Lack of school engagement among adolescents in this country remains a problem that can have very serious consequences including increased risk for school dropout, substance use, teenage pregnancy, and criminal activity. Clearly, identification of psychological variables (selfvariables) of individuals that facilitate or hinder adolescents' levels of school engagement would contribute greatly to the understanding of how to increase adolescents' psychological well-being and their achievement motivation and associated school engagement. The present study examined the degree of association of three specific self-variables (self-efficacy, goal orientation, and fear of failure) with school engagement for high school students. The results and implications for intervention and future research are addressed.

A causal model for understanding the complex interplay between student-reported teacher behaviors, student self-systems, and student engagement was tested. One hundred seventeen African American students in grades 1 through 12 completed a comprehensive questionnaire regarding teacher context, self, and engagement variables. A series of hierarchical regression analyses were conducted to test the hypothesized mediation models and to construct a path model. Most hypotheses were supported. Student self-system variables (perceived competency and autonomy) mediated relations between teacher context (structure and autonomy support), and engagement. Contrary to predictions, however, teacher involvement exerted a strong and direct effect on student engagement even when controlling for grade level and self-system variables. Given existing research showing that African American students are at risk for low teacher involvement and that engagement is critical for academic success, research and intervention strategies are urgently needed to promote teacher involvement with these students.

Objectives This article presents the results of an empirical test of a literature-based Patient-Centered Culturally Sensitive Health Care Model. The model was developed to explain and improve health care for ethnically diverse patients seen in community-based primary care clinics. Design Samples of predominantly low-income African American (N = 110) and non-Hispanic White American (N = 119) patients were recruited to complete questionnaires about their perceived health care provider cultural sensitivity and adherence to their provider's treatment regimen recommendations. Main Outcome Measures Patients completed written measures of their perceived provider cultural sensitivity, trust in provider, interpersonal control, satisfaction with their health care provider, physical stress and adherence to provider recommended treatment regimen variables (i.e., engagement in a health promoting lifestyle, and dietary and medication adherence). Results Two-group path analyses revealed significant links between patient-perceived provider cultural sensitivity and adherence to provider treatment regimen recommendations, with some differences in associations emerging by race/ethnicity. Conclusion The findings provide empirical support for the potential usefulness of the Patient-Centered Culturally Sensitive Health Care Model for explaining the linkage between the provision of patient-centered, culturally-sensitive health care, and the health behaviors and outcomes of patients who experience such care.

Present findings suggest that health interventions programs focus on assessing and increasing health self-efficacy and health value of these youth. College health professionals can design and evaluate the effectiveness of such health-promoting interventions.

These findings can be incorporated into training programs for health care providers, possibly resulting in more effective health care delivery to patients from diverse cultural backgrounds. Future research is needed to evaluate the impact of incorporating patient-identified cultural sensitivity into health care delivery on important outcome measures such as patient satisfaction and treatment adherence.