This article provides an introduction to the special issue on intervention development and cultural adaptation research with diverse families. The need for research on intervention development and on cultural adaptation of interventions is presented, followed by a discussion of frameworks on treatment development. Seven articles included in this special issue serve as examples of the stages of treatment and intervention development, and of the procedures employed in the cultural adaptation with diverse families. An overview of the seven articles is provided to illustrate the treatment development process and the use of pluralistic research methods. We conclude with a call to the field for creative and innovative intervention development research with diverse families to contribute to the body of evidence-based practice with these populations. PMID:16768015
Kumpfer, Karol; Magalhães, Catia; Xie, Jing
Family evidence-based interventions (FEBIs) are effective in creating lasting improvements and preventing children's behavioral health problems, even in genetically at-risk children. Most FEBIs, however, were designed for English-speaking families. Consequently, providers have difficulty engaging non-English-speaking populations in their own country or in other countries where the content, language, and recruitment methods of the FEBIs do not reflect their culture. The practical solution has been to culturally adapt existing FEBIs. Research suggests this can increase family engagement by about 40 %. This article covers background, theory, and research on FEBIs and the need to engage more diverse families. Steps for culturally adapting FEBIs with fidelity are presented based on our own and local implementers' experiences in 36 countries with the Strengthening Families Program. These steps, also previously recommended by a United Nations Office on Drugs and Crime panel of experts in family skills interventions, include: (1) creating a cultural advisory group, (2) assessing specific needs of cultural subgroups, (3) language translation, (4) hiring implementers from the culture, (5) developing culturally adapted training systems, (6) making cultural adaptations cautiously during repeated delivery, (7) continuous implementation quality and outcome evaluation to assure effectiveness in comparison with the original FEBI, (8) developing local and international dissemination partnerships, and (9) securing funding support for sustainability. Future efficacy trials should compare existing FEBIs to culturally adapted versions to determine comparative cost effectiveness.
Dumas, Jean E.; Arriaga, Ximena; Begle, Angela Moreland; Longoria, Zayra
This paper describes the Spanish adaptation of PACE--"Parenting Our Children to Excellence." Successfully offered in preschools and daycare centers since 2002, PACE is a research-based preventive intervention to support families in their parenting task through discussions and activities that address practical childrearing issues and promote child…
Stormshak, Elizabeth A.; Connell, Arin M.; Veronneau, Marie-Helene; Myers, Michael W.; Dishion, Thomas J.; Kavanagh, Kathryn; Caruthers, Allison S.
This study examined the impact of the Family Check-Up (FCU) and linked intervention services on reducing health-risk behaviors and promoting social adaptation among middle school youth. A total of 593 students and their families were randomly assigned to receive either the intervention or middle school services as usual. Forty-two percent of…
Saint-Laurent, Lise; Giasson, Jocelyne
This article reports on the effects of a family literacy program for first graders that had three main characteristics: (1) book reading with parents that adapts parental intervention to the child's gradually increasing skills in reading during the school year, (2) support for writing activities, and (3) enjoyable home activities complementing the…
Casacchia, Massimo; Roncone, Rita
In Italy, as in many countries, relatives are closely involved in caring for persons with physical and mental disorders. The Italian scenario lends itself to routine involvement of family members in psychiatric treatment because, despite becoming smaller and smaller, Italian families keep close ties, and men and women do not leave the parental home until relatively late. The authors describe the impact of international family psychosocial research on the Italian mental health services (MHSs) and the main psychosocial interventions currently in use, including family psychoeducational interventions and the "Milan family therapy approach." They also highlight the contribution Italian researchers have given to the study of important variables in integrated mental disorder care, such as family burden of care, relatives' attitudes, family functioning, and satisfaction with the MHSs. Finally, they discuss the difficulties of implementing and disseminating family interventions within the Italian MHS, despite the growing evidence of their effectiveness.
Dumas, Jean E.; Arriaga, Ximena; Begle, Angela Moreland; Longoria, Zayra
This paper describes the Spanish adaptation of PACE—Parenting Our Children to Excellence. Successfully offered in preschools and daycare centers since 2002, PACE is a research-based preventive intervention to support families in their parenting task through discussions and activities that address practical childrearing issues and promote child coping-competence. Developed in response to community calls, the new program is known as CANNE –Criando a Nuestros Niños hacia el Éxito. The paper makes the processes linking original and adapted versions explicit by accounting for the conceptual and practical decisions that were made as CANNE was being developed. We begin by summarizing the challenges of adapting and translating a behavioral intervention, and by describing the coping-competence model that informs both versions of the program. We turn then to a detailed account of the adaptation itself and of its results. Specifically, we describe: (a) the consultation process at the origin of this adaptation, (b) the adaptation of the manual and the steps taken to establish the extent to which the English and Spanish versions correspond (adaptation fidelity), and (c) the translation of the manual and the cross-language comparison of measures to demonstrate that they yield comparable data when administered in English and Spanish. PMID:20607140
Kim, Sun S; Kim, Seong-Ho; Fang, Hua; Kwon, Simona; Shelley, Donna; Ziedonis, Douglas
Background Korean men and women have the highest current smoking rates across all Asian ethnic subgroups in the United States. Methods This is a 2-arm randomized controlled study of a culturally adapted smoking cessation intervention. The experimental condition received eight weekly 40-minute individualized counseling sessions that incorporated Korean-specific cultural elements, whereas the control condition received eight weekly 10-minute individualized counseling sessions that were not culturally adapted. All participants also received nicotine patches for 8 weeks. Results One-hundred nine Korean immigrants (91 men and 18 women) participated in the study. The rate of biochemically verified 12-month prolonged abstinence was significantly higher for the experimental condition than the control condition (38.2% vs. 11.1%, χ2 = 10.7, p < 0.01). Perceived family norm significantly mediated the effect of cessation intervention on abstinence. Discussion Smoking cessation intervention for Korean Americans should be culturally adapted and involve family members to produce a long-term treatment effect. PMID:24878686
Pharoah, Fiona; Mari, Jair; Rathbone, John; Wong, Winson
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
Davey, Maureen P; Kissil, Karni; Lynch, Laura; Harmon, La-Rhonda; Hodgson, Nancy
Prior clinical research supports the effectiveness of cancer support groups for cancer patients and their families, yet African-American families continue to be underrepresented in cancer support groups and in cancer clinical research studies. In order to fill this gap, we developed and evaluated a culturally adapted family support group for African-American families coping with parental cancer. We encountered unexpected challenges in overcoming barriers to recruitment, partnering with oncology providers, and building trust with the African-American community and African-American families coping with parental cancer. We describe actions taken during the two phases of this study and lessons learned along the way about recruiting and engaging African-American families in cancer support group studies, partnering with oncology providers, networking with the African-American community, and the importance of demonstrating cultural sensitivity to overcome the understandable historical legacy of mistrust.
Campbell, Thomas L.
As we begin to understand the relationships between family interaction and physical health, we can develop interventions that focus on education, support, and problem solving. The author reviews existing research on family interventions in physical health and proposes guidelines for developing, implementing, and studying family interventions. PMID:21229055
Jack, S. M.; Catherine, N.; Gonzalez, A.; MacMillan, H. L.; Sheehan, D.; Waddell, C.
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
López-Larrosa, Silvia; González-Seijas, Rosa M; Carpenter, John S W
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.
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
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
Keiley, Margaret K; Zaremba-Morgan, Ali; Datubo-Brown, Christiana; Pyle, Raven; Cox, Milira
The multiple-family group intervention is an effective, yet affordable, 8-week treatment that is conducted in a juvenile correctional institution in Alabama with adolescents who sexually offend and their families. Data from 115 incarcerated male adolescents and their male and female caregivers collected at pre-, post-, and 1-year follow-up were used to determine that problem behaviors (internalizing, externalizing) decreased over pre- and posttest and the significant decreases in maladaptive emotion regulation predicted those changes. Adolescent-reported anxiety over abandonment and attachment dependence on parents increased significantly; these changes were predicted by decreases in maladaptive emotion regulation. Linear growth models were also fit over the 3 time points and indicate decreases in adolescent problem behavior and maladaptive emotion regulation.
Wootton, Ray W.
A special demonstration project attempted to find means of assisting hard-core multi-problem families in a predominantly rural Idaho county. A single agency was formed to coordinate community activities and provide a variety of services for the needs of the total family. Project personnel included a director, social worker, home economist, public…
de Montigny, F
The author presents a care plan based upon Sister Callista Roy's conceptual model, that is recognized as well suited to the family system. This, the first of two-part series, focuses on the first two steps of the care plan--the theoretical and practical aspects of data collection and data analysis. The subjects are a single mother and her son. During the first level of evaluation of the family system, the nurse observes and explores the family system's behavior as well as that of each of the family members using the four modes of adaptation: physiological needs, self-concept, role function, and interdependence relations. During the second level of evaluation, the nurse identifies observed and reported stimuli or factors within the family environment that influence observed behaviors. During the data analysis, the nurse determines if the reported or observed behaviors are adaptive or non-adaptive toward maintaining the bio-psycho-social integrity of the family. The nurse also determines if the behaviors allow for achievement of identified goals. The nurse establishes links between the behaviors and the stimuli, classes and organizes the findings, and formulates an appropriate nursing care plan. Next month's article will focus on the planning, implementation and evaluation of the nursing care plan. It will focus equally on the ways in which the nurse can facilitate the family's adaptation.
Antonovsky, Aaron; Sourani, Talma
Administered family Sense of Coherence (SOC) scale to 60 married Israeli males who were disabled by injury or illness and to their spouses. Data provide strong support for hypothesis that strength of SOC would be associated with adaptation, and showed considerable degree of consensus among spouses. (Author/NB)
Ortega, Enrique; Giannotta, Fabrizia; Latina, Delia; Ciairano, Silvia
Background: The family context has proven to be a useful target in which to apply prevention efforts aimed at child and adolescent health risk behaviors. There are currently a variety of cultural adaptation models that serve to guide the international adaptation of intervention programs. Objective: The cultural adaptation process and program…
Belcher, John R.; Peckuonis, Edward V.; Deforge, Bruce R.
Social capital has been extensively discussed in the literature as building blocks that individuals and communities utilize to leverage system resources. Similarly, some families also create capital, which can enable members of the family, such as children, to successfully negotiate the outside world. Families in poverty confront serious…
Alderfer, Melissa A
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.
Thompson, Ronald W.; Koley, Sarah
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…
Shields, Cleveland G.; Finley, Michelle A.; Chawla, Neelu
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…
Anderson, Patricia S.; And Others
This guide documents cost effective methods of providing community-based alternative court intervention services to youth. The service program was designed to assist adolescent status offenders and their families in resolving the underlying problems which bring the youths to the attention of the juvenile system. A Family Crisis Intervention Center…
de Shazer, Steve; Molnar, Alex
Describes four interventions in brief family therapy, illustrated by case examples. Interventions are aimed at helping clients solve problems, and three assumptions about the nature of change are described. Results of these interventions suggest there is no clinical distinction between clients' perceived change and observed change. (JAC)
Gaudin, James M., Jr.
To identify remedial and preventive interventions that target dysfunctional processes in the family, this study compared the structure and processes of neglectful and non-neglectful families. A sample of 102 neglectful families was identified and recruited from the caseloads of protective service workers in Georgia. A comparison group of 103…
Debarger, Angela Haydel; Choppin, Jeffrey; Beauvineau, Yves; Moorthy, Savitha
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…
Fareo, Dorcas Oluremi
All couples look forward to having normal healthy babies. The issues of disabilities in their children shake the families and serve as sources of severe psychological disruption to family adjustment. The parents of such children live with many difficult issues and frequently experience trauma, grief and stress. This article deals with counselling…
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
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.
Raspa, Melissa; Bailey, Donald, Jr.; Bann, Carla; Bishop, Ellen
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…
Pedersen, Anita L; Crnic, Keith A; Baker, Bruce L; Blacher, Jan
This study explores accurate conceptualization of the adaptation construct in families of children with developmental delay aged 3 to 8 years. Parents' self-reported measures of adaptation and observed dyadic relationship variables were examined. Confirmatory factor analysis and longitudinal growth modeling were used to evaluate the nature of adaptational processes. Results indicate that adaptational processes vary across adaptation index, child developmental level, and parent gender. Adaptation indices did not load onto a single construct at any time point. Several adaptational processes remained stable across time, although others showed linear or quadratic change. The findings of the current study indicate that it is time for a change in how adaptation is conceived for families of children with developmental delay.
Weine, Stevan Merrill
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.
WEINE, STEVAN MERRILL
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
Gill, Anne M.; Hyde, Luke W.; Shaw, Daniel S.; Dishion, Thomas J.; Wilson, Melvin N.
This article describes a case study in the use of the Family Check-Up (FCU), a family-based and ecological preventive intervention for children at risk for problem behavior. The FCU is an assessment-driven intervention that utilizes a health maintenance model; emphasizes motivation for change; and offers an adaptive, tailored approach to…
Fosco, Gregory M.; Dishion, Thomas J.
This study examined outcomes associated with the Family Check-Up (FCU), an adaptive, tailored, family-centered intervention to enhance positive adjustment of middle school youth and prevent problem behavior. The FCU intervention model was delivered to families in 3 public middle schools. The study sample comprised 377 families, and participants were randomly assigned to receive either the intervention or school as usual. Participation in the intervention was relatively high, with 38% of the families receiving the FCU. Participation in the intervention improved youth self-regulation over the 3 years of the study. Self-regulation skills, defined as effortful control, predicted both decreased depression and increased school engagement in high school, with small to medium effect sizes. The results have implications for the delivery of mental health services in schools that specifically target family involvement and parenting skills. PMID:20495673
de Montigny, F
Last month, the author presented the first two steps necessary in the development of a nursing care plan. This care plan utilized Sister Callista Roy's conceptual model and was designed to evaluate the family system. The readers became familiar with the Joly family, whose family system was evaluated (this included Diane and Jessie). Analysis of the collected data identified two nursing diagnoses and the author explained the way that nursing diagnosis is derived. The first identified nursing diagnosis revealed a threat to the beneficiary, the second diagnosis revealed a threat to the family system. This second article is devoted to the three other steps involved in the development of a nursing care plan that will assist the nurse in developing a systematic strategy in caring for this type of family. The planning step consists of the identification of objectives for care. These objectives must be specific, measurable and realistic as well as able to answer the question: "What changes are intended for this family?" Suggestions are offered for objective development. Once the objectives are finalized, the nurse chooses pertinent and realistic interventions that permit her/him, as well as Diane, to attain the identified objectives. The nurse's interventions are centred around stimuli that are increased, decreased or maintained by the goal of modifying or reinforcing observed behaviors. In the care plan example developed for the Joly family, the identified interventions are not all inclusive and serve as suggestions. During the course of the interventions the nurse must constantly readjust and adapt the interventions to fit with changing needs.(ABSTRACT TRUNCATED AT 250 WORDS)
Dykens, Elisabeth M.
Purpose of review Developmental disabilities are increasingly recognized, and remarkable progress is being made on the genetic and neurobiological underpinnings of many disorders. Yet, only a tiny percentage of the disability literature addresses families of children with disabilities. A review of recently published family studies reveals salient trends and gaps. Recent findings Consistent with previous work, high levels of parent stress, illness, anxiety, and depression are apparent. Studies in the USA focused on parents of children with autism; in contrast, studies on parents of children with intellectual disabilities were almost always conduced abroad. Compared to other disabilities, families of children with psychiatric disorders and genetic syndromes are understudied. The majority of family studies are descriptive, with very few trials or interventions aimed at reducing parental stress. Of these, mindfulness practices and a peer-mentor model of treatment delivery hold much promise for effective stress reduction. Psychoeducational programs and respite care are differentially beneficial. Summary A new era of family intervention research is in order. This work can take advantage of many advances in telemedicine, peer-mentor models, smart technology, and biomarkers as indices of change. Benefit could also stem from group interventions with parents who share similar concerns, regardless of their child’s diagnostic label. PMID:25594421
Diamond, G; Siqueland, L
Looking at the field as a whole through metaanalysis, Shadish et al concluded (based on 162 studies) that marital and family therapies were significantly more effective than no treatment and at least as effective as other forms of psychotherapy. Although these reviews and others are positive, individual studies raise many questions. For instance, based on research findings, family treatments increasingly have become standard care for patients with schizophrenia. It remains unclear what degree and type of family involvement is needed for which patients at which stage of their disorder. In the area of anxiety and depression, there are too few studies to make any strong conclusion. Although investigators such as Barrett, Cobham, and Diamond have produced some positive results, the Lewinsohn and Clark studies fail to demonstrate the added benefit of family involvement. Although Brent's study showed CBT to reduce depression faster, family therapy and supportive therapy did just as well in the long run, and family conflict was a strong risk factor for relapse. In the area of anorexia, Russell and Robins produced strong results from family interventions, whereas Geist found no difference between different types of family interventions. Family treatments for obesity have been inconsistent. In a metaanalysis of 41 studies, parental involvement did not contribute significantly to outcomes. In the Epstein study, however, which included 5- and 10-year follow-up, the results of family intervention were impressive. Although many of these studies can be cited for various methodologic flaws, the most consistent problem is that sample sizes are too small to detect difference between two or more active treatments. The most consistent findings (and most well-done, large studies) that support the efficacy of family-based interventions are done with externalizing problems. Work groups led by Patterson, Eisenstadt, Webster-Stratton, Alexander, and Henggeler all have produced impressive
Duncan, Larissa G.; Coatsworth, J. Douglas; Greenberg, Mark T.
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…
McFarlane, William R
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.
Muehler, Konrad; Bade, Ragnar; Preim, Bernhard
We describe scripting facilities to create medical animations for intervention planning based on medical volume data and derived segmentation information. A data independent scripting language has been developed to separate animation scripts from imaging data. The scripting facilities are adaptive and allow to reuse one script to create animations for many different patients. With expressive animations, we support the individual planning process, the preoperative documentation as well as discussions between medical doctors, for example in a tumor board. We also discuss the enhancement of interactive explorations with animations generated on the fly.
Kumpfer, Karol L.; Xie, Jing; O'Driscoll, Robert
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…
Moore, Barbara C.
Objective: This article selectively reviews evidence-based family and peer interventions for co-occurring mental illness and substance use disorders. Although few researchers have specifically investigated family interventions for dual disorders, considerable empirical evidence exists for the effectiveness of such interventions in treating each of…
Morrison, Diane M; Hoppe, Marilyn J; Gillmore, Mary Rogers; Kluver, Carisa; Higa, Darrel; Wells, Elizabeth A
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 and adaptations necessary to make the intervention relevant to the culture and circumstances of participants. This article discusses issues that arise during the course of replication, with illustrations from a replication to test the efficacy of an HIV prevention intervention for youth, using a randomized controlled design. Analysis of the issues raised leads us to suggest that a "science of replication" needs to be developed.
Marsiglia, Flavio F.; Booth, Jamie M.
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…
Valdez, Avelardo; Cepeda, Alice; Parrish, Danielle; Horowitz, Rosalind; Kaplan, Charles
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…
Kumpfer, Karol L; Johnson, Jeannette L
The scientific literature consistently reports that while children of substance abusers may be at biological, psychological, or environmental risk, the effects of these risks can be abbreviated through the use of effective interventions and treatments. Research has consistently demonstrated reductions in family and child dysfunction when effective family intervention programs are consistently utilized. While a number of effective family-based approaches have been developed and evaluated, only a few have been designed specifically for children of substance abusing parents. Just two have been tested in randomized control trials -The Streghtening Families Program and Focus on the Family. The Streghtening Families Program has demonstrated statistically significant reductions in family and child dysfunctions across several ethnocultural groups when consistently utilized. Clinical and advanced graduate programs should stress training in these evidence-based practices as well as how to adapt these models to be more culturally sensitive and age or gender appropriate in order to serve a growing and needy population of families.
Russell, Candyce S.
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)
Morrison, Diane M.; Hoppe, Marilyn J.; Gillmore, Mary Rogers; Kluver, Carisa; Higa, Darrel; Wells, Elizabeth A.
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…
Barrera, Manuel, Jr.; Castro, Felipe G.; Strycker, Lisa A.; Toobert, Deborah J.
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 article are to (a) describe…
Active family involvement and important family roles in the early intervention to preschool transition have been mandated by laws, recognized by the position statements of professional organizations, and validated through evidence-based research. In order to involve families in this process, reduce stresses, and conquer the challenges families may…
Collins, Kathryn S; Strieder, Frederick H; DePanfilis, Diane; Tabor, Maureen; Freeman, Pamela A Clarkson; Linde, Linnea; Greenberg, Patty
Families living in urban poverty, enduring chronic and complex traumatic stress, and having difficulty meeting their children's basic needs have significant child maltreatment risk factors. There is a paucity of family focused, trauma-informed evidence-based interventions aimed to alleviate trauma symptomatology, strengthen family functioning, and prevent child abuse and neglect. Trauma Adapted Family Connections (TA-FC) is a manualized trauma-focused practice rooted in the principles of Family Connections (FC), an evidence supported preventive intervention developed to address the glaring gap in services for this specific, growing, and underserved population. This paper describes the science based development of TA-FC, its phases and essential components, which are based on theories of attachment, neglect, trauma, and family interaction within a comprehensive community-based family focused intervention framework.
Watson, Donnie W.; Mouttapa, Michele; Reiber, Chris; McCuller, William Jason; Arancibia, Ruben; Kavich, Julia A.; Nieves, Elena; Novgrod, Judith; Mai, Noemi; Bisesi, Lorrie; Sim, Tiffanie
A non-randomized control trial was conducted to assess the feasibility and efficacy of the Life Interventions for Family Effectiveness (LIFE) project: a family-based, evidence-based comprehensive substance abuse intervention for at-risk adolescents and their families. The Matrix Adolescent Treatment Model of program delivery was utilized in the…
Duhamel, Fabie; Dupuis, France; Reidy, Mary; Nadon, Nathalie
Congestive heart failure is a major source of anxiety for both patients and their family. This article presents the results of a qualitative case study aimed at evaluating family nursing interventions from the perspective of the family members and a clinical nurse specialist (CNS). A CNS applied a family nursing intervention program with 4 couples. Data were obtained through semistructured interviews preintervention and postintervention for the couples and postintervention for the CNS. The transcripts of the interviews were submitted for content analysis. For the couples, results show both spouses subject to a high level of suffering, which can be alleviated through a family nursing meeting that allows them to obtain a better understanding of each other's experience. For the CNS, family interventions were considered a privilege since they helped relieve suffering and her own feelings of powerlessness. These results have the potential to improve family nursing interventions and enhance CNS practice.
Beardslee, William R; Klosinski, Lee E; Saltzman, William; Mogil, Catherine; Pangelinan, Susan; McKnight, Carl P; Lester, Patricia
In response to the needs of military families confronting the challenges of prolonged war, we developed Families OverComing Under Stress (FOCUS), a multi-session intervention for families facing multiple deployments and combat stress injuries adapted from existing evidence-based family prevention interventions (Lester et al. in Mil Med 176(1): 19-25, 2011). In an implementation of this intervention contracted by the US Navy Bureau of Medicine and Surgery (BUMED), FOCUS teams were deployed to military bases in the United States and the Pacific Rim to deliver a suite of family-centered preventive services based on the FOCUS model (Beardslee et al. in Prev Sci 12(4): 339-348, 2011). Given the number of families affected by wartime service and the changing circumstances they faced in active duty and veteran settings, it rapidly became evident that adaptations of this approach for families in other contexts were needed. We identified the core elements of FOCUS that are essential across all adaptations: (1) Family Psychological Health Check-in; (2) family-specific psychoeducation; (3) family narrative timeline; and (4) family-level resilience skills (e.g., problem solving). In this report, we describe the iterative process of adapting the intervention for different groups of families: wounded, ill, and injured warriors, families with young children, couples, and parents. We also describe the process of adopting this intervention for use in different ecological contexts to serve National Guard, Reserve and veterans, and utilization of technology-enhanced platforms to reach geographically dispersed families. We highlight the lessons learned when faced with the need to rapidly deploy interventions, adapt them to the changing, growing needs of families under real-world circumstances, and conduct rigorous evaluation procedures when long-term, randomized trial designs are not feasible to meet an emergent public health need.
The purpose of this review is to examine the research literature on interventions for children with type 1 diabetes and their families, with a specific focus on three types of intervention (educational and psychosocial/behavioral interventions that focus on individuals with diabetes and family interventions for families, usually parents, of individuals with diabetes). The aim of the review is to determine what interventions produce what outcomes in what populations of children and families. The review includes articles that met the following criteria: (a) empirical study reporting the impact of an intervention on such outcomes as knowledge, behavior, self-care, and metabolic control; (b) children with type 1 diabetes and/or their families as primary subjects; (c) publication between 1980 and January 1, 1999; and (d) publication in English. A total of 41 published papers were included. On the basis of this review, conclusions are as follows: (a) Educational interventions are useful in improving diabetes knowledge but not consistently helpful in improving metabolic control; (b) psychosocial interventions, especially coping skills training and peer support, assist primarily adolescents to improve adjustment and sometimes metabolic control; and (c) family interventions may be helpful in reducing parent-child conflict about diabetes management and care.
Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L
Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals—a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality. PMID:26825969
Pagoto, Sherry; Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L
Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals--a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality.
Slobodin, Ortal; de Jong, Joop T V M
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.
A growing body of research evidence has confirmed the efficacy of family-interventions as adjuncts to antipsychotics for the treatment of schizophrenia. Much of the recent evidence for such interventions derives from Asian, principally Chinese, studies. These trials have shown that relatively simple forms of family-interventions have wide ranging benefits, and can be implemented successfully in routine clinical settings. With the accumulation of this evidence in their favour, family-interventions for schizophrenia in Asia are poised to take the next critical step, that of wider implementation and improved accessibility for potential users. However, several issues merit consideration. Family-interventions need to be based on a culturally-informed theory, which incorporates cultural variables of relevance in these countries. While the ideal format for conducting family-interventions is still to be determined, it is quite evident that for such interventions to be useful they need to be simple, inexpensive, needs-based, and tailored to suit the socio-cultural realities of mental health systems in Asian countries. The evidence also suggests that delivery by non-specialist personnel is the best way to ensure that such services reach those who stand to benefit most from these treatments. However, there are several existing challenges to the process of dissemination of family-interventions. The major challenges include the achievement of a critical mass of trained professionals capable of delivering these interventions, and finding innovative solutions to make family-interventions more acceptable to families. If these hurdles are overcome, we could look forward to a genuine collaboration with families, who have always been the mainstay of care for the mentally ill in Asia.
Barr-Anderson, Daheia J.; Adams-Wynn, Alexis W.; DiSantis, Katherine I.; Kumanyika, Shiriki
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 behavior 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 behaviors 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 do 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. PMID:23057473
Correia Leite, Carina Sofia; Da Silva Pereira, Ana Paula
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.…
Black, William G., Jr.
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…
Rotheram-Borus, Mary Jane; Rice, Eric; Comulada, W Scott; Best, Karin; Elia, Carla; Peters, Katherine; Li, Li; Green, Sara; Valladares, Ena
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.
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
McWhirter, Ellen Hawley; And Others
This article describes concepts underlying the idea of the "family as a system"; compares and contrasts four approaches to family therapy (those of Virginia Satir, Jay Haley, Murray Bowen, and Salvador Minuchin); and offers suggestions to teachers referring parents for family counseling. (DB)
Nahum-Shani, Inbal; Qian, Min; Almirall, Daniel; Pelham, William E.; Gnagy, Beth; Fabiano, Gregory A.; Waxmonsky, James G.; Yu, Jihnhee; Murphy, Susan A.
In recent years, research in the area of intervention development has been 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…
Sung-Chan, P; Sung, Y W; Zhao, X; Brownson, R C
Effective interventions are needed to address the growing epidemic of childhood obesity. In the past 35 years, family-based approach has gradually developed as a preferred intervention. This review aimed to examine the methodological rigour and treatment effectiveness of family-based interventions according to intervention types and theoretical orientations. A total of 15 randomized controlled trials (RCTs) of family-based lifestyle interventions for children and adolescents aged 2-19 years were included. The adapted Methodological Quality Rating Scales (MQRS) and a four-grade qualitative scoring scheme were adopted to evaluate the methodological rigour and the effectiveness of treatment, respectively. The average MQRS score was 7.93 out of 14 points. Ten of the 15 RCTs had well aligned their research questions with appropriate research methods. The overall short-term outcome of the15 RCTs were satisfactory with an average score of 3.1. Family-based interventions rooted in behaviour theory achieved better results than those theoretically connected to family systems theory in terms of treatment effectiveness. Results suggest future studies to improve the methodological design and continue to explore the potential of the family systems approach.
The purpose of this clinical research project was to examine the usefulness of a family nursing intervention program offered to families experiencing illness suffering related to HIV/AIDS. The interventions were based on the Family Caregiving Model and the Illness Beliefs Model. Sixteen Thai families with one or more family members living with HIV/AIDS were offered three to four family clinical sessions by an advanced practice family nurse. The audiotaped family clinical sessions and field notes were analyzed using thematic analysis. The outcomes reported by families included a competence to manage illness care of family members experiencing HIV/AIDS, new meaning and purpose, improved family interaction, embraced facilitating beliefs and changed constraining beliefs, and a recognition of the family's strengths.
Fuchs, Douglas; Fuchs, Lynn S.
Classroom research on adaptive teaching indicates few teachers modify instruction for at-risk students in a manner that benefits them. Responsiveness-To-Intervention, with its tiers of increasingly intensive instruction, represents an alternative approach to adaptive instruction that may prove more workable in today's schools.
Epley, Pamela H.; Summers, Jean Ann; Turnbull, Ann P.
Relationships between parent ratings of Part C/early intervention (EI) services and family outcomes for families of young children with disabilities were examined--specifically, the early childhood outcomes (ECO)-recommended family outcomes and family quality of life (FQOL). Measures included the Early Childhood Services Survey, the ECO Center…
Gewirtz, Abigail H; Pinna, Keri L M; Hanson, Sheila K; Brockberg, Dustin
The high operational tempo of the current conflicts and the unprecedented reliance on National Guard and Reserve forces highlights the need for services to promote reintegration efforts for those transitioning back to civilian family life. Despite evidence that parenting has significant influence on children's functioning, and that parenting may be impaired during stressful family transitions, there is a dearth of empirically supported psychological interventions tailored for military families reintegrating after deployment. This article reports on the modification of an empirically supported parenting intervention for families in which a parent has deployed to war. A theoretical rationale for addressing parenting during reintegration after deployment is discussed. We describe the intervention, After Deployment, Adaptive Parenting Tools (ADAPT), and report early feasibility and acceptability data from a randomized controlled effectiveness trial of ADAPT, a 14-week group-based, Web-enhanced parenting training program. Among the first 42 families assigned to the intervention group, participation rates were high, and equal among mothers and fathers. Satisfaction was high across all 14 sessions. Implications for psychological services to military families dealing with the deployment process are discussed.
Gewirtz, Abigail H.; Pinna, Keri L. M.; Hanson, Sheila K.; Brockberg, Dustin
The high operational tempo of the current conflicts and the unprecedented reliance on National Guard and Reserve forces highlights the need for services to promote reintegration efforts for those transitioning back to civilian family life. Despite evidence that parenting has significant influence on children’s functioning, and that parenting may be impaired during stressful family transitions, there is a dearth of empirically-supported psychological interventions tailored for military families reintegrating after deployment. This paper reports on the modification of an empirically-supported parenting intervention for families in which a parent has deployed to war. A theoretical rationale for addressing parenting during reintegration after deployment is discussed. We describe the intervention, After Deployment, Adaptive Parenting Tools (ADAPT), and report early feasibility and acceptability data from a randomized controlled effectiveness trial of ADAPT, a 14-week group-based, web-enhanced parenting training program. Among the first 42 families assigned to the intervention group, participation rates were high, and equal among mothers and fathers. Satisfaction was high across all fourteen sessions. Implications for psychological services to military families dealing with the deployment process are discussed. PMID:24564441
Eggenberger, Sandra K; Sanders, Marita
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
Gingerich, Susan L.; Bellack, Alan S.
Well-controlled clinical trials have established the efficacy of a number of family-based psychosocial interventions for the treatment of schizophrenia. Reviews seven studies with long term follow-up. (Author)
Lovett, David L.; Haring, Kathryn A.
This article explores three broad themes about transitions that have emerged in a naturalistic study of experiences of families with young children with disabilities. Generalizations regarding early transitions include families going through a birth crisis have difficulty understanding all the information they are provided. Not only is their role…
Connell, David B.
This study describes the natural activities, behaviors and social interactions of 32 infants in their own homes. Participating families were from Oklahoma City, Oklahoma and Salem, Oregon; were involved in the Child and Family Resource Program (CFRP); and had a child between the ages of 11 to 14 months when the study was conducted. The families…
Alvarado, Rose; Kumpfer, Karol L.
This bulletin summarizes the results of a training and technology transfer program focussing on strengthening families for the prevention of delinquency. A national search was conducted for representative family strengthening programs, and through a process that involved national conferences, regional training sessions, and technical assistance,…
Upshur, Carole C.
This speech reports on data collected by the Early Intervention Collaborative Study (EICS), which is a longitudinal study following the development of 190 young children with disabilities (and their families) who entered 29 publicly funded early intervention programs in Massachusetts and New Hampshire in the period from 1985 to 1987. The…
Kiser, Laurel J; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M
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.
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.
ABSTRACT 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. PMID:27392007
Adams, Alexandra K.; LaRowe, Tara L.; Cronin, Kate A.; Prince, Ronald J.; Wubben, Deborah P.; Parker, Tassy; Jobe, Jared B.
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…
Sorrell, Jeanne M
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.
Hammer, Leslie B.; Kossek, Ellen Ernst; Anger, W. Kent; Bodner, Todd; Zimmerman, Kristi L.
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…
Nierkens, Vera; Hartman, Marieke A.; Nicolaou, Mary; Vissenberg, Charlotte; Beune, Erik J. A. J.; Hosper, Karen; van Valkengoed, Irene G.; Stronks, Karien
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
Zarit, Steven H.
A widespread bias exists among legal, medical, and social service professionals that the appropriate placement for elderly individuals with cognitive impairment (dementia) is a nursing home. Two major reasons for institutionalization are to remove the patient from a potentially harmful situation and to relieve the family of the burden of care.…
Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J.; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K. Brown, Larry
ABSTRACT 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). PMID
Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K Brown, Larry
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).
Yasui, Miwa; Dishion, Thomas J
This article links the empirical literature on race and ethnicity in developmental psychopathology with interventions designed to reduce adolescent problem behavior. We present a conceptual framework in which culture is endogenous to the socialization of youth and the development of specific self-regulatory strategies. The importance of cultural influence is identified at three levels: (a) intrapersonal developmental processes (e.g., ethnic identity development, development of coping modifies mechanisms and self-regulatory mechanisms), (b) family socialization processes (e.g., racial and ethnic socialization), and (c) interaction with larger societal contexts (e.g., maintenance of bicultural competence in adapting to mainstream and ethnic cultures). We discuss limitations of current assessment and intervention practices that focus on reducing adolescent problem behavior with respect to the cultural issues identified above. We propose that empirically supported adaptive and tailored interventions for adolescent problem behavior are optimal for serving multicultural children and families. To empower such interventions to better serve children and families of color, it is essential that assessments that guide the adaptation and tailoring process include culturally salient dynamics such as ethnic identity, racial socialization, and culturally informed parenting practices.
Gilmore, Linda; Campbell, Marilyn; Shochet, Ian
Students with developmental disabilities have many challenges with learning and adaptive behaviour, as well as a higher prevalence rate of mental health problems. Although there is a substantial body of evidence for effcacious interventions for enhancing resilience and promoting mental health in typically developing children, very few programs…
Holmbeck, Grayson N; Greenley, Rachel Neff; Coakley, Rachael Millstein; Greco, Joshua; Hagstrom, Jennifer
Research on the adjustment of families of children with spina bifida is reviewed, with a focus on delineating the impact of spina bifida on family functioning, the strengths and weaknesses of past research, and the needs for future evidence-based research on family interventions with this population. PsychINFO and MEDLINE literature searches were used to identify studies of family functioning and family-based interventions for children with spina bifida. Identified studies were empirically evaluated for the presence or absence of key methodological or analytic criteria. Thirty-two studies of family functioning were identified from 25 separate research groups; most studies displayed significant methodological limitations. No published studies of interventions to promote adaptive family functioning were identified. Methodologically sound, longitudinal, and theory-driven studies of family functioning are needed, as are randomized family-based intervention trials to promote adaptive functioning and better psychosocial outcomes in families of children with spina bifida. Specific recommendations for future work as well as clinical implications are noted.
Hammer, Leslie B.; Kossek, Ellen E.; Anger, W. Kent; Bodner, Todd; Zimmerman, Kristi L.
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
Westman, J C
Government has played an increasing role in family life because too many parents have not fulfilled their childrearing responsibilities. The misuse of parental power in child abuse and the abdication of parental responsibilities in child neglect have necessitated governmental interventions in order to protect children. A parent license would validate parental rights, establish parental responsibility, and provide a basis for the societal support of parenting in the form of financial benefits, parent education and training, and protective services for children when necessary. By generally increasing competent parenting, it would substantially reduce the need for governmental interventions in families.
Nahum-Shani, Inbal; Qian, Min; Almirall, Daniel; Pelham, William E.; Gnagy, Beth; Fabiano, Gregory A.; Waxmonsky, James G.; Yu, Jihnhee; Murphy, Susan A.
Increasing interest in individualizing and adapting intervention services over time has led to the development of adaptive interventions. Adaptive interventions operationalize the individualization of a sequence of intervention options over time via the use of decision rules that input participant information and output intervention…
Gray, Wendy N; Janicke, David M; Fennell, Eileen B; Driscoll, Danielle C; Lawrence, Robert M
Adolescents with HIV are at high risk for suboptimal adherence but have been ignored by the literature. Treatment outcome and feasibility data for the first-known adaptation of Behavioral Family Systems Therapy (BFST) targeting adherence among adolescents with HIV are presented for four adolescents with suboptimal adherence. The intervention was delivered in an alternating home-based and telehealth format and a multi-method adherence assessment approach was used. Adherence improved for three adolescents, viral load decreased for two adolescents, and barriers to adherence declined for all participants. Delivery of an adapted BFST intervention was acceptable to families and may be a promising treatment approach.
Shulman, Shmuel; Prechter, Eti
Changes in adolescents' perceptions of the family as they adapt to residential schooling were studied for 51 residential and 57 nonresidential tenth graders in a school in Israel. No differences in the perception of family climate were found between the groups, suggesting no change with the individual's act of leaving. (SLD)
Kruskal, M O; Thomasgard, M C; Shonkoff, J P
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)
Hammer, Leslie B; Kossek, Ellen Ernst; Anger, W Kent; Bodner, Todd; Zimmerman, Kristi L
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 surveys were completed, 9 months apart, by 239 employees at 6 intervention (N = 117) and 6 control (N = 122) grocery store sites. Thirty-nine supervisors in the 6 intervention sites received the training consisting of 1 hr of self-paced computer-based training, 1 hr of face-to-face group training, followed by instructions for behavioral self-monitoring (recording the frequency of supportive behaviors) to facilitate 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, whereas 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.
Mas, Joana M.; Baqués, Natasha; Balcells-Balcells, Anna; Dalmau, Mariona; Giné, Climent; Gràcia, Marta; Vilaseca, Rosa
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…
Zheng, Yuzhu; Maude, Susan P.; Brotherson, Mary Jane; Merritts, Ashley
Research highlights the importance of early childhood intervention (ECI) for children with disabilities, and there is an increasing interest in China with respect to research on ECI. However, little research exists exploring the experience of families of young children with disabilities receiving ECI services and supports in China. The purpose of…
Kaslow, Nadine J.; Broth, Michelle Robbins; Smith, Chaundrissa Oyeshiku; Collins, Marietta H.
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…
Khetani, Mary Alunkal
Participation in the natural settings of home and community is one of four major goals for families receiving Part C early intervention services. While participation has been formally recognized as an important service-related outcome, there is a need to build knowledge about its key features to adequately apply the concept in practice. The need…
Humphreys, Janice; And Others
Elder abuse has received attention among professionals only recently; consequently, guidelines for identification and intervention strategies for the professional in the clinical setting remain speculative and untested. Because the problem of family violence is multidimensional, no professional can be expected to meet the needs of every member of…
Friedrich, William N.; Copeland, Donna R.
Suggests that behavioral problems that frequently occur in pediatric cancer treatment settings, such as food refusal and the resistance to treatment, can be successfully treated utilizing family therapy techniques. Presents the theoretical background that supports this mode of intervention and several case studies. (Author/WAS)
Berryman, Mere; Woller, Paul
This paper examines Early Intervention (EI) service provision from within one Ministry of Education region in New Zealand. It does this in order to better understand what works well and what needs to change if children from Maori families, of Early Childhood age, are to be provided with the most effective EI services. By engaging with Maori…
Garbacz, S. Andrew; McIntosh, Kent; Eagle, John W.; Dowd-Eagle, Shannon E.; Hirano, Kara A.; Ruppert, Traci
Parent educational involvement is an important avenue for enhancing student outcomes. Schools seek myriad ways to include families; however, the parent involvement practices used by schools lack coordination and are disconnected from existing school approaches. School wide Positive Behavioral Interventions and Supports (PBIS) is a systematic and…
Haley, William E.
Conducted longitudinal follow-up to previously published experimental study of effectiveness of group intervention for dementia family caregivers. Found methodological and clinical issues relevant to future studies included issues of differential attrition from treatment, selection of participants,and need for measures appropriate to long-term…
Johnson, Lee N.; Carswell, Andrew T.; Palmer, Lance; Sweaney, Annie L.; Mullis, Rebecca M.; Leonas, Karen K.; Moss, Joan Koonce; Mauldin, Teresa
Life Skills Literacy (LSL) is a multidisciplinary intervention model that helps families living with limited resources (including poverty) achieve sustainable well-being. This model, based on ecological theory and a readiness for change framework, prepares people to learn from the program and teaches necessary life skills. The LSL project…
Limiñana-Gras, Rosa M.; Colodro-Conde, Lucía; Cuéllar-Flores, Isabel; Sánchez-López, M. Pilar
The goal of this study is to investigate the efficacy of psychoeducational interventions geared to reducing psychological distress for caregivers in a sample of 90 family caregivers of elderly dependent (78 women and 12 men). We conducted an analysis of the statistical and clinical significance of the changes observed in psychological health…
Fife, B L; Von Ah, D M; Spath, M L; Weaver, M T; Yang, Z; Stump, T; Farag, S
The primary purpose of this research was to develop and evaluate the efficacy and feasibility of a brief, cost-effective family-focused intervention to promote adaptive coping and quality of life throughout a parent's bone marrow transplantation (BMT). Targeted outcomes were cohesion, decreased use of avoidance coping, open communication and effective management of emotional distress. Participants included an intervention group of 31 families and 29 families in a control group who received usual care. Each family included the BMT recipient, a partner/caregiver and children 10-18 years old. The intervention included two dyadic sessions for the BMT recipient and the partner/caregiver, one individual session for the caregiver and two digital video discs (DVDs) for children. Statistical analyses indicated that the intervention had a positive impact on at least one aspect of the adaptation of each family member. Caregivers reported the most distress but benefitted least from the intervention, whereas recipients and children reported improvement in distress. Ratings of satisfaction/acceptability were high, with 97% responding that they would recommend the intervention to others. Plans for future research include increased intervention intensity for the caregiver, a larger more diverse sample and implementation over an extended period post BMT.
Balcells-Balcells, A.; Gine, C.; Guardia-Olmos, J.; Summers, J. A.
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…
Wiggins, Shirley A
Postoperative pain and symptom management at home following pediatric tonsillectomy and adenoidectomy (T & A) is challenging. There are few randomized clinical trials that have established postoperative care interventions that are specific and effective during home recovery. The purpose of this pilot feasibility study was to describe how children and their families implemented a randomly assigned alarm intervention designed to promote postoperative around-the-clock administration of analgesics. Thirteen children from 12 through 18 years of age were randomly assigned to either the around-the-clock (RTC) intervention group (n = 7) or the usual care group (UCG) of controls (n = 6). The RTC intervention group was requested to use an alarm as a reminder to awaken and administer analgesia during the nighttime hours of sleep. Children randomly assigned to the UCG of controls were given the same discharge education as the RTC intervention group that emphasized around-the-clock administration of analgesia. The UCG of controls were not requested to use the alarm intervention. Both groups documented pain intensity and other symptoms daily for 3 days in a diary. All children wore an actigraphy-score wrist monitor to assess sleep during the same 3 days. Telephone interviews were conducted with the children and mothers at 24 hours and 10 to 14 days after surgery. Nonparametric statistics were used to compare differences between the two groups. Children in the RTC intervention group administered significantly (p = .014) more analgesics by the second postoperative day than the UCG of controls. Pain intensity was moderate to severe for both groups. The mean hours of nighttime sleep for the two groups did not differ. Themes that emerged from the qualitative analysis of the interviews included painful challenges; struggling with decisions; making things work; a lengthy recovery; and family support. Results supported the need for research to establish evidenced-based home care
Ferreira-Umpiérrez, Augusto; Fort-Fort, Zoraida
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
Marlowe, Douglas B; Festinger, David S; Arabia, Patricia L; Dugosh, Karen L; Benasutti, Kathleen M; Croft, Jason R; McKay, James R
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.
Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony
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
Wade, Shari L; Wolfe, Christopher R; Pestian, John P
We developed a Web-based intervention for pediatric traumatic brain injury (TBI) and examined its feasibility for participants with limited computer experience. Six families, including parents, siblings, and children with TBI, were given computers, Web cameras, and high-speed Internet access. Weekly videoconferences with the therapist were conducted after participants completed on-line interactive experiences on problem solving, communication, and TBI-specific behavior management. Families were assigned to videoconference with NetMeeting (iBOT cameras) or ViaVideo. Participants ranked the Web site and videoconferences as moderately to very easy to use. ViaVideo participants rated videoconferencing significantly more favorably relative to face-to-face meetings than did NetMeeting participants. Both the Web site and videoconferencing were rated as very helpful. All families demonstrated improved outcomes on one or more target behaviors, including increased understanding of the injury and improved parent-child relationships. All parents and siblings and all but 1 child with TBI said they would recommend the program to others. We conclude that a face-to-face intervention can be successfully adapted to the Web for families with varied computer experience.
Dishion, Thomas; Forgatch, Marion; Chamberlain, Patricia; Pelham, William E.
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
Adams, Alexandra K.; LaRowe, Tara L.; Cronin, Kate A.; Prince, Ronald J.; Wubben, Deborah P.; Parker, Tassy; Jobe, Jared B.
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 community mentors work with 2–5-year-old American Indian children and their primary caregivers to promote goal-based behavior change. During Year 2, intervention families receive monthly newsletters and attend monthly group meetings to participate in activities designed to reinforce and sustain changes made in Year 1. Control families receive only curricula materials during Year 1 and monthly newsletters during Year 2. Each of the two arms of the study comprises 60 families. Primary outcomes are decreased child BMI z-score and decreased primary caregiver BMI. Secondary outcomes include: increased fruit/vegetable consumption, decreased TV viewing, increased physical activity, decreased soda/sweetened drink consumption, improved primary caregiver biochemical indices, and increased primary caregiver self-efficacy to adopt healthy behaviors. Using community-based participatory research and our history of university–tribal partnerships, the community and academic researchers jointly designed this randomized trial. This article describes the study design and data collection strategies, including outcome measures, with emphasis on the communities’ input in all aspects of the research. PMID:22956296
Kumpfer, K. L.
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
Cicchetti, Dante; Rogosch, Fred A; Toth, Sheree L
The malleability of insecure and disorganized attachment among infants from maltreating families was investigated through a randomized preventive intervention trial. Findings from research on the effects of maltreatment on infant attachment were incorporated into the design and evaluation of the intervention. One-year-old infants from maltreating families (N = 137) and their mothers were randomly assigned to one of three intervention conditions: (a) infant-parent psychotherapy (IPP), (b) psychoeducational parenting intervention (PPI), and (c) community standard (CS) controls. A fourth group of infants from nonmaltreating families (N = 52) and their mothers served as an additional low-income normative comparison (NC) group. At baseline, mothers in the maltreatment group, relative to the nonmaltreatment group mothers, reported greater abuse and neglect in their own childhoods, more insecure relationships with their own mothers, more maladaptive parenting attitudes, more parenting stress, and lower family support, and they were observed to evince lower maternal sensitivity. Infants in the maltreatment groups had significantly higher rates of disorganized attachment than infants in the NC group. At postintervention follow-up at age 26 months, children in the IPP and PPI groups demonstrated substantial increases in secure attachment, whereas increases in secure attachment were not found for the CS and NC groups. Moreover, disorganized attachment continued to predominate in the CS group. These results were maintained when intent to treat analyses were conducted. The findings are discussed in terms of the utility of translating basic research into the design and evaluation of clinical trials, as well as the importance of preventive interventions for altering attachment organization and promoting an adaptive developmental course for infants in maltreating families.
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... depression : Recent findings and future prospects. Biological Psychiatry, 49, 1101–1110. Beardslee, W. R., & Knitzer, J. (2003). Strengths-based family
Distelberg, Brian; Castanos, Carolina
Family businesses (FBs) are a significant population in the world and therefore part of most practicing marriage and family therapists (MFTs) clientele; however, little is mentioned about FBs in the training of MFTs. This article offers some guidance to practicing MFTs who service this population, as well as MFTs who wish to expand their practice into a focused consultation practices with FB systems. This article uses Doherty's Levels of Family Involvement Model as a road map for MFTs to organize the vast amount of literature on FB systems as well as the many ways in which MFTs might serve FBs. We also offer suggestions for the necessary skills, experiences, and levels of engagement required at each level of intervention provided by MFTs.
Asen, Eia; Fonagy, Peter
This is the second of two companion papers that provide an overview of mentalization-based concepts and techniques when working with the seeming "mindlessness" of intra-family violence. The focus of this paper is on general mentalization-oriented approaches and specific interventions that aim to (1) disrupt the non-mentalizing cycles that can generate intra-family violence and (2) encourage the emergence of patterns of family interactions that provide the foundation for non-violent alternatives. Various playful exercises and activities are described, including the taking of "mental state snapshots" and "selfies" in sessions and staging inverted role-plays, as well as using theatrical masks and creating body-mind maps and scans. These can make "chronic" relationship issues come alive in session and permit "here and now" experiences that generate a safe context for mentalizing to take place. At the core of the work is the continuous focus on integrating experience and reflection. Without acute awareness of the thoughts and feelings occurring in the sessions, mere reflection is not likely to enable change. By increasing mentalizing in the family system, family members' trusting attitudes grow, both within and outside the family.
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.
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
Cardona, José Parra; 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
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.
Recent studies demonstrated that family members of a cancer patient show as much or even higher psychological distress as the cancer patients themselves. There are several reasons for psychological distress among family members. The family of the cancer patient is expected to provide patient care. There are shared responsibilities for decision-making, providing concrete care-giving, meeting the financial and social costs, maintaining stability and adapting to change. In addition, some family caregivers are involved in direct patient care. These responsibilities place both physical and emotional burdens on the family members. It has been shown that spouses demonstrate levels of emotional and functional disruption as great or greater than that of the patient and that these problems often worsen with time, independent of the patient's mood or health. Health problems of caregivers have a very important influence on their ability to meet these demands and it is reported that care-giving affects the physical health of spouse caregivers. Some caregivers may be physically weak or sick, and some may also demonstrate symptoms of cancer. Based on these findings, family members of the cancer patient are called "second-order patients". Therefore, various kinds of care programs are needed to provide support for family members and such interventions are aimed at psychiatric, physical, socio-economic problems. Bereavement is one of the most striking events in human experience. Although bereavement is not a disease, it is associated with excess risk of mortality and morbidity. Bereaved individuals show various physical and psychological symptoms and some of the bereaved individuals develop psychiatric disorders such as bereavement reaction, major depression and post-traumatic stress disorder. Therefore, psychiatric interventions are needed for these bereaved individuals. In the bereavement care clinic, interventions are aimed at psychiatric, physical, socio-economical problems
Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D
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.
Gant, Judith R.
Objectives This study examined the differential impact of two telehealth programs for women caring for an older adult with a neurocognitive disorder. Outcomes examined were depressive symptoms, upset following disruptive behaviors, anxious and angry mood states, and caregiving self‐efficacy. Methods Women cohabitating with a family member diagnosed with a neurocognitive disorder were assigned via random allocation to either of the following: (1) a 14‐week behavioral intervention using video instructional materials, workbook and telephone coaching in behavioral management, pleasant events scheduling, and relaxation or (2) a basic education guide and telephone support comparison condition. Telephone assessments were conducted by interviewers blind to treatment condition at pre‐intervention, post‐intervention, and 6 months following intervention. Results For those providing in‐home care at post‐treatment, depressive symptoms, upset following disruptive behaviors, and negative mood states were statistically lower in the behavioral coaching condition than in the basic education and support condition. Reliable change index analyses for Beck Depression Inventory II scores favored the behavioral coaching condition. Caregiving self‐efficacy scores for obtaining respite and for managing patient behavioral disturbances were significantly higher in the coaching condition. Effect sizes were moderate but not maintained at the 6‐month follow‐up. Conclusions This study provides some initial evidence for the efficacy of a telehealth behavioral coaching intervention compared with basic education and telephone support. Carers' abilities to maintain strategy use during progressive disorders such as Alzheimer's disease likely require longer intervention contact than provided in the current study. Dementia carers, including those living in rural areas, can benefit from accessible and empirically supported interventions that can be easily disseminated across distances
Highfield, Linda; Hartman, Marieke A.; Mullen, Patricia Dolan; Rodriguez, Serena A.; Fernandez, Maria E.; Bartholomew, L. Kay
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
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
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.
Chambless, Dianne L
Family-focused therapy for anxiety disorders (FFT-AD), a flexible couple/family treatment provided in conjunction with cognitive-behavioral therapy (CBT) for anxiety disorders, is described. The treatment is based upon research showing that anxious patients are more likely to drop out of or fare poorly in CBT when they live with a family member who is hostile toward or emotionally over-involved with the patient, accommodates excessively to the patient's anxiety, or is perceived by the patient to be destructively critical. An adaptation of FFT for bipolar disorder, the treatment is intended for patients with anxiety disorders, regardless of their specific disorder type. FFT-AD is illustrated with two cases.
Cann, Warren; Rogers, Helen; Matthews, Jan
Reports on a preliminary evaluation of the Metropolitan Family Intervention Service at the Victorian Parenting Centre, Melbourne, Australia. It presents an analysis of pre-post data collected from 589 mothers who commenced and completed parenting programs between 1999 and early 2003. Significant improvements were noted in measures of parental…
Eisler, Ivan; Ellison, Matthew; Flinter, Frances; Grey, Jo; Hutchison, Suzanne; Jackson, Carole; Longworth, Louise; MacLeod, Rhona; McAllister, Marion; Metcalfe, Alison; Murrells, Trevor; Patch, Christine; Pritchard, Stuart; Robert, Glenn; Rowland, Emma; Ulph, Fiona
Many families experience difficulty in talking about an inherited genetic condition that affects one or more of them. There have now been a number of studies identifying the issues in detail, however few have developed interventions to assist families. The SPRinG collaborative have used the UK Medical Research Council's guidance on Developing and Evaluating Complex Interventions, to work with families and genetic counsellors (GCs) to co-design a psycho-educational intervention to facilitate family communication and promote better coping and adaptation to living with an inherited genetic condition for parents and their children (<18 years). The intervention is modelled on multi-family discussion groups (MFDGs) used in psychiatric settings. The MFDG was developed and tested over three phases. First focus groups with parents, young people, children and health professionals discussed whether MFDG was acceptable and proposed a suitable design. Using evidence and focus group data, the intervention and a training manual were developed and three GCs were trained in its delivery. Finally, a prototype MFDG was led by a family therapist and co-facilitated by the three GCs. Data analysis showed that families attending the focus groups and intervention thought MFDG highly beneficial, and the pilot sessions had a significant impact on their family' functioning. We also demonstrated that it is possible to train GCs to deliver the MFDG intervention. Further studies are now required to test the feasibility of undertaking a definitive randomised controlled trial to evaluate its effectiveness in improving family outcomes before implementing into genetic counselling practice. PMID:26443265
Tulsky, James A
Whether patient suffering is caused by physical symptoms, unwanted medical intervention, or spiritual crisis, the common pathway to relief is through a provider who is able to elicit these concerns and is equipped to help the patient and family address them. This paper reviews the current state of knowledge in communication at the end of life, organized according to a framework of information gathering, information giving, and relationship building; and then focuses on interventions to enhance communication among patients, providers, and families. Several observations emerge from the existing literature. Patients have highly individualized desires for information and we cannot predict patient preferences. Communication coding methodology has advanced significantly yet the current systems remain poorly understood and largely inaccessible. Physicians and other health care providers do not discuss sufficiently treatment options, quality of life or respond to emotional cues from patients, and there is plenty of room for improvement. On the positive side, we have also learned that physicians and other health care providers can be taught to communicate better through intensive communication courses, and that communication interventions can improve some patient outcomes. Finally, huge gaps remain in our current knowledge, particularly with regard to understanding the relationship between communication style and outcomes. These findings suggest several recommendations. We should create larger and more diverse datasets; improve upon the analysis of recorded communication data; increase our knowledge about patient preferences for information; establish a stronger link between specific communication behaviors and outcomes; and identify more efficient ways to teach providers communication skills.
Lietz, Cynthia A; Julien-Chinn, Francie J; Geiger, Jennifer M; Hayes Piel, Megan
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.
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.
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…
Fasula, Amy M; Fogel, Catherine I; Gelaude, Deborah; Carry, Monique; Gaiter, Juarlyn; Parker, Sharon
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.
Narayanan, H.S.; Girimaji, S.R.; Gandhi, D.H.; Raju, K. Maruthai; Rao, P. Madhu; Nardev, G.
SUMMARY A novel programme of intervention - brief inpatient family intervention - was formulated to impart the training skills to the parents of mentally retarded children to optimise the development of their retarded child. During the period of this study. 106 mentally retarded children with different socio-demographic backgrounds and degrees of handicap participated in this programme, with encouraging results. The individualised management plan, spread over 2 weeks of inpatient stay, included intensive counselling, training of the parents in techniques of multisensory stimulation, speech, motor, and self-help skills training, behaviour modification and medical management, as required. The programme could serve as a suitable model for professionals working with the mentally retarded, to implement with limited resources. PMID:21927322
Escobar-Chaves, Soledad Liliana; Markham, Christine M; Addy, Robert C; Greisinger, Anthony; Murray, Nancy G; Brehm, Brenda
Media consumption may contribute to childhood obesity. This study developed and evaluated a theory-based, parent-focused intervention to reduce television and other media consumption to prevent and reduce childhood obesity. Families (n = 202) with children ages 6-9 were recruited from a large, urban multiethnic population into a randomized controlled trial (101 families into the intervention group and 101 into the control group), and were followed for 6 months. The intervention consisted of a 2-hour workshop and six bimonthly newsletters. Behavioral objectives included: (i) reduce TV watching; (ii) turn off TV when nobody is watching; (iii) no TV with meals; (iv) no TV in the child's bedroom; and (v) engage in fun non-media related activities. Parents were 89% female, 44% white, 28% African American, 17% Latino, and 11% Asian, mean age 40 years (s.d. = 7.5); 72% were married. Children were 49% female, mean age 8 years (s.d. = 0.95). Sixty-five percent of households had three or more TVs and video game players; 37% had at least one handheld video game, and 53% had three or more computers. Average children's weekday media exposure was 6.1 hours. At 6 months follow-up, the intervention group was less likely to report the TV being on when nobody was watching (adjusted odds ratio (AOR) = 0.23, P < 0.05), less likely to report eating snacks while watching TV (AOR = 0.47, P < 0.05), and less likely to have a TV in the child's bedroom (AOR = 0.23, P < 0.01). There was a trend toward reducing actual media consumption but these outcomes did not reach statistical significance. Effective strategies to reduce children's TV viewing were identified.
Loveland-Cherry, C J
Substance abuse often begins in adolescence and is a major factor determining health outcomes for adolescents and adults; thus, it is an important focus for prevention strategies. The use of drugs, especially alcohol, can lead to chronic addiction to substances as well as contribute to a number of common chronic conditions. These conditions include cancer, cardiovascular disease, disability from accidents or violence, and unplanned pregnancy and are major causes of morbidity and mortality among adolescents and adults. As the major social unit responsible for socialization of children and stabilization of adult personalities, the family has been the target of prevention efforts. In this chapter the empirical literature on family interventions to prevent substance use in adolescents is critically reviewed, generalizations and implications for practice identified, and directions for future research projected.
Rivera, Daniel E; Pew, Michael D; Collins, Linda M
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.
Sakata, Karen Namie; Mishima, Silvana Martins
This qualitative study examines the social relationships between the Community Health Agents (CHAs) and the Family Health team (FH), highlighting cooperative interventions and interactions among workers. A total of 23 participant observations and 11 semi-structured interviews were conducted with an FH team in a city in the interior of São Paulo, Brazil. The results revealed that CHAs function as a link in the development of operational actions to expedite teamwork. These professionals, while creating bonds, articulate connections of teamwork and interact with other workers, developing common care plans and bringing the team and community together, as well as adapting care interventions to meet the real needs of people. In communication practice, when talking about themselves they talk about the community itself because they are the community's representatives and spokespersons on the team. The conclusion is that the CHA may be a strategic worker if his/her actions include more political and social dimensions of work in healthcare.
Marlowe, Douglas B; Festinger, David S; Arabia, Patricia L; Dugosh, Karen L; Benasutti, Kathleen M; Croft, Jason R
Adaptive interventions apply a priori decision rules for adjusting treatment services in response to participants' clinical presentation or performance in treatment. This pilot study (n = 30) experimentally examined an adaptive intervention in a misdemeanor drug court. The participants were primarily charged with possession of marijuana (73%) or possession of drug paraphernalia (23%). Results revealed that participants in the adaptive condition had higher graduation rates and required significantly less time to graduate from the program and achieve a final resolution of the case. It took an average of nearly 4 fewer months for participants in the adaptive intervention to resolve their cases compared with those participating in drug court as usual. Participants in the adaptive condition also reported equivalent satisfaction with the program and therapeutic alliances with their counselors. These data suggest that adaptive interventions may enhance the efficiency and effectiveness of drug courts and justify examining adaptive interventions in large-scale drug court studies.
Marlowe, Douglas B.; Festinger, David S.; Arabia, Patricia L.; Dugosh, Karen L.; Benasutti, Kathleen M.; Croft, Jason R.
Adaptive interventions apply a priori decision rules for adjusting treatment services in response to participants’ clinical presentation or performance in treatment. This pilot study (N = 30) experimentally examined an adaptive intervention in a misdemeanor drug court. The participants were primarily charged with possession of marijuana (73%) or possession of drug paraphernalia (23%). Results revealed that participants in the adaptive condition had relatively higher graduation rates and required significantly less time to graduate from the program and achieve a final resolution of the case. It took an average of nearly 4 fewer months for participants in the adaptive intervention to resolve their cases as compared to drug court as-usual. Participants in the adaptive condition also reported equivalent satisfaction with the program and therapeutic alliances with their counselors. These data suggest that adaptive interventions may enhance the efficiency and effectiveness of drug courts, and justify examining adaptive interventions in large-scale drug court studies. PMID:19785978
Kidwell, Kelley M.; Hyde, Luke W.
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…
As universal newborn hearing systems (screening, diagnosis, intervention) are being established around the world, the success of children who are identified to be deaf and hard of hearing is critically impacted by parent's reactions, acceptance, and advocacy for their child. It is imperative for professionals who are creating systems for Early Hearing, Detection, and Intervention to understand and learn from families' experiences in order to improve this process. This manuscript will identify the areas in which parents have spoken out about the professionals they have encountered through the system: what parents wish for in a healthy, productive relationship with professionals; and how parents can play a part in advocating for a system in which families needs are met so that infants identified to be deaf or hard of hearing can reach their full potential.
Copenhaver, Michael M.; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A.; Kamarulzaman, Adeeba; Altice, Frederick L.
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
Kao, Tsui-Sui; Gibbs, Marilyn Beth; Clemen-Stone, Susan; Duffy, Sonia
The purpose of this integrative review is to describe, compare, and synthesize traditional and computer-based family interventions that aim to change adolescents' risky sexual behaviors and substance abuse. Family interventions have been shown to generate protective effects for preventing adolescents from risky behaviors. It is not clear, however, whether there are significant differences or similarities in the designs and effects of traditional and computer-based family interventions. An integrative literature review was conducted to describe and compare the designs and effects of traditional and computer-based family interventions. Both interventions have generated significant effects on reducing risky behavior among adolescents. Interventions guided by theory, tailored to participants' culture/gender, and which included sufficient boosting dosages in their designs demonstrated significant short- or long-term effects in terms of reducing adolescents' risky behaviors. Regardless of delivery method, well-designed family interventions are noted to maximize familial protective effects and reduce risky behaviors.
Linke, Sarah E; Larsen, Britta A; Marquez, Becky; Mendoza-Vasconez, Andrea; Marcus, Bess H
Cardiovascular diseases (CVD) comprise the leading cause of mortality worldwide, accounting for 3 in 10 deaths. Individuals with certain risk factors, including tobacco use, obesity, low levels of physical activity, type 2 diabetes mellitus, racial/ethnic minority status and low socioeconomic status, experience higher rates of CVD and are, therefore, considered priority populations. Technological devices such as computers and smartphones are now routinely utilized in research studies aiming to prevent CVD and its risk factors, and they are also rampant in the public and private health sectors. Traditional health behavior interventions targeting these risk factors have been adapted for technology-based approaches. This review provides an overview of technology-based interventions conducted in these priority populations as well as the challenges and gaps to be addressed in future research. Researchers currently possess tremendous opportunities to engage in technology-based implementation and dissemination science to help spread evidence-based programs focusing on CVD risk factors in these and other priority populations.
Lally, J. Ronald
This report documents the develoment of a two-pronged, model approach to early intervention with families in low-income communities. Since 1988, the Far West Laboratory's Center for Child and Family Studies and agencies in two low-income communities have been collaborating members of the Bay Area Early Intervention Program (BAEIP). BAEIP organizes…
McLaughlin, Tara W.; Denney, Maria K.; Snyder, Patricia A.; Welsh, Jill L.
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…
Behl, Diane D.; Houston, K. Todd; Guthrie, W. Spencer; Guthrie, Nancy K.
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…
Popp, Tierney K.; You, Hyun-Kyung
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…
Davison, Kirsten K; Lawson, Hal A; Coatsworth, J Douglas
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.
Perrino, Tatiana; Estrada, Yannine; Huang, Shi; St George, Sara; Pantin, Hilda; Cano, Miguel Ángel; Lee, Tae Kyoung; Prado, Guillermo
The Familias Unidas intervention is an efficacious family-based preventive intervention for reducing substance use and other health risks among Hispanic youth. A current randomized controlled trial (RCT) is examining this intervention's efficacy when delivered via the Internet (eHealth). eHealth interventions can overcome logistical barriers to participation, yet there is limited information about the feasibility of these interventions, especially among ethnic minorities. This paper examines participation and predictors of participation in the eHealth Familias Unidas intervention in a sample of 113 Hispanic families whose adolescent had behavioral problems. Analyses examined multidimensional ways of characterizing participation, including the following: (1) total intervention participation, (2) initial engagement (participating in at least one of the first three intervention sessions), (3) completing the pre-recorded, eHealth parent group sessions, and (4) participating in the live, facilitator-led, eHealth family sessions. Participation in this eHealth intervention was comparable to, and in most cases higher than, previous, face-to-face Familias Unidas interventions. High levels of baseline family stress were associated with lower initial engagement and lower family session participation. Greater parental Hispanicism was associated with more participation in eHealth parent group sessions and across the total intervention. Higher levels of baseline effective parenting, in other words less intervention need, were significantly associated with lower levels of total intervention participation and lower levels of family session participation. Implications for preventive interventions delivered via Internet are discussed.
Gibbs, D. A.; Krieger, K. E.; Cutbush, S. L.; Clinton-Sherrod, A. M.; Miller, S.
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…
Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco
Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts.
Ho, Henry C. Y.; Mui, Moses; Wan, Alice; Ng, Yin-Lam; Stewart, Sunita M.; Yew, Carol; Lam, Tai Hing; Chan, Sophia S.
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
Clark, Mary Jo
Obesity disproportionately affects U.S. ethnic minority preschool children, placing them at risk for obesity related co-morbidities and premature death. Effective culturally appropriate interventions are needed to improve health behaviors and reduce obesity in young high-risk minority children, while their behaviors are still developing. All known obesity intervention studies (e.g., diet and physical activity) since 2000 targeting U.S. ethnic minority preschool children were reviewed. Five electronic databases and eight published literature reviews were used to identify the studies. Intervention studies without identified ethnic minority participants were excluded. Ten obesity interventions studies met the review criteria. Published cultural adaptation guidelines were used to develop a mechanism to analyze, score, and rank the intervention adaptations. Cultural adaptations varied widely in rigor, depth, and breadth. Results indicated a relative absence of appropriately adapted obesity interventions for ethnic minority groups, suggesting a need for more rigorous cultural adaptation guidelines when designing obesity interventions for diverse ethnicities. Culturally appropriate adaptations appeared to enhance intervention relevance, effectiveness, and feasibility. The purpose of this literature review was to evaluate 1) the type and extent of cultural adaptations strategies applied to the interventions, and 2) how these adaptations related to the study outcomes. PMID:24159268
Trecartin, Kelly; Carroll, Diane L
Anxiety is shared by patients and family members (FMs) and can increase throughout the FMs waiting during invasive cardiac procedures (ICP). The purpose of this study was to measure the effects of an informational report (IR) and a postprocedure visit (PPV), on the anxiety of waiting FMs. There were 151 FMs assigned to 3 groups; Group 1 (50 FMs: standard of care [SOC]), Group 2 (50 FMs: SOC + IR), and Group 3 (51 FMs: SOC + IR + PPV). Pre/ postvariables measured were: blood pressure (BP), heart rate (HR), skin temperature (ST), and anxiety. When comparing the BP, HR, ST, and anxiety there were no differences between groups with either SOC or IR. There was a significant reduction in anxiety, from baseline to the PPV in Group 3 (F = 10.1; p < .000). A PPV had an impact on FMs and a PPV should be incorporated as a nursing intervention during ICP.
Llanque, Sarah M.; Enriquez, Maithe; Cheng, An-Lin; Doty, Leilani; Brotto, Marco A.; Kelly, Patricia J.; Niedens, Michelle; Caserta, Michael S.; Savage, Lynette M.
This study describes an evaluation of a community-based psychoeducational intervention, called The Family Series Workshop, for caregivers of community-dwelling persons with Alzheimer’s disease or related dementias (ADRD). In a one-group pretest–posttest design, participants (n = 35) attended six weekly sessions. Caregiver stress, coping, and caregiving competence were evaluated along with demographic characteristics of participants. There was a significant improvement found for caregiving competence, and a marginally significant increase in coping with humor. Using regression analysis we also found that coping with humor, along with stress, were significant predictors of caregiving competence. These findings indicate that it is possible to increase caregiving competence utilizing a “grassroots” approach and that it is feasible to hold educational, group discussions on a plethora of challenging caregiving topics. PMID:25609602
LaBrie, Joseph W.; Feres, Nashla; Kenney, Shannon R.; Lac, Andrew
This study examined whether a self-reported family history of alcohol abuse (FH+) moderated the effects of a female-specific group motivational enhancement intervention with first-year college women. First-year college women (N= 287) completed an initial questionnaire and attended an intervention (n=161) or control (n=126) group session, of which 118 reported FH+. Repeated measures ANCOVA models were estimated to investigate whether the effectiveness of the intervention varied as a function of one’s reported family history of alcohol abuse. Results revealed that family history of alcohol abuse moderated intervention efficacy. Although the intervention was effective in producing less risky drinking relative to controls, among those participants who received the intervention, FH+ women drank less across five weeks of follow-up than FH− women. The current findings provide preliminary support for the differential effectiveness of motivational enhancement interventions with FH+ women. Keywords: college women, intervention, alcohol abuse, family history, motivational interviewing PMID:19162406
Bagner, Daniel M.; Rodríguez, Gabriela M.; Blake, Clair A.; Rosa-Olivares, Jose
The purpose of this study was to examine the feasibility, acceptability, and initial outcome of a home-based adaptation of Parent-Child Interaction Therapy for at-risk infants with externalizing behavior problems. Seven 12- to 15-month-old infants and their families were recruited at a large pediatric primary care clinic to participate in a home-based parenting intervention to prevent subsequent externalizing behavior problems. Home-based assessments were conducted at baseline, postintervention, and a 4- to 6-month follow-up. Six of the 7 (86%) families completed the intervention, and all completers reported high satisfaction with the intervention. All of the mothers demonstrated significant improvements and statistically reliable changes in their interactions with their infant, and most reported clinically significant and statistically reliable changes in infant behavior problems. The current study provides preliminary support for the use of this brief, home-based parenting intervention in addressing behavior problems as early as possible to improve access to an intervention for at-risk infants and their families. Successes and challenges with the development and implementation of this intervention are discussed along with directions for future research and clinical practice. PMID:25414568
Leko, Melinda M.; Roberts, Carly A.; Pek, Yvonne
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…
Kumar, Hulikal Shivashankara Santosh; Kumar, Vadlapudi
The inventory of proteins used in different kingdoms appears surprisingly similar in all sequenced eukaryotic genome. Protein domains represent the basic evolutionary units that form proteins. Domain duplication and shuffling by recombination are probably the most important forces driving protein evolution and hence the complexity of the proteome. While the duplication of whole genes as well as domain encoding exons increases the abundance of domains in the proteome, domain shuffling increases versatility, i.e. the number of distinct contexts in which a domain can occur. In this study we considered five important adapter domain families namely WD40, KELCH, Ankyrin, PDZ and Pleckstrin Homology (PH domain) family for the comparison of Domain versatility, Abundance and domain sharing between them. We used ecological statistics methods such as Jaccard’s Similarity Index (JSI), Detrended Correspondence Analysis, k-Means clustering for the domain distribution data. We found high propensity of domain sharing between PH and PDZ. We found higher abundance of only few selected domains in PH, PDZ, ANK and KELCH families. We also found WD40 family with high versatility and less redundant domain occurrence, with less domain sharing. Hence, the assignments of functions to more orphan WD40 proteins that will help in the identification of suitable drug targets. PMID:28246462
Forgatch, Marion S; Kjøbli, John
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.
Dwyer, Laura; Oh, April; Patrick, Heather; Hennessy, Erin
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
McNaughton, Diane B.; Cowell, Julia Muennich; Fogg, Louis
Children of Mexican immigrants are exposed to multiple ecological risks that heighten their likelihood of experiencing depressive symptoms. In previous studies, affirming parent–child communication has been found to be protective against depressive symptoms in Hispanic youth. Interventions focused on enhancing communication between parents and youth have the possibility of strengthening protective factors for children. The aims of this study were to (1) adapt an evidence-based parent–child communication intervention (Mission Possible) for cultural relevance for low-income, low-literacy Mexican immigrant mothers and their children and (2) assess feasibility of delivering the adapted intervention in a school setting. Adaptation took place in a series of focus groups of mother–child dyads. The revised intervention was delivered to 27 mother–child dyads in two elementary schools. Feasibility was supported by high participant satisfaction, 80% attendance rate, and 75% retention rate. This preliminary work suggests strategies for school nurses to partner with immigrant families and outlines a potential intervention that expands the school nursing role. PMID:23616468
Eldevik, Sigmund; Jahr, Erik; Eikeseth, Svein; Hastings, Richard P.; Hughes, Carl J.
Data from Norway were analyzed to evaluate early behavioral intervention for children with intellectual disabilities. The intervention group (n = 11) received approximately 10 hours per week of behavioral intervention; the eclectic comparison group (n = 14) received treatment as usual. After 1 year, changes in intelligence and adaptive behavior…
Simeonsson, Rune J.; And Others
The importance of evaluation in early childhood interventions of infants and toddlers with developmental disabilities is discussed. Eight questions guiding the evaluation process are presented, focusing on intervention expectations, purposes of intervention, personalization of intervention, and specification of anticipated outcomes, among others.…
Barrio, Concepcion; Yamada, Ann-Marie
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…
Compas, Bruce E.; Forehand, Rex; Keller, Gary; Champion, Jennifer E.; Rakow, Aaron; Reeslund, Kristen L.; McKee, Laura; Fear, Jessica M.; Colletti, Christina J. M.; Hardcastle, Emily; Merchant, Mary Jane; Roberts, Lori; Potts, Jennifer; Garai, Emily; Coffelt, Nicole; Roland, Erin; Sterba, Sonya K.; Cole, David A.
A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9-15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at post-intervention (2 months), after completion of 4 monthly booster sessions (6…
Li, Li; Ji, Guoping; Liang, Li-Jung; Ding, Yingying; Tian, Junru; Xiao, Yongkang
This article analyzes the efficacy of the Together for Empowerment Activities (TEA) intervention in decreasing depressive symptoms and improving social support for persons living with HIV (PLH) and their family members. A total of 79 families, consisting of 88 PLH and 79 family members, were recruited from Anhui province, China, and randomized to the TEA intervention (n = 38) or a control condition (n = 41). The intervention was delivered at three levels: 1) TEA Gathering (small group for PLH and family members); 2) TEA Time (home-based family activities with children that accompany each TEA Gathering); and 3) TEA Garden (community events that build social integration). Face-to-face interviews were administered at baseline, 3, and 6 months. Mixed-effects regression models and kernel density estimation were used for data analysis. PLH and their family members in the intervention reported significant improvements in depressive symptoms, social support, and family functioning at the 3-month and 6-month follow-up assessments compared to those in the control condition. Heterogeneous intervention effects on social support and family functioning were indicated at the 6-month follow-up. The intervention could have various effect patterns for different subgroups within the intervention condition. This study provides preliminary data to support the feasibility and efficacy of a multilevel intervention.
Schwichtenberg, A.; Poehlmann, J.
Background: Interventions based on applied behaviour analysis (ABA) are commonly recommended for children with an autism spectrum disorder (ASD); however, few studies address how this intervention model impacts families. The intense requirements that ABA programmes place on children and families are often cited as a critique of the programme,…
Salminen, Marika; Vahlberg, Tero; Ojanlatva, Ansa; Kivela, Sirkka-Liisa
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…
de la Caba Collado, Mariangeles; Rojas, Isabel Bartau
The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…
Curtis, David F.
This investigation examined the effectiveness of a pilot, manualized 10-week intervention of family skills training for ADHD-related symptoms. The intervention combined behavioral parent training and child focused behavioral activation therapy. Participants were families with children ages 7-10 diagnosed with ADHD-Combined Type. This pilot…
Toth, Sheree L.; Sturge-Apple, Melissa L.; Rogosch, Fred A.; Cicchetti, Dante
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
Lofton, Saria; Julion, Wrenetha A; McNaughton, Diane B; Bergren, Martha Dewey; Keim, Kathryn S
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.
Brittain, Kelly; Taylor, Jacquelyn Y; Wu, Chun Yi
African American women are at greater risk for complications related to high blood pressure. This study examined relationships between high blood pressure, pulse pressure, body mass index, family adaptability, family cohesion and social support among 146 Urban African American women. Significant relationships were found between family adaptability and systolic blood pressure (p = .03) and between adaptability and pulse pressure (p ≤ .01). Based on study results, practitioners should routinely assess family functioning, specifically family adaptability, in African American women who are at risk for high blood pressure or diagnosed with high blood pressure to minimize complications associated with hypertension.
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
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
Distelberg, Brian; Williams-Reade, Jackie; Tapanes, Daniel; Montgomery, Susanne; Pandit, Mayuri
Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.
Schölmerich, Vera L. N.; Kawachi, Ichiro
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…
Madan-Swain, Avi; And Others
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…
Malekpour, Mokhtar; Aghababaei, Sara; Hadi, Samira
The aim of the present study was to investigate and compare the effectiveness of family, child, and family-child based intervention on the rate of ADHD symptoms in third grade students. The population for this study was all of students with ADHD diagnoses in the city of Isfahan, Iran. The multistage random sampling method was used to select the 60…
Lapidus, Leah Blumberg
This paper describes a project designed to facilitate and evaluate child and family mental health in the community, inside and outside of Head Start programs. Also detailed is a study of the effects of "Community Impact" programs and 6-week, focused, group interventions for children and families in programs predicted to increase…
Nilsen, Liv; Frich, Jan C; Friis, Svein; Røssberg, Jan Ivar
The objective of this study is to explore patients' and family members' experiences of the different elements of a psychoeducational family intervention. A qualitative, explorative study was performed based on digitally recorded in-depth interviews with 12 patients and 14 family members. The interview data were transcribed in a slightly modified verbatim mode and analysed using systematic text condensation. Six themes that both patients and family members experienced as important in the family intervention were identified: alliance, support, anxiety and tension, knowledge and learning, time, and structure. A good relationship between the group leaders and participants was essential in preventing dropout. Meeting with other people in the same situation reduced feelings of shame and increased hope for the future. Hearing real life stories was experienced as being more important for gaining new knowledge about psychosis than lectures and workshops. However, many patients experienced anxiety and tension during the meetings. The group format could be demanding for patients immediately after a psychotic episode and for those still struggling with distressing psychotic symptoms. Group leaders need to recognise patients' levels of anxiety before, and during, the intervention, and consider the different needs of patients and family members in regards to when the intervention starts, the group format, and the patients' level of psychotic symptoms. The findings in the present study may help to tailor family work to better meet the needs of both patients and family members.
Compas, Bruce E.; Forehand, Rex; Thigpen, Jennifer C.; Keller, Gary; Hardcastle, Emily J.; Cole, David A.; Potts, Jennifer; H. Watson, Kelly; Rakow, Aaron; Colletti, Christina; Reeslund, Kristen; Fear, Jessica; Garai, Emily; McKee, Laura; Merchant, M. J.; Roberts, Lorinda
Objective: In a long-term follow-up of a randomized controlled trial (Compas et al., 2009) to examine the effects at 18- and 24-month follow-ups of a family group cognitive-behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a history of major depressive disorder…
Antoni, Michael H
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
Bassuk, Ellen L; DeCandia, Carmela J; Tsertsvadze, Alexander; Richard, Molly K
Family homelessness has become a growing public health problem over the last 3 decades. Despite this trend, few studies have explored the effectiveness of housing interventions and housing and service interventions. The purpose of this systematic review is to appraise and synthesize evidence on effective interventions addressing family homelessness. We searched 10 major electronic databases from 2007 to 2013. Empirical studies investigating effectiveness of housing interventions and housing and service interventions for American homeless families regardless of publication status were eligible for inclusion. Outcomes included housing status, employment, parental trauma and mental health and substance use, children's behavioral and academic status, and family reunification. Study quality was appraised using the Effective Public Health Practice Project tool. Six studies were included in this review. Overall, there was some postintervention improvement in housing and employment, but ongoing residential and work stability were not achieved. Methodological limitations, poor reporting quality, and inconsistent definitions across outcomes hindered between-study comparisons. Substantial limitations in research underscore the insufficiency of our current knowledge base for ending homelessness. Although many families were no longer literally homeless, long-term residential stability and employment at a livable wage were not ensured. Developing and implementing evidence-based approaches for addressing homelessness are long overdue.
Hilliard, Marisa E; Powell, Priscilla W; Anderson, Barbara J
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
Presents a case study of the effectiveness of a combination of a family literacy home intervention program with one-on-one intense tutoring for nonreading families. Notes that the family began to make positive changes in their reading environment, attitudes, and interactions which had a positive effect on their child's reading progress at school.…
Girvin, Heather; DePanfilis, Diane; Daining, Clara
Objective: An exploratory analysis of self-report data gathered by the Family Connections program is used to build a predictive model of program completion. Method: The sample includes 136 families in a poor, urban neighborhood who meet risk criteria for child neglect. Families are randomly assigned to receive 3- or 9-month interventions.…
Casses, Melissa M.; Paquette, Kelli R.
Part C of the Individuals with Disabilities Education Act (IDEA) early intervention services utilizes a family-based model of support for families of infants and toddlers with disabilities. Family-based services stem from the research of parent-child interactions as the primary means for developmental growth. This article will advocate strategies…
Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D.
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
Robbins, Michael S; Horigian, Viviana E; Szapocznik, José
Brief Strategic Family Therapy (BSFT) is an empirically-supported treatment for children and adolescents with behavior problems and substance use problems. For three decades, the efficacy and effectiveness of BSFT has been established through the results of rigorous clinical trials studies conducted at the University of Miami's Center for Family Studies. BSFT is based on family systems approaches, most notably the work of Salvador Minuchin and Jay Haley, but has been refined to meet the pressing needs of youth with behavior problems. BSFT theory and interventions cover four broad domains: joining with family members and the family system, assessing problematic family interactions, creating a motivational context for change, and restructuring family interactions.
Li, Li; Liang, Li-Jung; Ji, Guoping; Wu, Jie; Xiao, Yongkang
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
Brown, Nicola; Luckett, Tim; Davidson, Patricia M; Di Giacomo, Michelle
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.
Brown, Nicola; Luckett, Tim; Davidson, Patricia M.; Di Giacomo, Michelle
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
Njoroge, Wanjiku F. M.
This article reveals the complicated relationships among culture, family, trauma, and service delivery for immigrant families. The author describes a family who first came into contact with the service delivery system referred by the pediatrician, whose practice was an important point of entry for the early childhood work that followed. The family…
Birmes, Philippe; Raynaud, Jean-Philippe; Daubisse, Laetitia; Brunet, Alain; Arbus, Christophe; Klein, Rémy; Cailhol, Lionel; Allenou, Charlotte; Hazane, Franck; Grandjean, Hélène; Schmitt, Laurent
This study compared, 18-24 months after an industrial disaster, in two groups of children (those with clinically relevant PTSD symptoms versus those with low PTSD symptoms), the child's perception of family cohesion and adaptability, the child's experience of the explosion, and parental characteristics. Enmeshed family cohesion or rigid family adaptability were more frequently found in children with low PTSD symptoms. PTSD symptoms in the mother, living in a family of 3 or more children, and being female were significantly associated with PTSD symptoms in the children. The assessment of traumatized children should include assessment of family's adaptability and cohesion.
Reinschmidt, Kerstin M; Teufel-Shone, Nicolette I; Bradford, Gail; Drummond, Rebecca L; Torres, Emma; Redondo, Floribella; Elenes, Jo Jean; Sanders, Alicia; Gastelum, Sylvia; Moore-Monroy, Martha; Barajas, Salvador; Fernandez, Lourdes; Alvidrez, Rosy; de Zapien, Jill Guernsey; Staten, Lisa K
Diabetes health disparities among Hispanic populations have been countered with federally funded health promotion and disease prevention programs. Dissemination has focused on program adaptation to local cultural contexts for greater acceptability and sustainability. Taking a broader approach and drawing on our experience in Mexican American communities at the U.S.-Mexico Border, we demonstrate how interventions are adapted at the intersection of multiple cultural contexts: the populations targeted, the community- and university-based entities designing and implementing interventions, and the field team delivering the materials. Program adaptation involves negotiations between representatives of all contexts and is imperative in promoting local ownership and program sustainability.
Williford, Amanda P.; Shelton, Terri L.
Background: This study examined the effectiveness of an adaptation of an empirically-supported intervention delivered using mental health consultation to preschoolers who displayed elevated disruptive behaviors. Method: Ninety-six preschoolers, their teachers, and their primary caregivers participated. Children in the intervention group received…
Karst, Jeffrey S; Van Hecke, Amy Vaughan; Carson, Audrey M; Stevens, Sheryl; Schohl, Kirsten; Dolan, Bridget
Raising a child with an autism spectrum disorder (ASD) is associated with increased family chaos and parent distress. Successful long-term treatment outcomes are dependent on healthy systemic functioning, but the family impact of treatment is rarely evaluated. The Program for the Education and Enrichment of Relational Skills (PEERS) is a social skills intervention designed for adolescents with high-functioning ASD. This study assessed the impact of PEERS on family chaos, parenting stress, and parenting self-efficacy via a randomized, controlled trial. Results suggested beneficial effects for the experimental group in the domain of family chaos compared to the waitlist control, while parents in the PEERS experimental group also demonstrated increased parenting self-efficacy. These findings highlight adjunctive family system benefits of PEERS intervention and suggest the need for overall better understanding of parent and family outcomes of ASD interventions.
Biron, Caroline; Ivers, Hans; Brun, Jean-Pierre
Adapted study designs use process evaluation to incorporate a measure of intervention exposure and create an artificial control and intervention groups. Taking into account exposure levels to interventions combines process and outcome evaluation and strengthens the design of the study when exposure levels cannot be controlled. This study includes longitudinal data (two assessments) with added process measures at time 2 gathered from three complex participatory intervention projects in Canada in a hospital and a university. Structural equation modelling was used to explore the specific working mechanisms of particular interventions on stress outcomes. Results showed that higher exposure to interventions aiming to modify tasks and working conditions reduced demands and improved social support, but not job control, which in turn, reduced psychological distress. Exposure to interventions aiming to improve relationships was not related to psychosocial risks. Most studies cannot explain how interventions produce their effects on outcomes, especially when there are multiple concurrent interventions delivered in several contexts. This study advances knowledge on process evaluation by using an adapted study design to capture the active ingredients of multicomponent interventions and suggesting some mechanisms by which the interventions produce their effects on stress outcomes. It provides an illustration of how to conduct process evaluation and relate exposure levels to observed outcomes. Copyright © 2016 John Wiley & Sons, Ltd.
McFarlane, Elizabeth; Dodge, Rachel A. B.; Burrell, Lori; Crowne, Sarah; Cheng, Tina L.; Duggan, Anne K.
Objective To determine the specific aspects of early parenting in psychosocially at-risk families most strongly related to children’s social-emotional adaptation to school. Methods Cohort study of families (n=318) identified as at-risk for maltreatment of their newborns. Quality of early parenting was observed in the home when the child was one year old. Social-emotional adaptation to school was reported by teachers in first grade. Multivariable models assessed the independent influence of early parenting variables on social-emotional adaptation. Results Early parenting and social-emotional adaptation to school varied greatly across families. Parental warmth was associated with lower teacher ratings of shyness, concentration problems, and peer rejection. Parental lack of hostility was associated with decreased teacher ratings of concentration problems and peer rejection. Parental encouragement of developmental advance was associated with lower ratings of aggression and peer rejection. Provision of materials to promote learning and literacy was associated with lower ratings of concentration problems. Conclusions In this sample of families with multiple psychosocial risks for child maltreatment, specific aspects of early parenting were associated with better social-emotional adaptation to school in the first grade in theoretically predicted ways. Improving parental knowledge about positive parenting via anticipatory guidance should be a focus of well child visits. Well child visit-based interventions to improve the quality of early parenting especially among at-risk families should be studied for their impact on parenting behavior and on children’s successful social-emotional adaptation to school. Primary care providers should reinforce complementary services, such as home visiting, that seek to promote positive parenting. PMID:20816655
MacDonell, Kathleen Watson; Prinz, Ronald J
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.
Castro, Felipe González; Barrera, Manuel; Holleran Steiker, Lori K.
This article examines issues and challenges in the design of cultural adaptations that are developed from an original evidence-based intervention (EBI). Recently emerging multistep frameworks or stage models are examined, as these can systematically guide the development of culturally adapted EBIs. Critical issues are also presented regarding whether and how such adaptations may be conducted, and empirical evidence is presented regarding the effectiveness of such cultural adaptations. Recent evidence suggests that these cultural adaptations are effective when applied with certain subcultural groups, although they are less effective when applied with other subcultural groups. Generally, current evidence regarding the effectiveness of cultural adaptations is promising but mixed. Further research is needed to obtain more definitive conclusions regarding the efficacy and effectiveness of culturally adapted EBIs. Directions for future research and recommendations are presented to guide the development of a new generation of culturally adapted EBIs. PMID:20192800
Robinson, Gary; Tyler, William; Jones, Yomei; Silburn, Sven; Zubrick, Stephen R.
This article describes challenges met implementing an early intervention programme for Aboriginal parents and their children in the NT (Northern Territory) of Australia in the context of efforts to remediate Aboriginal disadvantage. The intervention is an adaptation of an 8- to 10-week, manualised parenting programme designed for four- to…
Tuck, Inez; Baliko, Beverly; Schubert, Christine M; Anderson, Lorraine
Homicide causes negative unintended consequences for family survivors. Family survivors face complicated grief and overwhelming loss with minimal support from others. The authors offered a retreat intervention as a way to ameliorate the effects of the homicidal death for family survivors of homicide. An exploratory longitudinal pilot study examined the feasibility and acceptability of the intervention and explored the impact of the TOZI© Healing intervention on participants' distress symptoms. Eight family members participated in the 2-day retreat and completed surveys at five time intervals over 30 months. Descriptive statistics and correlations were used to analyze the data. Although sample sizes were too small to achieve statistical significance, changes on selected holistic health outcomes, supported by overwhelmingly positive focus group responses to the intervention, affirm the need for further study.
Mazefsky, Carla A.; Williams, Diane L.; Minshew, Nancy J.
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…
Uruk, Ayse C.; Sayger, Thomas V.; Cogdal, Pamela A.
This study specifically examined the influence of family cohesion and adaptability on college students' trauma symptoms and psychological well-being in a sample of 189 undergraduate students. The participants were administered the Family Adaptability and Cohesion Evaluation Scales-III (FACES-III), L.A. Symptom Checklist, and Scales of…
Distelberg, Brian; Castanos, Carolina
Family businesses (FBs) are a significant population in the world and therefore part of most practicing marriage and family therapists (MFTs) clientele; however, little is mentioned about FBs in the training of MFTs. This article offers some guidance to practicing MFTs who service this population, as well as MFTs who wish to expand their practice…
Natera Rey, Guillermina; Mora-Rios, Jazmin; Tiburcio Sainz, Marcela; Medina Aguilar, Perla
In this article, the authors comment on the contribution of the Alcohol, Drugs and the Family research group to draw public and scientific attention to the suffering and needs of families coping with addiction problems. The article also describes the impact of the stress-strain-coping-support model and the 5-Step Method on the research,…
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
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
Moreault, L; Gagnon, C; Labrecque, E
The "Marrainage" project involves the implementation and evaluation of an intervention to prevent negligence in at-risk families with at least one child between the age of 0 and 5. The goal of the intervention is to introduce into those families, working nonprofessionals who can help them create their own natural support network and improve the quality of the family environment. The sponsors offer the following support services: emotional support, counselling-information, physical assistance, social skills development, positive feedback, and material needs. The sponsors work most often with the mother. The services provided to children consist mainly of outings, games and personal care. Such interventions have positive effects on the family environment, particularly on the parents' abilities and the psychological well-being of the mother. On the other hand, there is no conclusive evidence of a positive impact on the use of the families' natural networks.
Toth, Sheree L; Sturge-Apple, Melissa L; Rogosch, Fred A; Cicchetti, Dante
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.
Meneses, Karen; Gisiger-Camata, Silvia; Schoenberger, Yu-Mei; Weech-Maldonado, Robert; McNees, Patrick
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
Krattenmacher, Thomas; Beierlein, Volker; Grimm, Johann Christian; Bergelt, Corinna; Romer, Georg; Möller, Birgit
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
O'Hara, David M.; Levy, Judith M.
The article reviews literature pertaining to general effects of a developmentally disabled child on a family with particular emphasis on implications for families with learning disabled children. Covered are aspects of individual and family life cycles during various life stages, sibling adjustment, and intervention approaches with the child and…
Collins, Kathryn S.; Strieder, Frederick H.; DePanfilis, Diane; Tabor, Maureen; Clarkson Freeman, Pamela A.; Linde, Linnea; Greenberg, Patty
Families living in urban poverty, enduring chronic and complex traumatic stress, and having difficulty meeting their children's basic needs have significant child maltreatment risk factors. There is a paucity of family focused, trauma-informed evidence-based interventions aimed to alleviate trauma symptomatology, strengthen family functioning, and…
Simmons, Sandra F.; Ouslander, Joseph G.
Purpose: This study evaluated whether the satisfaction levels of long-term-care residents and their family members concerning incontinence and mobility care were sensitive to an improvement intervention. Design and Methods: A randomized, controlled intervention trial with incontinent long-term-care residents was conducted wherein research staff…
Berkowitz, Steven J.; Stover, Carla Smith; Marans, Steven R.
Objective: This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE). Method: One-hundred seventy-six 7…
Hurth, Joicey; Goff, Paula
The procedural safeguards required by the Infants and Toddlers with Disabilities Program (Part C) of the Individuals with Disabilities Education Act (IDEA) are intended to protect the interests of families with infants and toddlers with special needs and of the early intervention system. Early intervention system personnel are legally obligated to…
Hocking, Matthew C.; Kazak, Anne E.; Schneider, Stephanie; Barkman, Darlene; Barakat, Lamia P.; Deatrick, Janet A.
Family-based interventions in pediatric cancer face challenges associated with integrating psychosocial care into a period of intensive treatment and escalating stress. Little research has sought input from parents on the role of interventions delivered shortly after diagnosis. This mixed-methods study obtained parents’ perspectives on the potential role of family-based interventions. Twenty-five parents provided feedback on the structure and timing of psychosocial interventions via focus groups and a questionnaire. Qualitative analyses resulted in three themes that were illustrative of a traumatic stress framework: 1) tension between focusing on child with cancer and addressing other family needs, 2) factors influencing parents’ perception of a shared experience with other parents, and 3) the importance of matching interventions to the trajectory of parent adjustment. Quantitative data indicated that parents preferred intervention within six months of diagnosis, with almost half favoring within two months of diagnosis, and the majority wanted interventions targeted to parents only. Qualitative themes highlight the importance of using a traumatic stress framework to inform the development of family-based interventions for those affected by pediatric cancer. PMID:24337762
Vaughn, Bobbie J.; Clarke, Shelley; Dunlap, Glen
Functional assessments and assessment-based interventions were conducted with an 8-year-old boy with disabilities and severe problem behavior in the context of two family routines: using the home bathroom and dining in a fast-food restaurant. A multiple baseline design demonstrated the effectiveness of the intervention package as implemented by…
Burgio, Louis; Stevens, Alan; Guy; Delois; Roth, David L.; Haley, William E.
Purpose: We developed manual-guided, replicable interventions based on common needs and cultural preferences of White and African American family caregivers (CGs) of individuals with dementia, and we evaluated these interventions after a 6-month follow-up. Design and Methods: We randomly assigned White (n = 70) and African American (n = 48) CGs of…
Winslow, Emily B.; Bonds, Darya; Wolchik, Sharlene; Sandler, Irwin; Braver, Sanford
Participation rates in parenting programs are typically low, severely limiting the public health significance of these interventions. We examined predictors of parenting program enrollment and retention in a sample of 325 divorced mothers. Predictors included intervention timing and maternal reports of child, parent, family, and sociocultural risk…
Roberts, Clare; Mazzucchelli, Trevor; Studman, Lisa; Sanders, Matthew R.
The outcomes of a randomized clinical trial of a new behavioral family intervention, Stepping Stones Triple P, for preschoolers with developmental and behavior problems are presented. Forty-eight children with developmental disabilities participated, 27 randomly allocated to an intervention group and 20 to a wait-list control group. Parents…
Hulette, Annmarie C.; Dunham, Mackenzie; Davis, Mindy; Gortney, Jason; Lieberman, Alicia F.
This article describes the Attachment Vitamins program, a trauma-informed parent group intervention for families with young children. Attachment Vitamins is a relational psychoeducational intervention based on the principles of Child-Parent Psychotherapy (CPP). Its goal is to repair the impact of chronic stress and trauma through strengthening the…
Aylward, Brandon S.; Jensen, Chad D.; Cushing, Christopher C.; Davis, Ann M.; Bovaird, James A.
Objective To examine the effectiveness of a family-based behavioral group intervention (Positively Fit; PF) for pediatric obesity relative to a brief family intervention (BFI) in a sample of treatment-seeking children and adolescents. Methods Families (n = 93) were randomized to treatment condition. Assessments were conducted at pre- and posttreatment and at 12-month follow-up. Outcome indices included standardized body mass index (BMI) and quality of life (QOL). Results Results indicated a significant reduction in zBMI at posttreatment and follow-up across both conditions. At follow-up, BFI and PF participants evidenced average reductions of .12 and .19 zBMI units, respectively. Children demonstrated better outcomes than adolescents across both conditions. Results indicated clinically significant improvements in parent-reported QOL at postintervention and in self-reported QOL at follow-up for PF participants. Conclusions Results suggest the effectiveness of family-based interventions for pediatric obesity in clinical settings among younger children. Neither intervention was effective in terms of reducing zBMI among adolescents. PMID:21852343
Allen, Rebecca S.; Harris, Grant M.; Burgio, Louis D.; Azuero, Casey B.; Miller, Leslie A.; Shin, Hae Jung; Eichorst, Morgan K.; Csikai, Ellen L.; DeCoster, Jamie; Dunn, Linda L.; Kvale, Elizabeth; Parmelee, Patricia
Context Palliative care patients and their family caregivers may have a foreshortened perspective of time left to live, or the expectation of the patient’s death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms. Objectives To conduct a randomized controlled trial examining the effectiveness of retired senior volunteers (RSVs) in delivering a reminiscence and creative activity intervention aimed at alleviating palliative care patient and caregiver distress. Methods Of the 45 dyads that completed baseline, 28 completed post-intervention and 24 completed follow-up. The intervention group received three home visits by RSVs; control group families received three supportive telephone calls by research staff. Measures included symptom assessment and associated burden, depression, religiousness/spirituality, and meaning in life. Results Patients in the intervention group reported a significantly greater reduction in frequency of emotional symptoms (P = 0.02) and emotional symptom bother (P = 0.04) than the control group, as well as improved spiritual functioning. Family caregivers in the intervention group were more likely than control caregivers to endorse items on the Meaning in Life Scale (P = 0.02). Only improvement in intervention patients’ emotional symptom bother maintained at follow-up after discontinuing RSV contact (P = 0.024). Conclusion Delivery of the intervention by RSVs had a positive impact on palliative care patients’ emotional symptoms and burden and caregivers’ meaning in life. Meaningful prolonged engagement with palliative care patients and caregivers, possibly through alternative modes of treatment delivery such as continued RSV contact, may be necessary for maintenance of therapeutic effects. PMID:24667180
Mautone, Jennifer A.; Marshall, Stephen A.; Sharman, Jaclyn; Eiraldi, Ricardo B.; Jawad, Abbas F.; Power, Thomas J.
Although numerous studies have evaluated the effectiveness of multimodal psychosocial interventions for children with attention deficit hyperactivity disorder, these programs are limited in that there has not been an explicit focus on the connection between family and school. This study was designed to develop and pilot test a family-school…
Wade, Shari L.; Carey, Joanne; Wolfe, Christopher R.
This study examined whether an online problem-solving intervention could improve parental adjustment following pediatric traumatic brain injury (TBI). Families of children with moderate-to-severe TBI were recruited from the trauma registry of a large children's hospital and randomly assigned to receive online family problem solving therapy (FPS; n…
Parette, P.; Chuang, S-J. L.; Huer, M. B.
This study employed an intensive structured interview method with first-generation Chinese American family participants (n = 6) residing in the Los Angeles area to examine families' perceptions of disability and the role of schools in augmentative and alternative communication (AAC) interventions. As reported in other studies, parents (a) valued…
Brody, Gene H.; Chen, Yi-fu; Kogan, Steven M.; Smith, Karen; Brown, Anita C.
This study focused on the buffering effects of Adults in the Making (AIM), a family-centered preventive intervention, on the link between life stress and increases in risk behaviors among 347 rural, southern African Americans as they left high school. Of the families, 174 were assigned to the prevention condition and 173 to a control condition.…
Bennett, Tess; And Others
Effects of family-oriented early intervention on the home environment were explored in a 6-month study of 23 handicapped children (ages birth to 5) and their families, who participated as members of an experimental or control group. The Home Observation for Measurement of the Environment (HOME) Inventory was administered to evaluate differences in…
Brandt, Patricia A.; Magyary, Diane L.
Nursing specialists are prepared at the master's level to function as members of interdisciplinary and family-centered early intervention teams for disabled children. A specialty program of study emphasizes advanced and specialized clinical practice; education of clients, families, staff, and professionals; consultation; research use; evaluation…
Research and Training Center on Family Support and Children's Mental Health, 2006
"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" discusses family-based interventions and how they may have both direct and indirect effects. While the measurement of direct outcomes for a targeted group is important, a…
Tolan, Patrick; Gorman-Smith, Deborah; Henry,David
Four hundred twenty-four families who resided in inner-city neighborhoods and had a child entering 1st grade were randomly assigned to a control condition or to a family-focused preventive intervention combined with academic tutoring. SAFEChildren, which was developed from a developmental-ecological perspective, emphasizes developmental tasks and…
Herman, Keith C.; Borden, Lindsay A.; Hsu, Chinghui; Schultz, Tia R.; Carney, Megan Strawsine; Brooks, Connie M.; Reinke, Wendy M.
Much progress has been made in helping families improve their relationships and provide effective environments for their children. However, an ongoing challenge in implementing these practices is to actively engage families in interventions for youth. Most effective treatments for youth require some level of caregiver involvement. Research has…
Fareo, Dorcas Oluremi
All couples look forward to having normal healthy babies. The issues of disabilities in their children shake the families and serve as sources of severe psychological disruption to family adjustment. The parents of such children live with many difficult issues and frequently experience trauma, grief and stress. Intervention programmes are…
Colonnesi, Cristina; Wissink, Inge B.; Noom, Marc J.; Asscher, Jessica J.; Hoeve, Machteld; Stams, Geert Jan J. M.; Polderman, Nelleke; Kellaert-Knol, Marijke G.
Objectives: We evaluated a new attachment-oriented intervention aimed at improving parental mind-mindedness, promoting positive parent-child relationships, and reducing child psychopathology in families with adopted children. Method: The sample consisted of 20 families with adopted children (2-5 years of age). After the pretest, the intervention…
Votava, Kristen M.
The purpose of this study was to gain an understanding of six state-wide policies and procedures used in the family assessment process within early intervention services. This study looked at the administrative understanding of the family assessment federal regulations, state policies and procedures, and local implementation from the perspective…
Linville, Deanna; Lyness, Anne Prouty
The purpose of this qualitative study was to understand how 20 families have adapted after adopting children between the ages of 3 and 5 years from eastern European institutions. The researcher visited a Romanian orphanage and then interviewed 20 families about their experiences with the adoption process and with family adaptation postadoption. Several themes emerged from the parents' stories regarding their search for support and resources to aid in parenting their children. Family therapists who are interested in working with families who adopt internationally from institutional settings can learn from the stories of parents.
Mas, Joana Maria; Giné, Climent; McWilliam, Robin A.
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…
Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.
Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. Study design A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Conclusion Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved
Davey, Maureen; Gulish, Laurel; Askew, Julie; Godette, Karen; Childs, Nicole
The purpose of this pilot study was to gain a deeper understanding of how adolescents are affected by their mothers' breast cancer and to discover their opinions about how future intervention programs should be designed. Three focus groups were conducted with a total of 10 adolescents. Findings indicate that adolescents' lives had been complicated…
Bendixen, Roxanna M; Elder, Jennifer H; Donaldson, Susan; Kairalla, John A; Valcante, Greg; Ferdig, Richard E
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.
Adams, Marc A.; Sallis, James F.; Norman, Gregory J.; Hovell, Melbourne F.; Hekler, Eric B.; Perata, Elyse
Background Physical activity (PA) interventions typically include components or doses that are static across participants. Adaptive interventions are dynamic; components or doses change in response to short-term variations in participant's performance. Emerging theory and technologies make adaptive goal setting and feedback interventions feasible. Objective To test an adaptive intervention for PA based on Operant and Behavior Economic principles and a percentile-based algorithm. The adaptive intervention was hypothesized to result in greater increases in steps per day than the static intervention. Methods Participants (N = 20) were randomized to one of two 6-month treatments: 1) static intervention (SI) or 2) adaptive intervention (AI). Inactive overweight adults (85% women, M = 36.9±9.2 years, 35% non-white) in both groups received a pedometer, email and text message communication, brief health information, and biweekly motivational prompts. The AI group received daily step goals that adjusted up and down based on the percentile-rank algorithm and micro-incentives for goal attainment. This algorithm adjusted goals based on a moving window; an approach that responded to each individual's performance and ensured goals were always challenging but within participants' abilities. The SI group received a static 10,000 steps/day goal with incentives linked to uploading the pedometer's data. Results A random-effects repeated-measures model accounted for 180 repeated measures and autocorrelation. After adjusting for covariates, the treatment phase showed greater steps/day relative to the baseline phase (p<.001) and a group by study phase interaction was observed (p = .017). The SI group increased by 1,598 steps/day on average between baseline and treatment while the AI group increased by 2,728 steps/day on average between baseline and treatment; a significant between-group difference of 1,130 steps/day (Cohen's d = .74). Conclusions The adaptive
Seiverling, Laura; Hendy, Helen M; Yusupova, Stella
The present study examined changes in child and family mealtime patterns before and after intensive behavioral feeding intervention at a multidisciplinary hospital-based program for 50 children. At preintervention and postintervention, caregivers completed surveys to report child feeding goals and the About Your Child's Eating scale (AYCE). In addition, at postintervention, each caregiver rated intervention effectiveness for his or her child's feeding goals identified at preintervention and provided intervention satisfaction ratings. Results revealed that caregivers perceived all three AYCE family mealtime patterns to improve from preintervention to postintervention, the majority of caregivers rated intervention as being effective for improving the specific child feeding goals identified at preintervention, and caregivers gave high satisfaction ratings for the intervention.
Anderson, Kathryn Hoehn; Friedemann, Marie-Luise
A Web-based certificate program for international health professionals to acquire understanding of family health and strategies to implement culturally sensitive health care of families is outlined. In four Web courses and a project, students progress interactively to apply culture, family, and interdisciplinary health system theories to assessments and clinical interventions with families in the interdisciplinary setting. Four online educational strategies to facilitate student success from the virtual classroom to actual clinical care are described: adjusting to the technology, communicating the learning progress openly, giving mutual feedback, and implementing evidence-based family care. Outcomes addressing student learning and skill enhancement, family interaction, and student and faculty experiences in the virtual learning environment are explored. Overall, students learned to work successfully with families in health care, experienced increasing comfort and competency in challenging situations, introduced family care in their work setting, and emerged as leaders while working in interdisciplinary teams.
Karst, Jeffrey S; Van Hecke, Amy Vaughan
Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.
Schatz, Mona Struhsaker; Salz, Michael
This paper describes the experiences of a psychologist and social worker trainer from 1992-1995 as she traveled throughout Post-Peristroika Russia and Eastern Europe working with families. The author describes how being in another country caused her to adjust her notions of what is "normal," and she discusses how culture contributes to…
Withrow, Rebecca L.
Counselors and early interventionists increasingly serve Spanish-speaking families. Yet, often, cultural accommodations merely imply use of interpreters or bilingual providers. Cultural competence requires self-awareness and understanding the client's community and specific risk and resiliency factors. Implications for serving clients of Latino…
Hill, Laura G.; Owens, Robert W.
Purpose: Most studies of adherence use a single global measure to examine the relation of adherence to outcomes. These studies inform us about effects of overall implementation but not about importance of specific program elements. Previous research on the Strengthening Families Program 10-14 has shown that outcomes were unrelated to global…
The experience of consultants in a pediatric hospital indicates that infant failure to thrive is almost always associated with strain in the relationships of the infant's caregivers. Consequently, a nontraditional, long-term, home-based, and family-centered model of evaluation and treatment of failure to thrive has been developed which involves…
Jinks, Annette; English, Sue; Coufopoulos, Anne
Purpose: The purpose of this paper is to conduct an in-depth quantitative and qualitative evaluation of a family-based weight loss and healthy life style programme for clinically obese children in England. Design/methodology/approach: The mixed method case study evaluation used included obtaining pre and post measurements of anthropometry and a…
Interian, Alejandro; Martinez, Igda; Rios, Lisbeth Iglesias; Krejci, Jonathan; Guarnaccia, Peter J.
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
Riley, William T.; Serrano, Katrina J.; Nilsen, Wendy; Atienza, Audie A.
Recent advances in mobile and wireless technologies have made real-time assessments of health behaviors and their influences possible with minimal respondent burden. These tech-enabled real-time assessments provide the basis for intensively adaptive interventions (IAIs). Evidence of such studies that adjust interventions based on real-time inputs is beginning to emerge. Although IAIs are promising, the development of intensively adaptive algorithms generate new research questions, and the intensive longitudinal data produced by IAIs require new methodologies and analytic approaches. Research considerations and future directions for IAIs in health behavior research are provided. PMID:26086033
Riley, William T; Serrano, Katrina J; Nilsen, Wendy; Atienza, Audie A
Recent advances in mobile and wireless technologies have made real-time assessments of health behaviors and their influences possible with minimal respondent burden. These tech-enabled real-time assessments provide the basis for intensively adaptive interventions (IAIs). Evidence of such studies that adjust interventions based on real-time inputs is beginning to emerge. Although IAIs are promising, the development of intensively adaptive algorithms generate new research questions, and the intensive longitudinal data produced by IAIs require new methodologies and analytic approaches. Research considerations and future directions for IAIs in health behavior research are provided.
Josephson, Allan M.
Objective: This article discusses the pedagogy of teaching family therapy in the new millennium. It draws on the strengths of "family systems therapy" but goes beyond it--suggesting a new paradigm, new terminology, and a new teaching perspective. It discusses the historical background of family therapy training, a scientific foundation for what…
Grácio, Jaime; Gonçalves-Pereira, Manuel; Leff, Julian
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.
Dunbar, Sandra B.; Clark, Patricia C.; Reilly, Carolyn M.; Gary, Rebecca A.; Smith, Andrew; McCarty, Frances; Higgins, Melinda; Grossniklaus, Daurice; Kaslow, Nadine; Frediani, Jennifer; Dashiff, Carolyn; Ryan, Richard
Background Lowering dietary sodium and adhering to medication regimens are difficult for persons with heart failure (HF). Because these behaviors often occur within the family context, this study evaluated the effects of family education and partnership interventions on dietary sodium (NA) intake and medication adherence (MA). Methods HF patients and family member (FM) dyads (N = 117) were randomized to: usual care (UC), Patient-FM education (PFE), or a family partnership intervention (FPI). Dietary NA (3-day food record), Urine NA (24-hour urine) and MA (MEMS®) were measured at baseline (BL) prior to randomization, and at 4 and 8 months (M). Results FPI and PFE reduced Urine NA at 4 M, and FPI differed from UC at 8 M (p=.016). Dietary NA decreased from BL to 4M with both PFE (p=.04) and FPI (p=.018) lower than UC. The proportion of subjects adherent to NA intake (≤ 2500 mg/day) was higher at 8 M in PFE and FPI vs UC (χ2(2)=7.076, p=.029). MA did not differ among groups across time. Both FPI and PFE groups increased HF knowledge immediately after intervention. Conclusions Dietary NA intake, but not MA, was improved by the PFE and FPI interventions compared with UC. UC was less likely to be adherent with dietary NA. Greater efforts to study and incorporate family-focused education and support interventions into HF care are warranted. PMID:24331203
Lehan, Tara J; Stevens, Lillian Flores; Arango-Lasprilla, Juan Carlos; Díaz Sosa, Dulce María; Espinosa Jove, Irma Guadalupe
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.
Department of the Army position , policy or decision unless so designated by other documentation. 2 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704...participant enrollment with this plan in place. 15. SUBJECT TERMS Military dependents, recruiting, military bases, obesity 16. SECURITY CLASSIFICATION OF...INTRODUCTION: Obesity and overweight are at epidemic levels in American Warfighters and their family members, and impact health, health care costs, absenteeism
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
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.
Heller, Tamar; Gibbons, Hailee M; Fisher, Dora
This scoping review addressed the following questions: (a) What types of caregiver interventions are being done in both aging and developmental disability research? (b) How are these interventions similar and different? (c) What kinds of outcomes do these interventions have? (d) What innovative approaches are these interventions using? and (e) What can each field (developmental disabilities and gerontology) learn from the other based on this review? The disability review spanned 20 years (1992-2012), resulting in 14 studies; the aging review spanned 5 years (2008-2012), resulting in 55 studies. Data from the final selected studies were then extracted and compared on research design, type of intervention (governmental programs, small-group psychosocial, and other), and outcomes. Generally, in both fields, family-support interventions benefited participants' well-being and improved service access and satisfaction. Increased partnership between the fields of aging and developmental disabilities is critical to future scholarship in caregiving for both populations.
Janicke, David M; Lim, Crystal S; Perri, Michael G; Bobroff, Linda B; Mathews, Anne E; Brumback, Babette A; Dumont-Driscoll, Marilyn; Silverstein, Janet H
The Extension Family Lifestyle Intervention Project (E-FLIP for Kids) is a three-arm, randomized controlled trial assessing the effectiveness of two behavioral weight management interventions in an important and at-risk population, overweight and obese children and their parents in rural counties. Participants will include 240 parent-child dyads from nine rural counties in north central Florida. Dyads will be randomized to one of three conditions: (a) a Family-Based Behavioral Group Intervention, (b) a Parent-Only Behavioral Group Intervention, and (c) an Education Control Condition. Child and parent participants will be assessed at baseline (month 0), post-treatment (month 12) and follow-up (month 24). Assessment and intervention sessions will be held at Cooperative Extension Service offices within each participating county. The primary outcome measure is change in child BMI z-score. Additional key outcome measures include child body fat, waist circumference, dietary intake, physical activity, blood lipids, blood glucose, blood pressure, physical fitness, quality of life, and program and participants costs. Parent BMI, dietary intake, and physical activity also will be assessed. Randomized controlled trials testing the effectiveness of childhood obesity interventions in real-world community-based settings are extremely valuable, but much too rare. The E-FLIP for Kids trial will evaluate the impact of a community-based intervention delivered to families in rural settings utilizing the existing Cooperative Extension Service network on long-term child behavior, weight status and biological markers of diabetes and early cardiovascular disease. If successful, a Parent-Only intervention program may provide a cost-effective and practical intervention for families in underserved rural communities.
Spoth, Richard; Redmond, Cleve; Shin, Chungyeol; Azevedo,Kari
This study examines the effects of 2 brief family-focused interventions on the trajectories of substance initiation over a period of 6 years following a baseline assessment. The 2 interventions, designed for general-population families of adolescents, were the 7-session Iowa Strengthening Families Program (ISFP) (Molgaard & Spoth, 2001) and the…
Hartmann, Miriam; Gilles, Kate; Shattuck, Dominick; Kerner, Brad; Guest, Greg
Research suggests that spousal communication and male involvement in decision making can positively influence family-planning use and continuation. However, few existing studies explore the dynamics of this communication and how they factor into family-planning decision making. Building upon a recent evaluation of a theory-based male-involvement intervention in Malawi, this study aimed to fill this gap by examining the role of communication in the intervention's success, through semi-structured in-depth interviews with male participants and female partners of study participants. Results support the idea that communication is an integral component of successful interventions to increase male involvement in family planning. Participants reported improvements in spousal communication, increased frequency of communication, and an increase in shared decision making as a result of the study, which directly contributed to their family-planning use. This effect was often mediated through increased knowledge or reduced male opposition to family planning. Further analysis of communication and decision-making dynamics revealed shifts in gendered communication norms, leading to improvements in spousal relationships in addition to contraceptive uptake. This study shows that interventions can and should encourage spousal communication and shared decision making, and it provides an effective model for involving men in family-planning use.
Ichikawa, Carolliny Rossi de Faria; Bousso, Regina Szylit; Misko, Maira Deguer; Mendes-Castillo, Ana Marcia Chiaradia; Bianchi, Estela Regina Ferraz; Damião, Elaine Buchhorn Cintra
Objectives to perform the cultural adaptation of the Family Management Measure into the Brazilian Portuguese language. Method the method complied with international recommendations for this type of study and was composed of the following steps: translation of the instrument into the Portuguese language; reaching consensus over the translated versions; assessment by an expert committee; back translation; and pretest. Results these stages enabled us to obtain conceptual, by-item, semantic, idiomatic, and operational equivalences, in addition to content validation. Conclusion the Family Management Measure is adapted to the Brazilian Portuguese language and that version is named Instrumento de Medida de Manejo Familiar. PMID:24553711
Caruthers, Allison S; Van Ryzin, Mark J; Dishion, Thomas J
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 sixth 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. Furthermore, 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.
Daniel, Tinuke Oluyomi; Kilanowski, Colleen K; Collins, R Lorraine
Background The bias toward immediate gratification is associated with maladaptive eating behaviors and has been cross-sectionally and prospectively related to obesity. Engaging in episodic future thinking, which involves mental self-projection to pre-experience future events, reduces this bias and energy intake in overweight/obese adults and children. To examine how episodic future thinking can be incorporated into clinical interventions, a Web-based system was created to provide training for adults and children in their everyday lives. Objective Our study examined the technical feasibility, usability, and acceptability of a Web-based system that is accessible by mobile devices and adapts episodic future thinking for delivery in family-based obesity interventions. Methods We recruited 20 parent-child dyads (N=40) from the surrounding community and randomized to episodic future thinking versus a nutritional information thinking control to test the feasibility of a 4-week Web-based intervention. Parents were 44.1 (SD 7.8) years of age with BMI of 34.2 (SD 6.8) kg/m2. Children were 11.0 (SD 1.3) years of age with BMI percentile of 96.0 (SD 1.8). Families met weekly with a case manager for 4 weeks and used the system daily. Adherence was collected through the Web-based system, and perceived acceptance of the Web-based system was assessed postintervention. Measurements of body composition and dietary intake were collected at baseline and after the 4 weeks of intervention. Results All 20 families completed the intervention and attended all sessions. Results showed parents and children had high adherence to the Web-based system and perceived it to be easy to use, useful, and helpful. No differences between conditions were found in adherence for parents (P=.65) or children (P=.27). In addition, results suggest that basic nutrition information along with episodic future thinking delivered through our Web-based system may reduce energy intake and weight. Conclusions We
Shonkoff, J P; Hauser-Cram, P
In an evaluation of 31 selected studies, statistical procedures for synthesizing data (meta-analysis) were used to assess the effects of early intervention services on disabled children younger than 3 years of age and on their families. Results indicate that early intervention is effective in promoting developmental progress in infants and toddlers with biologically based disabilities. Programs that served a heterogeneous group of children, provided a structured curriculum, and targeted their efforts on parents and children together appeared to be the most effective. Definitive evaluation of the efficacy of early intervention programs is tempered by the restricted range of outcomes measured and by a paucity of information about the children and families enrolled in such programs, as well as about the specific nature of the services received. Despite their limitations, available data provide the basis for a rational pediatric approach to early intervention programs, while highlighting specific directions for further investigation.
Lofton, Saria; Julion, Wrenetha A.; McNaughton, Diane B.; Bergren, Martha Dewey; Keim, Kathryn S.
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…
Ji, Mingxia; Hui, Eadaoin; Fu, Hong; Watkins, David; Tao, Linjin; Lo, Sing Kai
The understanding and application of forgiveness varies across cultures. The current study aimed to examine the effect of a culture-adaptive Forgiveness Intervention on forgiveness attitude, self-esteem, empathy and anxiety of Mainland Chinese college students. Thirty-six participants were randomly allocated to either experimental groups or a…
Nandola, Naresh N.; Rivera, Daniel E.
This paper presents a novel model predictive control (MPC) formulation for linear hybrid systems. The algorithm relies on a multiple-degree-of-freedom formulation that enables the user to adjust the speed of setpoint tracking, measured disturbance rejection and unmeasured disturbance rejection independently in the closed-loop system. Consequently, controller tuning is more flexible and intuitive than relying on move suppression weights as traditionally used in MPC schemes. The formulation is motivated by the need to achieve robust performance in using the algorithm in emerging applications, for instance, as a decision policy for adaptive, time-varying interventions used in behavioral health. The proposed algorithm is demonstrated on a hypothetical adaptive intervention problem inspired by the Fast Track program, a real-life preventive intervention for improving parental function and reducing conduct disorder in at-risk children. Simulation results in the presence of simultaneous disturbances and significant plant-model mismatch are presented. These demonstrate that a hybrid MPC-based approach for this class of interventions can be tuned for desired performance under demanding conditions that resemble participant variability that is experienced in practice when applying an adaptive intervention to a population. PMID:20830213
Ahlert, Ingrid A; Greeff, Abraham P
The study objective was to identify and explore resilience qualities that help protect and support families facing the adversity associated with having a child with hearing loss. The Resiliency Model of Family Stress, Adjustment, and Adaptation (M. A. McCubbin & H. I. McCubbin, 1993, 1996) provided the study's theoretical framework. The 54 participating families resided in Western Cape Province, South Africa, and were identified according to the nature of the crisis (having a child with hearing loss) and the family's developmental phase. Quantitative and qualitative measures were used for data collection. The results showed that family time and routines, social support, affirming communication, family hardiness, problem-solving skills, religion, a search for meaning, and acceptance of the child's hearing status were associated with family resilience. Strengthening these elements helps families to grow, meet challenges, and reestablish balance and harmony within the family system.
Knowlden, A P; Sharma, M
The family and home environment is a highly influential psychosocial antecedent of paediatric obesity. The purpose of this investigation was to systematically analyze family and home-based randomized control trials aimed at treating overweight and obesity in children ages 2-7 years. In gathering materials for this review, a search of Cumulative Index to Nursing and Allied Health, MEDLINE, Education Resources Information Center, Psychology and Behavioural Sciences Collection and CENTRAL databases was conducted for the time frame of January 2001 to August 2011. The data extraction spanned three phases resulting in a total of nine interventions that met the specified inclusion criteria. Among the identified studies, eight produced significant outcomes. The majority of the programmes incorporated educational sessions targeting parents as the primary modality for intervention delivery. Less than one-quarter of the interventions included home visitations; however, all of the interventions included home-based activities to reinforce behaviour modification. Only three of the interventions applied social and behavioural theory, and only two interventions employed process evaluation. Additional research is needed to gauge the efficacy of the home and family milieu for treating paediatric obesity.
Shea, Beverley; Nahwegahbow, Amy; Andersson, Neil
Many efforts to reduce family violence are documented in the published literature. We conducted a systematic review of interventions intended to prevent family violence in Aboriginal communities. We retrieved studies published up to October 2009; 506 papers included one systematic review, two randomized controlled trials, and fourteen nonrandomized studies or reviews. Two reviews discussed interventions relevant to primary prevention (reducing the risk factors for family violence), including parenting, role modelling, and active participation. More studies addressed secondary prevention (where risk factors exist, reducing outbreaks of violence) such as restriction on the trading hours for take away alcohol and home visiting programs for high risk families. Examples of tertiary prevention (preventing recurrence) include traditional healing circles and group counselling. Most studies contributed a low level of evidence. PMID:21052554
Gopalan, Geetha; Bannon, William; Dean-Assael, Kara; Fuss, Ashley; Gardner, Lauren; LaBarbera, Brooke; McKay, Mary
Differences between child welfare- and nonchild welfare-involved families regarding barriers to child mental health care, attendance, program satisfaction, and relationship with facilitators are examined for a multiple family group service delivery model aimed at reducing childhood disruptive behaviors. Although child welfare-involved caregivers…
Stejskal, Taryn M
Rehabilitation professionals have become increasingly aware that family members play a critical role in the recovery process of individuals after brain injury. In addition, researchers have begun to identify a relationship between family member caregivers' well-being and survivors' outcomes. The idea of a continuum of care or following survivors from inpatient care to community reintegration has become an important model of treatment across many hospital and community-based settings. In concert with the continuum of care, present research literature indicates that family intervention may be a key component to successful rehabilitation after brain injury. Yet, clinicians interacting with family members and survivors often feel confounded about how exactly to intervene with the broader family system beyond the individual survivor. Drawing on the systemic nature of the field of marriage and family therapy (MFT), this article provides information to assist clinicians in effectively intervening with families using theory-based interventions in community settings. First, a rationale for the utilization of systems-based, as opposed to individual-based, therapies will be uncovered. Second, historically relevant publications focusing on family psychotherapy and intervention after brain injury are reviewed and their implications discussed. Recommendations for the utilization of systemic theory-based principles and strategies, specifically cognitive behavioral therapy (CBT), narrative therapy (NT), and solution-focused therapy (SFT) will be examined. Descriptions of common challenges families and couples face will be presented along with case examples to illustrate how these theoretical frameworks might be applied to these special concerns postinjury. Finally, the article concludes with an overview of the ideas presented in this manuscript to assist practitioners and systems of care in community-based settings to more effectively intervene with the family system as a whole
Carvalho, Renato G.; Novo, Rosa F.
Introduction: In this quantitative, cross-sectional study we analyse the relationship between family socioeconomic status (SES) and students' adaptation to school life, as expressed through several indicators of achievement, integration (adaptation to transitions, behaviour problems, risk behaviours, interpersonal difficulties, participation in…
Horner, Sharon D
The focus of this article is on the use of home visits in an asthma self-management intervention study with rural families who have a school-aged child with asthma. The study design involved randomization of the sample by elementary schools, then baseline (pretest) and postintervention data collection.(1) The purpose of this article is to describe challenges with, and pose solutions for, implementing home visits for asthma self-management in rural areas. Home visiting is a strategy for program delivery that takes advantage of the home context for tailoring services to address the family's individual needs. The advantages of intervening in the home include being able to (a) use actual home conditions for individualizing the asthma education to meet families' needs; (b) match home visitors with family in terms of ethnicity and language; (c) retain a high percentage of families over the year-long duration of the study; and (d) not add to family burden of managing asthma.
Baker, Megan; Biringen, Zeynep; Meyer-Parsons, Beatrice; Schneider, Abby
This study evaluated the new online Emotional Attachment and Emotional Availability (EA2) Intervention for use with adoptive families in enhancing parent-child EA, parental perceptions of EA, child attachment behaviors, parent-child emotional attachment, and reducing parent-reported child behavioral problems and parenting-related stress. Participants in this study were adoptive parents and their adopted children ages 1.5 to 5 years old (N = 15 dyads). Participants were placed in an immediate intervention group (IG) or a delayed intervention group (DG) that would receive the 6-week EA2 Tele-Intervention after the IG. Results revealed significant differences in the IG in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment, improvements not seen in the DG. Analysis of effects of the DG after receiving the EA2 Tele-Intervention revealed significant differences over time also in most of these qualities.
Mitchell, Deborah J.
The purpose of this qualitative, grounded theory study was to describe adaptations for culturally and linguistically diverse families of English language learning students with autism spectrum disorders. Each family's parent was interviewed three separate times to gather information to understand the needs and experiences regarding their…
This bibliography of literature from the 1970s related to crises, family stress, coping, and adaptation contains references of particular interest to professionals in the areas of counseling, education, and family social, psychological and health services. The bibliography is divided into 26 categories; references are classified according to major…
Measham, Toby; Guzder, Jaswant; Rousseau, Cécile; Pacione, Laura; Blais-McPherson, Morganne; Nadeau, Lucie
The support of refugee children and their families is a worldwide concern. This article will highlight models of mental health care for refugee children and their families, focusing on collaborative care with primary care providers. Case vignettes are provided to illustrate how collaborative care can support refugee children׳s psychological well-being and positive adaptation following migration.
Flittner O'Grady, Allison; Thomaseo Burton, E; Chawla, Neelu; Topp, David; MacDermid Wadsworth, Shelley
Repeated military deployments have been a common experience for many military families in the past 15 years. While there has been an increase in research and intervention focused on the effects on families of military deployments, much of this work has not focused specifically on the particular needs of young children. Talk, Listen, Connect: Multiple Deployments (TLC-II MD), a multimedia kit designed for home use, is among the first interventions directed toward young children. Created by Sesame Workshop and using popular Sesame Street characters, TLC-II MD was designed to support and equip families with young children with skills to address challenges associated with multiple deployments. This study utilized a randomized experimental design to evaluate the impact of TLC-II MD relative to a control condition using a Sesame Workshop multimedia kit not tailored to military families. Parents in both groups reported that children enjoyed the video overall and watched it repeatedly. Also in both groups, caregivers' depressive symptoms and children's aggressive behaviors declined significantly over time. Caregivers in the test group reported significantly larger increases in comfort discussing the deployment with their child and stronger perceptions that the DVD helped children to cope. Thus, the resilience-oriented materials were helpful to both groups, but those tailored to military families were significantly more likely to be perceived as helpful. Findings offer evidence regarding the ability of multimedia self-administered interventions to assist military families.
Hudziak, Jim; Ivanova, Masha Y
All health is tied to emotional and behavioral health. To improve population health, we need innovative approaches to healthcare that target emotional and behavioral health. The Vermont Family Based Approach (VFBA) is a healthcare paradigm that aims to improve population health by improving emotional and behavioral health. Because the family is a powerful health-promoting social institution, the VFBA also aims to shift the delivery of healthcare to the family level. This article introduces the VFBA, and presents the main empirical findings that informed the approach in the context of the early childhood period.
Divan, Gauri; Hamdani, Syed Usman; Vajartkar, Vivek; Minhas, Ayesha; Taylor, Carol; Aldred, Catherine; Leadbitter, Kathy; Rahman, Atif; Green, Jonathan; Patel, Vikram
Background Evidence-based interventions for autism spectrum disorders evaluated in high-income countries typically require highly specialised manpower, which is a scarce resource in most low- and middle-income settings. This resource limitation results in most children not having access to evidence-based interventions. Objective This paper reports on the systematic adaptation of an evidence-based intervention, the Preschool Autism Communication Therapy (PACT) evaluated in a large trial in the United Kingdom for delivery in a low-resource setting through the process of task-shifting. Design The adaptation process used the Medical Research Council framework for the development and adaptation of complex interventions, focusing on qualitative methods and case series and was conducted simultaneously in India and Pakistan. Results The original intervention delivered by speech and language therapists in a high-resource setting required adaptation in some aspects of its content and delivery to enhance contextual acceptability and to enable the intervention to be delivered by non-specialists. Conclusions The resulting intervention, the Parent-mediated intervention for Autism Spectrum Disorder in South Asia (PASS), shares the core theoretical foundations of the original PACT but is adapted in several respects to enhance its acceptability, feasibility, and scalability in low-resource settings. PMID:26243710
civilian wives ....................... 14 3. High work stress by family pattrn with gender ............... 21 4 . Financial hardship by family pattern with...Group: Soldier White NonHispanic 63 53 50 47 Black NonHispanic 25 37 42 46 Hispanic 9 7 7 6 Other 3 4 2 1 Education Less than High School 0 0 1 0 GED...Children: Parents 1 36 41 59 59 2 42 47 33 33 3 15 9 6 6 4 5 3 1 i 5 1 0 1 0 6 or More 0 0- 0 1 Age of ’Youngest Child Less than One Year 12 10 21 16 1
Dirks, Tineke; Hadders-Algra, Mijna
During the past two decades, awareness of the role of the family in the child's life has increased and the term "family-centred services" (FCS) has been introduced to facilitate care for children with special needs and their families. It is, however, unclear how various early intervention programmes incorporate family involvement in service…
Almirall, Daniel; DiStefano, Charlotte; Chang, Ya-Chih; Shire, Stephanie; Kaiser, Ann; Lu, Xi; Nahum-Shani, Inbal; Landa, Rebecca; Mathy, Pamela; Kasari, Connie
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-age children with autism spectrum disorder (ASD) who are minimally verbal. Sixty-one children, ages 5-8 years, participated in a sequential, multiple-assignment randomized trial (SMART). All children received a developmental behavioral communication intervention: joint attention, symbolic play, engagement and regulation (JASP) with enhanced milieu teaching (EMT). The SMART included three 2-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. Nonlinguistic communication outcomes included initiating joint attention and behavior regulation, and play. The adaptive intervention beginning with JASP+EMT+SGD was estimated as superior. There were significant (p < .05) between-group differences in change in spontaneous communicative utterances and initiating joint attention. School-age 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.
Lewin, Amy; Hodgkinson, Stacy; Waters, Damian M; Prempeh, Henry A; Beers, Lee S; Feinberg, Mark E
Teen childbearing is associated with a range of adverse outcomes for both mothers and children, and perpetuates an intergenerational cycle of socioeconomic disadvantage. Fathers may be an underappreciated source of support to teen mothers and their children. The strongest and most consistent predictor of positive father involvement is a positive coparenting relationship between the mother and father. Thus, strengthening the coparenting relationship of teen parents may be protective for both parents and children. This paper describes the rationale, the intervention model, and the cultural adaptation of Strong Foundations, an intervention designed to facilitate and enhance positive coparenting in teen parents. Adapted from an evidence-based coparenting program for adult, cohabiting parents, this intervention was modified to be developmentally and culturally appropriate, acceptable, and feasible for use with urban, low-income, minority expectant teen mothers and their male partners. The authors present lessons learned from the cultural adaptation of this innovative intervention. Pilot testing has shown that this model is both acceptable and feasible in this traditionally hard to reach population. Although recruitment and engagement in this population present specific challenges, young, urban minority parents are deeply interested in being effective coparents, and were open to learning skills to support this goal.
Abel, Eileen Mazur; Chung-Canine, Unju; Broussard, Karen
Despite the fact that children are negatively impacted by family separation and divorce (Amato, 2001 ; Dreman & Shemi, 2004 ; Kelly, 2000 ) there is a paucity of information regarding evidence-based social work practice with children coping with family disruption. In order to address this gap, the authors describe the process and outcomes of a quasi-experimental evaluation (N = 79) designed to reduce the behavioral, emotional, and academic problems that children often face when experiencing divorce or parental separation. Results of data analysis (paired t-tests, independent t-tests, and analysis of variance) suggest (p < .05) that the intervention is effective in helping children cope with family disruption.
Poslawsky, Irina E; Naber, Fabiënne BA; Bakermans-Kranenburg, Marian J; van Daalen, Emma; van Engeland, Herman; van IJzendoorn, Marinus H
In a randomized controlled trial, we evaluated the early intervention program Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI) with 78 primary caregivers and their child (16-61 months) with Autism Spectrum Disorder. VIPP-AUTI is a brief attachment-based intervention program, focusing on improving parent-child…
Heim, Eva; Chowdhary, Neerja; Maercker, Andreas; Albanese, Emiliano
Background Cultural adaptation of mental health care interventions is key, particularly when there is little or no therapist interaction. There is little published information on the methods of adaptation of bibliotherapy and e-mental health interventions. Objective To systematically search for evidence of the effectiveness of minimally guided interventions for the treatment of common mental disorders among culturally diverse people with common mental disorders; to analyze the extent and effects of cultural adaptation of minimally guided interventions for the treatment of common mental disorders. Methods We searched Embase, PubMed, the Cochrane Library, and PsycINFO for randomized controlled trials that tested the efficacy of minimally guided or self-help interventions for depression or anxiety among culturally diverse populations. We calculated pooled standardized mean differences using a random-effects model. In addition, we administered a questionnaire to the authors of primary studies to assess the cultural adaptation methods used in the included primary studies. We entered this information into a meta-regression to investigate effects of the extent of adaptation on intervention efficacy. Results We included eight randomized controlled trials (RCTs) out of the 4911 potentially eligible records identified by the search: four on e-mental health and four on bibliotherapy. The extent of cultural adaptation varied across the studies, with language translation and use of metaphors being the most frequently applied elements of adaptation. The pooled standardized mean difference for primary outcome measures of depression and anxiety was -0.81 (95% CI -0.10 to -0.62). Higher cultural adaptation scores were significantly associated with greater effect sizes (P=.04). Conclusions Our results support the results of previous systematic reviews on the cultural adaptation of face-to-face interventions: the extent of cultural adaptation has an effect on intervention efficacy
Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu
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.
Hauser-Cram, P; Warfield, M E; Shonkoff, J P; Krauss, M W; Upshur, C C; Sayer, A
In this study we investigated the extent to which the family environment predicted differences in trajectories of adaptive development in young children with Down syndrome. The sample was comprised of 54 children with Down syndrome and their families who were studied from infancy through the age of 5 years as part of a longitudinal study of children with disabilities. Hierarchical linear modeling (HLM) was used to estimate the parameters of hierarchical growth models in domains of adaptive development. Results indicated that growth in communication, daily living skills, and socialization domains were predicted by measures of the family environment (i.e., family cohesion and mother-child interaction) above and beyond that predicted by maternal education. Further, Bayley MDI measures during infancy did not predict changes in adaptive development in any of the domains. The results are discussed in terms of implications for service provision and for expanding theoretical frameworks to include the development of children with disabilities.
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.
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
Durand, V. Mark; Hieneman, Meme; Clarke, Shelley; Wang, Mo; Rinaldi, Melissa L.
The present study was a multisite randomized clinical trial assessing the effects of adding a cognitive-behavioral intervention to positive behavior support (PBS). Fifty-four families who met the criteria of (a) having a child with a developmental disability, (b) whose child displayed serious challenging behavior (e.g., aggression, self-injury,…
Demaso, David Ray; Marcus, Nicole Eldridge; Kinnamon, Carolyn; Gonzalez-Heydrich, Joseph
Objective: This study tested the feasibility and safety of a computer-based application for families facing childhood depression. The Depression Experience Journal (EJ) is a psychoeducational intervention based on a narrative model involving the sharing of personal stories about childhood depression. Method: Semistructured interviews assessed…
Whitlatch, Carol J.; Judge, Katherine; Zarit, Steven H.; Femia, Elia
Purpose: The Early Diagnosis Dyadic Intervention (EDDI) program provides a structured, time-limited protocol of one-on-one and dyadic counseling for family caregivers and care receivers who are in the early stages of dementia. The goals and procedures of EDDI are based on previous research suggesting that dyads would benefit from an intervention…
van Otterloo, Sandra G.; van der Leij, Aryan
Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…
Kutcher, Stanley; Lauria-Horner, Bianca; MacLaren, Connie; Bujas-Bobanovic, Maja; Karlovic, Zlatko
Introduction: Depression is frequently unrecognized and undertreated. Therefore, there is a need to increase the knowledge and skills of primary care physicians regarding management of depression. The aim of this study was to determine if a brief educational intervention can affect family physicians' knowledge of the diagnosis and treatment of…
Madding, Carolyn Conway
This article discusses the increasing population of children from diverse backgrounds and suggests commonsense methods for team development of cultural competence for the provision of appropriate early intervention services to linguistically and culturally diverse families. Recommendations for using interpreters and developing models for family…
Haring, Kathryn A.; Lovett, David L.
An 8-year study examined the experiences of 23 rural families in the Early Intervention Early Childhood process. Findings indicated a lack of prenatal care and limited access to medical care, specialists, and local doctors due to geographic isolation and shortages of service personnel. Recommendations for improving rural service delivery are…
Steiner, Lilly M.
This study examines a family literacy intervention conducted in two first-grade classrooms with culturally diverse student populations. In the treatment and control classrooms, six parents and a classroom teacher learned practices for building home-school partnerships. Data were analyzed to determine changes in home-literacy practices, increases…
Current educational policy promotes the use of evidence-based practices to maximize children's learning outcomes. With the goal of enhancing a child's ability to learn functional language, the purpose of this study was to focus on involving families through the utilization of evidence-based intervention based upon the Applied Behaviour Analysis…
Caldwell, Christopher Les; Horne, Arthur M.; Davidson, Bernard; Quinn, William H.
Parenting practices are major influences on incidents of juvenile delinquency. Stress experienced by parents of children with behavioral problems is a leading contributor to parenting practices. We investigated the extent to which parental stress was reduced by participation in an established multiple group family intervention, the Family…
Trivette, Carol M.; Dunst, Carl J.; Hamby, Deborah W.
The extent to which the influences of family-systems intervention practices could be traced to variations in parent-child interactions and child development was investigated by meta-analytic structural equation modeling (MASEM). MASEM is a procedure for producing a weighted pooled correlation matrix and fitting a structural equation model to the…
Aschbrenner, Kelly; Bartels, Stephen; Mueser, Kim; Carpenter-Song, Elizabeth; Kinney, Allison
This focus group study explored the potential benefits and challenges of involving family members and significant others in a healthy lifestyle program for people with serious mental illness (SMI). Six focus group interviews were conducted with a total of 30 people with SMI, who were participants in a healthy lifestyle intervention. Separate focus…
Judge, Katherine S.; Bass, David M.; Snow, A. Lynn; Wilson, Nancy L.; Morgan, Robert; Looman, Wendy J.; McCarthy, Catherine; Kunik, Mark E.
Purpose: This article provides a detailed description of a telephone-based care coordination intervention, Partners in Dementia Care (PDC), for veterans with dementia and their family caregivers. Essential features of PDC included (a) formal partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association Chapters; (b) a…
Harrison, Melody; And Others
Analysis of a national survey of 398 parents of preschool children with deafness or partial hearing found that, although Individualized Family Service Plans had not been developed for almost one-half of respondents, parents reported overall satisfaction with their child's early intervention program. (Author/DB)
Dembo, Richard; Ramirez-Garnica, Gabriela; Schmeidler, James; Rollie, Matthew; Livingston, Stephen; Hartsfield, Amy
Reports results of a study of the long term impact of a Family Empowerment Intervention (FEI) on recidivism among all 303 youths processed at Hillsborough County Juvenile Assessment Center who entered the project. Results provide support for sustained effect of FEI services in reducing recidivism. (BF)
Anderson, John D.; Newby, Rachel; Kehm, Rebecca; Barland, Patricia; Hearst, Mary O.
Objectives: Successful childhood obesity intervention models that build sustainable behavioral change are needed, particularly in low-income, ethnic minority communities disparately affected by this problem. Method: Families were referred to Taking Steps Together (TST) by their primary care provider if at least one child had a body mass index…
Winter, Leanne; Morawska, Alina; Sanders, Matthew R.
There is a paucity of research considering the effect of behavioral family intervention (BFI) on parenting knowledge and the relative importance of both knowledge and parent confidence in reducing parenting dysfunction and problematic child behavior is unclear. In this study ninety-one parents (44 mothers, 47 fathers) of children aged 2-10 years…
Rutherford, Helena J. V.; Mayes, Linda C.; Fisher, Philip A.
The use of theory-driven models to develop and evaluate family-based intervention programs has a long history in psychology. Some of the first evidence-based parenting programs to address child problem behavior, developed in the 1970s, were grounded in causal models derived from longitudinal developmental research. The same translational…
Segrott, Jeremy; Rothwell, Heather; Pignatelli, Ilaria; Playle, Rebecca; Hewitt, Gillian; Huang, Chao; Murphy, Simon; Hickman, Matthew; Reed, Hayley; Moore, Laurence
Purpose: Involvement of parents/carers may increase effectiveness of primary school-based alcohol-misuse prevention projects through strengthening family-based protective factors, but rates of parental engagement are typically low. This paper reports findings from an exploratory trial of a school-based prevention intervention--Kids, Adults…
McWilliam, P. J., Ed.; Bailey, Donald B., Jr., Ed.
This book presents 21 case studies of young children with disabilities in a variety of family situations and settings, for early interventionists to study in planning and applying recommended practices. Section I, "Defining and Delivering Quality Services in Early Intervention," provides two introductory chapters: "The Search for Quality…
Kelly, Amber; Ponsford, Jennie; Couchman, Grace
The present study examined the impact of a family inclusive intervention on the multidimensional self-concept of individuals with traumatic brain injury (TBI). Forty one individuals with TBI and a matched control group completed the Tennessee Self-Concept Scale: Second Edition (TSCS: 2), the Rosenberg Self-Esteem Scale (RSE), the Family Assessment Device (FAD), and the Hospital Anxiety and Depression Scale (HADS) on two occasions: at immediate contact (pre-group, T1) and post-group (3 months after initial contact, T2). Controls did not attend the intervention. Total scores for the measures, as well as scores on subdomains of self-concept, taken pre- and post-intervention for the TBI sample and at the same time for matched controls were compared between groups using Multivariate Analysis of Variance (MANOVA); followed by a series of repeated measures analyses of variance (ANOVA) to determine whether significant changes occurred. Contrary to the main aim, the use of a family-focused intervention did not result in self-concept improvement, either globally or across self-concept domains. Nor did mood or family functioning improve for the TBI sample. Measures remained stable across time for the controls.
Belcher, Harolyn M. E.; Hairston-Fuller, Tody C.; McFadden, Jenese
Public Law 99-457 extended the landmark Public Law 94-142 legislation to include early intervention for infants and toddlers with or at-risk for development of developmental disabilities. Currently over 300,000 infants and toddlers and their families in the United States receive services through Part C of the Individuals with Disabilities…
Rees, Rachel; Mahon, Merle; Herman, Rosalind; Newton, Caroline; Craig, Gordon; Marriage, Josephine
UK professionals use a range of intervention approaches to promote communication development in pre-school deaf children by influencing the familys' interaction style. This investigation surveyed the approaches used and explored how these translated into specific practices. An online questionnaire was developed and reviewed by a panel of experts.…
Klasnja, Predrag; Hekler, Eric B.; Shiffman, Saul; Boruvka, Audrey; Almirall, Daniel; Tewari, Ambuj; Murphy, Susan A.
Objective This paper presents an experimental design, the micro-randomized trial, developed to support optimization of just-in-time adaptive interventions (JITAIs). JITAIs are mHealth technologies that aim to deliver the right intervention components at the right times and locations to optimally support individuals’ health behaviors. Micro-randomized trials offer a way to optimize such interventions by enabling modeling of causal effects and time-varying effect moderation for individual intervention components within a JITAI. Methods The paper describes the micro-randomized trial design, enumerates research questions that this experimental design can help answer, and provides an overview of the data analyses that can be used to assess the causal effects of studied intervention components and investigate time-varying moderation of those effects. Results Micro-randomized trials enable causal modeling of proximal effects of the randomized intervention components and assessment of time-varying moderation of those effects. Conclusions Micro-randomized trials can help researchers understand whether their interventions are having intended effects, when and for whom they are effective, and what factors moderate the interventions’ effects, enabling creation of more effective JITAIs. PMID:26651463
Hurd, Noelle M; Valerio, Melissa A; Garcia, Nicole M; Scott, Anthony A
This study examined the effectiveness of an adapted 4-session HIV prevention program. Participants included 490 adolescents who participated in either the 8- or the adapted 4-session HIVEd program. Analyses to identify mean changes in HIV-related knowledge, attitudes, self-efficacy, and behavioral intentions between participants in either the 4- (n = 274) or 8-session (n = 216) programs were completed. Findings indicate participants in both programs had positive changes at post interview across all study outcomes. No significant differences in changes between participants in the 4- and 8-session programs were found except that male adolescents in the 4-session program had significantly higher mean changes in condom knowledge (p < .01). The adaptation of the 8-session HIVEd program was undertaken to better reach and accommodate the needs of a high risk incarcerated adolescent population. Findings demonstrate that HIV prevention interventions for high risk populations may be successfully adapted and condensed when based on rigorously evaluated and theoretically driven programs.
Fife, Betsy L.; Scott, Linda L.; Fineberg, Naomi S.; Zwickl, Beth E.
This study evaluated an intervention to facilitate adaptive coping by persons living with HIV (PLWH), with the participation of their cohabiting partners as a dimension of the intervention. An experimental design with randomization was used, and 84 PLWH and their partners were recruited. The intervention was based on a psychosocial educational model that incorporated 4 two-hour sessions focused on communication, stress appraisal, adaptive coping strategies, and building social support. Both members of the dyad were included in each session. The comparison control included four supportive phone calls to the PLWH alone. Data were collected from both the PLWH and their partners in each of the two groups at baseline, immediately following the intervention, and 3 months and 6 months post-treatment. Data were analyzed using RM ANOVA, with change scores from the partner data being covariates. Findings indicated that the design was a feasible model, which demonstrated potential for the management of stress, and possibly problems such as adherence, in PLWH. A manual was developed as a part of this intervention and is currently available. PMID:18191771
Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth
This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya.
Brown, Larry K.; Raffaelli, Marcela; Lima, Lori-Ann
Latino youth are the fastest growing ethnic group in the United States and are at considerable risk for HIV and other sexually transmitted infections (STIs), given that they have an earlier onset of sexual activity and use condoms less consistently than European American adolescents. Theorists and scholars have emphasized the importance of taking culture into account in sexuality interventions with Latino adolescents, yet few culturally tailored interventions have been developed for this population. Given the emphasis on familismo and collectivism among Latinos, family-based programs are likely to be well received and could contribute to long-term maintenance of adolescent safety. In this synthesis of the relevant literature, cultural factors that have been identified as relevant to Latino sexuality are reviewed and implications for family-based intervention with Latinos are addressed. PMID:19181820
Petrenko, Christie L. M.
Although the scientific community has recognized the effects of prenatal alcohol exposure on development for over 40 years, the empirical study of positive behavioral interventions and family support programs for people with fetal alcohol spectrum disorders (FASD) has only just emerged over the last 10 to 15 years. In this time, dedicated researchers have developed innovative programs that have generally produced large effects and have been acceptable to children with FASD and their families. This body of work demonstrates that children with FASD can benefit from interventions that are appropriately tailored to their neurodevelopmental disabilities. Despite this progress, much work lies ahead to meet the significant needs of people with FASD. This review evaluates available sources of information, including theoretical and Lived Experience models, empirical evidence on existing programs, and best practice guidelines, to guide future research priorities and clinical practice. Three priorities for future intervention research are offered. PMID:26380802
Heslin, Margaret; Forster, Anne; Healey, Andy; Patel, Anita
Objectives: To examine the economic evidence for interventions aimed at family carers of stroke patients. Data sources: Searches (limited to those published in English since 1990) were performed in key databases along with hand searches of relevant papers. Review methods: Papers were restricted to studies including any economic data (broadly defined) for any intervention targeting carers explicitly or explicitly referring to a carer element, beyond involving carers in the care or intervention for patients (i.e. more than just carers being invited to observe an intervention targeted at the patient). Two reviewers independently screened full papers and extracted data using guidance from the National Institute for Health and Care Excellence, and quality assessment using the Newcastle-Ottawa Quality Assessment Scale (cohort studies), the Delphi list (randomised controlled trials) and guidelines on economic quality from the British Medical Journal. Data were reviewed descriptively as meta analyses were inappropriate due to non-comparability of studies. Results: Ten papers were included in the review. These were heterogeneous in their design, intervention and economic analyses making comparison difficult. Only three of the ten papers included economic evaluations. All three reported that the intervention was less costly and had better or equivalent outcomes than the control comparator although two of these were based on the same intervention using the same dataset. Conclusion: There is some limited evidence that interventions for family carers of stroke patients are effective and cost effective. However, due to variation in the types of interventions examined, little can be concluded regarding implications for clinical practice. PMID:25758943
Grau, Lauretta E; Krasnoselskikh, Tatiana V; Shaboltas, Alla V; Skochilov, Roman V; Kozlov, Andrei P; Abdala, Nadia
Cultural adaptation is an important step in the process of implementing health promotion interventions that, having been proven to be effective in one culture, are being applied in another. This study describes the results of a formative investigation to culturally adapt a STI/HIV risk reduction intervention for use in St. Petersburg, Russia. Analyses of data from brief elicitation interviews, focus groups, community experts, and a pilot test of the adapted intervention identified environmental, cognitive-information processing, and affect-motivation factors that needed to be addressed during the adaptation process. The participant/counselor relationship was adapted to reflect a hierarchical (cf. collaborative) relationship in order to accommodate Russian expectations about patient interactions with healthcare experts. Key skills building activities (e.g., identification of personal risk behaviors, role-playing) were approached gradually or indirectly in order to maintain participants' engagement in the intervention, and close-ended questions were added to assist participants in understanding unfamiliar concepts such as "triggers" and self-efficacy. Information about the prevalence of HIV/STI infections and alcohol use included data specific to St. Petersburg to increase the personal relevance of these materials and messages. Intervention components were tailored to participants' risk reduction and informational needs. No gender differences that would have justified adaptation of the intervention approach or content were noted. Examples of specific adaptations and the key issues to attend to when adapting behavioral interventions for use in Russian clinical settings are discussed.
Compas, Bruce E.; Forehand, Rex; Thigpen, Jennifer C.; Keller, Gary; Hardcastle, Emily J.; Cole, David A.; Potts, Jennifer; Haker, Kelly; Rakow, Aaron; Colletti, Christina; Reeslund, Kristen; Fear, Jessica; Garai, Emily; McKee, Laura; Merchant, M.J.; Roberts, Lorinda
Objective In a long-term follow-up of a randomized controlled trial (Compas et al., 2009), to examine the effects at 18- and 24-month follow-ups of a Family Group Cognitive Behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a history of major depressive disorder (MDD). Method Parents with a history of MDD and their 9 to 15-year-old children were randomly assigned to a FGCB intervention or a Written Information (WI) comparison condition. Children’s internalizing, externalizing, anxiety/depression, and depressive symptoms, episodes of MDD and other psychiatric diagnoses, and parents’ depressive symptoms and episodes of MDD were assessed at 18- and 24-months after randomization. Results Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing symptoms at 18-months and significantly lower in externalizing symptoms at 18- and 24-months. Rates of MDD were significantly lower for children in the FGCB intervention over the 24-month follow-up (odds ratio = 2.91). No significant effects were found for parents’ symptoms of depression or episodes of MDD. Conclusions Support was found for a FGCB preventive intervention for children of parents with a history of MDD significantly reducing children’s episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up. PMID:21707137
Lee, Romeo B
Men's gender roles have contributed to family violence, but the ramifications of these roles in the development of community-based programmes for men have not been given much attention. A small-scale qualitative examination of the familial context of Filipino men's positions and roles, and their domestic violence experiences and attitudes was carried out using eight discussion groups, each group with seven to eight members. Verbatim tape-recorded transcripts were analysed using accepted techniques for theoretical analysis to establish emergent themes. Discussants saw themselves as being at the helm of their families. Men were knowledgeable of and took responsibility for their gender roles exerting control over the focus and direction of all their family affairs, including the gender roles of their wives/partners. This control demonstrated facets of their hegemonic masculinity such as sexual objectification and dominance. Men in this society come from a traditional position of power, dominance and privilege. They will be particularly sensitive to interventions aimed at reducing violence against women which will inquire into their private lives. In their view, such interventions were both a direct challenge to their family leadership and a basis for 'losing face'. Strategies for positive interventions include the need for male-sensitive and male-centred approaches which avoid demonising or stereotyping men.
Compas, Bruce E.; Forehand, Rex; Keller, Gary; Champion, Jennifer E.; Rakow, Aaron; Reeslund, Kristen L.; McKee, Laura; Fear, Jessica M.; Colletti, Christina J. M.; Hardcastle, Emily; Merchant, Mary Jane; Roberts, Lori; Potts, Jennifer; Garai, Emily; Coffelt, Nicole; Roland, Erin; Sterba, Sonya K.; Cole, David A.
A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9–15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted. PMID:19968378
Compas, Bruce E; Forehand, Rex; Keller, Gary; Champion, Jennifer E; Rakow, Aaron; Reeslund, Kristen L; McKee, Laura; Fear, Jessica M; Colletti, Christina J M; Hardcastle, Emily; Merchant, Mary Jane; Roberts, Lori; Potts, Jennifer; Garai, Emily; Coffelt, Nicole; Roland, Erin; Sterba, Sonya K; Cole, David A
A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9-15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted.
Robin, Arthur L
Adolescents with ADHD frequently argue with their parents about a variety of issues, especially when they also have Oppositional Defiant Disorder or Conduct Disorder. Family interventions have proven effective for ameliorating such conflicts in two independent investigations. After a comprehensive assessment including family interviews and self-report inventories, the therapist first teaches the parents contingency management techniques and then teaches the parents and adolescent problem solving communication skills. Contingency management techniques include one-on-one time, effective commands, positive incentive systems, and punishment systems. Problem solving involves discussing a specific dispute by defining the problem, generating a list of solutions, evaluating the solutions, and reaching a compromise. Communication training involves identifying specific negative communication skills and replacing them with positive communication skills. This article reviews research and provides practitioners with specific guidelines for implementing these family interventions.
Brown, P. Margaret; Bakar, Zaharah Abu; Rickards, Field W.; Griffin, P.
This study investigated parents' perceptions of their family's functioning and the level of early intervention support they received as they reflected on their involvement at an oral early intervention centre for children with hearing loss. Overall, parents reported high levels of family functioning and satisfaction with the services they had…
Sampson, William Alfred
In recent times, actor, comedian, and educator, Bill Cosby sparked a national debate over the role of poor black families in raising their children. Additionally, scholars including Reginald Clark, Annette Lareau, John Ogbu, Javier Tapia, James Comer, and William A. Sampson have done research that suggests that many poor black and Latino families…
and problem behaviors and increasing community reintegration and quality of life among veterans with TBI, and reducing caregivers’ distress...psychiatric symptoms in either Veterans or caregivers. Rather it targets problematic behavior that interferes with reintegration such as anger expression...Research Accomplishments Recruitment and consenting of 20 veterans and 20 family members to date Successful completion of the first and second
Background Evidence-based interventions are frequently modified or adapted during the implementation process. Changes may be made to protocols to meet the needs of the target population or address differences between the context in which the intervention was originally designed and the one into which it is implemented [Addict Behav 2011, 36(6):630–635]. However, whether modification compromises or enhances the desired benefits of the intervention is not well understood. A challenge to understanding the impact of specific types of modifications is a lack of attention to characterizing the different types of changes that may occur. A system for classifying the types of modifications that are made when interventions and programs are implemented can facilitate efforts to understand the nature of modifications that are made in particular contexts as well as the impact of these modifications on outcomes of interest. Methods We developed a system for classifying modifications made to interventions and programs across a variety of fields and settings. We then coded 258 modifications identified in 32 published articles that described interventions implemented in routine care or community settings. Results We identified modifications made to the content of interventions, as well as to the context in which interventions are delivered. We identified 12 different types of content modifications, and our coding scheme also included ratings for the level at which these modifications were made (ranging from the individual patient level up to a hospital network or community). We identified five types of contextual modifications (changes to the format, setting, or patient population that do not in and of themselves alter the actual content of the intervention). We also developed codes to indicate who made the modifications and identified a smaller subset of modifications made to the ways that training or evaluations occur when evidence-based interventions are implemented. Rater
Poole, Lucinda A; Lewis, Andrew J; Toumbourou, John W; Knight, Tess; Bertino, Melanie D; Pryor, Reima
Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self-harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual-level change and often neglect family or contextual influences. The efficacy of interventions may be enhanced with a broader therapeutic focus on family factors such as communication, conflict, support, and cohesion. This article describes a structured multi-family group approach to the treatment of adolescent depression: Behaviour Exchange Systems Therapy for adolescent depression (BEST MOOD). BEST MOOD is a manualized intervention that is designed to address both individual and family factors in the treatment of adolescent depression. BEST MOOD adopts a family systems approach that also incorporates psychoeducation and elements of attachment theories. The program consists of eight multifamily group therapy sessions delivered over 2 hours per week, where parents attend the first four sessions and young people and siblings join from week 5. The program design is specifically aimed to engage youth who are initially resistant to treatment and to optimize youth and family mental health outcomes. This article presents an overview of the theoretical model, session content, and evaluations to date, and provides a case study to illustrate the approach.
Kosse, Richelle C; Bouvy, Marcel L; de Vries, Tjalling W; Kaptein, Ad A; Geers, Harm CJ; van Dijk, Liset; Koster, Ellen S
Purpose Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. Intervention The ADAPT intervention consists of an interactive smartphone application (app) connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1) a questionnaire function to rate asthma symptoms and monitor these over time; 2) short movie clips with medication and disease information; 3) a medication reminder; 4) a chat function with peers; and 5) a chat function with the pharmacist. The pharmacist receives data from the patient’s app through the desktop application, which enables the pharmacist to send information and feedback to the patient. Study design The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient’s self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. Conclusion This study will provide in-depth knowledge on the effectiveness of an mHealth intervention to support asthma self-management in adolescents. These insights will also be useful for adolescents with other chronic diseases. PMID:28356720
dos Santos, Karina Tonini; Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba; Arcieri, Renato Moreira; Carvalho, Maria de Lourdes
This study analyses the status and work reality of Community Health Agents, with the purpose of contributing to the improvement of the Brazilian Health System (SUS) in small cities. It was discussed aspects related to their participation in the team of the Family Health Program (PSF) and their interaction with the community. It was observed a lack of motivation and experience, which compromises the quality of Agents performance in the community. It is known that these findings are reflex and consequence of an established context. It is necessary the team rethink their practice, specially the managers, having always as a fundament the principles that guide the SUS and PSF.
Harden, Janet; Falahee, Margaret; Bickes, Joan; Schafenacker, Ann; Walker, Julie; Mood, Darlene; Northouse, Laurel
Only a few programs are designed to help couples cope with the effects of prostate cancer, and typically, only their intervention outcomes are reported. The purpose of this study was to assess prostate cancer patients' and their spouses' satisfaction with an efficacious supportive-educative, family-based intervention, and factors associated with their satisfaction. We assessed the relationship of overall satisfaction with the intervention to (1) the patients' and spouses' appraisal and the resource and quality-of-life baseline scores and (2) changes in those scores after completing the intervention. Results showed that participants were very satisfied with the program. Patients who had higher scores on baseline measures, indicating more positive appraisal of their illness, better use of resources (eg, coping, self-efficacy), and higher overall quality of life, reported more satisfaction with the intervention. For spouses, few baseline measures were related to their satisfaction; however, spouses who reported positive changes after intervention (less negative appraisal and uncertainty, better communication) reported higher satisfaction with the program. Although satisfied with the program, factors associated with patients' and spouses' satisfaction differed. To translate effective interventions to clinical practice settings, it is important to assess participants' satisfaction with program content and delivery, as well as program outcomes.
Gesell, Sabina B.; Po’e, Eli K.; Escarfuller, Juan; Tempesti, Tommaso
OBJECTIVE: To test the effect of a culturally tailored, family-centered, short-term behavioral intervention on BMI in Latino-American preschool-aged children. METHODS: In a randomized controlled trial, 54 parent–child dyads were allocated to the intervention and 52 dyads were allocated to an alternative school-readiness program as the control condition. Parent–child dyads were eligible if the parent self-defined Latino, was at least 18 years old, had a 2- to 6-year-old child not currently enrolled in another healthy lifestyle program, had a valid telephone number, and planned on remaining in the city for the next 6 months. The Salud Con La Familia (Health with the Family) program consisted of 12 weekly 90-minute skills-building sessions designed to improve family nutritional habits and increase physical activity. Both programs were conducted in a community recreation center serving an urban neighborhood of mostly Spanish-speaking residents. RESULTS: Forty-two percent of participating preschool-aged children were overweight or obese. Controlling for child age, gender, and baseline BMI, the effect of the treatment condition on postintervention absolute BMI was B = –0.59 (P < .001). The intervention effect seemed to be strongest for obese children. CONCLUSIONS: A skills-building, culturally tailored intervention involving parent–child dyads changed short-term early growth patterns in these Latino-American preschool-aged children. Examining long-term effects would be a prudent next step. PMID:22869834
Nandola, Naresh N.; Rivera, Daniel E.
This paper presents a data-centric modeling and predictive control approach for nonlinear hybrid systems. System identification of hybrid systems represents a challenging problem because model parameters depend on the mode or operating point of the system. The proposed algorithm applies Model-on-Demand (MoD) estimation to generate a local linear approximation of the nonlinear hybrid system at each time step, using a small subset of data selected by an adaptive bandwidth selector. The appeal of the MoD approach lies in the fact that model parameters are estimated based on a current operating point; hence estimation of locations or modes governed by autonomous discrete events is achieved automatically. The local MoD model is then converted into a mixed logical dynamical (MLD) system representation which can be used directly in a model predictive control (MPC) law for hybrid systems using multiple-degree-of-freedom tuning. The effectiveness of the proposed MoD predictive control algorithm for nonlinear hybrid systems is demonstrated on a hypothetical adaptive behavioral intervention problem inspired by Fast Track, a real-life preventive intervention for improving parental function and reducing conduct disorder in at-risk children. Simulation results demonstrate that the proposed algorithm can be useful for adaptive intervention problems exhibiting both nonlinear and hybrid character. PMID:21874087
Goodkind, Jessica R.; LaNoue, Marianna D.; Milford, Jaime
American Indian (AI) adolescents experience higher rates of suicide and psychological distress than the overall U.S. adolescent population, and research suggests that these disparities are related to higher rates of violence and trauma exposure. Despite elevated risk, there is limited empirical information to guide culturally appropriate treatment of trauma and related symptoms. We report a pilot study of an adaptation to the Cognitive Behavioral Intervention for Trauma in Schools in a sample of 24 AI adolescents. Participants experienced significant decreases in anxiety and PTSD symptoms, and avoidant coping strategies, as well as a marginally significant decrease in depression symptoms. Improvements in anxiety and depression were maintained 6 months post-intervention; improvements in PTSD and avoidant coping strategies were not. Feasibility, appropriateness, and acceptability of CBITS are discussed in the context of efforts to develop culturally sensitive interventions for AI youth. PMID:21058132
Mwaikambo, Lisa; Speizer, Ilene S.; Schurmann, Anna; Morgan, Gwen; Fikree, Fariyal
This study presents findings from a systematic review of evaluations of family planning interventions published between 1995 and 2008. Studies that used an experimental or quasi-experimental design or had another way to attribute program exposure to observed changes in fertility or family planning outcomes at the individual or population levels were included and ranked by strength of evidence. A total of 63 studies were found that met the inclusion criteria. The findings from this review are summarized in tabular format by the type of intervention (classified as supply-side or demand-side). About two-thirds of the studies found were on demand generation type-programs. Findings from all programs revealed significant improvements in knowledge, attitudes, discussion, and intentions. Program impacts on contraceptive use and use of family planning services were less consistently found and less than half of the studies that measured fertility or pregnancy-related outcomes found an impact. Based on the review findings, we identify promising programmatic approaches and propose directions for future evaluation research of family planning interventions. PMID:21834409
Liddle, Howard A
For over four decades family therapy research and family centered evidence-based therapies for justice-involved youths have played influential roles in changing policies and services for these young people and their families. But research always reveals challenges as well as advances. To be sure, demonstration that an evidence-based therapy yields better outcomes than comparison treatments or services as usual is an accomplishment. But the extraordinary complexity embedded in that assertion feels tiny relative to what we are now learning about the so-called transfer of evidence-based treatments to real world practice settings. Today's family therapy studies continue to assess outcome with diverse samples and presenting problems, but research and funding priorities also include studying particular treatments in nonresearch settings. Does an evidence-based intervention work as well in a community clinic, with clinic personnel? How much of a treatment has to change to be accepted and implemented in a community clinic? Perhaps it is the setting and existing procedures that have to change? And, in those cases, do accommodations to the context compromise outcomes? Thankfully, technology transfer notions gave way to more systemic, dynamic, and frankly, more family therapy-like conceptions of the needed process. Implementation science became the more sensible, as well as the theoretically and empirically stronger overarching framework within which the evidence-based family based therapies now operate. Using the example of Multidimensional Family Therapy, this article discusses treatment development, refinement, and implementation of that adapted approach in a particular clinical context-a sector of the juvenile justice system-juvenile detention.
Fisher, Philip A.
The use of theory-driven models to develop and evaluate family-based intervention programs has a long history in psychology. Some of the first evidence-based parenting programs to address child problem behavior, developed in the 1970s, were grounded in causal models derived from longitudinal developmental research. The same translational strategies can also be applied to designing programs that leverage emerging scientific knowledge about the effects of early adverse experiences on neurobiological systems to reduce risk and promote well-being. By specifying not only behavioral targets but also affected underlying neural systems, interventions can become more precise and efficient. This chapter describes the development of a program of research focusing on an intervention for young children in foster care. The intervention emerged from social learning theory research and employs a translational neuroscience approach. The conceptual model guiding the research, which incorporates behavioral domains as well as stress-regulatory neural systems, is described. Finally, future directions for translational neuroscience in family-based intervention research are considered. PMID:27589501
de La Caba Collado, Mariangeles; Bartau Rojas, Isabel
The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The design, intervention and assessment process of this study was carried out in two phases over a period of a year and a half. For both phases, three different groups—of men/fathers, women/mothers and children—were established. Study variables (parenting skills and children's personal and social development) were evaluated before and after the intervention in every group, as well as during the entire process. The results, taking into account the improvements reported by all the participants (social workers, group monitors, fathers, mothers, children) show that inter-professional involvement and coordination at all phases of the intervention is vital in order to achieve small but significant improvements.
Distelberg, Brian J.; Emerson, Natacha D.; Gavaza, Paul; Tapanes, Daniel; Brown, Whitney N.; Shah, Huma; Williams-Reade, Jacqueline; Montgomery, Susanne
Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs–benefits of a family systems-based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi-prospective study compared the 12-month pre–post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost–benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed. PMID:27282311
Wu, Vincent; Barbash, Israel M.; Ratnayaka, Kanishka; Saikus, Christina E.; Sonmez, Merdim; Kocaturk, Ozgur; Lederman, Robert J.; Faranesh, Anthony Z.
PURPOSE To develop a system for artifact suppression in electrocardiogram (ECG) recordings obtained during interventional real-time magnetic resonance imaging. MATERIALS AND METHODS We characterized ECG artifacts due to radiofrequency pulses and gradient switching during MRI in terms of frequency content. A combination of analog filters and digital least mean squares adaptive filters were used to filter the ECG during in vivo experiments and the results were compared with those obtained with simple low-pass filtering. The system performance was evaluated in terms of artifact suppression and ability to identify arrhythmias during real-time MRI. RESULTS Analog filters were able to suppress artifacts from high-frequency radiofrequency pulses and gradient switching. Remaining pulse artifacts caused by intermittent preparation sequences or spoiler gradients required adaptive filtering because their bandwidth overlapped with that of the ECG. Using analog and adaptive filtering, a mean improvement of 38dB (n=11, peak QRS signal to pulse artifact noise) was achieved. This filtering system was successful in removing pulse artifacts which obscured arrhythmias such as premature ventricular complexes and complete atrioventricular block. CONCLUSION We have developed an online ECG monitoring system employing digital adaptive filters which enables the identification of cardiac arrhythmias during real-time MRI-guided interventions. PMID:21509878
Background Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. Methods/design Design: Controlled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Study area: Primary Health Care network (9 PHCTs). Study participants: Primary informal caregivers of patients receiving home health care from participating PHCTs. Sample: Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. Intervention: a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Control: Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request. Data analysis Dependent variables: Caregiver burden (short-form Zarit test), caregivers’ social support (Medical Outcomes Study), and
Stamp, Kelly D.; Dunbar, Sandra B.; Clark, Patricia C.; Reilly, Carolyn M.; Gary, Rebecca A.; Higgins, Melinda; Ryan, Richard M
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
Fischer, Iris; Camus-Kulandaivelu, Létizia; Allal, François; Stephan, Wolfgang
Wild tomato species are a valuable system in which to study local adaptation to drought: they grow in diverse environments ranging from mesic to extremely arid conditions. Here, we investigate the evolution of members of the Asr (ABA/water stress/ripening induced) gene family, which have been reported to be involved in the water stress response. We analysed molecular variation in the Asr gene family in populations of two closely related species, Solanum chilense and Solanum peruvianum. We concluded that Asr1 has evolved under strong purifying selection. In contrast to previous reports, we did not detect evidence for positive selection at Asr2. However, Asr4 shows patterns consistent with local adaptation in an S. chilense population that lives in an extremely dry environment. We also discovered a new member of the gene family, Asr5. Our results show that the Asr genes constitute a dynamic gene family and provide an excellent example of tandemly arrayed genes that are of importance in adaptation. Taking the potential distribution of the species into account, it appears that S. peruvianum can cope with a great variety of environmental conditions without undergoing local adaptation, whereas S. chilense undergoes local adaptation more frequently.
ALLEN, REBECCA S.
Manualized reminiscence and life review therapies are supported as an evidence-based, effective treatment for depression among older adults, but this therapeutic approach is usually individually administered and has rarely been applied in palliative care settings. We combined mutual reminiscence and life review with engagement in meaningful activity and examined the efficacy of this family-based dyadic intervention to decrease caregiving stress and increase family communication. Seventeen individuals living with chronic, life-limiting illnesses in the community and their family caregivers received three home visits with a master’s-level interventionist. During these sessions and through structured homework activities, the interventionist actively worked with the family to construct a personal Legacy Project, usually a scrapbook with photos, a cookbook, or audiotaped stories that celebrated the life of the ill individual. All participants in the intervention group initiated a Legacy Project and reported that Legacy activities improved family communication. Participation in Legacy creation also resulted in increased positive emotional experiences in patient and caregiver groups. These results are illustrated through careful examination of three case studies. PMID:20046967
Allen, Rebecca S
Manualized reminiscence and life review therapies are supported as an evidence-based, effective treatment for depression among older adults, but this therapeutic approach is usually individually administered and has rarely been applied in palliative care settings. We combined mutual reminiscence and life review with engagement in meaningful activity and examined the efficacy of this family-based dyadic intervention to decrease caregiving stress and increase family communication. Seventeen individuals living with chronic, life-limiting illnesses in the community and their family caregivers received three home visits with a master's-level interventionist. During these sessions and through structured homework activities, the interventionist actively worked with the family to construct a personal Legacy Project, usually a scrapbook with photos, a cookbook, or audiotaped stories that celebrated the life of the ill individual. All participants in the intervention group initiated a Legacy Project and reported that Legacy activities improved family communication. Participation in Legacy creation also resulted in increased positive emotional experiences in patient and caregiver groups. These results are illustrated through careful examination of three case studies.
McCall, Robert B; Muhamedrahimov, Rifkat J; Groark, Christina J; Palmov, Oleg I; Nikiforova, Natalia V; Salaway, Jennifer L; Julian, Megan M
This study examined whether interventions in Russian Baby Homes promoting warm, sensitive, and responsive caregiver-child interactions and relationships would be associated with advantages in those children's behavior years after they transitioned to family care. Children (N = 135) who had resided for at least 3 months (M = 13.8 months) in one of three intervention institutions were subsequently placed in Russian families (relatives or non-relatives) for at least 1 year (M = 33.5 months). When children were 1.5-10.8 years of age, parents provided ratings of attachment, indiscriminate friendliness, executive functioning, social-emotional development, and behavior problems. Despite very substantial differences in the developmental status of children at departure from the three institutions, there were fewer than expected significant differences between children from the three institutions at follow-up or as a function of being placed with relatives or non-relatives. Specifically, children reared in the most improved institution displayed less indiscriminate friendliness, were less aggressive/defiant, and had less externalizing behavior. Children from all three institutions who were placed into families at older ages tended to be rated more poorly on some measures. These results suggest that previously institutionalized children adjust well to family life, but improved institutional caregiving can have some persistent benefits over several years in children transitioned to families.
Huang, Keng-Yen; Calzada, Esther; Cheng, Sabrina; Barajas-Gonzalez, R Gabriela; Brotman, Laurie Miller
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.
Kong, Alberta S.; Farnsworth, Seth; Canaca, Jose A.; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L.
BACKGROUND In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. METHODS We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. RESULTS Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. CONCLUSION An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity. PMID:22320339
Imes, Christopher C.; Lewis, Frances M.; Austin, Melissa A.; Dougherty, Cynthia M.
Objective Evaluate the feasibility and acceptability of a behaviorally-focused intervention designed to increase perceived cardiovascular disease (CVD) and coronary heart disease (CHD) risk in young adults with a family history (FH) of CVD/CHD. Design Single group, pre-post-test design. Sample Fifteen, mostly female (n=13, 86.7%), White, young adults (mean age 20.8 years) with a minimum of a high school education with a FH of CVD/CHD. Measurements Feasibility examined the recruitment strategy, study procedures, appropriateness and quality of the study instruments, and problems that occurred during delivery of the intervention. Acceptability examined participants' engagement in the in person sessions and at home exercises and their feedback about the intervention. Intervention Two, in person sessions provided personalized, tailored messages about ten-year and lifetime CHD risk based on risk factors, FH from a three-generation pedigree, lipid levels, blood pressure, and smoking status, and brief counseling about how to engage in a healthy lifestyle to decrease CVD/CHD risk. Results The intervention was feasible and acceptable. Participants requested more information on healthy food choices, including which foods to avoid and which exercises most improve cardiovascular health. Conclusions Although requiring refinement, the intervention has potential public health implications and deserves further testing. PMID:24840334
Hagan, Melissa J.; Tein, Jenn-Yun; Sandler, Irwin N.; Wolchik, Sharlene A.; Ayers, Tim S.; Luecken, Linda J.
This study tested the effect of the Family Bereavement Program (FBP), a preventive intervention for bereaved families, on effective parenting (e.g., caregiver warmth, consistent discipline) 6 years after program completion. Families (n = 101; 69% female caregivers; 77% Caucasian, 11% Hispanic) with children between ages 8 and 16 who had…
Davidson, Emma M; Liu, Jing Jing; Bhopal, Raj; White, Martin; Johnson, Mark RD; Netto, Gina; Wabnitz, Cecile; Sheikh, Aziz
Context Adapting behavior change interventions to meet the needs of racial and ethnic minority populations has the potential to enhance their effectiveness in the target populations. But because there is little guidance on how best to undertake these adaptations, work in this field has proceeded without any firm foundations. In this article, we present our Tool Kit of Adaptation Approaches as a framework for policymakers, practitioners, and researchers interested in delivering behavior change interventions to ethnically diverse, underserved populations in the United Kingdom. Methods We undertook a mixed-method program of research on interventions for smoking cessation, increasing physical activity, and promoting healthy eating that had been adapted to improve salience and acceptability for African-, Chinese-, and South Asian–origin minority populations. This program included a systematic review (reported using PRISMA criteria), qualitative interviews, and a realist synthesis of data. Findings We compiled a richly informative data set of 161 publications and twenty-six interviews detailing the adaptation of behavior change interventions and the contexts in which they were undertaken. On the basis of these data, we developed our Tool Kit of Adaptation Approaches, which contains (1) a forty-six-item Typology of Adaptation Approaches; (2) a Pathway to Adaptation, which shows how to use the Typology to create a generic behavior change intervention; and (3) RESET, a decision tool that provides practical guidance on which adaptations to use in different contexts. Conclusions Our Tool Kit of Adaptation Approaches provides the first evidence-derived suite of materials to support the development, design, implementation, and reporting of health behavior change interventions for minority groups. The Tool Kit now needs prospective, empirical evaluation in a range of intervention and population settings. PMID:24320170
Auslander, Wendy; McGinnis, Hollee; Tlapek, Sarah; Smith, Penny; Foster, April; Edmond, Tonya; Dunn, Jerry
This study describes the process of adapting and implementing Girls Aspiring toward Independence (GAIN), a trauma-focused, group-based therapy adapted from Cognitive Behavioral Intervention for Trauma in Schools (CBITS) for girls in child welfare. Descriptive data were examined on 3 outcomes: posttraumatic stress disorder (PTSD), depression, and social problem-solving skills among adolescent girls in the child welfare system. Qualitative and quantitative methods were utilized to inform the adaptation of the CBITS intervention, evaluate feasibility, treatment fidelity, and acceptability, and to test the effects of the intervention. Girls ages 12 to 18 (N = 27) were randomly assigned to the experimental and usual care conditions. Participants' symptoms of PTSD and depression and social problem-solving skills were evaluated at pre, post- (3 months), and follow-up (6 months) assessments. Adaptations for GAIN were primarily related to program structure. Data indicated that the program was receptive to girls in child welfare and that it was feasible to recruit, randomize, assess outcomes, and implement with adequate fidelity. Retention was more successful among younger girls. Descriptive initial data showed greater reductions in the percentage of girls with PTSD and depression, and modest increases in social problem-solving skills in the experimental versus usual care condition. Despite the growth of knowledge in dissemination and implementation research, the application of trauma-focused empirically supported treatment to child welfare populations lags behind. A large-scale RCT is needed to determine if GAIN is effective in reducing mental health problems and social problem-solving in the child welfare population. (PsycINFO Database Record
Kastirke, Nadin; John, Ulrich; Goeze, Christian; Sannemann, Janine; Ulbricht, Sabina
The methods of reaching families for a home intervention trial (HIT) were analyzed in this study. The study aimed to reduce environmental tobacco smoke exposure among infants in one region of Germany. The systematic screening data of smoking among families in their homes were compared with reference data of a representative household sample of the state in which the study was conducted. The characteristics of participating and non-participating families were analyzed. All households (N = 3,570) containing at least one infant age 3 years or younger were selected using the residents` registration files and invited to participate in a screening assessment. Among these families, 3,293 (92.2 %) were contacted and from that group, 2,641 families participated in the screening. Compared with the reference sample, the screened sample included a higher proportion of families with employment and with more than 10 years of education. Participation in the HIT was recommended if at least one parent reported smoking one or more cigarettes per day during the previous 4 weeks. Among the 1,282 families that met the inclusion criteria, 71.5 % took part in the screening. Participating families, compared with non-participating families, were older, included more families with two parents living in the household, and had higher rates of employment. The effect size of the final regression model was small (Cohen's f (2) = 0.01). In conclusion, proactive approaches that are delivered at home may yield a high reach of the target population and particularly of socioeconomically disadvantaged populations.
Sam, David Lackland; Virta, Erkki
This study investigated the relationship between intergenerational value discrepancies and psychological adaptation among adolescents with immigrant background (mean age=15.5 years) in Norway and Sweden. Results from two cohorts (parents and their children) of immigrant and host-national families in the two countries (n=574) indicated that immigrant adolescents on the whole neither differed from their host peers with respect to psychological adaptation nor on value discrepancies. Value discrepancies were weakly related to psychological adaptation. Results are discussed as to whether the findings may reflect a general phenomenon for all adolescents or specific to those with immigrant background.
Weinreb, Linda; Upshur, Carole C.; Fletcher-Blake, Debbian; Reed, George; Frisard, Christine
Objective Although depression is common among homeless mothers, little progress has been made in testing treatment strategies for this group. We describe pilot test results of an adapted collaborative care model for homeless mothers with depression. Method We conducted a pilot intervention study of mothers screening positive for depression in 2 randomly selected shelter-based primary care clinics in New York over 18 months in 2010–2012. Study participants completed a psychosocial, health, and mental health assessment at baseline, 3 months, and 6 months. Results One-third of women screened positive for depression (123 of 328 women). Sixty-seven women (63.2% of the eligible sample) enrolled in the intervention. At 6 months, compared to usual-care women, intervention group women were more likely to be receiving depression treatment (40.0% vs 5.9%, P = .01) and antidepressant medication (73.3% vs 5.9%, P = .001, respectively) and had more primary care physician and care manager visits at both 3 months (74.3% vs 53.3%, P = .009 and 91.4% vs 26.7%, P < .001, respectively) and 6 months (46.7% vs 23.5%, P = .003 and 70% vs 17.7%, P = .001, respectively). More women in the intervention group compared to usual-care women reported ≥ 50% improvement in depression symptoms at 6 months (30% vs 5.9%, P = .07). Conclusions This pilot study found that implementing an adapted collaborative care intervention was feasible in a shelter-based primary care clinic and had promising results that require further testing. Trial Registration ClinicalTrials.gov identifier: NCT02723058 PMID:27486545
Parra Cardona, Jose Ruben; Domenech-Rodriguez, Melanie; Forgatch, Marion; Sullivan, Cris; Bybee, Deborah; Holtrop, Kendal; Escobar-Chew, Ana Rocio; Tams, Lisa; Dates, Brian; Bernal, Guillermo
Latinos constitute the largest ethnic minority group in the United States. However, the cultural adaptation and dissemination of evidence-based parenting interventions among Latino populations continues to be scarce despite extensive research that demonstrates the long-term positive effects of these interventions. The purpose of this article is threefold: (1) justify the importance of cultural adaptation research as a key strategy to disseminate efficacious interventions among Latinos, (2) describe the initial steps of a program of prevention research with Latino immigrants aimed at culturally adapting an evidence-based intervention informed by parent management training principles, and (3) discuss implications for advancing cultural adaptation prevention practice and research, based on the initial feasibility and cultural acceptability findings of the current investigation.
Cardona, Jose Ruben Parra; Domenech-Rodriguez, Melanie; Forgatch, Marion; Sullivan, Cris; Bybee, Deborah; Holtrop, Kendal; Escobar-Chew, Ana Rocio; Tams, Lisa; Dates, Brian; Bernal, Guillermo
Latinos constitute the largest ethnic minority group in the US. However, the cultural adaptation and dissemination of evidence-based parenting interventions among Latino populations continues to be scarce in spite of extensive research that demonstrates the long-term positive effects of these interventions. The purpose of this article is threefold: (a) justify the importance of cultural adaptation research as a key strategy to disseminate efficacious interventions among Latinos, (b) describe the initial steps of a program of prevention research with Latino immigrants aimed at culturally adapting an evidence-based intervention informed by parent management training (PMT) principles, and (c) discuss implications for advancing cultural adaptation prevention practice and research, based on the initial feasibility and cultural acceptability findings of the current investigation. PMID:22428711
Chi, Nai-Ching; Demiris, George; Lewis, Frances M; Walker, Amy J; Langer, Shelby L
The demand for family caregivers steadily increases as the number of people receiving hospice and palliative care rises. Family caregivers play a significant role in supporting their loved ones in end-of-life care. However, there is limited evidence about the effectiveness of the interventions for supporting family caregivers. This article synthesizes behavioral and educational interventions that support family caregivers in end-of-life care. A systematic review was conducted and searched interventional studies published between 2004 and 2014 in PubMed, CINAHL, Embase, and The Cochrane Library electronic databases. Fourteen studies were identified and analyzed: 4 educational studies, 6 cognitive behavioral therapy studies, and 4 psychoeducational studies. All educational and behavioral interventions had developed structures and treatment manuals and improved family caregivers' outcomes. The cognitive behavioral therapy resulted in more positive outcomes than the other 2 interventions. More rigorous randomized controlled trials are needed to replicate current effective interventions with larger and diverse sample. Future studies need to develop tools for assessing family caregivers' needs, create consistent and specific tools to effectively measure family caregivers' outcomes, incorporate a cost-effectiveness analysis, and find the most efficient intervention format and method.
Purcell, Rosemary; Baksheev, Gennady N; Mullen, Paul E
There is increasing recognition that family violence may be perpetrated by juveniles against their parents and siblings, however empirical research regarding the nature and causes of such violence is relatively limited. This study examines juvenile family violence in the context of an Intervention Order (IO) being sought against a relative aged 18years or less. All cases over a 3-year period involving an IO application in a major metropolitan Children's Court in Australia were analysed (n=438). The majority of applicants/victims were parents (78%) and to a lesser extent siblings (11%) and other relatives (9%). Most parents who sought applications were mothers (63%) and one-parent households were over-represented (66%). The majority of defendants/perpetrators were male (69%), though juvenile females constituted a significant minority (31%). Intervention orders were sought to prohibit property damage (61%), physical assaults (59%) and/or threats (53%). According to the victim reports, these behaviours emerged in the context of prolonged behavioural problems (49%), a desire to intimidate the victim (12%) or retaliation (8%). While 44% of IO applications were granted, the majority were not (56%) due to the victim discontinuing the application prior to a formal hearing. Of the orders that were granted, a third (32%) were subsequently reported as having been breached. Juvenile family violence is a serious social problem that requires more systematic research to identify the correlates of this behaviour and effective interventions to prevent or reduce its occurrence.
Perrino, Tatiana; Brincks, Ahnalee; Howe, George; Brown, C. Hendricks; Prado, Guillermo; Pantin, Hilda
Familias Unidas is a family-focused preventive intervention that has been found to reduce drug use and sexual risk behaviors among Hispanic adolescents. In some trials, Familias Unidas has also been found to be efficacious in reducing adolescent internalizing symptoms (i.e., depressive and anxiety symptoms), even though the intervention did not specifically target internalizing symptoms. This study examines potential mediators or mechanisms by which Familias Unidas influences internalizing symptoms, specifically the role of intervention-targeted improvements in parent-adolescent communication and reductions in youth externalizing behaviors. A total of 213 Hispanic eighth grade students with a history of externalizing behavior problems and their primary caregivers were recruited from the public school system. Participants, with a mean age of 13.8 years, were randomized into the Familias Unidas intervention or community practice control condition, and assessed at baseline, 6-months, 18-months, and 30-months post-baseline. A cascading mediation model was tested in which the Familias Unidas intervention was hypothesized to decrease adolescent internalizing symptoms through two mediators: improvements in parent-adolescent communication leading to decreases in externalizing behaviors. Findings show that the intervention had significant direct effects on youth internalizing symptoms at 30-months post-baseline. In addition, the cascading mediation model was supported in which the Familias Unidas intervention predicted significant improvements in parent-adolescent communication at 6-months, subsequently decreasing externalizing behaviors at 18-months, and ultimately reducing youth internalizing symptoms at 30-months post-baseline. Implications for prevention interventions are discussed. PMID:27154768
Grácio, Jaime; Gonçalves-Pereira, Manuel; Leff, Julian
The evidence regarding effectiveness of family interventions for psychosis (FIP) is strong and consistent. However, there is a gap in the research on the process of these interventions, and little is known about their active ingredients. This review aims to identify the active ingredients of FIP. We conducted a systematic literature review, focusing on qualitative research, and analyzed 22 papers in total. We found a single study comprehensively exploring the process of FIP. All other studies focused on particular aspects of process-related variables. The key elements of FIP seem to be the so-called "common therapeutic factors", followed by education about the illness and coping skills training. This review supports the value of a stepped model of intervention according to the needs of the families. However, the evidence reviewed also reveals a gap in the research findings based on the limited research available. FIP are complex, psychosocial interventions with multiple components, and more intensive, qualitative research is needed to establish linkages between process and outcome.
Wang, Wenzhi; Zhao, Donghai; Wu, Jianzhong; Wang, Taiping; Dai, Xiuying; Ma, Guangyu; Yang, Bin; Yuan, Chenglin; Bell, Gail S; de Boer, Hanneke M; Prilipko, Leonid L; Sander, Ley
To evaluate the effectiveness of a combined intervention on knowledge, attitude, and practice (KAP) of people with epilepsy and their families in rural areas of China, random samples of people with epilepsy and their family members from the intervention populations completed questionnaires prior to the intervention (2002, N=975) and 2 years later (N=950). There was no significant difference in important demographic variables between the two samples. KAP levels of patients and their family members improved over the study period. Worry about seizures, discrimination, and medical costs are the principal factors in patients' psychological burden. Psychological burden and inability to concentrate at work are the main influences of the disease on family members. Reduction of the psychological burden of patients and their family members is a significant aspect of treatment to which more attention should be paid in similar future interventions.
which the spouses work as a team but in which each spouse can function well independently probably adapt most easily to Army life . The Army can...marital and family life as well as to Army life " (Bowen, 1990a, p. 15). * An outcome or level of "fit" between families and systems in their environment...personal or family needs due to military hardships or conditions. While Bowen (1990b) 2 SATISFACTION WITH ARMY LIFE High Low F ltigh GROUP I GROUP 2
Jones, Kenneth T.; Gray, Phyllis; Whiteside, Y. Omar; Wang, Terry; Bost, Debra; Dunbar, Erica; Foust, Evelyn; Johnson, Wayne D.
Objectives. We assessed the efficacy of an HIV behavioral intervention adapted for Black men who have sex with men (MSM). Methods. We conducted serial cross-sectional surveys, 1 baseline measurement followed by initiation of an intervention and 3 follow-up measurements, among Black MSM in 3 North Carolina cities over 1 year. Results. We observed significant decreases in unprotected receptive anal intercourse at 4 months (by 23.8%, n=287) and 8 months (by 24.7%, n=299), and in unprotected insertive anal intercourse (by 35.2%), unprotected receptive anal intercourse (by 44.1%), and any unprotected anal intercourse (by 31.8%) at 12 months (n=268). Additionally, at 12 months, the mean number of partners for unprotected receptive anal intercourse decreased by 40.5%. The mean number of episodes decreased by 53.0% for unprotected insertive anal intercourse, and by 56.8% for unprotected receptive anal intercourse. The percentage of respondents reporting always using condoms for insertive and receptive anal intercourse increased by 23.0% and 30.3%, respectively. Conclusions. Adapting previously proven interventions designed for other MSM can significantly reduce HIV risk behaviors of Black MSM. PMID:18445795
Wainer, Allison L; Hepburn, Susan; McMahon Griffith, Elizabeth
The goal of this review is to advance the discussion regarding meaningful outcomes of early intervention for children with autism spectrum disorder. The rapid growth in the development and evaluation of early intervention approaches for autism spectrum disorder includes both therapist-driven and parent-mediated interventions. The majority of research on both approaches to early intervention focuses on promoting child outcomes (e.g. language acquisition) with less emphasis on family and parent outcomes (e.g. quality of life, self-efficacy). Given that parent buy-in is essential for parent-mediated interventions to be effective over time, increased attention to family outcomes that are of value to families and have the potential to be impacted positively by these interventions is needed to develop, disseminate, and sustain high-quality interventions in community settings. In this review, we draw from work on parent and family outcomes targeted in related fields (e.g. Part C early intervention, pediatric chronic illness, behavior management parent training) that we propose are particularly relevant for evaluating the impact of parent-mediated interventions in early intervention for autism spectrum disorder.
Puff, Jayme; Kolomeyer, Ellen; McSwiggan, Meagan; Pearte, Catherine; Lauer, Brea-Anne; Renk, Kimberly
Objective: This study examined relationships among emerging adults' perceived familial criticism, their depressive symptoms, and their college adaptation. Participants: The current study examined the responses of 412 emerging adults (300 females and 112 males) who were college students at a large southeastern university. The majority of these…
Zakirova, Venera G.; Gaysina, Guzel I.; Zhumabaeva, Asia
Relevance of the problem stated in the article, conditioned by the fact that the successful adaptation of orphans in a foster family requires specialized knowledge and skills, as well as the need of professional support. Therefore, this article aims at substantiation of the effectiveness of the developed pilot program psycho-pedagogical support of…
Walsh, Sophie; Shulman, Shmuel; Bar-On, Zvulun; Tsur, Antal
Parentification has been defined as the familial interactional pattern in which children and adolescents are assigned or assume roles and responsibilities normally the province of adults. Two studies were conducted to examine the role that parentification takes in the context of immigration with regard to its impact on adolescent adaptation. In…
Broyles, Shelia L.; Brennan, Jesse J.; Burke, Kari Herzog; Kozo, Justine; Taras, Howard L.
The purpose of this GEM is to describe how an existing nutrition education program--Nutrition Education Aimed at Toddlers, was adapted for Latino Families to achieve a good fit by considering several components--both surface and deep structure characteristics of culture, and report indicators of its acceptability. (Contains 1 table.)
Most recent articles on school psychologist involvement with families have been theoretical or conceptual in nature, and little has appeared regarding useful procedures. This article suggests an existing self-report measure that may be a useful addition to psychoeducational evaluations. Four case studies using the technique are presented, its…
Szapocznik, José; Schwartz, Seth J.; Muir, Joan A.; Brown, C. Hendricks
This article reviews the brief strategic family therapy (BSFT; J. Szapocznik, M. A. Scopetta, & O. E. King, 1978, The effect and degree of treatment comprehensiveness with a Latino drug abusing population. In D. E. Smith, S. M. Anderson, M. Burton, N. Gotlieb, W. Harvey, & T. Chung, Eds, A multicultural view of drug abuse, pp. 563–573, Cambridge, MA: G. K. Hall & J. Szapocznik, M. A. Scopetta, & O. E. King, 1978, Theory and practice in matching treatment to the special characteristics and problems of Cuban immigrants, Journal of Community Psychology, 6, 112–122.) approach to treating adolescent drug abuse and related problem behaviors. The treatment intervention is reviewed, including specialized features such as engagement of difficult families. Empirical evidence supporting the BSFT approach is presented. We then illustrate ways in which clinicians can use the model with troubled families whose adolescents may be at risk for drug use and HIV. Finally, future directions for BSFT research are described. PMID:23936750
Cousins, J H; Rubovits, D S; Dunn, J K; Reeves, R S; Ramirez, A G; Foreyt, J P
Mexican Americans are more likely to be obese than non-Hispanic whites, yet little research has been conducted on the treatment of obesity in Mexican Americans. The purpose of this study was to compare a family-based intervention with a traditional program oriented to the individual for achieving weight loss by obese Mexican American women. A total of 168 obese women were randomly assigned to one of three groups. Group 1 served as a comparison group and received only printed materials on nutrition, exercise, and behavioral principles for weight loss. Subjects in the individual group (group 2) received the same printed information, but they also attended classes led by bilingual registered dietitians. Subjects in the family group (group 3) received materials and attended classes that emphasized a family-oriented approach to making changes in eating habits and exercise behavior. Spouses and children attended classes with subjects in this group. Results revealed a significant linear trend in both body mass index and weight reduction across the groups, with losses greatest in the family group, followed by the individual group, and least in the comparison group. Both the individual and the family groups lost significantly more weight than the comparison group, although the difference between these two groups was not statistically significant. The results suggest that a culturally and linguistically appropriate program can achieve significant weight reduction among Mexican Americans. More research should be conducted on the effects of family and other types of social support on weight loss by Mexican Americans. PMID:1410236
Ornelas, India J.; Allen, Claire; Vaughan, Catalina; Williams, Emily C.; Negi, Nalini
Background Brief intervention is known to reduce drinking in primary care, however because health care access is limited for Latino immigrants, traditional brief interventions are unlikely to reach this population. Methods Using Barrera and Castro’s framework, our study aims to culturally adapt a screening and brief intervention program to reduce unhealthy alcohol use among Latino day laborers, a particularly vulnerable group of Latino immigrant men. We conducted 18 interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men. Interviews were conducted until saturation of themes was reached. Themes from interviews were used to identify sources of mismatch between traditional screening and brief intervention and our target population. Results Unhealthy alcohol use was common, culturally accepted, and helped relieve immigration-related stressors. Men had limited knowledge about how to change their behavior. Men preferred to receive information from trusted providers in Spanish. Men faced significant barriers to accessing health and social services, but were open to receiving brief interventions in community settings. Findings were used to design Vida PURA, a preliminary adaptation design of brief intervention for Latino day laborers. Key adaptations include providing brief intervention at a day labor worker center, by promotores trained to incorporate the social and cultural context of drinking for Latino immigrant men. Conclusions Culturally adapted brief intervention may help reduce unhealthy drinking in this underserved population. PMID:25153904
Sun, Virginia; Grant, Marcia; Koczywas, Marianna; Freeman, Bonnie; Zachariah, Finly; Fujinami, Rebecca; Del Ferraro, Catherine; Uman, Gwen; Ferrell, Betty
Background Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for lung cancer patients. This study tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I–IV non-small cell lung cancer (NSCLC). Methods FCGs who were identified by patients as the primary caregiver were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. FCGs in the intervention group were presented at interdisciplinary care meetings, and they also received four educational sessions organized in the physical, psychological, social, and spiritual domains. The sessions included self-care plans to support the FCG’s own needs. Caregiver burden, caregiving skills preparedness, psychological distress, and FCG QOL were assessed at baseline and 12 weeks using validated measures. Results A total of 366 FCGs were included in the primary analysis. FCGs who received the interdisciplinary palliative care intervention had significantly better scores for social well-being (5.84 vs. 6.86; p<.001) and lower psychological distress (4.61 vs. 4.20; p=.010) at 12 weeks compared to FCGs in the usual care group. FCGs in the intervention group had significantly less caregiver burden compared to FCGs in the usual care group (p=.008). Conclusions An interdisciplinary approach to palliative care in lung cancer resulted in statistically significant improvements in the FCG’s social well-being, psychological distress, and less caregiver burden. PMID:26150131
Buzhardt, Jay; Rusinko, Lisa; Heitzman-Powell, Linda; Trevino-Maack, Sylvia; McGrath, Ashley
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.
Boltz, Marie; Resnick, Barbara; Chippendale, Tracy; Galvin, James
A comparative trial using a repeated-measures design was designed to evaluate the feasibility and outcomes of the Family-Centered Function-Focused-Care (Fam-FFC) intervention, which is intended to promote functional recovery in hospitalized older adults. A family-centered resource nurse and a facility champion implemented a three-component intervention (environmental assessment and modification, staff education, individual and family education and partnership in care planning with follow-up after hospitalization for an acute illness). Control units were exposed to function-focused-care education only. Ninety-seven dyads of medical patients aged 65 and older and family caregivers (FCGs) were recruited from three medical units of a community teaching hospital. Fifty-three percent of patients were female, 89% were white, 51% were married, and 40% were widowed, and they had a mean age of 80.8 ± 7.5. Seventy-eight percent of FCGs were married, 34% were daughters, 31% were female spouses or partners, and 38% were aged 46 to 65. Patient outcomes included functional outcomes (activities of daily living (ADLs), walking performance, gait, balance) and delirium severity and duration. FCG outcomes included preparedness for caregiving, anxiety, depression, role strain, and mutuality. The intervention group demonstrated less severity and shorter duration of delirium and better ADL and walking performance but not better gait and balance performance than the control group. FCGs who participated in Fam-FFC showed a significant increase in preparedness for caregiving and a decrease in anxiety and depression from admission to 2 months after discharge but no significant differences in strain or quality of the relationship with the care recipient from FCGs in the control group. Fam-FFC is feasible and has the potential to improve outcomes for hospitalized older adults and their caregivers.
Spring, Hannah; Datta, Saugato; Sapkota, Sabitri
Despite the provision of free and subsidized family planning services and clients’ demonstrated intentions to delay pregnancies, family planning uptake among women who receive abortion and postabortion services at Sunaulo Parivar Nepal (SPN), one of Nepal’s largest non-governmental sexual and reproductive health (SRH) providers, remains low. Through meetings, interviews, and observations with SPN’s stakeholders, service providers, and clients at its 36 SRH centers, we developed hypotheses about client- and provider-side barriers that may inhibit postabortion family planning (PAFP) uptake. On the provider side, we found that the lack of benchmarks (such as the performance of other facilities) against which providers could compare their own performance and the lack of feedback on the performance were important barriers to PAFP uptake. We designed several variants of three interventions to address these barriers. Through conversations with team members at SPN’s centralized support office and service providers at SPN centers, we prioritized a peer-comparison tool that allows providers at one center to compare their performance with that of other similar centers. We used feedback from the community of providers on the tools’ usability and features to select a variant of the tool that also leverages and reinforces providers’ strong intrinsic motivation to provide quality PAFP services. In this paper, we detail the process of identifying barriers and creating an intervention to overcome those barriers. The intervention’s effectiveness will be tested with a center-level, stepped-wedge randomized control trial in which SPN’s 36 centers will be randomly assigned to receive the intervention at 1-month intervals over a 6-month period. Existing medical record data will be used to monitor family planning uptake. PMID:27446891
Inhestern, Laura; Haller, Anne-Catherine; Wlodarczyk, Olga; Bergelt, Corinna
Background Parental cancer has a significant impact on minor children and families. Psychosocial interventions for affected families can provide support where necessary. This systematic review aims at providing an overview of existing interventions and support programs and focuses on the systematic investigation of barriers and facilitators for using psychosocial interventions for families affected by parental cancer (PROSPERO; registration number CRD42014013020). Methods A search of five electronic databases (EMBASE, MEDLINE, PsycInfo, Psyndex, CINAHL) was conducted in June 2014, and updated in September 2015. We included any kind of studies reporting psychosocial support services or interventions for families affected by parental cancer. Study quality was assessed using the Mixed Method Assessment Tool. Narrative synthesis and thematic analyses were undertaken to examine the included interventions and to identify barriers and facilitators for use and implementation. Results A total of 36 studies covering 19 interventions and support services were included in the systematic review. Interventions focused on children, parents or several family members and analyses revealed a broad picture of theoretical background and primary aims. Several studies focused on developmental or implementation phases or descriptions of interventions. Other included studies reported results of evaluations using qualitative and quantitative methods. Results suggest that interventions are helpful and that participants improved in various outcomes. The thematic analyses indicate that barriers for use of support services refer to aspects concerning the patients and families, such as practical difficulties, perceived need for support or fear of stigma. Cancer patients who understood the need and benefit of support services may have used them more often. Additionally, intervention characteristics such as a flexible structure and accessibility were important to reach families affected by
Ramos, Zorangelí; Alegría, Margarita
Few studies addressing the mental health needs of Latinos describe how interventions are tailored or culturally adapted to address the needs of their target population. Without reference to this process, efforts to replicate results and provide working models of the adaptation process for other researchers are thwarted. The purpose of this article is to describe the process of a cultural adaptation that included accommodations for health literacy of a brief telephone cognitive-behavioral depression intervention for Latinos in low-resource settings. We followed a five-stage approach (i.e., information gathering, preliminary adaptation, preliminary testing, adaptation, and refinement) as described by Barrera, Castro, Strycker, and Toobert (2013) to structure our process. Cultural adaptations included condensation of the sessions, review, and modifications of materials presented to participants including the addition of visual aids, culturally relevant metaphors, values, and proverbs. Feedback from key stakeholders, including clinician and study participants, was fundamental to the adaptation process. Areas for further inquiry and adaptation identified in our process include revisions to the presentation of "cognitive restructuring" to participants and the inclusion of participant beliefs about the cause of their depression. Cultural adaptation is a dynamic process, requiring numerous refinements to ensure that an intervention is tailored and relevant to the target population.
Power, Thomas J.; Soffer, Stephen L.; Mautone, Jennifer A.; Costigan, Tracy E.; Jones, Heather A.; Clarke, Angela T.; Marshall, Stephen A.
Intervention researchers have often failed to assess treatment integrity; when integrity is examined, the focus is typically on whether the steps of intervention have been applied and not on quality of implementation. In the few studies that have investigated intervention quality, the emphasis has been on how intervention is delivered and not how it is received or the degree of participant engagement. This study was designed to examine participant engagement, specifically teacher investment, in the context of family interventions for children with attention-deficit/hyperactivity disorder (ADHD) that were linked with the school. The interventions included Family-School Success (FSS), a program that engages families and schools in a problem solving partnership, and Coping with ADHD through Relationships and Education (CARE), a program designed to provide education and support to families. Participants included the families and teachers of children in grades 2 through 6; 45 sets of families and teachers participated in FSS and 48 were in CARE. The Teacher Investment Questionnaire (TIQ) was designed to assess teacher engagement in intervention. The TIQ is a rating scale for clinicians to be completed during and after treatment. The findings provided support for the reliability and validity of the TIQ. Level of teacher involvement was demonstrated to decline with advancing grade level for FSS, but not CARE. Parent ratings of the quality of the family-school relationship as well as the level of teacher support for homework, assessed at baseline, were shown to be significantly related to clinician ratings of teacher investment post intervention. The findings highlight the importance of assessing participant engagement in intervention. Strategies to refine the assessment of teacher investment were discussed. PMID:20011679
Calzada, Esther J.; Brotman, Laurie Miller; Huang, Keng-Yen; Bat-Chava, Yael; Kingston, Sharon
Parent cultural adaptation and preschool behavioral and socioemotional functioning were examined in a community sample of urban families from diverse cultural backgrounds. Participants were 130 families of children (mean age = 4.1 years) attending eight public Pre-Kindergarten programs in urban communities. Parents completed a measure of cultural adaptation that taps into acculturation and enculturation, and teachers reported on children’s externalizing problems, internalizing problems and adaptive behavior in the classroom. Parents’ ethnic identity was a significant predictor of children’s functioning. The retention of parents’ culture of origin and specific aspects of acculturation are related to positive outcomes in a sample of culturally diverse families of preschoolers living in urban communities. Bicultural parents (those with high ethnic and US American identity) had children with lower levels of internalizing problems and higher levels of adaptive behavior relative to parents who were not bicultural. Implications for enhancing positive child outcomes through the promotion of parental ethnic identity are discussed. PMID:20559417
Cates, Carolyn Brockmeyer; Weisleder, Adriana; Mendelsohn, Alan L
Poverty related disparities in early child development and school readiness are a major public health crisis, the prevention of which has emerged in recent years as a national priority. Interventions targeting parenting and the quality of the early home language environment are at the forefront of efforts to address these disparities. In this article we discuss the innovative use of the pediatric primary care platform as part of a comprehensive public health strategy to prevent adverse child development outcomes through the promotion of parenting. Models of interventions in the pediatric primary care setting are discussed with evidence of effectiveness reviewed. Taken together, a review of this significant body of work shows the tremendous potential to deliver evidence-based preventive interventions to families at risk for poverty related disparities in child development and school readiness at the time of pediatric primary care visits. We also addresss considerations related to scaling and maximizing the effect of pediatric primary care parenting interventions and provide key policy recommendations.
Juffer, Femmie; Bakermans-Kranenburg, Marian J.; van IJzendoorn, Marinus H.
Background: As infant disorganized attachment is a serious risk factor for later child psychopathology, it is important to examine whether attachment disorganization can be prevented or reduced. Method: In a randomized intervention study involving 130 families with 6-month-old adopted infants, two attachment-based intervention programs were…
Leon, Federico R.; Lundgren, Rebecka; Sinai, Irit; Jennings, Victoria
A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on…
Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike
This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services.
Ho, Josephine; Pedersen, Sue D.; Virtanen, Heidi; Nettel-Aguirre, Alberto; Huang, Carol
Nutritional counseling for children with obesity is an important component of management. This randomized controlled trial was conducted to compare change in body mass index (BMI) z score after 6 months. Children 8 to 16 years with a BMI greater than the 85th percentile were randomized to standard of care nutrition counseling versus intervention with standard nutrition counseling including portion control tool training for the family. Measures were completed at baseline, 3 months, and 6 months. Fifty-one children were randomized to control and 48 to intervention. Mean age was 11 years (SD = 2.2). Mean BMI z score was 2.7 (SD = 0.4). Forty-five percent were male (n = 45). Follow-up at 6 months was 73.7% (73/99). Although no differences were seen between the groups, there was a significant decrease in BMI z score between baseline and 6 months within each group. PMID:27699184
Miller, Gregory E.; Brody, Gene H.; Yu, Tianyi; Chen, Edith
Children of low socioeconomic status (SES) are at elevated risk for health problems across the lifespan. Observational studies suggest that nurturant parenting might offset some of these health risks, but their design precludes inferences about causal direction and clinical utility. Here we ask whether a psychosocial intervention, focused improving parenting, strengthening family relationships, and building youth competencies, can reduce inflammation in low-SES, African Americans from the rural South. The trial involved 272 mothers and their 11-y-old children from rural Georgia, half of whose annual household incomes were below the federal poverty line. Families were randomly assigned to a 7-wk psychosocial intervention or to a control condition. When youth reached age 19, peripheral blood was collected to quantify six cytokines that orchestrate inflammation, the dysregulation of which contributes to many of the health problems known to pattern by SES. Youth who participated in the intervention had significantly less inflammation on all six indicators relative to controls (all P values < 0.001; effect sizes in Cohen’s d units ranged from −0.69 to −0.91). Mediation analyses suggested that improved parenting was partially responsible for the intervention’s benefits. Inflammation was lowest among youth who received more nurturant-involved parenting, and less harsh-inconsistent parenting, as a consequence of the intervention. These findings have theoretical implications for research on resilience to adversity and the early origins of disease. If substantiated, they may also highlight a strategy for practitioners and policymakers to use in ameliorating social and racial health disparities. PMID:25049403
Lindberg, Nangel M.; Stevens, Victor J.; Vega-López, Sonia; Kauffman, Tia; Calderón, Mariana Rosales; Cervantes, María Antonieta
Background This study assessed the feasibility of a culturally-appropriate weight-loss intervention targeting obese Spanish-speaking Mexican women. Methods This 12-month weight-loss program was based on behavioral interventions previously used successfully with English-speaking participants. Cultural adaptations included: female interventionists, minimal written materials, emphasis on group activities, focus on Mexican traditions and beliefs, and skill-building approach to food measurement. All sessions were conducted in Spanish. The study had few exclusionary criteria, which allowed participation of women with a wide range of literacy levels. Results Recruitment exceeded expectations, with 47 participants enrolling in the program. Not counting participants who became pregnant during the study, attendance at 6 and 12 months was 62% and 50% respectively. Mean weight loss at 6 and 12 months was 5.3 kg and 7.2 kg, respectively, with a mean reduction in BMI of 4.0 kg/m2 and 5.5 kg/m2 from baseline to 6 and 12 months, respectively. Discussion This pilot study shows that it is feasible to develop and implement culturally-appropriate behavioral lifestyle interventions for obesity treatment in Mexican-American women. PMID:22460538
Lindberg, Nangel M; Stevens, Victor J; Vega-López, Sonia; Kauffman, Tia L; Calderón, Mariana Rosales; Cervantes, María Antonieta
This study assessed the feasibility of a culturally-appropriate weight-loss intervention targeting obese Spanish-speaking Mexican women. This 12-month weight-loss program was based on behavioral interventions previously used successfully with English-speaking participants. Cultural adaptations included: female interventionists, minimal written materials, emphasis on group activities, focus on Mexican traditions and beliefs, and skill-building approach to food measurement. All sessions were conducted in Spanish. The study had few exclusionary criteria, which allowed participation of women with a wide range of literacy levels. Recruitment exceeded expectations, with 47 participants enrolling in the program. Not counting participants who became pregnant during the study, attendance at 6 and 12 months was 62 and 50 % respectively. Mean weight loss at 6 and 12 months was 5.3 and 7.2 kg, respectively, with a mean reduction in BMI of 4.0 and 5.5 kg/m(2) from baseline to 6 and 12 months, respectively. This pilot study shows that it is feasible to develop and implement culturally-appropriate behavioral lifestyle interventions for obesity treatment in Mexican-American women.
Kidd, Lori I; Zauszniewski, Jaclene A; Morris, Diana L
This pilot clinical trial tested effectiveness of a poetry writing intervention for family caregivers of elders with dementia. This paper presents findings from a larger study using mixed methods to examine outcome variables of self-transcendence, resilience, depressive symptoms, and subjective caregiver burden. Findings reported here focus on qualitative analysis of in-depth interviews conducted with participants following their poetry writing experience. A grounded theory approach was used. Themes that arose from the data support a mid-range theory of self-affirmation in caregivers with subthemes of achievement, catharsis, greater acceptance, empathy, self-awareness, reflection, creative and fun, positive challenge, and helping others.
Rakha'lskiĭ, Iu E; Dru'z, V F
Clinical and psychosocial examinations of 70 families of senile schizophrenic patients and 40 families of healthy persons showed that in the patients' and controls' families, the identical events were caused by the subjects' age itself: lower status and adaptation of senile persons, rationalistic attitude of the relatives toward them, conflicts, disintegrated families, dysharmonic relations. In line with the schizophrenic process, the patients have less frequently higher status, enjoy more care of siblings, more rationalistic attitude of the relatives, higher conflict rate, larger variety of familial cooperation disorders and adaptations.
Liu, Ran; Xu, Chuan; Zhang, Qiangqiang; Wang, Shiyi; Fang, Weiguo
The fungal kingdom potentially has the most complex chitin synthase (CHS) gene family, but evolution of the fungal CHS gene family and its diversification to fulfill multiple functions remain to be elucidated. Here, we identified the full complement of CHSs from 231 fungal species. Using the largest dataset to date, we characterized the evolution of the fungal CHS gene family using phylogenetic and domain structure analysis. Gene duplication, domain recombination and accretion are major mechanisms underlying the diversification of the fungal CHS gene family, producing at least 7 CHS classes. Contraction of the CHS gene family is morphology-specific, with significant loss in unicellular fungi, whereas family expansion is lineage-specific with obvious expansion in early-diverging fungi. ClassV and ClassVII CHSs with the same domain structure were produced by the recruitment of domains PF00063 and PF08766 and subsequent duplications. Comparative analysis of their functions in multiple fungal species shows that the emergence of ClassV and ClassVII CHSs is important for the morphogenesis of filamentous fungi, development of pathogenicity in pathogenic fungi, and heat stress tolerance in Pezizomycotina fungi. This work reveals the evolution of the fungal CHS gene family, and its correlation with fungal morphogenesis and adaptation to ecological niches. PMID:28300148
Dirks, Tineke; Hadders-Algra, Mijna
During the past two decades, awareness of the role of the family in the child's life has increased and the term 'family-centred services' (FCS) has been introduced to facilitate care for children with special needs and their families. It is, however, unclear how various early intervention programmes incorporate family involvement in service delivery. The present study systematically analyses the nature of family involvement in six frequently used early intervention programmes for infants at high risk of developmental disorders: neurodevelopmental treatment, treatment according to Vojta, Conductive Education, Infant Health and Development Program, Infant Behaviour Assessment and Intervention Program, and Coping with and Caring for infants with special needs - a family-centred programme (COPCA). The analysis shows that the role of the family is diverse: it varies from parent training to be a therapist without attention to family function (in Vojta) to the autonomous family that receives coaching (COPCA). The data suggest two trends over time: (1) from child-focused to family-focused orientation; and (2) from professionally directed guidance to coaching based on equal partnership.
Bekele, Esubalew T; Lahiri, Uttama; Swanson, Amy R.; Crittendon, Julie A.; Warren, Zachary E.; Sarkar, Nilanjan
Emerging technology, especially robotic technology, has been shown to be appealing to children with autism spectrum disorders (ASD). Such interest may be leveraged to provide repeatable, accurate and individualized intervention services to young children with ASD based on quantitative metrics. However, existing robot-mediated systems tend to have limited adaptive capability that may impact individualization. Our current work seeks to bridge this gap by developing an adaptive and individualized robot-mediated technology for children with ASD. The system is composed of a humanoid robot with its vision augmented by a network of cameras for real-time head tracking using a distributed architecture. Based on the cues from the child’s head movement, the robot intelligently adapts itself in an individualized manner to generate prompts and reinforcements with potential to promote skills in the ASD core deficit area of early social orienting. The system was validated for feasibility, accuracy, and performance. Results from a pilot usability study involving six children with ASD and a control group of six typically developing (TD) children are presented. PMID:23221831
Puig, Victoria I.
This study was designed to gain insight into how early intervention (EI) services incorporate the cultural and linguistic resources of families and how EI professionals and families build partnerships with each other. Through observation and interview, the author looked deeply at the experiences of a small group of culturally and linguistically…
Quinn, William H.; Van Dyke, David J.
This study evaluated a multiple-family group-intervention program (MFGI) for first-time juvenile offenders. The recidivism rate for subjects who completed the MFGI (the Family Solutions Program) was compared to recidivism rates of two other groups of first-time juvenile offenders. Using logistic regression analysis predicting who will recidivate,…
Connell, Arin; Bullock, Bernadette Marie; Dishion, Thomas J.; Shaw, Daniel; Wilson, Melvin; Gardner, Frances
This study used latent transition analysis (LTA) to examine changes in early emotional and behavioral problems in children age 2 to 4 years resulting from participation in a family-centered intervention. A sample of 731 economically disadvantaged families was recruited from among participants in a national food supplement and nutrition program.…
Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.
The overall aim of this multi-informant study was to examine pre-post treatment changes, and maintenance at 3-year follow-up, for multiple dimensions of the family context, for a modular intervention that has previously demonstrated significant clinical improvements in child behavior and maintenance of these effects. Family outcomes included…
Hogue, Aaron; Dauber, Sarah; Henderson, Craig E.; Liddle, Howard A.
Reliable therapist-report methods appear to be an essential component of quality assurance procedures to support adoption of evidence-based practices in usual care, but studies have found weak correspondence between therapist and observer ratings of treatment techniques. This study examined therapist reliability and accuracy in rating intervention target (i.e., session participants) and focus (i.e., session content) in a manual-guided, family-based preventive intervention implemented with 50 inner-city adolescents at risk for substance use. A total of 106 sessions selected from three phases of treatment were rated via post-session self-report by the participating therapist and also via videotape by nonparticipant coders. Both groups estimated the amount of session time devoted to model-prescribed treatment targets (adolescent, parent, conjoint) and foci (family, school, peer, prosocial, drugs). Therapists demonstrated excellent reliability with coders for treatment targets and moderate to high reliability for treatment foci across the sample and within each phase. Also, therapists did not consistently overestimate their degree of activity with targets or foci. Implications of study findings for fidelity assessment in routine settings are discussed. PMID:24068479
Perrino, Tatiana; Pantin, Hilda; Huang, Shi; Brincks, Ahnalee; Brown, C Hendricks; Prado, Guillermo
Familias Unidas is an intervention that has been found to be efficacious in preventing and reducing substance use, sexual risk, and problem behaviors among Hispanic youth. While it does not specifically target youth internalizing symptoms, the intervention works to strengthen parenting and family factors associated with reduced risk of internalizing symptoms (i.e., depression, anxiety symptoms). This study examines the effects of Familias Unidas on internalizing symptoms among high-risk youth, as well as the role of family level factors in the intervention's effects. A total of 242 12-17-year-old Hispanic youth with a history of delinquency and their primary caregivers were recruited from the school and juvenile justice systems, and randomly assigned to the Familias Unidas intervention or community practice control. A linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms from baseline to 6 and 12 months post-baseline. Results show that the Familias Unidas intervention was more efficacious than control in reducing youth internalizing symptoms. Baseline youth externalizing and internalizing symptoms did not moderate the intervention's effects on the trajectory of youth internalizing symptoms. While parent-adolescent communication did not significantly moderate the intervention's effects, changes in parent-adolescent communication mediated the intervention's effects on internalizing symptoms, showing stronger intervention effects for youth starting with poorer communication. Findings indicate that the Familias Unidas intervention can reduce internalizing symptoms among high-risk Hispanic youth, and that improving parent-youth communication, a protective family factor, may be one of the mechanisms by which the intervention influences youth internalizing symptoms.
Shea, Katriona; Tildesley, Michael J; Runge, Michael C; Fonnesbeck, Christopher J; Ferrari, Matthew J
Optimal intervention for disease outbreaks is often impeded by severe scientific uncertainty. Adaptive management (AM), long-used in natural resource management, is a structured decision-making approach to solving dynamic problems that accounts for the value of resolving uncertainty via real-time evaluation of alternative models. We propose an AM approach to design and evaluate intervention strategies in epidemiology, using real-time surveillance to resolve model uncertainty as management proceeds, with foot-and-mouth disease (FMD) culling and measles vaccination as case studies. We use simulations of alternative intervention strategies under competing models to quantify the effect of model uncertainty on decision making, in terms of the value of information, and quantify the benefit of adaptive versus static intervention strategies. Culling decisions during the 2001 UK FMD outbreak were contentious due to uncertainty about the spatial scale of transmission. The expected benefit of resolving this uncertainty prior to a new outbreak on a UK-like landscape would be £45-£60 million relative to the strategy that minimizes livestock losses averaged over alternate transmission models. AM during the outbreak would be expected to recover up to £20.1 million of this expected benefit. AM would also recommend a more conservative initial approach (culling of infected premises and dangerous contact farms) than would a fixed strategy (which would additionally require culling of contiguous premises). For optimal targeting of measles vaccination, based on an outbreak in Malawi in 2010, AM allows better distribution of resources across the affected region; its utility depends on uncertainty about both the at-risk population and logistical capacity. When daily vaccination rates are highly constrained, the optimal initial strategy is to conduct a small, quick campaign; a reduction in expected burden of approximately 10,000 cases could result if campaign targets can be updated on
Shea, Katriona; Tildesley, Michael J.; Runge, Michael C.; Fonnesbeck, Christopher J.; Ferrari, Matthew J.
Optimal intervention for disease outbreaks is often impeded by severe scientific uncertainty. Adaptive management (AM), long-used in natural resource management, is a structured decision-making approach to solving dynamic problems that accounts for the value of resolving uncertainty via real-time evaluation of alternative models. We propose an AM approach to design and evaluate intervention strategies in epidemiology, using real-time surveillance to resolve model uncertainty as management proceeds, with foot-and-mouth disease (FMD) culling and measles vaccination as case studies. We use simulations of alternative intervention strategies under competing models to quantify the effect of model uncertainty on decision making, in terms of the value of information, and quantify the benefit of adaptive versus static intervention strategies. Culling decisions during the 2001 UK FMD outbreak were contentious due to uncertainty about the spatial scale of transmission. The expected benefit of resolving this uncertainty prior to a new outbreak on a UK-like landscape would be £45–£60 million relative to the strategy that minimizes livestock losses averaged over alternate transmission models. AM during the outbreak would be expected to recover up to £20.1 million of this expected benefit. AM would also recommend a more conservative initial approach (culling of infected premises and dangerous contact farms) than would a fixed strategy (which would additionally require culling of contiguous premises). For optimal targeting of measles vaccination, based on an outbreak in Malawi in 2010, AM allows better distribution of resources across the affected region; its utility depends on uncertainty about both the at-risk population and logistical capacity. When daily vaccination rates are highly constrained, the optimal initial strategy is to conduct a small, quick campaign; a reduction in expected burden of approximately 10,000 cases could result if campaign targets can be updated on
Kuhaneck, Heather Miller; Madonna, Stephanie; Novak, Audrey; Pearson, Emily
This systematic review examined the literature published from January 2006 to April 2013 related to the effectiveness of occupational therapy interventions for children with autism spectrum disorder (ASD) and their parents to improve parental stress and self-efficacy, coping, and resilience and family participation in daily life and routines. From the 4,457 abstracts, 34 articles were selected that matched the inclusion criteria. The results were mixed and somewhat inconclusive because this body of literature is in its infancy. Studies of children with ASD do not routinely measure parental and family outcomes. Recommendations include an emphasis on family measures other than parental stress and a greater focus on measures of parental and family functioning in all future studies of pediatric interventions to more fully understand the impact of interventions in a wider context.
McGlothlin, Joel W; Kobiela, Megan E; Feldman, Chris R; Castoe, Todd A; Geffeney, Shana L; Hanifin, Charles T; Toledo, Gabriela; Vonk, Freek J; Richardson, Michael K; Brodie, Edmund D; Pfrender, Michael E; Brodie, Edmund D
Novel adaptations must originate and function within an already established genome . As a result, the ability of a species to adapt to new environmental challenges is predicted to be highly contingent on the evolutionary history of its lineage [2-6]. Despite a growing appreciation of the importance of historical contingency in the adaptive evolution of single proteins [7-11], we know surprisingly little about its role in shaping complex adaptations that require evolutionary change in multiple genes. One such adaptation, extreme resistance to tetrodotoxin (TTX), has arisen in several species of snakes through coevolutionary arms races with toxic amphibian prey, which select for TTX-resistant voltage-gated sodium channels (Nav) [12-16]. Here, we show that the relatively recent origins of extreme toxin resistance, which involve the skeletal muscle channel Nav1.4, were facilitated by ancient evolutionary changes in two other members of the same gene family. A substitution conferring TTX resistance to Nav1.7, a channel found in small peripheral neurons, arose in lizards ∼170 million years ago (mya) and was present in the common ancestor of all snakes. A second channel found in larger myelinated neurons, Nav1.6, subsequently evolved resistance in four different snake lineages beginning ∼38 mya. Extreme TTX resistance has evolved at least five times within the past 12 million years via changes in Nav1.4, but only within lineages that previously evolved resistant Nav1.6 and Nav1.7. Our results show that adaptive protein evolution may be contingent upon enabling substitutions elsewhere in the genome, in this case, in paralogs of the same gene family.
Augusto, Cláudia Cristina Vieira Carvalho de Oliveira Ferreira; Araújo, Beatriz Rodrigues; Rodrigues, Vítor Manuel Costa Pereira; de Figueiredo, Maria do Céu Aguiar Barbieri
OBJECTIVES: to adapt and validate the Inventory of Family Protective Factors (IFPF) for the Portuguese culture. This instrument assesses protective factors that contribute to family resilience. Studies addressing resilience are embedded within the salutogenic paradigm, i.e. it addresses protective factors of individuals or groups without underestimating risk factors or vulnerability. METHOD: in order to assess the IFPF's linguistic and conceptual equivalence, the instrument was translated, retro-translated and the think-aloud protocol was used. We then verified the instrument's sensitiveness, reliability and validity of results to assess its psychometric characteristics. A factor analysis was performed of the principal components with varimax rotation of the scale's items and Cronbach's alpha coefficient was calculated for each dimension. A total of 85 families with disabled children, selected through simple random sampling, self-administered the instrument. RESULTS: the IFPF presents psychometric characteristics that are appropriate for the Portuguese population (Cronbach's alpha = .90). CONCLUSION: the IFPF was adapted and validated for the Portuguese culture and is an instrument to be used in studies intended to assess protective factors of family resilience. PMID:25591096
Park, Youngil; Jeong, Hee Sun
With the increase in multi-cultural families, Korea is seeing a rapid increase in immigrated housewives, who are closely related to food culture. However, studies for the diet of multi-cultural families, which is most closely related to our lives have not been sufficiently researched. With this background, this study conducted research for immigrated women nationwide about food cultures to provide the possibility which Korean food culture would be developed harmoniously with various foreign food cultures. In this study, the immigrated women seemed to have adapted to Korean food culture quickly, but they showed differences according to some conditions like countries they are from and the time they have been in Korea. To achieve this, we need to conduct consistent and in depth studies for food cultures in multi-cultural families so that we can make healthy development in food culture, harmonious with traditional Korean culture. PMID:21103087
Blank Wilson, Amy; Farkas, Kathleen
Social work research has identified the crucial role that service practitioners play in the implementation of evidence-based practices. This has led some researchers to suggest that intervention research needs to incorporate collaborative adaptation strategies in the design and implementation of studies focused on adapting evidence-based practices to real-world practice settings. This article describes a collaborative approach to service adaptations that was used in an intervention study that integrated evidence-based mental health and correctional services in a jail reentry program for people with serious mental illness. This description includes a discussion of the nature of the collaboration engaged in this study, the implementation strategies that were used to support this collaboration, and the lessons that the research team has learned about engaging a collaborative approach to implementing interventions in research projects being conducted in real-world social service delivery settings.
Miller-Graff, Laura E; Cummings, E Mark; Bergman, Kathleen N
The role of emotional security in promoting positive adjustment following exposure to marital conflict has been identified in a large number of empirical investigations, yet to date, no interventions have explicitly addressed the processes that predict child adjustment after marital conflict. The current study evaluated a randomized controlled trial of a family intervention program aimed at promoting constructive marital conflict behaviors thereby increasing adolescent emotional security and adjustment. Families (n = 225) were randomized into 1 of 4 conditions: Parent-Adolescent (n = 75), Parent-Only (n = 75), Self-Study (n = 38) and No Treatment (n = 37). Multi-informant and multi-method assessments were conducted at baseline, post-treatment and 6-month follow-up. Effects of treatment on destructive and constructive conflict behaviors were evaluated using multilevel models where observations were nested within individuals over time. Process models assessing the impact of constructive and destructive conflict behaviors on emotional insecurity and adolescent adjustment were evaluated using path modeling. Results indicated that the treatment was effective in increasing constructive conflict behaviors (d = 0.89) and decreasing destructive conflict behaviors (d = -0.30). For the Parent-Only Group, post-test constructive conflict behaviors directly predicted lower levels of adolescent externalizing behaviors at 6-month follow-up. Post-test constructive conflict skills also indirectly affected adolescent internalizing behaviors through adolescent emotional security. These findings support the use of a brief psychoeducational intervention in improving post-treatment conflict and emotional security about interparental relationships.
Drini, Sima; Criscuolo, Alexis; Lechat, Pierre; Imamura, Hideo; Skalický, Tomáš; Rachidi, Najma; Lukeš, Julius; Dujardin, Jean-Claude; Späth, Gerald F
All eukaryotic genomes encode multiple members of the heat shock protein 70 (HSP70) family, which evolved distinctive structural and functional features in response to specific environmental constraints. Phylogenetic analysis of this protein family thus can inform on genetic and molecular mechanisms that drive species-specific environmental adaptation. Here we use the eukaryotic pathogen Leishmania spp. as a model system to investigate the evolution of the HSP70 protein family in an early-branching eukaryote that is prone to gene amplification and adapts to cytotoxic host environments by stress-induced and chaperone-dependent stage differentiation. Combining phylogenetic and comparative analyses of trypanosomatid genomes, draft genome of Paratrypanosoma and recently published genome sequences of 204 L. donovani field isolates, we gained unique insight into the evolutionary dynamics of the Leishmania HSP70 protein family. We provide evidence for (i) significant evolutionary expansion of this protein family in Leishmania through gene amplification and functional specialization of highly conserved canonical HSP70 members, (ii) evolution of trypanosomatid-specific, non-canonical family members that likely gained ATPase-independent functions, and (iii) loss of one atypical HSP70 member in the Trypanosoma genus. Finally, we reveal considerable copy number variation of canonical cytoplasmic HSP70 in highly related L. donovani field isolates, thus identifying this locus as a potential hot spot of environment-genotype interaction. Our data draw a complex picture of the genetic history of HSP70 in trypanosomatids that is driven by the remarkable plasticity of the Leishmania genome to undergo massive intra-chromosomal gene amplification to compensate for the absence of regulated transcriptional control in these parasites.
Drini, Sima; Criscuolo, Alexis; Lechat, Pierre; Imamura, Hideo; Skalický, Tomáš; Rachidi, Najma; Lukeš, Julius; Dujardin, Jean-Claude; Späth, Gerald F.
All eukaryotic genomes encode multiple members of the heat shock protein 70 (HSP70) family, which evolved distinctive structural and functional features in response to specific environmental constraints. Phylogenetic analysis of this protein family thus can inform on genetic and molecular mechanisms that drive species-specific environmental adaptation. Here we use the eukaryotic pathogen Leishmania spp. as a model system to investigate the evolution of the HSP70 protein family in an early-branching eukaryote that is prone to gene amplification and adapts to cytotoxic host environments by stress-induced and chaperone-dependent stage differentiation. Combining phylogenetic and comparative analyses of trypanosomatid genomes, draft genome of Paratrypanosoma and recently published genome sequences of 204 L. donovani field isolates, we gained unique insight into the evolutionary dynamics of the Leishmania HSP70 protein family. We provide evidence for (i) significant evolutionary expansion of this protein family in Leishmania through gene amplification and functional specialization of highly conserved canonical HSP70 members, (ii) evolution of trypanosomatid-specific, non-canonical family members that likely gained ATPase-independent functions, and (iii) loss of one atypical HSP70 member in the Trypanosoma genus. Finally, we reveal considerable copy number variation of canonical cytoplasmic HSP70 in highly related L. donovani field isolates, thus identifying this locus as a potential hot spot of environment–genotype interaction. Our data draw a complex picture of the genetic history of HSP70 in trypanosomatids that is driven by the remarkable plasticity of the Leishmania genome to undergo massive intra-chromosomal gene amplification to compensate for the absence of regulated transcriptional control in these parasites. PMID:27371955
Goodkind, Jessica R; Lanoue, Marianna D; Milford, Jaime
American Indian adolescents experience higher rates of suicide and psychological distress than the overall U.S. adolescent population, and research suggests that these disparities are related to higher rates of violence and trauma exposure. Despite elevated risk, there is limited empirical information to guide culturally appropriate treatment of trauma and related symptoms. We report a pilot study of an adaptation to the Cognitive Behavioral Intervention for Trauma in Schools in a sample of 24 American Indian adolescents. Participants experienced significant decreases in anxiety and posttraumatic stress disorder symptoms, and avoidant coping strategies, as well as a marginally significant decrease in depression symptoms. Improvements in anxiety and depression were maintained 6 months postintervention; improvements in posttraumatic stress disorder and avoidant coping strategies were not.
Background Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. Methods/Design Objectives: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment. A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. Discussion This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts. PMID:20738846
Mandt, A K
The curriculum revolution might have been born at the University of Detroit in their RN-to-BSN program. Situated in an urban environment where violence is an ever-present problem, the faculty developed an innovative clinical course for senior students, entitled Nursing and Crises Intervention for Victims of Family Violence. The curriculum was designed to respond to a social problem that affects individuals, families, and groups at both physical and psychological levels. It was hoped that creative use of the educational process would promote nursing intervention with a population whose needs have traditionally been unrecognized and unmet by the profession. The response to the course has been very positive and students have applied the content in nontraditional clinical agencies such as shelters for battered women and children, sexual abuse centers, and phone crisis centers. More importantly, these RN students report not only a change in personal attitudes, but an integration and application of their knowledge in their own professional practice. They act as educators to their peers and colleagues while reshaping their own practice in light of their newly acquired sensitivity. By creatively using the nursing curriculum, educators can prepare nurses to deal with many of the social ills affecting individuals, families, and groups. In so doing, they encourage nurses to step into the forefront of health care. They invite nursing practitioners to become proactive rather than reactive. Ultimately, such curriculum creativity will ensure that clients currently ignored or unrecognized by the health care system are identified and treated in a caring fashion by the profession that prides itself on its ability to care.
Roulette, Jennifer W; Hill, Laura G; Diversi, Marcelo; Overath, Renee
Objective: Most reports of adaptations to evidence-based prevention programmes for delivery to specific cultural groups describe formal adaptation procedures. In this paper, we report on how practitioners identify and manage issues of perceived cultural mismatch when delivering a scripted, evidence-based intervention. Design: We used grounded…
Background The chloroplast-localized ribulose-1, 5-biphosphate carboxylase/oxygenase (Rubisco), the primary enzyme responsible for autotrophy, is instrumental in the continual adaptation of plants to variations in the concentrations of CO2. The large subunit (LSU) of Rubisco is encoded by the chloroplast rbcL gene. Although adaptive processes have been previously identified at this gene, characterizing the relationships between the mutational dynamics at the protein level may yield clues on the biological meaning of such adaptive processes. The role of such coevolutionary dynamics in the continual fine-tuning of RbcL remains obscure. Results We used the timescale and phylogenetic analyses to investigate and search for processes of adaptive evolution in rbcL gene in three gymnosperm families, namely Podocarpaceae, Taxaceae and Cephalotaxaceae. To understand the relationships between regions identified as having evolved under adaptive evolution, we performed coevolutionary analyses using the software CAPS. Importantly, adaptive processes were identified at amino acid sites located on the contact regions among the Rubisco subunits and on the interface between Rubisco and its activase. Adaptive amino acid replacements at these regions may have optimized the holoenzyme activity. This hypothesis was pinpointed by evidence originated from our analysis of coevolution that supported the correlated evolution between Rubisco and its activase. Interestingly, the correlated adaptive processes between both these proteins have paralleled the geological variation history of the concentration of atmospheric CO2. Conclusions The gene rbcL has experienced bursts of adaptations in response to the changing concentration of CO2 in the atmosphere. These adaptations have emerged as a result of a continuous dynamic of mutations, many of which may have involved innovation of functional Rubisco features. Analysis of the protein structure and the functional implications of such mutations put
Lieberman, Alicia F; Van Horn, Patricia
Infants and young children of parents in the military deserve special attention because the first years of life are pivotal in establishing trusting attachment relationships, which are based on the developmental expectation that parents will be reliably available and protective both physically and emotionally. For young children in military families, the stresses of extended absences of mothers and/or fathers as the result of deployment abroad, recurrent separations and reunions resulting from repeated deployments, or parents struggling with the emotional sequelae of their war experiences, and the traumatic impact of parental injury and death can strain and derail the normative expectation of parental availability and protectiveness. This article describes the key features of mental health in infancy and early childhood, the developmentally expectable early anxieties that all children experience in the first years of life across cultures and circumstances, and the ways in which these normative anxieties are exacerbated by the specific circumstances of military families. The article also describes interventions that may be helpful in supporting military families and their children with the specific challenges they face.
Hu, Ruofei; Cancela, Jorge; Cea, Gloria; Vlachopapadopoulou, Elpis-Athina; Fotiadis, Dimitrios I.; Fico, Giuseppe
Childhood obesity is becoming one of the 21st century’s most important public health problems. Nowadays, the main treatment of childhood obesity is behavior intervention that aims at improve children’s lifestyle to arrest the disease. Information and communication technologies (ICTs) have not been widely employed in this intervention, and most of existing ICTs systems are not having a long-term effect. The purpose of this paper is to define a system to support family-based intervention through a state-of-the-art analysis of family-based interventions and related technological solutions first, and then using the analytic hierarchy process to derive a childhood obesity family-based behavior intervention model, and finally to provide a prototype of a system called OB CITY. The system makes use of applied behavior analysis, affective computing technologies, as well as serious game and gamification techniques, to offer long term services in all care dimensions of the family-based behavioral intervention aiming to provide positive effects to the treatment of childhood obesity. PMID:27602306
Hu, Ruofei; Cancela, Jorge; Arredondo Waldmeyer, Maria Teresa; Cea, Gloria; Vlachopapadopoulou, Elpis-Athina; Fotiadis, Dimitrios I; Fico, Giuseppe
Childhood obesity is becoming one of the 21st century's most important public health problems. Nowadays, the main treatment of childhood obesity is behavior intervention that aims at improve children's lifestyle to arrest the disease. Information and communication technologies (ICTs) have not been widely employed in this intervention, and most of existing ICTs systems are not having a long-term effect. The purpose of this paper is to define a system to support family-based intervention through a state-of-the-art analysis of family-based interventions and related technological solutions first, and then using the analytic hierarchy process to derive a childhood obesity family-based behavior intervention model, and finally to provide a prototype of a system called OB CITY. The system makes use of applied behavior analysis, affective computing technologies, as well as serious game and gamification techniques, to offer long term services in all care dimensions of the family-based behavioral intervention aiming to provide positive effects to the treatment of childhood obesity.
Celano, Marianne P; Holsey, Chanda Nicole; Kobrynski, Lisa J
Low-income African American children have disproportionately higher asthma morbidity and mortality. Education alone may not address barriers to asthma management due to psychosocial stress. This study evaluated the efficacy of a home-based family intervention integrating asthma education and strategies to address stress using a community-based participatory research model. Children age 8 to 13 with poorly controlled asthma and their caregivers were recruited from an urban hospital and an asthma camp. Caregivers with elevated scores on a stress measure were enrolled. Forty-three families were randomized to the 4- to 6-session Home Based Family Intervention (HBFI) or the single session of Enhanced Treatment as Usual (ETAU). All families received an asthma action plan and dust mite covers; children performed spirometry and demonstrated MDI/spacer technique at each home visit. The HBFI addressed family-selected goals targeting asthma management and stressors. Asthma management, morbidity, family functioning, and caregiver stress were assessed at baseline, postintervention, and 6 months after the intervention. ED visits and hospitalizations were ascertained by medical record review for a year after intervention completion. Only one child (5%) in HBFI had an asthma-related hospitalization compared to 7 patients (35%) in ETAU in the year following intervention. Participants in both groups demonstrated improved asthma management and family functioning, and reduced ED visits, symptom days, missed school days, and caregiver stress, but there were no differential treatment effects. The results suggest that a home-based intervention addressing medical and psychosocial needs may prevent hospitalizations for children with poorly controlled asthma and caregivers under stress.
Merz, Emily C.; Landry, Susan H.; Johnson, Ursula Y.; Williams, Jeffrey M.; Jung, Kwanghee
Caregiver responsiveness has been theorized and found to support children’s early executive function (EF) development. This study examined the effects of an intervention that targeted family child care provider responsiveness on children’s EF. Family child care providers were randomly assigned to one of two intervention groups or a control group. An intervention group that received a responsiveness-focused online professional development course and another intervention group that received this online course plus weekly mentoring were collapsed into one group because they did not differ on any of the outcome variables. Children (N = 141) ranged in age from 2.5 to 5 years (mean age = 3.58 years; 52% female). At pretest and posttest, children completed delay inhibition tasks (gift delay-wrap, gift delay-bow) and conflict EF tasks (bear/dragon, dimensional change card sort), and parents reported on the children’s level of attention problems. Although there were no main effects of the intervention on children’s EF, there were significant interactions between intervention status and child age for delay inhibition and attention problems. The youngest children improved in delay inhibition and attention problems if they were in the intervention rather than the control group, whereas older children did not. These results suggest that improving family child care provider responsive behaviors may facilitate the development of certain EF skills in young preschool-age children. PMID:26941476
Zhang, Jing; Pelletier, Janette; Doyle, Antoinette
The goal of this paper was to examine promising effects of a bilingual family literacy program: to track the changes of families' literacy activities through a bilingual family literacy intervention, and to examine the children literacy gains in both Chinese and English across socioeconomic sub-groups. The intervention was an eight-week, two hours…
Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Hu-Cordova, Maria; Alvarado-Goldberg, Karla; Maher, Lauren M.; Escudero, Pia
This pilot feasibility study provided a preliminary test of a community-partnered intervention that targeted engaging parents and improving parent functioning. This intervention was combined with the Cognitive-Behavioral Intervention for Trauma in Schools (CBITS), allowing for a comparison of the CBITS-as-usual (CBITS) with the CBITS-plus-family…
Dawson Rose, Carol; Gutin, Sarah A; Reyes, Michael
HIV prevention efforts with people living with HIV are critical, and Positive Prevention (PP) interventions have expanded globally to address this growing need. This article provides an overview of U.S. PP literature addressing evidence-based interventions. It continues by looking at the prevention needs and care issues of people living with HIV in Mozambique and the larger African context, and then discusses which U.S. PP models may be best suited for adaptation and use in Mozambique. The research suggests that the lessons learned from these U.S.-developed interventions can be modified to develop theoretically sound interventions. These interventions must be culturally specific and include a collaborative approach for best results.
Shrestha, Roman; Krishnan, Archana; Altice, Frederick L.; Copenhaver, Michael
Background Real-world clinical settings like addiction treatment programs are ill-equipped to deploy and sustain the existing-resource-demanding evidence-based interventions (EBIs) that target HIV-infected people who use drugs (PWUDs), and this has left a critical void in current HIV prevention efforts. In response to this unmet need, we have conducted formative research in addiction treatment settings that has resulted in Holistic Health for HIV (3H+) – an empirically adapted, substantially abbreviated version of Holistic Health Recovery Program (HHRP+), a CDC-recommended EBI targeting HIV-infected PWUDs. Methods Using a non-inferiority randomized controlled trial design, we will determine whether the abbreviated 3H+ intervention is comparable (i.e., within a 10% margin) and cost-effective relative to the original HHRP+ intervention in terms of reducing HIV risk behaviors and improving antiretroviral therapy (ART) adherence among HIV-infected PWUDs in addiction treatment who report drug- or sex-related HIV risk behaviors. Conclusions This article provides a description of the development and adaptation of the 3H+ intervention, the innovative non-inferiority comparative experimental design for testing the 3H+ to the HHRP+. Furthermore, it provides empirical evidence from a formal cost-effectiveness analysis justifying the cost-effectiveness of the 3H+ intervention when compared to the HHRP+ intervention. If confirmed to be comparable and more cost-effective, as hypothesized, the 3H+ intervention has the potential to be readily and immediately integrated within common clinical settings where large numbers of HIV-infected PWUDs receive clinical services. PMID:26253181
Bonacci, Jason; Chapman, Andrew; Blanch, Peter; Vicenzino, Bill
Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling
DeVoe, Ellen R.; Dean, Kara; Traube, Dorian; McKay, Mary M.
The purpose of this article is to describe the development of a family-based intervention designed to target the harmful effects of exposure to family and community violence on urban youth and their parents. The program, “Supporting Urban Residents to be Violence-Free in a Violent Environment (SURVIVE),” is a 12-week multiple family group (MEG) intervention modeled upon similar children’s mental health programs implemented with urban youth of color and their families in several major U.S. cities. The design and implementation of the SURVIVE Community Project were guided by a collaborative partnership between community members, including mental health professionals, teachers, and parents from the Bronx, and an interdisciplinary team of university-based researchers. In order to establish the feasibility and relevance of the program for urban communities, 25 families with children ages 7–11 participated in a pilot test of the curriculum. The description of the SURVIVE Community Project provided here is based on this work, and includes a discussion of facilitation issues. Implications for family-based intervention targeting urban children and families affected by violence are highlighted. PMID:21369343
Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Hernandez Robles, Eden; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.
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…
Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin
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…
Bowen, Shelly-Ann K.; Saunders, Ruth P.; Richter, Donna L.; Hussey, Jim; Elder, Keith; Lindley, Lisa
Most HIV-prevention funding agencies require the use of evidence-based behavioral interventions, tested and proven to be effective through outcome evaluation. Adaptation of programs during implementation is common and may be influenced by many factors, including agency mission, time constraints, and funding streams. There are few theoretical…
Fortier, M. A.; Blount, R. L.; Wang, S.-M.; Mayes, L. C.; Kain, Z. N.
Background The goal of this project was to identify key effective components of ADVANCE, a family-centred preoperative intervention programme, through the use of a dismantling approach. ADVANCE was previously demonstrated to be more effective than parental presence and just as effective as midazolam in reducing children's preoperative anxiety. The total programme, however, may be difficult to implement in hospitals across the country. Methods Subjects in this follow-up dismantling report were 96 children aged 2–10 who were part of the original study and who underwent anaesthesia and surgery. Baseline characteristics, parental adherence to the components of ADVANCE, and child and parent anxiety were assessed. Results We found that greater parental adherence to the ADVANCE intervention was associated with lower child anxiety before surgery. The two components of ADVANCE that emerged as having a significant impact on children's anxiety were practising with the anaesthesia mask at home and parental planning and use of distraction in the preoperative holding area. In fact, not only did children experience significantly less preoperative anxiety when their parents were adherent to mask practise and use of distraction, their anxiety tended to remain stable and relatively low throughout the preoperative period. Conclusions Shaping and exposure (i.e. practise with the anaesthesia mask) and parental use of distraction in the surgical setting are two beneficial components that could be included in preoperative preparation programmes that will be designed in the future. PMID:21324929
Bowen, Shelly-Ann K; Saunders, Ruth P; Richter, Donna L; Hussey, Jim; Elder, Keith; Lindley, Lisa
Most HIV-prevention funding agencies require the use of evidence-based behavioral interventions, tested and proven to be effective through outcome evaluation. Adaptation of programs during implementation is common and may be influenced by many factors, including agency mission, time constraints, and funding streams. There are few theoretical frameworks to understand how these organizational and program-related factors influence the level of adaptation. This study used constructs from both Rogers's diffusion theory and Rütten's framework for policy analysis to create a conceptual framework that identifies determinants hypothesized to affect the level of adaptation. Preliminary measures of these constructs were also developed. This framework and its measures assess organizational and program-related factors associated with adaptation and could serve as a model to assess implementation and adaptation in fields outside of HIV prevention.
Segrin, Chris; Figueredo, Aurelio J.; Harrington, Joanne; Sheppard, Kate; Passalacqua, Stacey; Pasvogel, Alice; Bishop, Maria
Purpose The primary purpose was to test the effectiveness of two telephone-delivered psychosocial interventions for maintaining and improving quality of life (QOL) (psychological, physical, social, and spiritual well-being) among 71 prostate cancer survivors and the 70 intimate or family partners who were supporting them in their recovery. Methods This study used a three-wave repeated measures experimental design. Both the interpersonal counseling intervention (TIP-C) and health education attention condition (HEAC) were delivered using the telephone. Results Improvements in depression, negative affect, stress, fatigue, and spiritual well-being were significantly higher for survivors in the HEAC than for those in the TIP-C condition. Partners in the HEAC condition showed significantly greater improvements in depression, fatigue, social support from family members, social well-being, and spiritual well-being compared to partners in the TIP-C condition. The results revealed superior outcomes for those assigned to the HEAC intervention. Conclusions The psychosocial interventions in this study were effective in maintaining or improving the QOL for prostate cancer survivors and their partners. Both the survivor and their intimate partner or family member benefitted from the interventions. Future research is needed to determine the optimal timing and client characteristics for each intervention. PMID:21170682
Kubicek, Katrina; Beyer, William; Weiss, George; Kipke, Michele D.
Objectives HIV rates for African American young men who have sex with men (AAYMSM) have reached as much as 14.7%, compared to 2.5% and 3.5% among Caucasian and Latino YMSM. However, there remains a lack HIV prevention interventions for this population. This study describes the use of Photovoice in the adaptation process of an evidence-based intervention (Adult Identity Mentoring) to make it developmentally and culturally appropriate for AAYMSM. Methods Thirty-six AAYMSM (ages 18–24) participated in weekly working group sessions to conduct a community, youth and data-driven adaptation process. Photovoice was used as a technique to facilitate guided discussions on topics that were identified for the new curriculum. Results Through Photovoice discussions, we identified a new focus for the adapted intervention, Young Men’s Adult Identity Mentoring (YM-AIM): development and maintenance of healthy intimate relationships. This new focus and resulting curriculum are rooted in the voices and perceptions of the target population. Conclusions Including youth was integral to the adaptation process and the use of techniques such as Photovoice helped ensure that the resulting adaptation was relevant to the target population. PMID:21460254
Cantu, Angel Marie; Hill, Laura G; Becker, Linda G
The aims of this study were to determine (1) the degree to which an evidence-based intervention (EBI) delivered outside the context of a research trial remained faithful to the content and design of the programme as intended and as reported in experimental trials of the same programme, and (2) whether implementation quality affected programme outcomes. We report results of an observational study of 11 sites involved in the statewide dissemination of a popular family-focused prevention programme, the Strengthening Families Programme for Parents and Youth 10–14. We found numerous differences between the community-based implementations we observed and researcher-driven implementations of the same programme, but variability in programme delivery and adherence to content were unrelated to programme outcomes. We conclude that short-term outcomes of well-designed EBIs delivered by well-trained facilitators may be robust to minor changes in delivery and content. However, the effects of implementation quality on longer-term outcomes are unknown. PMID:25339977
Herscovici, Cecile Rausch; Kovalskys, Irina; Orellana, Liliana
Although weight restoration is a crucial factor in the recovery of anorexia nervosa (AN), there is scarce evidence regarding which components of treatment promote it. In this paper, the author reports on an effort to utilize research methods in her own practice, with the goal of evaluating if the family meal intervention (FMI) had a positive effect on increasing weight gain or on improving other general outcome measures. Twenty-three AN adolescents aged 12-20 years were randomly assigned to two forms of outpatient family therapy (with [FTFM] and without [FT]) using the FMI, and treated for a 6-month duration. Their outcome was compared at the end of treatment (EOT) and at a 6-month posttreatment follow-up (FU). The main outcome measure was weight recovery; secondary outcome measures were the Morgan Russell Global Assessment Schedule (MRHAS), amenorrhea, general psychological symptoms, and eating disorder symptoms. The majority of the patients in both groups improved significantly at EOT, and these changes were sustained through FU. Given its primarily clinical nature, findings of this investigation project preclude any conclusion. Although the FMI did not appear to convey specific benefits in causing weight gain, clinical observation suggests the value of a flexible stance in implementation of the FMI for the severely undernourished patient with greater psychopathology.
Meiser, Bettina; Peate, Michelle; Levitan, Charlene; Mitchell, Philip B; Trevena, Lyndal; Barlow-Stewart, Kristine; Dobbins, Timothy; Christensen, Helen; Sherman, Kerry A; Dunlop, Kate; Schofield, Peter R
We developed and pilot-tested the first online psycho-educational intervention that specifically targets people with a family history of depression ('LINKS'). LINKS provides genetic risk information and evidence-rated information on preventive strategies for depression and incorporates a risk assessment tool and several videos using professional actors. LINKS was pilot-tested in the general practitioner (GP) setting. The patient sample included people with a family history of at least one first-degree relative (FDR) with major depressive disorder (MDD) or bipolar disorder (BD). Patients attending participating GP practices were invited to enroll in the study by letter from their GP. Patients who self-identified as having at least one first-degree relative (FDR) with MDD or BD were eligible. Patients completed questionnaires, pre-post viewing LINKS, with measures assessing satisfaction, relevance, emotional impact and perceived improvement of understanding. Six GP practices participated, and 24 patients completed both questionnaires. Of these, all reported that they were satisfied or very satisfied with LINKS, and 74 % reported that LINKS met their expectations, and 21 % that it exceeded their expectations. LINKS was judged highly acceptable by this sample of GP attendees, and results indicate that an assessment of its effectiveness in a larger controlled trial is warranted.
Bakker, Martin Paul; Ormel, Johan; Verhulst, Frank C.; Oldehinkel, Albertine J.
Adolescent family adversity is a considerable adaptive challenge in an increasingly turbulent developmental period. Using data from a prospective population cohort of 2230 Dutch adolescents, we tested risk-buffering interactions between adolescent family adversity and self-regulation capacities on mental health. We used two adaptive…
Fallon, Moira A.; Russo, Theresa J.
This study surveyed 253 military families with children who have disabilities to determine if they experienced difficulties in adapting to military life. Responses indicated that 25 percent of children with disabilities were 3 years or younger and 75 percent were age 4 through 6 years. Twenty-one families reported not having adjusted to military…
Pelham, William E; Fabiano, Gregory A; Waxmonsky, James G; Greiner, Andrew R; Gnagy, Elizabeth M; Pelham, William E; Coxe, Stefany; Verley, Jessica; Bhatia, Ira; Hart, Katie; Karch, Kathryn; Konijnendijk, Evelien; Tresco, Katy; Nahum-Shani, Inbal; Murphy, Susan A
Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Children with ADHD (ages 5-12, N = 146, 76% male) were treated for 1 school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication.
goal of this research is to create an intervention for the positive reintegration of women in the National Guard and Reserves into their civilian and...Document specific challenges and facilitators involved in family reintegration for women and 2) Develop and pilot test a telephone- delivered coping...population. 15. SUBJECT TERMS women , National Guard, family reintegration 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18
Brooner, Robert K; Kidorf, Michael S; King, Van L; Stoller, Kenneth B; Neufeld, Karin J; Kolodner, Ken
This 6-month randomized clinical trial (with 3-month follow-up) used a 2x2 design to compare the independent and combined effectiveness of two interventions designed to improve outcomes in treatment-seeking opioid dependent patients (n=236): motivated stepped care (MSC) and contingent voucher incentives (CVI). MSC is an adaptive treatment strategy that uses principles of negative reinforcement and avoidance to motivate both attendance to varying levels of counseling services and brief periods of abstinence [Brooner, R.K., Kidorf, M., 2002. Using behavioral reinforcement to improve methadone treatment participation. Sci. Pract. Perspect. 1, 38-46; Brooner, R.K., Kidorf, M.S., King, V.L., Peirce, J.M., Bigelow, G.E., Kolodner, K., 2004. A modified "stepped care" approach to improve attendance behavior in treatment seeking opioid abusers. J. Subst. Abuse Treat. 27, 223-232]. In contrast, CVI [Higgins, S., Delaney, D.D., Budney, A.J., Bickel, W.K., Hughes, J.R., Foerg, B.A., Fenwick, J.W., 1991. A behavioral approach to achieving initial cocaine abstinence. Am. Psychiatr. 148, 1218-1224] relies on positive reinforcement to motivate drug abstinence. The results showed that the combined approach (MSC+CVI) was associated with the highest proportion of drug-negative urine samples during both the randomized and 3-month follow-up arms of the evaluation. The CVI-only and the MSC-only conditions evidenced similar proportions of drug-negative urine samples that were both significantly greater than the standard care (SC) comparison group. Voucher-based reinforcement was associated with better retention, while adaptive stepped-based care was associated with better adherence to scheduled counseling sessions. These results suggest that both CVI and MSC are more effective than routine care for reducing drug use in opioid dependent outpatients, and that the overall benefits of MSC are enhanced further by adding positive reinforcement.
Wright, Linnie Green
In this study the author examined the effects of a dyadic, mother-paired play intervention-The Mommy and Me Play Program-an innovative intervention program designed using a live-action modeling technique in which mothers serve as "natural helpers" to each other. By identifying natural strengths in mothers and employing opportunities for scaffolded learning, this intervention aimed to enhance mother-child play interactions and children's social and emotional competence. Fifty mother-child dyads from a single, low-income, African American, urban community were assessed in this study on measures of mother-child play interactions and children's social and emotional competency. Results from this pilot were not statistically significant, but provide important information regarding future research with this intervention program. These preliminary findings indicated that mothers with fewer play skills pre-intervention demonstrated improvement in their play skills post-intervention beyond other intervention participants; and children of those same mothers showed the greatest decrease in angry and aggressive behaviors in the classroom when compared to other participating children from pre- to post-intervention. Implications for research and practice in community-based, intervention work with low-income, ethnic-minority families are discussed.
Connell, Arin; Bullock, Bernadette Marie; Dishion, Thomas J; Shaw, Daniel; Wilson, Melvin; Gardner, Frances
This study used latent transition analysis (LTA) to examine changes in early emotional and behavioral problems in children age 2 to 4 years resulting from participation in a family-centered intervention. A sample of 731 economically disadvantaged families was recruited from among participants in a national food supplement and nutrition program. Families with toddlers between age 2 and 3 were randomized either to the Family Check-Up (FCU) or to a nonintervention control group. The FCU's linked interventions were tailored to each family's needs. Assessments occurred at age 2, 3, and 4. The FCU followed age 2 and age 3 assessments. Latent class analyses were conducted on mother reports of behavior and emotional problems from age 2 to 4 to study transitions among the following four groups: (a) externalizing only, (b) internalizing only, (c) comorbid internalizing and externalizing, and (d) normative. LTA results revealed that participation in the FCU increased the likelihood of transitioning from either the comorbid or the internalizing class into the normative class by age 4. These results suggest family interventions in early childhood can potentially disrupt the early emergence of both emotional and behavioral problems.
The American Dietetic Association (ADA), recognizing that overweight is a significant problem for children and adolescents in the United States, takes the position that pediatric overweight intervention requires a combination of family-based and school-based multi-component programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutrition education. Furthermore, although not yet evidence-based, community-based and environmental interventions are recommended as among the most feasible ways to support healthful lifestyles for the greatest numbers of children and their families. ADA supports the commitment of resources for programs, policy development, and research for the efficacious promotion of healthful eating habits and increased physical activity in all children and adolescents, regardless of weight status. This is the first position paper of ADA to be based on a rigorous systematic evidence-based analysis of the pediatric overweight literature on intervention programs. The research showed positive effects of two specific kinds of overweight interventions: a) multicomponent, family-based programs for children between the ages of 5 and 12 years, and b) multicomponent, school-based programs for adolescents. Multicomponent programs include behavioral counseling, promotion of physical activity, parent training/modeling, dietary counseling, and nutrition education. Analysis of the literature to date points to the need for further investigation of promising strategies not yet adequately evaluated. Furthermore, this review highlights the need for research to develop effective and innovative overweight prevention programs for various sectors of the population, including those of varying ethnicities, young children, and adolescents. To support and enhance the efficacy of family- and school-based weight interventions, community-wide interventions should be undertaken; few such interventions have been conducted and
Rintell, David; Melito, Richard
This article presents a model for intervening with families that are addressing a new diagnosis of multiple sclerosis (MS) in one member. The model is collaborative, integrative, and family-centered. It involves both working with the family collaboratively and providing strategies to promote greater collaboration within the family. The model integrates elements of crisis intervention theory, psycho-education, and family-centered approaches. The model was developed with families addressing MS, and was piloted with three families. The intervention was found to improve family members' ability to collaborate with each other. Such increased collaboration may enhance the family's ability to manage long-term illness more effectively, help the family address the impact of the illness on all family members, and generally improve the family's quality of life.
Compas, Bruce E.; Champion, Jennifer E.; Forehand, Rex; Cole, David A.; Reeslund, Kristen L.; Fear, Jessica; Hardcastle, Emily J.; Keller, Gary; Rakow, Aaron; Garai, Emily; Merchant, Mary Jane; Roberts, Lorinda
In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers; 86% Caucasian), changes in adolescents’ (mean age 11 years; 42% female) coping and parents’ parenting skills were examined as mediators of the effects of a family group cognitive behavioral preventive intervention on adolescents’ internalizing and externalizing symptoms. Changes in hypothesized mediators were assessed at 6-months and changes in adolescents’ symptoms were measured at 12-month follow-up. Significant differences favoring the family intervention as compared with a written information comparison condition were found for changes in composite measures of parent-adolescent reports of adolescents’ use of secondary control coping skills and direct observations of parents’ positive parenting skills. Changes in adolescents’ secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing and externalizing symptoms accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children’s internalizing symptoms and parenting were found from baseline to 6-month follow-up. Implications for the prevention of psychopathology in offspring of depressed parents are highlighted. PMID:20873898
Reuben, Julia D.; Shaw, Daniel S.; Brennan, Lauretta M.; Dishion, Thomas J.; Wilson, Melvin N.
Objective This study focused on whether a brief family-based intervention for toddlers, the Family Check-Up (FCU), designed to address parent management skills and prevent early conduct problems, would have collateral effects on maternal depressive symptoms and subsequent child emotional problems. Method Parents with toddlers were recruited from the Women, Infants, and Children Nutritional Supplement Program based on the presence of socioeconomic, family, and child risk (N= 731). Families were randomly assigned to the FCU intervention or control group with yearly assessments beginning at child age 2. Maternal depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale at child ages 2 and 3. Child internalizing problems were collected from primary caregivers, alternative caregivers, and teachers using the Child Behavior Checklist at ages 7.5 and 8.5. Results Structural equation models revealed that mothers in families randomly assigned to the FCU showed lower levels of depressive symptoms at child age 3, which in turn were related to lower levels of child depressed/withdrawal symptoms as reported by primary caregivers, alternative caregivers, and teacher at ages 7.5–8.5. Conclusions Findings suggest that a brief, preventive intervention improving maternal depressive symptoms can have enduring effects on child emotional problems that are generalizable across contexts. As there is a growing emphasis for the use of evidence-based and cost-efficient interventions that can be delivered in multiple delivery settings serving low-income families and their children, clinicians and researchers welcome evidence that interventions can promote change in multiple problem areas. The FCU appears to hold such promise. PMID:26302250
Sánchez, Jesús; Serna, Claudia A; de La Rosa, Mario
Despite the unique and challenging circumstances confronting Latino migrant worker communities in the U.S., debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Project Salud adopted a community-based participatory research model and utilized focus group methodology with 83 Latino migrant workers to explore the relevance of culturally adapting an evidence-based HIV prevention intervention to be disseminated within this population. Findings from this study indicate that, despite early reservations, Latino migrant workers wanted to participate in the cultural adaptation that would result in an intervention that was culturally relevant, respectful, responsive to their life experiences, and aligned with their needs. This study contributes to the cultural adaptation/fidelity debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance without sacrificing high fidelity to the core components that have established efficacy for evidence-based HIV prevention interventions.
Pires, Thiago; de Assis, Simone Gonçalves; Avanci, Joviana Quintes; Pesce, Renata Pires
ABSTRACT OBJECTIVE To describe the process of cross-cultural adaptation of the General Functioning Scale of the Family, a subscale of the McMaster Family Assessment Device, for the Brazilian population. METHODS The General Functioning Scale of the Family was translated into Portuguese and administered to 500 guardians of children in the second grade of elementary school in public schools of Sao Gonçalo, Rio de Janeiro, Southeastern Brazil. The types of equivalences investigated were: conceptual and of items, semantic, operational, and measurement. The study involved discussions with experts, translations and back-translations of the instrument, and psychometric assessment. Reliability and validity studies were carried out by internal consistency testing (Cronbach’s alpha), Guttman split-half correlation model, Pearson correlation coefficient, and confirmatory factor analysis. Associations between General Functioning of the Family and variables theoretically associated with the theme (father’s or mother’s drunkenness and violence between parents) were estimated by odds ratio. RESULTS Semantic equivalence was between 90.0% and 100%. Cronbach’s alpha ranged from 0.79 to 0.81, indicating good internal consistency of the instrument. Pearson correlation coefficient ranged between 0.303 and 0.549. Statistical association was found between the general functioning of the family score and the theoretically related variables, as well as good fit quality of the confirmatory analysis model. CONCLUSIONS The results indicate the feasibility of administering the instrument to the Brazilian population, as it is easy to understand and a good measurement of the construct of interest. PMID:27355464
Ganasen, Menega; Yaacob, Norhayati; Rahman, Raja Noor Zaliha Raja Abd; Leow, Adam Thean Chor; Basri, Mahiran; Salleh, Abu Bakar; Ali, Mohd Shukuri Mohamad
Lipolytic enzymes with cold adaptation are gaining increasing interest due to their biotechnological prospective. Previously, a cold adapted family I.3 lipase (AMS8 lipase) was isolated from an Antarctic Pseudomonas. AMS8 lipase was largely expressed in insoluble form. The refolded His-tagged recombinant AMS8 lipase was purified with 23.0% total recovery and purification factor of 9.7. The purified AMS8 lipase migrated as a single band with a molecular weight approximately 65kDa via electrophoresis. AMS8 lipase was highly active at 30°C at pH 10. The half-life of AMS8 lipase was reported at 4 and 2h under the incubation of 30 and 40°C, respectively. The lipase was stable over a broad range of pH. It showed enhancement effect in its relative activity under the presence of Li(+), Na(+), K(+), Rb(+) and Cs(+) after 30min treatment. Heavy metal ions such as Cu(2+), Fe(3+) and Zn(2+) inhibited AMS8 activity. This cold adapted alkalophilic AMS lipase was also active in various organic solvent of different polarity. These unique properties of this biological macromolecule will provide considerable potential for many biotechnological applications and organic synthesis at low temperature.
Marziali, Elsa; Donahue, Peter
Purpose: The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. Design and Methods: After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based…
Olcay-Gül, Seray; Tekin-Iftar, Elif
The purpose of this study was to examine whether (a) family members were able to learn to write a social story and deliver social story intervention to teach social skills to their children (age 12 to 16) with ASD, (b) youths with ASD acquired and maintained the targeted social skills and generalized these skills across novel situations. Multiple…
Lindsey, Michael A.; Hayward, R. Anna; DePanfilis, Diane
Objective: This study examines the impact of the Family Connections (FC) intervention on preventing behavioral problems among urban, predominantly African American children at risk of neglect. Method: Secondary data analyses using mixed model analyses of variance (ANOVA) with repeated measures were used to examine gender differences in child…
Hanson, Marci J.
Children with Down syndrome and their families who participated in an early intervention program between 1974 and 1977 were interviewed 25 years later. Parents reported challenges such as medical complications, teasing or ostracism, and lack of adequate services and supports as children reached adulthood. Parents also described joys and…
Feinberg, Mark E.; Solmeyer, Anna R.; McHale, Susan M.
Sibling relationships are an important context for development, but are often ignored in research and preventive interventions with youth and families. In childhood and adolescence, siblings spend considerable time together, and siblings' characteristics and sibling dynamics substantially influence developmental trajectories and outcomes. This…
Mann, Michael J.; Kristjansson, Alfgeir L.; Sigfusdottir, Inga Dora; Smith, Megan L.
Background: Although an ecological perspective suggests the importance of multiple levels of intervention, most bullying research has emphasized individual- and school-focused strategies. This study investigated community and family factors that influence school efforts to reduce odds of group bullying behavior and victimization. Methods: We used…
Robertson, Rachel E.
No studies of parent-implemented behavior interventions for children with autism spectrum disorders (ASD) have purposefully examined their effectiveness and acceptability with African American families. The present study used a multiple baseline across participants design to evaluate the effectiveness of parent-implemented differential…
Claxton, Melanie; Onwumere, Juliana; Fornells-Ambrojo, Miriam
Family interventions for psychosis (FIp) are effective in reducing service user relapse and carer distress in people with schizophrenia-spectrum conditions. Several treatment and best practice guidelines recommend FIp for all people with schizophrenia. However, outcome findings in relation to early psychosis groups have been inconsistent. The current paper reports a systematic review and meta-analyses of articles that evaluated FIp in early psychosis with a clearly defined comparison group. A combination of electronic database searches (using PsychINFO, Medline, and CENTRAL), citation searches and hand searches of key journals and reviews was conducted. Peer-reviewed articles published in English from database inception to June 2016 were included. Methodological quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool (EPHPP). Seventeen papers from 14 studies met inclusion criteria for review, the overall quality of which was moderate. Meta-analytic synthesis showed that FIp improved service user functioning and reduced the likelihood of relapse by the end of treatment. Psychotic symptoms were significantly reduced in the FIp group at follow up, but this was not evident at end of treatment. In terms of FIp target mechanisms, carers receiving FIp were more likely to shift from high to low expressed emotion and less likely to report patient focused criticism or engage in conflict communication than carers randomized to standard care. Carer burden and well-being were improved by the end of treatment but gains were not sustained at follow up. FIp had no impact on carer emotional over-involvement. The findings indicate that FIp is an effective intervention for early psychosis service users and their relatives. However, further research is required to establish which key therapeutic components of FIp are most effective for whom, in addition to understanding the mechanisms by which FIp might affect positive change.
Rossetti, Louis M.
This paper discusses early intervention issues that all members of the early intervention team should become familiar with, including epidemiology; who should provide intervention services; and the importance of early identification and caregiver involvement for the efficacy of intervention services. (JDD)
Calderon, R; Bargones, J; Sidman, S
Children with hearing loss are at risk for outcomes below their potential despite institution of educational approaches at increasingly younger ages. Research suggests some benefits of early intervention (EI) for these children and their families. However, previous investigators have not delineated broader family, child, and program variables that warrant consideration in understanding the role, success, and limitations of EI. The present study involved 28 hearing families and their children with hearing impairments aged 42 to 87 months, 9 to 42 months postgraduation from an EI program. The information gathered included demographics, duration and intensity of the EI, parent involvement, and educational and communication choices. Results provide a descriptive profile of children with hearing loss and their hearing families from EI through the preschool years. The discussion reflects upon EI in the context of this population's significant heterogeneity. Complex and confounding factors are presented that may affect children's and families' short- or long-term progress and the goals of EI.
Bere, Tarisai; Nyamayaro, Primrose; Magidson, Jessica F; Chibanda, Dixon; Chingono, Alfred; Munjoma, Ronald; Macpherson, Kirsty; Ndhlovu, Chiratidzo Ellen; O'Cleirigh, Conall; Kidia, Khameer; Safren, Steven A; Abas, Melanie
Few evidence-based interventions to improve adherence to antiretroviral therapy have been adapted for use in Africa. We selected, culturally adapted and tested the feasibility of a cognitive-behavioural intervention for adherence and for delivery in a clinic setting in Harare, Zimbabwe. The intervention consisted of a single, 50-minute problem-solving cognitive-behavioural intervention session with four skill-based booster sessions, delivered by four lay adherence counsellors in the context of HIV care. Adaptation followed a theoretically driven approach to intervention adaptation, Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT), and included modifications to language, session length, tailoring content for delivery by lay counsellors and inclusion of culturally competent probes. The feasibility of the intervention was evaluated using a mixed-methods assessment, including ratings of provider fidelity of intervention delivery, and qualitative assessments of feasibility using individual semi-structured interviews with counsellors (n = 4) and patients (n = 15). The intervention was feasible and acceptable when administered to 42 patients and resulted in improved self-reported adherence in a subset of 15 patients who were followed up after 6 months. Next steps from this study include conducting a randomised control trial to evaluate the adapted intervention compared to standard of care in a larger sample over a long-term follow-up.
Smith, Justin D.; Dishion, Thomas J.; Brown, Kimbree; Ramos, Karina; Knoble, Naomi B.; Shaw, Daniel S.; Wilson, Melvin N.
The valid and reliable assessment of fidelity is critical at all stages of intervention research and is particularly germane to interpreting the results of efficacy and implementation trials. Ratings of protocol adherence typically are reliable, but ratings of therapist competence are plagued by low reliability. Because family context and case conceptualization guide the therapist's delivery of interventions, the reliability of fidelity ratings might be improved if the coder is privy to client context in the form of an ecological assessment. We conducted a randomized experiment to test this hypothesis. A subsample of 46 families with 5-year-old children from a multisite randomized trial who participated in the feedback session of the Family Check-Up (FCU) intervention were selected. We randomly assigned FCU feedback sessions to be rated for fidelity to the protocol using the COACH rating system either after the coder reviewed the results of a recent ecological assessment or had not. Inter-rater reliability estimates of fidelity ratings were meaningfully higher for the assessment information condition compared to the no-information condition. Importantly, the reliability of the COACH mean score was found to be statistically significantly higher in the information condition. These findings suggest that the reliability of observational ratings of fidelity, particularly when the competence or quality of delivery is considered, could be improved by providing assessment data to the coders. Our findings might be most applicable to assessment-driven interventions, where assessment data explicitly guides therapist's selection of intervention strategies tailored to the family's context and needs, but they could also apply to other intervention programs and observational coding of context-dependent therapy processes, such as the working alliance. PMID:26271300
Smith, Justin D; Dishion, Thomas J; Brown, Kimbree; Ramos, Karina; Knoble, Naomi B; Shaw, Daniel S; Wilson, Melvin N
The valid and reliable assessment of fidelity is critical at all stages of intervention research and is particularly germane to interpreting the results of efficacy and implementation trials. Ratings of protocol adherence typically are reliable, but ratings of therapist competence are plagued by low reliability. Because family context and case conceptualization guide the therapist's delivery of interventions, the reliability of fidelity ratings might be improved if the coder is privy to client context in the form of an ecological assessment. We conducted a randomized experiment to test this hypothesis. A subsample of 46 families with 5-year-old children from a multisite randomized trial who participated in the feedback session of the Family Check-Up (FCU) intervention were selected. We randomly assigned FCU feedback sessions to be rated for fidelity to the protocol using the COACH rating system either after the coder reviewed the results of a recent ecological assessment or had not. Inter-rater reliability estimates of fidelity ratings were meaningfully higher for the assessment information condition compared to the no-information condition. Importantly, the reliability of the COACH mean score was found to be statistically significantly higher in the information condition. These findings suggest that the reliability of observational ratings of fidelity, particularly when the competence or quality of delivery is considered, could be improved by providing assessment data to the coders. Our findings might be most applicable to assessment-driven interventions, where assessment data explicitly guides therapist's selection of intervention strategies tailored to the family's context and needs, but they could also apply to other intervention programs and observational coding of context-dependent therapy processes, such as the working alliance.
Auslander, Wendy F.; And Others
Examined relationships among family stress, family capabilities, and health status of 53 children diagnosed with insulin-dependent diabetes mellitus. Found that higher levels of family stress and lower levels of family resources were significantly associated with poor metabolic control. Findings suggest that family stress and resources are…
Robinson, Beatrice E.; Galbraith, Jennifer S.; Lund, Sharon M.; Hamilton, Autumn R.; Shankle, Michael D.
We describe the process of adapting a community-level, evidence-based behavioral intervention (EBI), Community PROMISE, for HIV-positive African American men who have sex with men (AAMSM). The Centers for Disease Control and Prevention (CDC) Map of the Adaptation Process (MAP) guided the adaptation process for this new target population by two…
Family-based study design will play a key role in identifying rare causal variants, because rare causal variants can be enriched in families with multiple affected subjects. Furthermore, different from population-based studies, family studies are robust to bias induced by population substructure. It is well known that rare causal variants are difficult to detect from single-locus tests. Therefore, burden tests and non-burden tests have been developed, by combining signals of multiple variants in a chromosomal region or a functional unit. This inevitably incorporates some neutral variants into the test statistics, which can dilute the power of statistical methods. To guard against the noise caused by neutral variants, we here propose an 'adaptive combination of P-values method' (abbreviated as 'ADA'). This method combines per-site P-values of variants that are more likely to be causal. Variants with large P-values (which are more likely to be neutral variants) are discarded from the combined statistic. In addition to performing extensive simulation studies, we applied these tests to the Genetic Analysis Workshop 17 data sets, where real sequence data were generated according to the 1000 Genomes Project. Compared with some existing methods, ADA is more robust to the inclusion of neutral variants. This is a merit especially when dichotomous traits are analyzed. However, there are some limitations for ADA. First, it is more computationally intensive. Second, pedigree structures and founders' sequence data are required for the permutation procedure. Third, unrelated controls cannot be included. We here show that, for family-based studies, the application of ADA is limited to dichotomous trait analyses with full pedigree information.
The Walking Interventions Through Texting (WalkIT) Trial: Rationale, Design, and Protocol for a Factorial Randomized Controlled Trial of Adaptive Interventions for Overweight and Obese, Inactive Adults
Hurley, Jane C; Hollingshead, Kevin E; Todd, Michael; Jarrett, Catherine L; Tucker, Wesley J; Angadi, Siddhartha S
Background Walking is a widely accepted and frequently targeted health promotion approach to increase physical activity (PA). Interventions to increase PA have produced only small improvements. Stronger and more potent behavioral intervention components are needed to increase time spent in PA, improve cardiometabolic risk markers, and optimize health. Objective Our aim is to present the rationale and methods from the WalkIT Trial, a 4-month factorial randomized controlled trial (RCT) in inactive, overweight/obese adults. The main purpose of the study was to evaluate whether intensive adaptive components result in greater improvements to adults’ PA compared to the static intervention components. Methods Participants enrolled in a 2x2 factorial RCT and were assigned to one of four semi-automated, text message–based walking interventions. Experimental components included adaptive versus static steps/day goals, and immediate versus delayed reinforcement. Principles of percentile shaping and behavioral economics were used to operationalize experimental components. A Fitbit Zip measured the main outcome: participants’ daily physical activity (steps and cadence) over the 4-month duration of the study. Secondary outcomes included self-reported PA, psychosocial outcomes, aerobic fitness, and cardiorespiratory risk factors assessed pre/post in a laboratory setting. Participants were recruited through email listservs and websites affiliated with the university campus, community businesses and local government, social groups, and social media advertising. Results This study has completed data collection as of December 2014, but data cleaning and preliminary analyses are still in progress. We expect to complete analysis of the main outcomes in late 2015 to early 2016. Conclusions The Walking Interventions through Texting (WalkIT) Trial will further the understanding of theory-based intervention components to increase the PA of men and women who are healthy, insufficiently
Aschbrenner, Kelly; Bartels, Stephen; Mueser, Kim; Carpenter-Song, Elizabeth; Kinney, Allison
This focus group study explored the potential benefits and challenges of involving family members and significant others in a healthy lifestyle program for people with serious mental illness (SMI). Six focus group interviews were conducted with a total of 30 people with SMI, who were participants in a healthy lifestyle intervention. Separate focus groups were conducted for high and low achievers in the program based on clinically significant weight loss or significant increase in fitness. Thematic analysis revealed that social support for diet and exercise was a perceived benefit to involving others in a healthy lifestyle program. Other perceived benefits were the potential to increase others' understanding of the challenges of living with mental illness and to enhance the quality of relationships. Participants identified practical and logistical concerns that could interfere with participation, including partner reliability and desirability, scheduling, and lack of financial resources. Participants in the high achiever group expressed a greater desire to involve others in exercise than did participants in the low achiever group. Programs aimed at helping people with SMI make lifestyle changes may increase their effectiveness by involving significant others. Mobilizing social support networks for health behavior change is an ideal role for social workers.
Bakas, Tamilyn; Clark, Patricia C; Kelly-Hayes, Margaret; King, Rosemarie B; Lutz, Barbara J; Miller, Elaine L
Stroke is a leading cause of severe, long-term disability. Most stroke survivors are cared for in the home by a family caregiver. Caregiver stress is a leading cause of stroke survivor institutionalization, which results in significant costs to the healthcare system. Stroke family caregiver and dyad intervention studies have reported a variety of outcomes. A critical analysis of 17 caregiver intervention studies and 15 caregiver/stroke survivor dyad intervention studies was conducted to provide evidence-based recommendations for the implementation and future design of stroke family caregiver and dyad interventions.
Background This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West. Methods The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships). Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships. Results Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff. Conclusions This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal additional costs for
Marshall, Catherine A; Larkey, Linda K; Curran, Melissa A; Weihs, Karen L; Badger, Terry A; Armin, Julie; García, Francisco
Cancer is a family experience, and family members often have as much, or more, difficulty in coping with cancer as does the person diagnosed with cancer. Using both family systems and sociocultural frameworks, we call for a new model of health promotion and psychosocial intervention that builds on the current understanding that family members, as well as the individuals diagnosed with cancer, are themselves survivors of cancer. We argue that considering culture, or the values, beliefs, and customs of the family, including their choice of language, is necessary to understand fully a family's response to cancer. Likewise, acknowledging social class is necessary to understand how access to, and understanding of, otherwise available interventions for families facing cancer can be limited. Components of the model as conceptualized are discussed and provide guidance for psychosocial cancer health disparities research and the development of family-focused, strength-based, interventions.
Comprehensive Training of Personnel and Technical Assistance in Establishment of Home Intervention Program for Families of Infants, Toddlers, and Preschool Aged Children with Hearing Impairment. Final Report.
Barringer, Don; Johnson, Dorothy
This final report describes activities and accomplishments of an outreach project of Project SKI-HI, a family-centered, home intervention model designed to provide training to early intervention professionals serving infants, toddlers, and preschoolers with hearing impairments. In the project, an early intervention professional or a parent advisor…
Abanto, Jenny; Albites, Ursula; Bönecker, Marcelo; Paiva, Saul M; Castillo, Jorge L; Aguilar-Gálvez, Denisse
The lack of a Family Impact Scale (FIS) in Spanish language limits its use as an indicator in Spanish-speaking countries and precludes comparisons with data from other cultural and ethnic groups. The purpose of this study was therefore to adapt the FIS cross-culturally to the Peruvian Spanish language and assess its reliability and validity. In order to translate and adapt the FIS cross-culturally, it was answered by 60 parents in two pilot tests, after which it was tested on 200 parents of children aged 11 to 14 years who were clinically examined for dental caries experience and malocclusions. Internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the FIS on the same 200 parents enabled the test-retest reliability to be assessed via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the FIS with global ratings of oral health and clinical groups, respectively. Mean (standard deviation) FIS total score was 5.20 (5.86). Internal consistency was confirmed by Cronbach's alpha 0.84. Test-retest reliability revealed excellent reproducibility (ICC = 0.96). Construct validity was good, demonstrating statistically significant associations between total FIS score and global ratings of oral health (p=0.007) and overall wellbeing (p=0.002), as well as for the subscale scores (p<0.05) with exception of the financial burden subscale. The FIS was also able to discriminate between children with and without dental caries experience and malocclusions (p<0.05). Satisfactory psychometric results for the Peruvian Spanish FIS confirm it as a reliable, valid instrument for assessing the impact on the family caused by children's oral conditions.
Stoll, Shelley C.; Lara, Marielena; Ramos-Valencia, Gilberto; Stephens, Tyra Bryant; Persky, Victoria; Uyeda, Kimberly; Lesch, Julie Kennedy; Malveaux, Floyd J.
Adaptation of evidence-based interventions upon implementation into new practice settings is universal, yet poorly understood. During a cross-site evaluation of the implementation of a proven intervention for pediatric asthma care coordination into 4 resource-challenged settings, we conducted in-depth interviews with site representatives, who reported how and why they modified intervention components. Interview notes were coded for themes. We focused on a single theme from a respondent who described the adaptation process as “backing” the intervention into ongoing services; we found evidence of a similar process at other sites. We labeled this process “retrofitting” to signify adaptation that consists of altering existing services to align with intervention components, rather than modifying the intervention to fit a new setting. Advantages of retrofitting may include allowing organizations to keep what works, capitalizing on existing support for program activities, elevating the role of local knowledge, and potentially promoting the sustainability of effective innovations. PMID:27560722
Nahum-Shani, Inbal; Hekler, Eric B; Spruijt-Metz, Donna
Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)-suites of interventions that adapt over time to an individual's changing status and circumstances with the goal to address the individual's need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely, the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide the establishment of a useful model for JITAI construction. The proposed framework includes an organizing scheme for translating the relatively static scientific models underlying many health behavior interventions into a more dynamic model that better incorporates the element of time. This framework will help to guide the next generation of empirical work to support the creation of effective JITAIs.
Nahum-Shani, Inbal; Hekler, Eric B.; Spruijt-Metz, Donna
Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)--suites of interventions that adapt over time to an individual’s changing status and circumstances with the goal to address the individual’s need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide the establishment of a useful model for JITAI construction. The proposed framework includes an organizing scheme for translating the relatively static scientific models underlying many health behavior interventions into a more dynamic model that better incorporates the element of time. This framework will help to guide the next generation of empirical work to support the creation of effective JITAIs. PMID:26651462
Marsh, S; Foley, L S; Wilks, D C; Maddison, R
Family involvement in interventions to reduce sedentary time may help foster appropriate long-term screen-based habits in children. This review systematically synthesized evidence from randomized controlled trials of interventions with a family component that targeted reduction of sedentary time, including TV viewing, video games and computer use, in children. MEDLINE, PubMed, PsycInfo, CINAHL and Embase were searched from inception through March 2012. Seventeen articles were considered eligible and included in the review. Studies were judged to be at low-to-moderate risk of bias. Despite inconsistent study results, level of parental involvement, rather than the setting itself, appeared an important determinant of intervention success. Studies including a parental component of medium-to-high intensity were consistently associated with statistically significant changes in sedentary behaviours. Participant age was also identified as a determinant of intervention outcomes; all three studies conducted in pre-school children demonstrated significant decreases in sedentary time. Finally, TV exposure appeared to be related to changes in energy intake rather than physical activity. Future studies should assess the effects of greater parental involvement and child age on success of sedentary behaviour interventions. More research is required to better understand the relationship between screen time and health behaviours, particularly energy intake.
Dunlop, Susan Rebecca; Kent, Vicky P; Lashley, Mary; Caruana, Trish
Progressive supranuclear palsy (PSP) is a rare, progressive, and terminal neurodegenerative disease characterized by problems with ambulation, balance, mobility, vision, speech, swallowing, and behavior during the 7- to 10-year course of the illness. Substantial evidence in the nursing literature supports the benefits of patient education, self-management, chronic disease management, telehealth, and nurse navigation programs, which enhance patient and caregiver knowledge, improve day-to-day management by developing an awareness of resources, decrease dependence on services, and address caregiver needs. The Cure PSP Care Guide is a targeted telehealth nursing intervention aimed at providing knowledge, guidance, and resources to the vulnerable individuals and families living with PSP; identifying local resources; and building community. During the course of two telephone calls, individuals and their caregivers are assessed to develop a Cure PSP Care Guide designed to provide guidance along the trajectory. A knowledge assessment, self-efficacy scale, and Caregiver Strain Index are administered before and after the intervention to determine the program intervention effect. Caregiver knowledge assessments improved after the intervention, whereas strain scores were static. Qualitative data show the ability of the intervention to address caregiver needs for knowledge and support, daily management tips, and resource identification. The preliminary quantitative and qualitative data collected on this pilot project justify further exploration of the use of telehealth to remotely deliver nurse case management to the vulnerable individuals and families living with PSP.
Shapiro, Alyson F; Nahm, Eun Young; Gottman, John M; Content, Kristi
The transition to parenthood brings with it challenges to a couple's relationship, which in turn are likely to negatively impact coparenting and overall family process. The focus of the current study was to examine the effects of the Bringing Baby Home psycho-educational intervention at the first postintervention follow-up for promoting positive coparenting and family process within the mother-father-baby family system. Expectant parents (N = 181) were recruited from the greater Seattle area to participate in a longitudinal random clinical trials study. Families were randomly assigned to a control, workshop, or workshop plus support group. Observational coding indexed both parent and baby contribution to family interaction during the Lausanne Triadic Play procedure. Principal components analysis was used to create summary factors describing the family play. Results of intent-to-treat analyses indicated that the Bringing Baby Home program was successful in promoting less competition during family play. There also was an effect of workshop timing, suggesting that fathers who took the workshop prebirth were less likely to exhibit intrusiveness during mother-baby focused play than those who received it postbirth. Implications for promoting the formation of positive family-level relations are discussed.
Hewitt, Olivia; Keeling, Natalie; Pearce, Malcom
Between 10% and 15% of people with a learning disability have behaviour that challenges others, and half of these people live within the family home (Emerson et al., "Research in Developmental Disabilities," 2001; 22, 77). Current best practice in managing challenging behaviour combines person-centred planning, functional analysis, and…
Sussman, Andrew L.; Montoya, Carolyn; Davis, Sally; Wallerstein, Nina; Kong, Alberta S.
Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR) approach was conducted toward the development of a nutritional and physical activity (DVD) and clinician toolkit for a school-based health center (SBHC) weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC) recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334. PMID:23984053
Büyükçoban, Sibel; Çiçeklioğlu, Meltem; Demiral Yılmaz, Nilüfer
In the complex environment of intensive care units, needs of patients’ relatives might be seen as the lowest priority. On the other hand, because of their patients’ critical and often uncertain conditions, stress levels of relatives are quite high. This study aims to adapt the Critical Care Family Need Inventory, which assesses the needs of patients’ relatives, for use with the Turkish-speaking population and to assess psychometric properties of the resulting inventory. The study was conducted in a state hospital with the participation of 191 critical care patient relatives. Content validity was assessed by expert opinions, and construct validity was examined by exploratory factor analysis (EFA). Cronbach’s alpha coefficient was used to determine internal consistency. The translated inventory has a content validity ratio higher than the minimum acceptable level. Its construct validity was established by the EFA. Cronbach’s alpha coefficient for the entire scale was 0.93 and higher than 0.80 for subscales, thus demonstrating the translated version’s reliability. The Turkish adaptation appropriately reflects all dimensions of needs in the original CCFNI, and its psychometric properties were acceptable. The revised tool could be useful for helping critical care healthcare workers provide services in a holistic approach and for policymakers to improve quality of service. PMID:26357593
Nam, Kiwoong; Lee, Kyeong Won; Chung, Oksung; Yim, Hyung-Soon; Cha, Sun-Shin; Lee, Sae-Won; Jun, JeHoon; Cho, Yun Sung; Bhak, Jong; Magalhães, João Pedro de; Lee, Jung-Hyun; Jeong, Jae-Yeon
Cetacean body structure and physiology exhibit dramatic adaptations to their aquatic environment. Fibroblast growth factors (FGFs) are a family of essential factors that regulate animal development and physiology; however, their role in cetacean evolution is not clearly understood. Here, we sequenced the fin whale genome and analysed FGFs from 8 cetaceans. FGF22, a hair follicle-enriched gene, exhibited pseudogenization, indicating that the function of this gene is no longer necessary in cetaceans that have lost most of their body hair. An evolutionary analysis revealed signatures of positive selection for FGF3 and FGF11, genes related to ear and tooth development and hypoxia, respectively. We found a D203G substitution in cetacean FGF9, which was predicted to affect FGF9 homodimerization, suggesting that this gene plays a role in the acquisition of rigid flippers for efficient manoeuvring. Cetaceans utilize low bone density as a buoyancy control mechanism, but the underlying genes are not known. We found that the expression of FGF23, a gene associated with reduced bone density, is greatly increased in the cetacean liver under hypoxic conditions, thus implicating FGF23 in low bone density in cetaceans. Altogether, our results provide novel insights into the roles of FGFs in cetacean adaptation to the aquatic environment. PMID:28074842
Wainscott, Sarah Dawson
Families are faced with numerous decisions shortly after their infants are identified with a hearing loss. The goal of the study was to gain insight into the family decision-making process including how families receive and respond to information and how family priorities and concerns for their child's future relate to the decisions they make. Of…