Family functioning screening, referral, and behavioral health utilization in a family medicine setting.

INTRODUCTION: The objective of this study was to determine the preliminary feasibility and acceptability of screening for family functioning in a family medicine setting, and secondarily to explore differences in parent-child dyad interest in behavioral health service utilization by demographics, pediatric behavioral symptoms, and pediatric QOL. METHOD: The McMaster Family Assessment Device General Functioning subscale was used to assess family functioning among 58 parent-child (ages 11-26) dyads in family medicine. Feasibility and acceptability were assessed through study interest and participation and interest and attendance in behavioral health services. Associations with interest in services, Child Behavior Checklist, Pediatric QOL Inventory, and select demographics were conducted using independent samples t-tests and Mann-Whitney tests. RESULTS: Fifty-eight parent-child dyads participated in the study. Close to half of dyads who expressed interest in the survey completed the assessment (46%). Dyads who completed the assessment had a family functioning impairment rate of 45%, and 54% of dyads with impairment expressed interest in services. Interest in services was significantly associated with several domains of childrens' behavioral health symptoms and pediatric QOL, but no demographics. DISCUSSION: Dyads experienced high rates of clinically significant family functioning impairment, without interest in receiving colocated behavioral health services. Future research should continue to explore how family functioning assessment can be utilized to identify child behavioral health symptoms broadly and engage families in colocated behavioral health services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Family Functioning Assessment and Child Psychosocial Symptoms in Family Medicine.

PURPOSE: Children and young adults underutilize behavioral health services, in part due to the challenges with identifying and providing services for child behavioral health in primary care. The objective of this study was to determine if a brief assessment of family functioning captures specific child psychosocial symptoms in a Family Medicine practice. DESIGN AND METHODS: Eighty-three parent child dyads, in which the parent or child was a patient at the Family Medicine practice, participated in a cross-sectional study, including assessments of demographics, family functioning, child behavioral health symptoms, and health related pediatric quality of life (HRQOL). Bivariate correlations, independent samples t-test, and linear and logistic regression tested associations of parent and child reported family functioning with child behavioral health symptoms and HRQOL. RESULTS: Parent and child reports of family functioning were significantly associated. Child, but not parent reports of family functioning were significantly associated with parent and child reports of behavioral health symptoms. Parent's reports of increased family functioning impairment were only significantly associated with parent's reports of decreased HRQOL. Family functioning impairment was associated with parent and child reports of increased behavioral health symptoms and decreased HRQOL. CONCLUSION: Future work should determine if screening for family functioning impairment, may serve as a means of identifying and treating child behavioral health symptoms in Family Medicine. PRACTICE IMPLICATIONS: Identifying impaired family functioning may serve to engage children and their parents in services, who may otherwise not be identified as having symptoms.

Youth weight status and family functioning in paediatric primary care.

The purpose of this study is to examine the associations between family functioning and youth overweight and obesity in a sample of primary care paediatric patients. Specially, we hypothesize that caregivers of youth with an overweight/obese weight status will report more impaired family functioning. A cross-sectional descriptive study was conducted with 329 caregivers of youth ages 2 to 18 seen in paediatric primary care. Caregivers completed the Family Assessment Device General Functioning Scale and clinical demographics, including parent-reported youth height and weight to calculate body mass index (BMI). Family functioning was used as a continuous total variable, and as a dichotomous variable based on clinically impaired or healthy family functioning. Analyses included descriptive statistics, Pearson's correlations, and independent t tests. Caregivers who reported impaired family functioning based on the clinical cutoff score were more likely to report that their youth had a higher BMI and BMI z-score. Caregivers with impaired family functioning and who identified as being in two-parent families, with at least a Bachelor's degree, and a moderate to high family income were more likely to report their youth was a higher weight status. Further screening and assessment of family functioning in combination with youth weight status among a larger diverse sample of primary care paediatric patients over time will provide insight into what aspects of family functioning may contribute to maintaining a healthy lifestyle or adopting new health behaviours to prevent and/or treat obesity in youth.

Family Functioning in Pediatric Primary Care Patients.

INTRODUCTION: The purpose of this study was to pilot a brief measure of family functioning (Family Assessment Device-General Functioning [FAD_GF]) with caregivers of children aged 2 to 18 years, seen for routine pediatric primary care visits. METHODS: This study evaluated the psychometric properties of the FAD_GF in a pediatric primary care sample of 400 families. Confirmatory factor analysis was used to validate the FAD_GF using R, and WLSMV was used to estimate missing variables. RESULTS: The FAD_GF was found to be reliable with this sample, α = .90. The model fit was χ2(54) = 56.44, P = .38, with root mean square error of approximation = .01 and comparative fit index = .99. The 12 items were significantly predicted by family functioning, and family functioning explained more than 20% of the variance in the items, R2 > .25. Overall, 12.6% (n = 46) of families were identified as having clinically impaired family functioning. DISCUSSION: The FAD_GF provides clinicians the ability to make evidence-informed decisions regarding referrals to family therapists.