Understanding the findings of resilience-related research for fostering the development of African American adolescents

"Honesty, Communication and Trust Are What Bring Peace of Mind": Narratives of HIV Risk Among Hispanic/Latino Men Who Have Sex with Men in the Southern United States

For Hispanic/Latino MSM (HLMSM) in the South, HIV burden remains high, and HIV elimination is a national priority. Between July and September 2016, using a strengths-based approach informed by resilience theory, we conducted qualitative interviews with HIV-negative HLMSM in five southern cities in the United States with elevated HIV prevalence. We analyzed data using a qualitative content analysis approach, assessing for interrater reliability. A brief behavioral survey was also conducted. We enrolled 51 HLMSM (mean age = 33 years, range = 15-63). HLMSM discussed the climate of fear about HIV and homosexuality impeding HIV prevention, including the impact of stigma and taboo. Three main strengths-based strategies emerged for preventing HIV: assessing partner risk, establishing boundaries for sexual interactions, and self-education. Future HIV prevention efforts may benefit from balancing risk-based approaches with those that emphasize resilience, address partner trustworthiness and safety, and focus on providing novel outlets for HIV prevention education.

Understanding posttraumatic stress trajectories in adolescent females: A strength-based machine learning approach examining risk and protective factors including online behaviors

Heterogeneity in the course of posttraumatic stress symptoms (PTSS) following a major life trauma such as childhood sexual abuse (CSA) can be attributed to numerous contextual factors, psychosocial risk, and family/peer support. The present study investigates a comprehensive set of baseline psychosocial risk and protective factors including online behaviors predicting empirically derived PTSS trajectories over time. Females aged 12-16 years (N = 440); 156 with substantiated CSA; 284 matched comparisons with various self-reported potentially traumatic events (PTEs) were assessed at baseline and then annually for 2 subsequent years. Latent growth mixture modeling (LGMM) was used to derive PTSS trajectories, and least absolute shrinkage and selection operator (LASSO) logistic regression was used to investigate psychosocial predictors including online behaviors of trajectories. LGMM revealed four PTSS trajectories: resilient (52.1%), emerging (9.3%), recovering (19.3%), and chronic (19.4%). Of the 23 predictors considered, nine were retained in the LASSO model discriminating resilient versus chronic trajectories including the absence of CSA and other PTEs, low incidences of exposure to sexual content online, minority ethnicity status, and the presence of additional psychosocial protective factors. Results provide insights into possible intervention targets to promote resilience in adolescence following PTEs.

Factors influencing the negotiation of ethnic identity among 1.5 and second-generation Asian migrants: A mixed methods systematic review

INTRODUCTION

Whilst positive ethnic identity is associated with higher self-esteem, prosocial tendencies and peer acceptance, it is inversely associated with depressive symptoms and drug use among ethnic minority individuals. Negotiating ethnic identity is particularly challenging for 1.5-and second-generation migrant populations, finding themselves positioned between host culture and culture of origin. To inform positive youth development policies and practices, this systematic literature review aimed to identify factors influencing the negotiation of ethnic identity for 1.5-and second-generation Asian migrants living in high-income countries.

METHODS

A mixed-methods systematic review was conducted of peer-reviewed literature in four databases: MEDLINE, EMBASE, PsychInfo and Scopus. Articles were screened by title, abstract and full text to ascertain whether they met the inclusion criteria. Quality of studies were assessed using MMAT Version 2011. Mixed-method thematic analysis was used to synthesis the data according to Bronfenbrenner's Ecological Model.

RESULTS

Forty-seven studies met the inclusion criteria. The review findings confirm a wide range of factors influencing the negotiation of ethnic identity from three systems in Bronfenbrenner's Ecological Model, most commonly from the macrosystem (e.g stereotyping), followed by microsystem (e.g family) and individual factors (e.g heritage language use).

CONCLUSIONS

Results indicate negotiating ethnic identity can be challenging and difficult, where the culture/norms of country of origin and host country play a significant role. Positive youth development policies and practices need to reflect these wide range of factors. More research is needed in countries where data is not available to facilitate greater response to needs of this increasing population group.

Racial-Ethnic Protective Factors and Mechanisms in Psychosocial Prevention and Intervention Programs for Black Youth

Extending previous reviews related to cultural responsiveness in the treatment of ethnic minority youth, the current review provides a critical assessment and synthesis of both basic and applied research on the integration of three racial-ethnic protective factors (racial identity, racial socialization, Africentric worldview) in psychosocial prevention and intervention programs for Black children and adolescents. Seventeen programs meeting inclusion and exclusion criteria were evaluated for the extent to which racial-ethnic protective factors and related mechanisms were integrated, applied, and tested in such programs. A systematic assessment of these programs revealed that several prevention and intervention programs drew upon the three factors, particularly Africentric worldview. In addition, a number of studies hypothesized and assessed mechanisms, both those previously identified in conceptual literature and those that emerged from the interventions themselves. A set of recommendations encouraging the implementation of these factors into future prevention and intervention programs, examples of how clinicians can infuse these factors into psychotherapy, and areas for future research are discussed.

Assessing the effects of a complementary parent intervention and prior exposure to a preadolescent program of HIV risk reduction for mid-adolescents

OBJECTIVES

We (1) evaluated the impact of an evidence-based HIV prevention program with and without a parent component among mid-adolescents living in the Caribbean and (2) determined the effect of prior receipt of a related intervention during preadolescence on intervention response.

METHODS

A randomized, controlled 4-cell trial of a 10-session, theory-based HIV prevention intervention involving 2564 Bahamian grade-10 youths (some of whom had received a comparable intervention in grade 6) was conducted (2008-2011). Randomization occurred at the level of the classroom with follow-up at 6, 12, and 18 months after intervention. The 3 experimental conditions all included the youths' curriculum and either a youth-parent intervention emphasizing adolescent-parent communication, a parent-only goal-setting intervention, or no parent intervention.

RESULTS

An intervention delivered to mid-adolescents in combination with a parent-adolescent sexual-risk communication intervention increased HIV/AIDS knowledge, condom-use skills, and self-efficacy and had a marginal effect on consistent condom use. Regardless of prior exposure to a similar intervention as preadolescents, youths benefited from receipt of the intervention.

CONCLUSIONS

Preadolescents and mid-adolescents in HIV-affected countries should receive HIV prevention interventions that include parental participation.

Social Ecology of Adherence to Hypertension Treatment in Latino Migrant and Seasonal Farmworkers

PURPOSE

This study explored Latino migrant/seasonal farmworkers' (MSFWs') adherence to hypertension treatment.

DESIGN

A cross-sectional correlational study was conducted.

METHOD

Forty-five Latino MSFWs from two farmworker health clinics completed Spanish versions of the Morisky Medication Adherence Scale, the Blood Pressure Knowledge Scale and Blood Pressure Self-Care Scale, the Perceived Stress Scale, the Acculturation Rating Scale for Mexican Americans-II, the Short Assessment of Health Literacy for Spanish-Speaking Adults, health care access questions, and blood pressure measurements.

RESULTS

MSFWs had poor medication adherence (51%). Blood pressure knowledge, perceived stress, acculturation, health literacy, and health care access accounted for 49% of the variance in blood pressure self-care. Higher acculturation level and health literacy were associated with better blood pressure control (p = .01).

DISCUSSION

MSFWs had poor medication adherence and blood pressure control. Blood pressure knowledge and acculturation played a role in blood pressure self-care.

IMPLICATIONS

Culturally appropriate educational programs are needed to help MSFWs' adherence to hypertension treatment.

Resilience as a research framework and as a cornerstone of prevention research for gay and bisexual men: theory and evidence

This commentary presents the content and results of a recent symposium held to discuss how resiliencies among gay and bisexual men, and other men who have sex with men, could inform HIV prevention interventions. We outline the argument for including resiliencies in prevention work and present a critique of the deficit-based approached to public health research as it applies to this line of inquiry. The commentary makes the case that HIV prevention work would be more efficacious if it were designed to incorporate naturally occurring resiliencies that manifest among gay male communities rather than primarily using interventions that address vulnerabilities among men who continue to reside in high risk contexts. The commentary concludes by listing a set of resiliency variables and constructs proposed at the meeting that could be tested in theoretically-based investigations to raise resiliencies among gay and bisexual men thereby lowering HIV risks in this population.

"I'm a keep rising. I'm a keep going forward, regardless": exploring Black men's resilience amid sociostructural challenges and stressors

A growing number of health and social science research findings document Black men's adversities, but far less is known about their strengths. The purpose of this study was to explore resilience among low-income, urban, Black men. Semistructured interviews produced rich narratives, which uncovered numerous sociostructural stressors in men's lives, such as racism, incarceration, and unemployment. Most men were resilient despite these challenges, however, and described five main forms of resilience: (a) perseverance; (b) a commitment to learning from hardship; (c) reflecting and refocusing to address difficulties; (d) creating a supportive environment; and (e) drawing support from religion/spirituality. Analysis of men's challenge and resilience narratives revealed the need to understand and promote low-income, urban, Black men's resilience via a broader ecosocial perspective which acknowledges the importance of social and community-level protective factors to support individual men's efforts to survive and thrive amid their adversities.

The effect of resilience on posttraumatic stress disorder in trauma-exposed inner-city primary care patients

Posttraumatic stress disorder (PTSD) has previously been associated with increased risk for a variety of chronic medical conditions and it is often underdiagnosed in minority civilian populations. The current study examined the effects of resilience on the likelihood of having a diagnosis of PTSD in an inner-city sample of primary care patients (n=767). We measured resilience with the Connor-Davidson Resilience Scale, trauma with the Childhood Trauma Questionnaire and Trauma Events Inventory, and assessed for PTSD with the modified PTSD symptom scale. Multiple logistic regression model with presence/absence of PTSD as the outcome yielded 3 significant factors: childhood abuse, nonchild abuse trauma, and resilience. One type of childhood abuse in moderate to severe range (OR, 2.01; p = .0001), 2 or more types of childhood abuse in moderate to severe range (OR, 4.00; p < or = .0001), and 2 or more types of nonchildhood abuse trauma exposure (OR, 3.33; p < or = .0001), were significantly associated with an increased likelihood of PTSD, while resilience was robustly and significantly associated with a decreased likelihood of PTSD (OR, 0.93; p < or = .0001). By understanding the role of resilience in recovery from adverse experiences, improved treatment and interventional methods may be developed. Furthermore, these results suggest a role for assessing resilience in highly traumatized primary care populations as a way to better characterize risk for PTSD and direct screening/psychiatric referral efforts.

Predicting resilient adolescents and youths: validation of a screening test in Colombia

BACKGROUND

This article presents the validation of the Child and Youth Resilience Measure-58 (CYRM-58) in the Colombian context and in Spanish language.

METHODS

CYRM-58 has 58 questions and was developed by an international team of researchers coordinated by the Resilience Research Centre (Dalhousie University, Canada). Simplified CYRM Colombia is a test that uses 7 questions of CYRM-58; for its validation we tested reproducibility in 22 persons aged 14 to 23 years.

RESULTS

We validated content and internal consistency in 39 resilients, 43 youth with deviant behaviors, and 66 controls matched by age and sex. We estimated internal consistency by non-parametric factorial analysis, and we assessed content validity by means of the Mann-Whitney test, bootstrap regression and logistic regression. The reproducibility was found to be in the range of 75-86%. Correlation between measurements was 75%.

CONCLUSION

The best predictive model or Simplified CYRM Colombia was found to have seven questions (sensitivity = 96%, specificity = 76%, power = 80%).

Intrinsic component of resilience among entry level medical students in the United Arab Emirates

BACKGROUND

Resilience is the capacity to recover and to cope successfully with everyday challenges. Resilience has intrinsic and extrinsic components and an effort has been made to study the intrinsic component and its association with sociodemographic factors, among the entry level students of the Integrated Bachelor of Medicine and Bachelor of Surgery (MBBS) course.

METHOD

The present study was conducted in Gulf Medical University, using a self-administered questionnaire, comprising of two parts, distributed to all the students who consented to participate. The first part contained questions on socio-demographic details while the second part contained questions on the intrinsic and extrinsic components of resilience of the students. The data collected was analysed using Predictive Analytic Software (PASW) 18.0 using frequency, mean, SD and median.

RESULTS

Among the 58 students who participated 24 (41.4%) were males and 34 (58.6%) females, of which 70.7% were < 20 years and 29.3% ≥ 20years. The mean score for the intrinsic component of resilience was 48.9 (SD, 5 and range 35-60). The median scores showed no significant variation (p<0.05) with age, gender, religion, nationality, family structure, highest education among parents, the person they share their feelings with or the number of friends. However, minimally higher scores were noted in the median scores of students from nuclear families, with Western nationality and those whose parents had a university level education, who shared their feelings with people of their own generation or outside their family and who have 5-9 friends.

CONCLUSION

The intrinsic component of resilience was found to be almost uniform for the study group and the level is high. A study has to further look into its effect on coping with the stresses encountered during the academic year.

Development of a family-based program to reduce risk and promote resilience among families affected by maternal depression: theoretical basis and program description

Depression is a family matter. It not only diminishes the quality-of-life of the depressed person, but also strains the resources of the family unit and increases the children's risk of developing significant problems that start early and persist into adulthood. Although treatment of a parent's depression is critical, many families also need professional intervention to reduce children's risk. This article reviews the evidence on needs of these families and shows that the theoretical and clinical evidence exists to support the design of interventions for families affected by maternal depression. A preventive intervention developed from this foundation is described, the Keeping Families Strong (KFS) program, that is designed to promote resilience and reduce the risk for psychological disorders in children of parents with depression. The pilot study on the KFS program, conducted in adult mental health outpatient settings, is described. Families participate in 10 meetings 90 min each, with a group for parents and for children (10 years and older) conducted concurrently. The program structure and content are described, the challenges of implementing a family preventive intervention in actual clinical settings are discussed, and a case example is provided, as well as preliminary outcome data on ten families. In sum, we provide a strong rationale for the potential of preventive interventions for families affected by maternal depression.