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Abstract: “Why should I care about doing Measurement-Based Care (MBC)'” This is a phrase that the editor often hears, either explicitly or implied, when working to champion and implement MBC within integrated primary care (IPC) settings. As an implementation and education specialist within the Veterans Health Administration (VHA) healthcare system, the editor has attended many MBC presentations and meetings where this question is uttered by frontline IPC clinicians, often frustrated with the growing demands on their practice. Many of these sentiments are usually framed around the assumption that MBC is not very important or useful, clinically speaking. This sets up a familiar debate of research versus practice: While many clinicians have heard MBC is “good for us,” what accounts for the failure to implement MBC clinically' One of the major aims of this guest editorial is to invite the reader to consider the evidence base we have so far, rethink perceived barriers to MBC, and to ultimately decide for oneself that “the juice is worth the squeeze” for routine clinical practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000789
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Abstract: Introduction: The pandemic has significantly impacted medical residents. We created and implemented a biannual biopsychosocial-spiritual Wellness Check Program (WCP) to help internal medicine residents self-assess for burnout, enhance resilience, and to promote early identification and referral to mental health services. We report the preliminary findings from our quality improvement pilot effort at Loma Linda University Health (LLUH). Method: Residents participated in biannual sessions with licensed therapists employed by Loma Linda University, Office of Physician Vitality (OPV). Visits consisted of an evidence-guided discussion about general wellbeing, relationships, family life, coping strategies, and referrals. Archived, confidential WCP session notes between July 1, 2019 and December 31, 2019 were reviewed and a simple tally system was used to record coping strategies, concerns, and referrals made. Results: Partner and family issues were the most prevalent concern, followed by mental health issues, and relationships with colleagues, faculty, or staff. Most residents described several coping strategies: 66.36% listed two to three, and 26.36% listed four or more. Referrals were offered to community or employee assistance program therapists, follow-up with the OPV, psychiatry, couple counseling, given Web based psychoeducational links, or referred to their program director. Nine other residencies requested the WCP providing anecdotal evidence of its feasibility and usefulness. Discussion: As the pandemic surged, these visits normalized reflections about wellbeing, intentional coping strategies, and resilience practices. We continue to gather data to refine and further structure this program and help residents monitor and address their resilience needs and wellness. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000727
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Abstract: Comments on the original article by Bignall et al (see record 2023-07853-001) regarding adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice. The commentator states their belief that the article is genuinely applied research and reading the article reiterates the importance of adapting some of their practices to engage in more culturally sensitive strategies. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000797
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Abstract: Americans today report facing multiple stressors, including the COVID-19 pandemic (American Psychological Association, 2020), anxiety disorders (American Psychiatric Association, n.d.), chronic stress (Bergland, 2017), and more. As smartphones become increasingly ingrained in our society, many adults seek out self-directed stress management techniques facilitated via smartphone. A plethora of options are available, and mobile health applications have become increasingly popular in recent years (Lau et al., 2020). With over 70 million downloads across available platforms and users in over 190 countries (Headspace Inc., 2022), the mobile application Headspace may be one of the most well-known mobile health apps. As of May 2022; Headspace can be accessed via the mobile app or the product website (https://www .headspace.com/). (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000737
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Abstract: Given the seismic shift of the behavioral health care delivery system to virtual care since the COVID-19 pandemic, as well as the growing need for these services, policy decisions around tele-behavioral health are ones that Congress and the administration must address in order to close the gap between what Americans need and what services are available. The Bipartisan Policy Center (BPC) took an in-depth look at the use of telehealth services by traditional Medicare beneficiaries during the COVID-19 pandemic. Based on the results, we offer our conclusions and recommendations for the future. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000793
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Abstract: I invite readers to ponder the complexities of modern medicine and the impacts of treatments on individuals, their families, and their quality of life. I want readers to challenge themselves- asking difficult questions regarding what really matters during end of life- personhood, dignity, and an acknowledgement that a person is much more than only functioning physiology. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000709
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Abstract: This poem is inspired by Brian Sinclair, an Indigenous Canadian man who passed away in 2008 after waiting 34 hours to be seen in an emergency department in Winnipeg, Manitoba. His death was entirely preventable. He died due in part to groupthink, ignorance, and systemic racism. This poem explores the “othering” that many Indigenous individuals, such as Brian, experience in healthcare settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000779
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Abstract: Over the last 2 years in their role as a director of diversity, the author had a sense of fulfillment from hosting small group discussions with medical students on implicit bias. Many of these discussions are centered around cases they developed to mirror their own experiences. As an educator having small group discussions was important for the author. Their goal was to train well-rounded health care professionals with diverse thoughts and skills to serve everyone regardless of how they speak or where they are from. The author wanted to engage in conversations with their students and have a chance to truly observe if they understood the issue of microaggressions. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000730
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Abstract: Article presents a poem which relates a COVID-19 pandemic experience. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000766
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Abstract: This short 55-word story highlights an Internal Medicine resident’s experience talking to the family of a patient dying while on life support in the ICU, and the family dynamic while the resident discusses end of life care and withdrawal of life support. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000760
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Abstract: This article focuses on Jennifer Yturrionbeitia and the C-WHO team, who were nominated for the annual Don Bloch Award. This award is the quintessential organizational award for members who have advanced the field of collaborative care, and who show intellectual, behavioral, and relational qualities. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000799
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Abstract: On October 15th, 2022, Cornerstone Whole Healthcare Organization became the first organization to receive the Don Bloch Award, CFHA’s primary organizational award of significance. Named after Don Bloch, MD, a seminal founder of CFHA and the award’s very first recipient, the Don Bloch award recognizes an individual, and now an organization, whose work and character exemplify Don Bloch and thus advances the field of integrated care, regardless of career stage. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000795
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Abstract: For this inaugural reflection, the author began by thinking about what the Collaborative Family Healthcare Association (CFHA) has been for them, and they suspect for many others. As a naïve early career professional, the author joined CFHA with wide-eyed optimism about the future of the integrated care movement and the giddy excitement only a true nerd can appreciate when you get to befriend the individuals who have made one's career possible. This community is the space where peers and leaders sharpened the author's knowledge and where they became a passionate advocate for integrated care. Activities within CFHA have inspired several initiatives in their institution and community. Yet, when they think of CFHA, it is not the technical access or the ocean of knowledge that comes to mind. Instead, what lights up for them is the feeling that this is a community to which they belong. This is illuminated by the warmth of handshakes and hugs, contagious laughter, shared meals, and moments of joys and sorrows. This sense of belonging they received from CFHA has instilled confidence and agency in other areas of their professional development. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Mar 2023 00:00:00 GMT DOI: 10.1037/fsh0000788
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Abstract: Introduction: While behavioral parent training (BPT) is the first line treatment for preschool aged children with disruptive behavior, only a fraction of families receive these therapies. The integration of BPT within the pediatric primary care (PPC) setting is a promising way to address this need, as the PPC setting is the first and only point of contact for most children diagnosed with mental health disorders. We piloted a clinical innovation by implementing an adapted BPT group in an urban, academic, PPC practice, serving a low-income, predominantly Black population. Method: Using a formative program development approach and a cultural adaptation framework, structural and cultural adaptations to the program were implemented to increase engagement and adaptability of the group to meet the needs of our PPC population. Results: Learnings indicated that these adaptations were feasible and acceptable to families. Specifically, they were effective in engaging families and transforming the practice of primary care providers. Discussion: Our work offers a case example to guide efforts to thoughtfully and effectively adapt evidence-based interventions for disruptive behavior in primary care settings. These processes provide one strategy to ameliorate behavioral health disparities in diverse, racial/ethnic minority populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Mon, 10 Oct 2022 00:00:00 GMT DOI: 10.1037/fsh0000749
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Abstract: Introduction: Emerging adulthood is a distinct and challenging developmental stage of life. It may be particularly stressful for Hispanic emerging adults due to various cultural stressors. However, there is little research on the impact of one particular cultural stressor, the acculturation gap. Therefore, this study aims to examine whether acculturation gap conflicts are associated with self-rated health. Method: Participants were recruited in Arizona and Florida, and 200 Hispanic emerging adults (ages 18–25) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression. Results: Coefficients from a hierarchical multiple regression model indicated that higher levels of acculturation gap conflicts were associated with lower self-rated health after controlling for psychological stress and other demographic variables. Discussion: This is the first study on acculturation gap conflicts and self-rated health among Hispanics. Findings from this study indicate that acculturation gap conflicts are associated with self-rated health and merit further investigation as they may have implications for health interventions targeting Hispanics. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 11 Aug 2022 00:00:00 GMT DOI: 10.1037/fsh0000726
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Abstract: Background: Chronic pelvic pain (CPP) in women is both common and disabling, and access to interdisciplinary care is limited. Patient education programs may represent a pragmatic approach to delivering interdisciplinary care, but to date the specific educational needs of patients with CPP are unknown. Method: We surveyed 136 patients at a tertiary CPP treatment center to identify their educational needs and preferences; 71 (52%) completed surveys. Based on the results, we developed an interdisciplinary educational program, including expert presentations and an extensive participant handbook. We modified our program to a webinar format following the advent of COVID-19. Participants registered for the webinar only or for our study involving completion of three measures of pain-related functioning before and 2 months after the webinar. Results: Our survey results indicated that CPP patients were most interested in learning about the diagnosis and treatment of CPP, coping with CPP, and diet and exercise in the context of CPP; patients also indicated a preference for brief, one-time programs. Of the 164 webinar participants, 64 (39%) enrolled in the study and completed baseline measures; 20 (31%) of those returned follow-up measures 2 months after the webinars. Participants who completed follow-up measures reported significant reduction in pain-related interference; no other significant differences were observed. Participants who completed feedback surveys were positive in their evaluation of the program. Conclusion: Patients with CPP desire more knowledge about their complex symptoms. Addressing their specific needs through educational supports may enhance their ability to manage their symptoms independently. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 11 Aug 2022 00:00:00 GMT DOI: 10.1037/fsh0000725
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Abstract: Objective: TeleDREAMS, a distance learning version of the Developing a Research Participation Enhancement and Advocacy Training Program for Diverse Seniors (DREAMS) program, provides remote clinical research process and advocacy education to older adults with Parkinson’s disease (PD) and their care partners. Method: Participants engaged in remote learning, reading eight weekly clinical research process and advocacy education modules. They also had weekly half hour phone discussions with staff about each module. Participants (PD: n = 28, care partner: n = 15) were tested on health literacy, quality of life, depression, research involvement, and advocacy measures. Results: People with PD improved on health literacy postintervention. PD participants who participated with care partners improved more on health literacy than those without care partners. PD participants’ attrition rates were lower for PD participants in TeleDREAMS than those of the similar, in-person program DREAMS program studied before TeleDREAMS. Most participants reported research involvement and patient advocacy for older adults with PD 6 to 9 months postprogram. Conclusions: TeleDREAMS may improve health literacy in participants with Parkinson’s and their care partners. If increased advocacy and health and research literacy translates to increased research involvement, then TeleDREAMS could be an important strategy for researchers interested in increasing participation. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 23 Jun 2022 00:00:00 GMT DOI: 10.1037/fsh0000684
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Abstract: Introduction: The novel coronavirus disease 2019 (COVID-19) significantly disrupted therapy service delivery for children with disabilities and their families. Parents of children with disabilities have been particularly impacted as a large degree of responsibility has been placed on them to both manage and deliver therapies remotely. However, little is known regarding whether sociodemographic factors are associated with parents’ perceptions of therapy service delivery during COVID-19. This study explored the relationship between sociodemographic factors and parents’ satisfaction with therapies for children with disabilities during COVID-19. Method: Two hundred seven parents of children with disabilities completed an online survey battery that included the Family-Provider Partnership Scale and sociodemographic characteristics and assessed their satisfaction with their child[ren]’s therapies during COVID-19. Results: Access to telehealth, receipt of only school-based therapies, parent education, number of household essential workers, and total number of children were associated with satisfaction with therapy service and/or the family-provider partnership. Discussion: By better understanding the association between sociodemographic factors and parent perception of therapy service delivery, providers can better support families in optimizing service delivery during the remainder of COVID-19 mitigation efforts and during future periods of service disruption. This study provides insight into the sociodemographic characteristics that are associated with lower levels of satisfaction and thus require more tailored support from providers. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 16 Jun 2022 00:00:00 GMT DOI: 10.1037/fsh0000720
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Abstract: Introduction: Telehealth is the use of electronic information and technology for long-distance clinical care. In direct-to-patient (DTP) telehealth, the patient initiates care from a personal computer or mobile device to a medical provider. While information on standard clinic-to-clinic telehealth exists, less is known about DTP telehealth in pediatric populations. Using quantitative and qualitative data, we examined DTP telehealth for low-income pediatric patient-families and compared the experience of English and non-English speakers. Method: Telehealth visits for acute and preventive care took place from April 2020 to May 2020 at a pediatric primary care clinic (80% Medicaid-insured, 40% non-English-speaking). Patients and primary care providers conducted the visit through the clinic’s portal or other platforms (WhatsApp, FaceTime, Zoom). Providers completed an electronic survey with patient feedback about the telehealth experience and their own observations. An iterative inductive/deductive approach informed a coding scheme for free-text survey responses consisting of five domains. Results: REDCap surveys were completed for 258 (52%) of telehealth visits. There was an overrepresentation of English visits compared to the overall clinic population and the majority of visits were via mobile phone. Visits with English speakers utilized the patient portal and had positive process ease ratings more often than those with non-English speakers. Providers rated most telehealth visits as satisfactory, with contributing elements including family call environment, technology process and experience, value added, and barriers. Discussion: Expanding telehealth in pediatrics without worsening health disparities requires building digital health that is user-friendly on mobile technology, facilitating patient preferred language, and simplifying logistical processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 09 Jun 2022 00:00:00 GMT DOI: 10.1037/fsh0000685
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Abstract: Introduction: Caregiver and family engagement in dialysis decisions varies over the end-stage kidney disease treatment trajectory, with family preferences as primary consideration factors for patients starting dialysis. This interpretive phenomenological study explores how dialysis patients and their partners experience dialysis decisions. Methods: Thirteen patient-decision partner dyads (26 participants) were interviewed together about their experience with dialysis decision-making. A 5-step iterative process of data analysis occurred concurrently with data collection. Results: The patients received in-center hemodialysis (n = 6) and home dialysis (peritoneal dialysis or home hemodialysis (n = 7). Decision partner relationships included romantic partners (n = 9) and either parent, sibling, or friend (n = 4). Fifty-7 percent of participants were White; 46% of patients were women, and 76% of decision partners were women. Three interrelated themes were identified: Their body, but not their life; Seeking semiliberation, and Decision-making is caring. Discussion: Dyads were attuned to patient autonomy while managing the collateral effects of dialysis. Shifting the paradigm of dialysis treatment decisions from promoting patient autonomy to dialogues exploring relational autonomy helps providers balance the competing demands of incentivized standards to promote home dialysis with patients and their decision partners realities. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Jun 2022 00:00:00 GMT DOI: 10.1037/fsh0000718
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Abstract: Introduction: The prevalence of behavioral health disorders in children is approximately 15%–20%, yet less than half of the children ever receive treatment for these conditions. The lack of access to behavioral health care is common in urban areas but even more difficult to access in rural areas. Screening for behavioral health in a primary care setting is one of the first strategies to reduce this problem and improve access to care. The primary goal of this study was to examine behavioral health screening practices of pediatric primary care providers in a rural midwestern state. Method: A survey that queried family practice/internal medicine and pediatric providers who provide care to pediatric patients was delivered to over 300 primary care providers across the state. The number of surveys returned was 112. Results: The Modified Checklist for Autism tool was administered by 80% of pediatric providers and 30% of family practice primary care providers. The Patient Health Questionnaire for depression was administered by 72% of pediatric and 80% of family practice providers. Most of the primary care providers had a behavioral health provider present in the clinic, which likely resulted in higher screening rates compared to the national average. Discussion: The screening practices of the family practice and pediatric subspecialities reflect their respective current professional organization recommendations. Although most providers believe it is important to screen for developmental and behavioral disorders, further system changes are needed to support screening for development and broader behavioral problems along with depression among family practice providers. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Jun 2022 00:00:00 GMT DOI: 10.1037/fsh0000707
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Abstract: Introduction: Suicide is a serious mental health concern and the second leading cause of death for adolescents in the United States. Suicide risk is a complex interaction of social, psychological, and physiological factors. Previous research has identified family functioning as being related to adolescent suicide risk, but it is not well studied in clinical settings. This study uses the Behavioral Health Screen–Primary care (BHS-PC) to examine the relationship between current suicide risk in adolescent and a dysfunctional family environment. Method: Adolescents presenting for primary care appointments (n = 6,609; age 14–17) completed the BHS-PC, a broad-based, psychometrically validated screening tool that measures a wide range of adolescent behavioral and mental health concerns. Using data from the BHS-PC, hierarchical logistic regression modeling was used to build and compare models of current suicide risk to determine the effect of including family factors. Fisher’s Exact test was utilized to examine the relationship between family functioning and firearm access, a critical factor in youth safety and risk of completing suicide. Results: In the final model, three family functioning related variables were associated with current suicide risk in adolescents: never talking to adult family member about their concerns, witnessing violence in the home, and arguing in the home. In addition, all but one family functioning factor was related to adolescent firearm access. Conclusions: Family functioning and access to firearms are critical to understanding adolescent suicide risk. Utilizing a holistic approach in primary care to screen for adolescent suicide risk may improve clinical response and linkages to care. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 19 May 2022 00:00:00 GMT DOI: 10.1037/fsh0000680
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Abstract: Introduction: COVID-19 has placed Asian Americans (AA) at higher risk for discrimination within the U.S. This exacerbates the mental health distress of AA parents, who are also experiencing COVID-19-related stress (e.g., health, financial, work, childcare). The risk factors associated with mental health outcomes for AA parents are not well understood. This brief report examined the relationships among COVID-19 stress, discrimination, and psychological distress of AA parents during the initial months of the pandemic. Method: Baseline data of an ongoing longitudinal examination into the COVID-19 experiences of AA parents and their families were utilized. Participants were 166 AA parents of children ages 2–19 years. They completed an online survey about their experiences of COVID-19-related stress (i.e., childcare, school, work), discrimination, and psychological distress. Results: The majority of AA parents were highly stressed due to school closures and childcare changes; school-age parents reported significantly more stress resulting from school closures than parents of young children or adolescents. Over 21% of AA parents experienced some discrimination resulting from COVID-19; the majority reported discrimination fears for themselves and their family/friends. Experiencing discrimination was positively associated with psychological distress, as was COVID-19 stress related to work performance and relationship quality. Conversely, the majority of parents reported increased quality time with their family (i.e., children, partners). Discussion: AA parents are experiencing high levels of COVID-19-related stress, and have the added psychological burden of experiencing and fearing racial/ethnic discrimination. However, the pandemic has led to families spending more quality time together. Implications for future studies are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 19 May 2022 00:00:00 GMT DOI: 10.1037/fsh0000715
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