Families Systems & Health最新文献

{"title":"Latent class analysis of behavioral health service use among underserved youth in integrated primary care.","authors":"Alfonso L Floyd, Chimereodo Okoroji, Katrina A Markowicz, Stephanie Crewe, Heather A Jones","doi":"10.1037/fsh0000992","DOIUrl":"https://doi.org/10.1037/fsh0000992","url":null,"abstract":"<p><strong>Objective: </strong>To identify distinct and heterogeneous typologies of behavioral health service use and associated factors based on need, predisposing, and enabling determinants, among a predominantly Black and publicly insured youth population in integrated pediatric primary care (IPPC). This study aims to address the unmet behavioral health needs of youth by understanding the characteristics associated with behavioral health engagement in order to tailor interventions accordingly.</p><p><strong>Method: </strong>Latent class analysis was used to explore distinct subgroups among 416 youth (<i>M</i>_age = 10.81, <i>SD</i>_age = 3.74; 51% female; 74% Black; 74% public insurance) receiving integrated behavioral health services in a large, urban pediatric primary care setting in the Southeastern United States. Caregivers completed the Pediatric Symptom Checklist-17 to assess psychosocial problems in youth.</p><p><strong>Results: </strong>Latent class analyses revealed two distinct classes of IPPC youth: \"high attention and mixed problems,\" primarily younger boys with nonprivate insurance coverage, and \"low attention/externalizing and moderate internalizing problems,\" primarily older girls with private insurance coverage.</p><p><strong>Conclusions: </strong>These findings highlight the need for behavioral health services in IPPC for behavioral health specialists, pediatricians, and other interdisciplinary professionals to provide tailored, culturally responsive, and flexible treatment to address the unmet and unique behavioral health needs of this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to preventive care and medical screenings among children with Down syndrome in South Carolina as described by parents.","authors":"Vinita Oberoi Leedom, Sonja A Rasmussen, Russell Kirby, Geoffrey I Scott, Dwayne E Porter, Daniela B Friedman","doi":"10.1037/fsh0000987","DOIUrl":"https://doi.org/10.1037/fsh0000987","url":null,"abstract":"<p><strong>Introduction: </strong>Studies have evaluated the receipt of preventive care among children with Down syndrome, but barriers surrounding access to screenings and health care in general have not been well described among this population across the United States. This study describes parental perspectives on barriers to screenings and health care.</p><p><strong>Method: </strong>Twenty-four semistructured interviews with parents of children with Down syndrome were administered to families across South Carolina in 2022. Thematic analysis was used to identify salient themes related to barriers to care.</p><p><strong>Results: </strong>Barriers to preventive care identified by families included ineffective care coordination, insurance-related concerns, health care provider access shortages, and language barriers.</p><p><strong>Discussion: </strong>Findings can be used to address problems with major aspects of medical care and to make care more family-centered and accessible for children with Down syndrome. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved pediatric behavioral health appointment scheduling in an integrated primary care program.","authors":"Anjali D Sapkal, Jasmine R Holt, Devin P Adams, Hilary M Bowers, Vanessa Sarabia, Alissa Jae Lazo-Kim, Jason Schweitzer, Andrew Richardson, Anne Bird, Kathryn A Hollenbach","doi":"10.1037/fsh0000985","DOIUrl":"https://doi.org/10.1037/fsh0000985","url":null,"abstract":"<p><strong>Introduction: </strong>To better understand appointment scheduling for pediatric behavioral health (BH) referrals, we examined appointment scheduling behavior among patients with and without access to primary care mental health integration (PCMHI).</p><p><strong>Method: </strong>A prospective cohort study compared PCMHI and non-PCMHI pediatric patients with BH referrals from January 17, 2022, to June 10, 2022. Six pediatric primary care clinics affiliated with a southern California Children's Hospital were studied: two PCMHI and four non-PCMHI clinics with similar patient demographic characteristics. BH referrals at PCMHI clinics are directly referred to the embedded integrated health therapists. Non-PCMHI clinics referred patients to community BH services. Data were collected from electronic health record abstraction and telephone interviews.</p><p><strong>Results: </strong>PCMHI (<i>n</i> = 471) and non-PCMHI (<i>n</i> = 97) groups did not differ significantly in patient characteristics. About 87.3% (<i>n</i> = 172) of PCMHI patients eligible for an integrated health therapist initial BH appointment scheduled their appointment within 14 days compared to 9.2% (<i>n</i> = 7) of the non-PCMHI patients (χ² = 148.2, <i>p</i> < .001). There was no difference in median days to initial BH appointment between the cohorts, PCMHI: 21 (interquartile range = 15, 27.5) and non-PCMHI: 23 (interquartile range = 13, 35), <i>p</i> = .71. Primary reasons for not scheduling initial BH appointments were similar for both groups and included confusion about the referral and patient/parent busy schedules.</p><p><strong>Conclusion: </strong>Patients in the PCMHI cohort were more likely to schedule their initial BH appointment compared to the non-PCMHI cohort. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preoperative relational screener and associations with weight loss: A pilot feasibility study.","authors":"Haley M Kiser, Keeley J Pratt, Ashleigh Pona, Lindsay Breslin, LeeAnn Swager","doi":"10.1037/fsh0000967","DOIUrl":"https://doi.org/10.1037/fsh0000967","url":null,"abstract":"<p><strong>Introduction: </strong>Family factors and stressful life events are reasons for not proceeding immediately with metabolic and bariatric surgery, yet there is no formal screening for these factors during routine preoperative psychological evaluation. This pilot study determined the feasibility of implementing a preoperative relational screener and referral to a behavioral health consultation, and associations between relational factors with 12-month weight loss.</p><p><strong>Method: </strong>Preoperative patients (<i>N</i> = 137) were asked to participate. Feasibility was noted by interest, completion of screener, screening as impaired on the relational measures, and completion of consultation. For patients proceeding to surgery, five models were conducted to determine changes in percent total weight loss (%TWL) over 12 months, based on the interaction with visits and screening as impaired, family functioning, stressful life events, death of a close friend or relative, and major financial crisis.</p><p><strong>Results: </strong>Sixty-seven patients were interested; 57 completed the screener (85.1%, 79% female, 72% White); 43 screened (75.4%) as impaired on ≥ 1 assessment and were eligible for the consultation, 21 patients (48.8%) completed the consultation. Patients who screened as impaired had poorer %TWL (<i>p</i> = .013) compared to patients who did not. Patients with ≥ 1 stressful life event had poorer %TWL compared to those who did not experience any (<i>p</i> = .008), including the top two endorsed events-death of a close friend (<i>p</i> ≤ .001) or a major financial crisis (<i>p</i> = .009).</p><p><strong>Conclusion: </strong>The relational screener provides additional information about patients' psychosocial needs and challenges before surgery. This is critical considering the majority of participants screened as impaired on at least one assessment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supervision needs of novice behavioral health clinicians in integrated primary care settings.","authors":"Nicholas Schmoyer-Edmiston, Gulsah Kemer, Stacy A Ogbeide, Megan LaLonde-Pittman, Catalina Kraft, Lauren Robins, Judith Wambui Preston","doi":"10.1037/fsh0000986","DOIUrl":"https://doi.org/10.1037/fsh0000986","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical supervision is a foundational experience for novice behavioral health clinicians (BHCs), with the provision of high-quality supervision in the integrated primary care (IPC) context being imperative. While the literature highlights skills, knowledge, and considerations for supervisors in these settings, less is known about the supervision needs of novice BHCs.</p><p><strong>Method: </strong>This article presents the findings of a classical Delphi study with a panel of 12 novice BHCs who have received supervision in an IPC setting.</p><p><strong>Results: </strong>The Delphi panelists achieved statistical consensus on 68 statements across nine themes, highlighting a wide range of supervisory needs of novice BHCs in IPC settings.</p><p><strong>Discussion: </strong>This study expands upon the existing literature on supervision in IPC settings by indicating the various needs of novice BHCs receiving supervision in IPC. Implications for the planning, implementation, and evaluation of supervision in IPC settings are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective associations of insomnia and nightmares with suicidal behavior among primary care patients.","authors":"Logan M Smith, Justin C Baker, Craig J Bryan","doi":"10.1037/fsh0000973","DOIUrl":"https://doi.org/10.1037/fsh0000973","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia and nightmares have both been associated with suicide risk and are both known to be commonly reported in a primary care setting. However, we are unaware of any studies examining the sleep-suicide relationship in the primary care setting. Clarifying these relationships could reveal important clues for improving suicide prevention efforts in primary care and other medical settings.</p><p><strong>Method: </strong>Participants included 2,744 primary care patients recruited from six clinics located at five U.S. military installations. Participants completed measures of suicidal ideation, insomnia, and nightmares at baseline and suicidal ideation and suicide attempts were tracked at 6- and 12-month follow-up interviews.</p><p><strong>Results: </strong>Of the 1,792 patients with follow-up data, 57 (3.2%) attempted suicide during the 12-month follow-up. Patients who attempted suicide during follow-up were more likely than patients who did not attempt suicide to have clinical insomnia and nightmares at least weekly. When adjusting for baseline suicidal ideation, clinical insomnia and nightmares at least weekly remained significant predictors of follow-up suicide attempts.</p><p><strong>Conclusions: </strong>Our findings suggest that insomnia and nightmares are accurate predictors of subsequent suicidal behavior among a primary care population and may offer positive predictive value for suicidal behavior over and above what can be provided by assessing suicidal ideation alone. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextualizing relationship quality between pregnant Black women and the fathers of their babies: A latent class analysis.","authors":"Rosemary Adaji, Dawn P Misra, David Todem, Dorothy Pathak, Carmen Giurgescu","doi":"10.1037/fsh0000982","DOIUrl":"https://doi.org/10.1037/fsh0000982","url":null,"abstract":"<p><strong>Background: </strong>Black women in the United States experience higher rates of adverse maternal and birth outcomes (e.g., depressive symptoms and preterm birth), influenced by social and psychosocial factors including mother-father relationship quality. Existing measures of relationship quality often overlook the unique dynamics within Black families, requiring a more nuanced approach.</p><p><strong>Objective: </strong>This study aims to contextualize the multidimensional nature of relationship quality between pregnant Black women and the fathers of their babies.</p><p><strong>Method: </strong>Using a cross-sectional design, we analyzed data from 405 women enrolled in the Biosocial Impacts on Black Births study. Participants completed questionnaires at 19-29 weeks gestation on six indicators of relationship quality: frequency of contact, frequency of father's involvement during pregnancy, relationship before and during pregnancy, support, and conflict. Latent class analysis was used to identify a construct of relationship quality.</p><p><strong>Results: </strong>Three distinct classes of relationship quality were identified: \"no relationship,\" \"conflictual relationship,\" and \"good relationship.\" Sensitivity analyses showed that while marital or cohabitation status was highly correlated with both the relationship indicators and identified classes, its inclusion as an additional indicator did not alter classification in the latent class model. These classes highlight the intricacies of relationship dynamics, which may be specific to Black families.</p><p><strong>Conclusion: </strong>This study underscores the importance of considering the multifaceted context of relationship quality, which is essential for designing culturally informed public health strategies or interventions. The implications of our findings are significant for both research and clinical interventions aimed at improving birth outcomes for diverse populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of youth involvement in decision making about growth hormone treatment.","authors":"Victoria A Miller, Walter Faig, Morgan Snyder, Elizabeth A Friedrich, Rui Xiao, Adda Grimberg","doi":"10.1037/fsh0000964","DOIUrl":"https://doi.org/10.1037/fsh0000964","url":null,"abstract":"<p><strong>Introduction: </strong>Youth decision-making involvement (DMI) regarding growth hormone (GH) may be beneficial. Identification of correlates of DMI may inform the development of strategies to encourage youth involvement and enhance self-efficacy. The goal of this study was to examine the associations of DMI regarding GH treatment with youth and parent characteristics.</p><p><strong>Method: </strong>Youth, aged 8-14 years (34% female), undergoing GH stimulation testing and a parent (94% mothers) completed surveys at the time of testing (Visit 1; 2019-2023); the Decision-Making Involvement Scale was completed 3 months later. Surveys collected demographics; decision-making involvement; youth coping skills, parent social support; parent autonomy support; parental perceived worry, scarcity, and instability regarding the child's current/future environments; and parents' achievement goals for their child. Correlations and multivariable linear regressions were used to identify factors significantly associated with Decision-Making Involvement Scale subscales.</p><p><strong>Results: </strong>The analysis included 44 parents who indicated that a decision about GH was made and that they discussed the decision with the youth, as well as 30 youth who remembered having such a discussion. On multivariable modeling, youth who had more engaged coping skills and parents who perceived resources in the world as scarce reported higher youth DMI. Parents with older children, less worry about their children being out in the world, and less desire for the child to avoid activities that he/she might not do well in reported higher youth DMI.</p><p><strong>Discussion: </strong>Parental worry and youth coping may be important targets of intervention when seeking to facilitate youth involvement in GH-related decision making. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning to telemental health: Sociodemographic predictors of integrated behavioral health care utilization pre- and peri-COVID.","authors":"Angela R Hiefner, Margaret L Smith, Sarah B Woods","doi":"10.1037/fsh0000981","DOIUrl":"https://doi.org/10.1037/fsh0000981","url":null,"abstract":"<p><strong>Introduction: </strong>The transition to telehealth as a result of the COVID-19 pandemic brought the potential to ameliorate or exacerbate disparities in access to behavioral health care. This study examined patient-specific sociodemographic predictors of integrated behavioral health (IBH) utilization prior to and during COVID to identify variations in care access.</p><p><strong>Method: </strong>Data from three primary care clinics across two medical centers (<i>N</i> = 819 patients), and multivariate general linear modeling, were used to test direct associations between age, sex, primary language, and race/ethnicity and use of IBH services pre-COVID (March 2019-February 2020) versus peri-COVID (March 2020-February 2021). Moderated effects due to health care system-specific telehealth modalities were also tested.</p><p><strong>Results: </strong>Findings suggest patients completing peri-COVID IBH visits were significantly younger than pre-COVID, specifically among patients seen in academic medical center settings with primarily video-based IBH care. Results also indicate patients engaging in peri-COVID IBH were significantly more likely to identify as Hispanic/Latino than non-Hispanic White, specifically among county-funded clinic patients receiving phone-based IBH.</p><p><strong>Discussion: </strong>The transition to telehealth-delivered IBH care may have reduced behavioral health care access for aging patients, who are least likely to be comfortable with video-based care. The use of phone visits may have improved access for underserved Hispanic/Latino patients, who may experience barriers to in-person care. Aligning telemental health care with primary care patients' preferences and access to telehealth-ready devices may amplify IBH-related improvements to mental health care access. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity, equity, and inclusion initiatives: A qualitative study on community health clinic team member perspectives.","authors":"Samantha Pelican Monson, Laura Ramzy, Shambhavi Prathap, Rocio I Pereira","doi":"10.1037/fsh0000953","DOIUrl":"10.1037/fsh0000953","url":null,"abstract":"<p><strong>Introduction: </strong>Health care organizations have recognized the necessity of addressing diversity, equity, and inclusion (DEI)-related issues to promote anti-racism and improve workplace culture. Little is known about the short- and long-term impacts on staff perceptions of inclusion, psychological safety, and belongingness, or what aspects of DEI initiatives hold meaning and value for team members. In particular, the perspective of clinical staff identifying as racial-ethnic minorities/persons of color (POC), who disproportionately occupy support staff roles with less power on the team, has been unclear and understudied. The purpose of this study was to investigate what makes organizational DEI efforts meaningful and impactful in creating a sense of inclusion for POC clinic team members and identifies perceived barriers to inclusion efforts.</p><p><strong>Method: </strong>A qualitative study was conducted across 13 community health clinics within a safety-net health care system in Colorado. Semi-structured interviews were conducted with 40 participants (77.5% female; <i>M</i>_age 41; 77.5% POC). Participants' clinic roles included support staff team members (75%), medical providers (15%), and clinic leadership (10%).</p><p><strong>Results: </strong>Findings illustrated elements of existing DEI initiatives, ranging from the most beneficial to the most detrimental, including some common across all participant groups and some unique to specific races and/or role groups.</p><p><strong>Discussion: </strong>All participants endorsed common beneficial elements of DEI initiatives. Participants identifying as POC and in roles with less power in the clinic (i.e., support staff members) shared elements with the potential to cause harm. Avoiding detrimental elements and incorporating beneficial elements will allow teams to engage in meaningful DEI initiatives. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}