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1.
J Soc Distress Homeless ; 33(1): 142-151, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38854663

RESUMEN

Despite increasing attention to the importance of examining factors that impact housing instability and homelessness, the field lacks a validated scale of housing instability. The current study examined the reliability and validity of a seven-item scale that measures housing instability. Data were taken from a larger study which implemented the Domestic Violence Housing First model across five domestic violence agencies in the Pacific Northwest. A total of 406 participants were interviewed every six months over a period of two years. A Spanish version of the scale was administered to Spanish-speaking participants. Results provide an overview of the psychometric functioning of the scale and support its utility in assessing housing instability and homelessness. Specifically, the scale demonstrated concurrent and predictive validity, and showed evidence of scalar equivalence over time and across both language and locality. The current scale is therefore a succinct and psychometrically sound measure of housing instability which can be used moving forward to track housing instability in English and Spanish speakers, as well as in urban and rural settings.

2.
Health Promot Pract ; : 15248399241236182, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38462918

RESUMEN

People who use languages other than English (LOE) are rarely included in research in the United States. LOE communities face numerous health disparities that are rooted in language injustice and other intersecting oppressions including racism and xenophobia. Equitable inclusion of LOE communities in research is an important step to disrupt health disparities. We propose a new conceptual framework on language justice in research to support researchers in conducting equitable multilingual research. This language justice in research framework comprises six core pillars of best practices required for achieving language justice during all the stages of the research process including conceptualization, budgeting, data collection and analysis, and dissemination. We also present key definitions, examples of how core pillars can be applied, and structural solutions to achieving language justice. The application of the language justice in research framework is designed: (a) to achieve health equity, data equity, and antiracism across the research continuum and (b) to disrupt health disparities in systems and institutions that are disproportionately impacting LOE communities.

3.
JAMA Netw Open ; 6(6): e2320213, 2023 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-37358850

RESUMEN

Importance: Intimate partner violence (IPV) is a leading cause of homelessness and a serious threat to public health and well-being. Objective: To determine whether the Domestic Violence Housing First (DVHF) model improves safety, housing stability, and mental health over 2 years. Design, Setting, and Participants: This longitudinal comparative effectiveness study interviewed IPV survivors and reviewed their agency records. All unstably housed or homeless IPV survivors entering domestic violence (DV) services were eligible to participate in the study, ensuring capture of typical variability in service delivery (eg, some survivors would enter services when agencies had the capacity to provide DVHF and others would receive services as usual [SAU]). Clients from 5 DV agencies (3 rural and 2 urban) referred by agency staff in a Pacific Northwest state of the United States were assessed between July 17, 2017, and July 16, 2021. Interviews were conducted in English or Spanish at entry into services (baseline) and at 6-, 12-, 18-, and 24-month follow-up visits. The DVHF model was compared with SAU. The baseline sample included 406 survivors (92.7% of 438 eligible). Of the 375 participants retained at the 6-month follow-up (92.4% retention), 344 had received services and had complete data across all outcomes. Three hundred sixty-three participants (89.4%) were retained at the 24-month follow-up. Intervention: The DVHF model has 2 components: housing-inclusive advocacy and flexible funding. Main Outcomes and Measures: Main outcomes included housing stability, safety, and mental health, which were assessed using standardized measures. Results: Of the 344 participants (mean [SD] age, 34.6 [9.0] years) included in the analyses, 219 (63.7%) received DVHF and 125 (36.3%) received SAU. Most participants identified as female (334 [97.1%]) and heterosexual (299 [86.9%]). Two hundred twenty-one participants (64.2%) were from a racial and ethnic minority group. Longitudinal linear mixed-effects models showed that receiving SAU was associated with greater housing instability (mean difference, 0.78 [95% CI, 0.42-1.14]), DV exposure (mean difference, 0.15 [95% CI, 0.05-0.26]), depression (mean difference, 1.35 [95% CI, 0.27-2.43]), anxiety (mean difference, 1.15 [95% CI, 0.11-2.19]), and posttraumatic stress disorder (mean difference, 0.54 [95% CI, 0.04-1.04]) compared with receiving the DVHF model. Conclusions and Relevance: Evidence in this comparative effectiveness study suggests that the DVHF model was more effective than SAU in improving the housing stability, safety, and mental health of survivors of IPV. The DVHF's amelioration of all of these interconnected public health issues-relatively quickly and with long-term continuance-will be of substantial interest to DV agencies and others working to support unstably housed IPV survivors.


Asunto(s)
Violencia Doméstica , Vivienda , Humanos , Femenino , Adulto , Etnicidad , Grupos Minoritarios , Sobrevivientes/psicología
4.
J Interpers Violence ; 38(5-6): 4790-4813, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36052457

RESUMEN

Intimate partner violence (IPV) is a widespread and devastating phenomenon resulting in a myriad of long-term consequences for survivors and their children. IPV victimization not only has negative health and economic consequences, it has also been linked to homelessness and housing instability. In response, the Domestic Violence Housing First (DVHF) model is being used in some domestic violence (DV) agencies to help survivors attain safe and stable housing. The model includes using individualized advocacy and/or flexible funding to help survivors meet these goals. Using a longitudinal, quasi-experimental design, the current study involved conducting interviews with survivors and examining agency records to investigate the effectiveness of this model. We hypothesized that survivors who received DVHF would experience less re-abuse and greater housing stability over 12 months compared to those who received services as usual (SAU). The sample included 345 IPV survivors who had been homeless or unstably housed when they approached one of five DV programs for help. Interviews were spaced 6 months apart (when survivors first sought services as well as 6 months and 12 months later). Longitudinal analyses showed that survivors who received the DVHF model reported greater improvements in housing stability at both the 6-month and 12-month time points compared to those receiving SAU. At the 12-month time point, survivors who had received DVHF reported decreased physical, psychological, and economic abuse, as well as the use of their children against them as a form of abuse. This study adds to a growing body of evidence supporting this model's effectiveness and adds to our understanding of factors impacting the long-term housing stability and safety for IPV survivors.


Asunto(s)
Víctimas de Crimen , Violencia Doméstica , Violencia de Pareja , Humanos , Niño , Vivienda , Violencia Doméstica/psicología , Violencia de Pareja/psicología , Víctimas de Crimen/psicología , Sobrevivientes/psicología
5.
J Fam Violence ; 38(3): 395-406, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38455870

RESUMEN

Intimate partner violence (IPV) is a leading cause of homelessness, yet little evidence exists about effective strategies to assist IPV survivors as they work to avoid homelessness while freeing themselves from abuse. An ongoing demonstration evaluation is examining if and how one promising model assists IPV survivors in obtaining safe and stable housing over time. The Domestic Violence Housing First (DVHF) model involves providing IPV survivors with mobile advocacy and/or flexible funding, depending on individual needs, in order to attain these goals. We hypothesized that those receiving DVHF would experience greater housing stability and less re-abuse compared to survivors receiving services as usual. The current study evaluated the short-term efficacy of the DVHF model with a sample of 345 homeless or unstably housed survivors who sought services and who completed in-person interviews shortly after contacting the DV agency, as well as six months later. Those who received the DVHF model showed greater improvement in their housing stability compared to those receiving services as usual, as well as decreased economic abuse. Both groups experienced a sharp decline in all forms of abuse. The Domestic Violence Housing First model shows promise in helping unstably housed DV survivors achieve safe and stable housing. Study findings have implications for DV agencies as well as those funding such services. Understanding which interventions work best for which survivors is critical to ensuring that service providers are effectively working toward long-term housing stability and well-being for IPV survivors and their children.

6.
Prev Sci ; 23(2): 271-282, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34718947

RESUMEN

Low-income Latina/o immigrants are very likely to experience intense contextual challenges in the USA, such as limited exposure to culturally relevant parent training (PT) prevention interventions. This prevention study consisted of an exploratory randomized controlled trial, aimed at empirically testing the implementation feasibility and initial efficacy of a culturally adapted version of the evidence-based PT intervention known as GenerationPMTO©. The parenting intervention was adapted to overtly address immigration-related stressors, discrimination, and challenges associated with biculturalism. Seventy-one Mexican-origin immigrant mothers participated in this study and were allocated to one of two conditions: (a) culturally adapted GenerationPMTO (i.e., CAPAS-Youth) or (b) wait-list control. Measurements were completed at baseline (T1) and intervention completion (T2). When compared to mothers in the control condition at T2, CAPAS-Youth participants reported significant improvements on four of the core parenting practices delivered in the CAPAS-Youth intervention. As hypothesized, no significant differences in limit-setting skills were identified at T2. With regards to adolescents' outcomes, mothers exposed to CAPAS-Youth reported significant improvements in youth internalizing and externalizing behaviors at T2 when compared to a wait-list control condition. Mothers in both conditions also reported significant reductions in levels of immigration-related stress. Current findings indicate the feasibility of implementing CAPAS-Youth within a context of considerable adversity, as well as the beneficial impacts of the parent-based intervention on salient parenting and youth outcomes.


Asunto(s)
Emigrantes e Inmigrantes , Responsabilidad Parental , Adolescente , Emigración e Inmigración , Femenino , Hispánicos o Latinos , Humanos , Madres
7.
J Community Psychol ; 50(4): 1831-1853, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34146356

RESUMEN

Domestic violence (DV) is a leading cause of homelessness for women, yet many DV agencies are just beginning to focus on helping clients stabilize their housing situations. The purpose of this study was to better understand the contexts and service needs of unstably housed and homeless DV survivors, to promote more efficient and successful service matching from DV agencies. We examined whether DV survivors could be grouped by particular features, histories, and contextual factors, and how these group differences impacted what they needed from DV agencies. The sample included 406 homeless and unstably housed DV survivors who had recently sought DV services. Latent class analysis supported the identification of four distinct classes: (1) highest disadvantages service seeker, (2) moderate disadvantages-criminal legal system service seeker, (3) moderate disadvantages service seeker, and (4) lower disadvantages service seeker. Additionally, we were able to profile each class, and test the types of services survivors in each class needed from agencies.


Asunto(s)
Criminales , Violencia Doméstica , Personas con Mala Vivienda , Femenino , Vivienda , Humanos , Sobrevivientes
8.
J Community Psychol ; 50(6): 2659-2681, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-34921735

RESUMEN

Using data from an ongoing longitudinal study, we examined the impact of the COVID-19 stay-at-home orders on a racially diverse population of unstably housed domestic violence (DV) survivors over time. Specifically, we examined survivors' safety, housing stability, and mental health before, during, and after the onset of COVID-19, and how demographic, social, and familial factors attenuated or exacerbated the effect of the stay-at-home orders. Approximately 300 participants were initially interviewed after they sought services from a DV agency, and then again, every 6 months over 2 years. COVID-19 stay-at-home orders occurred midway through the completion of this multi-year study. Longitudinal mixed effects models were estimated to examine the impact of COVID-19 on the safety, housing stability, and mental health of survivors over time. We also examined models with several time-varying (e.g., employment, income, social support, and number of children) and time-invariant (baseline outcome scores, racial/ethnic identity, education, and disability status) control variables. Results revealed that safety, housing stability and mental health were improving for study participants before the onset of the COVID-19 pandemic but plateaued after the stay-at-home orders were issued. Experiences of abuse, housing instability, and mental health symptomatology did not worsen as a result of the COVID-19 stay-at-home orders. Notably, social support and housing services emerged as important predictors of outcomes, such that participants who received housing-related services and greater social support reported less abuse, less housing instability, and lower mental health distress. COVID-19 temporarily disrupted the positive trajectory unstably housed DV survivors were experiencing in regard to safety, housing stability and mental health. These findings provide critical insight into the importance of service access during and after global catastrophes. Additional resources and support may be helpful in assisting survivors to return to their pre-pandemic recovery and growth trajectories.


Asunto(s)
COVID-19 , Violencia Doméstica , Niño , Vivienda , Humanos , Estudios Longitudinales , Salud Mental , Pandemias , Sobrevivientes/psicología
9.
Am J Community Psychol ; 67(3-4): 447-455, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33326615

RESUMEN

Rigorously evaluating community-based interventions for multiply marginalized populations is fraught with challenges under the best of circumstances. This manuscript describes the methodology chosen to evaluate an innovative model designed to help survivors of intimate partner violence obtain safe and stable housing. We justify the choice of evaluation design from a community psychology perspective and detail why we believe the multi-method, multi-source design, that also focuses on social context, will maximize ecological validity and, therefore, propel the scale-up of the intervention if it is found to be effective. Longitudinal data are being collected from program recipients over time, the advocates who worked with them, agency service records, and monthly documentation of agency resources on hand that can impact services provided. Special attention is focused on capturing contextual information that can impact program success. While randomized control trials are still too often heralded as "the gold standard" for measuring intervention effectiveness, we maintain that the current design, which was developed in partnership with key community stakeholders, holds more promise when evaluating many community-based programs.


Asunto(s)
Violencia de Pareja , Humanos , Proyectos de Investigación , Sobrevivientes
10.
Fam Process ; 60(4): 1185-1201, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33382100

RESUMEN

Child maltreatment is a major public health issue in the United States. In the federal fiscal year 2017, approximately 7.5 million children were referred to child welfare services (CSW) in the nation. Developmental, emotional, behavioral, and cognitive problems are prevalent among children referred to CWS. For those in foster care, temporary or permanent placement frequently introduces additional instability into a child's already chaotic life, increasing their risk for deleterious physical and mental health outcomes. Limited research exists documenting the impact of efficacious culturally adapted parent training (PT) interventions aimed at serving low-income ethnic minority families involved in CWS. The objective of this study was twofold: to explicate how a culturally adapted PT intervention for diverse families involved in CWS was perceived by participants and to better understand how interventionists adapted to families' needs. In this study, we conducted in-depth interviews with 14 parents who had completed the adapted intervention, as well as all of the interventionists providing the intervention. A thematic analysis approach was used to analyze and interpret the data. Parents indicated the positive impact that the intervention had on enhancing their parenting skills, as well as their ability to cope with the challenges associated with having a child removed by CWS. Interventionists described the gradual adaptations they implemented, in an effort to increase its cultural and contextual relevance. Research findings are relevant to the family therapy field as they increase understanding about culturally adapted PT interventions for ethnic minority families within CWS contexts.


El maltrato infantil es un gran problema de salud pública en los Estados Unidos. En el año fiscal federal 2017, se derivó a aproximadamente 7.5 millones de niños a servicios de bienestar infantil en el país. Entre los niños derivados a los servicios de bienestar infantil predominan los problemas emocionales, conductuales y del desarrollo. En los niños que están en acogida, su ubicación temporaria o permanente con frecuencia suma inestabilidad a la vida ya caótica de un niño, lo cual incrementa su riesgo de sufrir consecuencias perjudiciales en su salud mental y física. Existen escasas investigaciones que documentan los efectos de intervenciones eficaces con capacitaciones para padres culturalmente adaptadas y orientadas a asistir a familias de minorías étnicas de bajos recursos implicadas en servicios de bienestar infantil. El objetivo de este estudio fue doble: explicar cómo los participantes de una intervención con una capacitación de padres culturalmente adaptada para familias diversas implicadas en los servicios de bienestar infantil percibieron esta intervención y comprender mejor cómo los intervencionistas se adaptaron a las necesidades de las familias. En este estudio realizamos entrevistas detalladas con 14 padres que habían realizado la intervención adaptada, así como con todos los intervencionistas que llevaron a cabo la intervención. Se utilizó un método de análisis temático para analizar e interpretar los datos. Los padres indicaron el efecto positivo que tuvo la intervención en la mejora de sus habilidades de crianza, así como en su capacidad de afrontar las dificultades que surgen cuando los servicios de bienestar infantil les sacan un hijo. Los intervencionistas describieron las adaptaciones graduales que implementaron con el objetivo de aumentar su relevancia cultural y contextual. Los resultados de la investigación son relevantes para el área de la terapia familiar, ya que amplían el conocimiento sobre las intervenciones con capacitaciones para padres culturalmente adaptadas y orientadas a familias de minorías étnicas dentro del contexto de los servicios de bienestar infantil.


Asunto(s)
Minorías Étnicas y Raciales , Responsabilidad Parental , Niño , Protección a la Infancia , Etnicidad , Humanos , Grupos Minoritarios , Padres , Estados Unidos
11.
Fam Process ; 59(3): 1094-1112, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-31381814

RESUMEN

Culturally adapted evidence-based parenting interventions constitute a key strategy to reduce widespread mental health disparities experienced by Latinx populations throughout the United States. Most recently, the relevance of culturally adapted parenting interventions has become more prominent as vulnerable Latinx populations are exposed to considerable contextual stressors resulting from an increasingly anti-immigration climate in the country. The current study was embedded within a larger NIMH-funded investigation, aimed at contrasting the differential impact of two culturally adapted versions of the evidence-based parenting intervention known as GenerationPMTO©. Specifically, a sample of low-income Mexican-origin immigrants was exposed either to a culturally adapted version of GenerationPMTO primarily focused on parent training components, or to an enhanced culturally adapted version in which parenting components were complemented by sessions focused on immigration-related challenges. The sample for the study consisted of 103 Mexican-origin immigrant families (190 individual parents). Descriptive analysis and generalized estimating equations (GEEs) indicated that exposure to the enhanced intervention, which included context- and culture-specific sessions, resulted in specific benefits for parents. However, the magnitude of the impact was not uniform for mothers and fathers and differed according to the type of immigration-related stress being examined (i.e., intrafamilial vs. extrafamilial stress). Overall, findings indicate the relevance of overtly addressing contextual (e.g., discrimination) and cultural challenges in culturally adapted interventions, as well as the need to increase precision according to the extent to which immigration-related stressors impact immigrant mothers and fathers in common and contrasting ways. Implications for family therapy practice and research are discussed.


Las intervenciones basadas en evidencia, dirigidas a padres y adaptadas a la cultura son una estrategia clave para reducir las desigualdades en salud mental generalizadas que las poblaciones de latin@s experimentan en los Estados Unidos. Más recientemente, la relevancia de intervenciones dirigidas a padres adaptadas a la cultura ha adquirido más peso al estar las poblaciones de latin@s expuestas a factores estresantes contextuales considerables como resultado de un ambiente cada vez más contrario a la inmigración en el país. Este estudio fue incluido dentro de una investigación de mayor escala financiada por NIMH cuyo objetivo era contrastar el impacto diferencial de dos versiones adaptadas a la cultura de la intervención basada en evidencia y dirigida a padres conocida como GenerationPMTO© . En específico, se expuso una muestra de inmigrantes de origen mexicano de bajo ingreso, o a una versión de GenerationPMTO adaptada a la cultura y enfocada principalmente en elementos de entrenamiento de padres, o a una versión reforzada adaptada a la cultura en la cual los elementos de padres se complementaron con sesiones enfocadas en retos asociados a la inmigración. La muestra para el estudio consistió de 103 familias inmigrantes de origen mexicano (190 padres individuales). Análisis descriptivos y ecuaciones de estimación generalizadas indicaron que la exposición una intervención reforzada, que incluía sesiones contextual y culturalmente específicas, generaron beneficios específicos para los padres. Sin embargo, la magnitud del impacto no fue uniforme para madres y padres y fue distinta según el tipo de estrés por inmigración examinado (p.ej., estrés intrafamiliar versus estrés extrafamiliar). En general, los hallazgos indican la relevancia de enfrentar abiertamente retos contextuales (p.ej., discriminación) y culturales en intervenciones adaptadas a la cultura, así como la necesidad de aumentar la precisión conforme a cómo los factores estresantes asociados a la inmigración afectan a madres y padres inmigrantes de la misma y diferentes maneras. Se discuten las implicaciones para la práctica e investigación de terapia familiar.


Asunto(s)
Asistencia Sanitaria Culturalmente Competente/métodos , Educación no Profesional/métodos , Terapia Familiar/métodos , Americanos Mexicanos/psicología , Estrés Psicológico/terapia , Adulto , Niño , Trastornos de la Conducta Infantil/etnología , Trastornos de la Conducta Infantil/terapia , Preescolar , Emigrantes e Inmigrantes/psicología , Femenino , Humanos , Masculino , México/etnología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Pobreza/etnología , Pobreza/psicología , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Estados Unidos , Poblaciones Vulnerables/etnología , Poblaciones Vulnerables/psicología
12.
Fam Process ; 58(2): 334-352, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30076593

RESUMEN

Latino/a populations in the United States are negatively impacted by widespread mental health disparities. Although the dissemination of culturally relevant parent training (PT) programs constitutes an alternative to address this problem, there is a limited number of efficacious culturally adapted PT prevention interventions for low-income Latino/a immigrant families with adolescents. The current manuscript describes the level of acceptability of a version of the GenerationPMTO® intervention adapted for Latino/a immigrant families, with an explicit focus on immigration-related challenges, discrimination, and promotion of biculturalism. Qualitative reports were provided by 39 immigrant parents who successfully completed the prevention parenting program. The majority of these parents self-identified as Mexican-origin. According to qualitative findings, participants reported overall high satisfaction with immigration and culture-specific components. Parents also expressed high satisfaction with the core GenerationPMTO parenting components and provided specific recommendations for improving the intervention. Current findings indicate the need to adhere to the core components that account for the effectiveness of PT interventions. Equally important is to thoroughly adapt PT interventions according to the cultural values and experiences that are relevant to target populations, as well as to overtly address experiences of discrimination that negatively impact underserved Mexican-origin immigrant families. Due to the exploratory nature of this study, the efficacy and effectiveness of the adapted prevention intervention remains to be established in empirical research.


Las poblaciones latinas de los Estados Unidos están afectadas negativamente por desigualdades generalizadas en el área de salud mental. Aunque la difusión de programas de capacitación para padres culturalmente pertinentes constituye una alternativa para abordar este problema, existe un número limitado de capacitaciones para padres con intervenciones preventivas adaptadas culturalmente que son eficaces para familias inmigrantes latinas con adolescentes de bajos recursos. El presente manuscrito describe el nivel de aceptabilidad de una versión de la intervención GenerationPMTO® adaptada para familias inmigrantes latinas, que hace hincapié específicamente en dificultades relacionadas con la inmigración, la discriminación y la promoción del biculturalismo. Treinta y nueve padres inmigrantes que completaron satisfactoriamente el programa preventivo sobre crianza proporcionaron informes cualitativos. La mayoría de estos padres se autoidentificaron como de origen mexicano. De acuerdo con los resultados cualitativos, los participantes informaron una alta satisfacción en general con la inmigración y los componentes específicos de la cultura. Los padres también expresaron una alta satisfacción con los componentes principales relativos a la crianza de GenerationPMTO y ofrecieron recomendaciones específicas para mejorar la intervención. Los resultados actuales indican la necesidad de cumplir con los componentes principales que justifican la eficacia real de las intervenciones de capacitación para padres. Es igualmente importante adaptar totalmente las intervenciones de capacitación para padres de acuerdo con los valores culturales y las experiencias que son relevantes para las poblaciones objetivo, así como abordar expresamente las experiencias de discriminación que afectan negativamente a las familias inmigrantes de bajos recursos de origen mexicano. Debido a la índole exploratoria de este estudio, la eficacia real y la eficacia teórica de la intervención de prevención adaptada quedan por demostrarse en la investigación empírica.


Asunto(s)
Asistencia Sanitaria Culturalmente Competente , Emigrantes e Inmigrantes/educación , Americanos Mexicanos/educación , Responsabilidad Parental , Padres/educación , Aculturación , Adolescente , Cultura , Curriculum , Emigrantes e Inmigrantes/psicología , Práctica Clínica Basada en la Evidencia , Disparidades en el Estado de Salud , Humanos , Salud Mental , Americanos Mexicanos/psicología , México/etnología , Investigación Cualitativa , Racismo , Estados Unidos
13.
Glob Soc Welf ; 6(3): 199-207, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32095423

RESUMEN

Research suggests that parenting programs are effective for preventing behavioral and emotional difficulties in children, but a lot more attention needs to be paid to issues of context and culture during the development, testing and implementation of these interventions. The views and needs of underserved and disenfranchised communities in the US and the Global South are often not taken into account for the development and testing of interventions. The successful implementation of evidence-based interventions for vulnerable children and families in underserved and marginalized communities requires careful consideration of how existing paradigms of prevention, evaluation, and implementation science impact issues of social justice and equity. This paper will describe how a team of parenting program researchers has been collaborating with their partners globally in generating local knowledge by balancing the need for rigorous scientific methods with issues of power. Authors from the U.S., Latin America, Africa and Southeast Asia draw on their experiences regarding challenges and successes with issues regarding study design and measurement, the transferability and adaptation of interventions, and the dissemination and implementation of different parenting interventions while placing communities at the center of their efforts through participatory methods. We describe innovative approaches that span the continuum of intervention development, adaptation, optimization, evaluation, implementation, and scale up of different parenting programs for vulnerable children and families across the world. We conclude by offering specific and pragmatic recommendations to increase access of culturally relevant and effective parenting programs in these communities.

14.
J Interpers Violence ; 34(14): 2920-2937, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-27520021

RESUMEN

The Community Advocacy Project is an evidence-based practice that has been shown to lead to numerous positive changes in the lives of intimate partner violence (IPV) survivors. Prior research conducted in the Midwest United States, and with primarily African American and Anglo American survivors, has shown that this short-term, community-based advocacy intervention results in increased safety and quality of life even 2 years after the intervention ends. The current study describes the process of culturally adapting and disseminating this program in Monterrey, Mexico, with a sample of low-income Mexican IPV survivors exposed to a variety of considerable contextual stressors. Interviews were conducted with advocates, advocate supervisors, and survivors to examine the acceptability and utility of the intervention. Twenty-seven IPV survivors, seven advocates, and four advocate supervisors participated in the intervention research. Advocates and their supervisors were highly laudatory, believing the intervention to be culturally relevant and effective. Encouraging changes were found for survivors as well, with positive changes over time being found on safety, quality of life, social support, and depression.


Asunto(s)
Participación de la Comunidad/estadística & datos numéricos , Violencia de Pareja/prevención & control , Defensa del Paciente/estadística & datos numéricos , Maltrato Conyugal/prevención & control , Sobrevivientes/estadística & datos numéricos , Adulto , Estudios de Factibilidad , Femenino , Humanos , Violencia de Pareja/estadística & datos numéricos , Masculino , México , Defensa del Paciente/psicología , Pobreza , Calidad de Vida , Apoyo Social , Maltrato Conyugal/estadística & datos numéricos , Sobrevivientes/psicología
15.
J Women Aging ; 29(6): 543-550, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28027018

RESUMEN

Women are living with HIV into middle and older age and are likely to face multiple comorbidities and stressors as they age. This study focused on understanding how women who experience multiple forms of oppression and ongoing adversity are still able to adapt and stand strong. Using a theoretical framework of resilience and a feminist research ideology, interviews of eight middle-aged and older African American women living with HIV were analyzed. Despite experiences of HIV-related discrimination, trauma, and violence, these women demonstrated a remarkable ability to adapt and maintain support. Implications for research and practice are discussed.


Asunto(s)
Envejecimiento/psicología , Negro o Afroamericano/psicología , Infecciones por VIH/psicología , Pobreza/psicología , Resiliencia Psicológica , Adulto , Anciano , Discriminación en Psicología , Exposición a la Violencia/psicología , Femenino , Feminismo , Humanos , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Investigación Cualitativa , Apoyo Social , Heridas y Lesiones/psicología
16.
Fam Process ; 55(2): 321-37, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26503301

RESUMEN

Family therapists have a unique opportunity to contribute toward the reduction of widespread mental health disparities impacting diverse populations by developing applied lines of research focused on cultural adaptation. For example, although evidence-based prevention parent training (PT) interventions have been found to be efficacious with various Euro-American populations, there is a pressing need to understand which specific components of PT interventions are perceived by ethnic minority parents as having the highest impact on their parenting practices. Equally important is to examine the perceived cultural relevance of adapted PT interventions. This qualitative investigation had the primary objective of comparing and contrasting the perceived relevance of two culturally adapted versions of the efficacious parenting intervention known as Parent Management Training, the Oregon Model (PMTO). According to feasibility indicators provided by 112 Latino/a immigrant parents, as well as findings from a qualitative thematic analysis, the core parenting components across both adapted interventions were identified by the majority of research participants as relevant to their parenting practices. Participants exposed to the culturally enhanced intervention, which included culture-specific sessions, also reported high satisfaction with components exclusively focused on cultural issues that directly impact their parenting practices (e.g., immigration challenges, biculturalism). This investigation illustrates the relevant contributions that family therapy scholars can offer toward addressing mental health disparities, particularly as it refers to developing community-based prevention interventions that achieve a balance between evidence-based knowledge and cultural relevance.


Asunto(s)
Asistencia Sanitaria Culturalmente Competente/métodos , Emigrantes e Inmigrantes/psicología , Terapia Familiar/métodos , Hispánicos o Latinos/psicología , Responsabilidad Parental/psicología , Padres/educación , Adulto , Educación no Profesional/métodos , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Padres/psicología , Investigación Cualitativa
17.
Behav Res Ther ; 75: 32-9, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26523886

RESUMEN

OBJECTIVE: To conduct a pilot effectiveness trial of a brief dissonance-based eating disorder preventative program, the Body Project, when implemented at primary care medical clinics. METHOD: Sixty-six female adolescents between the ages of 13 and 17 who reported at least some body image dissatisfaction were recruited at two primary care clinics and randomized to Body Project groups or an educational video control condition; eating disorder risk factors and symptoms were measured at pretest, posttest, and 3-month follow-up. RESULTS: Body Project versus educational video control participants showed significantly greater reductions in thin-ideal internalization, pressure to be thin, dieting, and eating disorder symptoms at posttest, which were medium to large effect sizes. Body Project participants also showed greater decreases in body dissatisfaction and negative affect at posttest, though these moderate sized effects were not significant. Effects persisted through 3-month follow-up. CONCLUSION: Average pre-post effect sizes (d = 0.58) compare favorably to those observed in past Body Project efficacy (average d = 0.59) and effectiveness trials (average ds of 0.43 and 0.69), suggesting that primary care clinics may represent a novel venue for offering and extending the reach of this eating disorder prevention program.


Asunto(s)
Imagen Corporal/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/prevención & control , Atención Primaria de Salud/métodos , Adolescente , Disonancia Cognitiva , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Femenino , Humanos , Educación del Paciente como Asunto/métodos , Proyectos Piloto , Grupos de Autoayuda , Estudiantes , Resultado del Tratamiento
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