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This paper studies the creation of organisations via people processing (Prottas 1979), taking as its case study a new and developing family centre that aims to offer various social and health services under the same roof. The study draws on ethnomethodology, meaning that organisations are herein understood as being created and continuously produced in and through interaction. The data consist of 11 audio-recorded meetings from the centre's steering group, which includes managers from different service fields and welfare agencies. In analysing the creation of the centre through people processing, this paper scrutinises how the meeting participants orient themselves toward and produce the centre's client categories, what characteristics they connect to these categories, and how they do boundary work regarding which categories belong or not to the centre's target groups. The meeting participants produce three different family based client categories. The first category is ordinary families, those without any special problems who just pop into the centre to see other people. These families are distinguished from the second category, best matching families, who are defined as having problems that would benefit from the integrated, multi-professional work conducted at the centre. The third category, families with too specific needs, refers to client groups whose service needs are at least partly beyond the centre's expertise and resources. The centre needs these people-processing activities to make sense of its mission, clients and co-partners; this ongoing reasoning process allows the emerging centre to exist and find its place in the local service system. [ABSTRACT FROM AUTHOR]

Parenting education interventions and parenting programs are important for health promotion efforts among children and families; however, the majority of parenting programs are directed towards and attended by mothers. This is problematic because research has consistently demonstrated that fathers' active participation in the family can have a positive influence on mothers' well-being, children's self-esteem, success in school, and interpersonal relationships. In this paper, using an intersectional poststructuralist framework, document analysis, and Bacchi and Goodwin's "What's the problem represented to be" approach (WPR), we analyzed the program policies of 12 organizations that provide family-centred services in the Downtown Eastside of Vancouver, British Columbia, Canada. We identified the following three discourses: organizations strive to be client-centred and provide choices; organizations want to empower their participants; and women need safe place to raise their families. Our analysis revealed that fathers are absent or represented as problems in program policies, and that this has consequences for not only fathers but also mothers and children. Highlights: Dominant discourses of gender are upheld through the exclusion of fathers in program policies. The exclusion of fathers in policies produces them as either absent/problematic and can adversely affect families. Organizations uphold damaging discourses of masculinity that can undermine efforts to prioritize the needs of mothers. Changing language in policies may help family-centred organizations shift services and better support families. [ABSTRACT FROM AUTHOR]

This paper utilizes data gathered as part of an exploratory study to assess the costs and impact of the Common Assessment Framework (CAF), to examine the impact that the lead professional role had on families and workers. The study found that both families and workers believed the lead professional to be central to the CAF process, providing a range of support, coordinating multi‐agency responses to need and acting as a single point of contact between families and workers. The paper highlights the need for consideration to be given to inter‐agency working, data sharing, training for workers and the capacity implications for those taking on the role. The extent to which the lead professional might be more integrated into the continuum of support for vulnerable children and families is also examined. The paper highlights the need to consider the lead professional's role in not only preventing the need for more intensive services, such as those provided by statutory social work, but also maintaining outcomes achieved once a child protection plan is closed, or a child is reunified with his or her birth family after a period of being in care. The implications of the findings for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

The Common Assessment Framework provides a model of early intervention, which is familiar in local authorities throughout England, and asserts a participatory framework of child and family engagement. This paper is based on a qualitative study of parents and children who were subject to a multi‐agency process of early intervention in children's social care in a local authority in the Midlands of England. I advance the concept of assemblage to consider the basis of an active service user participation as rather more a struggle to achieve than something that has been granted by practitioner agencies. Interview extracts are used to show the enrolment and assembly of participation as a process of service users developing their active human agency in a multi‐agency setting. The article explores the assembling of skills in administration and management of meetings and plans, accessing knowledge and expertise through service user networks, and challenging professional expertise and institutional space while developing personal qualities of confidence and voice as a means of marshalling an effective participation in a multi‐agency setting. [ABSTRACT FROM AUTHOR]

This paper presents the findings from a qualitative study that sought to understand the experiences of frontline staff working in Oxfordshire County Council (OCC) Children's Social Care Services and their views on a new family safeguarding model (Family Solutions Plus). Focus group interviews were conducted with 20 frontline staff and managers in different teams across OCC Children's Social Care Services using video conferencing software. Thematic analysis identified three overarching themes: Preparation for the implementation of Family Solutions Plus, staff views on the implemented model, and challenges to its implementation. Staff voiced strong support for the new model, which places a much greater emphasis than previous practice on supporting the whole family, developing parenting skills and keeping children safe with their families. The challenges associated with the transition to a new model were considerable in the short term, partly due to the COVID‐19 pandemic, but there was optimism that the new model could be sustained and stabilized over time. [ABSTRACT FROM AUTHOR]

The working relationship is considered a central feature of direct practice with human services clients. There are many challenges when it comes time to end a working relationship, yet limited guidance for workers on successful relationship ending. This paper aims to increase understanding of the process of the ending phase of the working relationship for parents and workers working with families where child neglect is an issue. The paper draws on data from a small-scale qualitative Australian study of perceptions of parents, family workers, and supervisors involved in eight parent-worker relationships. Using semistructured interviews, participants were asked to explore how they experienced the relationship. The findings illuminate important aspects about the ending phase of the relationship; in particular, challenging the idea that parents' returning to services for support is a sign that the service has not provided a successful intervention. The paper challenges social workers to consider recurring parent-worker relationships similar to other professional relationships where there are episodes of service but the relationship is there to be reactivated where needed. [ABSTRACT FROM AUTHOR]

Family group conferencing (FGC) coordinators in public mental healthcare are confronted with clients who have little faith in professionals and organizations, who hold off decisions in their family life, who avoid care and who sometimes behave in a hostile manner. A lack of initiative to deal with their situation is not only reserved for clients - all bystanders, including professionals, can suffer from it. The multiplicity and severity of the client's problems lead to a situation wherein everyone involved waits for the initiative of the other. The independence of the FGC coordinator - a fellow citizen, who is free of organizational loyalties and comes to assist other citizens in establishing a plan - seems to work well with the client group of the public mental healthcare. However, the coordinator cannot always prevent deferral or failure of conferences. Drawing on empirical and theoretical findings, this paper considers the possibility of collecting feedback as a way to contribute positively to the alliance between FGC coordinators and those for whom a conference is deployed. We highlight findings from three case studies that centred on multiproblem families. The findings indicate the importance of feedback theory for FGC coordinators in enhancing trust and engagement. [ABSTRACT FROM AUTHOR]

Two-parent families with dependent children are known to be at lower risk of poverty and significantly less reliant on state financial help than lone-parent households. It might therefore be expected that the factors influencing partnership transitions among low-income women would represent a key area of policy interest. However, driven by concerns about weak work incentives, policy focus and research has to date concentrated on understanding lone parents’ labour supply and encouraging the transition from benefits into employment. Surprisingly little is therefore known about demographic decision making among women reliant on UK means-tested welfare. As part of a wider qualitative study exploring family formation, partnership dissolution and repartnering decisions among low-income mothers, this paper examines whether and to what extent entitlement to welfare benefits or tax credits influenced the decision to live with or apart from a partner or child's father. The research found that the aspects of welfare that remove or reduce a mother's access to an independent income and require one partner in a couple to be financially dependent on the other had been strongly influential in partnering decisions and living arrangements. Policy implications are discussed. [ABSTRACT FROM AUTHOR]

Australia has a well-accepted system of universal child and family health ( CFH) services. However, government reports and research indicate that these services vary across states and territories, and many children and families do not receive these services. The aim of this paper was to explore professionals' perceptions of the challenges and opportunities in implementing a national approach to universal CFH services across Australia. Qualitative data were collected between July 2010 and April 2011 in the first phase of a three-phase study designed to investigate the feasibility of implementing a national approach to CFH services in Australia. In total, 161 professionals participated in phase 1 consultations conducted either as discussion groups, teleconferences or through email conversation. Participants came from all Australian states and territories and included 60 CFH nurses, 45 midwives, 15 general practitioners ( GPs), 12 practice nurses, 14 allied health professionals, 7 early childhood education specialists, 6 staff from non-government organisations and 2 Australian government policy advisors. Data were analysed thematically. Participants supported the concept of a universal CFH service, but identified implementation barriers. Key challenges included the absence of a minimum data set and lack of aggregated national data to assist planning and determine outcomes; an inconsistent approach to transfer of information about mothers and newborns from maternity services to CFH nursing services or GPs; poor communication across disciplines and services; issues of access and equity of service delivery; workforce limitations and tensions around role boundaries. Directions for change were identified, including improved electronic data collection and communication systems, reporting of service delivery and outcomes between states and territories, professional collaboration, service co-location and interprofessional learning and development. [ABSTRACT FROM AUTHOR]

Aim This paper reports a study testing of the validity and reliability of the personnel version of the Family Empowerment Scale in family services in Finland. Background The role of family services in parental reinforcement is important, given their extensive reach to most families and their aim of promoting family welfare. No instruments applicable to this situation were available in Finland. The Family Empowerment Scale is a widely used instrument that measures parent's empowerment. The personnel version of the Family Empowerment Scale enables an evaluation of the reinforcement of empowerment. Design This study used a cross-sectional survey design. Methods The Family Empowerment Scale was modified to measure how family services personnel evaluate reinforcement of parental empowerment. In May 2009, a questionnaire was sent to unit heads ( n = 457) in public social, health and educational services for families with children aged 0-9 years. The construct, convergent and discriminant validities, reliability and responsiveness of the personnel version of the Family Empowerment Scale were assessed. Results According to confirmatory factor analysis, the personnel version of the Family Empowerment Scale comprised three subscales (family, service system and community) as in the original Family Empowerment Scale. Confirmed convergent and discriminant validities supported the same construct. The reliability of the personnel version of the Family Empowerment Scale was acceptable. The reinforcement level of parental empowerment was high. Parental empowerment was reinforced most in health and least in educational services. Conclusion The psychometric properties of the personnel version of the Family Empowerment Scale were acceptable. It can serve as a generic instrument for assessing reinforcement of empowerment in family services in Finland. [ABSTRACT FROM AUTHOR]

Family services offer the possibility of producing data sets, capable of primary analyses to measure service efficacy, and secondary analyses to develop nuanced understandings of family needs. In this article, we report secondary analysis of data drawn from 1,151 families elicited upon intake to family centres in Ireland. The aim was to examine correlates of children's socio-emotional functioning, with focus on the quality of relationships between children and parents. Participating families completed surveys containing socio-demographic questions and standardised instruments tapping into children's social, emotional and behavioural strengths and difficulties, parents' mental health, and closeness and conflict in parent–child relationship. Findings indicated that parents' perceptions of their children's socio-emotional functioning significantly influenced the quality of the child–parent relationship. Higher levels of conflict were significantly associated with psychological difficulties, whilst greater closeness was significantly related to prosocial behaviours. These relationships held after controlling for a range of child, parent and family socio-demographic variables, such as the child's experience of chronic illness or stressful life events, both of which independently predicted poorer outcomes. Results are discussed in terms of the dynamic, reciprocal nature of family relationships whereby parent–child conflict and children's problematic socio-emotional functioning likely influence, and are influenced by, each other. [ABSTRACT FROM AUTHOR]

Background: In 2016, the Government of the southern Indian state of Kerala launched the Aardram mission, a set of reforms in the state's health sector with the support of Local Self Governments (LSG). Primary Health Centres (PHCs) were slated for transformation into Family Health Centres (FHCs), with extended hours of operation as well as improved quality and range of services. With the COVID-19 pandemic emerging soon after their introduction, we studied the outcomes of the transformation from PHC to FHC and how they related to primary healthcare service delivery during COVID-19. Methods: A qualitative study was conducted using In-depth interviews with 80 health system actors (male n = 32, female n = 48) aged between 30–63 years in eight primary care facilities of four districts in Kerala from July to October 2021. Participants included LSG members, medical and public health staff, as well as community leaders. Questions about the need for primary healthcare reforms, their implementation, challenges, achievements, and the impact of COVID-19 on service delivery were asked. Written informed consent was obtained and interview transcripts – transliterated into English—were thematically analysed by a team of four researchers using ATLAS.ti 9 software. Results: LSG members and health staff felt that the PHC was an institution that guarantees preventive, promotive, and curative care to the poorest section of society and can help in reducing the high cost of care. Post-transformation to FHCs, improved timings, additional human resources, new services, fully functioning laboratories, and well stocked pharmacies were observed and linked to improved service utilization and reduced cost of care. Challenges of geographical access remained, along with concerns about the lack of attention to public health functions, and sustainability in low-revenue LSGs. COVID-19 pandemic restrictions disrupted promotive services, awareness sessions and outreach activities; newly introduced services were stopped, and outpatient numbers were reduced drastically. Essential health delivery and COVID-19 management increased the workload of health workers and LSG members, as the emphasis was placed on managing the COVID-19 pandemic and delivering essential health services. Conclusion: Most of the health system actors expressed their belief in and commitment to primary health care reforms and noted positive impacts on the clinical side with remaining challenges of access, outreach, and sustainability. COVID-19 reduced service coverage and utilisation, but motivated greater efforts on the part of both health workers and community representatives. Primary health care is a shared priority now, with a need for greater focus on systems strengthening, collaboration, and primary prevention. [ABSTRACT FROM AUTHOR]

This study investigated the factors associated with clinical symptoms and level of functioning at baseline and after 4 months of navigation, in youth with mental health and/or addiction concerns involved with a family navigation service. Participants in this pre‐post study were caregivers who accessed a mental health and addictions navigation service between March 2018 and July 2019 on behalf of their youth aged 13–26 who had mental health and/or addiction concerns. Evaluations were conducted at baseline and at 4 months after entering navigation. The dependent variable, youth mental health symptoms and functioning, was assessed by caregivers using the Symptoms and Functioning Severity Scale. The sample included 345 caregivers of youth (youth: mean age 18 years, 57% male). At intake, using multiple linear regression, caregiver strain (β = 0.481, p < 0.001), youth completion of ADLs (β = −0.156, p = 0.002) and youth motivation (β = −0.110, p = 0.021) contributed significantly to variance in symptoms and functioning (R2 = 0.373, p < 0.001). Using ANOVA to compare complete pre/post data (n = 115), there was a significant main effect of time on the youth symptoms and functioning score (F[1, 107] = 9.278, p = 0.003). Furthermore, the interaction of time, youth completion of ADLs (low vs. high at baseline) and youth motivation (low vs. high at baseline) was significant (F[1, 107] = 4.699, p = 0.032). Youth with low motivation and low completion of ADLs at baseline experienced the largest improvements in symptoms and functioning after 4 months of navigation. These findings suggest that this group of youth should be a primary target in mental health and addiction navigation. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and associated physical distancing restrictions have exacerbated social, economic and health disadvantage within our communities. With increases in mental health difficulties and family violence already being seen, there is concern that the risk of child maltreatment risk may also be increased. The current study aimed to explore the experience of the COVID‐19 pandemic for families identified to be at risk of child maltreatment in Victoria, Australia. Understanding the experiences of the pandemic for families already at risk is essential in identifying how to best support vulnerable parents and young children during this challenging time. Interviews were conducted with 11 parents currently involved with Child Protection Services, and nine clinicians working within a child and family health services, supporting clients with child protection involvement. Parents and clinicians described a range of pandemic related stressors including employment and financial stress, worry about infection and changes to service access. In addition, parents with children in out of home care discussed decreased access to their children resulting from physical distancing restrictions. Parents and clinicians perceived the pandemic to be having a negative impact on parent mental health, parenting stress and isolation. Although parents raised minimal concerns about the impact of the pandemic on child well‐being, clinicians expressed concerns about the rise in risk factors for child maltreatment. Parents discussed a range of coping strategies which they perceived to be helpful during the pandemic, and clinicians and parents described the need for additional mental health support and support to access basic needs. The study highlights the importance of ensuring at risk families have access to parenting and mental health support throughout the pandemic and the importance of ensuring children within at‐risk families are sighted and their safety assessed. [ABSTRACT FROM AUTHOR]

This study evaluated the impact on caregiver strain and family empowerment among caregivers of children with disabilities who received training and education as part of a family-centred community-based early intervention programme in South India. This prospective open cohort longitudinal study compared change from baseline to two years post-intervention among caregivers of the first cohort of children who were enrolled in the programme. Paired t-tests determined effect on the Modified Caregiver Strain Index (MCSI) and Family Empowerment Scale (FES), and p-values were adjusted for multiple comparisons using the False Discovery Rate approach. Of the 308 caregivers (91% women), 44% provided care to children with cerebral palsy and 56% to children with other developmental delays. The mean age of the children at baseline was 3.3 (±1.5 years). The overall mean change from baseline in the FES was 4.1 (95% CI: 3.3, 4.9; p < 0.001) representing improved empowerment. The mean change for the MCSI score was −3.7 (95% CI: −4.5, −2.9; p < 0.001) representing reduced caregiver strain. A family-centred early intervention programme that provides training and education to caregivers of children with developmental delays demonstrated positive change in caregiver strain and family empowerment. The well-being of a child is influenced by the well-being of their caregiver. Improving caregiver well-being can help improve care and support for children with developmental delays. A family-centred early intervention therapy programme that includes training and education to caregivers can reduce strain and improve family empowerment. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Pacific populations in New Zealand are aging, but little is known in the health-care environment about their experiences with cognitive impairment. AIM: The aim was to explore the needs of Pacific peoples affected by age-related cognitive decline from the perspectives of health-care providers. METHODS: Six health-care service providers from organisations focused on Pacific patients were interviewed to determine services available to aged Pacific peoples, access, and whether they met Pacific people's needs. RESULTS: Three areas of concern were identified by all participants: access to services; getting a diagnosis; and communication and language. Many experienced a lack of information and poor access to services. Diagnosis of cognitive impairment was frequently made difficult by inconsistent access to general practitioners in lower socio-economic areas. Communication was hindered by poor access to information in Pacific languages. DISCUSSION: Common themes noted by all participating health-care providers indicated the needs of aged Pacific people experiencing cognitive decline were often not being met. [ABSTRACT FROM AUTHOR]

In a national and international context where there is a concern about the effectiveness of social care services for children and families to address chronic, enduring social problems and where there are finite resources available, the concept of social innovation in social work policy and practice to address need in new ways is receiving increased attention. Whilst an attractive term, social innovation in child and family services is not without its challenges in terms of conceptualisation, operationalisation, implementation and evidencing impact. This article reports on the development and evaluation of the Early Intervention Support Service (EISS), a newly designed family support service in Northern Ireland set up as part of a government-supported innovation and transformation programme that aims to deliver a voluntary, targeted, flexible and time-limited service to families experiencing emergent problems. Using the EISS as a case study, the challenges, benefits in terms of addressing policy imperatives and future direction of social innovation in social work practice are reflected upon. [ABSTRACT FROM AUTHOR]

This article describes the benefits of monthly family team meetings for parents involved with child welfare. Findings are shared from semi-structured, qualitative interviews conducted with 17 parents whose children had been placed in substitute care. While much of the scholarship on family meetings focuses on opportunities for family voice, this study found that parents received multiple benefits from meetings including, but not limited to, the opportunity for input into decision-making. Specifically, parents appreciated receiving information and feedback, encouragement, and a range of other supports from members of the team. Meetings also facilitated communication and improved the coordination of services and other efforts by team members. Notably, parents reported that regular meetings helped to hold caseworkers and other providers accountable regarding their activities and duties related to the case, often resulting in better follow through. Parents and their advocates were also able to use meetings to push child welfare to respond in a timely way to parents' progress. These findings should be viewed as preliminary evidence of how a particular model of family meetings might work and thereby expand our understanding of what family team decision meetings can do to improve parents' experiences and child welfare outcomes more generally. [ABSTRACT FROM AUTHOR]

This article elucidates the challenges parents face when they lose the care of their children and their experiences of family counselling as a support service in Norway. A qualitative study following five mothers and one father whose children were in care was conducted through two focus groups and six individual interviews. The study found that the parents struggled to understand why their children had been placed in care and felt disempowered by the Child Protection Services (CPS). This situation led to complicated relationships with the CPS. We drew upon positioning theory and Goffman's theories about stigma and identity in this study, and these theories are explicitly used in discussing our analytic results. The study reveals the challenges encountered by CPS due to their dual role: On the one hand, they remove the children, and on the other, they offer support. The parents in this study also received assistance from the Family Counselling Services. Important results of this study are the parents' experiences of the two systems and, in particular, the different positions the systems seemed to place them in. [ABSTRACT FROM AUTHOR]

Family support services, an integral part of many welfare systems across the developed world, have witnessed a growing demand for the use of relationship and strengths‐based whole‐family approaches in the belief that this increases service engagement and effect. Despite this, knowledge that delivering services using such approaches can be challenging and calls for the identification and exploration of methods likely to promote and sustain their use. Restorative approach is an ethos and method centred on building and sustaining positive relationships, which is increasingly being adopted in family and children's services in the United Kingdom. Despite this, the scarcity of research conducted in this area as yet, means little is known of its use and effect in this context. This article draws on empirical data collected in a wider study exploring the efficacy of different family service delivery models to describe the use of restorative approach in family service provision and determine whether its adoption promotes sustained use of strengths and relationship‐based whole‐family approaches when working with families. Furthermore, it explores whether the process incorporates wider evidence‐based methods of change. [ABSTRACT FROM AUTHOR]

This study aimed to explore Australian parents' use of universally available well‐child health services. It used an online survey of 719 parents of children aged from birth to 5 years in all states and territories to examine patterns of service use and consumer preferences. In Australia, several health professional groups provide advice to pregnant women, infants, children, and parents, offering health promotion, developmental screening, parenting support, and referral to specialist health services if required. The survey examined parents' use of different child and family health providers, and their preferences for support with several common parenting issues. The study indicated that families with young children obtain primary healthcare from a range of service providers, often more than one, depending on children's ages and needs. Parents frequently visit general practitioners for immunisation and medical concerns. They attend dedicated child and family health nurses for parenting advice and well‐child checks and prefer them as an information source for many health issues. However, a substantial proportion of parents (44.1%) do not currently visit a child and family health nurse, often because they not only do not perceive a need but also sometimes because these services are unknown, inaccessible, or considered unsuitable. They may seek advice from less qualified sources. There is potential for increased collaboration between child and family health providers to ensure effective resource use and consistency of parenting information and advice. Nursing services may need to address accessibility and appropriateness of care. [ABSTRACT FROM AUTHOR]

Informed by the Network-Episode Model, 26 African-American men with serious mental illness and 26 members of their kinship networks completed in-depth qualitative interviews about their experiences with the mental health care system to better understand racial differences in mental health care. The aim was to better understand communication among kin networks, clients, and treatment agencies with a focus on the opportunities for kinship involvement. Although kin were involved in clients' everyday lives, they were largely excluded from the community mental health agency (CMHA) and treatment decisions. In addition to incorporating family resources, enhanced efforts by CMHAs to collaborate with kin may increase knowledge about mental illness and mental health care in the African-American community, removing an impediment to service access and client retention. [ABSTRACT FROM AUTHOR]

Objective To assess the self-care of patients with heart failure (HF), reliable and validated instruments are needed. The aim of this study was to test the validity and reliability of the Danish version of the European Heart Failure Self-care Behavior Scale (EHFScBS-9) based on previous studies reporting 1, 2 and 3 factors, respectively. Methods A convenience sample of 147 patients with HF completed the EHFScBS-9. Psychometric properties of the Danish version of the EHFScBS-9 were tested with factor loadings, factor correlations and goodness-of-fit indices for four different measurement models based on confirmatory factor analysis. Results All of the items, except item 9 about regular exercise, demonstrated satisfactory item-total correlation ≥0.30. Regarding the fit of the models on the sample data, the most superior fit was observed for the two-factor solution in terms of root-mean-square error of approximation (RMSEA), goodness-of-fit index (GFI), adjusted GFI (AGFI) and comparative fit index (CFI), which all reached the predefined threshold value, except for the normed fit index (NFI) at 0.90. Factor score determinacy (FSD) for the four models tested was 0.88 for the one-factor solution, 0.54 and 0.87 for the two-factor model, 0.83-0.55 for the first three-factor model and 0.87-0.38 for the second three-factor model. Conclusions The EHFScBS-9 questionnaire is a valid and reliable instrument to assess heart failure-specific self-care behaviours in a Danish population. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. Background Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. Design The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. Methods Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. Findings Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. Conclusion For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally. [ABSTRACT FROM AUTHOR]

Summary The evaluation of the specific level of family risk is a central topic to better understand the diversity of families assisted by Child and Family Protection Services, and also to design and address effective social interventions. Professionals of these services tend to have a great amount of knowledge and experience that has been rarely taken into account in research about at-risk families. In this study the level of family risk, according to data reported both by practitioners and mothers receiving family preservation intervention, is analyzed in a sample of 106 mothers assisted by state Child and Family Protection Services in Huelva, Spain. Findings A frequent profile of poor and multi-assisted families was found, but there was also an important level of heterogeneity in the level of risk, suggesting that these families are not a homogeneous group. The global valuation of family risk informed by professionals was significantly related to data reported by mothers using a standardized tool of family risk factors. Analyses presented also show significant relations with both the family socio-demographic profile and data of the case history involving protection services: higher levels of family risk were mainly associated with higher levels of economic, educational, and labor precariousness, and with more complex and complicated case indicators. Applications Implications of these results concerning both the importance of incorporating systematic evaluations of family risk by means standardized tools to practice and considering practitioners as a relevant source of information in family research are discussed. [ABSTRACT FROM AUTHOR]

Background: Despite primary health care being recognised as an ideal setting to effectively respond to those experiencing family violence, responses are not widely integrated as part of routine health care. A lack of evidence testing models and approaches for health sector integration, alongside challenges of transferability and sustainability, means the best approach in responding to family violence is still unknown. The Primary Health Care Family Violence Responsiveness Evaluation Tool was developed as a guide to implement a formal systems-led response to family violence within New Zealand primary health care settings. Given the difficulties integrating effective, sustainable responses to family violence, we share the experience of primary health care sites that embarked on developing a response to family violence, presenting the enablers, barriers and resources required to maintain, progress and sustain family violence response development. Methods: In this qualitative descriptive study data were collected from two sources. Firstly semi-structured focus group interviews were conducted during 24-month follow-up evaluation visits of primary health care sites to capture the enablers, barriers and resources required to maintain, progress and sustain a response to family violence. Secondly the outcomes of a group activity to identify response development barriers and implementation strategies were recorded during a network meeting of primary health care professionals interested in family violence prevention and intervention; findings were triangulated across the two data sources. Results: Four sites, representing three PHOs and four general practices participated in the focus group interviews; 35 delegates from across New Zealand attended the network meeting representing a wider perspective on family violence response development within primary health care. Enablers and barriers to developing a family violence response were identified across four themes: 'Getting started', 'Building effective relationships', 'Sourcing funding' and 'Shaping a national approach to family violence'. Conclusions: The strong commitment of key people dedicated to addressing family violence is essential for response sustainability and would be strengthened by prioritising family violence response as a national health target with dedicated resourcing. Further analysis of the health care system as a complex adaptive system may provide insight into effective approaches to response development and health system integration. [ABSTRACT FROM AUTHOR]

Background Parental empowerment is known to increase parents' resources and to reduce stress, and therefore to improve family well-being. Professionals working in family services (child health clinics, school health care, day care, preschool and primary school) encounter families in various everyday settings and can significantly support parental empowerment. Aim This study aimed (i) to identify associations between parental empowerment and demographic and family service characteristics (i.e. parents' participation and perceived influence, decision-making and access to information) and (ii) to identify predictors of maternal and paternal empowerment. Method Study design was cross-sectional. Participants were mothers (n = 571) and fathers (n = 384) of children aged 0-9 who were selected by stratified random sampling in 2009. Associations were analysed by t-test, one-way analysis of variance and multiple linear regression analysis. Results Sufficient perceived influence and joint decision-making by family and professionals on family service appointments emerged as significant variables of increased parental empowerment. Access to adequate information about municipal services was also associated with high empowerment. These family service characteristics were associated with parents' sense that they were able to manage in everyday life and had influence on specific service situations and family services in general. Mothers with a child aged under 3 or a child in home care or primary school, and fathers with a lower education feel less empowered in family services than other parents. Conclusion Knowledge about the factors associated with parental empowerment can contribute to further reinforce parental empowerment, help identify parents who need special attention and contribute to the development of family services. [ABSTRACT FROM AUTHOR]

The role of incarceration and community reentry after incarceration has been studied extensively for individual and community health; however, little attention has been given to the experiences of individuals who provide support to those in reentry. Through a community-academic partnership, seven focus groups were conducted with 39 individuals supporting a family member in reentry in the summer of 2012. The primary objectives of the focus groups were to explore community experiences and perspectives regarding providing support during a family members reentry from a period of incarceration and any desired support for themselves during this time. Five themes emerged under a metatheme of stress, indicating that family members experience acute stress as a result of family reentry that adds to the chronic stress they already endure. Programs that acknowledge the difficult role of family members as supporters during an individual's reentry and provide support to them are desperately needed. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes contributes significantly to the burden of disease in South Africa. Proteinuria is a marker for chronic kidney and cardiovascular disease. All guidelines recommend testing for microalbuminuria because intervention at this stage can prevent or delay the onset of disease. Currently, none of the community health centres (CHCs) in Cape Town test for microalbuminuria, and there are concerns about its costs and feasibility. Objectives: The aim of this study was to assess the practicality, costs and consequences of introducing a screening test for microalbuminuria into primary care. Design: Chronic care teams were trained to screen and treat all patients with diabetes (n = 1 675) over a one-year period. The fidelity of screening, costs and consequences was evaluated. Setting and subjects: Patients with type 2 diabetes and chronic care teams at two community health centres in the Cape Town Metro district. Outcome measures: Data to evaluate screening were extracted from the records of 342 randomly selected patients. Data to evaluate treatment were taken from the records of all 140 patients diagnosed with microalbuminuria. Results: Of the patients with diabetes, 14.6% already had macroalbuminuria. Of the eligible patients, 69.9% completed the screening process which led to a diagnosis of microalbuminuria in another 11.7%. Of those who were positively diagnosed, the opportunity to initiate angiotensin-converting enzyme (ACE) inhibitors was missed in 20%, while 49.2% had ACE inhibitors initiated, or the dosage thereof increased. It would cost the health system an additional R1 463 to screen 100 patients and provide additional ACE inhibitor treatment for a year to the 12 that were diagnosed. Conclusion: The study demonstrated the feasibility of incorporating microalbuminuria testing into routine care. The costs involved were minimal, compared to the likely benefits of preventing end-stage renal failure and the costs of dialysis (estimated at R120 000 per year per patient). [ABSTRACT FROM AUTHOR]

This article summarizes the findings of a project investigating women’s experiences with the Canadian child protection (CPS) and family law (FLS) systems. We examine both service systems together here because although both privilege children’s best interests as their primary consideration and define the concept similarly, the two systems diverge in their expectations of women relative to child custody. While FLS requires women to accept custody arrangements that provide close and continued contact between themselves and their former abusive partners, CPS expects women to leave these same abusive partners or risk removal of their children. The results of thirty-five qualitative interviews with women demonstrate their struggles, firstly, in having their experiences of intimate partner violence (IPV) recognized by professionals in the FLS, and, secondly, in becoming caught between the opposing expectations of CPS and FLS while not receiving help from either. Recommendations for change to improve these services are included in this article. [ABSTRACT FROM PUBLISHER]

leitlein l., smit e.s., de vries h. & hoving c. (2012) Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention. Journal of Advanced Nursing 68(10), 2185-2194. Abstract Aims. This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Background. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. Methods. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices ( n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. Results. The majority of practice nurses did not intend to adopt the new intervention ( n = 85; 61·2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Conclusion. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. [ABSTRACT FROM AUTHOR]