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The purpose of this study was to elucidate characteristics of vaccine-hesitant nurses at two large Southern California medical centers where rates of COVID-19 vaccination were lower than expected.This study is a secondary analysis of nurse participants in a cross-sectional study conducted at the two medical centers. Participants completed an online survey regarding their demographics; work setting and role characteristics; influenza vaccination history; COVID-19 knowledge and beliefs; and personal history of COVID-19 exposure, diagnosis, and disease impact (infection or death) on those closest to them.Of 869 nurse participants, most (78.6%) were vaccinated and 21.4% were unvaccinated; more than half of the unvaccinated participants reported being unwilling to be vaccinated ("vaccine hesitant"). The χ 2 comparisons revealed no significant differences between vaccinated and vaccine-hesitant nurses in terms of education, contact with COVID-19 patients, work environment, or having friends and family impacted by COVID-19. Binary logistic regression showed that nurses who had no history of recent influenza vaccination were 10 times more likely to be vaccine hesitant, those who had inaccurate knowledge about COVID-19 vaccines were seven times more likely to be vaccine hesitant, and younger nurses and those with a prior COVID-19 diagnosis were approximately three times more likely to be vaccine hesitant. Furthermore, 17.3% of all participants were unwilling to recommend COVID-19 vaccination to others.The findings offer a nuanced understanding of vaccine hesitancy among nurses and will be useful to the planning and development of policies, campaigns, and interventions aimed at increasing vaccination rates among nurses. Changing attitudes is essential, and particular attention must be paid to nurses who are unwilling to recommend vaccination to others. Effective interventions are needed.

The role of spirituality in families is an important factor in family resilience. Currently, however, no quantitative instruments exist that adequately assess this phenomenon. This study introduced the adapted Spiritual Perspective Scale-Family Version (SPS-FV) and explored its psychometric qualities among 574 majority ethnic minority individuals living in public housing. Structural equation modeling analyses supported a two-dimensional structure (shared spiritual beliefs, shared spiritual behaviors), and the results supported the SPS-FV as a useful tool in assessing perceptions of family spirituality. Family and consumer sciences (FCS) professionals can enhance their work in low-income, ethnic minority communities by using the SPS-FV as a means to support individuals and families in identifying family spirituality as a significant resource in individual and family resilience.

Spirituality is an important factor in couples’ therapy, yet few tools exist for therapists to utilize in the context of couples therapy. The Marital Selflessness Scale (MSS), a dyadic measure is d...

In this study, we evaluated the status of and attitudes toward COVID-19 vaccination of healthcare workers in two major hospital systems (academic and private) in Southern California. Responses were collected via an anonymous and voluntary survey from a total of 2491 participants, including nurses, physicians, other allied health professionals, and administrators. Among the 2491 participants that had been offered the vaccine at the time of the study, 2103 (84%) were vaccinated. The bulk of the participants were middle-aged college-educated White (73%), non-Hispanic women (77%), and nursing was the most represented medical occupation (35%). Political affiliation, education level, and income were shown to be significant factors associated with vaccination status. Our data suggest that the current allocation of healthcare workers into dichotomous groups such as “anti-vaccine vs. pro-vaccine” may be inadequate in accurately tailoring vaccine uptake interventions. We found that healthcare workers that have yet to receive the COVID-19 vaccine likely belong to one of four categories: the misinformed, the undecided, the uninformed, or the unconcerned. This diversity in vaccine hesitancy among healthcare workers highlights the importance of targeted intervention to increase vaccine confidence. Regardless of governmental vaccine mandates, addressing the root causes contributing to vaccine hesitancy continues to be of utmost importance.

The goal of this study was to develop and evaluate psychometric properties of the PrEP Sexual Expectancies Scale (PSEXS). The PSEXS represents a range of expectations for how PrEP use will affect one’s sexual experience. The scale was developed to understand perceived reinforcements of PrEP use among men who have sex with men (MSM), including sexual risk-taking. The study builds upon Expectancy Theory to develop a measure of sex-related PrEP expectancies with a representative sample of 1155 MSM participants from Ukraine and 408 MSM participants from the U.S. Expectancy items represented two domains: increased sexual risk-taking and enhancement of sexual experience. Confirmatory analyses showed that a two-factor model provided a good fit to the data. The PSEXS scale had a high internal reliability in both samples (Ukraine α = 0.88, U.S. α = 0.83), and the identified fafctor structure explains a large amount of variance in both samples. Recent studies suggest that expectations of intimacy and better sexual experience can be a significant deciding factor for PrEP uptake. The PSEXS provides researchers with a useful measure for examining MSM’s expectancy beliefs about the impact of PrEP use on their sexual life.

Purpose: World Health Organization (WHO) defines intimate partner violence (IPV) as physical, sexual or psychological harm caused by an intimate partner or ex-partner. There are few studies describing interpersonal violence (IPV) among physicians. Our study describes IPV experienced by U.S. physicians. Methods: This was a multicenter survey administered to 4 physician groups in 2015 to 2016. In total 400 respondents returned survey results. Measures included current IPV, childhood abuse, mental health, professional role, and demographics. Results: IPV was reported by 24% of respondents. The most frequent abuses reported were: verbal (15%), physical (8%) followed by sexual abuse (4%) and stalking (4%). Logistic regression model found that IPV was more likely to be reported by older participants (aged 66–89), those who experienced childhood abuse, working less than full time, and had been diagnosed with a personality disorder. Women and Asian Americans reported slightly higher IPV rates. Conclusions: Our study has implications for both medical education and intervention development. Universal screening and education that addresses clinical implications when treating peers who experience IPV are needed. Workplace interventions that consider unique physician characteristics and experiences are needed, as well as programs that support sustained recovery. This is the first survey to our knowledge that confirms that physicians experience IPV at a rate consistent or higher than the national level. We developed a standardized instrument to assess IPV in male and female physicians at various career stages. We also identified significant predictors that should be included in IPV screening of potential physician victims.

Behavioral and physical health integration has been shown to be beneficial for overall health outcomes, as well as financial benefits. The current research clearly shows benefits, but lacks evidence specific to couples and family therapy (CFT) as a medium or profession within mental health integrated sites. This study tests the cost offsets of Mastering Each New Directions (MEND), a family system psychosocial approach to chronic illness (CI). Using retrospective charges from 107 CI adult patients, MEND (with an average of 25 sessions) was estimated to produce a 12-month cost savings of $16,684 or a 34.3% reduction in healthcare costs. This reduction significantly outweighed the cost of the intervention for a total net savings of $9,251 per participant in 12 months. Variations in cost reductions by demographic and treatment dosage are explored, and results suggest that a family systems psychosocial intervention can offer a health system an overall cost savings.Se ha demostrado que la integración de la salud conductual y física es beneficiosa para los resultados en la salud en general, y que a su vez tiene beneficios económicos. La presente investigación muestra claramente beneficios, pero carece de indicios específicos para la terapia familiar y de pareja como medio o profesión dentro de centros integrados de salud mental. Este estudio evalúa los costos y la compensación de Mastering Each New Directions (MEND), un enfoque psicosocial de sistemas familiares para las enfermedades crónicas. Utilizando los gastos retrospectivos de 107 pacientes adultos con enfermedades crónicas, se calculó que el enfoque MEND (con un promedio de 25 sesiones) produce ahorros de $16.684 en los costos de 12 meses o una reducción del 34,3 % en los costos de asistencia sanitaria. Esta reducción sobrepasó considerablemente el costo de la intervención por un total de ahorros netos de $9251 por participante en 12 meses. Se analizan las variaciones en las reducciones de costos por dosis demográfica y de tratamiento, y los resultados sugieren que una intervención psicosocial de sistemas familiares puede ofrecer ahorros en los costos generales del sistema de salud.行为健康和身体健康综合起来已被证明对整体的健康结果和经济效益都是有益的。本研究清楚地表明了各种益处，但在心理健康综合部门，伴侣和家庭治疗(CFT) 作为一种媒介或职业的特定数据是缺失的。这项研究测试了掌握每个新方向(MEND)这种方法的成本补偿，它是一种针对慢性疾病的家庭系统心理社会方法(CI)。此研究使用了来自107名慢性病成年患者的回顾性花销，MEND(平均25次治疗)估计可节省12个月累计16684美元的费用，或减少34.3%的医疗费用。这一减额大大超过了实施干预措施的费用，12个月里每个参与者总共净节省9 251美元。本研究探讨了人口统计学和治疗剂量在降低成本方面的差异，结果表明，家庭系统、社会心理干预可以为卫生系统整体节省成本。.

BACKGROUND Tracking self-efficacy may be useful for identifying children at risk for medical noncompliance. We created the Pediatric Rating of Chronic Illness Self-Efficacy (PRCISE) to measure self-efficacy in youth dealing with a chronic illness. METHOD Data were collected from 217 families where one child aged 7-20 (Mage = 13.62, SDage = 2.92; 62.7% Latino, 58.1% female) had a chronic illness. Parent participants provided demographic information. Youth completed a depression measure, the Patient Health Questionnaire for Adolescents and the PRCISE. To determine the underlying latent structure of the scale, an exploratory factor analysis was conducted using parallel analysis. We also carried out two multiple linear regressions to explore the data and establish preliminary predictive validity. RESULTS The measure was reduced to 15 items, demonstrating a one-factor solution with strong reliability. Predictors of lower self-efficacy included having parents who had not attended college, being African American, and having higher Patient Health Questionnaire for Adolescents scores, R2 = .23, F(11, 174) = 5.62, p

A critical and often overlooked issue is the lack of measurement tools that are congruent with the systemic and developmental guiding principles of the Marital and Family Therapy field. In this current study, we test the dyadic supervision evaluation (DSE) focusing on the internal consistency, specifically the developmental trajectory of trainee and supervisor factors during a year in supervision. This study demonstrates how these factors stabilize over time. The DSE psychometrics are evaluated with a sample of 205 dyads that are tested longitudinally over four time points. We employ repeated measures ANOVA with intra-class correlation (ICC) to measure the level of consistency of the subscales over time. The results of this analysis show that the factors for trainees have an ICC average range of 0.66–0.80, and the factors for supervisors have an ICC average range of 0.69–0.84.

Few measures parallel the robust depth offered in the existing multidimensional and ecologically informed theories of resilience. This study sought to evaluate the test–retest reliability, construc...

Assessments of power in couples’ relationships often only survey one partner, but they do not take into consideration both partners’ perceptions. Thus, many assumptions about power and equality in relationships have not been quantitatively tested due to a lack of dyadic measures of power. Therefore, the purpose of the Gender and Relationships Study was to develop and test a new scale of equality and relative power for couples, the Relationship Balance Assessment (RBA). The RBA may be useful for research and for clinical work with couples to help raise awareness of the balance of power in their relationship. A review of the literature has shown a shift away from focusing on monetary resources and decision-making dominance towards examining relationship processes and the connection between gender and power. This study prescreened a pool of process-oriented questions based on the qualitative literature. Then exploratory factor analysis of data from 268 individuals and 91 couples identified 12 consistent latent factors underlying relationship equality. These 12 subscales are summed up with the TREASURES acronym: Time Discretion, Relational Power, Emotional Power (Emotional Expression and Avoidance subscales), Accommodation, Spending and Saving subscales, Union or Sexual Dominance, Rational Power, Economic Role Power (Status and Childcare subscales), and Social Choices.

Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η2 = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η2 = .64) and stress (η2 = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.

Aims Translabial ultrasound (TUS) is a useful tool for identifying and assessing synthetic slings. This study evaluates the ability of urology trainees to learn basic pelvic anatomy and sling assessment on TUS. Methods Eight urology trainees (six residents and two medical students) received a lecture reviewing basic anatomy and sling assessment on TUS followed by review of two training cases. Next, they underwent a 126-question examination assessing their ability to identify anatomic planes and structures in those planes, identify the presence of slings, and assess the location and intactness of a sling. The correct response rate was compared to that of an attending radiologist experienced in reading TUS. Non-parametric tests (Fisher's exact, chi-squared tests, and Yates correction) were used for statistical analysis, with P

In pediatric chronic illness, little is known about the relational interactions between adolescent patients, parents, and illnesses and how they influence self-management of illness. We conducted interviews with 32 individuals (16 dyads) representing adolescents diagnosed with a chronic illness and their primary parent who had been referred to a psychosocial treatment program for challenges with illness management. Interviews were conducted individually and analyzed dyadically using grounded theory to better understand the relational processes that may be contributing to illness management difficulties. Results include a theory of patient-parent illness responses and how parental illness meanings play a role in adolescent self-management. Results can be used to better understand and treat family relational patterns that may be influencing pediatric illness management challenges.

This study addresses the need for empirically validated tools to support the training, supervision, and the discovery of best practices in Marital and Family Therapy (MFT). This project represents a first step in developing the Dyadic Supervision Evaluation (DSE), an assessment tool that is grounded in developmental and systemic theory and is psychometrically strong. An Exploratory Factor Analysis (EFA) approach was applied to data from 88 trainee-supervisor dyads across four time periods during the first year of clinical training, resulting in 20 factors, including 9 factors for trainees and 11 factors for supervisors with internal reliabilities ranging from α’s = .82–.98. Discussion addresses the utility of the DSE in documenting the developmental and dyadic progression of supervision during the first year of MFT training.

The World Health Organization indicates depression is the leading cause of disability worldwide. At the same time researchers have found religion/spirituality is inversely associated with depression. However, the mechanisms by which spirituality/religion impacts mental health have not been clearly identified particularly in non-western populations. Relational spirituality is a concept that focuses attention on the ways people relate to the sacred. This study examines whether different ways of relating to the sacred are implicated in levels of depression and whether marital partners affect each other’s level of relational spirituality and depression. Ninety-one (n = 91) married heterosexual couples in the Caribbean Island of Antigua completed measures of relational spirituality and depression. Data were analysed using path analysis and through Actor Partner Interdependence Model methods. Results of the analysis showed wives’ and husbands’ depression scores covaried (COV = 6.59, Pearson r = .28, p

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.

Over the past decade, the concept of family resilience among impoverished families has increased as a main focus area for family scholars. Similarly, individual, family, and community-level factors that promote family resilience and their impact on behavioral health outcomes have particularly received increased amounts of attention. To date, however, few empirical studies have simultaneously validated the socioecological determinants of family resilience within multi-dimensional conceptual frameworks. In the current study, we test such a model using a cross-sectional design among 380 women and men with an average age of 35 experiencing poverty as a chronic stressor, the majority of whom are ethnic minorities. Individual, family and community determinants of family resilience are examined for their differential effect on outcomes of physical and mental health, as well as risks for substance abuse. Results from structural equation modeling provide support for the model. Findings suggest that community-level determinants impact health through indirect pathways. In this case, community factors predict family and individual-level determinants, and individual factors then directly predict health. Similarly, the relationship between family-level determinants and health was indirect through individual-level factors. Although, a strong positive relationship was found between individual-level determinants and health, the relationship between individual-level factors and substance abuse was also found to be indirect through health. Methodological limitations and implications for family life education, clinical interventions, policy, and future research that are socioecologically-informed are discussed.

Introduction: National guidelines recommend primary care providers (PCPs) screen patients for depression with a standardized tool and address positive screenings. However, depression prevalence is lower in Latinos (8% to 15%, with Spanish speakers at 8%) than non-Latino whites (22%). As a result of these prevalence differences, PCPs may use ethnicity and language of the patient to determine depression screening behaviors. This study examined standard of care (SoC) depression treatment recommendations by ethnicity and language for patients who screened positive for major depression during a medical visit. Methods: 275 patients scored ≥10 on the Patient Health Questionnaire–9 screening; a chart review assessed treatment referrals, followed by semistructured interviews with 18 patients and 7 PCPs regarding depression treatment behaviors. Results: 138 patients (50%) received SoC treatment recommendations. After controlling for age, gender, and race, a binary logistic regression was performed to determine language and ethnicity effects on SoC depression treatment recommendations (psychotherapy/pharmacotherapy vs other). Spanish-speaking Latinos were 72% less likely to receive SoC recommendations than English speakers (odds ratio [OR] = 0.39). Interviews with Spanish-speaking patients confirmed that negative perceptions about medications, patient noncompliance, and a shortage of bilingual behavioral health providers within the clinic impacted SoC recommendations and uptake. Conclusions: Spanish-speaking Latinos did not receive or follow through with SoC recommendations as often as English speakers regardless of ethnicity. Future studies should explore reasons why language is a barrier to SoC recommendations for Latinos and explore culturally and linguistically sensitive methods to effectively treat Spanish speakers for depression during a medical visit.

Although self-concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent-child attachment have been linked to self-concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3-month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self-concept, as predicted by depressive symptoms and parent-child attachment, in a sample of 50 youths (MAunque el autoconcepto se cosidera muy importante para la adaptación psicosocial de los adolescentes que sufren una enfermedad crónica (EC), pocas investigaciones se han centrado en qué lo predice. Teniendo en cuenta que la depresión y el apego entre padres e hijos se ha asociado con el autoncepto en la población en general, el objetivo de este estudio fue evaluar estas relaciones longitudinalmente en una muestra de adolescentes con EC. Utilizando datos de los participantes del programa Mastering Each New Direction (MEND), un programa ambulatorio psicosocial, familiar e intensivo de tres meses para adolescentes con EC, usamos modelos multinivel para evaluar los cambios longitudinales en el autoconcepto como los predicen los síntomas depresivos y el apego entre padres e hijos en una muestra de 50 jóvenes (Edad promedio = 14.56, desvío estándar = 1.82) que participaron en el programa MEND. Tanto el “tiempo pasado en el programa” como las disminuciones de los síntomas depresivos estuvieron asociados con aumentos en el autoconcepto con el paso del tiempo. Los niveles iniciales más altos de apego evasivo a la madre y al padre también estuvieron asociados con mayores niveles iniciales de autoconcepto. Enfocarse en los síntomas depresivos y apoyar los cambios adaptativos en el apego puede ser clave para promover un autoconcepto saludable en las poblaciones de pacientes pediátricos con enfermedades crónicas. La asociación entre el apego evasivo y los puntajes iniciales más altos de autoconcepto pueden reflejar diferencias en la autonomía, la autoconfianza o la depresión de los participantes. Entre las limitaciones del estudio se encuentran la variabilidad de la cantidad de tiempo pasado en el programa, la reducción de las valoraciones de los últimos intervalos de tiempo y la incapacidad de analizar y exponer completamente todas las posibles covariables debido a un tamaño muestral pequeño (p. ej.: poder).虽然自我概念已被确认为青少年应对慢性疾病心理社会调试的一个突出因素,然而很少有研究着重预测自我概念。鉴于抑郁和家长-儿童依恋在人群中和自我概念相关,该研究的目的即在一个有慢性病青少年样本中纵向评估这些关系。我们使用从”掌握每个新方向” (MEND)项目(一个为期三个月的针对有慢性病青少年的以家庭为基础的心理社会)中得来的参与者数据和多层面模型来测试自我概念在由50位参与MEND项目青少年(M

Aims Coffee reduction has been a strategy to prevent urinary symptoms with conflicting evidence. We aimed to study the effects of regular and decaffeinated coffee on urinary symptoms among low and frequent coffee users, who were young and healthy. Methods We conducted a double-blinded parallel study on subjects, who were restricted from consuming caffeinated items outside the study. After subjects completed 5 days of caffeine abstinence they consumed regular coffee (450 mg/d caffeine content) or decaffeinated coffee (12 mg/d caffeine content) for 5 days. Previous caffeine use and urinary symptoms were assessed by a diet survey, urogenital distress inventory, and interstitial cystitis problem and symptom indices (ICPI, ICSI). Results Forty nine subjects completed the study. When assessing the submeasures “frequency” and “urgency” on ICPI and ICSI subjects drinking coffee reported a significant increase in urgency (P

The goal of this study was to develop a broad, multidimensional assessment of individual, family, and community resilience for use in evaluating socioeconomic mobility programs. The Individual, Fam...

As a result of the high rate at which young Marines are getting married and divorced, a group of Navy chaplains created a new comprehensive three stage intervention program entitled, Intimate Relationships Awareness, Training, and Enrichment program (iRelate) to address the various relationship needs of the single, engaged, and married Marines. This article presents preliminary program evaluation data for Stage I and Stage II of the iRelate program, with additional data from Marines that are engaged to be married and Marines that were in the process of getting divorced. Results showed, prior to attending Stage I and Stage II of the program, Marines presented with high levels of marriage idealism and overconfidence. Twenty-nine percent stated, because they are Marines, they are capable of taking on adult responsibilities and 32.4 % believed that marriage would require some effort. Of the Marines that were in the process of getting divorced, 40 % indicated that they were too young to be married, 50 % stated if they could do it over again they would have taken more time to get to know their spouse prior to getting married. The post course data indicated that the Marines’ level of idealism and overconfidence decreased, as 63.2 % of the Marines developed a more realistic expectation of marriage, by realizing that marriage will require a lot of hard work. Additionally, Marines felt more prepared for their marriage [t (177) = 7.62, p

Aging families encounter non-normative and age-related challenges that often cause stress on the family system. The concept of family resilience provides a relevant strength-based perspective for recognizing the multigenerational transitions and challenges encountered by families as they age. Based on the existing family resilience and successful aging literature we outline and provide potential clinical direction for three key constructs (flexibility, social support, and spirituality/religiosity) which have the largest supportive body of evidence in the aging and resilience literature. Recognizing the characteristics that contribute to aging well through a family resilience lens lays the foundation for strength-based intervention with aging families.

It is estimated that 30% of all school-aged children suffer from some form of chronic illness (Pai & Ostendorf, 2011). Unfortunately, compared to the general population, children with chronic illne...

This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor–partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed.

Changing economic times and government policies are reshaping the way the U.S. Department of Housing and Urban Development (HUD) provides services nationwide; there is both a growing demand for housing and a desire to help families become self-sufficient. In this study, the authors examined factors that contribute to increased socioeconomic mobility through the lens of family resilience. Analyzing cross-sectional data from 411 families in the San Bernardino County HUD District using discriminant function analysis, results of this study show strong preliminary evidence that certain components of family resilience predict whether an individual head of household will have full-time employment. The results of this study provide implications for social service programs aimed at socioeconomic mobility.

Families living in poverty face a host of challenges, which creates a multi-stressed environment (Seccombe, 2002). While it is known that poverty disproportionately coexists with lowered mental hea...

The role of social support is an important factor in building resilience within families. While robust definitions of social support exist, few assessments parallel these conceptual frameworks. This study tested the psychometric properties of one commonly used measure of social support (SSI) with 651 low income families through a local public housing program. Results of this study show that the SSI can approach a more robust assessment of social support when the measure is used as a multi-dimensional tool. Conclusions offer a subscale scoring system for this assessment which can be used in both research and clinical practice.

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.

Nearly three decades of research on mentoring has offered empirically supported processes in developing a mentoring relationship. Yet the application of mentoring within family businesses has received little exploration. Since much of the current mentoring literature is focused on general workplace mentoring, it is not clear how the multidimensional and interdependent systems within family businesses might complicate the translation of the existing literature to family business populations. This study examines interorganizational family business mentoring relationships to determine whether there are any issues which differentiate it from the existing mentoring research findings.

This study relied on theories of family resilience to examine and differentiate the roles of community social support and family resilience in regards to access and utilization of healthcare and employment resources for public housing residents. The study assessed 234 public housing residents and used structured regressions to test the role of family resilience, internal and external community social support on outcomes associated with economic mobility. Results suggest that external community social support is associated with increased access to and use of health and employment resources. Additionally, residents with higher levels of resilience sought social support from outside of their communities to a greater degree, thereby increasing their access and use of resources. Increases in internal community support were associated with increases in external community support, but alone, limited access to and use of resources. Implications of the findings for policy, interventions, and future research are discussed.

Background Fathers are at risk for depression during a mother's gestation and postpartum. Assessment, detection, and treatment are hampered by the lack of consensus on this issue. The purpose of this study was to reach expert consensus through the Delphi method on the defining factors of depression in peripartum fathers. Methods Purposive sampling resulted in the surveying of 14 international expert panelists. The study used a modified Delphi approach in which experts participated in two rounds of open-ended and scale questionnaires, followed by two rounds of opportunities to adjust their responses and/or comment on evolving data until consensus was achieved. Results Experts responded to 10 questions on terminology, diagnostics, symptomology, risk/protective factors, biological factors, assessment tools/protocol, cost implications, and key stakeholders. Of these 10 questions presented for discussion, the analysis resulted in 197 coded themes. Consensus was met for 119 of the 197 coded responses (60.41%). Limitations Diversity of opinion within this Delphi Study was excluded for the sake of consensus. Regression to the mean may have occurred after continuous surveying and when evolving results were shared with panelists. Critics of Delphi methodologies have pointed to the issue of small expert samples typically used and the subjectivity of “expert.” Conclusion Consensus identified diagnostic criteria and symptomology that differentiates the paternal experience of peripartum depression. Experts indicated the importance of a father's social context, biological risk factors, limitations of current assessment tools, key stakeholders, and potential financial costs. Stakeholders on this issue would benefit from translating consensus into assessment and treatment.

This study evaluates a human ecology conceptual framework for family businesses where the value orientations within the family business system are considered a distinct construct from unity in values. This study uses the 2007 American Family Business Survey to differentiate values from unity. Findings from this study support this human ecology differentiation and results include a lack of relationship between unity and values, and the disproportionate role of unity in the creation and maintenance of formal processes, whereas values, and specifically “family-first” businesses tend to preference the creation of family councils. Implications include relevance for future investigative studies focused on the role of family involvement, and practical implication for the creation and maintenance of formal processes such as family councils.

Literature focused on the strength of the boundary around the family system has often provided mixed advice with some suggesting a rigid boundary and others suggesting a diffuse boundary. This study argues that these conflicting findings are due to the limitation of underlying research methods. This study employs a mixed method design that incorporates qualitative data, social network analysis, and multilevel modeling to categorize family businesses into three distinct boundary strength categories. Findings from this study suggest that extremes in boundary strengths provide unique challenges for family businesses. This study also identifies the impact of various levels of boundary strength on nonfamily employees.

This study tests the application of an ecosystems perspective on family businesses. Specific focuses are given to values, resources and unity within family businesses. Two separate samples are examined, the American Family Business Survey and a multilevel sample. Results from this study support the ecosystems perspective. Family businesses are shown to vary by their value for family growth in comparison to business growth. This value variation across family businesses was shown to predict internal goals and resource transfers within family businesses. This study also shows the benefit to family businesses in unifying values across individuals, as unity of values is a stronger predictor of satisfaction even when controlling for the family business’ tendency to privilege the family or business growth.

This article extends and expands current systems views of family business and provides a framework for interpreting family business holistically . The framework extends the definition of family-first and business-first systems and adds three categories that typify the gradations of firms that represent balanced systems emphases. In addition, this article discusses the goals, resource transfers, strengths, and limitations of each type of system and describes how firm adaptability and resource flows influence and change these family business systems; it argues that to understand family business health, one must understand the values and goals that guide the family, business, and ownership systems, as well as the overall family business system; and it presents an inclusive definition of family and business based on systems membership.

This interview with Dr. Szapocznik reveals the importance of building an intervention on the foundation of empirical evidence and family systems theory. Szapocznik is the director of the Center for Family Studies and professor at the University of Miami. He is a chair of the National Hispanic Science Network on Drug Abuse. Szapocznik is also the founder of brief strategic family therapy (BSFT). BSFT is a family-based model for adolescent problem behaviors, such as conduct problems and substance abuse. Throughout the research on BSFT, Szapocznik has been able to show that BSFT is effective and that it can be used with historically difficult populations. Finally, Szapocznik's research has shown that family approaches to adolescent problems are more efficacious than individual and group models of therapy.

Coffee reduction has been a strategy to prevent urinary symptoms with conflicting evidence. We aimed to study the effects of regular and decaffeinated coffee on urinary symptoms among low and frequent coffee users, who were young and healthy.We conducted a double-blinded parallel study on subjects, who were restricted from consuming caffeinated items outside the study. After subjects completed 5 days of caffeine abstinence they consumed regular coffee (450 mg/d caffeine content) or decaffeinated coffee (12 mg/d caffeine content) for 5 days. Previous caffeine use and urinary symptoms were assessed by a diet survey, urogenital distress inventory, and interstitial cystitis problem and symptom indices (ICPI, ICSI).Forty nine subjects completed the study. When assessing the submeasures "frequency" and "urgency" on ICPI and ICSI subjects drinking coffee reported a significant increase in urgency (P 0.05) and frequency (P 0.05), whereas subjects drinking decaffeinated coffee experienced no difference in those submeasures in comparison to no caffeine intake. However, previous "low coffee users" experienced the largest increase of urinary symptoms, whereas previous "frequent coffee users" showed fewer symptoms when exposed to regular coffee.The study suggests that avoiding high-dosage coffee consumption prevents urgency and frequency, which supports recommendations to limit caffeinated beverages. The study differentiates between subjects having a history of low and frequent coffee use. Subjects, who are not used to regular coffee consumption, seem to be more vulnerable to the effects of coffee on urinary symptoms. Better understanding of the effects of coffee on urinary symptoms may improve patients counseling. Neurourol. Neurourol. Urodynam. 36:432-437, 2017. © 2015 Wiley Periodicals, Inc.

© 2014 Taylor & Francis. Objectives: Develop an empirically grounded measure that can be used to assess family and individual resilience in a population of older adults (aged 50-99).Methods: Cross-sectional, self-report data from 1006 older adults were analyzed in two steps. The total sample was split into two subsamples and the first step identified the underlying latent structure through principal component exploratory factor analysis (EFA). The second step utilized the second half of the sample to validate the derived latent structure through confirmatory factor analysis (CFA).Results: EFA produced an eight-factor structure that appeared clinically relevant for measuring the multidimensional nature of resilience. Factors included self-efficacy, access to social support network, optimism, perceived economic and social resources, spirituality and religiosity, relational accord, emotional expression and communication, and emotional regulation. CFA confirmed the eight-factor structure previously achieved with covariance between each of the factors. Based on these analyses we developed the multidimensional individual and interpersonal resilience measure, a broad assessment of resilience for older adults.Conclusion: This study highlights the multidimensional nature of resilience and introduces an individual and interpersonal resilience measure developed for older adults which is grounded in the individual and family resilience literature.

Current research focused on stress responsive illnesses such as asthma has identified a crucial role for families in the progression and maintenance of stress responsive illnesses. What is currently not clear is the differential effect of maternal versus paternal engagement in the management of pediatric asthma. This study explores whether or not mother, father, or the combined engagement has an effect on the management of pediatric asthma. A subsample of the Fragile Families Child and Wellbeing Study (FFCW Study) was used to examine the role of parental engagement (n = 475; 41.9% female, 58.1% male). Path analysis and actor partner interdependence modeling processes were used to examine the differential effect of mother and father engagement. A final nested model with only direct effects from the father's level of engagement proved to be the best fitting model, χ2(9) = 16.738, p = .05298, CFI = 0.995, GFI = 0.989, RMSEA = 0.043. Within this model father engagement had a moderating effect for child's emergency room (ER) use (β = -.124, p < .05). The mother's effect was best modeled as an indirect effect as this increased the father's level of engagement, but did not have a direct effect on the outcome of ER usage. This study is consistent with other studies that found that the predictability of a father's role and routine had positive health outcomes for the asthmatic child. Implications for future research and practice are identified and discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

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.