Conducting school-based research with newcomer immigrant adolescents: Challenges and solutions.

Newcomer immigrant adolescents (NIA) represent a particularly vulnerable group in the United States, facing numerous stressors placing them at risk for social-emotional and academic concerns. Schools play a critical role in supporting NIA in the United States. Despite this, insufficient research addressing the needs of this group within schools has been conducted. Considering the complexity of engaging in community-based research with marginalized populations, such as NIA, in this article, we elaborate on the challenges we faced during our research with NIA and propose solutions to these challenges. We do so with the goal of promoting continued engagement of such efforts within our field as to better address the needs of NIA within the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A modified measurement-based care approach to improve mental health treatment engagement among racial and ethnic minoritized youth.

Despite high levels of need, racial and ethnic minoritized (REM) youth are much less likely than their White peers to engage in mental health treatment. Concerns about treatment relevance and acceptability and poor therapeutic alliance have been shown to impact treatment engagement, particularly retention, among REM youth and families. Measurement-based care (MBC) is a client-centered practice of collecting and using client-reported progress data throughout treatment to inform shared decision-making. MBC has been associated with increased client involvement in treatment, improved client-provider communication, and increased satisfaction with treatment services. Despite its promise as a treatment engagement strategy, MBC has not been studied in this capacity with REM youth or systematically modified to address the needs of culturally-diverse populations. In this article, we propose a culturally-modified version of MBC, Strategic Treatment Assessment with Youth (STAY), to improve treatment engagement among REM youth and families. Specifically, STAY is designed to target perceptual barriers to treatment to improve treatment retention and ultimately, client outcomes. The four STAY components (i.e., Introduce, Collect, Share, and Act) are based on an existing MBC practice framework and modified to address perceptual barriers to treatment among REM youth. The clinical application of this model is presented via a case example. Finally, future research directions to explore the use of MBC as a treatment retention strategy with REM client populations are provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Internalizing symptoms, intersectional discrimination, and social support among Asian-Pacific Islander sexual and gender minority adults.

OBJECTIVE: This study examined associations of discrimination, social support, and their interaction, with internalizing symptoms among Asian-Pacific Islander (API) sexual and gender minority (SGM) adults in the U.S. METHOD: Analyses included data from 544 participants who completed an online survey, including measures of three internalizing symptoms (anxiety, depression, and somatization), five forms of discrimination (racism, heterosexism/cisgenderism, and three forms of intersectional discrimination), and two types of social support (acceptance for sexual/gender identity, general social support). RESULTS: All forms of discrimination were positively associated with all internalizing symptoms, with the strongest associations with somatization symptoms; further, acceptance for sexual/gender identity was negatively associated with all internalizing symptoms. Overall social support did not buffer associations of discrimination with internalizing symptoms. Positive associations between discrimination and symptoms were generally stronger at higher social support levels, and social support had weaker negative associations with internalizing symptoms at higher discrimination levels. CONCLUSION: Findings suggest the importance of increasing sexual/gender identity-specific social support, attending to somatization symptoms as an important manifestation of discrimination and reducing societal discrimination to address mental health needs of API SGM adults in the U.S. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Three-Tiered Model for Addressing the Mental Health Needs of Immigrant-Origin Youth in Schools.

To date, little research has systematically considered the ways in which schools can better address the needs of immigrant-origin youth (IOY). Further, considering the increased negative attitudes toward and policies targeting IOY and families within the U.S., there is a need to go beyond targeting just IOY at risk for mental health concerns and promote a culture of inclusion throughout the school. The goal of this paper is to address ways in which schools can best attend to the mental health needs of IOY by systematically integrating prevention and intervention efforts across three tiers of support within the school setting. Specifically, we propose a three-tiered model of school based mental health services for IOY. Based on a thorough review of current literature, we propose universal, selective, and targeted programming to support the MH needs of IOY and families. We discuss implications for implementation as well as future directions for research.

Multigroup Ethnic Identity Measurement invariance across adolescence and diverse ethnic groups.

INTRODUCTION: Ethnic identity is an important protective factor for various ethnic groups and developmental periods. Although existing measures assessing ethnic identity are well known, less is known about the measurement invariance of the Multigroup Ethnic Identity Measure (MEIM) across adolescent ethnic groups. The present study evaluates the factor structure of MEIM (Roberts et al., 1999) and tests the measurement invariance across early and middle adolescence and ethnic background (N = 4940). METHODS: Data from an ethnic minority sample of youth (54% girls; Mage = 13.88, grades 6th - 12th; 60% African American, 22% multi-ethnic, 8% Latinx, 5% Asian, 5% American Indian) in the United States of America were examined using confirmatory factor analysis (CFA) and multi-group measurement invariance via a structural equation modeling (SEM) framework. Models for invariance were tested using full information maximum likelihood-robust (FIML-R) estimation in Mplus. RESULTS: CFA supported a three-factor solution (i.e., cognitive clarity, behavioral engagement, and affective pride). The model indicated scalar invariance across early and middle adolescence and partial scalar invariance across the five self-identified racial/ethnic minority groups. There were no grade differences on the ethnic identity factors. Among the racial/ethnic groups, multi-ethnic youth reported the lowest levels on all three ethnic identity factors compared to the other groups. CONCLUSIONS: Results of this study point to the validity of using the MEIM for meaningful comparisons of ethnic identity across ethnic groups and across early and middle adolescence. Implications for the interpretation and use of this measure with diverse adolescents are discussed.

The Distal Role of Adolescents' Awareness of and Perceived Discrimination on Young Adults' Socioeconomic Attainment among Mexican-Origin Immigrant Families.

Cultural-ecological frameworks posit that there are harmful effects of social stratification on developmental outcomes. In particular, awareness of aspects of social stratification in society and interpersonal experiences of discrimination, more generally and within specific contexts, may differentially influence outcomes across life stages; yet, few studies have examined the distal effects during adolescence on early adult developmental outcomes. The current study fills this gap by examining distal mechanisms linking adolescents' (Time 1: ages 13-15) awareness of and perceived general and school discrimination to young adults' (Time 3: ages 23-25) socioeconomic attainment (i.e., educational attainment, occupational prestige, earned income) through adolescents' (Time 2: ages 16-18) academic adjustment (i.e., grades and educational expectations). The study also examined variation by adaptive culture (i.e., English and Spanish language use behavior, familism values) and youth gender. Data are from the Children of Immigrants Longitudinal Study (N = 755 Mexican-origin adolescents and their foreign-born parents; 51.5% male adolescents; Time 1 M age = 14.20 years). The results revealed that adolescent's awareness of societal discrimination (Time 1) related to adolescents' higher grades (Time 2), which, in turn, related to higher educational attainment and occupational prestige in early adulthood (Time 3). For young women, but not men, sources of perceived discrimination within the school context during adolescence related to lower educational attainment. Additional variation by adaptive culture and gender was also found. Implications discussed are related to positive development among Mexican-origin youth in immigrant families.

Risk and protective factors for suicide among Guyanese youth: Youth and stakeholder perspectives.

Guyana, a low-to-middle-income country (LMIC) in South America, leads the world in youth suicide. As an understanding of risk and protective factors is critical to the development of culturally informed suicide prevention efforts, research exploring these factors among youth in Guyana is needed. The current study expands on current research on adolescent suicide in Guyana and LMICs broadly by using qualitative focus groups and interviews to explore adult stakeholders' and youth's perspectives. Participants included 17 adult stakeholders and 40 adolescents in Guyana. Data were analysed using a grounded theory approach. Themes related to participants' perceptions of risk factors for suicide included demographic characteristics, pressure and expectations, adults' responses to youth, limited coping with stressful life events and exposure to suicide. Themes related to protective factors for suicide included positive social support and involvement in community activities. Findings have implications for the development and tailoring of suicide prevention efforts for Guyanese youth.

Ethnic identity and substance use in multiracial youth: the moderating role of support networks.

Background: Substance use in multiracial adolescents exceeds rates identified in the general population. Despite this fact, there is limited research examining risk and protective factors for multiracial substance use. Objectives: The current study examined the moderating effect of social support on the relationship between ethnic identity and substance use in a sample of multiracial adolescent youth. Methods: Multiracial youth (N = 523) completed a survey that asked questions related to their ethnic identity, perceived social support, and substance use. A series of path analyses were conducted to test the hypothesized relationships between ethnic identity, social support, and substance use. Results: Analyses indicated that ethnic affirmation was negatively related to frequency of, but not quantity of substance use. Teacher support was negatively related to both frequency and quantity of substance use, while parent support was only related to frequency. Further, teacher and parent support emerged as moderators of ethnic affirmation and frequency and quantity of substance use respectively. Conclusions/Importance: Our findings add to the current understandings of the relationship between ethnic identity, social support, ethnic identity, and substance use among the understudied multiracial adolescent population.

Components Analyses of a School-Based Cognitive Behavioral Treatment for Youth Depression.

The current study sought to build upon research on cognitive behavioral therapy (CBT) as the first-line treatment for depressed youth by investigating the effects of the various components of a CBT treatment on changes in depressive symptoms in young female participants. Female participants 9-14 years of age (n = 40; M age = 10.58 years) with a diagnosis of a depressive disorder from the CBT-only treatment condition of a larger randomized clinical trial were included in the current study. Participants engaged in a 20-session, 11-week, school-based CBT group intervention (ACTION Treatment; Stark et al., 2006). Depressive symptoms were assessed pre- and posttreatment, and intervention components were coded based on review of audio recordings of treatment sessions. Data were examined using two-level mixed-effects models using hierarchical linear modeling with full maximum likelihood estimation. Results indicated that higher quality behavioral intervention components were associated with greater improvement in posttreatment depression scores, higher quality cognitive intervention components were marginally associated with worsening posttreatment depression scores, and relational intervention components were not associated with depression outcome. Age significantly moderated the relationships between intervention components and depression outcome, with younger female participants benefiting most from higher quality behavioral and relational intervention components. These findings provide preliminary evidence about the differential impact of CBT components on depression treatment outcome for young female participants, with consideration of age as a moderator. This study highlights the importance of continuing to dismantle CBT treatment components for youth depression, as such findings can be used to design more potent, developmentally tailored interventions.

A prospective examination of anxiety as a predictor of depressive symptoms among Asian American early adolescent youth: The role of parent, peer, and teacher support and school engagement.

OBJECTIVE: The current study sought to examine the prospective relationship between anxiety and depressive symptoms among Asian American (AA) early adolescents, a crucial period for the development of depression among youth. Further, as guided by cultural-ecological frameworks, a second aim of this study was to identify protective factors (i.e., parent support, peer support, teacher support, and school engagement) that might buffer the relationship between anxiety and depressive symptoms among this understudied population. METHOD: Participants included AA youth (N = 186; Mage = 12.50, SD = 1.16; 51.1% male) who completed questionnaires on 2 occasions with a 1-year interval. RESULTS: Results from path analysis indicated that high anxiety symptoms were related to increased depressive symptoms over time. Further, teacher support was related to decreased depressive symptoms over time. Additionally, teacher and parent support moderated the association between adolescents' anxiety and depressive symptoms. CONCLUSIONS: Findings contribute to our understanding of the development of depression among early adolescent youth and have implications for the development of programming for Asian American youth with anxiety and depression. (PsycINFO Database Record

Pediatric Primary Care Providers' Use of Behavioral Health Consultation.

This column describes a qualitative study in which 32 primary care providers (PCPs) reported barriers to and facilitators of using a behavioral health (BH) consultation program. Barriers included program incompatibility with organizational culture, limited exposure to the program, existing access to referral sources, and negative beliefs about BH consultation. Reported facilitators included having personal relationships with BH program staff, exposure to program information, and positive beliefs about BH consultation. PCPs recommended outreach activities and optimal program features to increase use of BH consultation.

Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example.

Increased attention has been placed on evaluating the extent to which clinical programs that support the behavioral health needs of youth have effective processes and result in improved patient outcomes. Several theoretical frameworks from dissemination and implementation (D&I) science have been put forth to guide the evaluation of behavioral health program implemented in the context of real-world settings. Although a strong rationale for the integration of D&I science in program evaluation exists, few examples exist available to guide the evaluator in integrating D&I science in the planning and execution of evaluation activities. This paper seeks to inform program evaluation efforts by outlining two D&I frameworks and describing their integration in program evaluation design. Specifically, this paper seeks to support evaluation efforts by illustrating the use of these frameworks via a case example of a telemental health consultation program in pediatric primary care designed to improve access to behavioral health care for children and adolescents in rural settings. Lessons learned from this effort, as well as recommendations regarding the future evaluation of programs using D&I science to support behavioral health care in community-based settings are discussed.

Psychosocial interventions for use in pediatric primary care: An examination of providers' perspectives.

INTRODUCTION: The integration of psychosocial interventions in primary care settings is 1 mechanism to increase access to mental health care to youth in need. Although the delivery of psychosocial interventions by primary care providers (PCPs) reflects 1 example of this integration, research indicates that various barriers to implementation by PCPs exist. With the goal of informing a framework to guide the selection of treatments amenable to PCP practice, the authors sought to examine which criteria might influence a PCP's intention to use a given psychosocial intervention. METHOD: Using survey methodology, 49 PCPs ranked characteristics of interventions for feasibility and applicability to their patient populations and setting. RESULTS: Survey respondents found the following characteristics most important: time to employ, applicability to multiple disorders, ease of use, and ease of learning. Providers who endorsed more negative beliefs and attitudes toward addressing psychosocial concerns in youth were more likely to see certain criteria, such as ease of use and ease of learning, as more important. DISCUSSION: The authors illustrate the potential application of these findings to the selection of psychosocial interventions for use in primary care and discuss future research directions. (PsycINFO Database Record

Advancing Evidence-Based Assessment in School Mental Health: Key Priorities for an Applied Research Agenda.

Evidence-based assessment (EBA) is a critically important aspect of delivering high-quality, school-based mental health care for youth. However, research in this area is limited and additional applied research on how best to support the implementation of EBA in school mental health (SMH) is needed. Accordingly, this manuscript seeks to facilitate the advancement of research on EBA in SMH by reviewing relevant literature on EBA implementation in schools and providing recommendations for key research priorities. Given the limited number of published studies available, findings from child and adolescent mental health and implementation science research are also included to inform a robust and comprehensive research agenda on this topic. Based on this literature review, five priorities for research on EBA in SMH are outlined: (1) effective identification of assessment targets, (2) appropriate selection of assessment measures, (3) investigation of organizational readiness for EBA, (4) study of implementation support for EBA, and (5) promotion of EBA data integration and use. Each priority area includes recommended directions for future research. A comprehensive and robust research agenda is warranted to build the science and practice of implementing EBA in SMH. Specific directions for this agenda are offered.

Measuring Community-Based Participatory Research Partnerships: The Initial Development of an Assessment Instrument.

BACKGROUND: Although the partnership between academic researchers and community members is paramount to community-based research efforts, a limited number of measures exist to evaluate this construct. Of those in existence, no assessment measures include a comprehensive coverage of the many dimensions of partnerships. In addition, these measures were not designed through an extensive community-based participatory research (CBPR) model, in which the strengths of traditional assessment techniques were integrated with input from stakeholders. OBJECTIVES: The purpose of this article was to describe the creation of a measure to evaluate key dimensions of partnerships forged between researchers and community members using a CBPR approach to measurement development. METHODS: The iterative process of developing this measure consisted of integrating valuable feedback from community partners and researchers, via multiple rounds of item sorting and qualitative interviewing. RESULTS: The resultant measure, titled Partnership Assessment In community-based Research (PAIR), consists of 32 items, and comprises 5 dimensions: communication, collaboration, partnership values, benefits, and evaluation. The innovative process of using CBPR in the development of measures, the benefits of this approach, and the lessons learned are highlighted. CONCLUSIONS: PAIR was developed out of a need identified jointly by community members and researchers, and is intended to characterize the range of relationships between researchers and community members engaging in community-based research and programming.