The associations of psychosocial work exposures with suicidal ideation in the national French SUMER study.

BACKGROUND: The literature remains scarce on the work-related risk factors for suicide and suicidal ideation. The objectives were to explore the associations of psychosocial work exposures with suicidal ideation in a nationally representative sample of the working population. METHODS: The study was based on the sample of 25,977 employees (14,682 men and 11,295 women) of the national French 2016-17 SUMER survey. The outcome was suicidal ideation assessed using the PHQ-9 instrument. Psychosocial work exposures included various factors from the job strain and effort-reward imbalance models, and other concepts. Statistical analyses were performed using weighted methods, including weighted logistic regression models. Other occupational exposures and covariates were considered. Gender differences were tested. RESULTS: The prevalence of suicidal ideation was 3.5 % without any difference between genders. Psychosocial work exposures were found to be associated with suicidal ideation. The strongest association was observed between workplace bullying and suicidal ideation. Associations were also found between job strain model factors, job insecurity, low esteem, work-family conflict, ethical conflict, teleworking, and low meaning, and suicidal ideation. The associations were in general similar for men and women. LIMITATIONS: The study had a cross-sectional design and no causal interpretation could be done. A reporting bias and a healthy worker effect may be suspected. CONCLUSION: Psychosocial work exposures played a major role in suicidal ideation. More research may be needed to confirm our results, as suicidal ideation is an important warning signal for suicide prevention. More primary prevention towards the psychosocial work environment may be useful to reduce suicidal ideation at the workplace.

Indirect associations between immigration-related stressors and latine adolescents' depressive symptoms: The moderating roles of familism, nativity, and gender.

OBJECTIVES: This study examined the indirect relationship between immigration-related stressors and depressive symptoms via family conflict and whether familism values moderated this relationship in a sample of U.S. Latine youth. We also explored nativity and gender differences in the predictive model. METHOD: Participants were 306 Midwestern Latine youth (Mage = 15.50, 46.2% girls, 79.9% Mexican origin) and their primary caregivers who completed measures of study constructs. A series of path models examined the potential mediating role of family conflict and the moderating effects of familism values, gender, and nativity. RESULTS: For the overall sample, parental exposure to immigration-related stressors was related to higher youth depressive symptoms through higher levels of family conflict. However, multigroup models revealed significant differences by nativity and gender. The indirect effect through family conflict was only significant for non-U.S.-born youth with low to average levels of familism-support and average to high levels of familism-obligation; it was not significant for U.S.-born youth. Furthermore, the indirect association was only significant for boys with average to high levels of familism-obligation; no significant indirect effects were found for girls. CONCLUSIONS: The results indicate that the indirect pathway linking immigration-related stressors to depressive symptoms via family conflict depends on youth familism values, nativity status, and gender. Findings highlight the distinct effects of familism-support and obligation and the need to consider sociodemographic diversity within Latine communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationships between work-family conflict and life satisfaction and happiness among nurses: a moderated mediation model of gratitude and self-compassion.

Background: Researchers and practitioners are concerned with the impact of work-family conflict on the well-being of workers, including those in the health care sector, and previous research suggested that nurses were experiencing a range of negative outcomes. Aim: To investigate the potentially mediating role of self-compassion and moderating role of gratitude in the relationships between work-family conflict and both life satisfaction and happiness among Saudi nurses. Method: A cross-sectional survey was conducted with 368 nurses (men age = 35.18, SD = 6.67, 70.65% of females). Nurses were recruited via social media using convenience sampling techniques. They completed the Satisfaction with Life Scale, the Subjective Happiness Scale, the Gratitude Questionnaire-6, the Self-Compassion Scale, and the Work-Family Conflict Scale, as well as a set of demographic questions. The data were analyzed using PROCESS MACRO model 4 and 8, and the reporting followed STROBE checklist. Results: As expected, the study found a negative relationship between work-family conflict and both life satisfaction and happiness. These relationships were mediated by self-compassion. For the relationships between work-family conflict and life satisfaction and happiness, and between family-work conflict and happiness, this mediation was moderated by gratitude. Conclusion: This study built on positive psychology and demonstrated that the positive personality traits of self-compassion and gratitude can engender enhanced life satisfaction and happiness among Saudi nurses.

Work-family conflict categories and support strategies for married female nurses: a latent profile analysis.

Objective: To clarify subgroups of married female nurses experiencing work-family conflict (WFC), explore the factors associated with the subgroups, and determine how desired support strategies differ among the subgroups. Methods: Data was collected from a sample of 646 married female nurses from public hospitals in Zhejiang Province, China, in December 2021. Latent profile analysis was used to group the participants, and multiple logistic regression was used to identify factors associated with higher WFC. The STROBE criteria were used to report results. Results: According to latent profile analysis, there were three distinct profiles of WFC among married female nurses: "low-conflict type," "work-dominant-conflict type," and "high-conflict type." These profiles differed in the number of children, night shifts, family economic burden, childcare during working hours, family harmony, colleague support, and nurse-patient relationships. Nurses with multiple children, higher pressures in childcare during working hours, heavier family economic burdens, lower family harmony, lower colleague support, and poorer nurse-patient relationships are more likely to be classified as "high-conflict type" nurses. Conclusion: This study found that married female nurses experience different types of WFCs. The structure of these WFCs and their associated factors suggests that customized intervention strategies can be developed to address the specific needs of married female nurses.

Immigrant Origin and Disability Increase Risk for Anxiety Among Youth During COVID-19: The Role of Unmet Needs for Support in Distance Learning and Family Conflicts.

PURPOSE: Shifting to distance learning due to COVID-19 may decrease teacher support and increase family conflicts, potentially increasing anxiety. Nevertheless, there is scarce information on this topic among disability and/or immigrant-origin groups. Thus, we investigated whether these minority groups reported more anxiety than the reference group-Finnish-origin youth without disabilities-and whether unmet needs for support in distance learning and family conflicts mediated differences in anxiety during the pandemic. Differences in these mediators were also investigated. METHODS: Population-based data of 165,033 youth aged 12 to 29 from the cross-sectional Finnish School Health Promotion study were obtained in 2021 using total population sampling. Logistic regressions with Stata were used to investigate the differences between the target (youth with disabilities, immigrant backgrounds, or both of these characteristics) and reference groups. The Karlson-Holm-Breen method was used to test for mediation. RESULTS: The groups with disabilities (odds ratio [OR] = 4.14 [95% confidence interval (CI): 4.02-4.27]), immigrant backgrounds (OR = 1.15 [95% CI: 1.06-1.25]), or both of these characteristics (OR = 5.03 [95% CI: 4.59-5.52]) reported anxiety more often than the reference group. The difference between the minority and reference groups in unmet needs in distance learning and family conflicts were significant. Immigrant-origin youth with disabilities were most vulnerable to family conflicts, and the groups with disabilities were more prone to unmet needs. Unmet needs and family conflicts accounted for 28% of the association between immigrant-origin youth without disabilities and anxiety, whereas the mediating percentage was smaller for immigrant-origin youth with disabilities (13%) and Finnish-origin youth with disabilities (11%). DISCUSSION: Immigrant-origin youth with disabilities need targeted support to prevent anxiety. Alleviating family conflicts and unmet needs in distance learning during crises could help decrease anxiety. Support for distance learning should be provided to youth with disabilities, regardless of their immigrant backgrounds.

Children's empathy moderates the association between perceived interparental conflict and child health.

Interparental conflict is known to negatively impact child well-being, including behavioral and physiological well-being. Children's empathy - that is, vicariously experiencing others' emotions - may increase children's sensitivity to and the biological repercussions of interparental conflict. Although empathy represents a valued trait and is an important part of socioemotional development, its influence on children's physical health is unknown. This study examined whether empathy moderates the association between perceived interparental conflict and both child systemic inflammation and parent-rated overall child health in a sample of children between the ages of seven to nine. Children and their parents participating in the long-term evaluation of the Family Foundations program, a randomized trial of a perinatal preventative intervention, provided data approximately eight years following enrollment into the program. We collected peripheral blood samples via dried blood spots, anthropometric measurements, and child and parent psychosocial questionnaires. Results indicated significant positive main effects of child empathy on both C-reactive protein (CRP; B = 0.26, SE = 0.11, p =.026) and Interleukin-6 (IL-6; B = 0.20, SE = 0.10, p =.045) levels. Further, child affective empathy moderated the associations between perceived interparental conflict and both CRP (B = 0.39, SE = 0.19, p =.050) and parent-reported child health (B = 0.30, SE = 0.13, p =.021), such that greater empathy strengthened the negative associations between interparental conflict and child health. Overall, findings suggests that there may be a biological cost of being more empathic in high-conflict environments and highlight the need for tools to help more empathic children appropriately manage vicarious emotions.

Observed collaborative and intrusive parenting behaviours associated with psychosocial outcomes of adolescents with type 1 diabetes and their maternal caregivers.

AIMS: Maternal caregiver involvement is strongly associated with psychosocial and glycemic outcomes amongst adolescents with type 1 diabetes (T1D); however, previous studies have lacked detailed, objective examinations of caregiver involvement. We examined the relationship between observed parenting behaviors and psychosocial and glycemic outcomes amongst youth with T1D. METHODS: Data collected from adolescents with T1D (age 11-17) and their female caregivers as a part of a randomized controlled trial were analyzed. These included structured, observation-based scores of adolescent-caregiver dyads engaged in videotaped interactions and selected psychosocial and glycemic outcome measures. RESULTS: In adjusted analyses, higher levels of intrusive parenting behaviors during observed interactions were associated with higher diabetes distress in adolescents, but no difference in HbA1c. Associations between intrusive parenting behaviors and psychosocial outcomes were stronger for females compared to males for both diabetes distress and quality of life. Similarly, associations between collaborative parenting behaviors and quality of life were stronger for female adolescents than males. No associations were observed between collaborative parenting behaviors and glycemic outcomes. Consistent with previous work, we noted higher levels of adolescent-reported family conflict were associated with lower adolescent quality of life and higher diabetes distress with no significant difference between male and female adolescents. CONCLUSION: These findings indicate that high levels of intrusive parenting behaviors, such as lecturing or over-controlling behaviors, are associated with lower levels of adolescent well-being, particularly among adolescent girls. This work suggests that interventions to reduce intrusive parenting by maternal caregivers could result in improved psychosocial outcomes for adolescents with T1D.

Work-family conflicts and sickness absence-a register-linked cohort study among young and early midlife employees.

BACKGROUND: Work-family conflicts (WFC) have been associated with poor mental health, poor self-rated health and sickness absence. However, studies on short sickness absence are lacking and more information is needed also about long sickness absence regarding the direction of WFC, and potential explaining factors particularly among young and early middle-aged employees. METHODS: The Helsinki Health Study baseline survey (2017) among 19- to 39-year-old municipal employees (N = 3683, 80% women, response rate 51.5%) was linked to employer's sickness absence data. The associations of work-to-family conflicts (WTFC) and family-to-work conflicts (FTWC) with short (1-7 days) and long (over 7 days) sickness absence were analyzed using negative binomial regression analysis. Covariates were age, gender, family-related factors and work-related factors. Stratified analyses by occupational class were performed. The results are presented as rate ratios and their 95% confidence intervals. RESULTS: High WTFC were associated with short (1.25, 1.12-1.40) and long (1.37, 1.11-1.70) sickness absence. High FTWC were also associated with short (1.12, 1.03-1.22) and long (1.24, 1.06-1.45) sickness absence. Adjustment for family-related factors strengthened the associations, whereas adjustment for work-related factors abolished the associations between WTFC and sickness absence. Associations between WFC and sickness absence were observed among two lowest occupational classes only. CONCLUSION: WFC are associated with both short and long sickness absence. Work-related factors including the quality of supervisory work and shift work play a role in the association. Intervention studies could determine if improvements in combining work and family life lead to a reduction in sickness absence.

Number of children ever-born and its associated factors among currently married Ethiopian women: evidence from the 2019 EMDHS using negative binomial regression.

BACKGROUND: Ethiopia's population is growing at about 2.7% annually with a fertility rate of 4.1 births per woman. However, as per the knowledge of the researcher, not enough studies have been done in Ethiopia to identify factors associated with women's fertility levels. OBJECTIVE: To assess the number of children ever born and its associated factors among currently married reproductive-age Ethiopian women. METHOD: Data of 5613 currently married women were extracted from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). Stata version 14 was used for data extraction, processing, and analysis. Descriptive data were summarized using descriptive statistics. A multivariable negative binomial regression was used for the inferential analysis. Incidence rate ratio (IRR) and its 95% CI were respectively used to measure the associations and their statistical significance. RESULT: The median number of children ever born per currently married Ethiopian woman was 3 with an iterquarter range of 4 (1-5) children. Age of a woman at her first birth (aIRR = 0.958, 95% CI: 0.954, 0.961), being protestant (aIRR = 1.128, 95%CI: 1.068, 1.193), being Muslim (aIRR = 1.096, 95% CI: 1.043, 1.151), and being from other religious groups than Orthodox Christianity (aIRR = 1.353, 95% CI: 1.036, 1.766) are positively associated with bearing more children. On the other hands, completing primary education (aIRR = 0.664, 95% CI: 0.640,0.689), secondary education(aIRR = 0.541, 95%CI: 0.504,0.582), higher education(aIRR = 0.527, 95%CI: 0.479, 0.580), being from a richest household(aIRR = 0.899, 95%CI: 0.840, 0.962), using modern contraceptive (aIRR = 0.877, 95%CI: 0.847, 0.908), living in the Afar (aIRR = 0.785, 95%CI: 0.718,0.859), Amhara (aIRR = 0.890, 95%CI: 0.718,0.859), Gambella (aIRR = 0.894, 95%CI: 0.820,0.974), and Addid Ababa(0.845, 95%CI: 0.760,0.939) are negatively associated with bearing more children. CONCLUSION: Promoting women's empowerment, encouraging women's academic advancement, and community-based educational intervention are recommended to have optimal and decreased numbers of children.

Determinants of unmet need for family planning among currently married reproductive age women at Dewa Chefa District of Oromia special zone, Amhara region, Ethiopia, 2021; a case-control study.

BACKGROUND: Unmet need for family planning is a proportion of women among reproductive age group who want to stop or delay childbearing but are not using any method of contraception. One in ten married women face unmet need for family planning world-wide whereas, one in five women in Africa. Thus, by understanding factors associated with unmet need specific to the study area; the study contributes to planning and intervention of programs, gives additional finding for controversies in earlier studies, and also helps as a baseline for other researchers conducting studies on similar topics. METHODS: A community-based unmatched case-control study was conducted from March 29-April 25, 2021 G.C on 462 currently married reproductive age women (154 cases and 308 controls) in Dewa Chefa District. Currently married reproductive-age women who were fecund, and wanted to limit or delay childbearing but were not using any contraceptive methods were taken as cases and currently married reproductive-age women who were using family planning or did not want to use were taken as controls. A structured and pre-tested questionnaire was used to collect data. Collected data were entered into Epi-data 3.1 and exported to SPSS 23 for analysis. Binary Logistic regression was conducted and variables with p-value < 0.05 were taken as statistically significant. RESULTS: A total of 462 women participated in this study, with 100% response rate. The mean age of the respondents was 27.92 years (with SD of ± 6.3) Age of woman 35-49 [AOR = 6.6 (1.1-39)], having poor knowledge on family planning [AOR = 1.9 (1.1-3.1)], using family planning decided by husband [AOR = 3.8 (2.1-6.9)], using family planning decided together [AOR = 2.3 (1.07-5.1)] and have no support and disapproval of husband for family planning use [AOR = 2.1 (1.08-4)] were factors significantly associated with unmet need. CONCLUSION AND RECOMMENDATIONS: Age of the woman, main decider of family planning use, knowledge about family planning and support and approval of spouse for family planning use were found to have significant association with unmet need for family planning. Thus, family planning providers, District health office, and other concerned bodies should strengthen female empowerment and male involvement in the program with strong couple counseling to reduce unmet need.

Peer factors and prosocial behavior among Chinese adolescents from difficult families.

Adolescents from difficult families (ADF) is a vulnerable group in China, and there have been few studies focused on them at present. To improve the welfare system for vulnerable groups and gain a better understanding of the situation regarding ADF, it is important to identify the association between peer factors, family functioning, and prosocial behavior among ADF. 1047 adolescents aged 10-15 from difficult families were selected from 21 counties in 7 provinces across China based on the multistage stratified sampling method. Regression analysis and moderation analyses were performed to identify the association of prosocial behavior with peer factors and family functioning. Lower peer quality and poorer family functioning were significantly associated with less prosocial behavior. The was no significant association between peer quantity and prosocial behavior. Family functioning moderated the relationship between peer quality and prosocial behavior. ADF with higher quality peers are more likely to show more prosocial behavior, and poor family functioning would weaken the association between peer quality and prosocial behavior. The protection of ADF can begin by improving family functioning and guiding ADF to form relationships with high-quality peers.

Female workers with long working hours are more likely to have depressive symptoms when having family-to-work conflict.

PURPOSE: Workers' health can be influenced by risk factors from their family environments as well as their work environments. This paper sought to examine how the association between long working hours and depressive symptoms differs based on the level of FWC after being stratified by worker's gender. METHODS: We used the dataset of 20,384 full-time wage workers from the sixth Korean Working Conditions Survey (2020). Long working hours were defined as working 52 h or more per week. FWC was measured using a 2-item questionnaire, and depressive symptoms were measured using the WHO-5 well-being index. Applying modified Poisson regression, we evaluated how the association between long working hours and depressive symptoms differs by the level of FWC male and female workers separately. RESULTS: In the analysis of the female workers, long working hours were associated with depressive symptoms in the high FWC group (PR 1.35, 95% CI 1.17, 1.55) after adjusting for potential confounders whereas no association was observed in the low FWC group. Among the male workers, a statistically significant association was observed in both high FWC (PR 1.22, 95% CI 1.07, 1.38) and low FWC (PR 1.28, 95% CI 1.12, 1.47) groups. CONCLUSION: FWC may act as a workplace stressor that potentially amplifies the health impact of long working hours among female workers.

Relationship between work-family conflict and anxiety/depression among Chinese correctional officers: a moderated mediation model of burnout and resilience.

BACKGROUND: Correctional officers tend to have high levels of work-family conflict (WFC). WFC has been found associated with various forms of psychological distress and to affect the overall well-being of correctional officers. Burnout and resilience may affect the relationship between WFC and psychological distress, however, this association still remains unclear. This study aimed to examine the mediating effect of burnout on the relationship between WFC and anxiety/depression and the moderating role of resilience, within the context of correctional officers. METHODS: A cross-sectional online survey was conducted in China from October 2021 to January 2022. WFC, burnout, resilience, anxiety, and depression were evaluated using the Work-Family Conflict Scale (WFCS), Maslach Burnout Inventory-General Survey (MBI-GS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Depression Anxiety Stress Scale (DASS). Mediation and moderation models were then tested using the PROCESS macro in SPSS, with burnout being a mediator and resilience playing a moderating role in the relationship between WFC and anxiety/depression. RESULTS: A total of 472 correctional officers were included. Burnout was found to mediate the relationship between WFC and anxiety (b = 0.14, 95%CI [0.10, 0.19]) and the relationship between WFC and depression (b = 0.23, 95%CI [0.18, 0.28]). Additionally, resilience played a moderating role in the direct effect of WFC on anxiety (b = - 0.02, p < 0.01) and the first half of the indirect effect of WFC on anxiety (b = - 0.007, p < 0.05). Furthermore, resilience was also found to moderate the first half of the indirect effect of WFC on depression (b = - 0.02, p < 0.01), but not the direct effect of WFC on depression (b = - 0.005, p > 0.05). CONCLUSION: The findings of the present study may improve our understanding by elucidating the fundamental mechanisms of the connection between WFC and psychological distress among correctional officers. The results have significant implications for policymakers and individuals, as they suggest that diverse interventions may help promote the mental well-being of correctional officers.

Within-Family Differences in Intergenerational Contact: The Role of Gender Norms in a Patrilineal Society.

Intergenerational contact is important to older adults' quality of life, but less is known about within-family differences in older parents' contact between sons and daughters, especially in countries with patrilineal traditions. Applying latent profile analysis to data on 3,228 Korean older adults' frequency of meeting and communication with each of their children, this study identified within-family patterns of intergenerational contact. Nearly half of parents exhibited gender-balanced patterns of meeting across children, while 13% reported "more frequent contact with daughters" and 39% reported "more frequent contact with sons." On the other hand, "equally high contact" (77%) was the most common pattern for communication. Multinomial regression results showed that the derived patterns were differentiated by parents' education, marital status, region, economic satisfaction, health, and depressive symptoms. The results highlighted the enduring nature of patrilineal traditions as well as the differing patterns of contact that Korean older adults have with their children.

Children's Physical Proximity to Interparental Conflict: Resilient Process and Retrospective Perceptions of Parent-Child Relationships.

This retrospective study sought to determine (a) whether physical proximity to interparental conflict in childhood moderates the link between frequency of exposure to interparental conflict and subsequent levels of resilience in adulthood and (b) whether retrospective perceptions of parent-child relations and insecurity mediate the link between interparental conflict and resilient development. A total of 963 French students aged 18-25 years were assessed. Our study showed that the children's physical proximity to interparental conflict is a major long-term risk factor for their subsequent development and their retrospective perceptions of parent-child relations.

Interparental Conflict and Early Adolescent Depressive Symptoms: Parent-Child Triangulation as the Mediator and Grandparent Support as the Moderator.

A notable ambiguity persists concerning whether distinct forms of parent-child triangulation (unstable coercive coalition, stable coalition, detouring-attacking, detouring supportive, parentification) might mediate the association between interparental conflict and early adolescent depressive symptoms similarly within the context of Chinese Confucianism. Filling this research gap, this study aimed to examine the mediating role of the five dimensions of parent-child triangulation in the association between interparental conflict and early adolescent depressive symptoms, as well as the moderating effect of grandparent support on this mediating pathway. Data were drawn from a sample of 761 Chinese adolescents (M age = 12.82 ± 0.47, 49.1% girls). Structural equation model analyses indicated that unstable coercive coalition, stable coalition, and detouring-attacking behaviors partially mediated the association between interparental conflict and adolescent depressive symptoms, while detouring-supportive behaviors and parentification did not demonstrate such mediating effects. Unlike Western societies, a negative correlation was observed between interparental conflict and parentification in the context of China. Grandparent support mitigated the adverse effects of both interparental conflict and the unstable coercive coalition on early adolescent depressive symptoms.

Longitudinal predictors of children's self-blame appraisals among military families reported for family violence.

BACKGROUND: Although children's self-blame appraisals are recognized as important sequelae of child victimization that contribute to subsequent adjustment problems, little is known about the factors that predict their development and longitudinal course. OBJECTIVE: The current study examines the stability and longitudinal predictors of children's self-blame appraisals among a sample of children reported for family violence. PARTICIPANTS AND SETTING: Children (N = 195; 63 % female) aged 7 to 17 years (Mage = 12.17) were recruited as part of a longitudinal assessment of families referred to the United States Navy's Family Advocacy Program due to allegations of child physical abuse, sexual abuse, or intimate partner violence. METHODS: Children completed assessments on self-blame at 3 time points (baseline, 9-12 months, and 18-24 months) and baseline measures of their victimization experience, caregiver-child conflict, and depression. RESULTS: In univariate analyses, victimization that involved injury (r = 0.29, p < .001), the number of perpetrators (r = 0.23, p = .001), the number of victimization types (r = 0.32, p < .001), caregiver-child conflict (r = 0.36, p < .001), and depression (r = 0.39, p < .001) were each positively associated with baseline self-blame. When examined in a single longitudinal multilevel model, results indicated only caregiver-child conflict (b = 0.08, p = .007) and baseline depression (b = 0.06, p = .013) predicted increases in self-blame. CONCLUSION: Findings suggest clinicians and researchers may consider assessment of victimization characteristics, caregiver-child relationships, and depression symptoms to identify children most at risk for developing self-blame appraisals.

Experiences With Work-Family Conflict, Breastfeeding, and Perinatal Mental Health Among Women Returning to Work After Giving Birth: A Mixed Methods Study.

OBJECTIVE: This study aimed to examine working mothers' experiences with returning to work after giving birth, work-family conflict, breastfeeding, and mental health. METHODS: A sequential, mixed methods design was used to administer an online survey to capture job characteristics and perceptions of work-family conflict among first-time mothers in Georgia who gave birth within the previous year ( N = 26). Then, interviews were conducted to understand their experiences with returning to work, work-family conflict, breastfeeding, and mental health. RESULTS: Many participants worked in educational settings and returned to full-time work after giving birth. Qualitative themes from 12 interviews captured the context of participants' work environments, types of work-family conflict, and factors that alleviated work-family conflict. CONCLUSIONS: Employers need to incorporate support for work-family conflict and perinatal mental health into workplace breastfeeding programs and maternity leave policies.