Conversations about children’s weight-related health are described as sensitive and challenging from the perspectives of families and health care providers. There is a need for training packages to support these critical conversations that are based on relevant scientific literature and have demonstrated feasibility, appropriateness, and acceptability in clinical practice. This practice improvement project created and tested the feasibility, appropriateness, and acceptability of a training package (training and point-of-care tool) to guide pediatric primary care providers (PPCPs) in weight-related conversations with families. An interdisciplinary team created a point-of-care tool and training informed by the literatures on weight-related conversations, weight stigma, and prevention of obesity and eating disorders. Eleven PPCPs participated in the pilot and interviews about their experience. Participants commented positively on intervention content. Despite support for its appropriateness and acceptability with clinicians, only 4 of 11 participants used the point-of-care tool for patient visits. PPCPs identified helpful elements in the training package, indicated they would reference tools before rather than during clinical encounters, and suggested ways to address barriers to increase tool use. Findings support the acceptability of the package content and training delivery. Embedding guidance in electronic practice tools commonly used in clinical encounter workflows could increase their use.
Youth emotional support systems combine schools, community services, and youth-facing platforms, but availability leaves questions about trusted access. To identify recurring conditions of experienced usability across contrasting service arrangements. A qualitative multiple-case study combines 18 policy, institutional, and public-report documents with interviews with 26 adolescents aged 14–18 and 12 adult key informants in Zhengzhou, Shenzhen, Chengdu, and Ningbo. Six common codes organize comparisons of institutional accounts, youth experiences, and counterexamples. Across the sampled arrangements, formal connections coexisted with gaps in responsibility at referral handoffs. Digital convenience and local proximity offered routes into support while exposing different problems of privacy and follow-up. Youth input was associated with reported changes to activities, opening hours, facilities, and training, alongside limited influence over wider service rules. Adopted suggestions and supported navigation qualified accounts of exclusion and discontinuity. These contrasts locate three recurring interfaces: handoff responsibility, exposure at entry, and the decision authority reached by feedback. The comparison supports an interface-level proposition: experienced usability varies within organizational models around these three interfaces. Organizational labels identify contexts; interfaces specify the relations through which access is experienced. Confidential entry, responsive feedback, and supported referral are design hypotheses for prospective evaluation.
As suggested by family systems theory, bidirectional associations between maternal and child depressive symptoms have been supported in previous research. However, less is known about whether family-level factors uniquely contribute variance to these longitudinal associations. This study examined family routines and household chaos as potential associational variables in the expected longitudinal associations between maternal and child depressive symptoms. A community sample of 308 mothers of elementary school-aged children (M = 8.10 years) completed online surveys across 11 months during the COVID-19 pandemic. Mothers reported on their own and their child’s depressive symptoms (DASS-21 and RCADS-25-P), as well as family routines (FRI) and household chaos (CHAOS). Path analyses were used to test bidirectional associations between maternal and child depressive symptoms and examine possible associational pathways through family routines and household chaos. Maternal and child depressive symptoms were positively associated over time in a bidirectional model (β = 0.25, p = .003; β = 0.12, p = .04). The associational pathway involving T1 child depressive symptoms, T8 household chaos, and T10 maternal depressive symptoms was significant (β = 0.04, p = .04). However, other considered associational pathways including household chaos or family routines were not significant. Maternal and child depressive symptoms were associated with one another longitudinally. Household chaos, but not family routines, emerged as an associational variable sharing variance with earlier child depressive symptoms and later maternal depressive symptoms. This finding supports household chaos as a potential target for future investigation in understanding the associations between child and maternal depressive symptoms.
Children’s self-control develops within a broader family system. In China, where grandparental involvement in childrearing is widespread, how multiple family processes are jointly associated with children’s self-control remains insufficiently understood. This study examined the unique and shared associations of parents’ self-control, parent-grandparent coparenting, and parental burnout with children’s self-control and explored the organization of their specific components within the broader family system. Participants were 623 parent-child dyads from Chinese intergenerational coparenting families, with children reporting self-control and parents reporting the three family processes. Hierarchical regression and commonality analyses examined incremental, unique, and shared associations, and network analysis was conducted to explore component-level associations. Parents’ self-control, parent-grandparent coparenting, and parental burnout were independently associated with children’s self-control in the final model, which explained 17
