Journal of Child and Family Studies

, Volume 24, Issue 6, pp 1575–1581 | Cite as

Family Strain Among White and Latino Parents of Children with Mental and Behavioral Health Disorders

  • Melanie Sberna Hinojosa
  • Caprice Knapp
  • Lindsey Woodworth
Original Paper


Caring for children with mental and behavioral health conditions can lead to family strain. Research indicates that Latino children are less likely to adhere to recommended treatment for their mental health diagnoses, increasing the potential for family strain. Little research has focused on understanding the different predictors of family strain among white and Latino families of children with mental health or behavioral health diagnoses. This paper uses a model of family strain to understand how stressors, resources, and perceptions predict family strain for white and Latino parents of children with a mental or behavioral health condition. Data from a telephone survey of 268 parents of children with a mental or behavioral health condition were analyzed to understand predictors of strain using the Family Strain Index scale. Findings indicate that family strain does differ between white and Latino families. Latino families’ strain was predicted by age of parent (β = −0.381, P < 0.001), perceptions of treatment quality (β = 0.306, P < 0.001), and child’s current symptom burden (β = −0.390, P < 0.001). White family strain was related to their child’s health status (β = −0.240, P < 0.001), symptom burden (β = −0.339, P < 0.001), and parent’s level of education (β = −0.315, P < 0.001).


Children Mental health Family strain Latino Families 


  1. Alegria, M., Polo, A., Gao, S., Santana, L., Rothstein, D., Jimenez, A., et al. (2008). Evaluation of a patient activation and empowerment intervention in mental health care. Medical Care, 46(3), 247–256. doi: 10.1097/MLR.0b013e318158af5200005650-200803000-00004.CrossRefPubMedCentralPubMedGoogle Scholar
  2. August, K. J., Nguyen, H., Ngo-Metzger, Q., & Sorkin, D. H. (2011). Language concordance and patient-physician communication regarding mental health needs. Journal of the American Geriatrics Society, 59(12), 2356–2362. doi: 10.1111/j.1532-5415.2011.03717.x.CrossRefPubMedGoogle Scholar
  3. Berg, J., Anderson, N. L. R., Tichacek, M. J., Tomizh, A. C., & Rachelefsky, G. (2007). One gets so afraid: Latino families and asthma management—An exploratory study. Journal of Pediatric Health Care, 21, 361–371.CrossRefPubMedGoogle Scholar
  4. Brannan, A. M., Helfinger, C. A., & Foster, E. M. (2003). The role of caregiver strain and other family variables in determining children’s use of mental health services. Journal of Emotional and Behavioral Disorders, 11(2), 77–91.CrossRefGoogle Scholar
  5. Brannan, A. M., Manteuffel, B., Holden, W., & Helflinger, C. A. (2006). Use of the family resource scale in children’s mental health: Reliability and validity among economically diverse samples. Administration and Policy in Mental Health and Mental Health Services Research, 33(2), 182.CrossRefPubMedGoogle Scholar
  6. Brehaut, J. C., Kohen, D. E., Garner, R. E., Miller, A. R., Lach, L. M., Klassen, A. F., et al. (2009). Health among caregivers of children with health problems: Findings from a Canadian population-based study. American Journal of Public Health, 99(7), 1254–1262.CrossRefPubMedCentralPubMedGoogle Scholar
  7. Bumbalo, J., Ustinich, L., Ramcharran, D., & Schwalberg, R. (2005). Economic impact on families caring for children with special health care needs in New Hampshire: The effect of socioeconomic and health-related factors. Maternal and Child Health Journal, 9(2), s3–s11.CrossRefPubMedGoogle Scholar
  8. Bussing, R., Zima, B. T., Gary, F. A., Mason, D. M., Leon, C. E., Sinha, K., et al. (2003). Social networks, caregiver strain, and utilization of mental health services among elementary school students at high risk for ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 42(7), 842.CrossRefPubMedGoogle Scholar
  9. Caregiving, National Alliance for, & AARP; American Association of Retired Persons. (2009). Caregivers of children: A focused look a those caring for a child with special needs under the age of 18. In Metlife Foundation (Ed.). Bethesda, MD.Google Scholar
  10. CAHMI, Child and Adolescent Health Measurement Initiative. (2010). 2005/2006 National Survey of Children with Special Health Care Needs. Retrieved November 15, 2010, from Data Resource Center for Child and Adolescent Health Website
  11. ECHO; Experience of Care and Health Outcomes. (2013). Retrieved from
  12. Flores, G., & Tomany-Korman, S. C. (2008). Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics, 121, e286–e298.CrossRefPubMedGoogle Scholar
  13. Hinojosa, M. S., Hinojosa, R., Fernandez-Baca, D., Knapp, C., & Thompson, L. A. (2012a). Parental strain, parental health and community characteristics among children with attention-deficit/hyperactivity disorder (ADHD). Academic Pediatrics, 12(6), 502–508.CrossRefPubMedGoogle Scholar
  14. Hinojosa, M. S., Hinojosa, R., Fernandez-Baca, D., Knapp, C. A., & Thompson, L. A. (2012b). Racial and ethnic variation in ADHD, comorbid illnesses, and parental strain. Journal for Health Care of the Poor and Underserved, 23(1), 273–289.CrossRefGoogle Scholar
  15. Hutchinson, K. C., Willard, V. W., Hardy, K. K., & Bonner, M. J. (2009). Adjustment of caregivers of pediatric patients with brain tumors: A cross-sectional analysis. Psycho-Oncology, 18, 515–523.CrossRefPubMedGoogle Scholar
  16. Kuhlthau, K., Kahn, R., Hill, K. S., Gnanasekaran, S., & Ettner, S. L. (2010). The well-being of parental caregivers of children with activity limitations. Maternal Child Health, 14, 155–163.CrossRefGoogle Scholar
  17. McCubbin, M. A. (1998). Family stress, resources, and family types: chronic illness in children. Family Relations, 37, 203–210.CrossRefGoogle Scholar
  18. Newacheck, P. W., Strickland, B., Shonkoff, J. P., Perrin, J. M., McPherson, M., McManus, M., et al. (1998). An epidemiologic profile of children with special health care needs. Pediatrics, 102, 117–123.CrossRefPubMedGoogle Scholar
  19. Okumura, M. J., Van Cleave, J., Gnanasekaran, S., & Houtrow, A. (2009). Understanding factors associated with work loss for families caring for CSHCN. Pediatrics, 124, s392–s398.CrossRefPubMedGoogle Scholar
  20. Poor communications, cultural barriers impacting quality of health care for minorities. (2002). Quality Letter for Healthcare Leader, 14(4), 11–13, 11.Google Scholar
  21. Porterfield, S. L., & McBride, T. D. (2007). The effect of poverty and caregiver education on perceived need an access to health services among children with special health care needs. American Journal of Public Health, 97(2), 323–329.CrossRefPubMedCentralPubMedGoogle Scholar
  22. Riley, A. W., Lyman, L. M., Spiel, G., Dopfner, M., Lorenzo, M. J., Ralston, S. J., et al. (2006). The Family Strain Index (FSI): Reliability, validity, and factor structure of a brief questionnaire for families of children with ADHD. European Child and Adolescent Psychiatry, 15(S1), I72.CrossRefPubMedGoogle Scholar
  23. Sanders, L. M., Thompson, V. T., & Wilkinson, J. D. (2007). Caregiver health literacy and the use of child health services. Pediatrics, 119(1), e86–e92.CrossRefPubMedGoogle Scholar
  24. SPSS. (2009). PASW Statistics 18, Release Version 18.0. Chicago, IL. Retrieved from
  25. Vitaliano, P. P., Zhang, J., & Scanlan, J. M. (2003). Is caregiving hazardous to one’s physical health?: A meta-analysis. Psychological Bulletin, 129(6), 946–972.CrossRefPubMedGoogle Scholar
  26. Yu, S. M., & Singh, G. K. (2009). Household language use and health care access, unmet need, and family impact among CSHCN. Pediatrics, 124, s414–s419.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Melanie Sberna Hinojosa
    • 1
  • Caprice Knapp
    • 1
  • Lindsey Woodworth
    • 1
  1. 1.Institute for Child Health PolicyUniversity of FloridaGainesvilleUSA

Personalised recommendations