Faculty Bibliography

Importance: Low-income minority children living in urban neighborhoods are at high risk for mental health problems and underachievement. ParentCorps, a family-centered, school-based intervention in prekindergarten, improves parenting and school readiness (ie, self-regulation and preacademic skills) in 2 randomized clinical trials. The longer-term effect on child mental health and academic performance is not known. Objective: To examine whether ParentCorps delivered as an enhancement to prekindergarten programs in high-poverty urban schools leads to fewer mental health problems and increased academic performance in the early elementary school years. Design, Setting, and Participants: This is a 3-year follow-up study of a cluster randomized clinical trial of ParentCorps in public schools with prekindergarten programs in New York City. Ten elementary schools serving a primarily low-income, black student population were randomized in 2005, and 4 consecutive cohorts of prekindergarten students were enrolled from September 12, 2005, through December 31, 2008. We report follow-up for the 3 cohorts enrolled after the initial year of implementation. Data analysis was performed from September 1, 2014, to December 31, 2015. Interventions: ParentCorps included professional development for prekindergarten and kindergarten teachers and a program for parents and prekindergarten students (13 two-hour group sessions delivered after school by teachers and mental health professionals). Main Outcomes and Measures: Annual teacher ratings of mental health problems and academic performance and standardized tests of academic achievement in kindergarten and second grade by testers masked to the intervention or control group randomization. Results: A total of 1050 children (4 years old; 518 boys [49.3%] and 532 girls [50.7%]) in 99 prekindergarten classrooms participated in the trial (88.1% of the prekindergarten population), with 792 students enrolled from 2006 to 2008. Most families in the follow-up study (421 [69.6%]) were low income; 680 (85.9%) identified as non-Latino black, 78 (9.8%) as Latino, and 34 (4.3%) as other. Relative to their peers in prekindergarten programs, children in ParentCorps-enhanced prekindergarten programs had lower levels of mental health problems (Cohen d = 0.44; 95% CI, 0.08-0.81) and higher teacher-rated academic performance (Cohen d = 0.21; 95% CI, 0.02-0.39) in second grade. Conclusions and Relevance: Intervention in prekindergarten led to better mental health and academic performance 3 years later. Family-centered early intervention has the potential to prevent problems and reduce disparities for low-income minority children. Trial Registration: clinicaltrials.gov Identifier: NCT01670227.

Asian Americans have lower levels of physical activity (PA) compared to other racial/ethnic groups; however, there is little understanding of the social and cultural determinants of PA in this population. Few analyses describe specific PA domains (occupation-, transportation-, recreation-related), focus on one Asian subgroup, or use validated scales. The study objective was to assess the association between acculturation and activity behaviors (meeting 2008 PA guidelines, activity minutes by PA domain, sitting time) in a cross-sectional sample of urban-dwelling, Chinese American immigrants. Data were from the Chinese American Cardiovascular Health Assessment (CHA CHA) 2010-11 among participants with valid reports of PA minutes, assessed by the WHO Global Physical Activity Questionnaire (n = 1772). Acculturation was assessed using the Stephenson Multigroup Acculturation Scale, a 32-item instrument which characterizes two acculturative dimensions: ethnic society (Chinese) immersion and dominant society (American) immersion (maximum possible scores = 4). Multivariable models regressing activity behaviors on acculturation were run, adjusting for age, sex, household income, education, and age at immigration. Ethnic society immersion was high (mean = 3.64) while dominant society immersion was moderate (mean = 2.23). Higher ethnic society immersion was associated with less recreation-related PA (- 40.7 min/week); higher dominant society immersion was associated with a higher odds of meeting PA guidelines (OR: 1.66 (1.25, 2.20), p < 0.001) and more recreation-related PA (+ 36.5 min/week). Given low PA levels in Chinese adults in China, results suggest that PA for leisure may increase and become a more normative behavior among Chinese American immigrants with acculturation. Understanding acculturation level may inform strategies to increase PA in Chinese Americans.

Background/UNASSIGNED:children in low-income countries (LICs). Currently, there is little information available on the use of brief screening instruments Increased attention is being paid to identifying and responding to the social-emotional and behavioral needs of in LICs. The lack of psychometrically sound brief assessment tools creates a challenge in determining the population prevalence of child social-emotional and behavioral risk burden in Sub-Saharan African (SSA) country contexts. This study sought to determine the reliability and validity of three brief parent-rated screening tools-the Social Competence Scale (SCS), Pictorial Pediatric Symptom Checklist (PPSC), and the Strengths and Difficulties Questionnaire (SDQ)-in Uganda. These tools consider both strength- and pathology-based dimensions of child outcomes. Methods/UNASSIGNED:Parents of 154 Ugandan 5-9 year-old children who were enrolled in Nursery to Primary 3 in Kampala (the capital city of Uganda) and part of a school-based mental health intervention trial were recruited and interviewed. About 54% of parents had educational attainment of primary school level or less. One hundred and one of these parents were interviewed a second time, about 5 months after the first/baseline assessment. Data from both time points were utilized to assess reliability and validity. Results/UNASSIGNED:Inspection of psychometric properties supports the utility of these three brief screening measures to assess children's social-emotional and behavioral functioning as demonstrated by adequate internal consistency, temporal stability, discriminant validity, concurrent validity, and predictive validity. Subscales from three screening measures were inter-related and associated with family characteristics, such as parental depression and food insecurity, in the expected directions. Conclusion/UNASSIGNED:This study provides evidence supporting the appropriateness of using three tools and applying the developmental and behavioral constructs measured in each assessment in a low-income African setting.

The present longitudinal study examined cultural adaptation (i.e., acculturation and enculturation) and its correlates in a sample of 189 Mexican and Dominican immigrant women. Acculturation and enculturation were measured within the domains of language competence, identity and cultural knowledge at two time points over a one-year period. Across groups and domains, cultural adaptation was generally stable over time; only American cultural knowledge showed change, and only for MA women. Several correlates of cultural adaptation were identified. For Mexican women, living in poverty and in immigrant-dense neighborhoods was associated with lower acculturation. For Dominican women, age at immigration was the most robust correlate and was associated with more acculturation and less enculturation, though poverty and neighborhood characteristics emerged as significant for Dominican women too. Findings are consistent with the notion of cultural adaptation as a complex construct that is influenced by cultural context as well as individual immigrant characteristics.

At least half of the well-documented achievement gap for low-income Black children is already present in kindergarten, due in part to limited opportunities for acquiring foundational skills necessary for school success. There is some evidence that low-income minority children from immigrant families have more positive outcomes than their non-immigrant counterparts, although little is known about how the immigrant paradox may manifest in young children. This study examines foundational school readiness skills (academic and social-emotional learning) at entry into pre-kindergarten (pre-k) and achievement in kindergarten and second grade among Black children from low-income immigrant and non-immigrant families (N = 299). Immigrant and non-immigrant children entered pre-k with comparable readiness scores; in both groups, reading scores decreased significantly from kindergarten to second grade and math scores decreased significantly for non-immigrant children and marginally for immigrant children. Regardless of immigrant status, pre-k school readiness and pre-k classroom quality were associated with elementary school achievement. However, declines in achievement scores were not as steep for immigrant children and several predictive associations were moderated by immigrant status, such that among those with lower pre-k school readiness or in lower quality classrooms, immigrant children had higher achievement test scores than children from non-immigrant families. Findings suggest that immigrant status provides young Black students with some protection against individual- and classroom-level risk factors for early underachievement in elementary school.

Parent involvement is a robust predictor of academic achievement, but little is known about school- and home-based involvement in immigrant families. Drawing on ecological theories, the present study examined contextual characteristics as predictors of parent involvement among Afro-Caribbean and Latino parents of young students in urban public schools. Socioeconomic disadvantage was associated with lower home-based involvement. Several factors were associated with higher involvement, including parents' connection to their culture of origin and to U.S. culture, engagement practices by teachers and parent-teacher ethnic consonance (for Latinos only). Findings have implications for promoting involvement among immigrant families of students in urban schools.

Minority children living in disadvantaged neighborhoods are at high risk for school dropout, delinquency, and poor health, largely due to the negative impact of poverty and stress on parenting and child development. This study evaluated a population-level, family-centered, school-based intervention designed to promote learning, behavior, and health by strengthening parenting, classroom quality, and child self-regulation during early childhood. Ten schools in urban districts serving primarily low-income Black students were randomly assigned to intervention or a "pre-kindergarten education as usual" control condition. Intervention included a family program (a 13-week behavioral parenting intervention and concurrent group for children) and professional development for early childhood teachers. The majority (88 %) of the pre-kindergarten population (N = 1,050; age 4) enrolled in the trial, and nearly 60 % of parents in intervention schools participated in the family program. This study evaluated intervention impact on parenting (knowledge, positive behavior support, behavior management, involvement in early learning) and child conduct problems over a 2-year period (end of kindergarten). Intent-to-treat analyses found intervention effects on parenting knowledge, positive behavior support, and teacher-rated parent involvement. For the highest-risk families, intervention also resulted in increased parent-rated involvement in early learning and decreased harsh and inconsistent behavior management. Among boys at high risk for problems based on baseline behavioral dysregulation (age 4, 23 % of sample), intervention led to lower rates of conduct problems at age 6. Family-centered intervention at the transition to school has potential to improve population health and break the cycle of disadvantage for low-income, minority families.

Background: Increased attention has been paid to identifying and responding to the mental health and social emotional needs of young children in low income countries. There is lack of brief screening scales and assessment tools to characterize child mental health burden or to evaluate impact of early intervention in Sub-Saharan African (SSA) countries. This study sought to determine reliability and validity of three different parent/caregiver brief screening tools in a SSA country - Uganda. The Pediatric Symptom Checklist (14 item Pictorial Scale) (Gardner et al., 2007), assesses child behavioral problems using a pictorial format that takes into account the low literacy rates in SSA countries. The Social Competence Scale (12 items) (Gouley, et al., 2007) utilizes a strength-based evaluation approach to assess children's emotional regulation and prosocial/communication competence. The Strength and Difficult Questionnaire (SDQ; 25 items) (Goodman, et al., 1997, 2009), is available in 80 languages, focuses on psychiatric symptoms and assesses hyperactivity, emotional symptoms, peer problems and conduct problems. Methods: Parents of 303 Ugandan 4-9 year-old children from the community were recruited and interviewed, and 103 of these who were also part of an ongoing school-based mental health intervention trial were interviewed a 2nd time (about 5 months after 1st assessment). Data from both time points were utilized to establish reliability and validity. Data from the control sample (n=42) were used for evaluating test-retest reliability. The mean age of participating parents was 35.92 years (SD = 9.80 years). About one third of parents (32%) were single, and 48% had primary or less education. Study children were an average 6.51 years old (SD = 1.08 years) and all were enrolled in Nursery to Primary 3 in Kampala, Uganda. For the purpose of validation measurement, we also included Patient Health Questionnaire (assessing parental depression; Kroenke et al., 2001; alpha=.83) and Parenting Stress Scale (PSI, Abidin, 1995; 5 items, alpha= .63). Findings: Consistent with developers' conceptual frameworks, two factors emerged from the Pictorial Scale (Internalizing and Externalizing problems) and Social Competence Scales (Emotion regulation and Prosocial/Communication skills). However, for the SDQ scale, only one-factor emerged, with estimated 21-27% of children having abnormal level of problem behaviors. All three brief screening tools applied in this study had adequate reliability and validity. Reliability (assessed by Chronbach's alpha) ranged from .61-.68 for Pictorial scale, .61-.63 for SDQ, and .71-.87 for Social Competence Scale. All social emotional and mental health scales included were related in expected ways. The strength-based Social Competence scale is also sensitive to intervention evaluation. Interpretation: Our findings suggest that selection of instruments needs to include parent literacy levels and cultural contexts. A strength-based measure may be more relevant than pathology-based measures in SSA context