Examination of the Multilevel Sexual Stigma Model of Intimate Partner Violence Risk Among LGBQ+ College Students: A Prospective Analysis Across Eighteen Institutions of Higher Education.

Sexual stigma operates at multiple levels (institutional, group, individual), which serves to disadvantage sexual minority (LGBQ+) individuals and increases risk for deleterious outcomes. The current study evaluated a novel multilevel sexual stigma model of intimate partner violence (MLSSM-IPV) that incorporates multiple levels of sexual stigma as related to IPV risk via several pathways (e.g. hazardous drinking, affective symptoms). We evaluated this model in a longitudinal study of LGBQ+ undergraduate college students (n = 2,415) attending 18 universities who completed surveys in the Fall and Spring semesters. Group-level sexual stigma on each campus was assessed via surveys with heterosexual students (n = 8,517) and faculty, staff, and administrators (n = 2,865), and institutional-level stigma was evaluated via a campus climate assessment. At the campus level, institutional stigma was related to LGBQ+ students' self-stigma and identity concealment. Moreover, self-stigma prospectively predicted IPV victimization, and hazardous drinking mediated the relations between self-stigma and IPV perpetration and victimization. Results suggest that interventions addressing stigma and hazardous drinking may be efficacious in reducing IPV among LGBQ+ students. Further, comprehensive efforts to improve campus climate for LGBQ+ students are likely to produce a plethora of benefits for these students.

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).

Empowerment Transformation Training Reduces Rape Among Girls and Young Women in South Sudan and the Kakuma Refugee Camp.

PURPOSE: Rape occurs at high rates in South Sudan and Kakuma refugee camps, a region characterized by armed conflict, gender inequity, and economic crisis. To date, we know little about how to prevent rape in this region of the world. As such, the purpose of this study was to examine outcomes of Empowerment Transformation Training (ETT) (an adapted empowerment self-defense program; empowerment self-defense) among female participants in South Sudan and the Kakuma refugee camp. METHODS: Schools were assigned to the treatment (ETT) condition (n = 7) or control (life skills) condition (n = 9) and used as the unit of analysis given the cluster-randomized design. Female participants anonymously completed a baseline (T1) and 12-month follow-up (T2) paper and pencil survey. RESULTS: Annual rape victimization rates decreased from 10.7% to 5.5% in the ETT schools (risk ratio [RR] = 0.51); there was no change in the control schools (10.0%-9.0%). Empowerment Transformation Training (ETT) schools had increased confidence at T2 (T1: 42.4%; T2: 75.4%; RR = 1.79) and greater rates of confidence at T2 compared to control schools (54.3%; RR = 1.39). Knowledge of effective self-defense strategies (T2) was greater for ETT schools (47.4%) compared to control schools (30.1%) (RR = 1.57). DISCUSSION: The ETT program reduced rates of rape, increased confidence, disclosures of rape (among victims), and knowledge of effective self-defense strategies. Empowerment self-defense programs are a critical component to rape prevention across global communities, including those characterized by armed conflict, gender inequity, and economic crisis.

The Role of Minority Stress in Psychological Distress and Hazardous Drinking Among Sexual Minority College Student Victims of Intimate Partner Violence.

Sexual minority, individuals who are not heterosexual, college students experience high rates of intimate partner violence (IPV), which is linked to a myriad of deleterious outcomes. However, little work has evaluated whether there are differences in IPV outcomes among sexual minority college students as compared to heterosexual college students. Further, the extent to which minority stress at the institutional and individual level relates to IPV outcomes among sexual minority students is understudied. As such, the purpose of the current study was to evaluate IPV outcomes in a large sample of undergraduate students attending 18 medium- to large-sized universities across the contiguous U.S. Results supported that sexual minority victims of IPV had more anxious and depressive symptoms than heterosexual victims of IPV but were not more likely to engage in hazardous drinking. Further, analyses supported that several campus-level (but not individual-level) indicators of minority stress moderated the relation between IPV victimization and negative outcomes among sexual minority students, such that the association between IPV and negative outcomes was stronger among students embedded in campuses with higher levels of minority stressors. Results support the critical importance of interventions addressing campus-level minority stressors to reduce deleterious IPV outcomes among sexual minority college student victims.

Indigenous Cultural Identity Protects Against Intergenerational Transmission of ACEs Among Indigenous Caregivers and Their Children.

A large body of empirical research has demonstrated that caregiver adverse childhood experiences (ACEs) predict ACEs in one's child, a phenomenon known as the intergenerational transmission of ACEs. Little of this empirical research, however, has focused specifically on Indigenous peoples despite a growing body of theoretical literature and the wisdom of Elders and Traditional Knowledge Keepers that speaks to the presence of this phenomenon within Indigenous communities as well as the protective role of Indigenous cultural identity in preventing the intergenerational transmission of ACEs. The purpose of the current study was to conduct an empirical evaluation of this hypothesis, specifically that Indigenous cultural identity and social support protects against the intergenerational transmission of ACEs among Indigenous peoples and their children in the USA. Participants were 106 Indigenous women caregivers of children ages 10 to 14 in South Dakota who completed surveys. Results showed that Indigenous cultural identity moderated the association between caregiver ACEs and child ACEs. At high levels of cultural identity, there was no association between caregiver ACEs and child ACEs. At low levels of Indigenous cultural identity, however, there was a strong and positive relationship between caregiver ACEs and child ACEs. Social support did not moderate the association between caregiver ACEs and child ACEs. These findings underscore the need for initiatives that enhance Indigenous cultural identity and social support among Indigenous caregivers to prevent the intergenerational transmission of ACEs.

Rates and Correlates of Intimate Partner Abuse Among Indigenous Women Caregivers.

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful.

Coparenting support in the context of difficult children: Mother and father differences.

While parenting children with difficult behaviors can intensify stress within the entire family system, families may lean on other familial relationships to mitigate that stress. The coparenting relationship is known to play a key role within the family system for child outcomes and familial interactions, but it is not clear whether it eases the stress and challenge of raising a difficult child, nor how that plays out differently for mothers versus fathers. Ninety-six couples (89.7% married) parenting young children (Mean age = 3.22 years) were included in this study. Using cross-sectional and aggregated daily response data, actor-partner interdependence models were used to examine how mothers' and fathers' perceived coparenting support lessened or intensified parenting stress and/or daily problems with their child/children-for themselves or their parenting partner. We found that greater coparenting support reported by mothers coincided with stronger links between the mother's report of child difficulty and daily problems encountered by both mothers and fathers. In contrast, when fathers reported greater coparenting support, the intensity between reported child difficulty and daily problems decreased for mothers, and fathers reported lower parenting stress. Coparenting support also moderated associations between parents' perception of child difficulty and daily problems with their children. These results suggest that mothers incur heightened coparenting support from fathers when experiencing more difficult child behavior and that coparenting support experienced by fathers may alleviate parenting challenges for mothers. These findings further contribute to the literature by emphasizing distinct differences between mothers and fathers in coparenting associations within the family system.

Access to Online Formative Assessments in Lower-Division Undergraduate Biology Courses: Investigating Barriers to Student Engagement.

Instructors use a variety of online formative assessment (FA) activities to support learning outside class. Previous studies have revealed barriers for students in online courses, but little is known about the barriers students experience when completing online FA assignments. Understanding these barriers to access is critical to fostering more inclusive learning for all students. Using a framework from previous work in online learning, we examined student perceptions of online FA access with respect to five barrier categories: technical resources, instructor organization, social interactions, personal engagement, and learning environment. We developed and administered a survey to more than 1200 undergraduate biology students at 2-year and 4-year institutions. Students responded to statements using Likert scales and open-ended prompts. Statistical models indicated differences in access across the barrier categories and revealed that demographic characteristics were associated with certain barrier categories. Furthermore, technical resources, instructor organization, and personal engagement barriers were associated with lower course performance. In open-ended responses, students most frequently suggested that changes to scheduling logistics, course delivery, and FA format would improve their online FA experience. We discuss how these findings and student suggestions can inform instruction, particularly how instructors can alter their FA characteristics to better suit their student populations.

Examining long-term intervention effects to promote teacher problem-solving and communication skills in the rural context.

Conjoint behavioral consultation (CBC), a teacher-parent partnership intervention, has been shown to yield immediate improvements in problem-solving skills and communication quality with parents for kindergarten through third grade teachers in rural schools. The purpose of the present study was to determine whether CBC can yield maintained effects on teacher skills and communication over a 1-year follow-up period. We used an experimental design to examine maintenance effects of CBC (nCBC = 84, nControl = 68). Outcomes were assessed four times: baseline, 12-week posttest (immediate effects), and twice during a 1-year follow-up period (maintenance effects). Longitudinal growth modeling revealed that immediate improvements in perceived problem-solving competence and communication quality with parents for teachers in the CBC condition compared to teachers in the control condition were maintained 1-year postintervention. CBC appears to support teachers' professional practices over time. Implications for enhancing families' and schools' capacities to address student behavior concerns are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effectiveness of a Sexual Assault Self-defense Program for American Indian Girls.

This study evaluated the effectiveness of a 6-session (12-hour) empowerment self-defense classroom delivered curriculum (i.e., IMpower) among American Indian girls. Girls (N = 74) in one middle school and two high schools on an Indian Reservation in the Great Plains region of the United States received the intervention and completed a pre-test and a post-test six months following the final program session. The surveys administered assessed hypothesized intermediary (i.e., efficacy to resist a sexual assault, self-defense knowledge), primary (i.e., sexual violence victimization), and secondary (i.e., physical dating violence, sexual harassment) outcomes. Native American girls (N = 181) in five middle schools and three high schools in a nearby city where there was no sexual assault prevention occurring completed surveys assessing sexual violence, physical dating violence, and sexual harassment victimization approximately six months apart, thus serving as a comparison to girls in the treatment condition on primary and secondary outcomes. Girls exposed to the IMpower program reported significant increases over time in efficacy to resist a sexual assault and knowledge of effective resistance strategies. Furthermore, propensity score analyses suggested that girls who received the IMpower program reported significantly fewer types of sexual assault and sexual harassment at follow-up compared to girls in the control condition. However, no effect was found for physical dating violence. These data suggest that empowerment self-defense is a promising approach in preventing sexual assault and sexual harassment among American Indian girls.

Latinx adolescents' academic self-efficacy: Explaining longitudinal links between ethnic-racial identity and educational adjustment.

OBJECTIVE: This longitudinal study had three aims: (a) to examine whether ethnic-racial identity (ERI; i.e., public regard, private regard, and centrality) was associated with academic self-efficacy and changes in educational adjustment (i.e., educational values and academic performance) among Latinx adolescents over 3 years, (b) to investigate whether academic self-efficacy would operate as a promotive mechanism in links between domains of ERI and changes in educational adjustment, and (c) to explore within-group variability by gender on the relations between domains of ERI, academic self-efficacy, and educational adjustment. METHOD: Data came from 329 Latinx families (i.e., middle school students and their parents) living in the Southwest U.S. Parents' data were used from the first wave and adolescents' (M = 13.69, SD = .56; 53% girls) data were used from three study waves. A series of structural equation models were estimated. RESULTS: All three domains of ERI related to higher levels of academic self-efficacy. Further, public regard was associated with increased levels of educational values, whereas private regard and centrality did not associate with either indicator of educational adjustment. Results provided support for academic self-efficacy serving as a mediator of associations between private regard and centrality and educational adjustment. The results were consistent across gender. CONCLUSIONS: The findings suggest that fostering ERI is promotive of Latinx adolescents' academic self-efficacy. Further, through academic self-efficacy, private regard and centrality support educational adjustment. ERI and academic self-efficacy may be potential targets for programming aimed to address educational disparities among Latinx adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The associations of maternal/paternal modeling, self-efficacy, and ethnic fit on math/science achievement among Latinx students.

INTRODUCTION: This paper examined individual, family, and peer roles in promoting Latinx youths' math and science performance. The role of maternal/paternal modeling in education was examined as shaping academic self-efficacy and, in turn, math/science grades among a population considered at risk of low academic achievement. Moreover, the study tested the moderating roles of class ethnic fit (i.e., feelings of fit based on having same-ethnic peers in class) and gender. METHOD: Cross-sectional data came from a southwestern U.S. sample of Latinx adolescents (N = 329; 54% female, Mage = 13.69 years, SD = 0.56) who reported on maternal/paternal educational modeling, academic self-efficacy, math/science grades, class ethnic fit, and gender. RESULTS: Adolescents' perceptions of maternal modeling, but not paternal, related to higher levels of academic self-efficacy which, in turn, related to higher math/science performance. Moderation results revealed: (a) for adolescents who perceived low science class ethnic fit, high levels of parental modeling related to higher levels of academic self-efficacy which, in turn, were related to higher science grades, and (b) maternal modeling positively related to girls', but not boys', academic self-efficacy and paternal modeling positively related to girls', but not boys', math/science performance. CONCLUSIONS: These results suggest maternal modeling is a promotive factor, supporting Latinx youths' academic self-efficacy which, in turn, related to math/science grades. Additionally, a negative direct relation between maternal modeling and science grades suggests maternal modeling generally support academic self-efficacy, but not necessarily science attainment. These associations are nuanced as they are informed by context and parent-child gender.

Development of and Preliminary Evidence for a Psychological Service Barriers Measure Among College Sexual Assault Survivors.

Sexual assault is a widespread problem on college campuses, and survivors rarely use campus supports. However, there is no established measure of service barriers for this population. This study develops and provides preliminary evidence for a measure of psychological service barriers. Data were collected from 100 college sexual assault survivors. Results provide evidence for three factors: social-emotional barriers, negative treatment barriers, and minimization barriers. Additional tests offer evidence for consistency and reliability in these factors over time and across campus supports. This work offers preliminary evidence for the psychometric properties of this measure and lays the groundwork for future validation research.

Psychological distress prevalence and associated stressors and supports among urban-displaced Congolese adults in Kenya.

BACKGROUND: There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries. METHOD: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18-80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress. RESULTS: More than half of the participants (52.8%) reported symptoms indicative of psychological distress. Factors associated with increased psychological distress included perceiving to have a useful role in one's family or community, AOR = 1.85; 95% CI [1.1.17, 3.11], p = .012, feeling confused or not knowing what to do, AOR = 2.13; 95% CI [1.20, 4.6], p = .014, and feeling afraid to leave home for medical/health care to help with an illness, AOR = 1.57; 95% CI [1.17, 2.15], p < .01. Additionally, ethnic Banyamulenge Congolese adults without legal refugee status had an increased likelihood of experiencing psychological distress, AOR = .07; 95% CI [0, .74], p = .035. CONCLUSION: Future research is warranted to understand how to implement targeted mental health and psychosocial support (MHPSS) to improve urban-displaced adults' sense of safety and belonging. Our findings suggest that legal refugee status is an important structural determinant of mental health, which should be considered in MHPSS practice and policy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mexican-origin parents' workplace discrimination and well-being: The roles of familism values, family conflict, and gender.

OBJECTIVE: This study examined Mexican-origin parents' perceived workplace discrimination, familism, family conflict, and gender as related to parents' well-being (i.e., self-esteem, depressive symptoms, and general physical health) over a 2-year period during the 2007-2009 "Great Recession" in the U.S. METHOD: Data were drawn from two waves of a larger study of 246 Mexican-origin predominantly immigrant families with adolescents. Using a matched-pairs sample of mothers and fathers, path analyses were conducted to test the hypothesized relations. RESULTS: Moderation analyses revealed that high levels of familism weakened the link between workplace discrimination and parents' depressive symptoms, whereas high levels of parent-youth conflict exacerbated the association to parents' psychosocial well-being. There was variation by parent gender, with parent-youth conflict being more strongly associated with fathers' self-esteem than mothers'. CONCLUSIONS: Findings indicate that Mexican-origin parents' familism can mitigate and family conflict can exacerbate the risks of workplace discrimination on parents' psychosocial well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Testing an Integrated Model of Alcohol Norms and Availability, Binge Drinking, and Teen Dating Violence.

This study examined an integrated model that proposes that alcohol availability and alcohol norms will directly and indirectly via binge drinking predict physical, sexual, and emotional teen dating violence (TDV) victimization. These data come from 22,336 high school students (49.6%) from 69 schools who participated in the New Hampshire Youth Risk Behavior Survey in 2017. All teens included in the analyses reported dating in the past year. Perceptions of alcohol availability and peer and parental acceptance of teen drinking related to an increased likelihood of binge drinking, and binge drinking related to an increased risk of physical, sexual, and emotional TDV victimization. Also, alcohol availability and perceived parental and peer norms exerted a direct influence on the increased likelihood of TDV victimization. Lastly, we examined the moderating role of gender on these associations. Only one significant association emerged, such that for boys, but not for girls, perceived parental alcohol norms related to an increased likelihood of emotional TDV victimization. Findings suggest that TDV prevention and risk reduction initiatives need to focus on efforts that reduce binge drinking in teens. Reducing alcohol availability and shifting perceptions of parental alcohol norms and peer alcohol norms could be helpful in reducing both binge drinking and TDV victimization.

Associations among Mexican-origin youth's sibling relationships, familism and positive values, and adjustment problems.

Finding ways to protect youth from maladjustment during adolescence and young adulthood is important, and youth of Mexican descent are key targets for such efforts given that they experience higher rates of depressive symptoms, risky behaviors, and sexual risk behaviors compared to youth from other ethnic/racial groups. Using a sample of younger (Mage Time 1 = 12.77 years) and older (Mage Time 1 = 15.70 years) siblings from an 8-year longitudinal study of 246 Mexican-origin families, we conducted path analyses to test whether older siblings' reports of sibling intimacy predicted younger siblings' later positive values and adjustment problems controlling for prior adjustment and maternal and paternal warmth. Additionally, we tested whether younger siblings' familism values moderated and their positive values mediated the sibling intimacy to adjustment problem linkages. Findings revealed that sibling intimacy in early adolescence predicted younger siblings' adjustment problems in young adulthood via their positive values in later adolescence, but only for younger siblings with strong familism values. This study highlights the importance of examining promotive factors, such as positive relationship qualities and familism values, and how positive values protect against problems in young adulthood. Results also have practical implications for prevention programs including the utility of promoting positive sibling relationships and values. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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.

Self-harm and self-regulation in urban ethnic minority youth: a pilot application of dialectical behavior therapy for adolescents.

BACKGROUND: Difficulties in coping with stress and regulating emotions are transdiagnostic risk factors for self-harming behavior. Due to sociocultural stressors, ethnic minority adolescents may be at greater risk for self-regulation difficulties and self-harm. Dialectical behavior therapy for adolescents (DBT-A) frames adaptive skill acquisition as a mechanism of change, but few studies have investigated its impact on ethnic minority adolescents' self-regulation (i.e. coping, emotion regulation). Therefore, this pilot study examined relations between self-regulation and self-harm among ethnic minority adolescents and investigated changes in their self-regulation upon completing DBT-A. METHODS: A clinically referred sample of 101 ethnic minority adolescents (Mage  = 14.77; female = 69.3%) completed questionnaires about a history of self-harm, coping (DBT Ways of Coping Checklist), and emotion regulation (Difficulties in Emotion Regulation Scale). Of the initial sample, 51 adolescents (Mage  = 14.73; female = 80.4%) entered a 20-week DBT-A program due to self-harm and/or Borderline Personality features. RESULTS: In a pretreatment sample, the frequency of dysfunctional coping, but not of adaptive coping, differentiated self-injurers from non-self-injurers. Full information maximum likelihood estimation was used to address high attrition (60.8%) from DBT-A. Those who completed DBT-A (n = 20) reported significantly improved emotion regulation. Adaptive coping at pretreatment predicted increased DBT skills use at post-treatment. CONCLUSIONS: This non-randomized pilot study highlights dysfunctional coping and emotion dysregulation as risk factors for self-harm and suggests that 20-week DBT-A may help improve emotion regulation. Future research should employ a randomized design to further examine the effect of DBT-A on these transdiagnostic processes of psychopathology. KEY PRACTITIONER MESSAGE: Due to cultural and environmental stressors, ethnic minority adolescents may be at greater risk for developing self-regulatory difficulties - transdiagnostic mechanisms known to underly self-harming behaviors; however, we know little about whether empirically supported treatments for self-harm will improve youth's coping and emotion regulation. In a clinically referred, pretreatment sample of ethnic minority youth, levels of BPD symptomatology, emotion dysregulation, and dysfunctional coping, but not of adaptive coping, differentiated teens who self-harmed from those who did not. Self-harming ethnic minority youth who participated in an uncontrolled, pilot trial of dialectical behavior therapy for adolescents (DBT-A) at an urban mental health clinic reported improved emotion regulation at post-treatment. Baseline emotion regulation skills were not predictive of treatment-related changes, suggesting that other factors, such as DBT-A, may have played a decisive role in improving teens' emotion regulation. In contrast, adaptive coping skills at pretreatment were linked to increased DBT skills use at post-treatment, indicating that patients' baseline coping skills may play a predictive role in psychotherapy outcomes. Future research should employ a randomized control trial to examine the effect of DBT-A on vulnerable ethnic minority youth's development of self-regulation. It should also investigate the hypothesized mediating role of self-regulation in effecting lasting clinical gains.

Listening to the Voices of Community Health Workers: A Multilevel, Culture-Centered Approach to Overcoming Structural Barriers in U.S. Latinx Communities.

Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semistructured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations.