Faculty Bibliography

BACKGROUND: Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. METHODS/DESIGN: The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. DISCUSSION: The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings. TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.

A large theoretical and empirical literature documents the central role of familismo (i.e., a strong emphasis on family) in the functioning of Latino youth. Few studies, however, have examined its association with early childhood functioning. The present study explored the potential risk and protective effects of maternal familismo on the adaptive and mental health functioning of 4 - 5 year old Latino children. A sample of 205 Mexican and 147 Dominican immigrant families was recruited from New York City. Mothers reported on their level of familismo, and acculturative status. Mothers and teachers rated child adaptive behavior and internalizing and externalizing problems. Findings suggest that maternal familismo is not uniformly associated with positive or negative early developmental outcomes but that its effects are moderated by child gender, family poverty and cultural (e.g., maternal ethnic and US American identity) characteristics. In addition, different mechanisms were identified for each ethnic group. Familismo was associated both positively (for boys) and negatively (for poor children) with adaptive behavior in the Mexican American sample. In the Dominican American sample, familismo showed a wide range of positive, albeit moderated, effects. Prevention efforts that help parents critically evaluate the impact of familismo on family processes, and preserve those manifestations of familismo that are protective, may best promote Latino child well-being.

Asian American (ASA) children experience high rates of mental health problems. Although there is a pressing need to utilize population approaches, emerging frameworks from the fields of public and population health have not been applied to ASA children. This paper addresses this gap by first discussing applications of the National Prevention Strategy (NPS), a population strategy developed from the Social Determinants of Health perspective, to guide ASA prevention work. Next, we provide a practical example to illustrate how the NPS can be applied to prevention program design (using ParentCorps as an example) and dissemination and implementation processes to broadly address ASA children's mental health needs. Finally, we present preliminary data on the feasibility of applying this population strategy to ASA families and a framework for researchers who are considering disseminating and implementing evidence-based programs to ASA or ethnic minority pediatric populations.

Given the disproportionately high rates of obesity-related morbidity among low-income, ethnic minority youth, obesity prevention in this population is critical. Prior efforts to curb childhood obesity have had limited public health impact. The present study evaluates an innovative approach to obesity prevention by promoting foundational parenting and child behavioral regulation. This pre-post intervention study evaluated an enhanced version of ParentCorps with 91 families of pre-Kindergarten students in low-income, urban communities. Assessments included tests of knowledge and parent report. Consistent with findings from two randomized controlled trials of ParentCorps, parent knowledge and use of foundational parenting practices increased and child behavior problems decreased. Child nutrition knowledge and physical activity increased and television watching decreased; for boys, sleep problems decreased. Comparable benefits occurred for children at high risk for obesity based on child dysregulation, child overweight, and parent overweight. Results support a "whole child," family-centered approach to health promotion in early childhood.

Parent training has great potential to alter the developmental trajectories of young Latino children with or at risk for behavior problems. However, traditional parent training programs may seem culturally irrelevant or inappropriate to Latino parents as they promote practices that are based on white, middle class standards. The current study of treatment acceptability used focus group and key informant interviewing methodology to investigate Latina mothers' views on the causes of young children's misbehavior and the acceptability of evidence-based parenting strategies. The sample consisted of Spanish- and English-speaking Latina mothers of 3- to 6-year-olds recruited from day-care centers and preschools in New York City. Focus groups were conducted with 34 mothers, and key informant interviews with 5 mothers whose children had behavior problems. Results showed that the most commonly viewed causes of child misbehavior were child temperament, fighting in the home, and negative peer influence. Mothers found some evidence-based parenting strategies acceptable (e.g., the use of praise, social rewards) and others objectionable (e.g., selective ignoring in pubic situations, the elimination of spanking). For some strategies, there was little consensus on its acceptability (e.g., time-out). Taken together, results highlight the critical need for aligning parent and clinician goals at the outset of treatment, and of including a strong psychoeducational component in parent training programs because not all of its components are consistent with Latino cultural norms and beliefs. 2012

OBJECTIVE:To evaluate the impact of an early childhood, family-centered, school-based intervention on children's kindergarten academic achievement.METHODS:This was a cluster (school) randomized controlled trial with assessments from pre-kindergarten (pre-k) entry through the end of kindergarten. The setting was 10 public elementary schools with 26 pre-k classes in 2 school districts in urban disadvantaged neighborhoods serving a largely black, low-income population. Participants were 1050 black and Latino, low-income children (age 4; 88% of pre-k population) enrolled in 10 schools over 4 years. Universal intervention aimed to promote self-regulation and early learning by strengthening positive behavior support and effective behavior management at home and school, and increasing parent involvement in education. Intervention included after-school group sessions for families of pre-k students (13 2-hour sessions; co-led by pre-k teachers) and professional development for pre-k and kindergarten teachers. The outcome measures were standardized test scores of kindergarten reading, writing, and math achievement by independent evaluators masked to intervention condition (primary outcome); developmental trajectories of teacher-rated academic performance from pre-k through kindergarten (secondary outcome).RESULTS:Relative to children in control schools, children in intervention schools had higher kindergarten achievement test scores (Cohen's d = 0.18, mean difference = 2.64, SE = 0.90, P = .03) and higher teacher-rated academic performance (Cohen's d = 0.25, mean difference = 5.65, SE = 2.34, P = .01).CONCLUSIONS:Early childhood population-level intervention that enhances both home and school environments shows promise to advance academic achievement among minority children from disadvantaged, urban neighborhoods.

Limited socioeconomic family and neighborhood resources are known to influence multiple aspects of school readiness skills. Early parent involvement in education is hypothesized to attenuate risk for academic underachievement related to socioeconomic disadvantage. The current study used multilevel modeling to test whether parent involvement moderates the effects of family and neighborhood level socioeconomic resources on school readiness among a sample of 171 urban 4-year-olds. Parent involvement moderated the effect of family and neighborhood socioeconomic resources on the social-emotional-behavioral components of school readiness. Increased parent involvement in education was related to lower rates of behavior problems among children of single parents and among children from neighborhoods with higher levels of childcare burden. In contrast, parent involvement did not moderate the relation between socioeconomic risk and cognitive-academic components of school readiness skills

Anxiety is one of the most prevalent mental health problems in young children but there has been a dearth of studies focusing on Asian American children. This study examines the patterns and the predictors of childhood anxiety and related symptoms in young children in a diverse Asian American (ASA) sample (n = 101). Findings indicate that ASA children are at higher risk for anxiety, somatization, and depressive problems than their peers. Parents' level of acculturation (i.e., American identity, English competence), parental negative emotion socialization, conflicted parent-child relationship, child emotional knowledge and adaptive skills, as well as teachers' ethnic background and school class types were all associated with ASA children's anxiety. A combination of cultural, family, and school factors explained from 17 to 39 % of the variance in anxiety symptoms. Findings inform prevention services for young ASA children.

This study examined the mental health and academic functioning of 442 4- and 5-year old children of Mexican (MA) and Dominican (DA) immigrant mothers using a cultural framework of Latino parenting. Data were collected on mothers' self-reported acculturative status, parenting practices and cultural socialization, and on children's behavioral functioning (mother- and teacher-report) and school readiness (child test). Results provide partial support for the validity of the framework in which mothers' acculturative status and socialization of respeto (a Latino cultural value of respect) and independence (a U.S. American cultural value) predict parenting practices. For both groups, English language competence was related to less socialization of respeto, and other domains of acculturative status (i.e., U.S. American/ethnic identity, and U.S. American/ethnic cultural competence) were related to more socialization of respeto and independence. Socialization of respeto was related to the use of authoritarian practices and socialization of independence was related to the use of authoritative practices. Socialization of respeto was also related to lower school readiness for DA children, whereas socialization of independence was related to higher school readiness for MA children. Independence was also related to higher teacher-rated externalizing problems for MA children. For both groups, authoritarian parenting was associated with more parent-reported internalizing and externalizing problems. The discussion focuses on ethnic subgroup differences and similarities to further understanding of Latino parenting from a cultural perspective. (PsycINFO Database Record (c) 2012 APA, all rights reserved).