Louis Davis Brown

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent–child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience’s impact on the parent–child relationship within the social–ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents’ perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic analysis approach for qualitative research. In-depth individual interviews (n = 21) were conducted with members of a parent support group (PSG) (85% female) based in a community-based organization serving families. Demographic information and ACE scores were collected for each participant to describe the sample. Results: Key findings highlighted parents’ perspectives on improved resilience through self-regulation and social support following participation in PSGs, conceptualized as an inter-level construct within the SEM mechanism due to its influence on parents’ well-being, traversing SEM levels. Under Theme 1: The Many Faces of Parental Resilience, Theme 3: The Power of Close Relationships, Theme 4: Community Resources as a Buffer, and Theme 7: Change Through a Policy Lens: “Anything that protects them,” parents expressed a strong desire for ACE prevention and mitigation strategies and called for systemic policy change to combat ACEs. Conclusions: Parental resilience perceptions are valuable and hold promise to inform the future institutionalization of a multi-level parent resilience-focused framework, which will aid in ACE prevention and mitigation.

Background: The negative impact of Adverse Childhood Experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development. Hence, the parent-child environment plays a crucial role in preventing and mitigating ACEs through positive childhood experiences that elicit parental resilience. However, our understanding of the parent-child relation-ship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels) is limited. Objective: This study explores parents’ perspectives on parental resilience as a protective factor for preventing ACEs and supporting PCEs at every level of the SEM, while considering parents’ personal ACE scores and emotional regulation (ER) scores. Method: This study uses a thematic analysis approach for qualitative research. In-depth individual interviews were conducted with members of a parent support group (PSG) (82% female, n = 14) based in a community-based organi-zation serving families (n = 17 parent interviews). Demographic information, ER, and ACE scores were collected for each participant. Results: Seven themes and 16 subthemes were identified, including parents experiencing aspects of emotional regulation from joining a PSG at all SEM levels, sensing a communication disconnect with school teachers, and parents desiring ACE prevention/mitigation training. Conclusion: ‪The insights on parental resilience perceptions are valuable and hold promise to inform future multi-level prevention strategies and mitigation practices using the SEM.

Community coalitions have the potential to elicit diverse participants' perspectives on complex issues and generate shared commitment to adaptive strategies. Ideally, these approaches have been found effective elsewhere. Despite evidence that leadership plays a generally important role in coalitions, there have been limited prior findings about how leadership may support the use of evidence‐based practices. The purpose of the current study was to assess whether three facets of inclusive leadership—engaging communication, inclusive decision making, and inclusion of community residents—predicted the number, reach, and fidelity of coalitions' evidence‐based practices. The study context was 64 Pennsylvania and Missouri youth substance misuse prevention coalitions. Multiple regressions were used to estimate the lagged effects of communication, inclusive decision making, and inclusion of community residents on the number of evidence‐based practices used, their reach, and fidelity, respectively. Inclusive leadership was positively associated with the number of evidence‐based practices coalitions used and how many parents and youth those programs reached, but not with evidence‐based practice fidelity. Findings from this study indicate that inclusive coalition leadership warrants the time and skills entailed. Community psychologists are well‐suited to support coalitions in this empowering approach to decision making and implementation.

Low-income children are among the most affected by unintentional injuries. Although these injuries are preventable, outreach to low-income families in Hispanic and rural communities can be challenging. Community Health Workers (CHWs) are effective partners in reaching these populations. This study sought to determine whether a CHW-led intervention would reduce common hazards that increase the risk of unintentional injuries in low-income rural Hispanic homes along the Texas–Mexico border. CHWs conducted home visits to assess for injury hazards and distribute safety devices to 47 families with children ages 0 to 5 in five low-income rural border communities. CHWs provided follow-up assessments and support 30 days later. Analyses examined changes in the proportion of hazards from visits 1 to 2, with relative risks estimating the impact of safety devices on hazard reduction. Findings showed a 26.2% reduction in the total number of common hazards present in homes from visit 1 to visit 2 ( p < .001). There was a 70% reduction in the overall risk of a hazard being present at visit 2, relative to visit 1 ( relative risk = 0.30, 95% CI [0.28, 0.33], p < .001). This study suggests that tailored CHW interventions can reduce home safety hazards. CHWs are well suited to inform hard-to-reach Hispanic and rural populations, addressing feelings of distrust and promoting acceptance of recommended environmental changes. More rigorous evaluations of this intervention strategy are needed.

Grocery stores can provide a conducive environment for interventions targeting healthy eating and access to health services, particularly in low-income communities. A wide array of organizations deliver nutrition and related programs in community settings, but rarely in a coordinated fashion. Collaboration of local health promotion organizations with grocery stores could increase consumers’ access to and selection of healthy foods and related services. This evaluation of the In-Store Programming and Outreach Coalition (IPOC) uses thematic analysis of first-person accounts from coalition members. To our knowledge, this is the first study of such a coalition. We present perspectives from six stakeholders about the IPOC strengths, challenges, and recommendations for strengthening the delivery of in-store interventions. Themes identified include partnership, increased client reach and cross-referrals, conflicting work schedules, leadership, and recommendations to identify coalition leaders and expand services to other grocery stores. We conclude that grocery stores can offer a suitable setting for programming and community outreach through coalitions.

This study explores the relations between adverse childhood experiences (ACEs), mental health and resilience among Hispanic adults living in the United States – Mexico Border region. Numerous studies have investigated the negative impact of ACEs on adult mental health, but the concept of resilience as a protective factor for mental health in the Hispanic communities has limited consideration in ACE treatment interventions. The proposed study addresses this gap in knowledge by investigating relations between ACEs, resilience, and mental health. An online survey was administered to 221 university students to assess the relationship between ACEs, mental distress and resilience. Using hierarchical linear regression, three models were estimated. First, including demographics, second including ACEs and low resilience, followed by the interaction of ACEs and resilience. Analyses indicate that ACEs were associated with mental distress (B = 1.02, 95% CI 0.37 – 1.68, p < 0.01) and low resilience was associated with mental distress (B = 5.37, 95% CI 3.15 – 7.59, p < .01). The interaction between ACEs and low resilience was also related to mental distress (B = 1.32, 95% CI 0.17 – 2.47, p = 0.03), indicating that ACEs had a larger association with mental distress among respondents with low resilience. Findings highlight the importance of the direct association between resilience and mental distress, along with the moderating influence of resilience on the relation between ACEs and mental health. Interventions promoting resilience may be effective in reducing mental distress, especially among individuals with a history of ACEs.

Purpose: To determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention. Design: Quasi-experimental evaluation. Setting: El Paso, Texas. Sample: Among 656 baseline participants, 374 (54%) completed the 12-month assessment. Intervention: In Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6 months were identical across conditions. Measures: CHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale. Analysis: Regression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment. Results: Participants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23 kg (2.71 lbs.) and their BFP declined 2% over 12 months. Conclusion: Findings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.

Background: Over 5000 community anti-drug coalitions operating in the USA serve as a cornerstone of federal drug prevention. These coalitions, however, have demonstrated effectiveness in preventing substance use only when they use technical assistance (TA) and implement evidence-based programs (EBPs). The absence of TA and EBP implementation by coalitions is a key research-to-practice gap. The Coalition Check-Up TA system is designed to fill this gap by supporting community coalition implementation of EBPs. Existing TA models for evidence-based coalition approaches are resource intensive and coalition model specific. The Coalition Check-Up is a lower cost strategy that works with a variety of types of coalitions to support sustainable implementation of EBPs. This study protocol describes a hybrid type 3 effectiveness-implementation trial applying Wandersman’s Interactive Systems Framework to test the effects of the Coalition Check-Up on coalition EBP implementation capacity and outcomes. The Interactive Systems Framework outlines how the prevention support system—especially TA—bolsters EBP dissemination and implementation. Methods: Using a cluster randomized controlled design, this trial will test the overall effectiveness of the Coalition Check-Up, including how it contributes to EBP implementation and prevention of youth substance use. The first aim is to estimate the impact of the Coalition Check-Up on coalitions’ capacity to do their work. We will recruit 68 anti-drug coalitions for random assignment to the Coalition Check-Up or “TA as usual” condition. We will evaluate whether the Coalition Check-Up improves coalition capacity using measures of coalition member responses about team processes, coalition network composition, and collaborative structure. Our second aim is to estimate the impact of the Coalition Check-Up on implementation of EBPs, and our third aim is to estimate the impact of the Coalition Check-Up on youth substance use. Discussion: This project will clarify how the Coalition Check-Up, a scalable approach to TA due to its low cost, affects coalition capacity to support EBP implementation. Analyses also provide insight into causal pathways from the prevention support system to the prevention delivery system outlined by the Interactive Systems Framework. Results will build the evidence-base for how to support community coalitions’ sustainable implementation of evidence-based prevention programs and policies. Trial registration: Clinicaltrials.gov registration number NCT04592120. Registered on October 19, 2020.