Prevention and Intervention Research With Latino Families: A Translational Approach

The present paper takes a translational approach in applying the themes of the current special section to prevention and intervention science in Latino families. The paper reviews the current literature on cultural processes in prevention and intervention research with Latino families. Overall, many prevention and intervention programs have either been developed specifically for Latino families or have been modified for Latino families with great attention paid to the socio-cultural needs of these families. Nevertheless, few studies have tested the role of cultural values or acculturation processes on outcomes. We make recommendations based on findings within basic science and in particular this special section on the incorporation of these values and processes into prevention and intervention science with Latino families

Ethnic Identity in Context of Ethnic Discrimination: When Does Gender and Other-Group Orientation Increase Risk for Depressive Symptoms for Immigrant-Origin Young Adults?

Objectives: Ethnic discrimination increases risk for depressive symptoms, but less is known about factors that influence the impact of this cultural challenge on psychological adjustment for immigrant-origin college students. Sociocultural identity development is especially relevant during emerging adulthood. Studies examining exacerbating or buffering impacts of ethnic identity have yielded mixed results. The current study examines conditions under which one aspect of ethnic identity, affirmation/belonging, moderates the impact of perceived ethnic discrimination stress on depressive symptoms. This was expected to vary by other-group orientation and gender, in accordance with rejection sensitivity theory. Method: A multicultural sample of 290 non-White immigrant-origin emerging adults (aged 18–25) from mixed cultural backgrounds and generational statuses attending a college in the Southeastern United States completed electronic self-report questionnaires. Results: More robust support was provided for social identity theory rather than rejection sensitivity theory: stronger affirmation/belonging was inversely associated with depressive symptoms across the sample, with a notable buffering impact for women. Trend-level results indicated a protective effect for those endorsing stronger affirmation/belonging paired with greater other-group orientation. Additionally, women with weaker affirmation/belonging demonstrated greater increased depressive symptoms compared to men with weaker affirmation/belonging. Conclusions: For this sample, social identity theory was relevant to the impact of affirmation/belonging on the relation between ethnic discrimination and depressive symptoms contingent on other-group orientation and gender. This finding underscores the importance of examining ethnic identity in a nuanced manner. Implications for these results extend to college counseling centers, where inclusion of sociocultural identity in case conceptualization would be useful

How do New Immigrant Latino Parents Interpret Problem Behavior in Adolescents?

Parents are gatekeepers for their children’s mental-health treatment, yet many are unclear about what behaviors warrant intervention. Seeking treatment is further complicated for immigrant parents whose cultural backgrounds may influence their understanding of mental health. This analysis uses qualitative data from [MASKED], which is a representative study of newly immigrated youth (12–18 years) and their parents, to examine parental perceptions of mental health and to determine patterns of help seeking and service use. Sixteen parents participated in semistructured qualitative interviews that used vignettes to elicit parental beliefs about adolescent behavior and mental health. Findings suggest parents 1) identify behavior that meets diagnostic criteria as problematic; 2) ascribe those behaviors to a range of etiologies; and 3) desire to intervene. Two areas of service delivery emerged as problematic: many parents expect services delivered in ways that conflict with current practice standards, and new immigrant families often encounter cultural and practical barriers to accessing care

Activation, Self-management, Engagement, and Retention in Behavioral Health Care: A Randomized Clinical Trial of the DECIDE Intervention

Importance: Given minority patients’ unequal access to quality care, patient activation and self-management strategies have been suggested as a promising approach to improving mental health care. Objective: To determine whether the DECIDE (Decide the problem; Explore the questions; Closed or open-ended questions; Identify the who, why, or how of the problem; Direct questions to your health care professional; Enjoy a shared solution) intervention, an educational strategy that teaches patients to ask questions and make collaborative decisions with their health care professional, improves patient activation and self-management, as well as engagement and retention in behavioral health care. Design, Setting, and Patients: In this multisite randomized clinical trial performed from February 1, 2009, through October 9, 2011 (date of last follow-up interview), we recruited 647 English- or Spanish-speaking patients 18 to 70 years old from 13 outpatient community mental health clinics across 5 states and 1 US territory. A total of 722 patients were included in analyses of secondary outcomes. Interventions: Three DECIDE training sessions delivered by a care manager vs giving patients a brochure on management of behavioral health. Main Outcomes and Measures: Primary outcomes were patient assessment of activation (Patient Activation Scale) and self-management (Perceived Efficacy in Patient-Physician Interactions). Secondary outcomes included patient engagement (proportion of visits attended of those scheduled) and retention (attending at least 4 visits in the 6 months after the baseline research assessment), collected through medical record review or electronic records. Results: Patients assigned to DECIDE reported significant increases in activation (mean ß?=?1.74, SD?=?0.58; P?=?.003) and self-management (mean ß?=?2.42, SD?=?0.90; P?=?.008) relative to control patients, but there was no evidence of an effect on engagement or retention in care. Conclusions and Relevance: The DECIDE intervention appears to help patients learn to effectively ask questions and participate in decisions about their behavioral health care, but a health care professional component might be needed to augment engagement in care. DECIDE appears to have promise as a strategy for changing the role of minority patients in behavioral health care. Trial Registration: clinicaltrials.gov Identifier: NCT0122632

Ethnic differences among substance using adolescents in a treatment dissemination project.

Despite evidence of ethnic differences in substance use patterns among adolescents in community samples, clinical studies have not found ethnic differences in posttreatment outcomes. Prior clinical studies have been limited by small samples, focus on broad treatment modalities, and lack of consideration of important covariates. We investigated ethnic differences in substance use frequency and problems in a large sample of White (60%), African American (12%), and Latino (28%) adolescents prior to and following an evidence-based treatment. Participants included 4,502 adolescents (29% female), with ages 13–18 years, who received Motivational Enhancement Therapy/Cognitive Behavior Therapy 5 Sessions. At baseline, African American adolescents demonstrated less frequent use, fewer problems, and less comorbidity than Whites or Latinos. Consistent with prior research, there were no ethnic differences in substance use outcomes among assessment completers (71%) when controlling for baseline differences. However, African Americans, older adolescents, and males were less likely to complete the posttreatment assessment. Implications for clinical service and effectiveness research are discussed

Commands, Competence, and Cariño : Maternal Socialization Practices in Mexican American Families

Early research on the socialization of Latino children has posited that mothers exercise authoritarian practices, compared with lateral reasoning (authoritative) strategies emphasized by Anglo mothers. This work aimed to categorize fixed types of parenting practices tied to the mother’s personality rather than to culturally bounded contexts; it often ignored the emotional warmth or harshness present in compliance attempts and relied on interview questions rather than naturalistic observation. We built from ecocultural theory to observe daily home activities in which Mexican American mothers attempted to correct their young child’s behavior or encourage completion of a task (compliance attempt). We observed 24 first or second-generation mothers and their 4-year-old children and analyzed the activity contexts and multiple forms of 1,477 compliance attempts. Mothers typically led with direct verbal commands in their attempt to achieve compliance. Many blended commands with other compliance strategies, rather than repeating simple behaviors. Drawing on Crockenberg and Litman’s (1990) differentiation of variable compliance strategies, we find that most mothers relied on low power-assertive methods, including verbal commands, rather than inductive strategies that involved reasoning. Few compliance episodes prompted high power-assertive or harsh strategies. The degree of reliance on verbal commands and the complexity of mothers’ repertoires appear to be related to their education and acculturation levels

Latina/o Parent Activation in Children’s Mental Health Treatment: The Role of Demographic and Psychological Factors

Patient activation has recently emerged as a critical component of effective health care (Hibbard & Greene, 2013), but Latina/o populations demonstrate lower levels of activation compared to non-Latina/o Whites (Cunningham, Hibbard, & Gibbons, 2011). The current study examined demographic and psychological factors associated with immigrant Latina/o parent activation in parents seeking mental health services for their children. Additionally, the study tested whether psychological factors (parental depressive symptoms, parenting stress, perceived severity of child psychopathology) were associated with the effectiveness of an activation intervention among immigrant Latina/o parents (MEPREPA—short for “me preparo”/I prepare [MEtas, PReguntar, Escuchar, Preguntar para Aclarar/goals, questioning, listening, questioning to clarify]). Results demonstrated that parenting stress and perceived severity of child psychopathology were associated with lower levels of parent activation. Additionally, although there was a treatment effect for all parents, stratified group analyses suggested that parents with higher depressive symptoms and greater parenting stress benefited more from the MEPREPA intervention compared to controls. Stratified analyses also showed that the intervention had a greater positive impact on parent activation in health care among parents whose children had more severe symptoms. Clinical and research implications are discussed

Making my family proud: The unique contribution of familism pride to the psychological adjustment of Latinx emerging adults

Objectives: Familism values serve to provide key cultural scripts in Latinx families, and these values have been associated with positive psychosocial outcomes for Latinx youth (Stein et al., 2014). Yet, how familism values intersect with the experience of positive emotions remains relatively unknown. In particular, familism pride may be an important positive emotion that links familism values to positive psychosocial outcomes. To fill this gap in the literature, the current study developed a measure of familism pride and examined its unique prediction to psychosocial outcomes. Method: Self-report survey data were collected from 2 samples of Latinx emerging adults who were part of a psychology subject pool at a comprehensive university in Los Angeles designated as an Hispanic-serving institution. Sample 1 (n = 352) was 72.2% women with a mean age of 18.9 years, whereas Sample 2 was 68.6% women with a mean age of 19.3 years. Results: Factor analyses supported that familism pride was distinct from familism values (familial support, obligation, reference, respeto). Familism pride was associated with fewer depressive symptoms and greater experience of joy when controlling for familism values in both samples. Conclusions: Our study underscores the importance of examining emotional processes in the study of familism and suggests a new dimension of familism that has not received research attention

Becoming an American parent: Overcoming challenges and finding strengths in a new immigrant Latino community

One in five children living in the United States is an immigrant or a child of an immigrant, and 62% of these children are Latino. Through qualitative methods, this study identifies ways that Latino immigrant parents with adolescent children cope with their new environment and how that environment shapes their parenting practices. Two primary themes emerge: overcoming new challenges and finding new strengths. Immigrant parents discuss the challenges of overcoming fears of the unknown; navigating unfamiliar work, school, and neighborhood environments; encountering and confronting racism; and losing family connections and other forms of social capital. In response to these challenges, immigrant parents discuss developing bicultural coping skills, increasing parent–child communication, empathizing with and respecting their adolescent children, and fostering social supports. The results fit well with a risk and protective factor framework and provide a basis for improving policies and programs to support effective parenting in Latino immigrant families

Parent–Child Cultural Value Gaps and Depressive Symptoms Among Mexican American Youth

Cultural value gaps between Mexican American parents and their children are hypothesized to place youth at risk for poor mental health outcomes. While most studies examine these gaps on broad measures of acculturation, the present study examined value gaps in affiliative obedience, a cultural value that has at its core the belief that respect and deference must be shown to parents and adults. The present study hypothesized that adolescents would exhibit greater depressive symptoms when youth demonstrated lower levels of affiliative obedience than their mothers. Moreover, we examined whether gender, nativity status, and age predicted cultural value gaps and moderated the relationship between gaps and depressive symptoms. These questions were evaluated in a school-based sample of 159 Mexican American families whose children were either US born (n = 82) or foreign-born (n = 77). Twenty-five percent of the sample demonstrated a cultural value gap where youth endorsed lower levels of affiliative obedience than their parents, and this group reported the greatest depressive symptoms. Age moderated this relationship, and the greatest association between cultural value gaps and depression was found among the older group of early adolescents