Cultural Values,Counseling Stigma,and Intentions to Seek Counseling Among Asian American College Women

The authors explored the extent to which Asian American college women's perceived stigma about counseling mediated the relationship between their adherence to Asian cultural values and intentions to seek counseling. Participants, 201 Asian American college women (age range = 18–24 years), completed measures of Asian cultural values, perceived stigma regarding counseling, and intentions to seek counseling, along with a demographic questionnaire. Asian cultural values were positively correlated with perceived counseling stigma; both Asian cultural values and social stigma were negatively correlated with intentions to seek counseling. The main analysis showed that perceived counseling stigma partially mediated the relationship between participants' Asian cultural values and intentions to seek counseling.     

Relation of Family Problems to Patterns of Delinquent Involvement Among Urban Youth

The relation of patterns of family problems and patterns of delinquent behavior over time was evaluated among a sample of inner-city minority adolescent males. Empirically derived groups were identified and included: nonoffenders, chronic minor offenders, escalators, and serious chronic offenders. Patterns of family problems were also identified and differentially related to delinquency groups. Members of the group involved in serious chronic offending were more likely to have families characterized by multiple problems including disruption, conflict, and lack of parental involvement, sometimes so extreme as to meet the legal requirement of neglect. They were also more likely to have families characterized by deviant behavior and attitudes. The finding of specific relations between types of family problems and patterns of delinquent behavior has important implications for intervention and prevention. Rather than assuming a general relation between family functioning and delinquent involvement, specific aspects of family functioning may need to be targeted to affect different patterns of delinquent involvement.     

Family Violence and Health Among Elderly in Croatia

This article presents the research carried out on a sample of 303 elderly men and women. In the last year they reported experiencing violence in the family as follows: psychological abuse (24.1%), financial exploitation (6.4%), physical abuse (4.4%), and sexual abuse (2.1%). The abusers were most often husbands (30.15%), sons (16.64%), daughters (14.01%), and wives (9.21%). In the partner relationship, 44%?of the women and 35%?of the men had experienced at least some form of violence. The results showed that elderly men and women who were victims of family abuse had poorer psychological health than those without such experiences. Elderly who had experienced partner violence consumed alcohol more often than those who had experienced violence by other household members.     

Stress,Coping, and Mental Health Among Rural,Village, and Urban Women in Tunisia

The present study investigated stressors, coping strategies, and mental health among 45 Tunisian women living in 3 distinct environments within Tunisia: a rural Bedouin community, a mid-size village, and the capital city of Tunis. Individual interviews were conducted with each woman via a semi-structured questionnaire, which allowed for the collection of qualitative as well as quantitative information. Statistical analyses indicated no significant differences between the middle-class village and urban women on stressor levels, number of coping strategies used, or levels of psychological distress. However, the rural group of Bedouin women reported significantly greater stressor levels and numbers of depressive symptoms than the village and/or urban women. The qualitative information confirmed the greater stress of the rural environment, largely due to extreme poverty. The results suggest that rapid social changes in Tunisia since independence have improved the lives of middle-class women in the villages and cities, but have had very little impact on the situations of rural Bedouin women.     

Postnatal Depression and Infant Health Practices Among High-Risk Women

Women’s postnatal depressive symptoms have been associated with many adverse outcomes for children. The current study examined the frequency association with relative risk between postnatal depressive symptoms and mothers’ use of preventative infant health practices. The study used the Edinburgh Postnatal Depression Scale (EPDS) and Parental Health and Depression Questionnaire (PHDQ) to identify women’s depressive symptoms in a prospective longitudinal sample of 134 high-risk non-white mothers receiving well-baby health services. Unadjusted frequency comparisons examined the effect of women’s postnatal depressive symptoms on infant outcomes. Results found that compared to 60 women without postnatal depressive symptoms, 74 women with symptoms engaged in significantly fewer well-child health-visits, were less likely to use home safety devices or place their infants in the preferred back-to-sleep position, and did not complete immunizations. Depressed women were also more likely to lack knowledge of nurturing and sensitive parenting, use corporal punishment and inappropriate foods, and to show poor parenting practices. These findings provide additional supportive evidence that more efforts are needed to identify and assess women’s depressive symptoms to promote health and safety of young children. Methodological limitations and recommendations for future research are addressed.     

Parenting Competency Across Pregnancy and Postpartum Among Urban Minority Women

Taking a life-course perspective, we explored the sense of parenting efficacy during the pregnancy-postpartum transition among a group under-represented in much of adult developmental research, minority women. Our intent was to describe the women's report of parenting competency in a major life transition occurring within the context of an impoverished urban environment. We also explored associations with depression, social support, and life events. One hundred and eighty-two African-American and Hispanic mothers at community health centers in low-income urban areas completed measures early in the third trimester and again at 3 months postpartum. Across time, the levels of reported parental efficacy and satisfaction increased while depressive symptoms decreased. Negative life events and levels of depressive symptomatology differentially influenced women's experience of parenting satisfaction and efficacy feelings before and after their babies were born.     

Family Support and Mental Health Service Use Among Suicidal Adolescents

Despite the fact that multiple evidence-based treatments exist for suicidal adolescents, these youth are unlikely to engage in mental health treatment. While family members can be influential in connecting adolescents to mental health care, suicidal youth are more likely to be exposed to family environments characterized by abuse, neglect, and to have poorer parent–child attachment quality than non-suicidal youth. This study analyzed data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the relationships between perceived levels of parental support, symptom severity, and mental health service use in a nationally representative sample of suicidal adolescents in the U.S. (n = 1804). Higher levels of parental support were associated with a lower likelihood of mental health service use, lower levels of depression, and lower likelihood of an actual suicide attempt. Additionally, the presence of a suicide attempt and higher levels of depression were associated with a higher likelihood of mental health service use. When mediation effects were tested, the presence of a suicide attempt partially mediated the relationship between parental support and mental health service use. Implications discussed include the protective nature of parental support the need for more family-based interventions for this population.     

Review and Comparison of Electronic Patient-Facing Family Health History Tools

Family health history (FHx) is one of the most important pieces of information available to help genetic counselors and other clinicians identify risk and prevent disease. Unfortunately, the collection of FHx from patients is often too time consuming to be done during a clinical visit. Fortunately, there are many electronic FHx tools designed to help patients gather and organize their own FHx information prior to a clinic visit. We conducted a review and analysis of electronic FHx tools to better understand what tools are available, to compare and contrast to each other, to highlight features of various tools, and to provide a foundation for future evaluation and comparisons across FHx tools. Through our analysis, we included and abstracted 17 patient-facing electronic FHx tools and explored these tools around four axes: organization information, family history collection and display, clinical data collected, and clinical workflow integration. We found a large number of differences among FHx tools, with no two the same. This paper provides a useful review for health care providers, researchers, and patient advocates interested in understanding the differences among the available patient-facing electronic FHx tools.     

Eating Disorders Among Urban and Rural African American and European American Women

Abstract

It is alleged that eating disorders are nonexistent in African American women and that eating disorder symptomatology occurs predominantly among White middle class women (Kumanyika, Wilson, & Guilford-Davenport, 1993; Smolak & Striegel-Moore, 2001). This research attempted to identify differences in eating disorder symptomatology in African American and White American women. An eating disorder is a disability because it can damage the person physically, emotionally and socially. It can be undetected for years and society may reinforce the hidden disorder by being complimentary regarding the thin appearance of the person. The Eating Disorder Inventory (EDI) was used to measure psychological traits and symptom clusters associated with the understanding and treatment of eating disorders (Garner, 1990). Measures of self-esteem, depression and coping were also examined. Findings indicated differences between African American and White women on the Ineffectiveness scale of the EDI, differences between the urban/rural women on Ineffectiveness and Perfectionism, and differences in coping strategies and education among this sample group of women. Successful treatment usually involves psychotherapy and/or medication for depression.     

Job Pressures, Organizational Support, and Health Among Norwegian Women Managers

Questionnaire data were collected from 191 professional and managerial women in Norway. Measures included demographic and work characteristics, job pressures (hours worked, level of management, work-family conflict), organizational supports (acceptance, support, training and development, challenging and visible jobs), and health indicators (life satisfaction, psychosomatic complaints, emotional exhaustion). Emotional exhaustion and psychosomatic complaints were combined into a stress index. Results indicated that women who experienced high role conflict and work-family pressures also reported poor health outcomes and little life satisfaction. Organizational initiatives to support and develop women's careers were associated with lower exhaustion and psychosomatic symptomatology and more life satisfaction. While the relationship between women's employment and physical and psychological well-being is not clear-cut, there is perhaps a need for organizations to focus on initiatives that will allow diversity in the choices women make with regard to involvement in careers and family, as well as a need to find ways to support and encourage such diversity. Not only may this have a beneficial effect on women workers' health and energy to use at work, but it may also make way for alternative career paths into top management positions for professional women.     

The Relationship Between Family Stress and Behavioral Health Among African American Adolescents

African American youth, especially those who live in low-income communities, are at increased risk for experiencing higher juvenile justice involvement, poorer mental health, low school engagement, higher illicit drug use, and STIs, relative to their higher income peers and those from other ethnic backgrounds. However, few studies have examined the relationship between family stressors and these multiple youth concerns. This study examines the relationship between family stress (i.e., having an adult in the home with a history of mental illness, substance use, and incarceration) and youth concerns such as substance use, mental health challenges, low school engagement, juvenile justice involvement, and STI risk behaviors. A total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on the above constructs. Logistic regressions controlling for age, gender, socioeconomic status, and sexual orientation indicated that adolescents who reported higher rates of family stress were significantly more likely to report mental health problems, delinquent behaviors, juvenile justice involvement, drug use, risky sex, and lower school engagement factors. Findings suggest that attending to the developmental concerns of youth also requires addressing the needs of the family unit.     

Poverty and Depressed Mood Among Urban African-American Adolescents: A Family Stress Perspective

We examined the role of family stress as a mediator of the relationship between poverty and depressed mood among 1,704 low-income, inner-city African- American adolescents. Nearly half of participants (47%) reported clinically significant levels of depressive symptoms. Being female, reporting higher levels of family stress, and scoring higher on a poverty index were significantly associated with increased reports of depressed mood. Family stress significantly mediated the relationship between poverty and adolescent depressed mood, explaining 50% of the total effect. Sex-specific analyses revealed that this relationship only held for females, and there was no direct relationship between poverty and depressed mood for males. Results lend further support to family stress theory, although they suggest that the model may be more relevant for females than males. Implications for community-based preventive intervention and social policy are discussed.     

Cancer Genetics Service Interest in Women with a Limited Family History of Breast Cancer

Women with a limited family history of breast cancer may be interested in cancer genetics information although their objective risk of breast cancer may not indicate routine referral to cancer genetics services. This study examined factors related to interest and use of cancer genetics services in a community sample of women with a limited family history of breast cancer (N = 187) who had no previous contact with cancer genetics services. Participants provided demographic information and ratings of perceived risk, cancer distress, attitudes, and intentions to initiate cancer genetics services. Participants were given information about a cancer genetics clinic that served women having concerns about their breast cancer risk. Women were contacted within 6 weeks and 8 months following their study appointment. Six weeks following their study appointment, 25% of women had initiated cancer genetics services. Eight months following their study appointment, 18% of women reported having completed a cancer genetics service appointment. Baseline intentions independently predicted both initiation at 6 weeks and appointment at 8 months. Cancer distress was positively associated with cancer genetics service initiation and appointment. Results suggest that some women with a limited family history of breast cancer are interested in seeking out cancer genetics information. Women with a limited family history of breast cancer may benefit from the availability of cancer genetics information provided through primary healthcare settings.     

Representations of Mental Health Among Middle‐Aged Urban Chinese Men

Little is understood by the ideas that urban Chinese population holds about mental health. Insufficient research and recognition of mental illnesses, and a dearth of social resources for mental health support and promotion limit understandings of how daily life stresses restrict the quality of life of China's urban population. Drawing on in‐depth interviews with 15 middle‐age urban men, we map out men's accounts of how they battle to cope with the demands of everyday social, political, and familial pressures. The study reveals that the representations of mental health are shaped by notions of control over emotions, adherence to Confucian philosophy, familial obligations, and the need to demonstrate social obedience and conformity. Data also suggest that the participants represent stable family support along with healthy social interactions as important enabling factors of positive mental health, whereas pressures of modernity are regarded as significant disruptive factors in mental health. The theory of social representations guides the process as well as analytic interpretations of this research. Copyright © 2015 John Wiley & Sons, Ltd.     

Impact of Genetic Counseling in Women with a Family History of Breast Cancer in Italy

As the impact of breast cancer (BC) risk assessment in asymptomatic women with a family history of BC had never been explored in Italy, we performed a study on a retrospective series of women who had undergone BC risk assessment. To this aim, a semi-structured telephone interview was administered to 82 women. Most participants considered the information received as clear (96.2 %) and helpful (76.8 %). Thirty-eight (46.3 %) stated that their perceived risk of BC had changed after the counseling: for 40.2 % it had decreased, for 6.1 % increased; however, women highly overestimating their risk at the baseline (≥4-fold) failed to show improvements in risk perception accuracy. Sixty-six women (80.5 %) stated they had followed the recommended surveillance, while 19.5 % had not, mainly due to difficulties in arranging examinations. Most women (89.0 %) had shared the information with their relatives, with 57.3 % reporting other family members had undertaken the recommended surveillance. BC risk assessment was associated with high rates of satisfaction and had a favorable impact on risk perception in a subgroup of women. The impact on surveillance adhesion extended to relatives. Organized programs for identification and surveillance may help identify a larger fraction of at-risk women and overcome the reported difficulties in arranging surveillance.     

Investigation of the Use of a Family Health History Application in Genetic Counseling

The paper-based pedigree is the current standard for family health history (FHH) documentation in genetic counseling. Several tools for electronic capture of family health data have been developed to improve re-use and accessibility, data quality and standardization, ease of updating, and integration with electronic medical records. One such tool, the tablet-based Proband application, provides a flexible approach to data capture in dynamic and diverse clinical settings. This study compared Proband FHH collection to paper-based methods and investigated the usability of Proband in a clinical setting. After one use by 23 genetic counselors and students, Proband had 91% accuracy with a FHH audio scenario, which was significantly less (p?<?0.001) than paper’s 96% accuracy. These differences were attributed to incorrect or missing ages of grandparents (p?<?0.001) and great-aunts/uncles (p?=?0.012) and missing documentation of consanguinity (p?<?0.001). Possible explanations for these differences include greater experience with paper FHH documentation and pre-populated prompts for consanguinity on the paper template used. Proband’s perceived usability increased with use, with individual System Usability Scores increasing between first and last use (p?=?0.033). We conclude that tools for dynamic, provider-driven FHH documentation such as Proband show promise for improving risk assessment accuracy and quality patient care.