Ashley Butler

• Baylor University

Objective: The COVID-19 pandemic presented unique stressors for parents of youth with chronic health conditions including type 1 diabetes (T1D), such as managing youths’ diabetes self-management demands without usual routines, changes in interactions with health care system, and concerns about increased health risks related to COVID-19 exposure. Wh...

Background. Youth with Type 1 diabetes (T1D) who are Black, Hispanic, or lower socioeconomic status (SES) have lower rates of diabetes device use, higher hemoglobin A1c (HbA1c), and higher rates of diabetic ketoacidosis (DKA). However, the associations of individual-level social determinants of health (SDoH) and neighborhood-level factors with devi...

Background Type 1 diabetes (T1D) is a common, chronic pediatric health condition with complicated management demands. African American and Latino children with T1D have troubling disparities in glycemic outcomes and acute complications. While there are empirically supported behavioral interventions to support disease management in youth with T1D, t...

Background: Diabetes distress, the emotional burden of caring for the chronic demands of diabetes, has not been well described in children and pre‐adolescents with type 1 diabetes (T1D). This gap is particularly evident among youth of lower socioeconomic status (SES) and/or racial/ethnic minorities. Since these groups are more likely to have dispar...

Background Emerging adulthood is a vulnerable period for poor blood glucose control and self‐management behaviors (SMBs) among individuals with type 1 diabetes. Racial/ethnic minority young adults have poorer glycemic outcomes than non‐Hispanic whites; however, little is known about possible racial/ethnic differences in frequency of SMBs among emer...

The 2nd annual Health Equity Summer Research Summit organized by the Center of Excellence (COE) in Health Equity, Training and Research, Baylor College of Medicine (BCM), was a forum to catalyze the fertilization and exchange of cutting-edge ideas in the area of disparity research in medicine. The summit fosters understanding of current health equi...

Objective: This study aimed to describe parents' perceptions of the factors that facilitate or are barriers to their involvement in children's type 1 diabetes (T1D) management among African American and Latino parents. Methods: African American and Latino parents (N = 28) of 5- to 9-year-old children with T1D completed audio-recorded, semi-struc...

In this chapter, we will review the empirical research on the family processes and parent behaviors that influence children and adolescents with diabetes , including youth with type 1 diabetes (T1D) and youth with type 2 diabetes (T2D). First, we review research which documents a relationship between sociodemographic characteristics of the family a...

Research has identified a broad range of risk factors during early childhood that have neurobiological consequences and negatively affect children’s mental health. Such risk factors disproportionately affect racial/ethnic minority youth. Disparities in children’s mental health service use have also been documented for minority youth. Yet, compared...

Despite increased recognition of disparities in youth mental health, racial/ethnic disparities in mental health burden and in mental health service use persist. This phenomenon suggests that research documenting disparities alone has not led to extensive action in practice settings in order to significantly reduce disparities. In this commentary, w...

Purpose of review: Community-engaged research (CER), which is characterized by collaborations between researchers and community partners, is a promising approach to bridge the gaps in translating research evidence into care settings and to address health disparities. This review describes CER in investigations focused on pediatric diabetes. Recen...

Purpose: Comorbid psychiatric conditions in adolescents with depression are a public health concern. However, little is known about the prevalence of comorbidities in separate racial/ethnic groups. This study estimated the national prevalence of comorbidities for black, Hispanic, and white adolescents separately, and compared the prevalence of com...

Purpose of review: Type 1 diabetes (T1D) incidence in youth is growing across all racial/ethnic backgrounds, with the most marked increase in African-American youth under 5. Underrepresented racial/ethnic minorities are at an increased risk for health complications. This review focuses on the reported disparities, demographics of samples in behavi...

Multiple sources of burden for youth with type 1 diabetes (T1D) impact key outcomes including quality of life, self-management, and glycemic control. Professional diabetes organizations recommend diabetes care providers screen for psychosocial and behavioral challenges and implement strategies to support youth with T1D. The purpose of this article...

Purpose of review: Pervasive disparities in T2DM among minority adults are well-documented, and scholars have recently focused on the role of social determinants of health (SDOH) in disparities. Yet, no research has summarized what is known about racial/ethnic disparities in youth-onset T2DM. This review summarizes the current literature on racial...

Objective : This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D). Using a T1D Exchange Registry sample of non-Hispanic White, African Amer...

Preventive parenting interventions delivered by parent peer specialists may be a viable alternative to professional-led interventions and offer an advantage of increasing access in medically underserved areas. The objective of this pilot study was to assess the feasibility and preliminary outcomes of a 10-session, peer specialist-delivered preventi...

This study examines the impact of maternal depression on reductions in children’s behavior problems severity following implementation of the Brief Behavioral Intervention—a brief, manualized parent management training treatment. The parents of 87 children aged 2–6 years of age received parent management training at a metropolitan hospital. Parents...

Stress is known to negatively affect health and is a potentially serious barrier to diabetes-related health outcomes. This paper synthesizes what is known about stress and glycemic control among people with type 1 and type 2 diabetes across the lifespan. Chronic stress—especially in relation to living with diabetes—was most strongly associated with...

This article reviews the literature reporting engagement (enrollment, attendance, and attrition) in culturally adapted parent training for disruptive behavior among racial/ethnic minority parents of children ages 2 to 7 years. The review describes the reported rates of engagement in adapted interventions and how engagement is analyzed in studies, m...

Experts encourage parents and practitioners to engage in shared decision making (SDM) to provide high quality child mental health care. However, little is known regarding SDM among families of children with common mental health conditions. The objectives of this study were to examine associations between parental report of SDM and parental percepti...

Objective: Health Self-Empowerment Theory (health motivation, health self-efficacy, health self-praise, and active coping) was examined as a predictor of levels of engagement in four health-promoting behaviors (health responsibility behaviors, regular exercise, healthy eating, and stress management behaviors) among low-income African American adol...

High quality care in pediatrics involves shared decision making (SDM) between families and providers. The extent to which children with common mental health disorders experience SDM is not well known. The objectives of this study were to examine how parent-reported SDM varies by child health (physical illness, mental health condition, and comorbid...

Objective: Examine the impact of the Health Self-Empowerment Theory-based, culturally sensitive Health Self-Empowerment (HSE) Workshop Series to Modify and Prevent Obesity on levels of health promoting (health-smart) behaviors, motivators of and barriers to these behaviors, health promoting lifestyle variables, and health status indicators (Body M...

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 exam...

Objective: Approximately 260,000 of youth in the United States are gang-affiliated. There is a paucity of data available to identify the prevalence of mental health disorders in this population. Gang members share many of the features of “at risk” or juvenile justice involved youth who deny gang membership. The authors identified rates of psychiatr...

Background: Identification of psychosocial correlates of health care utilization has become an important strategy in improving clinical care. The objective of the study was to examine the fit of the Information-Motivation-Behavioral Skills (IMB) model, applied to health care utilization among children with sickle cell disease (SCD). Procedure: P...

Parent management training is an evidence-based treatment for disruptive behavior. However, the number of treatment sessions can be high, contributing to high attrition rates. The purpose of this study was to examine post-treatment, 6-month, and 1-year treatment outcomes of the Brief Behavioral Intervention. One hundred twenty children aged 2-6.5 y...

Objective: Although in many studies authors have documented the relationship between neighborhood socioeconomic status and child mental health, few have examined the association between neighborhood conditions and mental health disorders. The objective of this study was to determine whether parent-reported neighborhood conditions are associated wi...

This study examined the cross-racial measurement equivalence of the three Eyberg Child Behavior Inventory Intensity Scale factors, found by Stern and Johnson: Oppositional Defiant Behavior, Attention Difficulties, and Conduct Problems. Cross-racial measurement equivalence was examined between 278 low-income African American and 119 non-Latino White...

The course and efficacy of parent-child interaction therapy (PCIT) were examined in 18 socioeconomically disadvantaged African American families of preschoolers with disruptive behavior disorders. Mothers reported significant improvements in child disruptive behavior but not in maternal depressive symptoms or parenting stress. Attrition was 56%, mo...

This study used Health Self-Empowerment (HSE) Theory as a framework for examining the predictors of engagement in both a health-promoting lifestyle and individual health-promoting behaviors among low-income African American mothers and non-Hispanic white mothers (N = 96), each of whom is the primary caregiver for a chronically ill adolescent. The i...

This study examined the Eyberg Child Behavior Inventory (ECBI) discrepancy hypothesis, which asserts that a discrepancy in score elevations on the ECBI Intensity and Problem Scales is related to problematic parenting styles. The Intensity Scale measures the frequency of child disruptive behavior, and the Problem Scale measures parent perception of...

Disruptive behaviours constitute the most frequent reason for referral of young children to mental health services. Parent–child interaction therapy (PCIT) is a theoretically grounded, assessment-driven, empirically supported treatment for children with disruptive behaviour disorders. PCIT is based on Baumrind's research demonstrating positive outc...