Cesalie Stepney

Asthma Self-Management is Sub-Optimal in Urban Hispanic and African American/Black Early Adolescents with Uncontrolled Persistent Asthma

Introduction. Youth as young as 11 are given responsibility to manage their asthma. Yet, little is known regarding early adolescents’ asthma self-management behaviors. This study characterizes urban early adolescents’ asthma self-management behaviors and perceived responsibility to manage asthma, exploring demographic differences and examining the relationship between asthma responsibility and disease management. Methods. About 317 Hispanic and African American/Black early adolescents (mean age = 12.71) with persistent, uncontrolled asthma reported prevention and symptom management steps, and responsibility for asthma care. We used Poisson, cumulative logistic, logistic, and linear mixed-effects regression models to assess the relationships among demographic predictors, prevention and management behaviors, and responsibility for asthma care. Results. Fifty percent took 7–9 prevention steps; few saw physicians when asymptomatic or took daily medication. When symptomatic, 92% used medication to treat symptoms and 56% sought medical attention. Controlling for asthma responsibility, fewer older youth reported observing how they feel when asthma is likely to start, observing symptom changes, or asking for help. More boys reported taking medication daily or upon trigger exposure. Controlling for age, gender, and race/ethnicity, those reporting more asthma responsibility were less likely to report taking management steps, seeking preventive care, asking for help, or going to a doctor/hospital for their asthma. Conclusions. Early adolescents’ asthma self-management is suboptimal. With increasing age, they are less observant regarding their asthma and less likely to seek help. Although they perceive themselves to have greater responsibility for managing their asthma, early adolescents do less to care for their asthma, suggesting they are being given responsibility for asthma care prematurely.

Perceptions of parents' ethnic identities and the personal ethnic-identity and racial attitudes of biracial adults.

The present study examined the relationship of perceived parental closeness and parental ethnic identity on personal ethnic identity and colorblindness beliefs in 275 part-White biracial Americans (M age = 23.88). Respondents completed online measures of their personal ethnic identity (minority, White, and multiracial), perceived parental ethnic identity, parental closeness, and attitudes about the state of race relations and the need for social action in the United States. Using path modeling, results show that part-White biracial individuals perceive their ethnic identity to be strongly linked to their parental racial identities, especially when they had closer parental relationships. Moreover, stronger minority identity was linked to less colorblind attitudes, and greater White identity was linked to greater colorblind attitudes suggesting that patterns of identity may influence how biracial individuals view race-relations and the need for social action. Implications for biracial well-being and their understanding of prejudice and discrimination are discussed.

My Child is Diagnosed With Asthma, Now What? Motivating Parents to Help Their Children Control Asthma

Pediatric asthma is often undiagnosed, and therefore untreated. It negatively impacts children’s functioning, including school attendance and performance, as well as quality of life. Schoolwide screening for asthma is becoming increasingly common, making identification of possible asthma particularly relevant for school nurses. Nurses may need to help parents cope with the new diagnosis, and teach them skills to manage the illness. The aim of this article is to present a three-phase model of how parents cope with a newly diagnosed pediatric chronic illness. Using asthma as an example, we describe these phases (Emotional Crisis, Facing Reality, and Reclaiming Life), illustrate how parents progress through the phases, and discuss situations associated with possible regression. Next, we offer strategies framed around a theory of asthma self-management to assist school nurses and other medical providers to motivate parents to develop successful disease management skills.

The increasing impact of socioeconomics and race on standardized academic test scores across elementary, middle, and high school.

For students and schools, the current policy is to measure success via standardized testing. Yet the immutable factors of socioeconomic status (SES) and race have, consistently, been implicated in fostering an achievement gap. The current study explores, at the school-level, the impact of these factors on test scores. Percentage of students proficient for Language and Math was analyzed from 452 schools across the state of New Jersey. By high school, 52% of the variance in Language and 59% in Math test scores can be accounted for by SES and racial factors. At this level, a 1% increase in school minority population corresponds to a 0.19 decrease in percent Language proficient and 0.33 decrease for Math. These results have significant implications as they suggest that school-level interventions to improve academic achievement scores will be stymied by socioeconomic and racial factors and efforts to improve the achievement gap via testing have largely measured it.

Girls Leading Outward (GLO): A School-Based Leadership Intervention to Promote Resilience for At-Risk Middle School Girls

Girls Leading Outward (GLO) is a positive youth development program for at-risk middle school girls that not only seeks to prevent future problems but also aims to foster resilience. GLO focuses predominately on urban, African-American, and Latina students from low-income communities, with a goal of reaching them prior to their transition to high school. It provides a safe space for girls to express their opinions, voice their concerns, and develop positive relationships with their peers. Through the program, girls are equipped with the skills necessary to effectively problem-solve, overcome obstacles, and manage conflicts with others. Key skills learned include emotion regulation, effective communication and assertiveness, active listening, goal setting, and problem solving. These skills are developed through weekly lunch and after-school groups beginning in the seventh grade and continuing in the eighth grade. These skills are then applied in the context of a community service project that further serves to promote engagement in community action and leadership. Building students’ skills in a context that provides them with a new perspective on themselves and their future, while fostering a sense of community with a group of like-minded peers, may be sufficiently powerful to create a positive trajectory for middle school girls. This intervention draws on ecological systems theory (The ecology of human development, Cambridge, MA, 1979; Community psychology: Linking individuals and communities, Belmont, CA, 2007), a model in which an individual is embedded within multiple systems (e.g., school, family, neighborhood contexts) that each impacts the individual’s mental health and behaviors. GLO differs from typical after-school programs in that involves a weekly in-school component and asks participants to conduct a school-based community service project. Through positive in-school visibility, the role that these students play in the school setting can shift from “at-risk girls” to “student leaders,” which will also positively impact the overall school environment. In order to evaluate program impact, the GLO participants are assessed at baseline and at the end of the school year using self- and teacher report. The assessment includes measures of self-efficacy, perseverance, and overall social–emotional competence. Qualitative data are also collected from the participants and the group facilitators in order to better understand how the intervention influences social–emotional and leadership development.

Social-Normative Expectations Mediates School Climate’s Association With Academic Achievement in Latino Middle School Students:

Many Latino students miss opportunities to develop their full potential in U.S. schools. Increasing attention is being paid to the malleable, nonacademic, factors that can affect student learning. The current study sought to evaluate the impact of school climate on Language Arts grade for Latino students in a large, low-income, urban middle school. In addition, the novel construct of Social-Normative Expectations, student perceptions of school-wide norms about achievement expectations for their peers, was explored in relation to school climate and academic achievement. The study sample reflected 513 Latino students, Grades 7 and 8. A mediation model found that approximately 30% of the variance in final Language Arts grades was accounted for by the predictors, including control variables (R2 = .299). A distinctive mediation effect was also found, whereby the impact of school climate was associated with an approximately .6 points lower final grade mediated through the indirect pathway of Social-Normative Expectations (b = −0.064, SE = 0.019, 95% confidence interval [CI] = [−0.104, −0.028]). Implications of these findings are discussed.