Longitudinal Effects of Peer, School, and Parenting Contexts on Substance Use Initiation in Middle Adolescence

Purpose: Preventing substance use initiation (SUI) can reduce negative consequences associated with adult substance use disorder. The role of involvement with deviant peers, school connectedness, and parenting quality on SUI was investigated among a community sample (N = 387).Method: PROCESS tested whether three parenting quality factors (Parental Knowledge and Affective Relationships, Parental Control, and Parental Communication and Involvement) served as moderators of two different mediation pathways (involvement with deviant peers and school connectedness) on three SUI outcomes (alcohol, cigarettes, and marijuana).Results: Involvement with deviant peers mediated the relation between school connectedness and substance use. Low school connectedness predicted high deviant peer affiliation, which, in turn, predicted high SUI. School connectedness did not mediate involvement with deviant peers and substance use. Parenting quality factors were not significant moderators.Conclusion: Supporting adolescents who lack strong school connections may help prevent involvement with deviant peers, which, in turn, may prevent SUI.

Psychometric Properties of a Comprehensive Parenting Practice Measure for Parents of Adolescents

Many measures exist that assess parenting skills and practices. Few comprehensive measures for parents of adolescents (13-17 years) exist. The aim of the current study was to develop a comprehensive assessment measure of parenting practices based on items from existing measures. Research and clinical settings can benefit from the advancement of a valid and more inclusive measure of parenting to assess youth behavior and functioning. This study utilized a sample that included 387 caregivers and youth (mean age of youth = 13.6, SD = .59) from a longitudinal study examining contextual influences on youths'substance use initiation. Exploratory factor analysis (EFA) was conducted on 12 parent-report measures of parenting. Confirmatory factor analysis (CFA) was conducted on a second sample, which included peers (N = 362, mean age of peers = 13.6, SD = 1.09) and peers' caregivers of the youth included in the original sample. The EFA results indicated a three-factor solution (i.e., parental knowledge and affective relationships, parental control, parental communication and involvement), which was supported in the CFA. The final measure demonstrated strong internal consistency and satisfactory convergent and discriminant validity. This study supported the sound psychometrical features of the Parenting Practice Measure (PPM), a comprehensive measure of parenting quality for adolescent samples. The PPM can serve as a tool for clinicians to design more targeted treatment plans and evaluate the effectiveness of treatments when working with parents with children in the early teenage years.

Medical and Psychosocial Experiences of Family Caregivers With Children Fed Enterally at Home

BACKGROUND

Pediatric home enteral nutrition (HEN) studies that evaluate the psychosocial aspects of caregiving are limited. Overlooking the psychosocial needs of the caregiver may result in negative outcomes such as lack of adherence to the HEN regimen. This study determined whether caregivers report psychosocial situations more frequent and difficult to manage than medical situations.

METHODS

A questionnaire, which identified 10 psychosocial and 10 medical issues related to pediatric HEN, was mailed to 150 caregivers (37 responded), who rated the statements for frequency and difficulty. Each statement was ranked from most frequent/difficult to least frequent/difficult by mean cross-product score (frequency x difficulty). To indicate overall burden, a medical total composite score (MTCS) and a psychosocial total composite score (PTCS) were calculated by summing the cross-products of the respective problems. Paired t tests compared MTCS to PTCS and also the psychosocial frequency means and difficulty means to the same for the medical problems.

RESULTS

Of the top 10 problems, 7 were psychosocial, whereas 3 were medical. Caregivers reported incidences of psychosocial problems more frequently (p < .003) than medical problems, and they had more difficulty (p < .001) with the psychosocial situations than with the medical ones. The PTCS was significantly higher (p < .001) than the MTCS.

CONCLUSIONS

The psychosocial situations were perceived as causing a greater burden and greater difficulty in coping with everyday life. Health professionals need to understand and address the psychosocial difficulties of the caregiver in order to provide support for the caregiver and promote positive growth and development of the child.

Transforming mental health services to address gender disparities in depression risk factors

Depression in older women is a significant and growing problem. Women who experience life stressors across the life span are at higher risk for developing depression than their male counterparts. Research has focused primarily on identifying and reducing the symptoms of depression for the general aging population, disregarding gender-specific differences in the foundational causes of depression. This article examines how women's unique experiences influence the development of depression and highlights how the current mental health system could better meet older women's needs by moving from a gender-neutral model to one that emphasizes women's experiences.

Association of Supplemental Nutrition Assistance Program (SNAP) with health related quality of life and disease state of HIV infected patients

The literature on the potential clinical and non-clinical benefits of participation in food assistance programs for people living with HIV in developed countries is scarce. We conducted a cross-sectional study of 165 HIV infected adults to determine the impact of the Supplemental Nutrition Assistance Program (SNAP) on HIV disease status and health related quality of life (HQROL). There was no significant association between SNAP participation and disease status; CD4 cell count (β = 0.02, P = 0.837) and viral load (β = 0.02, P = 0.836). The mean scores for all the HRQOL domains were lower compared to the US population, but none were associated with SNAP participation. Higher scores on the general health domain, were marginally associated with SNAP participation (β = 0.16, P = 0.071). In this study, SNAP participation was not significantly associated with less disease progression, and only marginally associated with quality of life among this population of HIV infected individuals.

Self-Silencing and Age as Risk Factors for Sexually Acquired HIV in Midlife and Older Women

Objectives: This study explores the contribution of psychosocial factors on sex behaviors of midlife and older women. Methods: A community-based sample of ethnically diverse women ( N = 572) between the ages of 50 and 93 completed standardized measures of self-silencing, self-esteem, sensation-seeking behavior, HIV-related stigma behavior, sexual assertiveness, and safer sex behaviors. Results : Results from the regression analysis indicated the model significantly predicted safer sex behaviors ( p < .001), with self-silencing (β = —.115, p < .05) and age (β = .173, p < .001) as significant predictors. Bivariate correlation analysis indicated an inverse correlation between HIV stigma ( p < .05) and safer sex behaviors. Discussion: Implications for further study and practice are discussed to include considerations for development of age- and gender-appropriate prevention interventions assisting women with interpersonal processes combined with skills for active involvement in addressing high-risk sex behaviors.

Characteristics of evidence-based child maltreatment interventions

This project summarizes, using a treatment protocol review technique, characteristics of effective interventions from nine studies of child maltreatment that examined recovery from abuse or the effects of maltreatment on child and parent outcomes. Results suggest that stronger effects are yielded by targeting parents and the parent-child interaction context in home-based settings during early childhood, designing multicomponent interventions delivered by professionals for teaching parenting competency skills, and targeting families of higher risk children.

Treatment foster care services: a research agenda for child welfare

Treatment foster care is a recent and rapidly expanding multisystem service. This article summarizes the empirical literature on treatment foster care and offers suggestions for future research directions. Results from program evaluations and experimental research suggest that treatment foster care is an effective alternative to residential treatment for seriously troubled and troubling children. The research has lacked rigorous controls regarding the populations served, however, as well as the critical components of interventions used in treatment foster care that produce positive results for the children. Integration with pertinent research findings from other disciplines is also necessary because of the multisystemic needs of the diverse population of children served in treatment foster care.