Christina K. Wilson

Neighborhood disorder, spiritual well-being, and parenting stress in African American women.

Using a culturally informed risk-protective framework, the purpose of this study was to examine spiritual well-being (existential, religious) as a moderator (protective factor) in the relation between neighborhood disorder (risk factor) and parenting stress in a high-risk sample of low-socioeconomic status (SES) African American women (N = 144). These women, who were primary caregivers of children between 8 and 12 years old, reported on disorder in their existential and religious well-being, neighborhoods, and 3 types of parenting stress. Women who perceived more disorder in their neighborhood had more parenting stress, and women who reported more existential and religious well-being had less parenting stress. Existential (characterized by a sense of purpose in life), but not religious (characterized by a sense of life in relation with God) well-being moderated the relation between neighborhood disorder and all types of parenting stress, such that women with medium or high levels of existential well-being had low levels of parenting stress at low levels of neighborhood disorder, but higher levels of parenting stress at higher levels of neighborhood disorder. No moderation effects were found at low levels of existential well-being. Results are framed in a context that emphasizes their relevance to incorporating family interventions that bolster culturally relevant resilience factors, such as spirituality, pertinent to low-SES African American families.

Student perspectives on sexual health: implications for interprofessional education

Abstract Interprofessional collaboration requires that health professionals think holistically about presenting concerns, particularly for multimodal problems like sexual dysfunction. However, health professions students appear to receive relatively little sexual health education, and generally none is offered on an interprofessional basis. To assess current degree of interprofessional thinking in sexual health care, 472 health professions students in Georgia, United States, were presented with a sexual dysfunction vignette and asked to rate the relevance of, and their familiarity with, interventions offered by several professionals. They also were asked to identify the most likely cause of the sexual dysfunction. Students rated relevance and familiarity with interventions as highest for physicians and lowest for dentists, with higher ratings of nurses by nursing students. More advanced students reported greater familiarity with mental health, physician, and physical therapy interventions. Finally, nursing students were less likely to attribute the dysfunction to a physical cause. These findings indicate that students may prioritize biomedical approaches in their initial assessment and may need additional supports to consider the spectrum of biopsychosocial factors contributing to sexual functioning. To encourage interprofessional critical thinking and prepare students for interprofessional care, sexual health curricula may be improved with the inclusion of interprofessional training. Specific recommendations for curriculum development are offered.

Maternal PTSD and Children's Adjustment: Parenting Stress and Emotional Availability as Proposed Mediators

OBJECTIVES Maternal posttraumatic stress disorder (PTSD) is a risk factor for negative child adjustment, but it is unclear whether this association is direct (e.g., a mothers PTSD symptoms are observed, learned, and internalized by children which results in behavioral and emotional problems) or indirect, through parent-child relationship difficulties or parenting stress. We hypothesized that parenting stress and maternal emotional availability would exhibit indirect effects on relationships between maternal PTSD and childrens functioning. METHOD Participants were 52 trauma-exposed mothers and their children (aged 7-12 years). Mothers completed measures of PTSD and parenting stress and reported on their childrens functioning. Emotional availability was assessed through observer-rated mother-child interactions. RESULTS Emotional availability was not related to PTSD or child outcomes. Parenting stress had a substantial indirect effect on the relationships between maternal PTSD and child emotion regulation, internalizing, and externalizing behaviors. CONCLUSIONS Results highlight the need to target parenting stress in interventions with trauma-exposed families.

It's Supposed to Be Personal: Personal and Educational Factors Associated with Sexual Health Attitudes, Knowledge, Comfort and Skill in Health Profession Students

The health professional and the patient are cultural beings with beliefs and attitudes that are shaped by family traditions, social development, and exposure to novel experiences. As such, it is especially important for health profession students to gain awareness about the personal and educational factors that likely inform their practice and educational experiences and, as a result, impact their attitudes, knowledge, comfort, and skill in the area of sexual health. The current study sought to understand personal factors in health profession students associated with these sexual health competencies. Several early personal factors (gender, social class, and family sexuality communication), current personal factors (religion, spirituality, and relationship history), and educational factors (perceived quality of education and experience) were significantly related with sexual health competency. Results suggest that there is potential value to tailored interventions, student self-reflection, and interprofessional education among health profession students’ for the promotion of sexual health competency.

Mediators of the childhood emotional abuse–hopelessness association in African American women☆

Although there is an association between experiencing childhood emotional abuse and feeling hopeless as an adult, it is critical to understand the factors that may be protective in this relationship. The goal of this study was to determine if two protective factors, namely spiritual well-being, including both religious and existential well-being, and positive self-esteem, served to mediate the association between childhood emotional abuse and adult hopelessness. The sample for this investigation was low-income African American women suicide attempters who were abused by a partner in the prior year (N=121). A path analysis revealed that in this sample, the childhood emotional abuse-hopelessness link was mediated by existential well-being and positive self-esteem, as well as by the two-mediator path of emotional abuse on existential well-being on self-esteem on hopelessness. Results suggested that existential well-being may be a more salient protective factor for hopelessness than religious well-being among abused, suicidal African American women who experienced childhood emotional abuse. Findings highlight the value of culturally relevant strategies for enhancing existential well-being and self-esteem in this at-risk population to reduce their vulnerability to feelings of hopelessness.

Child Abuse, Social Support, and Social Functioning in African American Children

This study examined the relationship among child abuse (physical, emotional, and sexual), social support from friends and family, and social functioning in a sample of low-income African American children (N = 152). With the exception of the association between sexual abuse and peer support, all of the correlations among study variables were significant. The relationship between child physical and emotional abuse and social functioning were mediated by both family and peer support; however, only family (not peer) support was a significant mediator in the sexual abuse-social functioning link. Additionally, there was no difference found in the strength of mediation via family support versus peer support. Results suggest that mental health professionals should inquire about and attempt to increase children’s levels of social support from family and peers when working with abused youth in order to promote healthy psychological and psychosocial outcomes.

Existential Well-Being, Drug Abuse, and Parenting Stress in African American Women

The current study examined the influence of existential well-being and drug abuse on parenting stress in a sample of low-income African American women (n = 152). Whereas existential well-being served as a protective factor against all three forms of parenting stress measured (parental distress, difficult child, and parent–child dysfunctional interaction), drug abuse was a risk factor for all three. Existential well-being was also inversely related to drug abuse. A path analysis was conducted to further elucidate the cross-sectional associations among these variables. A positive, indirect effect of existential well-being on two of the three components of parenting stress, parental distress and perceived child behavior problems, but not the third, parent–child relationship quality, through level of drug abuse was found in support of partial meditation. Clinical implications regarding enhancing and using existential well-being as a culturally-relevant coping mechanism for African American caregivers are considered, and the etiological mechanisms of parenting stress are discussed.

Intimate Partner Violence, Spiritual Well-Being, and Parenting Stress in African-American Women

Sequelae associated with intimate partner violence (IPV) include negative emotional, physical, and parenting outcomes. This study explored spiritual well-being as a potential mediator of the relations between IPV (physical and nonphysical abuse) and parenting stress scores in a sample of 152 low-income, African-American women. Path analytic models identified spiritual well-being as a mediator of the nonphysical (but not physical)–IPV parenting stress (three subscales) link. These findings suggest that spiritual well-being may be a protective factor against parenting stress for African-American women who experience nonphysical IPV, and an important target for culturally informed preventative interventions and treatment in this population.

Attitudes Toward HIV Among Health Professions Students in the Southeastern United States: Implications for Interprofessional Education

INTRODUCTION The Southeastern United States is disproportionately affected by HIV, and unfavorable attitudes toward HIV among healthcare providers in these communities can negatively impact persons living with HIV (PLWH). Moreover, attitudinal differences between providers impede collaboration in interdisciplinary HIV treatment teams and can have detrimental effects on patient care. Identifying attitudinal differences during health professions training and student characteristics associated with those differences may help narrow these gaps by revealing potential areas for improving education. METHODS Health professions students in nursing, allied health, medical, mental health, and dental training programs in Georgia (n = 475) completed measures of attitudes toward HIV and patient care for PLWH, and measures of personal and educational characteristics including religiosity, attitudes toward lesbian, gay, bisexual, and transgender (LGBT) patients, and clinical and classroom experiences relevant to sexual health. RESULTS Beliefs about disclosing patients’ HIV status without consent, concerns about the effects of working with PLWH on students’ health, and perceptions of adequacy of HIV education differed across disciplines. Several personal and educational factors were correlated with students’ attitudes (e.g., having positive attitudes toward LGBT patients, more patient contact hours relevant to sexual health). CONCLUSION Addressing HIV-related concepts in health professions training (e.g., exposure to patients with sexual health concerns or who are LGBT) could improve attitudes about HIV and patient care. Interprofessional clinical and classroom opportunities, where students with varied personal and educational backgrounds can learn from and with each other about HIV, also could improve student attitudes and interdisciplinary collaboration in HIV clinical care. Received: 12/26/2013 Accepted: 03/19/2013 Published: 04/22/2014