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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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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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Huang KY, Lee D, Nakigudde J, Cheng S, Gouley KK, Mann D, Schoenthaler A, Chokshi S, Kisakye EN, Tusiime C, Mendelsohn A. Use of Technology to Promote Child Behavioral Health in the Context of Pediatric Care: A Scoping Review and Applications to Low- and Middle-Income Countries. Front Psychiatry 2019; 10:806. [PMID: 31798470 PMCID: PMC6865208 DOI: 10.3389/fpsyt.2019.00806] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
Background: The burden of mental, neurological, and substance (MNS) disorders is greater in low- and middle-income countries (LMICs). The rapid growth of digital health (i.e., eHealth) approaches offer new solutions for transforming pediatric mental health services and have the potential to address multiple resource and system barriers. However, little work has been done in applying eHealth to promote young children's mental health in LMICs. It is also not clear how eHealth has been and might be applied to translating existing evidence-based practices/strategies (EBPs) to enable broader access to child mental health interventions and services. Methods: A scoping review was conducted to summarize current eHealth applications and evidence in child mental health. The review focuses on 1) providing an overview of existing eHealth applications, research methods, and effectiveness evidence in child mental health promotion (focused on children of 0-12 years of age) across diverse service contexts; and 2) drawing lessons learned from the existing research about eHealth design strategies and usability data in order to inform future eHealth design in LMICs. Results: Thirty-two (32) articles fitting our inclusion criteria were reviewed. The child mental health eHealth studies were grouped into three areas: i) eHealth interventions targeting families that promote child and family wellbeing; ii) eHealth for improving school mental health services (e.g., promote school staff's knowledge and management skills); and iii) eHealth for improving behavioral health care in the pediatric care system (e.g., promote use of integrated patient-portal and electronic decision support systems). Most eHealth studies have reported positive impacts. Although most pediatric eHealth studies were conducted in high-income countries, many eHealth design strategies can be adapted and modified to fit LMIC contexts. Most user-engagement strategies identified from high-income countries are also relevant for populations in LMICs. Conclusions: This review synthesizes patterns of eHealth use across a spectrum of individual/family and system level of eHealth interventions that can be applied to promote child mental health and strengthen mental health service systems. This review also summarizes critical lessons to guide future eHealth design and delivery models in LMICs. However, more research in testing combinations of eHealth strategies in LMICs is needed.
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Affiliation(s)
- Keng-Yen Huang
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Douglas Lee
- College of Osteopathic Medicine, New York Institute of Technology, New York, NY, United States
| | - Janet Nakigudde
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Sabrina Cheng
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Kathleen Kiely Gouley
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Devin Mann
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Antoinette Schoenthaler
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Sara Chokshi
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | | | | | - Alan Mendelsohn
- Department of Population Health, New York University School of Medicine, New York, NY, United States
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Wang C, Shao X, Do KA, Lu HK, O’Neal CR, Zhang Y. Using Participatory Culture-Specific Consultation with Asian American Communities: Identifying Challenges and Solutions for Asian American Immigrant Families. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2019. [DOI: 10.1080/10474412.2019.1614453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Cixin Wang
- University of Maryland, College Park, Maryland, USA
| | - Xiaoping Shao
- Chinese Culture and Service Center, Inc, Gaithersburg, Maryland, USA
- George Washington University, Washington, DC, USA
| | - Kieu Anh Do
- University of Maryland Eastern Shore, Princess Anne, Maryland, USA
| | - Huixing Kate Lu
- Chinese Culture and Service Center, Inc, Gaithersburg, Maryland, USA
| | | | - Yuan Zhang
- University of Connecticut, Storrs, Connecticut, USA
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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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Ssewamala FM, Sensoy Bahar O, McKay MM, Hoagwood K, Huang KY, Pringle B. Strengthening mental health and research training in Sub-Saharan Africa (SMART Africa): Uganda study protocol. Trials 2018; 19:423. [PMID: 30081967 PMCID: PMC6080393 DOI: 10.1186/s13063-018-2751-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children in Sub-Saharan Africa (SSA) comprise half of the total regional population, yet existing mental health services are severely under-equipped to meet their needs. Although effective interventions for the treatment of disruptive behavioral disorders (DBDs) in youth have been tested in high-poverty and high-stress communities in developed countries, and are relevant for widespread dissemination in low- and middle-income countries (LMICs), most of these evidence-based practices (EBPs) have not been utilized in SSA, a region heavily impacted by poverty, diseases including HIV/AIDS, and violence. Thus, this paper presents a protocol for a scale-up longitudinal experimental study that uses a mixed-methods, hybrid type II, effectiveness implementation design to test the effectiveness of an EBP, called Multiple Family Group (MFG) aimed at improving child behavioral challenges in Uganda while concurrently examining the multi-level factors that influence uptake, implementation, sustainment, and youth outcomes. METHODS The MFG intervention will be implemented and tested via a longitudinal experimental study conducted across 30 public primary schools located in both semi-urban and rural communities. The schools will be randomly assigned to three study conditions (n = 10 per study condition): (1) MFG delivered by trained family peers; (2) MFG delivered by community health workers; or; (3) comparison: usual care comprising mental health care support materials, bolstered with school support materials. A total of 3000 children (ages 8 to 13 years; grades 2 to 7) and their caregivers (N = 3000 dyads); 60 parent peers, and 60 community health workers will be recruited. Each study condition will comprise of 1000 child-caregiver dyads. Data will be collected at baseline, 8 and 16 weeks, and 6-month follow-up. DISCUSSION This project is the first to test the effectiveness of the MFG intervention while concurrently examining multi-level factors that influence overall implementation of a family-based intervention provided in schools and aimed at reaching the large child population with mental health service needs in Uganda. Moreover, the study draws upon an EBP that has already been tested for delivery by parent peers and community facilitators, and hence will take advantage of the advancing science behind task-shifting. If successful, the project has great potential to address global child mental health needs. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03081195 . Registered on 16 March 2017.
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Affiliation(s)
- Fred M. Ssewamala
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130 USA
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130 USA
| | - Mary M. McKay
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130 USA
| | - Kimberly Hoagwood
- Department of Child and Adolescent Psychiatry, School of Medicine, New York University, 550 First Avenue, New York, NY 10016 USA
| | - Keng-Yen Huang
- Department of Child and Adolescent Psychiatry, School of Medicine, New York University, 550 First Avenue, New York, NY 10016 USA
| | - Beverly Pringle
- National Institute of Mental Health, 6001 Executive Boulevard, Bethesda, MD 20892 USA
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Ridgeway JL, Wang Z, Finney Rutten LJ, van Ryn M, Griffin JM, Murad MH, Asiedu GB, Egginton JS, Beebe TJ. Conceptualising paediatric health disparities: a metanarrative systematic review and unified conceptual framework. BMJ Open 2017; 7:e015456. [PMID: 28780545 PMCID: PMC5724162 DOI: 10.1136/bmjopen-2016-015456] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE There exists a paucity of work in the development and testing of theoretical models specific to childhood health disparities even though they have been linked to the prevalence of adult health disparities including high rates of chronic disease. We conducted a systematic review and thematic analysis of existing models of health disparities specific to children to inform development of a unified conceptual framework. METHODS We systematically reviewed articles reporting theoretical or explanatory models of disparities on a range of outcomes related to child health. We searched Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus (database inception to 9 July 2015). A metanarrative approach guided the analysis process. RESULTS A total of 48 studies presenting 48 models were included. This systematic review found multiple models but no consensus on one approach. However, we did discover a fair amount of overlap, such that the 48 models reviewed converged into the unified conceptual framework. The majority of models included factors in three domains: individual characteristics and behaviours (88%), healthcare providers and systems (63%), and environment/community (56%), . Only 38% of models included factors in the health and public policies domain. CONCLUSIONS A disease-agnostic unified conceptual framework may inform integration of existing knowledge of child health disparities and guide future research. This multilevel framework can focus attention among clinical, basic and social science research on the relationships between policy, social factors, health systems and the physical environment that impact children's health outcomes.
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Affiliation(s)
- Jennifer L Ridgeway
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Zhen Wang
- Department of Health Sciences Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Lila J Finney Rutten
- Department of Health Sciences Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle van Ryn
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Joan M Griffin
- Department of Health Sciences Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - M Hassan Murad
- Department of Health Sciences Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Gladys B Asiedu
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jason S Egginton
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy J Beebe
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Huang KY, Abura G, Theise R, Nakigudde J. Parental Depression and Associations with Parenting and Children's Physical and Mental Health in a Sub-Saharan African Setting. Child Psychiatry Hum Dev 2017; 48:517-527. [PMID: 27544380 PMCID: PMC5318298 DOI: 10.1007/s10578-016-0679-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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
Depression is one of the most prevalent mental health challenges in low- and middle-income countries. However, the mechanisms of parental depression on children's development are understudied in these countries. This study examined the prevalence of parental depression, contextual predictors of parental depression, and the associations between parental depression, parenting and children's development in one of the Sub-Saharan African countries-Uganda. Three hundred and three Ugandan parents of young children were recruited and interviewed. Results indicated that about 28 % of parents were depressed. Contextual factors such as low educational attainment, food insecurity, low social support, and high number of children were associated with parental depression. Structural equation modeling also indicated that Ugandan parents' depression was associated with less optimal parenting, and higher problem behavior, lower social competence, and poorer physical health and school functioning in children. Results provide several cross cultural consistency evidence in associations among parental depression, parenting, and child development.
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Affiliation(s)
- Keng-Yen Huang
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 1st FL, New York, NY, 1006, USA.
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 1st FL, New York, NY, 1006, USA.
| | - Gloria Abura
- College of Health Science, Makerere University, PO Box 7072, Kampala, Uganda
- College of Health Science, Makerere University, PO Box 7072, Kampala, Uganda
| | - Rachelle Theise
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 1st FL, New York, NY, 1006, USA
| | - Janet Nakigudde
- College of Health Science, Makerere University, PO Box 7072, Kampala, Uganda
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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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Kim SY, Shen Y, Hou Y, Tilton KE, Juang L, Wang Y. Annual Review of Asian American Psychology, 2014. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2015; 6:291-332. [PMID: 26925199 PMCID: PMC4765738 DOI: 10.1037/aap0000031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.
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Affiliation(s)
- Su Yeong Kim
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 471-5524
| | - Yishan Shen
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 983-7551
| | - Yang Hou
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 660-2236
| | - Kelsey E Tilton
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 956-459-4212
| | - Linda Juang
- University of Potsdam, College of Human Sciences, Education, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany, +49 (0)172 1882255,
| | - Yijie Wang
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 289-8136
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George U, Thomson MS, Chaze F, Guruge S. Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13624-48. [PMID: 26516884 PMCID: PMC4627052 DOI: 10.3390/ijerph121013624] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/24/2015] [Accepted: 10/20/2015] [Indexed: 11/16/2022]
Abstract
The Mental Health Commission of Canada's (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Over two decades of relevant literature on immigrants' health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed.
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Affiliation(s)
- Usha George
- Faculty of Community Services, Ryerson University, 99 Gerrard Street East, SHE-690; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Mary S Thomson
- Faculty of Community Services, Ryerson University, 99 Gerrard Street East, SHE-690; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Ferzana Chaze
- Community Studies, Sheridan College, 7899 McLaughlin Road, Brampton, ON L6Y 5H9, Canada.
| | - Sepali Guruge
- School of Nursing; Ryerson University, Faculty of Community Services; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
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Huang CY, Zane N. Cultural influences in mental health treatment. Curr Opin Psychol 2015; 8:131-136. [PMID: 29506788 DOI: 10.1016/j.copsyc.2015.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/26/2015] [Accepted: 10/03/2015] [Indexed: 12/15/2022]
Abstract
Research on mental health treatments from 2010 to 2015 has continued to highlight the critical role of culture on treatment services, processes, and outcomes for racial/ethnic minority groups. Studies showed that factors such as acculturation and phenotypic appearance were associated with risk for psychopathology. Issues such as face concern and acculturation level were associated with the quality of client-therapist relationships and the amount of information clients disclosed in sessions. While racial/ethnic minority clients generally preferred same-ethnicity therapists, findings showed relatively small effects for racial/ethnic match and positive treatment outcomes. Several studies provided additional evidence for the effectiveness of culturally-adapted, evidence-based treatments compared to non-adapted treatments for minority clients, and more researchers are beginning to delineate the processes involved in making these successful adaptations.
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Affiliation(s)
- Cindy Y Huang
- Asian American Center on Disparities Research, University of California, Davis One Shields Avenue, Davis, CA 95616, USA.
| | - Nolan Zane
- Asian American Center on Disparities Research, University of California, Davis One Shields Avenue, Davis, CA 95616, USA
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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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