Glenn Gamst

Effects of Latino Acculturation and Ethnic Identity on Mental Health Outcomes

The relationships among client-therapist ethnic match, client age group, client acculturation, ethnic identity, and generation level and their effect on client global assessment of function (GAF), total mental health visits, and costs were examined with a sample of 204 Latino adult and child community mental health clients. Acculturation was measured using the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II), and the Multigroup Ethnic Identity Measure (MEIM) served as the measure ofethnic identity. The adjusted findings indicated that GAF outcomes declined for Anglo-oriented Latino clients who reported low ethnic identity. These results are discussed in light ofa Multicultural Assessment Intervention Process Model (MAIP) that helps guide service delivery to community mental health consumers.

Cultural Competency Revised: The California Brief Multicultural Competence Scale

Abstract The authors describe the development of the California Brief Multicultural Competence Scale (CBMCS). The 21 -item CBMCS was derived from principal component analysis, item content validated by a panel of experts, and confirmatory factor analyses. Several studies provided internal consistency, subscale intercorrelations, criterion-related validation, and assessment of possible social desirability contamination.

Ethnic match and client ethnicity effects on global assessment and visitation

The effects of client-therapist ethnic match and client ethnicity on therapist-evaluated Global Assessment of Function (GAF) and visitation were investigated. The sample consisted of several thousand outpatient clients of a Southern California community mental health center. Findings indicated that unadjusted GAF-intake and GAF-termination scores were higher for ethnically matched Latino and Asian Americans but not for African and White Americans. Unadjusted GAF-difference scores for ethnically matched Latino and White Americans were higher than for African American clients. Unadjusted visitation or total visits was lower for ethnically matched Asian and Latino American clients, while African and White American clients had relatively high visitation levels regardless of the ethnic match status. After adjusting for 12 other variables, ethnically matched Asian American therapists consistently evaluated clients higher than did ethnically matched African American therapists. Adjusted visitation revealed fewer total visits for ethnically matched Latino and African American clients, while White Americans garnered higher visit levels when ethnically matched, and Asian Americans evidenced relatively high levels of visitation regardless of ethnic match status. Separate diagnostic category analyses revealed higher GAF-termination scores for ethnically matched African, Asian, and Latino American (schizophrenic) clients and ethnically matched Latino and Asian(mood disorder) clients. Implications for future research are discussed.

Effects of racial match on Asian American mental health consumer satisfaction.

This study investigated the effects of consumer–provider racial match on consumer service satisfaction and treatment outcomes (i.e., Client Satisfaction Questionnaire and GAF-Posttest) of 96 outpatient consumers, 66 of whom were adults and 30 of whom were parent/caregivers of child consumers. Data was obtained by telephone interviews over a 6-week period. After controlling for four other variables, client satisfaction was higher for racially matched consumers. Racially matched child consumers also had higher GAF-Posttest scores. Implications of these findings are discussed.

A Review and Critique of Multicultural Competence Measures: Toward a Social Justice-Oriented Health Service Delivery Model

This chapter critically reviews 16 cultural competence instruments within a social justice-oriented service delivery framework, namely, the Multicultural Assessment-Intervention Process (MAIP) model. Measurement properties of dimensionality, reliability, and validity are briefly examined to further elucidate the cultural competence construct. Implications for social justice-oriented behavioral health services are discussed.

An analysis of the Multicultural Assessment Intervention Process model

Multiple regression models linking client counselor preferences, client-provider ethnic/racial match and provider self-perceived cultural competence to clinical outcome was developed with samples of African American, Latino American and White American adult outpatient community mental health clients (n=1153). The models tested hypothesized relationships of cultural factors predicted by the Multicultural Assessment Intervention Process model. Measured variables included clients’ preferences for the language in which mental health services were to be provided and the culture (race/ethnicity) of the provider, client-provider ethnic/racial match, self-perceived provider cultural competence and clinical outcome as measured by Global Assessment of Functioning scores at Time 2 statistically controlling for client scores at Time 1. Results indicated that lack of a client-provider ethnic/racial match and higher levels of provider self-perceived sensitivity predicted African American clinical outcome. These same results plus higher levels of provider self-perceived awareness of cultural barriers predicted Latino American clinical outcome. None of the cultural variables were found to predict White American clinical outcome. Multicultural Assessment Intervention Process model implications are discussed.

Confirmatory Factor Analysis of the Acculturation Rating Scale–II Scale 2 The Case for Measurement of Marginality

The present study compared the dimensionality and viability of Cuéllar, Arnold, and Maldonado’s 18-item Marginality Scale to the recently proposed 17-item revision of this scale by Gutierrez, Franco, Powell, Peterson, and Reid. Confirmatory factor analyses indicated that a 15-item 3-factor solution based on Cuéllar et al. and a 17-item 2-factor solution based on Gutierrez et al. both produced adequate fits to the data. However, MANOVA results using Acculturation Rating Scale for Mexican Americans–II (ARSMA-II) Scale-1 acculturation typologies (separation, assimilation, integration, and marginalization) to form separate groups showed more sensitive differentiation with the Cuéllar et al. three-subscale structure (Anglo Marginalization, Mexican Marginalization, and Mexican American Marginalization) than the Gutierrez et al. two-subscale structure (Dominant Culture Marginality and Native Culture Marginality). Implications for future research were discussed.

Development and validation of the African American Women's Shifting Scale (AAWSS).

OBJECTIVE The purpose of this research was to develop and validate an instrument to measure shifting or self-altering strategies among African American women. METHOD A 13-item instrument was developed to measure aspects of shifting phenomena based on the empirical literature, feedback from focus groups, and cultural experts. The initial validation study, using principal axis analysis, was conducted with a national sample of 318 African American women. A second independent national sample of 190 African American women provided data for a confirmatory factor analysis. RESULTS Results indicated that the inventory was composed of the following 3 factors: Strong Black Woman, Awareness of Shifting Behavior, and Sensitivity to the Perceptions of Blacks. CONCLUSIONS A structural model was developed based on the Multicultural Assessment-Intervention Process (MAIP) framework that allowed for the exploration of the shifting construct. Implications for future research are discussed.

One-Way Within-Subjects ANOVA

The last command reads a csv file that contains the data from Table 11.5 in your textbook, and stores everything in the data frame mw115. The data are from a fictitious experiment that measured cognitive ability in 12 children at 30, 36, 42, and 48 months of age. The within-subjects ANOVA consists of the following steps: 1. The dependent variables are extracted from the data frame and stored in a matrix ; 2. The lm function is used to create a multivariate linear model (i.e., mlm) object that specifies the betweensubjects aspect of the experimental design; 3. The Anova function in the car package is used to i) specify the within-subjects aspects of the design; and ii) convert the mlm object to an aov object; 4. Finally, the summary function prints the ANOVA table, Mauchly Test, and the corrected p values for the within-subject variables.

Data Analysis Using Sas Enterprise Guide : Nonlinearly Transforming Variables in Order to Meet Underlying Assumptions

Overview Most of the statistical procedures we use are based on the assumption that the data are normally distributed, that there are no outliers potentially distorting the results of the analyses, and, if there are two or more distributions involved in the analysis, that the sets of scores have comparable variances (the assumption of homogeneity of variance). If these assumptions are violated, one option available to researchers is to transform the data to force the values to come closer to meeting the assumptions. Chapter 11 discussed standardizing variables based on existing norms, which is one form of transformation. Standardizing a variable (e.g., to z or linear T scores) is an example of a linear transformation , that is, one preserving the characteristics of the distribution. Thus, a distribution whose values are skewed remains so following the raw scores being converted to z scores. In the present chapter, we discuss transformations that are performed with the intention of modifying the shape of the distribution. These types of transformations are known as nonlinear transformations . Notes on transformations To transform data is to perform certain types of mathematical operations on the scores of a variable for each case in the data set. We do this by computing a new variable in much the same way as we showed in Chapter 7 when we computed new variables and in Chapter 11 when we discussed standardizing a variable based on external norms.