Article

Including Ethnic Minorities in Mental Health Intervention Research: A Practical Approach to a Long-Standing Problem

Department of Psychiatry and Biobehavioural Sciences, University of California, Los Angeles, Los Ángeles, California, United States
Culture Medicine and Psychiatry (Impact Factor: 1.29). 01/2004; 27(4):467-86. DOI: 10.1023/B:MEDI.0000005484.26741.79
Source: PubMed

ABSTRACT

This paper examines a controversy that arose while developing a supplement to Mental Health: A Report of the Surgeon General that was focused on ethnic minority mental health. The controversy involved whether and how to make recommendations about ethnic minorities seeking mental health care. We found that few studies provided information on outcomes of mental health care for ethnic minorities. In this paper, we discuss outcomes of mental health care for ethnic minorities and how to proceed in developing an evidence base for understanding mental health care and minorities. We conclude that entering representative (based on population) numbers of ethnic minorities in efficacy trials is unlikely to produce useful information on outcomes of care because the numbers will be too small to produce reliable findings. We also conclude that while conducting randomized efficacy trials for all mental health interventions for each ethnic group would be impractical, innovative and theoretically informed studies that focus on specific cultural groups are needed to advance the knowledge base. We call for theory-driven research focused on mental health disparities that has the potential for understanding disparities and improving outcomes for ethnic minority populations.

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    ABSTRACT: Multicultural responsiveness and adaptation have been a recent area of emphasis in prevention and intervention science. The changing demographics of the United States demand the development of intervention strategies that are acceptable and effective for diverse cultural and ethnic groups. The Family Check-Up (FCU) was developed to be an intervention framework that is flexible and adaptive to diverse cultural groups (Dishion & Stormshak, 200725. Dishion , T. J. , & Stormshak , E. A. ( 2007 ). Intervening in children's lives: An ecological, family-centered approach to mental health care . Washington , DC : American Psychological Association . [CrossRef]View all references). We empirically evaluated the extent to which the intervention is effective for improving youth adjustment and parent–child interactions for diverse cultural groups. A sample of 1,193 families was drawn from 2 large-scale randomized prevention trials conducted in diverse urban middle schools. We formulated 3 groups on the basis of youth self-identification of ethnicity (European American, African American, Hispanic) and examined group differences in the hypothesized mediating effect of family conflict (FC) on later antisocial behavior (ASB). Path analysis revealed that youths in the intervention condition reported significantly less ASB over a 2-year period (Grades 6–8). Moreover, youth-reported reductions in FC at 12 months were an intervening effect. Ethnicity did not moderate this relationship. Consistent with one of the primary tenets of coercion theory, participation in the FCU acts on ASB through FC across diverse ethnic groups, lending support to the multicultural competence of the model. Limitations of this study are discussed, along with areas for future research.
    Full-text · Article · Apr 2014 · Journal of Clinical Child & Adolescent Psychology
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    • "Recent empirical findings suggest the effectiveness of various means of adapting EBTs for use with diverse populations (Griner & Smith, 2006; Huey & Polo, 2008). However, using randomized trials to develop and test EBTs for all specific cultural groups may not always be feasible (e.g., Miranda et al., 2003) and may not account for within-group heterogeneity. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Multicultural responsiveness and adaptation have been a recent area of emphasis in prevention and intervention science. The changing demographics of the United States demand the development of intervention strategies that are acceptable and effective for diverse cultural and ethnic groups. The Family Check-Up (FCU) was developed to be an intervention framework that is flexible and adaptive to diverse cultural groups (Dishion & Stormshak, 2007). We empirically evaluated the extent to which the intervention is effective for improving youth adjustment and parent–child interactions for diverse cultural groups. Method: A sample of 1,193 families was drawn from 2 large-scale randomized prevention trials conducted in diverse urban middle schools. We formulated 3 groups on the basis of youth self-identification of ethnicity (European American, African American, Hispanic) and examined group differences in the hypothesized mediating effect of family conflict (FC) on later antisocial behavior (ASB). Results: Path analysis revealed that youths in the intervention condition reported significantly less ASB over a 2-year period (Grades 6 through 8). Moreover, youth-reported reductions in FC at 12 months were an intervening effect. Ethnicity did not moderate this relationship. Conclusions: Consistent with one of the primary tenets of coercion theory, participation in the FCU acts on ASB through FC across diverse ethnic groups, lending support to the multicultural competence of the model. Limitations of this study are discussed, along with areas for future research.
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    • "In order to develop an evidence base for mental health care for minority populations, specific ethnic and cultural issues must be taken into account [1] [2] [3] [4]. The US Surgeon General's report, " Culture, Race, and Ethnicity: A Supplement to Mental Health " and a recent white paper from the National Council of La Raza entitled " Critical Disparities in Latino Mental Health: Transforming Research into Action " [5] [6], points to the need for sub-group specific mental health research that explores the cultural variation and heterogeneity of the Latino population. "
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