Mary McKay

The purpose of this paper is to examine the impact of parental mental health and types of racial socialization. The sample consisted of 169 African-American parents and their children (ages 9-11) who participated in a federally funded research project, "Knowledge about the African American Research Experience" (KAARE). Bivariate analyses revealed significant positive relationships between parent mental health status and two forms of racial socialization: spiritual/religious coping, and racial awareness teaching, while multivariate analyses supported the positive association between parental mental health and spiritual/religious coping. These results suggest that parental characteristics may influence the use of specific types of racial socialization to assist youth in coping with discriminatory societal messages.

This exploratory study examines changes in suicidal ideation among a sample (N = 28) of homeless youth, ages 11-14, residing within family shelters in a large metropolitan area. Changes in suicidal ideation from pretest to posttest are compared across two group approaches to delivering HIV prevention. Youth and their families participating in the HOPE Family Program, incorporating a family strengthening approach, are compared to those receiving a traditional health education-only approach. Multivariate analyses reveal that youth in the HOPE Family Program were 13 times more likely to report a decrease of suicidal ideation. These findings indicate that health education programs integrating a family strengthening approach hold promise for positively impacting mental health outcomes for vulnerable youth.

Disciplinary records for 3rd through 8th grade students (n = 314) in an inner-city, public school were examined for one school year to assess students' variation in response to discipline. Rates of disciplinary referrals were compared for students who received no detentions or suspensions throughout the year ("never group" n = 117), students who received one or more detention or suspension in the fall but not in the spring ("fall group" n = 62), and students who received one or more detention or suspension in the fall and one or more detention or suspension in the spring ("fall + spring group" n = 75). Results indicated that during the fall, the "fall group" had nearly equivalent rates of referrals to the "fall + spring group"; however, the "fall group" exhibited significantly lower rates of referrals during winter and spring that were nearly equivalent to the "never group," as would be expected for a punishme...

The goal of this study was to examine the impact of supplementing Trauma-focused Cognitive Behavioral Therapy (TF-CBT; Cohen et al., 2006) with evidence-based engagement strategies on foster parent and foster youth engagement in treatment, given challenges engaging foster parents in treatment. A randomized controlled trial of TF-CBT standard delivery compared to TF-CBT plus evidence-based engagement strategies was conducted with 47 children and adolescents in foster care and one of their foster parents. Attendance, engagement, and clinical outcomes were assessed 1 month into treatment, end of treatment, and 3 months post-treatment. Youth and foster parents who received TF-CBT plus evidence-based engagement strategies were more likely to be retained in treatment through four sessions and were less likely to drop out of treatment prematurely. The engagement strategies did not appear to have an effect on the number of canceled or no-show sessions or on treatment satisfaction. Clinical outcomes did not differ by study condition, but exploratory analyses suggest that youth had significant improvements with treatment. Strategies that specifically target engagement may hold promise for increasing access to evidence-based treatments and for increasing likelihood of treatment completion.

Introduction. While the roll-out of antiretroviral therapy in South Africa should lead to a reduction in mother to child transmission, mortality and orphaning, it will also be accompanied by a large number of children entering adolescence and adulthood with a chronic infectious disease. Adolescence is a particularly vulnerable period for HIV-infected people in relation to mental health problems and engagement

Increased access to antiretroviral treatment worldwide makes it more possible for children diagnosed with HIV before their 15(th) birthday to age into adolescence and beyond. Many HIV+ youth navigate stressors including poverty and resource scarcity, which may converge to produce emotional distress. For over a decade, CHAMP (Collaborative HIV Prevention and Adolescent Mental Health Project) investigators partnered with youth, caregivers, providers and community stakeholders to address the health, mental health and risk taking behaviors of perinatally HIV-infected youth. This paper explores the mental health needs of aging cohorts of HIV+ youth, across three global contexts, New York (U.S.), Buenos Aires (Argentina), and KwaZulu-Natal (South Africa), to inform the development and implementation of combination HIV care and prevention supports for HIV+ youth. Analysis of data pooled across three countries involving HIV+ early adolescents and their caregivers over time (baseline and three month follow-up) was conducted. Univariate and multivariate analyses were applied to data from standardized measures used across sites to identify mental health needs of youth participants. The impact of the site specific versions of a family-strengthening intervention, CHAMP+U.S., CHAMP+Argentina, CHAMP+SA, was also examined relative to a randomized standard of care (SOC) comparison condition. Analyses revealed mental health resilience in a large proportion of HIV+ youth, particularly behavioral functioning and overall mental health. Yet, significant numbers of caregivers across country contexts reported impaired child emotional and prosocial wellbeing. Significant site differences emerged at baseline. Involvement in the CHAMP+ Family Program was related to significant improvement in emotional wellbeing and a trend towards enhanced prosocial behavior relative to SOC across global sites. Ongoing partnerships with youth, family and provider stakeholders across global sites helped to tailor programs like CHAMP+ to specific contextual needs. This has global intervention research and care implications as cohorts of HIV+ children age into adolescence.

This article presents the results of a study examining correlates of urban African American youth HIV knowledge. The influence of family level factors (e.g., family communication, parental AIDS knowledge and myths regarding HIV transmission, along with family composition and family income) are examined. In addition, the current study explores the influence of racial socialization processes, specifically the influence of religious/spiritual

The study objective was to examine how parental endorsement of cultural pride reinforcement messages may explain African American child anxiety. data were gathered from 72 African American parents and their elementary school-aged children. Results indicated stronger parental endorsement of cultural pride reinforce - ment messages predicted less child anxiety. Additionally, parental endorsement of these messages moderated the relationship between child

This study examines the rates of depressive symptoms and service use among caregivers whose children receive treatment for disruptive behavior disorders. Descriptive analyses examined preliminary baseline data from the Family Groups for Urban Youth with Disruptive Behaviors study for 212 caregivers to determine rates of caregiver depressive symptoms and lifetime mental health service use. Findings indicate that caregivers manifest substantially

The HOPE Family Project (HIV Prevention for Parents and Early Adolescents) is an eight- session, family-based group intervention modeled on three evidence-based curricula targeting HIV/AIDS and alcohol and drug abuse prevention. The design and implementation of the HOPE Family Project was carried out by an established community collaborative board. The project aims to educate and provide tailored support to families

The articles in this special issue are a significant contribution to the literature pertaining to racial socialization, which is defined as messages parents communicate about race and culture, how African Americans are perceived societally, and how to cope with discrimination due to their skin color. More specifically, these articles examine the relationship between racial socialization and parental mental health status, child socio-behavioral functioning, and the utilization of mental health and prevention services for both parent and child. Overall, the results of these articles indicate that various racial socialization practices do indeed influence key variables such as the child's behavioral functioning and decision-making, parental mental health status, and the receipt of prevention and mental health services. Implications of these findings suggest that racial socialization beliefs and practices may in fact influence the health and functioning of African American youth and families.

Summary Given the urgent need for HIV/AIDS interventions that will reverse current infection trends among urban minority youth, identifying effective and socially relevant approaches is of primary concern. HIV/AIDS prevention initiatives that are housed in, and led by, ...

This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.

Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policymakers, providers, and family support specialists have worked in partnership since 2002 to redesign and evaluate the children's mental health system. Five system strategies driven by empirically based practices and organized within a state-supported infrastructure have been used in the child and family service system with more than 2,000 providers: (a) business practices, (b) use of health information technologies in quality improvement, (c) specific clinical interventions targeted at common childhood disorders, (d) parent activation, and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems.

An ecological model for school-based mental health services that targets urban low-income aggressive children--a highly vulnerable and underserved population--is presented. The goals of the model are to increase children's and teachers' involvement in the delivery of services and to increase the integration of these services into existing school resources and activities. The model proposes that mental health service providers work in collaboration with teachers to deliver services that (1) can be managed by existing school resources and personnel, (2) are related to empirically based factors associated with reduced aggression and increased social functioning, and (3) are group administered to increase the number of children served and to reduce stigmatization associated with mental health services. The model is individualized and flexible by acknowledging that contexts for aggression differ across classrooms and children and by providing services specific to those contexts. Two studies are presented illustrating the application of this model to decrease aggression and increase academic engagement in low-income urban public schools.