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Tuda D, Stefancic A, Lam P, John D, Sadaghiyani S, Choo TH, Galfalvy H, Coronel B, Gil R, Lewis-Fernández R. Life is precious: A quasi-experimental study of a community-based program to prevent suicide among Latina adolescents in New York City. Suicide Life Threat Behav 2023. [PMID: 38050824 PMCID: PMC11150327 DOI: 10.1111/sltb.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes. METHODS Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models. RESULTS The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP. CONCLUSION The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.
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Affiliation(s)
- Daniela Tuda
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
- Center for Mental Health Services Research, Brown School, Washington University, St. Louis, Missouri, USA
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
| | - Ana Stefancic
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Peter Lam
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Dolly John
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Shima Sadaghiyani
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Tse-Hwei Choo
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York City, New York, USA
| | | | - Rosa Gil
- Comunilife, Inc., New York City, New York, USA
| | - Roberto Lewis-Fernández
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
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Evans K, Hasson RG, Teixeira S, Fitchett V, Crea TM. Unaccompanied Immigrant Children in ORR Foster Care: Community Level Facilitators of Adjustment Identified by Service Providers. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022; 41:1-14. [PMID: 35874463 PMCID: PMC9288734 DOI: 10.1007/s10560-022-00842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE While many studies address immigrant integration, few focus on the adjustment process for unaccompanied immigrant children in foster care in the United States- and even fewer look at community level prevention and intervention strategies for positive youth adjustment. This study uses a human rights framework to examine community level facilitators- both prevention and interventions- that aid the adjustment for unaccompanied immigrant children in foster care as they navigate life in the US. METHOD Seventy-nine service providers that work with unaccompanied immigrant children participated in 22 focus groups/interviews. Open coding was used to create a codebook, and then data were qualitatively analyzed using deductive and axial coding. RESULTS The major prevention strategies for community adjustment include welcoming communities and inter-agency collaborations. The major intervention strategies for systems level adjustment include community relationships, access to healthcare, and the church as an institution. DISCUSSION Implications include advocating for funding and programming to support mentors for every child, advocating for welcoming policies, and engaging unaccompanied immigrant children in research using participatory approaches.
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Affiliation(s)
- Kerri Evans
- School of Social Work, University of Maryland Baltimore County, 1000 Hilltop Cir, 21250 Baltimore, MD USA
| | - Robert G. Hasson
- Department of Social Work, Providence College, Providence, RI USA
| | | | | | - Thomas M. Crea
- Boston College School of Social Work, Chestnut Hill, MA USA
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Orengo-Aguayo R, Dueweke AR, Nicasio A, de Arellano MA, Rivera S, Cohen JA, Mannarino AP, Stewart RW. Trauma-focused cognitive behavioral therapy with Puerto Rican youth in a post-disaster context: Tailoring, implementation, and program evaluation outcomes. CHILD ABUSE & NEGLECT 2022; 129:105671. [PMID: 35580399 DOI: 10.1016/j.chiabu.2022.105671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/23/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has not yet been systematically evaluated in the Caribbean context, particularly with Hispanic youth exposed to multiple disasters. The objective of this project was twofold: 1) to train mental health providers in Puerto Rico in TF-CBT as part of a clinical implementation project within the largest managed behavioral health organization (MBHO) on the island, and 2) to conduct a program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. METHOD Fifteen psychologists were trained in TF-CBT. These psychologists then provided TF-CBT to 56 children and adolescents, ages 5-18, in community-based mental health clinics and one primary care clinic with a co-located psychologist in Puerto Rico. The mean number of traumatic events reported by youth referred for TF-CBT was 4.11. RESULTS Thirty-six out of 56 children enrolled in the project (64.3%) successfully completed all components of TF-CBT. Results demonstrated large effect sizes for reduction in youth-reported posttraumatic stress symptoms (PTSS) (Cohen's d = 1.32), depressive symptoms (Cohen's d = 1.32), and anxiety symptoms (Cohen's d = 1.18). CONCLUSIONS These results suggest that it was feasible to train providers in TF-CBT, that providers were able to deliver TF-CBT in community-based settings both in person and via telehealth (due to the COVID-19 pandemic), and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in Puerto Rico in a post-disaster context. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for Hispanic youth and disaster-affected youth in the Caribbean.
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Affiliation(s)
| | | | | | | | - Susana Rivera
- Serving Children and Adults in Need (SCAN) Inc., United States of America
| | | | | | - Regan W Stewart
- Medical University of South Carolina, United States of America
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Verhagen IL, Noom MJ, Lindauer RJL, Daams JG, Hein IM. Mental health screening and assessment tools for forcibly displaced children: a systematic review. Eur J Psychotraumatol 2022; 13:2126468. [PMID: 36212114 PMCID: PMC9542271 DOI: 10.1080/20008066.2022.2126468] [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] [Indexed: 11/03/2022] Open
Abstract
Background: An unprecedentedly large number of people worldwide are forcibly displaced, of which more than 40 percent are under 18 years of age. Forcibly displaced children and youth have often been exposed to stressful life events and are therefore at increased risk of developing mental health issues. Hence, early screening and assessment for mental health problems is of great importance, as is research addressing this topic. However, there is a lack of evidence regarding the reliability and validity of mental health assessment tools for this population. Objective: The aim of the present study was to synthesise the existing evidence on psychometric properties of patient reported outcome measures [PROMs] for assessing the mental health of asylum-seeking, refugee and internally displaced children and youth. Method: Systematic searches of the literature were conducted in four electronic databases: MEDLINE, PsycINFO, Embase and Web of Science. The methodological quality of the studies was examined using the COSMIN Risk of Bias checklist. Furthermore, the COSMIN criteria for good measurement properties were used to evaluate the quality of the outcome measures. Results: The search yielded 4842 articles, of which 27 met eligibility criteria. The reliability, internal consistency, structural validity, hypotheses testing and criterion validity of 28 PROMs were evaluated. Conclusion: Based on the results with regard to validity and reliability, as well as feasibility, we recommend the use of several instruments to measure emotional and behavioural problems, PTSD symptoms, anxiety and depression in forcibly displaced children and youth. However, despite a call for more research on the psychometric properties of mental health assessment tools for forcibly displaced children and youth, there is still a lack of studies conducted on this topic. More research is needed in order to establish cross-cultural validity of mental health assessment tools and to provide optimal cut-off scores for this population. HIGHLIGHTS Research on the psychometric properties of mental health screening and assessment tools for forcibly displaced children and youth is slowly increasing.However, based on the current evidence on the validity and reliability of screening and assessment tools for forcibly displaced children, we are not able to recommend a core set of instruments. Instead, we provide suggestions for best practice.More research of sufficient quality is important in order to establish crsoss-cultural validity and to provide optimal cut-off scores in mental health screening and assessment tools for different populations of forcibly displaced children and youth.
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Affiliation(s)
- Ilse L Verhagen
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Marc J Noom
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Joost G Daams
- Medical Library, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Irma M Hein
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
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