Risk and protective factors for urban African-American youth

The present study investigated risk and resilience processes in a sample of urban African-American youth. Risk and protective factors were assessed across ecological levels including individual, family and community. Both externalizing and internalizing symptomatology were included as measures of child adjustment. Youth and parental reports as well as various methods, such as the Experience Sampling Method, were used to capture the daily experiences of the adolescents from different perspectives. Poverty, hassles, and exposure to violence predicted higher rates of externalizing and internalizing symptoms. Individual and family protective variables emerged as powerful sources of resilience. An inner sense of confidence and helpful family support were associated with reductions in the deleterious effects of community poverty. Two main patterns, protective-stabilizing and overwhelming-risk, seemed to characterize most of the risk by protective factor interactions. The present findings are important for understanding the complex experiences of urban youth and furthering the literature on sources of risk and protection for African-Americans.     

The Weaving Healthy Families program: Promoting parenting practices,family resilience,and communal mastery

Parenting quality, family resilience, and community resilience and support have been found to be primary protective factors for the disproportionate burden of anxiety, posttraumatic stress disorder (PTSD), substance use disorder (SUD), depression, and suicide that US Indigenous youth and adults tend to experience. The purpose of this research study was to examine pilot results for outcomes related to relational factors for Indigenous family members who participated in the Weaving Healthy Families (WHF) program (translated to Chukka Auchaffi’ Natana, in the Choctaw tribal language), a culturally grounded and empirically informed program geared toward promoting wellness, family resilience, parenting practices, and community resilience while also preventing SUD and violence. This nonrandomized pre-experimental pilot intervention followed a longitudinal design, which included pre-test, a post-test, and a 6-, 9-, and 12-month post-intervention follow-up surveys. Repeated-measures regressions were utilized with generalized estimating equations (GEE) to examine changes in parenting, family resilience, and communal mastery before and after the intervention for 24 adults and adolescents (12–17) across eight tribal families. Results indicate that the overall quality of parenting improved, as measured by improved parental monitoring and reductions in inconsistent discipline and corporal punishment. We identified sex differences in positive parenting, poor monitoring, and corporal punishment, with greater decreases in these measures among males over time. Family resilience and communal mastery improved for adolescent and adult participants after the WHF program. Our results indicate promising improvements across relational, familial, and community ecological, which provide clear clinical implications.     

A Review of Factors that Promote Resilience in Youth with ADHD and ADHD Symptoms

The vast majority of research on youth with ADHD has focused on risk factors and describing the types of impairment individuals with ADHD experience. However, functional outcomes associated with ADHD are heterogeneous, and although many youth with ADHD experience significant negative outcomes (e.g., school dropout), some are successful in multiple domains of functioning (e.g., pursue and graduate college). There is a growing body of literature supporting the existence of factors that protect youth with ADHD from experiencing negative outcomes, but there is no published synthesis of this literature. Accordingly, the goals of this review are to conceptualize risk–resilience in the context of ADHD using a developmental psychopathology framework and to systematically review and critique evidence for promotive and protective factors in the context of ADHD. The literature search focused specifically on resilience in the context of ADHD symptoms or an ADHD diagnosis and identified 21 studies, including clinic, school, and community samples. Findings of promotive and/or protective factors are summarized across individual, family, and social–community systems. Overall, we know very little of the buffering processes for these youth, given that the study of promotive and protective factors in ADHD is in its infancy. The strongest evidence to date was found for social- and family-level systems. Specifically, multiple longitudinal studies support social acceptance as a protective factor, buffering against negative outcomes such as poor academic performance and comorbid depressive symptoms for youth with ADHD. There was also compelling evidence supporting positive parenting as a promotive factor. In terms of individual-level factors, positive or modest self-perceptions of competence were identified as a promotive factor in multiple studies. Future directions for research that will catalyze the study of resilience with ADHD are provided, and the potential for targeting protective mechanisms with intervention and prevention is discussed.     

Predicting Behavioral Health Outcomes Among Low-Income Families: Testing a Socioecological Model of Family Resilience Determinants

Over the past decade, the concept of family resilience among impoverished families has increased as a main focus area for family scholars. Similarly, individual, family, and community-level factors that promote family resilience and their impact on behavioral health outcomes have particularly received increased amounts of attention. To date, however, few empirical studies have simultaneously validated the socioecological determinants of family resilience within multi-dimensional conceptual frameworks. In the current study, we test such a model using a cross-sectional design among 380 women and men with an average age of 35 experiencing poverty as a chronic stressor, the majority of whom are ethnic minorities. Individual, family and community determinants of family resilience are examined for their differential effect on outcomes of physical and mental health, as well as risks for substance abuse. Results from structural equation modeling provide support for the model. Findings suggest that community-level determinants impact health through indirect pathways. In this case, community factors predict family and individual-level determinants, and individual factors then directly predict health. Similarly, the relationship between family-level determinants and health was indirect through individual-level factors. Although, a strong positive relationship was found between individual-level determinants and health, the relationship between individual-level factors and substance abuse was also found to be indirect through health. Methodological limitations and implications for family life education, clinical interventions, policy, and future research that are socioecologically-informed are discussed.     

Developing preventive mental health interventions for refugee families in resettlement

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training.     

Co-Occurring Youth Profiles of Adverse Childhood Experiences and Protective Factors: Associations with Health,Resilience, and Racial Disparities

It is important to understand racial/ethnic differences in adverse childhood experiences (ACEs), given their relationship to long-term physical and mental health, and the public health cost of the significant disparities that exist. Moreover, in order to inform interventions and promote resilience, it is critical to examine protective factors that mitigate the relationship between adversity and poor health. The current study utilized latent transition analyses (LTA) to examine co-occurring profiles of ACEs and protective factors (from school, family, and community contexts) and links to health outcomes among 30,668 Black (10.4%), Latinx (12.3%), and White youth (77.3%) ages 12–17 (52.5% male) who participated in the 2011–12 National Survey of Children's Health (NSCH). Results suggested that greater adversity was associated with worse health, while more access to protective factors was associated with better health. White youth had consistently lower endorsement of ACEs, greater access to protective factors, and better health compared to their Black and Latinx counterparts. Efforts to improve child health and racial/ethnic disparities in research and practice must consider adversity, protective factors, and the systemic inequities faced by racial/ethnic minority youth in the United States.     

Leadership in community mutual support groups for mental health: A qualitative case study from the leaders' perspective

This study explores the experience of leadership of member‐led community‐based mental health mutual support groups. Recent research has documented factors that affect these groups, including leader well‐being, but little is known about the experience of leadership at the individual level. We aimed to understand more about the experience of leadership and how leading members conceptualise their roles. Individual semi‐structured interviews were conducted with 14 leaders of a community mental health mutual support group in England and thematically analysed. Three themes were identified through which leading members conceptualised their roles and group dynamics: (a) “It's a family”; (b) professional values; and (c) working as a team. These knowledge frameworks appeared to influence leaders' well‐being and conceptualisations of their role. The potential impact of this on group stability is discussed. Recommendations are made that group and individual‐level processes be considered together in future research in mental health mutual support contexts due to their interconnected nature.     

Workforce Support for Urban After‐School Programs: Turning Obstacles into Opportunities

Organized after‐school programs can mitigate risk and build resilience for youth in urban communities. Benefits rely on high‐quality developmental experiences characterized by a supportive environment, structured youth–adult interactions, and opportunities for reflective engagement. Programs in historically disenfranchised communities are underfunded; staff are transient, underpaid, and undertrained; and youth exhibit significant mental health problems which staff are variably equipped to address. Historically, after‐school research has focused on behavior management and social‐emotional learning, relying on traditional evidence‐based interventions designed for and tested in schools. However, after‐school workforce and resource limitations interfere with adoption of empirically supported strategies and youth health promotion. We have engaged in practice‐based research with urban after‐school programs in economically vulnerable communities for nearly two decades, toward building a resource‐efficient, empirically informed multitiered model of workforce support. In this paper, we offer first‐person accounts of four academic–community partnerships to illustrate common challenges, variability across programs, and recommendations that prioritize core skills underlying risk and resilience, align with individual program goals, and leverage without overextending natural routines and resources. Reframing obstacles as opportunities has revealed the application of mental health kernels to the after‐school program workforce support and inspired lessons regarding sustainability of partnerships and practice.     

Acculturation and Latino Adolescent Mental Health: Integration of Individual,Environmental, and Family Influences

In order to address the mental health disparities that exist for Latino adolescents in the United States, psychologists must understand specific factors that contribute to the high risk of mental health problems in Latino youth. Given the significant percentage of Latino youth who are immigrants or the children of immigrants, acculturation is a key factor in understanding mental health among this population. However, limitations in the conceptualization and measurement of acculturation have led to conflicting findings in the literature. Thus, the goal of the current review is to examine and critique research linking acculturation and mental health outcomes for Latino youth, as well as to integrate individual, environmental, and family influences of this relationship. An integrated theoretical model is presented and implications for clinical practice and future directions are discussed.     

The Multilevel Relationships of HIV‐Related Stigma to Child and Caregiver Mental Health among HIV‐Affected Households in South Africa

HIV/AIDS‐related (HAR) stigma is still a prevalent problem in Sub‐Saharan Africa, and has been found to be related to mental health of HIV‐positive individuals. However, no studies in the Sub‐Saharan African context have yet examined the relationship between HAR stigma and mental health among HIV‐negative, HIV‐affected adults and families; nor have any studies in this context yet examined stigma as an ecological construct predicting mental health outcomes through supra‐individual (setting level) and individual levels of influence. Multilevel modeling was used to examine multilevel, ecological relationships between HAR stigma and mental health among child and caregiver pairs from a systematic, community‐representative sample of 508 HIV‐affected households nested within 24 communities in KwaZulu‐Natal, South Africa. Two distinct dimensions of HAR stigma were measured: individual stigmatizing attitudes, and perceptions of community normative stigma. Findings suggest that individual‐level HAR stigma significantly predicts individual mental health (depression and anxiety) among HIV‐affected adults; and that community‐level HAR stigma significantly predicts both individual‐level mental health outcomes (anxiety) among HIV‐affected adults, and mental health outcomes (PTSD and externalizing behavior scores) among HIV‐affected children. Differentiated patterns of relationships were found using the two different stigma measures. These findings of unique relationships identified when utilizing two conceptually distinct stigma measures, at two levels of analysis (individual and community) suggest that HAR stigma in this context should be conceptualized as a multilevel, multidimensional construct. These findings have important implications both for mental health interventions and for interventions to reduce HAR stigma in this context.     

Diamonds in the Rough: Bridging Gaps in Supports for At-Risk Immigrant and Refugee Youth

Immigrant youth come to Canada with enormous potential to make a significant, positive contribution to the future of their adopted country. In many cases, this potential is realised; in others, it is not. The ease with which immigrant youth and their families integrate into Canadian society has a strong impact on their futures; those who become marginalised during this process risk becoming alienated or involved with the criminal justice system. Interviews were conducted with 12 stakeholders (including representatives from social service agencies, community groups and the criminal justice and forensic mental health systems) who frequently come into contact with immigrant and refugee youth involved in criminal and/or gang activity. Based on the family, individual, peer, school and community risk and protective factors reported to have an influence on immigrant and refugee youth, recommendations are made for bridging gaps in programming and policy initiatives to support at-risk youth.     

Individual,Community, and National Resilience in Peace Time and in the Face of Terror: A Longitudinal Study

The present paper is based on thrice-repeated measures. The sample constituted 561 Jewish Israeli adults who experienced these terror attacks. The study examined individual, community and national resilience and their associations with resilience-promoting factors (sense of coherence, social support, and self-efficacy); as well as resilience-suppressing factors (distress symptoms, sense of danger, and exposure). Results indicated that resilience scores were quite stable across the three repeated measures, whereas sense of coherence, distress symptoms, sense of danger, and exposure significantly changed across the three repeated measures. Sense of coherence was the best predictor for individual, community, and national resilience.     

Hurricane Katrina and the Gulf Oil Spill: Lessons learned about short-term and long-term effects

The impact and lessons learned from Hurricane Katrina and the Gulf Oil Spill are described as an example of work done reflecting best practices and theory to gain a better understanding of risk and resilience for children and families. Hurricane Katrina, described as the worst natural disaster in the US history, resulted in traumatic separations of children and families and devastation of communities and schools. The impact was greater on families with fewer resources before the hurricane who were provided limited support to return and rebuild. Insufficient community support and economic resources contributed to prolonged traumatiaation and slow recovery. Many were still recovering from Hurricane Katrina when impacted by the Gulf Oil Spill. For families with multigenerational ties to the fishing and oil industries, the Gulf Oil Spill resulted in both cumulative trauma and increased risk. In implementing the behavioural health response, much was learned about promotive and protective factors for individual and community resilience. Services provided following the disasters were based on precepts of individual, family, and community resilience. To enhance recovery and support resilience, the development of regional coalitions across at risk areas provides important coordination before disasters occur for better preparation and response.     

Gay-Straight Alliances Vary on Dimensions of Youth Socializing and Advocacy: Factors Accounting for Individual and Setting-Level Differences

Gay‐Straight Alliances (GSAs) are school‐based youth settings that could promote health. Yet, GSAs have been treated as homogenous without attention to variability in how they operate or to how youth are involved in different capacities. Using a systems perspective, we considered two primary dimensions along which GSAs function to promote health: providing socializing and advocacy opportunities. Among 448 students in 48 GSAs who attended six regional conferences in Massachusetts (59.8 % LGBQ; 69.9 % White; 70.1 % cisgender female), we found substantial variation among GSAs and youth in levels of socializing and advocacy. GSAs were more distinct from one another on advocacy than socializing. Using multilevel modeling, we identified group and individual factors accounting for this variability. In the socializing model, youth and GSAs that did more socializing activities did more advocacy. In the advocacy model, youth who were more actively engaged in the GSA as well as GSAs whose youth collectively perceived greater school hostility and reported greater social justice efficacy did more advocacy. Findings suggest potential reasons why GSAs vary in how they function in ways ranging from internal provisions of support, to visibility raising, to collective social change. The findings are further relevant for settings supporting youth from other marginalized backgrounds and that include advocacy in their mission.     

Together Helping Reduce Youth Violence for Equity (ThrYve): Examining the Development of a Comprehensive Multisectoral Approach to Youth Violence Prevention

Comprehensive approaches to youth violence prevention are needed to simultaneously address multiple risk factors across socioecological levels. ThrYve (Together Helping Reduce Youth Violence for Equity) is a collaborative initiative focused on addressing broader factors influencing youth violence, including social determinants of health. Using a participatory approach, the development of ThrYve is examined through an empirical case study. Through a Systems Advisory Board (SAB), ThrYve deploys multiple strategies that support cross-sector collaboration involving over 40 partners across 13 community sectors. Based on the Institute of Medicine’s model for public health action in communities, the SAB identified 87 change levers (i.e., program, policy, practice changes) to support community and systems-level improvements. As a result of the collaborative process, in the first couple of years, ThrYve facilitated 85 community actions and changes across sectors. The changes aligned with identified risk and resilience needs of the youth served in the community. The findings further support prior research, which suggests disparities related to gender may influence risk and resilience factors for youth violence. The study also indicates the importance of continuing to examine academic performance as a factor related to youth resilience.     

The Role of Familial Incarceration and Ethnic Identity in Suicidal Ideation and Suicide Attempt: Findings from a Longitudinal Study of Latinx Young Adults in California

Suicide is a leading cause of death among young adults; however, contextual risks and cultural factors are rarely studied in the context of ethnic minority suicidal ideation (SI) and suicidal attempt (SA). This study assessed the association between familial incarceration and suicide behaviors and examined ethnic identity as a potential moderator. Data from a longitudinal study of health among Hispanics (n = 1,094) in California were used to test associations between familial incarceration, ethnic identity, and SA and SI, adjusting for demographic factors and covariates. Approximately 18% and 8% of respondents reported SI and SA, respectively. Compared to no incarceration, or the incarceration of a relative, parental incarceration was associated with higher odds (AOR: 2.09, 95% CI: 1.23–3.34) of SI whereas higher affective ethnic identity reduced the odds (AOR: 0.52, 95% CI: 0.31–0.89) of SA. Ethnic identity moderated the association between parental incarceration and SI (AOR: 0.33, 95% CI: 0.13–0.79). Incarceration of a family member can set the stage for exclusion from critical institutions and can have long‐term consequences for adult mental health. Promoting a positive ethnic identity may be a promising prevention strategy that could bolster resilience among at‐risk, urban minority youth.     

Uplifting the Family: African American Parents’ Ideas of How to Integrate Religion into Family Health Programming

Religion has been reported as a strong cultural-historical and protective factor in the African American community, particularly for African American youth regarding risky behavior prevention. Despite the historical and scholarly evidence of its utility, the opportunities for using religion and the Black Church in supporting the mental, emotional, and physical health of Black youth have not been fulfilled. Furthermore, partnering with the community to conduct research and program development increases the likelihood of use and success. The purpose of this study was to partner with the community and learn and conceptualize how to integrate or use religion in a family health program. Seven focus groups were conducted with African American parents/guardians regarding how a family health program could use religion to enhance the mental and physical wellbeing of Black families. A community sample of parents and guardians conveyed religious/spiritual values that a program should adopt and teach to participants (particularly parents) and ways that a program could use religion and the Black Church to function and succeed. These values include respect, love, prayer, fellowship/community, physical health, Scripture, faith, and empathy/understanding. Participants further provided specifics regarding how such programming might be implemented and offered real world implications for the development of religious family health planning. Parents/guardians indicated that religious values and methods should be used together to bolster family health, prevent risky behavior in youth, and support community functioning.     

The Relationship Between Cumulative Risk and Promotive Factors and Violent Behavior Among Urban Adolescents

Resiliency theory posits that some youth exposed to risk factors do not develop negative behaviors due to the influence of promotive factors. This study examines the effects of cumulative risk and promotive factors on adolescent violent behavior and tests two models of resilience—the compensatory model and the protective model—in a sample of adolescent patients (14–18 years old; n = 726) presenting to an urban emergency department who report violent behavior. Cumulative measures of risk and promotive factors consist of individual characteristics and peer, family, and community influences. Hierarchical multiple regression was used to test the two models of resilience (using cumulative measures of risk and promotive factors) for violent behavior within a sample of youth reporting violent behavior. Higher cumulative risk was associated with higher levels of violent behavior. Higher levels of promotive factors were associated with lower levels of violent behavior and moderated the association between risk and violent behaviors. Our results support the risk-protective model of resiliency and suggest that promotive factors can help reduce the burden of cumulative risk for youth violence.     

Assessment of awareness of connectedness as a culturally-based protective factor for Alaska native youth

Research with Native Americans has identified connectedness as a culturally based protective factor against substance abuse and suicide. Connectedness refers to the interrelated welfare of the individual, one's family, one's community, and the natural environment. We developed an 18-item quantitative assessment of awareness of connectedness and tested it with 284 Alaska Native youth. Evaluation with confirmatory factor analysis and item response theory identified a 12-item subset that functions satisfactorily in a second-order four-factor model. The proposed Awareness of Connectedness Scale (ACS) displays good convergent and discriminant validity, and correlates positively with hypothesized protective factors such as reasons for living and communal mastery. The measure has utility in the study of culture-specific protective factors and as an outcomes measure for behavioral health programs with Native American youth.