Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Prescriptions

Intervention Description: The intervention described in the study involved providing food prescriptions for 30 pounds of various healthy foods to participants in low-income communities. Participants were able to redeem these food prescriptions every 2 weeks for up to 6 months, totaling 12 redemptions. The food prescriptions included a variety of fruits, vegetables, lean protein, low-fat dairy, and whole grains, with an emphasis on fresh produce and nutrition education materials

Intervention Results: Participants (n = 172) in the program reported a 94.1% decrease in the prevalence of food insecurity (p < .01) at the end of the program. An average of 29.2 pounds of fruits and vegetables were distributed per family per distribution, and 99% of participants reported eating "all" or "most" of the food provided. Program costs were $12.20 per participant per redemption. Interviews revealed that providers and participants felt the program was well received and highly needed.

Conclusion: This pilot study demonstrates the framework and feasibility of a collaborative clinic-based food prescription program to address food insecurity. Future research should examine the sustained impact of such programs on behavioral and health outcomes.

Study Design: single group pre-post evaluation design

Setting: School-based clinic

Population of Focus: Adult patients and parents of pediatric patients from three clinics serving north Pasadena residents

Sample Size: 172

Age Range: Not explicitly provided

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention, Family-Based Interventions, Consultation (Parent/Family),

Intervention Description: During infancy, the American Academy of Pediatrics Bright Futures fourth edition health supervision guidelines recommend frequent well-child visits (WCVs) in which providers are expected to screen for and address maternal depression, intimate partner violence (IPV), and health-related social needs (HRSN). We spread an evidence-based approach that implements these recommendations (Developmental Understanding and Legal Collaboration for Everyone; DULCE) with 3 aims for 6-month-old infants and their families: 75% receive all WCVs on time, 95% are screened for 7 HRSNs, and 90% of families with concrete supports needs and 75% of families with maternal depression or IPV receive support. Between January 2017 and July 2018, five DULCE teams (including a community health worker, early childhood system representative, legal partner, clinic administrator, pediatric and behavioral health clinicians) from 3 communities in 2 states participated in a learning collaborative. Teams adapted DULCE using Plan-Do-Study-Act cycles, reported data, and shared learning monthly. Run charts were used to study measures. The main outcome was the percent of infants that received all WCVs on time.

Intervention Results: The percentage of families who completed all WCVs on time increased from 46% to 65%. More than 95% of families were screened for HRSNs, 70% had ≥1 positive screen, and 86% and 71% of those received resource information for concrete supports and maternal depression and IPV, respectively.

Conclusion: Quality improvement-supported DULCE expansion increased by 50% the proportion of infants receiving all WCVs on time and reliably identified and addressed families' HRSNs, via integration of existing resources.

Study Design: Program evaluation

Setting: Three communities from the Early Childhood Learning and Innovation Network for Communities recruited clinics serving predominantly Medicaid-insured patients

Population of Focus: Families with newborns up to 8 weeks of age

Sample Size: Five local DULCE site teams and 692 families with infants

Age Range: Families with infants 0-6 months

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Care Coordination, Medicaid,

Intervention Description: N/A

Intervention Results: Children who were not white, living in non-English households, with less family income or education, or who were uninsured had lower rates of access to a medical home and its components. A medical home was associated with beneficial child outcomes for all six of the outcomes and the family-centered care component was associated with better results in five outcomes. ED visits were less likely for children who received care coordination (aOR 0.81, CI 0.70-0.94).

Conclusion: Our study highlights the role of key components of the medical home and the importance of access to family-centered health care that provides needed coordination for children. Health care reforms should consider disparities in access to a medical home and specific components and the contributions of each component to provide quality primary care for all children.

Study Design: We analyzed data from the 2016-2017 National Survey of Children's Health (NSCH) to assess five key medical home components - usual source of care, personal doctor/nurse, family-centered care, referral access, and coordinated care - and their associations with child outcomes. Health outcomes included emergency department (ED) visits, unmet health care needs, preventive medical visits, preventive dental visits, health status, and oral health status. We used multivariate regression controlling for child characteristics including age, sex, primary household language, race/ethnicity, income, parental education, health insurance coverage, and special healthcare needs.

Setting: NSCH survey; United States

Population of Focus: Practitioners in children's health

Sample Size: 61572

Age Range: 0-17

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family), Family-Based Interventions, Patient-Centered Medical Home,

Intervention Description: In collaboration with veteran parents’ focus groups, we created an experienced co-designed care bundle including IFDC mobile application, which together with staff training programme comprised the IFDC programme. Infant outcomes were compared with retrospective controls in a prepost intervention analysis.

Intervention Results: Infants in the IFDC group were discharged earlier: median corrected GA (36+0 (IQR 35+0–38+0) vs 37+1 (IQR 36+3–38+4) weeks; p=0.003), with shorter median LOS (41 (32–63) vs 55 (41–73) days; p=0.022)

Conclusion: This is the first reported study from a UK tertiary neonatal unit demonstrating significant benefits of family integrated care programme. The IFDC programme has significantly reduced LOS, resulted in the earlier achievement of full enteral and suck feeds

Study Design: Implemented the Integrated Family Delivered Care (IFDC) program to a subset of infants while also having a control group. Compared infant outcomes.

Setting: NICU - London

Population of Focus: Families of NICU patients - healthcare providers and professionals working in neonatal intensive care units, as well as parents of preterm infants who are receiving care in these units.

Sample Size: 89 families - 89 infants who were admitted to the neonatal units of the participating healthcare facility. However, for the purpose of the outcome analysis, infants were included if they were less than 34 weeks gestational age, admitted for at least 14 days, and received the entire period of care in the neonatal units. This resulted in a sample size of 37 infants .

Age Range: Parents of infants

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Social Supports, Access, Housing Supports

Intervention Description: The current qualitative, longitudinal study examined mothers’ perceptions of how receipt of flexible funding designed to increase their housing stability may have also impacted their children’s safety, stress, mood and behavior. Forty-two mothers in the Washington, D.C. metro area were interviewed three times over a six-month period about their own safety and housing stability, as well as their children’s. Ninety-five percent of the mothers and their children were housed at the six-month interview.

Intervention Results: Ninety-five percent of the mothers and their children were housed at the six-month interview. Mothers described improvements in children’s stability and safety, decreases in children’s stress levels, and improvements to their mood and behavior. They also discussed the symbiotic relationship between their own stress and well-being, and their children’s.

Conclusion: The provision of flexible funding to assist domestic violence survivors with their housing also collaterally impacted their children’s safety, stress, mood and behavior.

Study Design: qualitative, longitudinal study

Setting: Washington, D.C. metro area

Sample Size: Forty-two mothers

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Curricular Activities/Training, Family-Based Interventions,

Intervention Description: Adapting the evidence base program 'Empowering Parents, Empowering Communities'

Intervention Results: Thirteen parents completed the programme (including one parent who required two attempts). We found improvements in child behavioural difficulties, parenting knowledge and practices, while parental well-being and social support were unchanged. Participants were highly satisfied overall, with indications that the peer-led model mitigated negative expectancies of services and normalized experiences of parenting in challenging conditions.

Conclusion: Parental self-care and ‘the good enough parent’ were strongly endorsed topics, although some content (e.g. timeout) was deemed impractical. These promising findings warrant further testing under controlled conditions.

Study Design: mixed-methods, formative evaluation

Setting: London, UK

Population of Focus: social workers, public health practitioners

Sample Size: N= 15; Parents living in temporary housing with children aged 2-11years old

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family), Extra-Curricular Activities, PARENT_FAMILY, CLASSROOM_SCHOOL, Family-Based Interventions

Intervention Description: This was an 11-week, two group, randomized feasibility study. Participants were children and their parents at one OOSP on a rural American Indian reservation. Children, ages 6–9, were randomized to receive the Generations Health (GH) intervention or comparison condition. The GH group received daily activities focused on physical activity (PA), nutrition, sleep, and reducing TV/screen time, and frequently engaged parents. The comparison group received usual OOSP activities. To assess intervention feasibility, we measured recruitment and participation rates and program satisfaction. We assessed pre- to posttest changes in body composition, PA and sleep patterns, dietary intake and Healthy Eating Index-2010 (HEI-2010) scores, TV/screen time, and nutrition knowledge. We report recruitment and participation rates as percentages and participants’ program satisfaction as means. Two-tailed paired t tests and 95% confidence intervals were used to detect changes in behavioral and health outcome variables.

Intervention Results: Forty-six children met age eligibility criteria; following screening, 52% (24/46) met the inclusion criteria and 96% (23/24) were randomized to the study. Overall, 91% of the children participated in the intervention and 100% participated in at least some of the posttest assessments. Parents reported high program satisfaction (mean rating of 4, on a 1–5 scale). Our outcome measure for child adiposity, zBMI, was reduced by 0.15 in the GH group, but increased by 0.13 in the comparison condition. Meaningful changes were evident for total kilocalories, HEI-2010 scores, PA, TV/screen time, and nutrition knowledge.

Conclusion: High recruitment, participation and program satisfaction and positive health and behavioral outcomes at 11 weeks provide encouraging indications of the feasibility and potential effectiveness of the intervention.

Study Design: Feasibility RCT

Setting: American Indian Reservation

Population of Focus: Rural students

Data Source: Activity monitors (PA levels), questionnaire (sedentary/screen activity)

Sample Size: 24 students

Age Range: Ages 6-9

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Programs

Intervention Description: The intervention in the study involved the opening of a new full-service supermarket in a food desert neighborhood in Pittsburgh, Pennsylvania.

Intervention Results: After the supermarket's opening, SNAP participants' food security improved and intake of added sugars declined in the intervention neighborhood, but both were unchanged in a comparison neighborhood without a new supermarket. Intervention neighborhood participants also experienced relative declines in the percentage of daily calories from solid fats, alcoholic beverages, and added sugars.

Conclusion: Findings suggest that HFFI amplifies the effects of SNAP participation on improving food security and dietary quality in food deserts.

Study Design: Quasi-experimental pre-post design

Setting: Community-based

Population of Focus: Households in food desserts

Sample Size: 280

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Prescriptions

Intervention Description: The intervention in the study was a meal kit program called Slice and Spice, developed specifically for the research project. Participants received meal kits weekly for six weeks, each containing three recipes that served four people. The recipes and other aspects of the meal kit program were selected based on input from focus groups with the target audience. All recipes met specific nutrition criteria per serving based on the 2015–2020 Dietary Guidelines for Americans recommendations.

Intervention Results: Data were collected on participants’ use, acceptability, and willingness to pay for the meal kits and analyzed using descriptive statistics. The intervention was highly utilized, and participants reported high acceptability ratings for most recipes. After the intervention, participants were willing to pay $88.61 ± 47.47 for a meal kit with three meals, each with four portions, which was higher than indicated at baseline and similar to the cost to produce the kits.

Conclusion: Meal kits may offer a creative solution to improving food access if affordable for families with low income.

Study Design: pre-post-test design using a double post-test

Setting: Urban community in the southeastern United States

Population of Focus: African American adults aged 18 years or older who identified as the main food preparer in their households and had a child under the age of 18 living with them

Sample Size: 36

Age Range: 18-42

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Family-Based Interventions

Intervention Description: We used a retrospective case control design tocompare infants who were exposed to homeless-ness and similar infants who were born to low-income families but did not experience a home-less episode during the study period. Beginningwith records of all families who entered emer-gency shelter in Massachusetts in the periodfrom January 1, 2008, to June 30, 2015, welinked Emergency Assistance enrollment rec-ords with Medicaid claims for each family mem-ber.

Intervention Results: The analysis showed that homeless infants had slightly higher Medicaid enrollment in the years following birth compared to the comparison group. The average monthly income for homeless families was lower than that of comparison families. The study found that homeless infants had higher rates of certain health conditions during the first year of life, such as low birth weight, upper respiratory infections, lower respiratory diseases, and developmental disorders, compared to the comparison group. Despite these differences, within-year median months of service use were similar for both groups

Conclusion: infants exposed to homelessness had higher rates of health conditions, longer neonatal intensive care unit stays, more emergency department visits, and higher annual healthcare spending compared to infants in stable housing. These differences in health conditions persisted for two to three years, with asthma diagnoses, emergency department visits, and healthcare spending remaining significantly higher through age six. The findings suggest that while screening and access to healthcare can be improved for homeless infants, long-term solutions require a broader focus on addressing housing instability and income disparities. The study highlights the significant impact of unstable housing leading to homelessness on newborns' health outcomes

Study Design: retrospective case-control design

Setting: Massachusetts

Sample Size: 5,762 infants who experienced a homeless episode and 5,553 infants in the comparison group who did not experience homelessness.

Age Range: up to 6 yrs of age

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Prescriptions

Intervention Description: Six-month program offering group-based nutrition and cooking education along with subsidies for fresh produce worth $1 per family member per day, redeemable weekly.

Intervention Results: Participation in a produce prescription program combining subsidies for produce and nutrition education decreased food insecurity (P < 0.001) and diastolic blood pressure significantly (P = 0.019).

Conclusion: These findings highlight the promise of this program and similar programs for improving patient food security and health outcomes among the most vulnerable, underserved communities while aiding in setting realistic expectations and suggestions for program implementation.

Study Design: Program evaluation with repeated measures over 6 months.

Setting: Primary care sites

Population of Focus: Familes

Sample Size: 122

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Mobile Programs,

Intervention Description: Within a community-based participatory action research (CPBAR) framework, the JHCAIH and partners designed and administered household surveys at baseline and 3 months after MoGro's launch. A randomly selected 20% of households participated at each timepoint.

Intervention Results: About 75% of respondents indicated that MoGro had changed the foods they purchased, and 68% reported that MoGro had changed how their families ate. After MoGro's launch, food availability increased significantly and food insecurity decreased.

Conclusion: The evaluation documented MoGro's impact in the community; high self-reported positive changes, significant increases in food availability, and decreases in food insecurity.

Study Design: Community-based participatory action research (CPBAR) framework

Setting: Community-based

Population of Focus: Families

Sample Size: Unknown

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Social Supports, Screening Tool Implementation, Family-Based Interventions,

Intervention Description: We assessed a cross-sectional sample of dyadic parent–child patients and young adult patients up to age 21 from one pediatric SCD center. Food insecurity, housing instability, and dietary quality were measured using validated US instruments and a food frequency questionnaire. Better dietary quality was defined using US dietary guidelines. Multivariate regression assessed for associations among dietary quality and food insecurity with or without (±) housing instability and housing instability alone.

Intervention Results: 70% reported less than or equal to one economic instability: 40% housing instability alone and 30% both food insecurity and housing instability. Eighty percent received more than or equal to one federal food assistance benefit. Compared to no economic instability, food insecurity ± housing instability was significantly associated with higher intake of higher dairy and pizza, while housing instability alone was significantly associated with higher dairy intake. Food insecurity ± housing instability was significantly associated with lower intake of whole grains compared to housing instability alone.

Conclusion: Our sample reported high frequencies of both food insecurity and housing instability; having more than or equal to one SDoH was associated with elements of poorer diet quality. Screening families of children with SCD for food insecurity and housing instability may identify those with potential nutrition-related social needs.

Study Design: cross-sectional

Sample Size: n=100

Age Range: mean age 10.6 ±

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Prescriptions

Intervention Description: The intervention included a family-based, home-delivery produce prescription and nutrition education program. Participants received approximately 24 hours of nutrition education content, which included monthly virtual cooking classes, bi-weekly brief video-based education, recipe videos, and recipe and skill-building instruction cards included in every produce delivery. The program also offered additional nutrition education resources through the YMCA and FLiP Patient Navigators at the end of the 12-month program

Intervention Results: Qualitative data revealed themes around reduced food hardship, healthy eating, budget flexibility, and family bonding. Fruit and vegetable consumption increased in a small subgroup of children, but post-intervention intake remained below recommended levels, particularly for vegetables. FI scores were not significantly different post-intervention, but qualitative findings indicated improved access and reliability of food.

Conclusion: This is the first intervention of its kind to be evaluated for feasibility and our results suggest the intervention is well-received and supportive. However, further study, with a larger sample size, is needed to understand factors influencing participation and assess effectiveness.

Study Design: Pilot mixed-methods longitudinal behavioral intervention

Setting: Community-based

Population of Focus: Families

Sample Size: 25

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community), Social Supports, Family-Based Interventions, Housing Programs

Intervention Description: Rapid Rehousing Program

Intervention Results: Participants expressed feelings of insecurity in emergency shelters due to lack of privacy, theft, unsanitary conditions, and safety concerns. Families noted improvements in children's behavior and academic performance after moving into their own homes. Participants reported feeling safer and more secure once they had their own space and autonomy. Families expressed a sense of security and belonging after being housed, leading to improved relationships with family and friends and a sense of hope for the future.

Conclusion: The study highlighted the importance of the Rapid Rehousing Program in improving the security and well-being of families experiencing homelessness. Moving from emergency shelters to their own homes provided a sense of security, autonomy, and hope for the future. Recommendations included providing clear expectations about housing subsidies, offering financial education, and enhancing case management to support long-term housing security for families

Setting: Salt Lake City, UT

Population of Focus: policymakers, social service providers, researchers

Sample Size: n=31

Age Range: average age 37.5 yrs of age

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Access, Sleep Environment Modification

Intervention Description: This study was intended to better understand how low-income, African-American mothers understand and act upon safe sleep recommendations for newborns and how providers counsel these mothers. We conducted focus groups with 60 African-American, low-income, first-time mothers and telephone interviews with 20 providers serving these populations to explore provider counseling and patient decision making.

Intervention Results: The large majority of mothers reported understanding, but not following, the safe-sleeping recommendations. Key reasons for non-compliance included perceived safety, convenience, quality of infant sleep and conflicting information from family members. Mothers often take measures intended to mitigate risk associated with noncompliance, instead increasing SIDS risk. Providers recognize that many mothers are non-compliant and attribute non-compliance largely to cultural and familial influence. However, few provider attempts are made to mitigate SIDS risks from non-compliant behaviors.

Conclusion: We suggest that counseling strategies should be adapted to: (1) provide greater detailed rationale for SIDS prevention recommendations; and (2) incorporate or acknowledge familial and cultural preferences. Ignoring the reasons for sleep decisions by African-American parents may perpetuate ongoing racial/ethnic disparities in SIDS.

Study Design: N/A

Setting: Georgia

Data Source: Mother interview

Sample Size: 80 mothers

Age Range: Parents of infants less than 6 months

Intervention Components (click on component to see a list of all articles that use that intervention): Multicomponent Approach, Care Coordination, Family-Based Interventions,

Intervention Description: The intervention in the study was the addition of a community health worker (CHW) to the HealthySteps (HS) care team. The HS model consists of different tiers of service, and the most intensive tier (tier 3) is called comprehensive services. It includes ongoing collaborative team–based well-child visits, care coordination, and systems navigation, which are provided to families determined to be most at risk according to screenings, clinical judgment, and caregiver concerns. Through this program, behavioral health treatment for concerns related to development, behavior, parent-child relationship, and parental mental health is also provided to families. When social determinants of health (SDOH) concerns are identified by pediatric primary care providers, HS Specialists work with families to address their needs. In this study, families were directed to meet with a separate health care worker, similar to a CHW, to receive referrals to address their SDOH needs. The study showed that the overall referral success rate for HS families participating in this study was 88%, and having an HS + CHW team resulted in a successful referral rate of 100% for food services and 89% for childcare services.

Intervention Results: Medical charts with documentation of HS comprehensive services between January and June 2018 were reviewed at 3 primary care clinics: 2 with an HS Specialist (HSS Only) and 1 with an HS Specialist and CHW (HSS + CHW). Eighty-six referrals were identified, 78 of which had documented outcomes. Outcomes were categorized as successful, unsuccessful, and not documented. The HSS + CHW group had a higher rate of successful referrals (96%) than the HSS Only group (74%). Statistical analysis (χ2 = 8.37, P = .004) revealed a significant association between the referral outcome and having a CHW on a primary care team with an HS Specialist.

Conclusion: Yes, the study reported statistically significant findings related to the success of referrals when comparing the HSS Only group with the HSS + CHW group. The referral success rate was 74% for the HSS Only group compared with 96% for the HSS + CHW group, and this difference was statistically significant (χ2 = 8.37, P = .004). Additionally, a logistic regression analysis showed that participation in HSS + CHW compared with HSS Only related to an increased likelihood of a successful referral. The logistic regression model was statistically significant (χ21 = 8.0, P < .001), explaining 19.0% of the variance in successful referrals and correctly classifying 88.5% of cases. These findings indicate that the inclusion of a community health worker on the HealthySteps care team was associated with a significantly higher likelihood of successful referrals to community resources.

Study Design: The study design was a retrospective chart review. Data for the study were collected through retrospective chart reviews of all 192 families who received HealthySteps (HS) comprehensive services over a 6-month period. The chart reviews were conducted to identify the documentation of referrals to community resources or community health workers (CHWs) by HS Specialists. The study also included descriptive analyses of the demographics of study participants and conducted comparisons between the HSS Only group and the HSS + CHW group to assess potential confounding variables.

Setting: The study took place in a large urban city and was conducted in three pediatric primary care practices. The city where the study was conducted had a significant percentage of individuals living below the poverty threshold, with many families facing numerous hardships simultaneously, such as limited access to health care and medical insurance.

Population of Focus: The target audience for the study is likely healthcare professionals, policymakers, and researchers interested in improving access to social determinants of health resources for families with young children living in low-income, underserved urban settings. The study provides insights into the effectiveness of a community health worker (CHW) within a primary care team with a HealthySteps (HS) Specialist in increasing successful connections to community resources for pediatric patients. The findings of the study may be useful for healthcare professionals and policymakers seeking to improve the health outcomes of children living in poverty by addressing social determinants of health.

Sample Size: The study included a total of 192 participants, with 96 participants in the combined HSS Only group and 96 participants in the HSS + CHW group. The demographic data from the two HSS Only sites were combined to form a single HSS Only group due to the small sample size at each site.

Age Range: The age group of the children in the study varied, with ages ranging from birth to 53 months in the combined HealthySteps Specialist (HSS) Only sample, and from birth to 48 months in the HealthySteps Specialist + community health workers (HSS + CHW) group. The study included children from birth to early childhood, encompassing a critical developmental period.

Intervention Components (click on component to see a list of all articles that use that intervention): Prenatal Care Access, Family-Based Interventions, Access,

Intervention Description: program facilitation and identified developmental benefits of a two-generation program beginning prenatally.

Intervention Results: Our core category, Engaging From Both Sides, included (a) Mitigating Adversity (focused codes Developing Trust, Letting Go of Fear, and Putting in the Effort); (b) Continual Learning (focused codes Staying Connected, and Taking it to the Community); (c) Fostering Families (focused codes Cultivating Optimism, and Happiness and Love); (d) Unravelling Cycles of Crisis (focused codes Advocating, and Helping Parents’ Parent); and (e) Becoming Mainstream (focused codes Knowing Someone Has Your Back, and Managing Stress, Anxiety, and Anger). We found significant improvements in child Fine Motor, Problem-Solving, and Personal-Social domains between program intake and exit.

Conclusion: Our study adds to existing literature regarding mechanisms of two-generation programs beginning prenatally. Mitigating effects of intergenerational adversity was the primary motivation for interaction and engagement of staff and parents in two-generation programming, which improved child development.

Study Design: convergent, concurrent mixed methods study

Setting: Canada

Population of Focus: public health professionals

Sample Size: 10 agency staff, 14 focus groups of parents, 100 children

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Social Supports,

Intervention Description: Supportive housing

Intervention Results: Consistent with findings from the larger project of which this was a part, supportive housing improved housing outcomes for families, especially those most at risk form homelessness. Its effects on child welfare outcomes varied by study site more than by risk level. Family characteristics and experiences that predicted housing and child welfare outcomes also varied by site and added limited accuracy to predictive models. Theoretical moderators did not influence supportive housing’s effects.

Conclusion: Supportive housing increases housing security and may influence child welfare outcomes in some contexts. Family characteristics and experiences marginally improve targeting of supportive housing to insecurely housed families involved with CPS.

Setting: five U.S. sites

Sample Size: 500 insecurely housed families involved in child protective services

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Counseling (Parent/Family), Family-Based Interventions

Intervention Description: Parent-Child Interaction Therapy (PCIT) and Child-Parent Psychotherapy (CPP)

Intervention Results: Both time-limitedPCITand time-limitedCPPweresuccessfully implementedwithsimilarlyhigh levelsof interventionfidelity(>90%)andsatisfactionbymothers(85%).Completionratesweresimilaracrossboth time-limitedPCIT(76.6%)andtime-limitedCPP(71.4%).Bothtime-limitedCPPandPCITresultedin decreasesinchildren’sposttraumaticstress,parentalstress,andincreasesinmaternalpositiveverbalizations.Onlytime-limitedPCITresultedinsignificant improvementsinexternalizingbehaviorproblemsin childrenandreductionsinmaternalnegativeverbalizations.

Conclusion: Time-limited adaptations of parent–child interaction therapy (PCIT) and child–parent psychotherapy (CPP) within a sample of children experiencing homelessness was acceptable, feasible, and holds significant promise for helping families within a homeless shelter environment and by extension, other transitional and/or shelter environments. A full randomized trial is warranted to determine which program may offer a more effective intervention.

Study Design: randomized controlled trial

Setting: Florida

Population of Focus: public health and mental health professionals

Sample Size: 144 children from 144 families

Age Range: 18 months to 5 yrs of age

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family), Family-Based Interventions, Patient-Centered Medical Home,

Intervention Description: Created a Parent Participation Improvement Program. Then offered it to the study group while maintaining a control group

Intervention Results: A Mann-Whitney U test was performed to compare parents’ partnership scores between the intervention and control groups. The difference between the partnership scores of the two groups was significant (MannWhitney U = 99.50, p<.001).

Conclusion: The aim of this study was to develop the Parent Participation Improvement Program for parents in neonatal care and to evaluate its effects. This program was proven effective for increasing attachment and partnership in both mothers and fathers. The program, developed in accordance with King’s goal attainment theory, will serve as a useful reference in developing standardized guidelines for promoting parent participation in neonatal care, and it is expected to bridge the gap between theory and practice by applying family-centered care to the practical base of neonatal care.

Study Design: This study consisted of two phases. The first phase was developing the Parent Participation Improvement Program. The second phase, a parallel, 2-group randomized controlled trial with a prospective pretest-posttest experimental design, was conducted to evaluate the program’s effectiveness.

Setting: NICU South Korea - neonatal intensive care unit (NICU). The Parent Participation Improvement Program was implemented in this NICU to promote parent participation in clinical activities and evaluate its effects on parents' partnerships with nurses, attachment to infants, and infants' body weight

Population of Focus: Parent dyads of Premature infants - parents of infants in neonatal intensive care units, healthcare professionals working in neonatal care, and researchers interested in family-centered care and parent participation in clinical activities.

Sample Size: 124 parents - The sample size for the study consisted of 66 premature infants and their 132 parents (66 mothers and 66 fathers) . The infants were randomly assigned to either the intervention group or the control group, with 62 infants and their 124 parents included in the final analysis . The sample size was calculated to ensure the study had sufficient power to detect the estimated effect size .

Age Range: parents of infants - the parents showed that their mean age was 34.6 years in the intervention group and 34.97 years in the control group . The infants included in the study were premature, with a mean gestational age of 28.42 weeks in the intervention group and 29.75 weeks in the control group .

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT_FAMILY, Family-Based Interventions

Intervention Description: In this study, the feasibility of a family-focused, YMCA-based prevention program for children at risk of T2D was evaluated between September 2015 and July 2016 in Tucson, Arizona. A 12-week YMCA-led lifestyle intervention was adapted for 9-12-year-old children and their families to encourage healthy eating, physical activity, and supportive home environments. Two YMCA locations were randomized to offer either a face-to-face lifestyle coach-led intervention or an alternating face-to-face and digitally-delivered intervention. Program feasibility and preliminary effects on child anthropometric and behavioral outcomes were assessed at baseline and post-intervention.

Intervention Results: Forty-eight children (10.9 ± 1.2 years old; 45% female; 40% Hispanic; 43% White; 87% obese) and their parents enrolled, and 36 (75%) completed 12-week measures. Weekly program attendance averaged 61%. Participants and coaches highly rated program content and engagement strategies. Statistically significant changes in child BMI-z score (-0.05, p = 0.03) and family food and physical activity environment (+5.5% family nutrition and physical activity score, p = 0.01) were observed.

Conclusion: A YMCA-led family-focused T2D intervention was feasible for the YMCA and participants and effects on child weight, behavior, and the home environment warranted further investigation.

Study Design: Feasibility pilot trial with pre-/postintervention

Setting: YMCA (2 locations)

Population of Focus: Children at risk of type 2 diabetes and their families

Data Source: Accelerometer, observational

Sample Size: 48 children

Age Range: Ages 9-12 (10.9 +/- 1.2 years)

Intervention Components (click on component to see a list of all articles that use that intervention): Parent Engagement, Family-Based Interventions,

Intervention Description: Adapt and pilot test a parenting intervention for homeless families in transitional housing.

Intervention Results: Feasibility data indicate an intervention spanning several weeks may be difficult to implement in the context of transitional housing. Yet, acceptability of the adapted intervention among participants was consistently high.

Conclusion: The findings of this pilot work suggest several implications for informing continued parenting intervention research and practice with homeless families in transitional housing.

Setting: Transitional Housing Units

Population of Focus: researchers, public health, social workers,

Intervention Components (click on component to see a list of all articles that use that intervention): Telemedicine Systems (Hospital), Family-Based Interventions,

Intervention Description: Services for Children with Special Healthcare Needs (CSHCN) have been challenging in terms of cost and access to appropriate healthcare services. The objectives of this study were to examine cost, caring, and family-centered care in relationship to pediatric specialty services integrating telemedicine visits compared to traditional face-to-face visits only for (CSHCN) in rural, remote, and medically underserved areas.

Intervention Results: Results indicated no significant differences in family costs when the telemedicine group was compared to traditional face-to-face care. When the telemedicine group was asked to anticipate costs if telemedicine was not available, there were significant differences found across all variables, including travel miles, cost of travel, missed work hours, wages lost, child care cost, lodging cost, other costs, and total family cost (p < 0.001). There were no differences in the families' perceptions of care as caring. Parents/guardians perceived the system of care as significantly more family-centered when using telemedicine (p = 0.003).

Conclusion: The results of this study underscore the importance of facilitating access to pediatric specialty care by use of telemedicine. We endorse efforts to increase healthcare access and decrease cost for CSHCN by expanding telemedicine and shaping health policy accordingly.

Study Design: Prospective, quasiexperimental study

Setting: Department of Health Children's Medical Services (CMS), Title V Program

Population of Focus: Parents or legal guardians of Children with Special Healthcare Needs (CSHCN) enrolled in the Florida Department of Health Children's Medical Services (CMS), Title V Program in the Southeast Region of Florida. The sample included families with household incomes below 200% of the Federal Poverty Level (FPL) who had children requiring pediatric specialty care.

Sample Size: 222 parents or legal guardians of CSHCN receiving pediatric specialty care. The traditional group (n = 110) included families receiving face-to-face pediatric specialty care and the telemedicine group (n = 112) included families who had telemedicine visits along with traditional face-to-face pediatric specialty care.

Age Range: Adult parents or legal guardians of chlildren receiving care ages 0 to 17 years

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Policy/Guideline (National), Social Supports,

Intervention Description: Sector Wheel for Under-Resourced Populations

Intervention Results: Interviews revealed parenting stress and worsening family mental health during homelessness. Participants described barriers to navigating housing, social, and health services with children, including not knowing where to seek help, difficulty connecting to health and social services in the community, and a lack of family-focused services. Parents encountered discrimination by landlords and lack of access to permanent housing in safe neighborhoods.

Conclusion: Findings demonstrate a need for delivering family-centered and comprehensive services to homeless-experienced veteran families that recognize the multifaceted needs of this population. Advocacy initiatives are needed to address discrimination against veterans experiencing family homelessness and increase access to affordable permanent housing in safe neighborhoods for families.

Study Design: qualitative study

Setting: L.A. County, CA

Population of Focus: policy makers, social workers, public health specialists

Sample Size: n=18 veteran parents

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, School-Based Family Intervention, Access,

Intervention Description: We sought to understand the experiences of community integration among homeless-experienced veteran families. We used a two-stage, community-partnered approach. First, we analysed 16 interviews with homeless-experienced veteran parents (parents who served in the military; n = 9) living in permanent housing and providers of homeless services (n = 7), conducted from February to September 2016, for themes of community integration. Second, we developed a workgroup of nine homeless-experienced veteran parents living in a permanent housing facility, who met four times from December 2016 to July 2017 to further understand community integration. We audio-recorded, transcribed and analysed the interviews and workgroups for community integration themes.

Intervention Results: We describe our findings across three stages of community integration: (a) first housed, (b) adjusting to housing and the community, and (c) housing maintenance and community integration. We found that parents tended to isolate after transitioning into permanent housing. After this, families encountered new challenges and were guarded about losing housing. One facilitator to community integration was connecting through children to other parents and community institutions (e.g. schools). Although parents felt safe around other veterans, many felt judged by non-veterans. Parents and providers reported a need for resources and advocacy after obtaining housing. We share implications for improving community integration among homeless-experienced veteran families, including providing resources after obtaining housing, involving schools in facilitating social connections, and combating stigma.

Conclusion: Parents tended to isolate after transitioning into permanent housing. After this, families encountered new challenges and were guarded about losing housing. One facilitator to community integration was connecting through children to other parents and community institutions (e.g. schools). Although parents felt safe around other veterans, many felt judged by non-veterans. Parents and providers reported a need for resources and advocacy after obtaining housing.

Study Design: two-stage, community-partnered approach

Setting: United States

Population of Focus: researchers, public health specialists

Sample Size: n=16 parents

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Family-Based Interventions, Health Literacy

Intervention Description: N/A

Intervention Results: Compared with children in parent-led households, those in grandparent-led households had increased physical health conditions (oral health problems: 18.9% vs 13.1%, P = .0006; overweight/obesity: 40.3% vs 29.7%, P = .0002); emotional, mental, and developmental health conditions (attention deficit hyperactivity disorder: 16.3% vs 8.0%; behavioral/conduct problems: 13.9% vs 6.1%; depression: 6.6% vs 3.1%; learning disability: 13.9% vs 6.2%, P < .0001 for all); and special health care needs (28.2% vs 17.8%, P < .0001). They also had decreased prevalence of health care utilization (usual source of sick care: 65.7% vs 79.5%, preventive checkups: 64.6% vs 77.1%; preventive dental visits: 73.8% vs 80.6%; specialty care: 78.6% vs 90.2%, P ≤ .0001 for all) and increased prevalence of forgone care (5.9% vs 2.8%, P = .0020). After adjustment, the associations with caregiver type remained statistically significant for all emotional, mental, and developmental conditions listed; special health care needs; usual source of sick care and preventive checkups.

Conclusion: Grandparent caregivers may benefit from additional support to ensure that grandchildren receive timely health care services.

Study Design: We used 4 years of pooled data from the National Survey of Children's Health, representative of United States children ages 0 to 17 years, and applied bivariate analyses and logistic regressions adjusted for sociodemographic confounders to compare grandparent- and parent-led households on key measures of interest.

Setting: NSCH Survey; United States

Population of Focus: Granparent-led households w/ children

Sample Size: 117371

Age Range: 0-17

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Programs

Intervention Description: Grow Your Groceries program involved providing home gardening kits, specifically fabric grow bags, to families at risk of food insecurity in Chicago. The program aimed to address food insecurity during the COVID-19 pandemic by empowering participants to grow their own healthy food. Participants received support and resources to cultivate fruits, vegetables, and herbs at home using the provided grow kits.

Intervention Results: Qualitative data were analyzed using an iterative coding process. Quantitative data were analyzed using descriptive statistics. Most participants reported confidence in using a grow kit to grow food, increased healthy food consumption, easier access to healthy food, and high likelihood of growing food again. Additionally, participants described increased connections within their communities, increased interaction with their family, and personal growth as benefits of the program.

Conclusion: Results demonstrate the benefits of a novel home gardening program that uses fabric grow bags to address food insecurity. A larger scale program evaluation is necessary to better understand the impacts of participating in this home gardening program.

Study Design: Participatory approach

Setting: Community-based

Population of Focus: Families

Sample Size: 78

Age Range: 18-66

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Targeting Interventions to Focused Groups

Intervention Description: N/A

Intervention Results: There were 62,965 respondents. After survey weighting, Asians (OR 1.78, 95% CI 1.19-2.66) as an aggregate group were more likely to report discrimination than non-Hispanic Whites. When Asians were disaggregated, Japanese (3.12, 1.36-7.13) and Koreans (2.42, 1.11-5.29) were more likely to report discrimination than non-Hispanic Whites. Self-reported discrimination was marginally associated with not having a usual source of care (1.25, 0.99-1.57). Koreans were the only group associated with not having a usual source of care (2.10, 1.23-3.60). Foreign-born Chinese (ROR 7.42, 95% CI 1.7-32.32) and foreign-born Japanese (ROR 4.15, 95% CI 0.82-20.95) were more associated with self-reported discrimination than being independently foreign-born and Chinese or Japanese.

Conclusion: Differences in self-reported discrimination in a healthcare setting and not having a usual source of care were observed among Asian ethnic subgroups. Better understanding of these differences in their sociocultural contexts will guide interventions to ensure equitable access to healthcare.

Study Design: Using the California Health Interview Survey (CHIS) 2015-2017, we used logistic regression models to assess associations among Asian ethnic subgroup, self-reported discrimination, and not having a usual source of care. Interactions between race and self-reported discrimination, foreign-born status, poverty level, and limited English proficiency were also analyzed.

Setting: California Health Interview Survey (CHIS) 2015-2017; California

Population of Focus: Respondents represented adults age 18 + residing in California who identified as White, Black, Hispanic, American Indian/Alaska Native, Asian (including Chinese, Filipino, Japanese, Korean, Vietnamese, and Other Asian), and Other.

Sample Size: 62965

Age Range: 18+

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions,

Intervention Description: The Market to MyPlate (M2MP) program is a 7-week nutrition education and hands-on cooking intervention designed for low-income adults and their families. The program aimed to improve dietary behaviors and increase access to healthy foods among participants

Intervention Results: Compared to control, PAE participants reported larger increases from pre- to post-intervention in fruit (P = 0·001) and vegetable consumption (P = 0·002), with no differences in cooking frequency. Interview analyses identified key themes in behaviour changes due to M2MP, including reported increases in dietary variety, cooking self-efficacy and children's participation in cooking.

Conclusion: PAE participants who received an intervention that directly increased their access to fresh produce (via produce allocations) increased their reported fruit and vegetable consumption. Though participants' cooking frequency did not change, interviewees reported increased variety, cooking confidence and family participation in cooking.

Study Design: Mixed methods evaluation embedded within a cluster randomised controlled trial

Setting: Community-based

Population of Focus: Familes

Sample Size: 120

Age Range: 36-42

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Incentives,

Intervention Description: The intervention in the study involved a same-day supermarket double-dollar incentive on the purchase of fresh, frozen, or canned fruit and vegetables, combined with nutrition education in the store.

Intervention Results: Compared to the controls, incentivized shoppers-who were given an immediate 50 percent discount on qualifying fruit and vegetables-increased weekly spending on those items by 27 percent; this change was for fresh produce. There was no change in purchases of frozen and canned produce or unhealthful foods. Estimated annual average daily consumption of fruit and vegetables by the incentivized shoppers and by one designated child per incentivized household did not change. Attendance at Cooking Matters events was low.

Conclusion: These findings support financial incentive programs to increase fruit and vegetable purchasing but suggest that effective complementary approaches are needed to improve diet quality.

Study Design: randomized control trial

Setting: Supermarket

Population of Focus: Households with children

Sample Size: 605

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Consultation (Parent/Family), Family-Based Interventions, Provider/Patient Communication Portal,

Intervention Description: N/A

Intervention Results: In multivariate analyses, there were no significant differences in access to care according to parental citizenship status. Children with 2 noncitizen parents had fewer doctor visits and were less likely to go to the emergency department in the past year than those with 2 citizen parents. Among children with 1 or 2 noncitizen parents, their parents reported worse experiences in care than those with 2 citizen parents. Similar results were observed for language use. Parents of children in bilingual and Spanish-only households were less likely to report that their children's doctors explained things clearly, and parents in Spanish-only households were less likely to communicate via telephone or e-mail than those in English-only households.

Conclusion: Health policy should focus on provider-parent communication to ensure health care equity for Latino children whose parents are not citizens or do not speak English.

Study Design: Analyses were conducted to determine the associations between access (usual of source of care, delay in receiving needed care, health insurance), utilization (physician visits in past year, emergency department visits), and experiences (doctor listens, doctor explains instructions clearly, communication via telephone or e-mail) according to parental citizenship status and household language use after adjusting for confounders.

Setting: 2011 and 2012 California Health Interview Survey; California

Population of Focus: Latinx children

Sample Size: 2841

Age Range: <12

Intervention Components (click on component to see a list of all articles that use that intervention): Counseling (Parent/Family), Family-Based Interventions, Access,

Intervention Description: Parents as key protective systems in the lives of children experiencing homelessness

Intervention Results: Results suggest that associations of emotional reactivity with parenting behavior depend on the context of the parent–child interaction and how emotional reactivity is measured.

Conclusion: Observed and subjective emotional reactivity were largely uncorrelated, except for positive emotions during problem-solving tasks. Adaptive parenting behavior was related to lower scores on measures of subjective and observed negative emotions and higher observed scores for positive emotions during problem-solving tasks, as well as higher observed scores of positive emotions during teaching tasks. Physiological reactivity was not related to parenting behaviors.

Study Design: examined how subjective (i.e., self-report), observed, and physiological measures of parent emotional reactivity relate to each other and to observed parenting behaviors in problem-solving and teaching parent–child interaction tasks.

Setting: Emergency Homeless shelter

Population of Focus: researchers, public health professionals, mental health professionals

Sample Size: 50 children and their caregivers

Age Range: 4-7 year olds

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Incentives,

Intervention Description: Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention.

Intervention Results: Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared to control ($1.83, 95% CI=$0.29, 3.88). The largest increase was for fresh F&V ($1.97, 95% CI=$0.49, 3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14, 95% CI =$1.93, 8.34) than among non-SNAP-eligible participants who redeemed coupons ($3.88, 95% CI =$1.67, 6.08).

Conclusion: A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. SNAP-eligible customers saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low income families.

Study Design: randomized control design

Setting: A supermarket in a low-income rural Maine community

Population of Focus: Low-income and SNAP supermarket customers

Sample Size: 401

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Access,

Intervention Description: mastery motivation (MM) in high risk children

Intervention Results: Children completed behavioral tasks to assess MM, and measures linked with school readiness were assessed directly or by parent report. Higher MM was associated with better social and emotional functioning and emotion regulation but not math achievement or executive functioning. Follow-up analyses indicated that MM was indirectly associated with prosocial behavior through better emotion-regulation abilities.

Conclusion: Implications are discussed for further research and for interventions designed to address educational disparities and promote school success for children experiencing homelessness.

Setting: Unknown

Population of Focus: public health practicioners, mental health specialists, educators, etc

Sample Size: 85 children living with their family in an emergency shelter

Age Range: 3-5 years old

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT_FAMILY, Family-Based Interventions

Intervention Description: Regular moderate-to-vigorous physical activity and high physical fitness are extremely important to the health of children and track to positive health profiles in adulthood. Family-based interventions to improve moderate-to-vigorous physical activity are essential given that children live within a structure of parental influence. The purpose of this study was to examine the effect of a parent planning skills intervention to support child physical activity on the subsequent moderate-to-vigorous physical activity (primary outcome) and fitness of their children across 26 weeks (primary endpoint).

Intervention Results: Generalized linear mixed modeling conducted in 2019 showed that the patterns varied by condition over time (β=-0.05, p<0.05), where children in the planning intervention significantly increased moderate-to-vigorous physical activity compared with the education condition at 6 weeks and 13 weeks but not at 26 weeks. Aerobic fitness (p=0.04, d=0.26) was the only significant health-related physical fitness change between the two groups and favored the planning group over the education group.

Conclusion: There was initial efficacy of the planning intervention, but effectiveness waned by 26 weeks. These changes appeared to be sufficient for modest changes in aerobic fitness. Future research should aim to improve the maintenance of these early positive changes and assist parents in planning for activities that also include opportunities to improve child musculoskeletal fitness.

Study Design: Two-arm RCT

Setting: Families in Victoria, British Columbia

Population of Focus: Students not meeting 60 minutes of MVPA per day

Data Source: Accelerometer

Sample Size: 102 students

Age Range: Ages 6-12

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Financial Incentives, Food Prescriptions

Intervention Description: The intervention involves providing additional fruit and vegetable vouchers to pregnant Women, Infants, and Children (WIC) clients as a strategy to improve food security and diet quality. The study aimed to assess the impact of this intervention on food insecurity and fruit and vegetable intake among pregnant WIC clients.

Intervention Results: Participants in intervention and comparison counties completed surveys at enrollment and approximately three months later (n = 609). Mean ± SD food insecurity at baseline was 3.67 ± 2.79 and 3.47 ± 2.73 in the intervention and comparison groups, respectively, and the adjusted between-group change from baseline to follow-up in food insecurity was 0.05 [95% CI: −0.35, 0.44] (p > 0.05). F&V intake (in cup equivalents) was 2.56 ± 0.95 and 2.51 ± 0.89 at baseline in the two groups, and the adjusted mean between-group difference in changes from baseline was −0.06 [−0.23, 0.11] (p > 0.05). Recruitment and data collection for this study coincided with the most intensive of America’s COVID relief efforts. Our results may indicate that small increases in highly targeted food resources make less of a difference in the context of larger, more general resources being provided to individuals and households in need.

Conclusion: Our results may indicate that small increases in highly targeted food resources make less of a difference in the context of larger, more general resources being provided to individuals and households in need.

Study Design: comparion group

Setting: San Francisco, California

Population of Focus: Pregnant individuals with low income enrolled in the Women, Infants, and Children (WIC) program.

Sample Size: 770

Age Range: 26-35

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT_FAMILY, Training (Parent/Family), Electronic PA, Family-Based Interventions, Media Campaign (Print Materials, Radio, TV), COMMUNITY

Intervention Description: Social media is an important communication tool during times of crisis because of its vast reach. Understanding the effectiveness of sharing public health guidance and promoting school children's physical activity during the COVID-19 pandemic can inform dissemination best practices. We classified 418 posts from parent/community members of a school-based physical activity Facebook group by content type, and used concurrent mixed methods to examine (1) differences in dissemination effectiveness (reactions, shares, and comments) between two pandemic phases and (2) themes and sentiments of comments. Phase I included school closures through the release of national school re-entry guidelines (March 1, 2020 – May 15, 2020) and Phase II extended through the school year start (May 16, 2020 – August 1, 2020).

Intervention Results: Policy and guidance posts prompted more comments while feel-good stories produced more reactions compared to other content types. Members reacted more during Phase II, which mainly consisted of policy and guidance (86%). Four major themes of information and resources, personal disclosures, questions and concerns, and support for educators emerged.

Conclusion: Sharing public health guidance for schoolchildren on social media was an effective strategy to disseminate information when in-person discourse was limited. Creating social media spaces where discussion is encouraged can provide social and emotional support for parents/community members.

Study Design: Concurrent Mixed Methods

Setting: Social media (public Facebook group in a large metropolitan area in the southwest US)

Population of Focus: Parents of school-aged children

Sample Size: 418 posts to a public Facebook group with approximately 1,500 members

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions,

Intervention Description: N/A

Conclusion: 1. Grandparental involvement, including contact with grandchildren, caregiving behaviors, and support, has a significant impact on the well-being of grandchildren. 2. The study identified a range of child outcomes reported globally, shedding light on the diverse ways in which grandparental involvement affects grandchildren's health and development. 3. The review highlighted the need for well-informed research and policy decisions to support grandparents and the children under their care. 4. The study presented a conceptual framework to better measure and theorize pathways of care, aiming to inform research design and policy implications 28. These findings underscore the importance of recognizing and understanding the influence of grandparents on the health and development of their grandchildren, and the need for further research and policy considerations in this area.

Study Design: Systematic Review

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions,

Intervention Description: The intervention, Flint Kids Cook, took place in a farmers' market commercial kitchen and included nine total hours of instruction over six consecutive weeks (one session per week). The program aimed to improve children's knowledge, skills, and self-efficacy for cooking healthy foods through interactive nutrition education and food preparation activities. It was facilitated by a credentialed chef and a registered dietitian, with a focus on caregiver support and access to healthy foods through take-home educational materials, recipes, and child-friendly cooking utensils

Intervention Results: Mean HRQoL summary score improved (P < 0·001) from baseline (77·22 ± 14·27) to programme exit (81·62 ± 14·43), as did mean psychosocial health summary score (74·68 ± 15·68 v. 79·04 ± 16·46, P = 0·001). Similarly, physical (P = 0·016), emotional (P = 0·002), social (P = 0·037), and school functioning (P = 0·002) improved. There was a correlation between change in HRQoL summary score and change in ATC (r = -0·194, P = 0·025) as well as change in cooking self-efficacy (r = -0·234, P = 0·008). Changes in HRQoL and psychosocial health summary scores were not correlated with dietary changes, which included decreased added sugar (P = 0·019) and fruit juice (P = 0·004) intake.

Conclusion: This study is the first to report modest yet significant improvements in HRQoL among children and adolescents who participated in a healthy cooking programme. Results suggest that cooking programmes for youth may provide important psychosocial health benefits that are unrelated to dietary changes.

Study Design: Pre-post research study

Setting: Farmer's market

Population of Focus: Children

Sample Size: 186

Age Range: 8/15/2024

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, School-Based Family Intervention, Access to Provider through Hotline,

Intervention Description: To identify whether there were differential patterns of children's school attendance and stability, we employed a repeated measures latent class analysis (RMLCA; Collins & Lanza, 2009). Latent class analysis is a person-centered technique that is used to identify mutually exclusive and exhaustive subgroups of participants within the population of interest based on similar patterns of responses to indicator variables (i.e., similar experiences with school attendance and stability).

Intervention Results: The results of the current study have important implications for young children who experience homelessness and suggest promoting school attendance as one avenue to support academic achievement.

Conclusion: Preventing homelessness, especially for families, will take coordination across disciplines and systems, including addressing the cost of housing, extreme poverty, educational disparities, and lack of support for mental health and drug abuse, to name only a few of the complicated issues that contribute to homelessness across the country.

Study Design: person-centered analytic technique

Setting: Massachusetts

Population of Focus: Teachers, public health professionals

Sample Size: N/A

Age Range: Kindergarten through 3rd grade (5-9 yr olds)

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Social Supports,

Intervention Description: We used a semistructured interview protocol with three sections that solicited participants accounts of family housing and homelessness chronologically, beginning with the circumstances that led to their current episode of homelessness (e.g., Thinking back over the past few months, what is it that brought you to the shelter?), the experiences and impacts of their current episode of homelessness (e.g., What has your stay been like here at the shelter?; How has it been for you/your children?; Since you’ve been here, has there been any change in your relationship(s) with your child(ren)?), and their expectations and concerns for the future when they obtain housing (e.g., As you think ahead to your move back to the community, what are the things you are hopeful about or looking forward to?; Are there things you are concerned or nervous about?). Interviews were conducted by trained interviewers who were graduate students in psychology or who had prior experience interviewing vulnerable people. Initial interviews were reviewed by the first author to verify the quality of the interviews and to provide guidance as needed. Interviewers also completed interview summary forms (Miles et al., 2014) to provide additional information on each interview (e.g., main issues or themes from the interview, information gained or not gained from the interview, issues or questions that could be pursued in future interviews).

Intervention Results: Findings showed that families’ experiences prior to their homelessness were characterized by vulnerability, instability, and isolation. In the emergency shelter system, families faced new challenges in environments that were restrictive, noisy, chaotic, and afforded little privacy. Participants described a further disruption of relationships and described having to change their family practices and routines.

Conclusion: Future research is needed on ways in which shelters can be more hospitable, supportive, and helpful for parents and their families to minimize negative impacts and facilitate timely rehousing of families.

Study Design: qualitative study

Setting: Canada

Sample Size: n=18

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Food Programs

Intervention Description: The intervention included a multi-component, multi-level Community-Based Participatory Research (CBPR) approach. It utilized a farm-to-school program and parent curricula to enhance community capacity and reduce obesity risk among Native American families. The intervention focused on promoting healthy eating habits, increasing vegetable consumption, and addressing food insecurity within the community

Intervention Results: Vegetable intake significantly increased in intervention children compared to controls for squash (p = 0.0007) and beans (p = 0.0002). Willingness to try scores increased for beans in intervention children (p = 0.049) and tomatoes in both groups (p = 0.01).

Conclusion: FRESH is the first study to implement a farm-to-school intervention in rural, tribally owned ECEs. Future interventions that target healthy dietary intake among children should incorporate a comprehensive parent component in order to support healthy eating for all household members.

Study Design: Randomized wait-list controlled trial

Setting: School and community-based

Population of Focus: Families

Sample Size: 363

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Family-Based Interventions, Housing Supports

Intervention Description: A grounded theory approach was used to analyze semi-structured, qualitative interviews.

Intervention Results: Frontline providers exercised street-level bureaucratic discretion when interpreting child protection reporting mandates and they found ways to adapt the HF model to this population. In doing so, they worked to juggle both their mandates to child protection and to principles of HF to create a “child safety-modified” form of HF.

Conclusion: While our study shows that providers are modifying HF to address the needs of families involved in child welfare, it also raises questions as to the degree to which HF can be done with high fidelity when used with this population.

Study Design: grounded theory

Setting: 2 U.S. States

Sample Size: 13 participants working in programs that encouraged direct collaboration with Child Protective Services (CPS) in the program model and 13 participants from three non-CPS-aligned sites in a second state.

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT_FAMILY, Family-Based Interventions

Intervention Description: Seventy-one mother-child-pairs were divided into two categories based on mothers' musical background. Each pair performed 8 weeks exercise intervention using movement-to-music video program. SB and PA were assessed objectively by accelerometer, and exercise activity, fidelity, and enjoyment were assessed via exercise diaries and questionnaires. Logistic regression model was used to analyze associations in the main outcomes between the groups.

Intervention Results: Those children whose mothers had musical background (MB) had greater probability to increase their light PA during the intervention, but not moderate-to-vigorous PA compared to those children whose mothers did not have musical background (NMB). SB increased in both groups. Mothers in the NMB group had greater probability to increase their light and moderate-to-vigorous PA and decrease their SB than mothers in the MB group. However, exercise adherence decreased considerably in all groups. Completeness, fidelity, and enjoyment were higher among the NMB group compared to the MB group.

Conclusion: The present results showed that mothers without musical background were more interested in movement-to-music exercises, as well as their children. For further studies it would be important to evaluate an effect of children's own music-based activities on their SB and PA.

Study Design: RCT

Setting: Mother-child pairs using a music to move video program in the Pirkanmaa area, Finland

Population of Focus: Mother-child pairs in subgroup analysis of an intervention group in RCT called Moving Sound

Data Source: Accelerometers, exercise diary, questionnaires

Sample Size: 71 mother-child pairs

Age Range: Age 6

Intervention Components (click on component to see a list of all articles that use that intervention): Telemedicine Systems (Hospital), Family-Based Interventions,

Intervention Description: NICU graduates require ongoing surveillance in follow-up clinics because of the risk of lower cognitive, motor, and academic performance. We hypothesized that multiple programmatic changes, including availability of telemedicine consultation before hospital discharge, would improve NICU follow-up clinic attendance rates. In this retrospective study, we included infants who survived and were premature (≤29 6/7 weeks/<1500 g) or had brain injury (grade III/IV intraventricular hemorrhage, stroke or seizure, hypoxic ischemic encephalopathy). We compared rates of follow-up for the early cohort (January 2018-June 2019; no telemedicine) with the late cohort (May 2020-May 2021; telemedicine available); and performed a mediation analysis to assess other programmatic changes for the late cohort including improved documentation to parents and primary care provider regarding NICU follow-up.

Intervention Results: The rate of successful 12-month follow-up improved from 26% (early cohort) to 61% (late cohort) (P < .001). After controlling for maternal insurance, the odds of attending a 12-month follow-up visit were 3.7 times higher for infants in the late cohort, for whom telemedicine was available (confidence interval, 1.8-7.9). Approximately 37% of this effect was mediated by including information for NICU follow-up in the discharge documentation for parents (P < .001).

Conclusion: Telemedicine consultation before NICU discharge, in addition to improving communication regarding the timing and importance of NICU follow-up, was effective at improving the rate of attendance to NICU follow-up clinics.

Study Design: Retrospective chart review

Setting: Children’s Hospital at a Medical Center in Maine with a level III NICU

Population of Focus: Infants who had been admitted to the NIC

Sample Size: 257 infants (152 infants were included in the early cohort, and 105 infants were included in the late cohort)

Age Range: Infants 0-12 months corrected age

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT_FAMILY, Family-Based Interventions

Intervention Description: Family health promoters from participating communities delivered 6 healthy eating modules, 4 physical activity modules, and 2 modules synthesizing information in 12 home visits (60-90 minutes) within the first 6 months. Up to 12 follow-up phone calls to each participant occurred within the second 6 months.

Intervention Results: In total, 151 persons (81 adolescents and 70 adults; 44 families) were randomly assigned. At 12 months, significant improvement occurred in Healthy Eating Index scores for adults in the intervention group compared with controls (change, +8.6 vs -4.4; P < .01) and persisted at 24 months (+7.4 from baseline; P < .01). No differences were observed for adolescents and no significant differences occurred between groups for physical activity.

Conclusion: This intervention produced sustained dietary quality improvement among adults but not among adolescents. Program outcomes are relevant to communities working to decrease cardiovascular risk among immigrant populations.

Study Design: RCT

Setting: U.S. Midwest city (community-based/home visiting)

Population of Focus: Hispanic, Somali, and Sudanese communities in Rochester, Minnesota

Data Source: Self-report and accelerometers

Sample Size: 151 (81 adolescents, 70 adults across 44 families)

Age Range: Ages 12-14

Intervention Components (click on component to see a list of all articles that use that intervention): Counseling (Parent/Family), Family-Based Interventions, Access,

Intervention Description: ested a model of parenting stress as a mediator between maternal depressive symptoms, emotion regulation, and child behavior problems using a sample of homeless, substance-abusing mothers.

Intervention Results: A path analysis showed that maternal depressive symptoms were positively associated with child behavior problems through increased parenting stress whereas maternal cognitive reappraisal was negatively associated with child behavior problems through decreased parenting stress. Moreover, maternal expressive suppression was negatively related to child externalizing problems. Findings support the parenting stress theory and highlight maternal parenting stress as a mechanism associated with homeless children's mental health risk.

Conclusion: This study has significant implications for understanding the parenting processes underlying child's resilience in the context of homelessness and maternal substance use.

Population of Focus: social workers, medical providers, public health professionals

Sample Size: 119 homeless mothers and their young children

Age Range: Mothers aged 18–24 years, children aged 0-6 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Provider Training/Education, Health Insurance Coverage, Targeting Interventions to Focused Groups

Intervention Description: N/A

Intervention Results: Fifty percent of adolescents experienced PCMH care, with little change between 2004 and 2013. Adolescents with MH need (N = 3,794) had significantly lower odds of experiencing PCMH care compared with those without MH need (odds ratio, .78; 95% confidence interval, .69-.87). Among adolescents with MH needs, being uninsured and living with a parent who did not graduate high school were negatively associated with PCMH care, whereas parental usual source of care was positively associated (odds ratio, 1.69; 95% confidence interval, 1.28-2.22).

Conclusion: Increasing care accessibility, integrating MH services into primary care settings, and targeting socioeconomically disadvantaged subgroups could improve rates of PCMH care among adolescents with MH needs.

Study Design: This was a secondary analysis of Medical Expenditure Panel Survey data (2004-2013). The sample included adolescents aged 12-17 years with ≥1 office-based visits in the past year (N = 18,717). Questions assessing a usual source of care and care that is accessible, comprehensive, family-centered, and compassionate were used to define PCMH care. For adolescents with MH needs, multivariable logistic regression was used to describe the association between PCMH care and sample characteristics.

Setting: Medical Expenditure Panel Survey

Population of Focus: Adolescents

Sample Size: 3794

Age Range: 12/17/2024