Single mothers' perceptions of neighborhood social cohesion, parenting stress, adverse childhood experiences in early childhood and Black children's behavior problems in middle childhood and adolescence.

This study examined the roles of neighborhood social cohesion, adverse childhood experiences (ACEs), and parenting stress in early childhood on child behavioral outcomes in middle childhood and adolescence among socioeconomically disadvantaged Black families. To test a model linking perceptions of neighborhood social cohesion, single mothers' parenting stress, ACEs, and behavior problems in middle childhood and adolescence. We used four waves of longitudinal data from a subsample of 800 unmarried Black mothers and their children (at child birth and ages 3, 5, 9, and 15) from the Future of Families and Child Wellbeing Study, a nationally representative data set. Structural equation modeling with latent variables was used to measure direct and indirect effects. Mothers' perceptions of neighborhood social cohesion were significantly and negatively associated parenting stress (ß = -0.34, p < 0.05); parenting stress was significantly and positively related to adverse childhood experiences (ß = 0.40, p < 0.05) and behavior problems (ß = 0.32, p < 0.05); Adverse childhood experiences were significantly and positively related to behavior problems (ß = 0.26, p < 0.05); and behavior problems were indirectly influenced by neighborhood social cohesion through adverse childhood experiences (ß = -0.14, p < 0.05) and parenting stress (ß = 0.10, p < 0.05). Neighborhood factors may play a significant role in parenting stress, adverse childhood experiences in early childhood, and children's behavior problems in middle childhood and adolescence among some single mothers and children in economically and socially disadvantaged Black families. Interventions that enhance neighborhood social cohesion and foster supportive interactions among community members and organizations are recommended.

Depression and HIV risks: Engaging older African American women in HIV prevention education through the church.

This report describes the recruitment of a sample of older African American women to test the effectiveness of an educational HIV prevention intervention that sought to reduce depressive symptoms and thereby HIV risks in this population. The outreach venue is the Black church. A framework for maximizing response is suggested. Of 62 women who participated in two arms of the intervention, 29 were assigned randomly to a four-session discussion group (experimental condition) and 33 were assigned to a one-session informational group (control condition) focused on HIV prevention education. Between-within subjects analyses of variance showed that participation in the study was associated with a significant improvement in the women's psychological status, i.e., decreased depressive symptoms. This change in depressive symptoms was due in part to the experimental condition assignment. Implications for future HIV prevention interventions, research, and methods used to maximize the probability of response among older African American women are discussed.

Adverse childhood experiences and behavior problems among poor Black children: Nonresident father involvement and single mothers' parenting stress.

BACKGROUND: Adverse childhood experiences (ACEs) in early childhood and developmental outcomes during the middle childhood and adolescent years have been understudied among low-income Black families. OBJECTIVE: To test a model linking economic hardship, single mothers' parenting stress, ACEs, and nonresident fathers' involvement in early childhood to behavior problems in middle childhood and adolescence. PARTICIPANTS AND SETTING: We used six waves of longitudinal data from a subsample of 800 unmarried Black mothers, nonresident fathers, and their children (at child birth and ages 1, 3, 5, 9, and 15) from the Fragile Families and Child Wellbeing Study, a nationally representative data set. METHOD: Structural equation models with latent variables that incorporate path analysis and confirmatory factor analysis were tested. RESULTS: Mothers' economic hardship was associated directly with parenting stress (beta = 0.27, p < .001) and related both directly (beta = 0.22, p < .001) and indirectly (through parenting stress) to the children's increased likelihood of exposure to ACEs (indirect effect = 0.05, p < .001). Nonresident fathers' involvement early on (child's age 1 to 5) was associated directly with reductions in the mothers' economic hardship (beta = -0.18, p < .001), children's reduced exposure to ACEs (beta = -0.15, p < .001), and fewer behavior problems in middle childhood and adolescence (beta = -0.10, p < .001). CONCLUSION: Nonresident Black fathers' involvement in single-mother families may buffer the adverse consequences over time for economically and socially disadvantaged Black children of exposure to ACEs in early childhood. Interventions that encourage sustained involvement by nonresident Black fathers with young children and their single mothers are recommended.

HIV Prevention Programming for Older African American Women: The Impact of a Faith-Based and Behavioral Science Partnership on Depressive Symptoms.

Objective: The current study sought to test the effect of an HIV prevention intervention on depressive symptoms in a sample of older African American women. Design Setting and Participants: A pretest-posttest randomized control group design was conducted in a mega-church in Los Angeles with a sample of 62 older African American women, aged ≥50 years, 29 of whom were randomly assigned to the experimental condition and 33 to the comparison/control condition. Measures: A measure of psychological wellbeing (CES-D) was utilized to test the effect of the four-session group intervention vs the one-session informational group intervention on change in depressive symptoms from pretest to posttest. Demographic characteristics included: measures of age in years; relationship and employment statuses (coded 1 for yes, 0 for no); and educational attainment. Results: Participation in the study was associated with a significant improvement in the women's psychological wellbeing from baseline to time 2; ie, decreased depressive symptoms. This change was greater for women in the four-session experimental group than for those in the one-session comparison group, due in part to a marginally significant interaction between time and experimental conditions. Conclusions: This study demonstrates the utility of faith-based/behavioral-scientist partnerships in HIV programming. Findings contribute to the evidence on interventions that might reduce depressive symptoms and HIV risk among older African American women.

Adverse experiences in early childhood and their longitudinal impact on later behavioral problems of children living in poverty.

BACKGROUND: Adverse childhood experiences (ACEs) are an identified risk factor for the social and emotional development of children. What is less known is the long-term effects of ACEs when poverty and ACEs coincide. OBJECTIVE: Using longitudinal cohort-panel data, we examined whether exposure to ACEs by the age of three among poor children would longitudinally result in behavioral problems at ages three, five, nine, and 15, after controlling for mothers' socioeconomic status and their children's characteristics. PARTICIPANTS AND SETTING: We used a subsample of 2750 children and their parents living in urban poverty from the Fragile Families and Child Wellbeing study. METHODS: Logistic regression modeling was used to obtain adjusted odds ratios of ACE categories predicting behavioral problems after accounting for family socioeconomic position. RESULTS: Our findings indicate that experiencing ACEs in early childhood was significantly associated with later behavioral outcomes from childhood to adolescence. Exposure to multiple ACEs before the age of three was significantly associated with the top-risk behavior group at age five; the odd ratios were 2.0 (CI = 1.3-3.1) and 2.9 (CI = 1.8-4.6) for two ACEs and three or more ACEs, respectively. At both ages nine and 15, children experiencing two or more ACEs had 1.9 to 3.2 times higher odds to demonstrate more the top 10th percentile of behavioral problems. Among covariates, mothers' race and education, and children's gender and temperament were identified as significant factors to determine behavior problems. CONCLUSIONS: The findings support policies and programs for families with children who have experienced economic disadvantages and early childhood adversity.

The Effects of Collaborative Care Training on Case Managers' Perceived Depression-Related Services Delivery.

OBJECTIVE: This study examined the effects of a depression care quality improvement (QI) intervention implemented by using Community Engagement and Planning (CEP), which supports collaboration across health and community-based agencies, or Resources for Services (RS), which provides technical assistance, on training participation and service delivery by primarily unlicensed, racially and ethnically diverse case managers in two low-income communities in Los Angeles. METHODS: The study was a cluster-randomized trial with program-level assignment to CEP or RS for implementation of a QI initiative for providing training for depression care. Staff with patient contact in 84 health and community-based programs that were eligible for the provider outcomes substudy were invited to participate in training and to complete baseline and one-year follow-up surveys; 117 case managers (N=59, RS; N=58, CEP) from 52 programs completed follow-up. Primary outcomes were time spent providing services in community settings and use of depression case management and problem-solving practices. Secondary outcomes were depression knowledge and attitudes and perceived system barriers. RESULTS: CEP case managers had greater participation in depression training, spent more time providing services in community settings, and used more problem-solving therapeutic approaches compared with RS case managers (p<.05). CONCLUSIONS: Training participation, time spent providing services in community settings, and use of problem-solving skills among primarily unlicensed, racially and ethnically diverse case managers were greater in programs that used CEP rather than RS to implement depression care QI, suggesting that CEP offers a model for including case managers in communitywide depression care improvement efforts.

Single Parenting and Child Behavior Problems in Kindergarten.

Two waves of data from a sample of 89 poor and near-poor single black mothers and their preschool children were used to study the influences of parenting stress, physical discipline practices, and nonresident fathers' relations with their children on behavior problems in kindergarten. The results indicate that higher levels of parent stress, more frequent spanking, and less frequent father-child contact at time 1 were associated with increased teacher-reported behavior problems at time 2. In addition, more frequent contact between nonresident biological fathers and their children moderated the negative effect of harsh discipline by mothers on subsequent child behavior problems. Specifically, when contact with the father was low, maternal spanking resulted in elevated levels of behavior problems; with average contact, this negative effect of spanking was muted; and with high contact, spanking was not associated with increased behavior problems in kindergarten. The implications of these findings for future research and policy are discussed.

Parenting Efficacy and the Early School Adjustment of Poor and Near-Poor Black Children.

This short-term longitudinal study investigated whether maternal educational attainment, maternal employment status, and family income affect African-American children's behavioral and cognitive functioning over time through their impacts on mothers' psychological functioning and parenting efficacy in a sample of 100 poor and near-poor single black mothers and their 3- and 4-year-old focal children. Results indicate that education, working status, and earnings display statistically significant, negative, indirect relations with behavior problems and, with the exception of earnings, statistically significant, positive, indirect relationships with teacher-rated adaptive language skills over time. Findings suggest further that parenting efficacy may mediate the link between poor and near-poor single black mothers' depressive symptoms and their preschoolers' subsequent school adjustment. Implications of these findings for policy and program interventions are discussed.

Low-wage maternal employment and parenting style.

This three-year longitudinal study investigated whether low-wage employment was associated with improved psychological and parenting outcomes in a sample of 178 single mothers who were employed and unemployed current and former welfare recipients both before and subsequent to the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. Participation in employment predicted fewer depressive symptoms and less negative parenting style over time. Employment at time 1 was associated with a reduced likelihood of receiving welfare in the interim between times 1 and 2, less financial strain at time 2, and (through these) a decrease in mothers' depressive symptoms at time 2. Fewer depressive symptoms at time 2, in turn, predicted less negative parenting style, net of the mothers' earlier demographic, mental health, and parenting characteristics. Mothers with higher education attainment were more likely to be employed (and to earn more) at both time points. Implications of these findings for welfare policies are discussed.

The effects of family and neighborhood characteristics on the behavioral and cognitive development of poor Black children: a longitudinal study.

Using data from an ongoing study of 178 single-mother, Black families, this study investigates the relations among family resources (mothers' employment, income from employment, and educational attainment), maternal depressive symptoms, neighborhood quality in the preschool years and over time, and child developmental outcomes (behavior problems, broad reading, calculation) in the early school years. Results indicate that behavior problems in school-age children were associated with behavior problems early on, the child's gender, the mother's depressive symptoms and, to some extent, her employment status. However, these findings were conditioned by the mother's educational attainment and her evaluation of neighborhood problems early on. Better broad reading scores were associated with higher maternal educational attainment, especially for school-age girls of employed mothers, whereas higher calculation scores were predicted by fewer school-age behavior problems and, in the presence of higher neighborhood problems in the preschool years, mothers' higher educational attainment.