Families, Systems & Health : the Journal of Collaborative Family Healthcare

INTRODUCTION: Screening to promote social-emotional well-being in toddlers has positive effects on long-term health and functioning. Communication about social-emotional well-being can be challenging for primary care clinicians for various reasons including lack of time, training and expertise, resource constraints, and cognitive burden. Therefore, we explored clinicians' perspectives on identifying and communicating with caregivers about social-emotional risk in toddlers. METHOD: In 2021, semistructured interviews were conducted with pediatric clinicians (N = 20) practicing in Federally Qualified Health Centers in a single metropolitan area...

INTRODUCTION: Primary care is at the forefront of addressing the pediatric mental health (MH) crisis due to its broad reach to young children and prevention and health promotion orientation. However, the promise of the delivery system for population impact remains unrealized due to several barriers, including pragmatic screening, decisional uncertainty, and limited access to evidence-based services. METHOD: This article lays the conceptual foundations for the articles in this Special Section on Mental Health, Earlier in Pediatric Primary Care, which all apply a translational mindset to proposed strategies and solutions to overcome the barriers that have limited the potential of pediatric primary care for improving the MH and wellbeing of all children...

Leading national health organizations have declared pediatric mental health an urgent public health issue. Pediatric primary care is an ideal setting to improve mental health in young children; however, various existing barriers limit the effective identification of social-emotional risk among toddlers. This special section of Families, Systems, & Health includes four articles that identify multilevel barriers and facilitators to population-level early childhood mental health screening, identification, and referral and describe implementation strategies that may be used to improve pediatric mental health...

INTRODUCTION: Despite the well-documented youth mental health crisis, there has been a lag in the development of a specialized workforce to meet needs of young people experiencing these challenges. Little is known about the comfort of primary care pediatricians when faced with children and adolescents with mental health care concerns. METHOD: A brief online survey was conducted to assess patterns of behavioral and mental health concerns in pediatric practices affiliated with a pediatric health system in Alabama...

INTRODUCTION: Hematopoietic stem cell transplantation (HCT) greatly impacts the social, emotional, and physical well-being of the patient and their family. The transplant process imposes significant lifestyle restrictions that result in patient and family isolation, which has been further amplified during the COVID-19 pandemic era. While hospital systems recognize the importance of family engagement, the pandemic underscored the need to translate this philosophy more fully into practice...

INTRODUCTION: The primary care behavioral health (PCBH) model is one of the most widely implemented integrated care approaches. However, research on the model has been limited by inconsistent measurement and reporting of model fidelity. One way of making measurement of PCBH model fidelity more routine is to incorporate fidelity indicators into the electronic medical record (EMR), though research regarding the accuracy of EMR data is mixed. In this study, we aimed to assess the reliability of EMR data as a PCBH fidelity measurement tool by comparing key EMR indicators of PCBH fidelity to those recorded by an observational coder...

INTRODUCTION: Evidence is lacking about how to integrate family and community voice into systems of care. This is particularly relevant in public health crises when reducing barriers to health care and resources is critical for everyone, but especially community members who typically experience more barriers to care. Addressing this gap, this study investigated the voice strategies used by systems of care to respond to the COVID-19 pandemic. METHOD: We conducted semi-structured interviews in three U...

INTRODUCTION: A growing number of children have developmental delay (DD) or intellectual and developmental disabilities (IDD), and early intervention (EI) can improve their developmental trajectory. However, access to EI is fraught with disparities. This article describes the development of Parent Navigator (PN) program that placed three parents with lived experience in a pediatric medical home to serve as community health workers to provide support to families with a child with DD or IDD to access EI and other needed resources...

In this article, the author frames the development of integrated care and the Collaborative Family Healthcare Association (CFHA) through the ecocycle planning model. With four distinct stages of development and renewal-gestation, birth, maturity, and creative destruction-the ecocycle planning model encourages organizations to consider ways to ask questions to avoid a rigidity trap, which in the model appears as a process after maturity. As CFHA approaches its 30th year in 2024, the author documents a rough, imperfect history for a shared understanding of how integrated care and CFHA reached maturity and invites the readers to engage in critical questions to avoid the rigidity trap...

A poem describing the author's emotional response to seeing the children of elderly patients in hospital wards. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This poem recounts the author's experience as a child living with a mother suffering from bipolar disorder. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This poem recounts a patient's experience with pancreatic cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This sonnet is a brief symbolic meditation on the brevity of life and the "thin red line": by turns blood (stream/supply and life-giving), a boundary to be crossed (the Rubicon), the limit of our medical (and surgical) endeavors, and finally our horizon. "The thin red line" is also a metaphor for resistance, attributed in part to Kipling's poem Tommy : in particular to resilience by the few, against ostensibly superior forces. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This narrative recounts a medical resident's experience with a patient's desire to not receive life sustaining treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A seminal National Academies of Sciences, Engineering, and Medicine consensus report released in May 2021- Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care -emphasizes the importance of ensuring that high-quality primary care is accessible to all people, regardless of whether they have paid for it and in spite of its limited availability. This report outlines five recommendations for primary care stakeholders seeking to transform the health care landscape. This article summarizes these recommendations; identifies progress made toward high-quality primary care implementation since the report's publication; and outlines examples of policies, operational approaches, and advocacy strategies we believe are necessary to implement high-quality primary care...

Reviews the book The empathy exams: Essays . Empathy is a universally important aspect of both life and medicine that helps cultivate a therapeutic relationship between healthcare professionals and patients, family and loved ones, community members and friends, and beyond. As the times have evolved, empathy has become increasingly essential in not only elevating the quality of patient-centered care but also nurturing meaningful relationships and compassionate bonds among communities and families. Empathy encompasses an emotional understanding of another's pain and suffering and also invites self-reflection and humility...

Child health inequities are largely the result of entrenched, structural barriers created by racism, sexism, xenophobia, classism, and ableism that generally persist across the life course (Braveman & Gottlieb, 2014). The impact of such inequities may be magnified for those with complex needs who face considerable challenges in adulthood (Bethell et al., 2014), such as preterm infants, who experience threats to both short- and longterm health and development. Challenges in integrated care remain for all children, especially this population, despite extensive work across many decades to address such issues...

Intersectionality is a transformative analytic tool for identifying and challenging how intersecting, systemic power relations generate differential outcomes in quality of life (P. Collins, 2019; Crenshaw, 1989). Intersectionality identifies how varied forms of power relations are interconnected and mutually constituted: simultaneously influencing and influenced by one another. As these power relations interact to shape social experiences, they result in social inequalities including unequal distributions of harm, violence, and neglect...

INTRODUCTION: Most Americans with symptoms of depression and anxiety receive treatment exclusively from their primary care providers (PCPs). Existing primary care interventions typically do not occur within the initial patient interaction, rely on delivery by mental health specialists, and have lengthy training programs. This study evaluated the feasibility and acceptability of the training workshop for an ultra-brief cognitive-behavioral therapy (UB-CBT) single-session intervention for depression and anxiety symptoms that was developed to address these barriers...

INTRODUCTION: Mothers are key influencers in daughters' decision making about risk behaviors. Much research on parent-child relationships and communication has been conducted among predominantly White, nonimmigrant families. However, parent-child relationships and communications about risk behaviors may significantly differ for Black immigrant families. In particular, transnational behaviors that serve to maintain multiple social identities with attributes from both the receiving and sending nations may shape communication about risky behaviors...