Sociodemographic, psychosocial and physical health correlates of common mental disorder symptoms among mothers in Trinidad and Tobago: Examining ethnic variations.

Historical and cultural experiences have shaped the life experiences of cultural communities in Trinidad and Tobago. Using a cultural focus, the goal of this investigation was to examine ethnic variations both in the prevalence of common mental disorder (CMD) symptoms as well as in the associations between sociodemographic, psychosocial, physical health correlates and CMDs among mothers in Trinidad and Tobago. Participants included 1002 mothers (359 African-, 353 Indo- and 290 Mixed-Ethnic Trinidadian). Mean comparisons indicated similarities in the levels of depression, somatisation and anxiety across ethnic groups. The associations between physical ill health, experiences of pain and depression and between physical ill health and somatisation were stronger for Mixed-Ethnic Trinidadian than Indo-Trinidadian mothers. The relationship between early experiences of domestic violence and depression was stronger for Indo-Trinidadian than Mixed-Ethnic Trinidadian mothers. The associations between early experiences of domestic violence and depression and between experiences of pain and somatisation were stronger for African Trinidadian than Mixed-Ethnic Trinidadian mothers. Thus beyond the direct effects, mothers belonging to specific ethnic groups indicated greater or lesser vulnerabilities to CMDs depending on their exposure to specific correlates. Results have applicability for the development of culturally sensitive interventions for mothers experiencing CMDs.

Multilevel and cross-level effects of neighborhood and family influences on children's behavioral outcomes in Trinidad and Tobago: the intervening role of parental control.

The objective of this investigation was to examine the associations among neighborhood conditions, neighborhood collective efficacy, family economic disadvantage, parental control behaviors, and children's behavioral outcomes using multilevel and cross-level analyses. The proposed conceptual model incorporated propositions advanced by social disorganization theory, the structural-process model, as well as the Family Stress Model. Data were collected from a nationally representative sample of 1,337 families with children between 3 and 6 years (668 boys) drawn from 45 communities in Trinidad and Tobago. Neighborhood level indicators were assessed using census as well as parent reports whereas individual level constructs were assessed using parent reports. Findings indicated support for the Family Stress Model in that harsh punishment and parental monitoring functioned as mediators of the relationship between family economic disadvantage and behavioral difficulties (parental monitoring for prosocial behaviors). Findings from the multilevel analyses indicated that the relationship between neighborhood infrastructure deprivation and children's behavioral difficulties and prosocial behaviors was mediated through neighborhood collective efficacy and parental harsh punishment. Cross-level interactions indicated that neighborhood collective efficacy buffered the relationship between parental discipline, monitoring, harsh discipline and behavioral difficulties. Given the importance of communities and families in influencing children's behavioral outcomes, due consideration must be given to utilizing multilevel and cross-level perspectives both in research as well as in the development of intervention programs. Policies and programs designed to improve neighborhoods conditions, promote neighborhood collective efficacy, and advance the socioeconomic opportunities for families can help enhance the well-being of children.

A multilevel analysis of the role of parental and community variables on young children's health.

OBJECTIVE: The purpose of this study was to examine the associations among community characteristics, family economic adversity, parents' health beliefs, and parents' and children's health using cross-level mediation analyses. METHODS: Survey data were collected from a nationally representative sample of 1,337 families with children between 3 and 6 years nested within 45 Trinidad and Tobago community clusters. RESULTS: At the individual level, parents' health belief of internality was a significant mediator between family economic adversity, adult health, and children's health. In the cross-level mediation analyses, health belief of internality was a significant mediator between community health problems and children's health. There were between-community variations in the relationship between adult health, health belief of powerful others, and children's health. CONCLUSIONS: There is strong evidence of the role of community and family influences on children's health. Findings indicate the need to use a multilevel analytical approach in studies of children's health.