ABSTRACT
Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.
Subject(s)
Black or African American , Social Justice , Female , Humans , Chlorhexidine , Colonialism , Ethnicity , Skin Pigmentation , Indigenous PeoplesABSTRACT
Most scientifically tested physical activity interventions end when research funding ends; interventions that last struggle to sustain benefits. We hypothesize that long-term public health impact will benefit from a shift in how interventionists conceptualize physical activity - from a form of medicine, of value for its innate health benefits, to a malleable medium, of value for the dynamic contexts it creates.
Subject(s)
Exercise , Public Health , HumansABSTRACT
Objective: This study examined parents' participation in a school-and home-based prevention and early intervention service model designed to promote positive parenting and parent involvement in schooling. Method: Paraprofessionals (n = 32) employed by four social service agencies provided parenting support and education through parent groups, home/community visits, case management, and individual contacts to African American and Latino/a families in urban high-poverty communities (n = 375). In this open trial, we identified longitudinal trajectories of parents' participation across all service formats over the course of a full school year using latent class growth models, then examined group differences in baseline child and family characteristics, participation in specific service formats, and parenting skills practice across the year. Results: Four distinct trajectories were identified: parents with consistently low participation; parents whose participation declined and subsequently rebounded; parents with increasing participation; and parents with consistently high participation. Significant differences between trajectory groups were identified on baseline child and family characteristics, and the number and types of service formats in which parents participated participation. Parents across trajectories consistently practiced parenting skills over the school year, with parents who demonstrated increasing participation over time showing the most growth in the number of skills practiced each month. Conclusions: Unique patterns of parent participation across a school year in paraprofessional-delivered services indicates the promise of capitalizing on multiple opportunities to engage parents and suggests the potential for paraprofessional staff to overcome longstanding disparities in parent involvement in children's mental health services.
Subject(s)
Child Rearing , Early Intervention, Educational , Mental Health Services , Parenting , Parents/education , Parents/psychology , Schools , Black People/psychology , Black People/statistics & numerical data , Child , Child Rearing/psychology , Female , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Humans , Male , Parenting/psychology , PovertyABSTRACT
In 2018, in response to increasingly oppressive and widespread federal immigration enforcement actions in the United States (U.S.) and around the globe - including family separation, immigration raids, detention, deportation of people who have lived in the country for much of their lives - the Society for Community Research & Action produced a statement on the effects of deportation and forced separation on immigrants, their families, and communities (SCRA, 2018). The statement focused exclusively on the impacts of deportation and forced family separation, documenting the damage done by oppressive U.S. policies and practices. We felt it was imperative to document this harm, and yet were uncomfortable producing a narrow paper that focused solely on harm. There are multiple ways immigrants and their allies resist deportation and other forms of oppression. This resistance is done individually, collectively, and in settings that vary in size and scope, including community-based, faith-based, direct care, and educational settings, as well as entire municipalities and transnational organizing settings. Settings facilitate resistance in many ways, focusing on those who are oppressed, their oppressors, and systems of oppression. In this statement, we describe the unique and overlapping ways in which settings facilitate resistance. We situate this review of the scientific and practice literature in the frameworks of change through social settings, empowering settings, healing justice, and decolonization. We also document recommendations for continued resistance.
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Emigrants and Immigrants , Mental Disorders , Emigration and Immigration , Humans , Policy , Societies, Scientific , United StatesABSTRACT
This paper describes the process of a community-academic partnership to navigate implementation challenges for a school-based service model led by paraprofessionals to promote positive parenting in high poverty urban communities. We describe the process by which we (a) identified implementation challenges, (b) sustained a university-community collaboration to redesign the paraprofessional service model, and (c) assessed the feasibility of the new model involving four social service agencies in 16 schools with over 600 families. The structure and process of the collaboration and refinement are described with attention to who was best positioned to engage in the collaboration and how the partnership worked to balance scientific rigor with responsiveness to paraprofessional workforce strengths. Feasibility data indicated that the revised model was successfully implemented by paraprofessional staff; 92.2% of possible staff monthly reports were completed and discussion of key goals was incorporated into 94.2% of interactions. Continual monitoring provided critical feedback from stakeholders as we drew on and interpreted these various sources of information to build and refine the service model. We suggest that these processes are critical steps to bridge the research-to-practice gap, by promoting practices that are aligned with the needs of children and families, and the staff who serve them.
Subject(s)
Community Mental Health Services/organization & administration , Community Participation , Parenting , Social Work/organization & administration , Stakeholder Participation , Child , Delivery of Health Care , Feasibility Studies , Humans , Implementation Science , Schools , Urban PopulationABSTRACT
Schools have long been the primary setting for children's mental health services but have neither the resources nor the expertise to manage these services independently. The critical importance of school success for children's adjustment provides a strong rationale for schooling as an essential component of children's mental health services. In this article, we review evidence for how schooling and mental health coalesce, suggesting an alignment of school and community mental health resources that prioritizes successful schooling as a key mental health outcome. We describe collaborative principles and ecological practices that advance a public health focus on children's mental health while also reducing the burden on schools to maintain mental health services. We close with a model of mental health services illustrating these principles and practices in high-poverty urban schools and propose future directions for research and practice to promote positive mental health for all children and youth.
Subject(s)
Healthcare Disparities/standards , Intersectoral Collaboration , Mental Health Services/standards , Public Health/standards , School Health Services/standards , Adolescent , Child , HumansABSTRACT
Dissemination and implementation science (DI) has evolved as a major research model for children's mental health in response to a long-standing call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an overemphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children's healthy development and for utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation's mental health burden by supporting the needs and values of families and communities within their own unique social ecologies.
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Mental Health Services/trends , Public Health , Research/trends , Science , Child , Forecasting , Humans , Mental Health , Social EnvironmentABSTRACT
Leaders @ Play is a park after-school program for urban middle school youth designed to leverage recreational activities for social emotional learning. Mental health and park staff co-facilitated sports and games to teach and practice problem solving, emotion regulation, and effective communication. Additional practice occurred during multi-family groups and summer internships as junior camp counselors. We examined feasibility and promise via an open trial (n = 3 parks, 46 youth, 100 % African American, 100 % low-income, 59 % female, M = 13.09 years old). Improvements in social skills and reductions in problem behaviors lend support to after school programs as a space for mental health promotion.
Subject(s)
Parks, Recreational , Poverty , Problem Solving , Recreation , Resilience, Psychological , Self-Control , Social Learning , Sports , Urban Population , Adolescent , Child , Communication , Female , Humans , MaleABSTRACT
In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.
Subject(s)
Evidence-Based Practice , Health Personnel/education , Mental Health Services/organization & administration , Program Development/methods , Adolescent , Adolescent Health Services/organization & administration , Child , Child Behavior Disorders/therapy , Child Health Services/organization & administration , Cognitive Behavioral Therapy , Female , Health Policy , Humans , Illinois , Male , Mental Health , Parents , Practice Guidelines as Topic , Program EvaluationABSTRACT
This study examined a model for mental health consultation, training and support designed to enhance the benefits of publicly-funded recreational after-school programs in communities of concentrated urban poverty for children's academic, social, and behavioral functioning. We assessed children's mental health needs and examined the feasibility and impact of intervention on program quality and children's psychosocial outcomes in three after-school sites (n = 15 staff, 89 children), compared to three demographically-matched sites that received no intervention (n = 12 staff, 38 children). Findings revealed high staff satisfaction and feasibility of intervention, and modest improvements in observed program quality and staff-reported children's outcomes. Data are considered with a public health lens of mental health promotion for children in urban poverty.
Subject(s)
Child Care/methods , Health Promotion/methods , Mental Health , Teaching/methods , Adolescent , Adult , Child , Child, Preschool , Community Mental Health Services/methods , Evidence-Based Practice/methods , Feasibility Studies , Female , Humans , Male , Needs Assessment , Poverty , Recreation , Referral and Consultation , Schools , Urban Population , Young AdultABSTRACT
Although sustainability is frequently described as a project goal in community-based programs, concentrated efforts to sustain interventions beyond the conclusion of research funding have only recently emerged as a focus of implementation research. The current paper describes a study of behavioral consultation to after-school program staff in low-SES, urban communities. Following consultation, staff use of four recommended tools and strategies was examined, emphasizing facilitators and barriers to sustainability. Results indicated high perceived utility and intention to use intervention components, but low sustainability at two follow-up time points within 1 year after the initial consultation concluded. Findings suggest that ongoing implementation support in community settings may be necessary to ensure the sustainability of interventions and meet the mental health needs of participating high-risk youth.
Subject(s)
Community Mental Health Services/organization & administration , Health Promotion/organization & administration , Schools/organization & administration , Urban Population , Adolescent , Adult , Behavior , Child , Child, Preschool , Female , Humans , Interpersonal Relations , Male , Middle Aged , Program Evaluation , Socioeconomic FactorsABSTRACT
The National Center for Advancing Translational Sciences (NCATS) has defined translation as the process of turning observations into interventions that are adopted, sustained, and improve health. Translation must attend to research and community systems and context at multiple levels, and to key stakeholders. Dissemination and implementation (D&I) sciences are informed by an understanding of the critical role of people and systems in disseminating, adopting, and sustaining innovations within real-world settings. Thus, the D&I sciences provides a set of principles that can guide the translational work of Clinical and Translational Science Award (CTSA) programs from basic research to public health. In this special communication, our cross-domain working group of the CTSA consortium, comprised of experts in methods and processes, workforce development, evaluation, stakeholder engagement, and D&I sciences, share a vision of how CTSAs can enhance translation across the translational spectrum through the integration of D&I sciences into the critical areas of methods and processes, workforce development, and evaluation. We propose a set of recommendations for NCATS national and local leaders that are intended to move D&I sciences out of a position of unfamiliarity and ancillary value and into the core identity of who CTSAs are, how they think, and what they do, to advance translation and health.
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[This corrects the article DOI: 10.1017/cts.2021.815.].
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[This corrects the article DOI: 10.1017/cts.2020.23.].
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A primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Health's (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic-public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic-public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.
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Schools remain among the most frequent providers of children's mental health services, particularly in low-income urban settings. Several decades of research have focused on training teachers to implement evidence-based interventions for minimizing disruptive behavior. Studies consistently demonstrate robust improvements in student behavior and learning; however, the impact on teachers' work-related stress or satisfaction is not well understood. Six urban, high-poverty elementary schools were randomly assigned to a school mental health services model (Links to Learning; L2L) for referred, disruptive students or to services and professional development as usual (SAU). Teachers (n = 71, K-4 general education teachers) in L2L schools participated in professional development and consultation in two universal and two targeted interventions to reduce disruptive behaviors and promote learning. Teachers (n = 65) in SAU schools participated in professional development as usual. Multiple regression models examined teacher reports of individual-level self-efficacy, classroom-level student functioning, and school-level organizational health as predictors of stress and satisfaction. Findings revealed no significant difference between conditions on teacher work-related stress or satisfaction. Organizational health was the strongest predictor of stress and satisfaction. Training on and implementation of evidence-based classroom interventions did not appear to significantly impact teachers' work-related stress or satisfaction. Instead, findings point to organizational climate and teacher connectedness as potential levers for change, supporting prior work on teacher stress and satisfaction in schools. The significance of targeting organizational factors may be particularly significant in urban school districts.
Subject(s)
Faculty/organization & administration , Faculty/psychology , Occupational Stress/psychology , Personal Satisfaction , Schools/organization & administration , Urban Population , Child , Female , Humans , Male , Occupational Stress/diagnosis , Occupational Stress/epidemiology , Self Report , Students/psychologyABSTRACT
OBJECTIVE: This study examined a school- and home-based mental health service model, Links to Learning, focused on empirical predictors of learning as primary goals for services in high-poverty urban communities. METHOD: Teacher key opinion leaders were identified through sociometric surveys and trained, with mental health providers and parent advocates, on evidence-based practices to enhance children's learning. Teacher key opinion leaders and mental health providers cofacilitated professional development sessions for classroom teachers to disseminate 2 universal (Good Behavior Game, peer-assisted learning) and 2 targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by mental health providers and parent advocates for children in kindergarten through 4th grade diagnosed with 1 or more disruptive behavior disorders. Services were Medicaid-funded through 4 social service agencies (N = 17 providers) in 7 schools (N = 136 teachers, 171 children) in a 2 (Links to Learning vs. services as usual) × 6 (pre- and posttests for 3 years) longitudinal design with random assignment of schools to conditions. Services as usual consisted of supported referral to a nearby social service agency. RESULTS: Mixed effects regression models indicated significant positive effects of Links to Learning on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-groups effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum-based measures. Effects were strongest for young children, girls, and children with fewer symptoms. CONCLUSION: Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high-poverty urban communities.