BACKGROUND: Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning. There is urgent need to investigate the value of systematically incorporating caregivers in SBIRT-A procedures.
OBJECTIVE: This randomized effectiveness trial will advance research and scope on SBIRT-A in primary care by conducting a head-to-head test of 2 conceptually grounded, evidence-informed approaches: a standard adolescent-only approach (SBIRT-A-Standard) versus a more expansive family-based approach (SBIRT-A-Family). The SBIRT-A-Family approach enhances the procedures of the SBIRT-A-Standard approach by screening for AOD risk with both adolescents and caregivers; leveraging multidomain, multireporter AOD risk and protection data to inform case identification and risk categorization; and directly involving caregivers in brief intervention and referral to treatment activities.
METHODS: The study will include 2300 adolescents (aged 12-17 y) and their caregivers attending 1 of 3 hospital-affiliated pediatric settings serving diverse patient populations in major urban areas. Study recruitment, screening, randomization, and all SBIRT-A activities will occur during a single pediatric visit. SBIRT-A procedures will be delivered digitally on handheld tablets using patient-facing and provider-facing programming. Primary outcomes (AOD use, co-occurring behavior problems, and parent-adolescent communication about AOD use) and secondary outcomes (adolescent quality of life, adolescent risk factors, and therapy attendance) will be assessed at screening and initial assessment and 3-, 6-, 9-, and 12-month follow-ups. The study is well powered to conduct all planned main and moderator (age, sex, race, ethnicity, and youth AOD risk status) analyses.
RESULTS: This study will be conducted over a 5-year period. Provider training was initiated in year 1 (December 2023). Participant recruitment and follow-up data collection began in year 2 (March 2024). We expect the results from this study to be published in early 2027.
CONCLUSIONS: SBIRT-A is widely endorsed but currently underused in pediatric primary care settings, and questions remain about optimal approaches and overall effectiveness. In particular, referral to treatment procedures in primary care remains virtually untested among youth. In addition, whereas research strongly supports involving families in interventions for adolescent AOD, SBIRT-A effectiveness trial testing approaches that actively engage family members in primary care are absent. This trial is designed to help fill these research gaps to inform the critical health decision of whether and how to include caregivers in SBIRT-A activities conducted in pediatric primary care.
BACKGROUND: ClinicalTrials.gov NCT05964010; https://www.clinicaltrials.gov/study/NCT05964010.
UNASSIGNED: PRR1-10.2196/54486.

This randomized controlled trial tested the Family Assessment and Feedback Intervention (FAFI), a new intervention to enhance family engagement with emotional and behavioral health services. The FAFI is a guided conversation with families about results of their multidimensional assessment that is set in the context of motivational enhancement. It differs from other assessment-with-feedback interventions by extending the focus of assessment beyond the target child to parents and the family environment, addressing parental emotional and behavioral problems and competencies, spanning a broad range of children\'s and parents\' strengths and difficulties, and being generalizable to many settings and practitioners. Participants were 81 families in primary care pediatrics. The FAFI was associated with a significant increase in parental mental health literacy and with an increase in parental attitudinal engagement with health supports and services that closely approached statistical significance (p = .052), while controlling for children\'s age and gender and family socioeconomic status.

UNASSIGNED: Developmental dislocation of the hip (DDH) is a common congenital deformity of the skeletal system in children.
UNASSIGNED: To investigate the efficacy of post-surgery cluster nursing in children with DDH.
UNASSIGNED: A total of 60 children with DDH who underwent hip joint orthopedic surgery in our hospital from September 2021 to September 2022 were enrolled as the research participants in this prospective study, and divided into the control group and the observation group according to the numerical table method, with 30 patients in each group. The control group was given routine pain care, and the observation group was given cluster pain care. The hip joint function scores, pain scores, self-rating anxiety score (SAS) were compared between the two groups and between before intervention and after intervention in the two groups.
UNASSIGNED: The pain score of the children and the SAS of the primary caregivers after the intervention in the observation group were lower than those in the control group (P< 0.05), and the hip joint function score and family satisfaction degree were higher than those in the control group (P< 0.05).
UNASSIGNED: Family-based cluster pain care can reduce pain in children with DDH after surgery, promote hip joint functional recovery, reduce the negative emotions of caregivers, and improve family satisfaction, and has clinical popularization value.

UNASSIGNED: Stress is an overwhelming feeling in patients with breast cancer (BC). However, The effect of virtual education has not been fully regulated. Hence, this study intends to compare the impact of 2 virtual education methods on perceived stress and stress coping in women with BC.
UNASSIGNED: A 3-armed randomized clinical trial was conducted among 315 women with BC who were referred to the Cancer Institute in Tehran. They were randomly assigned to 3 groups: (a) Family-based, receiving family-based training package; (b) peer-support, receiving peer-support educational package; and (c) control, receiving routine hospital care. Data were collected through demographic and disease characteristics, the Perceived Stress Scale (PSS-14), and Coping Inventory for Stressful Situations (CISS-21) questionnaires before and 3 months after the intervention.
UNASSIGNED: The effect of the group factor after controlling the before-intervention scores in perceived stress, problem-oriented, emotion-oriented, and avoidance-oriented strategies were P < 0.0001, P = 0.015, P < 0.0001, and P = 0.111, respectively. Also, the effect of the confounding factor of BC disease stage in the dependent variables was P = 0.527, P = 0.275, P = 0.358, and P = 0.609, respectively. The effect size test showed that before the intervention, the mean scores of perceived stress, problem-oriented, emotion-oriented, and avoidance-oriented strategies were 32.00 ± 7.03, 19.36 ± 4.68, 25.10 ± 5.90, and 17.65 ± 6.64 respectively, but after the intervention showed a decrease in mean scores of perceived stress, emotion-oriented, and avoidance strategies.
UNASSIGNED: What is vibrant in virtual family-based education is far more effective than peer support when problem-oriented coping increases. Conversely, reducing perceived stress in women with BC receiving enough information and family support should be considered.

Individuals with specific language impairment (SLI) struggle with language acquisition despite average non-verbal intelligence and otherwise typical development. One SLI account focuses on grammar acquisition delay. The current study aimed to detect novel rare genetic variants associated with performance on a grammar assessment, the Test of Early Grammatical Impairment (TEGI), in English-speaking children. The TEGI was selected due to its sensitivity and specificity, consistently high heritability estimates, and its absence from all but one molecular genetic study. We performed whole exome sequencing (WES) in eight families with SLI (n = 74 total) and follow-up Sanger sequencing in additional unrelated probands (n = 146). We prioritized rare exonic variants shared by individuals with low TEGI performance (n = 34) from at least two families under two filtering workflows: (1) novel and (2) previously reported candidate genes. Candidate variants were observed on six new genes (PDHA2, PCDHB3, FURIN, NOL6, IQGAP3, and BAHCC1), and two genes previously reported for overall language ability (GLI3 and FLNB). We specifically suggest PCDHB3, a protocadherin gene, and NOL6 are critical for ribosome synthesis, as they are important targets of SLI investigation. The proposed SLI candidate genes associated with TEGI performance emphasize the utility of precise phenotyping and family-based genetic study.

E-Health childhood obesity treatment interventions may serve as favorable alternatives to conventional face-to-face programs. More studies are needed to evaluate the effectiveness of such interventions beyond immediately post-program completion, including exploring program features impacting effectiveness. This randomized controlled trial with a qualitative component and waitlisted control group will evaluate the effectiveness of a 10-week family-focused e-Health program for school-aged children with overweight/obesity and explore the experience of families completing the program. The primary outcome is the change in BMI z-score and will be assessed from baseline to 10 weeks. Secondary outcomes include (the change in) waist circumference, dietary intake, physical activity, quality of life, and experiences, and will be assessed at baseline, post-10 weeks, and/or immediately, 3-, 6-, and/or 12-months post-program completion. Independent t-tests will be used to compare the differences in means and analyses of variances (ANOVAs) will be conducted to investigate the impact of the program or of being waitlisted and the effect size of the program on quantitative outcome measures. Reflexive thematic analysis will be used with qualitative data. Findings from this study are expected to provide learnings to upscale conventional childhood obesity treatment services, in the hopes of curbing the rising rate of childhood obesity.

BACKGROUND: Because overweight and obesity are still increasing and prevention of childhood obesity is more likely to be effective when initiated in preschool children, the Child Health Service in the south of Sweden developed a structured child-centred health dialogue model targeting all 4-year-old children and their families. The aim of this study was to describe parents\' recalled experiences of this health dialogue in children with overweight.
METHODS: A qualitative inductive approach with purposeful sampling was used. Thirteen individual interviews with parents (including 11 mothers and 3 fathers) were conducted and analysed with qualitative content analysis.
RESULTS: The analysis resulted in two categories: \'A valuable visit with a subtle individual impact\' that described parents\' recalled experiences of the health dialogue and \'There is a complex interaction between weight and lifestyle\' that reflected the parents\' perceptions of the relationship between their children\'s weight and lifestyle.
CONCLUSIONS: Parents recalled the child-centred health dialogue as important and described discussing a healthy lifestyle as one of the obligations of the Child Health Service. Parents wanted confirmation that their family lifestyle was healthy; however, they did not want to discuss the relationship between their family lifestyle and their children\'s weight. Parents expressed that when their child followed the child\'s growth curve, then this indicated healthy growth. This study supports using the child-centred health dialogue as a model to provide structure for discussing a healthy lifestyle and growth but highlights the difficulties of discussing body mass index and overweight, especially in the presence of children.

UNASSIGNED: This study examined the feasibility of an activity tracker and app intervention to increase physical activity in whole families.
UNASSIGNED: This was a single-arm feasibility study with pre-post-intervention measures. Between 2017 and 2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family programme in Queensland, Australia. It was delivered using Garmin activity trackers and apps, weekly motivational text messages and an introductory session. Online surveys and semi-structured interviews conducted with parents assessed intervention usage, acceptability, usability, perceived usefulness, use of physical activity self-management strategies and programme influence. Analyses included descriptive statistics, Wilcoxon signed-rank test and qualitative content analysis.
UNASSIGNED: Overall, 38 families completed the post-intervention survey (95% family retention; 90% children, 95% mothers, 88% fathers). Garmin activity tracker usage was high (i.e. nearly 24/7 during the 6 weeks intervention). Families also used the Garmin apps regularly (i.e. mostly 2-6 times per week). Further, 80% of mothers and 52% of fathers read the motivational mobile text messages. Usability and perceived usefulness of the Garmin activity trackers and apps were rated high. Both parents significantly increased their use of physical activity self-management strategies from pre to post-intervention. Parents expressed that the intervention had increased awareness of physical (in)activity in the family, encouraged to be active and promoted outdoor family activities.
UNASSIGNED: Using activity trackers and apps to increase physical activity in the whole family was well received by children and parents which suggests that this intervention approach is feasible. However, further testing is needed amongst more diverse family populations. These early findings support the implementation of a randomised controlled trial to examine intervention efficacy.

Alcohol use represents a global health problem, especially for Latin American youth. As part of the Global Smart Drinking Goals campaign, a family-based preventive intervention was adapted and piloted in Mexico based on an existing evidence-based program, Guiding Good Choices. In this study, we explored the malleability and session-specific mean-level changes in protective and risk factors targeted by the adapted family intervention as related to the prevention of underage alcohol use and abuse. The sample consisted of 177 parents working at four private local companies who had children between the ages of 8 and 16. Data were collected before and after each program session. Linear mixed-effects models were used to examine growth trajectories and session-specific mean differences for selected etiologic factors. Significant effects on protective and risk factors were found. Among protective factors, positive family involvement showed the most considerable linear growth over time, while clear standards for youth showed the largest within-session increase. The greatest linear decrease in risk was observed for family conflict, which also showed the greatest pre-, and post-session reduction. Our findings suggest that the adapted program helped families develop protection against, and reduce risk of, alcohol use in their adolescent children. Results from this exploratory pilot study provide support for further rigorous evaluation and dissemination of the adapted intervention for Hispanic families.
饮酒是一个全球性的健康问题，对拉丁美洲青年尤其如此。作为全球明智饮酒目标运动的一部分，一项基于家庭的预防干预措施在墨西哥进行了调整和试点，依据的是现有的循证项目 “指导良好选择”。在本研究中，我们探讨了文化调适后的家庭干预措施所针对的保护性和风险性因素的可塑性和特定时段的平均水平变化，这些因素与预防未成年酒精使用和滥用有关。该研究的样本包括177名父母，他们在当地四家私营公司工作，子女年龄在8岁至16岁之间。每个项目之前和之后都进行数据收集。研究采纳线性混合效应模型用于检查选定病因因素的生长轨迹和会话特异性平均差异。也找到对保护因素和危险因素均有显著的影响。在保护性因素中，积极的家庭参与随着时间的推移呈现出最显著的线性增长，而明确的青少年标准在会议期间的增长最大。家庭冲突风险的线性下降幅度最大，项目培训前和项目培训会议后的下降幅度也最大。我们的研究结果表明，改编后的项目有助于家庭发展对青少年儿童饮酒的保护，并降低其饮酒风险。这项探索性试点研究的结果为进一步严格评估和推广适合西班牙裔家庭的干预措施提供了支持。.

Background: Family-based programs show considerable promise in preventing overweight and obesity in young children. However, dissemination is difficult because significant participant and staff involvement is required. This study examined the short-term efficacy of adding parental feeding content to a widely-used nutrition education curriculum for families in low-resourced communities comparing the influence of two delivery methods (in-class and online) on parents\' feeding knowledge, practices, and styles. Methods: In this cluster randomized controlled trial, parents of 2- to 8-year-old children enrolled in the EFNEP (Expanded Food and Nutrition Education Program) in Colorado and Washington were randomly assigned to: in-class nutrition education only, in-class nutrition education with in-class feeding content, or in-class nutrition education with online feeding content. Data from the 382 participants who completed both pretest and posttest assessments are reported in this study. Results: Multilevel analyses showed empirical support for the influence of the program on parents\' feeding knowledge, practices, and styles. Online and in-class methods were equally effective in delivering feeding content in low-resourced communities. Consistent effects were seen across the two delivery methods for encouraging children to try new foods (p < 0.05), use of child-centered feeding practices (i.e., greater responsiveness, p < 0.05), child involvement in food preparation (p < 0.05), and understanding the number of presentations often necessary for child acceptance of a new food (p < 0.001). Location and language differences were seen across some constructs. Conclusions: This study demonstrates the efficacy of in-class and online approaches to feeding highlighting the program\'s positive effects on promoting healthy feeding behaviors for parents of children in low-resourced families. ClinicalTrials.gov Identifier: NCT03170700.