Miwa Yasui

Ethnic Identity and Psychological Adjustment:: A Validity Analysis for European American and African American Adolescents

This research studied the role of ethnic identity as a protective factor among European American (n = 77) and African American (n = 82) adolescents identified either as high risk or successful. Adolescents participated in a multiagent, multimethod assessment of depression, internalizing and externalizing behaviors, competence, and academic achievement. The levels of ethnic identity were the same across ethnic groups but were higher among successful adolescents. Bivariate correlations revealed that ethnic identity was significantly associated with all measures of adjustment in the expected directions. Predicted validities were statistically higher among African American youth than for European Americans on depression, total competence, and GPA. Similar associations were found when comparing ethnic identity to a construct of socioeconomic disadvantage. Findings suggest that ethnic identity is central to the self-system and motivation for youth who develop in contexts that potentially undermine children’s socioemotional adjustment.

Predicting Early Adolescent Gang Involvement From Middle School Adaptation

This study examined the role of adaptation in the first year of middle school (Grade 6, age 11) to affiliation with gangs by the last year of middle school (Grade 8, age 13). The sample consisted of 714 European American (EA) and African American (AA) boys and girls. Specifically, academic grades, reports of antisocial behavior, and peer relations in 6th grade were used to predict multiple measures of gang involvement by 8th grade. The multiple measures of gang involvement included self-, peer, teacher, and counselor reports. Unexpectedly, self-report measures of gang involvement did not correlate highly with peer and school staff reports. The results, however, were similar for other and self-report measures of gang involvement. Mean level analyses revealed statistically reliable differences in 8th-grade gang involvement as a function of the youth gender and ethnicity. Structural equation prediction models revealed that peer nominations of rejection, acceptance, academic failure, and antisocial behavior were predictive of gang involvement for most youth. These findings suggest that the youth level of problem behavior and the school ecology (e.g., peer rejection, school failure) require attention in the design of interventions to prevent the formation of gangs among high-risk young adolescents.

Direct Observation of Family Management: Validity and Reliability as a Function of Coder Ethnicity and Training

This study examines the influence of coder ethnicity on the validity and reliability of direct observations of family management. Eight coders, 4 European American (EA) and 4 African American (AA), were randomly assigned to conduct behavior ratings of videotaped family interactions of European American and African American families, under two conditions: untrained and trained. Results indicated statistical differences between EA and AA coder ratings of family management practices across both untrained and trained conditions, suggesting the presence of ethnocentric perceptions of coders. Specifically, EA coders tended to rate AA families as exhibiting poorer family management skills compared with those of EA families. AA coder ratings for EA and for AA families showed no statistical differences. Although not statistically significant, posttraining coding results indicated a trend toward decreased differences among coder perceptions, especially in improving the validity and reliability of EA coder ratings of AA families. These findings are discussed with respect to recommendations for cross-cultural research as well as general theories of ethnic socialization.

Advances in EBI Development for Diverse Populations: Towards a Science of Intervention Adaptation

This introduction examines major issues and challenges as presented in this special issue of Prevention Science, “Challenges to the Dissemination and Implementation of Evidence Based Prevention Interventions for Diverse Populations.” We describe the Fidelity-Adaptation Dilemma that became the origin of dynamic tensions in prevention science. It generated controversies and debates and new perspectives on the dissemination and implementation of evidence-based interventions (EBIs) within diverse populations. The five articles in this special issue address many of these challenges. These dynamic tensions have culminated in a reframing of this dilemma that now argues that fidelity and adaptation are both equally important imperatives. These five articles also examine the abiding challenges of engagement and sustainability. Also, two commentaries from expert research investigators reflect on these five articles and their contributions to prevention science. The current introduction describes this “second generation” of EBIs as they may contribute towards a reduction of the health disparities and inequities that disproportionately affect sectors of the major ethnocultural populations in the USA. We also present a systems analysis of approaches and challenges in the dissemination and implementation of EBIs within the contemporary integrative care environment. Finally, we mention an initiative for, “building a science of intervention adaptation,” that proposes systematic research and the creation of an archive of scientific data on the benefits and problems of intervention adaptation. Collectively, these new directions can integrate scientific rigor and sensitivity to cultural factors, for enhancing the effectiveness and reach of this second generation of evidence-based interventions with diverse ethnocultural populations.

Shared Understanding as a Gateway for Treatment Engagement: A Preliminary Study Examining the Effectiveness of the Culturally Enhanced Video Feedback Engagement Intervention

OBJECTIVE For ethnic minority families, the bridging of clinician-client differences is essential to their engagement in treatment. The Culturally Enhanced Video Feedback Engagement (CEVE) intervention aims to enhance client engagement through fostering clinician-client shared cultural understanding. The present study tested the effectiveness of the CEVE on client-rated clinician cultural competence and therapeutic alliance. METHOD Nineteen ethnic minority families with children aged 3-6 years were randomized to the CEVE (n = 9) or treatment as usual (n = 10) at an outpatient clinic. RESULTS Results from linear mixed effects regression models indicated a significant effect of the CEVE on intercept, suggesting that clinician cultural competence and therapeutic alliance were significantly higher in the CEVE condition. No effect was found for clinician growth in skills. CONCLUSIONS The results indicate that the CEVE enhances client treatment engagement via clinician cultural competence and clinician-client alliance, suggesting its promise as a clinical engagement tool, particularly for treatments serving ethnic minority families.

Socialization of Culture and Coping with Discrimination Among American Indian Families: Examining Cultural Correlates of Youth Outcomes

Objective: The current study examines the interrelations between observed parental cultural socialization and socialization of coping with discrimination, and youth outcomes among a sample of 92 American Indian adolescents and their parents in a rural reservation. Method: Path analysis is used to examine the relationships among observed parental socialization (cultural socialization and socialization of coping with discrimination), and youth-reported perceived discrimination, ethnic identity and depression. Results: Findings reveal that higher levels of observed parental cultural socialization and socialization of coping with discrimination predict lower levels of depression as reported by youth 1 year later. Path analyses also show that observed parental cultural socialization and socialization of coping with discrimination are positively associated with youth ethnic identity. Conclusions: These findings point to the importance of integrating familial socialization of culture and coping with discrimination in fostering resilience among American Indian youth.

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families’ engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.

U.S. Caregivers with Mental Health Problems: Parenting Experiences and Children's Functioning

The 2007 National Survey of Childrens Health was used to determine the prevalence of poor mental health among U.S. mothers, fathers, and guardians, specific parenting experiences and childrens functioning. More guardians (13.7%) reported poor mental health compared to mothers (7.7%) and fathers (5.3%), generalizing to 4.6 million U.S. caregivers with poor mental health. Caregivers with poor mental health were at least 3 times more likely to report childrens problematic functioning after accounting for sociodemographic factors and parenting stress and experiences. Research and clinical activities should recognize poor caregiver mental health as a condition that affects parenting and childrens functioning.

The Culturally-Enhanced Videofeedback Engagement (CEVE) Framework: Qualitative findings in families of children with disruptive behavior problems

While cultural competence has been promoted as a way to reduce mental health disparities among ethnic minority populations, there remains a gap between theory and practice. This study examined the use of the Culturally Enhanced Videofeedback Engagement (CEVE) intervention as a clinical tool to facilitate culturally anchored shared understanding to foster treatment engagement among ethnic minority families with children with disruptive behavior disorders (DBDs) participating in a family clinic. In-depth qualitative analysis of individual interviews compared parents’ experiences of the therapy process among 9 intervention families and 10 families participating in treatment as usual. Thematic analysis of semistructured interviews with parents revealed that for families in the intervention group, clinician cultural and clinical competence and the therapeutic relationship were important characteristics of the intervention condition that enhanced parents’ experience of treatment.

The Cultural Ecogram: A Tool for Enhancing Culturally Anchored Shared Understanding in the Treatment of Ethnic Minority Families

Ethnic and racial disparities in mental health care continue to exist, highlighting the increasing concern within the realm of clinical practice as to how clinicians are to effectively integrate the central role of culture and context into the treatment delivery process for culturally diverse children and families. The current article presents the Cultural Ecogram—a clinical engagement tool designed to facilitate the development of a culturally anchored shared understanding—as one method that may facilitate clinician-client shared understanding on the client’s cultural, ethnic, and racial context central to the effective implementation of treatments with ethnic minority children and families.