An Innovative Educational Intervention for Pediatric Nurse Practitioner Faculty to Meet Social Justice Curriculum Standards.

The association between adverse childhood experiences and negative health outcomes is a public health concern, particularly affecting disadvantaged groups and contributing to health disparities. Pediatric nurse practitioners are well-positioned to address this issue, emphasizing the importance of incorporating social justice concepts into nursing education to develop a pediatric workforce with the necessary skills to curb health disparities. However, evidence-based approaches to incorporating these concepts into pediatric nursing education are limited. To address this gap, we describe an innovative educational intervention that harnesses the power of narratives to empower future pediatric nurse practitioners as champions of social justice and health equity.

Development of the Tool to Empower Parental Telling and Talking (TELL Tool): A digital decision aid intervention about children's origins from donated gametes or embryos.

Objective: This study aimed to create and develop a well-designed, theoretically driven, evidence-based, digital, decision Tool to Empower Parental Telling and Talking (TELL Tool) prototype. Methods: This developmental study used an inclusive, systematic, and iterative process to formulate a prototype TELL Tool: the first digital decision aid for parents who have children 1 to 16 years of age and used donated gametes or embryos to establish their families. Recommendations from the International Patient Decision Aids Standards Collaboration and from experts in decision aid development, digital health interventions, design thinking, and instructional design guided the process. Results: The extensive developmental process incorporated researchers, clinicians, parents, children, and other stakeholders, including donor-conceived adults. We determined the scope and target audience of the decision aid and formed a steering group. During design work, we used the decision-making process model as the guiding framework for selecting content. Parents' views and decisional needs were incorporated into the prototype through empirical research and review, appraisal, and synthesis of the literature. Clinicians' perspectives and insights were also incorporated. We used the experiential learning theory to guide the delivery of the content through a digital distribution plan. Following creation of initial content, including storyboards and scripts, an early prototype was redrafted and redesigned based on feedback from the steering group. A final TELL Tool prototype was then developed for alpha testing. Conclusions: Detailing our early developmental processes provides transparency that can benefit the donor-conceived community as well as clinicians and researchers, especially those designing digital decision aids. Future research to evaluate the efficacy of the TELL Tool is planned.

Alpha Test of the Donor Conception Tool to Empower Parental Telling and Talking.

OBJECTIVE: To conduct an alpha test of the prototype of a digital decision aid to help parents disclose donor conception to their children, the Donor Conception Tool to Empower Parental Telling and Talking (TELL Tool). DESIGN: Convergent mixed-methods design. SETTING: Virtual interviews in places convenient to the participants. PARTICIPANTS: A purposeful sample (N = 16) of nine gamete-donor and embryo-recipient parents and eight clinicians, as one parent was also a clinician. METHODS: We conducted cognitive interviews to explore participants' perceptions about the TELL Tool prototype and observe patterns of use. The International Patient Decision Aid Standards (i.e., usability, comprehensibility, and acceptability) guided the development of the qualitative interview guide and directed the qualitative analysis. We also collected data about participants' perceptions and ratings of the helpfulness of each of the prototype's webpages regarding parents' decision making about disclosure. Descriptive statistics were used to analyze the helpfulness ratings before we merged the two data sets to optimize understanding. RESULTS: Participants reported that the TELL Tool was a helpful digital decision aid to help parents tell their children how they were conceived. Most (93.7%) webpage rating scores indicated that the content was very helpful or helpful. The participants identified content and technical areas that needed refinement and provided specific recommendations such as adding concise instructions (usability), tailoring adolescent language (comprehensibility), and softening verbiage (acceptability). CONCLUSION: Alpha testing guided by the International Patient Decision Aid standards was an essential step in refining and improving the TELL Tool prototype before beta testing.

Systematic Review of Self-Report Measures of Maternal Self-Efficacy.

OBJECTIVE: To synthesize the literature to identify self-report measures used to assess maternal self-efficacy (MSE) among mothers of infants 0 to 1 year of age. DATA SOURCES: OVID (MEDLINE), CINAHL, PsycINFO, Scopus, Google Scholar. STUDY SELECTION: We searched for research articles that included self-report measurement of MSE and were published from January 2000 to September 2021. We selected this time frame to focus on a contemporary context and to build on an earlier systematic review of self-report measures of self-efficacy in parents that captured a subset of MSE measures across a broader time period (1970-2016). DATA EXTRACTION: We extracted measures of MSE with descriptive details, including level of self-efficacy assessed (e.g., global, domain-specific, task-specific), concept(s) assessed, reliability, eligible age ranges, instrument origins, development, use, and translations. DATA SYNTHESIS: In many studies of MSE, researchers used measures not specifically designed for self-efficacy and instead used measures for closely related concepts such as confidence or competence. We identified only four measures that were used to assess MSE among mothers of infants. Among these, we found variation in the level of self-efficacy being measured and the intended age range. Importantly, we also found that measures of MSE were primarily validated for use within Western and/or English-speaking cultures/countries. CONCLUSION: We identified four instruments to measure MSE in mothers of infants, and each has strengths and weaknesses. Future researchers should focus on clear conceptual and operational alignment between MSE and its measurement; the development of an English, task-specific MSE measure; and further development and testing of measures of MSE outside of Western and/or English-speaking cultures/countries.

Emerging Frontline Leaders' Voices in Response to COVID-19 Crisis.

BACKGROUND: The COVID-19 pandemic has significantly affected healthcare institutions, introducing new challenges for nurse leaders and their colleagues. However, little is known about how the pandemic has specifically affected the lives of these leaders and what methods and strategies they are using to overcome pandemic-related challenges. OBJECTIVES: The aim of this study was to examine the effect of the 2019 pandemic on emerging healthcare leaders and highlight methods and strategies they used to overcome pandemic-related challenges. METHODS: The participants in this study represent a diverse group of interprofessional healthcare faculty enrolled in a transformational leadership course (Paths to Leadership) when the pandemic first appeared. Three months into the pandemic, the leadership cohort was invited to participate in this qualitative study, exploring four questions: Q1: How have you transformed your working styles in response to the pandemic? Q2: How have you adjusted your personal life in response to the pandemic? Q3: How have you used leadership skills learned from Paths to Leadership during the pandemic? Q4: What lessons have you learned from the pandemic? Participant narratives were analyzed by a team of nurse researchers using conventional qualitative content analysis. RESULTS: Themes for Q1 (working styles) included shifted from face-to-face to telework, faced novel disease and decisions, worked more from home, and challenged to maintain contact with professional peers and team. Themes for Q2 (personal life) included accommodate adults working and children learning from home, looked for and found the positive, and continue to struggle. Themes for Q3 (leadership skills) included reflective practice, listening, holding, and reframing. Finally, themes for Q4 (pandemic lessons) included leadership, human connection, be prepared, taking care of ourselves, and connecting with nature. DISCUSSION: The 2019 pandemic brought hardships and opportunities to faculty members enrolled in an interprofessional transformational leadership course. In conjunction with this course, the pandemic provided a unique opportunity for participants to apply newly acquired relationship building, positive organizational psychology, and reframing skills during a time of crisis. Nursing leaders, whose educational offerings may be immediately "put to the test," may find our lessons learned helpful as they develop strategies to cope with unanticipated future challenges.

Parents' experiences telling children conceived by gamete and embryo donation about their genetic origins.

OBJECTIVE: To gain an in-depth understanding of parents' experiences telling children conceived by gamete and embryo donation about their genetic origins. DESIGN: Qualitative, descriptive. SETTING: Families' homes. PATIENTS: Gamete or embryo donation recipient parents living in the United States and who told their children, from birth to 16 years, about their genetic origins. INTERVENTIONS: Individual semistructured (n = 12) or dyadic (n = 2) parent interviews. MAIN OUTCOME MEASURES: Directed qualitative content analysis. RESULTS: Fourteen families that comprised 16 gamete or embryo donation recipient parents and represented 24 donor-conceived children between the ages of 4 months and 16 years participated in the study. Single parents (n = 3) and both parents in most two-parent families (n = 9) led the initial telling conversations. Parents recounted personal short stories using language that was both developmentally and medically appropriate. Multiple strategies, including children's books, were used by parents to aid them in their telling. The oldest donor-conceived children in each family were first informed of their genetic origins at birth (n = 10 families) or at 6 months (n = 1 family; "practice runs") or from 3.5 to 12 years (n = 3 families). The telling conversations took place during routine family activities that naturally brought parents and children in close proximity, usually in the home. CONCLUSIONS: Awareness of the nuances of parents' telling conversations with their children through the age of 16 years can help guide clinical counseling and the development of tools to aid parents in their telling conversations.

Using poetry as data to explore daily and formal care decision making within African American dementia dyads.

There is limited research exploring how daily and formal care decision making occurs within African American dementia dyads as well as how these dyads navigate decision making across the dementia trajectory. Through semi-structured interviews, five African American dementia dyads shared their decision-making processes. We used a multimethod approach to the analysis of data, including qualitative and quantitative content analysis and the creation of I Poems. This novel use of I Poems provided a uniquely personal account of the lived experiences of the African American persons living with dementia, while other analyses revealed that within dyads, daily care decision making was led by African American persons living with dementia, whereas formal care decision making varied between dyads. There was intra-dyad congruence regarding who the final decision maker was in daily and formal care. Clinicians and researchers may be able to tailor interventions based on the dyad's involvement in these decision-making processes.

A closer look at quality of life in the hepatocellular carcinoma literature.

PURPOSE: Adults with hepatocellular carcinoma (HCC) have a high symptom burden. Their quality of life (QOL) has been shown to be significantly impacted by both the disease and its treatment, adding to the high symptom burden that these patients experience. The primary aims of this paper are as follows: (1) to identify how QOL is being defined in HCC literature and (2) to identify how QOL is being measured in the HCC literature using Ferrell's model of QOL. METHODS: A systematic review was completed of relevant studies published after 2014, using PubMed, CINHAL, and PsycInfo. Relevant studies were reviewed by 2 reviewers using PRISMA guidelines. RESULTS: From a total of 1312 papers obtained in the initial database search, 30 met inclusion criteria and are included in this review. From the included articles, 10% included a definition of QOL and 3% addressed the spiritual domain of QOL. Majority of study participants were in the early stage of HCC, though the majority of adults with HCC are diagnosed in the advanced stage. Only 3% of included studies included greater than 22% population of advanced stage of HCC. CONCLUSION: The results of this systematic review demonstrate the need for future research into QOL in the advanced stage of QOL. It also identified gap in the literature concerning the definition of QOL in HCC and the spiritual domain of QOL in HCC.

Oocyte donation disclosure decisions: a longitudinal follow-up at middle childhood.

Few studies have captured oocyte donation (OD) parents' decision processes about intended and actual disclosure over time. Likewise, OD children's perceptions about their family composition during middle childhood are underexplored. To address these gaps, a longitudinally followed cohort of OD recipient families was invited to participate in a qualitative, follow-up study. With an 86% response rate after 12 years, families were composed of oocyte recipient mothers (n = 6) and biological fathers (n = 6) representing 12 donor-oocyte conceived children (10.33 ± 1.23 years; mean ± SD). Of the 12 children, two that were aware and two that were unaware of their conceptual origins completed conversational interviews. Only one family in the initial cohort had disclosed OD to their children by the 12-year follow-up, despite 43% of parents intending to disclose and another 43% undecided about disclosure during pregnancy. Four parental disclosure patterns emerged at 12 years: (i) wanting to disclose; (ii) conflicted about disclosure; (iii) not planning to disclose; and (iv) having disclosed. Children that were unaware of their conceptual origins displayed no knowledge of their method of conception. There is a need for family-centric interventions to assist 'wanting to disclose' parents in their disclosure process and 'conflicted about disclosure' parents in their decision-making process post-OD treatment.

Health literacy as predictors of fluid management in people receiving hemodialysis in China: A structural equation modeling analysis.

OBJECTIVES: To explore the impact of health literacy (HL) on perceived benefits of fluid restriction (PBFR), self-reported fluid restriction (SRFR) and relative-interdialytic weight gain (R-IDWG) in people receiving hemodialysis (HD). METHODS: We conducted a cross-sectional study in two nephrology departments from two hospitals in Guangzhou, China (n = 226). The HL questionnaire, PBFR Subscale of Health Belief Model Constructs and Fluid Adherence Subscale of the HD Patients Therapy Adherence Scale were used. R-IDWG was calculated by the mean IDWG (from 3 consecutive HD), divided by the dry weight. RESULTS: In structural equation modeling, three domains of the HL questionnaire, namely Actively Managing My Health, Social Support and Actively Engaging with Healthcare Providers (HCPs), were directly and positively associated with PBFR. Higher Actively Managing My Health predicted higher SRFR both directly and indirectly. Sufficient Social Support and adequate Actively Engaging with HCPs predicted higher SRFR indirectly. All three HL domains predicted R-IDWG indirectly. CONCLUSION: Improving patients' HL could increase their understanding of PBFR and be more apt to follow fluid restrictions and reduce R-IDWG. PRACTICE IMPLICATIONS: A better understanding of the relationships among HL, PBFR, SRFR and R-IDWG will allow for tailored interventions to decrease R-IDWG in people receiving HD.

Quality of life in "chronic" cancer survivors: a meta-analysis.

PURPOSE: Cancer survivors are now living longer giving rise to a new concept-chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis. METHODS: A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10. RESULTS: Physical health (CES = - 0.894; CI, - 1.472, - 0.316), role-physical health (CES = - 2.039; CI, - 2.643, - 1.435), and mental health (CES = - 0.870; CI, - 1.447, - 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies. CONCLUSION: QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.

The effect of video-mediated communication on father-infant bonding and transition to fatherhood during and after Satogaeri Bunben.

AIMS: The study aimed to explore the effect of video-mediated communication on father-infant bonding and transition to fatherhood during and after Satogaeri Bunben. BACKGROUND: Satogaeri Bunben is a Japanese perinatal tradition that results in the pregnant wife and husband living apart, which may interfere with father-infant bonding and transition to fatherhood. DESIGN/METHODS: A mixed-methods study was conducted from July 2012 to November 2015. Participants were divided into two groups (Treatment/Control). Quantitative data included Taiji kanjyo Hyotei Syakudo (TKHS) , communication methods, husband's visitation records and video-mediated communication records and satisfaction of video-mediated communication experience. Qualitative data included participants' journal entries about their experience and feelings toward their infants during Satogaeri Bunben. RESULTS: Fourteen treatment and thirteen control dyads/couples participated in the study. There were significant differences between groups in the frequency of fathers' visitation during Satogaeri Bunben, as well as on the THKS between groups in cross-sectional analysis and in treatment group in longitudinal analysis. Fathers' journal entries revealed the use of video-mediated communication in both groups, specifically commenting about these experiences and the impact of additional visual cues when communicating. CONCLUSION: Video-mediated communication provides a sense of virtual co-presence, which may help support father-infant bonding and transition to fatherhood; however, it does not completely substitute for face-to-face interaction.

Assessment of the Information Sources and Interest in Research Collaboration Among Individuals with Vascular Ehlers-Danlos Syndrome.

BACKGROUND: Patient-centered research requires active engagement of patients. The vascular Ehlers-Danlos Syndrome (vEDS) research collaborative was established to ascertain patient-centered vEDS research priorities and to engage affected individuals as research partners. Evaluation of access to information and interest in research among individuals with vEDS was the first step undertaken as part of this work. METHODS: A 28-question survey was created to evaluate 4 domains of interest: diagnostic and clinical care history, vEDS experience, information resources, and willingness to collaborate with researchers. The survey was created in REDCap™ and disseminated between January and April 2018 via the vEDS social media pages, blogs, and advocacy Web sites. Results were collated and described. A single open-ended question yielded additional narrative data, which were analyzed qualitatively. RESULTS: Of the 300 responses, 228 (76%) were completed on behalf of oneself. The vEDS diagnosis was confirmed by genetic testing for 85% of respondents. When asked "Did a physician explain vEDS to you and how to manage it?" 25% answered no. Most had a primary care provider (65%), cardiologist (56%), and vascular surgeon (52%). Only 32% had a local vascular surgeon. The most commonly reported frustration was no cure/treatment available and the emergency rooms do not know what VEDS is (64.5% and 61.8%, respectively). The Internet was the most useful information source (62.3%) followed by a geneticist (18.4%). Most (87.7%) are willing to share their medical records for research studies (87.7%) and wished to be contacted about future studies (83.8%); however, only 65.4% would be willing to upload medical records via a secure confidential Web application. The most common reason for interest in research partnership was to advance research for a treatment/cure (83.8%) and helping others learn from their experiences (82.9%). The qualitative analysis provided additional insights into the patient experience living with vEDS. CONCLUSIONS: Among individuals with vEDS, there is substantial frustration with the lack of treatment, lack of knowledge among health care providers, and a high degree of interest in research involvement. The survey highlights an opportunity to discuss the optimal modality for research participation and methodologies for building trust in the research teams. The methodology lessons learned can also be applied to other rare vascular diseases.

Emerging Views of Kinships Created Through Oocyte Donation.

BACKGROUND: The United States has the highest number of oocyte donation cycles, which account for an estimated one-quarter of all worldwide oocyte donation cycles. Although there has been a steady rise in oocyte donation treatment, understanding the kinship views of those intimately involved is lacking. These include women oocyte donors and parents who received donor oocytes to establish a pregnancy. PURPOSE: To explore the views and perspectives about genetic relationships and lineages among women who were oocyte donors and parents who received donated oocytes 10 to 12 years after donors and parents underwent oocyte donation procedures to establish a pregnancy. STUDY DESIGN AND METHODS: A longitudinal cohort of pregnant women who received donor oocytes participated in an expanded, follow-up study 12 years postpregnancy that included the women's heterosexual partners and biological fathers. Women who donated oocytes anonymously 10 to 12 years prior also participated. Qualitative content analysis was used to analyze participants' in-depth interviews. RESULTS: Six women who received donor oocytes and their heterosexual partners and biological fathers (n = 6), representing 12 children conceived by oocyte donation, and 3 women who donated oocytes anonymously representing 3 children participated. Themes that emerged from the women oocyte donors included a reexamination of anonymity and contact with recipient families, managing disclosure to their own children about possible half-siblings, and potential for consanguinity. For recipient parents, there was an overwhelming sense of gratitude to the women oocyte donors, concerns about navigating genetic information gaps, and contemplating future contact with the donors and/or half-siblings. CLINICAL IMPLICATIONS: Nurses can play a vital role in supporting and educating women oocyte donors and recipient parents about navigating complex relationship issues in donor kinships.

Economic models for sustainable interprofessional education.

Limited information exists on funding models for interprofessional education (IPE) course delivery, even though potential savings from IPE could be gained in healthcare delivery efficiencies and patient safety. Unanticipated economic barriers to implementing an IPE curriculum across programs and schools in University settings can stymie or even end movement toward collaboration and sustainable culture change. Clarity among stakeholders, including institutional leadership, faculty, and students, is necessary to avoid confusion about IPE tuition costs and funds flow, given that IPE involves multiple schools and programs sharing space, time, faculty, and tuition dollars. In this paper, we consider three funding models for IPE: (a) Centralized (b) Blended, and (c) Decentralized. The strengths and challenges associated with each of these models are discussed. Beginning such a discussion will move us toward understanding the return on investment of IPE.

Children with ADHD draw-and-tell about what makes their life really good.

PURPOSE: The purpose of this study was to engage children with attention deficit hyperactivity disorder (ADHD) in a developmentally sensitive way to explore the children's subjective well-being. Explicitly, their life satisfaction, or what makes their life "really good." To date, little is known about the subjective life experience of children with ADHD or how incorporating children's views separate from the purview of adults and pathology might enhance our understanding or change our approach to evaluation and/or intervention. DESIGN AND METHODS: A parallel convergent mixed-methods design was used to collect data from a convenience sample of children with ADHD (N = 20) ages 7 to 11 years old. This article focuses solely on the qualitative data obtained through semi-structured interviews using the art-based approach draw-and-tell conversation (DTC). The DTC data were analyzed using qualitative content analysis. In addition, each parent (N = 20) independently completed demographic and health-related forms to provide descriptive and contextual variables. RESULTS: Three themes were discerned in the DTC analysis-activity, nature, and connections. Most children (90%) described engaging in some form of activity, often outdoors, and with others; though the focus of activity was varied. Nature was evidenced directly and indirectly in many of the children's (85%) stories. Over half (65%) of the children described some variation in relational connection across a continuum that contributed to, or detracted from, their sense of well-being/life satisfaction. PRACTICE IMPLICATIONS: Children shared that doing things, outdoors, with others, [emphasis added] made their life "really good". Children's stories yielded insightful and actionable information that is relevant to each individual child/family, and to nursing assessment, intervention, and advocacy. These child-granted insights also extend our attention beyond pharmacological and behavioral focused interventions, to include the children's own innate health promoting interests that help to make their life really good.

Psychometric testing of the healthy eating and physical activity self-efficacy questionnaire and the healthy eating and physical activity behavior recall questionnaire for children.

PURPOSE: The purpose of this study was to develop and assess the psychometric properties for two related questionnaires: the Healthy Eating and Physical Activity Self-Efficacy Questionnaire for Children (HEPASEQ-C) and the Healthy Eating and Physical Activity Behavior Recall Questionnaire for Children (HEPABRQ-C). DESIGN AND METHODS: HEPASEQ-C and HEPABRQ-C were administered to 517 participating children with 492 completing. Data were analyzed to evaluate for reliability and validity of the questionnaires. RESULTS: Content validity was established through a 10-person expert panel. For the HEPASEQ-C, item content validity index (CVI) ranged from 0.80 to 1.00. The CVI for the total questionnaire was 1.0. All HEPASEQ-C items loaded on a single factor. Cronbach's alpha was deemed acceptable (.749). For the HEPABRQ-C, item CVI ranged from 0.88 to 1.00. CVI for the total questionnaire was 1.0. Pearson product moment correlation between HEPASEQ-C and HEPABRQ-C scores was significant (r = .501, p = .000). PRACTICE IMPLICATIONS: The HEPASEQ-C and HEPABRQ-C are easily administered and provide helpful insights into children's self-efficacy and behavior recall. They are easy to use and applicable for upper elementary school settings, in clinical settings for individual patients, and in health promotion settings.

The Impact of a Video-Mediated Communication on Separated Perinatal Couples in Japan.

Japanese communication relies heavily on nonverbal cues and context. The purpose of this study was to examine the impact of video-mediated communication (VMC) on communication satisfaction and marital relationships in young couples separated during the perinatal period as they honor the Japanese tradition of Satogaeri Bunben. Couples were assigned to the VMC treatment group ( n = 14) or control group ( n = 13). A mixed-methods approach to data collection and analysis was used. Longitudinal quantitative analysis from the Primary Communication Inventory and Intimate Bond Measure revealed significant differences between the Husband groups. Primary Communication Inventory and Intimate Bond Measure were strongly correlated regardless of group. Qualitative analysis of participant diaries revealed the addition of visual cues helped create a sense of "virtual co-presence," which was both positive and negative. In conclusion, VMC appears to improve communication in the separated Japanese perinatal couples, especially through the addition of visual cues provided with VMC.

"Who Are You From?": The Importance of Family Stories.

This article emphasizes the importance of family stories, or intergenerational narratives, and their health benefits across the lifespan. Knowing and sharing the story of who you are from complements the current focus on knowing and sharing one's geographic heritage, or where you are from. Knowing one's family stories creates meaning that goes beyond the individual to provide a sense of self, through time, and in relation to family. This expanded sense of self is referred to as our intergenerational self, which not only grounds an individual but also provides a larger context for understanding and dealing with life's experience(s) and challenges. This connection across generations appears to contribute to resilience at all stages of life. This shift in focus challenges family nurses to rethink and/or prioritize the use of family stories as a key health-promoting intervention for not only children but also their parents, and their parents' parents.

Testing the committee approach to translating measures across cultures: Translating primary communication inventory from English to Japanese.

This paper presents the initial translation process and follow-up psychometric evaluation of the Japanese version of the Primary Communication Inventory (J-PCI). The J-PCI was developed using the committee approach to translation and then used in a study exploring Japanese couples' communication satisfaction while separated during Satogaeri Bunben - a Japanese perinatal tradition. The committee approach attends to cultural nuance and context and is especially useful when languages have dissimilar linguistic roots and cultures, such as Japanese and English. The translation process and evaluation included five steps; (i) selection of the original PCI for research; (ii) selection of translators; (iii) development of the J-PCI using a committee approach; (iv) an initial small pilot study; and (v) a larger follow-up study. The J-PCI has good initial validity and reliability, although some nuances were observed in scoring.