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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).

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 aimed to assess the effectiveness of Participatory Learning School and Family Based Intervention Program for Preventing Game Addiction by Developing Self-Regulation of gaming addiction among students of grades 4 and 5 in Bangkok. A quasi-experimental study was implemented among students of grades 4 and 5 at primary schools in Bangkok selected through multistage random sampling. Two comparable schools were randomly assigned to either the intervention or control group. Then, 310 students in the randomly selected classrooms were allocated to each group. The intervention group received the self-regulation program with school and family involvement to prevent gaming addiction. Master teachers attended in-house training on prevention of gaming addiction in children. Parents of these children received a gaming addiction prevention manual and guidelines. The program lasted 8 weeks. The control group received no intervention. Knowledge and Attitude About Gaming Questionnaire, Game Addiction Screening Test (GAST), and Game Addiction Protection Scale were utilized to assess subjects at baseline, immediately after, and 3 months post-intervention. Descriptive statistics, chi-square, and independent -test were used to describe characteristics of the participants, and repeated measures ANOVA was analyzed to test the effectiveness of the intervention. The findings revealed that there were significant differences in knowledge, attitude, self-regulation, and gaming addiction behaviors ( < 0.05) immediately and 3 months post-intervention. Positive effects of the intervention included increase in knowledge, attitude, and self-regulation, whereas the GAST score was significantly decreased ( < 0.05) immediately and 3 months after the program. The program based on self-regulation and school and family participation is effective for preventing gaming addiction in students of grades 4 and 5 in Bangkok, Thailand.

This pilot study of the redesigned Resilience Clinic, a group-based psychoeducational intervention designed to promote relational health and child and family resilience provides preliminary evidence that participation in this intervention is associated with decreased caregiver stress, anxiety, and child behavioral concerns.

Theory-informed strategies for engaging parents in children's physical activity (PA) promotion show promise. However, behavior-change interventions must become more rigorous in both their application of theory and the reporting of its use to continue to advance the field. This study aims to elucidate how 2 behavior change theories were used to develop parent communication materials in a 20-week communications campaign, nested within a multilevel (school-home) intervention to promote children's PA. The innovation described in this study is derived from the Supporting Physical Literacy at School and Home (SPLASH) feasibility study (2021-2022). A team of 7 experts, including graduate students, researchers, faculty, and child PA specialists, collaboratively designed the process used to develop the intervention content. With experience in theory-informed interventions and health-related communication campaigns, they held recurring meetings to refine the approach. A four-step process was used to develop the theory-informed parent communication materials: (1) establish a theoretical foundation for communication materials (ie, social cognitive theory and self-determination theory) and conduct focus groups with the priority population; (2) identify and select PA parenting behaviors aligned with evidence and behavioral theories to form PA parenting objectives that advance children's PA; (3) identify theoretical determinants of parent behavior change and outline methods for applying determinants to address PA parenting objectives; (4) operationalize theory-informed strategy and draft, review, and finalize materials. Parent communications were delivered through print materials and electronic channels, including email, text messages, Facebook (Meta Platforms, Inc), and activity videos. This descriptive study advances progress in the development of school-based PA promotion efforts seeking to incorporate parent engagement strategies by detailing how behavior-change theories can be operationalized to improve PA parenting behaviors. This methodology is valuable for others seeking to translate theoretical constructs into behavior-change communication messages.

While digital innovation, including chatbots, offers a potentially cost-effective means to scale public health programs in low-income settings, user engagement rates remain low. Barriers to participant engagement (eg, perceived difficulty of use, busyness, low levels of digital literacy) may exacerbate inequality when adopting digital-only interventions as alternatives to in-person programs. This cross-sectional study nested within a 2×2 clustered factorial trial that followed the Multiphase Optimization Strategy principles investigated the relationship between behavioral determinants (ie, human and socioeconomic characteristics that facilitate the use of digital health interventions [DHIs]) and caregiver intention to use a digital public health intervention, ParentText, an open-source, rule-based parenting chatbot designed to promote positive parenting, improve adolescent health, and reduce risky behaviors. Caregivers of adolescent girls (10-17 years; N=1034 caregivers) were recruited by implementation partners from a community-wide project aimed at HIV prevention in two districts of Mpumalanga, South Africa. A Digital Health Engagement Model was adapted from the technology acceptance model, the PEN-3 model theoretical frameworks, and the Theory of Planned Behavior to investigate the relationship between behavioral determinants and the intentions of caregivers to engage in ParentText. Community facilitators administered baseline surveys to caregivers during intervention onboarding. Regression models tested associations between behavioral determinants (ie, perceived ease of use, perceived usefulness, attitude, hedonic motivation, habit, price value, and social influence) and intentions of caregivers to use the parenting chatbot. Interaction effects were explored to examine whether individual-level sociodemographic and psychosocial characteristics moderate associations between overall behavioral determinants and intentions to use the chatbot. Caregivers reported a mean of 2.85 (SD 0.79) and 2.90 (SD 0.72) out of a maximum score of 4 regarding their intention to use their mobile data and to continue using ParentText in the future, respectively. Overall behavioral determinants predicted by 76% (odds ratio 1.76, 95% CI 1.72-1.81) the intentions of caregivers to spend mobile data and by 85% (odds ratio 1.85, 95% CI 1.81-1.90) their intentions to use ParentText in the future. Moderator analysis suggested the interaction effects of age, paternal absence, financial efficacy, and stress on the relationship between overall behavioral determinants and intention outcomes. This is the first known study to investigate the associations between overall behavioral determinants and participant intentions to use a parenting chatbot in a low-income setting. This study identifies behavioral determinants of engagement for improved delivery of DHIs, considering the need to provide low-cost, scalable parenting support through digital platforms that engage parents, especially those in low-income contexts. Future research should explore methods to investigate mechanisms that regulate behavior to enhance the development of DHIs.

Over the past 3 decades, digital and screen media have evolved from broadcast, stationary platforms to a complex environment of interactive, omnipresent, mobile media. Thus, clinical guidance centered around unidimensional concepts such as \"screen time\" must be modernized to help families navigate the intricate digital ecosystems of readily available entertainment and information. This study aimed to identify and examine distinct latent profiles of media use in families with young children. We hypothesized that latent profile analysis (LPA) would identify different media use profiles characterized by more heavy, reactive, individual, and permissive media use and more intentional, regulated, or shared uses of media. We analyzed data from 398 preschool-aged children. English-speaking parents were recruited through community settings. Participants completed surveys regarding several aspects of family media use, such as child device use or activities, parent concerns and attitudes, limit setting and mediation, parent media use, and technology interference, examined in an LPA. The number of latent media profiles was determined using Bayesian Information Criteria. Parents also completed validated scales of parenting stress, depression symptoms, parenting style, child behavior, child sleep, and household disorganization. Multivariable logistic regression was used to examine parent, child, and household predictors of group membership. The LPA yielded 2 distinct groups that differed in the duration of media used by parents and children, to calm children or help them fall asleep. Statistically significant differences between groups included: families in group 1 (n=236, which we termed social-emotional drivers) had parents who preferred interactions via text or email to in-person (P=.01) and were more likely to use media to calm their children (P=.03); in contrast, families in group 2 (n=162, intentional media) used more task-oriented media, like audio and nongame apps (P=.01), had more concerns about effects of media on child language development (P=.04), and used more media restrictions (P=.01). In regression models, female sex of the parent respondent, greater number of siblings, and later child sleep midpoint independently predicted group 1 membership. Findings suggest divergent family media use patterns that can be categorized into 2 main media user groups: those using media to buffer social situations or regulate emotions and those planning mobile device use around functional purposes and concerns around media exposure. Profiles were associated with household size and child sleep. More research is needed to examine the impact of social and emotional uses of media on child outcomes.

Occupational therapy has highlighted the necessity for planning and executing interventions in collaboration with clients, families, and caregivers to facilitate their progress. Thus, in pediatric occupational therapy, it is essential to position the family as a primary client and to actively involve them in the intervention process. These interventions often incorporate tools that facilitate parental engagement in home-based activities. However, no tools have been specifically designed to support parents comprehensively in achieving their parenting goals in everyday situations. To address this gap, we developed a mobile app called the Children's Occupation Support Mobile System (COSMO) to support occupational therapists, children, and parents in a collaborative manner to achieve intervention goals in daily life. The aim of the study is to develop the COSMO and validate its content in terms of legibility, visibility, and accessibility. This study was conducted in two stages: (1) designing a prototype of COSMO and (2) validating its content using the Delphi method. The prototype was developed based on a conceptual model of parenting strategies, which was derived from interviews with mothers raising children with developmental disabilities. This study included 10 Japanese pediatric occupational therapists, who were selected using convenience sampling to ensure diversity and heterogeneity in attributes. The Delphi survey was conducted entirely through a web-based questionnaire emailed to the experts. Participants rated their agreement with each item on a 5-point Likert scale. A mean item score of ≥3.75 (75%) indicated consensus. The prototype was designed through a series of 13 one-hour meetings held monthly. The functional framework of COSMO was structured into four core components based on previous research: (1) collaborative goal setting, (2) home strategy-an action plan to achieve goals, (3) self-reflection-a record of implemented strategies, and (4) progress reports-data storage for tracking outcomes. For validating the content, the 2 Delphi rounds resulted in a total mean score of 4.44 for legibility, 4.86 for visibility, and 4.84 for accessibility. In the free-text responses, there were references to improvements in the wording and to the burden of writing the reflections. Therefore, the wording was revised to avoid jargon and use plain language. The burden of COSMO use was reduced by simplifying the use process by incorporating optional inputs for some of its functions. COSMO was developed as a comprehensive tool to integrate functions while aiming to reduce the burden on parents. This may reduce resistance to app use and make it easier for more parents to use it. Future studies should evaluate the generalizability and effectiveness of the prototype as an intervention. Limitations of this study include the absence of end-user testing, a geographically limited expert panel, and a limited discussion of implementation challenges across diverse health care settings.

Early exposure to adverse childhood experiences (ACEs), such as parental substance use, elevates the risk of future substance use and drug overdose, and in the absence of intervention, could perpetuate a cycle of substance-related ACEs across generations. Although research suggests that effectively decreasing the prevalence and impact of ACEs and substance use can benefit from addressing both family- and community-level factors in tandem, there is a critical gap in the evidence base pertaining to interventions that effectively integrate these 2 factors to prevent substance use and ACEs. This study aims to conduct a rigorous evaluation of a novel intervention that integrates the established, evidence-based Strengthening Families Program with clinically trained, trauma-informed family advocates who will assist families in accessing resources related to ACEs and social determinants of health. This study uses a hybrid type 1 effectiveness-implementation trial design, which is used to test a clinical intervention while gathering information on its delivery during the effectiveness trial and on the potential for implementation in real-world settings. Our hybrid type 1 design consists of 3 components. A cluster-randomized controlled trial will be used to test the effectiveness of the intervention on substance use, overdose, and ACEs in 36 New Jersey communities. A robust process evaluation informed by the Consolidated Framework for Implementation Research will be used to explore implementation barriers and facilitators. A cost evaluation will be conducted to accurately estimate the costs required to implement the intervention components and assess the cost-effectiveness of the intervention. Funding was awarded in 2022, and institutional review board approval was obtained in November 2023. Intervention and evaluation development lasted approximately 1 year, with study partners engaged in the co-design process to ensure alignment with the principles of community-placed behavioral health research. Study recruitment began in November 2023 and is anticipated to continue until September 2026. Final data collection is anticipated by March 2027, followed by data analysis. This study evaluates a novel intervention that integrates New Jersey's established, evidence-based Strengthening Families Program with clinically trained, trauma-informed family advocates who will assist families in accessing community resources. By evaluating both family- and community-level outcomes through a hybrid type 1 design, the study bridges a key gap in the evidence base and provides a framework for combining multilevel interventions to reduce the long-term impacts of ACEs and substance use on youth and families. Future findings will provide critical insight related to intervention effectiveness, implementation barriers and facilitators, and the intervention's associated costs and cost-effectiveness.