Visioning Family-Centered Care in Genetics: What Parents and Providers Have to Say

The purpose of this multisite exploratory research study involving focus groups of consumers and service providers was to generate stakeholder input for a statewide strategic plan for genetic services in the southwestern region of the United States. This article describes the qualitative methods by which the data were collected and summarizes major themes in participants’ perceptions about genetic services. It also describes processes related to obtaining genetic services and characteristics of an ideal service delivery system for children affected by genetic disorders and the families that care for them. Implications for practice and policy are also reviewed.     

The Context of Caretaking in Rural Areas: Family Factors Influencing the Level of Functioning of Seriously Mentally Ill Patients Living at Home

After the deinstitutionalization of psychiatric hospitals, many families became primary caregivers for seriously mentally ill individuals. Mental health services became further reduced with the advent of managed care and reductions in health and mental health care. The dearth of community-care options often results in psychiatric patients being quickly stabilized in hospital units and discharged to live with their families. The lack of community resources is particularly acute in rural areas. Given these realities the current study sought to determine if family caretaking variables are related to patient outcomes. Family factors including the perception of burden, expressed emotion (EE), and primary caregivers’ social support were tested in a model of caretaking that examines the relationship between these factors and patients’ symptom expression and social and occupational functioning. The sample includes 49 predominantly African American families living in a rural area and with a chronically ill family member who had been previously diagnosed with a psychotic disorder. Primary caregivers and patients were interviewed using adapted measures of burden, EE, and social support. Patients were administered a revised version of the Brief Psychiatric Rating Scale. Results suggest less perceived burden, increased caregiver support and, to a lesser extent, EE explain approximately one-fifth of the variance in patient functioning. These results support previous research demonstrating the importance of family factors for seriously mentally ill patient outcomes. Results are discussed in terms of implications for assisting families in the current era of diminished resources.     

Chinese childbearing decision-making in mainland China in the post-one-child-policy era

In 2016, China enacted its two-child policy, further lifted to a three-child policy in 2021, in response to low birth rates and imbalanced sex ratios resulting from the almost 40-year one-child policy. Despite this, China's birthrate is at a historic low as fewer parents are having children. Now more than ever, inductive explorations are needed to understand what motivates Chinese parents to have first and second children in the post-one-child policy era, particularly explorations that situate individual decision-making within the larger social context. Individual and relational choices occur in larger sociopolitical contexts. Understanding these “personal” actions involves considering how micro and macro processes inform each other. In this study, we elicited qualitative responses from Chinese mothers (N = 117) with two children in early childhood (firstborn ≤8 years old) from Liao Ning province. Most mothers were well educated, employed, and married to children's fathers. Using inductive thematic analysis procedures, we coded qualitative responses about the factors that motivated mothers to have first and second children. Our data revealed that (a) mothers expressed different reasons for having firstborns compared to secondborns, and (b) decision-making occurred against a backdrop of interacting micro-level and macro-level influences (e.g., cultural norms, national policy changes). In particular, mothers described the decision to have secondborns as more deliberative than with firstborns, considering long-term benefits siblinghood and shared demands of elderly caregiving. If efforts to stimulate the national birthrate are likely to succeed, policymakers should consider micro-level as well as macro-level factors that shape mothers' childbearing decision-making.     

Randomized controlled trial of a prenatal focused coparenting consultation for unmarried black fathers and mothers: One-year infant and family outcomes

In the infant mental health field, scant conceptual attention has been given to coparenting and family adaptations of non-white family systems, with no evidence-based, community-informed coparenting interventions responsive to unmarried Black mothers’ and fathers’ life circumstances. This study examined 1-year post-partum child and family outcomes of a novel, modest dosage (six sessions) prenatal focused coparenting consultation (FCC) using randomized controlled trial methodology. One-hundred-thirty-eight expectant families (one or both parents identified as Black/African American) were randomized to an intervention (N = 70) or treatment-as-usual (TAU; control) condition (N = 68). TAU families received navigational support in accessing existing community services for pregnant families. Intervention families received TAU plus 6 dyadic FCC sessions led by a Black male-female Community Mentor team. When infants were three and 12 months old, parents reported on coparenting, father engagement, interparental aggression, depressive symptoms, and infant social and emotional adjustment. Intent-to-treat analyses focusing on 12-month post-partum data indicated significant intervention effects on coparenting, interparental psychological aggression, and infants’ emotional adjustment. Improvement was also seen in depression and father engagement, with gains for both groups. Results suggest FCC delivered by same-race Community Mentors to unmarried Black coparents transitioning to parenthood supports infant and family adaptation during the first year of life.     

Not so far from home: How family characteristics predict child care quality

This study examined the relationship between family background and child care quality for 636 children enrolled in 120 day care centres in three states in the US with widely varying regulations for child care centre quality. Family characteristics accounted for a substantial portion of the variance in day care quality. Mother' attitudes towards child-rearing and parent' education were the most potent family-level predictors of quality. State child care policy variables were also strong predictors of quality. Findings also suggest that the influence of environment on children's development cannot be partitioned simply into family and out-of-home child care effects; rather, the child care environment is an extension of the family environment, with parents determining characteristics of both.     

Improvements in Unmarried African American Parents' Rapport,Communication, and Problem‐Solving Following a Prenatal Coparenting Intervention

This report examines effects of a coparenting intervention designed for and delivered to expectant unmarried African American mothers and fathers on observed interaction dynamics known to predict relationship adjustment. Twenty families took part in the six‐session “Figuring It Out for the Child” (FIOC) dyadic intervention offered in a faith‐based human services agency during the third trimester of the mother's pregnancy, and completed a postpartum booster session 1 month after the baby's arrival. Parent referrals for the FIOC program were received from a county Health Department and from OBGYNs and Pregnancy Centers in the targeted community. All intervention sessions were delivered by a trained male–female paraprofessional team whose fidelity to the FIOC manualized curriculum was independently evaluated by a team of trained analysts. At both the point of intake (“PRE”) and again at an exit evaluation completed 3 months postpartum (“POST”), the mothers and fathers were videotaped as they completed two standardized “revealed differences” conflict discussions. Blinded videotapes of these sessions were evaluated using the System for Coding Interactions in Dyads. Analyses documented statistically significant improvements on 8 of 12 variables examined, with effect sizes ranging from moderate to large . Overall, 14 families demonstrated beneficial outcomes, 3 did not improve, and 3 showed some signs of decline from the point of intake. For most interaction processes, PRE to POST improvements were unrelated to degree of adherence the paraprofessional interventionists showed to the curriculum. However, better interventionist competence was related to decreases in partners' Coerciveness and Negativity and Conflict, and to smaller increases in partner Withdrawal. Implications of the work for development and delivery of community‐based coparenting interventions for unmarried parents are discussed.     

Predicting mothers' reports of children's mental health three years after Hurricane Katrina

This study explored pathways through which hurricane-related stressors affected the psychological functioning of elementary school aged children who survived Hurricane Katrina. Participants included 184 mothers from the New Orleans area who completed assessments one year pre-disaster (Time 1), and one and three years post-disaster (Time 2 and Time 3, respectively). Mothers rated their children's behavior problems at Time 3 only (n = 251 children; 53.0% male; mean age: 10.19 years, SD = 1.68 years). A path analytic model indicated that hurricane-related stressors were associated with increased maternal psychological distress and school mobility in the first post-disaster year, which were associated with higher child internalizing and externalizing symptoms three years post-disaster. Mediation analysis indicated that hurricane-related stressors were associated with child symptoms indirectly, through their impact on maternal psychological distress. Findings underscore the importance of interventions that boost maternal and child mental health and support children through post-disaster school transitions.     

I Love to Tell the Story: Reshaping the Narrative of Adoption

Abstract : This article argues that a Christian theological understanding of adoption can be a helpful corrective to some of the negative interpretations and assumptions around adoption that continue to circulate in secular culture. The article proceeds as follows: First, I argue that the way in which Christians understand and describe the experience of being adopted into God's family counters the idea that one's birth family is one's “real” family. Second, I argue that a Christian understanding of adoption mitigates the tendency to view adoption as a sort of “Plan B.” Finally, I argue that because of the value Christians place on caring for those in need, and the replacement of kin relationships with relationships of love and faith, the metaphor of adoption can and should be used more widely, to create broader networks of family that encompass far more than mere blood ties.     

The Intergenerational Transmission of Contending Place Identities

Although a considerable amount of research exists regarding the transfer of political orientations within the family, little systematic attention has been devoted to studying the transmission of place (territorial) identities in contexts where such identities constitute a basic cleavage of political competition. This article examines the transfer of place identities in Catalonia, Spain, where contending identities, along with left‐right ideology, give shape to a distinctive regional political life. Using data from region‐wide household surveys, we analyze the reproduction of place identities as observed in parent‐child pairs and triads and find that it exceeds the reproduction of other political orientations, including left‐right self‐location and party preference. The direct transmission model fares well against the rival hypothesis of indirect transmission via parental social characteristics and the competing impact of the local context. Parent‐child congruence varies according to the homogeneity of parental place identities, the same‐sex and cross‐sex combinations of parents and their children, and the ethnic composition of neighborhoods.     

An Exploration of Families' Psychosocial Well-Being in a South African Context

The aim of this study was to explore and describe aspects that contribute to the psychosocial well-being of families from diverse cultures in a South African context by analysing data obtained through narratives, drawings and interviews with families. Participant families took part voluntarily in family interviews (N=36), written narratives (N=23) and drawings (N=14). These different methods of data collection provided rich data on family psychosocial well-being in a South African context with culturally diverse families, as well as on those aspects that influence family psychosocial well-being. The findings suggest that communication, mutual support, togetherness as a family and spirituality are the most prominent contributing factors, while financial difficulties and interpersonal conflicts or arguments are the most prominent hindering factors with regard to family psychosocial well-being in this group of participants.