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Applied machine learning to identify differential risk groups underlying externalizing and internalizing problem behaviors trajectories: A case study using a cohort of Asian American children. PLoS One 2023; 18:e0282235. [PMID: 36867610 PMCID: PMC9983857 DOI: 10.1371/journal.pone.0282235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Internalizing and externalizing problems account for over 75% of the mental health burden in children and adolescents in the US, with higher burden among minority children. While complex interactions of multilevel factors are associated with these outcomes and may enable early identification of children in higher risk, prior research has been limited by data and application of traditional analysis methods. In this case example focused on Asian American children, we address the gap by applying data-driven statistical and machine learning methods to study clusters of mental health trajectories among children, investigate optimal predictions of children at high-risk cluster, and identify key early predictors. METHODS Data from the US Early Childhood Longitudinal Study 2010-2011 were used. Multilevel information provided by children, families, teachers, schools, and care-providers were considered as predictors. Unsupervised machine learning algorithm was applied to identify groups of internalizing and externalizing problems trajectories. For prediction of high-risk group, ensemble algorithm, Superlearner, was implemented by combining several supervised machine learning algorithms. Performance of Superlearner and candidate algorithms, including logistic regression, was assessed using discrimination and calibration metrics via crossvalidation. Variable importance measures along with partial dependence plots were utilized to rank and visualize key predictors. FINDINGS We found two clusters suggesting high- and low-risk groups for both externalizing and internalizing problems trajectories. While Superlearner had overall best discrimination performance, logistic regression had comparable performance for externalizing problems but worse for internalizing problems. Predictions from logistic regression were not well calibrated compared to those from Superlearner, however they were still better than few candidate algorithms. Important predictors identified were combination of test scores, child factors, teacher rated scores, and contextual factors, which showed non-linear associations with predicted probabilities. CONCLUSIONS We demonstrated the application of data-driven analytical approach to predict mental health outcomes among Asian American children. Findings from the cluster analysis can inform critical age for early intervention, while prediction analysis has potential to inform intervention programing prioritization decisions. However, to better understand external validity, replicability, and value of machine learning in broader mental health research, more studies applying similar analytical approach is needed.
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Cui Y, Wang F. The research focus and development trend of art therapy in Chinese education since the 21st century. Front Psychol 2022; 13:1002504. [PMID: 36591086 PMCID: PMC9798422 DOI: 10.3389/fpsyg.2022.1002504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Since the 21st century, art therapy has made great progress and development in China's education. To find out the relationship between art therapy and special children, hundreds of related literatures were analyzed using co-word analysis software, which shows that art therapy is increasingly important in special children and their education. Expressive art therapy has a good development prospect in college students' mental health education and group counseling. The connotation of group painting therapy is constantly enriched. The theme research of mandala painting therapy is closely related, and painting art therapy focuses on the psychological counseling research of different groups, but the two are still in the marginal position in the whole research, and have not been paid attention to. Therefore, in the future research, firstly, we should continue to strengthen the research of art therapy and expressive art therapy in special education and individual mental health education; second, further broaden the depth and breadth of group painting therapy; third, strengthen the study of mandala painting therapy and painting art therapy.
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Affiliation(s)
- Yingying Cui
- Moscow Art School, Weinan Normal University, Weinan, China,*Correspondence: Yingying Cui,
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Barbati A, Geraci A, Niro F, Pezzi L, Sarchiapone M. Do Migration and Acculturation Impact Somatization? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16011. [PMID: 36498084 PMCID: PMC9737361 DOI: 10.3390/ijerph192316011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Somatization is a phenomenon in which the individual experiences physical symptoms attributable to mental projections. It is a widely used term in common parlance to figuratively describe a stressful situation. Syndromes directly related to the mind have been described; pathologies are influenced by somatization. However, the extent of somatization is also related to social and cultural factors. In fact, each culture expresses varying levels of somatization characteristic of the country of origin. A disease can even manifest with different symptoms in different ethnic groups. The migration process arises from the need for change on the part of those who undertake it and culminates in the integration of the person in the host country. This process induces changes in the person of a psychological nature, which also affects somatization. In fact, the most integrated subjects show levels of somatization comparable to those of the host country. These considerations support the thesis that psychological changes are an integral part of health and can affect the development of organic and somatized pathologies.
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Affiliation(s)
- Antonello Barbati
- Department of Medicine and Health Science, University of Molise, 86100 Campobasso, Italy
| | | | - Fabiana Niro
- Department of Pathology, Federico II University of Naples, 80138 Naples, Italy
| | - Letizia Pezzi
- Rehabilitation Unit, ASST Cremona-Ospedale di Cremona, 26100 Cremona, Italy
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, 86100 Campobasso, Italy
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Psychological toll of being awakened: Asian-origin youth's critical reflection and mental health. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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5
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Huang KY, Nakigudde J, Kisakye EN, Sentongo H, Dennis-Tiwary TA, Tozan Y, Park H, Brotman LM. Advancing scalability and impacts of a teacher training program for promoting child mental health in Ugandan primary schools: protocol for a hybrid-type II effectiveness-implementation cluster randomized trial. Int J Ment Health Syst 2022; 16:28. [PMID: 35718782 PMCID: PMC9206883 DOI: 10.1186/s13033-022-00538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/06/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Children in low-and-middle-income countries (LMICs) are facing tremendous mental health challenges. Numerous evidence-based interventions (EBIs) have been adapted to LMICs and shown effectiveness in addressing the needs, but most EBIs have not been adopted widely using scalable and sustainable implementation models that leverage and strengthen existing structures. There is a need to apply implementation science methodology to study strategies to effectively scale-up EBIs and sustain the practices in LMICs. Through a cross-sector collaboration, we are carrying out a second-generation investigation of implementation and effectiveness of a school-based mental health EBI, ParentCorps Professional Development (PD), to scale-up and sustain the EBI in Uganda to promote early childhood students' mental health. Our previous studies in Uganda supported that culturally adapted PD resulted in short-term benefits for classrooms, children, and families. However, our previous implementation of PD was relied on mental health professionals (MHPs) to provide PD to teachers. Because of the shortage of MHPs in Uganda, a new scalable implementation model is needed to provide PD at scale. OBJECTIVES This study tests a new scalable and sustainable PD implementation model and simultaneously studies the effectiveness. This paper describes use of collaboration, task-shifting, and Train-the-Trainer strategies for scaling-up PD, and protocol for studying the effectiveness-implementation of ParentCorps-PD for teachers in urban and rural Ugandan schools. We will examine whether the new scale-up implementation approach will yield anticipated impacts and investigate the underlying effectiveness-implementation mechanisms that contribute to success. In addition, considering the effects of PD on teachers and students will influence by teacher wellness. This study also examines the added value (i.e. impact and costs) of a brief wellness intervention for teachers and students. METHODS Using a hybrid-type II effectiveness-implementation cluster randomized controlled trial (cRCT), we will randomize 36 schools (18 urban and 18 rural) with 540 teachers and nearly 2000 families to one of three conditions: PD + Teacher-Wellness (PDT), PD alone (PD), and Control. Primary effectiveness outcomes are teachers' use of mental health promoting strategies, teacher stress management, and child mental health. The implementation fidelity/quality for the scale-up model will be monitored. Mixed methods will be employed to examine underlying mechanisms of implementation and impact as well as cost-effectiveness. DISCUSSION This research will generate important knowledge regarding the value of an EBI in urban and rural communities in a LMIC, and efforts toward supporting teachers to prevent and manage early signs of children's mental health issues as a potentially cost-effective strategy to promote child population mental health in low resource settings. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov (registration number: NCT04383327; https://clinicaltrials.gov/ct2/show/NCT04383327 ) on May13, 2020.
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Affiliation(s)
- Keng-Yen Huang
- grid.240324.30000 0001 2109 4251Department of Population Health, New York University Grossman School of Medicine, 227 East, 30th St, 7th Floor, New York, NY 10016 USA
| | - Janet Nakigudde
- grid.11194.3c0000 0004 0620 0548College of Health Science, Makerere University, PO Box 7072, Kampala, Uganda
| | - Elizabeth Nsamba Kisakye
- grid.466898.d0000 0004 0648 0949Uganda Ministry of Education and Sports, Embassy House, PO Box 7063, Kampala, Uganda
| | - Hafsa Sentongo
- grid.415705.2Uganda Ministry of Health, Plot 6 Lourdel Road, PO Box 7272, Kampala, Uganda
| | - Tracy A. Dennis-Tiwary
- grid.257167.00000 0001 2183 6649Department of Psychology, Hunter College of the City University of New York, 695 Park Avenue, New York, USA
| | - Yesim Tozan
- grid.137628.90000 0004 1936 8753College of Global Public Health, New York University, 708 Broadway, New York, USA
| | - Hyung Park
- grid.240324.30000 0001 2109 4251Department of Population Health, New York University Grossman School of Medicine, 227 East, 30th St, 7th Floor, New York, NY 10016 USA
| | - Laurie Miller Brotman
- grid.240324.30000 0001 2109 4251Department of Population Health, New York University Grossman School of Medicine, 227 East, 30th St, 7th Floor, New York, NY 10016 USA
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Wang J, Liew J, Li X. Two Sides to Face: Integrity- and Achievement-Centered Face-Saving, Parental Psychological Control, and Depressive Symptoms in Chinese American Adolescents. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2022. [DOI: 10.1177/00220221221074295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Depressive symptoms can be serious, but often overlooked, health risk factors, especially for Asian Americans who are vulnerable to acculturation stress but tend to underreport mental health problems. The present study examines how specific cultural values and parenting practices are associated with Chinese American adolescents’ depressive symptoms. One hundred and nine Chinese American adolescents (61% females; Mage = 15.93 years, SDage = 1.39 years) and their parents completed online surveys about their endorsement of traditional Chinese cultural values that reflect integrity and achievement as two forms of face-saving, parents’ use of psychological control, and adolescents’ depressive symptoms. Parents’ endorsement of Conformity To Norms was positively associated with adolescents’ endorsement of the same value, which further correlated positively with adolescents’ depressive symptoms. However, adolescents’ endorsement of Family Recognition Through Achievement was neither associated with parents’ endorsement of the value nor with adolescents’ depressive symptoms. In addition, while parental psychological control was positively related to adolescents’ value belief in Conformity To Norms and depressive symptoms, parental psychological control was negatively related to adolescents’ value belief in Family Recognition Through Achievement. The findings suggest the richness and complexities of the face-saving cultural values and the usefulness of unpacking parenting dimensions in understanding familial processes and developmental specificity among immigrant youth.
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Affiliation(s)
- Jun Wang
- Texas A&M University, College Station, USA
| | | | - Xin Li
- Texas A&M University, College Station, USA
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Liu JL, Wang C, Do KA, Bali D. Asian American adolescents' mental health literacy and beliefs about helpful strategies to address mental health challenges at school. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jia Li Liu
- Asian American Studies ProgramUniversity of MarylandCollege ParkMarylandUSA
| | - Cixin Wang
- Asian American Studies ProgramUniversity of MarylandCollege ParkMarylandUSA
- Department of Counseling, Higher Education, and Special EducationUniversity of MarylandCollege ParkMarylandUSA
| | - Kieu Anh Do
- Department of Human EcologyUniversity of Maryland Eastern ShorePrincess AnneMarylandUSA
| | - Diksha Bali
- Department of Counseling, Higher Education, and Special EducationUniversity of MarylandCollege ParkMarylandUSA
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Obeid S, Sacre H, Haddad C, Akel M, Fares K, Zakhour M, Kheir N, Salameh P, Hallit S. Factors associated with fear of intimacy among a representative sample of the Lebanese population: The role of depression, social phobia, self-esteem, intimate partner violence, attachment, and maladaptive schemas. Perspect Psychiatr Care 2020; 56:486-494. [PMID: 31549436 DOI: 10.1111/ppc.12438] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/30/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess fear of intimacy (FOI) in the Lebanese population, and its correlates such as depression, social phobia, self-esteem, attachment, and maladaptive schemas. DESIGN/METHODS This cross-sectional study, conducted between November 2017 and May 2018, enrolled 707 community-dwelling participants. RESULTS Higher FOI scores were associated with an increase in the defectiveness schema (β = 0.483), social phobia score (β = 0.16), mistrust schema (β = 0.519), vulnerability schema (β = 0.482), emotional deprivation schema (β = 0.548), attachment style D (dismissing) (β = 0.913) and failure schema, whereas lower FOI was significantly associated with an increase in the entitlement schema (β = -0.362), insufficient schema (β = -0.377), and the self-esteem score (β = -0.288). PRACTICE IMPLICATIONS Implementing educational programs are needed to enable persons to develop healthy intimate relationships, taking into account attachment styles and inappropriate early schemas.
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Affiliation(s)
- Sahar Obeid
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Lebanese Order of Pharmacists, Beirut, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Kassandra Fares
- Faculty of Science, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Maha Zakhour
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Nelly Kheir
- Faculty of Pedagogy, Holy Family University, 5534, Batroun, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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Abstract
Approximately one-third of early childhood pupils in Ghana are struggling with meeting basic behavioral and developmental milestones, but little is known about mechanisms or factors that contribute to poor early childhood development. With a lack of developmental research to guide intervention or education program and policy planning, this study aimed to address these research gaps by examining a developmental mechanism for early childhood development. We tested a mediational mechanism model that examined the influence of parental wellbeing on parenting and children's development. Two hundred and sixty-two Ghanaian parents whose children attended early childhood classes (nursery to 3rd grade) were recruited. Data were gathered through parent interviews and Structural Equation Modeling was utilized to examine pathways of the model. Results support the mediational model that Ghanaian parents' depression was associated with less optimal parenting, and in turn greater child externalizing behavioral problems. This study adds new evidence of cross cultural consistency in early childhood development.
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Huang X, Chen W, Lin Y, Zhang Q, Ling L. Association between acculturation and body weight status among migrant children in Guangzhou, China: a cross-sectional study. BMJ Open 2018; 8:e018768. [PMID: 29934379 PMCID: PMC6020954 DOI: 10.1136/bmjopen-2017-018768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the association between acculturation and body weight status among internal migrant children in China. DESIGN, SETTING AND PARTICIPANTS A cross-sectional study was conducted among 1154 pairs of migrant children aged 11-17 years and their primary caregivers in Guangzhou, China, from April to May 2016. MEASURES Migrant children's body weight status was measured by body mass index. Acculturation was measured by a questionnaire, developed and validated by the research team. The questionnaire had three dimensions with five factors, namely language, social interaction, custom, dressing and diet. Social anxiety was measured by Social Anxiety Scale for Children. Food intake was measured by the food frequency table that was developed from a previous study. Logistic regression was performed to examine the association between acculturation and overweight/obesity while controlling for migrant children's and their caregivers' demographic characteristics, children's social anxiety and food intake. RESULTS Seventy-six out of 1154 (6.6%) migrant children were overweight, and 36 (3.1%) were obese. The overall prevalence of overweight/obesity was 12.5% in boys, and 6.1% in girls (p<0.001), respectively. The mean scores of acculturation were 41.8 (SD=14.6). Migrant children had the highest level of acculturation in the aspect of dressing (mean=61.7, SD=16.6), followed by language (mean=47.9, SD=22.3), diet (mean=45.0, SD=18.5), social interaction (mean=42.4, SD=21.3) and custom (mean=27.6, SD=19.2). After controlling for confounding factors, the levels of acculturation was negatively associated with overweight/obesity (adjusted OR (aOR)=0.98, 95% CI 0.97 to 1.00, p=0.030). Furthermore, migrant children who had urban-to-urban migrant caregivers were more likely to be overweight/obese (aOR=2.07, 95% CI 1.16 to 3.69, p=0.014) than their counterparts living with rural-to-urban migrant caregivers. CONCLUSIONS The low levels of acculturation was associated with overweight/obesity among migrant children in Guangzhou, China. Promoting healthy acculturation and social campaign on healthy body weight may help prevent childhood overweight/obesity. Young migrant children, boys and children living with urban-to-urban migrant caregivers should be the target subgroups.
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Affiliation(s)
- Xiaoling Huang
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Yanwei Lin
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Qi Zhang
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
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Huang KY, Calzada E, Cheng S, Barajas-Gonzalez RG, Brotman LM. Cultural Adaptation, Parenting and Child Mental Health Among English Speaking Asian American Immigrant Families. Child Psychiatry Hum Dev 2017; 48:572-583. [PMID: 27612477 PMCID: PMC5344775 DOI: 10.1007/s10578-016-0683-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Contrary to the "model minority" myth, Asian American children, especially those from low-income immigrant families, are at risk for both behavioral and emotional problems early in life. Little is known, however, about the underlying developmental mechanisms placing Asian American children at risk, including the role of cultural adaptation and parenting. This study examined cultural adaptation, parenting practices and culture related parenting values and child mental health in a sample of 157 English speaking Asian American immigrant families of children enrolled in early childhood education programs in low-income, urban neighborhoods. Overall, cultural adaptation and parenting cultural values and behaviors were related to aspects of child mental health in meaningful ways. Parents' cultural value of independence appears to be especially salient (e.g., negatively related to behavior problems and positively related to adaptive behavior) and significantly mediates the link between cultural adaptation and adaptive behavior. Study findings have implications for supporting Asian American immigrant families to promote their young children's mental health.
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Affiliation(s)
- Keng-Yen Huang
- Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Esther Calzada
- School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Sabrina Cheng
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | | | - Laurie Miller Brotman
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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Thomson KC, Guhn M, Richardson CG, Ark TK, Shoveller J. Profiles of children's social-emotional health at school entry and associated income, gender and language inequalities: a cross-sectional population-based study in British Columbia, Canada. BMJ Open 2017; 7:e015353. [PMID: 28751486 PMCID: PMC5642671 DOI: 10.1136/bmjopen-2016-015353] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Early identification of distinct patterns of child social-emotional strengths and vulnerabilities has the potential to improve our understanding of child mental health and well-being; however, few studies have explored natural groupings of indicators of child vulnerability and strengths at a population level. The purpose of this study was to examine heterogeneity in the patterns of young children's social and emotional health and investigate the extent to which sociodemographic characteristics were associated. DESIGN Cross-sectional study based on a population-level cohort. SETTING All kindergarten children attending public schools between 2004 and 2007 in British Columbia (BC), Canada. PARTICIPANTS 35 818 kindergarten children (age of 5 years) with available linked data from the Early Development Instrument (EDI), BC Ministry of Health and BC Ministry of Education. OUTCOME MEASURE We used latent profile analysis (LPA) to identify distinct profiles of social-emotional health according to children's mean scores across eight social-emotional subscales on the EDI, a teacher-rated measure of children's early development. Subscales measured children's overall social competence, responsibility and respect, approaches to learning, readiness to explore, prosocial behaviour, anxiety, aggression and hyperactivity. RESULTS Six social-emotional profiles were identified: (1) overall high social-emotional functioning, (2) inhibited-adaptive (3) uninhibited-adaptive, (4) inhibited-disengaged, (5) uninhibited-aggressive/hyperactive and (6) overall low social-emotional functioning. Boys, children with English as a second language (ESL) status and children with lower household income had higher odds of membership to the lower social-emotional functioning groups; however, this association was less negative among boys with ESL status. CONCLUSIONS Over 40% of children exhibited some vulnerability in early social-emotional health, and profiles were associated with sociodemographic factors. Approximately 9% of children exhibited multiple co-occurring vulnerabilities. This study adds to our understanding of population-level distributions of children's early social-emotional health and identifies profiles of strengths and vulnerabilities that can inform future intervention efforts.
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Affiliation(s)
- Kimberly C Thomson
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Chris G Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Tavinder K Ark
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jean Shoveller
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Guo S, Kim JJ, Bear L, Lau AS. Does Depression Screening in Schools Reduce Adolescent Racial/Ethnic Disparities in Accessing Treatment? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 46:523-536. [DOI: 10.1080/15374416.2016.1270826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sisi Guo
- Department of Psychology, University of California, Los Angeles
| | - Joanna J. Kim
- Department of Psychology, University of California, Los Angeles
| | - Laurel Bear
- Gateway to Success, Alhambra Unified School District
| | - Anna S. Lau
- Department of Psychology, University of California, Los Angeles
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Aratani Y, Liu CH. English Proficiency, Threshold Language Policy and Mental Health Service Utilization among Asian-American Children. Arch Psychiatr Nurs 2015; 29:326-32. [PMID: 26397437 DOI: 10.1016/j.apnu.2015.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 05/26/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022]
Abstract
This paper explores the role of English proficiency, ethnicity, and California's threshold language policy in the rates of discontinuing mental health services among Asian-American children. We used data from the 2001-2006 Client and Services Information (CSI) System, which contains county-level information about service users in public mental health systems. Our data included 59,218 service users under the age of 18. We used logistic regression to determine the likelihood of discontinuing services, while controlling for sociodemographic and clinical characteristics. English-speaking Asians were 11% more likely than English-speaking Whites to discontinue mental health services. Non-English-speaking Asians were 50% significantly more likely to stay in services. The results also revealed some inter-ethnic variations in the discontinuation patterns; however, the patterns of mental health service utilization appear to be driven by the availability of mental health services in Asian-ethnic languages in county of residence. Further research is needed to understand the intake and referral processes that Asian children go through within the mental health service system.
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Affiliation(s)
- Yumiko Aratani
- Columbia University Mailman School of Public Health, National Center for Children in Poverty, New York, NY.
| | - Cindy H Liu
- Commonwealth Research Center, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA.
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Huang KY, Nakigudde J, Calzada E, Boivin MJ, Ogedegbe G, Brotman LM. Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial. Trials 2014; 15:471. [PMID: 25443043 PMCID: PMC4289288 DOI: 10.1186/1745-6215-15-471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 11/17/2014] [Indexed: 12/03/2022] Open
Abstract
Background Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. Methods/Design The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. Discussion The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings. Trial registration This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.
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Affiliation(s)
- Keng-Yen Huang
- Department of Population Health, New York University Langone Medical Center, 227 East 30th Street, 1st Floor, New York, NY 10016, USA.
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Huang KY, Calzada E, Kamboukos D, Rhule D, Sharma KC, Cheng S, Brotman LM. Applying Public Health Frameworks to Advance the Promotion of Mental Health Among Asian American Children. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2014; 5:145-152. [PMID: 25505500 PMCID: PMC4258409 DOI: 10.1037/a0036185] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Asian American (ASA) children experience high rates of mental health problems. Although there is a pressing need to utilize population approaches, emerging frameworks from the fields of public and population health have not been applied to ASA children. This paper addresses this gap by first discussing applications of the National Prevention Strategy (NPS), a population strategy developed from the Social Determinants of Health perspective, to guide ASA prevention work. Next, we provide a practical example to illustrate how the NPS can be applied to prevention program design (using ParentCorps as an example) and dissemination and implementation processes to broadly address ASA children's mental health needs. Finally, we present preliminary data on the feasibility of applying this population strategy to ASA families and a framework for researchers who are considering disseminating and implementing evidence-based programs to ASA or ethnic minority pediatric populations.
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Affiliation(s)
- Keng-Yen Huang
- Department of Population Health New York University School of Medicine
| | - Esther Calzada
- Department of Population Health New York University School of Medicine
| | - Dimitra Kamboukos
- Department of Population Health New York University School of Medicine
| | - Dana Rhule
- Department of Population Health New York University School of Medicine
| | | | - Sabrina Cheng
- Department of Population Health New York University School of Medicine
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Guo S, Kataoka SH, Bear L, Lau AS. Differences in School-Based Referrals for Mental Health Care: Understanding Racial/Ethnic Disparities Between Asian American and Latino Youth. SCHOOL MENTAL HEALTH 2013. [DOI: 10.1007/s12310-013-9108-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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