Summary: The family is an important contributor to the cultural conditions that support health. Current challenges in family health promotion interventions include programme design that is not always guided by theory and change mechanisms. Multifaceted programmes also make it hard to examine what works for whom, given different family roles and the range of lifestyle behaviour and mechanisms examined within diverse conceptual frameworks and cultures. We performed a scoping review on the heterogeneous literature to map and categorize the models and mechanisms by which a family may promote health behaviours among its members. We searched five electronic databases and grey literature up to 2020. Publications were included if they examined health-promoting behaviours, influences at the family level, and outlined the behavioural mechanisms involved. Two hundred and forty studies were identified. Ecological systems theory, social cognitive theory, family systems theory and the theory of planned behaviour were the frameworks most widely used in explaining either study context and/or mechanism. The most frequently studied family mechanisms involved aspects of family support, supervision and modelling, while some studies also included individual-level mechanisms. Majority of the studies investigated parental influence on the child, while few studies assessed the elderly family member as a recipient or actor of the influences. Studies on African, Asian and Middle Eastern populations were also in the minority, highlighting room for further research. Improving the understanding of context and behavioural mechanisms for family health promotion will aid the development of public health policy and chronic disease prevention programmes, complementing efforts targeted at individuals.

Despite the different origins of cerebrovascular activity induced by neurogenic and nonneurogenic conditions, a standard assumption in functional studies is that the consequence on the vascular system will be mechanically similar. Using a recently developed arterial spin labeling method, we examined arterial blood volume, arterial-microvascular transit time, and cerebral blood flow (CBF) in the gray matter and in areas with large arterial vessels under hypercapnia, visual stimulation, and a combination of the two. Spatial heterogeneity in arterial reactivity was observed between conditions. During hypercapnia, large arterial volume changes contributed to CBF increase and further downstream, there were reductions in the gray matter transit time. These changes were not significant during visual stimulation, and during the combined condition they were moderated. These findings suggest distinct vascular mechanisms for large and small arterial segments that may be condition specific. However, the power relationships between gray matter arterial blood volume and CBF in hypercapnia (α = 0.69 ± 0.24) and visual stimulation (α = 0.68 ± 0.20) were similar. Assuming consistent capillary and venous volume responses across these conditions, these results offer support for a consistent total CBV–flow relationship typically assumed in blood oxygen-level dependent calibration techniques.

The impacts of COVID-19 may be magnified in a shared environment like the household, especially with people spending extended time at home during the pandemic. Family resilience is the ability of a family to adapt to crisis and can be a protective factor against stress and negative affect. While there have been calls to address family resilience during the pandemic, there is a lack of empirical study on its benefit. In this dyadic observational study, we sought to investigate the concordance of family members’ psychological responses to COVID-19, whether dyad members’ risk factors (COVID-19 exposure and financial impact) mutually affected each other’s psychological responses, and importantly, whether family resilience was a significant factor in these responses. A total of 200 family dyads from the same household completed the Family Resilience Assessment Scale and questionnaires on COVID-19 threat perception, impacts, and exposure. We found concordant dyad responses for COVID-19 threat perception, but not for psychological impact. Using the Actor-Partner-Interdependence Model framework, we found that one’s psychological impact was affected by the financial impact from both dyad members. After controlling for risk factors and demographic covariates, we found that family resilience significantly associated with lower COVID-19 psychological impact, though not with threat perception. The findings suggest that both family and individual factors need to be addressed and there may be benefit in addressing multilevel risk and protective factors using an ecological systems approach, which may help prepare the population for future crises.

Background: Life-space mobility (LSM) refers to the movement of people over time and the areas through which they move to achieve life goals of health, employment, security, and participation for active aging. Objective: The Elderly Activity Life-Space Envelopes program is a large interdisciplinary mixed methods LSM study in older adults of 50 years and above. The overarching aims were to discover why, where, and when older adults travel and how they get to their destinations. Methods: In this paper, we focus on the methodology of the main quantitative phase. This community-based study comprised an in-person multidomain geriatric assessment with physical performance measures, followed by a 14-day travel diary. For the multidomain geriatric assessment, we structurally underpinned important population health constructs including the WHO International Classification of Functioning, Disability and Health, Frailty, and Intrinsic Capacity. We also described home meso-environments by incorporating authoritative open-source environmental attributes. These facilitated the categorization of LSM determinants into health, social, and environmental domains. The LSM outcomes include self-reported and objective geographical information science LSM measures. We further developed a suite of geographical information science LSM outcomes in alignment with our overarching aims. Quota sampling based on age groups, housing typology, and frailty status was applied. A customized, smartphone-based digital travel diary was designed, and barometric sensors were enabled to capture 3D LSM in capable smartphones. Results: We recruited 1131 older adults with an average age of 63.8 (SD 7.6) years. The large majority (n=1062, 95%) successfully documented their travel diary on their smartphones with the rest on paper-based travel diaries. For the digital data, a total of 88,166 node points were recorded. There were 76,741 trips and 106,323 trip legs documented through the e-travel diary platform. Valid vertical LSM data were obtained from 228 participants. The majority (n=842, 75%) lived in public apartments, and 29% (n=326) were prefrail or frail. Conclusions: We provide a practical, feasible yet comprehensive protocol integrating LSM within important population health themes. Also, the development of an objective, systematic outcomes framework will form the basis for future LSM studies in the field. We aim to analyze the interactions between LSM outcomes, explore its diverse determinants, and identify senior travel phenotypes. We hope to develop interdisciplinary policy−driven interventions to ultimately improve the quality of life in older adults.