Faculty Bibliography

ABSTRACT Minority children attending schools in urban socioeconomically disadvantaged neighborhoods are at high risk for conduct problems. Although a number of family and neighborhood characteristics have been implicated in the onset and progression of conduct problems, there remains incomplete understanding of the unique contributions of poverty-related factors early in development. This prospective study of 298 black public school children considered family- and neighborhood-level predictors of teacher-reported conduct problems from pre-kindergarten through first grade. Results from multi-level analyses indicate that percentage of poor residents in a student's neighborhood made a robust independent contribution to the prediction of development of conduct problems, over and above family- and other neighborhood-level demographic factors. For children of single parents, the percentage of black residents in the neighborhood also predicted the development of conduct problems. School-based interventions to prevent conduct problems should consider impact for children at highest risk based on neighborhood poverty.

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.

The current study examined whether parent psychological resources (parenting stress, depression, and social support from friends and family) moderated the effects of early family preventive intervention on parenting among high-risk families. Ninety-two preschool-age children (M age = 3.94 years) at familial risk for conduct problems participated in a randomized controlled trial of a family intervention to prevent conduct problems. The majority of families were African American or Latino and experienced multiple stressors associated with poverty and familial antisocial behavior. Families were randomized to a 22-session group-based intervention or to a no-intervention, assessment-only control condition. Parents reported on their psychological resources (parenting stress, depression and social support from friends and family) at baseline. Parenting (responsive, harsh, stimulation for learning) was assessed through self-report and observational measures four times over 24 months. Previously-reported intervention effects on responsive parenting and stimulation for learning were moderated by depression and social support from friends, respectively, such that benefits were concentrated among those at greatest risk (i.e., depressed, limited support from friends). The intervention effect on harsh parenting was not moderated by any of the parent psychological resources examined, such that parents with high and low resources benefited comparably. Consideration of moderators of preventive intervention effects on parenting provides important information about intervention impact among families experiencing multiple barriers to engagement and effective parenting. Findings suggest that parents with diminished psychological resources are just as likely to benefit. Family-focused, group-based intervention is promising for strengthening parenting among the highest risk families.

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

Objective. Peers can play a critical role in asthma management, with attitudes toward friends with asthma hindering or supporting self-management. We explored minors' attitudes toward peers with asthma, testing if attitudes varied by grade, sex, asthma knowledge, and asthma status. Methods. Three hundred and eighty-one students in grades 5-11 (51% female; 51% White, non-Hispanic; 12% with asthma) read five vignettes about peers with asthma, and rated the characters on 10 adjective pairs (e.g., afraid/brave and sad/happy). Three vignettes portrayed an aspect of uncontrolled asthma (asthma-related school absence, asthma-related limited physical activity, and asthma-related school nurse visit). One vignette depicted controlled asthma; one described taking medication publically. We computed a total attitude score for each vignette and a mean attitude score across the three uncontrolled vignettes. Linear regression analyses tested the effect of each predictor (grade, sex, asthma knowledge, and asthma status) on attitudes, as well as the interaction of asthma status with the remaining three predictors. Results. Grade was the most robust predictor. Participants in higher grades tended to have more favorable attitudes toward peers with asthma, except for the controlled asthma vignette where participants in lower grades had more favorable attitudes. There were significant interactions between grade and asthma status for the stop-running-and-taking-medication-publically vignettes: among those with asthma, participants in higher grades had more favorable attitudes. Sex interacted with asthma status for the overall uncontrolled, absence, and stop-running vignettes; among those with asthma, girls had more favorable attitudes. Conclusion. With increased grade, minors have better attitudes toward peers with asthma. Living with asthma may normalize asthma. Clinicians can use grade-specific findings to counsel patients.

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.