Frederick L. Newman

Familias Unidas: The Efficacy of an Intervention to Promote Parental Investment in Hispanic Immigrant Families

This paper reports a test of the efficacy of Familias Unidas, a Hispanic-specific, ecologically focused, parent-centered preventive intervention, in promoting protection against and reducing risk for adolescent behavior problems. Specifically, the intervention was designed to foster parental investment, reduce adolescent behavior problems, and promote adolescent school bonding/academic achievement, all protective factors against drug abuse and delinquency. One-hundred sixty seven Hispanic families of 6th and 7th grade students from three South Florida public schools were stratified by grade within school and randomly assigned to intervention and no-intervention control conditions. Results indicated that Familias Unidas was efficacious in increasing parental investment and decreasing adolescent behavior problems, but that it did not significantly impact adolescent school bonding/academic achievement. Summer-vacation rates of adolescent behavior problems were six times higher in the control condition than in the intervention condition. Furthermore, change in parental investment during the intervention was predictive of subsequent levels of adolescent behavior problems. The findings suggest that Familias Unidas is efficacious in promoting protection and reducing risk for adolescent problem behaviors in poor immigrant Hispanic families.

An approach to psychotherapy change process research: introduction to the special section.

This special section has a dual focus. One is on psychotherapy change research. The other is to explicate an approach to develop a program of research that builds on 2 aspects of scientific discovery: decomposition of observed phenomena and localization of specific elements that may combine to produce a complex whole. These aspects are considered within an ordered framework of 8 steps in the development and testing of a model, moving from discovery to model construction, validation, and prediction of complex outcomes. Studies on psychotherapy change processes were selected, after a masked review, to represent different levels in developing a program of research. Although it is argued that the early steps of decomposition and localization are important when developing a program of research, current editorial practices in first-tier journals, including the Journal of Consulting and Clinical Psychology, typically consider this type of study to be too preliminary for a scientific archival journal. Should this practice be revisited?

Internal Barriers to Help Seeking for Middle-Aged and Older Women Who Experience Intimate Partner Violence

ABSTRACT There has been relatively little qualitatively or quantitatively published research to guide the field in identifying and addressing barriers to seeking help for older women who experience domestic violence. Women over the age of 45 have seldom been participants in research on domestic violence. This paper describes results from a qualitative study that focused on reactions to and internalization of abusive behaviors of an intimate partner. Twenty-one focus groups were conducted with 134 middle-aged and older women. Analysis of the data identified six factors that describe reactions to abusive behavior that become barriers to help seeking, including self-blame, powerlessness, hopelessness, the need to protect family, and the need to keep such abuse secret from others. These findings are discussed with implications for community outreach and future research.

Barriers to help-seeking for older women who experience intimate partner violence: A descriptive model

ABSTRACT Purpose: The paper describes a model of barriers to help-seeking (MBHS) for older women who experience domestic violence (DV). Design and Methods: Data were collected from 134 women ages 45 to 85 years in 21 focus groups. Computer-assisted qualitative data analysis software (ATLAS.ti) was used to organize transcript analysis and provided access to the quotations upon which codes, themes, relationship maps, and other elements of the analysis were constructed. Results: Twelve themes emerged that showed strong relationships with experience of DV and barriers to help-seeking concepts. The resulting model of barriers to help-seeking (MBHS) illustrates how identified internal and external factors interrelate with each other and with an abusers behaviors to create help-seeking barriers. The model also reflects the determination that, for study participants, there was no discernable point where characteristics of the experience of DV ended and resistance to help-seeking began. Implications: Development of services specifically suitable to the needs and desires of older women who experience DV is vital. Professionals in all service segments must more fully understand the help-seeking barriers that older DV victims face. To this end, the research community is challenged to replace myths and stereotypes about the nature and prevalence of DV among older people with empirically derived knowledge.

Psychosocial outcomes in later life: a multivariate model.

A conceptual model was developed to identify developmental self-regulatory pathways to optimal psychosocial outcomes in adulthood. The model delineates influences among age, possible selves, developmental processes (i.e., coping, control), and well-being. Results showed age effects on all constructs except selective control. Three consistently common predictors of well-being (i.e., goal pursuit, goal adjustment, and optimization) emerged. The effects of age on well-being were differentially mediated by developmental processes. Specifically, negative age-related changes in offensive processes (i.e., goal attainment) were offset by positive influences of defensive processes (i.e., goal adjustment), which had the net effect of preserving well-being. The model demonstrates a more optimistic pattern of aging in which gains offset losses leading to positive outcomes and highlights the importance of examining both independent and combined influences of age, self, and developmental processes on psychosocial outcomes.

Nonphysical Abuse: Findings in Domestic Violence Against Older Women Study

ABSTRACT This article reports findings regarding nonphysical abuse of middle-aged and older women in intimate relationships based on 21 focus groups with 134 women ages 45 to 85 years. Computer assisted qualitative data analysis was used to organize and analyze data. Descriptions of nonphysical violence appeared clustered under the notion that power and control dynamics were integrally related to the effect of such abuse on older women and that as a result nonphysical abuse might be more difficult to endure and have more lasting effects than physical violence. Generational influences and the context of long-lasting, abusive relationships appeared to contribute to attitudes of participants regarding nonphysical abuse. These findings have not been previously documented in women in this target age group.

Randomized Controlled Trial to Determine the Effectiveness of an Interactive Multimedia Food Safety Education Program for Clients of the Special Supplemental Nutrition Program for Women, Infants, and Children

BACKGROUND Pregnant women and the very young are among those most susceptible to foodborne infections and at high risk of a severe outcome from foodborne infections. OBJECTIVE To determine if interactive multimedia is a more effective method than pamphlets for delivering food safety education to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clients. DESIGN A randomized controlled trial of WIC clients was conducted. Self-reported food safety practices were compared between pre- and postintervention questionnaires completed >or=2 months after the intervention. SUBJECTS/SETTING Pregnant WIC clients or female caregivers (usually mothers) of WIC clients who were 18 years of age or older and able to speak and read English were recruited from an inner-city WIC clinic. INTERVENTION Participants were randomized to receive food safety pamphlets or complete an interactive multimedia food safety education program on a computer kiosk. MAIN OUTCOME MEASURES Change from pre- to postintervention food safety scores. STATISTICAL ANALYSES PERFORMED A mean food safety score was determined for each participant for the pre- and postintervention questionnaires. The scores were used in a two-group repeated measures analysis of variance. RESULTS Of the 394 participants, 255 (64.7%) completed the postintervention questionnaire. Satisfaction with the program was high especially among those with no education beyond high school. When considering a repeated measures analysis of variance model with the two fixed between-subject effects of group and age, a larger improvement in score in the interactive multimedia group than in the pamphlet group (P=0.005) was found, but the size of the group effect was small (partial eta(2)=0.033). Women aged 35 years or older in the interactive multimedia group had the largest increase in score. CONCLUSIONS The interactive multimedia was well-accepted and resulted in improved self-reported food safety practices, suggesting that interactive multimedia is an effective option for food safety education in WIC clinics.

Theory-driven Intervention Improves Calcium Intake, Osteoporosis Knowledge, and Self-efficacy in Community-Dwelling Older Black Adults

OBJECTIVE To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. DESIGN Randomized repeated measures experimental design. SETTING Churches and community-based organizations. PARTICIPANTS Men and women (n = 110) 50 years old and older from 3 south Florida counties. INTERVENTION Participants randomly assigned to either of 2 groups: Group 1 (experimental group) or Group 2 (wait-list control group). Group 1 participated in 6 weekly education program sessions immediately following baseline assessment, and Group 2 started the program following Group 1s program completion. A tested curriculum was adapted to meet the needs of the target population. MAIN OUTCOME MEASURES Dietary calcium intake, osteoporosis knowledge, health beliefs, and self-efficacy. ANALYSIS Descriptive and summary statistics, repeated measures analysis of variance, and regression analysis. RESULTS Of the total participants, 84.6% completed the study (mean age = 70.2 years). Overall, an educational program developed with a theoretical background was associated with improvement in calcium intake, knowledge, and self-efficacy, with no effect on most health belief subscales. Assigned group was the major predictor of change in calcium intake. CONCLUSIONS AND IMPLICATIONS A theory-driven approach is valuable in improving behavior to promote bone health in this population. Health professionals should consider using more theory-driven approaches in intervention studies.

Food Safety Education Using an Interactive Multimedia Kiosk in a WIC Setting: Correlates of Client Satisfaction and Practical Issues

OBJECTIVE To assess acceptability of food safety education delivered by interactive multimedia (IMM) in a Supplemental Nutrition Program for Women, Infants and Children Program (WIC) clinic. METHODS Female clients or caregivers (n=176) completed the food-handling survey; then an IMM food safety education program on a computer kiosk. Satisfaction with program, participant demographics, and change in food-handling behavior were assessed by univariate analyses. RESULTS Over 90% of the participants enjoyed the kiosk, and most (87.5%) reported using computers a lot. Compared with participants with education beyond high school, participants with less education were more likely to report enjoying the kiosk (98.2% vs 88.1%, P = .007), preferred learning with the kiosk (91.7% vs 79.1%, P = .02), and would like to learn about other topics using IMM (95.4% vs 86.6%, P = .04). CONCLUSIONS AND IMPLICATIONS Food safety education delivered by IMM was well accepted by inner-city WIC clinic clients, including those with less education.

Health and Cultural Determinants of Voluntary HIV Testing and Counseling Among Middle-Aged and Older Latina Women

The rate of cases of HIV/AIDS in older people is increasing; indeed one out of every four people with HIV/AIDS is over age 50. This study describes the correlates of HIV Voluntary Counseling and Testing (VCT) using structural equation modeling techniques for a sample of 135 middle-aged and middle-aged and older Latinas in South Florida. Over 60% of participants had been tested for HIV. Provider endorsement was found to be the strongest predictor of VCT (odds ratio [OR] = 6. 38), followed by having a clinic as a regular source of healthcare (OR = 3.88). Social work implications are provided.