ABSTRACT
The community reinforcement and family training (CRAFT) program provides group support for families affected by substance use disorders. During the COVID-19 pandemic traditional in-person support groups were limited and moved to online formats out of necessity and safety. This negatively impacted both recipients of group interventions as well as group facilitators. Research on the feasibility and effectiveness of a free, online CRAFT approach was limited at the time of this current study. This study attempted to measure the feasibility of the continued online application of CRAFT groups that utilized Zoom video conferencing software. A quasi-experimental, one-group posttest-only, mixed methods design was utilized in this study to obtain findings to answer these research questions. The sample of this study included data from a free, 12-week online group. These data included surveys from group participants (n=9) and group facilitators (n=8). Participant surveys utilized quantitative and qualitative data to measure group participant satisfaction and the effectiveness of the online group format. Group facilitator surveys utilized quantitative and qualitative items to measure group facilitator satisfaction, ease of access and feasibility of ongoing online group format. Data were analyzed using descriptive statistics (charts) in IBM SPSS as well as analyses of qualitative data conducted by the researcher. The findings concerning the effectiveness and feasibility of the ongoing application of such online groups were largely inconclusive. However, the findings of this study could inform future studies intended to measure the effectiveness and feasibility of similar ongoing, free, online CRAFT programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
This study evaluated the effects of an enhanced version of the Family Check-Up Online (FCU-O), adapted to address parent and family functioning in response to the COVID-19 pandemic. In order to increase accessibility, the FCU-O was delivered as a web-based application coupled with online coaching support, a service delivery model that is consistent with pandemic-related limitations for in-person intervention, as well as the limited staffing and resources available in many schools and health care settings despite the increased need for mental health services driven by the pandemic. This registered clinical trial (blinded) tested the effects of the intervention on parental mental health, parenting behaviors, and family functioning from pre-treatment to 2-month follow-up. Families were randomly assigned to receive the FCU-O (N = 74) or to a wait-list control condition (N = 87). Random assignment to the FCU-O was associated with significant improvements in parental well-being, including reduced anxiety, depression, and perceived stress. Further, the FCU-O predicted significant improvements in adaptive parenting skills (e.g. less negative/coercive parenting, greater proactive parenting), and enhancements in family-relational functioning (e.g. improved coparenting). Effect sizes were small to moderate in magnitude (partial eta squared values between 0.03 and 0.11). The results indicate that online delivery of a family-centered intervention may represent a promising approach for addressing pandemic-related impacts on parent and family functioning.
Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Mental Health , Parents/psychology , Parenting/psychologyABSTRACT
Backgrounds: Hikikomori, pathological social withdrawal, is becoming a crucial mental health issue in Japan and worldwide. We have developed a 3-day family intervention program for hikikomori sufferers based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). This study aims to confirm the effectiveness of the 3-day program by a randomized controlled trial. Methods: This study was registered on the UMIN Clinical Trials Registry (UMIN000037289). Fifteen parents were assigned to the treat as usual (TAU) group (TAU only; Age Mean, 65.6; SD, 7.8), and 14 to the Program group (program + TAU; Age Mean, 67.9; SD, 8.6). This study was discontinued due to the COVID-19 pandemic; the recruitment rate was 36.3% of our target sample size of 80. Results: Perceived skills improved temporally and stigma temporally worsened in the TAU group. Confidence decreased and attitude showed no change in both groups. Aggressive behaviors of hikikomori sufferers were significantly worsened in the Program group; however, no serious domestic violence was reported. In the TAU group, Avoidance and irregular life patterns were improved. Activity levels were worsened in both groups. Two participants (16.7%) in the Program group and one participant (7.7%) in the TAU group reported actual behavioral changes (e.g., utilizing support). Conclusion: We could not draw general conclusions on the effectiveness of the program due to the study discontinuation. Nevertheless, this study indicates the necessity for revision of the program to improve family members' confidence in engaging with hikikomori sufferers, with safer approaching by families.
ABSTRACT
The community reinforcement and family training (CRAFT) program provides group support for families affected by substance use disorders. During the COVID-19 pandemic traditional in-person support groups were limited and moved to online formats out of necessity and safety. This negatively impacted both recipients of group interventions as well as group facilitators. Research on the feasibility and effectiveness of a free, online CRAFT approach was limited at the time of this current study. This study attempted to measure the feasibility of the continued online application of CRAFT groups that utilized Zoom video conferencing software. A quasi-experimental, one-group posttest-only, mixed methods design was utilized in this study to obtain findings to answer these research questions. The sample of this study included data from a free, 12-week online group. These data included surveys from group participants (n=9) and group facilitators (n=8). Participant surveys utilized quantitative and qualitative data to measure group participant satisfaction and the effectiveness of the online group format. Group facilitator surveys utilized quantitative and qualitative items to measure group facilitator satisfaction, ease of access and feasibility of ongoing online group format. Data were analyzed using descriptive statistics (charts) in IBM SPSS as well as analyses of qualitative data conducted by the researcher. The findings concerning the effectiveness and feasibility of the ongoing application of such online groups were largely inconclusive. However, the findings of this study could inform future studies intended to measure the effectiveness and feasibility of similar ongoing, free, online CRAFT programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
The purpose of this research is to study the efficacy of the home-based Hero program in promoting positive emotions and prosocial behavior during the COVID-19 pandemic. The sample included 237 12- to 15-year-old adolescents from Argentina. The level of positive emotions and prosocial behavior toward strangers, friends and family in the adolescent intervention group increased through the three evaluation periods. The Hero program was focused on recognizing one's own emotions and provided an opportunity to reflect on different positive aspects of life, thus allowing a change in perspective related to immediate negative events. Moreover, the program provided an opportunity to change adolescents' perspective from personal worries to concerns about others, including friends, family members, and even strangers in need. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
There is a consensus that individuals with Autism Spectrum Disorder (ASD) fall short of the recommended 60-minute daily moderate-to-vigorous physical activity (MVPA), and some experience motor delays and abnormalities. Yet ASD interventions focusing on addressing these challenges are insufficient in the existing literature. Research evidence supports the effectiveness of neurotypical (NT) sibling involvement in ASD intervention, therefore, using NT siblings as intervention agents to promote PA and motor skills in their sister/brother with ASD may be a viable option. The three studies within this dissertation were conducted during the COVID-19 pandemic when free and unstructured physical activity (PA) was suggested to be achieved by playing with siblings. This dissertation's first investigation was a qualitative study investigating the perceptions of NT siblings and caregivers on prospective sibling-guided motor intervention in children with ASD. The principal investigator also gathered information that ball games, in-person format, once or twice per week frequency, weekend days, and 30-minute session duration were most preferred. Prior to designing and implementing the PA intervention, a cross-sectional study was conducted with 18 parent-ASD-NT triads (54 participants) to understand PA, parental perceived motor competence, and PA-related family dynamics in children with ASD during COVID-19. The findings from the PA questionnaire revealed that children with ASD spent a significantly greater amount of time in sedentary behaviors (mean = 2379.06 mins;SD = 1480.10) during an entire week than in leisure time activities (mean = 316.88 mins;SD = 301.48) and sports activities (mean = 183.00 mins;SD = 153.94). Also, parents perceived their children's competence on most skills listed in the parental proxy of the Pictorial Scale of Perceived Movement Skill Competence (PMSC-parent) as not too good or sort of good. In addition, it was indicated that NT siblings' self-efficacy in supporting children with ASD was lower than that of parents. By incorporating the findings from the first two studies, the third study within this dissertation provided an online family-implemented PA intervention for children with ASD to promote the variables that were measured in the cross-sectional study. The intervention used a randomized control trial with three intervention conditions: (a) Group A: PA intervention carried out by both a parent and a NT sibling, (b) Group B: PA intervention delivered by a parent only, and (c) Group C: control condition with only sedentary activities provided, rather than PA intervention. Among families who completed more than 60% of the intervention, significant differences were found in scores of object control skills [F (1,6) = 17.163, p = 0.006, etap2 = 0.741], fundamental motor skills [F (1,6) = 7.385, p = 0.035, etap2 = 0.552], and PMSC-parent total scores [F (1,6) = 6.914, p = 0.039, etap2 = 0.535] over time across the three groups [F (2,6) = 6.838, p = 0.028, etap2= 0.695], [F (2,6) = 13.507, p = 0.006, etap2 = 0.818], and [F (2,6) = 6.844, p = 0.028, etap2 = 0.695], with Group A showed more significant improvements. In addition, a significant within-group difference was found in parent-ASD interaction across time [F (1,6) = 6.964, p = 0.039, etap2 = 0.537]. Lastly, a process evaluation was conducted to examine the reach, dose, fidelity, and participant enjoyment. Results from this dissertation inform the design of future sibling-guided motor and PA interventions for children with ASD and encourage researchers to provide quality and enjoyable motor, PA intervention, and play-based services in an online format at the family level. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
COVID-19 led to widespread disruption of services that promote family well-being. Families impacted most were those already experiencing disparities due to structural and systemic barriers. Existing support systems faded into the background as families became more isolated. New approaches were needed to deliver evidence-based, low-cost interventions to reach families within communities. We adapted a family strengthening intervention developed in Kenya ("Tuko Pamoja") for the United States. We tested a three-phase participatory adaptation process. In phase 1, we conducted community focus groups including 11 organizations to identify needs and a community partner. In phase 2, the academic-community partner team collaboratively adapted the intervention. We held a development workshop and trained community health workers to deliver the program using an accelerated process combining training, feedback, and iterative revisions. In phase 3, we piloted Coping Together with 18 families, collecting feedback through session-specific surveys and participant focus groups. Community focus groups confirmed that concepts from Tuko Pamoja were relevant, and adaptation resulted in a contextualized intervention-"Coping Together"-an 8-session virtual program for multiple families. As in Tuko Pamoja, communication skills are central and applied for developing family values, visions, and goals. Problem-solving and coping skills then equip families to reach goals, while positive emotion-focused activities promote openness to change. Sessions are interactive, emphasizing skills practice. Participants reported high acceptability and appropriateness, and focus groups suggested that most content was understood and applied in ways consistent with the theory of change. The accelerated reciprocal adaptation process and intervention could apply across resource-constrained settings.
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The Health and Social Care Board in Northern Ireland commissioned an audit of social work case files from across service teams to establish whether Think Family Northern Ireland (Think Family NI) and FFP have become embedded across three different services (Community Mental Health Teams (CMHTs), and addictions and children's services). The audit sought to: identify the extent to which these services co-worked to support families;highlight good practice;and identify areas for improvement. A random sample of files was selected from the three services in four of the five Health and Social Care Trusts, the main statutory provider of services in Northern Ireland. Data were collected from 108 case files. The COVID-19 lockdown ended fieldwork prematurely and electronic data from some files were unavailable (n = 12). Of the 103 families in the final sample, the mother was the primary focus in 85% of cases and, in total, parents had caring responsibilities for 258 children, the majority of whom were aged under 16 years. Joint planning was only evident in 18.5% of cases. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Because of the COVID-19 pandemic, the Get Up & Go program, an established effective 10-week healthy weight program for children ages 6-14 years provided free to families, has offered the option of a synchronous virtual delivery. Pre- and postassessments include a parental questionnaire about child's health behaviors, and weight and height measurements of children. Over 3 cycles, 116 and 107 families registered for virtual and in-person delivery, respectively, with 70 (60.3%) and 84 (78.5%) attending ≥1 session (p = 0.003). More families in virtual delivery spoke Spanish (41.4% vs. 22.6%, p = 0.01), but children did not differ in age, gender, and severe obesity status, and baseline behavior scores and graduation rates were similar. Improvement from baseline in BMIp95 was -3.71 [standard deviation (SD) 5.26] for virtual delivery and -1.95 (3.69) (p = 0.06) for in-person. Behavior questionnaire improvement [+15.9 (12.9) vs. +14.2 (12.0), p = 0.51] did not differ. The virtual implementation demonstrated good effect and may be useful in nonpandemic environments.
ABSTRACT
People living with dementia (PLWD) often experience behavioral and psychological symptoms of dementia (BPSD) which are burdensome to those diagnosed, their families, and society. Many non-pharmacologic interventions have demonstrated efficacy in reducing BPSD in research but have had limited uptake in the community, possibly due to lack of feasibility and limited acceptance by PLWD and their family caregivers. Acutherapy and weighted blankets are non-pharmacologic interventions that have improved outcomes among older adults, but few studies have focused on PLWD and BPSD. The purpose of this research was to explore the potential of acutherapy and weighted blankets as non-pharmacologic interventions to reduce BPSD in PLWD. The research presented in this 3-paper dissertation was guided by 6 specific aims: 1. Identify, examine, and synthesize the state of the science relating to the effects of acutherapy on BPSD. (Paper 1) 2. Explore perspectives of family caregivers of community dwelling older adults with Alzheimer's disease or related dementias (ADRD) regarding BPSD and use of non-pharmacologic interventions for BPSD management. (Paper 2) 3. Explore perspectives of family caregivers of community dwelling older adult family members with ADRD regarding changes in their caregiving experiences, BPSD displayed by their relatives with ADRD and BPSD management strategies used during the COVID-19 pandemic. (Paper 2) 4. Explore initial perceptions of family caregivers regarding weighted blankets as an in-home care strategy for community dwelling PLWD following a brief description and visual presentation of weighted blankets. (Paper 3) 5. Examine feasibility and acceptability of a virtually delivered, in-home weighted blanket intervention for older adults with ADRD living in the community as perceived by the family caregiver and the person with ADRD. (Paper 3) 6. Examine feasibility of collecting outcome measures of BPSD, cognitive function, and quality of life of care recipients with ADRD, and well-being and self-reported health status of family caregivers. (Paper 3) Aims were addressed using: a scoping review methodology (Aim 1);a qualitative approach using semi-structured interviews with 21 family caregivers living with community dwelling PLWD (Aims 2, 3, and 4);a prospective, within subjects, pre-post design study with 21 community dwelling PLWD and their family caregivers (Aims 5 and 6). This dissertation research had 6 key findings: 1) Acutherapy is a safe non-pharmacologic care strategy for PLWD and a potential treatment for BPSD, but additional research is needed to determine efficacy;2) The caregiving experience of family caregivers of community dwelling PLWD was described as an interdependent partnership between the caregiver and the PLWD;3) Family caregivers and PLWD experienced challenges to in-home care prior to the COVID-19 pandemic, many of which were compounded by it;4) The virtually delivered, in-home weighted blanket intervention was feasible and acceptable to PLWD and their family caregivers;5) Collecting outcome measures of care recipient cognitive function, caregiver well-being and caregiver self-reported health was feasible;6) Collecting outcome measures of care recipient BPSD and quality of life was feasible through measures completed by caregiver report, but not by care recipient self-report. The efficacy of feasible and acceptable care strategies for community dwelling PLWD must be determined to promote broader uptake by clinicians, support service providers, and families. As BPSD are overwhelming for PLWD, their families, and society, we are in dire need of evidence-based non-pharmacological interventions to reduce the burden and improve the quality of life of PLWD and their families. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Purpose: This article compares outcomes of a family-based prevention program from its original in-person mode to an online mode in response to the COVID-19 pandemic. Celebrating Families!TM is designed to improve parenting skills, family functioning, and family relationships to break the cycle of substance use problems. Method: This mixed-methods, quasi-experimental study compared outcomes of in-person and online treatment conditions and content analysis of open-ended responses to a satisfaction survey. Results: Both groups showed improvement in outcomes, with moderate effect sizes and high satisfaction. Average scores of the online groups were generally lower than the in-person scores. Qualitative data yielded participants' accounts of improvements in parenting behaviors, family relationships, coping skills, and knowledge insights. Conclusions: Despite the contexts of COVID-19, findings provided evidence that such relational group interventions can be feasibly administered online and can effect changes required to break the cycle of substance use problems and adverse family experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
The COVID-19 pandemic has posed unprecedented challenges to the U.S. mental healthcare system. Immediate action has been required to transform existing social work practice models to ensure uninterrupted delivery of essential mental health services. This paper describes how clinicians in a residential program, who offered an in-person multi-family education workshop, rapidly pivoted in the context of the pandemic to develop and implement an alternative and unique multi-family intervention model - a virtual family town hall. This innovative telehealth practice model serves as an exemplar of best practices amidst the COVID-19 pandemic as it prioritized health and safety, increased accessibility, and allowed clinicians to effectively respond to family members' heightened informational needs.