Latina/o parent activation in children’s mental health treatment: The role of demographic and psychological factors.

Abstract

K. (2017). Latina/o parent activation in children's mental health treatment: The role of demographic and psychological factors. Journal of Latina/o Psychology, 5, 290-305. Abstract:Patient activation has recently emerged as a critical component of effective health care (Hibbard & Greene, 2013), but Latina/o populations demonstrate lower levels of activation compared to non-Latina/o Whites (Cunningham, Hibbard, & Gibbons, 2011). The current study examined demographic and psychological factors associated with immigrant Latina/o parent activation in parents seeking mental health services for their children. Additionally, the study tested whether psychological factors (parental depressive symptoms, parenting stress, perceived severity of child psychopathology) were associated with the effectiveness of an activation intervention among immigrant Latina/o parents (MEPREPA-short for "me preparo"/I prepare [MEtas, PReguntar, Escuchar, Preguntar para Aclarar/goals, questioning, listening, questioning to clarify]). Results demonstrated that parenting stress and perceived severity of child psychopathology were associated with lower levels of parent activation. Additionally, although there was a treatment effect for all parents, stratified group analyses suggested that parents with higher depressive symptoms and greater parenting stress benefited more from the MEPREPA intervention compared to controls. Stratified analyses also showed that the intervention had a greater positive impact on parent activation in health care among parents whose children had more severe symptoms. Clinical and research implications are discussed. Keywords: parent activation | Latina/o | parenting stress | parental depression Article:To understand how best to intervene therapeutically with Latina/o families, researchers need to consider how Latina/o families engage in mental health treatment. Without an actively engaged patient, our interventions may not realize their full potential, thereby limiting their impact on the mental health outcomes we seek to ameliorate. Mental health researchers need to understand what factors influence patient activation and how to target these in order to deliver more effective interventions. Increased focus on the role of patient activation may also provide a fruitful avenue to address known racial/ethnic disparities in mental health service utilization in Latina/o populations (Alegría et al., 2002). However, few studies have examined patient

Parenting Self-Efficacy in Immigrant Families—A Systematic Review

“…As noted by Wittkowski et al (2017), in this approach one specific aspect of the parenting role is assessed, and the items should be all task-specific, age-specific, and situationspecific. Among the papers included in our review, three out of eleven studies used measures of PSE in relation to specific tasks, such as meeting the child's basic needs and navigating through the process of adaptation to new environment (Ali, 2008), managing child's health (Stein et al, 2017), and enhancing adolescent cultural identification (Kiang et al, 2017). Various methodological approaches were applied to measuring narrowdomain PSE, from relying on semi structured interviews on a number of task specific topics, both with individual participants and in focus groups (Ali, 2008), via a short survey comprising three questions about parental cognitions of their task-specific efficacy (Kiang et al, 2017), to a standardized 13-item Parent Patient Activation Measure (PAM) used at three distinct time points (Stein et al, 2017).…”

“…In their randomized controlled trial (RCT) with the use of MEPREPA intervention (an abbreviation of "me preparo"/I am ready MEtas, Preguntar, Escuchar, Preguntar para Aclarar/aims, asking questions, listening, asking to receive explanations), in a group of Latino/a families, Stein et al (2017) show that parental stress probably leads to a low self-efficacy that contributes to low activation of parents in seeking mental health services for their children with ADHD symptoms. As a result, parents can be less effective in providing their child with access to necessary assistance, and less optimistic in perceiving their abilities to support beneficial changes.…”

“…Sixth, mainly mothers (Yu-wen Ying, 1999;Yakhnich, 2016;Martinez et al, 2018) or only mothers (Ceballo and Hurd, 2008;Stein et al, 2017) participated in the analyzed studies. In the intervention dedicated to Syrian parents none of the fathers participated, although they were invited to the program (El-Khani et al, 2018).…”

“…The studies concerning interventions ("TRT+Parenting" programme, SITICAF, MEPREPA) show that actions of this kind increase parenting efficacy (El-Khani et al, 2018), increase parents' sense of responsibility, and improve the quality of the parent-child relationship (Yu-wen Ying, 1999). Parents with higher depressive symptoms, greater parenting stress, and whose children had more serious symptoms benefited more from the intervention as compared to the controls (support group) (Stein et al, 2017). Generally, high attendance and program completion ratios indicate that families are willing to participate in interventions of this kind because they need them.…”

“…The lowest scoring item was the inclusion of characteristics of subjects lost after enrolment in the study or subjects not participating from the eligible population, and the inclusion of information on details of the sample size. Only one study was a cohort one (Stein et al, 2017), in which it was possible to randomize subjects into intervention groups. In this study a research assistant was blind to intervention status when conducting a baseline interview prior to starting a group and then during data collection and analysis.…”