Reaching Latino Families Through Pediatric Primary Care: Outcomes of the CANNE Parent Training Program

The lack of culturally adapted parenting programs for Latinos contributes to low engagement in effective parenting programs. Criando a Nuestros Niños Hacio el Éxito (CANNE), a culturally adapted program, improves family dynamics by decreasing problematic child behavior and helping parents manage stress. CANNE was delivered with 12 Latino parents of children (age 3–7). Increased attendance and participation resulted in less child behavior problems and parenting stress from preintervention to postintervention. A culturally relevant adaptation of an evidence-based parenting program improved engagement, child behavioral outcomes, and parenting stress. Implications of mental health services in primary care facilities for Latino families are addressed.     

Alcohol Counseling in Hospital Trauma: Examining Two Brief Interventions

Hospital trauma centers intervene with patients who incur alcohol‐related injuries. This prospective study, using professional counselors and trainees, investigated brief counseling interventions (BCIs). Participants were randomized to either a conventional BCI examining quantity and frequency of drinks or a personalized BCI exploring overintoxication. No statistically significant difference between risky drinkers randomized to either intervention in a hospital trauma center was observed. Findings indicate that a personalized BCI may be an alternative to a quantitative BCI in reducing risky alcohol consumption.     

Comparing the Social Images of Youth In and Out of Residential Care

The literature indicates that youths in residential care have been associated with negative social images. However, there have been few studies focused on these social images, specifically, comparing them with the images of youths in normative contexts. To address this issue, we conducted two studies comparing the social images people have about youths in residential care to those they hold about youths living out of care. Both studies were conducted in Portugal: Study 1 explores these images through an open‐ended questionnaire; Study 2 examines these images with a quantitative instrument. Overall, the results indicate that the perception about youths in residential care was more negative than the perception about youths out of care. Additionally, the first study probed the effect of socioeconomic status of the youths on the social images held about them and the second examined the role of the respondents' professional contact with youth in care population on these social images. The implications of the social images people have about youth in residential care for the research and intervention towards the wellbeing of this population are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

Childhood self-regulatory skills predict adolescent smoking behavior

Cigarette smoking is the primary preventable cause of premature death. Better self-regulatory capacity is a key psychosocial factor that has been linked with reduced likelihood of tobacco use. Studies point to the importance of multiple forms of self-regulation, in the domains of emotion, attention, behavior, and social regulation, although no work has evaluated all of these domains in a single prospective study. Considering those four self-regulation domains separately and in combination, this study prospectively investigated whether greater self-regulation in childhood is associated with reduced likelihood of either trying cigarettes or becoming a regular smoker. Hypotheses were tested using longitudinal data from a cohort of 1709 US children participating in the Panel Study of Income Dynamics – Child Development Supplement. Self-regulation was assessed at study baseline when children ranged in age from 6 to 14 years, using parent-reported measures derived from the Behavior Problems Index and Positive Behavior Scale. Children ages 12–19 self-reported their cigarette smoking, defined in two ways: (1) trying and (2) regular use. Separate multiple logistic regression models were used to evaluate odds of trying or regularly using cigarettes, taking account of various potential confounders. Over an average of five years of follow-up, 34.5% of children ever tried cigarettes and 10.6% smoked regularly. Higher behavioral self-regulation was the only domain associated with reduced odds of trying cigarettes (odds ratio (OR) = .85, 95% confidence interval (CI) = .73–.99). Effective regulation in each of the domains was associated with reduced likelihood of regular smoking, although the association with social regulation was not statistically significant (ORs range .70–.85). For each additional domain in which a child was able to regulate successfully, the odds of becoming a regular smoker dropped by 18% (95% CI = .70–.97). These findings suggest that effective childhood self-regulatory skills across multiple domains may reduce future health risk behaviors.     

A comparison of the diagnostic accuracy of the AD8 and BCAT-SF in identifying dementia and mild cognitive impairment in long-term care residents

We compared the accuracy of the Brief Cognitive Assessment Tool—Short Form (BCAT-SF) and AD8 in identifying mild cognitive impairment (MCI) and dementia among long-term care residents. Psychometric analyses of 357 long-term care residents (n = 228, nursing home; n = 129, assisted living) in Maryland referred for neuropsychological evaluation evidenced robust internal consistency reliability and construct validity for the BCAT-SF. Furthermore, hierarchical logistic regression and receiver operating characteristic curve analyses demonstrated superior predictive validity for the BCAT-SF in identifying MCI and dementia relative to the AD8. In contrast, previously reported psychometric properties or cut scores for the AD8 could not be cross-validated in this long-term care sample. Based on these findings, the BCAT-SF appears to be a more reliable and valid screening instrument than the AD8 for rapidly identifying MCI and dementia in long-term care residents.     

Investigating Occupational Stress,Racial Identity,and Mentoring for African American Women in Health Care

This study examined the influence of racial identity and mentoring experiences on occupational stress among African American women in health care (N = 76). The women were surveyed about their occupational stress (role stress, psychological strain, and personal resources), racial identity, demographic information, and mentoring experiences. Results indicated that racial identity was negatively related to role stress and psychological strain, and level of education was closely related to personal resources. Mentoring was not found to have a significant impact on occupational stress as hypothesized. The implications for enhancing occupational satisfaction were discussed in relation to advocacy for career development professionals.     

The Relation of Exposure to Traumatic Events and Longitudinal Mental Health Outcomes for Children Enrolled in Systems of Care: Results from a National System of Care Evaluation

This study examined the relation between children's history of exposure to potentially traumatic events (PTEs) and clinical and functional mental health trajectories over a 18‐month period among a national sample of youth referred for services in children's behavioral health systems of care (SOCs). Using data from the national evaluation of the Comprehensive Community Mental Health Services program for communities funded from 1997 to 2000, the study sample included 9556 children and their families. Latent growth modeling was used to assess the effect of history of exposure to PTEs on trajectories in a number of behavioral health outcomes during the 3‐year period following referral to services, controlling for child demographic characteristics (gender, race, and age). Results revealed that, on average, children in SOCs exhibited significant improvements over time on all four outcome measures. Children with a history of exposure to PTEs had higher rates of internalizing and externalizing problem behaviors and functional impairments and fewer behavioral and emotional strengths at baseline, but experienced improvements in these outcomes at the same rates as children without exposure to a traumatic event. Finally, child race, gender, and age also were associated with differences in behavioral health trajectories among service recipients. Implications for SOCs, including approaches to make them more trauma‐informed, are discussed.     

Companion Animals and Vulnerable Youth: Promoting Engagement between Youth and Professional Service Providers

Vulnerable youth have fewer social ties as a result of inadequate housing and a lack of social support. It is well established that many of these youth tend to underutilize mental health, medical, and social services. Among marginalized and stigmatized populations, the affirming and nonjudgmental presence of companion animals appears to be important for developing collaborative relationships between youth and professional service providers. This paper reviews literature on the benefits of companion animals for assisting providers in their attempts to help youth find a stable living environment. Recommendations are made for providers considering incorporating therapy animals into their existing services.     

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.