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Familismo and adolescent health: the role of key cultural and familial processes on Latino youth substance use

Description

A secondary data analysis was conducted to investigate the direct and indirect effects of family traditionalism, family cohesion, and parent involvement on alcohol, cigarette, and marijuana use in a sample of pre-adolescent youth (N = 635) and their parents (N

A secondary data analysis was conducted to investigate the direct and indirect effects of family traditionalism, family cohesion, and parent involvement on alcohol, cigarette, and marijuana use in a sample of pre-adolescent youth (N = 635) and their parents (N = 462). Aim one hypothesized that family cohesion and family traditionalism would be indicators of a higher order construct, operationalized as familismo. Aims two and three hypothesized that family traditionalism, family cohesion, and parent involvement would be protective against youth substance use. Finally, aim four hypothesized that acculturation would decrease the protective effects of family traditionalism and family cohesion on substance use.

Using second order confirmatory factor analysis, aim one found that family cohesion and family traditionalism were indicators of a second order structure. Regarding aims two and three, a consistent significant association was found between family cohesion and parent involvement across alcohol, cigarette, and marijuana use outcomes. As well, family cohesion was significantly and inversely associated with past 30-day alcohol use amount ( = -.21, p < 0.05), lifetime alcohol use ( = -.19, p < 0.05), and lifetime marijuana use ( = -.31, p < 0.001). Counter to what was hypothesized, a significant positive relationship between family traditionalism and past 30-day alcohol use amount was found. No significant indirect effects were found. Specific to aim four, significant moderation effects were found between family cohesion and acculturation on alcohol and cigarette use. Higher acculturated youth had greater past 30-day alcohol and cigarette use amount compared to low acculturated youth; as family cohesion increased, alcohol and cigarette use for both low and high-acculturated youth decreased.

This study has important implications for social work and future research specific to culture, family, and youth substance use. This study may assist direct social work practitioners, school personnel, and other professionals that work with Latino youth and families in the tailoring of services that are culturally sensitive and relevant to this population and provides further understanding regarding the impact of culture and family on Latino youth substance use. Findings and limitations are discussed specific to social work practice, policy, and research.

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2015

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Implementation of a Family-Based Obesity Intervention Within a Pediatric Primary Care

Description

Background: 
Approximately 1 in 5 U.S. school-aged children are obese. There are many known health complications associated with obesity including premature death. Family-based obesity interventions that promote healthy lifestyle habits are effective at enabling children to make changes needed to

Background: 
Approximately 1 in 5 U.S. school-aged children are obese. There are many known health complications associated with obesity including premature death. Family-based obesity interventions that promote healthy lifestyle habits are effective at enabling children to make changes needed to avoid long-term health complications associated with obesity. The purpose of this evidence-based practice intervention was to evaluate the effectiveness of a family-based obesity intervention on familial lifestyle behaviors related to nutrition, physical activity, and screen time.

Methods:
Two overweight-obese children (according to CDC criteria) ages 8-12 years old visiting a pediatric primary care clinic in a suburban neighborhood located in the southwest region were recruited to participate in this evidence-based practice intervention based on inclusion and exclusion criteria. Familial lifestyle behaviors were assessed using the Family Health Behavior Scale (FHBS) prior to receiving an educational intervention addressing nutritional, physical activity, and screen time recommendations and again after following these recommendation for 6-weeks. Additionally, scheduled follow-up phone calls were made every 3 or 6-weeks addressing any parental questions that surfaced. Data was insufficient for statistical analysis, however, anecdotal recommendations for future implementation of this intervention resulted.

Results:
Of the two patients who participated, pre- and post-intervention data was only attainable from one patient. That patient did have improved scores within each of the 4 FHBS subscales (parent behaviors, physical activity, mealtime routines, and child behaviors). Overall, 11 of the 27 behaviors assessed improved, 12 behaviors resulted in no change, and 4 behaviors worsened. Recommendations related to a more successful implementation of this intervention in the future include improved provider participation (buy-in), utilization of broader inclusion criteria, consideration of the implementation time-frame, and application of the Health Belief Model for addressing existing barriers for each patient prior to implementing the intervention.

Conclusions:
In order to determine the effectiveness of this intervention a larger sample size and completed post-intervention data are needed. The small sample size and lack of post-intervention data inhibits proper data analyzation and significance from being determined.

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Date Created
2018-05-02

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Equine Assisted Learning: An Evidence-Based Intervention for Families

Description

Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy

Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy which is being used increasingly to promote mental health in both adults and children. This study sought to build and deliver an evidence-based, family-centered equine assisted learning program aimed at promoting family function, family satisfaction and child social-emotional competence, and to measure its acceptability and preliminary effect.

Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.

Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.

Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.

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Date Created
2019-05-02