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de Tantillo L, McCabe BE, Zdanowicz M, Ortega J, Gonzalez JM, Chaparro S. Implementing Strategies to Recruit and Retain a Diverse Sample of Heart Failure Patients. Hisp Health Care Int 2024:15404153241248144. [PMID: 38646673 DOI: 10.1177/15404153241248144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Introduction: The increased prevalence, severity, and mortality of heart disease and specifically heart failure among Hispanic and Black populations are a concern for clinicians and researchers. Additionally, patients of poor socioeconomic status also have worse outcomes for cardiovascular disease. To address disparities, it is necessary to address the persistent lack of representation in clinical research of diverse populations, including the Hispanic and Black populations and individuals who are of low socioeconomic status. Method: This study was a pilot randomized trial of a medication adherence intervention for heart failure patients conducted at a safety net hospital and affiliated pharmacy with a diverse patient population. Using an evidence-based multifactorial approach, this investigation implemented and adapted best practices to support the inclusion of Hispanic, Black, and socioeconomically diverse participants. Results: A total of 40 participants were recruited, 58% were Hispanic, 38% Black, and 5% White. A total of 40% reported the need for socioeconomic assistance. At 30 days after discharge, follow-up data were obtained for 37 of 40 (93%) of participants either by interview, electronic record, or both. Conclusion: Findings suggest that a combination of strategies used in this trial can be applied to recruit and retain ethnically and socioeconomically diverse participants.
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Affiliation(s)
- Lila de Tantillo
- Brooks Rehabilitation College of Healthcare Sciences, Keigwin School of Nursing, Jacksonville University, Jacksonville, FL, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling (SERC), Auburn University, Auburn, AL, USA
| | | | - Johis Ortega
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Juan M Gonzalez
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Sandra Chaparro
- Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL, USA
- Herbert Wertheim School of Medicine, Florida International University, Miami, FL, USA
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McConaha CD, McCabe BE, Falcon AL. Anxiety, Depression, Coping, Alcohol Use and Consequences in Young Adult College Students. Subst Use Misuse 2023; 59:306-311. [PMID: 37849302 DOI: 10.1080/10826084.2023.2270550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Young adult college students experience a high risk for heavy alcohol use and resulting consequences. Symptoms of anxiety and depression increase this risk. Coping style has been associated with alcohol use and consequences, with approach coping being inversely related to use and consequences, and avoidance coping being directing related to use and consequences. The purpose of this study is to examine whether coping style moderates or mediates the relationship between anxiety/depression and alcohol use and consequences. METHODS 250 young adult college students ages 18 to 25 years (Women = 85, 34%) anonymously self-reported anxiety, depression, coping style, alcohol use and consequences. RESULTS Path analysis showed that avoidance coping was positively related to alcohol use (β = 0.33, p < 0.05), social consequences (β = 0.39, p < 0.05), and personal consequences (β = 0.26, p < 0.05), while approach coping was inversely related to use (β = -0.20, p = 0.005). Coping did not moderate the relationship between anxiety and depression and alcohol use or consequences. Avoidance coping mediated the relationship between depression and alcohol use (β = 0.14, p < 0.05), social consequences (β = 0.16, p < 0.05), and personal consequences (β = 0.11, p < 0.05). CONCLUSION Findings build on alcohol use and consequences research, and support further research into implementing coping-based alcohol use interventions. Interventions aimed at reducing avoidance coping and increasing approach coping may be beneficial for young adult college students.
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Affiliation(s)
- Candace D McConaha
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Ashley L Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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Gonzalez-Guarda RM, McCabe BE, Nagy GA, Stafford AM, Matos L, Lu M, Felsman I, Rocha-Goldberg P, Cervantes RC. Acculturative Stress, Resilience, and a Syndemic Factor Among Latinx Immigrants. Nurs Res 2023; 72:249-258. [PMID: 37350696 PMCID: PMC10299814 DOI: 10.1097/nnr.0000000000000655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND The process of immigration and subsequent adaptation can expose Latinx immigrants to chronic and compounding challenges (i.e., acculturative stress), but little is known about how resilience factors and these stressors interact to influence syndemic conditions, intertwined epidemics that disproportionally affect historically marginalized communities. OBJECTIVES The purpose of this study was to describe the influence of acculturative stress and resilience on the syndemic factor underlying substance abuse, intimate partner violence, HIV risk, and mental conditions. METHODS Baseline cross-sectional data from a community-engaged, longitudinal study of 391 adult (ages 18-44 years) Latinx immigrants in North Carolina were obtained using standardized measures available in English and Spanish. Structural equation modeling tested the syndemic model, and random forest variable importance identified the most influential types of acculturative stressors and resilience factors, including their interactions, on the syndemic factor. RESULTS Results indicated that a single syndemic factor explained variations in heavy drinking, drug use, intimate partner violence, depression, and anxiety and fit the data well. Age, being a woman, acculturative stress, acculturation to the United States, and emotional support were significantly related to the syndemic factor. The relationship between acculturative stress and the syndemic factor was buffered by ethnic pride, coping, enculturation, social support, and individual resilience. The most influential acculturative stressors were marital, family, and occupation/economic stress. DISCUSSION Findings from this study underscore the importance of considering the co-occurrence of behavioral and mental health conditions among Latinx immigrants. Health promotion programs for Latinx immigrants should address acculturative stress and bolster ethnic pride, social support, and coping as sources of resilience.
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Affiliation(s)
| | - Brian E. McCabe
- Auburn University, Dept of Special Education, Rehabilitation, and Counseling, Auburn, AL
| | - Gabriela A. Nagy
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC
| | | | | | - Min Lu
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
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Fernandez-Pineda M, McCabe BE, Cianelli R, Villegas N, Ferrer L, Peragallo Montano N. Assessment of miscarriage factors among Latinas who live in the U.S.: a cross-sectional study. Front Glob Womens Health 2023; 4:1127695. [PMID: 37181543 PMCID: PMC10169706 DOI: 10.3389/fgwh.2023.1127695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Latinas in the US are underrepresented in miscarriage research, yet face several risk factors for having a miscarriage, including intimate partner violence, and increasing maternal age. Increased acculturation is associated to increased risk of intimate partner violence and adverse pregnancy outcomes among Latinas yet is also understudied in the realm of miscarriage. Thus, this study aimed to analyze and compare sociodemographic characteristics, health-related factors, intimate partner violence, and acculturation among Latinas with and without a history of miscarriage. Methods This study utilizes a cross-sectional design to analyze baseline data from a randomized clinical trial on the effectiveness of "Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care" (SEPA), a human immunodeficiency virus risk reduction intervention for Latinas. Survey interviews were conducted in a private room at the University of Miami Hospital. Survey data analyzed include demographics, a bi-dimensional acculturation scale, a health and sexual health survey, and the hurt, insult, threaten, and scream tool. This study's sample was 296 Latinas, 18 to 50 years old, with and without a history of miscarriage. Data analyses included descriptive statistics, t-tests for continuous variables, negative binomial for counts, and chi-square for dichotomous or categorical variables. Results Most Latinas were Cuban (53%), lived in the U.S. an average of 8.4 years, had 13.7 years of education, and a monthly family income of $1,683.56. Latinas with history of miscarriage were significantly older, had more children, more pregnancies, and poorer self-rated health than Latinas without history of miscarriage. Although not significant, a high percentage of intimate partner violence (40%) and low levels of acculturation were reported. Discussion This study contributes new data about different characteristics of Latinas who have and have not experienced a miscarriage. Results can help identify Latinas at risk for miscarriage or its adverse-related outcomes and help develop public health policies focusing on preventing and managing miscarriage among Latinas. Further research is warranted to determine the role of intimate partner violence, acculturation, and self-rated health perceptions among Latinas who experience miscarriage. Certified nurse midwives are encouraged to provide Latinas with culturally tailored education on the importance of early prenatal care for optimal pregnancy outcomes.
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Affiliation(s)
- Madeline Fernandez-Pineda
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, NC, United States
| | - Brian E. McCabe
- Department of Special Education, Rehabilitation, and Counseling (SERC), College of Education, Auburn University, Auburn, AL, United States
| | - Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, United States
- Pontificia Universidad Catolica de Chile, Escuela de Enfermeria, Santiago, Chile
| | - Natalia Villegas
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lilian Ferrer
- Pontificia Universidad Catolica de Chile, Escuela de Enfermeria, Santiago, Chile
| | - Nilda Peragallo Montano
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Falcon A, Halstead VA, McCabe BE. College students' experiences with substance use at electronic music events: A qualitative study. J Am Coll Health 2023; 71:686-694. [PMID: 33830897 DOI: 10.1080/07448481.2021.1904953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: To understand college students' experiences with substance use at electronic music events (EME), including harm-reduction strategies and receptivity to educational intervention.Participants: A purposeful sample of undergraduate students at a private Southeastern university was recruited from April 2019 to May 2019 using online advertising and in-person tabling.Methods: A qualitative, descriptive research design utilizing semistructured focus groups.Results: Five focus groups were conducted (n = 18). A thematic analysis revealed three main themes: substance use is commonplace; substance use and protective behaviors; and universities' role in substance education. Additional categories and subcategories were identified within each theme.Conclusion: Substance use at EME is a common experience for college students. Several challenges and opportunities exist for universities working to promote harm reduction practices. Prevention efforts should be event-specific, incorporate student input to engage learning more effectively, and work to reduce barriers that deter students from taking safety precautions when using substances.
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Affiliation(s)
- Ashley Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Valerie A Halstead
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
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Stafford AM, Sojda D, Emerson MM, Nagy GA, McCabe BE, Gonzalez-Guarda RM. Age of Immigration and Depressive Symptoms Among Young Adult Latinx Immigrants: A Test of Explanatory Models. Hisp Health Care Int 2023; 21:14-21. [PMID: 35317632 PMCID: PMC10236318 DOI: 10.1177/15404153221088929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Introduction: Latinx immigrants who migrate to the United States (US) as young children are more likely to experience depression than those who migrate later in life. Our purpose is to test three models that may explain the relationship between age of immigration and depressive symptoms among Latinx immigrants. Methods: A secondary analysis of baseline data from a community-based, longitudinal study of Latinx young adults in the US Southeast was conducted. Latinx immigrants who migrated before the age of 19 years (n = 157) were included, and path analysis was conducted. Results: Age of immigration and depressive symptoms were negatively related (b = -0.19, S = 0.08, p = .015), while acculturative stress and depressive symptoms were positively related (b = 0.04, SE = 0.01, p < .001). No significant indirect effects were found. Conclusion: Our results highlight the importance of assessing acculturative stress and age of immigration as social drivers of mental health in Latinx immigrant children.
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Affiliation(s)
| | - Diana Sojda
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | - Gabriela A. Nagy
- Duke University School of Nursing, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian E. McCabe
- Dept of Special Education, Rehabilitation, and Counseling (SERC), Auburn University, Auburn, Alabama, USA
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Santisteban DA, Mena MP, McCabe BE, Abalo C, Puccinelli M. Comparing individually based and family-based treatments for internalizing, externalizing, and family symptoms in Latino youth. Fam Process 2022; 61:1144-1161. [PMID: 35437789 DOI: 10.1111/famp.12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 01/16/2022] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
Rigorous randomized trials that test promising culturally centered treatments for Latino youth and families are needed. This study adds to the knowledge base by comparing the efficacy of Culturally Informed and Flexible Family Treatment for Adolescents (CIFFTA) to an Individually Oriented Treatment-As-Usual (ITAU) in its ability to retain Latino youth and families in treatment, reduce internalizing and externalizing child symptoms, and improve family functioning. CIFFTA uses an adaptive/flexible approach to deliver individual therapy, family therapy, and psycho-educational modules tailored to each family's unique clinical and cultural characteristics. Two hundred Latino adolescents 11-14 years of age completed a baseline assessment, were randomly assigned to CIFFTA or ITAU, then were assessed again after 16 weeks of intervention. Results show that CIFFTA had significantly higher retention (83%) than ITAU (71%), OR = 2.05, p = .036. Youth in both conditions showed significant reductions in youth and parent reported externalizing and internalizing behaviors, and there were no differences in change between conditions. Parents in CIFFTA reported significantly greater reductions in family conflict, d = 0.38, p = .025 than in ITAU. In CIFFTA, children of less acculturated Latino parents showed more improvement than the children of more acculturated parents. In ITAU, the reverse was true, children of more acculturated parents reported more improvement. This evidence of CIFFTA's impact on retention, family conflict, and differential effect depending on cultural values and behaviors, has important implications for the field of Latino psychology and family treatment.
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Affiliation(s)
| | - Maite P Mena
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling (SERC), Auburn University, Auburn, Alabama, USA
| | | | - Marc Puccinelli
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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Falcon A, Halstead V, McCabe BE, Porter AW. Pilot randomized controlled trial using the theory of planned behavior to promote sexual consent of undergraduates in Greek-letter organizations. J Am Coll Health 2022:1-5. [PMID: 35737996 DOI: 10.1080/07448481.2022.2082849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Sexual assault is prevalent among undergraduates in Greek-letter organizations (GLO). Prevention efforts promote sexual consent, though few explicitly employ theoretical constructs known to positively influence behavior. This study evaluated theory-informed educational posters promoting sexual consent seeking. PARTICIPANTS Forty undergraduate GLO students (20 female, 20 male) were recruited through in-person, email, and social media solicitation. Data collection was completed March-November 2019 during the spring and fall semesters. METHODS A double-blind randomized controlled trial was conducted. Intervention participants viewed theory-informed educational posters promoting sexual consent. RESULTS The intervention group demonstrated more favorable consent intention (p = .024; η2 = 0.131) and consent subjective norms (p = .040; η2 = 0.109). Intervention group males showed a greater improvement in one of four consent attitudes (p = .045; η2 = 0.211). CONCLUSIONS Brief exposures to theory-informed messaging may help to improve subjective norms and behavioral intent to seek sexual consent among undergraduate GLO members.
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Affiliation(s)
- Ashley Falcon
- School of Nursing and Health Studies, University of Miami, Miami, Florida, USA
| | - Valerie Halstead
- School of Nursing and Health Studies, University of Miami, Miami, Florida, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Andrew W Porter
- School of Nursing and Health Studies, University of Miami, Miami, Florida, USA
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McCabe BE, McConaha CD, Falcon AL. Social norms and club drug use of young adult college students during Music Week. J Addict Dis 2022; 41:149-155. [PMID: 35713275 DOI: 10.1080/10550887.2022.2086424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Young adult college students have high rates of substance use, theoretically related to social norms. Behavioral norms refer to the quantity of substances that students think others use, and attitudes refer to how much students or others approve of substance use. Prior research has shown a relationship between behavioral norms, student attitudes, and perceived parental attitudes and alcohol and marijuana use. However, the relationship between social norms and use of club drugs (e.g., MDMA) has not been studied.Objective: The purpose of this cross-sectional study was to expand knowledge about young adult college student social norms and club drug use.Methods: 200 young adult undergraduates (Women = 97, 49%) were recruited from a campus recreational facility on a large private Southeastern university in April 2019. Students self-reported behavioral norms, student attitudes, parental perceived attitudes, club drug use during a typical week and during music week, and substance use consequences.Results: Logistic and negative binomial regressions showed that student attitudes were significantly related to club drug use in a typical week (OR = 2.07, p = .005), during music week (OR = 2.08, p = .001), and consequences of use (RR = 1.23, p < .001), but behavioral norms and perceived parental attitudes were not.Conclusions: Findings build on social norms research with alcohol and marijuana use. Attitudes may be more important to consider than behavioral norms or perceived parental attitudes for interventions to reduce club drug use.Young adults (18-25 years old) have a high risk for substance use; both alcohol and drug use increase throughout adolescence and peak in young adulthood.1-3 Young adults have high heavy episodic drinking (35% past month) and illicit drug use (25% past month), with greater MDMA use (10% vs 7%) and marijuana use (35% vs. 15%) than other adults.4 Alcohol and marijuana use has been linked to many negative consequences, such as blackouts, physical injuries, unprotected sex, and even death.5,6 Club drug use is also linked to negative consequences, such as memory lapse, headaches, loss of energy, trouble sleeping, depression, confusion, anxiety, irritability, nausea, and changes in heart rate and blood pressure.7,8.
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Affiliation(s)
- Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Candace D McConaha
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Ashley L Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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10
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Bravo LG, Nagy GA, Stafford AM, McCabe BE, Gonzalez-Guarda RM. Adverse Childhood Experiences and Depressive Symptoms among Young Adult Hispanic Immigrants: Moderating and Mediating Effects of Distinct Facets of Acculturation Stress. Issues Ment Health Nurs 2022; 43:209-219. [PMID: 34524941 PMCID: PMC10955679 DOI: 10.1080/01612840.2021.1972190] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hispanic immigrants experience more adverse childhood experiences (ACEs) and depressive symptom chronicity/severity than non-Hispanic peers. Acculturation stress relates to both depressive symptoms and ACEs, but the mechanism is not well-understood. We conducted a secondary data analysis of baseline data, from an ongoing longitudinal study to test theoretically-based mediating and moderating effects of acculturation stress on the relationship between ACEs and depression in a sample of young adult Hispanic immigrants (N = 391). Results indicated ACEs predicted depressive symptoms. Mediation and moderation effects were significant for cumulative and distinct facets of acculturation stress. Implications for mental health nurses are discussed.
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Affiliation(s)
- Lilian G. Bravo
- University of North Carolina at Chapel Hill, School of Nursing
| | - Gabriela A. Nagy
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
- Duke University School of Nursing
| | | | - Brian E. McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University
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Nelson BM, McCabe BE, Falcon AL. Willingness to intervene to protect the group from consequences of substance use. Journal of Substance Use 2021. [DOI: 10.1080/14659891.2021.2018729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Bridget M. Nelson
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Brian E. McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Ashley L. Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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McCabe BE, Stenzel H, Li Q, Cervantes RC, Gonzalez-Guarda RM. Multidimensional Acculturation, Acculturative Stress and Alcohol or Drug Use of Adult Latinx Immigrants. J Psychoactive Drugs 2021; 53:431-438. [PMID: 34694207 DOI: 10.1080/02791072.2021.1992045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few studies have used a multidimensional acculturation framework, i.e., cultural practices, identity, and values, to investigate links with alcohol or drug use of Latinx immigrants to the U.S. This cross-sectional study tested links between measures of acculturation (language-based Hispanicism and Americanism, cultural identity, familism), acculturative stress, and alcohol or drug use, controlling for age and gender. 391 adult (18-44 years old) Latinx immigrants (69% women) completed measures on past 6-month behavior in Spanish or English. Results showed that Americanism was related to alcohol use severity, heavy episodic drinking, drug use severity, and any drug use. Acculturative stress was related to alcohol use severity, drug use severity, and any drug use, but not heavy episodic drinking. Familism was inversely related to drug use severity and any drug use, but not alcohol use severity or heavy episodic drinking. Cultural identity and Hispanicism were not related to alcohol or drug use. Consistent with previous research, a language-based measure of acculturation to the U.S. (Americanism) and acculturative stress were related to alcohol and drug use. Incremental validity of a multidimensional acculturation approach was limited. Intervention adaptations for Latinx immigrants should address stress reduction and mitigating adoption of receiving cultural practices.
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Affiliation(s)
- Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Harley Stenzel
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Qing Li
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
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Matsuda Y, McCabe BE, Behar-Zusman V. Mothering in the Context of Mental Disorder: Effect of Caregiving Load on Maternal Health in a Predominantly Hispanic Sample. J Am Psychiatr Nurses Assoc 2021; 27:373-382. [PMID: 32102585 PMCID: PMC8560279 DOI: 10.1177/1078390320907693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Mothering in the context of mental disorders presents with multiple challenges. However, this phenomenon is poorly understood: It is not known how child caregiving affects the health of their mothers. AIMS The purpose of this study was to examine associations between child caregiving load and health indicators in mothers receiving outpatient behavioral health services for mental or substance use disorders. METHOD A total of 172 mothers (80% Hispanic/Latina) completed surveys on their mental and physical health, and children's behaviors and medical problems. Child caregiving load consisted of number of children living with the mother, and presence of children's internalizing, externalizing, or medical problems. RESULTS Child caregiving load had significantly positive associations with mother's psychological distress, fatigue, pain, and body mass index. Child internalizing and medical problems were associated with mothers' poor health status. CONCLUSIONS Hispanics/Latinos experience health disparities, and Hispanic/Latina mothers who are already at risk due to their mental disorders experience an additional health burden associated with caring for children with emotional or health problems. Psychiatric and mental health nurse practitioners should assess child caregiving impact on mothers with mental disorders and seek to mitigate their caregiving burden and maintain their health. Further research is needed to clarify child characteristics and the mechanisms associated with maternal caregiver burden, suboptimal self-care, and adverse health outcomes. Structural Ecosystems Therapy for women in Recovery (SET-R) study/Healthy Home; Clinical Trial ID NCT02702193.
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Affiliation(s)
- Yui Matsuda
- Yui Matsuda, PhD, APHN-BC, MPH, University of Miami, Coral Gables, FL, USA
| | - Brian E McCabe
- Brian E. McCabe, PhD, Auburn University, Auburn, AL, USA
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Ernst ME, Williams JR, McCabe BE. Racial/Ethnic Differences in Stress, Coping, and Distress Among Mothers With a Child in the ICU. Am J Crit Care 2021; 30:275-284. [PMID: 34195780 DOI: 10.4037/ajcc2021416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Having a child in the intensive care unit (ICU) is a stressful event that can cause negative mental health outcomes for parents, but little is known about the experience of parental stress among members of racial/ethnic minority groups. OBJECTIVE To examine the stress and coping process in a racially/ethnically diverse sample of mothers of a child who was acutely admitted to an ICU. METHODS Participants (N = 103) completed a cross-sectional self-report survey; 86.4% completed it within a week of their child's ICU admission. Analysis of variance was used to examine racial/ethnic differences in perceived ICU-related stressors, coping behaviors, and distress level. Linear regression was used to examine the moderating effects of race/ethnicity on the relationships between stressors, coping behaviors, and distress. RESULTS Mothers across racial group experienced similar stressors during the acute phase of their child's ICU admission. African American mothers reported greater overall use of coping behaviors, particularly avoidance coping, and experienced higher levels of distress than did Hispanic or non-Hispanic White mothers. Hispanic mothers experienced the least distress. The interaction of race/ethnicity and emotion-focused coping moderated the stress and coping process. CONCLUSIONS Racial and ethnic diversity in sampling should be a priority in future studies of the stress and coping process of mothers with a child in an ICU. Critical care nurses should minimize known stressors for these mothers and encourage and support their preferred coping behaviors, recognizing that these may differ across racial/ethnic groups.
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Affiliation(s)
- Mary E. Ernst
- Mary E. Ernst is a nursing professor, Seminole State College School of Nursing, Altamonte Springs, Florida
| | - Jessica Roberts Williams
- Jessica Roberts Williams is an assistant professor, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina
| | - Brian E. McCabe
- Brian E. McCabe is an assistant professor, Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama
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Williams JR, McCabe BE, Tantillo LD, Levoy K, Behar-Zusman V. Health Correlates of Abuse History and Moderating Effect of Parenting Stress for Mothers with Mental Disorders. Issues Ment Health Nurs 2021; 42:555-563. [PMID: 32965137 PMCID: PMC8020494 DOI: 10.1080/01612840.2020.1820121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Parenting stress is common and may lead to worsening health, particularly in the context of other risk factors such as mental disorders or a history of abuse. This study investigated how parenting-related stress impacts the effect of abuse experiences on health among mothers with mental health disorders. Survey data was analyzed from 172 predominantly Hispanic mothers receiving outpatient behavioral health services. Most (80.2%) mothers had experienced abuse. Those reporting childhood abuse had 3.82 greater odds of experiencing abuse in adulthood. Findings demonstrated worse health outcomes among those experiencing abuse in both childhood and adulthood and those with a greater number of abuse experiences. Caregiving load intensified the relationship between abuse and anxiety and sleep disturbance. Parenting self-agency intensified the relationship between abuse and cigarette use. These findings have important implications for mental health nursing practice by identifying parenting-stress as an important target for interventions to improve health among women with histories of abuse and mental health disorders.
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Affiliation(s)
- Jessica R Williams
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Lila de Tantillo
- Keigwin School of Nursing, Jacksonville University, Jacksonville, Florida, USA
| | - Kristin Levoy
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Victoria Behar-Zusman
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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16
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McCabe BE, Gonzalez-Guarda R, de Tantillo L, Mitrani VB. A Mental Health-Physical Health-Violence (MPV) Syndemic Factor in Women with Mental Disorders. Stigma Health 2020; 4:383-390. [PMID: 33094162 DOI: 10.1037/sah0000152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study extended research on syndemics for women with mental disorders by including self-reported mental and physical health conditions. Syndemics explain complex relationships among co-occurring conditions, and the social circumstances that influence their overlap. Data were from the baseline assessment of a randomized trial of Healthy Home, a nursing home-visit intervention for women with children. 172 adult women who were in mental health or substance use treatment completed measures (in Spanish or English) of anxiety, depression, violence during adulthood, physical health, and cigarette use. Structural Equation Modeling was used to evaluate a single-factor syndemic, and to test the relationships of theoretical predictors of the syndemic: income, number of children, women's abuse during childhood, mental health stigma, social support, and stress. Results supported a single factor syndemic model that explained variation in mental health, physical health, and violence during adulthood. Stress, β = .45, p < .001, and stigma, β = .22, p = .007, were related to the syndemic factor. There was evidence that self-reported mental and physical health share covariation, which suggested that integrated services for women with mental disorders may have synergistic effects on health. Findings suggest the need to develop and test interventions that address stress and stigma as a means of reducing health disparities for women with mental disorders.
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Affiliation(s)
- Brian E McCabe
- School of Nursing and Health Studies, University of Miami
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17
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Matsuda Y, Kim YJ, Salani DA, McCabe BE, Mitrani VB. Predictors of parenting self-agency among mothers receiving substance abuse or mental health treatment. Int J Ment Health Nurs 2019; 28:1132-1141. [PMID: 31199073 PMCID: PMC6736753 DOI: 10.1111/inm.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2019] [Indexed: 11/28/2022]
Abstract
Mothers' mental health or substance use disorders impact the behaviours of their children both short-term and long-term. There is increased concern for mothers with mental health or substance use disorders to effectively handle parenting challenges. Children of these mothers are at risk for emotional and behavioural adjustment problems as well as poor academic performances. Parenting self-agency refers to parents' perceptions of their confidence and ability to overcome barriers and manage issues in parenting. Examining the factors that predict parenting self-agency aids in understanding how nurses can assist mothers and families. The purpose of this study was to explore predictors of parenting self-agency among mothers who are impacted by mental health or substance use disorders. A secondary analysis was conducted using the baseline assessment data of a randomized trial that examined the efficacy of a nurse-led family-strengthening home-health intervention. The data were obtained from 172 mothers who were receiving outpatient treatment for substance use or other mental health disorders and had children under 18. A multivariate linear regression analysis was conducted to find predictors of parenting self-agency among participating mothers. The authors found that increased children's externalizing problems and intensity of hassle predicted lower parenting self-agency, and family cohesion predicted higher parenting self-agency. The authors conclude that treatments need to address family as a whole to increase mothers' parenting self-agency, thus assisting these mothers in raising their children in the best possible environment.
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Affiliation(s)
- Yui Matsuda
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Young-Ju Kim
- College of Nursing, Sungshin Women's University, Seoul, South Korea
| | - Deborah A Salani
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Brian E McCabe
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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Abstract
Normative beliefs about typical student behavior are related to student drinking, but ethnic minority students may not view themselves as "typical" and may not match drinking behavior to perceptions of typical behavior. Data were from 18,748 U.S. students in the Fall 2014 National College Health Assessment. Students self-reported ethnicity: White, not Hispanic (63%), Asian/Pacific Islander (12%), Hispanic/Latino (11%), Black/African American (8%), Native American/Alaska Native (3%), or Biracial/Other (4%). Students self-reported binge drinking (5+ standard drinks) in the last two weeks, and estimated peak %BAC was calculated. Controlling for age, gender, and fraternity/sorority membership, Hispanic/Latino and Black/African American ethnicity moderated the norms binge drinking and estimated %BAC relationships for and students. Prevention and intervention efforts, such as personalized normative feedback, that use drinking norms should be modified for students from ethnic minority groups. Specifically, norms from students with greater perceived similarity-not "typical" students-should be used in prevention interventions.
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Affiliation(s)
- Brian E McCabe
- School of Nursing & Health Studies, University of Miami, Coral Gables, FL, USA
| | - Debbiesiu L Lee
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Coral Gables, FL
| | - Terilyn Viray
- Department of Public Health Sciences, Miller School of Medicine, Miami, FL
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Abstract
This study examined cutoff scores on the new (2014) US-AUDIT (Alcohol Use Disorders Identification Test), adapted for U.S. standard drinks. No studies have examined optimal cutoff scores on the US-AUDIT for college students. 250 undergraduates (65% men) completed the US-AUDIT. At-risk drinkers reported at least four binge drinking episodes per week. Likely alcohol use disorder was assessed with a self-report diagnostic measure. Using the Youden method, the ideal cutoff to identify at-risk drinkers for the US-AUDIT was 5 for men (sensitivity = .93, specificity = .96) and 6 for women (sensitivity = .77, specificity = .86); and to identify likely alcohol use disorder was 13 for men (sensitivity = .69, specificity = .81) and 8 for women (sensitivity = .83, specificity = .80). Cutoffs were lower than the original AUDIT. Different US-AUDIT cutoffs for men and women should be used for likely alcohol use disorder, which may reflect differences in drinking quantity and frequency. Empirical guidelines for alcohol screening with the new US-AUDIT may be used to enhance research or identification of at-risk drinkers in college settings, or for college students in primary care or other health care settings.
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Affiliation(s)
- Brian E McCabe
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | - Ahnalee M Brincks
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI
| | - Valerie Halstead
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | | | - Ashley Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
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Abstract
Little is known about relationships between child maltreatment and adulthood intimate partner violence (IPV), depression, and risky drinking in Latinas. 548 Latinas in a sexual health randomized control trial (RCT) self-reported childhood physical, sexual, and emotional abuse, IPV, depression, and risky drinking. Childhood abuse was related to adulthood IPV, OR = 1.27, depression, OR = 2.02, and high-risk drinking, OR = 2.16. Childhood emotional abuse was linked to depression, OR = 2.19; childhood physical abuse to risky drinking, OR = 2.62; and childhood sexual abuse to depression, OR = 2.78 and risky drinking, OR = 2.38. Results may inform prevention/intervention efforts for mental health nurses.
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Affiliation(s)
- Brian E McCabe
- a School of Nursing & Health Studies , University of Miami , Coral Gables , FL , USA
| | - Betty S Lai
- b Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education , Boston College , Chestnut Hill , MA , USA
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Cianelli R, Villegas N, McCabe BE, de Tantillo L, Peragallo N. Self-efficacy for HIV Prevention Among Refugee Hispanic Women in South Florida. J Immigr Minor Health 2018; 19:905-912. [PMID: 27470226 DOI: 10.1007/s10903-016-0462-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The number of refugees increased in recent years due to factors worldwide, including violence, wars, political strife, and natural disasters. Refugees who are Hispanic women (RHW) in South Florida are a vulnerable population at risk of acquiring HIV infection. Although studies have shown a relationship between self-efficacy for HIV prevention and behavior changes, none have studied RHW. The purpose of this study was to assess whether predictors suggested by the literature were related to self-efficacy for HIV prevention in a sample of RHW. The study is a secondary analysis that uses baseline data from a randomized controlled experimental study, SEPA. A total of 99 refugee Hispanic women from South Florida, 18-50 years of age, participated in the study. There were two predictors of self-efficacy. HIV knowledge was positively related to self-efficacy, and living with a partner was inversely related to self-efficacy for HIV prevention. Culturally competent sexual health education interventions in this population may impact self-efficacy for HIV prevention.
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Affiliation(s)
- Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA. .,Escuela de Enfermeria, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Natalia Villegas
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| | - Brian E McCabe
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| | - Lila de Tantillo
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| | - Nilda Peragallo
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
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Abstract
This article provides a preliminary evaluation of a campus sleep health program for undergraduate university students. In this study, 5 focus groups with 38 undergraduates assessed perceptions about sleep in relationship to college experiences. Additionally, 35 undergraduate students participated in campus sleep improvement workshops, and completed a brief self-report survey before and after the workshop. Results showed five themes emerged from focus groups: (a) Sleep and its impact on academics, (b) Understanding of the importance of sleep, (c) Procrastination and its impact on sleep, (d) Stress, and (e) Sleep and extracurricular/social activities. Based on self-report surveys, there was no improvement in perceived sleep importance, but perceived sleep confidence of undergraduate student-participants increased significantly after the workshop. The sleep health program for undergraduates showed promising results, and should be evaluated using a larger, more rigorous design in future studies.
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Affiliation(s)
- Brian E McCabe
- a School of Nursing and Health Studies , University of Miami , Coral Gables , Florida , USA
| | - Adam S Troy
- b Department of Health Professions , University of Central Florida , Orlando , Florida , USA
| | - Hersila H Patel
- c University of Miami , Department of Public Health Sciences , Miami , Florida , USA
| | - Valerie Halstead
- a School of Nursing and Health Studies , University of Miami , Coral Gables , Florida , USA
| | - Mayra Arana
- d Nicklaus Children's Hospital , Miami , Florida , USA
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Abstract
Barriers in advanced practice nurses' work environment impede effective use in acute care settings, reduce job satisfaction, and increase intent to leave. Fostering psychological ownership for work through improved work design has increased satisfaction, motivation, and productivity, and lowered turnover in other fields, and may have similar effects for advanced practice nurses. This multilevel cross-sectional survey study examined the relationship between advanced practice nurse work environment and psychological ownership using data from a survey of advanced practice nurses and nurse executives in Florida hospitals. Barriers in scope of practice and exclusion from hospital governance were common. Advanced practice nurses reported good relations with physicians and moderate organizational climate but poor relations with administrators and limited control over work. Organizational climate had a strong positive relationship with psychological ownership. Fostering advanced practice nurse psychological ownership could improve job satisfaction and decrease turnover leading to increased effectiveness in acute care settings.
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Abstract
OBJECTIVES Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study's objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. DESIGN Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. RESULTS Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = -.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). CONCLUSIONS Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women's health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.
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Affiliation(s)
- Brian E McCabe
- a School of Nursing and Health Studies , University of Miami , FL , USA
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Mitrani VB, De Santis JP, McCabe BE, Deleon DA, Gattamorta KA, Leblanc NM. The Impact of Parental Reaction to Sexual Orientation on Depressive Symptoms and Sexual Risk Behavior Among Hispanic Men Who Have Sex with Men. Arch Psychiatr Nurs 2017; 31:352-358. [PMID: 28693870 PMCID: PMC5721521 DOI: 10.1016/j.apnu.2017.04.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/15/2017] [Accepted: 04/09/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE This study examined the relationship of parent reaction to sexual orientation with depressive symptoms and safer sex among Hispanic adult men who have sex with men (MSM). We also examined men's acculturation to the U.S. (Americanism) in relation with these variables. METHOD Cross-sectional data collected from July 2011 to December 2012, from 125 MSM with a mean age of 43.02years. Instruments included the Perceived Parent Reaction Scale, the Centers for Epidemiological Studies Depression Scale, the Safer Sex Behavior Questionnaire and the Bidimensional Acculturation Scale. Data was analyzed using Hierarchical generalized linear models (GZLM). RESULTS Among men whose parents knew of their sexual orientation, rejection of son's sexual orientation from mother (p=0.032) and from father (p=0.004) was related to higher number of depressive symptoms. Parent reactions were not directly related to safer sex behaviors. Americanism was associated with lower depressive symptoms (p=0.001) but was not related to safer sex behaviors. CONCLUSIONS Current parent attitudes about their sons' sexual orientation had an effect on the sons' emotional wellbeing and acculturation may play a protective role. Mental health and primary care clinicians working with Hispanic MSM should assess for level of family support and provide resources to assist with disclosure and family acceptance of sexual orientation as indicated, particularly among recently immigrated men who may be at higher risk.
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Affiliation(s)
- Victoria B Mitrani
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Joseph P De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA.
| | - Brian E McCabe
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Diego A Deleon
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Karina A Gattamorta
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Natalie M Leblanc
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
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Gonzalez-Guarda RM, McCabe BE, Mathurin E, DeBastiani SD, Peragallo Montano N. The Influence of Relationship Power and Partner Communication on the Syndemic Factor among Hispanic Women. Womens Health Issues 2017; 27:478-484. [PMID: 28410973 DOI: 10.1016/j.whi.2017.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 02/15/2017] [Accepted: 02/27/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study expands research on the substance abuse, intimate partner violence, human immunodeficiency virus (HIV), and depression syndemic theory for Hispanic women. We hypothesized relationship power and partner communication would be related to the syndemic. METHODS Data were used from the baseline assessment of an effectiveness trial of SEPA (Salud/Health, Educación/Education, Prevención/Prevention, and Autocuidado/Self-care), an HIV/sexually transmitted infection risk reduction program for Hispanic women. Hispanic adult women (n = 320) completed measures (in Spanish or English) of relationship power, partner communication about HIV, and acculturation. The syndemic was defined with a factor model of substance abuse, intimate partner violence, risk for HIV/sexually transmitted infection, and depression using structural equation modeling. RESULTS Controlling for acculturation and education, relationship power was inversely related to the syndemic factor (β = -0.49, p < .001), but partner communication was not (β = 0.14, p = .054). Acculturation and education were also related to the syndemic factor. These variables combined accounted for more than one-half (53%) of the variance in the syndemic factor. CONCLUSIONS Findings suggest the need to develop and test interventions that address the power dynamics of intimate relationships as a means of reducing health disparities among Hispanic women.
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Affiliation(s)
| | - Brian E McCabe
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida
| | - Esther Mathurin
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida
| | - Summer D DeBastiani
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida
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Gattamorta KA, Varela A, McCabe BE, Mena MP, Santisteban DA. Psychiatric Symptoms, Parental Attachment, and Reasons for Use as Correlates of Heavy Substance Use Among Treatment-Seeking Hispanic Adolescents. Subst Use Misuse 2017; 52:392-400. [PMID: 27849405 PMCID: PMC5270234 DOI: 10.1080/10826084.2016.1229338] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
UNLABELLED In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents. METHODS This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14-17 years old (N = 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents. RESULTS Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use. CONCLUSION These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use.
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Affiliation(s)
- Karina A Gattamorta
- a School of Nursing and Health Studies , University of Miami , Coral Gables , Florida , USA
| | - Alberto Varela
- b Educational Psychology , University of Utah , Salt Lake City , Utah , USA
| | - Brian E McCabe
- a School of Nursing and Health Studies , University of Miami , Coral Gables , Florida , USA
| | - Maite P Mena
- a School of Nursing and Health Studies , University of Miami , Coral Gables , Florida , USA
| | - Daniel A Santisteban
- a School of Nursing and Health Studies , University of Miami , Coral Gables , Florida , USA
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Gonzalez-Guarda RM, McCabe BE, Leblanc N, De Santis JP, Provencio-Vasquez E. The contribution of stress, cultural factors, and sexual identity on the substance abuse, violence, HIV, and depression syndemic among Hispanic men. Cultur Divers Ethnic Minor Psychol 2016; 22:563-571. [PMID: 27159650 PMCID: PMC5053835 DOI: 10.1037/cdp0000077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVES The purpose of this study was to confirm the substance abuse, violence, HIV, and depression syndemic among Hispanic men, and to test whether stress and sociocultural factors, including acculturation, family support, and sexual orientation, predict this syndemic. METHOD A cross-sectional survey was administered to 164 Hispanic men using standardized measures for Hispanic Stress (Cervantes, Padilla, & Salgado de Snyder, 1991), substance abuse (Kelly et al., 1994), violence (Peragallo et al., 2005), risk for HIV (González-Guarda, Peragallo, Urrutia, Vasquez, & Mitrani, 2008), and depression (Center for Epidemiologic Studies Scale, CES-D; Radloff, 1977). RESULTS Results from Structural Equation Modeling (SEM) supported the syndemic factor among Hispanic men. While family/cultural stress and homosexual identity were risk factors for the syndemic factor, family support was protective. CONCLUSIONS More longitudinal research is needed to identify influences on the syndemic factor among diverse Hispanic communities. Interventions that address stress and enhance family supports may show promise in addressing and preventing syndemics among Hispanic men. (PsycINFO Database Record
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Affiliation(s)
- Rosa Maria Gonzalez-Guarda
- University of Miami School of Nursing and Health Studies, Center of Excellence for Health Disparities Research: El Centro
| | - Brian E. McCabe
- University of Miami School of Nursing and Health Studies, Center of Excellence for Health Disparities Research: El Centro
| | - Natalie Leblanc
- University of Miami School of Nursing and Health Studies, Center of Excellence for Health Disparities Research: El Centro
| | - Joseph P. De Santis
- University of Miami School of Nursing and Health Studies, Center of Excellence for Health Disparities Research: El Centro
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McCabe BE, Schaefer Solle N, Gattamorta K, Villegas N, Cianelli R, Mitrani VB, Peragallo N. Development and psychometric evaluation of a condom use self-efficacy measure in Spanish and English. HIV Clin Trials 2016; 17:212-7. [PMID: 27491797 DOI: 10.1080/15284336.2016.1213487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Condom self-efficacy is an important construct for HIV/STI prevention and intervention. A psychometrically sound measure of the self-efficacy for using condoms that has been designed for Hispanic women to respond in Spanish or English is needed. OBJECTIVES The goal of this study was to develop and evaluate a brief self-report measure of condom use self-efficacy. METHODS We developed a 15-item measure of condom use self-efficacy based on expert knowledge of measurement and HIV/STI prevention with Hispanic women using a translation-back translation approach. Participants were 320 Hispanic women from the Southeastern US. RESULTS Internal consistency of the full measure was 92. A short form of the instrument with a subset of five items also had acceptable internal consistency, alpha = .80, and was significantly correlated with the full scale, rs = .93, p < .001. A single latent factor explained 9-48% of the variation in these items. Evidence of construct validity of the short form was provided by correlations of the scale with two self-report measures of condom use: rs = .34** with condom use, rs = .37** with condom use during vaginal sex. CONCLUSIONS Either the full measure or the five-item measure could be used in studies where condom use is an important behavioral outcome, such as evaluating prevention interventions, with Hispanic women. Future studies should examine the performance of this measure with other groups, including Hispanic men and members of other ethnic and language groups.
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Affiliation(s)
- Brian E McCabe
- a School of Nursing and Health Studies , University of Miami , Coral Gables , FL , USA
| | | | - Karina Gattamorta
- a School of Nursing and Health Studies , University of Miami , Coral Gables , FL , USA
| | - Natalia Villegas
- a School of Nursing and Health Studies , University of Miami , Coral Gables , FL , USA
| | - Rosina Cianelli
- a School of Nursing and Health Studies , University of Miami , Coral Gables , FL , USA
| | - Victoria B Mitrani
- a School of Nursing and Health Studies , University of Miami , Coral Gables , FL , USA
| | - Nilda Peragallo
- a School of Nursing and Health Studies , University of Miami , Coral Gables , FL , USA
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McCabe BE, Gonzalez-Guarda RM, Peragallo NP, Mitrani VB. Mechanisms of Partner Violence Reduction in a Group HIV-Risk Intervention for Hispanic Women. J Interpers Violence 2016; 31:2316-37. [PMID: 25805845 PMCID: PMC4641820 DOI: 10.1177/0886260515575608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The objective of this study was to test whether partner communication about HIV and/or alcohol intoxication mediated reductions in intimate partner violence (IPV) in SEPA (Salud [health], Educación [education], Promoción [promotion], y [and] Autocuidado [self-care]), a culturally specific, theoretically based group HIV-risk reduction intervention for Hispanic women. SEPA had five sessions covering sexually transmitted infection (STI)/HIV prevention, partner communication, condom negotiation and use, and IPV. SEPA reduced IPV and alcohol intoxication, and improved partner communication compared with controls in a randomized trial with adult U.S. Hispanic women (SEPA, n = 274; delayed intervention control, n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Parallel process latent growth curve models indicated that partner communication about HIV mediated the reduction in male-to-female IPV in SEPA, B = -0.78, SE = 0.14, p< .001, but alcohol intoxication did not, B = -0.15, SE = 0.19, p = .431. Male-to-female IPV mediated the intervention effect on female-to-male IPV, B = -1.21, SE = 0.24, p< .001. Skills building strategies originally designed to enhance women's communication with their partners about sexual risk behaviors also worked to reduce male-to-female IPV, which in turn reduced female-to-male IPV. These strategies could be integrated into other types of health promotion interventions.
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Gattamorta KA, McCabe BE, Mena MP, Santisteban DA. A Latent Profile Analysis Investigating Factors Impacting Latino Adolescents' Attendance in Treatment. Couns Psychol 2016; 44:871-894. [PMID: 28529350 PMCID: PMC5433795 DOI: 10.1177/0011000016642843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, we examined data from 200 families to investigate whether family functioning and adolescent psychiatric symptomatology were associated with differential attendance in a family-based or individually focused intervention for Latino adolescents. Latent profile analysis was used to identify families, and regression models were used to examine whether profiles exhibited differential attendance. Overall, three latent profiles were observed. The first described families where parents and adolescents reported discrepancies on psychiatric symptoms and family conflict. The second profile described families with elevated adolescent psychiatric symptoms but no family conflict. The third profile described families with low family cohesion and high levels of adolescent psychiatric symptoms. For this third profile, attendance in family-based treatment was significantly higher than in individual treatment. Results indicate that a family-based intervention may be better able to address issues of poor family cohesion.
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Affiliation(s)
- Karina A. Gattamorta
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Brian E. McCabe
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Maite P. Mena
- School of Education and Human Development, University of Miami, Coral Gables, FL, USA
| | - Daniel A. Santisteban
- School of Education and Human Development, University of Miami, Coral Gables, FL, USA
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McCabe BE, Mitchell EM, Gonzalez-Guarda RM, Peragallo N, Mitrani VB. Transnational Motherhood: Health of Hispanic Mothers in the United States Who Are Separated From Children. J Transcult Nurs 2016; 28:243-250. [PMID: 27093905 DOI: 10.1177/1043659616644960] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Immigration often results in the separation of families, and in particular transnational parenting, which is the separation of mothers from children. Transnational mothers may have greater risks for poor mental health and behavioral conditions such as substance abuse, violence, sexual risk, and depression. This study was a secondary analysis of self-reported data from 425 Hispanic mothers (328 with no separations, 60 separated from an adult child, and 37 separated from a minor child) enrolled in a randomized trial of a sexual health group intervention in South Florida (USA). Separations were related to mother's age, years in the United States, family income, number of people living on income, acculturation to the United States, occupational/economic stress, immigration stress, and lifetime exposure to abuse. A follow-up analysis described the types of childhood or adulthood abuse experienced by mothers with separations. These findings provide new information for nurses about the experience of immigrant mothers.
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Affiliation(s)
| | - Emma M Mitchell
- 2 University of Virginia School of Nursing, Charlottesville, VA, USA
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Schirle L, McCabe BE. State variation in opioid and benzodiazepine prescriptions between independent and nonindependent advanced practice registered nurse prescribing states. Nurs Outlook 2016; 64:86-93. [PMID: 26712387 PMCID: PMC4754105 DOI: 10.1016/j.outlook.2015.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/19/2015] [Accepted: 10/04/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many people lack access to primary care services in the United States. One possible solution is to increase utilization of advanced practice registered nurses (APRNs). A common patient safety concern about independent prescribing by APRNs is that prescribers will increase prescriptions for medications with abuse/dependence potential, such as opioids or benzodiazepines. PURPOSE The purpose was to investigate the relationship in opioid- and benzodiazepine-prescribing rates between independent vs. nonindependent APRN prescribing states. METHODS Tertiary analysis of a Centers for Disease Control and Prevention study reporting state variation in prescribing rates of opioids and benzodiazepines using 2012 Intercontinental Marketing Services Health retail prescription data representing 259,000,000 prescriptions. Analyses were performed using different definitions for independent states: (a) states allowing at least one APRN type independent prescribing and (b) states allowing all APRN types independent prescribing. ANOVA tests were used to test for differences in mean number of opioid- and benzodiazepine-prescribing rates per 100 residents. Analysis of Covariance tests were employed controlling for state characteristics previously determined to affect controlled substance-prescribing rates (e.g., Medicare rates, race, socioeconomic status, number of physicians/capita). RESULTS/DISCUSSION There were significantly higher opioid and benzodiazepine prescriptions in states with nonindependent APRN prescribing laws than those in states with independent APRN prescribing laws and no significant differences in long-acting opioids or high-dose opioids. This study found no evidence to support the argument that independent prescribing increases prescriptions with abuse potential. CONCLUSION Independent prescriptive authority, only one piece of APRN practice, has been one of the most controversial issues but one with great potential to help ease access to U.S. health care problems. Empirical evidence demonstrating the safety of this practice can help promote this potential.
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Affiliation(s)
- Lori Schirle
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, FL 33146, Office Phone: 305-284-2528
| | - Brian E. McCabe
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, FL 33146, Office Phone: 305-284-1530
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Santisteban DA, Mena MP, Muir J, McCabe BE, Abalo C, Cummings AM. The efficacy of two adolescent substance abuse treatments and the impact of comorbid depression: results of a small randomized controlled trial. Psychiatr Rehabil J 2015; 38:55-64. [PMID: 25799306 PMCID: PMC5021542 DOI: 10.1037/prj0000106] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this randomized trial was to investigate the efficacy of 2 behavioral treatments focusing on different change mechanisms in ameliorating a borderline personality disorder constellation of behaviors and substance use in adolescents referred by juvenile diversion programs. METHODS Forty adolescents 14-17 years of age and meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for borderline personality disorder and substance use disorders were randomized to integrative borderline personality disorder-oriented adolescent family therapy (I-BAFT) or individual drug counseling. This design allowed a comparison of 2 manualized interventions, 1 family based and 1 individually oriented. Profiles of clinical change were used to detect impact and estimate treatment effect sizes. RESULTS Primary analyses showed that both interventions had a clinically significant impact on borderline personality disorder behaviors 12 months after baseline but with no differential treatment effects. The impact on substance use was more complex. Subgroup analyses revealed that adolescents with depression had significantly more severe profiles of borderline personality disorder and substance use. These youths were the only group to show reductions in substance use, but they only did so if they received the I-BAFT intervention. Study data also documented the high dosage of intensive residential treatment needed by this population. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Results highlight the intensive treatment needs of juvenile justice-involved youths with co-occurring substance use and borderline personality disorder including depression, the hybrid outpatient and residential treatment often required by this population, and the promise of a family-oriented approach, particularly for youths with severe symptoms and co-occurring depression. (PsycINFO Database Record
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Affiliation(s)
- Daniel A Santisteban
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
| | - Maite P Mena
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
| | - Joan Muir
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Brian E McCabe
- School of Nursing and Health Studies, University of Miami
| | - Clara Abalo
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
| | - Amanda M Cummings
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
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McCabe BE, Feaster DJ, Mitrani VB. Health correlates of co-occurring substance use for women with HIV in cocaine use recovery. Addict Behav 2014; 39:725-8. [PMID: 24368003 DOI: 10.1016/j.addbeh.2013.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 11/27/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND The goal of this study was to examine clinical correlates of alcohol, opioid, cannabis, sedative, or other co-occurring substance use disorders in a sample of 124 HIV+ women in recovery from cocaine use disorders. METHODS Data was collected from a baseline assessment for a randomized trial comparing a family therapy intervention to a health promotion group intervention. Substance use disorders were assessed with a computer-administered structured diagnostic interview. Psychological distress was measured with the Brief Symptom Inventory. Sleep problems were measured with the Short Sleep Index from the Hamilton Anxiety and Depression Rating Scales. Pain was assessed with items from the Medical Outcomes Study-HIV scale. HIV health was assessed with blood tests for T-cell count and HIV Viral Load Suppression, as well as a nurse-administered symptom assessment. RESULTS Women with a co-occurring opioid use disorder were significantly more likely to have psychological distress and sleep problems, but less likely to have severe pain. Even though there was no difference in T-cell count or Viral Load, women with opioid use disorder were significantly more likely to have high HIV symptoms. CONCLUSIONS Women in recovery with HIV who have co-occurring cocaine use and opioid use disorders were more likely to have several indicators of worse mental and physical health. Interventions may need to be tailored to meet the needs of this subgroup of women. Future research should examine whether these co-occurring conditions are associated with greater likelihood of relapse or poor treatment response, and whether this higher-risk profile exists in other groups.
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Gonzalez-Guarda RM, McCabe BE, Vermeesch AL, Cianelli R, Florom-Smith AL, Peragallo N. CULTURAL PHENOMENA AND THE SYNDEMIC FACTOR: SUBSTANCE ABUSE, VIOLENCE, HIV, AND DEPRESSION AMONG HISPANIC WOMEN. Ann Anthropol Pract 2013; 36:212-231. [PMID: 24575326 DOI: 10.1111/napa.12001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Researchers exploring the health of Hispanics in South Florida utilizing a combination of qualitative and quantitative research methods have identified that substance abuse, violence, risky sexual behavior, and depression are not only conceptualized as tightly interrelated health and social problems, but also hold together in a measurement model to represent an underlying phenomenon (i.e., the Syndemic Factor). The purpose of this study is to test hypothesized relationships between cultural phenomena and the Syndemic Factor among community-dwelling Hispanic women. Standardized questionnaires assessing Acculturation, Hispanic Stress, Familism, and the Syndemic Factor were administered to a cross-sectional sample of 548 Hispanic women from South Florida. Structural equation modeling was used to analyze relationships. The model explained 61 percent of the variance in the Syndemic Factor. There was a large positive relationship between the Syndemic Factor and Hispanic Stress, and a small inverse relationship between the Syndemic Factor and Familism. Women with high Hispanic Acculturation and low U.S. Acculturation scored lower on the Syndemic Factor than Integrated/Bicultural women. Familism buffered the relationship between Hispanic Stress and the Syndemic Factor. Structural, community, family, and individual prevention strategies that address underlying conditions associated with the Syndemic Factor must be developed and formally evaluated.
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Affiliation(s)
| | - Brian E McCabe
- University of Miami School of Nursing and Health Studies
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Vermeesch AL, Gonzalez-Guarda RM, Hall R, McCabe BE, Cianelli R, Peragallo NP. Predictors of depressive symptoms among Hispanic women in South Florida. West J Nurs Res 2013; 35:1325-38. [PMID: 23858067 DOI: 10.1177/0193945913496152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
U.S. Hispanics, especially women, experience a disproportionate amount of disease burden for depression. This disparity among Hispanic women necessitates examination of factors associated with depression. The objective of this study was to use an adaptation of the Stress Process Model to test whether self-esteem mediated the relationship between Hispanic stress and depressive symptoms. Data for this secondary analysis were from a previous randomized-control HIV prevention trial. Participants were 548 Hispanic women (19-52 years). Data collection measures included the Center for Epidemiological Studies-Depression Scale, Rosenberg Self-Esteem Scale, and Hispanic Stress Scale. The bootstrap method in Mplus 6 was used to test mediation. Results indicated that self-esteem was inversely related to depression, and Hispanic stress was found to be positively related to depression. Self-esteem partially mediated the relationship between stress and depression. Strategies to improve/maintain self-esteem should be considered in future interventions for Hispanic women with depression.
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Abstract
Prescription opioid use has grown rapidly, but few studies examined whether users have similar treatment responses as heroin users. Participants were 1,648 opioid users in Florida Access to Recovery (2004-2007). Participants engaged in methadone or buprenorphine maintenance had better retention than those in nonmaintenance treatment. Heroin only users (HO) had better engagement in nonmaintenance treatments and had worse retention than prescription opioid only users (PO). In methadone maintenance, PO were more likely to report opioid abstinence during treatment than heroin and prescription opioid users (H&P). Future research should focus on understanding and improving the treatment experience of opioid use subgroups.
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Affiliation(s)
- Brian E McCabe
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL 33146, USA.
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Mitrani VB, McCabe BE, Gonzalez-Guarda RM, Florom-Smith A, Peragallo N. Participation in SEPA, a sexual and relational health intervention for Hispanic women. West J Nurs Res 2013; 35:849-66. [PMID: 23493674 DOI: 10.1177/0193945913480276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HIV and intimate partner violence (IPV) risks are linked in Hispanic women, so integrated interventions can efficiently produce meaningful change. Integrated interventions for Hispanic women are promising, but factors that put Hispanic women at risk for HIV and violence may also impede engagement with interventions. This study examined barriers and facilitators of engagement in a group educational intervention, SEPA (Salud, Educación, Prevención y Autocuidado [Health, Education, Prevention, and Self-Care]), for Hispanic women. A total of 274 Hispanic women from South Florida in the SEPA condition of a randomized controlled trial completed baseline measures of violence, depression, familism, Hispanic stress, acculturation, and demographics, and 57% of the women engaged (attended two of five sessions). Education, IPV, and acculturation predicted engagement. Understanding engagement advances intervention development/refinement. Hispanic women who experience relationship violence are open to group interventions. Further program development and outreach work are needed to connect women with low education, who are particularly vulnerable.
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Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research, El Centro School ofNursing and Health Studies, University of Miami, Coral Gables, FL 33146, USA.
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Gonzalez-Guarda RM, Vermeesch AL, Florom-Smith AL, McCabe BE, Peragallo NP. Birthplace, culture, self-esteem, and intimate partner violence among community-dwelling Hispanic women. Violence Against Women 2013; 19:6-23. [PMID: 23363655 DOI: 10.1177/1077801212475336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to explore variations in demographics, culture, self-esteem, and intimate partner violence among Hispanic women according to birthplace, and to identify factors associated with these differences in intimate partner violence (IPV). Baseline data from a randomized control trial testing the efficacy of an HIV prevention program were used. Path analyses identified differences in IPV between Colombian women and women from other Central/South American countries. Self-esteem was the only factor associated with these differences. Interventions addressing the unique needs of Hispanic women from different subgroups are needed.
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Abstract
OBJECTIVE Examined the effects of Structural Ecosystems Therapy (SET), a family intervention for women living with HIV or AIDS, compared to a psycho-educational health group (HG) intervention, and reciprocal relationships between women and family members. METHOD Women (n = 126) and their family members (n = 269) were randomized to one of two conditions and assessed every 4 months for 12 months. Family functioning, drug use, and psychological distress was reported by multiple family members. RESULTS Multilevel growth curve modeling showed a different family functioning trajectory between SET and HG, B = -0.05, SE = 0.02, p < .01. There was no intervention effect on the trajectory of family-level drug abstinence or psychological distress, but there was a significant difference in the trajectory of psychological distress after controlling for change in family functioning, B = -0.28, SE = 0.13, p < .05. There was an indirect effect from treatment through change in family functioning to change in psychological distress, B = 0.29, SE = 0.12, p < .05. With respect to reciprocal effects, family drug abstinence significantly predicted women's abstinence 4 months later, B = 0.22, SE = 0.06, p < .001. CONCLUSION Findings demonstrated the interdependence of family members and the impact of family in relapse prevention and partially supported SET's potential for maintaining family functioning and well-being for women living with HIV or AIDS in drug recovery.
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Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research: El Centro, School of Nursing and Health Studies, University of Miami, Coral Gables, FL 33124, USA.
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Abstract
A small randomized trial investigated a new family-based intervention for Hispanic adolescents who met DSM-IV criteria for substance abuse disorder. The Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) is a tailored/adaptive intervention that includes a flexible treatment manual and multiple treatment components. The study used an "add on" design to isolate the effects on substance abuse, behavior problems, and parenting practices attributable to the newly developed components. Twenty-eight Hispanic adolescents and their families were randomized either to the experimental treatment or to traditional family therapy (TFT) and were assessed at baseline and 8-month follow-up. Despite the small sample, results revealed statistically significant time × treatment effects on both self-reported drug use (marijuana + cocaine), F(1, 22) = 10.59, p < .01, η² = .33 and adolescent reports of parenting practices, F(1, 22) = 9.01, p < .01, η² = .29. Both sets of analyses favored CIFFTA participants. There was a significant time × treatment effect, F(1, 22) = 6.72, p = .02, η² = .23, favoring CIFFTA on parent report of parenting practices using a composite that matched the variables used for adolescents, but only a nonsignificant trend, F(1, 22) = 2.43, p = .13, η² = .10, with a composite that used all parenting subscales. Parent reports of adolescent behavior problems did not show a significant time or time × treatment effect. These results show the promise of this adaptive treatment for substance abuse in Hispanic adolescents and suggest the need for a larger randomized trial to fully investigate this treatment.
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Affiliation(s)
- Daniel A Santisteban
- El Centro, School of Nursing and Health Studies, University of Miami, Coral Gables, FL 33124, USA.
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Mitrani VB, Feaster DJ, Weiss-Laxer NS, McCabe BE. Malaise, motivation and motherhood: predictors of engagement in behavioral interventions from a randomized controlled trial for HIV+ women in drug abuse recovery. AIDS Behav 2011; 15:396-406. [PMID: 20512409 PMCID: PMC3051343 DOI: 10.1007/s10461-010-9714-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Drug abuse has serious consequences for the wellbeing of persons with HIV/AIDS but suboptimal rates of client engagement limit the efficacy of interventions. The present study examines and compares client characteristics that predicted engagement (defined as attendance at two or more sessions) in a family intervention (SET) and a group intervention within a randomized trial aimed at preventing relapse and improving medication adherence for 126 predominantly African American HIV+ women in drug abuse recovery. Intervention engagement (60% overall) was not significantly different across the two interventions. Fewer physical and mental symptoms (malaise) (P < 0.05), living independently (P < 0.05), living with children (P < 0.05), and readiness to change (P < 0.05) were associated with engagement across the two interventions. Results from this study can be used to inform outreach and engagement approaches for women dually affected by drug abuse and HIV/AIDS.
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Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research: El Centro, School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, FL, USA.
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Mitrani VB, McCabe BE, Robinson C, Weiss-Laxer NS, Feaster DJ. Structural Ecosystems Therapy for recovering HIV-positive women: child, mother, and parenting outcomes. J Fam Psychol 2010; 24:746-755. [PMID: 21171773 PMCID: PMC3051342 DOI: 10.1037/a0021638] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study presents results of a subgroup analysis from a randomized trial to examine whether Structural Ecosystems Therapy (SET), a family intervention intended to improve medication adherence and reduce drug relapse of HIV-seropositive (HIV+) women recovering from drug abuse, provided benefits for families with children. Data from 42 children and 25 mothers were analyzed at baseline, and 4, 8, and 12 months post-baseline. Results of longitudinal Generalized Estimating Equations analyses suggested that SET was more efficacious than the Health Group (HG) control condition in decreasing children's internalizing and externalizing problems and reducing mothers' psychological distress and drug relapse. Children in SET reported improvements in positive parenting as compared to the children in HG, but there were no differences in mother-reported positive parenting, or parental involvement as reported by either the children or mothers. These findings suggest that family interventions such as SET may be beneficial for mothers and children. An adaptation of SET specifically for families with children could further enhance benefits and improve acceptability and cost-effectiveness.
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Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research: El Centro, University of Miami School of Nursing and Health Studies, Coral Gables, FL 33126, USA.
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Feaster DJ, Mitrani VB, Burns MJ, McCabe BE, Brincks AM, Rodriguez AE, Asthana D, Robbins MS. A randomized controlled trial of Structural Ecosystems Therapy for HIV medication adherence and substance abuse relapse prevention. Drug Alcohol Depend 2010; 111:227-34. [PMID: 20538417 PMCID: PMC2950218 DOI: 10.1016/j.drugalcdep.2010.04.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2009] [Revised: 04/26/2010] [Accepted: 04/30/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Substance abuse in women with HIV/AIDS overshadows other priorities, including health care. Substance abuse may cause women to avoid health care systems and not adhere to their medication regimen. METHODS A randomized controlled trial tested the efficacy of Structural Ecosystems Therapy (SET) relative to a psychoeducational Health Group (HG) in 126 HIV+ women in recovery. SET, a 4-month intervention, focused on building family support for relapse prevention and HIV medication adherence. Over 12-month follow-up, women were assessed for drug use and medication adherence every 2 months; CD4 T-cell count and HIV viral load were assessed every 4 months. RESULTS Levels of drug use did not differ by condition. There was a significant difference in curvature of the rates of change in drug use with SET increasing and then decreasing and HG decreasing and then increasing. Women in SET were more likely to increase substance abuse services in response to relapse and separate from drug using household members than were women in HG. These two changes explained the decline in drug use observed within SET between 6 and 12 months. SET showed declines in medication adherence but increases in CD4 T-cell count relative to HG. The increase in CD4 T-cell count in SET was related to increasing proportions of women in SET taking antiretroviral medications. CONCLUSION The results of the trial were mixed. Women in SET did not show better drug use or medication adherence outcomes, but did show improvement in CD4 T-cell count and theoretical mechanisms of action on drug relapse.
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Affiliation(s)
- Daniel J. Feaster
- Center for Family Studies, Department of Epidemiology and Public Health, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Victoria B. Mitrani
- School of Nursing and Health Studies, University of Miami, P.O. Box 248153, Coral Gables, FL 33124, United States
| | - Myron J. Burns
- Department of Psychology, Nevada State College, Henderson, NV, 89002, United States
| | - Brian E. McCabe
- School of Nursing and Health Studies, University of Miami, P.O. Box 248153, Coral Gables, FL 33124, United States
| | - Ahnalee M. Brincks
- Center for Family Studies, Department of Epidemiology and Public Health, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Allan E. Rodriguez
- Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Deshratn Asthana
- Department of Psychiatry and Behavioral Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Michael S. Robbins
- Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, United States
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Suarez-Morales L, Martino S, Bedregal L, McCabe BE, Cuzmar IY, Paris M, Feaster DJ, Carroll KM, Szapocznik J. Do therapist cultural characteristics influence the outcome of substance abuse treatment for Spanish-speaking adults? Cultur Divers Ethnic Minor Psychol 2010; 16:199-205. [PMID: 20438158 PMCID: PMC2954416 DOI: 10.1037/a0016113] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This secondary data analysis of the Clinical Trials Network's Motivational Enhancement Therapy effectiveness trial with Spanish-speaking substance users examined whether the degree of birthplace and acculturation similarities between clients and therapists, as well as the therapists' own level of acculturation and birthplace were related to the clients' participation in treatment and level of substance use during outpatient substance use treatment. Sixteen therapists and their 235 clients from the larger effectiveness trial were included in the analyses for this study. Results of the multilevel regression models for client participation in substance use treatment and client days of substance use, taking into account within and between therapist cultural characteristics, revealed that birthplace match and acculturation similarity between each therapist and his or her clients did not predict client outcomes. Instead, therapists' birthplace and level of acculturation independently predicted days of substance use, but not treatment participation for monolingual Spanish-speaking clients. These findings are discussed in the context of the results of the main effectiveness trial and of psychotherapy research with ethnic minority populations, in particular Hispanic minorities.
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Affiliation(s)
- Lourdes Suarez-Morales
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | | | | | - Brian E McCabe
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Ivette Y Cuzmar
- Health Sciences Center Office of Community Affairs, University of New Mexico
| | | | - Daniel J Feaster
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | | | - José Szapocznik
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
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Mitrani VB, Vaughan EL, McCabe BE, Feaster DJ. Conflict Resolution and Distress in Dementia Caregiver Families: Comparison of Cubans and White Non-Hispanics. Hisp Health Care Int 2008; 6:80-88. [PMID: 20448830 DOI: 10.1891/1540-4153.6.2.80] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study investigated the role of family conflict resolution as a mediator of the relationship between ethnicity and psychological distress in dementia caregivers. The sample was composed of the families of 182 caregivers who participated in REACH (Resources for Enhancing Alzheimer's Caregiver Health). The sample consisted of 84 Cuban American and 98 non-Hispanic White American families. Mediation analyses revealed that both income and conflict resolution partially mediated the relationship between ethnicity and caregiver psychological distress. Specifically, Cuban American families were less likely than non-Hispanic White families to reach a resolution to their disagreements, which may have rendered the caregiver at greater risk for psychological distress. These results suggest that Cuban American caregivers may benefit from interventions that improve the family's ability to resolve conflicts.
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Mitrani VB, Feaster DJ, McCabe BE, Czaja SJ, Szapocznik J. Adapting the structural family systems rating to assess the patterns of interaction in families of dementia caregivers. Gerontologist 2005; 45:445-55. [PMID: 16051907 PMCID: PMC2413070 DOI: 10.1093/geront/45.4.445] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study adapted the Structural Family Systems Ratings (SFSR), an observational measure of family interactions, for dementia caregivers. This article presents the development of the SFSR-Dementia Caregiver adaptation (SFSR-DC) and examines relationships between specific family-interaction patterns and caregiver distress. DESIGN AND METHODS The families of 177 Cuban American and White non-Hispanic American caregivers of dementia patients were assessed at baseline, 6, 12, and 18 months. Structural family theory and clinical experience were used to identify family interaction patterns believed to be related to caregiver emotional functioning. Factor analysis was used to refine subscales and develop a multiscale measure. RESULTS Six reliable subscales were related to caregiver distress and included in the SFSR-DC. There were two second-order factors. The SFSR-DC was provisionally cross-validated and showed invariance across the two ethnic groups. IMPLICATIONS The SFSR-DC provides a method for examining specific and multiple interaction patterns in caregiver families and thus can advance knowledge regarding the role of the family in the stress processes of caregiving. These findings support the relevance of family interactions in caregiver distress and suggest that a treatment approach aimed at supporting family closeness and conflict resolution and reducing negativity might enhance caregiver well-being.
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Affiliation(s)
- Victoria B Mitrani
- Center for Family Studies, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1425 N.W. 10th Avenue, Miami, FL 33136, USA.
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