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Summary The study aims to test the efficacy of a family‐centred healthy lifestyle program in primary care health centres among children with overweight or obesity, evaluating the results at 3, 6, and 9 months post‐intervention. A single‐blind, randomised controlled cluster study where participants will be blinded to group assignment to reduce bias will be followed. The intervention comprises a 6‐month program with intensive and maintenance behavioural therapies, including dietary modifications and guidelines for physical activity, administered by a multidisciplinary team. Participants will be assigned to an intervention group or a treatment‐as‐usual control group. Primary health centres in Seeb Wilayat, serving densely populated areas and willing to participate, will be included. Randomisation will be conducted at the cluster level to improve recruitment efficiency. A sample size calculation will ensure adequate power to detect significant differences. Ethical approval is granted and informed consent/assent will be obtained from all participants. The proposed study focusses on testing the efficacy of a family‐centred healthy lifestyle program in primary care centres through a controlled, randomised study. Successful outcomes could lead to informed interventions, improvements in the health system, policy recommendations, positive community impacts, information on behavioural therapies, and improved long‐term health outcomes for affected children and their families. This study will contribute to the literature by providing a culturally sensitive and evidence‐based solution to a pressing public health issue, which can be adapted to similar contexts in Oman and beyond. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion Implications This study explores the perception of intergenerational family board games by three generations (school‐age children, parents, and grandparents).Playing board games is a rewarding experience throughout life and is particularly relevant to take into account in intergenerational studies as this activity is often shared by different generations aiming to spend time together.Semistructured interviews were conducted with 30 participants who were recruited through word of mouth and by distributing flyers in local shops such as bakeries, laundromats, or grocery stores. The interviews were analyzed using thematic analysis.Board games were seen as a way to connect, share values, and understand each other better, evoking many emotions. Participants viewed them as a means to strengthen intergenerational bonds. Each generation experienced unique benefits from board games based on their specific life challenges.Board games offer an efficient means of maintaining family dynamics and provide opportunities for players of different generations to better understand each other and thereby reduce the intergenerational gap.Board games offer enjoyable family leisure, fostering emotional connections and communication across generations. They help children experience emotions, allow parents to support their children's development, and enable older adults to connect with younger generations. [ABSTRACT FROM AUTHOR]

Background: Diaries have been used regularly in international settings as an evidence‐based and easily applicable intervention following a person‐centred approach in the intensive care unit (ICU). In addition, a diary web application known as 'Post‐ICU' has been implemented. Aim: To explore the usability of an innovative digital diary from the perspectives of intensive care patients' relatives. Study Design: A cross‐sectional online survey study was applied among a convenience sample of relatives in the ICUs of two hospitals in the Netherlands. The investigator‐developed questionnaire included, among other things, items with the appreciation of the layout, user friendliness and functionality of the diary. Relevance and applicability were rated between 1 and 10. Data were analysed with SPSS© software, version 27, and reported as the means (±standard deviation [SD]) and percentages. Results: Sixty‐three relatives with an average age of 51 years (SD ± 14.3) participated in the study; there was a slight predominance of women (57%). All but one participant found using the digital diary easy and were able to upload photos to the diary. The participants had invited other relatives (75%) and nurses (61%) to write in the diary, which they viewed as easily feasible (89%). The relevance and applicability of the diary were rated with mean scores of 8.1 (SD ± 1.9) and 8.3 (SD ± 1.6), respectively. Conclusions: The participants found the Post‐ICU diary web application highly valuable and easily feasible. Perceived ease of use, perceived usefulness and technophobia were not found to influence the usability of the digital diary. Relevance to Clinical Practice: The implementation of this new digital tool supports a person‐centred ICU policy because of its focus on the personal diary entries of the patient and the collaborative writing process featuring relatives and professionals. [ABSTRACT FROM AUTHOR]

Borderline Personality Disorder (BPD) is a distressing mental illness that is overrepresented in adolescents and youth and which was previously thought difficult to treat. Families and carers of those with BPD can also experience high levels of distress and burden and can struggle in their support of those with BPD. The Families and Carers Training and Support (FACTS) program is an innovative skills and education program for family members and carers of someone with BPD informed by mentalisation‐based treatment (MBT) principles. To address a gap in the research, the present study aimed to see what effect, if any, a carer‐focused intervention has on the young people with BPD themselves. To assess this, interviews were conducted with eight young people whose family members participated in the program. Overall, the young people felt there had been positive changes during and after their family members' participation in the program. They felt the communication with their family members improved; they also felt more understood and that they had more space and freedom in the home and that the tension in the household decreased. Additionally, several young people felt they would have liked to be more involved in the process and to take part in the program alongside their family members. The findings indicate that interventions focusing on building understanding and self‐awareness in carers of those BPD can be important in ameliorating the challenging impact of BPD on young people and their families. [ABSTRACT FROM AUTHOR]

Background: Many people view people with intellectual disability primarily as needing help. That perspective limits relationships and can promote discrimination. We sought to better understand social relationships among young adults with intellectual disability. Method: Seven postsecondary students with intellectual disability participated in a photovoice study, sharing photos and stories about giving and receiving help. They participated in individual interviews, a group meeting, and a photo exhibition, and helped identify results and conclusions. Results: Participants viewed themselves as helpers and recipients of help. Themes were: foundational importance of families; openness to being helped; personal growth through challenging experiences; and tension between wanting to help and risks of helping others. Participants wanted to raise awareness that people with disabilities can help others, educate them about disability, and contribute to research. Conclusions: Many young adults with intellectual disability want to contribute to relationships, which are often limited by others' expectations about disability. [ABSTRACT FROM AUTHOR]

Languages vary in their complexity; caregivers vary in the way they structure their communicative interactions with children; and boys and girls can differ in their language skills. Using a multilevel modelling approach, we explored how these factors influence the path of language acquisition for young children growing up around the world (mean age 2‐years 9‐months; 56 girls). Across 43 different sites, we analysed 103 mother–child pairs who spoke 3,170,633 utterances, 16,209,659 morphemes, divided across 20 different languages: Afrikaans, Catalan, Cantonese, Danish, Dutch, English, Farsi, French, German, Hebrew, Icelandic, Irish, Italian, Japanese, Mandarin, Norwegian, Portuguese, Spanish, Swedish and Turkish. Using mean length of utterance (MLU) as a measure of language complexity and developmental skill, we found that variation in children's MLU was significantly explained by (a) between‐language differences; namely the rate of child MLU growth was attuned to the complexity of their mother tongue, and (b) between‐mother differences; namely mothers who used higher MLUs tended to have children with higher MLUs, regardless of which language they were learning and especially in the very young (<2.5 years‐old). Controlling for family and language environment, we found no evidence of MLU sex differences in child speech nor in the speech addressed to boys and girls. By modelling language as a multilevel structure with cross‐cultural variation, we were able to disentangle those factors that make children's pathway to language different and those that make it alike. Research Highlights: The speech of 103 mother–child pairs from 20 different languages showed large variation in the path of early language development.Language, family, but not the sex of the child, accounted for a significant proportion of individual differences in child speech, especially in the very young.The rate at which children learned language was attuned to the complexity of their mother tongue, with steeper trajectories for more complex language.Results demonstrate the relative influence of culture, family, and sex in shaping the path of language acquisition for different children. [ABSTRACT FROM AUTHOR]

The pandemic offered a unique opportunity to shift gendered expectations and create a more equal division of domestic labor in the home. As an organizational unit, the home represents a significant domain to investigate gendered power relations and transformations. Change was especially possible for couples where employed fathers, who typically left for work, began to spend far more time at home. Surveys show that the opposite happened, and the share of domestic work done by women increased. This article explores the social dynamics that drove these trends. We draw on in‐depth interviews with 20 couples (for a total of 40 parents). We leverage the variation between the accounts of each partner in a couple to explore how gender contributed to inequality in the home during the pandemic. We show that the physical and symbolic division of domestic space contributed to heightened gender inequalities during the pandemic. We divide our sample into three groups: cases where paternal income exceeds maternal income, cases where maternal income exceeds paternal income, and cases with comparable income levels for both parents. We demonstrate how the division of space, both physically and symbolically, contributes to the ongoing gender inequality experienced by all three groups. Our results expand on quantitative studies which show that gender inequality deepened during the pandemic by revealing the mechanisms and lived experinces behind the trend. [ABSTRACT FROM AUTHOR]

The international literature on women and work calls on scholars to consider geographical, sociocultural, and institutional contexts governing women's employment dynamics over their life course. In Indonesia (and other lower middle‐income regions in Southeast Asia), female labor force participation is lower in urban areas than rural areas. The largest drop‐off occurs after marriage and childbearing. In this article, we argue that class and spatial context matters in examining the relationship between gender norms, gendered mobilities, and employment outcomes in mega‐urban settings. Using qualitative research, we probe beyond conventional demographic studies to explore the dynamics of married women's (decisions to stay, leave, change, or return to) employment in Greater Jakarta, Indonesia's largest urban core. Our participants were discouraged from employment participation by norms that prioritize married women's role as primary caregivers, and spatial and workplace/regulatory constraints. Our analysis underscores how the participants' employment‐related decisions consistently revolve around the concept of opportunity costs, defined as conflicts and tensions arise from mother's time away from children due to gender norms, lack of childcare and flexible formal employment options, and the long working and commuting hours in Greater Jakarta. Economic pressures for women to participate in the labor market are not matched by work–family policies, which are still rooted in entrenched ideals of women as wives and mothers. [ABSTRACT FROM AUTHOR]

Prader–Willi syndrome (PWS) is a genetic condition caused by a lack of paternally‐expressed imprinted genes at chromosome 15q11.2‐q13 and characterized by hyperphagia, behavioral challenges, and variable intellectual disability. Once a PWS diagnosis is established, sharing diagnosis information with an affected child can be challenging due to its early age of onset and diverse phenotype. This mixed‐methods study aimed to evaluate how parents and guardians have shared a PWS diagnosis with their child and examine the motivating and influencing factors behind their disclosure. Parents and guardians of children with PWS aged at least 5 years completed a survey, and a select group completed an interview. A total of 51 surveys and 15 interviews were completed, with the majority of participants (n = 46; 90%) having shared at least some diagnosis information with their child. Parents and guardians were more likely to disclose if they self‐reported a higher level of knowledge about PWS (p = 0.004) and if their child is currently older (p = 0.02) and/or has at least one sibling (p = 0.046). Interview analysis revealed 15 themes and 10 subthemes that illustrated parents' motivations, methods, and experiences with disclosure. This research provides information for others considering disclosure of PWS or another rare diagnosis with their child. [ABSTRACT FROM AUTHOR]

This study investigates the effect of problem‐solving training on the interpersonal problem‐solving skills of mothers of children with special needs. The parallel randomised controlled trial was conducted between August 2021 and March 2022. A priori power analysis was conducted, and 98 mothers who met the inclusion criteria were included in the study. The analysis indicated that a sample size of 39 participants per group was required. Data were collected using a personal information form and the Interpersonal Problem Solving Inventory. The mothers were divided into control and experimental groups. The participants in the experimental group were given a problem‐solving training program, while the control group was not exposed to any intervention. There was no significant difference in the pre‐training test scores for any of the dimensions (p > 0.05). However, the post‐training test scores in the experimental group were significantly higher than post‐training test scores in the control group (p < 0.05). There were significant differences between the pre‐training and post‐training test scores in the experimental group (p < 0.05). Interpersonal problem‐solving skills can be improved by providing problem‐solving training to the mothers of children with special needs. Based on the findings of this study, it is recommended that psychiatric nurses provide training to protect and improve the wellbeing of children with special needs and their families. [ABSTRACT FROM AUTHOR]

Background Method Discussion In the intensive care unit (ICU), delirium in patients and long‐term mental health challenges in both patients and their family members are highly prevalent. To address these issues, patient‐ and family‐centered care has been recommended to alleviate the burdens associated with critical illness and ICU admission. We have developed the patient‐ and FAMily‐centered care in the adult ICU intervention (FAM–ICU intervention). This multi‐component intervention comprises several concrete and manageable components and operationalizing patient‐ and family‐centered care principles in clinical practice. In this protocol, we describe a study aiming to evaluate the feasibility and acceptability of the FAM–ICU intervention in the adult ICU setting, including the feasibility of collecting relevant patient‐ and family‐member outcome data.We will conduct a pre‐/post two‐group study design. We plan to recruit 30 adult ICU patients and their close family members at Herlev University Hospital in Denmark. The pre‐group (n = 15) will receive usual care and the post‐group (n = 15) will receive the FAM–ICU intervention. The FAM–ICU intervention involves interdisciplinary training of the ICU team and a systematic approach to information sharing and consultations with the patients and their family. Feasibility outcomes will include recruitment and retention rates, intervention fidelity, and the feasibility of participant outcome data collection. Acceptability will be assessed through questionnaires and interviews with clinicians, patients, and family members. Data collection is scheduled to begin in January 2025.This study will assess the feasibility and acceptability when implementing the FAM–ICU intervention and the feasibility of conducting a main trial to investigate its effectiveness on delirium in patients and the mental health of patients and family members. The data from the feasibility study will be used to guide sample size calculations, trial design, and final data collection methods for a subsequent stepped‐wedge randomized controlled trial. [ABSTRACT FROM AUTHOR]

Purpose: Quality of life (QOL) among young breast cancer survivors (YBCS) is often worse than QOL of older breast cancer survivors or age‐matched peers without a history of cancer. Families commonly support YBCS, particularly during treatment, but little is known about long‐term YBCS and family member QOL. The purpose of this study was to identify demographic, clinical, and psychosocial predictors of physical and mental QOL in YBCS and biological relatives and investigate associations between their QOL (i.e., QOL interdependence). Methods: This secondary data analysis includes a random sample of long‐term YBCS (≤ 45 years old at diagnosis) and up to two female relatives at baseline (post‐treatment) and 18‐month follow‐up. The sample consists of 189 dyads (YBCS and one relative) and 121 triads (YBCS and two relatives). Actor‐partner interdependence models (APIMs) were used to estimate the influence of YBCS's and relatives' demographic, clinical, and psychosocial factors on their own QOL (actor effects) and the other persons' QOL (partner effects). Results: For YBCS and relatives, QOL at the baseline was associated with their QOL at 18‐months. YBCS's perceived cancer risk was associated with their own and relatives' QOL. Older relatives' physical QOL at baseline was associated with younger relatives' physical QOL at follow‐up. Age, race, marital status, years since diagnosis, education, out‐of‐pocket costs of care, routine sources of care, income, family support, fear of recurrence, anxiety, and depression were also significant predictors of QOL. Conclusions: Findings revealed independent and interdependent effects on QOL. These predictors point to potential targets of support for families. Trial Registration: ClinicalTrials.gov ID: NCT01612338 [ABSTRACT FROM AUTHOR]

The internalisation of stigma has adverse effects on the recovery and quality of life of people with severe mental illnesses. Studies have shown that life experiences in one's close environment are highly relevant in explaining the onset and development of self‐stigma. Families play a critical role in the daily care of people with severe mental illness and have a profound impact on patient recovery. This qualitative study explored the influence of family on stigma internalisation among people with severe mental illness in the context of Chinese culture. A grounded theory design was used. Semi‐structured interviews were conducted with 20 patients with severe mental illness and 10 family members, and observations were carried out among five of the families. The data analysis followed three steps (open, axial and selective coding) and involved the use of a constant comparative method and memo writing. The COREQ reporting checklist was used to report the results. Our findings revealed that families can facilitate and impede stigma internalisation in people with severe mental illness via negative or positive daily interactions. A theoretical framework was developed to present the potential effects of the identified family factors on stigma internalisation. Three major family factors influencing patients' internalised stigma were identified, namely, "beliefs of family members" at the individual level, "responses within the family" at the intrafamilial level and "differentiated family environment" at the level of the whole family system, in which "biased beliefs of family members" could bring about "negative responses within the family" and further result in patients' internalised stigma. Our findings suggested that mental health stigma internalised by ill people should be viewed within the broad context of the family. Family‐based programs aimed at improving positive interactions and support within the family need to be developed and launched, with particular attention given to interventions for affiliate stigma, coping with stigma and families' negative responses towards people with severe mental illness to prevent the internalisation of stigma by patients. [ABSTRACT FROM AUTHOR]

Introduction: Living liver donation improves survival of end‐stage liver disease (ESLD) patients. Yet, it continues to represent a small proportion of United States (U.S.) liver transplantation with existing racial disparities. We investigated the interplay of donor–recipient relationship and donor race to understand donor subgroups with no significant increase. Methods: We studied 4407 living liver donors in the U.S. from January 1, 2012, to December 31, 2022 (median age = 36 years, and 59% were biologically related to the recipient). We quantified the change in the number of donors per 3‐year increment using negative binomial regression (incidence rate ratio [IRR]), stratified by donor–recipient relationship and race/ethnicity. Results: Among biologically related donors, the observed annual number of White donors increased from 146 to 253, Hispanic donors from 18 to 53, and Black donors decreased from 11 to 10. Among unrelated donors, White donors increased from 65 to 221, Hispanic donors from 4 to 25, and Black donors from 3 to 11. For the IRR of biologically related donors aged <40 and ≥40 years, White donors increased by 18% and 22%; Hispanic donors increased by 25% and 54%; and Black donors did not change. Likewise, the IRR of unrelated donors aged <40 and ≥40 years, White donors increased by 48% and 55%; Hispanic donors increased by 52% and 65%; and Black donors did not change. Conclusions: While biologically related donors represent the majority of donors, unrelated donors have substantially risen in recent years, primarily driven by White donors. Although the rate of unrelated donations increased among Hispanic donors, the absolute number remains very small (≤25 donors/year). Interventions are needed to increase education among Hispanic and Black communities to grow unrelated living liver donations across race/ethnicity. [ABSTRACT FROM AUTHOR]

Issue Addressed: Australian children fall short of meeting the dietary, physical activity and sedentary behaviour guidelines. This study aimed to test the feasibility, acceptability and potential efficacy of a parental text message and social media program on, primarily, their school‐aged children's vegetable consumption and movement behaviours, and, secondarily, their own. Methods: Between August and November 2022, we conducted a two‐armed randomised controlled trial with 242 parents/caregivers of primary school‐aged children in New South Wales. The 'Adventure & Veg' intervention ran for 8 weeks, promoting vegetable eating behaviours, local outdoor physical activity opportunities and ideas for reducing screen time. Feasibility and acceptability were assessed via recruitment and retention data, intervention metrics and self‐reported participant data. Vegetable intake and movement behaviour data were collected via online‐surveys and effect sizes were examined. Results: Most participants reported that they enjoyed receiving the text messages (88%) and the delivery frequency was acceptable (94%). Limitations to Facebook as a delivery platform were reported. The majority of participants used the text messages to influence the vegetable eating (65%) and movement (77%) behaviours of their child. Significant effects were observed among intervention child participants compared with control for mean daily vegetable consumption (0.45 serves, CI:.19;.71, p =.001, d =.5); weekly vegetable variety (1.85, CI:.25; 3.45, p <.001, d =.6); and weekly physical activity variety (.64 CI:.09; 1.19, p =.022, d =.3). Parents in the intervention group increased their daily vegetable intake by.44 serves (CI:.11;.78, p =.01, d =.4). Conclusions: A parental text message and social media program has potential to support children's vegetable intake and movement behaviours. Further research is required to explore different online delivery methods to promote local outdoor activity options. So What?: The Adventure & Veg program holds promise as a stand‐alone health promotion intervention or as a useful adjunct to current family or school‐based healthy lifestyle programs. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion Implications The objective of this study is to make the distinction between courtesy stigma and parent‐blame, two related but unique forms of judgment, and to explore the consequence of courtesy stigma and parent‐blame.Having a child who uses substances has been linked to numerous adverse mental and physical health implications for family members. Parents, in particular, are at great risk of experiencing negative consequences including courtesy stigma and parent‐blame.We conducted in‐depth interviews with eight mothers of individuals who use substances. Data were analyzed using thematic analysis.Three primary themes were identified: the spreading impact of stigma, parent‐blame, and coping with stigma and blame.In this study we were able to distinguish between courtesy stigma and parent‐blame when considering the experiences of mothers of people who use substances. Findings suggest that stigma and blame leave mothers feeling judged and alone when navigating complex family dynamics.Family support organizations offer accepting spaces that counter judgment and generate a sense of connectedness. Our findings stress the importance of professionals cultivating an awareness of the consequence of stigma and blame when working with mothers of people who use substances. [ABSTRACT FROM AUTHOR]

Introduction: Screen media serves an essential role in adolescents' lives, posing growth opportunities and mental health challenges. Family plays a crucial role in mitigating these challenges. This systematic review offers a comprehensive analysis of the family factors related to adolescent screen media use and mental health. Methods: A systematic search was conducted in PubMed, CINAHL, PsycINFO, Scopus, and Embase, adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines using the following inclusion criteria: English, peer‐reviewed, observational design, and published since 2013; adolescent samples aged 10–17 years; and examining screen media use, family factors, and internalizing problems. The role of family factors as predictors, moderators, and mediators was also examined. Results: Of the 3587 records, 32 met the inclusion criteria. These studies, primarily cross‐sectional, presented a global perspective of 14 countries. A heterogeneous range of family factors, screen media use, and mental health outcomes were examined, revealing significant associations between elevated screen media use and internalizing problems. Positive family processes and democratic media‐specific parenting mitigate such association. A few studies underscored family socioeconomic status (SES), noting elevated screen media use and mental health risks among adolescents in families of low SES. Conclusions: Accumulating evidence supports the important role of positive family contexts in fostering balanced screen media use and mental health in adolescents, accentuating the need for professional screening and education to promote positive screen media use among adolescents and families. Further research requires refinement in measurement and methodology to better capture the intricate relationship between family dynamics, screen media use, and adolescent mental health. [ABSTRACT FROM AUTHOR]

Introduction: In childhood intervention, parent–therapist collaboration is central to the family‐centred approach. Despite long‐standing discussion in occupational therapy literature, the field faces challenges, including inconsistent terminology and difficulties in translating theory into practice. This paper represents the first part of a comprehensive scoping review study aimed at developing foundational concepts for collaborative practices with parents in occupational therapy for children. Therefore, this paper focusses on mapping existing practices, types, and approaches articulated in the literature. Methods: We searched English‐language sources published worldwide from 1998 to 2022 discussing collaborative practices with parents in occupational therapy for children aged 0–10 with any diagnosis, including multidisciplinary practices. Seven databases were searched. Data from peer‐reviewed indexed literature, theses and dissertations, and book chapters were extracted and analysed through basic numerical and descriptive analyses before being synthesised into similar categories. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic reviews and Meta‐Analysis—extension for Scoping Reviews were used. Results: The scoping review yielded 299 papers. Parent–therapist collaboration was prominent in clinics, family homes, schools, and hospitals, particularly during therapy implementation, goal setting, and planning. Most reported practice types included 'interventions with parent engagement', 'parent‐directed interventions', and 'parent education'. 'Family‐centred', 'occupational‐focussed', and 'client–therapist collaborative' approaches were frequently mentioned. There were inconsistencies in the terms used to describe collaborative practice characteristics. Conclusion: Over the past 24 years, the collaborative practice literature has expanded and evolved, with parent–therapist collaboration observed across various occupational therapy settings. Inconsistencies in this collaboration across different therapeutic stages were revealed, which could impact intervention success and sustainability. Further research is needed to explore parent–therapist collaboration mechanisms within and across stages. This scoping review also underscores the need for a common framework to guide practice and research. PLAIN LANGUAGE SUMMARY: This literature review explores how occupational therapists and parents work together in childhood intervention. Collaboration is essential for understanding and meeting children's needs within their family and community settings. However, occupational therapists and parents face challenges in applying family‐centred practices and using a common language to bridge theory with practice. To address these challenges, we examined 299 papers published between 1998 and 2022 to understand how collaborative practices with parents have been described in the literature. Our review revealed that therapists and parents collaborate across various settings, such as clinics, schools, homes, and hospitals, mainly during therapy sessions, goal setting, and planning interventions. Collaborative practices take different forms. For instance, therapists often encourage parents to actively engage and take the lead in therapy, requiring therapists to recognise and respect parents' priorities and learning preferences. They often develop strategies together to support the child within family routines. While we found several studies on therapist–parent collaboration, the review outlined inconsistencies in how this practice was described and applied, which could affect its success. Therefore, more research is needed to understand the best ways in which collaboration can occur at each stage of therapy. The need for a core guideline for collaborative practice with parents in occupational therapy was also observed. While therapist–parent collaboration is used in occupational therapy for children, there is a clear need to minimise inconsistencies and gaps found in the literature, as well as to ensure a common language to promote intervention quality and success. [ABSTRACT FROM AUTHOR]

Introduction: In occupational therapy for children, collaborative practice with parents is crucial for meaningful family‐centred interventions, yet it remains undefined and inconsistently addressed. This study aimed to establish foundational concepts for collaborative practice with parents in occupational therapy for children in progressing the field with a universal description. Methods: This paper encompasses the second dataset of a larger scoping review and a preliminary validation of findings by an advisory panel. Data were gathered from indexed sources on collaborative practice with parents in occupational therapy for children (ages 0–10) using MedLine, PsychInfo, ERIC, Embase, OTSeeker, Scopus, and ProQuest Central. Data were extracted, charted, and descriptively analysed by paired independent reviewers. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis—extension for Scoping Reviews were used. A draft definition of collaborative practices, developed based on preliminary review findings and an operational definition, was validated by an advisory panel of 13 experienced Australian occupational therapists, whose input was integrated into a final, comprehensive description of collaborative practice. Results: The scoping review encompassed 299 sources, revealing three major components of collaborative practice: 'collaborative practice aims', 'parent–therapist partnership', and 'strategies for collaboration'. The advisory panel endorsed the draft definition, confirmed its professional relevance, and suggested some modifications. Conclusion: The major outcome of this study is an evidence‐based and discipline‐specific preliminary description of collaborative practice with parents in occupational therapy for children. This description provides a common language and foundational concepts for the future development of a collaborative practice framework to guide practice and research. Future studies can explore specific components, exploring their mechanisms and significance. Further expanded validation is required, incorporating the perspectives of a wider community of occupational therapists and families to enhance the description's applicability. PLAIN LANGUAGE SUMMARY: In occupational therapy for children, collaboration between parents and occupational therapists has been long acknowledged as important in the occupational therapy literature. It is an essential shift away from practices led by professionals to a practice that encourages parents to be engaged therapy partners. However, there has been little consistency in terms of a definition or description of collaborative practice and in what parts of therapy collaboration is used. To develop a draft definition of collaborative practice, we extracted relevant information from 299 papers between 1998 and 2022. Then, an advisory panel of 13 experienced Australian occupational therapists validated and enhanced our final description of collaborative practice. The data from the review was grouped into three major components of collaborative practice: 'collaborative practice aims', 'parent–therapist partnership', and 'strategies for collaboration'. The advisory panel confirmed the draft definition and its relevance and suggested some modifications, which were used to refine the description. The major outcome of this study is a preliminary description of collaborative practice with parents in occupational therapy for children that is based on the research evidence. This description provides a common language and foundational concepts for the future development of a collaborative practice framework to guide practice and research. Future studies are needed to explore specific components of collaborative practice, their relevance, and how they operate in practice. Further validation of the collaborative practice description is needed that would incorporate the perspectives of parents, families, and a wider community of occupational therapists to enhance the description's applicability. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to investigate the effects of religion and law on child marriage in Sanandaj, Iran. Background: The prevalence of child marriage is 16.65% in Iran and 11% in the Kurdish city of Sanandaj. This study considers the legality and legitimacy of this practice in Iran. Method: Eligible participants were selected through purposive sampling. Participants included three groups: parents of a married child (n = 7), women who were child brides (n = 19), and experts (sociologists, marriage concluders, and marriage counselors; n = 7). The research question was "What impact do religious and legal factors have on the decision of families in child marriage?" The data were gathered using semistructured in‐depth interviews and analyzed by conventional content analysis method. Results: The findings were generally categorized into four main themes including law–religion issues (subthemes: marriageable age in civil law, Sharia principles), predisposed religious interpretations (subthemes: religious interpretations confirming child marriage, interpretations rejecting child marriage), institutional factors (subthemes: official agencies, religious factors), and religious viewpoint of families toward child marriage (subthemes: avoidance of sin, reference of parents/children to religious rules). Conclusions: The intersection of law, religion, and family institutions, with their interconnected rules, encourage child marriage (particularly for girls) in Sanandaj, Iran. Any change in these factors (mostly civil law and Sharia) may influence the demands of families for child marriage. [ABSTRACT FROM AUTHOR]

The internet and digital technologies have penetrated all domains of people's lives, and family life is no exception. Despite being a characterizing feature of contemporary family change, the digitalization of family life has yet to be systematically theorized. Against this backdrop, this article develops a multilevel conceptual framework for understanding the digitalization of family life and illustrates the framework by synthesizing state‐of‐the‐art research from multiple disciplines across global contexts. At a micro level, as individuals "do" family online, digitalization influences diverse aspects of family practices, including family formation, functioning, and contact. How individuals "do" family online is not free‐floating but embedded in macro‐level economic, sociocultural, and political systems underpinning processes of digitalization. Bridging the micro–macro divide, family‐focused online communities serve as a pivotal intermediary at the meso level, where people display family life to, and exchange family‐related support with, mostly nonfamily members. Meso‐level online communities are key sites for forming and diffusing collective identities and shared family norms. Bringing together the three levels, the framework also considers cross‐level interrelations to develop a holistic digital ecology of family life. The article concludes by discussing the contributions of the framework to understanding family change and advancing family scholarship in the digital age. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Implications To examine how having more than one trans person in a family facilitates investments in or divestments from cisnormativity.While there is now a robust body of literature on trans people's experiences with cisgender family members and vice versa, largely missing has been a focus on families where more than one person in the family is trans.This paper focuses on a subsample of 10 families from a large international qualitative longitudinal study conducted across six countries, focused on trans young people and their families. The paper draws on interviews conducted in 2022 and 2023 with families in which more than one family member was trans. Transcribed interviews were analyzed thematically.The themes developed indicate that while for some families having multiple trans family members may mean that some cisgender family members invest further in cisnormativity, for other family members the existence of multiple trans family members may encourage divestments from cisnormativity, to the benefit of trans young people. Specifically, themes focus on multiple trans family members highlighting cisnormativity, and conversely, multiple trans family members indicating likelihood of support and offering a safe haven.The paper concludes by emphasizing that while encouraging divestments from cisnormativity should not be the work of trans people, it is nonetheless important that research continues to investigate the experiences of families in which more than one person is trans. [ABSTRACT FROM AUTHOR]

This study aimed to enhance the interpretability and clinical utility of the strength and stressors in parenting (SSF) questionnaire, a parent‐reported questionnaire designed to assess strength, stress and associated risks of mental ill‐health in parents of children with developmental disabilities. Responses to the SSF and a demographic questionnaire were collected from 576 parents of children with (n = 203) and without (n = 373) developmental disabilities. To enhance the interpretability of the SSF, a subset of 129 parents were invited to complete an additional questionnaire consisting of three free‐text questions regarding recent help‐seeking behavior, experiences of mental ill‐health and experiences of parenthood. Parents' responses to the free‐text questions were then categorized as indicative of higher or lower degrees of stress and compared to their SSF score distribution to derive empirical cut‐offs for strength, stress and risk of mental ill‐health as measured by the SSF. The credibility of these cut‐offs was evaluated by comparing the cut‐offs with SSF scores collected from the other 447 parents. Finally, SSF scores from parents of children without developmental disabilities (n = 373) were used to generate percentile values for the SSF to enable a standardized interpretation of SSF scores. To increase the utility of the SSF, we examined a recurring pattern of missing answers to items 23 and 33–38, noted in previous studies of the SSF and repeated in the present study. These items were excluded from further analysis since our examination revealed that they were not missing at random but rather constituted real differences in parental experiences, such as receiving a healthcare allowance, or caring for more than one child. The proposed empirical cut‐offs performed well in discriminating between the two groups and yielded a specificity of 77–89% and a sensitivity of 68–76% for the strength, stress and risk of mental ill‐health subscales of the SSF. This study also presents a conversion chart associating each SSF score with a corresponding percentile value. We propose modifications to the SSF, whereby items 23 and 33–38 are excluded, which will enable a more reliable assessment of parental experiences. This will, together with the empirical cut‐offs and percentile values, enhance the interpretability and clinical utility of the SSF. [ABSTRACT FROM AUTHOR]

Scholars are increasingly recognizing that substantial gender heterogeneity exists among transgender populations; that is, gender identities that defy the ubiquitous binary categories of male and female. However, the developing research base on the families of transgender adults focuses almost exclusively on the family members of transgender persons with binary gender identities, a noteworthy shortcoming considering the prevalence of nonbinary gender identities among transgender populations and the pervasive assumption that only two genders exist. To address this gap, the current study sought to uncover how the parents of transgender adults with nonbinary gender identities come to understand, make sense of, and negotiate nonbinary gender identities in their families. Fourteen parents—12 mothers and 2 fathers—completed in‐depth, semi‐structured interviews, and the collected data were analyzed using reflexive thematic analysis. Analyses generated three broad themes that best‐described these parents' experience with their child's gender, which was heavily shaped by the pervasiveness of cisnormativity: (a) varied attempts to understand nonbinary gender; (b) a nonbinary “double‐edged sword”; and (c) familial resilience. Directions for future research, clinical practice, and policy change are discussed, including the therapeutic benefit of dialectical thinking and the need for legislation that legally affirms and protects nonbinary persons. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Discussion Early child development occurs within an interactive environment, initially dominated by parents or caregivers, and is heavily influenced by the dynamics of this social context. The current study probed the neurobiology of “family personality”, or family functioning, in the context of parent–child dyadic interaction using a two‐person neuroimaging modality.One hundred and five parent–child dyads (child mean age 5 years 4 months) were recruited. Functional near‐infrared spectroscopy (fNIRS) hyperscanning was employed to measure neural synchrony while dyads completed a mildly stressful interactive task. Family functioning was measured through the Family Adaptability and Cohesion Scale IV (FACES‐IV).Synchrony during stress was significantly greater than synchrony during both baseline and recovery conditions for all dyads. A significant interaction between neural synchrony in each task condition and familial balanced flexibility was found, such that higher levels of balanced flexibility were associated with greater changes in frontal cortex neural synchrony as dyads progressed through the three task conditions.Parent–child dyads from families who display heightened levels of balanced flexibility are also more flexible in their engagement of neural synchrony when shifting between social conditions. This is one of the first studies to utilize a two‐person imaging modality to explore the links between family functioning and interbrain synchrony between parents and their children. [ABSTRACT FROM AUTHOR]

Background: Communication disabilities, such as primary progressive aphasia (PPA), impact family members as well as the individuals with the condition. To provide adequate communication care to people with PPA (PwPPA) and their family members, it is crucial to understand the communication needs from the family members' perspectives. To date, research on the communication needs of people with primary progressive aphasia and their family members from the perspectives of family members has been limited. Aims: The specific research objectives were to explore (a) the communication needs pertaining to PwPPA in the early, middle and late stages; and (b) the communication needs pertaining to family members of PwPPA in the early, middle and late stages, from the perspectives of family members. Methods & Procedures: This study employed a qualitative description approach, underpinned by the pragmatic paradigm. Data collection involved semi‐structured qualitative interviews with eight family members (relatives of four individuals with the logopenic variant of PPA, of two individuals with the nonfluent variant of PPA, of one individual with the semantic variant of PPA and of one individual with mixed PPA). Qualitative content analysis was used to identify codes and categories in relation to the research objectives. Outcomes & Results: Qualitative content analysis revealed eight categories of communication needs pertaining to the PwPPA: person‐specific needs; diagnosis and disclosure; general communication difficulties; impact on communication in everyday life; impact on cognition; impact on psychosocial well‐being; impact on person's dignity and autonomy; and future planning. Six categories were identified pertaining to the family members: information about and awareness of PPA; impact of communication difficulties on family/others; increased responsibilities for the family in everyday life; impact on psychosocial well‐being; and future planning. Conclusions & Implications: This investigation has expanded our knowledge in the area by providing insights about communication needs which speech‐language pathologists and other health professionals should be aware of and take into account when providing communication care to PwPPA and their families. WHAT THIS PAPER ADDS: What is already known on the subject: Person‐ and family‐centred communication care is optimally guided by the person's and family's needs and values. Research on communication care for people with primary progressive aphasia has underscored the inclusion of family members. Previous research has investigated the impact and experiences of living with primary progressive aphasia from the family member perspective. What this paper adds to existing knowledge: To date, research focusing on identifying the communication needs of people with primary progressive aphasia and their family members from the perspective of family members is limited. This study adds the family members' perspectives on the communication needs pertaining to themselves and their relatives with primary progressive aphasia in the early, middle and late stages of primary progressive aphasia. What are the potential or clinical implications of this work?: Several clinical implications have been raised. Family members experience communication needs for themselves and should be included as recipients of communication care. Clinicians supporting people with primary progressive aphasia should be cognizant of the impact of communication fatigue on everyday life and therapy tasks. Communication care for this population should include communication partner training, support for psychosocial well‐being and support with communication around future planning. [ABSTRACT FROM AUTHOR]

Background: Children of parents with a severe mental illness have an increased risk of developing a lifetime mental illness. We aimed to compare the effects of a preventive family‐based intervention, VIA Family, with treatment as usual (TAU) on these children's global functioning. Methods: Between 2017 and 2021, we conducted a pragmatic, rater‐blinded, two‐arm parallel‐group superiority trial in Denmark. Families with at least one child aged 6–12 years and at least one biological parent with schizophrenia spectrum disorder, bipolar disorder, or recurrent major or moderate depression were included. We randomly allocated 95 families with their 113 children to VIA Family or TAU (ratio 1:1). VIA Family was individually tailored and based on case management. The intervention included options for psychoeducation, parental support, and treatment for emerging child psychiatric symptoms. Blinded raters assessed children and their families at baseline and after 18 months. The primary outcome was the difference in change between groups at end‐of‐treatment in daily global functioning measured with the Children's Global Assessment Scale. Secondary outcomes were emotional and behavioral problems and days absent from school. We analyzed data blinded to allocation. Results: At post‐intervention, differences in mean change from baseline between VIA Family and TAU were non‐significant (CGAS: −1.20, 95% CI = −6.61; 4.21, p = 0.66), as were the differences on the secondary and exploratory outcomes. Conclusion: Contrary to our hypothesis, we did not find a superior effect of VIA Family compared with TAU. The short follow‐up period and large sample heterogeneity might explain the null findings. Therefore, a possible long‐term, preventive treatment effect has yet to be explored. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to (1) identify similarities and differences in psychosocial burdens and support needs experienced by parent, partner and adult‐child caregivers and (2) identify support needs of family caregivers regarding peer support programs. Methods: Semi‐structured interviews (n = 30) were conducted with family caregivers of cancer patients. Interviews were transcribed and analyzed by inductive content analysis to identify themes. Results: Ten categories of burden were identified for all three groups of caregivers. Partners emphasized the time burden through caregiving, parents and adult‐child caregivers accentuated the emotional burden. All caregivers wished for peer‐to‐peer exchange which will provide the feeling not to be alone, to share emotions and to prepare for what will come next. Preferences for matching with peers with similar prognosis for their sick relative and similar living conditions were found. Conclusions: Partner, parent and adult‐child caregivers describe similar burdens of caregiving. They wish for peer support programs that allow them to share their experiences with persons who understand their situation. Therefore, caregivers desire a good match with peers to enhance the positive outcome of peer exchange. [ABSTRACT FROM AUTHOR]

Background: The health‐related quality of life instrument with 8 items (HINT‐8) was developed to measure health‐related quality of life (HRQoL) in Korea. However, the HINT‐8 has not yet been validated among the family caregivers of people with dementia (PwD). Design: A cross‐sectional pilot study. Objective: The study aimed to examine the convergent and discriminant validity of the HINT‐8 among family caregivers of individuals with dementia. Sample: Forty‐seven family caregivers of PwD. Measurements: HINT‐8 was compared with the 5‐level EQ‐5D (EQ‐5D‐5L) to assess its convergent and discriminant validity. Additionally, the association between the two instruments assessing HRQoL was examined using the short‐form Bédard‐Zarit Burden Interview (SZBI). Results: The HINT‐8 was a promising and valid HRQoL instrument for family caregivers of PwD. There was a significantly high correlation between the overall HINT‐8 and EQ‐5D‐5L indices (r = 0.85, p <.001). The HINT‐8 had acceptable psychometric properties compared to the commonly used EQ‐5D‐5L, as indicated by the subdomains associated with family caregiversʼ burden measured by the SZBI. Conclusion: Future studies should compare the HINT‐8 with existing dementia carer‐specific QoL instruments among a larger study sample to enhance its statistical power and confirm its reliability and structural validity. [ABSTRACT FROM AUTHOR]

Background: Providing care for people with dementia incorporates a level of burden which can affect quality of life for both the caregiver and the recipient of care. This study measures the level of burden experienced by Jordanian caregivers for people with dementia and explore related predictors. Methods: Through a cross‐sectional survey, participants were invited through convenience sampling to participate in a structured interview. Results: A total of 406 participants completed the survey. According to Zarit Burden Interview, the mean burden score of the sample was 26.2 (SD = 16.2). This score falls under the mild to moderate burden level. Older age of the patient, severe dementia, lower number of caregivers, if the caregiving negatively affected family relations, and if the caregiving negatively affected jobs, were significant predictors of burden. Conclusion: Caregivers in the current study reported no burden to a minimum burden. This result does not mean that these caregivers have no or minimal stress or that they do not have psychological needs; on the contrary, these results call for more attention to providing extra psychological and emotional support to caregivers of patients with dementia in order to decrease the burden level and maintain their efforts in caregiving. Future studies are required to discern the shape and context of unmet caregiver needs, assessment, and support. [ABSTRACT FROM AUTHOR]

Assisted reproduction often involves biological contributions by third parties such as egg/sperm donors, mitochondrial DNA donors, and surrogate mothers. However, these arrangements are also characterised by a biological relationship between the child and at least one intending parent. For example, one or both intending parents might use their own eggs/sperm in surrogacy, or an intending mother might conceive using donor sperm or gestate a donor embryo. What happens when this relationship is absent, as in the case of 'double‐donor surrogacy' arrangements (DDS)? Here, a child is conceived using both donor eggs and sperm, carried by a surrogate, and raised by the commissioning parents. In this paper, I critically examine proposals to allow DDS in the United Kingdom, and the intentionalist justification for treating this practice distinctly (morally and legally speaking) from private adoption. I argue that the intentionalist approach cannot plausibly justify such a distinction and that other approaches to moral parenthood are also unlikely to succeed. [ABSTRACT FROM AUTHOR]

The modern concept of 'family' in the United States recognizes many types of social groups as families, a conceptual shift which was largely helped along by advancements in assisted reproductive technologies enabling those formerly unable to biologically reproduce to have children, as well as by social movements aimed at garnering recognition for these emergent nonbiologically related social groups spearheaded by LGBTQ+ and adoption activists. That these social groups are now recognized as types of families is unquestionably an improvement to the concept, though there are still defects in the concept that preclude these nonnuclear families from achieving the same social–ontological status as nuclear families. Drawing from the nascent philosophical field of conceptual engineering, I analyze our current conception of 'family' and argue that it is tacitly exclusionary of nonnuclear families, which can be attributed to a combination of widespread genetic essentialism and linguistic practices that unduly cast the nuclear family as a more desirable type of family by emphasizing genetic relatedness as a valuable quality. I then offer proposals to ameliorate these defects, such as educational interventions to reduce genetic essentialism and the introduction of new terminology that does not connote one type of family as being superior to another. In doing so, my hope is to reveal and begin to resolve an overlooked defect in the concept of 'family' in order to bolster the movement to view all families as equal. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore how professionals with personal experiences of family‐related childhood adversity describe and make sense of the relationship between their experience and their supportive practice. It builds on interviews with 10 professionals working within two Swedish non‐governmental organizations offering support to children experiencing family‐related adversity. The findings show that the participants draw upon their own experiences when identifying children's need for individual support, recognition, belonging, knowledge and hope. Together, these five aspects can be said to form an experience‐informed narrative about children's support needs. The paper concludes by suggesting that the concept of a 'professional peer' may be a useful term for encompassing the dual role of professionals who have personal experiences of family‐related childhood adversity and who provide support to children in similar situations. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have addressed beliefs about treatment for opioid use disorder (OUD) among family members of people with OUD, particularly in rural communities. This study examined the beliefs of rural family members of people with OUD regarding treatment, including medication for OUD (MOUD), and recovery. Methods: Semi‐structured qualitative interviews were conducted with rural Vermont family members of people with OUD. Twenty family members completed interviews, and data were analyzed using thematic analysis. Results: Four primary themes related to beliefs about OUD treatment emerged: (1) MOUD is another form of addiction or dependency and should be used short‐term; (2) essential OUD treatment components include residential and mental health services and a strong support network involving family; (3) readiness as a precursor to OUD treatment initiation; and (4) stigma as an impediment to OUD treatment and other health care services. Conclusions: Rural family members valued mental health services and residential OUD treatment programs while raising concerns about MOUD and stigma in health care and the community. Several themes (e.g., MOUD as another form of addiction, residential treatment, and treatment readiness) were consistent with prior research. The belief that MOUD use should be short‐term was inconsistent with the belief that OUD is a disease. Findings suggest a need for improved education on the effectiveness of MOUD for family members and on stigma for health care providers and community members. [ABSTRACT FROM AUTHOR]

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Introduction: Among people diagnosed with Amyotrophic Lateral Sclerosis (ALS), there are parents with children living at home. Children in families experiencing severe illness are exposed to stress and health risks. Since 2010, healthcare personnel in Norway must assess whether patients have children under 18 years of age and make sure the children's needs for support are met. A child's ability to cope with family life affected by a serious illness depends on how the parent without the disease manages the situation. Little is known about how the partner of someone affected by ALS manages being next of kin and a parent simultaneously, and what kind of support they need. Methods: During 2021–2022, six semi‐structured interviews were conducted with partners to persons with ALS, whom had children living at home. The interviews were transcribed verbatim and analysed through qualitative content analysis. Results: Three themes with subthemes emerged: (1) Together, yet alone; (a) restricted home life, (b) missing the sharing of responsibilities and tasks as equal parents, and (c) caught between children's and partner's needs; (2) Experience of coping while waiting for death; (a) cherishing the moments, (b) sense of coping and concern, and (c) ensuring to get recharged; and (3) Support in times of need; (a) difficult to ask the network for help and (b) the healthcare system does not see the whole family. Conclusions: Our respondents felt alone, caught between the needs of their children and partner, without necessary support from the services, and were left to handle everyday life with all new challenges on their own. Future healthcare services need to consider the challenges faced by families dealing with life‐limiting illnesses. A family‐focused perspective is needed, so is peer support and interventions that address both emotional and practical aspects of life with an ill partner. [ABSTRACT FROM AUTHOR]

A quarter of all children grow up in a family where a parent experiences a mental illness (FaPMI). Research activity in this area is growing rapidly and it is now critical to better understand the extant knowledge in the field. This scoping review of quantitative FaPMI literature parallels a qualitative literature review and a series of Delphi studies with key stakeholders (e.g. lived experience and clinicians), that is part of a larger program of research to achieve consensus regarding the direction of FaPMI research; including making recommendations about outcomes and measures. The programme of research aims to promote and facilitate greater comparison and learning across studies and settings. Initially this scoping review summarises the quality and focus (e.g. country and sampling) of 50 quantitative studies from 2000 to 2023 and then classifies studies according to outcomes for parents, children and families. Six to eleven years were the most common child sample group and girls were slightly underrepresented (49/51) and parents were 88% mothers. Analogous parent and child outcomes were; mental illness/psychopathology, wellbeing, mental health literacy, trauma and stressful experiences, coping, help seeking/service need, within family relationships and supports, outside family relationships and supports. Additional outcomes for parents were; parenting skills, parent competence and parenting stress and for children in relation to their; cognitive functioning and caregiving. The family related outcomes were the within and outside family relationships and supports. Since 2000 there have been 136 different survey instruments employed with approximately 80% used in only one study. This suggests that the broader goals of the program of research are warranted as there is a need for less heterogeneity in measures used. Suggested areas for future research include a sampling focus on fathers, economic evaluations of programs, parent mental health literacy, trauma, genetics and integrating well‐being concepts into research designs. Child research should focus on mental health literacy, the level and impact of caring responsibilities, assessing past trauma and the roles of close family and external supports. [ABSTRACT FROM AUTHOR]

Rationale: To date, family satisfaction with emergency medical technicians (EMTs) has only been reported through narrative statements in subjective evaluations. Although a quantitative assessment of healthcare professional satisfaction is desirable, no specific measures have been devised to assess family satisfaction with the healthcare and care provided by EMTs. Aims and Objectives: This study aimed to develop and validate an EMT care family satisfaction scale to measure patient satisfaction with prehospital emergency care. Methods: The study population comprised 216 family members (N = 216) of patients who used ambulances between November 2020 and May 2021 in a single region in Japan. Questionnaires were distributed to the participants who provided informed consent. An exploratory factor analysis of construct validity was performed to validate the Family Satisfaction Scale. The Cronbach's alpha was used to validate the internal consistency reliability of the scale. Results: The exploratory factor analysis results revealed a four‐factor structure: 'explanation and communication,' 'physical treatment,' 'psychological support,' and 'environment in the ambulance.' The Cronbach's range (0.80–0.93) for the total score for each of these four factors and the overall total score confirmed favorable internal reliability of this study. Conclusions: The family satisfaction scale developed in this study was constructed and validated to highlight the role of EMTs and needs of the families in the prehospital care settings. Moreover, this scale can be applied in the evaluation and consideration of interventions to improve family satisfaction with EMTs. [ABSTRACT FROM AUTHOR]

Background: People with severe learning disabilities and complex needs are more likely to experience delayed discharge from hospital; however, there is little research into their experience in hospital and as they move out as part of the Transforming Care Programme. Methods: Six family members of people with complex needs who had moved out of hospital took part in four focus groups co‐facilitated with an expert‐by‐experience consultant. Participants' relatives had hospital admissions that ranged from 6 weeks to 11 years. Transcripts were analysed using reflexive thematic analysis. Additional reflections are included from an expert‐by‐experience consultant to capture their unique perspective. Results: Family members reported stories of abuse in hospital and parallel experiences of institutionalisation and trauma, resulting in long‐lasting impacts on themselves and their relative. Family members felt let down and undervalued by professionals. They described relief when their relatives moved out of hospital, but there were on‐going difficulties accessing the right support in the community and so stability felt fragile. Conclusions: Key recommendations to support community living include respecting family members' expertise, improving partnership working and offering psychological support for family members and people with complex needs post‐discharge. Accessible Summaries: We wanted to understand the experiences of families of people with complex needs living in a mental health hospital and moving out of hospital.Family members talked about how difficult the experience of being in hospital had been for their relative and for themselves.Family members felt very unsupported and let down by professionals.Family members talked about feeling relieved that their relative had moved out of hospital.There had been lots of on‐going problems accessing the right support for their relative.Family members and their relatives need specialist support to help the person with complex needs to live in the community and out of hospital. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the processes and experiences of intergenerationally tied relocation in which older parents from mainland China join their already migrated children in Hong Kong to provide domestic and childcare support. Background: Studies on tied migration have mainly focused on couple‐based moves within a human capital framework. With the increasing trend of grandparenting migrants, studies have expanded to address intergenerationally tied relocation. Method: We conducted thematic analysis of in‐depth interview data of 34 mainland Chinese respondents, including 15 parent–child pairs and four adult children. Results: The decision to relocate is influenced by the established history of intergenerational supportive exchange relationships. The initial motivation for tied relocation is to benefit the adult children. Older parents' postrelocation experiences can affect their later decision to leave or remain, with key factors including financial dependence, emotional stress, and difficulty in balancing the duty of care between migrant children and distant family members. In planning for future eldercare, the goal is to meet the needs of both generations. Options include non‐coresidential care, reliance on the parents' hometown sibling network, or living in nearby mainland cities closer to Hong Kong. Conclusion: The study highlights the complex interplay of family relationships and responsibilities in the phenomenon of intergenerationally tied relocation. The findings unveil the dynamic roles and adaptive strategies families utilize to facilitate the transfer of care and support across generations and geographies. Implications: Policy and services should be developed to assist aging immigrant families in their adaptation and integration, and formulate strategies for meeting future care needs. [ABSTRACT FROM AUTHOR]

Background: Children with autism spectrum disorder (ASD) can experience issues in motor development and fall short of physical activity (PA) recommendations. Family members, especially parents and siblings, play important roles in influencing their motor behaviors. Objective: This study investigated motor behaviors (i.e., levels of PA, parent‐perceived motor competence, and related family dynamics) in children with ASD during a historical event—the COVID‐19 pandemic—during which most service approaches were not being used, and children with ASD were staying at home with their parents and neurotypical (NT) siblings. Methods: This cross‐sectional study recruited 17 ASD–NT–parent triads (51 participants in total). Motor behaviors were all measured by questionnaires and surveys, with levels of PA also measured objectively using ActiGraph GT3X. Descriptive analyses were conducted. Results: Children with ASD participated in more types of sedentary activities than leisure‐time and sports activities. Parents perceived a low level of motor competence in their children with ASD, and compared with siblings, they perceived more interactions and higher self‐efficacy in supporting PA in children with ASD. Conclusion: The findings of this study can be helpful to us as we evolve our understanding and strategies to influence motor behaviors in children with ASD, ultimately to advance our service‐delivery model to include family‐based approaches. Implications: This study should inform future ASD studies of the importance of providing quality family‐based PA/education programs for children with ASD and boosting parents' and NT siblings' self‐efficacy in supporting PA in children with ASD. [ABSTRACT FROM AUTHOR]

Issues Addressed Methods Results Conclusions So What? In Australia, Aboriginal and Torres Strait Islander young people in remote settings are most‐affected by young onset type 2 diabetes (T2D). It is necessary to understand young people's experiences, including factors impacting on self‐management, to improve models of care.A phenomenological methodology underpinned this qualitative study in Western Australia's Kimberley region. Two Aboriginal Community Controlled Health Services supported recruitment of seven Aboriginal young people aged 12–24 with T2D, who participated in interviews. A carer and health professional of one young person in each site were also interviewed and relevant medical record data reviewed to assist with triangulation of data. De‐identified transcripts were inductively coded and a coding structure developed with oversight by a Kimberley Aboriginal researcher.Young people reported varied experiences and emotions relating to a T2D diagnosis. Most recounted this was upsetting and some reported current negative impact on emotional wellbeing. Challenges with understanding and managing diabetes were highlighted, particularly regarding healthy eating, physical activity and medication. Family are a prominent source of self‐management support, with the intergenerational impact of diabetes being evident for each participant. Positive relationships with health professionals, entailing continuity of care, were valued.There are significant emotional and medical challenges for young people with T2D and their families. Recommendations from this work will contribute to the development of local resources and initiatives to improve diabetes‐related support.Alongside broader efforts to support good health at the societal level, enhanced health education and family‐oriented support structures including Aboriginal clinical staff for young people with T2D are needed. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion This article tracks changes in stories of parental authority in Norway from a youth perspective, comparing how three generations talked about their own relationships with their parents while growing up.Previous research has described contemporary youth–parent relationships as being characterized by both diminution of parental authority, due to a democratization of family life, and by more covert forms of parental control. In addition to shedding light on generational differences in youths' perspectives on parental authority, the analysis reveals important nuances with regard to the ambiguous dynamics of power in contemporary youth–parent relationships.Through a narrative analysis of the stories of 67 participants, the article maps out how the three generations talked about different ways of “doing authority,” connoting how parental authority was relationally constructed and normatively anchored in their stories.Although the successive democratization of the youth–parent relationship is visible across the three generations, this democratization does not entail a corresponding loss in parental authority.The normative sources by which youth legitimize parental authority have changed to include ideals of the equal and close parent who is deserving of respect and hence retains an emotional authority. [ABSTRACT FROM AUTHOR]

Aims: To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co‐workers. Design, setting and participants: Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey. Measurements: Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio‐economic status. Findings Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%–62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%–23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13–1.95), younger people, rural, Australian‐born (vs. respondents born overseas in non‐English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model. Conclusions: Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives. [ABSTRACT FROM AUTHOR]

Eating disorders are complex mental health conditions exacerbated by high mortality rates. International and national guidelines recommend family involvement in the treatment process, recognising the family as an important source of support to young people. Research suggests fathers engage less in the process compared to mothers. In studies exploring parental perspectives, most samples consisted of mothers, with fathers minimally represented. Few studies explore family involvement from the perspective of fathers. This study aimed to explore the experiences of fathers regarding their involvement in the treatment process. Qualitative descriptive methods were used, involving focus group interviews of seven fathers. Interviews were assisted by a semi‐structured interview guide. A qualitative content analysis approach was used to analyse the data regarding paternal experiences of engagement in the treatment process. Fathers understood the importance of the whole family working together but viewed mothers as taking a more central role in the treatment process, with fathers more at the periphery. Gender emerged as an influencing factor in paternal involvement, with mothers primarily taking on responsibility for the child with the eating disorder and fathers providing secondary support. Healthcare providers need to be aware of the contribution of gendered roles within the family system and consider this when working with families within the treatment process. Consequently, mental health nurses have an important role in encouraging fathers to become actively involved in the treatment process. [ABSTRACT FROM AUTHOR]

Background: Epidermolysis bullosa (EB) comprises a group of rare types of genodermatoses characterized by extreme mucocutaneous fragility, leading to blistering and/or erosions, even with minimal trauma. Continuous care through wound management is an integral part of daily life for the families and individuals affected. The aim of this study was to assess the social reality and impacts on families of having minor members diagnosed with EB in Spain. Methods: A qualitative methodology was employed, utilizing four focus groups entailing participation by 24 parents (19 mothers and five fathers) of minors diagnosed with EB in Spain. Results: Negative impacts on the family nucleus were evident in four priority areas of analysis: sociorelational, economic‐labour, physical and psychoemotional, with significant differences observed based on the severity of the symptoms. Conclusion: Impacts on the family nucleus are noticeable from birth, influencing all other daily life routines and complicating family planning and organization. There is an imperative need to enhance the availability of sociohealth resources and to adopt an interdisciplinary approach to address their biopsychosocial needs. Patient or Public Contribution: The active participation of relatives of minors diagnosed with Epidermolysis Bullosa (EB) is invaluable to sociohealth professionals, legislators and researchers. A team member conducts their professional activities at DEBRA España (national patient association dedicated to enhancing the quality of life for individuals with EB and their families), actively engaging in all study phases. [ABSTRACT FROM AUTHOR]

Aim: To study cross‐sectional relationships between step‐up height and waist circumference (WC), a potential proxy for sarcopenic obesity, in Swedish children and parents. Methods: Participants were recruited from Swedish schools in disadvantaged areas in 2017. Height, body weight, WC and maximal step‐up height were measured in 67 eight‐year‐old children and parents: 58 mothers, with a mean age of 38.5 and 32 fathers, with a mean age of 41.3. Sedentary time and physical activity were registered by an accelerometer. Associations between maximal step‐up height and WC were analysed using Pearson's correlation and adjusted linear regression. Results: Abdominal obesity, WC ≥ 66 centimetres (cm) in children, ≥88 cm in women and ≥102 cm in men, was observed in 13% and 35% of girls and boys, and in 53% and 34% among mothers and fathers, respectively. Negative associations between maximal step‐up height and WC were found for children (r = −0.37, p = 0.002) and adults (mothers r = −0.58, p < 0.001, fathers r = −0.48, p = 0.006). The associations remained after adjustments for height, body mass index (BMI) and physical activity in adults. Reduced muscle strength clustered within families (r = 0.54, p < 0.001). Conclusion: Associations between reduced muscle strength and abdominal obesity were observed in children and parents. Sarcopenic obesity may need more attention in children. Our findings support family interventions. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the relationship between socioenvironmental sugar promotion and geographical inequalities in the prevalence of dental caries amongst 5‐year‐olds living across small areas within England. Methods: Ecological data from the National Dental Epidemiology Programme (NDEP) 2018–2019, comprising information on the percentage of 5‐year‐olds with tooth decay (≥1 teeth that are decayed into dentine, missing due to decay, or filled), and untreated tooth decay (≥1 decayed but untreated teeth), in lower‐tier local authorities (LAs) of England. These were analysed for association with a newly developed Index of Sugar‐Promoting Environments Affecting Child Dental Health (ISPE‐ACDH). The index quantifies sugar‐promoting determinants within a child's environment and provides standardized scores for the index, and its component domains that is, neighbourhood‐, school‐ and family‐environment, with the highest scores representing the highest levels of sugar promotion in lower‐tier LAs (N = 317) of England. Linear regressions, including unadjusted models separately using index and each domain, and models adjusted for domains were built for each dental outcome. Results: Participants lived across 272 of 317 lower‐tier LAs measured within the index. The average percentage of children with tooth decay and untreated tooth decay was 22.5 (SD: 8.5) and 19.6 (SD: 8.3), respectively. The mean index score was (0.1 [SD: 1.01]). Mean domain scores were: neighbourhood (0.02 [SD: 1.03]), school (0.1 [SD: 1.0]), and family (0.1 [SD: 0.9]). Unadjusted linear regressions indicated that the LA‐level percentage of children with tooth decay increased by 5.04, 3.71, 4.78 and 5.24 with increased scores of the index, and neighbourhood, school and family domains, respectively. An additional model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.37, and by family domain it increased to 6.33. Furthermore, unadjusted models indicated that the LA‐level percentage of children with untreated tooth decay increased by 4.72, 3.42, 4.45 and 4.97 with increased scores of the index, and neighbourhood, school, and family domains, respectively. The model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.24 and by family domain rose to 6.47. School‐domain was not significantly associated with either outcome in adjusted models. Conclusions: This study reveals that socioenvironmental sugar promotion, particularly within neighbourhood‐ and family‐environments, may contribute to geographical inequalities in dental caries in children. Further research involving data on individual‐level dental outcomes and confounders is required. [ABSTRACT FROM AUTHOR]

Objective: Through qualitative in‐depth interviews with interracial parents across the United States, this study explores how multiracial families as a unit experience monoracism via racial surveillance, voyeurism, and dissection. Background: Despite increasing representations of mixed‐race families in various media, studies find that many people in the United States assume that family members should phenotypically resemble each other and also represent one obvious racial category. Interracial partners and multiracial families experience the paradox of being both the "ideal" family in a post‐racial US society, but also an anomalous family that challenges assumptions about what family is. This study examines two broad research questions: (1) How do interracial parents and their multiracial families experience racism and/or other forms of discrimination? (2) How do families make sense of and respond to these experiences? Method: This study utilized qualitative in‐depth interviews with 19 sets of interracial parents, or 38 individuals, in the US Black‐White, Asian‐White, and Black‐Asian families are included in the sample. Results: Interracial parents in this study discussed experiencing racial dissection, surveillance, and voyeurism in their daily lives, which the author identified as mechanisms of monoracism. Monoracism, typically studied as an experience of multiracial people, is a form of oppression that targets those who do not fit into one racial category. However, monoracism also impacts multiracial family units. As a result, multiracial families were often prepared to prove their familial bonds, such as through birth certificates, or altered their behavior in public as a means of "performing" family in more obvious ways. Conclusion: Through a MultiCrit lens, this study reveals how interracial parents and their children experience monoracism. This study extends previous scholarship by exploring how multiracial families as a unit experience and navigate monoracism in their daily lives. [ABSTRACT FROM AUTHOR]

When children experience extreme or persistent stressors (e.g., maltreatment, housing insecurity, intimate partner violence), prolonged elevation of the stress‐response system can lead to disrupted development of multiple physiological systems. This response, known as toxic stress, is associated with poor physical and mental health across the life course. Emerging evidence suggests that the effects of toxic stress may be transmitted through generations, but the biological and behavioral mechanisms that link caregivers' childhood history with the health of the children they care for remain poorly understood. The purpose of this report is to describe the research protocol for The CARING (Childhood Adversity and Resilience In the Next Generation) Study, a cross‐sectional study of caregivers with children aged 3–5 years designed to (1) examine the intergenerational transmission of toxic stress and protective factors; (2) explore three hypothesized pathways of transmission: parenting, daily routines, stressors, and supports; and (3) explore the extent to which genotypic variation in candidate genes related to caregiving and stress contribute to caregivers' and children's susceptibility to the effects of early childhood experiences (i.e., gene × environment interactions). We expect that findings from this study will provide critical data needed to identify targets for precision health interventions, reduce health disparities related to toxic stress, and prevent cycles of adversity among families at risk. [ABSTRACT FROM AUTHOR]