Acculturation Stress Magnifies Child Depression Effect of Stressful Life Events for Latinx Youth 3 Years Later.

Introduction: Experiences of stressful life events (SLEs) during childhood are associated with greater risk for youth psychopathology. Although SLEs are reported in greater frequency by Latinx families, Latinx populations remain largely absent in the SLE literature. Furthermore, Latinx populations face added stressors related to socio-political climate, acculturation, and racism and discrimination. The purpose of this study was to explore the intersection between parent-reported SLEs and acculturation (i.e., socio-political climate-related) stressors for Latinx youth. Greater frequency of caregiver reported SLEs were hypothesized to predict higher depressive symptoms in their children three years later, and acculturation stress was hypothesized to amplify these effects. Method: The community-recruited, low-income sample for this study consisted of 198 Latinx caregivers (98.5% mothers, 77.3% foreign-born) and their children (M age = 7.4, 47.5% female). Study hypotheses were tested using MPlus. Results: Consistent with prior literature, more SLEs reported at age 7 by parents were associated with more child-reported depressive symptoms at age 10 but only among boys. However, for both boys and girls, there was a significant interaction between acculturation stress and family SLEs. Specifically, as the amount of acculturation stress reported at age 7 increased, the negative impact of family SLEs on child-reported depressive symptoms at age 10 was magnified, regardless of gender. Conclusion: Adding to the literature on SLEs within Latinx families, these results indicate that acculturation and socio-political climate stressors need be considered in discussions of the effects of life stress on Latinx youth and their families.

Structural Factors Contributing to Compassion Fatigue, Burnout, and Secondary Traumatic Stress Among Hospital-Based Healthcare Professionals During the COVID-19 Pandemic.

High levels of burnout among healthcare providers (HCPs) have been a widely documented phenomenon, which have been exacerbated during the COVID-19 pandemic. In the United States, qualitative studies that are inclusive of HCPs in diverse professional roles have been limited. Therefore, we utilized a qualitative-quantitative design to examine professional quality of life in terms of compassion fatigue, burnout, and secondary traumatic stress among hospital-based HCPs, including social workers, hospitalists, residents, and palliative care team members during COVID-19. HCPs (n = 26) participated in virtual semi-structured focus groups or individual interviews and online surveys (n = 30) including the Professional Quality of Life (ProQOL) Scale. While ProQOL scores indicated low levels of compassion fatigue, burnout, and secondary traumatic stress, thematic analysis of our qualitative data included rich descriptions of compassion fatigue, burnout, and secondary traumatic stress. Safety concerns and value misalignment characterized structural stressors perceived to contribute to HCP compassion fatigue, burnout, and secondary traumatic stress. The discrepancy between our qualitative and quantitative findings may be indication that modifications to current screenings are warranted. These findings also suggest a need to identify and implement structural and policy changes that increase HCPs' physical and emotional safety and promote better alignment of institutional interests with HCP values.

Expansion of the Community Engagement Studio Method: Deepening Community Participation in Health Care Innovation.

BACKGROUND: The Community Engagement Studio (CE Studio) method has emerged as a valuable model for community participation in health innovation research, and we advance the model by expanding the timing and number of CE Studio sessions, as well as facilitation. OBJECTIVES: The authors expanded the CE Studio method first to include five sessions corresponding to five phases of innovation: a) health experiences, b) community readiness,c) design features, d) adoption, and e) sustainability. Community experts were engaged throughout the duration of the research. Second, the authors positioned the CE Studio Team to be deeply embedded within the research team and the community of interest through community health workers. METHODS: The expanded CE Studio method was incorporated into a federally funded research project focused on a health technology platform. The CE Studio Team held five sessions with each of four community expert panels (total of 20 sessions) based on race/ethnicity and language: African American, Asian American, English-speaking Latinx, and Spanishspeaking Latinx. CONCLUSIONS: CE Studio sessions revealed community experts' shared and unique evolving and deepening perspectives that show promise for expanding the model.

"It felt like hitting rock bottom": A qualitative exploration of the mental health impacts of immigration enforcement and discrimination on US-citizen, Mexican children.

Latino immigrant families in the United States were disproportionately affected by intensified interior immigration enforcement under the Trump administration. US-citizen children are victimized by policies targeting their immigrant parents; research is sparse regarding how these polices affect children who experience parental deportation and children who are at risk for parental deportation. Additionally, anti-immigrant rhetoric can result in increased discrimination that also threatens children's psychological health. This qualitative study (N = 22) explores children's lived experiences of discrimination, parental deportation or threat of parental deportation, and perceived impacts on mental health. Interviews conducted from 2019 to 2020 revealed that children who are directly affected by or at risk for parental deportation experience detrimental impacts to their psychological well-being. Children experience discrimination as Latinos and children of immigrants, which is also detrimental to their mental/emotional health. Incorporating children's perspectives is critical to informing public health interventions. Findings demonstrate the need for family-friendly immigration reform.

Las familias inmigrantes latinas en los Estados Unidos se vieron desproporcionadamente afectadas por las acciones del servicio de inmigración bajo la administración de Trump. Los niños y niñas con ciudadanía estadounidense son víctimas de las políticas dirigidas a sus padres inmigrantes; las investigaciones son escasas con respecto a cómo estas políticas afectan a los menores afectados por la deportación de sus padres así como los que corren riesgo de que sus padres sean deportados. Además, la retórica antiinmigrante puede provocar un aumento en la discriminación, lo cual también representa una amenaza para la salud psicológica de estos niños y niñas. Este estudio cualitativo (N = 22) explora las experiencias de discriminación y de deportación o amenaza de deportación de los padres vividas por los menores así como los impactos percibidos en su salud mental. Las entrevistas realizadas entre 2019 y 2020 revelan que las niñas y niños directamente afectados por la deportación o el riesgo de deportación de sus padres sufren un impacto perjudicial en su bienestar psicológico. Los menores experimentan discriminación como latinos e hijos de inmigrantes, lo cual también perjudica su salud mental y emocional. Es crucial que se incorporen las perspectivas de estos menores al informar las intervenciones de salud pública. Los hallazgos demuestran la necesidad de una reforma migratoria que sea solidaria con las familias.

Emotional wellbeing and coping among Latinx young adults in the time of COVID-19.

The COVID-19 pandemic has disrupted the wellbeing of the general US population, but even more so among Latinx young adults. The current study provides a detailed picture of the emotional wellbeing and coping of Latinx young adults during the first summer of the pandemic. Six virtual focus groups (n = 21) were conducted between May and August of 2020 with a community-based sample of Latinx young adults to explore (1) how the pandemic affected wellbeing and (2) how they coped with pandemic-related stress. Contextualistic thematic analysis identified important themes and subthemes. Perceived stressors impacting emotional wellbeing yielded one overarching theme: COVID-related disruptions in the participants' environment. To manage this heightened stress, another overarching theme was self-care and intentionality during the pandemic. Future studies should examine the wellbeing of young adults across social contexts and at more recent stages of the pandemic. Findings from this study suggest culturally- and developmentally-tailored interventions are needed as this population navigates contextual stress during a sensitive period in their life.

Maternal and Child Depressive Symptoms in a Sample of Low-income Families of Color: The Mediating Role of Child Adaptability.

Maternal depressive symptoms are linked with child internalizing concerns, such as depressive symptoms. The impact that maternal depressive symptoms have on the onset and maintenance of child depressive symptoms might be especially salient in families of color who are low-income because of elevated rates of maternal depressive symptoms and environmental stressors in those populations. The relationship between maternal and child depressive symptoms might be partially explained by a child's capacity to flexibly respond to stressors in the environment, a construct known as adaptability. A simple mediation model was conducted with a sample of low-income, Black/African American and Latina mothers and their children (n = 128). Results suggested that child adaptability partially mediated the link between maternal and child depressive symptoms. We discussed how this study can inform research and practice that aim to assist low-income families of color with mental health needs.

The intersection of immigration policy impacts and COVID-19 for Latinx young adults.

For many Latinx young adults, COVID-19 has exposed exclusionary policies that heighten risk for contracting the virus and that leave them and their parents unprotected. This study has a dual purpose; first, to quantitatively examine immigration policy impacts of discrimination, isolation, threats to family, and vulnerability, and their association to economic consequences experienced by Latinx young adults in Central Texas during the initial months of the COVID-19 pandemic. Second, to qualitatively explore how policy impacts affected Latinx young adults during the pandemic, and the coping mechanisms they utilized to minimize these impacts. Quantitative results show that on average, Latinx young adults (N = 83) reported low discrimination and isolation but moderate threats to family and vulnerability, with rates of isolation and vulnerability higher for foreign-born than U.S.-born Latinx young adults. Perceived discrimination due to one's own or family immigration status was associated with economic hardship. Qualitative findings show that Latinx young adults (n = 21) experienced (a) precarious conditions that pose a threat of COVID-19 infection for Latinxs, (b) parental job loss due to vulnerable employment leads to deprivation, and (c) policies that disproportionally discriminate against the Latinx community and exclude them from vital services. Despite these challenges, participants also drew on resilience and expressed hope for the future. The article concludes with implications for policymakers and practitioners to provide protections and services to Latinx young adults and their family members.

A storyboarding approach to train school mental health providers and paraprofessionals in the delivery of a strengths-based program for Latinx families affected by maternal depression.

Mental health professionals in schools and the community are often overburdened and underfunded in high-need areas, limiting their capacity to deliver needed family-based mental health interventions. To address this issue, paraprofessional school personnel (e.g., family engagement liaisons) can facilitate these family-based mental health interventions alongside licensed mental health professionals, thereby increasing access to mental health services for families with mental health needs. To train professional and paraprofessional school personnel in maternal depression and interventions, we used storyboarding, a narrative storytelling method traditionally used to create films. Latinx families who had previously participated in a family-focused program for maternal depression shared real life stories focused on themes of (a) maternal depression, (b) impact on children, (c) cultural views and role of immigration, (d) self-harm and suicide, and (e) what families need. In this conceptual paper, we describe our engagement of families in a multistep process of storyboarding that resulted in video modules of family stories for a training website and in-person workshop for school professionals and paraprofessionals. We conclude with how community-engaged tools such as storyboarding can be used to increase awareness and reduce stigma of maternal depression among staff training to deliver family-focused mental health programs in schools.

Mexican immigrant parents' hopes for their children and parenting strategies in different immigration climates.

In the present article, we explore the hopes that immigrant parents of Mexican origin have for their children and the strategies they employ to foster such hopes in light of immigration status, immigration climate, and transnational lived experiences. We conducted six focus groups with 42 immigrant parents of Mexican origin living in Arizona and Texas to explore their hopes and strategies used to foster hopes. Parents, the majority of whom were mothers, defined hopes in terms of what they can provide to their children, including (a) a better life through education and economic opportunities, (b) a strong moral and civic upbringing, and (c) safety from neighborhood crime and hostile immigrant climates. Parents fostered these hopes through the strategies of using self as example, parental involvement and monitoring, self-sacrifice, and family unity. Mothers of unauthorized immigration status raising children in a harsh immigration climate also avoided undue public exposure to ensure their children's safety, a task that was difficult for fathers as breadwinners. Immigration status and climate influenced parents' ability to provide opportunities for their children to pursue educational and career opportunities. We discuss parents' hopes and parenting strategies in the context of different immigration climates, highlight emerging gender differences, and provide recommendations for research and practice.

En el presente artículo, analizamos las esperanzas que tienen los padres inmigrantes de origen mexicano para sus hijos y las estrategias que emplean para alimentar dichas esperanzas teniendo en cuenta la situación migratoria, el ambiente de inmigración y las experiencias transnacionales vividas. Organizamos seis grupos de análisis con 42 padres inmigrantes de origen mexicano que viven en Arizona y Texas con el fin de analizar sus esperanzas y estrategias utilizadas para alimentar esperanzas. Los padres, la mayoría de los cuales eran madres, definieron las esperanzas desde el punto de vista de lo que les pueden facilitar a sus hijos, por ejemplo, una vida mejor mediante oportunidades educativas y económicas, una fuerte educación cívica y moral, y protección contra la delincuencia barrial y los ambientes hostiles de inmigrantes. Los padres alimentaron estas esperanzas mediante las estrategias de uso de su propio ejemplo, su participación y supervisión, el sacrificio propio y la unidad familiar. Las madres de situación migratoria no autorizada que criaron hijos en un ambiente hostil de inmigrantes también evitaron la exposición pública excesiva para garantizar la seguridad de sus hijos, una tarea que fue difícil para los padres como sostenes de la familia. La situación y el ambiente migratorios influyeron en la capacidad de los padres de brindar posibilidades a sus hijos de seguir oportunidades educativas y profesionales. Explicamos las esperanzas de los padres y las estrategias de crianza en el contexto de diferentes ambientes de inmigración, destacamos las diferencias de género que surgieron, y ofrecemos recomendaciones para la investigación y la práctica.

Economic and Social Consequences of COVID-19 and Mental Health Burden Among Latinx Young Adults During the 2020 Pandemic.

Latinx young adults 18-25 years old face unique challenges that disproportionately put them at high risk of experiencing health as well as economic and social burden due to the Coronavirus disease (COVID-19) pandemic. The present study examined how economic and psychosocial consequences as a result of the pandemic were associated with mental health issues among a community sample of Latinx young adults (N = 83) from Central Texas. Participants completed an online survey of COVID-related experiences and mental health needs. The survey asked about personal and family experiences of COVID-19 in two significant areas: (a) economic strain (e.g., economic hardship, food insecurity) and (b) psychosocial burden (e.g., losing relationships, substance use). Regression analyses examined the association of COVID-19 consequences on level of mental health symptoms and clinically significant outcomes. Relative to economic consequences, psychosocial consequences due to the COVID-19 pandemic were associated with higher levels of mental health symptoms. In contrast, in few cases, economic strain resultant from the pandemic was correlated with clinically significant outcomes among this sample. Collectively, findings suggest that the costs of the pandemic do not only pertain to mortality from illness but also to morbidity as it relates to deteriorating social circumstances and mental health. Findings from this study call for immediate attention to implement policies and programs to help mitigate the economic and social-emotional consequences of COVID-19 such as easy access to low-cost virtual mental health resources to Latinx young adults.

Los adultos jóvenes latinos de 18 a 25 años enfrentan desafíos únicos que los ponen de manera desproporcionada en un alto riesgo de sufrir consecuencias de salud, económicas y sociales debido a la pandemia del COVID-19. El estudio presente examinó cómo las consecuencias económicas y psicosociales a raíz de la pandemia se asociaron con problemas de salud mental en una muestra comunitaria de adultos jóvenes latinos (N = 83) del centro de Texas. Los participantes completaron una encuesta en línea sobre experiencias relacionadas con el COVID-19 y necesidades de salud mental. La encuesta incluyó preguntas sobre las experiencias personales y familiares del COVID-19 en dos áreas importantes: (a) tensión económica (por ejemplo, dificultades económicas, inseguridad alimentaria) y (b) carga psicosocial (por ejemplo, pérdida de relaciones, consumo de sustancias). Los análisis de regresión examinaron la asociación de las consecuencias del COVID-19 en el nivel de los síntomas de salud mental y los resultados clínicamente significativos. En comparación a las consecuencias económicas, las consecuencias psicosociales debido a la pandemia de COVID-19 se asociaron con niveles más altos de síntomas de salud mental. Por el contrario, en unos pocos casos, la tensión económica resultante de la pandemia se correlacionó con resultados clínicamente significativos en esta muestra. En conjunto, los hallazgos sugieren que los costos de la pandemia no solo se refieren a la mortalidad por enfermedad, sino también a la al deterioro de las circunstancias sociales y la salud mental. Los hallazgos de este estudio exigen atención inmediata para implementar políticas y programas que ayuden a mitigar las consecuencias económicas y socioemocionales del COVID-19, como el fácil acceso a recursos virtuales de salud mental de bajo costo para adultos jóvenes latinos.

An ecological expansion of the adverse childhood experiences (ACEs) framework to include threat and deprivation associated with U.S. immigration policies and enforcement practices: An examination of the Latinx immigrant experience.

The Adverse Childhood Experiences (ACEs) framework has contributed to advances in developmental science by examining the interdependent and cumulative nature of adverse childhood environmental exposures on life trajectories. Missing from the ACEs framework, however, is the role of pervasive and systematic oppression that afflicts certain racialized groups and that leads to persistent threat and deprivation. In the case of children from immigrant parents, the consequence of a limited ACEs framework is that clinicians and researchers fail to address the psychological violence inflicted on children from increasingly restrictive immigration policies, ramped up immigration enforcement, and national anti-immigration rhetoric. Drawing on the literature with Latinx children, the objective of this conceptual article is to integrate the ecological model with the dimensional model of childhood adversity and psychopathology to highlight how direct experience of detention and deportation, threat of detention and deportation, and exposure to systemic marginalization and deprivation are adverse experiences for many Latinx children in immigrant families. This article highlights that to reduce bias and improve developmental science and practice with immigrants and with U.S.-born children of immigrants, there must be an inclusion of immigration-related threat and deprivation into the ACEs framework. We conclude with a practical and ethical discussion of screening and assessing ACEs in clinical and research settings, using an expanded ecological framework that includes immigration-related threat and deprivation.

Emotional Reactions and Coping of Mexican Mixed-Status Immigrant Families in Anticipation of the 2016 Presidential Election.

The present study illuminates the emotions of mixed-status families as they anticipated the 2016 Presidential election. From a 6-year longitudinal case study of four Mexican immigrant families, we present interviews from May of 2016, prior to the presidential primaries, and from November of 2016, the day before or the day of the presidential election. Using a multiple case study method (Stake, 2006, Multiple case study analysis. Guilford Press, New York; Yin, 2014, Case study research: Design and methods (5th ed.). Sage, Los Angeles, CA), our primary goal was to describe how immigrant Mexican adults and their preadolescent and adolescent children (or grandchildren) personally and collectively reacted emotionally to the events leading up to the 2016 presidential election, and how they managed and coped with their emotions. Our secondary goal was to explain how their emotional reactions changed over time and were influenced by age and immigration status. Initially, participants expressed concern and fear about the anti-immigration rhetoric by the conservative political movement, but largely felt reassured that such rhetoric would not prevail. In the days immediately preceding the election, a notable change seemed apparent among all participants, regardless of immigration status. They expressed having intense emotions ranging from fear and angst to disbelief, anger, and denial, which they attempted to manage through external (e.g., community involvement, activism, solidarity) and internal (e.g., family communication, cognitive strategies) actions. Older adolescents had a better understanding of the implications of the election for their family than younger adolescents did. We provide recommendations for family practice and policy aimed to support and advocate on behalf of immigrant families.

El presente estudio explica las emociones de las familias cuyos miembros tienen distinta situación migratoria mientras esperaban la elección presidencial de 2016. De un caso práctico longitudinal de seis años de cuatro familias de inmigrantes mexicanos, presentamos entrevistas de mayo de 2016, antes de las primarias presidenciales, y de noviembre de 2016, el día antes o el día de la elección presidencial. Utilizando un método de casos prácticos múltiples (Stake, 2006; Yin, 2014), nuestro objetivo principal fue describir cómo los adultos inmigrantes mexicanos y sus hijos preadolescentes y adolescentes (o nietos) reaccionaron personal y colectivamente a los acontecimientos previos a la elección presidencial de 2016, y cómo manejaron y afrontaron sus emociones. Nuestro objetivo secundario fue explicar cómo sus reacciones emocionales cambiaron con el tiempo y estuvieron influenciadas por la edad y la situación inmigratoria. Inicialmente, los participantes expresaron preocupación y miedo acerca de la retórica contra los inmigrantes por parte del movimiento político conservador, pero en su gran mayoría estaban convencidos de que dicha retórica no prevalecería. Los días inmediatamente anteriores a la elección, se hizo evidente un cambio notable entre todos los participantes, independientemente de la situación de inmigración. Ellos dijeron tener emociones intensas, desde miedo y angustia hasta incredulidad, ira y rechazo, que intentaron manejar mediante medidas externas (p. ej.: participación en la comunidad, activismo, solidaridad) e internas (p. ej.: comunicación familiar, estrategias cognitivas). Los adolescentes mayores tuvieron una mejor comprensión de las implicancias de la elección para su familia que los adolescentes más jóvenes. Ofrecemos recomendaciones para la práctica familiar orientadas a apoyar y a abogar por las familias inmigrantes.

The Association Between Exposure to Maternal Depression During Year 2 of a Child's Life and Future Child Problem Behavior.

INTRODUCTION: We examined the association of exposure to maternal depression during year 2 of a child's life with future child problem behavior. We conducted a secondary analysis to investigate whether race/ethnicity is a moderator of this relationship. METHODS: We used Fragile Families and Child Well-Being Study data (age 3 N = 3288 and 49% Black, 26% Hispanic, 22% non-Hispanic White; age 5 N = 3001 and 51% Black, 25% Hispanic, 21% non-Hispanic White; age 9 N = 3630 and 50% Black, 25% Hispanic, 21% non-Hispanic White) and ordinal logistic regression to model problem behavior at ages 3, 5, and 9 on maternal depression status during year 2. RESULTS: At age 9, children whose mother was depressed during year 2 were significantly more likely to have higher internalizing (AOR = 1.92, 95% CI: 1.42,2.61) and externalizing (AOR = 1.65, 95% CI: 1.10,2.48) problem behavior scores. In our secondary analysis, race/ethnicity did not have moderating effects, potentially due to a limitation of the data that required use of maternal self-reported race/ethnicity as a proxy for child race/ethnicity. DISCUSSION: Exposure to maternal depression after the prenatal and perinatal periods may have a negative association with children's behavioral development through age 9. Interventions that directly target maternal depression during this time should be developed. Additional research is needed to further elucidate the role of race/ethnicity in the relationship between maternal depression and child problem behavior.

Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis.

We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.

Food Insecurity and Housing Instability Partially Mediate the Association Between Maternal Depression and Child Problem Behavior.

Maternal depression is a risk factor for the development of problem behavior in children. Although food insecurity and housing instability are associated with adult depression and child behavior, how these economic factors mediate or moderate the relationship between maternal depression and child problem behavior is not understood. The purpose of this study was to determine whether food insecurity and housing instability are mediators and/or moderators of the relationship between maternal depression when children are age 3 and children's problem behaviors at age 9 and to determine whether these mechanisms differ by race/ethnicity. We used data from the Fragile Families and Child Wellbeing Study. Food insecurity and housing instability at age 5 were tested as potential mediators and moderators of the relationship between maternal depression status at age 3 and problem behavior at age 9. A path analysis confirmed our hypothesis that food insecurity and housing instability partially mediate the relationship between maternal depression when children are age 3 and problem behavior at age 9. However, housing instability was only a mediator for externalizing problem behavior and not internalizing problem behavior or overall problem behavior. Results of the moderation analysis suggest that neither food insecurity nor housing instability were moderators. None of the mechanisms explored differed by race/ethnicity. While our findings stress the continued need for interventions that address child food insecurity, they emphasize the importance of interventions that address maternal mental health throughout a child's life. Given the central role of maternal health in child development, additional efforts should be made to target maternal depression.

The Relationship Between Maternal Depression, Externalizing and Internalizing Problems in Children, and Caregiving Burden in Urban Low-Income Ethnic and Racial Minority Families.

A strong relationship exists between maternal depression and externalizing and internalizing problems in children, and caregiving burden might mediate this relationship. Yet, caregiving burden has rarely been tested as a mechanism underlying the relationship between maternal depression and child emotional and behavioral outcomes. Caregiving burden might be especially high in ethnic and racial minority mother-child dyads in low-income settings where there are more stressors in the environment and rates of maternal depression are elevated. A path analysis with 132 low-income urban mothers who mostly identified as racial and ethnic minorities confirmed our hypothesis that maternal depression has a direct effect on child externalizing and internalizing problems, and also an indirect effect through caregiving burden. We discuss implications of the findings with respect to research, practice, and policy with low-income, ethnic and racial minority families whose mothers have depression and care for children who exhibit externalizing and internalizing problems.

Mexican Immigrant Fathers' Recognition of and Coping with Maternal Depression: The Influence of Meaning-Making on Marital and Co-Parenting Roles among Men Participating in a Family Intervention.

Fathers play a critical role in recognizing and responding to maternal depression and providing support to the family during the mothers' illness and recovery. Our study adopted a dualmethod approach consisting initially of sample interviewing with 10 Mexican immigrant fathers, about their partner's depression and recovery, co-parenting, and fathers' coping. Fathers, their partners, and children participated in a family intervention to support the mother's recovery and address the needs of the family. Approximately 12 months from sample interviews and 8 months after the intervention, we conducted in-depth case studies with three of those fathers to explore how their recognition, support, and coping evolved. Results from interviews across time points present fathers' initial and evolving understanding of maternal depression, while a case study example reflects how fathers' recognition of their partners' depression changed, as did their marital and family interactions, as they shifted attribution of their partners' depression from a controllable state to one of illness. Receipt of accurate information about depression increased fathers' recognition of depression and allowed them to expand traditional gender norms to take an active role in supporting their partners and children. Fathers' experiences were not without emotional cost, with many men recounting anxiety, shame, loneliness, and helplessness. This study underscores the importance of including fathers in interventions and research on maternal depression in immigrant families, and it offers recommendations for culturally grounded familyfocused, interventions.

El padre de familia ocupa una posición crítica en el reconocimiento y el manejo de la depresión materna y como fuente de apoyo para la familia durante la enfermedad y la recuperación de la madre. Nuestro estudio adoptó una metodología doble consistiendo inicialmente de entrevistas con 10 padres de familias mexicanos migrantes en los Estados Unidos, acerca de la depresión y recuperación de su pareja, la crianza de los hijos en pareja, y el manejo del estrés paterno. Padres, sus parejas, y sus hijos participaron en una intervención familiar para la recuperación de la madre y abordar las necesidades de la familia. Unos 12 meses después de las primeras entrevistas y ocho meses después de la intervención, dirigimos estudios de caso con tres padres para explorar como el reconocimiento, el apoyo, y el enfrentamiento al estrés evolucionaron después de la intervención. Los resultados de entrevistas muestran como los padres perciben la depresión maternal, y un estudio de caso refleja como el reconocimiento de la depresión en su pareja cambió, así como las relaciones en pareja y en familia, cuando los padres atribuían la depresión de la madre como una enfermedad. Los padres reconocieron más los síntomas de la depresión al recibir información más precisa, lo cual les permitió desafiar reglas tradicionales masculinas para tomar un rol activo en apoyar a sus parejas e hijos. Sin embargo, los padres sufrieron un costo emocional sintiendo ansiedad, vergüenza, soledad, e impotencia. Debemos incluir a los padres en intervenciones e investigaciones sobre la depresión materna en familias migrantes, y recomendamos intervenciones culturales y enfocadas en la familia.

Translating research to support practitioners in addressing disparities in child and adolescent mental health and services in the United States.

Despite increased recognition of disparities in youth mental health, racial/ethnic disparities in mental health burden and in mental health service use persist. This phenomenon suggests that research documenting disparities alone has not led to extensive action in practice settings in order to significantly reduce disparities. In this commentary, we present a framework to actively target this research-to-practice gap by describing the development of a resource titled, "Addressing the Mental Health Needs of Racial and Ethnic Minority Youth-A Guide for Practitioners." We begin by presenting social justice as the impetus for eliminating disparities and then reviewing current knowledge and efforts aimed at reducing disparities. Subsequently, we describe knowledge transfer frameworks and goals guiding our work. Finally, we detail the steps taken in our approach to translation and implications for subsequent dissemination of this guide. Translation focused on evidence-based information on (a) mechanisms that contribute to disparities, and (b) strategies for providers to address disparities in their work. We reflect on the framework guiding our translation to offer future directions for others interested in bridging research and action. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping.

The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers' mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths' attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9-16 years to explore their perspectives on maternal depression. All youth had participated in a 12-week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture-specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.

La experiencia psicológica de la depresión materna y su efecto en las familias de inmigrantes latinos generalmente no se reconoce ni se trata. Los niños pueden sentirse especialmente desamparados y confundidos con respecto a los cambios que observan en el estado de ánimo y la conducta de sus madres, y con respecto al deterioro de las relaciones familiares. Dada la interdependencia de las estructuras familiares de los hogares de los inmigrantes latinos, la depresión materna puede ser perjudicial para las estrategias de adaptación y las atribuciones de los jóvenes latinos así como para sus relaciones con sus madres. El enfoque cuantitativo de la mayoría de las investigaciones sobre depresión materna en muestras de latinos limita nuestra comprensión de los procesos familiares en la depresión materna. El presente estudio cualitativo analiza el efecto percibido de la depresión materna en las estrategias de adaptación y las atribuciones de los jóvenes latinos. Esta investigación consistió en grupos focales con 12 participantes de entre 9 y 16 años para analizar sus perspectivas sobre la depresión materna. Todos los jóvenes habían participado en una intervención grupal multifamiliar de 12 semanas centrada en el refuerzo de los puntos fuertes familiares y culturales para abordar la depresión materna en las familias de inmigrantes latinos. Los resultados de los grupos focales aclararon la experiencia fundamental de los jóvenes que viven con depresión materna e indicaron que existen consideraciones del desarrollo en cuanto a cómo los jóvenes reconocen y entienden la depresión materna, y hacen frente a una vida familiar perturbada. Además, los jóvenes informaron que recurrieron a estas formas de afrontamiento propias de su cultura: usaron como apoyo las relaciones estrechas entre hermanos y la estructura familiar, pidieron a los padres y a parientes lejanos que participen en prácticas de crianza adicionales y fortalecedoras, y participaron en prácticas religiosas para refugiarse del estrés familiar. Proponemos consideraciones sobre intervenciones y otras áreas de investigación.

A Community-Responsive Adaptation to Reach and Engage Latino Families Affected by Maternal Depression.

As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community. We describe a cultural adaptation framework that is responsive to the unique opportunities and challenges of identifying and recruiting vulnerable families through community partnerships, and of addressing the needs of families by incorporating multiple community perspectives. Specifically, we apply these principles to the cultural adaptation of an intervention originally developed for low-income African American and White families facing maternal depression. The new intervention, Fortalezas Familiares (Family Strengths), was targeted to Latino immigrant families whose mothers were in treatment for depression in mental health and primary care clinics. We conclude with key recommendations and directions for how family researchers and practitioners can design the cultural adaptation of interventions to be responsive to the practices, preferences, and needs of underserved communities, including families and service providers.