Improving psychosocial services for vulnerable families with young children: strengthening links between health and social services in Germany.
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SUBMITTER: Renner I
PROVIDER: S-EPMC6282766 | biostudies-literature | 2018 Dec
REPOSITORIES: biostudies-literature
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Improving psychosocial services for vulnerable families with young children: strengthening links between health and social services in Germany.
Renner Ilona I Saint Victoria V Neumann Anna A Ukhova Daria D Horstmann Sabine S Boettinger Ullrich U Dreibus Martina M Kerl-Wienecke Astrid A Wulff Pilar P Mechthild Paul P Thaiss Heidrun H
BMJ (Clinical research ed.) 20181207
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Project description:Objective/backgroundInsufficient and/or poor-quality sleep may contribute to poor social-emotional well-being, and vice versa, among young children who have experienced maltreatment. This study examined longitudinal associations between sleep and social-emotional functioning among a sample of infants and toddlers from families involved with Child Protective Services (CPS) for maltreatment.ParticipantsParticipants were 123 parents and their infant or toddler (baseline age 10 to 24 months) from families referred to CPS for maltreatment.MethodsData were collected at baseline and at 3, 6 and 9 months post-baseline. At all time points, parents completed a questionnaire about their child's social-emotional functioning including internalizing behavior, externalizing behavior, and competence in social-emotional skills and social relatedness. At 3 months post-baseline, parents reported about their child's sleep problems and daily napping behavior.ResultsHigher baseline externalizing behavior was associated with a greater propensity for sleep problems at 3 months post-baseline. Sleep problems at 3 months post-baseline were associated with higher internalizing and higher externalizing behavior at 9 months post-baseline. Daily napping at 3 months post-baseline was associated with lower internalizing behavior, lower externalizing behavior, and higher competence at 9 months post-baseline.ConclusionsAmong this sample of young children from families involved with CPS for maltreatment, parents' concerns about their child having a sleep problem longitudinally associated with children's internalizing and externalizing behavior. Children's daily napping behavior longitudinally associated with later internalizing behavior, externalizing behavior, and competence.
| S-EPMC6851456 | biostudies-literature
Project description:BackgroundParental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed method evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness.MethodsThe study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost-effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5-18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are as follows: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention and at 6- and 12-month follow-up.DiscussionGiven the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings.Trial registrationISRCTN Registry, ISRCTN13365858 . Registered 5th February 2019.
| S-EPMC8015312 | biostudies-literature
Project description:BackgroundThe quality of social and emotional wellbeing services for Indigenous families of young children is not known, in many settings especially services provided by primary care centers.MethodsOur primary objective was to assess delivery of social and emotional wellbeing services to the families of young (3-11 months) and older (12-59 months) Indigenous children attending primary care centers. Our secondary objective was to assess if delivery differed by geographic location. Two thousand four hundred sixty-six client files from 109 primary care centers across Australia from 2012 to 2014 were analysed using logistic regression and generalised estimating equations.ResultsThe proportion of families receiving social and emotional wellbeing services ranged from 10.6% (102) (food security) to 74.7% (1216) (assessment of parent child interaction). Seventy one percent (71%, 126) of families received follow up care. Families of children aged 3-11 months (39.5%, 225) were more likely to receive social and emotional wellbeing services (advice about domestic environment, social support, housing condition, child stimulation) than families of children aged 12-59 months (30.0%, 487) (adjusted odds ratio [aOR] 1.68 95% CI 1.33 to 2.13). Remote area families (32.6%, 622) received similar services to rural (29.4%, 68) and urban families (44.0%, 22) (aOR 0.64 95% CI 0.29, 1.44).ConclusionsThe families of young Indigenous children appear to receive priority for social and emotional wellbeing care in Australian primary care centers, however many Indigenous families are not receiving services. Improvement in resourcing and support of social and emotional wellbeing services in primary care centers is needed.
| S-EPMC5807859 | biostudies-literature
Project description:Study aimPsychosocial stress can complicate the first phase of life for young families. One group that has received little attention so far are families with increased parental stress and conflict potential. This paper aims to 1) classify knowledge and use of support services for families with increased parental stress and conflict potential and 2) describe the psychosocial characteristics and parenting behaviours of these families.MethodsFor this purpose, data from a representative cross-sectional study in 2015 with n=7 549 families as well as the follow-up study with n=905 families were analyzed. Parents who took their child to a pediatrician's office for a screening examination (U3-U7a) completed a written questionnaire. Knowledge and use of services were assessed using four pre-defined stress groups (unstressed, socioeconomically stressed, with parental stress and conflict potential, and highly burdened).ResultsFamilies with increased parental stress and conflict potential are less likely to receive support offers. Despite high knowledge of selective prevention services, they use these offers less frequently than socioeconomically or highly stressed families. They are more likely to report dysfunctional parenting behaviors.ConclusionThis raises the question of whether families with increased parental stress and conflict potential receive too little support because they have no clearly visible need for help or whether they are adequately provided for due to the high socioeconomic resources, service knowledge, and use of universal medical and family education services. The results provide important information for the care of families in various stressful situations and contribute to the assessment of the need for support.
| S-EPMC11248269 | biostudies-literature
Project description:International evidence supports the effect of intensive family preservation and reunification services in preventing children's placement in out-of-home care (OOHC). Evidence within Australia is scarce. This protocol paper describes a hybrid effectiveness-implementation evaluation of the Victorian Family Preservation and Reunification (FPR) Response implemented by MacKillop Family Services. Participants include families engaged in the program and staff involved in program delivery. A pre-post study design will be used to assess the effectiveness of the FPR in improving family outcomes from intake to closure, including: (i) parenting knowledge, skills, and capability; (ii) family safety and home environment; (iii) child development, adolescent behaviour, education attendance and attachment; (iv) connection to services; and (v) prevention of children from entering or re-entering OOHC. Interviews and focus groups will be conducted with staff to evaluate the program's fidelity, reach, feasibility, acceptability, and enablers and barriers to implementation. Quantitative data will be analysed using descriptive statistics and a series of paired-samples t-tests and F tests to examine changes in outcomes over time; thematic analysis will be used for qualitative data. If the FPR can yield significant improvements in families' outcomes, this would provide strong support for its scale-up across Australia, to better support vulnerable families.
| S-EPMC8508066 | biostudies-literature
Project description:BackgroundHealth outcomes are significantly influenced by unmet social needs. Although screening for social needs has become common in health care settings, there is often poor linkage to resources after needs are identified. The structural barriers (eg, staffing, time, and space) to helping address social needs could be overcome by a technology-based solution.ObjectiveThis study aims to present the design and evaluation of a chatbot, DAPHNE (Dialog-Based Assistant Platform for Healthcare and Needs Ecosystem), which screens for social needs and links patients and families to resources.MethodsThis research used a three-stage study approach: (1) an end-user survey to understand unmet needs and perception toward chatbots, (2) iterative design with interdisciplinary stakeholder groups, and (3) a feasibility and usability assessment. In study 1, a web-based survey was conducted with low-income US resident households (n=201). Following that, in study 2, web-based sessions were held with an interdisciplinary group of stakeholders (n=10) using thematic and content analysis to inform the chatbot's design and development. Finally, in study 3, the assessment on feasibility and usability was completed via a mix of a web-based survey and focus group interviews following scenario-based usability testing with community health workers (family advocates; n=4) and social workers (n=9). We reported descriptive statistics and chi-square test results for the household survey. Content analysis and thematic analysis were used to analyze qualitative data. Usability score was descriptively reported.ResultsAmong the survey participants, employed and younger individuals reported a higher likelihood of using a chatbot to address social needs, in contrast to the oldest age group. Regarding designing the chatbot, the stakeholders emphasized the importance of provider-technology collaboration, inclusive conversational design, and user education. The participants found that the chatbot's capabilities met expectations and that the chatbot was easy to use (System Usability Scale score=72/100). However, there were common concerns about the accuracy of suggested resources, electronic health record integration, and trust with a chatbot.ConclusionsChatbots can provide personalized feedback for families to identify and meet social needs. Our study highlights the importance of user-centered iterative design and development of chatbots for social needs. Future research should examine the efficacy, cost-effectiveness, and scalability of chatbot interventions to address social needs.
| S-EPMC11297373 | biostudies-literature
Project description:ImportanceSocial determinants of health (SDOH) are associated with health outcomes. Thus, providing referrals for unmet social needs within clinical settings may improve the health of children.ObjectiveTo examine the prevalence and demographic characteristics of pediatric families with unmet social needs and their association with families accepting help from a pediatric clinical practice.Design, setting, and participantsThis cross-sectional study examined data from a comprehensive SDOH screening and referral program at a large academic pediatric practice in the US. Participants were caregivers of patients younger than 17 years and indicated at least 1 social need. Data were collected from April 16, 2018, through September 29, 2019, and analyzed from November 18, 2019, through December 17, 2019. The data review was finalized December 20, 2023.ExposureScreening for SDOH in primary care.Main outcome and measuresThe main outcome was interest in assistance among patient families with at least 1 social need. Factor analyses categorized social needs as basic needs, stress, challenges to economic mobility, and marginalization. χ2 Tests and multivariable Poisson regression were used to examine the associations between patient characteristics and caregiver interest in assistance.ResultsThere were 758 caregivers (median [IQR] age, 34 [29-40] years; 614 mothers [81.0%]) reporting at least 1 unmet social need, such as food or utility insecurity or unemployment. The median age of children was 23 months (IQR, 4-70 months), and 163 (21.5%)were of Asian, Pacific Islander, or Native Hawaiian ; 213 (28.1%) of Black; 156 (20.6%) of Latino or Hispanic; 37 (4.9%) of White ; and 122 (16.1%) of other race and ethnicity. A total of 315 caregivers (41.6%) were not interested in assistance. Families with basic needs (adjusted prevalence ratio [PR], 5.56; 95% CI, 3.33-10.00), stress (adjusted PR, 1.75; 95% CI, 1.43-2.17), challenges to economic mobility (adjusted PR, 2.17; 95% CI, 1.67-2.86), or marginalization (adjusted PR, 1.41; 95% CI, 1.15-1.72) were more likely to be interested in assistance. Additionally, Black race (adjusted PR, 1.23; 95% CI, 1.01-1.49), other race and ethnicity (adjusted PR, 1.22; 95% CI, 1.01-1.47), and inadequate social support (adjusted PR, 1.85; 95% CI, 1.32-2.63) were associated with acceptance of referral services.Conclusions and relevanceThese findings suggest that the implementation of referral programs may help to achieve health equity, especially among marginalized populations, and improve the referral process for families who have social needs but are not interested in assistance.
| S-EPMC11871544 | biostudies-literature
Project description:PurposeThis study examined the pattern of psychosocial care in breast cancer survivors.MethodsIn a prospective study with measurements before surgery, 1 month, 8 months, and 5 years thereafter, we examined the proportion of breast cancer survivors who were aware about, had been offered and received various types of psychosocial services from psychologists, social workers, doctors, self-help groups etc. The degree of helpfulness per service among users was ascertained with Likert scales. Determinants of awareness, offer and use were investigated using binary logistic regression analyses. How the services are inter-related was tested with principal component analyses.ResultsAmong 456 breast cancer survivors who participated until 5 years, psychological services were known by 91%, offered to 68%, and used by 55% of patients. Social services were known by 86%, offered to 65%, and used by 51%. Women ≥ 65 years were less likely to be informed about (odds ratio (OR) 0.2) and get offers for psychosocial services (OR 0.4 for social and 0.5 for psychological services) than women < 65 years. The services rated most helpful were social services in the hospital, psychological counselling by a consultant and psychotherapy in private practices.ConclusionThese findings underline the importance of psychosocial support by physicians in addition to the "professional" mental health and social care providers. They also show that elderly women in need for support might be in danger of not being well-informed about the services available.
| S-EPMC9984346 | biostudies-literature
Project description:BackgroundThe use of digital communication platforms to improve health behaviors has increased dramatically over the last decade. Public health practitioners have adopted digital communication technologies such as text messages, mobile apps, and social media to reach diverse populations. However, the effectiveness of digital communication platforms used by community-serving agencies remains unclear, and patterns of engagement and acceptability of different platforms have not been studied.ObjectiveThis review aimed to identify the types of digital communication strategies used by community-serving organizations to promote healthy behaviors, assess the strength of evidence for health behavioral change, and describe the degree of consumer engagement with and acceptability of these strategies. The study population included low-income pregnant women, parents of young children, and adolescents.MethodsA systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, Scopus, Web of Science, CINAHL, and APA PsycInfo, covering research conducted from 2009 to 2022. Studies were included if they examined the use of digital communication (ie, texting, mobile apps, or social media) to promote healthy behaviors in the target population. Risk of bias and strength of evidence were assessed using the Effective Public Health Practice Project Risk of Bias tool and criteria from Agency for Healthcare Research and Quality, respectively.ResultsTwenty-three peer-reviewed research studies published between 2012 and 2022, conducted in the United States, the United Kingdom, and Australia, were included in the review. The sample comprised studies exploring the use of texting (n=12), apps (n=6), social media (n=3), and multiple platforms (n=2; eg, texting and mobile apps). Targeted health behaviors included healthy diet, physical activity, obesity prevention, healthy pregnancy, breastfeeding, vaccine use, smoking cessation, and nutrition benefit redemption. The sample included 8 randomized controlled trials, 6 pretest-posttest design, 3 mixed methods studies, 2 pilot studies, 1 feasibility study, 1 prospective cohort study, 1 descriptive study, and 1 cross-sectional study. The median sample size was 77.5. There was no strong evidence to suggest the effectiveness of digital media campaigns in improving health behaviors; however, there were moderate to high levels of engagement and high levels of acceptability across digital platforms.ConclusionsLow-income pregnant women, parents of young children, and adolescents demonstrated moderate levels of engagement with and high levels of acceptability of digital media health campaigns conducted by community-serving agencies. The effectiveness of these strategies in improving health behaviors was inconclusive. Additional rigorous studies with larger sample sizes are required. In addition, more research is required to consistently measure and report participants' engagement with each platform. Digital communication platforms are critical tools for public health practitioners, and future investigations of the effectiveness of these platforms in engaging clients and improving health behaviors will maximize client services.
| S-EPMC9938444 | biostudies-literature
Project description:BackgroundLower socioeconomic status (SES) is associated with poorer dietary habits and fewer family meals. Therefore, initiatives to empower families with a lower SES to adopt healthier meal practices are employed. The objective of this study was to evaluate a nationwide intervention "Dinner is served at 1-2-3 euros", developed by a Belgian retailer in collaboration with social organizations. It targets families with a lower SES and aims to promote more balanced and freshly cooked meals by providing recipe booklets of affordable meals at a guaranteed price of 1, 2, or 3 euros per portion. The process evaluation aimed to gain insight into the implementation process (Reach, Recruitment, Dose-delivered, Context), the satisfaction with the intervention (Dose-received), and the perceived impact of intervention participation.MethodsA mixed-methods study combining qualitative (i.e., focus groups and individual interviews) and quantitative research (i.e., surveys) was conducted. An interview with the retailer (n = 1), three focus group interviews with the involved social organizations (n = 15), and interviews with participants of "Dinner is served at 1-2-3 euros" (n = 26) were carried out, as well as surveys among these social organizations and participants.ResultsSocial organizations were generally satisfied with the project and appreciated the collaboration with the retailer. The main barrier to implement the project was a lack of time to help participants subscribing. Participants appreciated the inspiration from the recipe booklets, and the recipes' ease of preparation, their healthiness, and the variety. However, the recipes were sometimes deemed too exotic for participants' children. Participants also appreciated the budget friendliness, although the price guarantee mechanism of 1, 2 or 3 euros per portion was not always clear. Positive effects were mentioned in areas such as perceived healthy cooking and eating, improved cooking skills and ideas, and reduced financial concerns.ConclusionsIn general, participants and social organizations were satisfied with the delivery and implementation of the intervention. Participants also noted some positive effects on their meal practices. Future research should provide insight into the intervention's effectiveness and impact on the healthiness of participants' dietary choices.Trial registrationThe study protocol was pre‑registered prior to data collection at Clinicaltrials.gov (NCT05595551-27/10/2022).
| S-EPMC11539700 | biostudies-literature