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Etengoff C, Lefevor GT, Huynh KD, Rodriguez EM, Luong E. Development and Validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale. JOURNAL OF HOMOSEXUALITY 2024; 71:1727-1756. [PMID: 37140591 DOI: 10.1080/00918369.2023.2201870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Despite the psychosocial strain of homonegative religious attitudes, many people with minoritized sexual identities also hold religious identities and benefit from integrating their sexual minority and religious identities. However, for research and clinical practice to advance, a reliable and valid measure of sexual and religious identity integration is needed. The present study reports on the development and validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale. Participants were comprised of two subsamples for whom sexual and religious identity is particularly salient (Latter-day Saints and Muslims) as well as a third subsample of the general sexual minority population-totaling 1,424 individuals (39% POC, 62% cisman, 27% ciswoman, 11% trans/non-binary/genderqueer). Exploratory and confirmatory factor analyses indicated that the 5-item scale measures a single unidimensional construct. This scale demonstrated good internal consistency in the total sample (α = .80) as well as metric and scalar invariance along relevant demographics. The SMRII also evidenced strong convergent and discriminant validity, significantly correlating with other measures of religious and sexual minority identity typically between r = .2 and r = .5. Taken together, initial findings indicate that the SMRII is a psychometrically sound measure that is brief enough to be utilized in research and clinical settings.Public Significance Statement: This article introduces the Sexual Minority and Religious Identity Integration Scale (SMRII) as a reliable and valid assessment of the degree to which individuals integrate their sexual minority and religious identities. This five-item measure is brief enough to be utilized in both research and clinical settings.
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Affiliation(s)
- Chana Etengoff
- Derner School of Psychology, Adelphi University, Garden City, New York, USA
| | - G Tyler Lefevor
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Kiet D Huynh
- Center for LGBTQ Evidence-Based Applied Research, Palo Alto University, Palo Alto, California, USA
| | - Eric M Rodriguez
- Department of Social Sciences, New York City College of Technology, Brooklyn, New York, USA
| | - Emily Luong
- Derner School of Psychology, Adelphi University, Garden City, New York, USA
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Brown K, Lucassen MFG, Núñez-García A, Rimes KA, Wallace LM, Samra R. A Web-Based Intervention to Support the Mental Well-Being of Sexual and Gender Minority Young People: Mixed Methods Co-Design of Oneself. JMIR Form Res 2024; 8:e54586. [PMID: 38772025 DOI: 10.2196/54586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Sexual and gender minority youth are at greater risk of compromised mental health than their heterosexual and cisgender peers. This is considered to be due to an increased burden of stigma, discrimination, or bullying resulting in a heightened experience of daily stress. Given the increasing digital accessibility and a strong preference for web-based support among sexual and gender minority youth, digital interventions are a key means to provide support to maintain their well-being. OBJECTIVE This paper aims to explicate the co-design processes and underpinning logic of Oneself, a bespoke web-based intervention for sexual and gender minority youth. METHODS This study followed a 6-stage process set out by Hagen et al (identify, define, position, concept, create, and use), incorporating a systematic scoping review of existing evidence, focus groups with 4 stakeholder groups (ie, sexual and gender minority youth, professionals who directly support them, parents, and UK public health service commissioners), a series of co-design workshops and web-based consultations with sexual and gender minority youth, the appointment of a digital development company, and young adult sexual and gender minority contributors to create content grounded in authentic experiences. RESULTS Oneself features a welcome and home page, including a free accessible to all animation explaining the importance of using appropriate pronouns and the opportunity to create a user account and log-in to access further free content. Creating an account provides an opportunity (for the user and the research team) to record engagement, assess users' well-being, and track progress through the available content. There are three sections of content in Oneself focused on the priority topics identified through co-design: (1) coming out and doing so safely; (2) managing school, including homophobic, biphobic, or transphobic bullying or similar; and (3) dealing with parents and families, especially unsupportive family members, including parents or caregivers. Oneself's content focuses on identifying these as topic areas and providing potential resources to assist sexual and gender minority youth in coping with these areas. For instance, Oneself drew on therapeutic concepts such as cognitive reframing, stress reduction, and problem-solving techniques. There is also a section containing relaxation exercises, a section with links to other recommended support and resources, and a downloads section with more detailed techniques and strategies for improving well-being. CONCLUSIONS This study contributes to research by opening up the black box of intervention development. It shows how Oneself is underpinned by a logic that can support future development and evaluation and includes diverse co-designers. More interactive techniques to support well-being would be beneficial for further development. Additional content specific to a wider range of intersecting identities (such as care-experienced Asian sexual and gender minority youth from a minority faith background) would also be beneficial in future Oneself developments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/31036.
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Affiliation(s)
- Katherine Brown
- Centre for Research in Psychology and Sports Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Mathijs F G Lucassen
- School of Health & Psychological Sciences, City, University of London, London, United Kingdom
| | - Alicia Núñez-García
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, United Kingdom
| | - Katharine A Rimes
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom
| | - Louise M Wallace
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, United Kingdom
| | - Rajvinder Samra
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, United Kingdom
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Shuler SL, Klimczak K, Pollitt AM. Queer in the Latter Days: An Integrated Model of Sexual and Religious Identity Development Among Former Mormon Sexual Minority Adults. JOURNAL OF HOMOSEXUALITY 2024; 71:1201-1230. [PMID: 36715727 DOI: 10.1080/00918369.2023.2169087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Sexual minority individuals often have complicated relationships with conservative religion, including conflicts between their sexual and religious identities. Sexual minority members of the Church of Jesus Christ of Latter-Day Saints (CJCLDS) experience unique struggles, given the policies and doctrine of the CJCLDS and its commitment to heteronormative family structures and gender roles. A better understanding of the identity development trajectory for sexual minority individuals formerly involved in the church can deepens our understanding of sexual identity development in constrained contexts and help promote successful identity integration within this subpopulation. Transcripts from semi-structured interviews with thirty-four sexual minority individuals who identified as former members of the CJCLDS were analyzed using an inductive thematic approach, followed by a deductive theory-building process in which Cass's Homosexual Identity Formation Model and Genia's Religious Identity Development Model were overlaid on themes. We present a model that captures the trajectory of sexual and religious identity development that captures the experiences of sexual minority adults within the constraints of the CJCLDS, a non-affirming religious denomination.
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Affiliation(s)
- Shay L Shuler
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Connecticut, USA
| | - Korena Klimczak
- Department of Clinical and Counseling Psychology, Utah State University, Logan, Utah, USA
| | - Amanda M Pollitt
- Department of Health Sciences, Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
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Mishu MP, Tindall L, Kerrigan P, Gega L. Cross-culturally adapted psychological interventions for the treatment of depression and/or anxiety among young people: A scoping review. PLoS One 2023; 18:e0290653. [PMID: 37878658 PMCID: PMC10599551 DOI: 10.1371/journal.pone.0290653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/12/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Mental health problems among young people are a major global public health challenge. Psychological interventions may improve mental health, yet most are developed in western cultures, and it is unclear whether they are applicable to other geographical settings and can be delivered successfully to diverse populations. We identified empirical studies focusing upon cross-culturally adapted psychological interventions and examined the cultural adaptation process used and the effectiveness of the interventions in the treatment of depression and/or anxiety disorders among young people (defined here as children and adolescents aged between 8-18 years). METHOD We conducted a scoping review aligning to the guidelines reported in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) Statement. Stakeholder engagement enabled us to discuss the findings of the review and obtain feedback. RESULTS We identified 17 studies of cross-culturally adapted psychological interventions that considered the appropriate language, metaphors, culturally appropriate terms, and cultural values of young people. Most studies (n = 11) adopted a randomised control trial (RCT) methodology. Six studies used the ecological validity and cultural sensitivity framework. Planned adaptation, cultural adaptation of content, and surface and deep structure level adaptations were used in other studies. Apart from one pilot study, all studies reported that culturally adapted interventions resulted in improvements in depression and/or anxiety symptoms in young people. The results suggest the potential effectiveness of cross-culturally adapted interventions within this context. Our stakeholder consultations demonstrated that engaging different community-level stakeholders in the adaptation process was highly recommended. CONCLUSIONS Whilst most included studies indicated improvements in depression and/or anxiety symptoms in young people following a cross-culturally adapted intervention, more work is needed in this area. In particular, focus should be placed upon identifying the dimensions of interventions that should be culturally adapted to make them acceptable, engaging and effective.
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Affiliation(s)
- Masuma Pervin Mishu
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Lucy Tindall
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom
| | - Philip Kerrigan
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom
| | - Lina Gega
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
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Coping Strategies to Enhance the Mental Wellbeing of Sexual and Gender Minority Youths: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148738. [PMID: 35886595 PMCID: PMC9319075 DOI: 10.3390/ijerph19148738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Robust population-based research has established that sexual and gender minority youths (SGMYs) are at an increased risk of mental ill-health, but there is a dearth of literature that seeks to explore how to best support SGMY mental wellbeing. This scoping review aims to identify findings related to coping strategies and/or interventions for building resilience and/or enhancing the mental wellbeing of SGMYs. PRISMA extension for scoping review (PRISMA-ScR) guidelines was utilized for this review. Studies were included if they were peer-reviewed papers containing primary data; reported psycho-social coping strategies for SGMY; were conducted with SGMYs in the adolescent age range; and were published in English. MEDLINE, Embase, and PsycINFO databases were searched. Of the 3692 papers initially identified, 68 papers were included with 24 intervention-focused studies of 17 unique interventions found. The most commonly cited therapeutic modality was cognitive behavioral therapy (CBT) (n = 11 studies). Despite the need to support the mental wellbeing of SGMYs, few interventions focused on this area and unique populations have been reported upon in the peer-reviewed literature. As a result, there is considerable potential to develop supports for SGMYs.
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Sonneville SA. Spiritual support of transgender individuals: a literature review. J Health Care Chaplain 2022; 29:196-210. [PMID: 35776733 DOI: 10.1080/08854726.2022.2080965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Spiritual support has been a staple of healthcare before hospitals in western civilizations were established by communities of faith. Research has demonstrated that wellbeing is associated with balanced care for the body, mind, and spirit. Healthcare disparities are being identified as disproportionally impacting transgender and gender nonconforming (TGNC) individuals. The root cause of this disparity is being studied as are medical and wellbeing interventions, including the benefit of spiritual support. This author's objective was two-fold. First, to identify opportunities for extending spiritual support to TGNC individuals in healthcare by chaplains. Secondly, to identify evidence of current spiritual support advocacy initiatives and interventions for TGNC patients in healthcare by chaplains.
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Affiliation(s)
- Seth A Sonneville
- Program Director, , Wellbeing & Inclusion, Center for Wellbeing, Children's Mercy, Kansas City, MO, USA
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Bazán A, Mansilla M. La adaptación afirmativa de los tratamientos psicológicos para minorías sexuales: una revisión sistemática. CLÍNICA CONTEMPORÁNEA 2022. [DOI: 10.5093/cc2022a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Client-led culturally responsive CBT – integrating familism in the treatment of chronic depression: a case study. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Britain has increasingly become a multi-cultural society. In order to improve access to primary care psychological therapy including cognitive behavioural therapy (CBT), there has been an increase in focus on cultural adaptation and cultural responsiveness. To date, these adaptations have focused on domains such as language, beliefs and values. In this case, familism was the focus for adaptation. The client was a 22-year-old female from a black African-British background. She presented with severe symptoms of chronic depression as measured on routine standard questionnaires and the interview. She had minimal success from previous interventions and was struggling to make progress. Therapy was guided by the client’s views on what issues had a bearing on her difficulties. The client hypothesised that familism factors with themes around ‘my parents’ culture’ and ‘family comes first’ were interacting with her cognitive behavioural factors to maintain her problem. She requested the involvement of her family in her treatment plan. In line with the Improving Access to Psychological Therapies–Black, Asian and Minority Ethnic service user Positive Practice Guide, this was integrated as part of her formulation. Upon involvement of her father in a single session, the client attained reliable improvement. She attributed her improvement to this involvement. By the end of therapy, she reached recovery, which was maintained at 3-month follow-up. This study was responsive to the client’s own perceived cultural needs through the integration of familism into her CBT formulation. It illustrates a client-led cultural adaptation of CBT to treat chronic depression.
Key learning aims
It is hoped that the reader will increase their understanding of the following from reading this case study:
(1)
Creating an environment where clients can freely discuss their perceived cultural factors from the outset.
(2)
Client-led cultural responsiveness to their expressed cultural needs.
(3)
Familism as a domain for adapting CBT.
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Lee J, Hong J, Zhou Y, Robles G. The Relationships between Loneliness, Social Support, and Resilience among Latinx Immigrants in the United States. CLINICAL SOCIAL WORK JOURNAL 2020; 48:99-109. [PMID: 33583968 PMCID: PMC7880232 DOI: 10.1007/s10615-019-00728-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Globally, international migrants are at elevated risk for experiencing loneliness due to separation from social networks in their countries of origin. In the United States, the political rhetoric has been particularly exclusionary against Latinx immigrants, exposing them to discrimination and fear of deportation. Such environments may result in heightened levels of social isolation, which may contribute to greater risk of poor mental and physical health outcomes. Latinx immigrants, however, may access social support in their destination communities that buffers against these negative outcomes. This study sought to examine how social support and loneliness shape Latinx immigrants' abilities to address the challenges related to migration. Multivariate linear regression analyses were conducted with survey data collected from Latinx immigrants in New York City (n=306). Results revealed that Latinx immigrants with greater social support and less feelings of loneliness were more resilient. Specifically, findings suggest that social support may partially protect against the negative impact of isolation on Latinx immigrants' capacity to thrive. Clinical social workers who work with immigrant groups may consider how migration during the life course affects immigrants' social supports and experiences of loneliness. Social work interventions that integrate strategies to increase social support may provide opportunities to address social isolation and other obstacles associated with migration. Such approaches acknowledge loneliness not only as a psychological symptom, but also as a consequence of unfavorable social environments towards immigrant populations. Future research may develop and assess culturally relevant strategies to promote social support and reduce loneliness among marginalized immigrants.
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Affiliation(s)
- Jane Lee
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Jeeyeon Hong
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Yuanjin Zhou
- School of Social Work, University of Washington, Seattle, WA, USA
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Bernal G, Rivera-Medina CL, Cumba-Avilés E, Reyes-Rodríguez ML, Sáez-Santiago E, Duarté-Vélez Y, Nazario L, Rodríguez-Quintana N, Rosselló J. Can Cognitive-Behavioral Therapy Be Optimized With Parent Psychoeducation? A Randomized Effectiveness Trial of Adolescents With Major Depression in Puerto Rico. FAMILY PROCESS 2019; 58:832-854. [PMID: 31077610 DOI: 10.1111/famp.12455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive-behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre- to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1-year follow-up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT-alone showed an increase. The implication of these findings is discussed.
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Affiliation(s)
- Guillermo Bernal
- University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | | | | | | | | | | | - Lelis Nazario
- University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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Stavropoulos V, Cokorilo S, Kambouropoulos A, Collard J, Gomez R. Cognitive Behavioral Therapy Online for Adult Depression: A 10 Year Systematic Literature Review. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1573400515666190628125914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background:
Acceptance, adherence and efficacy aspects of Cognitive Behavioural
Therapy (CBT) online have invited significant interest, especially in the context of “stepped care”
models, which advocate progressive stages of intervention in addressing depression. Objectives: The
current work aspires to comprehensively identify critical factors linked to the applicability of online
CBT, in order to inform clinical practices and future research targeting depressive behaviors in early
and middle adulthood.
Methods:
To serve these goals: a) the PRISMA systematic literature perspective is followed; b) a
systematic search of online databases between 2008-2018 was undertaken and; c) a compositehybrid
model, resulting from the integration of broadly adopted conceptualizations from the areas of
psychological treatment and internet use behaviors, was combined with an interpretative phenomenological
analysis perspective to organize the findings.
Results:
In total, 28 studies were included in the present review. Factors defining the efficacy, adherence
and acceptability of online CBT targeting depression (during early and middle adulthood)
were classified into parameters related to the individual receiver, the context and the CBT activities
involved.
Conclusion:
Despite the cautiousness warranted by the limitations, as well as the diverge methodology of
the reviewed studies, findings appear to favour the provision of brief, therapist supported, online
CBT interventions, especially in addressing moderate depression during early and middle adulthood.
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Affiliation(s)
| | - Sandra Cokorilo
- The Cairnmillar Institute, School of Psychology, Melbourne, Australia
| | | | - James Collard
- The Cairnmillar Institute, School of Psychology, Melbourne, Australia
| | - Rapson Gomez
- Federation University, Mount Helen, VIC 3350, Australia
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12
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Ibañez GE, Whitt E, Rosa MDL, Martin S, O'Connell D, Castro J. Developing a Culturally Appropriate HIV and Hepatitis C Prevention Intervention for Latino Criminal Justice Clients. JOURNAL OF CORRECTIONAL HEALTH CARE 2018; 22:206-17. [PMID: 27302706 DOI: 10.1177/1078345816653875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The population within the criminal justice system suffers from various health disparities including HIV and hepatitis C virus (HCV). African American and Latino offenders represent the majority of the offender population. Evidence-based interventions to prevent HIV and HCV among criminal justice clients are scant and usually do not take cultural differences into account. Toward this end, this study describes the process of culturally adapting an HIV/HCV prevention intervention for Latino criminal justice clients in Miami, Florida, by using the ecological validity model. Recommendations for culturally adapting an intervention for Latinos include an emphasis on language and integrating cultural themes such as familism and machismo.
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Affiliation(s)
- Gladys E Ibañez
- Epidemiology Department, Florida International University, Miami, FL, USA
| | - Elaine Whitt
- Center for Drug and Health Studies, University of Delaware, Newark, DE, USA
| | - Mario de la Rosa
- Epidemiology Department, Florida International University, Miami, FL, USA
| | - Steve Martin
- Center for Drug and Health Studies, University of Delaware, Newark, DE, USA
| | - Daniel O'Connell
- Center for Drug and Health Studies, University of Delaware, Newark, DE, USA
| | - Jose Castro
- Miller School of Medicine, Division of Infectious Diseases, University of Miami, Miami, FL, USA
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Bemak F, Chung RCY. Refugee Trauma: Culturally Responsive Counseling Interventions. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12144] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Fred Bemak
- Counseling and Development Program; George Mason University
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Hall WJ. Psychosocial Risk and Protective Factors for Depression Among Lesbian, Gay, Bisexual, and Queer Youth: A Systematic Review. JOURNAL OF HOMOSEXUALITY 2017; 65:263-316. [PMID: 28394718 PMCID: PMC5634914 DOI: 10.1080/00918369.2017.1317467] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Many lesbian, gay, bisexual, or queer (LGBQ) youth suffer from depression. Identifying modifiable risk and protective factors for depression can inform the development of psychosocial interventions. The aim of this review is to evaluate the methodological characteristics and summarize the substantive findings of studies examining psychosocial risk and protective factors for depression among LGBQ youth. Eight bibliographic databases were searched, and 35 studies that met all inclusion criteria were included for review. Results show that prominent risk factors for depression include internalized LGBQ-related oppression, stress from hiding and managing a socially stigmatized identity, maladaptive coping, parental rejection, abuse and other traumatic events, negative interpersonal interactions, negative religious experiences, school bullying victimization, and violence victimization in community settings. Prominent protective factors include a positive LGBQ identity, self-esteem, social support from friends, and family support. LGBQ youth may face an array of threats to their mental health originating from multiple socioecological levels.
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Affiliation(s)
- William J Hall
- a School of Social Work and Cecil G. Sheps Center for Health Services Research , University of North Carolina , Chapel Hill , North Carolina , USA
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Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center. Community Ment Health J 2015; 51:385-92. [PMID: 25107309 PMCID: PMC4321971 DOI: 10.1007/s10597-014-9750-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 06/17/2014] [Indexed: 01/08/2023]
Abstract
The present study investigated whether a culturally-tailored problem-solving intervention delivered by a trained depression care specialist (DCS) would improve depressive symptoms over a 6 month period among Hispanic/Latino patients in a federally-qualified community health center by the California-Mexico border. Participants included 189 low income Hispanic/Latino patients of Mexican heritage. Based on the improving mood-promoting access to collaborative treatment (IMPACT) evidence-based treatment, patients received evidence-based problem-solving therapy. The Patient Health Questionnaire-9 (PHQ-9) was administered to assess changes in self-reported depressive symptoms between baseline and monthly for a 6-month follow up period. The majority of participants were female (72.5%) with a mean age of 52.5 (SD = 11.7). The mean PHQ-9 at baseline was 16.9 (SD = 4.0) and at the 6-month follow-up, the average PHQ-9 decreased to 9.9 (SD = 5.7). A linear mixed model analysis showed significant improvement in PHQ-9 scores over a 6 month period (F = 124.1; p < 0.001) after controlling for age, gender, smoking and diabetes. There was a significant three way interaction between time, gender and smoking (p = 0.01) showing that the depressive symptoms among male smokers did not improve as much as non-smoking males and females. Results suggest that a culturally-tailored problem solving approach can significantly reduce depressive symptoms among Hispanic/Latino low-income patients.
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Austin A, Craig SL. Empirically Supported Interventions for Sexual and Gender Minority Youth. ACTA ACUST UNITED AC 2015; 12:567-78. [PMID: 25923879 DOI: 10.1080/15433714.2014.884958] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
When empirically supported treatments (ESTs) are effectively adapted for use with minority populations, they may be more efficacious. As such, there is a need to adapt existing ESTs for use with diverse sexual and gender minority youth (SGMY). The unique bias-based challenges faced by SGMY require the integration of affirmative practices into ESTs to effectively address the specific needs of this underserved group of youth. The primary purpose of the authors in this article is to present a clearly articulated stakeholder driven model for developing an affirmative adapted version of cognitive behavioral therapy (CBT) for use with diverse SGMY. The authors' approach to adaptation follows the "adapt and evaluate" framework for enhancing cultural congruence of interventions for minority groups. A community based participatory research approach, consistent with a stakeholder driven process, is utilized to develop the intervention from the ground up through the voices of the target community. Researchers conducted 3 focus groups with culturally diverse SGMY to explore salient aspects of youths' cultural and SGM identities in order to inform the intervention and ensure its applicability to a wide range of SGMY. Focus group data is analyzed and integrated into an existing group-based CBT intervention. The following themes emerge as critical to affirmative work with diverse SGMY: (1) the interplay between cultural norms, gender norms, sexual orientation, and gender identity; (2) the complex role of religious community within the lives of SGMY; and (3) consideration of extended family and cultural community as youth navigate their SGM identities.
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Affiliation(s)
- Ashley Austin
- a School of Social Work, Barry University , Miami Shores , Florida , USA
| | - Shelley L Craig
- b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
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Davidson TM, Soltis K, Albia CM, de Arellano M, Ruggiero KJ. Providers' perspectives regarding the development of a web-based depression intervention for Latina/o youth. Psychol Serv 2015; 12:37-48. [PMID: 25133417 PMCID: PMC4333062 DOI: 10.1037/a0037686] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Latina/o youth appear to be at significant risk for depression and, of concern, is the high underutilization of mental health services observed in this population. There is a tremendous need for novel intervention methods to better serve the unique needs of this population. This article describes the development of Rise Above (Siempre Sale el Sol), a Web-based, self-help, depression intervention for Latina/o adolescents funded by the National Institute of Mental Health. We applied a cultural adaptation model to an evidence-based depression treatment to reduce potential service barriers and increase the relevance and potential efficacy of the intervention for Latina/o youth. We conducted thematic interviews with 32 national experts to obtain feedback that would inform our application of the cultural adaptation model, the potential efficacy of the intervention, and the feasibility of implementation. Future directions for the evaluation of Rise Above (Siempre Sale el Sol) are described.
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Culturally adapted cognitive behaviour therapy for Māori with major depression. COGNITIVE BEHAVIOUR THERAPIST 2015. [DOI: 10.1017/s1754470x14000233] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractMāori are the indigenous people of New Zealand and in 2006 comprised approximately 15% of the country's population. Epidemiological data suggests Māori experience rates of depression that are higher than the general population and are less likely to engage in treatment for mental health issues. The main aim of this study was to evaluate the effectiveness of an adapted approach to psychotherapy with Māori. The broad goals of which were to provide empirically grounded guidance for therapists aspiring to provide best practice to their Māori clients. This paper documents the evaluation of a cognitive behavioural therapy (CBT) treatment protocol specifically designed and adapted for delivery to adult Māori clients with a diagnosis of depression. The treatment protocol was administered to 16 Māori clients with a primary diagnosis of depression. The adapted treatment incorporated Māori processes for engagement, spirituality, family involvement and metaphor. The intervention exhibited considerable promise with large significant reductions in depressive symptomatology in the participant group. Furthermore, significant reductions in negative cognition were observed. This is the first piece of applied clinical research that has examined the effectiveness of an individual psychological therapy exclusively with Māori and the first to examine individual psychotherapy outcomes with an indigenous population using an effectiveness study. The findings have a number of implications for the treatment of Māori clients with depression. This study provides useful guidelines for clinicians providing psychological treatment to Māori and provides strong support for the cultural adaptation of psychological treatment with ethnic minority groups.
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Antoniades J, Mazza D, Brijnath B. Efficacy of depression treatments for immigrant patients: results from a systematic review. BMC Psychiatry 2014; 14:176. [PMID: 24930429 PMCID: PMC4084503 DOI: 10.1186/1471-244x-14-176] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/04/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The unprecedented rates of global migration present unique challenges to mental health services in migrant receiving countries to provide efficacious and culturally salient treatment for mental health conditions including depression. This review aimed to identify and evaluate the effectiveness of depression interventions specifically directed towards first-generation immigrant populations. METHODS We conducted a systematic review of original research published between 2000 and 2013 that investigated depression interventions in first generation immigrants. RESULTS Fifteen studies were included; the majority focused on Latino immigrants living in the United States (US). Twelve studies investigated the use of psychotherapies; the remainder examined collaborative care models and physical exercise-based interventions. Cognitive Behavioral Therapy and Behavioral Activation tended to improve depressive symptoms, especially when culturally adapted to suit clients while Problem Solving Therapy improved depressive symptomology with and without adaptations. Collaborative care and exercise did not significantly improve depressive symptoms. CONCLUSION Depression may be effectively treated by means of psychotherapies, especially when treatments are culturally adapted. However the reviewed studies were limited due to methodological weaknesses and were predominantly undertaken in the US with Latino patients. To improve generalizability, future research should be undertaken in non-US settings, amongst diverse ethnic groups and utilize larger sample sizes in either randomized clinical trials or observational cohort studies.
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Affiliation(s)
- Josefine Antoniades
- Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC 3168, Australia.
| | - Danielle Mazza
- Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC 3168, Australia
| | - Bianca Brijnath
- Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC 3168, Australia
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Nelson LE, Walker JJ, DuBois SN, Giwa S. Your blues ain't like mine: considering integrative antiracism in HIV prevention research with black men who have sex with men in Canada and the United States. Nurs Inq 2014; 21:270-282. [PMID: 24894761 DOI: 10.1111/nin.12055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2013] [Indexed: 11/28/2022]
Abstract
Evidence-based interventions have been developed and used to prevent HIV infections among black men who have sex with men (MSM) in Canada and the United States; however, the degree to which interventions address racism and other interlocking oppressions that influence HIV vulnerability is not well known. We utilize integrative antiracism to guide a review of HIV prevention intervention studies with black MSM and to determine how racism and religious oppression are addressed in the current intervention evidence base. We searched CINAHL, PsychInfo, MEDLINE and the CDC compendium of evidence-based HIV prevention interventions and identified seventeen interventions. Three interventions targeted black MSM, yet only one intervention addressed racism, religious oppression, cultural assets and religious assets. Most interventions' samples included low numbers of black MSM. More research is needed on interventions that address racism and religious oppression on HIV vulnerability among black MSM. Future research should focus on explicating mechanisms by which multiple oppressions impact HIV vulnerability. We recommend the development and integration of social justice tools for nursing practice that aid in addressing the impacts of racism and other oppressions on HIV vulnerability of black MSM.
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Reyes-Rodríguez ML, Baucom DH, Bulik CM. Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study. ACTA ACUST UNITED AC 2014; 5:136-146. [PMID: 25598951 DOI: 10.1016/s2007-1523(14)72009-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. METHOD A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. RESULTS The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). CONCLUSIONS The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery.
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Affiliation(s)
| | - Donald H Baucom
- Department of Psychology, University of North Carolina, Chapel Hill, NC
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC ; Department of Nutrition, University of North Carolina, Chapel Hill, NC
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Flickinger TE, Berry S, Korthuis PT, Saha S, Laws MB, Sharp V, Moore RD, Beach MC. Counseling to reduce high-risk sexual behavior in HIV care: a multi-center, direct observation study. AIDS Patient Care STDS 2013; 27:416-24. [PMID: 23802144 PMCID: PMC3704109 DOI: 10.1089/apc.2012.0426] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A key opportunity to reduce HIV transmission lies with healthcare providers counseling HIV-infected patients about safer sex. We audio-recorded and transcribed clinical encounters between 45 healthcare providers and 417 of their HIV-infected patients at four outpatient sites in the United States. We used logistic regressions to evaluate associations between patient and provider characteristics, and the occurrence of discussion (any talk about sex) and counseling (advice about safer sex). Of the 417 encounters, discussion of sex occurred in 187 (45% of encounters, 95% CI: 40-50%). Counseling occurred for 49% (95% CI: 35-63%) of patients reporting unsafe sex. Discussion of sex was more likely with younger or less-educated patients and with less cultural difference between patient and provider, while counseling was associated with greater provider mindfulness and lower provider empathy. These findings suggest targets to improve communication regarding sexual risk reduction in HIV care.
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Affiliation(s)
- Tabor E Flickinger
- Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Souza VD. Adolescentes em cena: uma proposta educativa no campo da saúde sexual e reprodutiva. Rev Esc Enferm USP 2011; 45 Spec No 2:1716-21. [DOI: 10.1590/s0080-62342011000800014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 11/30/2011] [Indexed: 11/22/2022] Open
Abstract
Objetivou-se descrever a experiência sobre a elaboração de material educativo, no formato de performance teatral criada e encenada por adolescentes, como estratégia para a obtenção de uma atitude reflexiva e autônoma desses sujeitos, no campo afetivo-sexual e reprodutivo. Processo de intervenção e de investigação desenvolvido em uma escola pública de Belo Horizonte - Minas Gerais, Brasil - com 12 estudantes de 14 a 18 anos. A análise baseou-se no método de educação pela experiência, de John Dewey. Foram realizadas 23 oficinas até a produção do espetáculo e do vídeo Sexo sim, Doença Não, exibido para alunos do ensino médio. A produção de tecnologias educativas, construída pelos próprios adolescentes, possibilitou a ampliação de suas vivências e a re-significação de conhecimentos. Também auxiliou a compreensão da realidade cotidiana desses sujeitos, permitindo a ligação entre o interno (o pensamento do adolescente) e o externo (que concretiza os fenômenos sociais) no campo afetivo-sexual e reprodutivo.
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González-Prendes AA, Hindo C, Pardo Y. Cultural Values Integration in Cognitive-Behavioral Therapy for a Latino With Depression. Clin Case Stud 2011. [DOI: 10.1177/1534650111427075] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Cindy Hindo
- Arab American and Chaldean Council, Sterling Heights, MI, USA
| | - Yobany Pardo
- St. Joseph Mercy Hospital Oakland, Pontiac, MI, USA
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Confirmatory Factor Analysis of the Valued Living Questionnaire in a Black American Sample: Implications for Cognitive Research and Practice. COGNITIVE THERAPY AND RESEARCH 2011. [DOI: 10.1007/s10608-011-9405-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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