RESUMEN
Justice-involved youth have high rates of mental health symptoms and diagnoses. Unaddressed mental health needs are associated with exposure to adversity and trauma, as well as unidentified or mislabeled symptoms that may be present early in life. Justice-involved youth disproportionately come from low-income families and minoritized populations. Community-based interventions that address family and community factors associated with justice involvement are key to improving mental health and life trajectory outcomes for youth. Policies and interventions that address unmet educational needs, support families, and promote early identification of youth in need of social, educational, and mental health services are reviewed.
Asunto(s)
Delincuencia Juvenil , Humanos , Adolescente , Niño , Trastornos Mentales/terapia , Servicios Comunitarios de Salud MentalRESUMEN
The Collaborative Action on Child Equity (CACE) pursued child-focused program and policy research through the Morehouse School of Medicine's Transdisciplinary Collaborative Center (TCC). CACE engaged with partners representing 13 states in the United States to implement the Smart and Secure Children Parent Leadership Program (SSC) and to develop local child-focused Policy Action Plans. The objectives of SSC are to support the development of parental agency and leadership in order to achieve positive health and academic readiness among school-aged children. Of the 13 partners, 9 were able to successfully implement SSC, with more than 350 parent-peer learners completing the program. Additionally, several partners were able to successfully develop Policy Action Plans. We discuss our efforts to bring SSC to scale in a national replication effort and to build policy development, implementation and evaluation capacity in organizations serving children and families. We highlight lessons learned in this replication effort and consider their implications for revisions to our training protocols, recruitment and implementation strategies, methods for providing technical assistance and evaluation models. SSC has demonstrated encouraging efficacy results, was developed using community-based participatory research methods and, as such, the lessons learned are critical for how we engage diverse communities to advance positive child development and academic success.
Asunto(s)
Investigación Participativa Basada en la Comunidad/organización & administración , Familia/psicología , Liderazgo , Padres/psicología , Niño , Humanos , Instituciones Académicas , Estados UnidosRESUMEN
BACKGROUND: US breast cancer deaths have been declining since 1989, but African American women are still more likely than white women to die of breast cancer. Black/white disparities in breast cancer mortality rate ratios have actually been increasing. METHODS: Across 762 US counties with enough deaths to generate reliable rates, county-level, age-adjusted breast cancer mortality rates were examined for women who were 35 to 74 years old during the period of 1989-2010. Twenty-two years of mortality data generated twenty 3-year rolling average data points, each centered on a specific year from 1990 to 2009. Mixed linear models were used to group each county into 1 of 4 mutually exclusive trend patterns. The most recent 3-year average black breast cancer mortality rate for each county was also categorized as being worse or not worse than the breast cancer mortality rate for the total US population. RESULTS: More than half of the counties (54%) showed persistent, unchanging disparities. Roughly 1 in 4 (24%) had a divergent pattern of worsening black/white disparities. However, 10.5% of the counties sustained racial equality over the 20-year period, and 11.7% of the counties actually showed a converging pattern from high disparities to greater equality. Twenty-three counties had 2008-2010 black mortality rates better than the US average mortality rate. CONCLUSIONS: Disparities are not inevitable. Four US counties have sustained both optimal and equitable black outcomes as measured by both absolute (better than the US average) and relative benchmarks (equality in the local black/white rate ratio) for decades, and 6 counties have shown a path from disparities to health equity.
Asunto(s)
Neoplasias de la Mama/mortalidad , Disparidades en el Estado de Salud , Población Negra , Neoplasias de la Mama/etnología , Femenino , Humanos , Factores de Tiempo , Población BlancaRESUMEN
This supplement highlights the efforts of Morehouse School of Medicine's Prevention Research Center and its partners to reduce the disparities experienced by African American women for breast and cervical cancer in Georgia, North Carolina and South Carolina. The project (entitled the Southeastern U.S. Collaborative CEED, or SUCCEED) is supported by a Centers for Disease Control and Prevention (CDC) grant to establish a Center of Excellence in the Elimination of Disparities (CEED). This introductory paper provides an overview describing the project's goals and core components and closes by introducing the adjoining papers that describe in more detail these components. The program components for SUCCEED include providing training and technical assistance for implementing evidence-based interventions for breast and cervical cancer; supporting capacity-building and sustainability efforts for community-based organizations; promoting the establishment of new empowered community coalitions and providing advocacy training to cancer advocates in order to affect health systems and policies.
Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Neoplasias de la Mama/etnología , Servicios de Salud Comunitaria/organización & administración , Disparidades en el Estado de Salud , Neoplasias del Cuello Uterino/etnología , Neoplasias de la Mama/prevención & control , Conducta Cooperativa , Femenino , Humanos , Objetivos Organizacionales , Facultades de Medicina , Sudeste de Estados Unidos/epidemiología , Neoplasias del Cuello Uterino/prevención & controlRESUMEN
The Cancer Prevention and Control Research Network surveyed 282 cancer control planners to inform its efforts to increase the use of evidence-based cancer control programs (EBPs; programs that have been scientifically tested and have successfully changed behavior). Respondents included planners from organizations in state Comprehensive Cancer Control coalitions as well as other governmental and nongovernmental organizations and community-based coalitions. Respondents provided information about personal and organizational characteristics, their cancer control programs, their attitudes toward EBPs, and their awareness and use of Web-based resources for EBPs. Although findings showed strong preferences for cancer control programs that have been shown to work, less than half of respondents (48%) had ever used EBP resources. Regardless of whether they had used EBP resources, almost all respondents (97%) indicated that further training would help them and their organizations adopt and adapt EBPs for use in their communities. The most frequently endorsed training needs were finding and securing additional resources (such as funding and technical assistance), followed by adapting EBPs for cultural appropriateness. The Cancer Prevention and Control Research Network consortium is using these findings to develop a Web-based interactive training and decision support tool that is responsive to the needs identified by the survey respondents.
Asunto(s)
Personal Administrativo/psicología , Redes Comunitarias , Práctica Clínica Basada en la Evidencia , Federación para Atención de Salud , Conocimientos, Actitudes y Práctica en Salud , Neoplasias/prevención & control , Personal Administrativo/estadística & datos numéricos , Redes Comunitarias/estadística & datos numéricos , Participación de la Comunidad/psicología , Relaciones Comunidad-Institución , Agencias Gubernamentales , Federación para Atención de Salud/clasificación , Federación para Atención de Salud/estadística & datos numéricos , Promoción de la Salud , Humanos , Innovación Organizacional , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , Texas , Revisión de Utilización de RecursosRESUMEN
Two studies were conducted to explore the degree to which single- and multiple-risk profiles were evident in samples of African American early adolescents in low-income inner-city, rural, and suburban schools. Study 1 examined early adolescent risk status (i.e., single, multiple) in relation to later adjustment in a representative sample (70% European American, 30% African American). Youth who experienced a single risk in early adolescence had moderately increased levels of school dropout and criminal arrests, whereas youth with multiple risks (i.e., combination of 2 or more risks) had significantly increased levels of school dropout, criminal arrests, and teen parenthood. Study 2 examined the extent to which single- and multiple-risk profiles were evident in cross-sectional samples of African American youth from low-income inner-city and rural areas. About one fourth of both the inner-city and rural samples of African American youth were composed of youth in the single-risk category. A significantly greater proportion of boys in the inner-city sample (20%) than boys in the rural sample (13%) experienced multiple risks. Girls across the rural and inner-city samples did not differ in terms of risk. Overall, more than 60% of African American youth in these two low-income samples did not evidence risk for later adjustment problems. Implications for research and intervention are discussed.
Asunto(s)
Conducta del Adolescente/etnología , Negro o Afroamericano/psicología , Asunción de Riesgos , Adolescente , Conducta del Adolescente/psicología , Adulto , Negro o Afroamericano/estadística & datos numéricos , Agresión/psicología , Niño , Estudios de Cohortes , Crimen/etnología , Crimen/psicología , Femenino , Estudios de Seguimiento , Humanos , Relaciones Interpersonales , Masculino , North Carolina/epidemiología , Pobreza , Embarazo , Embarazo en Adolescencia/etnología , Embarazo en Adolescencia/psicología , Población Rural/estadística & datos numéricos , Ajuste Social , Abandono Escolar/psicología , Población Urbana/estadística & datos numéricos , Población Blanca/psicología , Población Blanca/estadística & datos numéricosRESUMEN
This paper describes the theoretical basis and content of the universal student component of the Guiding Responsibility and Expectations for Adolescents for Today and Tomorrow (GREAT) Schools and Families' middle school violence prevention program for changing school climate. The GREAT Student Program builds on and extends the content of the sixth grade Responding In Peaceful and Positive Ways (RIPP-6) social-cognitive violence prevention program through an expanded conceptual framework that focuses on changing school norms and explicitly incorporates cultural and contextual goals. The program consists of twenty 40-minute lessons taught by a trained facilitator on a weekly basis during the school day.