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Families' lives were severely disrupted by the COVID-19 pandemic, including a reconfiguration of daily routines and rituals, an elevation in daily social, educational, and economic stressors, and, for many, traumatic loss due to COVID-associated deaths. Families facing adversity can effectively adapt and forge positive growth by coming together to connect, problem solve, and foster a positive outlook, while also drawing on support from kin, social, community, sociocultural, and spiritual resources. We describe the stressors experienced by families during the pandemic, including the ongoing fallout of the pandemic and associated economic stressors. We discuss implications for families to prepare for future disasters, particularly the anticipated threats posed by climate change, in order to build the adaptability and resilience they will need to thrive. We propose that applying a research-informed family resilience conceptual framework can help us learn from the pandemic experience to prepare for a challenging and uncertain future. To bolster family resilience, it is crucial to provide accessible and family-centred mental health care and support. We provide a rationale for focusing on coparenting processes, or \"collaborative parenting,\" broadly defined to encompass diverse family systems, to foster strong family functioning and positive child development. We present two programs that aim to support coparenting as examples of strategies designed to build families' capacities for resilience. In summary, we draw lessons from the pandemic to guide preparations for the future, with a lens focused on empowering and strengthening families, while also considering the systems in which they are situated. La vie des familles a été gravement perturbée par la pandémie de COVID-19, avec notamment une reconfiguration des routines et des rituels quotidiens, une augmentation des facteurs de stress sociaux, éducatifs et économiques et, pour beaucoup, une perte traumatique due aux décès associés à la COVID. Les familles confrontées à l'adversité peuvent s'adapter efficacement et se développer positivement en se réunissant pour établir des liens, résoudre des problèmes et adopter une attitude positive, tout en s'appuyant sur le soutien des proches, des ressources sociales, communautaires, socioculturelles et spirituelles. Nous décrivons les facteurs de stress subis par les familles pendant la pandémie, y compris les retombées actuelles de cette dernière et les facteurs de stress économiques associés. Nous examinons les implications pour les familles de se préparer aux futures catastrophes, en particulier aux menaces anticipées posées par le changement climatique, afin de développer l'adaptabilité et la résilience dont elles auront besoin pour s'épanouir. Nous proposons que l'application d'un cadre conceptuel de résilience familiale fondé sur la recherche nous aide à tirer les leçons de l'expérience de la pandémie pour nous préparer à un avenir difficile et incertain. Pour favoriser la résilience des familles, il est essentiel de fournir des soins de santé mentale et un soutien accessibles et centrés sur la famille. Nous expliquons pourquoi il faut se concentrer sur les processus de coparentalité, ou « parentalité collaborative », définis au sens large pour englober divers systèmes familiaux, afin de favoriser un fonctionnement familial solide et un développement positif de l'enfant. Nous présentons deux programmes visant à soutenir la coparentalité comme des exemples de stratégies conçues pour renforcer les capacités de résilience des familles. En résumé, nous tirons les leçons de la pandémie pour guider les préparatifs pour l'avenir, avec un objectif axé sur l'autonomisation et le renforcement des familles, tout en tenant compte des systèmes dans lesquels elles se trouvent. Public Significance Statement Family resilience describes processes whereby children and families respond to adversity by deepening family bonds, fostering a positive outlook, and adapting to changing demands and circumstances in a way that fosters positive growth. In the wake of the COVID-19 pandemic, children and families continue to experience relational, social, and economic stressors, with mental health needs that far surpass available services. Family-centred and accessible mental health care services that aim to strengthen family resilience are needed for individuals, families, and societies in order to heal from the pandemic and prepare for future global challenges.

Since the Basic Law of Shokuiku (nutrition education) was established in 2005, the Japanese government has been promoting nutrition education among children to encourage better eating habits. This study analyzes the 2019 survey data on people’s attitudes towards nutrition education, in order to elucidate the relationship between the results of nutrition education, attitude towards nutrition education and proper eating habits, and the experience of nutrition education. The results reveal that people who received nutrition education at elementary school and middle school tend to have a more positive attitude towards nutrition education. In addition, family conversation on foods during elementary school years has a positive effect on nutritionally balanced eating behavior.

Background The psychosocial needs of families in which a parent is affected by life-threatening illness and has dependent children are extensive. However, few family-based interventions have been scientifically evaluated and even fewer have been evaluated long term. Therefore, the specific objectives of this study were to describe the parents’ perceptions of the timing and length of FTI in relation to the illness trajectory, to explore what activities learnt by the FTI still were practiced in the long-term and what content of FTI was perceived as most valuable to cope in the long-term. Methods This qualitative study involved a follow-up with nine parents (ill parents, n  = 3, coparents, n  = 6) 4 to 5 years after participating in FTI, where one parent was cared for in specialised palliative homecare. FTI is a psychosocial family-based intervention that consists of 6–11 manual-based meetings with the families led by an educated interventionist. FTI focuses on facilitating family communication about illness-related subjects, supporting parenting, and making the children’s needs visible. The data collection consisted of interviews and was analysed according to the phenomenographic method, focused on variations in perceptions. Results The parents perceived FTI as a way to alleviate feelings of loneliness, and some families were still using the obtained communication tools at the time of the interview. They also perceived that FTI contributed to the children being more open about their own feelings and thoughts. However, the parents wanted extended support after FTI ended based on their individual needs, for example, during and after bereavement, deteriorated health or occasional challenges faced by children in crisis. The parents perceived the peer support gained in conjunction with FTI as important social and emotional support both during and after the intervention. The interventionists were perceived as professional persons who promoted open and honest communication during FTI. Conclusion FTI is found to promote family communication both in a short- and long-term perspectives according to parents. They also found FTI useful in reducing their feelings of loneliness. Support over a longer period of time is desired and extra FTI meetings may strengthen the family as a whole in parallel with additional support for parents and children during the illness trajectory and in bereavement. They received support in dealing with strong and difficult emotions and learned conversational techniques that they still used at the time of the interview, indicating that the lessons learnt was integrated and valuable many years after the last FTI meeting.

Family functioning is associated with several adolescent health outcomes, and many family-based interventions (FBIs) exist to improve family functioning. However, most FBIs assess family functioning retrospectively at baseline and post intervention, thereby overlooking the daily fluctuations in family functioning throughout the intervention. Ecological momentary assessment (EMA) is a method involving a high frequency of assessments and has been underused to assess family functioning across parent and adolescent dyads. Further, limited research exists on the use of EMA in bilingual populations. The purpose of this study was to assess an EMA protocol's feasibility and acceptability and to analyze within-person and between-person variance in family functioning reports in a sample of primarily Spanish-speaking parent and adolescent dyads. Participants completed a baseline assessment (including demographics and family functioning assessment), a 7-day protocol with a once-daily family assessment questionnaire using an EMA app, and an acceptability questionnaire at the conclusion of the study. We recruited 7 mothers (mean age 37.29, SD 3.82 years) and 8 adolescents (n=7, 88% females; mean age 11.86, SD 1.07 years) who identified themselves as Hispanic/Latinx. The participants showed overall satisfaction with the EMA protocol. The daily assessments were completed relatively quickly (mean 3 minutes and 16 seconds, SD 11 minutes and 5 seconds) after the prompt notification was received, and the response rate across the daily assessments was 90% (87/97). The reported family functioning was relatively high across both adolescents (mean 4.57) and parents (mean 4.59). The variance across adolescents (SD 0.459) was larger than that within their individual reports of family functioning (SD 0.122). Alternatively, the variance across parents was smaller (SD 0.132) than that reported among parents' individual reports of family functioning (SD 0.286). Our findings highlight the heterogeneity between adolescent and parent responses. Finally, the visual inspection of data underscored the individualized patterns and reported differences in the family functioning reports across parents and adolescents. Our findings emphasize the value of EMA in studying family (eg, adolescent-caregiver) behaviors. EMA's ability to capture immediate experiences presents a nuanced picture of daily interactions and offers suggestions for practice when using the EMA methodology in populations such as the one included in this study (ie, primarily Spanish-speaking parent-adolescent dyads).

Severe mental illness causes suffering for the patient as well as the patient’s immediate family. The Swedish National Board of Health and Welfare has recommended the implementation of multifamily psychoeducation in order to assist patient and family in the recovery process. The aim of this study was to determine how introducing multifamily psychoeducation in Sweden has been viewed by professionals. Semi-structured interviews were conducted with 11 service providers, who were involved in evaluating multifamily psychoeducation. Our main findings fell under the headings of defensive culture and unsuitable model. Resistance to introducing the new intervention was found on multiple levels. The model proposed was considered too rigid for both the target group and the organizations because it could not be adjusted to the needs of patients, families, or facilitators. Despite good evidence for the effectiveness of the intervention, there were difficulties introducing the multifamily psychoeducation model in clinical practice. The feasibility of an intervention needs to be evaluated before adopting it as a national guideline.

ABSTRACT Background: Expressed emotion (EE) being a part of the family environment could adversely affect the course and prognosis of schizophrenia. Aim: This study aimed to assess the effects of family intervention among the caregivers of persons with schizophrenia. Methods and Materials: The experimental research design was used for 80 caregivers of persons with schizophrenia. Sociodemographic interview schedule of caregivers, family emotional involvement and criticism scale, and mini international neuropsychiatric interview (MINI 6.0) were used for data collection. A standardized family intervention program involving 10 sessions was provided to caregivers. The intervention included six sessions of family psychoeducation, two sessions of communication training, one session of stress management, and one session on recap and referral services over a period of 2-3 months. The intervention used methods of social case and group work, social work principles, and therapeutic activities. The methodologies adopted a brainstorming technique, case vignettes, role plays, and video clippings concerning the topics of the day. Brief handout on intervention was given. Results: The RMANOVA score (F = 35.892; P =0.001) revealed that there was a significant reduction in EE of the caregivers of the intervention group who underwent the family intervention program in comparison with the control group. Conclusion: Family-based intervention was found to be effective for reducing EE in schizophrenia.

Objective This scoping review aimed to synthesize the published literature on family‐based childhood obesity prevention interventions from 2015 to 2021 that focused on children 2–5 years of age from racial and/or ethnic minority households. Methods A PICOS (population, intervention, comparison, outcome, and setting) framework was used to guide the development of the research question, search strategy, and inclusion/exclusion criteria. To be included, the study must have been a randomized controlled trial or quasi‐experimental trial that enrolled participants 2–5 years of age and their caregivers who identified as being from a racial and/or ethnic minority group in the United States. The study must have also examined a family‐based intervention that incorporated components to prevent childhood obesity (i.e., fruits and vegetable intake, parental responsive feeding, physical activity), be conducted in a remote (i.e., online, text, mail), home, community, primary care setting, or early childhood education institution setting, and report on body mass index (BMI, kg/m2), BMI z‐score, anthropometric measures (weight, waist circumference, fat mass, etc.), changes in health behaviors, or increase in nutritional knowledge. Results Fourteen individual studies were identified. Most interventions used multiple components for promoting nutritional knowledge and behavioral changes among families. Eight interventions included culturally tailored components targeting four aspects: (1) language barriers, (2) food choices, (3) relationships between family members, and (4) rapport building. Conclusions There is limited research in this field focusing on children from racial and/or ethnic minority groups. Future efforts should invest in developing culturally appropriate interventions for these groups.

This study evaluated the efficacy of a family-centered preventive intervention, the Family Check-Up (FCU), delivered as an online, eHealth model to middle school families. To increase accessibility of family-centered prevention in schools, we adapted the evidence-based FCU to an online format, with the goal of providing a model of service delivery that is feasible, given limited staffing and resources in many schools. Building on prior research, we randomly assigned participants to waitlist control ( n = 105), FCU Online as a web-based intervention ( n = 109), and FCU Online with coaching support ( n = 108). We tested the effects of the intervention on multiple outcomes, including parental self-efficacy, child self-regulation, and child behavior, in this registered clinical trial (NCT03060291). Families engaged in the intervention at a high rate (72% completed the FCU assessment) and completed 3-month posttest assessments with good retention (94% retained). Random assignment to the FCU Online with coaching support was associated with reduced emotional problems for children ( p = .003, d = −0.32) and improved parental confidence and self-efficacy ( p = .018, d = 0.25) when compared with waitlist controls. Risk moderated effects: at-risk youth showed stronger effects than did those with minimal risk. The results have implications for online delivery of family-centered interventions in schools.

Background Women with prior gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes; however, this risk can be reduced by engaging in positive health behaviours e.g. healthy diet and regular physical activity. As such behaviours are difficult to obtain and maintain there is a need to develop sustainable behavioural interventions following GDM. We aimed to report the process of systematically developing a health promotion intervention to increase quality of life and reduce diabetes risk among women with prior GDM and their families. We distil general lessons about developing complex interventions through co-production and discuss our extensions to intervention development frameworks. Methods The development process draws on the Medical Research Council UK Development of complex interventions in primary care framework and an adaptation of a three-stage framework proposed by Hawkins et al. From May 2017 to May 2019, we iteratively developed the Face-it intervention in four stages: 1) Evidence review, qualitative research and stakeholder consultations; 2) Co-production of the intervention content; 3) Prototyping, feasibility- and pilot-testing and 4) Core outcome development. In all stages, we involved stakeholders from three study sites. Results During stage 1, we identified the target areas for health promotion in families where the mother had prior GDM, including applying a broad understanding of health and a multilevel and multi-determinant approach. We pinpointed municipal health visitors as deliverers and the potential of using digital technology. In stage 2, we tested intervention content and delivery methods. A health pedagogic dialogue tool and a digital health app were co-adapted as the main intervention components. In stage 3, the intervention content and delivery were further adapted in the local context of the three study sites. Suggestions for intervention manuals were refined to optimise flexibility, delivery, sequencing of activities and from this, specific training manuals were developed. Finally, at stage 4, all stakeholders were involved in developing realistic and relevant evaluation outcomes. Conclusions This comprehensive description of the development of the Face-it intervention provides an example of how to co-produce and prototype a complex intervention balancing evidence and local conditions. The thorough, four-stage development is expected to create ownership and feasibility among intervention participants, deliverers and local stakeholders. Trial registration ClinicalTrials.gov NCT03997773 , registered retrospectively on 25 June 2019.

Family-centered capacity-building practices have been shown to benefit children and families. However, limited research explores these practices for children who use augmentative and alternative communication. This study explored an intervention to teach family members to implement an Aided Language Modeling (ALM) strategy across natural activities at home. A single case multiple probe design was used to evaluate the intervention with five family members and a girl with autism. Results showed the intervention increased family members’ percentage of high-fidelity ALM strategy use and rate of ALM. Descriptively, a modest increase was also observed in the proportion of the child’s communication using the speech-generating device. Social validity interviews suggested the goals, procedures, and outcomes were socially valid and supported family capacity building.