aim of this study was to report on the methods and results of the systematic adaptation of Active Plus to the wishes and needs of the subgroup of single people older than 65 years who have one or more chronic diseases, as this specific target population may encounter specific challenges regarding PA and social network. Methods The Intervention Mapping (IM) protocol was used to systematically adapt the existing intervention to optimally suit this specific target population. A literature study was performed, and quantitative as well as qualitative data were derived from health care professionals (by questionnaires, n=10) and the target population (by focus group interviews, n=14), which were then systematically integrated into the adapted intervention. Results As the health problems and the targeted behavior are largely the same in the original and adapted intervention, the outcome of the needs assessment was that the performance objectives remained the same. As found in the literature study and in data derived from health professionals and focus groups, the relative importance and operationalization of the relevant psychosocial determinants related to these objectives are different from the original intervention, resulting in a refinement of the change objectives to optimally fit the specific target population. This refinement also resulted in changes in the practical applications, program components, intervention materials, and the evaluation and implementation strategy for the subgroup of single, chronically impaired older adults. Conclusions This study demonstrates that

Tele-Intervention: The Wave of the Future Fits Families' Lives Today

ERIC Educational Resources Information Center

Behl, Diane D.; Houston, K. Todd; Guthrie, W. Spencer; Guthrie, Nancy K.

2010-01-01

This article provides information on providing early intervention services virtually using distance communication technologies. It describes "tele-intervention," a new method of providing services to children and their families, and how it is used in a family with a deaf child. Tele-intervention has proven to be a viable service delivery model for…

Fat, sugar and water intakes among families from the IDEFICS intervention and control groups: first observations from I.Family.

PubMed

Arvidsson, L; Bogl, L-H; Eiben, G; Hebestreit, A; Nagy, P; Tornaritis, M; Moreno, L A; Siani, A; Veidebaum, T; De Henauw, S; Lissner, L

2015-12-01

The objective of this paper is to investigate differences in diets of families in intervention versus control communities 5 years after the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants intervention ended. Altogether, 4,691 families from the I.Family study with at least one participating parent and one child are included in this analysis. Diet quality indicators, defined as propensities to consume fat, sugar, water and fruit and vegetables, are calculated from a 59-item food frequency questionnaire. Multilevel linear models with random intercepts for study centre are used to determine whether mean diet indicators, calculated at the family level, differed as a function of previous exposure to the intervention. Families in the intervention communities reported a significantly lower sugar propensity (19.8% vs. 20.7% of total food items, p < 0.01) and a higher water propensity (47.3% vs. 46.0% of total beverages, p < 0.05) compared with families in the control communities, while fat and fruit and vegetables propensities were similar. No significant diet differences between intervention and control children were present at the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants baseline. This result indicates better diet quality in intervention families, which was not present in children when their diets were assessed before the intervention, and gives some cause for optimism regarding the sustainability of some aspects of the diet intervention. © 2015 World Obesity.

Adaptation of a Motivational Interviewing Intervention to Improve Antidepressant Adherence among Latinos

PubMed Central

Interian, Alejandro; Martinez, Igda; Rios, Lisbeth Iglesias; Krejci, Jonathan; Guarnaccia, Peter J.

2009-01-01

Poor antidepressant adherence is a significant issue in depression treatment that adversely affects treatment outcomes. While being a common problem, it tends to be more common among Latinos. To address this problem, the current study adapted a Motivational Interviewing (MI) intervention to improve adherence among Latinos with depression. The adaptation process included six focus groups that elicited participants’ perspectives (N = 30), applying the intervention with test cases (N = 7) to fine tune the intervention, and eliciting feedback on the intervention (N = 5). The findings generated from these adaptation phases are described, along with a case example. Examples of adaptations to the MI included reframing antidepressant adherence as a way to luchar (struggle) against problems, focusing on motivation for improving depression and not just medication, refining methods for imparting antidepressant information, and inclusion of personalized visual feedback on dose-taking. The findings provide a description of the antidepressant issues experienced by a group of Latinos, as well as considerations for applying MI with this population. The intervention remained grounded in MI principles, but was contextualized for this Latino group. PMID:20438160

Family-Centered Early Intervention Visual Impairment Services through Matrix Session Planning

ERIC Educational Resources Information Center

Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara

2017-01-01

Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…

Longitudinal effects of adaptive interventions with a speech-generating devicein minimally verbal children with ASD

PubMed Central

Almirall, Daniel; DiStefano, Charlotte; Chang, Ya-Chih; Shire, Stephanie; Kaiser, Ann; Lu, Xi; Nahum-Shani, Inbal; Landa, Rebecca; Mathy, Pamela; Kasari, Connie

2016-01-01

Objective There are limited data on the effects of adaptive social communication interventions with a speech-generating device in autism. This study is the first to compare growth in communications outcomes among three adaptive interventions in school-aged children with autism spectrum disorder (ASD) who are minimally verbal. Methods Sixty-one children, aged 5–8 years participated in a sequential, multiple-assignment randomized trial (SMART). All children received a developmental communication intervention: joint attention, symbolic play, engagement and regulation (JASP) with enhanced milieu teaching (EMT). The SMART included three two-stage, 24-week adaptive interventions with different provisions of a speech-generating device (SGD) in the context of JASP+EMT. The first adaptive intervention, with no SGD, initially assigned JASP+EMT alone; then intensified JASP+EMT for slow responders. In the second adaptive intervention, slow responders to JASP+EMT were assigned JASP+EMT+SGD. The third adaptive intervention initially assigned JASP+EMT+SGD; then intensified JASP+EMT+SGD for slow responders. Analyses examined between-group differences in change in outcomes from baseline to week 36. Verbal outcomes included spontaneous communicative utterances and novel words. Non-linguistic communication outcomes included initiating joint attention and behavior regulation, and play. Results The adaptive intervention beginning with JASP+EMT+SGD was estimated as superior. There were significant (P<0.05) between-group differences in change in spontaneous communicative utterances and initiating joint attention. Conclusions School-aged children with ASD who are minimally verbal make significant gains in communication outcomes with an adaptive intervention beginning with JASP+EMT+SGD. Future research should explore mediators and moderators of the adaptive intervention effects and second-stage intervention options that further capitalize on early gains in treatment. PMID:26954267

Family partnership and education interventions to reduce dietary sodium by patients with heart failure differ by family functioning.

PubMed

Dunbar, Sandra B; Clark, Patricia C; Stamp, Kelly D; Reilly, Carolyn M; Gary, Rebecca A; Higgins, Melinda; Kaslow, Nadine

2016-01-01

Determine if family functioning influences response to family-focused interventions aimed at reducing dietary sodium by heart failure (HF) patients. Lowering dietary sodium by HF patients often occurs within the home and family context. Secondary analysis of 117 dyads randomized to patient and family education (PFE), family partnership intervention (FPI) or usual care (UC). Dietary sodium measures were obtained from 3-day food record and 24-h urine samples. In the poor family functioning groups, FPI and PFE had lower mean urine sodium than UC (p < .05) at 4 months, and FPI remained lower than UC at 8 months (p < .05). For good family functioning groups, FPI and PFE had lower mean sodium levels by 3-day food record at 4 and 8 months compared to the UC group. Optimizing family-focused interventions into HF clinical care maybe indicated. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of pharmacy student interventions in an urban family medicine clinic.

PubMed

Ginzburg, Regina

2014-06-17

To determine the number of interventions made by pharmacy students at an urban family medicine clinic and the acceptance rate of these recommendations by the healthcare providers. The secondary objective was to investigate the cost avoidance value of the interventions. A prospective, unblinded study was conducted to determine the number and cost avoidance value of clinical interventions made by pharmacy students completing advanced pharmacy practice experiences (APPEs) in an urban family medicine clinic. Eighteen students completed this experience in the 8 months studied. Of the 718 interventions performed, 77% were accepted by physicians, including 58% of the 200 interventions that required immediate action. Projected avoidance was estimated at $61,855. The clinical interventions by pharmacy students were generally well received by healthcare providers and resulted in significant cost savings. Pharmacy students can play an important role in a family medicine clinic.

A Theory of Secondary Teachers' Adaptations When Implementing a Reading Intervention Program

ERIC Educational Resources Information Center

Leko, Melinda M.; Roberts, Carly A.; Pek, Yvonne

2015-01-01

This study examined the causes and consequences of secondary teachers' adaptations when implementing a research-based reading intervention program. Interview, observation, and artifact data were collected on five middle school intervention teachers, leading to a grounded theory composed of the core component, reconciliation through adaptation, and…

Testing the 4Rs and 2Ss Multiple Family Group intervention: study protocol for a randomized controlled trial.

PubMed

Acri, Mary; Hamovitch, Emily; Mini, Maria; Garay, Elene; Connolly, Claire; McKay, Mary

2017-12-04

Oppositional defiant disorder (ODD) is a major mental health concern and highly prevalent among children living in poverty-impacted communities. Despite that treatments for ODD are among the most effective, few children living in poverty receive these services due to substantial barriers to access, as well as difficulties in the uptake and sustained adoption of evidence-based practices (EBPs) in community settings. The purpose of this study is to examine implementation processes that impact uptake of an evidence-based practice for childhood ODD, and the impact of a Clinic Implementation Team (CIT)-driven structured adaptation to enhance its fit within the public mental health clinic setting. This study, a Hybrid Type II effectiveness-implementation research trial, blends clinical effectiveness and implementation research methods to examine the impact of the 4Rs and 2Ss Multiple Family Group (MFG) intervention, family level mediators of child outcomes, clinic/provider-level mediators of implementation, and the impact of CITs on uptake and long-term utilization of this model. All New York City public outpatient mental health clinics have been invited to participate. A sampling procedure that included randomization at the agency level and a sub-study to examine the impact of clinic choice upon outcomes yielded a distribution of clinics across three study conditions. Quantitative data measuring child outcomes, organizational factors and implementation fidelity will be collected from caregivers and providers at baseline, 8, and 16 weeks from baseline, and 6 months from treatment completion. The expected participation is 134 clinics, 268 providers, and 2688 caregiver/child dyads. We will use mediation analysis with a multi-level Structural Equation Modeling (SEM) (MSEM including family level variables, provider variables, and clinic variables), as well as mediation tests to examine study hypotheses. The aim of the study is to generate knowledge about effectiveness and

Family-Centered Preventive Intervention for Military Families: Implications for Implementation Science

DTIC Science & Technology

2011-01-01

Gladstone, T . R. G., Wright, E. J., & Cooper, A. B. (2003). A family-based approach to the prevention of depressive symptoms in children at risk: Evidence...intervention that addresses obstacles to communication and the lack of attention to parenting common in families affected by parental depression (Beardslee...trauma, and depression /life adversity), as well as being integrated with the military public health model. Furthermore, although each of the

In-Home Intervention with Families in Distress: Changing Places to Promote Change

ERIC Educational Resources Information Center

Waisbrod, Nirit; Buchbinder, Eli; Possick, Chaya

2012-01-01

This article examines the benefits of in-home family therapy with severely distressed families through the analysis of four cases that demonstrate the creative use of this intervention with families whose children were placed in a full-time day care facility. Although the efficacy of home intervention with distressed families has been documented,…

Outcomes Reported by Spanish-Speaking Families in Early Intervention

ERIC Educational Resources Information Center

Olmsted, Murrey G.; Bailey, Donald B., Jr.; Raspa, Melissa; Nelson, Robin E.; Robinson, Nyle D.; Simpson, Mary Ellen; Guillen, Chelsea

2010-01-01

In this study, the authors use data from two states to compare how families participating in early intervention who completed a Spanish version of the Family Outcomes Survey (FOS) (n = 291) compared with Hispanic (n = 486) and non-Hispanic (n = 2,363) families who completed the English version. In general, most families reported positive outcomes,…

Family-focused preventive interventions: evaluating parental risk moderation of substance use trajectories.

PubMed

Guyll, Max; Spoth, Richard L; Chao, Wei; Wickrama, K A S; Russell, Daniel

2004-06-01

Four years of longitudinal data from 373 families participating in a randomized intervention-control clinical trial were used to examine whether intervention effects on adolescent alcohol and tobacco use trajectories were moderated by family risk, as defined by parental social emotional maladjustment. Consistent with earlier outcome evaluations based on analyses of covariance, analyses confirmed that both the Preparing for the Drug Free Years program and the Iowa Strengthening Families Program favorably influenced alcohol use index trajectories across the time frame of the study; only the latter program, however, evidenced positive effects on a tobacco use index. Concerning the primary research question, analyses provided no support for family risk moderation of any intervention effect. Findings indicate the feasibility of developing universal preventive interventions that offer comparable benefits to all families.

Effects of a Controlled Family-Based Health Education/Counseling Intervention

ERIC Educational Resources Information Center

Salminen, Marika; Vahlberg, Tero; Ojanlatva, Ansa; Kivela, Sirkka-Liisa

2005-01-01

Objective: To describe the effects of a controlled family-based health education/counseling intervention on health behaviors of children with a familial history of cardiovascular diseases (FH-CVDs). Methods: The intervention group (IG, n=432) received 5 counseling sessions. The control groups 1 (CG1, n=200) and 2 (CG2, n=423) received no…

An eHealth Intervention to Promote Physical Activity and Social Network of Single, Chronically Impaired Older Adults: Adaptation of an Existing Intervention Using Intervention Mapping.

PubMed

Boekhout, Janet M; Peels, Denise A; Berendsen, Brenda Aj; Bolman, Catherine Aw; Lechner, Lilian

2017-11-23

Especially for single older adults with chronic diseases, physical inactivity and a poor social network are regarded as serious threats to their health and independence. The Active Plus intervention is an automated computer-tailored eHealth intervention that has been proven effective to promote physical activity (PA) in the general population of adults older than 50 years. The aim of this study was to report on the methods and results of the systematic adaptation of Active Plus to the wishes and needs of the subgroup of single people older than 65 years who have one or more chronic diseases, as this specific target population may encounter specific challenges regarding PA and social network. The Intervention Mapping (IM) protocol was used to systematically adapt the existing intervention to optimally suit this specific target population. A literature study was performed, and quantitative as well as qualitative data were derived from health care professionals (by questionnaires, n=10) and the target population (by focus group interviews, n=14), which were then systematically integrated into the adapted intervention. As the health problems and the targeted behavior are largely the same in the original and adapted intervention, the outcome of the needs assessment was that the performance objectives remained the same. As found in the literature study and in data derived from health professionals and focus groups, the relative importance and operationalization of the relevant psychosocial determinants related to these objectives are different from the original intervention, resulting in a refinement of the change objectives to optimally fit the specific target population. This refinement also resulted in changes in the practical applications, program components, intervention materials, and the evaluation and implementation strategy for the subgroup of single, chronically impaired older adults. This study demonstrates that the adaptation of an existing intervention is an

Evaluating process in child and family interventions: aggression prevention as an example.

PubMed

Tolan, Patrick H; Hanish, Laura D; McKay, Mary M; Dickey, Mitchell H

2002-06-01

This article reports on 2 studies designed to develop and validate a set of measures for use in evaluating processes of child and family interventions. In Study 1 responses from 187 families attending an outpatient clinic for child behavior problems were factor analyzed to identify scales, consistent across sources: Alliance (Satisfactory Relationship with Interventionist and Program Satisfaction), Parenting Skill Attainment, Child Cooperation During Session, Child Prosocial Behavior, and Child Aggressive Behavior. Study 2 focused on patterns of scale scores among 78 families taking part in a 22-week preventive intervention designed to affect family relationships, parenting, and child antisocial and prosocial behaviors. The factor structure identified in Study 1 was replicated. Scale construct validity was demonstrated through across-source convergence, sensitivity to intervention change, and ability to discriminate individual differences. Path analysis validated the scales' utility in explaining key aspects of the intervention process. Implications for evaluating processes in family interventions are discussed.

Adapting an Evidence-Based HIV-Prevention Intervention for Women in Domestic Violence Shelters

PubMed Central

Cavanaugh, Courtenay E.; Campbell, Jacquelyn; Braxton, Nikia; Harvey, Jenna; Wingood, Gina

2016-01-01

Objective Despite the documented intersection of intimate partner violence and HIV, there is a paucity of evidence-based HIV prevention interventions for female survivors of intimate partner violence in the United States. This paper describes the adaptation of an effective HIV prevention intervention, Sisters Informing Sisters about Topics on AIDS (SISTA), for women in domestic violence shelters and the steps taken to improve the adapted intervention’s implementation. Method The adaptation process was guided by the ADAPT-ITT framework and data collected from directors, direct client service providers, and residents of two domestic violence shelters located in urban areas, as well as topical experts. Results Eleven of 12 shelter staff (92%) reported that HIV interventions had never been implemented at their shelter and 64% reported they had not provided residents with educational brochures about HIV prevention. Changes made to adapt SISTA for this population and enhance the implementation of the intervention included reducing the intervention’s duration; adding education about the intersection of intimate partner violence, substance use, and HIV; and adding an HIV risk assessment and safety plan. Conclusions Next steps will include implementing the adapted intervention and evaluating its perceived acceptability and efficacy, and assessing whether contextual factors influence the intervention’s implementation. PMID:27398257

Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families.

PubMed

Hilliard, Marisa E; Powell, Priscilla W; Anderson, Barbara J

2016-10-01

As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals' and families' unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Preventive interventions in families with parental depression: children's psychosocial symptoms and prosocial behaviour.

PubMed

Solantaus, Tytti; Paavonen, E Juulia; Toikka, Sini; Punamäki, Raija-Leena

2010-12-01

The aim is to document the effectiveness of a preventive family intervention (Family Talk Intervention, FTI) and a brief psychoeducational discussion with parents (Let's Talk about the Children, LT) on children's psychosocial symptoms and prosocial behaviour in families with parental mood disorder, when the interventions are practiced in psychiatric services for adults in the finnish national health service. Patients with mood disorder were invited to participate with their families. Consenting families were randomized to the two intervention groups. The initial sample comprised 119 families and their children aged 8-16. Of these, 109 completed the interventions and the baseline evaluation. Mothers and fathers filled out questionnaires including standardized rating scales for children's symptoms and prosocial behaviour at baseline and at 4, 10 and 18 months post-intervention. The final sample consisted of parental reports on 149 children with 83 complete data sets. Both interventions were effective in decreasing children's emotional symptoms, anxiety, and marginally hyperactivity and in improving children's prosocial behaviour. The FTI was more effective than the LT on emotional symptoms particularly immediately after the intervention, while the effect of the LT emerged after a longer interval. The study supports the effectiveness of both interventions in families with depressed parents. The FTI is applicable in cultural settings other than the USA. Our findings provide support for including preventive child mental health measures as part of psychiatric services for mentally ill parents.

Adaptation and dissemination of an evidence-based obesity prevention intervention: design of a comparative effectiveness trial.

PubMed

Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L

2014-07-01

Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. Copyright © 2014 Elsevier Inc. All rights reserved.

Adaptation and Dissemination of an Evidence-Based Obesity Prevention Intervention: Design of a Comparative Effectiveness Trial

PubMed Central

Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L.; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L.; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L.

2014-01-01

Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program--Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. PMID:24952282

Different Strokes for Different Folks? Contrasting Approaches to Cultural Adaptation of Parenting Interventions.

PubMed

Mejia, Anilena; Leijten, Patty; Lachman, Jamie M; Parra-Cardona, José Ruben

2017-08-01

Relevant achievements have been accomplished in prevention science with regard to disseminating efficacious parenting interventions among underserved populations. However, widespread disparities in availability of parenting services continue to negatively impact diverse populations in high-income countries (e.g., the USA) and low- and middle-income countries. As a result, a scholarly debate on cultural adaptation has evolved over the years. Specifically, some scholars have argued that in diverse cultural contexts, existing evidence-based parenting interventions should be delivered with strict fidelity to ensure effectiveness. Others have emphasized the need for cultural adaptations of interventions when disseminated among diverse populations. In this paper, we propose that discussions on cultural adaptation should be conceptualized as a "both-and," rather than an "either-or" process. To justify this stance, we describe three distinct parenting intervention projects to illustrate how cultural adaptation and efficacy of evidence-based interventions can be achieved using contrasting approaches and frameworks, depending on cultural preferences and available resources of local contexts. Further, we suggest the need to develop guidelines for consistent reporting of cultural adaptation procedures as a critical component of future investigations. This discussion is relevant for the broader public health field and prevention science.

Evidence-Based Behavioral Interventions to Promote Diabetes Management in Children, Adolescents, and Families

PubMed Central

Hilliard, Marisa E.; Powell, Priscilla W.; Anderson, Barbara J.

2017-01-01

As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals’ and families’ unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. PMID:27690487

Minor Children of Palliative Patients: A Systematic Review of Psychosocial Family Interventions

PubMed Central

Krattenmacher, Thomas; Beierlein, Volker; Grimm, Johann Christian; Bergelt, Corinna; Romer, Georg; Möller, Birgit

2012-01-01

Abstract Although the whole family is affected by a parent's palliative disease, palliative care research does not yet routinely consider patients' minor children. Children's and adolescents' psychosocial functioning may be impaired during prolonged parental disease with poor prognosis. Therefore, more and more health care providers are establishing clinical initiatives for families of palliative patients with minor children. However, the number of these family interventions, as well as their theoretical and empirical backgrounds and evidence base, has yet to be determined. The purpose of this study was to systematically review structured and published interventions for this target group, as well as empirical studies on these interventions. The evidence base and impact of interventions on families were considered. Literature published between 1980 and present focusing on psychosocial family-, child- or parent-centered interventions during palliative care was retrieved from PsycINFO®, Embase, MEDLINE®, CINAHL®, and PSYNDEX databases. Five interventions met the inclusion criteria. Programs focused on different populations, had diverse empirical and theoretical backgrounds and features, and were evaluated by studies of varying methodological quality. This systematic review illustrates the lack of well designed and elaborated intervention concepts and evaluation studies in this field, highlighting the necessity of conceptual and methodological rigor to inform clinical practice on a sustainable basis in the future. PMID:22849598

Adaptive Strategies, Gender Ideology, and Work-Family Balance among Dutch Dual Earners

ERIC Educational Resources Information Center

Wierda-Boer, Hilde H.; Gerris, Jan R. M.; Vermulst, Ad A.

2008-01-01

Using questionnaire data on 149 Dutch dual-earner couples with young children participating in the European Famwork study, we examine how adaptive strategies and gender ideology relate to parents' perceived success in balancing work and family. Path analysis indicates that some adaptive strategies may harm individuals' work-family balance,…

Family-School Intervention for Children with ADHD: Results of Randomized Clinical Trial

PubMed Central

Power, Thomas J.; Mautone, Jennifer A.; Soffer, Stephen L.; Clarke, Angela T.; Marshall, Stephen A.; Sharman, Jaclyn; Blum, Nathan J.; Glanzman, Marianne; Elia, Josephine; Jawad, Abbas F.

2012-01-01

Accumulating evidence highlights the importance of using psychosocial approaches to intervention for children with ADHD that target the family and school, as well as the intersection of family and school. Objective This study was designed to evaluate the effectiveness of a family-school intervention, referred to as Family-School Success (FSS), designed to improve the family and educational functioning of students in grades 2 through 6 who meet criteria for ADHD combined and inattentive types. Key components of FSS were conjoint behavioral consultation, daily report cards, and behavioral homework interventions. Methods FSS was provided over the course of 12 weekly sessions, which included 6 group sessions, 4 individualized family sessions, and 2 school-based consultations. Families participating in the study were given the choice of placing their children on medication; 43% of children were on medication at the time of random assignment. Children (n=199) were randomly assigned to FSS or a comparison group controlling for non-specific treatment effects. Outcomes were assessed at post intervention and 3-month follow-up. The analyses controlled for child medication status. Results Study findings indicated that FSS had a significant effect on the quality of the family-school relationship, homework performance, and parenting behavior. Conclusions The superiority of FSS was demonstrated even though about 40% of the participants in FSS and CARE were on an optimal dose of medication and there were significant Time effects on each measure. This relatively brief intervention was able to produce effect sizes that were comparable to those of the more intensive MTA behavioral intervention. PMID:22506793

Preventive Intervention in Families at Risk: The Limits of Liberalism

ERIC Educational Resources Information Center

Snik, Ger; De Jong, Johan; Van Haaften, Wouter

2004-01-01

There is an increasing call for preventive state interventions in so-called families at risk - that is, interventions before any overt harm has been done by parents to their children or by the children to a third party, in families that are statistically known to be liable to harm children. One of the basic principles of liberal morality, however,…

Family Adaptation to Relocation: An Empirical Analysis of Family Stressors, Adaptive Resources, and Sense of Coherence

DTIC Science & Technology

1989-07-01

825. Lazarus , R. S., & Folkman , S. (1984). Stress, appraisal, and coping. New York: Springer. mcCuIbin, H. I., & Lavee, Y . (1986). Strengthenirg Army...Soirani, 1988; Lazarus & Folkman , 1984; Mckbbin & Patterson, 1983), family adaptation was defined broadly as a crmposite of the overall adjustment of...ongr- y of expectations that members and spouses had prior to arrival in West Germany with their actual experiences since arrival (Alpha: Members = .91

Lost in translation--the role of family in interventions among adults with diabetes: a systematic review.

PubMed

Torenholt, R; Schwennesen, N; Willaing, I

2014-01-01

Family interventions are increasingly recognized as important in the care of people with diabetes. The aim of this study was to synthesize the existing literature on family interventions among adults with Type 1 and Type 2 diabetes and to determine the degree to which they were family centred. The literature search was carried out in four databases (Scopus, CINAHL, PsycINFO and ERIC). Two reviewers independently screened the search results. Only English-language articles about interventions on education, care and/or support of adult individuals with diabetes involving the participation of both the individual with diabetes and at least one family member were included. From an initial 1480 citations, 10 reports were included. The intervention studies varied considerably in terms of design and population. The family dimension generally represented a modest part of the interventions: Two interventions applied a family-relevant theoretical framework. Disease knowledge and lifestyle changes were more prevalent intervention themes than family issues. Biological and behavioural outcomes were most prevalent, whereas psychosocial and family outcomes were used in six of the studies. The number of trials and statistically significant results in family interventions targeting adults with diabetes is limited. Because of inhomogeneity, it is difficult to come to a conclusion on effective approaches in family interventions. The interventions are inconsistent with regard to theoretical framework, intervention themes and measured outcomes. However, psychosocial and familial dimensions seem sensitive to family-based interventions. From development to evaluation, the family dimension needs to be included to prove the specific effect of family interventions. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Implementer-Initiated Adaptation of Evidence-Based Interventions: Kids Remember the Blue Wig

ERIC Educational Resources Information Center

Gibbs, D. A.; Krieger, K. E.; Cutbush, S. L.; Clinton-Sherrod, A. M.; Miller, S.

2016-01-01

Adaptation of evidence-based interventions by implementers is widespread. Although frequently viewed as departures from fidelity, adaptations may be positive in impact and consistent with fidelity. Research typically catalogs adaptations but rarely includes the implementers' perspectives on adaptation. We report data on individuals implementing an…

Parental antagonism and parent–offspring co-adaptation interact to shape family life

PubMed Central

Meunier, Joël; Kölliker, Mathias

2012-01-01

The family is an arena for conflicts between offspring, mothers and fathers that need resolving to promote the evolution of parental care and the maintenance of family life. Co-adaptation is known to contribute to the resolution of parent–offspring conflict over parental care by selecting for combinations of offspring demand and parental supply that match to maximize the fitness of family members. However, multiple paternity and differences in the level of care provided by mothers and fathers can generate antagonistic selection on offspring demand (mediated, for example, by genomic imprinting) and possibly hamper co-adaptation. While parent–offspring co-adaptation and parental antagonism are commonly considered two major processes in the evolution of family life, their co-occurrence and the evolutionary consequences of their joint action are poorly understood. Here, we demonstrate the simultaneous and entangled effects of these two processes on outcomes of family interactions, using a series of breeding experiments in the European earwig, Forficula auricularia, an insect species with uniparental female care. As predicted from parental antagonism, we show that paternally inherited effects expressed in offspring influence both maternal care and maternal investment in future reproduction. However, and as expected from the entangled effects of parental antagonism and co-adaptation, these effects critically depended on postnatal interactions with caring females and maternally inherited effects expressed in offspring. Our results demonstrate that parent–offspring co-adaptation and parental antagonism are entangled key drivers in the evolution of family life that cannot be fully understood in isolation. PMID:22810433

Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study.

PubMed

De Craemer, M; De Decker, E; De Bourdeaudhuij, I; Verloigne, M; Duvinage, K; Koletzko, B; Ibrügger, S; Kreichauf, S; Grammatikaki, E; Moreno, L; Iotova, V; Socha, P; Szott, K; Manios, Y; Cardon, G

2014-08-01

Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers. © 2014 World Obesity.

Effects of nursing intervention models on social adaption capability development in preschool children with malignant tumors: a randomized control trial.

PubMed

Yu, Lu; Mo, Lin; Tang, Yan; Huang, Xiaoyan; Tan, Juan

2014-06-01

The objectives of this study are to compare the effects of two nursing intervention models on the ability of preschool children with malignant tumors to socialize and to determine if these interventions improved their social adaption capability (SAC) and quality of life. Inpatient preschool children with malignant tumors admitted to the hospital between December 2009 and March 2012 were recruited and randomized into either the experimental or control groups. The control group received routine nursing care, and the experimental group received family-centered nursing care, including physical, psychological, and social interventions. The Infants-Junior Middle School Student's Social-Life Abilities Scale was used to evaluate SAC development of participants. Participants (n = 240) were recruited and randomized into two groups. After the intervention, the excellent and normal SAC rates were 27.5% and 55% in the experimental group, respectively, compared with 2.5% and 32.5% in the control group (p < 0.001). After the intervention, SAC in experimental group was improved compared with before intervention (54.68 ± 10.85 vs 79.9 ± 22.3, p < 0.001). However, no differences in SAC were observed between baseline and after intervention in the control group (54.70 ± 11.47 vs. 52 ± 15.8, p = 0.38). The family-centered nursing care model that included physical, psychological, and social interventions improved the SAC of children with malignancies compared with children receiving routine nursing care. Establishing a standardized family-school-community-hospital hierarchical multi-management intervention model for children is important to the efficacy of long-term interventions and to the improvement of SAC of children with malignancies. Copyright © 2014 John Wiley & Sons, Ltd.

Pathways family intervention for third-grade American Indian children1–3

PubMed Central

Teufel, Nicolette I; Perry, Cheryl L; Story, Mary; Flint-Wagner, Hilary G; Levin, Sarah; Clay, Theresa E; Davis, Sally M; Gittelsohn, Joel; Altaha, Jackie; Pablo, Juanita L

2016-01-01

The goal of the feasibility phase of the Pathways family intervention was to work with families of third-grade American Indian children to reinforce health behaviors being promoted by the curriculum, food service, and physical activity components of this school-based obesity prevention intervention. Family behaviors regarding food choices and physical activity were identified and ranked according to priority by using formative assessment and a literature review of school-based programs that included a family component. The family intervention involved 3 primary strategies designed to create an informed home environment supportive of behavioral change: 1) giving the children “family packs” containing worksheets, interactive assignments, healthful snacks, and low-fat tips and recipes to take home to share with their families; 2) implementing family events at the school to provide a fun atmosphere in which health education concepts could be introduced and reinforced; and 3) forming school-based family advisory councils composed of family members and community volunteers who provided feedback on Pathways strategies, helped negotiate barriers, and explored ideas for continued family participation. For strategy 2, a kick-off Family Fun Night provided a series of learning booths that presented the healthful behaviors taught by Pathways. At an end-of-year Family Celebration, a healthy meal was served, students demonstrated newly learned Pathways activities, and certificates were presented in recognition of completion of the Pathways curriculum. Based on evaluation forms and attendance rosters, strategies 1 and 2 were more easily implemented and better received than strategy 3. Implications for developing family involvement strategies for intervention programs are discussed. PMID:10195606

Brief Report: Adapting an In-Person Patient-Caregiver Communication Intervention to a Tailored Web-Based Format

PubMed Central

Zulman, Donna M.; Schafenacker, Ann; Barr, Kathryn L.C.; Moore, Ian T.; Fisher, Jake; McCurdy, Kathryn; Derry, Holly A.; Saunders, Edward W.; An, Lawrence C.; Northouse, Laurel

2011-01-01

Background Interventions that target cancer patients and their caregivers have been shown to improve communication, support, and emotional well-being. Objective To adapt an in-person communication intervention for cancer patients and caregivers to a web-based format, and to examine the usability and acceptability of the web-based program among representative users. Methods A tailored, interactive web-based communication program for cancer patients and their family caregivers was developed based on an existing in-person, nurse-delivered intervention. The development process involved: 1) building a multidisciplinary team of content and web design experts, 2) combining key components of the in-person intervention with the unique tailoring and interactive features of a web-based platform, and 3) conducting focus groups and usability testing to obtain feedback from representative program users at multiple time points. Results Four focus groups with 2 to 3 patient-caregiver pairs per group (n = 22 total participants) and two iterations of usability testing with 4 patient-caregiver pairs per session (n = 16 total participants) were conducted. Response to the program's structure, design, and content was favorable, even among users who were older or had limited computer and internet experience. The program received high ratings for ease of use and overall usability (mean System Usability Score of 89.5 out of 100). Conclusions Many elements of a nurse-delivered patient-caregiver intervention can be successfully adapted to a web-based format. A multidisciplinary design team and an iterative evaluation process with representative users were instrumental in the development of a usable and well-received web-based program. PMID:21830255

Colliding ideals - an interview study of how intervention researchers address adherence and adaptations in replication studies.

PubMed

von Thiele Schwarz, Ulrica; Förberg, Ulrika; Sundell, Knut; Hasson, Henna

2018-05-08

For an intervention to be considered evidence-based, findings need to be replicated. When this is done in new contexts (e.g., a new country), adaptations may be needed. Yet, we know little about how researchers approach this. This study aims to explore how researchers reason about adaptations and adherence when conducting replication studies, describe what adaptations they make and how these are reported in scientific journals. This was an interview study conducted in 2014 with principal investigators of Swedish replication studies reporting adaptations to an intervention from another country. Studies (n = 36) were identified through a database of 139 Swedish psychosocial and psychological intervention studies. Twenty of the 21 principal investigators agreed to participate in semi-structured telephone interviews, covering 33 interventions. Manifest content analysis was used to identify types of adaptations, and qualitative content analysis was used to explore reasoning and reporting of adaptations and adherence. The most common adaptation was adding components and modifying the content to the target population and setting. When reasoning about adaptations and adherence, the researchers were influenced by four main factors: whether their implicit aim was to replicate or improve an intervention; the nature of evidence outlying the intervention such as manuals, theories and core components; the nature of the context, including approaches to cultural adaptations and constraints in delivering the intervention; and the needs of clients and professionals. Reporting of adaptations in scientific journals involved a conflict between transparency and practical concerns such as word count. Researchers responsible for replicating interventions in a new country face colliding ideals when trying to protect the internal validity of the study while considering adaptations to ensure that the intervention fits into the context. Implicit assumptions about the role of replication

Pilot of "Families for Health": community-based family intervention for obesity.

PubMed

Robertson, W; Friede, T; Blissett, J; Rudolf, M C J; Wallis, M; Stewart-Brown, S

2008-11-01

To develop and evaluate "Families for Health", a new community based family intervention for childhood obesity. Programme development, pilot study and evaluation using intention-to-treat analysis. Coventry, England. 27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families. Families for Health is a 12-week programme with parallel groups for parents and children, addressing parenting, lifestyle change and social and emotional development. Change in baseline BMI z score at the end of the programme (3 months) and 9-month follow-up. Attendance, drop-out, parents' perception of the programme, child's quality of life and self-esteem, parental mental health, parent-child relationships and lifestyle changes were also measured. Attendance rate was 62%, with 18 of the 27 (67%) children completing the programme. For the 22 children with follow-up data (including four who dropped out), BMI z score was reduced by -0.18 (95% CI -0.30 to -0.05) at 3 months and -0.21 (-0.35 to -0.07) at 9 months. Statistically significant improvements were observed in children's quality of life and lifestyle (reduced sedentary behaviour, increased steps and reduced exposure to unhealthy foods), child-parent relationships and parents' mental health. Fruit and vegetable consumption, participation in moderate/vigorous exercise and children's self-esteem did not change significantly. Topics on parenting skills, activity and food were rated as helpful and used with confidence by most parents. Families for Health is a promising new childhood obesity intervention. Definitive evaluation of its clinical effectiveness by randomised controlled trial is now required.

Relationship between Family Adaptability, Cohesion and Adolescent Problem Behaviors: Curvilinearity of Circumplex Model.

PubMed

Joh, Ju Youn; Kim, Sun; Park, Jun Li; Kim, Yeon Pyo

2013-05-01

The Family Adaptability and Cohesion Evaluation Scale (FACES) III using the circumplex model has been widely used in investigating family function. However, the criticism of the curvilinear hypothesis of the circumplex model has always been from an empirical point of view. This study examined the relationship between adolescent adaptability, cohesion, and adolescent problem behaviors, and especially testing the consistency of the curvilinear hypotheses with FACES III. We used the data from 398 adolescent participants who were in middle school. A self-reported questionnaire was used to evaluate the FACES III and Youth Self Report. According to the level of family adaptability, significant differences were evident in internalizing problems (P = 0.014). But, in externalizing problems, the results were not significant (P = 0.305). Also, according to the level of family cohesion, significant differences were in internalizing problems (P = 0.002) and externalizing problems (P = 0.004). The relationship between the dimensions of adaptability, cohesion and adolescent problem behaviors was not curvilinear. In other words, adolescents with high adaptability and high cohesion showed low problem behaviors.

Relationship between Family Adaptability, Cohesion and Adolescent Problem Behaviors: Curvilinearity of Circumplex Model

PubMed Central

Joh, Ju Youn; Kim, Sun; Park, Jun Li

2013-01-01

Background The Family Adaptability and Cohesion Evaluation Scale (FACES) III using the circumplex model has been widely used in investigating family function. However, the criticism of the curvilinear hypothesis of the circumplex model has always been from an empirical point of view. This study examined the relationship between adolescent adaptability, cohesion, and adolescent problem behaviors, and especially testing the consistency of the curvilinear hypotheses with FACES III. Methods We used the data from 398 adolescent participants who were in middle school. A self-reported questionnaire was used to evaluate the FACES III and Youth Self Report. Results According to the level of family adaptability, significant differences were evident in internalizing problems (P = 0.014). But, in externalizing problems, the results were not significant (P = 0.305). Also, according to the level of family cohesion, significant differences were in internalizing problems (P = 0.002) and externalizing problems (P = 0.004). Conclusion The relationship between the dimensions of adaptability, cohesion and adolescent problem behaviors was not curvilinear. In other words, adolescents with high adaptability and high cohesion showed low problem behaviors. PMID:23730484

Hybrid Model Predictive Control for Sequential Decision Policies in Adaptive Behavioral Interventions.

PubMed

Dong, Yuwen; Deshpande, Sunil; Rivera, Daniel E; Downs, Danielle S; Savage, Jennifer S

2014-06-01

Control engineering offers a systematic and efficient method to optimize the effectiveness of individually tailored treatment and prevention policies known as adaptive or "just-in-time" behavioral interventions. The nature of these interventions requires assigning dosages at categorical levels, which has been addressed in prior work using Mixed Logical Dynamical (MLD)-based hybrid model predictive control (HMPC) schemes. However, certain requirements of adaptive behavioral interventions that involve sequential decision making have not been comprehensively explored in the literature. This paper presents an extension of the traditional MLD framework for HMPC by representing the requirements of sequential decision policies as mixed-integer linear constraints. This is accomplished with user-specified dosage sequence tables, manipulation of one input at a time, and a switching time strategy for assigning dosages at time intervals less frequent than the measurement sampling interval. A model developed for a gestational weight gain (GWG) intervention is used to illustrate the generation of these sequential decision policies and their effectiveness for implementing adaptive behavioral interventions involving multiple components.

Adapting Evidence-based Interventions using a Common Theory, Practices, and Principles

PubMed Central

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D.

2013-01-01

Objective Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families’ well-being, however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families’ everyday lives with a prevention framework. Method At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework which taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences, but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Results Successes and challenges are discussed for: 1) engaging parents and communities; 2) identifying and training Family Mentors to promote children and families’ well-being; and 3) gathering data for supervision, outcome evaluation, and continuous quality improvement (CQI). Conclusion To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers’ past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed. PMID:24079747

Balancing act: the influence of adaptability and cohesion on satisfaction and communication in families facing TBI in Mexico.

PubMed

Lehan, Tara J; Stevens, Lillian Flores; Arango-Lasprilla, Juan Carlos; Díaz Sosa, Dulce María; Espinosa Jove, Irma Guadalupe

2012-01-01

Much of what is known about family functioning in the face of traumatic brain injury (TBI) is based on research conducted in the United States. The purpose of this study was to (1) describe the levels of family adaptability, cohesion, communication, and satisfaction as reported by Mexican TBI survivors and their family caregivers, (2) test the hypothesis of the Circumplex Model that balanced families would exhibit better communication and greater satisfaction, and (3) explore how TBI survivors' and their family caregivers' perceptions of family adaptability and cohesion influenced their own and the other's perceptions of family communication and satisfaction. In the majority of dyads, both the TBI survivor and the family caregiver endorsed balanced family adaptability and cohesion. Both TBI survivors and their family caregivers reported a relatively high level of family communication and satisfaction. TBI survivors and family caregivers who reported greater levels of family adaptability and cohesion also endorsed better family communication and greater family satisfaction. In addition, individuals with TBI whose family caregiver endorsed balanced family adaptability and cohesion reported better family communication. Further, family caregivers of TBI survivors who reported balanced family adaptability and cohesion reported better family communication. Implications for research and practice are discussed.

Cultural Adaptation Quality of Family Life Scale for the Brazilian Portuguese.

PubMed

Jorge, Bianca Miguel; Levy, Cilmara Cristina Alves da Costa; Granato, Lídio

2015-01-01

To culturally adapt the Family Quality of Life Scale to the Brazilian Portuguese version and evaluate the instrument reliability and family quality of life of those who have children with hearing loss. The process of cultural adaptation of the scale followed the steps of the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measure. It was conducted in three stages: translation, back translation, and application in a pilot sample, as a way to check the comprehension difficulties of the items. After it had been completed, it was administered to 41 families who have children with hearing loss and, with their results, the quality of life and reliability were analyzed based on the Cronbach's alpha statistical test. In the first version (translation), among the 25 items, there were differences between the translators only in four items; after the corrections, the second version was done (back translation), in which other four more differences were found. Finally, after the final corrections, the last version was developed and used in the pilot sample without differences. Thus, it was applied to families with deaf children, who believe to be satisfied as to their quality of life. The Cronbach's alpha test found that the scale shows a satisfactory reliability. The Brazilian Portuguese version of the Family Quality of Life Scale is a tool of easy use and satisfactory reliability. The families are satisfied with their family quality of life.

Ten Adaptive Strategies for Family and Work Balance: Advice from Successful Families.

ERIC Educational Resources Information Center

Haddock, Shelley A.; Zimmerman, Toni Schindler; Ziemba, Scott J.; Current, Lisa R.

2001-01-01

Investigated adaptive strategies of middle class, dual earner couples (N=47) with children that are successfully managing family and work. Guided by grounded-theory methodology, analysis of interview data revealed these successful couples structured their lives around 10 major strategies. Each strategy is defined and illustrated through the…

Preventive interventions in families with parental depression: children’s psychosocial symptoms and prosocial behaviour

PubMed Central

Paavonen, E. Juulia; Toikka, Sini; Punamäki, Raija-Leena

2010-01-01

The aim is to document the effectiveness of a preventive family intervention (Family Talk Intervention, FTI) and a brief psychoeducational discussion with parents (Let’s Talk about the Children, LT) on children’s psychosocial symptoms and prosocial behaviour in families with parental mood disorder, when the interventions are practiced in psychiatric services for adults in the finnish national health service. Patients with mood disorder were invited to participate with their families. Consenting families were randomized to the two intervention groups. The initial sample comprised 119 families and their children aged 8–16. Of these, 109 completed the interventions and the baseline evaluation. Mothers and fathers filled out questionnaires including standardized rating scales for children’s symptoms and prosocial behaviour at baseline and at 4, 10 and 18 months post-intervention. The final sample consisted of parental reports on 149 children with 83 complete data sets. Both interventions were effective in decreasing children’s emotional symptoms, anxiety, and marginally hyperactivity and in improving children’s prosocial behaviour. The FTI was more effective than the LT on emotional symptoms particularly immediately after the intervention, while the effect of the LT emerged after a longer interval. The study supports the effectiveness of both interventions in families with depressed parents. The FTI is applicable in cultural settings other than the USA. Our findings provide support for including preventive child mental health measures as part of psychiatric services for mentally ill parents. PMID:20890622

Family Intervention and Services for Persons with Mental Illness in the People's Republic of China

ERIC Educational Resources Information Center

Yip, Kam-shing

2005-01-01

Family services and intervention for persons with mental illness is crucial in mental health services. In this paper, the writer attempts to describe family intervention and services for persons with mental illness in the People's Republic of China. Family intervention and services like home-based care, guardianship network, family counseling, and…

Effect of a Family Intervention on Psychological Outcomes of Children Affected by Parental HIV

PubMed Central

Li, Li; Liang, Li-Jung; Ji, Guoping; Wu, Jie; Xiao, Yongkang

2014-01-01

This study assesses intervention outcomes in children’s self-esteem, perceived parental care, and problem behavior and their potential connections to intervention outcomes in depressive symptoms and family functioning reported by parents living with HIV (PLH) and family members. A total of 79 families, consisting of 79 children, 88 PLH and 79 family members, were recruited from Anhui province, China. The intervention was delivered at the individual, family and community levels. Face-to-face interviews were administered at baseline, 3, and 6 months. A mixed-effects regression model was used to assess the intervention effect on the improvement of children’s reported self-esteem, parental care, and problem behavior. To further investigate the association between the parental measures and their children’s outcomes, we added parental measure as a time-varying covariate to explore whether the intervention effect on children was influenced by the parental measures. We observed some intervention effects related to children’s psychological measures accompanied by the improvement in mental health of PLH and family members. Our study findings highlight the importance of empowering families as a whole to confront HIV related challenges and the need to develop child-adequate and age-specific intervention strategies. PMID:24643313

Families overcoming under stress: implementing family-centered prevention for military families facing wartime deployments and combat operational stress.

PubMed

Lester, Patricia; Mogil, Catherine; Saltzman, William; Woodward, Kirsten; Nash, William; Leskin, Gregory; Bursch, Brenda; Green, Sara; Pynoos, Robert; Beardslee, William

2011-01-01

The toll of multiple and prolonged deployments on families has become clearer in recent years as military families have seen an increase in childhood anxiety, parental psychological distress, and marital discord. Families overcoming under stress (FOCUS), a family-centered evidence-informed resiliency training program developed at University of California, Los Angeles and Harvard Medical School, is being implemented at military installations through an initiative from Navy Bureau of Medicine and Surgery. The research foundation for FOCUS includes evidence-based preventive interventions that were adapted to meet the specific needs of military families facing combat operational stress associated with wartime deployments. Using a family narrative approach, FOCUS includes a customized approach utilizing core intervention components, including psychoeducation, emotional regulation skills, goal setting and problem solving skills, traumatic stress reminder management techniques, and family communication skills. The purpose of this study is to describe the development and implementation of FOCUS for military families. A case example is also presented.

Assessing cost-effectiveness in mental health: family interventions for schizophrenia and related conditions.

PubMed

Mihalopoulos, Cathrine; Magnus, Anne; Carter, Rob; Vos, Theo

2004-07-01

Existing evidence suggests that family interventions can be effective in reducing relapse rates in schizophrenia and related conditions. Despite this, such interventions are not routinely delivered in Australian mental health services. The objective of the current study is to investigate the incremental cost-effectiveness ratios (ICERs) of introducing three types of family interventions, namely: behavioural family management (BFM); behavioural intervention for families (BIF); and multiple family groups (MFG) into current mental health services in Australia. The ICER of each of the family interventions is assessed from a health sector perspective, including the government, persons with schizophrenia and their families/carers using a standardized methodology. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis based on disability-adjusted life years (DALYs) averted. The second stage involves application of 'second filter' criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using multivariate probabilistic sensitivity analysis. The most cost-effective intervention, in order of magnitude, is BIF (8000 Australian dollars per DALY averted), followed by MFG (21,000 Australian dollars per DALY averted) and lastly BFM (28,000 Australian dollars per DALY averted). The inclusion of time costs makes BFM more cost-effective than MFG. Variation of discount rate has no effect on conclusions. All three interventions are considered 'value-for-money' within an Australian context. This conclusion needs to be tempered against the methodological challenge of converting clinical outcomes into a generic economic outcome measure (DALY). Issues surrounding the feasibility of routinely implementing such interventions need to be addressed.

Behavior Support Interventions Implemented by Families of Young Children: Examination of Contextual Fit

ERIC Educational Resources Information Center

McLaughlin, Tara W.; Denney, Maria K.; Snyder, Patricia A.; Welsh, Jill L.

2012-01-01

Families are increasingly involved in the implementation of behavior support interventions to promote positive behaviors of young children in everyday family settings. Contextual fit, described as congruence between the behavior support intervention and the values, skills, resources, and routines of those who will implement the intervention, has…

Perceptions of risk factors for diabetes among Norwegian-Pakistani women participating in a culturally adapted intervention.

PubMed

Råberg Kjøllesdal, Marte K; Hjellset, Victoria T; Bjørge, Benedikte; Holmboe-Ottesen, Gerd; Wandel, Margareta

2011-06-01

To explore perceptions of diabetes risk factors among Pakistani immigrant women, as part of their explanatory model of the disease, and the changes in these perceptions after a culturally adapted intervention. Intervention study, carried out in Oslo, Norway, comprising 198 women. At baseline, about 75% of the women perceived sugar to be a risk factor for diabetes, about 30% mentioned physical inactivity and stress and close to 20% mentioned overweight. Twelve per cent could not identify any risk factors. When asked about foods to include in a diet to prevent diabetes, vegetables were mentioned by 45%, while 33% did not know any foods to include. Among those attending ≥60% of the educational sessions, the proportions mentioning little physical activity (p<0.001), overweight (p=0.001) and family history (p=0.007) as risk factors increased. Furthermore, the proportions mentioning legumes (p=0.001), fish (p<0.001), fibre (p=0.035) or vegetables (p=0.015) as important in a diet to prevent diabetes increased, and the proportion not knowing any food to include was reduced to 10% (p=0.004). Except for little physical activity, similar changes in responses were not registered in the control group. There is a need for improved knowledge about diabetes prevention among Pakistani immigrant women, and a culturally adapted intervention may contribute to this.

[Efficacy of family intervention in management of schizophrenic patients in China: a meta-analysis].

PubMed

Chen, Nan; An, Jing-huan; Yang, Min; Liu, Yuan-yuan

2015-11-01

To assess the efficacy of family intervention in management of schizophrenic patients in China. Chinese databases CNKI, VIP, WANFANG, CBM and English databases OVID Medline, Science Direct, Web of science, EBSCO were searched systematically from inception to January 2015. Quantitative and empirical studies on the outcomes of social disability screening scale (SDSS), brief psychiatric rating scale (BPRS) and positive and negative syndrome scale (PANSS) of family intervention for Chinese schizophrenic patients were selected. The effect size was derived from the standardized mean difference (SMD), and meta-analysis was conducted to compare effects of family intervention by intervention types, time of intervention, durations of illness and severity of schizophrenia. The study included 57 articles that met inclusion criteria. SDSS and PANSS scores revealed that the effect was positively associated with the length of intervention time (P<0.0001, P=0.0025); the effect of single family intervention was better than that of combined single and multiple family intervention (P<0.0001, P=0.0131); the effect was better for patients with severe conditions than those with less severe conditions (P<0.0001, P=0.0280). The SDSS showed that the effect was better for patients with shorter disease duration (P<0.0001). The results suggest that the long single family intervention would benefit to schizophrenic patients, particularly for severe patients with short disease duration.

Adolescent depressive disorders and family based interventions in the Family Options multicenter evaluation: study protocol for a randomized controlled trial.

PubMed

Lewis, Andrew J; Bertino, Melanie D; Skewes, Joanna; Shand, Lyndel; Borojevic, Nina; Knight, Tess; Lubman, Dan I; Toumbourou, John W

2013-11-13

There is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services. The Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent development, non-compliance of

Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

PubMed

Akram, Yasmin; Copello, Alex; Moore, David

2014-08-15

Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. Extensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded. The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted. This systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of

Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis.

PubMed

Ash, Tayla; Agaronov, Alen; Young, Ta'Loria; Aftosmes-Tobio, Alyssa; Davison, Kirsten K

2017-08-24

A wide range of interventions has been implemented and tested to prevent obesity in children. Given parents' influence and control over children's energy-balance behaviors, including diet, physical activity, media use, and sleep, family interventions are a key strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to identify gaps in the knowledge base. Using a comprehensive search strategy, we searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral domains targeted, and sample demographics were extracted from eligible articles using a comprehensive codebook. More than 90% of the 119 eligible interventions were based in the United States, Europe, or Australia. Most interventions targeted children 2-5 years of age (43%) or 6-10 years of age (35%), with few studies targeting the prenatal period (8%) or children 14-17 years of age (7%). The home (28%), primary health care (27%), and community (33%) were the most common intervention settings. Diet (90%) and physical activity (82%) were more frequently targeted in interventions than media use (55%) and sleep (20%). Only 16% of interventions targeted all four behavioral domains. In addition to studies in developing countries, racial minorities and non-traditional families were also underrepresented. Hispanic/Latino and families of low socioeconomic status were highly represented. The limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored interventions. To ensure a broad evidence base, more interventions implemented in developing countries and targeting racial

Familias Unidas for high risk adolescents: Study design of a cultural adaptation and randomized controlled trial of a U.S. drug and sexual risk behavior intervention in Ecuador.

PubMed

Jacobs, Petra; Estrada, Yannine A; Tapia, Maria I; Quevedo Terán, Ana M; Condo Tamayo, Cecilia; Albán García, Mónica; Valenzuela Triviño, Gilda M; Pantin, Hilda; Velazquez, Maria R; Horigian, Viviana E; Alonso, Elizabeth; Prado, Guillermo

2016-03-01

Developing, testing and implementing evidence-based prevention interventions are important in decreasing substance use and sexual risk behavior among adolescents. This process requires research expertise, infrastructure, resources and decades of research testing, which might not always be feasible for low resource countries. Adapting and testing interventions proven to be efficacious in similar cultures might circumvent the time and costs of implementing evidence-based interventions in new settings. This paper describes the two-phase study, including training and development of the research infrastructure in the Ecuadorian university necessary to implement a randomized controlled trial. Familias Unidas is a multilevel parent-centered intervention designed in the U.S. to prevent drug use and sexual risk behaviors in Hispanic adolescents. The current study consisted of Phase 1 feasibility study (n=38) which adapted the intervention and study procedures within a single-site school setting in an area with a high prevalence of drug use and unprotected sexual behavior among adolescents in Ecuador, and Phase 2 randomized controlled trial of the adapted intervention in two public high schools with a target population of families with adolescents from 12 to 14 years old. The trial is currently in Phase 2. Study recruitment was completed with 239 parent-youth dyads enrolling. The intervention phase and the first follow-up assessment have been completed. The second and third follow-up assessments will be completed in 2016. This project has the potential of benefitting a large population of families in areas of Ecuador that are disproportionally affected by drug trafficking and its consequences. MSP-DIS-2015-0055-0, Ministry of Public Health (MSP), Quito, Ecuador. Copyright © 2016 Elsevier Inc. All rights reserved.

Advances in family-based interventions in the neonatal ICU.

PubMed

Welch, Martha G; Myers, Michael M

2016-04-01

Despite advances in medical care, preterm infants remain at risk for many adverse outcomes. This article reviews findings from several recent neonatal ICU (NICU) interventions and a trial of a novel nurture-based approach, Family Nurture Intervention (FNI). Recent trials reviewed here find positive effects of a variety of family-related interventions focused on parental guidance. These interventions target prescribed physical activities with infants, parents' stress, and the parents' ability to recognize their positive and negative behaviors with their infants. Beneficial effects include reductions in parenting stress, maternal anxiety, and depression. A different approach, FNI, is aimed at establishing mother-infant emotional connection. As in other trials, FNI also decreased maternal symptoms of anxiety and depression, and increased maternal sensitivity. Additionally, FNI led to positive short and long-term effects on infant neurobehavioral outcomes at term and 18 months. A number of recent parent-based NICU interventions have been effective at reducing preterm parent stress. Another, FNI, has positive effects on both maternal and infant outcomes and promises to be cost-effective. Future decreases in long-term morbidity in preterm infants will increasingly rely on nonmedical interventions. Therefore, the rigorous development and testing of such interventions should be a high priority in perinatology research.

STRONG MILITARY FAMILIES INTERVENTION ENHANCES PARENTING REFLECTIVITY AND REPRESENTATIONS IN FAMILIES WITH YOUNG CHILDREN.

PubMed

Julian, M M; Muzik, M; Kees, M; Valenstein, M; Rosenblum, K L

2018-01-01

Military families face many challenges due to deployment and parental separation, and this can be especially difficult for families with young children. The Strong Military Families (SMF) intervention is for military families with young children, and consists of two versions: the Multifamily Group, and a Home-based psychoeducational written materials program. The Multifamily Group was designed to enhance positive parenting through both educational components and in vivo feedback and support during separations and reunions between parents and children (n = 78 parents). In the present study, we examine parenting reflectivity and mental representations in mothers versus fathers in military families, service members versus civilian spouses/parenting partners, and before versus after participation in the SMF Multifamily Group and Home-based interventions. Parenting reflectivity and mental representations were coded from the Working Model of the Child Interview (WMCI; C.H. Zeanah & D. Benoit, 1995). Results suggest that neither parenting reflectivity nor WMCI typology differs between mothers and fathers in military families, or between service members and civilian parenting partners. Furthermore, there was substantial stability in parenting reflectivity and WMCI typology from baseline to posttest, but participation in the Multifamily Group, relative to Home-based, was associated with improvements in both parenting reflectivity and WMCI ratings from baseline to postintervention. © 2017 Michigan Association for Infant Mental Health.

Variability in Adaptive Behavior in Autism: Evidence for the Importance of Family History

ERIC Educational Resources Information Center

Mazefsky, Carla A.; Williams, Diane L.; Minshew, Nancy J.

2008-01-01

Adaptive behavior in autism is highly variable and strongly related to prognosis. This study explored family history as a potential source of variability in adaptive behavior in autism. Participants included 77 individuals (mean age = 18) with average or better intellectual ability and autism. Parents completed the Family History Interview about…

A Family-School Intervention for Children with ADHD: Results of a Randomized Clinical Trial

ERIC Educational Resources Information Center

Power, Thomas J.; Mautone, Jennifer A.; Soffer, Stephen L.; Clarke, Angela T.; Marshall, Stephen A.; Sharman, Jaclyn; Blum, Nathan J.; Glanzman, Marianne; Elia, Josephine; Jawad, Abbas F.

2012-01-01

Objective: Accumulating evidence highlights the importance of using psychosocial approaches to intervention for children with attention-deficit/hyperactivity disorder (ADHD) that target the family and school, as well as the intersection of family and school. This study evaluated the effectiveness of a family-school intervention, Family-School…

Brief Family Intervention: Effectiveness and the Importance of Including the Father

ERIC Educational Resources Information Center

Martin, Barclay

1977-01-01

A brief family intervention consisting of training in conflict resolution and contingency management was given to families reporting high rates of parent-child problems of long duration. The implications of these findings for a strong systems view of families and family therapy are discussed. (Author)

Talking about parental substance abuse with children: eight families' experiences of Beardslee's family intervention.

PubMed

Pihkala, Heljä; Dimova-Bränström, Neda; Sandlund, Mikael

2017-07-01

Many children are affected by parental substance use disorder. Beardslee's family intervention (BFI) is a family-based psycho-educative method for children of mentally ill parents, used in psychiatric practise in several Nordic countries. The method has also been used to some extent when a parent suffers from substance use disorder. The aim of the study was to explore the family members' experiences of the BFI when a parent has a diagnosis of substance use disorder, to gain new knowledge about the process of the BFI in this area. Ten children and 14 parents were interviewed about their experiences 6 months after a BFI. The interviews were analyzed by qualitative content analysis. The children's psychological symptoms were measured by the Strengths and Difficulties Questionnaire at baseline and after 6 months. Increased openness about the substance use disorder in the families was a recurrent theme throughout the material and a central issue reported in the children's experiences. The children had a high level of psychological symptoms according to the SDQ at baseline, but the majority of them felt that the BFI made a positive difference in their families and for themselves. The parents reported improved wellbeing of their children. Positive experienced effects for children and parents are reported in families with parental substance use disorder, with possible connection to use of BFI. The present study suggests that Beardslee's family intervention is applicable as a preventive method for children in families with a parent suffering from substance use disorder.

A family intervention to reduce delirium in hospitalised ICU patients: A feasibility randomised controlled trial.

PubMed

Mitchell, Marion L; Kean, Susanne; Rattray, Janice E; Hull, Alastair M; Davis, Chelsea; Murfield, Jenny E; Aitken, Leanne M

2017-06-01

Family members could play an important role in preventing and reducing the development of delirium in Intensive Care Units (ICU) patients. This study sought to assess the feasibility of design and recruitment, and acceptability for family members and nurses of a family delivered intervention to reduce delirium in ICU patients. A single centre randomised controlled trial in an Australian medical/surgical ICU was conducted. Sixty-one family members were randomised (29 in intervention and 32 in non-intervention group). Following instructions, the intervention comprised the family members providing orientation or memory clues (family photographs, orientation to surroundings) to their relative each day. In addition, family members conducted sensory checks (vision and hearing with glasses and hearing aids); and therapeutic or cognitive stimulation (discussing family life, reminiscing) daily. Eleven ICU nurses were interviewed to gain insight into the feasibility and acceptability of implementing the intervention from their perspective. Recruitment rate was 28% of eligible patients (recruited n=90, attrition n=1). Following instruction by the research nurse the family member delivered the intervention which was assessed to be feasible and acceptable by family members and nurses. Protocol adherence could be improved with alternative data collection methods. Nurses considered the activities acceptable. The study was able to recruit, randomise and retain family member participants. Further strategies are required to assess intervention fidelity and improve data collection. Copyright © 2017 Elsevier Ltd. All rights reserved.

Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

PubMed

Sorrell, Jeanne M

2014-03-01

Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient. Copyright 2014, SLACK Incorporated.

Mechanisms of Change: Testing how Preventative Interventions Impact Psychological and Physiological Stress Functioning in Mothers in Neglectful Families

PubMed Central

Toth, Sheree L.; Sturge-Apple, Melissa L.; Rogosch, Fred A.; Cicchetti, Dante

2015-01-01

The present study applies a multilevel approach to an examination of the effect of two randomized preventative interventions with mothers in neglectful families who are also contending with elevated levels of impoverishment and ecological risk. Specifically, we examined how participation in either Child-Parent Psychotherapy (CPP) or Psychoeducational Parenting (PPI) interventions was associated with reductions in maternal psychological parenting stress and in turn physiological stress system functioning when compared to mothers involved in standard community services (CS) as well as a demographic comparison group of nonmaltreating mothers (NC). The resulting group sizes in the current investigation were: CPP (n = 44), PPI (n = 34), CS (n = 27), and NC (n = 52). Mothers and infants who were 13-months of age were randomly assigned to intervention group at baseline. Mothers completed assessments on stress within the parenting role at baseline and post-intervention. Basal cortisol was sampled at post-intervention and 1-year follow-up. Latent difference score analyses examined change in these constructs over time. Results suggested that mothers within the CPP intervention experienced significant declines in child-related parenting stress while mothers in the PPI intervention reported declines in parent-related parenting stress. In turn, significant decreases in stress within the CPP mothers were further associated with adaptive basal cortisol functioning at 1-year post-intervention. Results highlight the value of delineating how participation in preventtive interventions aimed at ameliorating child maltreatment in neglectful families within the context of poverty may operate through improvements in psychological and physiological stress functioning. Findings are discussed with respect to the importance of multi-level assessments of intervention process and outcome. PMID:26535951

Multidimensional family therapy HIV/STD risk-reduction intervention: an integrative family-based model for drug-involved juvenile offenders.

PubMed

Marvel, Francoise; Rowe, Cynthia L; Colon-Perez, Lissette; DiClemente, Ralph J; Liddle, Howard A

2009-03-01

Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/ STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies (www.cjdats.org). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/ STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.

Family Cohesion, Adaptability and Composition in Adolescents from Callao, Peru

ERIC Educational Resources Information Center

Villarreal-Zegarra, David; Paz-Jesús, Angel

2017-01-01

The objective of the study was to analyze if there are significant differences between family cohesion and adaptability according to the type of family composition (nuclear, extended, single parent and non-nuclear). This is a non-experimental and empirical research, in which a non-probabilistic, cross-sectional, selective and associative strategy…

Healthy Families Study: Design of a Childhood Obesity Prevention Trial for Hispanic Families

PubMed Central

Zoorob, Roger; Buchowski, Maciej; Beech, Bettina M.; Canedo, Juan R.; Chandrasekhar, Rameela; Akohoue, Sylvie; Hull, Pamela C.

2013-01-01

Background The childhood obesity epidemic disproportionately affects Hispanics. This paper reports on the design of the ongoing Healthy Families Study, a randomized controlled trial testing the efficacy of a community-based, behavioral family intervention to prevent excessive weight gain in Hispanic children using a community-based participatory research approach. Methods The study will enroll 272 Hispanic families with children ages 5–7 residing in greater Nashville, Tennessee, United States. Families are randomized to the active weight gain prevention intervention or an alternative intervention focused on oral health. Lay community health promoters implement the interventions primarily in Spanish in a community center. The active intervention was adapted from the We Can! parent program to be culturally-targeted for Hispanic families and for younger children. This 12-month intervention promotes healthy eating behaviors, increased physical activity, and decreased sedentary behavior, with an emphasis on parental modeling and experiential learning for children. Families attend eight bi-monthly group sessions during four months then receive information and/or support by phone or mail each month for eight months. The primary outcome is change in children’s body mass index. Secondary outcomes are changes in children’s waist circumference, dietary behaviors, preferences for fruits and vegetables, physical activity, and screen time. Results Enrollment and data collection are in progress. Conclusion This study will contribute valuable evidence on efficacy of a childhood obesity prevention intervention targeting Hispanic families with implications for reducing disparities. PMID:23624172

Examining inter-family differences in intra-family (parent-adolescent) dynamics using grid-sequence analysis.

PubMed

Brinberg, Miriam; Fosco, Gregory M; Ram, Nilam

2017-12-01

Family systems theorists have forwarded a set of theoretical principles meant to guide family scientists and practitioners in their conceptualization of patterns of family interaction-intra-family dynamics-that, over time, give rise to family and individual dysfunction and/or adaptation. In this article, we present an analytic approach that merges state space grid methods adapted from the dynamic systems literature with sequence analysis methods adapted from molecular biology into a "grid-sequence" method for studying inter-family differences in intra-family dynamics. Using dyadic data from 86 parent-adolescent dyads who provided up to 21 daily reports about connectedness, we illustrate how grid-sequence analysis can be used to identify a typology of intrafamily dynamics and to inform theory about how specific types of intrafamily dynamics contribute to adolescent behavior problems and family members' mental health. Methodologically, grid-sequence analysis extends the toolbox of techniques for analysis of family experience sampling and daily diary data. Substantively, we identify patterns of family level microdynamics that may serve as new markers of risk/protective factors and potential points for intervention in families. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Adapting health promotion interventions to meet the needs of ethnic minority groups: mixed-methods evidence synthesis.

PubMed

Liu, Jj; Davidson, E; Bhopal, Rs; White, M; Johnson, Mrd; Netto, G; Deverill, M; Sheikh, A

2012-01-01

There is now a considerable body of evidence revealing that a number of ethnic minority groups in the UK and other economically developed countries experience disproportionate levels of morbidity and mortality compared with the majority white European-origin population. Across these countries, health-promoting approaches are increasingly viewed as the long-term strategies most likely to prove clinically effective and cost-effective for preventing disease and improving health outcomes in those with established disease. To identify, appraise and interpret research on the approaches employed to maximise the cross-cultural appropriateness and effectiveness of health promotion interventions for smoking cessation, increasing physical activity and improving healthy eating for African-, Chinese- and South Asian-origin populations. Two national conferences; seven databases of UK guidelines and international systematic reviews of health promotion interventions aimed at the general population, including the Clinical Evidence, National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines Network databases (1950-2009); 11 databases of research on adapted health promotion interventions for ethnic minority populations, including BIOSIS, EMBASE and MEDLINE (1950-2009); and in-depth qualitative interviews with a purposive sample of researchers and health promoters. Theoretically based, mixed-methods, phased programme of research that involved user engagement, systematic reviews and qualitative interviews, which were integrated through a realist synthesis. Following a launch conference, two reviewers independently identified and extracted data from guidelines and systematic reviews on the effectiveness of interventions for the general population and any guidance offered in relation to how to interpret this evidence for ethnic minority populations. Data were thematically analysed. Reviewers then independently identified and critically appraised studies

Adaptive leadership: a novel approach for family decision making.

PubMed

Adams, Judith; Bailey, Donald E; Anderson, Ruth A; Galanos, Anthony N

2013-03-01

Family members of intensive care unit (ICU) patients want to be involved in decision making, but they may not be best served by being placed in the position of having to solve problems for which they lack knowledge and skills. This case report presents an exemplar family meeting in the ICU led by a palliative care specialist, with discussion about the strategies used to improve the capacity of the family to make a decision consistent with the patient's goals. These strategies are presented through the lens of Adaptive Leadership.

Modeling the Effects of Early Childhood Intervention Variables on Parent and Family Well-Being

ERIC Educational Resources Information Center

Dunst, Carl J.; Hamby, Deborah W.; Brookfield, Jeffri

2007-01-01

Structural equation modeling was used to evaluate the effects of family, child, and both early childhood intervention process and structural variables on parent and family well-being in a sample of 250 parents involved in birth to age three early childhood intervention programs. Family SES and income had direct positive effects, family-centered…

Culturally Based Intervention Development: The Case of Latino Families Dealing with Schizophrenia

ERIC Educational Resources Information Center

Barrio, Concepcion; Yamada, Ann-Marie

2010-01-01

Objectives: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this…

Cultural Adaptation, Parenting and Child Mental Health Among English Speaking Asian American Immigrant Families.

PubMed

Huang, Keng-Yen; Calzada, Esther; Cheng, Sabrina; Barajas-Gonzalez, R Gabriela; Brotman, Laurie Miller

2017-08-01

Contrary to the "model minority" myth, Asian American children, especially those from low-income immigrant families, are at risk for both behavioral and emotional problems early in life. Little is known, however, about the underlying developmental mechanisms placing Asian American children at risk, including the role of cultural adaptation and parenting. This study examined cultural adaptation, parenting practices and culture related parenting values and child mental health in a sample of 157 English speaking Asian American immigrant families of children enrolled in early childhood education programs in low-income, urban neighborhoods. Overall, cultural adaptation and parenting cultural values and behaviors were related to aspects of child mental health in meaningful ways. Parents' cultural value of independence appears to be especially salient (e.g., negatively related to behavior problems and positively related to adaptive behavior) and significantly mediates the link between cultural adaptation and adaptive behavior. Study findings have implications for supporting Asian American immigrant families to promote their young children's mental health.

Interventions to build resilience in family caregivers of people living with dementia: a comprehensive systematic review.

PubMed

Petriwskyj, Andrea; Parker, Deborah; O'Dwyer, Siobhan; Moyle, Wendy; Nucifora, Nikki

2016-06-01

Recent studies have indicated that family caregivers of people with dementia have higher rates of depression, anxiety and hopelessness, as well as higher levels of burden, stress and distress. Not all caregivers, however, succumb to the negative effects of caring. Caregivers who are able to recover from, resist or adapt to the physical and psychological demands of caring can be considered "resilient". The objective of this review was to examine the existing evidence regarding interventions for building resilience in family caregivers of people living with dementia. This review considered studies that included family caregivers of people with dementia. Studies investigating interventions to build resilience in family caregivers were considered by the review. For qualitative studies, the phenomena of interest were family caregivers' experiences of the interventions including factors affecting implementation and their subjective experience of outcomes. Studies conducted in any cultural or geographical context and any settings including participants' homes in the community, residential aged care or hospital, medical or allied health practice were considered for inclusion. Quantitative studies incorporating experimental and descriptive study designs and qualitative studies, including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion. Quantitative studies were included that contained either objective or subjective outcome measures (or a combination of both). In cases in which proxy measures of resilience were used, only those papers that explicitly related the aims of the intervention and the measurement of outcomes to resilience itself were considered for inclusion. Proxies could include, but were not limited to, self-efficacy, locus of control, perceived burden, psychological wellbeing, strength, coping, positive adjustment and resourcefulness. Qualitative studies were similarly

Consumer Feedback following Participation in a Family-Based Intervention for Youth Mental Health

PubMed Central

Lewis, Andrew J.; Bertino, Melanie D.; Robertson, Narelle; Knight, Tess; Toumbourou, John W.

2012-01-01

Background. This paper presents findings derived from consumer feedback, following a multicentre randomised controlled trial for adolescent mental health problems and substance misuse. The paper focuses on the implementation of a family-based intervention, including fidelity of delivery, family members' experiences, and their suggestions for program improvements. Methods. Qualitative and quantitative data (n = 21) were drawn from the Deakin Family Options trial consumer focus groups, which occurred six months after the completion of the trial. Consumer focus groups were held in both metropolitan and regional locations in Victoria, Australia. Findings. Overall reductions in parental isolation, increases in parental self-care, and increased separation/individuation were the key therapeutic features of the intervention. Sharing family experiences with other parents was a key supportive factor, which improved parenting confidence and efficacy and potentially reduced family conflict. Consumer feedback also led to further development of the intervention, with a greater focus on aiding parents to engage adolescents in services and addressing family factors related to adolescent's mood and anxiety symptoms. Conclusions. Participant feedback provides valuable qualitative data, to monitor the fidelity of treatment implementation within a trial, to confirm predictions about the effective mechanisms of an intervention, and to inform the development of new interventions. PMID:22988494

Mechanisms of change: Testing how preventative interventions impact psychological and physiological stress functioning in mothers in neglectful families.

PubMed

Toth, Sheree L; Sturge-Apple, Melissa L; Rogosch, Fred A; Cicchetti, Dante

2015-11-01

The present study applies a multilevel approach to an examination of the effect of two randomized preventive interventions with mothers in neglectful families who are also contending with elevated levels of impoverishment and ecological risk. Specifically, we examined how participation in either child-parent psychotherapy (CPP) or psychoeducational parenting intervention (PPI) was associated with reductions in maternal psychological parenting stress and in turn physiological stress system functioning when compared to mothers involved in standard community services as well as a demographic comparison group of nonmaltreating mothers. The resulting group sizes in the current investigation were 44 for CPP, 34 for PPI, 27 for community services, and 52 for nonmaltreating mothers. Mothers and their 13-month-old infants were randomly assigned to intervention group at baseline. Mothers completed assessments on stress within the parenting role at baseline and postintervention. Basal cortisol was sampled at postintervention and 1-year follow-up. Latent difference score analyses examined change in these constructs over time. Results suggested that mothers within the CPP intervention experienced significant declines in child-related parenting stress, while mothers in the PPI intervention reported declines in parent-related parenting stress. In turn, significant decreases in stress within the CPP mothers were further associated with adaptive basal cortisol functioning at 1-year postintervention. The results highlight the value of delineating how participation in preventive interventions aimed at ameliorating child maltreatment in neglectful families within the context of poverty may operate through improvements in psychological and physiological stress functioning. Findings are discussed with respect to the importance of multilevel assessments of intervention process and outcome.

The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention.

PubMed

Jortberg, Bonnie T; Rosen, Raquel; Roth, Sarah; Casias, Luke; Dickinson, L Miriam; Coombs, Letoynia; Awadallah, Nida S; Bernardy, Meaghann K; Dickinson, W Perry

2016-01-01

Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic interventions. The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care-based childhood obesity intervention. A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a childhood obesity program in primary care; secondary outcomes were changes in BMI percentile, BMI z-scores, blood pressure, and changes in lifestyle factors related to childhood obesity. Implementation of FFC is feasible, statically significant changes were seen for decreases in BMI percentile and BMI z-scores for participants who completed 9 to 15 months of follow-up; lifestyle factors related to childhood obesity in proved Spanish-speaking families and food insecurity were associated with less follow-up time (P < .01). A primary care-based childhood obesity intervention may result in significant clinical and lifestyle changes. © Copyright 2016 by the American Board of Family Medicine.

Investigating the Effect of an Adaptive Learning Intervention on Students' Learning

ERIC Educational Resources Information Center

Liu, Min; McKelroy, Emily; Corliss, Stephanie B.; Carrigan, Jamison

2017-01-01

Educators agree on the benefits of adaptive learning, but evidence-based research remains limited as the field of adaptive learning is still evolving within higher education. In this study, we investigated the impact of an adaptive learning intervention to provide remedial instruction in biology, chemistry, math, and information literacy to…

Patterns of adaptation to children's food allergies.

PubMed

Fedele, D A; McQuaid, E L; Faino, A; Strand, M; Cohen, S; Robinson, J; Atkins, D; Hourihane, J O'B; Klinnert, M D

2016-04-01

Families with food allergy (FA) are at risk of reduced quality of life and elevated anxiety. A moderate level of anxiety may be beneficial to sustain vigilance for food avoidance; however, excessive anxiety may increase risk for burden and maladjustment. The current study presents a framework for understanding the patterns of adaptation to FA across families and to identify typologies of families that would benefit from intervention. Participants included 57 children, 6-12 years old with documented FA, and their mothers. Families were assessed using the Food Allergy Management and Adaptation Scale. Families also completed measures of quality of life, anxiety, FA management, and psychosocial impairment. A hierarchical cluster analysis revealed that 56 of the 57 families of food-allergic children were categorized into four groups that differed on their adequacy of family FA management, levels of anxiety, and balanced psychosocial functioning: balanced responders (n = 23; 41%), high responders (n = 25; 45%), and low responders (n = 3; 5%). The fourth group, anxious high responders (n = 5; 9%), was characterized by extremely high maternal FA anxiety scores and low scores for balanced integration of FA management and psychosocial functioning. Families in clusters differed across illness and psychosocial outcome variables. Families with FA were characterized by patterns of FA management, anxiety, and ability to integrate FA demands into daily life. Identified adaptation patterns correspond with clinical impressions and provide a framework for identifying families in need of intervention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Costs of a work-family intervention: evidence from the work, family, and health network.

PubMed

Barbosa, Carolina; Bray, Jeremy W; Brockwood, Krista; Reeves, Daniel

2014-01-01

To estimate the cost to the workplace of implementing initiatives to reduce work-family conflict. Prospective cost analysis conducted alongside a group-randomized multisite controlled experimental study, using a microcosting approach. An information technology firm. Employees (n = 1004) and managers (n = 141) randomized to the intervention arm. STAR (Start. Transform. Achieve. Results.) to enhance employees' control over their work time, increase supervisor support for employees to manage work and family responsibilities, and reorient the culture toward results. A taxonomy of activities related to customization, start-up, and implementation was developed. Resource use and unit costs were estimated for each activity, excluding research-related activities. Economic costing approach (accounting and opportunity costs). Sensitivity analyses on intervention costs. The total cost of STAR was $709,654, of which $389,717 was labor costs and $319,937 nonlabor costs (including $313,877 for intervention contract). The cost per employee participation in the intervention was $340 (95% confidence interval: $330-$351); $597 ($561-$634) for managers and $300 ($292-$308) for other employees (2011 prices). A detailed activity costing approach allows for more accurate cost estimates and identifies key drivers of cost. The key cost driver was employees' time spent on receiving the intervention. Ignoring this cost, which is usual in studies that cost workplace interventions, would seriously underestimate the cost of a workplace initiative.

A Systematic Review of Literature on Culturally Adapted Obesity Prevention Interventions for African American Youth.

PubMed

Lofton, Saria; Julion, Wrenetha A; McNaughton, Diane B; Bergren, Martha Dewey; Keim, Kathryn S

2016-02-01

Obesity and overweight prevalence in African American (AA) youth continues to be one of the highest of all major ethnic groups, which has led researchers to pursue culturally based approaches as a means to improve obesity prevention interventions. The purpose of this systematic review was to evaluate culturally adapted obesity prevention interventions targeting AA youth. A search of electronic databases, limited to multicomponent culturally adapted obesity prevention controlled trials from 2003 to 2013, was conducted for key terms. Eleven studies met inclusion criteria. We used the PEN-3 model to evaluate the strengths and weaknesses of interventions as well as to identify cultural adaptation strategies. The PEN-3 model highlighted the value of designing joint parent-youth interventions, building a relationship between AA mentors and youth, and emphasizing healthful activities that the youth preferred. The PEN-3 model shows promise as an overarching framework to develop culturally adapted obesity interventions. © The Author(s) 2015.

Preparing the Field for Feasibility Testing of a Parenting Intervention for War-Affected Mothers in Northern Uganda.

PubMed

Wieling, Elizabeth; Mehus, Christopher; Yumbul, Cigdem; Möllerherm, Julia; Ertl, Verena; Laura, Achan; Forgatch, Marion; Neuner, Frank; Catani, Claudia

2017-06-01

In this article, we discuss the successful implementation of an adapted evidence-based parenting intervention for families affected by two decades of war in Northern Uganda. The adaptation and adoption of such interventions to support mental health and family functioning is widely endorsed by prevention scientists and considered a priority in global mental health. The preparation and early adoption phases of engaging with a highly vulnerable community affected by war trauma are documented in this paper along with a discussion of the steps taken to adapt a parenting intervention for cultural and contextual fit. This study is a component of an overall program of research aimed at reducing the long-term negative effects of war on parenting practices and childhood outcomes, which have considerable implications for preventing mental, neurological, and substance-use disorders. The processes described here cover a 4-year period culminating in the implementation of the nine-session Enhancing Family Connection intervention piloted with a group of 14 mothers. The lessons in cultural adaptation have been valuable and the feasibility results promising for further testing the intervention. © 2015 Family Process Institute.

Effectiveness of family work interventions on schizophrenia: evidence from a multicentre study in Catalonia.

PubMed

Tomás, Esther Pousa; Hurtado, Gemma; Noguer, Sílvia; Domènech, Cristina; García, Montse; López, Nuria; Negredo, Maríacruz; Penadés, Rafael; Reinares, María; Serrano, Dolors; Dolz, Montse; Gallo, Pedro

2012-11-01

Despite their proven efficacy, family work interventions on families of patients with schizophrenia are not being implemented in routine clinical practice in contexts where expressed emotion levels among caregivers are relatively high. This study aimed to explore the effectiveness of a family work intervention in a Mediterranean environment in Catalonia, Spain. Participants were 23 patients and 35 key relatives in five different clinical settings. The family intervention was provided by 10 trained health care professionals during a nine-month period. A six-month follow-up was also conducted. Statistically significant improvements were found in patients' clinical status, global functioning and social functioning levels, as well as in caregivers' burden of care. These results were maintained during follow-up. This is the first study to explore the effectiveness of family intervention in a high-expressed emotion context in Catalonia. The findings add weight to the growing literature supporting these interventions in different cultural settings.

Adaptive Interventions in Drug Court: A Pilot Experiment

PubMed Central

Marlowe, Douglas B.; Festinger, David S.; Arabia, Patricia L.; Dugosh, Karen L.; Benasutti, Kathleen M.; Croft, Jason R.; McKay, James R.

2009-01-01

This pilot study (N = 30) experimentally examined the effects of an adaptive intervention in an adult misdemeanor drug court. The adaptive algorithm adjusted the frequency of judicial status hearings and clinical case-management sessions according to pre-specified criteria in response to participants' ongoing performance in the program. Results revealed the adaptive algorithm was acceptable to both clients and staff, feasible to implement with greater than 85% fidelity, and showed promise for eliciting clinically meaningful improvements in drug abstinence and graduation rates. Estimated effect sizes ranged from 0.40 to 0.60 across various dependent measures. Compared to drug court as-usual, participants in the adaptive condition were more likely to receive responses from the drug court team for inadequate performance in the program and received those responses after a substantially shorter period of time. This suggests the adaptive algorithm may have more readily focused the drug court team's attention on poorly-performing individuals, thus allowing the team to “nip problems in the bud” before they developed too fully. These preliminary data justify additional research evaluating the effects of the adaptive algorithm in a fully powered experimental trial. PMID:19724664

Measuring Family Outcomes Early Intervention: Findings from a Large-Scale Assessment

ERIC Educational Resources Information Center

Raspa, Melissa; Bailey, Donald B., Jr.; Olmsted, Murrey G.; Nelson, Robin; Robinson, Nyle; Simpson, Mary Ellen; Guillen, Chelsea; Houts, Renate

2010-01-01

This article reports data from a large-scale assessment using the Family Outcomes Survey with families participating in early intervention. The study was designed to determine how families describe themselves with regard to outcomes achieved, the extent to which outcomes are interrelated, and the extent to which child, family, and program factors…

Improving Mental Health Outcomes of Burmese Migrant and Displaced Children in Thailand: a Community-Based Randomized Controlled Trial of a Parenting and Family Skills Intervention.

PubMed

Annan, Jeannie; Sim, Amanda; Puffer, Eve S; Salhi, Carmel; Betancourt, Theresa S

2017-10-01

The negative effects of displacement and poverty on child mental health are well-known, yet research on prevention interventions in low- and middle-income countries, especially fragile states, remains limited. We examined the effectiveness of a parenting skills intervention on mental health outcomes among Burmese migrant and displaced children living in 20 communities in Thailand. Participants were primary caregivers and children aged 7 to 15 years (n = 479 families). Families were randomly assigned to receive an adapted version of the Strengthening Families Program (n = 240) or a wait-list control condition (n = 239). Assessments were conducted at baseline and 1-month post-intervention for both conditions and at 6 months for treatment group only. One month after the program, children in the treatment condition showed significant reductions in externalizing problems (caregiver effect size (ES) -0.22, p = 0.02; child report ES -0.11, p = 0.02) and child attention problems compared with controls (caregiver report ES -0.23, p = 0.03). There was no significant treatment effect on children's internalizing problems (ES -0.06; p = 0.31). Children reported a significant increase in prosocial protective factors relative to controls (ES 0.20, p < 0.01). Results suggest that an evidence-based parenting skills intervention adapted for a displaced and migrant Burmese population facing high levels of adversity can have positive effects on children's externalizing symptoms and protective psychosocial factors. Clinicaltrials.gov: https://clinicaltrials.gov/show/NCT01829815.

The Gandhi Technique: A Biculturalization Approach for Empowering Asian and Pacific Islander Families.

ERIC Educational Resources Information Center

Fong, Rowena; Boyd, Carylee; Browne, Collette

1999-01-01

Western social-work interventions must be adapted to empower ethnic minority families. A case study of a Hawaiian family-centered, family-empowering, problem-solving intervention using the Gandhi Technique shows it to be compatible with Asian and Pacific-Islander values. Considerations for culturally competent social work practice with Asian and…

Targeting children's dietary behaviors in a family intervention: 'Entre familia: reflejos de salud'.

PubMed

Horton, Lucy A; Parada, Humberto; Slymen, Donald J; Arredondo, Elva; Ibarra, Leticia; Ayala, Guadalupe X

2013-01-01

This intervention sought to promote healthy eating with the ultimate goal of reducing childhood obesity risk. Three hundred and sixty-one Latino families living on the US-Mexico border with at least one child between 7-13 years of age were eligible to participate. Families randomly assigned to the four-month intervention received 14 contacts with a promotora (community health worker), consisting of 11 home visits and three telephone calls; the control condition was a delayed treatment intervention. Children reported on their dietary intake at baseline, immediately post-intervention and at the six month follow-up visit. The intervention reduced weekly consumption of fast food (p<0.05). A dose-response relationship was observed such that for every seven hours of promotora contact, monthly variety of fruits (p<0.01) and vegetables (p<0.01) increased by one. No other intervention effects were observed. Family-based interventions can improve children's eating habits, with the amount of contact with the promotora being key to success.

Unemployment Effects on the Family and the Child: Interventions for Counselors.

ERIC Educational Resources Information Center

Schliebner, Connie T.; Peregoy, John J.

1994-01-01

Examines the effects of long-term unemployment on families, marital relationships, and children. Discusses impact of financial hardship, stress, and emotional upheaval as they affect family systems. Presents counseling interventions for addressing needs of children in these families. Includes 54 citations. (Author/CRR)

Practicalities and Research Considerations for Conducting Childhood Obesity Prevention Interventions with Families

PubMed Central

Morgan, Philip J.; Jones, Rachel A.; Collins, Clare E.; Hesketh, Kylie D.; Young, Myles D.; Burrows, Tracy L.; Magarey, Anthea M.; Brown, Helen L.; Hinkley, Trina; Perry, Rebecca A.; Brennan, Leah; Spence, Alison C.; Campbell, Karen J.

2016-01-01

Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a key target for child obesity prevention programs. However, recruiting and engaging parents in such interventions can be a considerable challenge for researchers and practitioners. Members of the ‘Parenting, Child Behaviour and Well-being’ stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN) have considerable and varied expertise in conducting such interventions and can provide insights into addressing these challenges. This paper aims to highlight considerations regarding the design, implementation, and evaluation of obesity prevention interventions with families and provide practical insights and recommendations for researchers and practitioners conducting family-based research in this area. Case studies of three family-based interventions conducted by ACAORN members are highlighted to provide examples and contextualise the recommendations proposed. PMID:27834820

Brief Family Based Intervention for Substance Abusing Adolescents

PubMed Central

Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony

2015-01-01

Synopsis Research has consistently shown that a lack of parental involvement in the activities of their children predicts initiation and escalation of substance use. Parental monitoring, as well as youth disclosure about their whereabouts, parent child communication, positive parenting and family management strategies, e.g., consistent limit setting, and parental communication about and disapproval of substance use, have all been shown to protect against adolescent substance abuse and substance problems. Given the empirical evidence, family and parenting approaches to preventing and intervening on adolescent substance misuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief family-based intervention for adolescent substance use. PMID:26092741

Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: the shape-up following cancer treatment program.

PubMed

Koutoukidis, Dimitrios A; Lopes, Sonia; Atkins, Lou; Croker, Helen; Knobf, M Tish; Lanceley, Anne; Beeken, Rebecca J

2018-03-27

About 80% of endometrial cancer survivors (ECS) are overweight or obese and have sedentary behaviors. Lifestyle behavior interventions are promising for improving dietary and physical activity behaviors, but the constructs associated with their effectiveness are often inadequately reported. The aim of this study was to systematically adapt an evidence-based behavior change program to improve healthy lifestyle behaviors in ECS. Following a review of the literature, focus groups and interviews were conducted with ECS (n = 16). An intervention mapping protocol was used for the program adaptation, which consisted of six steps: a needs assessment, formulation of matrices of change objectives, selection of theoretical methods and practical applications, program production, adoption and implementation planning, and evaluation planning. Social Cognitive Theory and Control Theory guided the adaptation of the intervention. The process consisted of eight 90-min group sessions focusing on shaping outcome expectations, knowledge, self-efficacy, and goals about healthy eating and physical activity. The adapted performance objectives included establishment of regular eating, balanced diet, and portion sizes, reduction in sedentary behaviors, increase in lifestyle and organized activities, formulation of a discrepancy-reducing feedback loop for all above behaviors, and trigger management. Information on managing fatigue and bowel issues unique to ECS were added. Systematic intervention mapping provided a framework to design a cancer survivor-centered lifestyle intervention. ECS welcomed the intervention and provided essential feedback for its adaptation. The program has been evaluated through a randomized controlled trial.

Family adaptability and cohesion in families consisting of Asian immigrant women living in South Korea: A 3-year longitudinal study.

PubMed

Kim, Yeon-Pyo; Kim, Sun; Joh, Ju-Youn

2015-06-01

South Korea's low birth rate, aging society, and female migration to urban areas due to industrialization have caused an accelerated inflow of Asian female immigrants into Korea to marry Korean men, especially in rural areas. This study was performed to determine how family function of multicultural families changes over time and what factors affect the changes in family function of multicultural families. The study subjects were 62 Asian immigrant women married to South Korean men living in South Korea. In a 1st wave study in August 2008, the socioeconomic factors and Family Adaptability and Cohesion Scale III (FACES III) scores were measured. A 3-year follow-up study was then conducted in August 2011, and the results were compared with the 1st wave study results. The mean family adaptability score was 24.6 in the 1st wave study and 26.1 at the 3-year follow-up. The average family cohesion score was 31.0 in the 1st wave study and 36.7 at the 3-year follow-up. There was a statistically significant increase in family cohesion after 3 years (P < 0.001). In multiple regression analysis, age difference between husband and wife (P = 0.019) and subjective SES (P < 0.001) were found to be significantly correlated with positive changes of cohesion scores. Family adaptability did not change over time; however, conversely, family cohesion increased. The age difference between husband and wife and the subjective SES had a positive association with the changes in family cohesion. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Family support is associated with success in achieving weight loss in a group lifestyle intervention for diabetes prevention in Arab Americans.

PubMed

Pinelli, Nicole R; Brown, Morton B; Herman, William H; Jaber, Linda A

2011-01-01

We have recently shown the feasibility of a community-based, culturally-specific, Diabetes Prevention Program-adapted, goal-oriented group lifestyle intervention targeting weight loss in Arab Americans. The objective of this study was to examine factors associated with weight-loss goal attainment at 24-weeks of the lifestyle intervention. We assessed the relationship among demographic, psychosocial, and behavioral measures and the attainment of > or =7% decrease of initial body weight among 71 lifestyle intervention participants. Weight loss goal of > or = 7% of body weight was achieved by 44% of study participants. Demographic and psychosocial factors were not associated with weight loss. Individuals attaining the weight loss goal were more likely to have family support during the core curriculum sessions (70% vs 30%; P=.0023). Decrease in body weight was positively correlated with attendance at sessions (r=.46; P=.0016) and physical activity minutes (r=.66; P<.0001) and negatively correlated with reported caloric intake (r=-.49; P=.0023), fat intake (r=-.52; P=.0010), and saturated fat intake (r=-.39; P=.0175) in women; these trends were similar but not significant in men. Family support was an important predictor of attainment of the weight loss goal. Family-centered lifestyle interventions are likely to succeed in curtailing the rising epidemic of diabetes in the Arab-American Community.

Risk factors for poor attendance in a family-based pediatric obesity intervention program for young children.

PubMed

Williams, Natalie A; Coday, Mace; Somes, Grant; Tylavsky, Frances A; Richey, Phyllis A; Hare, Marion

2010-01-01

This study examined the role of demographic characteristics, psychological factors, and family functioning on attendance in a randomized controlled trial of a family-based pediatric obesity program. Participants included 155 children between the ages of 4 and 7 years (M age = 5.77, 57.4% female, 73.6% black, M body mass index = 25.5) and their primary caregivers who were randomized to the treatment group. Three groups of participants were created based on their patterns of attendance during the program: (1) noncompleters, (2) partial completers, and (3) completers. Results indicated no differences among the attendance groups in child gender, child body mass index, or child psychological functioning. Significant group differences were found with respect to race/ethnicity, parent marital status, and family income, such that noncompleters were more likely to be racial/ethnic minorities, to living in single parent households, and to have lower incomes than partial completers and completers. After controlling for the effects of these sociodemographic risk factors, noncompleters, and partial completers reported more family dysfunction characterized by high levels of disengagement than completers. Adapting existing weight management programs to include a focus on family engagement in the early stages of treatment may help to improve participation in family-based obesity interventions targeting high risk, socioeconomically disadvantaged youth.

Adaptive Intervention Design in Mobile Health: Intervention Design and Development in the Cell Phone Intervention for You (CITY) Trial

PubMed Central

Lin, Pao-Hwa; Intille, Stephen; Bennett, Gary; Bosworth, Hayden B; Corsino, Leonor; Voils, Corrine; Grambow, Steven; Lazenka, Tony; Batch, Bryan C; Tyson, Crystal; Svetkey, Laura P

2015-01-01

Background/Aims The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this manuscript is to describe the design and development of the intervention tested in the Cell Phone Intervention for You (CITY) study and to highlight the importance of adaptive intervention design (AID) that made it possible. The CITY study was an NHLBI-sponsored, controlled 24-month randomized clinical trial (RCT) comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (BMI ≥ 25 kg/m2) young adults. Methods Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, AID, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The AID strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. AID was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. Results The cellphone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive – providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over two years to

Utilizing community-based participatory research to adapt a mental health intervention for African American emerging adults.

PubMed

Mance, Gishawn A; Mendelson, Tamar; Byrd, Benjamin; Jones, Jahon; Tandon, Darius

2010-01-01

Adapting mental health interventions to heighten their cultural and contextual appropriateness may be critical for engaging ethnic/racial groups that have been traditionally excluded or marginalized. Community-based participatory research (CBPR) is a collaborative research approach that highlights unique strengths and expertise of those involved. Although intervention adaptations have garnered much attention there is little previous work specifically describing the adaptation process of mental health interventions using CBPR. This article summarizes the use of a CBPR approach to adapt a mental health intervention for urban adolescents and young adults disconnected from school and work, a population at elevated risk for poor mental health owing to the presence of numerous chronic stressors. We describe the process undertaken to modify the content and delivery format of an evidence-based intervention. Unique challenges of working with urban African American adolescents and young adults in a job training program are highlighted. By incorporating principles of co-learning and shared responsibility, this partnership was able to achieve positive outcomes. Our experience suggests that a CBPR approach can be used effectively to adapt a mental health intervention in collaboration with African American adolescents and emerging adults in a job training program.

Family Involvement in Early Intervention Service Planning: Links to Parental Satisfaction and Self-Efficacy

ERIC Educational Resources Information Center

Popp, Tierney K.; You, Hyun-Kyung

2016-01-01

The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…

Intervention Effects on Safety Compliance and Citizenship Behaviors: Evidence from the Work, Family, and Health Study

PubMed Central

Hammer, Leslie B.; Johnson, Ryan C.; Crain, Tori L.; Bodner, Todd; Kossek, Ellen Ernst; Davis, Kelly; Kelly, Erin L.; Buxton, Orfeu M.; Karuntzos, Georgia; Chosewood, L. Casey; Berkman, Lisa

2015-01-01

We tested the effects of a work-family intervention on employee reports of safety compliance and organizational citizenship behaviors in 30 healthcare facilities using a group-randomized trial. Based on Conservation of Resources theory and the Work-Home Resources Model, we hypothesized that implementing a work-family intervention aimed at increasing contextual resources via supervisor support for work and family and employee control over work time would lead to improved personal resources and increased employee performance on the job in the form of self-reported safety compliance and organizational citizenship behaviors. Multilevel analyses used survey data from 1,524 employees at baseline, 6-month and 12-month post-intervention follow-ups. Significant intervention effects were observed for safety compliance at the 6-month and organizational citizenship behaviors at the 12-month follow-ups. More specifically, results demonstrate that the intervention protected against declines in employee self-reported safety compliance and organizational citizenship behaviors, compared to employees in the control facilities. The hypothesized mediators of perceptions of family supportive supervisor behaviors, control over work time, and work-family conflict (work-to-family conflict, family-to-work conflict) were not significantly improved by the intervention. However, baseline perceptions of family supportive supervisor behaviors, control over work time, and work-family climate were significant moderators of the intervention effect on the self-reported safety compliance and organizational citizenship behavior outcomes. PMID:26348479

The Adaptation Process of Families with Children with Intellectual Disabilities in Catalonia

ERIC Educational Resources Information Center

Mas, Joana Maria; Giné, Climent; McWilliam, Robin A.

2016-01-01

The most important adaptation task that all families must undertake is the construction of a sustainable, meaningful, and congruent daily routine of family life (R. Gallimore, T. Weisner, L. Bernheimer, D. Guthrie, & K. Nihira, 1993). The aim of this mixed-method study was to understand, from the perspective of parents, how families adapt…

[Parental self-efficacy in family-centered early intervention].

PubMed

Sarimski, Klaus; Hintermair, Manfred; Lang, Markus

2012-01-01

Parental self-efficacy is seen as an important concern in family-centered early intervention. This article reports the data from 125 parents of young children with intellectual disabilities, hearing impairment or visual impairment. The relationship between parental self-efficacy, parental stress and several parent and child variables is analyzed. The results support the relevance of parental self-efficacy for parental coping. Some recommendations for promoting their experience of participation and partnership in early intervention services are discussed.

Translating the Social-Ecological Perspective Into Multilevel Interventions for Family Planning: How Far Are We?

PubMed

Schölmerich, Vera L N; Kawachi, Ichiro

2016-06-01

Scholars and practitioners frequently make recommendations to develop family planning interventions that are "multilevel." Such interventions take explicit account of the role of environments by incorporating multilevel or social-ecological frameworks into their design and implementation. However, research on how interventions have translated these concepts into practice in the field of family planning-and generally in public health-remains scarce. This article seeks to review the current definitions of multilevel interventions and their operationalization in the field of family planning. First, we highlight the divergent definitions of multilevel interventions and show the persistent ambiguity around this term. We argue that interventions involving activities at several levels but lacking targets (i.e., objectives) to create change on more than one level have not incorporated a social-ecological framework and should therefore not be considered as "multilevel." In a second step, we assess the extent to which family planning interventions have successfully incorporated a social-ecological framework. To this end, the 63 studies featured in Mwaikambo et al.'s systematic review on family planning interventions were reexamined. This assessment indicates that the multilevel or social-ecological perspective has seldom been translated into interventions. Specifically, the majority of interventions involved some form of activity at the community and/or organizational level, yet targeted and measured intrapersonal change as opposed to explicitly targeting/measuring environmental modification. © 2016 Society for Public Health Education.

Work participation and arthritis: a systematic overview of challenges, adaptations and opportunities for interventions.

PubMed

Hoving, Jan L; van Zwieten, Myra C B; van der Meer, Marrit; Sluiter, Judith K; Frings-Dresen, Monique H W

2013-07-01

Understanding the factors that play a role in maintaining people with inflammatory arthritis in the workforce may aid the design of interventions to support work participation. The objective of this systematic overview is to summarize qualitative studies that explore experiences of patients with inflammatory arthritis to remain employed or return to work. Bibliographic databases including MEDLINE, EMBASE and PsycInfo were searched until December 2011 to identify any qualitative studies that focused on experiences, challenges or adaptations of patients with inflammatory arthritis to remain employed. Thematic analyses were used to identify any first or higher order themes for which all data were entered into MAXQDA software. In addition, methodological quality was assessed using an eight-item checklist. Of 6338 citations, 10 studies were included. RA was the condition in eight studies. Individual interviews (six studies) were used more frequently than group interviews (four studies). Methodological quality varied from 2 to 8 points and had no effect on the number of themes identified. Thematic analyses showed seven key concepts important to patients, including disease symptoms, management of the disease, socioeconomic issues, work conditions and adaptations, emotional challenges, interpersonal issues affecting work and family life and meaning of work. By including studies from different countries and settings, we show a comprehensive overview of themes considered important by patients and strengthen our belief that these factors should be considered in interventions that aim to improve work participation for patients with inflammatory arthritis.

Targeting communication interventions to decrease oncology family caregiver burden

PubMed Central

Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

2012-01-01

Objectives The goal of this paper was to articulate and describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Data Sources Case studies of oncology family caregivers and hospice patients were selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Conclusion Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. Implications for Nursing Practice By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid patient, family, and team to best optimize all quality of life domains for patient as well as the lead family caregiver. PMID:23107184

Attachment-based interventions for families with young children.

PubMed

Woodhouse, Susan S

2018-05-21

Given a large body of research indicating links between child attachment and later mental health outcomes, interventions that promote children's secure attachment to their caregivers have the potential to contribute to prevention of psychopathology and promotion of well-being. A number of attachment-based interventions have been developed to support parents, enhance caregiving quality, and promote children's attachment security with the aim of improving children's mental health. There is now a growing evidence base to support the efficacy of a number of these interventions. The present literature review and introduction to the special issue on attachment-based interventions for families with young children describes key aspects of attachment theory and research that form the theoretical and empirical background for attachment-based interventions, and introduces seven case studies illustrating five different attachment-based interventions. The case studies represent a variety of attachment-based models, including both group and individual treatments, and show applications across a range of caregiver contexts. © 2018 Wiley Periodicals, Inc.

Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD).

PubMed

Beierlein, Volker; Bultmann, Johanna Christine; Möller, Birgit; von Klitzing, Kai; Flechtner, Hans-Henning; Resch, Franz; Herzog, Wolfgang; Brähler, Elmar; Führer, Daniel; Romer, Georg; Koch, Uwe; Bergelt, Corinna

2017-02-01

The concept of family functioning is gaining importance in psycho-oncology research and health care services. The Family Assessment Device (FAD) is a well-established measure of family functioning. Psychometric properties inherent in the German 51-item adaptation of the FAD are examined in different samples of families with parental cancer. Acceptance, reliability, and validity of FAD scales are analysed in samples from different study settings (N=1701 cancer patients, N=261 partners, N=158 dependent adolescent children 11 to 18years old). Missing items in the FAD scales (acceptance) are rare for adults (<1.1%) and adolescent children (<4.4%). In samples of adults and older adolescents (15 to 18years), all FAD scales except for the Roles scale are significantly reliable (0.75≤Cronbach's α≤0.88). The scales correlate highly (0.46≤Pearson's r≤0.59) with the criterion satisfaction with family life (convergent validity), and have smaller correlations (0.16≤r≤0.49) with measures of emotional distress and subjective well-being (divergent validity). In most FAD scales, adults seeking family counselling report worse family functioning (0.24≤Cohen's d≤0.59) than adults in other samples with parental cancer (discriminative validity). Overall, the German 51-item adaptation of the FAD reveals good acceptance, reliability, and validity for cancer patients and their relatives. Particularly the scale General Functioning shows excellent psychometric properties. The FAD is suitable in the assessment of families with parental cancer for adults and adolescents older than 11years. Copyright © 2016 Elsevier Inc. All rights reserved.

Key Elements of a Family Intervention for Schizophrenia: A Qualitative Analysis of an RCT.

PubMed

Grácio, Jaime; Gonçalves-Pereira, Manuel; Leff, Julian

2018-03-01

Schizophrenia is a complex biopsychosocial condition in which expressed emotion in family members is a robust predictor of relapse. Not surprisingly, family interventions are remarkably effective and thus recommended in current treatment guidelines. Their key elements seem to be common therapeutic factors, followed by education and coping skills training. However, few studies have explored these key elements and the process of the intervention itself. We conducted a qualitative and quantitative analysis of the records from a pioneering family intervention trial addressing expressed emotion, published by Leff and colleagues four decades ago. Records were analyzed into categories and data explored using descriptive statistics. This was complemented by a narrative evaluation using an inductive approach based on emotional markers and markers of change. The most used strategies in the intervention were addressing needs, followed by coping skills enhancement, advice, and emotional support. Dealing with overinvolvement and reframing were the next most frequent. Single-family home sessions seemed to augment the therapeutic work conducted in family groups. Overall the intervention seemed to promote cognitive and emotional change in the participants, and therapists were sensitive to the emotional trajectory of each subject. On the basis of our findings, we developed a longitudinal framework for better understanding the process of this treatment approach. © 2016 Family Process Institute.

Potential Mediators in Parenting and Family Intervention: Quality of Mediation Analyses

PubMed Central

Patel, Chandni C.; Fairchild, Amanda J.; Prinz, Ronald J.

2017-01-01

Parenting and family interventions have repeatedly shown effectiveness in preventing and treating a range of youth outcomes. Accordingly, investigators in this area have conducted a number of studies using statistical mediation to examine some of the potential mechanisms of action by which these interventions work. This review examined from a methodological perspective in what ways and how well the family-based intervention studies tested statistical mediation. A systematic search identified 73 published outcome studies that tested mediation for family-based interventions across a wide range of child and adolescent outcomes (i.e., externalizing, internalizing, and substance-abuse problems; high-risk sexual activity; and academic achievement), for putative mediators pertaining to positive and negative parenting, family functioning, youth beliefs and coping skills, and peer relationships. Taken as a whole, the studies used designs that adequately addressed temporal precedence. The majority of studies used the product of coefficients approach to mediation, which is preferred, and less limiting than the causal steps approach. Statistical significance testing did not always make use of the most recently developed approaches, which would better accommodate small sample sizes and more complex functions. Specific recommendations are offered for future mediation studies in this area with respect to full longitudinal design, mediation approach, significance testing method, documentation and reporting of statistics, testing of multiple mediators, and control for Type I error. PMID:28028654

Exploratory Evaluation and Initial Adaptation of a Parent Training Program for Hispanic Families of Children with Autism.

PubMed

Buzhardt, Jay; Rusinko, Lisa; Heitzman-Powell, Linda; Trevino-Maack, Sylvia; McGrath, Ashley

2016-03-01

The present paper takes a translational approach in applying the themes of the current special section to prevention and intervention science in Latino families. The paper reviews the current literature on cultural processes in prevention and intervention research with Latino families. Overall, many prevention and intervention programs have either been developed specifically for Latino families or have been modified for Latino families with great attention paid to the socio-cultural needs of these families. Nevertheless, few studies have tested the role of cultural values or acculturation processes on outcomes. We make recommendations based on findings within basic science and in particular this special section on the incorporation of these values and processes into prevention and intervention science with Latino families. © 2015 Family Process Institute.

Factors of caregiver burden and family functioning among Taiwanese family caregivers living with schizophrenia.

PubMed

Hsiao, Chiu-Yueh; Tsai, Yun-Fang

2015-06-01

To assess the degree of caregiver burden and family functioning among Taiwanese primary family caregivers of people with schizophrenia and to test its association with demographic characteristics, family demands, sense of coherence and family hardiness. Family caregiving is a great concern in mental illness. Yet, the correlates of caregiver burden and family functioning in primary family caregivers of individuals with schizophrenia still remain unclear. A cross-sectional descriptive study. A convenience sample of 137 primary family caregivers was recruited from two psychiatric outpatient clinics in Taiwan. Measures included a demographic information sheet and the Chinese versions of the Family Stressors Index, Family Strains Index, 13-item Sense of Coherence Scale, 18-item Caregiver Burden Scale, Family Hardiness Index and Family Adaptability, Partnership, Growth, Affection, and Resolve Index. Data analysis included descriptive statistics, Pearson's product-moment correlation coefficients, t-test, one-way analysis of variance and a stepwise multiple linear regression. Female caregivers, additional dependent relatives, increased family demands and decreased sense of coherence significantly increased caregiver burden, whereas siblings as caregivers reported lower degrees of burden than parental caregivers. Family caregivers with lower family demands, increased family hardiness and higher educational level had significantly enhanced family functioning. Sense of coherence was significantly correlated with family hardiness. Our findings highlighted the importance of sense of coherence and family hardiness in individual and family adaptation. Special attention needs to focus on therapeutic interventions that enhance sense of coherence and family hardiness, thereby improving the perception of burden of care and family functioning. Given the nature of family caregiving in schizophrenia, understanding of correlates of caregiver burden and family functioning would help

Adaptive Interventions and SMART Designs: Application to Child Behavior Research in a Community Setting

ERIC Educational Resources Information Center

Kidwell, Kelley M.; Hyde, Luke W.

2016-01-01

Heterogeneity between and within people necessitates the need for sequential personalized interventions to optimize individual outcomes. Personalized or adaptive interventions (AIs) are relevant for diseases and maladaptive behavioral trajectories when one intervention is not curative and success of a subsequent intervention may depend on…

Family Adaptation and Coping among Siblings of Cancer Patients, Their Brothers and Sisters, and Nonclinical Controls.

ERIC Educational Resources Information Center

Madan-Swain, Avi; And Others

1993-01-01

Examined coping and family adaptation in siblings (n=32) of cancer patients, their ill brothers and sisters (n=19), and control group of nonclinical children (n=10) with healthy siblings. Gender and age of sibling, birth order, and number of siblings were examined. Found better adaptation in larger families and decreased family involvement among…

The forgotten parent: Fathers' representation in family interventions to prevent childhood obesity.

PubMed

Davison, K K; Kitos, N; Aftosmes-Tobio, A; Ash, T; Agaronov, A; Sepulveda, M; Haines, J

2018-06-01

Despite recognition that parents are critical stakeholders in childhood obesity prevention, obesity research has overwhelmingly focused on mothers. In a recent review, fathers represented only 17% of parent participants in >600 observational studies on parenting and childhood obesity. The current study examined the representation of fathers in family interventions to prevent childhood obesity and characteristics of interventions that include fathers compared with those that only include mothers. Eligible studies included family-based interventions for childhood obesity prevention published between 2008 and 2015 identified in a recent systematic review. Data on intervention characteristics were extracted from the original review. Using a standardized coding scheme, these data were augmented with new data on the number of participating fathers/male caregivers and mothers/female caregivers. Out of 85 eligible interventions, 31 (37%) included mothers and fathers, 29 (34%) included only mothers, 1 (1%) included only fathers, and 24 (28%) did not provide information on parent gender. Of the interventions that included fathers, half included 10 or fewer fathers. Across all interventions, fathers represented a mere 6% of parent participants. Father inclusion was more common in interventions targeting families with elementary school-aged children (6-10 years) and those grounded in Ecological Systems Theory, and was less common in interventions focused on very young children (0-1 years) or the prenatal period and those targeting the sleep environment. This study emphasizes the lack of fathers in childhood obesity interventions and highlights a particular need to recruit and engage fathers of young children in prevention efforts. Copyright © 2018 Elsevier Inc. All rights reserved.

Preventing High-Risk Sexual Behavior in Early Adulthood with Family Interventions in Adolescence: Outcomes and Developmental Processes

PubMed Central

Caruthers, Allison S.; Van Ryzin, Mark J.; Dishion, Thomas J.

2013-01-01

Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up; FCU) were later assessed for the intervention’s effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N = 998 adolescents and their families) were randomly assigned to a family-centered intervention in 6th grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23% of the intervention families engaged in the FCU and approximately 18% engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Further, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed. PMID:23536124

Indicators of family resilience after the death of a child.

PubMed

Greeff, Abraham P; Vansteenwegen, Alfons; Herbiest, Tina

2011-01-01

The aim of this study was to identify and describe resilience qualities in families after losing a child. Questionnaires, including an open-ended question, were utilized to collect data independently from the parents and siblings of the deceased in 89 Belgian families. The results indicate that family strengths in general, and commitment to the family in particular, helped the families' adaptation after the loss. In addition, the adaptation process after the loss was aided if the family members viewed the crisis as a challenge. Both the siblings and the parents indicated that the extent to which a family experienced support from the community was directly related to family adaptation after the loss. Redefining the situation and utilizing social support from friends and family were underlined as effective family coping strategies. The findings could be used in interventions to promote family resilience, thereby affirming the reparative potential of families.

Family-centred approaches to healthcare interventions in chronic diseases in adults: a quantitative systematic review.

PubMed

Deek, Hiba; Hamilton, Sandra; Brown, Nicola; Inglis, Sally C; Digiacomo, Michelle; Newton, Phillip J; Noureddine, Samar; MacDonald, Peter S; Davidson, Patricia M

2016-05-01

Increasingly there is a focus on self-care strategies for both malignant and non-malignant conditions. Models of self-care interventions have focussed on the individual and less on the broader context of family and society. In many societies, decision-making and health seeking behaviours, involve family members. To identify elements of effective family-centred self-care interventions that are likely to improve outcomes of adults living with chronic conditions. Review paper. MEDLINE (Ovid), CINAHL, Academic Search Complete, PsychInfo and Scopus between 2000-2014. Quantitative studies targeting patient outcomes through family-centred interventions in adults were retrieved using systematic methods in January, 2015. Search terms used were: 'family', 'spouse', 'carer', 'caregiver', 'chronic', 'chronic disease', 'self-care', 'self-management' and 'self-efficacy'. Reference lists were reviewed. Risk of bias assessment was performed using the Cochrane Collaboration's tool. Data were reported using a narrative summary approach. Ten studies were identified. Improvements were noted in readmission rates, emergency department presentations, and anxiety levels using family-centred interventions compared with controls. Elements of effective interventions used were a family-centred approach, active learning strategy and transitional care with appropriate follow-up. Involving the family in self-care has shown some positive results for patients with chronic conditions. The benefits of family-centred care may be more likely in specific socio-cultural contexts. The review has year limits and further research needs to identify support for both the patients and family caregivers. © 2016 John Wiley & Sons Ltd.

Family Partner Intervention Influences Self-Care Confidence and Treatment Self-Regulation in Patients with Heart Failure

PubMed Central

Stamp, Kelly D.; Dunbar, Sandra B.; Clark, Patricia C.; Reilly, Carolyn M.; Gary, Rebecca A.; Higgins, Melinda; Ryan, Richard M

2015-01-01

Background Heart failure self-care requires confidence in one’s ability and motivation to perform a recommended behavior. Most self-care occurs within a family context, yet little is known about the influence of family on heart failure self-care or motivating factors. Aims To examine the association of family functioning and the self-care antecedents of confidence and motivation among heart failure participants and determine if a family partnership intervention would promote higher levels of perceived confidence and treatment self-regulation (motivation) at four and eight months compared to patient-family education or usual care groups. Methods Heart failure patients (N = 117) and a family member were randomized to a family partnership intervention, patient-family education or usual care groups. Measures of patient’s perceived family functioning, confidence, motivation for medications and following a low-sodium diet were analyzed. Data were collected at baseline, four and eight months. Results Family functioning was related to self-care confidence for diet (p=.02) and autonomous motivation for adhering to their medications (p=.05 and diet p=0.2). The family partnership intervention group significantly improved confidence (p=.05) and motivation (medications (p=.004; diet p=.012) at four months whereas patient-family education group and usual care did not change. Conclusion Perceived confidence and motivation for self-care was enhanced by family partnership intervention, regardless of family functioning. Poor family functioning at baseline contributed to lower confidence. Family functioning should be assessed to guide tailored family-patient interventions for better outcomes. PMID:25673525

The Healthy Children, Strong Families Intervention: Design and Community Participation

ERIC Educational Resources Information Center

Adams, Alexandra K.; LaRowe, Tara L.; Cronin, Kate A.; Prince, Ronald J.; Wubben, Deborah P.; Parker, Tassy; Jobe, Jared B.

2012-01-01

Healthy Children, Strong Families (HCSF) is a 2-year, community-driven, family-based randomized controlled trial of a healthy lifestyles intervention conducted in partnership with four Wisconsin American Indian tribes. HCSF is composed of 1 year of targeted home visits to deliver nutritional and physical activity curricula. During Year 1, trained…

By Design: Family-Centered, Interdisciplinary Preservice Training in Early Intervention.

ERIC Educational Resources Information Center

Whitehead, Amy; Ulanski, Betty; Swedeen, Beth; Sprague, Rae; Yellen-Shiring, Gail; Fruchtman, Amy; Pomije, Carrie; Rosin, Peggy

This training guide is a product of the Family-Centered Interdisciplinary Training Project in Early Intervention (Wisconsin), a project that is addressing the need for preservice training of professionals to serve infants, toddlers, and preschool children with disabilities and their families. The project is focused on students from the disciplines…

Computational model for behavior shaping as an adaptive health intervention strategy.

PubMed

Berardi, Vincent; Carretero-González, Ricardo; Klepeis, Neil E; Ghanipoor Machiani, Sahar; Jahangiri, Arash; Bellettiere, John; Hovell, Melbourne

2018-03-01

Adaptive behavioral interventions that automatically adjust in real-time to participants' changing behavior, environmental contexts, and individual history are becoming more feasible as the use of real-time sensing technology expands. This development is expected to improve shortcomings associated with traditional behavioral interventions, such as the reliance on imprecise intervention procedures and limited/short-lived effects. JITAI adaptation strategies often lack a theoretical foundation. Increasing the theoretical fidelity of a trial has been shown to increase effectiveness. This research explores the use of shaping, a well-known process from behavioral theory for engendering or maintaining a target behavior, as a JITAI adaptation strategy. A computational model of behavior dynamics and operant conditioning was modified to incorporate the construct of behavior shaping by adding the ability to vary, over time, the range of behaviors that were reinforced when emitted. Digital experiments were performed with this updated model for a range of parameters in order to identify the behavior shaping features that optimally generated target behavior. Narrowing the range of reinforced behaviors continuously in time led to better outcomes compared with a discrete narrowing of the reinforcement window. Rapid narrowing followed by more moderate decreases in window size was more effective in generating target behavior than the inverse scenario. The computational shaping model represents an effective tool for investigating JITAI adaptation strategies. Model parameters must now be translated from the digital domain to real-world experiments so that model findings can be validated.

Linking population, fertility, and family planning with adaptation to climate change: perspectives from Ethiopia.

PubMed

Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu

2013-09-01

Global climate change is felt disproportionately in the world's most economically disadvantaged countries. As adaption to an evolving climate becomes increasingly salient on national and global scales, it is important to assess how people at the local-level are already coping with changes. Understanding local responses to climate change is essential for helping countries to construct strategies to bolster resilience to current and future effects. This qualitative research investigated responses to climate change in Ethiopia; specifically, how communities react to and cope with climate variation, which groups are most vulnerable, and the role of family planning in increasing resilience. Participants were highly aware of changing climate effects, impacts of rapid population growth, and the need for increased access to voluntary family planning. Identification of family planning as an important adaptation strategy supports the inclusion of rights-based voluntary family planning and reproductive health into local and national climate change adaptation plans.

Implementation of a family intervention to increase fruit and vegetable intake: the Hi5+ experience.

PubMed

Harrington, Kathleen F; Franklin, Frank A; Davies, Susan L; Shewchuk, Richard M; Binns, Maria Brown

2005-04-01

Family is an important, yet challenging, target for dietary intervention. This article describes the implementation of Hi5+, a family fruit and vegetable (FV) promotion program. Complementing a fourth-grade school curriculum, the seven weekly Family Fun Nites were at-home family meal sharing and game evenings. A sample of families (N = 575; 69% consented) from schools in a southeastern U.S. urban area received tailored intervention materials based on their FV attitudes and family interaction styles. A pyramidal organizational design, using peer leaders, facilitated 71% of families to complete all seven sessions, whereas 84% completed at least one session. Significant independent predictors of program completion were attending an introductory Kick-Off Nite, interactive family style, additional adults in the household, married parents, being African American, earning more than 60,000 dollars, and additional children in the household. Family-specific issues and initial program experience are important considerations for implementing a family intervention.

Resilience as Regulation of Developmental and Family Processes

PubMed Central

MacPhee, David; Lunkenheimer, Erika; Riggs, Nathaniel

2015-01-01

Resilience can be defined as establishing equilibrium subsequent to disturbances to a system caused by significant adversity. When families experience adversity or transitions, multiple regulatory processes may be involved in establishing equilibrium, including adaptability, regulation of negative affect, and effective problem-solving skills. The authors’ resilience-as-regulation perspective integrates insights about the regulation of individual development with processes that regulate family systems. This middle-range theory of family resilience focuses on regulatory processes across levels that are involved in adaptation: whole-family systems such as routines and sense of coherence; coregulation of dyads involving emotion regulation, structuring, and reciprocal influences between social partners; and individual self-regulation. Insights about resilience-as-regulation are then applied to family-strengthening interventions that are designed to promote adaptation to adversity. Unresolved issues are discussed in relation to resilience-as-regulation in families, in particular how risk exposure is assessed, interrelations among family regulatory mechanisms, and how families scaffold the development of children’s resilience. PMID:26568647

Interventions to Reduce Harm from Smoking with Families in Infancy and Early Childhood: A Systematic Review

PubMed Central

Brown, Nicola; Luckett, Tim; Davidson, Patricia M.; Di Giacomo, Michelle

2015-01-01

Exposure to adult smoking can have deleterious effects on children. Interventions that assist families with smoking cessation/reduction and environmental tobacco smoke (ETS) avoidance can improve child health outcomes and reduce the risk of smoking initiation. The purpose of this review was to describe the state of the science of interventions with families to promote smoke-free home environments for infants and young children, including parent smoking reduction and cessation interventions, ETS reduction, and anti-smoking socialisation interventions, using the socio-ecological framework as a guide. A systematic review of peer-reviewed articles identified from journal databases from 2000 to 2014 was undertaken. Of 921 articles identified, 28 were included in the review. Considerable heterogeneity characterised target populations, intervention types, complexity and intensity, precluding meta-analysis. Few studies used socio-ecological approaches, such as family theories or concepts. Studies in early parenthood (child age newborn to one year) tended to focus on parent smoking cessation, where studies of families with children aged 1–5 years were more likely to target household SHSe reduction. Results suggest that interventions for reduction in ETS may be more successful than for smoking cessation and relapse prevention in families of children aged less than 5 years. There is a need for a range of interventions to support families in creating a smoke free home environment that are both tailored and targeted to specific populations. Interventions that target the social and psychodynamics of the family should be considered further, particularly in reaching vulnerable populations. Consideration is also required for approaches to interventions that may further stigmatise families containing smokers. Further research is required to identify successful elements of interventions and the contexts in which they are most effective. PMID:25785496

Family check-up effects across diverse ethnic groups: reducing early-adolescence antisocial behavior by reducing family conflict.

PubMed

Smith, Justin D; Knoble, Naomi B; Zerr, Argero A; Dishion, Thomas J; Stormshak, Elizabeth A

2014-01-01

Multicultural responsiveness and adaptation have been a recent area of emphasis in prevention and intervention science. The changing demographics of the United States demand the development of intervention strategies that are acceptable and effective for diverse cultural and ethnic groups. The Family Check-Up (FCU) was developed to be an intervention framework that is flexible and adaptive to diverse cultural groups (Dishion & Stormshak, 2007 ). We empirically evaluated the extent to which the intervention is effective for improving youth adjustment and parent-child interactions for diverse cultural groups. A sample of 1,193 families was drawn from 2 large-scale randomized prevention trials conducted in diverse urban middle schools. We formulated 3 groups on the basis of youth self-identification of ethnicity (European American, African American, Hispanic) and examined group differences in the hypothesized mediating effect of family conflict (FC) on later antisocial behavior (ASB). Path analysis revealed that youths in the intervention condition reported significantly less ASB over a 2-year period (Grades 6-8). Moreover, youth-reported reductions in FC at 12 months were an intervening effect. Ethnicity did not moderate this relationship. Consistent with one of the primary tenets of coercion theory, participation in the FCU acts on ASB through FC across diverse ethnic groups, lending support to the multicultural competence of the model. Limitations of this study are discussed, along with areas for future research.

The influence of family adaptability and cohesion on anxiety and depression of terminally ill cancer patients.

PubMed

Park, Young-Yoon; Jeong, Young-Jin; Lee, Junyong; Moon, Nayun; Bang, Inho; Kim, Hyunju; Yun, Kyung-Sook; Kim, Yong-I; Jeon, Tae-Hee

2018-01-01

This study investigated the effect of family members on terminally ill cancer patients by measuring the relationship of the presence of the family caregivers, visiting time by family and friends, and family adaptability and cohesion with patient's anxiety and depression. From June, 2016 to March, 2017, 100 terminally ill cancer patients who were admitted to a palliative care unit in Seoul, South Korea, were surveyed, and their medical records were reviewed. The Korean version of the Family Adaptability and Cohesion Evaluation Scales III and Hospital Anxiety-Depression Scale was used. Chi-square and multiple logistic regression analyses were used. The results of the chi-square analysis showed that the presence of family caregivers and family visit times did not have statistically significant effects on anxiety and depression in terminally ill cancer patients. In multiple logistic regression, when adjusted for age, sex, ECOG PS, and the monthly average income, the odds ratios (ORs) of the low family adaptability to anxiety and depression were 2.4 (1.03-5.83) and 5.4 (1.10-26.87), respectively. The OR of low family cohesion for depression was 5.4 (1.10-27.20) when adjusted for age, sex, ECOG PS, and monthly average household income. A higher family adaptability resulted in a lower degree of anxiety and depression in terminally ill cancer patients. The higher the family cohesion, the lower the degree of depression in the patient. The presence of the family caregiver and the visiting time by family and friends did not affect the patient's anxiety and depression.

Adapting the SLIM diabetes prevention intervention to a Dutch real-life setting: joint decision making by science and practice.

PubMed

Jansen, Sophia C; Haveman-Nies, Annemien; Duijzer, Geerke; Ter Beek, Josien; Hiddink, Gerrit J; Feskens, Edith J M

2013-05-08

Although many evidence-based diabetes prevention interventions exist, they are not easily applicable in real-life settings. Moreover, there is a lack of examples which describe the adaptation process of these interventions to practice. In this paper we present an example of such an adaptation. We adapted the SLIM (Study on Lifestyle intervention and Impaired glucose tolerance Maastricht) diabetes prevention intervention to a Dutch real-life setting, in a joint decision making process of intervention developers and local health care professionals. We used 3 adaptation steps in accordance with current adaptation frameworks. In the first step, the elements of the SLIM intervention were identified. In the second step, these elements were judged for their applicability in a real-life setting. In the third step, adaptations were proposed and discussed for those elements which were deemed not applicable. Participants invited for this process included intervention developers and local health care professionals (n=19). In the first adaptation step, a total of 22 intervention elements were identified. In the second step, 12 of these 22 intervention elements were judged as inapplicable. In the third step, a consensus was achieved for the adaptations of all 12 elements. The adapted elements were in the following categories: target population, techniques, intensity, delivery mode, materials, organisational structure, and political and financial conditions. The adaptations either lay in changing the SLIM protocol (6 elements) or the real-life working procedures (1 element), or a combination of both (4 elements). The positive result of this study is that a consensus was achieved within a relatively short time period (nine months) between the developers of the SLIM intervention and local health care professionals on the adaptations needed to make SLIM applicable in a Dutch real-life setting. Our example shows that it is possible to combine the perspectives of scientists and

Return on Investment of a Work-Family Intervention: Evidence From the Work, Family, and Health Network.

PubMed

Barbosa, Carolina; Bray, Jeremy W; Dowd, William N; Mills, Michael J; Moen, Phyllis; Wipfli, Brad; Olson, Ryan; Kelly, Erin L

2015-09-01

To estimate the return on investment (ROI) of a workplace initiative to reduce work-family conflict in a group-randomized 18-month field experiment in an information technology firm in the United States. Intervention resources were micro-costed; benefits included medical costs, productivity (presenteeism), and turnover. Regression models were used to estimate the ROI, and cluster-robust bootstrap was used to calculate its confidence interval. For each participant, model-adjusted costs of the intervention were $690 and company savings were $1850 (2011 prices). The ROI was 1.68 (95% confidence interval, -8.85 to 9.47) and was robust in sensitivity analyses. The positive ROI indicates that employers' investment in an intervention to reduce work-family conflict can enhance their business. Although this was the first study to present a confidence interval for the ROI, results are comparable with the literature.

Family-Based Interventions for Child and Adolescent Disorders

ERIC Educational Resources Information Center

Kaslow, Nadine J.; Broth, Michelle Robbins; Smith, Chaundrissa Oyeshiku; Collins, Marietta H.

2012-01-01

Emotional and behavioral symptoms and disorders are prevalent in children and adolescents. There has been a burgeoning literature supporting evidence-based treatments for these disorders. Increasingly, family-based interventions have been gaining prominence and demonstrating effectiveness for myriad childhood and adolescent disorders. This article…

Early intervention services of children with physical disabilities: complexity of child and family needs.

PubMed

Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline

2014-04-01

To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future. © 2013 Occupational Therapy Australia.