Understanding the Relationship between Religiosity and Caregiver–Adolescent Communication About Sex within African-American Families

Caregiver–adolescent communication about sex plays a critical role in the sexual socialization of youth. Many caregivers, however, do not engage their youth in such conversations, potentially placing them at risk for negative sexual health outcomes. Lack of caregiver–adolescent communication about sex may be particularly harmful for rural African American youth, as they often report early sex initiation and are disproportionately impacted by STIs. Moreover, sexual communication may be particularly challenging for families with strong religious backgrounds, potentially affecting the occurrence and breadth of topics covered during communication. Study aims were to: determine whether there was a relationship between caregiver religiosity and type of topics covered during communication about sex (e.g., general sexual health vs. positive aspects of sexuality) among 435 caregivers of early adolescent, African American youth; and if so, identify factors that might explain how religiosity affects communication about sex. Results indicated that caregiver religiosity was positively associated with communication about general, but not positive aspects of sexuality for caregivers of males. Attitudes towards communication about sex and open communication style mediated the relationship. There was no association between religiosity and communication about sex for caregivers of females. The findings from this study could provide a base to better understand and support the sexual socialization process within religious, African American families.     

Differences in family functioning in grandparent and parent-headed households in a clinical sample of drug-using African American adolescents

Grandparents play a critical role in African American families, providing support and important leadership functions. Little is known, however, about family functioning in grandparent-headed households with a drug-using adolescent. Such knowledge is particularly salient for researchers and therapists who work with drug-using adolescents and their families. Using a clinical sample of convenience, analyses were conducted to identify similarities and differences in adolescent substance use and behavior problems, family relationships, and family social ecology relationships between African American grandparent-headed (n=12) and parent-headed (n=54) households. Results indicated that adolescents from the 2 household types reported similar levels of problem behaviors, but that grandparents reported less delinquency with peers than did parents. Primary caregivers in grandparent-headed households reported less monitoring and supervision of peers and less within-family conflict. Implications for treatment are discussed.     

Direct and Indirect Effects of Caregiver Social Support on Adolescent Psychological Outcomes in Two South African AIDS-Affected Communities

Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV‐endemic, resource–scarce Southern African communities. A cross‐sectional household survey was conducted over 2009–2010 with 2,477 South African adolescents aged 10–17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu‐Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: (a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and (b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p < .001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network.     

Acceptability and feasibility of a brief substance use intervention for adolescents in Cape Town,South Africa: A pilot study

Substance use is prevalent among South African adolescents, but few interventions exist to reduce risk of harm. This study assesses the feasibility, acceptability and preliminary effects of a brief intervention for reducing adolescent substance use and other risk behaviours. This single-arm feasibility test recruited 30 substance-using adolescents and their primary caregiver. Participants received separate interventions (2 sessions for adolescents, 1 session for caregivers), with a subsample randomly selected for post-intervention interviews. Feasibility was measured by the proportion of eligible adolescents who were enrolled and retained in the study. Interviews explored acceptability, and changes in outcomes from baseline to 1-month follow-up assessed preliminary effects of the intervention. Thirty of 43 (69.8%) eligible adolescents and their caregivers were enrolled, with 29 adolescents (96.7%) and 28 caregivers (93.3%) completing the intervention. Twenty-eight adolescents (93.3%) and 29 caregivers (96.7%) were retained at follow-up. Frequency of alcohol, cannabis use and delinquent-type behaviours decreased significantly from baseline to follow-up. Participants appreciated the intervention content and delivery and felt that it facilitated behaviour change. Suggestions for improving the intervention were provided. This study found that the intervention is feasible, acceptable and had promising effects on adolescent behaviour. Efficacy must be established with a randomised controlled trial.     

Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

Perceptions of Adequate Personal Time and Wellbeing among African American Families with Adolescents

The current study examines the perception of adequate personal or leisure time, and its association with family and caregiver functioning, among a sample of low-income African American families. The investigation is grounded in Conservation of Resources (COR) theory which predicts that caregivers who perceive more adequate personal time will also report higher levels of optimism and lower levels of depressive symptoms, and will have adolescents who report more household routines and less psychologically controlling parenting. A total of 115 caregiver-adolescent (age 14–18) dyads were recruited from a low-income, predominantly African American neighborhood in a major metropolitan center in the United States as part of a larger survey on African American family life. Results indicate that caregivers report perceiving inadequate amounts of time to sleep, get enough exercise, and relax. Caregivers also report comparatively less adequate personal time than time with children. Analyses reveal that caregivers who perceive having more adequate leisure or personal time, report fewer depressive symptoms and higher levels of optimism, after controlling for perceptions of adequate financial resources. Alternatively, there was no association between perceptions of free or leisure time and parenting behaviors, including maintenance of household routines and the use of psychological control. The results underscore the need to examine non-material resources, and their association with wellbeing.     

Change in caregiver depression as a function of the Strong African American Families Program.

A randomized prevention trial contrasted families who participated in the Strong African American Families Program (SAAF), a preventive intervention for rural African American parents and their 11-year-olds, with control families. This article focuses on the program's effect on primary caregivers' depressive symptoms. Among the 167 caregivers with elevated scores on the Center for Epidemiologic Studies-Depression Scale, SAAF participation was associated with reduced depressive symptoms, enhanced parenting, and perceived improvements in youth behavior. Change in parenting (consistent discipline, youth monitoring, and open communication) but not change in youth intrapersonal competencies significantly mediated intervention effects on caregivers' depression. Results support the link between reduced depressive symptoms and stronger family relationships, particularly the importance of enhanced parenting efficacy in alleviating depressive symptoms.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.     

Paternal Caregivers’ Parenting Practices and Psychological Functioning among African American Youth Living in Urban Public Housing

Structural factors associated with public housing contribute to living environments that expose families to adverse life events that may in turn directly impact parenting and youth outcomes. However, despite the growth in research on fathers, research on families in public housing has practically excluded fathers and the role fathers play in the well‐being of their adolescents. Using a sample of 660 African American adolescents recruited from public housing, we examined the relationship between paternal caregivers’ (i.e., fathers’ and father figures’) parenting practices and adolescents’ depressive symptoms, attitudes toward deviance, and self‐efficacy. Using a latent profile analysis (LPA), we confirmed a four‐class model of paternal parenting practices ranging from high to low levels of monitoring and encouragement. Results from a one‐way ANOVA indicated that paternal caregivers with high (compared to moderate) levels of encouragement and monitoring were associated with youth who reported less depressive symptoms, higher levels of self‐efficacy, and less favorable attitudes toward deviance. Discriminant analysis results indicated that approximately half of the sample were correctly classified into two paternal caregiver classes. The findings provide evidence that some of these caregivers engage in parenting practices that support youths’ psychological functioning. More research is needed to determine what accounts for the variability in levels of paternal encouragement and supervision, including environmental influences, particularly for paternal caregivers exhibiting moderate‐to‐low levels of paternal encouragement and monitoring.     

Get the Message: Targeting Beliefs to Develop Risk Reduction Intervention Messages for African American Adolescents

Risk reduction interventions that promote condom use, a vital component of most HIV prevention interventions, have been successful in increasing condom use among African American adolescents. Understanding theoretical components that lead to behavior change and selecting relevant risk reduction messages remain important considerations for targeting new interventions and tailoring existing interventions. The present study sought to (1) identify the most important theoretical determinants of condom use intention in African American adolescent males and females, separately, using the integrative model of behavior prediction, and (2) identify underlying beliefs within the determinants that were good candidates for message development in similar interventions. Using 446 African American adolescents, multi‐group SEM indicated that the gender‐specific IM exhibited a better fit than the overall model. Specifically, the IM had a stronger capacity for predicting condom use intention and condom use behavior for adolescent boys. Using a specific criteria for message selection, specific condom use beliefs were discussed as potential candidate messages for both African American males and females.     

Adolescents in Residential Treatment: Caregiver and Peer Predictors of Risk Behavior and Academic Performance

The purpose of this research was to better understand the substance use and sexual risk taking behavior among high-risk adolescent populations placed in residential treatment facilities, including those in the foster care and juvenile justice systems. The primary predictors considered in this study included caregiver support, caregiver closeness, other adult support, adolescent self-disclosure/communication with caregiver, caregiver expectations about sexual behavior, and peer influence regards to drugs/alcohol and sexual behavior. Participants included 120 adolescent females in grades 7 to 12 (median grade?=?10; mean age 15.7 years), primarily African American (57.2 %) and White (29 %), in a residential treatment setting in a large urban area in the Midwest. Caregiver support and self-disclosure/communication with caregivers predicted condom use at most recent intercourse, but variables related to substance use were most consistently predictive of sexuality variables including onset and frequency of behavior. None of these support variables significantly predicted onset and frequency of substance use. Caregiver support was the contributing variable in predicting academic achievement.     

Association of Kinship Support and Externalizing Problems Among Low Income African American Mothers and Adolescents

The investigation examined whether mothers’ optimism and family routine in serial order, mediated the association of kin support with adolescents’ externalizing problems in a sample of urban, low income, African American mothers and adolescents (N?=?200). The study is grounded in the Integrative Model for the Study of Developmental Competencies in Minority Children, which predicts that mothers who receive more support from extended family will report higher levels of optimism and will create more routine and order in the home and in turn, will have adolescents who exhibit less problem behavior. Hypotheses were examined with structured interviews administered to mothers and adolescents. Results revealed that kin support was negatively associated with adolescents’ externalizing problems. Kin support was also positively linked to mothers’ optimism and family routine. Mothers’ optimism and family routine in serial order mediated the association of kin support with adolescents’ externalizing problems. Findings reveal some of the process through which kin support, a vital resource in many African American families, may be linked to positive outcomes. Implications for promoting adolescent adjustment and family relations are discussed.

     

Racial Differences in Responses to the Caregiver Strain Questionnaire

The aim of this study was to examine differences in responses to the Caregiver Strain Questionnaire (CGSQ) between African American and White caregivers of children with emotional and behavioral challenges. Significant item- and scale-level differences were detected across groups with African Americans consistently reporting less strain. We examined whether these differences were more likely due to nonequivalent measurement than to real differences in the experience of caregiver strain. Confirmatory factor analysis showed that the model fit the data well for both racial groups, but there were some differences in structural components. Internal consistency was equivalent across the groups. In an examination of criterion validity, regression analyses showed that African American caregivers experienced a slower rate of increase in objective caregiver strain at a given increase in child internalizing problems. No other race differences were found in the regression analyses. In general, we conclude that the CGSQ can be useful for detecting caregiver strain and identifying family support needs for both White and African American caregivers. Differences across groups in reports of caregiver strain, however, call for more research on racial differences in the impact on the family of caring for a child with emotional and behavioral disorders.     

Adolescent Girls and Their Mothers Talk About Experiences of Binge and Loss of Control Eating

Evidence suggests that adolescents’ experience of binge eating (BE) might differ in important ways from that of adults. Moreover, although BE appears more common in African American women than other disordered eating behaviors, little is known about the influence of cultural factors on this behavior in adolescents. The current investigation used qualitative methodology to examine the perceptions of White and African American adolescent girls and their mothers regarding experiences of binge and loss of control eating. Five focus groups were completed with 19 adolescent girls (aged 13–17, 58 % African American, 41 % White) who endorsed loss of control eating behaviors. Their mothers (N = 19) also completed separate, concurrent focus groups addressing food and eating behaviors. Responses to focus group questions were analyzed using thematic qualitative analysis. Adolescents’ awareness of their eating behaviors varied greatly. Girls reported some awareness of how emotions influence their eating behaviors, and described using food to achieve autonomy. Mothers evidenced awareness of their daughters’ problematic eating behaviors, the effects of emotions on eating for both their daughters and themselves, and sociocultural factors influencing diet. Data from these focus groups can inform the development of innovative interventions for adolescent girls engaging in loss of control eating.     

Order in the home: Family routines moderate the impact of financial hardship

The study examined whether frequency of adolescent reported family routines moderated the relation between caregivers' perceptions of financial resources and adolescents' behavioral and academic outcomes among a sample of inner-city African American families. The sample consisted of 115 adolescents (average age = 15.95) and their female caregivers participating in a large scale study on African American family life. The results revealed a significant main effect of financial resources and family routine on adolescent outcomes, such that an increase in both was related to less delinquency and more favorable academic outcomes. Family routines moderated the relation between financial resources and adolescent outcomes. Specifically, the study revealed that the link between lack of financial resources and negative adolescent outcomes was diminished for youth in high-routine homes. Alternatively, family routines did not have a significant impact on youth from high-resource homes. Results highlight the importance of organization and predictability for economically disadvantaged youth and families.     

Caregiver preference for reinforcement‐based interventions for problem behavior maintained by positive reinforcement

Social validity of behavioral interventions typically is assessed with indirect methods or by determining preferences of the individuals who receive treatment, and direct observation of caregiver preference rarely is described. In this study, preferences of 5 caregivers were determined via a concurrent‐chains procedure. Caregivers were neurotypical, and children had been diagnosed with developmental disabilities and engaged in problem behavior maintained by positive reinforcement. Caregivers were taught to implement noncontingent reinforcement (NCR), differential reinforcement of alternative behavior (DRA), and differential reinforcement of other behavior (DRO), and the caregivers selected interventions to implement during sessions with the child after they had demonstrated proficiency in implementing the interventions. Three caregivers preferred DRA, 1 caregiver preferred differential reinforcement procedures, and 1 caregiver did not exhibit a preference. Direct observation of implementation in concurrent‐chains procedures may allow the identification of interventions that are implemented with sufficient integrity and preferred by caregivers.     

Improving Couples’ Relationship Functioning Leads to Improved Coparenting: A Randomized Controlled Trial With Rural African American Couples

Family-centered prevention programs for couples with children are being increasingly disseminated, with the hope that improving couples’ romantic relationships will lead to other benefits for families. To date, however, it is unclear whether these interventions do in fact yield these benefits. The current study addressed this gap by examining whether postintervention improvements in couples’ relationship functioning following family-centered prevention predicted longer-term change in coparenting, and whether postintervention improvements in coparenting predicted longer-term change in relationship functioning. We used four waves of data collected over 2 years from 346 rural African American couples with an early adolescent child who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program, an intervention designed to promote strong couple, coparenting, and parent–child relationships in two-parent African American families. Results indicated that ProSAAF had significant short-term positive effects on both romantic relationship functioning and coparenting and that these effects did not differ in magnitude. Over time, however, only romantic relationship functioning postintervention was positively associated with long-term changes in coparenting; coparenting postintervention was not associated with long-term changes in relationship functioning and this association was significantly weaker than the other pathway. These findings support a key premise underlying relationship enhancement programs for parents, indicating that improving couples’ romantic relationship functioning can have longer-term benefits for the coparenting relationship as well. Further research examining long-term parent, child, and family outcomes following family-centered prevention for couples and the mechanisms of change underlying these outcomes is needed.     

A Qualitative Examination of the Relationship Between Body Image and Sexual Behavior: Perceptions from Latina and African American Adolescent Girls and Their Maternal Caregivers

Although prior work suggests that how adolescent girls feel about their body is associated with their sexual behavior, we have less insight into the reasons why. We conducted semi-structured interviews with 25 African American adolescent girls (11–14 years of age), 18 Latina adolescents (14–17 years of age), and their maternal caregivers to explore why this association may exist. Both adolescent girls and their maternal caregivers were asked “Who is more likely to have sex, a girl who likes the way her body looks or a girl who doesn’t like the way her body looks?” A similar question was asked about condom use. Interviews were digitally recorded, transcribed, and coded for emergent themes using thematic analysis. Participants’ responded that both girls with a positive body image and those with a negative body image may be likely to have sex because of self- and body-esteem. Two sub-themes emerged that further explained why low self- and body-esteem mattered for girls who have a negative perception of their body: (a) feeling appreciated (b) easily persuaded. Most participants noted that girls with a positive body image perception would be more likely to use condoms. Emergent themes for using condoms were: (a) pregnancy/STI protection; and (b) body preservation. Our findings have implications for empirically exploring the pathways through which body image perceptions relate to adolescent sexual behaviors, and the possibility that universal prevention programs may not resonate similarly for all adolescent girls.     

Use of an Orientation Session May Help Decrease Attrition in a Pediatric Weight Management Program for Low-Income Minority Adolescents

This study examined predictors of attrition from a pediatric weight-control program in a low-income minority community and the potential usefulness of an orientation session to increase length of treatment. Participants were 342 children and adolescents (M age=13.0 years old; 54% female; 89% African American; M BMI=44.2, M BMI z-score=6.0) and their caregivers who attended FitMatters, a multidisciplinary cognitive-behavioral program focused on long-term participation. Those who attended an orientation session stayed in treatment significantly longer, but attrition was not affected by demographic factors, weight status, or psychological functioning. These results indicate that an orientation session that clearly delineates the structure of a program and expected attitudinal and behavioral requirements for the families may help align expectations, as well as more effectively identify families who are ready to make concerted efforts to change the family lifestyle in support of their obese children's efforts.     

Caring for children with an intellectual disability: An exploratory qualitative study

This study explored family caregiver experiences of children with an intellectual disability in a rural South African day-care centre. The family caregivers (N = 15; mothers = 60%; age range = 35 to 68 years) completed in-depth interviews regarding their experiences providing care to children with intellectual disability. Data collection and analysis was done using phenomenological methods. The following themes emerged to characterise the family caregiver experiences: deeper understanding of intellectual disability; disability disclosure conditions; and social and economic support needs. Family support emerged as an important factor in the relationship between caregivers’ psychological stress and well-being.