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Acculturation Differences in Communicating Information About Child Mental Health Between Latino Parents and Primary Care Providers

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Abstract

Significant Latino-white disparities in youth mental health care access and quality exist yet little is known about Latino parents’ communication with providers about youth mental health and the role of acculturation in influencing this communication. We estimated regression models to assess the association between time in the US and the number of psychosocial issues discussed with the medical assistant (MA) and doctor, adjusting for child and parent mental health and sociodemographics. Other proxies of acculturation were also investigated including measures of Spanish and English language proficiency and nativity. Parent’s length of time in the US was positively associated with their communication of: their child’s psychosocial problems with their child’s MA, stress in their own life with their child’s MA, and their child’s school problems with their child’s doctor. These differences were especially apparent for parents living in the US for >10 years. Parent–child language discordance, parent and child nativity were also significantly associated with communication of psychosocial problems. Greater provider and MA awareness of variation in resistance to communicating psychosocial issues could improve communication, and improve the prevention, diagnosis and treatment of youth mental illness.

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References

  1. Merikangas KR, He J-p, Burstein M, et al. Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Alegria M, Sribney W, Woo M, Guarnaccia P, Torres M. Looking beyond nativity: the relation of age of immigration, length of residence, and birth cohorts to the risk of onset of psychiatric disorders for Latinos. Res Hum Dev. 2007;4(1&2):19–47.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cervantes RC, Padilla AM, Napper LE, Goldbach JT. Acculturation-related stress and mental health outcomes among three generations of Hispanic adolescents. Hisp J Behav Sci. 2013;35(4):451–68.

    Article  Google Scholar 

  4. Cook B, Barry CL, Busch SH. Racial/ethnic disparity trends in children’s mental health care access and expenditures from 2002 to 2007. Health Serv Res. 2013;48(1):129–49.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pumariega A, Glover S, Holzer C, Nguyen H. Administrative update: utilization of services. II. Utilization of mental health services in a tri-ethnic sample of adolescents. Community Ment Health J. 1998;34(2):145–56.

    Article  PubMed  CAS  Google Scholar 

  6. Kirby JB, Hudson J, Miller GE. Explaining racial and ethnic differences in antidepressant use among adolescents. Med Care Res Rev. 2009;67(3):342–63.

    Article  PubMed  Google Scholar 

  7. Olfson M, Gameroff M, Marcus S, Jensen P. National trends in the treatment of attention deficit hyperactivity disorder. Am J Psychiatr. 2003;160(6):1071–7.

    Article  PubMed  Google Scholar 

  8. Hudson JL, Miller GE, Kirby JB. Explaining racial and ethnic differences in children’s use of stimulant medications. Med Care. 2007;45(11):1068–75.

    Article  PubMed  Google Scholar 

  9. Hambidge SJ, Emsermann CB, Federico S, Steiner JF. Disparities in pediatric preventive care in the United States, 1993–2002. Pediatrics. 2007;161(1):30.

    Google Scholar 

  10. Hagan J, Shaw J, Duncan P, editors. Bright futures: guidelines for health supervision of infants, children, and adolescents, 3rd ed. Pocket guide. Elk Grove Village, IL: American Academy of Pediatrics; 2008.

  11. Bardes CL. Defining patient-centered medicine. N Engl J Med. 2012;366(9):782–3.

    Article  PubMed  CAS  Google Scholar 

  12. Tai-Seale M, Foo PK, Stults CD. Patients with mental health needs are engaged in asking questions, but physicians’ responses vary. Health Aff (Millwood). 2013;32(2):259–67.

    Article  Google Scholar 

  13. Cooper LA, Gonzales JJ, Gallo JJ, et al. The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients. Med Care. 2003;41(4):479–89.

    PubMed  Google Scholar 

  14. Nadeem E, Lange JM, Miranda J. Mental health care preferences among low-income and minority women. Arch Womens Ment Health. 2008;11(2):93–102.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Miranda J, Cooper L. Disparities in care for depression among primary care patients. J Gen Intern Med. 2004;19(2):120–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Brown JD, Riley AW, Wissow LS. Identification of youth psychosocial problems during pediatric primary care visits. Adm Policy Ment Health Ment Health Serv Res. 2007;34(3):269–81.

    Article  Google Scholar 

  17. Brown JD, Wissow LS, Riley AW. Physician and patient characteristics associated with discussion of psychosocial health during pediatric primary care visits. Clin Pediatr. 2007;46(9):812–20.

    Article  Google Scholar 

  18. Brown JD, Wissow LS, Zachary C, Cook BL. Receiving advice about child mental health from a primary care provider: African American and Hispanic parent attitudes. Med Care. 2007;45(11):1076–82.

    Article  PubMed  Google Scholar 

  19. Brown JD, Wissow LS. Discussion of maternal stress during pediatric primary care visits. Ambul Pediatr. 2008;8(6):368–74.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wells KB, Tang L, Carlson GA, Asarnow JR. Treatment of youth depression in primary care under usual practice conditions: observational findings from youth partners in care. J Child Adolesc Psychopharmacol. 2012;22(1):80–90.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Asarnow JR, Jaycox LH, Duan N, et al. Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics. JAMA. 2005;293(3):311–9.

    Article  PubMed  CAS  Google Scholar 

  22. Olds DL, Robinson J, Pettitt L, et al. Effects of home visits by paraprofessionals and by nurses: age 4 follow-up results of a randomized trial. Pediatrics. 2004;114(6):1560–8.

    Article  PubMed  Google Scholar 

  23. Derose KP. Networks of care: how Latina immigrants find their way to and through a county hospital. J Immigr Health. 2000;2(2):79–87.

    Article  PubMed  CAS  Google Scholar 

  24. Ware NC, Tugenberg T, Dickey B, McHorney CA. An ethnographic study of the meaning of continuity of care in mental health services. Psychiatr Serv. 1999;50(3):395–400.

    PubMed  CAS  Google Scholar 

  25. Pulido R, Monari M, Rossi N. Institutional therapeutic alliance and its relationship with outcomes in a psychiatric day hospital program. Arch Psychiatr Nurs. 2008;22(5):277–87.

    Article  PubMed  Google Scholar 

  26. van Os TWDP, van den Brink RHS, Tiemens BG, Jenner JA, van der Meer K, Ormel J. Communicative skills of general practitioners augment the effectiveness of guideline-based depression treatment. J Affect Disord. 2005;84(1):43–51.

    Article  PubMed  Google Scholar 

  27. Sanchez AR, King M. Mexican Americans’ use of counseling services: cultural and institutional factors. J Coll Stud Pers. 1986;27(4):344–9.

    Google Scholar 

  28. Organista PB, Marin G, Chun KM. Acculturation. In: Organista PB, Marin G, Chun KM, editors. The psychology of ethnic groups in the United States. London: Sage; 2010.

    Google Scholar 

  29. Organista PB, Marin G, Chun KM. The psychology of ethnic groups in the United States. London: Sage; 2010.

    Google Scholar 

  30. Berry JW. Acculturation: a conceptual overview. In: Bornstein MH, Cote LR, editors. Acculturation and parent-child relationships: measurement and development. Mahwah: Lawrence Erlbaum Associates; 2006.

    Google Scholar 

  31. Thomson MD, Hoffman-Goetz L. Defining and measuring acculturation: a systematic review of public health studies with Hispanic populations in the United States. Soc Sci Med. 2008;69(7):983–91.

    Article  Google Scholar 

  32. Thomson MD, Hoffman-Goetz L. Defining and measuring acculturation: a systematic review of public health studies with Hispanic populations in the United States. Soc Sci Med. 2009;69(7):983–91.

    Article  PubMed  Google Scholar 

  33. Marín G, Gamba RJ. A new measurement of acculturation for Hispanics: the bidimensional acculturation scale for Hispanics (BAS). Hisp J Behav Sci. 1996;18(3):297–316.

    Article  Google Scholar 

  34. Zea MC, Asner-Self KK, Birman D, Buki LP. The abbreviated multidimentional acculturation scale: empirical validation with two latino/latina samples. Cultur Divers Ethnic Minor Psychol. 2003;9(2):107.

    Article  PubMed  Google Scholar 

  35. Olmedo EL, Padilla AM. Empirical and construct validation of a measure of acculturation for Mexican Americans. J Soc Psychol. 1978;105(2):179–87.

    Article  Google Scholar 

  36. Abraido-Lanza AF, Armbrister AN, Florez KR, Aguirre AN. Toward a theory-driven model of acculturation in public health research. Am J Public Health. 2006;96(8):1342–6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kimbro RT. Acculturation in context: gender, age at migration, neighborhood ethnicity, and health behaviors*. Soc Sci Q. 2009;90(5):1145–66.

    Article  Google Scholar 

  38. Hunt LM, Schneider S, Comer B. Should, “acculturation” be a variable in health research? A critical review of research on US Hispanics. Soc Sci Med. 2004;59:973–86.

    Article  PubMed  Google Scholar 

  39. Alegria M. The challenge of acculturation measures: what are we missing? A commentary on Thomson & Hoffman-Goetz. Soc Sci Med. 2009;69(7):996.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Marin G. Issues in the measurement of acculturation among Hispanics. In: Marín G, Geisinger KF, editors. Psychological testing of Hispanics. Washington, DC: American Psychological Association; 1992.

  41. Wallen GR, Feldman RH, Anliker J. Measuring acculturation among Central American women with the use of a brief language scale. J Immigr Health. 2002;4(2):95–102.

    Article  PubMed  Google Scholar 

  42. Alegria M, Chatterji P, Wells K, et al. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatr Serv. 2008;59(11):1264–72.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Chen J, Vargas-Bustamante A. Estimating the effects of immigration status on mental health care utilizations in the United States. J Immigr Minor Health. 2011;13(4):671–80.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Thamer M, Richard C, Casebeer AW, Ray NF. Health insurance coverage among foreign-born US residents: the impact of race, ethnicity, and length of residence. Am J Public Health. 1997;87(1):96–102.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  45. Perry CE, Hatton D, Kendall J. Latino parents’ accounts of attention deficit hyperactivity disorder. J Transcult Nurs. 2005;16(4):312–21.

    Article  PubMed  Google Scholar 

  46. Brown JD, Wissow LS, Cook BL, Longway S, Caffery E, Pefaure C. Mental health communications skills training for medical assistants in pediatric primary care. J Behav Health Serv Res. 2013;40(1):20–35.

    Article  PubMed  Google Scholar 

  47. Street RL. Physicians’ communication and parents’ evaluations of pediatric consultations. Med Care. 1991;29(11):1146–52.

    Article  PubMed  Google Scholar 

  48. Wissow LS, Gadomski A, Roter D, et al. Improving child and parent mental health in primary care: a cluster-randomized trial of communication skills training. Pediatrics. 2008;121(2):266–75.

    Article  PubMed  Google Scholar 

  49. Vega W, Kolody B, Aguilar-Gaxiola S, Alderete E, Catalano R, Caraveo-Anduaga J. Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Arch Gen Psychiatry. 1998;55(9):771–8.

    Article  PubMed  CAS  Google Scholar 

  50. Cook BL, Alegria M, Guo J, Lin JY. Pathways and correlates connecting exposure to the U.S. and Latinos’ mental health. Am J Public Health. 2009;99(12):2247–54.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Alegria M, Mulvaney-Day N, Woo M, Torres M, Gao S, Oddo V. Correlates of past-year mental health service use among Latinos: results from the National Latino and Asian American Study. Am J Public Health. 2007;97(1):76–83. doi:10.2105/AJPH.2006.087197.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Keyes KM, Martins SS, Hatzenbuehler ML, Blanco C, Bates LM, Hasin DS. Mental health service utilization for psychiatric disorders among Latinos living in the United States: the role of ethnic subgroup, ethnic identity, and language/social preferences. Soc Psychiatry Psychiatr Epidemiol. 2012;47(3):383–94.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  53. Goodman R. The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry. 1999;40(5):791–9.

    Article  PubMed  CAS  Google Scholar 

  54. Goodman R, Ford T, Simmons H, Gatward R, Meltzer H. Using the strengths and difficulties questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry. 2000;177(6):534–9.

    Article  PubMed  CAS  Google Scholar 

  55. Achenbach TM, Becker A, Döpfner M, et al. Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: research findings, applications, and future directions. J Child Psychol Psychiatry. 2008;49(3):251–75.

    Article  PubMed  Google Scholar 

  56. Achenbach TM, Edelbrock C, Howell CT. Empirically based assessment of the behavioral/emotional problems of 2- and 3- year-old children. J Abnorm Child Psychol. 1987;15(4):629–50.

    Article  PubMed  CAS  Google Scholar 

  57. Bourdon KH, Goodman R, Rae DS, Simpson G, Koretz DS. The strengths and difficulties questionnaire: US normative data and psychometric properties. J Am Acad Child Adolesc Psychiatry. 2005;44(6):557–64.

    Article  PubMed  Google Scholar 

  58. Pastor P, Duran C. NHIS Mental health indicator: does it identify 2–3 year olds with emotional/behavioral problems? CDC–SAMSHA Children’s Mental Health SeminarMarch 17, 2010.

  59. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  60. Wulsin L, Somoza E, Heck J. The feasibility of using the Spanish PHQ-9 to screen for depression in primary care in Honduras. Prim Care Companion J Clin Psychiatry. 2002;4:191–5.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Diez-Quevedo C, Rangil T, Sanchez-Planell L, Kroenke K, Spitzer R. Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1,003 general hospital Spanish inpatients. Psychosom Med. 2001;63(4):679–86.

    Article  PubMed  CAS  Google Scholar 

  62. StataCorp. Stata statistical software release 12.0. College Station: Stata Corporation; 2011.

    Google Scholar 

  63. Rubin DB. Multiple imputation of nonresponse in surveys. New York: Wiley; 1998.

    Google Scholar 

  64. Little RJA, Rubin DB. Statistical analysis with missing data. Hoboken: Wiley; 2002.

    Book  Google Scholar 

  65. Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat. 1979;6(2):65–70.

    Google Scholar 

  66. Stockdale SE, Lagomasino IT, Siddique J, McGuire T, Miranda J. Racial and ethnic disparities in detection and treatment of depression and anxiety among psychiatric and primary health care visits, 1995–2005. Med Care. 2008;46:668–77.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Wang P, Lane M, Olfson M, Pincus H, Wells K, Kessler R. Twelve-month use of mental health services in the United States. Arch Gen Psychiatry. 2005;629–640:629.

    Article  Google Scholar 

  68. Foster BA, Read D, Bethell C. An analysis of the association between parental acculturation and children’s medication use. Pediatrics. 2009;124(4):1152–61.

    Article  PubMed  Google Scholar 

  69. Massey DS, Denton NA. Spatial assimilation as a socioeconomic outcome. Am Sociol Rev. 1985;50:94–106.

    Article  Google Scholar 

  70. Logan JR, Zhang W, Alba RD. Immigrant enclaves and ethnic communities in New York and Los Angeles. Am Sociol Rev. 2002; 299–322.

  71. Guarnaccia P, Pincay I, Shrout P, Alegría M, Lewis-Fernandez R, Canino G. Assessing diversity among Latinos: results from the NLAAS. Hisp J Behav Sci. 2007;29(4):510–34.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DEH. Acculturation and Latino health in the United States. 2005.

  73. Deyo RA, Diehl AK, Hazuda H, Stern MP. A simple language-based acculturation scale for Mexican Americans: validation and application to health care research. Am J Public Health. 1985;75(1):51–5.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

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Acknowledgments

We would like to acknowledge the support of NIMH R21 MH083625 (PI Wissow) and NIMH R01 MH091042 (PI Cook).

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Authors and Affiliations

  1. Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon Street, 4th Floor, Somerville, MA, 02143, USA

    Benjamin Lê Cook & Stephen Loder

  2. Department of Psychiatry, Harvard Medical School, 120 Beacon Street, 4th Floor, Somerville, MA, 02143, USA

    Benjamin Lê Cook

  3. Mathematica Policy Research, 1100 1st St NE #1200, Washington, DC, 20002, USA

    Jonathan D. Brown

  4. Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Street, #703, Baltimore, MD, 21287, USA

    Larry Wissow

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  1. Benjamin Lê Cook
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  2. Jonathan D. Brown
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  4. Larry Wissow
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Correspondence to Benjamin Lê Cook.

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Cook, B.L., Brown, J.D., Loder, S. et al. Acculturation Differences in Communicating Information About Child Mental Health Between Latino Parents and Primary Care Providers. J Immigrant Minority Health 16, 1093–1102 (2014). https://doi.org/10.1007/s10903-014-0010-2

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