Scale of Parental Playfulness Attitude (PaPA): Psychometric Properties With Latino Caregivers in the United States.

IMPORTANCE: Parent-child play is a beneficial and meaningful co-occupation. Therapists who want to optimize parent-child play for Latino- and Latina-American dyads need valid, reliable measures to assess caregiver playfulness in addition to preexisting measures of child playfulness. OBJECTIVE: To evaluate data collected from Latino-American caregivers with the Scale of Parental Playfulness Attitude (PaPA), a 28-item parent self-report to determine its construct validity, internal reliability, and cross-cultural validity. DESIGN: Quantitative exploratory design applying a latent-trait psychometric model. SETTING: Online survey. PARTICIPANTS: Convenience sample of 50 Spanish-speaking parents from the mainland United States recruited via snowballing (88% mothers, ages 24-47 yr; M = 34.8 yr; 82% first-generation Americans). The inclusion criteria were age ≥18 yr; literate in Spanish; primary caregiver to a child age 2.5-7 yr. Data from an existing sample of 50 parents dwelling in Puerto Rico were used to examine cross-cultural validity. OUTCOMES AND MEASURES: Rasch analysis demonstrated evidence for adequate construct validity: positive point-measure correlations, 93% fit of items, logical item hierarchy, and good progression of the rating scale. Range and mean for parent playfulness exceeded those of the items; principal-components analysis revealed one contrast of 4.46 eigenvalues, bringing unidimensionality into question. Evidence suggested excellent internal reliability (person-reliability index = 0.85, strata = 3.55) and good cross-cultural validity (25 of 28 items formed a similar hierarchy for parents dwelling in the mainland United States and Puerto Rico). CONCLUSIONS AND RELEVANCE: Although the PaPA can be used to assess caregiver playfulness with culturally diverse Latino-American dyads, further research is required. What This Article Adds: This study provides evidence for the construct validity and internal reliability of a tool that measures parent playfulness in the context of parent-child play. The PaPA is an important tool for occupational therapists working with Latino-American families.

Surviving the storm: A pragmatic non-randomised examination of a brief intervention for disaster-affected health and social care providers.

Disasters affect the well-being of individuals, families and communities. Health and social care providers are essential in response and recovery efforts and are among the most vulnerable to negative physical and mental health impacts of a disaster. Few evidence-based interventions are available to address the psychological needs of providers. The aim of this study was to examine the psychological distress of health and social care providers before and after participating in the brief group intervention, Resilience and Coping for the Healthcare Community (RCHC) and its expanded version, RCHC+. We conducted a pragmatic non-randomised cluster trial with 762 health and social care providers in south Texas and Puerto Rico post-Hurricanes Harvey and Maria. Participants completed surveys assessing post-traumatic stress (PTSD), anxiety, burnout and secondary traumatic stress (STS) prior to intervention delivery and at two time points post-intervention. We calculated the frequency of symptom cut-off scores at baseline, then estimated multilevel ordinal models to examine changes in symptoms across time. Prior to participation in the RCHC (approximately 12 months after the hurricanes), providers reported high levels of PTSD, anxiety and STS symptoms. After participation, providers in both intervention conditions reported a significant reduction in PTSD symptoms from baseline that was sustained over both time points. The likelihood of a reduction in symptoms of anxiety and STS from baseline was sustained at both time points for participants in the RCHC+ condition. These findings indicate that both the RCHC and RCHC+ interventions may reduce psychological distress for health and social care providers and could be an important part of advance planning to support provider's mental health during and after a disaster. Further examination of the RCHC in other disaster contexts could provide additional insight into the responsiveness of the intervention to reducing psychological distress symptoms.

Social networks and subjective wellbeing of adults in a Housing First program.

This study explored the social network properties and the correlates between social networks and subjective wellbeing of adults (N = 80) in a Housing First (HF) program. Using structured interviews, participants' social network properties were assessed. Bivariate correlations and backward multiple regression analyses were conducted to determine the association between social networks and subjective wellbeing. Findings indicate a combination of years of homelessness, years in housing, frequency of contact, intimate relationship, and perceived social support significantly predicted subjective wellbeing (F (5, 74) = 2.74, p = 0.025). While perceived social support was positively associated with subjective wellbeing, frequency of contact was negatively associated with subjective wellbeing. It is recommended that service providers develop strengths-focused perspectives of the social networks of HF residents as potential contributors to subjective wellbeing. Service providers may need to pay more attention to HF residents with frequent contacts with network members, as they may have more distress.

Adult mental health and child maltreatment: An ecological study across rural-urban and economic continua with implications for post-pandemic human services.

This ecological, county-level, cross-sectional study examines relationships between the mental health of adults (IV) and child maltreatment report rates (DV), as they vary by socioeconomic distress and rurality (n = 3015 counties), using the most recent available data from several linked sources. In a two-way model, maltreatment reports increased 20.1% for each additional half day of poor mental health in metro counties, 11.7% in nonmetro counties, and 13% in rural counties. Our zero-inflated negative binomial model, moderated by rurality and economic distress, showed a significant relationship between the number of poor mental health days and increased child maltreatment report rates in counties (χ2 = 145.52, p < 0.0001). Investment in prevention and treatment of adult mental health concerns is imperative, especially in light of the increase in mental health problems caused by the coronavirus disease 2019 pandemic and increased tension within national political debate. Our results indicate successful support of adult mental health will prevent child maltreatment and reduce the cyclical financial burden of child maltreatment and mental health concerns.

Early childhood mental health consultation: Care providers' experiences of the consultative relationship.

This article presents findings from a qualitative research study exploring child care teachers' experiences receiving early childhood mental health consultation (ECMHC). As an emerging intervention in early childhood education, ECMHC is already yielding promising results, namely in helping teachers better address challenging behaviors in their classroom and promote a more nurturing classroom environment. However, there remains a lack of personal testimony from teachers who receive this intervention. Considering that teachers are the primary focus of most ECMHC interventions, the purpose of this study was to examine child care teachers' personal experiences receiving consultation. Eight child care teachers were interviewed for this study. Results from this study illuminate key interpersonal processes in the development of the consultant-consultee relationship, indicate what teachers consider to be the most helpful components of consultation, and speak to the challenges that teachers experience in consultation. By examining the personal testimony of child care teachers who have received ECMHC services, consultants and researchers can consider ways to expand and improve future implementation of ECMHC.

Este artículo presenta resultados de un estudio de investigación cualitativa que explora experiencias de los maestros de guardería infantil que reciben la consulta de salud mental en la temprana niñez (ECMHC). Como una intervención que surge en el campo de la educación en la temprana niñez (ECE), la ECMHC está ya mostrando resultados prometedores, particularmente al ayudar a maestros a manejar mejor las conductas que son un desafío en la sala de clases y a promover un ambiente más acogedor dentro del aula. Sin embargo, se nota aún la falta de testimonios personales por parte de los maestros que reciben esta intervención. Considerando que los maestros son el enfoque principal de la mayoría de las intervenciones ECMHC, el propósito de este estudio fue examinar las experiencias de los maestros de guardería infantil que reciben esta consulta. Se entrevistaron ocho maestros de guardería infantil para este estudio. Los resultados de este estudio dan luz a procesos interpersonales claves en el desarrollo de la relación entre consulta y consultante, indican lo que los maestros consideran ser los componentes de la consulta que más ayudan, y hablan sobre los retos que los maestros experimentan en el proceso de consulta. Por medio de examinar el testimonio personal de maestros de guardería infantil que han recibido los servicios de ECMHC, los consultantes y los investigadores pueden considerar maneras de expandir y mejorar la futura implementación de ECMHC.

Cet article présente les résultats d'une étude de recherches qualitatives explorant les expériences des puéricultrices de crèches recevant une consultation de santé mentale précoce de l'enfance (abrégé en anglais ECMHC). En tant qu'intervention émergente dans l'éducation de la petite enfance, l'ECMHC offre déjà des résultats promettant, en particulier dans la manière dont elle aide les enseignants à mieux adresser des comportements difficiles dans leur classe et dont elle promeut un environnement éducatif plus chaleureux. Il reste cependant un manque de témoignages personnels d'enseignants ayant reçu cette intervention. Vu que les enseignants sont les premiers ciblés par la plupart des interventions ECMHC, le but de cette étude était d'examiner les expériences personnes des puéricultrices ou puériculteurs recevant l'intervention. Huit enseignants ont été interviewés pour cette étude. Les résultats de cette étude illuminent les processus interpersonnels clés dans le développement de la relation consultant-consulté, indiquent ce que les enseignants considèrent comme étant les composantes les plus importantes de la consultation, et montrent les défis dont les enseignants font l'expérience en consultation. En examinant le témoignage personnel de puéricultrices ou puériculteurs ayant reçu les services ECMHC, les consultants et les chercheurs peuvent considérer des manières d'étendre et d'améliorer la mise en place à venir de l'ECMHC.

Traumatic injury and access to care in rural areas: leveraging linked data and geographic information systems for planning and advocacy.

INTRODUCTION: The purpose of this ecological study was to apply Geographic Information System (GIS) methods to patterns of traumatic injury and access to trauma care to facilitate system planning and advocacy. METHODS: Four US state (Colorado) and national data sources were linked to examine county-level disparities. Average ambulance drive times to trauma centers for populated places in each county were estimated and mapped. RESULTS: Independent samples t-tests demonstrated Colorado's rural counties had significantly higher injury hospitalization rates (mean (M)=685.4 v M=566.3; p=0.005)) and fatality rates (M=93.8 v M=71.6, p<0.001), indicating residents with the least access to care are the most impacted by the burden of injury; this finding was supported by GIS analyses of drive times to level I and II trauma centers and underlying injury rates, which are visually displayed. CONCLUSIONS: These methods are useful tools for rural public health professionals to conduct system optimization, identify training and resource needs, assess prevention priorities, and advocate for trauma system support.

Promoting Outdoor Physical Activity for People and Pets: Opportunities for Veterinarians to Engage in Public Health.

Regular physical activity (PA) is a health promoting behavior that transcends species. The collective evidence of a positive relationship between PA and health in both people and animals suggests that implementation of outdoor, dog-associated activities to increase PA may synergistically enhance both human and dog health. A systematic literature review was performed to identify research investigating objective, quantitative health outcomes in both dogs and people exercising together. Within the confines of the search, only 2 studies fulfilled the criteria for complete review. One study was administered through a veterinary clinic and another through a human health care provider. Both studies focused on obesity treatment, either for the dog or for both the dog and the owner. Collectively this work demonstrates the feasibility of simultaneously promoting health in both groups through PA; however there are limitations to the generalizability of the findings. Additional research is needed to further investigate the feasibility and effectiveness of PA promotion in primary care veterinary clinics as well as the use of animal-assisted PA promotion as a preventative, not just therapeutic, tool. As diseases that can be prevented, at least in part, by regular PA are now the leading causes of morbidity and mortality in developed countries, veterinarians have the potential to significantly impact not only the health of their patients, but also that of the public.

Physician discussion about social activities in primary care encounters with older adults.

OBJECTIVE: Involvement in social activities is linked to positive health outcomes. This study focused on the prevalence of social activity discussions during the primary care medical encounter, and examined how patient, physician, and contextual factors were associated with discussions between physicians and older patients. METHODS: The research was a secondary analysis of 434 videotapes recorded during primary care medical visits between 1998 and 2000 in outpatient clinics. Recordings were coded to identify a number of variables related to patient, physician, and companion characteristics, physician discussion on various topics, and quality of the physician's interaction with the patient. RESULTS: Physicians discussed social activity in only 31% of medical encounters. Variables significantly associated with social activity discussions included patient and physician race/ethnicity, physician age group, physician supportiveness, and the geographical site of the visit. CONCLUSION: Results support the inclusion of discussion and counseling about social activities in medical encounters with older patients. Family physicians will likely experience improved patient satisfaction, and geriatric patients can potentially reap health benefits that improve both quality of life and medical outcomes. Additional research is needed to understand more fully the correlates and benefits of social activity discussion during the medical encounter.

Prevalence and correlates of doctor-geriatric patient lifestyle discussions: analysis of ADEPT videotapes.

BACKGROUND: This study identifies the prevalence and correlates of physician-geriatric patient discussions about physical activity and nutrition lifestyle behaviors. METHODS: Between August 1998 and July 2000, 423 older patient visits to 36 physicians were videotaped in three different primary care settings. The patient sample was primarily white, female, well-educated, and financially sufficient, although 12.7% of the encounters occurred in an inner city clinic. The major dependent variable-lifestyle discussion-is based on observations of physician behavior. Descriptive and multivariate logistic regression analyses were conducted in 2004. RESULTS: Nutrition talk was most prevalent, occurring in almost half the encounters (48.2%) followed by physical activity discussions (39.2%) then conjoint mention (22%). Discussions were significantly less likely to occur in acute visits. While ethnicity, gender, and length of visit were not significantly related, physician interaction style and patient vitality and education were significant predictors in the multivariate analyses. CONCLUSIONS: Given the impact of lifestyle behaviors on myriad health outcomes, the current prevalence rates of physician discussion, while higher than in many previous studies, remain sub-optimal. Practical assessment tools, training in behavioral counseling, and reimbursement incentives are recommended strategies for raising physical activity and nutrition discussion prevalence in primary care settings.