The Cost of Child Support: Policy Design and Father Identity

Child support policy is one of the key forces in the lives of families in the U.S., where 1 in 4 children and half of African American children live apart from their fathers (Carlson et al., 2017; Grall, 2020; U.S. Census Bureau, 2014). Most unmarried fathers of newborns express a strong desire and commitment to their children (Carlson & McLanahan, 2002; England & Edin, 2007). However, by the time their children turn five, fathers\u27; involvement (caregiving and time, provision of child support) diminishes greatly (Turner & Waller, 2017). This decrease in father involvement among low-income NRFs is thought to be related to unintended consequences of child support policy; however, little is known about the effect of child support policy design on father identity. Yet less is understood about how child support policy exerts this effect, or which specific aspects of policy design play a meaningful role. The overarching purpose of this research is to investigate the effect of child support policy design on father identity among low-income fathers living apart from their children using in-depth interviews with fathers, state-level policy design data, and transcripts of governors\u27 state of the state addresses. The findings of this study suggest that child support policy design influences fathers parenting self-esteem by increasing role strain

Doctoral Students’ Academic and Professional Network Development: A Collaborative Autoethnography of Students Engaged in Fatherhood Research

Aim/Purpose: The overarching purpose of this paper was to examine how a collaborative working group of doctoral students from different institutions evolved into a community of practice and developmental network. Specifically, the aim of this study was to examine this group’s progression from working group to support group, a process that occurred through academic support, social support, professional networking, professional development, and skill development. Background: Although doctoral cohorts are often formed within the same school, some informal groups may develop among students in the same discipline from different schools. The authors explored how the formation of a working group, through attendance at an annual academic conference, enhanced their doctoral education and expanded their network through social and academic support. Methodology: The participant-researchers in this study used collaborative autoethnography to collectively examine their participation in this group formed outside of their respective schools of social work. Having worked together for over a year, meeting monthly through video calls, on a discrete project, the participant-researchers embarked on this collaborative authoethnography as they discovered their transformation from working group to support group. This group of five participant-researchers examined their own feelings about their participation in the group and the consequent benefits of belonging to such a group. Contribution: This study makes an important contribution to the doctoral education literature about how doctoral students from different schools can form informal groups that serve as a key source of intra-disciplinary networking, resources, opportunities, and support. This contribution helps to further the research on what kinds of supports doctoral students need in order to remain in their programs and graduate. Findings: We found that a working group of doctoral students from different schools of social work can develop into a community that can be used for social, academic, and networking support. We discovered that relationships with peers across schools provided a supportive environment that was distinct from those formed within our schools. Joining together to achieve a common research goal encouraged members to extend content-specific support. In addition, this group found that members had the opportunity to compare experiences at their respective doctoral programs, which enhanced peer support. Recommendations for Practitioners: Special interest groups at national conferences should encourage doctoral students at different schools to form communities of practice or similar groups. This group formation may lead to opportunities for doctoral students to work on a common project (e.g., website, publication) and serve as a source of social and academic support. Recommendation for Researchers: More research is needed on whether this relationship among doctoral students within the same discipline at different schools is equally helpful among students in different disciplines. Additional research is also needed on whether communities formed during doctoral studies can promote future collaboration as students become professors or researchers. Impact on Society: The present study’s model is applicable for use in academic settings where doctoral students convene for conferences relating to research, teaching, and practice. This model can facilitate the formation of inter-university working groups among students with similar research interests, career trajectories, and life responsibilities. Such groups can enrich peer support, promote collaboration, and enhance professional development. Future Research: More research is needed on whether this kind of social support group amongst doctoral students can be sustained as the students transition into academic careers. Additional research is also needed on whether these types of informal groups work across research focus or whether it works best when students have the same research focus. </jats:p

Randomized trial of a hospice video decision aid for patients with advanced cancer and their caregivers.

42 Background: Although hospice provides high-quality end-of-life care for patients with advanced cancer, the service remains underutilized in part due to lack of adequate information provided to patients and families about hospice care. Methods: We conducted a single-site randomized clinical trial of a hospice video decision aid versus a verbal description in 150 hospitalized patients with advanced cancer and their caregivers. Patients without an available caregiver were eligible to participate. Intervention participants (75 patients; 18 caregivers) received a verbal description about hospice plus a six-minute video depicting hospice care. Control participants (75 patients; 26 caregivers) received only the verbal description. The primary endpoint was patient preference for hospice care immediately after the intervention, adjusting for baseline preferences. Secondary outcomes included patient and caregiver knowledge and perceptions of hospice, and hospice utilization. Results: Between 2/2017 and 1/2019, we enrolled 55.7% (150/269) of potentially eligible patients and 44 caregivers. Post-intervention, patients assigned to the video group were more likely to prefer hospice care (86.7% vs. 82.7%, OR = 2.85, P = 0.08), but this was not statistically significant. Patients in the video group reported greater knowledge about hospice (B = 0.50, P = 0.024) and were less likely to endorse that hospice care is only about death (6.7% vs. 21.6%, OR = 0.28, P = 0.035). Among patients who died (n = 116), those assigned to the intervention were more likely to utilize hospice (85.2% vs. 63.6%, P = 0.01) and had a longer hospice length-of-stay (LOS) (median 12 vs. 3 days, P &lt; 0.001). Post-intervention, caregivers assigned to the video were more likely to prefer hospice care for their loved ones (94.4% vs. 65.4%, P = 0.031), reported greater knowledge about hospice (B = 1.94, P &lt; 0.001), and were less likely to endorse that hospice care is only about death (0.0% vs. 23.1%, P = 0.066). Conclusions: Patients with advanced cancer and their caregivers who viewed a hospice video decision aid were more informed about hospice, reported more favorable perceptions of hospice, and were more likely to utilize hospice and have a longer hospice LOS. Clinical trial information: NCT03040102. </jats:p

Randomized trial of a hospice video decision aid for patients with advanced cancer and their caregivers.

11513 Background: Although hospice provides high-quality end-of-life (EOL) care for patients with advanced cancer and their family caregivers, the service remains underutilized in part due to lack of adequate information provided to patients and families about hospice care. Methods: We conducted a single-site randomized clinical trial of a hospice video decision aid versus a verbal description in 150 hospitalized patients with advanced cancer and their caregivers. Patients without an available caregiver were still eligible to participate. Intervention participants (75 patients; 18 caregivers) received a verbal description about hospice plus a six-minute video depicting hospice care. Control participants (75 patients; 26 caregivers) received only the verbal description. The primary endpoint was patient preference for hospice care immediately after the intervention, adjusting for baseline preferences. Secondary outcomes included patient and caregiver knowledge and perceptions of hospice (Hospice Perception and Knowledge Questionnaire). Results: Between 2/2017 and 1/2019, we enrolled 55.7% (150/269) of potentially eligible patients and 44 caregivers. Post-intervention, patients assigned to the video group were more likely to prefer hospice care at the EOL (86.7% vs. 82.7%, OR = 2.85, P = 0.08), but this was not statistically significant. Patients in the video group reported greater knowledge about hospice (B = 0.50, P = 0.024) and were less likely to endorse that hospice care is only about death (6.7% vs. 21.6%, OR = 0.28, P = 0.035). Post-intervention, caregivers assigned to the video were more likely to prefer hospice care for their loved ones (94.4% vs. 65.4%, P = 0.031), reported greater knowledge about hospice (B = 1.94, P &lt; 0.001), and were less likely to endorse that hospice care is only about death (0.0% vs. 23.1%, P = 0.066). Conclusions: Patients with advanced cancer and their caregivers who viewed a hospice video decision support tool were more informed about hospice care and reported more favorable perceptions of hospice. Future work should examine the impact of the video on hospice utilization and length-of-stay among patients with advanced cancer. Clinical trial information: NCT03040102. </jats:p

Sexual Health in Hematopoietic Stem Cell Transplantation Survivors

Sexual dysfunction is a common complication affecting the majority of hematopoietic stem cell transplant (HSCT) survivors. However, data on the relationships between sexual health domains, patient-reported quality of life (QoL), and psychological distress remain limited. We conducted secondary data analyses of baseline data from 2 randomized sexual health intervention clinical trials involving HSCT survivors who were at least 3 months post-HSCT and reported sexual dysfunction causing distress between February 2019 and February 2023. We assessed sexual health domains (ie, global satisfaction with sex, interest, and function [PROMIS Sexual Function and Satisfaction Measure]), QoL (Functional Assessment of Cancer Therapy - Bone Marrow Transplant), and psychological distress (Hospital Anxiety and Depression Scale) at the time of enrollment. Separate multivariate regression analyses examined the relationships of sexual health domains with QoL and psychological distress. Among the 185 enrolled patients (mean [SD] age, 54.8 [14.1] years), 88.1% identified as White, 35.1% identified as female, 83.2% were married or living with someone, and 93.5% identified as heterosexual/straight. Higher global satisfaction with sex was associated with better QoL (B = 0.988; P=.001) and lower depression (B = -0.119; P=.017) and anxiety symptoms (B = -0.124; P=.038). Higher patient-reported interest in sex was associated with better QoL (B = 2.651; P=.001) and lower depression symptoms (B = -0.387; P=.003). Sexual function domains were not associated with psychological distress or QoL, except for orgasm pleasure and erectile dysfunction (males only) (B = 0.277; P=.036), which was associated with QoL. Satisfaction with sex and interest in sex, in contrast to sexual function domains, were associated with QoL and psychological distress in HSCT survivors. These findings underscore that supportive care interventions targeting satisfaction with and interest in sex may serve an important role in improving the QoL and psychological health in this population. Future longitudinal studies should examine causal pathways