A descriptive examination of international family/shared meals: Prevalence, meal types, media at meals, and emotional well-being.

INTRODUCTION: Studies in the United States have shown associations between family/shared meal frequency and child health and well-being. Less is known about family/shared meal characteristics (e.g., frequency, meal type, meal activities) in adults and international samples and whether there are protective associations between family/shared meal frequency and emotional well-being. Also unknown, is whether family meals provide protective associations for other family members in the household. METHOD: In a 2022 cross-sectional study, an online survey was administered in the United States, Italy, and Germany. One adult respondent (49.5% female; Mage = 45.6) from each household (n = 1,983) reported on family/shared meals and well-being. A second family member (e.g., partner, child) responded in a subset of households (n = 1,915). Descriptive statistics by country, Spearman correlations between meal frequency and well-being, and Kruskal-Wallis comparisons of mood indicators across countries were run. RESULTS: The majority of adults across countries engaged in six or more family/shared meals per week, with more meals on weekends. Breakfast, lunch, and dinner family/shared meals were more common on weekends, and European countries reported engaging in a higher prevalence of all meal types. Higher frequency of family/shared meals was significantly correlated with fewer depressive symptoms, more connectedness, and higher levels of happiness in adults across countries and in a second household member. DISCUSSION: Family/shared meals were beneficial across an international sample and may provide protective spillover effects for multiple household members. Clinicians and researchers who work with families may want to consider assessing for and intervening on family meal frequency. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A three-arm randomized controlled trial using ecological momentary intervention, community health workers, and video feedback at family meals to improve child cardiovascular health: the Family Matters study design.

BACKGROUND: Numerous observational studies show associations between family meal frequency and markers of child cardiovascular health including healthful diet quality and lower weight status. Some studies also show the "quality" of family meals, including dietary quality of the food served and the interpersonal atmosphere during meals, is associated with markers of child cardiovascular health. Additionally, prior intervention research indicates that immediate feedback on health behaviors (e.g., ecological momentary intervention (EMI), video feedback) increases the likelihood of behavior change. However, limited studies have tested the combination of these components in a rigorous clinical trial. The main aim of this paper is to describe the Family Matters study design, data collection protocols, measures, intervention components, process evaluation, and analysis plan. METHODS/DESIGN: The Family Matters intervention utilizes state-of-the-art intervention methods including EMI, video feedback, and home visiting by Community Health Workers (CHWs) to examine whether increasing the quantity (i.e., frequency) and quality of family meals (i.e., diet quality, interpersonal atmosphere) improves child cardiovascular health. Family Matters is an individual randomized controlled trial that tests combinations of the above factors across three study Arms: (1) EMI; (2) EMI + Virtual Home Visiting with CHW + Video Feedback; and (3) EMI + Hybrid Home Visiting with CHW + Video Feedback. The intervention will be carried out across 6 months with children ages 5-10 (n = 525) with increased risk for cardiovascular disease (i.e., BMI ≥ 75%ile) from low income and racially/ethnically diverse households and their families. Data collection will occur at baseline, post-intervention, and 6 months post-intervention. Primary outcomes include child weight, diet quality, and neck circumference. DISCUSSION: This study will be the first to our knowledge to use multiple innovative methods simultaneously including ecological momentary intervention, video feedback, and home visiting with CHWs within the novel intervention context of family meals to evaluate which combination of intervention components are most effective in improving child cardiovascular health. The Family Matters intervention has high potential public health impact as it aims to change clinical practice by creating a new model of care for child cardiovascular health in primary care. TRIAL REGISTRATION: This trial is registered in clinicaltrials.gov (Trial ID: NCT02669797). Date recorded 5/02/22.

A Three-Arm Randomized Controlled Trial Using Ecological Momentary Intervention, Community Health Workers, and Video Feedback at Family Meals to Improve Child Cardiovascular Health: The Family Matters Study Design.

Background: Numerous observational studies show associations between family meal frequency and markers of child cardiovascular health including healthful diet quality and lower weight status. Some studies also show the "quality" of family meals, including dietary quality of the food served and the interpersonal atmosphere during meals, is associated with markers of child cardiovascular health. Additionally, prior intervention research indicates that immediate feedback on health behaviors (e.g., ecological momentary intervention (EMI), video feedback) increases the likelihood of behavior change. However, limited studies have tested the combination of these components in a rigorous clinical trial. The main aim of this paper is to describe the Family Matters study design, data collection protocols, measures, intervention components, process evaluation, and analysis plan. Methods/design: The Family Matters intervention utilizes state-of-the-art intervention methods including EMI, video feedback, and home visiting by Community Health Workers (CHWs) to examine whether increasing the quantity (i.e., frequency) and quality of family meals (i.e., diet quality, interpersonal atmosphere) improves child cardiovascular health. Family Matters is an individual randomized controlled trial that tests combinations of the above factors across three study Arms: (1) EMI; (2) EMI+Virtual Home Visiting with CHW+Video Feedback; and (3) EMI+Hybrid Home Visiting with CHW+Video Feedback. The intervention will be carried out across 6 months with children ages 5-10 (n=525) with increased risk for cardiovascular disease (i.e., BMI ≥75%ile) from low income and racially/ethnically diverse households and their families. Data collection will occur at baseline, post-intervention, and 6 months post-intervention. Primary outcomes include child weight, diet quality, and neck circumference. Discussion: This study will be the first to our knowledge to use multiple innovative methods simultaneously including ecological momentary assessment, intervention, video feedback and home visiting with CHWs within the novel intervention context of family meals to evaluate which combination of intervention components are most effective in improving child cardiovascular health. The Family Matters intervention has high potential public health impact as it aims to change clinical practice by creating a new model of care for child cardiovascular health in primary care. Trial Registration: This trial is registered in clinicaltrials.gov (Trial ID: NCT02669797). Date recorded 5/02/22.

Couple and family interventions for high mortality health conditions: A strategic review (2010-2019).

The earliest publications in the field of marriage and family therapy introduced interventions conducted with families experiencing complex health conditions. This strategic review captures an evaluation of efficacy for 87 couple and family interventions published between 2010 and 2019 with a focus on the leading causes of mortality in the United States. These health conditions include chromosomal anomalies and accidents with infants aged 0-4 years; accidents and cancer among children aged 5-14; accidents among adolescents aged 15-24; and heart disease, cancer, accidents, chronic lower respiratory diseases, stroke, Alzheimer's disease, diabetes, influenza/pneumonia, and nephritis/nephrosis among adults 25 and older. Results support the need for greater inclusion of couples and families in assessments and interventions. The greatest chasm in efficacy research was with minoritized couples and families. Implications include ways to initiate couple and family interventions in the context of health conditions with attention given to accessibility, recruitment, retention, and evaluation.

Family relationships and the interpersonal theory of suicide in a clinically suicidal sample of adolescents.

In a sample of suicidal adolescents (N = 117), we sought to identify how adolescents' attachment to their parents related to a key mechanism of suicide from the Interpersonal Theory of Suicide (IPTS). We tested both attachment-anxiety and attachment-avoidance, to both mother- and father-figures as correlates of the IPTS construct, perceived burdensomeness (PB). In addition, we tested PB as a mediator between these attachment variables and adolescent suicide ideation in a path analysis. Our path analysis indicated both mother- and father-related attachment anxiety were associated with PB and PB was related to suicide ideation. We also found an indirect effect of father-related attachment anxiety on suicide ideation. This study provides empirical support for earlier systemic work that proposes how family relationships may influence an adolescent's suicidal ideation. Finally, we provide practical clinical suggestions for how therapists may implement a systemic framework to address a suicidal adolescent and their family relationships.

Identification of resiliency processes in dual-trauma couples: An exploration of self-reported relational strengths and weaknesses.

OBJECTIVE: Empirical knowledge about "dual-trauma couples" (DTC), characterized by both partners with a history of trauma exposure and presentation of trauma-related symptoms, is especially deficient. We analyzed DTC partners' qualitative data culled from the Relationship Evaluation Questionnaire (Busby et al., 2001) to ascertain dyadic resiliency processes within dual-trauma couples. METHOD: A data-reductive thematic analysis on short-answer responses of reported relational strengths and weaknesses from female (n = 822) and male partners' (n = 831) yielded several processes that provide insight into individual perceptions, behaviors, and past experiences, and dyadic interactions that may foster or hinder effective resilience in DTC. RESULTS: Participant responses highlighted existing dyadic strengths that fostered effective couple adaptative processes: shared beliefs and goals, mutual collaboration and psychological flexibility, and dyadic connectedness. Barriers to couple resiliency included individual perceptions, behaviors, and past experiences, and dyadic interactions that exacerbated relational instability, emotional unsafety, contentious communication, and difficulties with distress tolerance. CONCLUSIONS: Results promote a balanced conceptualization (i.e., inclusion of both adaptive and maladaptive interactions) of couples affected by trauma exposure. Implications for clinical treatment and several areas for future research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

There, but gone.

The author, a licensed marriage and family therapist, briefly describes his therapy with a male patient who had suicidal ideation over a broken relationship with a lover. The patient had agreed to at least a half-dozen "no-harm contracts" to not kill himself. However, the patient no-showed at his next visit, and was found by police to have taken his life. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

We are in this together: Maintaining our health care teams' wellness during challenging times.

Efforts to prevent or mitigate burnout in health care practice(s) are longstanding in both biomedical and mental health arenas-from early training in classrooms, internships, and residencies to postgraduate work in primary, secondary, tertiary, and other care contexts (Berg & Garrard, 1980; Chen et al., 2019; Prins et al., 2007). From generic advice about work/ life balance, sleep hygiene, physical activity, and healthy eating to specific interventions across individual and organizational levels designed to support trainees and providers who are personally decompensating and/or potentially putting their patients at risk, scientific and lay literature, resources, programming, and protocols are extant. Whether and how we-as individuals, care teams, and care systems-have advanced these efforts effectively are similarly diverse. COVID-19 changed this conversation-or at least the urgency of it. In some ways, this makes perfect sense in light of the increased hours that many of us suddenly found ourselves working (read: no more work/life balance). But there were a lot of other things-less expected things happened. In this issue, Cornelius et al.'s (2021) engagement with health care workers in New York City is illustrative. Unlike traversing something that is difficult but has a clear endpoint (like a 24-hr shift or a four-year residency), we do not know when this pandemic will be over. It feels like running a marathon with no mile markers or celebratory finish line. And unlike offering responsive care to a specific community in a defined geographic area (like one impacted by a terrorist attack or a hurricane), we do not know where this pandemic's virus is. Because we cannot actually see COVID-19, we worry more about catching it. If we catch it, we might bring it home. If we bring it home, we could kill our spouses. Or our children. Maybe our whole families. It is hard to do good work when we carry emotional burdens like that. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Family Medicine Physicians' Perspectives Regarding Rural Behavioral Health Care: Informing Ideas for Increasing Access to High-Quality Services.

Primary care settings often function as the front lines for behavioral health services in rural areas. The lack of formal behavioral health care in rural areas is also well documented. Rural family practice physicians were interviewed regarding the state of behavioral health care in their communities and their ideas for increasing access to quality care. Thirteen family practice physicians in rural locations participated in in-depth semi-structured interviews. Interviews were transcribed, coded, and analyzed following a phenomenological design. Physicians described a lack of quality behavioral health services and challenges for integrating and collaborating with those that do exist. Participants also described the changing role of stigma, service delivery strategies that are currently working, and the unique role primary care plays in rural behavioral health care. Several ideas for increasing access to and efficacy of services are discussed; these ideas are informative for future research and interventions.

Testing Basic Assumptions of the Interpersonal Needs Questionnaire-15 in a Sample of Clinically Depressed and Suicidal Youth.

OBJECTIVE: Suicide is a leading cause of death in adolescence. The mechanisms of adolescent suicidality, however, are not fully understood. Although the Interpersonal-Psychological Theory of Suicide, as assessed by the Interpersonal Needs Questionnaire-15 (INQ), may be a promising framework, systematic study of its utility during adolescence is lacking. METHOD: To this end, we utilized factor analyses and hierarchical regression analyses to test the factor structure, correlates, and predictive validity of the INQ in a sample of clinically depressed and suicidal adolescents (N = 120, aged 12-18). The sample was mostly female (81.9%), ethnically diverse (68.2% non-White) and with nearly a third identifying as a sexual minority (31.8%). RESULTS: Contrary to studies including adult samples in which a two-factor solution is identified, results within this sample indicated three factors: perceived burdensomeness, thwarted belongingness, and perceived isolation. Perceived burdensomeness and the interaction between perceived burdensomeness and perceived isolation predicted suicide ideation above and beyond depression, but thwarted belongingness and perceived isolation did not. CONCLUSION: Perceived burdensomeness appears to play a role in adolescent suicidality and may be a point of intervention, yet the notable deviation from previous findings and the relative weakness of two of the factors warrant further study.

Evaluative coping, emotional distress, and adherence in couples with Type 2 diabetes.

INTRODUCTION: Spousal support is one of the strongest and most consistent predictors of Type 2 diabetes treatment adherence. However, the effects of both spouses' evaluations of dyadic coping on emotional distress and patients' physical health remain largely unknown. METHOD: Dyadic data from 117 married couples in which one member is diagnosed with Type 2 diabetes were evaluated in two separate models to explore the associations between (a) patients' and spouses' depression symptoms and patients' adherence to dietary and exercise regimens, and (b) patients' and spouses' acute stress levels and patients' adherence to dietary and exercise regimens. Finally, evaluative dyadic coping was included as a possible moderator between these associations. RESULTS: Results from an actor-partner interdependence model revealed significant actor effects of patients' depression symptoms on patients' adherence to dietary and exercise regimens. Spouses' evaluation of dyadic coping attenuated the direct paths between spouses' depression symptoms and patients' adherence to dietary regimens. No direct pathways were found from patients' or spouses' acute stress to patients' adherence to dietary and exercise regimens. However, spouses' evaluation of dyadic coping attenuated the direct paths between spouses' acute stress and patients' adherence to dietary regimens. DISCUSSION: Tapping into spouses' evaluations of dyadic coping has significant implications for patients' diabetes health outcomes (e.g., adherence to dietary and exercise treatment regimens). Findings from this study highlight the need for systemic interventions targeting both partners. (PsycINFO Database Record

Community health workers in diabetes care: A systematic review of randomized controlled trials.

INTRODUCTION: Maintaining optimal self-care in managing Type 2 diabetes is a common struggle for patients due to several barriers, including access to quality services, financial insecurity and/or lack of insurance, and emotional distress. Consequently, morbidity and mortality rates are high, alongside rising health care costs. Alternative approaches that address common barriers require further investigation. This systematic review of randomized controlled trials examines the effectiveness of using community health workers (CHWs) in Type 2 diabetes care. This effort is warranted to orient practitioners and researchers to the state of existing knowledge, and to direct clinical practice and future research. METHOD: Data were extracted from 17 peer-reviewed articles; they were examined with respect to theory integration, CHW intervention design, outcome variables, and findings. RESULTS: Approximately one-third of articles explicitly integrated theory into their research conceptualization and design. There was great variation across intervention dosages, attrition rates, and methods of CHW training. Main foci across studies' findings suggest that a CHW intervention has significant impacts on physical health outcomes, diabetes knowledge, self-care behaviors, and emotional distress and well-being. DISCUSSION: Principal implications relate to the need for more research regarding CHW intervention types and methods, and further investigation about the mechanisms of change within a CHW-delivered intervention. Findings support the case for more CHWs in treatment teams to bridge patients with the medical system. This research will serve to better equip providers in the support of patients managing Type 2 diabetes and advance the Triple Aim of health care. (PsycINFO Database Record

Clinical Training and Practice Patterns of Medical Family Therapists: A National Survey.

Medical family therapy (MedFT) has gained momentum as a framework in healthcare for individuals and families. However, little is known about what background training and clinical experiences Medical Family Therapists (MedFTs) have in everyday practice. This study investigated the clinical training of MedFTs and their practices in a variety of care settings. A survey was completed by 80 participants who use a MedFT framework in practice, with descriptive data on curriculum, clinical training, and treatment characteristics. Results reflect that many MedFTs lack formal coursework in key content areas of their graduate training and work primarily with psychological and relational concerns. Future research is needed to explore how MedFTs practice around specific mental health and chronic health conditions.

Couples coping with cardiovascular disease: A systematic review.

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of death for both men and women. Its potential ramifications on all aspects of life, for patients and partners, are just beginning to be understood. Although research has focused on the individual who has received the diagnosis, relatively little is known about how couples manage CVD. This article presents a systematic review of literature that focuses on how couples cope with one partner's CVD diagnosis. A systematic review is warranted to orient practitioners, policy makers, and researchers to the state of existing knowledge and its gaps and to identify what still needs to be done. METHOD: Data were extracted from 25 peer-reviewed articles that met our inclusion criteria. Content examined included theory integration, coping constructs and instruments, samples, analyses, and findings. RESULTS: Most articles successfully integrated theory in the studies' respective conceptualizations and designs. Most used valid and reliable instruments to measure coping. Principal limitations included problematic sampling strategies and analysis techniques, thereby limiting external validity. DISCUSSION: Principal implications of this review's findings relate to our fields' need to provide more care focused on dyads (vs. individual patients), adopt an integrated model in health care, and conduct systemic, longitudinal research to gain a better grasp on how coping changes over time. Doing so will serve to better equip providers in the support of patients and partners living with CVD. (PsycINFO Database Record

A decade review of publications in Families, Systems, & Health: 2005-2015.

INTRODUCTION: The purpose of this investigation was to review recent publication content and trends in Families, Systems, & Health (FSH). How do the journal's articles reflect current and emerging challenges in health care? We hope that our findings can guide special issues and content foci. METHOD: All work published in FSH between 2005 and 2015 was included (n = 452); each piece was coded for article type, general foci, and specific foci. RESULTS: The most common type of article published over the 10-year time frame was research reports (43%; n = 195), followed by other types (e.g., tribute pieces, poems), commentaries, conceptual/theory papers, literature reviews, and case studies. The most common general focus included family health and/or functioning (28%; n = 128). The most common specific foci centered on children (15%; n = 55). Common themes found in FSH's most frequently cited publications included family relationships in care, chronic physical illnesses, and mental health. Marked trends in journal content included increases in articles targeting family health and/or functioning and primary care and decreased attention to theory. DISCUSSION: FSH's emphasis on research reports to inform current and evolving interventions that target contemporary health challenges suggests that the journal is keeping stride with the most pressing issues in health care today. Future special issues can continue to serve and meet these needs. FSH's robust inclusion of other article types sustains the journal's mission to advance multiple ways of understanding health-care phenomena.

Disaster behavioral health capacity: Findings from a multistate preparedness assessment.

PURPOSE: To identify gaps in disaster behavioral health, the Preparedness and Emergency Response Learning Center (PERL) at the University of Minnesota's School of Public Health supported the development and implementation of a multistate disaster behavioral health preparedness assessment. Information was gathered regarding worker knowledge of current disaster behavioral health capacity at the state and local level, and perceived disaster behavioral health training needs and preferences. METHODS: Between May and July 2015, 143 participants completed a 31-item uniform questionnaire over the telephone by a trained interviewer. Trained interviewers were given uniform instructions on administering the questionnaire. Participants included county and city-level public health leaders and directors from Minnesota, Wisconsin, and North Dakota. FINDINGS: Findings demonstrate that across the three states there is a need for improved disaster behavioral health training and response plans for before, during, and after public health emergencies. This study identified perceived gaps in plans and procedures for meeting the disaster behavioral health needs of different atrisk populations, including children, youth, and those with mental illness. There was consistent agreement among participants about the lack of behavioral health coordination between agencies during emergency events. VALUE: Findings can be used to inform policy and the development of trainings for those involved in disaster behavioral health. Effectively attending to interagency coordination and mutual aid agreements, planning for effective response and care for vulnerable populations, and targeted training will contribute to a more successful public health response to emergency events.

A call to engage youth in health research.

Community-based participatory research (CBPR) is characterized by its collaborative efforts between professional researchers and lay community members to design, implement, and iteratively evaluate interventions. This approach creates knowledge and improves practice in ways that reflect the collective wisdom and expertise of all involved stakeholders. It represents a significant departure from conventional "top down" methods that define "collaboration" as professionals working with each other-but not with patients and families. It is our position, however, that these exciting developments are only most visible in adult medicine. We believe that it is important to engage youth in health-related CBPR for three primary reasons which are provided in this article. Examples of youth-engagement in health research are also provided. It is important that we do not leave our youth on the sidelines as we advance health care research. During this critical time in health care, we must endeavor to engage our youth as active stakeholders. As we use methods that bridge our professional expertise with teens' lived experience and wisdom, we can create sustainable interventions that are effective in preventing or mitigating the conditions that weigh most heavily on us all. (PsycINFO Database Record

A response to "joint principles: integrating behavioral health care into the patient-centered medical home".

Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011). The American Association for Marriage and Family Therapy (AAMFT) represents a mental health profession with a long track record in integrated primary care, particularly with family medicine. The authors begin by affirming several core themes in the joint principles-behavioral health (JP-BH) statement. They then offer a systemic/relational perspective on the patient-centered medical home that goes beyond the focus of the JP-HP.

Including the family in research evaluating integrated care: a call for expanding investigators' scope beyond single-person measures.

As providers across the fields of behavioral- and biomedical- care advance efforts to include patients' families in the care that they provide, we must also include families in the research that we conduct. Additional knowledge about families in treatment could help us screen families at risk for poor outcomes, design more appropriate family based interventions, and more completely assess the impact(s) of interventions on both patients and their families. In this account, we outline assessments that are useful in responding to this call. We consider tools that target general family functioning, that are sensitive to change and progress, and that are adaptable to common time- and administrative- constraints within medical settings. We highlight strengths and weaknesses within the pool of measures that are currently available, and offer suggestions and next-steps in instrument-design and development.