Cultural expectations and perceptions of risk communication among Afro-Caribbean mothers and daughters in the United States.

INTRODUCTION: Mothers are key influencers in daughters' decision making about risk behaviors. Much research on parent-child relationships and communication has been conducted among predominantly White, nonimmigrant families. However, parent-child relationships and communications about risk behaviors may significantly differ for Black immigrant families. In particular, transnational behaviors that serve to maintain multiple social identities with attributes from both the receiving and sending nations may shape communication about risky behaviors. The current study evaluated the association between transnational behavior and risk communication mediated by the mother-daughter relationship. METHOD: A total of 285 first- and second-generation Afro-Caribbean women, most of whom (80%) identified as Black, were recruited via purposeful sampling from Caribbean organizations, Caribbean-focused social media, and Caribbean festivals. Participants (daughters) completed a survey assessing their transnational behavior, perceptions of their relationship with their mother (in terms of interdependence, connectedness, and trust in hierarchy), and perceptions of their mother's communication about sex, alcohol use, and other drug use. RESULTS: Only the relationship between transnational behavior and communication about drugs was fully mediated by connectedness. The relationship between transnational behavior and communication about both alcohol use and other drug use was partially mediated by other facets of the mother-daughter relationship. DISCUSSION: Findings confirm previous research on parent-child closeness and communication about difficult topics and suggest that such relationships can promote healthy communication in multiple cultures. Children who stay connected to their country of origin stay connected to parents and, therefore, may have greater opportunity to engage in integrated communication about possible risk behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"Hopefully you've landed the waka on the shore": Negotiated spaces in New Zealand's bicultural mental health system.

The multifaceted context of Aotearoa / New Zealand offers insight into the negotiation of cultural discourses in mental health. There, bicultural practice has emerged as a theoretically rights-based delivery of culturally responsive and aligned therapies. Bicultural practices invite clinicians into spaces between Indigenous and Westernized knowing to negotiate and innovate methods of healing. In this article, we present findings from a qualitative study based on one year of ethnographic fieldwork. Drawing on negotiated spaces theory and critical interactionism, we report results of a situational analysis of interviews conducted with 30 service providers working within the bicultural mental health system. Through iterative map-making, we chart the discursive positions taken in the negotiated spaces between Indigenous and Western lifeworlds. In total, we identified five major positions of negotiated practices within the institutionalized discourses that constitute bicultural mental health. Findings indicate that negotiations from Westernized systems of care have been, at best, superficial and that monoculturalism continues to dominate within the bicultural framework. Implications are made for genuine engagement in the negotiated spaces, so treatment has resonance for clients living in multi-cultural, yet Western-dominant societies.

Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers.

Promotoras de salud (Spanish for female community health workers) are integral to efforts to enhance the health and well-being of Latinx individuals, families, and communities. The purpose of this study was to describe the challenges that promotoras face and the proposed solutions from the perspective of the promotoras themselves. Five promotoras who worked for a year as volunteers in a community-based participatory research study, Lazos Hispanos, participated in two group interviews. Eight challenges emerged-balancing their new work with their family commitments, handling their perceived imbalance of power with men, managing the emotional impact of hearing participants' problems, facing and handling the barriers imposed by having limited English language skills, feeling discouraged by the perception of ethnocentric beliefs and discrimination from some providers, feeling disheartened by the cultural beliefs of some Latinx participants, handling the lack of transportation for themselves and for the participants, and managing the burden of data collection for the research aspect of the program. The explanation of these challenges and the practical solutions they proposed are embedded in their intersecting identities. The solutions are a valuable addition to the practice of health promotion and community-based participatory research, particularly within Latinx communities.

Narratives of Generativity and Resilience among LGBT Older Adults: Leaving Positive Legacies despite Social Stigma and Collective Trauma.

The aim of many adults in middle to old age is to be generative. Generativity is the concern older adults direct toward the wellbeing of future generations. Being generative results in positive well-being during later life and is especially important to lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults who have experienced lifelong discrimination. In this study, we identified stigmatizing social influences that both negatively and positively acted to inform understandings of generativity and the ability to leave a legacy for future generations. Using a narrative analysis methodology, we identified three overarching redemptive narratives from study participants: (1) experiences during the HIV/AIDS pandemic, (2) absence of positive role models, and (3) religious conviction. These life story narratives inform how generative contributions can contribute toward a legacy of resilience, despite social stigma and collective trauma.

Lazos Hispanos: Promising Strategies and Lessons Learned in the Development of a Multisystem, Community-Based Promotoras Program.

U.S. Latinos face multiple inter-related barriers to access health and social services. Researchers and practitioners have called upon community-based participatory research (CBPR) to address such challenges and health disparities, with the community health worker-or promotoras-model evidencing positive outcomes. What is less clear, however, are the promising strategies to support the development of a multisystem, community-based promotoras program. In response, the current study applied a CBPR conceptual model as an organizing framework to develop a promotora program. Lazos Hispanos (Hispanic Links) was developed to enhance the health and well-being of Latinx residing in low-income communities in the Southeastern United States. This study highlights 16 lessons learned, anchored in the first two dimensions of the CBPR conceptual model: community context and partnership development. First, the community assessment and activities leading to Lazos Hispanos took nearly 2 years but were crucial to develop a strong basis for the program. Second, the development of a multicultural and interdisciplinary research team enriched every aspect of the program and enhanced culturally responsive community engagement. Selection, training, and ongoing support of the promotoras were fundamental to program success. Particularly important were the following: receiving mentorship from a successful promotora organization; delineating mutually agreed upon roles and responsibilities; following national training standards for community health workers; and, holding monthly meetings for training, support, and data collection. The engagement of community service providers as partners was facilitated by building upon existing community relationships, signing a memorandum of understanding that specified roles and responsibilities, conducting tours of provider facilities with the promotoras, and keeping providers abreast of the program via bi-annual community gatherings. The development process showed fidelity to the conceptual model. Lazos Hispanos has proven an asset to participants, the promotoras, and service providers as the program continues to develop a community-based, health supportive infrastructure.

A multistakeholder evaluation of Lazos Hispanos: An application of a community-based participatory research conceptual model.

The goal of Lazos Hispanos is to enhance the health and well-being of the Latinx community through promotoras, who connect community members with service providers for multiple health and social needs. A community-based participatory research conceptual model framed the multimethod evaluation of promotoras, service providers, and community participants at baseline and at the 1-year follow up. The promotoras increased their self-efficacy and knowledge, felt a strong sense of commitment to the community, viewed themselves as a bridge between participants and providers, and felt empowered by their new role. Service providers valued the promotoras as their ambassadors in the community and Lazos Hispanos as central to connecting service providers, promotoras, and community members; they noted that this collaboration increased their accountability with the Latinx community. This multistakeholder evaluation highlights the depth of positive changes achieved during the first year and the challenges of a community-embedded project and the benefits and possibilities of calling upon theoretically informed evaluation models.

Cultural Values and Behavior Among African American and European American Children.

OBJECTIVES: This study explores the relationships of individualistic (e.g., competition, material success) and collectivistic values (e.g., familism, respect) with risky and prosocial behavior among African-American and European-American youth. While previous work has focused upon immigrant adolescents, this study expands the research exploring cultural values to other racial-ethnic groups and to a younger developmental period. This study builds upon culture as individually experienced beliefs and practices, potentially espousing multiple cultural orientations and relationships to behavior. METHODS: Data from Cohort 3 of a study of 219 urban, suburban, and rural children included African-American (42%) and European-American(58%) children, 54% female, ranging from grades 1-5 (mean age = 9). Multigroup structural equation models were tested resulting in a measurement model that fit similarly across groups (RMSEA=.05, CFI =.94). RESULTS: African-American children reported higher levels of individualism, and African-American and European-American children reported espousing similar levels of collectivism. Children in higher grades were found to be more collectivistic and less individualistic. Individualistic values were related to children's lower prosocial and higher rates of problem and delinquent behavior. Collectivistic cultural values were associated with reduced rates of problem behaviors, controlling for race-ethnicity, gender and grade. CONCLUSIONS: Results provide support for the assertion that youth espouse multiple cultural orientations and that collectivistic cultural values can serve as promotive factors for children of diverse backgrounds. Practice and policy should seek to understand the role of family, school, and community socialization of multiple cultural orientations and nuanced associations with risk and resilience.

"Thank You for Including Us!" - Introducing a Community-Based Collaborative Approach to Translating Clinic Materials.

When working with clients in another language, having culturally relevant and properly translated clinic materials is vital to effective clinical practice. Not having them presents a barrier for bilingual therapists and their clients. This paper reviews common translation methods and introduces a multi-level, community-based approach for translating clinic materials for non-English speaking clients. Informed by decolonizing practices, this five-tier method includes members from the target community as cultural brokers to verify the accuracy and nuances of language for their cultural group, as well as a constant comparative method to ensure methodological rigor in the process of inclusion. We present community member's feedback and recommendations, as well as discuss advantages and challenges of using this collaborative culturally responsive translation method.

From Knowing to Doing: Guidelines for Socioculturally Attuned Family Therapy.

Family therapists know that clinical concerns are not separate from larger sociopolitical contexts. Attunement to clients' sociocultural experience is foundational to good practice, yet few guidelines integrate attention to the larger societal processes or address social equity. The purpose of this article is to help therapists move from knowing about sociocontextual issues to doing socioculturally attuned practice. We offer an overarching framework that returns to Bateson and the roots of family therapy through a call for third order transformation. The approach is responsive to societal context and an analysis of power while working through enduring concepts of major family therapy models. Transtheoretical guidelines that can be integrated across practice models to promote third order change are illustrated with case examples.

Third-Order Thinking in Family Therapy: Addressing Social Justice Across Family Therapy Practice.

We contend that the field of family therapy is undergoing a notable shift from second- to third-order thinking. We offer theoretical support and examples to demonstrate how third-order thinking provides a framework for integrating heightened sociocultural attunement into family therapy practice. We discuss the importance of third-order thinking relative to being prepared to invite families into third-order change. Finally, we offer a case example to show specific guidelines for third-order practice.

Afirmamos que el ámbito de la terapia familiar está sufriendo un cambio notable porque está pasando del pensamiento de segundo orden al pensamiento de tercer orden. Ofrecemos respaldo teórico y ejemplos para demostrar cómo el pensamiento de tercer oden ofrece un marco para integrar una mayor sensibilización sociocultural en la práctica de la terapia familiar. Debatimos la importancia del pensamiento de tercer orden relativa a estar preparados para invitar a las familias al cambio hacia el tercer orden. Finalmente, ofrecemos el ejemplo de un caso para mostrar pautas específicas sobre la práctica del tercer orden.

Harnessing the Power of Play in Emotionally Focused Family Therapy With Preschool Children.

Emotionally focused family therapy (EFFT) is an attachment-based therapy model that has been used with older children and adolescents. More recently, it has been suggested for use with young children. EFFT holds promise as a clinical treatment for young children coping with attachment problems, but more detailed guidelines are needed for implementing the model with this age-group. Whereas preschool and kindergarten age children are less able to participate in talk therapy than older children, accommodations need to be made to this approach when the identified patient is a young child. This article offers a variety of play therapy activities that may be incorporated within an EFFT framework to strengthen the emotional bonds in families with children ages four to six.

Creating culturally responsive family therapy models and research: introducing the use of responsive evaluation as a method.

Models of marriage and family therapy (MFT) typically reflect Western values and norms, and although cultural adaptations are made, many models/frameworks continue to be inappropriate or inadequate for use with non-Western cultures. Worldwide, therapists are examining ways of using MFT models in a culturally sensitive manner, especially when working with clients who are seen as having minority status or perceived as "other" by the dominant group. This essay suggests the use of responsive evaluation as a theoretically consistent methodology for creating and evaluating culturally responsive therapies. This approach rigorously evaluates each unique client/therapist context, culture, power, needs, and beliefs. We describe responsive evaluation and discuss how each component addresses the research needs of examining culturally responsive family therapies. A case illustration is offered delineating the process of conducting culturally responsive therapy with a Cambodian sample using solution-focused and narrative therapy.