Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol.

IntroductionBehavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successful implementation of evidence-based practices (EBPs) in community settings that serve low-income, ethnic minority families. Lay health workers (LHWs)-individuals without formal mental health training-represent an important workforce to increase engagement, as they are members of the communities they serve. However, the mobilisation of LHWs has not been well studied as an implementation strategy to extend the reach or effectiveness of EBPs in the USA. LHW-delivered implementation interventions that specifically support the engagement of Latinx parents in evidence-based BPT programmes have the potential to improve clinical and implementation outcomes.Methods and analysisA community-partnered approach will use the Quality Implementation Framework (QIF) to tailor and implement an LHW-delivered implementation intervention that aims to promote Latinx parent engagement in BPT programmes. Steps from the QIF will guide study activities to (1) conduct a mixed methods needs assessment to fit the implementation intervention to the local context, (2) adapt LHW-delivered implementation strategies to promote parent access to and engagement in Parent-Child Interaction Therapy and (3) conduct a hybrid effectiveness-implementation pilot trial to examine the feasibility, acceptability and preliminary effectiveness of the LHW implementation intervention at increasing engagement.Ethics and disseminationStudy procedures have been approved by the Institutional Review Board at the University of California, Santa Barbara. Results will be shared with the community-advisory group, at community-based meetings for other stakeholders involved in the pilot project, and submitted for publication in peer-reviewed journals

Containing and resisting masculinity: narratives of renegotiation among resilient male survivors of childhood sexual abuse

Male childhood sexual abuse survivors face the same social pressures as other men to live up to the tenets of masculinity. However, they contend with a disjuncture between cultural definitions of manhood and the discordant experience of sexual victimization. In-depth qualitative interviews were conducted with 16 resilient men varying in age, sexual orientation, socioeconomic status, and ethnicity. The authors analyzed the men’s narratives concerning male role socialization for toughness, stoicism, and aggressive sexuality, as well as the impact of childhood sexual abuse. Results indicate that in their paths toward recovery, the participants repeatedly described both containing and resisting traditional masculine roles and made conscious choices not to become perpetrators. The importance of raising awareness about masculinity myths in clinical interventions is discussed

Photography and Social Media Use in Community‐Based Participatory Research with Youth: Ethical Considerations

Community-based participatory researchers increasingly incorporate photography and social media into their work. Despite its relative infancy, social media has created a powerful network that allows individuals to convey messages quickly to a widespread audience. In addition to its potential benefits, the use of social media in research also carries risk, given the fast pace of exchanges, sharing of personal images and ideas in high accessibility, low privacy contexts and continually shifting options and upgrades. This article contributes to the literature examining ethical considerations for photography and social media use in community-based participatory research. We describe three key ethical dilemmas that we encountered during our participatory photography project with Latina/o youth: (a) use and content of images and risk; (b) incentives and coercion; and (c) social media activity and confidentiality. We provide our responses to these challenges, contextualized in theory and practice, and share lessons learned. We raise the question of how to contend with cultural shifts in boundaries and privacy. We propose that evaluating participant vulnerability versus potential empowerment may be more fitting than the standard approach of assessing risks and benefits. Finally, we recommend upholding the principles of participatory research by co-producing ethical practices with one's participants

A gale force wind: Meaning making by male survivors of childhood sexual abuse.

This in-depth qualitative study explores how 16 resilient male survivors of serious childhood sexual abuse, representing a range of racial, ethnic, and socioeconomic backgrounds, made meaning from their abuse experiences. Three main types of meaning making styles were identified in the narratives: meaning making through action, using cognitive strategies, and engaging spirituality. Meaning making through action included helping others and using creative expression to describe and process the abuse. Reasoning systems that helped survivors to understand why the abuse happened included developing a psycholog-ical framework for understanding the abuser or the role of the self in the abuse, using a sociocultural explanation, or developing a philosophical view. A few men made meaning through their spirituality. Meaning making styles seem to be related to experiences with therapy; the more experience these men had had with specialized trauma therapy, the more likely they were to make meaning by attempting to understand their perpetrators. In this study, men of color, regardless of socioeconomic class, were less likely than Caucasian men to have received specialized trauma therapy

Promoting Equity and Resilience: Wellness Navigators’ Role in Addressing Adverse Childhood Experiences

ObjectiveAdverse childhood experiences (ACEs) have demonstrable negative effects on long-term physical and mental health. Racial and ethnic minority children disproportionally experience ACEs due to the impacts of structural inequality and discrimination, which could drive health disparities. Pediatric settings offer an opportune context to address ACEs and improve health equity, and to link families to the necessary resources to promote resilience. Wellness navigators (WNs), who can reflect patients' cultural, linguistic, and other shared characteristics, have the potential to improve patient care and integrated behavioral health services to mitigate the public health impact of ACEs. In the current study, bilingual and bicultural WNs helped to deliver an ACEs screening and response to predominately Latinx patients in a pediatric service setting.MethodsQuantitative data on referrals made by WNs and qualitative interviews were analyzed to understand the role of WNs in ACEs screening.ResultsAmong families (infants and caregivers) that screened positive for ACEs, WNs addressed social determinants of health and, based on individual needs assessments, made referrals to community resources in over half of the cases. Insurance, childcare, and housing were the most frequent referral sources. WNs supported caregivers in initiating services with 94% of the referrals that were made. Qualitative interviews with medical providers and caregivers underscored WNs' role in the ACEs screening process. Implications for ACEs screening, trauma-responsive pediatric care, and integrating WNs into an integrated behavioral health team are discussed

Using Community-Based Participatory Research and Human-Centered Design to Address Violence-Related Health Disparities Among Latino/a Youth

High rates of exposure to violence and other adversities among Latino/a youth contribute to health disparities. The current article addresses the ways in which community-based participatory research (CBPR) and human-centered design (HCD) can help engage communities in dialogue and action. We present a project exemplifying how community forums, with researchers, practitioners, and key stakeholders, including youths and parents, integrated HCD strategies with a CBPR approach. Given the potential for power inequities among these groups, CBPR + HCD acted as a catalyst for reciprocal dialogue and generated potential opportunity areas for health promotion and change. Future directions are described

Using Community-Based Participatory Research and Human-Centered Design to Address Violence-Related Health Disparities Among Latino/a Youth.

High rates of exposure to violence and other adversities among Latino/a youth contribute to health disparities. The current article addresses the ways in which community-based participatory research (CBPR) and human-centered design (HCD) can help engage communities in dialogue and action. We present a project exemplifying how community forums, with researchers, practitioners, and key stakeholders, including youths and parents, integrated HCD strategies with a CBPR approach. Given the potential for power inequities among these groups, CBPR + HCD acted as a catalyst for reciprocal dialogue and generated potential opportunity areas for health promotion and change. Future directions are described

Mental Health Stigma Prevention: Pilot Testing A Novel, Language Arts Curriculum-Based Approach For Youth

BACKGROUND: Researchers have emphasized the importance of integrating mental health education with academic curriculum. The focus of the current studies was Mental Health Matters (MHM), a mental health curriculum that is integrated with English language arts. It is taught by trained community member volunteers and aims to increase knowledge and decrease stigma toward individuals with mental health disorders. METHODS: In Study 1, 142 sixth graders participated in MHM and completed pre- and postprogram measures of mental health knowledge, stigma, and program acceptability. Teachers also completed ratings of acceptability. Study 2 (N = 120 seventh graders) compared participants who had participated in MHM the previous year with those who had not using the same measures. RESULTS: Sixth grade students and teachers rated the program as highly acceptable. Participants significantly increased their knowledge and decreased their levels of stigma. Seventh graders who had participated in MHM had significantly more mental health knowledge than peers who had not, but there were no differences in stigma. CONCLUSIONS: The model appears to be acceptable to students and teachers. Future research is needed to assess the long-term effectiveness of integrating mental health education with other academic curriculum such as language arts or science