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Black adolescents in low-income communities are at increased risk of developing mental health problems due to the impact of cumulative poverty-related stressors and racial discrimination, yet Black youth have relatively low rates of mental health service utilization, resulting in significant unmet need. The Coping With Stress (CWS) Course is an evidence-based, cognitive behavioral intervention that has been shown to reduce the incidence of anxiety, mood, and conduct problems among predominantly White samples, as well as Asian and Latinx youth. In the past 25 years since the CWS Course was introduced, Black adolescents have either been severely underrepresented or conspicuously absent from program evaluation research on the CWS Course, with few exceptions. The purpose of this article is threefold: (1) to justify the need for cultural adaptations to the CWS Course for Black adolescents from low-income communities, (2) to describe the scientific basis for the specific surface structure and deep structure modifications made to the culturally adapted version of the CWS Course, known as Resilient In spite of Stressful Events or RISE, and (3) to illustrate the deep structure adaptations with a vignette drawn from implementation of the RISE program with Black adolescents in a low-income, urban community.

This study examined the relative contribution of two dimensions of parent engagement, attendance and homework adherence, to parent and child treatment response and explored whether early engagement was a stronger predictor of outcomes than later engagement. The sample consisted of parents of participants (n = 92; M age = 9.4 years, SD = 1.27; 67% male, 69% White) in a 12-session evidence-based family-school intervention for children with attention-deficit/hyperactivity disorder. Attendance was assessed using clinician records, and homework adherence was measured by rating permanent products. Outcomes included parent and teacher ratings of family involvement in education, parenting practices, and child functioning. Accounting for the contributions of baseline scores and attendance, homework adherence was a significant predictor of parental self-efficacy, the parent-teacher relationship, parenting through positive involvement, and the child's inattention to homework and homework productivity. Accounting for the contribution of baseline scores and homework adherence, attendance was a significant predictor of one outcome, the child's academic productivity. Early homework adherence appeared to be more predictive of outcomes than later adherence, whereas attendance did not predict outcomes during either half of treatment. These results indicate that, even in the context of evidence-based practice, it is the extent to which parents actively engage with treatment, rather than the number of sessions they attend, that is most important in predicting intervention response. Because attendance is limited as an index of engagement and a predictor of outcomes, increased efforts to develop interventions to promote parent adherence to behavioral interventions for children are warranted.

Accumulating evidence highlights the importance of using psychosocial approaches to intervention for children with attention-deficit/hyperactivity disorder (ADHD) that target the family and school, as well as the intersection of family and school. This study evaluated the effectiveness of a family-school intervention, Family-School Success (FSS), designed to improve the family and educational functioning of students in Grades 2-6 who meet criteria for ADHD combined and inattentive types. Key components of FSS were conjoint behavioral consultation, daily report cards, and behavioral homework interventions.FSS was provided over 12 weekly sessions, which included 6 group sessions, 4 individualized family sessions, and 2 school-based consultations. Participating families were given the choice of placing their children on medication; 43% of children were on medication at the time of random assignment. Children (n = 199) were randomly assigned to FSS or a comparison group controlling for non-specific treatment effects (Coping With ADHD Through Relationships and Education [CARE]). Outcomes were assessed at post-intervention and 3-month follow-up. The analyses controlled for child medication status.FSS had a significant effect on the quality of the family-school relationship, homework performance, and parenting behavior.The superiority of FSS was demonstrated even though about 40% of the participants in FSS and CARE were on an optimal dose of medication and there were significant time effects on each measure. This relatively brief intervention produced effect sizes comparable to those of the more intensive Multimodal Treatment Study of Children With ADHD (MTA) behavioral intervention.

Aim This study investigated whether components of attention and executive functioning improve when children with attention-deficit–hyperactivity disorder (ADHD) are treated with osmotic-release oral system (OROS) methylphenidate. Method Thirty children (24 males, six females; mean age 8y 6mo, SD 1y 11mo; range 6y 5mo –12y 6mo) with ADHD combined type participated in a double-blind, placebo-controlled crossover trial with the child’s clinically most effective dose as identified with a systematic open-label titration procedure. After 1 week on each treatment (placebo and OROS methylphenidate), a neuropsychological battery that assessed sustained attention, selective attention, attentional control, response inhibition, and working memory was administered. This battery included the Gordon Diagnostic System, seven subtests of the Test of Everyday Attention for Children, and two tests of working memory. Results Performance on two of three tests of response inhibition improved on OROS methylphenidate compared with placebo (p

The risk of adolescent pregnancy is elevated among teens living in areas of concentrated poverty. Although the majority of adolescent sexual risk reduction programs are based in schools, delivering programming in the neighborhood setting is an innovative approach that may enhance the engagement of high-risk youth. This study evaluates the process of implementing an adolescent pregnancy prevention program in the context of low-income, urban housing developments. The primary aims of this paper are: (1) to provide a detailed description of the recruitment and retention strategies employed by a pregnancy prevention program based in low-income housing; (2) to describe the feasibility of recruiting and retaining participants for this type of program; and (3) to examine the percentage of participants enrolled through different recruitment strategies. Some 305 adolescents from eight low-income, urban communities were included in the process study. Results revealed that successful recruitment and retention of adol...

The Pediatric Symptom Checklist-17 (PSC-17) is a brief form of the Pediatric Symptom Checklist that is designed to screen for behavioral health problems in primary care settings. It has been proposed to have three subscales: externalizing, internalizing, and attention problems. In the context of developing a behavioral health screening program in an inner-city primary care practice, we evaluated the construct validity of the PSC-17. A total of 331 families with children between 4 and 12 years of age who were seen for well-child care during the study were invited to complete the PSC-17 and 320 families (96.5%) did so. A confirmatory factor analysis was performed and the Comparative Fit Index and root mean square error of approximation fit statistics were calculated to determine whether the data fit the proposed three-factor model. We found that although the PSC-17 contained three subscales, several items did not load predominantly on the subscale that they were proposed to measure. Specifically, although the five items on the internalizing subscale loaded only on this subscale, only four of the seven externalizing items loaded exclusively on the externalizing subscale, and only two of the five attention items loaded exclusively on the attention problems subscale. Clinicians using the PSC-17 in urban low-income communities should recognize that the externalizing and attention problems subscales of the PSC-17 may not be valid measures of these dimensions of child behavior in this population.

This meta-analysis examines the relationship between active coping and psychosocial health among youth. Results from 40 studies of coping with interpersonal stress were synthesized using a random-effects model. Four areas of psychosocial functioning were examined: externalizing and internalizing behavior problems, social competence, and academic performance. The magnitude of the relationship between active coping and psychosocial functioning was small, with correlations ranging from 0.02 for internalizing behavior to 0.12 for academic performance. Mean effects were moderated by stressor controllability: youth who used active coping in response to controllable stressors had fewer externalizing problems and higher social competence, as compared to those who used active coping in response to uncontrollable stressors. Implications for primary prevention programs and directions for future research on child and adolescent coping are discussed.

Prevention and intervention research studies often fail to include an assessment of program integrity, and when they do, it is often examined in a limited way. Further, despite efforts to reform the intervention research process to include community stakeholders more actively in every phase of investigation, current practice generally employs a hierarchical model of integrity that fails to be responsive to community needs and priorities. In this article, we describe the traditional, hierarchical model of integrity and contrast this framework with a partnership model of treatment integrity. The limitations of the hierarchical model are illustrated through the description of two school-based prevention programs. Core features of the partnership model and steps for implementing this framework in research and practice are described. Although the partnership model has limitations when conducting efficacy research in clinical trials, it has clear advantages over the hierarchical model in conducting effectiveness research and research that is directly linked with practice. © 2005 Wiley Periodicals, Inc. Psychol Schs 42: 495–507, 2005.

This study examined psychometric properties of the Kindergarten Reading Engagement Scale (KRES), a brief teacher-report measure of classroom reading engagement. Participants were 27 students with identified reading deficits from a predominantly low-income, African-American community. Data were collected in kindergarten (Time 1) and first grade (Time 2). The KRES demonstrated strong internal consistency (Cronbach's alpha = .96) and modest test-retest reliability (r = .66). KRES ratings were significantly correlated with scores from the Word Reading subtest of the Wechsler Individual Achievement Test-Second Edition and the Sound Matching subtest of the Comprehensive Test of Phonological Processing, measured at Time 1 and Time 2. Strategies for refining the scale and implications for applying the KRES in school-based program evaluations are discussed.

Objective: Homework can have beneficial effects for students; however, it presents challenges, particularly for students with attention problems. Although effective homework interventions exist, intervention development and evaluation has been hampered by the lack of psychometrically sound measures. The primary purpose of this study was to evaluate the construct validity of the Homework Performance Questionnaire (HPQ), Parent and Teacher Versions, in a sample of children with ADHD. A secondary purpose was to examine variations in homework performance as a function of individual characteristics, such as academic achievement, quality of the family–school relationship, and child’s diagnostic status. Method: The sample included 91 children (34% female) with ADHD in Grades 2 to 6. Measures included parent and teacher ratings of homework performance and the quality of the parent–teacher relationship as well as direct assessment of child academic achievement and homework performance (i.e., samples of completed assignments). Correlational analyses were used to examine construct validity, and ANOVAs were used to evaluate group differences. Results: Each factor of the HPQ had a significant relationship with other measures of relevant constructs. There were no significant differences in homework performance between groups for ADHD subtype, medication status, or comorbidity, with the exception of learning disability. Children with ADHD and learning disabilities had significantly lower teacher ratings of academic competence. Conclusion: Results of the present study suggest that HPQ scores may be used to make valid inferences about the homework performance of children with attention problems. These rating scales may be helpful in progress monitoring and evaluating intervention effectiveness.

This study investigated whether components of attention and executive functioning improve when children with attention-deficit-hyperactivity disorder (ADHD) are treated with osmotic-release oral system (OROS) methylphenidate.Thirty children (24 males, six females; mean age 8y 6mo, SD 1y 11mo; range 6y 5mo -12y 6mo) with ADHD combined type participated in a double-blind, placebo-controlled crossover trial with the child's clinically most effective dose as identified with a systematic open-label titration procedure. After 1 week on each treatment (placebo and OROS methylphenidate), a neuropsychological battery that assessed sustained attention, selective attention, attentional control, response inhibition, and working memory was administered. This battery included the Gordon Diagnostic System, seven subtests of the Test of Everyday Attention for Children, and two tests of working memory.Performance on two of three tests of response inhibition improved on OROS methylphenidate compared with placebo (p0.01). Performance on one of two tasks assessing attentional control and one of five measures assessing sustained attention demonstrated clear improvement. There was no improvement on the two tasks assessing selective attention or the two tasks assessing working memory.When OROS methylphenidate was used to treat children with ADHD at the clinically most effective dose, general improvement was noted on tasks requiring response inhibition; response to treatment in other domains was either variable or not demonstrated.

Intervention researchers have often failed to assess treatment integrity; when integrity is examined, the focus is typically on whether the steps of intervention have been applied and not on quality of implementation. In the few studies that have investigated intervention quality, the emphasis has been on how intervention is delivered and not how it is received or the degree of participant engagement. This study was designed to examine participant engagement, specifically teacher investment, in the context of family interventions for children with attention-deficit/hyperactivity disorder (ADHD) that were linked with the school. The interventions included Family-School Success (FSS), a program that engages families and schools in a problem solving partnership, and Coping with ADHD through Relationships and Education (CARE), a program designed to provide education and support to families. Participants included the families and teachers of children in grades 2 through 6; 45 sets of families and teachers participated in FSS and 48 were in CARE. The Teacher Investment Questionnaire (TIQ) was designed to assess teacher engagement in intervention. The TIQ is a rating scale for clinicians to be completed during and after treatment. The findings provided support for the reliability and validity of the TIQ. Level of teacher involvement was demonstrated to decline with advancing grade level for FSS, but not CARE. Parent ratings of the quality of the family-school relationship as well as the level of teacher support for homework, assessed at baseline, were shown to be significantly related to clinician ratings of teacher investment post intervention. The findings highlight the importance of assessing participant engagement in intervention. Strategies to refine the assessment of teacher investment were discussed.

Despite a significant increase in the number of children and adolescents who receive clinical services for attention deficit hyperactivity disorder (ADHD), there is still a considerable level of unmet need. Children of ethnic minority status continue to lag well behind their non-minority counterparts in the rate of diagnosis and treatment for the disorder. Racial/ethnic disparities in service use are the result of a combination of access barriers and individual, cultural, and societal factors. The ADHD Help-Seeking Behavior Model is proposed as a framework for understanding factors that may be predictive of service use. Variables specific to ADHD and ethnic-minority populations are integrated within the framework of a four-stage pathway model encompassing problem recognition, decision to seek help, service selection, and service use. The authors argue that by systematically addressing factors related to service use for each ethnic minority group, more effective intervention initiatives can be developed to improve identification and treatment for ADHD among underserved children.