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16 result(s) for "Arora, Prerna G."
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Sources of Stress and Barriers to Mental Health Service Use Among Asian Immigrant-Origin Youth: A Qualitative Exploration
Asian immigrant-origin youth (IOY) are a large and growing population within the United States (U.S.). Yet, despite the high prevalence of mental health concerns, limited research has examined sources of stress that may lead to mental health concerns among Asian IOY. Further, despite low levels of mental health service use, no studies have directly explored the perceptions of Asian IOY about barriers to mental health service use generally. Hence, using a qualitative approach, this study sought to examine the perceptions of Asian IOY regarding sources of stress that may contribute to mental health concerns and barriers to mental health service use. Thirty-three (n = 33; 58% female) Asian IOY were directly queried through in-depth focus groups. Data were analyzed using a grounded theory approach. Themes relating to sources of stress that lead to mental health concerns among Asian IOY included (a) pressure to succeed and (b) stressors related to ethnic minority and immigrant status. Themes relating to barriers to mental health service use among Asian IOY included (a) parental reactions, (b) concerns with mental health treatment, (c) stigma against mental health services, (d) mental health literacy, and (e) pragmatic or logistical reasons. Findings provide insight into tailoring appropriate outreach efforts to increase mental health service use among Asian IOY.HighlightsWe directly queried Asian IOY to examine sources of stress and barriers to mental health service use.Parental pressure to succeed was the most frequently endorsed stressor.Parents are important gatekeepers to Asian immigrant-origin youth’s access to mental health services.
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.
Cultural Adaptations to Youth Mental Health Interventions: A Systematic Review
Disparities in mental health care access and use are a serious public health concern for racial and ethnic minority (REM) youth populations across the United States (US). Numerous evidence-based interventions (EBIs) have been developed to address youth mental health concerns; however, evidence suggests that EBIs may require cultural adaptations to have greater efficacy with REM populations. The following study engaged in a systematic review of the existing culturally-adapted EBIs for REM youth in the US. A three-stage systematic review was performed. A total of 52 studies describing the development or evaluation of culturally-adapted EBIs with REM youth populations were included. Information from studies was then abstracted via a rigorous coding process. Specifically, participant characteristics (e.g., age, population risk, race/ethnicity of target audience), intervention characteristics (e.g., name of the original program, target mental health outcome(s), delivery setting, intervention format, intervention orientation, interventionist), and cultural adaptation characteristics (e.g., guiding theory, individuals involved, cultural adaptation content, participatory methods used) were cataloged. Implications for current and future research regarding cultural adaptation of EBIs are presented. Highlights Comprehensive systematic review of culturally-adapted interventions for racial and ethnic minority youth in the US. Inclusion of studies with youth, as well as parents/caregivers as intervention participants. Coded content or type of cultural adaptations incorporated in psychological interventions. Reported extent of engagement in participatory-based approaches in culturally-adapted intervention studies. Findings underscore need to increase reporting on the content of and process by which cultural adaptations are made to interventions for youth.
A Pilot Evaluation of a School-Based Psychoeducational Program for Chinese and Latino/a Parents: Perceived Effectiveness and Acceptability
Immigrant parents and their adolescent children face unique stressors that have been linked to an increased prevalence of negative mental health outcomes. Limited research has evaluated the use of brief, culturally sensitive, school-based mental health programming for immigrant families. The current study sought to evaluate the effectiveness and acceptability of a mental health psychoeducational program for immigrant parents of adolescents. Additionally, the current study sought to explore the role of parental demographic characteristics on these outcomes. Sixty-seven immigrant parents of adolescents from urban communities participated in a pilot evaluation of a brief mental health program designed to educate parents regarding stressors their adolescents face and how to increase positive communication. Results suggest that immigrant participants perceived the training as both acceptable and effective in increasing their knowledge. Moreover, results indicated higher ratings of the training’s acceptability and effectiveness among younger parents, as well as those who identified as Latino/a. Implications for school mental health professionals serving immigrant parent populations 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.
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.
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.
Depressive Symptoms in Mexican-Origin Adolescents: Interrelations Between School and Family Contexts
This study, as guided by cultural-ecological frameworks, examined multiple contextual stressors, including subjective economic hardship, acculturation, discrimination, and negative perceptions of school safety, as simultaneously linked to adolescents’ depressive symptoms, as well as the role of gender, familism values, family cohesion, and school connectedness on these associations. Data come from the Children of Immigrants Longitudinal Study (Portes and Rumbaut 2012 ) that included second-generation 8th- and 9th-grade children of foreign-born parents from the Mexican-origin subsample ( n  = 755; 52% male; time 1  M age = 14.20 years). Adolescents were either born in (60%) or immigrated prior to age 5 to the USA. Results of the regression analysis conducted via M plus indicated that Mexican-origin female adolescents had higher levels of depressive symptoms at age 17. Subjective economic hardship, general discrimination, and negative perceptions of school safety were related to higher levels of depressive symptoms. Family cohesion was related to lower levels of depressive symptoms. Youth gender, familism values, family cohesion, and school connectedness were significant moderators. The present findings point to not only the harmful effects of subjective economic hardship, general discrimination, and negative perceptions of school safety on second-generation Mexican-origin adolescents’ mental health but also the significant protective role of school connectedness and family cohesion in promoting adolescents’ well-being. Implications for school psychology research and practice are discussed.
Strategic Treatment and Assessment for Youth (STAY): A Theoretically-Driven, Culturally-Tailored MBC Approach
Racial and ethnic minoritized (REM) youth are at greater risk for depression and suicide than their White peers. Despite this, REM youth are much more likely than their White peers to prematurely dropout of treatment. Culturally tailored and scalable engagement models to improve mental health treatment retention among REM youth with depressive symptoms and suicidal thoughts and behaviors (STB) are urgently needed. Strategic Treatment Assessment for Youth (STAY) is a theoretically-driven, culturally tailored measurement-based care (MBC) approach to treatment engagement for REM youth with depressive symptoms and suicide risk. Specifically, STAY uses MBC feedback processes to reduce perceptual barriers to treatment, thus improving treatment retention and ultimately, client outcomes among REM youth. In addition to standard MBC components, STAY includes a greater emphasis on providing a client-centered rationale for MBC which includes assessing and discussing treatment expectations, the use of individualized progress measures and alliance measures, and cultural competence training. The goal of this manuscript is to describe the STAY model based on initial theoretical development and preliminary clinician-informed refinements. Further, a case example of STAY is presented with a particular focus on the use of feedback processes. Finally, the current and future directions to empirically examine STAY as a treatment retention strategy with REM populations are provided.
Professional Development Needs and Training Interests: a Survey of Early Career School Psychologists
Early career psychologists (ECPs) are considered a distinct professional group that faces unique career challenges. Despite recent organizational efforts to increase engagement of these individuals, little is known about the professional development needs and training interests of ECPs, particularly within psychology’s subfields. As such, this study assessed ECPs’ professional development needs and training interests in school psychology, as well as their perceptions of how well their professional organization was in meeting their needs. One hundred ECP and graduate students responded to an online survey. Results indicated that participants had a strong interest in a variety of professional development topics, including developing short- and long-term career plans, the publication process, obtaining licensure, and work-life balance. Further, participants endorsed interest in various training formats, including brief workshops, ECP mentoring programs, and conference symposia. Participants stated that their professional organization currently met their needs moderately well, but reported seeking professional development support via a number of other sources. Researchers, faculty, and graduate students reported significantly higher perceptions of their professional organization than clinicians. Findings suggest areas for desired professional development and training format. Implications for professional organizations serving ECPs and school psychology graduate programs are addressed.