Search

This study evaluated whether a self-administered stress management training (SSMT) could improve quality of life (QOL) and reduce distress among Hispanics receiving chemotherapy across multiple community clinical settings. Participants were randomized to receive SSMT (n = 106) or usual care (UCO) (n = 113). The primary outcome-QOL (SF-36) and secondary outcomes depression (CES-D), and anxiety (STAI) were assessed longitudinally over four chemotherapy cycles. Acculturation (BAS) and patients' intervention adherence were assessed. About 63% of participants reported distress after the initial chemotherapy cycle. Hispanics with lower acculturation reported greater STAI-Trait scores (p = .003). No significant treatment effects on outcomes measures were observed for participants receiving SSMT. SSMT intervention techniques were reported useful and improved mental health scores were observed with patients on a psychotropic agent (p = .04). Hispanics experience an elevated level of distress, yet SSMT did not significantly improve primary outcomes. SSMT may be potentially effective when combined with a psychotropic agent. SSMT enhancing strategies are discussed.

Despite recognition of the central role that service accessibility (and availability) should assume within a system of care, the definition proposed in the feature article of this special issue does not identify specific factors that systems of care must take into account in order to serve diverse children with serious emotional disturbance and their families in a culturally competent manner. This paper provides support for inclusion of the concepts of access and availability in the system of care definition and presents important factors that systems of care must take into account in order to increase access in a culturally competent manner, a core system of care value.

This article presents a conceptual model of organizational cultural competence for use in mental health services that resulted from a comprehensive review of the research literature. The model identifies four factors associated with cultural competence in mental health services (community context, cultural characteristics of local populations, organizational infrastructure, and direct service support) and redefines cultural competence as the degree of compatibility among these factors. A strength of this model of organizational cultural competence is that it facilitates future research and practice in psychiatric services settings and links culturally competent practices to service parity.

The dropout of Latino adolescents from public schools has been linked to behavioral health issues such as delinquency and family conflict. Greater understanding is needed about the interplay of cultural, social, and developmental factors in this process. This article reports the findings of 14 group interviews conducted using a participatory approach with Latinos in a large school district in the southeastern USA. Findings support the need for comprehensive school-based interventions along the continuum from early intervention to intensive treatment for Latino adolescents who are at risk of dropping out. Participatory research is recommended for identifying strategies that integrate culturally and developmentally appropriate adaptations into existing behavioral health and dropout prevention services.

Latino student access to higher education has received significant national attention in recent years. This article describes a theory-based evaluation approach used with ENLACE of Hillsborough, a 5-year project funded by the W.K. Kellogg Foundation for the purpose of increasing Latino student graduation from high school and college. Theory-based evaluation guided planning, implementation as well as evaluation through the process of developing consensus on the Latino population of focus, adoption of culturally appropriate principles and values to guide the project, and identification of strategies to reach, engage, and impact outcomes for Latino students and their families. The approach included interactive development of logic models that focused the scope of interventions and guided evaluation designs for addressing three stages of the initiative. Challenges and opportunities created by the approach are discussed, as well as ways in which the initiative impacted Latino students and collaborating educational institutions.