Rates of teenage pregnancies are higher for African American and Latina adolescents compared to their White peers. African American and Latina adolescent mothers also experience more adversities than ...their White peers, such as higher rates of depression, school dropout, and economic disadvantage. Furthermore, children of adolescent mothers are at higher risk for adverse development. Parenting stress and social support can impact outcomes experienced by adolescent parents and their children. The present study examined the influence of adolescent mothers’ parenting stress and perceived social support on maternal depression at baseline (6 months after birth), and its impact on infant development 1 year later (18 months after birth). Participants were 180 adolescent mothers of African American or Latino/Hispanic descent. Results suggest that higher levels of parenting stress and less perceived social support were associated with higher levels of depression in the adolescent mothers at baseline. Higher levels of maternal depression were also associated with more developmental delays in infants 1 year post-baseline. Additionally, depression mediated the relationship between parenting stress and later child outcomes. These findings highlight the importance of examining parenting factors such as parenting stress, social support, and maternal depression in ethnic minority adolescent parents, and provide valuable information regarding unique risk and protective factors associated with positive maternal outcomes for ethnic minority adolescent parents and healthy development for their children.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract This study prospectively examines the transition from the child welfare system into the juvenile justice system among 10,850 maltreated children and adolescents and explores how patterns of ...risks, including severity and chronicity of maltreatment, adverse family environment, and social risk factors, affect service systems transition. Almost three percent of maltreated children and adolescents had their first juvenile justice adjudication within an average of approximately six years of their initial child protective services investigation (CPS). Social risk factors, including a child’s age at index CPS investigation (older), gender (boys), and race/ethnicity (Black and Hispanic) significantly predicted the risk of transition into the juvenile justice system. Recurrence of maltreatment and experiencing at least one incident of neglect over the course of the study period also increased the risk of transition into the juvenile justice system. However, subtypes of maltreatment, including physical, sexual, and other types of abuse did not significantly predict the risk of juvenile justice system transition. Finally, family environment characterized by poverty also significantly increased the risk of juvenile justice system transition. These findings have important implications for developing and tailoring services for maltreated children, particularly those at-risk for transitioning into the juvenile justice system.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Community‐based Participatory Research (CBPR), where consumers participate in the design and execution of an evaluation, holds promise for increasing the validity and usefulness of evaluations of ...services. However, there is no literature comparing methods and outcomes of studies conducted by professional evaluators with those conducted through a consumer‐driven evaluation process. We attempt to fill this gap by presenting the methods and results from a qualitative evaluation conducted by professional evaluators along with one conducted by a team of consumer researchers who engaged in a CBPR process. This paper includes: (a) methods, and findings that emerged from these evaluations each tasked with examining similar issues within the same community; (b) description of the process used to train the team of consumer researchers whose economic and educational backgrounds are different than most evaluators; and (c) lessons learned about how to prepare for and work with common barriers to implementing a CBPR evaluation.
Highlights
Training approach for community‐based participatory research (CBPR) is provided.
Data collected by consumer‐research team were seen as more authentic and resulted in greater use.
Lessons learned about overcoming common barriers in a CBPR approach are presented.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Objectives
Parenting stress has been linked with negative outcomes for parents and their infants (e.g., parental depression, negative parenting behaviors, poor attachment). Racial/ethnic minority ...adolescent mothers have increased risk for experiencing parenting stress compared to their White counterparts. Little is known about the changes in parenting stress over time for this population.
Methods
Growth mixture modeling (GMM) was conducted to determine the growth trajectory classes of 185 African American and Latina/Hispanic adolescent mothers over 2 years. Risk and protective factors (e.g., maternal depression, social support, self-esteem) were examined to determine their influence on parenting stress trajectories.
Results
Three distinct trajectories of parenting stress were found: low stable stress (40.90%), decreasing stress (35.78%), and high stable stress (23.28%). Lower maternal depression (
OR
= 2.35), higher self-esteem (
OR
= 1.29), lower perceived social support from family (
OR
= 0.53) and higher perceived support from friends (
OR
= 1.65) predicted placement into the low stable parenting stress group over the high stable parenting stress group. Adolescents living with family (
OR
= 2.74) and Latina race/ethnicity (
OR
= 2.78) also served as predictors of placement into the low stable parenting stress group. Higher self-esteem (
OR
= 1.66) predicted placement into the decreasing parenting stress group over the high stable parenting stress group.
Conclusions
These findings highlight the importance of perceived peer support by adolescent mothers, regardless of their support family support (e.g., living at home and receiving child care). Considering developmental factors such as peer relationships may be important when working with adolescent mothers.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Systems of care (SOC) have relied on the wraparound care process to individualize community‐based services for children and youth with serious emotional and behavioral difficulties. A core element of ...wraparound care is Child and Family Team meetings (CFTs), which are designed to give youth and families a leadership role in developing and guiding their plan of care. The National Wraparound Initiative (NWI) has identified Practice Standards regarding CFT implementation. This study examined CFT characteristics and the association between those characteristics and youth and family outcomes in a statewide SOC. Participants were 363 youth (Mage = 10.89, SD = 3.72) and their caregivers. Families completed measures of youth and caregiver functioning and symptoms at enrollment and 6‐month follow‐up. Care coordinators completed a survey assessing CFT implementation and characteristics following each meeting. Multiple regression analyses were used to examine the relationship between CFT characteristics and youth and caregiver outcomes. Results indicated that a higher number of CFTs was associated with poorer outcomes, while a higher percentage of natural supports at meetings was associated with better youth outcomes. Number of days to the first CFT was associated with greater caregiver strain. Implications for CFT implementation within wraparound are discussed.
Highlights
Significant relationships were observed between CFT characteristics and youth and family outcomes.
A higher number of CFTs was associated with poorer youth and family outcomes.
A higher percentage of natural supports was associated with better youth outcomes.
SOCs may have difficulty in fully implementing CFTs consistently with NWI Practice Standards.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Objective:Systems of care (SOCs) were developed to increase access to and quality of care for children with emotional and behavioral difficulties and their families through the provision of ...coordinated, community-based, culturally competent, family-driven services. SOCs focus on wraparound care that is individualized to meet each family’s needs. Previous research has illustrated significant disparities in outcomes of nonwraparound care on the basis of youths’ race-ethnicity. This study aimed to fill a research gap by examining disparities in outcomes for families receiving wraparound care coordination within an SOC.Methods:This exploratory study examined racial-ethnic disparities in outcomes observed at intake, during service provision, and at 6-month follow-up among 1,138 youths and their caregivers who participated in wraparound care coordination as part of a statewide SOC between 2016 and 2020. Analyses of variance and regression analyses were executed to investigate whether receiving services and/or the youths’ racial-ethnic identity predicted differences in behavioral health outcomes and characteristics of or satisfaction with care. Caregiver-reported outcomes were assessed with the Ohio Scales for Youth, the Child Trauma Screen, and the Caregiver Strain Questionnaire.Results:Results revealed few racial-ethnic disparities in the characteristics and outcomes of care coordination among participants at intake or in family involvement in the wraparound process. Participants across groups reported similar and significant improvement in outcomes. However, the results indicated some disparities in satisfaction with care.Conclusions:Results revealed the positive impact of care coordination on the health and well-being of youths and caregivers across racial-ethnic groups.
The coronavirus disease pandemic has highlighted significant gaps in community mental health services, placing vulnerable individuals at greater risk for mental health and substance use difficulties ...via disrupting their wellness journey. Guided by a wellness framework, a needs assessment was conducted among adult consumers of behavioral health services to understand their needs during the pandemic and to help develop and strengthen service delivery strategies. A team of three university researchers and four Consumer Researchers, who receive services at a publicly funded community mental health center, engaged in a community‐based participatory project in which 13 focus groups were conducted with 51 consumers. Several themes emerged from a thematic analysis of transcripts regarding consumer well‐being and healthcare needs, coping strategies employed, and the accessibility, benefits, and perception of clinical and support services during the pandemic. Results highlighted strengths in service delivery and areas in need of enhancement. Findings may inform similar community services that seek to enhance delivery of care among vulnerable populations.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
•Wraparound care coordination serves a broad population of youth with a variety of complex needs, yet little is known about the impact of wraparound services based on these needs.•Understanding ...youth’s needs and their impact on treatment services allows for more targeted care for youth and their families.•LCA analysis revealed five distinct classes of youth based on their presenting needs and the overall positive impact of wraparound services across classes.•Several patterns of service characteristics and outcomes were identified based on classes of youth needs.
Access to wraparound care coordination within systems of care (SOC) is increasing nationwide for youth with emotional and behavioral disorders and their families. Though wraparound care coordination serves a broad population of youth who experience a variety of complex needs, less is known about the impact of wraparound services based on these specified needs. Using latent class analysis, the current study aimed to first identify classes of youth based on their presenting needs and then examine the impact of class membership on treatment experiences and outcomes at baseline and six-month follow-up.
Caregiver-reported data from 1243 youth enrolled in wraparound care coordination services within a statewide SOC were used. Latent class analysis was used to determine classes of youth needs and regression results examined whether baseline characteristics, child and family team meeting characteristics, mental health outcomes, and perceptions of care differed based on identified classes.
Results revealed five distinct classes of youth needs: Behavioral Needs, ADHD-related Behavior Needs, Educational Needs, Mental Health Needs, and Multi-Needs. Overall participants saw improvement in all follow-up outcomes. Significant between-class differences were also found in all outcome categories measured.
The current results further solidify the benefits of comprehensive wraparound care within a SOC. Additionally, understanding youth’s needs and their impact on treatment services allows for more targeted care for youth and their families.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Little is known about how caregiver-specific needs may impact use of and engagement with care coordination and subsequent youth and family outcomes in behavioral health systems of care.•Latent class ...analysis identified four qualitatively different classes of caregivers including basic needs, physical needs, no needs and mental health/trauma needs.•Class membership was associated with aspects of care delivery and with caregiver ratings of strain at follow-up.•Assessing caregiver needs at presentation to care can provide direction for care coordinators to more directly target areas of family need through wraparound and individualize services.
Systems of care (SOC) provide a coordinated array of services to youth with serious emotional and behavioral problems and their families. Little is known about what caregiver-specific needs at presentation to care may contribute to use of and engagement with care coordination and subsequent youth and family outcomes. This study aimed to determine latent classes of youth enrolled in wraparound care coordination within a statewide SOC based on caregiver needs impacting youth functioning and identify the relationship between class membership and characteristics of participation in Child and Family Team meetings (CFTs) and mental health outcomes at six-month follow-up.
Participants were 703 youth (Mage = 11.21, SD = 3.67) and their caregivers that had information about caregiver needs and received a six-month follow-up assessment. Latent class analysis determined latent classes of families based on caregiver service needs at presentation to care, and differences in participation in care coordination and youth outcomes at 6-month follow up based on class membership was examined.
Results indicated four classes of caregiversPhysical Health Needs, No Needs, Basic Needs, and Mental Health/Trauma Needs. Class membership was associated with size of the CFT, number of CFTs attended by the youth, percentage of CFTs with a natural support present, and percentage of CFTs that occurred in the family’s home. Class membership was associated with caregiver ratings of objective strain at 6-month follow-up.
Assessing caregiver needs at presentation to care can provide direction for care coordinators to more directly target areas of family need through wraparound and individualize services.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Community‐based participatory research (CBPR) partnerships strive to promote community capacity building and sustainability, yet initiatives often suffer when grants or relationships with academic ...partners end. To address these concerns, researchers hoping to develop truly sustainable CBPR partnerships should consider factors that promote the development of community capacity and, ultimately, independence. In this first‐person account, using perspectives gathered from FAVOR, a Connecticut‐based family‐led advocacy organization and an academic researcher, we examine the practices and experiences of the members of a CBPR partnership focused on using community voice to inform changes in the state's children's behavioral health system of care. These practices ultimately led to FAVOR developing the necessary skills to assume full ownership of the community data‐gathering initiative, ensuring that the initiative would be sustained. Through the perspectives of five FAVOR staff and an academic researcher, we describe the factors that contributed to the organization being able to develop the capacity to independently continue their community data‐gathering initiative, including description of the training process and staff members' perspectives on training, autonomy, community value, and lessons learned. We use these stories and experiences to provide recommendations for other partnerships striving to promote capacity building and sustainability through community ownership of the research process.
Highlights
Community‐based participatory research (CBPR) should engender capacity‐building and sustainability.
CBPR initiatives face sustainability challenges after research partnerships and funding ends.
FAVOR's Community Conversations is a unique example of a community‐sustained CBPR initiative.
Through the partnership's intentional planning, FAVOR assumed ownership of the research process.
CBPR partners should co‐develop a plan to achieve community ownership at partnership outset.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
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