Eastern Caribbean family psychology with conduct-disordered adolescents from the Virgin Islands

Coping Strategies and Psychological Symptoms Among Children on St. Thomas in the Aftermath of Hurricanes Irma and Maria

Research has shown that experiencing a hurricane can lead to internalizing, externalizing, and posttraumatic stress (PTS) symptoms in children. However, the effects of experiencing two hurricanes within a short time frame have not been examined. Moreover, there is limited research examining how children's coping is linked to their psychological functioning and no research using the empirically supported conceptualization of coping that includes primary control coping (i.e., attempts to control the stressor) and secondary control coping (i.e., attempts to adapt to the stressor). This study examined the psychological functioning of 108 children and adolescents (69.7% Black, Non-Hispanic; 56.5% female; M age = 11.59 years, SD = 2.43) in Grades 3-12 as measured 3 months after experiencing Hurricanes Irma and Maria on the island of St. Thomas. Participants completed electronic questionnaires about their demographic characteristics, hurricane exposure (i.e., perceived life-threat, life-threatening events, loss/disruption after hurricanes), coping strategies utilized, and their psychological functioning (i.e., PTS, internalizing, and externalizing symptoms). A principal component analysis of the coping items determined four coping factors: primary control, secondary control, disengagement, and negative coping. Linear regressions, including children's age and aspects of hurricane exposure, found primary control coping was positively associated with PTS symptoms, β = .18, whereas secondary control coping was negatively associated with PTS and externalizing symptoms, βs = -.17 and -.19, respectively. Negative coping, but not disengagement coping, was positively associated with all three outcomes, βs = .31-.42. These findings suggest positive ways children can cope after experiencing a hurricane, informing possible early intervention efforts.

Multicenter study of human papillomavirus and the human papillomavirus vaccine: knowledge and attitudes among people of African descent

OBJECTIVE

To compare knowledge and attitudes of human papillomavirus (HPV) and the vaccine between different cultures of African descent.

METHODS

A cross-sectional survey of 555 African-Americans and Afro-Caribbeans residing in the US and the Bahamas (BHM) was conducted.

RESULTS

General knowledge about HPV and the HPV vaccine differed between the two countries significantly. Bahamian respondents were less likely to have higher numbers of correct knowledge answers when compared to Americans (Adjusted Odds Ratio [Adj. OR] 0.47, 95% Confidence Interval [CI] 0.30-0.75). Older age, regardless of location, was also associated with answering fewer questions correctly (Adj. OR 0.61, 95% CI 0.40-0.92). Attitudes related to HPV vaccination were similar between the US and BHM, but nearly 80% of BHM respondents felt that children should not be able to receive the vaccine without parental consent compared to 57% of American respondents.

CONCLUSIONS

Grave lack of knowledge, safety and cost concerns, and influence of parental restrictions may negatively impact vaccine uptake among African-American and Afro-Caribbean persons. Interventions to increase the vaccine uptake in the Caribbean must include medical provider and parental involvement. Effective strategies for education and increasing vaccine uptake in BHM are crucial for decreasing cervical cancer burden in the Caribbean.

A Cultural Scavenger Hunt: Tools of Engagement

The authors describe the use of a cultural scavenger hunt to engage visiting students in cultural conversations within a short-term study-abroad course in the Caribbean. Students from a host university developed questions designed to engage visiting students in dialog with local residents and encouraged the students to return with artifacts and answers to questions. The authors outline how they developed the scavenger hunt, the activities it required of the students, and possible variations for use in other settings. Students reported that the scavenger hunt helped them develop an appreciation for cultural diversity.

Developing an effective HIV/AIDS response for women and girls in the U.S. Virgin Islands

This article focuses on specific culturally and socially based gender issues that enhance HIV risk and complicate access to care and services for women and girls in the U.S. Virgin Islands (USVI). Literature review and interviews with clinicians providing HIV care in the USVI were used to examine causative factors for the high HIV prevalence rates among USVI women. Although the USVI population is almost evenly split between men (48%) and women (52%), females represent 46% of all USVI residents living with HIV and 33% of all people with AIDS. A primary barrier to adequate HIV/AIDS care for these women and girls is the insufficient number of clinicians available to provide that care. A primary barrier to adequate HIV prevention is the fact that, although the USVI are a territory of the United States, their cultural practices are those of the Caribbean. Thus, HIV programs developed on the U.S. mainland are often ineffective in USVI. A lack of consistent and accurate reporting to HIV/AIDS surveillance staff on the part of clinicians also hinders early trend detection efforts, as well as effective HIV management. Strategies to address HIV among USVI women and girls include: 1) increasing awareness of issues that impact them negatively and increase their vulnerability to HIV, 2) developing and funding delivery of effective, culturally appropriate HIV-related interventions, and 3) increasing the size and technical capacity of the USVI clinical workforce. Simultaneously updating current health care professionals on best practices for HIV screening, treatment, risk-reduction counseling and support could also substantially strengthen the USVI's response to HIV among women and girls.

Emerging linkages between substance abuse and HIV infection in St. Croix, US Virgin Islands

In the US Virgin Islands 575 cases of AIDS had been reported to the Centers for Disease Control and Prevention through mid-2003. Although males continue to be most affected by HIV/AIDS, the feminization of the epidemic is evidenced by recent data showing rates of infection increasing rapidly among women. This paper focuses on the role of substance abuse and the socially and culturally based gender issues that influence risk and vulnerability to HIV in this setting. 254 chronically drug- or alcohol-involved men and women were recruited and interviewed using targeted sampling strategies. Crack use was overwhelmingly reported by females when compared to males (84.7% vs. 48.8%). Women also reported a significantly higher number of sexual partners in the past month (5.6 vs. 2.3) and significantly more occasions of unprotected vaginal sexual contact (11.2 vs. 6.5). Rates of self-reported HIV infection were elevated among women as well (8.8% vs. 1.4%). Women's precarious economic position and lack of access to legitimate income-generating activities tended to drive them into 'survival sex' to support their subsistence and drug needs. As such, it would appear that substance abuse has an emerging role in the spread of the epidemic in St. Croix, particularly among women.

Families and family psychology at the millennium. Intersecting crossroads

This introduction to the International Perspectives section presents a global overview of various issues and trends that families and family psychologists confront at the beginning of the 21st century. These are presented in broad strokes so that a kaleidoscopic intermingling of pieces emerges. Some predictions are included about new and expanding directions the field of family psychology is likely to take in coming decades. The need for additional research to field test criteria sets for emerging relational diagnosis and to evaluate which are the most efficacious therapeutic interventions is highlighted (F. W. Kaslow, 1987, 1995b). This section also includes 3 other articles on various aspects of family psychology by leading psychologists from 3 diverse countries and continents--the Virgin Islands (R. Dudley-Grant, 2001), Israel (E. Halpern, 2001), and Japan (K. Kameguchi, 2001). Each is representative of the larger region in which each author teaches and practices. These articles are intended to present a collage of some of the problems families are experiencing, future trends, and a call to action for psychologists to intervene to prevent and ameliorate family distress. Each author describes the history and current status of family psychology in his or her country and relates key dilemmas to what is happening on the world scene.