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Description
Latino children are more than twice as likely to live in poverty than their non-Latino, White peers (Kids Count Data Center, 2017), yet limited work has aimed to understand neighborhood influences on pathways of mental health among Latino children. Substantial work documents the deleterious effects of living in a disadvantaged neighborhood on mental health outcomes throughout the lifespan (Leventhal & Brooks-Gunn, 2000). Parental and familial variables may explain neighborhood influences on children’s mental health during the first few years of life (May, Azar, & Matthews, 2018). The current study evaluated the influence of three neighborhood indicators (concentrated disadvantage, residential instability, and the percentage of residents identifying as Hispanic/Latino) on maternal postpartum depressive symptoms and child behavior problems at 3 and 4.5 years via mediation and moderated mediation models among a sample of 322 low-income, Mexican American mother-child dyads. Contrary to hypotheses and existing literature, concentrated disadvantage and residential instability were not predictive of maternal or child mental health outcomes. The percentage of residents identifying as Hispanic/Latino emerged as a protective neighborhood factor for both mothers and children. The neighborhood ethnocultural context may be especially relevant to understanding pathways of mental health specific to Mexican American families. More research is needed to understand specific parental and familial mechanisms underlying this protective effect.
ContributorsCurci, Sarah (Author) / Luecken, Linda J. (Thesis advisor) / Perez, Marisol (Committee member) / White, Rebecca MB (Committee member) / Arizona State University (Publisher)
Created2019
Description
There is a need to reinvent evidence-based interventions (EBIs) for pediatric anxiety problems to better address the demands of real-word service delivery settings and achieve public health impact. The time- and resource-intensive nature of most EBIs for youth anxiety has frequently been noted as a barrier to the utilization of EBIs in community settings, leading to increased attention towards exploring the viability of briefer, more accessible protocols. Principally, this research reports between-group effect sizes from brief-interventions targeting pediatric anxiety and classifies each as well-established, probably efficacious, possibly efficacious, experimental, or questionable. brief interventions yielded an overall mean effect size of 0.19 on pediatric anxiety outcomes from pre to post. Effect sizes varied significantly by level of intervention: Pre to post-intervention effects were strongest for brief-treatments (0.35), followed by brief-targeted prevention (0.22), and weakest for brief-universal prevention (0.09). No participant or other intervention characteristic emerged as significant moderators of effect sizes. In terms of standard of evidence, one brief intervention is well-established, and five are probably efficacious, with most drawing on cognitive and behavioral change procedures and/or family systems models. At this juncture, the minimal intervention needed for clinical change in pediatric anxiety points to in-vivo exposures for specific phobias (~3 hours), cognitive-behavioral therapy (CBT) with social skills training (~3 hours), and CBT based parent training (~6 hours, eight digital modules with clinician support). This research concludes with a discussion on limitations to available brief EBIs, practice guidelines, and future research needed to capitalize on the viability of briefer protocols in enhancing access to, and impact of, evidence-based care in the real-world.
ContributorsStoll, Ryan (Author) / Pina, Armando A. (Thesis advisor) / Gonzales, Nancy (Committee member) / MacKinnon, David (Committee member) / Perez, Marisol (Committee member) / Arizona State University (Publisher)
Created2019