RESUMEN
This article addresses two major African-American congregational care needs: (1) helping suffering people to access sustained mental health care, particularly in a large/mega-church; and (2) helping suffering people with multi-layered challenges to access appropriate, skilled care that transcends traditional barriers and is consistent with their faith. One model of congregational care is presented with concrete examples of how cultural, theological, and strategic concerns are discussed, with broad implications for diverse faith communities.
Asunto(s)
Negro o Afroamericano/psicología , Cristianismo/psicología , Consejo/métodos , Cuidado Pastoral/métodos , Religión y Psicología , Negro o Afroamericano/estadística & datos numéricos , Actitud Frente a la Salud/etnología , Clero/psicología , Humanos , Cuidado Pastoral/organización & administración , Investigación Cualitativa , EspiritualidadRESUMEN
Peer support interventions extend care and health information to underserved populations yet rarely address serious illness. Investigators from a well-defined academic-community partnership developed and evaluated a peer support intervention for African Americans facing advanced cancer. Evaluation methods used the Reach, Efficacy, Adoption, Implementation, Maintenance (RE-AIM) framework. Investigators initially recruited and trained 24 lay health advisors who shared information or support with 210 individuals. However, lay advisors reported barriers of medical privacy and lack of confidence working alone with people with cancer. Training was modified to match the support team model for peer support; training reached 193 volunteers, 104 of whom formed support teams for 47 persons with serious illness. Support teams were adopted by 23 community organizations, including 11 African American churches. Volunteers in teams felt prepared to implement many aspects of supportive care such as practical support (32%) or help with cancer or palliative care resources (43%). People with serious illness requested help with practical, emotional, spiritual, and quality of life needs; however, they rarely wanted advocacy (3%) or cancer or palliative care resources (5%) from support teams. Volunteers had difficulty limiting outreach to people with advanced cancer due to medical privacy concerns and awareness that others could benefit. Support teams are a promising model of peer support for African Americans facing advanced cancer and serious illness, with reach, adoption, and implementation superior to the lay advisor model. This formative initial evaluation provides evidence for feasibility and acceptance. Further research should examine the efficacy and potential for maintenance of this intervention.
Asunto(s)
Negro o Afroamericano/psicología , Neoplasias/psicología , Grupo Paritario , Apoyo Social , Voluntarios/organización & administración , Adulto , Anciano , Agentes Comunitarios de Salud/organización & administración , Investigación Participativa Basada en la Comunidad , Femenino , Cuidados Paliativos al Final de la Vida/organización & administración , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Cuidados Paliativos/organización & administración , Evaluación de Programas y Proyectos de SaludRESUMEN
The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of articles reviewed found at least one significant (p < .05) relationship between religiousness and better mental health. Evidence for relationships between greater religiousness and less psychopathology was strongest in the area of teenage substance use. Methods of measuring religion/spirituality were highly heterogeneous. Further research on the relationship of religion/spirituality to delinquency, depression, suicidality, and anxiety is warranted. Measurement recommendations, research priorities, and clinical implications are discussed.
Asunto(s)
Trastornos Mentales/psicología , Religión , Espiritualidad , Adolescente , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiologíaRESUMEN
A literature review on community studies of adolescent substance use, abuse, or dependence (SU/AID) and psychiatric comorbidity yielded 22 articles from 15 studies with information on rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. Results revealed that 60% of youths with SU/A/D had a comorbid diagnosis, and conduct disorder (CD) and oppositional defiant disorder (not attention-deficit/hyperactivity disorder) were most commonly associated with SU/A/D, followed by depression. Child psychopathology (particularly CD) was associated with early onset of substance use and abuse in later adolescence. The authors suggest that available data relevant to SU/A/D and psychiatric comorbidity can be used to better address such questions.
Asunto(s)
Trastornos Mentales/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/psicología , Niño , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/epidemiología , Trastornos de la Conducta Infantil/psicología , Comorbilidad , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
OBJECTIVE: Summary prevalence data are critical to determining the utility of DSM-IV criteria for alcohol use disorders among adolescents. This study examined cross-study consistency in the relative prevalence of DSM-IV alcohol symptoms, the ratio of alcohol abuse to dependence diagnoses, the prevalence of the physiological dependence subtype, and the proportion of subthreshold cases of dependence. METHOD: DSM-IV alcohol diagnosis and symptom prevalence data were obtained from five community and four clinical adolescent samples. RESULTS: There was a moderate level of cross-study agreement on the relative prevalence of alcohol symptoms (mean Spearman p = 0.47). The most common symptoms were dependence criteria: tolerance and drinking more or longer than intended. A relatively high degree of variability in the ratio of abuse to dependence diagnoses and the proportion with physiological dependence was observed. All samples included a significant proportion of subthreshold cases of dependence: up to 12% in community and up to 34% in clinical samples. CONCLUSIONS: Alcohol dependence symptoms of tolerance and drinking more or longer than intended have relatively high prevalence among adolescents. These high prevalence symptoms affect the ratio of abuse to dependence diagnoses in some studies, the prevalence of the physiological dependence subtype, and the proportion of subthreshold cases of dependence.