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112

CROSS-ETHNIC CONFIRMATORY FACTOR ANALYSIS OF THE REVISED PARENTAL SOCIALIZATION OF COPING QUESTIONNAIRE.. Paul Miller1, Sarah Jones2, Wai-Ying Chow2, Rachelle Beard1, Tim Ayers2, 1Arizona State University, West Campus, Phoenix, AZ United States; 2Arizona State University, Tempe, AZ United States

While there have been advances in the assessment of children´s coping, and increasing evidence of the association of coping with symptomatology (see Compas et al. 2001, for a review), far less research has been conducted on the ways in which parental socialization affects children´s coping with stressful events (e.g., Dusek & Dnako, 1994; Kliewer, Fearnow & Miller, 1996).

In the current study, coping socialization practices among African-American and Euro-American parents were examined as part of a larger NIH- funded study of the impact of parental job loss on children´s coping and symptomatology. The sample included 203 children and adolescents (109 females, and 94 males) ages 9-15 and their mothers and/or fathers (n= 350), and was predominately African American (49%), and Euro-American (43%). In a comparison of these two ethnic groups, Miller, Chow & Ayers (2004) found that differences in coping socialization between African-American and Euro-American families became nonsignificant once income level was introduced as a covariate. However, ethnicity did moderate the relation between child age and problem-focused coping.

Coping socialization was assessed using a revised version of the Parental Socialization of Coping Questionnaire (PSCQ-R, Miller, 2000). Confirmatory factor analysis of the original PSCQ showed that a six-factor structure of the measure was invariant across age and gender among a predominately Euro-American sample of 258, 7-13 year-old children of divorce (Miller, Kliewer, Hepworth, & Sandler, 1994). Concern has been raised, however, that instrumentation developed with Euro-American samples may threaten the validity of research when used with ethnic minority populations (Knight, Tein, Shell, Roosa, 1992; Knight, Virdin, & Roosa, 1994). While there has been some study of coping among African-American and Euro-American families in race-related stressful situations (Plumber & Slane, 1996), there has been no study of the scalar equivalence of parental coping socialization factors across these two ethnic groups.

The purpose of this study was to test a conceptual model of the factor structure of the newly revised Parental Coping Socialization Questionnaire (PSCQ-R, Miller, 2000). Confirmatory factor analysis will be used to test whether the original six factor model of coping socialization (Miller et al. 1994) provides a good fit to the structure of the revised measure, and whether these factors are invariant across age, gender, and ethnic group status and relate to study outcomes. If the model is confirmed, researchers will have a theory-driven instrument for assessing coping socialization among Euro-American and African American parents of children and adolescents.

113

PREVALENCE OF HOSPITALIZED INJURIES IN ARIZONA AND CALIFORNIA. THE ROLE OF RACE/ETHNICITY AND HISPANIC ACCULTURATION. PRELIMINARY RESULTS. Eduardo Romano1, Bruce Lawrence1, 1PIRE, Calverton, MD United States

Introduction

Discrepancies in the prevalence and consequences of hospitalized injuries across race/ethnic groups have been reported (e.g., Ellis and Trent, 2001). Anderson et al. (1998) showed acculturation among Hispanics may also play a role in shaping the prevalence of some child injuries. The role of acculturation on shaping injury prevalence among other age groups is largely unknown.

Objective

To investigate the role of race/ethnicity and acculturation on the prevalence of hospitalized injuries among Hispanics in California. The role of alcohol on these injuries is also studied.

Methods


The 1997 California Hospital Discharge data contains detailed information (but not acculturation) on all hospitalized injuries in California in 1997. We followed Romano et al. (2004) to add a stochastic, language-based measure of acculturation for 55966 Hispanics in the file. We apply this enhanced data to study the role of acculturation on the prevalence of Hospitalized injuries among Hispanics in California.

Results


Compared with Whites, Hispanics were overrepresented in head, pelvis, and upper extremity injuries (p<.01). Regarding cause, Hispanics were overrepresented in unintentional cut and pierce, machine, and fire-related injuries (p<.01). They were also over-represented in pedestrian injuries (p<.01) and firearm assaults (p<.01). Hispanics were underrepresented in falls and overexertion injuries (p<.01). Overall, Whites suffered a more extended length of stay (LOS) than Hispanics.

Among Hispanics victims, acculturated Hispanics were underrepresented in pelvis (p <.01) and upper extremity injuries (p<.05). Regarding cause of injury, acculturated Hispanics were overrepresented as occupants in MVCrashes (p<.01) and in poisonings (p<.01). Acculturated Hispanics were underrepresented in pedestrian injuries (p <.05), and in intentional (assault) firearm injuries (p <.05). Alcohol and anti-depressant were more prevalent among acculturated Hispanics, while tranquilizers among the less-acculturated ones. Alcohol was found an important co-factor of acculturation in intentional firearm injuries (p<.01) and unintentional MVCrashes (p<.01). Regarding length of stay, less-acculturated Hispanics had shorter hospitalizations than either acculturated Hispanics or Whites (p<.01). Other differences and interactions across gender, age groups, and among type of payers were also observed.

Discussion

Like with race/ethnicity, differences in the prevalence and severity (LOS) of injuries among Hispanics of different acculturation level were observed. These preliminary results suggest that at least for some type of injuries, prevention measures aimed to Hispanics should take the level of acculturation of these groups into account.



114 WITHDRAWN

115

WHAT IS PREVENTION SCIENCE? VIEWS AND PERCEPTIONS AMONG POPULATIONS OF INTEREST. Shannon Dzubin1, Fern Webb2, Karen Goraleski1, 1Research!America, Alexandria, VA United States; 2University of Florida, Jacksonville, FL United States

While all public health practitioners agree that prevention science is essential to improve the health of the population, little is known about how populations of interest define and view prevention science. This understanding is critical to increase understanding of what is valued within groups, what differences and similarities exist, and what areas of prevention science might be targeted to increase awareness of prevention science, and impact practice.

Specific aims were to:

1. Examine views about public health and prevention science from individuals in one of eight states;

2. Review the populations´ perception of prevention science;

3. Determine which diseases/conditions are of highest priorities for prevention research; and

4. Identify whether views and perceptions significantly differ among populations.

Commissioned by Research!America through a grant supported by the Robert Wood Johnson Foundation, these data are from statewide polls conducted by Harris Interactive between August 2003 and July 2004. Residents from Florida (n = 801), New Jersey (n = 800), Iowa (n = 800), New Mexico (n = 808), Ohio (n = 801), Mississippi (n = 800), Oregon (n = 803), and West Virginia (n = 808) participated. The 15-minute telephone survey relied upon a stratified sampling process to create representative samples of persons having telephones throughout the states. Households were selected using computerized random digit dialing to increase the likelihood that the number of households selected accurately represented the demographic distribution of proportions in each exchange. Survey data were weighted by age, sex, race/ethnicity, education, Metropolitan Statistical Area, household size and number of telephone lines. These data were then aggregated to give state averages.

One commonality among participants (n =6,492) was what is associated with prevention. Specifically, when asked how much the individual associated certain activities with prevention, wearing a seatbelt (72%), not smoking (71%) and safe sex (74%) were rated “associate very strongly” by the respondents. Areas of health lifestyle were less likely to be associated with prevention, such that maintaining a healthy diet (52%), regular physical exercise (50%), and keeping weight down (51%) scored lower.

Cancer is a high priority research topic with 97% stating that it should be a top or somewhat high priority. Heart disease was second, with 95% saying it should be a top or somewhat high priority. Implications are that US residents have similar definitions and views about prevention science. Poster presentation will show whether significant differences exist among residents of each state.



116

CONSIDERING APPALACHIAN ETHNICITY WHEN TAILORING INTERVENTION PROGRAMS. Jennifer Wiles1, Kim Horn1, Angela Lacey-Mccracken1, N Noerachmanto1, 1West Virginia University, Morgantown, WV United States

Many researchers have underscored ethnic identity as a key factor for understanding adolescents and their health behaviors. Whether their ethnic identity drives certain behaviors or not, understanding the identity concept has utility. Utilizing the nature of identity formation can help researchers tailor behavioral intervention programs to ensure or enhance efficacy for certain ethnic identities. To date, there is no study that focused on the issue of Appalachian as a sort of ethnic identity, specifically using the Multigroup Ethnic Identity Measurement (MEIM). Appalachian ethnicity is a concept receiving increased attention (Madze, 2000). Appalachia is defined by both culture and geography; it is framed by conflicting dynamics of poverty and abundant natural resources, desperate need and self-reliance. Appalachia has a very long history of exploitation, yet its culture is real and functioning through arts and crafts, traditional music, traditional foods, customs, traditions, and common language. The current study explored the concept of Appalachian ethnicity, which may be an important factor of health intervention and prevention programs and relevant due to the vital role that ethnicity plays in health beliefs and behaviors. The researchers adapted the MEIM instrument to focus on Appalachian issues using the standard scale from strongly disagree (1) to strongly agree (4) for questions in Ethnic Identity Search (EIS), Affirmation, Belonging, and Commitment (ABC), and Identification and Categorization as Appalachian (ICA). There were 48 West Virginia High School students, 56.3% were female; 91.7% were white. The reliability analysis revealed a Cronbach´s Alpha value of .859, similar to other MEIM studies. The MANOVA for gender and identity (very-loose, loose, moderate, strong, and very-strong identity) of ICA showed a statistically significant main effect. Girls scored higher than boys in ABC total scores (F(1, 44) = 6.922, p=.012,). Furthermore, the stronger the identity (ICA), the higher their total scores were in EIS (F(4, 44) =3.990, p=.009) and ABC (F(4,44) = 5.435, p=.002) total scores. The study results showed that girls have a clearer sense about their heritage, being Appalachian, a stronger attachment to their ethnicity, and feel better about their heritage. They are also happier than boys about being Appalachian. Overall, almost half of boys and girls (43.75%) had a strong or very strong Appalachian identity. Therefore, it may be vital for researchers to consider ethnicity when tailoring health behavior programs for the Appalachian community.



117

USING FOCUS GROUPS TO INFORM THE DEVELOPMENT OF A PREVENTIVE INTERVENTION FOR DEPRESSED PARENTS AND THEIR CHILDREN. Rhonda Boyd1, Guy Diamond1, Joretha Bourjolly2, 1University of Pennsylvania School of Medicine & Children's Hospital of Philadelphia, Philadelphia, PA United States; 2University of Pennsylvania School of Social Work, Philadelphia, PA United States

Extensive research documents the negative effects of maternal depression on children's socio-emotional functioning. Children of depressed mothers are at high risk for developmental delays, peer difficulties, negative cognitions, and externalizing and internalizing behavior problems. These children also have increased risk of Major Depressive Disorder, Conduct Disorder, and anxiety disorders. Despite this increased risk, few prevention studies are aimed at this population. In order to develop a family-based preventive intervention for children of depressed mothers, focus groups were conducted with depressed mothers and with mental health providers. The groups allow a phenomenological approach that is useful for creating a preventive intervention that is culturally and contextually appropriate.

Six focus groups were conducted with 18 depressed, multi-ethnic mothers receiving treatment at two community mental health agencies. Mothers ranged in age from 22 to 58 years and their racial/ethnic composition was as follows: 67% African American, 28% White, and 5% Latino. Preliminary findings from the groups indicate themes of social isolation, parenting difficulties, and difficulty managing multiple systems (e.g., schools, truancy boards, juvenile probation). Mothers reported significant life stresses (e.g., domestic violence, death of a child) and stated that therapy was helpful in dealing with both their depression and life circumstances. The children's mental health needs raised by mothers ranged from none to problems such as learning disability, ADHD, suicide, and depression. Mothers expressed a desire to participate in an intervention for depressed parents and their children.

To assess feasibility of implementing an intervention for depressed parents and their children, and to gain another perspective, focus groups also were conducted with 10 mental health providers at the same agencies. Providers identified several problems pertinent to this population: lack of social support, difficulties with parenting (e.g., lack of structure, irritability), and community difficulties (e.g., lack of resources, violence, drug trafficking). Importantly, the staff noted that there was limited attention to parenting issues in their current treatment. The focus groups provided important information concerning developing a prevention program for depressed parents and their children in community mental health. It is clear that these parents face multiple parenting challenges that can be addressed through a preventive intervention. An intervention should be accessible, practical, and developmentally-appropriate. Implications for how the significant themes provided by the focus groups will be incorporated into the development of the intervention will be further discussed.



118

INTERNATIONAL DISSEMINATION OF AN EVIDENCE-BASED FAMILY SKILLS TRAINING MODEL. Karol Kumpfer1, 1University of Utah, Salt Lake City, UT United States

Significance. Dissemination with quality and fidelity both impact outcomes for evidence-based programs. Little research exists on cultural adaptation and implementation variables leading to better outcomes across different cultures and countries. This paper symposium will include presentations by researchers who are implementing an evidence-based family strengthening program, the Strengthening Families Program (SFP), across four different countries: the USA (Kumpfer), Canada (DeWit), Britain (Foxcroft), and Sweden (Kimber). SFP includes 14 one-hour sessions of children´s social skills conducted when parents attend a parent training group. One hour of family skills training after these two classes allows for family practice time. While many cultural adaptations have been tested, only recently were age-adaptations developed. Two of these age-adaptations are being disseminated internationally--SFP 6-11 Years (Kumpfer & Whiteside, 2000) in Canada, Sweden, and Spain, and the 7-session SFP 10-14 Years (Kumpfer, Molgaard, & Spoth, 1997) in Britain and Sweden. SFP 6-11 was the first drug prevention program designed specifically for children of substance abusers. Later clinical trials applied SFP 6-11 and SFP 10-14 to universal populations of school students.Methods and Results. The 2-year longitudinal results of the NIDA-funded Washington D.C. randomized control study (N=715) will be presented that suggest that quality and fidelity are important as well as cultural adaptation. Latent growth curve modeling by Wilson (2004) found positive results on some outcome variables, however reductions in youth conduct disorders were not as strong if the program was presented over 7 vs 14 weeks or for lower risk youth. An “intent-to-treat” analysis was used that also weakened the results because 42% to 29% of enrolled families, depending on condition, never attended.Presenters. Each of the three presenters will discuss cultural adaptations made to SFP for their country and their research outcomes to date. Canada has significant outcome data from 4 years of a NIAAA multi-sites study involving alcohol involved families. The researchers from Britain and Sweden will be describing their selection, adaptation and translation process and beginning data collection and implementation with family groups. In addition, the training of the group facilitators and the on-line supervision with the program developer in the USA will be discussed to show how quality and fidelity can be improved through close communication.

119

AN OUTCOME EVALUATION OF THE STRENGTHENING FAMILIES PROGRAM 6-12 YEARS FOR ALCOHOL ABUSING PARENTS IN ONTARIO, CANADA. David Dewit1, 1Centre for Addiction and Mental Health, London, Ontario Canada

Significance. This paper presents effectiveness results of the Strengthening Families Program (SFP 6-12) in Ontario, Canada as part of a cross-national randomized clinical trial funded by NIAAA comparing program effectiveness in Ontario and Buffalo. The 14-session SFP 6-12 was originally designed for children of drug abusers. Since SFP had not been tested specifically for alcohol abusers, this was the focus of our study.Methods. Families (parents and children ages 9-12) were recruited from the client treatment caseloads and local community populations of 5 alcohol/drug treatment agencies located in Southern Ontario. At each agency, eligible families (up to 24 per cohort) were randomly assigned to either the SFP or a minimal intervention control program. To date, 254 families in Ontario have provided complete information on the pre and post-test and first follow-up. Selected outcomes (parent and child report) include family functioning, parenting practices, and child social skills. Other outcomes include parent aggression (parent report only) and child coping skills, family and peer self-esteem, and attitudes toward school (child report only).Results. Demographic baseline characteristics are as follows: female parent (90.2%), female child (47%), parent age ( =39.5, SD=5.67), child age ( =10.8, SD=1.21), number children in household ( =2.06, SD=1.00), number family moves ( =1.93, SD=2.13), number school changes ( =1.60, SD=1.85), not married or cohabiting (55.2%), white European (89%), Aboriginal (11%), African-American (4.4%), not graduated from HS (26.1%), not employed (39%), family income <$15K (29%), social assistance income (23.1%), non-cash benefits (24.1%), and child chronic health problems (26.4%), learning disabilities (26.8%), and medication attention problems (14.2%).Tests of equivalence on measured outcomes between experimental and control groups at baseline revealed equivalence of groups. Program effectiveness was evaluated using repeated measures ANCOVA. Results revealed favorable benefits associated with involvement in the SFP program. Significant “program condition by time” interactions (between post-test and follow-up) were found for parent´s report on standardized scales measuring parent involvement in activities with child, parent monitoring of child (parent and child report), absence of punitive parenting, parent non-aggression (physical), child social skills (assertion), and family functioning (low defensiveness). Post hoc comparisons of adjusted means revealed that significant differences between the SFP program and control condition occurred mainly at follow-up.

120

CULTURAL ADAPTATION AND PRELIMINARY RESULTS OF THE STRENGTHENING FAMILIES PROGRAM 6-11 IN SWEDEN. Birgitta Kimber1, 1Botkyrka Kommun, Huddinge, Sweden

Background. The Strengthening Families Program 10-14 years is already being tested in schools by the Karolinska Institute, however, there was a need to provide family strengthening prevention services to families at an earlier age. Hence, the SFP 6-11 program (Kumpfer & Whiteside, 2000) was selected for cultural adaptation, translation and evaluation. SFP had never been evaluated for effectiveness in a shorter format, as had the SFP 10-14, which has been found to be highly effective in preventing substance abuse (Spoth, Redmond, & Shin, 2001; Foxcroft, et al., 2003). In this symposium, the author will present the adaptation process, staff training and on-line quality controls, and the preliminary results of a pilot study with families from in a medium-sized town in Sweden. Methodology. The preventive intervention consisted in a culturally-adapted Strengthening Families Program (SFP), which was also translated into Swedish and also abbreviated in length. Three separate programs (1-hour of Parent Training, and Children´s Skills Training plus the Family Skills Training in the second hour) were run in parallel –for parents and children, aged three, six and eleven. Each of the programs lasted for seven to eight weeks. The program took place in two schools in the town with different socioeconomic catchment areas with regard to income, educational level and ethnic composition. Standardized outcome data (N= 60 families) was collected from parents and teachers for the six year-olds and eleven year-olds, and from parents alone for the three year-olds. The teachers also rated the children in various behavioral respects, such as concentration, aggression and compliance, each week over the intervention period. The parents rated their children´s behaviors prior to and after the intervention (pre-post). All sessions were video-taped for coding of fidelity and quality of the group leader´s skills.Results. The results of teacher and parent ratings will be presented and interpreted, as will certain aspects of implementation (attrition was almost zero). Long-term follow-up of the impacts of the program is currently in progress. The longitudinal study plans to make assessments of the children´s behavioral development once a year throughout their compulsory schooling (up to the age of 16). The process of international collaboration for adaptation and dissemination of evidence-based prevention programs will also be discussed.

121

ADAPTATION OF AN EVIDENCE-BASED FAMILY-FOCUSED PROGRAMME FOR THE U.K.. David Foxcroft1, 1Oxford Brookes University, Oxford, United Kingdom

Significance. In the United Kingdom more evidence is needed on which adolescent school-based substance misuse prevention programmes work best. The presenters conducted a Cochrane Collaboration Systematic Review (Foxcroft, et al., 2003) and found only 56 programmes of sufficient quality and most of these were from the United States. Of these programmes the “Strengthening Families Programme 10-14 Years (SFP 10-14) (Kumpfer, Molgaard, & Spoth, 1997) was highlighted as being potentially the most effective . It is not clear, however, if the best U.S. programmes will be as effective in the U.K. social and cultural context. Therefore it seems sensible to take the most promising programme (SFP 10-14) from the U.S., and culturally adapt it for U.K. research.Methods. SFP 10-14 works with parents and young people together in a series of 7 weekly meetings, and is aimed at skill development, parenting practices and conflict management. The initial step is to take the U.S. SFP10-14 materials, lesson plans, videos and approach and culturally-adapt them for use in the U.K., removing any irrelevant “americanisms” and replacing with material relevant to the U.K. social and cultural context. The adapted materials will then be tested with young people and their parents in two pilot sites. We then plan a large “full-scale” scientific evaluation of the SFP10-14 in many different sites across the U.K., providing evidence for the effectiveness and cost-effectiveness of the SFP10-14 in the U.K.Results. The Cochrane Collaboration results will be presented. Using a Numbers Needed To Treat (to prevent one youth from using alcohol or drugs) (NNT) analysis, we found that youth who received SFP were significantly less likely (NNT = 9) than their peers in schools without SFP to initiate alcohol and drug use. We will also present the preliminary results of the adaptation process and pilot study data including the recruitment and engagement strategies and rates. A U.K. evaluation of the SFP10-14 will tell us if these results are transferable to the U.K., that is the focus of the present study.
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