Academic detailing increases prescription drug monitoring program use among primary care practices.

OBJECTIVE: Clinical review of a prescription drug monitoring program (PDMP) is considered a valuable tool for opioid prescribing risk mitigation; however, PDMP use is often low, even in states with mandatory registration and use policies. The objective was to evaluate the impact of an academic detailing (AD) outreach intervention on PDMP use among primary care prescribers. METHODS: AD intervention was delivered to primary care based controlled substance prescribers (N = 87) and their associated PDMP delegates (n = 42) by a clinical pharmacist as 1 component of a large-scale, statewide initiative to improve opioid prescribing safety. Prescriber PDMP use behavior was assessed by prescriber self-report and analysis of objective 2016-2018 PDMP data regarding the number of monthly report requests. We compared means between pre- and postintervention using a paired t test and plotted the monthly average reports over time to assess the trend of mean reports over time. Generalized linear mixed model with a negative binomial distribution was used to assess the difference in the trend and magnitude of the combined count of reports for the entire sample and prescriber subsets that were segmented on the basis of the adoption status of PDMP. RESULTS: The monthly mean of reports by combined prescribers and delegates significantly increased after the AD intervention (mean 28.1 pre vs. 53.0 post; P < 0.001), with the increase in delegate reports (mean 17.1 pre vs. 60.0 post; P < 0.001) driving the overall increase. Reports were requested 40.4 times more often than in the preintervention period (P < 0.001). Patterns of pre- to postchanges in mean monthly report requests differed by baseline PDMP adoption status. CONCLUSION: The AD intervention was transformative in facilitating practice change to use delegates to run reports. Visits with both prescribers and delegates, including hands-on PDMP training and registration assistance, can be viewed as beneficial for practice facilitation.

Relationship between the broad autism phenotype, social relationships and mental health for mothers of children with autism spectrum disorder.

This study aimed to examine the mechanisms responsible for the association between the broad autism phenotype and depressive symptoms in mothers of a child with autism spectrum disorder. A total of 98 mothers who had a child with autism spectrum disorder between the ages of 2 and 16 years completed assessments of maternal broad autism phenotype, child behavior problems, romantic relationship satisfaction, friend support, family support, and maternal depressive symptoms. Results indicated that only romantic relationship satisfaction was a significant mediator of the relationship between maternal broad autism phenotype social abnormalities and maternal depressive symptoms, where greater broad autism phenotype social abnormalities were associated with lower relationship satisfaction, which in turn was associated with increased depressive symptoms. Child behavior problems were directly related to increased depressive symptoms. Implications regarding maternal mental health outcomes within this population as well as intervention implications are discussed.

Brief Report: The Development of Compliance in Toddlers at-Risk for Autism Spectrum Disorder.

Parents of children with autism spectrum disorder (ASD) report concerns with child compliance. The development of compliance in 24-, 30-, and 36-month-old high-risk children with ASD outcomes (n = 21), high-risk children without ASD (n = 49), and low-risk children (n = 41) was examined. The High-Risk/ASD group showed greater passive noncompliance at 24-months than the non-ASD groups and a smaller increase in compliance than the High-Risk/No ASD group. The High-Risk/ASD group also showed a smaller decline in active noncompliance than the Low-Risk group. After controlling for receptive language, the passive noncompliance findings were nonsignificant whereas compliance and active noncompliance findings retained significance. The growth of compliance is attenuated in children with ASD, while changes in passive noncompliance are in part associated with language comprehension.

Helicopter Parenting, Autonomy Support, and College Students' Mental Health and Well-being: The Moderating Role of Sex and Ethnicity.

Whereas parental involvement is consistently linked with positive child outcomes throughout development, parental involvement that is not developmentally appropriate and intrusive--a style of parenting called helicopter parenting--can be problematic for their child's adjustment and well-being. Helicopter parenting can be particularly harmful during emerging adulthood when young adults are working toward developmental goals of self-reliance and autonomy. The purpose of this study was to examine sex differences in the relation between helicopter parenting and autonomy support on college students' mental health and well-being. A secondary aim was to explore the extent to which there were ethnic differences (non-Hispanic White vs. Hispanic) in associations between parenting and college students' outcomes. We examined several domains of mental health, including dysphoria symptoms, social anxiety, and general well-being. A sample of 118 undergraduate students (Mage = 19.82 years, SD = 1.38; 83.1% female; 57% European American) completed measures of parenting and mental health and well-being. The results showed that higher levels of helicopter parenting predicted lower levels of well-being for females, whereas higher levels of autonomy support predicted lower levels of dysphoria symptoms and social anxiety among males. No ethnic differences were found. The findings highlight that parents' behavior continues to predict their child's well-being even in emerging adulthood, and that parenting may differentially predict male and female college students' mental health outcomes.

Predictors of Daily Relationship Quality in Mothers of Children with Autism Spectrum Disorder.

Mothers of children with autism spectrum disorder (n = 70) completed online measures of global constructs (i.e., stable individual characteristics measured at time 1), which included resilience, depressive symptoms, and family functioning, followed by 14 daily questionnaires assessing relationship quality and affect on a given day. The global constructs were examined as predictors of daily relationship quality using multilevel modeling. Daily affect was examined in association with daily relationship factors (partner conflict, support from partner, and relationship happiness). Depressive symptoms and family flexibility predicted daily relationship quality. On a daily level, affect was associated with relationship quality. Results emphasize the potential of interventions to improve the quality of parents' relationships by addressing maternal mental health, family functioning, and daily affect.

The Relationship Between Optimism, Coping, and Depressive Symptoms in Hispanic Mothers and Fathers of Children with Autism Spectrum Disorder.

This study examined gender differences in the relationship between dispositional optimism, coping, and depressive symptoms of Hispanic mothers (n = 46) and fathers (n = 43) of children with autism spectrum disorder. Coping was hypothesized to mediate the relationship between optimism and depressive symptoms. The results revealed that mothers reported greater depressive symptoms and greater use of positive and support coping than fathers; however, both mothers and fathers reported similar levels of optimism and use of avoidant coping. In addition, positive and avoidant coping strategies mediated the association between optimism and depressive symptoms for both mothers and fathers. Clinical implications for this study include interventions for improving optimistic outlooks as well as interventions that improve parents' coping skills and therefore reduce negative outcomes.

The impact of maternal, child, and family characteristics on the daily well-being and parenting experiences of mothers of children with autism spectrum disorder.

This study utilized a daily diaries method to explore the global factors that impact daily general affect and daily parenting interactions of mothers of children with autism spectrum disorder. Eighty-three mothers of a child with autism spectrum disorder between the ages of 3 and 13 years completed global assessments of maternal depressive symptoms, child autism spectrum disorder symptom severity, and family functioning. Mothers then reported on their daily negative and positive affect as well as their daily positive and frustrating parenting interactions for 14 consecutive days. The results indicated that higher levels of maternal depressive symptoms were related to decreased daily positive affect, whereas greater child social motivation impairments were related to increased daily positive affect. Only maternal depressive symptoms were associated with increased daily negative affect. Furthermore, higher levels of family cohesion were related to increased daily positive parenting interactions. Finally, higher maternal depressive symptoms as well as family rigidity were related to increased daily frustrating parenting interactions. Implications for interventions focused on the family system are discussed.

The Power of Positivity: Predictors of Relationship Satisfaction for Parents of Children with Autism Spectrum Disorder.

The current study uses the actor-partner interdependence model to examine the predictors of relationship satisfaction for mothers and fathers of children with autism spectrum disorder. Sixty-seven couples completed measures of optimism, benefit finding, coping strategies, social support, and relationship satisfaction. Results indicated that parent's positive strengths predicted better personal relationship satisfaction. Moreover, parents' benefit finding, use of emotional support, and perceived social support from their partner also predicted their partner's relationship satisfaction. The results of this study highlight the importance of focusing on positive factors that can enhance relationship quality. Implications for the development of parent-focused interventions are discussed.