Parents Of African American Children Research Articles

Engagement in Sedentary and Physically Active After-School Programs Among African American Children with ADHD and Disruptive Behavior Disorders.

Sport and physical activity (PA) programs are an important developmental resource for youth with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders. The purpose of this study is to assess sport participation rates, PA participation, and after-school supervision rates among African American children with ADHD and/or Disruptive Behavior Disorders. In this cross-sectional study, parents of African American children with elevated symptoms of ADHD, oppositional defiant disorder, and/or conduct disorder (N = 175, 6- to 12-y-old, 31% female) reported after-school program participation over the past year. Logistic regression analyses tested relationships between ADHD symptoms, oppositional defiant disorder symptoms, and conduct disorder symptoms, likelihood of regular participation (≥2d/wk) in sport, PA, and sedentary after-school programs, and likelihood of being supervised and unsupervised after school. All regressions controlled for age, sex, income, and medication status. Sample participation rates were descriptively compared with participation rates of same-aged peers regionally, and nationally, reported in 3 national surveys. Parents in the local sample reported higher rates of sedentary after-school program participation (54%) but lower rates of PA program participation (31%), and sport participation (12%) compared with same-aged peers. The local sample was less likely to be unsupervised after-school compared with same-aged peers with only 27% of parents reporting that their child was unsupervised ≥ 2days per week. Children endorsing oppositional defiant disorder (odds ratio = 2.05; P < .05) and conduct disorder (odds ratio = 5.74; P < .05) were more likely to be unsupervised more frequently after-school as compared with those not meeting endorsement. Given demonstrated benefits of youth sport programming and observed inequities in participation, there is a need to develop support models that connect parents, coaches, and social services agencies to facilitate inclusion. Sports medicine professionals are uniquely positioned to contribute to these efforts, as they are often key opinion leaders in both the youth sport and health care contexts.

Psychosocial Needs of African American Parents of Children with Cancer (FR215D)

Psychosocial Needs of African American Parents of Children with Cancer (FR215D)

Rapid and Deferred Help Seeking Among African American Parents of Children With Emotional and Behavioral Difficulties.

Little is known about the factors African American parents consider when seeking care for their child after emotional and behavioral difficulties emerge. This study aimed to examine factors associated with seeking professional care within 30 days after identifying a child's need (i.e., rapid care seeking) and with deferring care for ≥1 year. This cross-sectional study surveyed African American parents raising a child with emotional or developmental challenges (N=289). Logistic regression was used to examine associations of parent activation, medical mistrust, and care-seeking barriers with two outcomes: rapidly seeking care and deferring care seeking. About 22% of parents rapidly sought care, and 49% deferred care for 1 year or longer. Parents were more likely to rapidly seek care if they had higher parent activation scores; lived with other adults with mental health challenges; or, contrary to the authors' hypothesis, mistrusted doctors. Parents were less likely to rapidly seek care if the challenge did not initially bother them much or if their health insurance would not cover the service. Parents were more likely to defer care if they feared involuntary hospitalization for their child or if their health insurance would not cover the service. Parents were less likely to defer care if they had at least some college education or lived with other adults with mental health challenges. Community-based pediatric and child welfare professionals should be informed about facilitators and barriers to mental health care seeking as part of efforts to develop interventions that support African American families.

FACES: An Advocacy Intervention for African American Parents of Children With Autism.

Children with autism and their families often face challenges accessing early intervention and related services. African American children face additional challenges due to disparities in diagnoses and access to services. These disparities present a great need for parent advocacy to combat culturally insensitive service delivery and strained parent-professional partnerships. In this sequential mixed methods study, we piloted a 6-week parent-training intervention (FACES) among African American parents of children with autism and evaluated participants' empowerment, advocacy, and partnerships pre- and postintervention. Results indicated that parents' advocacy, sense of empowerment, and community support were strengthened, following the FACES program. Participants also described the FACES intervention as socially valid. Implications for research and practice are discussed.

The Influence of Race and Ethnicity on the Relationship between Family Resilience and Parenting Stress in Caregivers of Children with Autism.

We examined the relationship between family resilience and parenting stress among parents of children with autism spectrum disorder, with a specific focus on race/ethnicity as amoderator. Multivariate models indicated that family resilience was associated with parenting stress. Race/ethnicity significantly moderated the relationship between family resilience and parenting stress. The effects of family resilience on parenting stress were significantly different among parents of African American, Hispanic, and white children. These effects were strongest for parents of African American children. Compared to white and Hispanic children, parents of African American children with low levels of family resilience had 60-82% higher probability of parenting stress; while those with high levels of family resilience had 15-18% lower probability for parenting stress.

Relationship between parent mood and resilience and child health outcomes in pediatric asthma.

Asthma is the most common pediatric chronic disease and disproportionately affects urban, minority, and disadvantaged youth. This study explored the relationship between parent and child psychosocial functioning and asthma-related health outcomes in a sample of at-risk children with asthma. We hypothesized that greater parent resilience would be associated with better parent mood, more symptom-free days (SFDs), better child mood, and less child anxiety. Further, we hypothesized that parent resilience would moderate the relationship between parent mood and SFDs. We performed a secondary analysis of baseline cross-sectional enrollment data. Parents of African American children on Medicaid with persistent asthma reported their children's asthma SFDs and their own measures of parent quality of life, mood, and resilience, and child mood and anxiety. Baseline data from 217 parents (92.2% female, Mage = 33.8 years ± 9.5) of children (Mage = 6.6 years ± 2.3) were available. Parent resilience was significantly associated with parent mood. Better parent-reported quality of life (QOL) and mood were significantly associated with more child asthma SFDs. In contrast to our hypothesis, parent resilience did not moderate the relationship between parent mood and SFDs. Higher parent-reported QOL and mood were significantly associated with better parent report of child asthma SFDs. Although parent resilience was associated with parent mood, it did not moderate the relationship to child SFDs. Future research is warranted to better understand the unique contribution of resilience in families with children with asthma. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Comparing disordered eating and feeding practices in African American and Caucasian treatment-seeking youth with obesity

ABSTRACTObjectives: Examine racial differences in disordered eating and parental feeding in youth with obesity. Methods: A diverse sample of 131 treatment-seeking youth (Mage = 12.84 years; Rangeage = 8-18 years; 65.6% African American, 34.4% Caucasian) with obesity (MBMIz = 2.60) completed a disordered eating questionnaire; parents completed a questionnaire about feeding practices. Results: No significant differences in disordered eating between African American and Caucasian youth emerged. Significant differences were found on parent feeding where parents of African American children endorsed more frequent use of pressure to eat, including ensuring and monitoring enough is eaten. Conclusions: Generally, comparisons of disordered eating and parent feeding practices between African American and Caucasian youth with obesity were not significant. Racial differences on some aspects of parental feeding practices were found. Future research should identify cultural factors impacting these differences. Clinical implications include providing culturally sensitive psychoeducation and interventions to address unhealthy feeding practices in diverse families.

Shared decision-making, stigma, and child mental health functioning among families referred for primary care–located mental health services.

There is growing emphasis on shared decision making (SDM) to promote family participation in care and improve the quality of child mental health care. Yet, little is known about the relationship of SDM with parental perceptions of child mental health treatment or child mental health functioning. The objectives of this preliminary study were to examine (a) the frequency of perceived SDM with providers among minority parents of children referred to colocated mental health care in a primary care clinic, (b) associations between parent-reported SDM and mental health treatment stigma and child mental health impairment, and (c) differences in SDM among parents of children with various levels of mental health problem severity. Participants were 36 Latino and African American parents of children (ages 2-7 years) who were referred to colocated mental health care for externalizing mental health problems (disruptive, hyperactive, and aggressive behaviors). Parents completed questions assessing their perceptions of SDM with providers, child mental health treatment stigma, child mental health severity, and level of child mental health impairment. Descriptive statistics demonstrated the majority of the sample reported frequent SDM with providers. Correlation coefficients indicated higher SDM was associated with lower stigma regarding mental health treatment and lower parent-perceived child mental health impairment. Analysis of variance showed no significant difference in SDM among parents of children with different parent-reported levels of child mental health severity. Future research should examine the potential of SDM for addressing child mental health treatment stigma and impairment among minority families.

The Relationship Between Poverty Level and Urban African American Parents’ Awareness of Evidence-Based Interventions for Children With Autism Spectrum Disorders: Preliminary Data

This preliminary investigation examined the relationship between poverty level and parental awareness of evidence-based interventions in urban African American parents of children with autism spectrum disorder (ASD). Based on responses to a survey, more parents above the Federal Poverty Level (FPL) reported awareness of the interventions than parents who were below the FPL. Similarly, poverty level was related to parental awareness of the educational and therapeutic services their child received.

African-American Parents' Trust in their Child's Primary Care Provider

ObjectivePatients' trust in their primary care providers has important implications in terms of health outcomes and, among minority patients, mitigating racial health disparities. This study aims to identify family, provider, and health care setting characteristics that predict African American parents' trust in their child's primary care provider and whether provider partnership-building communication style explains this association. MethodsData were collected via retrospective telephone interviews completed 2 weeks after a child's health care visit to 1 of 7 pediatric primary care clinics in Washington, DC (3 community health centers, 3 private practices, and 1 hospital-based clinic). Four hundred twenty-five self-identified African American parents of children 0 to 5 years of age participated. Parents completed several standard survey instruments about trust and provider communication style as well as demographic questionnaires about their family and their child's provider. ResultsA step-wise linear regression revealed significant independent effects of having a previous relationship with the provider and seeing a provider in a community health center (CHC) on higher trust. There was also evidence of mediation by provider communication style, suggesting that parents who take their child to a CHC report greater trust in their child's provider because they have higher perceptions of provider partnership building. ConclusionsAfrican American parents' trust in their child's provider may be enhanced by continuity of care and greater use of a partnership-building communication style by providers.

Bridging the Digital Divide by Increasing Computer and Cancer Literacy: Community Technology Centers for Head-Start Parents and Families

This article describes the establishment of two community technology centers affiliated with Head Start early childhood education programs focused especially on Latino and African American parents of children enrolled in Head Start. A 6-hour course concerned with computer and cancer literacy was presented to 120 parents and other community residents who earned a free, refurbished, Internet-ready computer after completing the program. Focus groups provided the basis for designing the structure and content of the course and modifying it during the project period. An outcomes-based assessment comparing program participants with 70 nonparticipants at baseline, immediately after the course ended, and 3 months later suggested that the program increased knowledge about computers and their use, knowledge about cancer and its prevention, and computer use including health information-seeking via the Internet. The creation of community computer technology centers requires the availability of secure space, capacity of a community partner to oversee project implementation, and resources of this partner to ensure sustainability beyond core funding.

A Randomized Controlled Evaluation of the Effect of Community Health Workers on Hospitalization for Asthma

To test whether community health workers are able to reach low-income parents of African American children hospitalized for asthma and to reduce rehospitalization among them. A randomized controlled evaluation of usual care vs 2-year asthma coach intervention. An urban children's hospital and the surrounding community. A population-based sample of 306 children hospitalized for asthma met the inclusion criteria of being 2 to 8 years of age, of African American ethnicity, and having Medicaid coverage. Of these, 200 were contacted and 191 recruited with commitment to evaluation activities but, in order to assess reach, no commitment to participating in intervention. Coaches reinforced basic asthma education and encouraged key management behaviors through home visits and phone calls tailored to parent's readiness to adopt management practices and emphasizing a nondirective supportive style (cooperative and accepting of feelings and choices). The reach of intervention to parents, contacts with coaches, and rehospitalization over 2 years based on hospital records. Within 3 months of randomization to the asthma coach group, 89.6% of parents had at least 1 substantive contact with the coach, with an average of 21.1 contacts per parent over the 24-month intervention. The proportion of children rehospitalized was 35 of 96 (36.5%) in the asthma coach group and 55 of 93 (59.1%) in the usual care group (P < .01), controlling for parental education and child age, sex, and hospitalization in the year prior to the index hospitalization. In surveys, parents indicated the importance of the nondirective approach to support. An asthma coach can reach low-income parents of African American children hospitalized for asthma and reduce rehospitalization among the children.

Discipline in the African American community: the impact of socioeconomic status on beliefs and practices.

To describe and compare disciplinary beliefs and practices among African American parents from diverse socioeconomic backgrounds. A cross-sectional survey was conducted of self-identified African American parents of children <48 months of age at 2 ambulatory teaching clinics, 2 community health centers, and 3 private practices in Washington, DC, and the surrounding metropolitan area. Disciplinary beliefs and practices of African American parents were measured. A total of 175 of the 189 parents who were approached for the study completed the survey for a participation rate of 92.5%. Middle/upper socioeconomic status (SES) parents in this study were more likely to be married (60.9% vs 14.7%), older (31.4 years vs 25 years), and more educated (80% having attended at least some college vs 34.4%) than lower SES parents. There were no significant differences between middle/upper and lower SES parents with regard to their belief in a preferred disciplinary method (teaching, spanking, removing) or approach (positive, negative). Lower SES parents were more likely to endorse spanking a 1- to 3-year-old child if they were doing something that was not safe (90.5% vs 78.3%). Middle/upper SES parents were significantly more likely to reward their child for positive behavior than lower SES parents (66.1% vs 47.1%). Lower and middle/upper SES parents in this study population were reasonably similar with respect to disciplinary beliefs and practices. Exceptions to this generalization were that lower SES parents were more likely to endorse spanking as a response to an unsafe behavior on the part of the child, and middle/upper SES parents reported higher levels of reward for positive behavior.