Family-Centered Primary Care for Older Adults with Cognitive Impairment.

Cognitive impairment (e.g. dementia) presents challenges for individuals, their families, and healthcare professionals alike. The primary care setting presents a unique opportunity to care for older adults living with cognitive impairment, who present with complex care needs that may benefit from a family-centered approach. This indepth systematic review was completed to address three aims: (a) identify the ways in which families of older-adult patients with cognitive impairment are engaged in primary care settings, (b) examine the outcomes of family engagement practices, and (c) organize and discuss the findings using CJ Peek's Three World View. Researchers searched PubMed, Embase, and PsycINFO databases through July 2019. The results included 22 articles out of 6743 identified in the initial search. Researchers provided a description of the emerging themes for each of the three aims. It revealed that family-centered care and family engagement yields promising results including improved health outcomes, quality care, patient experience, and caregiver satisfaction. Furthermore, it promotes and advances the core values of medical family therapy: agency and communion. This review also exposed the inconsistent application of family-centered practices and the need for improved interprofessional education of primary care providers to prepare multidisciplinary teams to deliver family-centered care. Utilizing the vision of Patient- and Family-Centered Care and the lens of the Three World View, this systematic review provides Medical Family Therapists, healthcare administrators, policy makers, educators, and clinicians with information related to family engagement and how it can be implemented and enhanced in the care of patients with cognitive impairment.

Attachment, Parenting, and Obesogenic Behavior: A Dyadic Perspective.

Pediatric obesity is a growing health concern afflicting the United States. The treatment for pediatric obesity, as a health epidemic, costs billions of dollars to our nation, leaving providers and researchers searching for effective and sustainable ways to better manage the biological, psychological, and social health of individuals and families. While many assessments and interventions continue to emerge, researchers have predominately focused on intra-individual concerns among white non-Hispanic populations. This quantitative study was grounded in a relational theory (attachment theory), with a dyadic and primarily Hispanic sample. Evidence from our study supported that child attachment predicted child obesogenic behavior and that this relationship was mediated by child self-regulation. Children with insecure attachments had more obesogenic behaviors and lower self-regulation of eating than those with secure attachments. Family therapists should be on the frontlines of relational research and clinical interventions that interface with biopsychosocial health across diverse cultures and families.

A systematic review of evaluation research in integrated behavioral health care: Operational and financial characteristics.

INTRODUCTION: Integrated behavioral health care (IBHC) is an emerging solution for the delivery of behavioral health in primary care contexts. Although IBHC has been implemented and studied for more than 2 decades, little seems to be known about how it is best evaluated. This article illustrates a framework for IBHC evaluation based on the Three World view (with a focus on the operational and financial worlds) and delivers results from a systematic review on the operational and financial characteristics of existing IBHC research. METHOD: This study identified original reports of research that included an evaluation or assessment of the operational or financial success or sustainability of IBHC sites or programs. RESULTS: A total of 3,386 articles were found through the selected databases and 46 articles were found to meet the inclusion criteria. From the 46 articles that contained an IBHC evaluation including operational or financial variables, 9 operational and 11 financial characteristics were identified as barriers or strengths to sustainability or success. The characteristics of the evaluation participants, IBHC settings, and method of evaluation were also coded and analyzed. DISCUSSION: As a result of this systematic review of articles, evaluation of the success and sustainability of the operational and financial worlds can now be conceptualized at provider and practice levels. Collaboration and communication between medical and behavioral health providers was a significant operational characteristic related to success and sustainability. Financial characteristics indicated that continuous financial evaluation throughout implementation was important to success and sustainability. (PsycINFO Database Record