Words matter: The role of family weight talk in anxiety and depression.

Family weight talk, in the forms of both family weight teasing and encouragement to diet, has been linked to numerous adverse outcomes, including increased disordered eating, unhealthy weight control behaviors, and body mass index. However, little is known about its role in mental health outcomes, especially for emerging adults. Utilizing structural equation modeling, we examined the role of family weight teasing (FWT) and parental encouragement to diet in anxiety and depression and explored body weight perception as a moderator within a sample of 292 emerging adults. Results indicated that FWT was significantly associated with increased anxiety and depression. No significant relationships were found between parental encouragement to diet and the outcome variables, and no group differences emerged across body weight perception. Findings of this pilot study can be used to inform future research to decrease family weight talk and improve psychosocial outcomes for emerging adults.

A systematic review of the effectiveness of patient education through patient portals.

Objective: The objective of this study was to systematically review all literature studying the effect of patient education on patient engagement through patient portals. Introduction: Patient portals provide patients access to health records, lab results, medication refills, educational materials, secure messaging, appointment scheduling, and telehealth visits, allowing patients to take a more active role in their health care decisions and management. A debate remains around whether these additional aids actually improve patient engagement and increase their ability to manage their own health conditions. This systematic review looks specifically at the effect of educational materials included in patient portals. Materials and Methods: In accordance with PRISMA guidelines, the literature search was mapped across 5 databases (PubMed, CINAHL, Scopus, PsychINFO, Embase), and implemented on June 2, 2020. Results: Fifty-two studies were included in the review. Forty-six (88.5%) reported rates of patient utilization of educational resources in the patient portal. Thirty (57.9%) shared patients' perceptions of the usefulness of the education materials. Twenty-one (40.4%) reported changes in health outcomes following educational interventions through the patient portal. This review found that efforts are indeed being made to raise awareness of educational resources in patient portals, that patients are increasingly utilizing these resources, that patients are finding them useful, and that they are improving health outcomes. Conclusion: It seems that patient portals are becoming a powerful tool for patient education and engagement, and show promise as a means of achieving the quadruple aim of healthcare. Moving forward, research should establish more uniform methods of measurement in order to strengthen the literature surrounding the effectiveness of patient education through patient portals.

Family-Centered Primary Care for Older Adults with Cognitive Impairment.

Cognitive impairment (e.g. dementia) presents challenges for individuals, their families, and healthcare professionals alike. The primary care setting presents a unique opportunity to care for older adults living with cognitive impairment, who present with complex care needs that may benefit from a family-centered approach. This indepth systematic review was completed to address three aims: (a) identify the ways in which families of older-adult patients with cognitive impairment are engaged in primary care settings, (b) examine the outcomes of family engagement practices, and (c) organize and discuss the findings using CJ Peek's Three World View. Researchers searched PubMed, Embase, and PsycINFO databases through July 2019. The results included 22 articles out of 6743 identified in the initial search. Researchers provided a description of the emerging themes for each of the three aims. It revealed that family-centered care and family engagement yields promising results including improved health outcomes, quality care, patient experience, and caregiver satisfaction. Furthermore, it promotes and advances the core values of medical family therapy: agency and communion. This review also exposed the inconsistent application of family-centered practices and the need for improved interprofessional education of primary care providers to prepare multidisciplinary teams to deliver family-centered care. Utilizing the vision of Patient- and Family-Centered Care and the lens of the Three World View, this systematic review provides Medical Family Therapists, healthcare administrators, policy makers, educators, and clinicians with information related to family engagement and how it can be implemented and enhanced in the care of patients with cognitive impairment.

Bringing Inclusion Into Pediatric Primary Health Care: A Systematic Review of the Behavioral Health Treatment of Racial and Ethnic Minority Youth.

INTRODUCTION: Currently, pediatric behavioral health care accounts for one of the fastest growing health care expenditures. Children representing racial and ethnic minority groups are still found to experience significant behavioral health needs. Primary health care represents the first level of contact with the health care system. METHOD: The purpose of this systematic review was to synthesize articles discussing the behavioral health needs and treatment of racial and ethnic minority in primary care settings. RESULTS: Results yielded 40 articles meeting the inclusion criteria. Themes included: provider screening, provider selected treatments, prevalence and need, and stigma and patient-provider communication. CONCLUSIONS: Themes were discussed through the Ecological Systems Theory lens. Study limitations included its exclusion of intellectual disabilities like Autism Spectrum Disorder, lack of literature utilizing large minority samples, and lack of attention to the intersection between race and/or ethnicity alongside other demographics of concern like gender, age, social class, and geographical location.

Healthcare employees' social networks, burnout, and health.

INTRODUCTION: The purpose of this article is to introduce how social networks can be utilized as an effective approach to health informatics and to provide evidence from a quantitative research study regarding the effects of interpersonal interactions at work on healthcare employees' burnout and health. METHODS: Tests of moderation were calculated to explore whether interpersonal interactions at work changed the associations between job stress and burnout and health. The study used cross sectional data from a North Carolina convenience sample. Participants were 237 multidisciplinary employees from healthcare organizations who were at least 18 years of age. RESULTS: The results from this study provided evidence that more frequent friendly work-related communication benefitted employees' health, while more frequent hostile or difficult communication was detrimental to employees' burnout and health. DISCUSSION: In this article, an explanation for using social networks to collect quantitative, relational data to determine when interpersonal interactions at work are beneficial or detrimental to employees' health and burnout is provided. The article concludes with a discussion regarding how these results and methods can be used to advance the national movements aimed at addressing healthcare employees' health and burnout. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Attachment, Parenting, and Obesogenic Behavior: A Dyadic Perspective.

Pediatric obesity is a growing health concern afflicting the United States. The treatment for pediatric obesity, as a health epidemic, costs billions of dollars to our nation, leaving providers and researchers searching for effective and sustainable ways to better manage the biological, psychological, and social health of individuals and families. While many assessments and interventions continue to emerge, researchers have predominately focused on intra-individual concerns among white non-Hispanic populations. This quantitative study was grounded in a relational theory (attachment theory), with a dyadic and primarily Hispanic sample. Evidence from our study supported that child attachment predicted child obesogenic behavior and that this relationship was mediated by child self-regulation. Children with insecure attachments had more obesogenic behaviors and lower self-regulation of eating than those with secure attachments. Family therapists should be on the frontlines of relational research and clinical interventions that interface with biopsychosocial health across diverse cultures and families.

Type 2 diabetes as a familial illness: Findings from a focus group study.

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a prevalent illness with high societal and personal costs. Whereas there is some systemic research, there are still many pieces yet unknown about T2DM and families. The purpose of the current study is to understand the transgenerational health experiences related to T2DM for both patients and caregivers. METHOD: Focus groups were the primary methodology. Interviews were recorded, transcribed, and coded for themes. Participants were recruited via community fliers and e-mail listservs. The primary inclusion criterion was having a (a) family history of T2DM or (b) personal history of T2DM. Participants also needed to be at least 18 years old and be able to read and speak English. RESULTS: In 4 focus groups, 32 people were interviewed. The sample was entirely rural yet reasonably diverse. Five dominant themes emerged from the data: physical health comorbidities, T2DM is a lifestyle illness affecting the whole family, mental health stresses and comorbidities, personal and family relationship with T2DM, and sharing knowledge. DISCUSSION: Participants indicated that their families had been influenced by T2DM and that the illness had both physical and mental health comorbidities-both of which caused considerable stressors. Participants also reported that they valued the sharing of knowledge related to T2DM with each other and people in their lives. Limitations to the study include lack of generalizability because of small sample size and the majority of recruitment being done via technology. Future research should include larger, more diverse samples and quantitative data collection. Implications are also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors.

INTRODUCTION: This study utilizes triadic data to examine the association between mother-father-adolescent concordance (agreement) and discordance (disagreement) on home environment factors (i.e., parental encouragement of dieting, family functioning) and adolescent unhealthy weight control behaviors and binge eating. METHOD: A subsample of adolescent-mother-father triads (n = 833; adolescents ages 10-22) from two coordinated population-based studies (EAT 2010 and F-EAT) were used. Poisson regression analysis was used to estimate the relative risks of each eating disordered behavior. RESULTS: Triads were more concordant (range 9-42%) than discordant (range 4-24%). Triadic agreement that parents did not encourage dieting was associated with a lower risk of adolescent eating disordered behaviors in some triadic combinations. Additionally, triadic concordance on high family functioning was also associated with a lower risk of adolescent eating disordered behaviors among some triadic combinations. DISCUSSION: Results suggest that triadic concordance on healthy home environment factors is associated with fewer adolescent disordered eating behaviors in some triads. Family based interventions may want to consider focusing on strategies to help move mother-father-adolescent triads closer on seeing the home environment more similarly. Future research is needed on triadic concordance/discordance and disordered eating behaviors to confirm study results and to inform the development of family based interventions. (PsycINFO Database Record

A systematic review of evaluation research in integrated behavioral health care: Operational and financial characteristics.

INTRODUCTION: Integrated behavioral health care (IBHC) is an emerging solution for the delivery of behavioral health in primary care contexts. Although IBHC has been implemented and studied for more than 2 decades, little seems to be known about how it is best evaluated. This article illustrates a framework for IBHC evaluation based on the Three World view (with a focus on the operational and financial worlds) and delivers results from a systematic review on the operational and financial characteristics of existing IBHC research. METHOD: This study identified original reports of research that included an evaluation or assessment of the operational or financial success or sustainability of IBHC sites or programs. RESULTS: A total of 3,386 articles were found through the selected databases and 46 articles were found to meet the inclusion criteria. From the 46 articles that contained an IBHC evaluation including operational or financial variables, 9 operational and 11 financial characteristics were identified as barriers or strengths to sustainability or success. The characteristics of the evaluation participants, IBHC settings, and method of evaluation were also coded and analyzed. DISCUSSION: As a result of this systematic review of articles, evaluation of the success and sustainability of the operational and financial worlds can now be conceptualized at provider and practice levels. Collaboration and communication between medical and behavioral health providers was a significant operational characteristic related to success and sustainability. Financial characteristics indicated that continuous financial evaluation throughout implementation was important to success and sustainability. (PsycINFO Database Record

He Said, She Said: Examining Parental Concordance on Home Environment Factors and Adolescent Health Behaviors and Weight Status.

BACKGROUND: Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. OBJECTIVE: The main objective of the study was to examine whether and how parental concordance/discordance on factors in the home environment (eg, importance of family meals, parent feeding practices, encouraging child physical activity, and limit setting on child screen time) are associated with adolescent health behaviors and weight status. DESIGN: Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents' health behaviors and weight status. PARTICIPANT/SETTINGS: Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age=14.3 years) and their parents (n=2,104; 52% women; mean age=41.0 years) from Minneapolis and St Paul, MN, participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. RESULTS: Parental concordance on home environment factors was high for some factors (eg, 68% concordance on not pressuring adolescent to eat) and low for other factors (eg, 2% concordance on parent engaging in physically activity with child 4+ hours per week). Parental concordance on positive home environment factors (eg, frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (P<0.05), but not consistently. When parents were discordant, adolescents had higher consumption of fast food and more unhealthy weight control behaviors (P<0.05), but not consistently. CONCLUSIONS: Results suggest there is some degree of parental concordance on home environment factors; however, the results were inconsistent and approximately one-third of parents were discordant on these factors. Future research is needed to further examine the role of parental concordance/discordance on adolescent health behaviors and weight status.

Modeling the relationship between family home environment factors and parental health.

INTRODUCTION: Understanding parental health is an important part of understanding family health. Previous research suggests that family meals, familial relationship satisfaction, and family physical activity may separately be related to physical health. METHOD: The current study aims to combine these variables into a structural equation model to determine the collective relationship they have with adult health within a sample of parents (n = 1,435). Most parents were married, White, and highly educated. RESULTS: The relationship between family meals and parental health was significant (ß = -.07, t = -2.29, p < .05), with the full model having adequate fit and accounting for some of the overall variance in parental health. Familial relationship satisfaction and family physical activity were not found to be associated with parental health. Exploratory findings of the sample stratified by biological sex are described. DISCUSSION: Findings from the current study were consistent with a systemic perspective in that parents may have health benefits when they participate in family-level behavior (e.g., family meals). Additional areas for research and limitations to the current study are also discussed.