Barriers and Promoters of Mental Health Services Utilization in a Latino Context: A Literature Review and Recommendations from an Ecosystems Perspective

ABSTRACT

This article focuses on the problems of disparities in mental health service utilization in the Latino population in the United States. It begins with an overview of the Latino population within the United States, an exploration of the diversity within this group, and shared cultural values and traits with a particular focus on the problems of Latino poverty. A review of the literature follows, including identified barriers to and promoters of mental health services utilization. These are contextualized in a Latino perspective using an ecosystems framework. Recommendations are made for future practice, research, and policy regarding mental health and mental health services utilization in the Latino community.     

The Association of Alternative Financial Services Usage and Financial Access: Evidence from the National Financial Capability Study

This study examined the association of financial access and alternative financial services (AFS) using a nationally representative sample from the 2012 National Financial Capability Study (N = 25,509). Structural equation modeling was used to examine the relationship between financial access and AFS usage. Ordinary least squares regression was used to estimate the relationship between banked status and the overall AFS usage as a latent variable while controlling for sociodemographic variables, financial education, financial knowledge, and home ownership. Results suggested that being unbanked was positively associated with AFS usage after controlling for other covariates. Financial education and knowledge, age, gender, marital status, education, household income, and homeownership were significantly associated with AFS usage. These findings have implications for public policy and programs that work with the unbanked.     

Financial Knowledge and Behaviors of Chinese Migrant Workers: An International Perspective on a Financially Vulnerable Population

ABSTRACT

Making informed financial decisions is crucial to the wellbeing of Chinese migrant workers. Using interview survey data (N = 329), this study examined financial knowledge and behaviors of migrant workers in China. Results showed that participants demonstrated low levels of financial knowledge (51.4%) and beneficial financial behaviors (51.0%). Multivariate results indicated that a modest proportion of the variance in financial behaviors was explained by financial knowledge, attitudes, and socio-demographic characteristics (e.g., marital status and income). Findings underscore the importance of disseminating culturally-relevant educational interventions to financially at-risk, low-paid migrant workers in China.     

Employee financial wellness programs: Opportunities to promote financial inclusion?

ABSTRACT

Employee financial wellness programs (EFWPs) are a new practice that may promote financial inclusion by making it easier for workers with low- and moderate-incomes (LMI) to access financial services. We examine the strengths and limitations of workplace financial counseling, credit-building services, and small-dollar loans, and describe community collaboration to promote employee financial wellness. Findings suggest that these services are reaching a population that experiences financial exclusion, though evidence is mixed concerning how these services help workers with LMI resolve key financial challenges. Community collaboration focused on employee financial wellness presents opportunities to advocate for higher wages and better benefits.     

The Civic Orientation and Political Assimilation of Latino Immigrant Youth

ABSTRACT

In recent decades, the rapid and unprecedented expansion of the Latino immigrant population has dramatically reshaped the face of American society. Unfortunately, current scholarship on this topic largely overlooks a key cohort: adolescent and young adult Latino immigrants. Our lack of understanding regarding the political inclinations of this population is highly problematic if we wish to know where Latino politics is headed in the coming decades. Data from The National Longitudinal Study of Adolescent to Adult Health are used to systematically explore and test the core assumptions of several competing assimilation theories applied to Latino immigrant youths. Bivariate analyses suggest that young Hispanic immigrants lag behind their non-Latino and Black and White peers in electoral participation and political partisanship, and minimal differences are noted in commitment to key civic orientations. However, regression analyses that include controls for SES and other contextual variables in most cases reveal no differences between young Latino immigrants and their peers in their commitment to political engagement and crucial civic values. On the whole, our findings largely confirm the expectations of mainline assimilation theory and suggest young Latino immigrants are trending toward integration into the national civic community.     

Information Poverty and the Latino Community

Abstract

Social work education can help students to reach a higher understanding of the impact of information poverty on the Latino community by systematically integrating this content into social work curriculum areas of information society, information poverty, and Latino communities. The authors examine the prospects for poverty and inequality in the Latino community as the United States emerges into the information economy and suggest that the Latino population may continue to be at risk for poverty in the information age. This article reviews indicators such as education, access to computers and network communications that may influence access to the emerging economic order and offers technology-based practice strategies, such as community net works and e-commerce, to create local empowerment. It provides recommendations for curriculum development.     

Latino youth participation in community-based participatory research to reduce teen pregnancy disparities

BackgroundCommunity-based participatory research can provide a framework to build community capacity to do health equity research, particularly from community members who may not typically participate in research design and intervention.PurposeThe purpose of this paper is to describe a community-based coalition's partnership and engagement with Latino youth throughout the research process addressing health disparities in unintended teen pregnancy rates in a local community. Israel and colleagues' components of CBPR provide a framework to develop youth participation throughout the research process.MethodHigh school and college Latino youth participated in health equity research from community assessments to design an intervention and dissemination of results.ResultsWorking with youth can improve the integrity and validity of the research process and can also provide benefits to the community and individual youth members, resulting in increased community capacity for health equity research.DiscussionLessons learned about the direct and indirect benefits and challenges are presented. Community-based partnerships working with youth should consider documenting the individual and collective impact of community engagement on the youth from the onset of participation.     

Developing Financial Management Training in Low-Income Communities

Abstract

As welfare policy contractions and declines in real wages have placed severe financial pressures on low-income families, programs to improve financial management practices and to help the poor accumulate assets have grown. This article examines the need for such programs and the implications associated with implementing two prominent training strategies-one that focuses solely on financial management training and another that combines such training with savings incentives.

Based on data from a large financial management training program, we find that knowledge deficits about basic financial issues are substantial, and that the type of financial training program offered has important implications with respect to the subgroups of low-income people likely to be served within a community. We discuss program issues critical to the implementation of such programs in low-income communities, with a focus upon more carefully attending to their participant empowerment and community development potential.     

Financial Abuse of Elders and Dependent Adults: The FAST (Financial Abuse Specialist Team) Approach

ABSTRACT

The Financial Abuse Specialist Team, a partnership of professionals from diverse disciplines, volunteer their time to review cases of financial elder abuse and facilitate comprehensive service delivery. The team also advocates for legislative reform, educates the community about the problem, and trains professionals in how to recognize, prevent, and resolve financial elder abuse.     

Latino Immigrants in a New Destination State: A Qualitative Study of Provider Experiences

ABSTRACT

Latino immigrants are settling in new destination states that have fewer culturally and linguistically competent health and social service providers. Social workers are in an ideal position to serve Latino immigrants. Yet, limited literature is available on the strengths and needs of this population specific to new destination states. To help fill this gap, qualitative data were gathered in individual interviews with providers serving Latino immigrants in one new destination state. Key themes emerged from the data, suggesting the importance of family and community, the challenges of immigration-related stressors, and the strengths and gaps in service provision. Implications for practice and social work education are presented.     

Toward Culturally Sensitive Financial Education Interventions with Latinos

ABSTACT

To expand the financial capability of Latinos, culturally sensitive interventions are needed. A literature search was conducted to examine how financial education interventions have been used to improve financial outcomes for Latinos. Just 7 peer-reviewed intervention studies were identified, suggesting a substantial gap in knowledge in this area. Although conclusions about the effectiveness of financial education interventions with Latinos are limited, each study finds positive changes in financial attitudes or behaviors. Using Resnicow’s (1999) cultural sensitivity framework, surface and deep structure methods of tailoring financial education were identified. Implications for designing and testing culturally sensitive financial education interventions are discussed.     

The GIG

SUMMARY

The GIG¹ is an innovative community based intervention which offers education regarding pregnancy and sexually transmitted infection (STI) risks and prevention in the context of a social event that is open to the adolescent community. This intensive, six hour intervention features live and recorded music, celebrities from local radio stations, raffles and prizes, and a number of educational activities providing instruction regarding pregnancy and STI risks and prevention. A total of 609 Latino adolescents completed matched pre and posttest measures. The increase in the total mean score from pretest to posttest was found to be statistically significant, as were the separate analyses for items related to pregnancy and those related to STIs. Information regarding specific attitudes and areas of knowledge are provided. Important intervention components related to the research literature are discussed along with areas of success, especially with regard to risk factors, and those in need of further attention in future intervention events. Recommendations for reinforcing and enhancing the GIG messages are presented along with implications of the findings for social work and health care professionals responsible for designing interventions for at-risk youth.     

Program Design and Planning Strategies in the Delivery of Culturally Competent Health and Mental Health Prevention and Treatment Services to Latino Communities

SUMMARY

It is important that the delivery of health and mental health prevention and treatment services within Latino communities be culturally sensitive. This article outlines several ways in which agencies can develop programs that can meet the needs of Latino communities. The most important aspect of the provision of health prevention and treatment services is that the organization integrates itself into the community through outreach, recruitment, and inclusion in decision-making. In addition, the organization needs to be structured so communication and participation from the community and health professionals are open and mixed. Otherwise, the likelihood of success of the provision of services in the community will be diminished.     

Financial decision-making abilities and financial exploitation in older African Americans: Preliminary validity evidence for the Lichtenberg Financial Decision Rating Scale (LFDRS)

ABSTRACT

This study examines preliminary evidence for the Lichtenberg Financial Decision Rating Scale (LFDRS), a new person-centered approach to assessing capacity to make financial decisions, and its relationship to self-reported cases of financial exploitation in 69 older African Americans. More than one third of individuals reporting financial exploitation also had questionable decisional abilities. Overall, decisional ability score and current decision total were significantly associated with cognitive screening test and financial ability scores, demonstrating good criterion validity. Study findings suggest that impaired decisional abilities may render older adults more vulnerable to financial exploitation, and that the LFDRS is a valid tool.     

Adopting a financial capability and asset-building curriculum at historically Black colleges and universities

ABSTRACT

Social workers currently engage in financial capability practice with low-income and financially vulnerable individuals and families in diverse practice settings, but typically lack professional preparation for this work. In response, several schools of social work have begun adopting financial capability curricula. Using an in-depth interview methodology, this study examines the adoption of a curriculum in financial capability and asset building (FCAB) from the perspectives of faculty and administrators (N = 19) at four historically Black colleges and universities (HBCUs). Findings show that key reasons for curriculum adoption are prior working relationships and trust, relevance of FCAB content to student and community needs, and alignment with program, institutional, and professional goals. Using the diffusion of innovation theory to understand curriculum adoption in HBCUs suggests that perhaps trust and relationship building are particularly important in the case of minority serving institutions.     

Changes in Self-Rated Health During the Transition to Retiring Living Among Medicare Managed-Care Recipients

ABSTRACT

Moving into a retirement community may be precipitated by or bring about changes in health status. We hypothesized that moving into a retirement community would be associated with a decline in self-rated health (SRH), but that health-related factors would mitigate this association. We analyzed data from 58,272 participants in Cohort 3 of the Medicare Health Outcome Survey. Individuals answered questions regarding living status in 2000 and 2002. Those who moved into a retirement community were compared with those who did not. The primary outcome was change in SRH. We created adjusted and unadjusted models. A total of 2,520 participants (4.4%) moved into retirement communities between 2000 and 2002. There were no substantial differences in the mean change in SRH between those who moved and those who did not. In adjusted and unadjusted models, moving was not significantly associated with changes in SRH. In an analysis stratified by SRH, only those with the best SRH had a significant decline in SRH during the move. SRH mainly remained stable for most people regardless of moving into a retirement community. These findings argue against environmental context being a main determinant of self-perceived health status among older adults.     

A Framework of Asset-Accumulation Stages and Strategies

Based on a study with 298 low-income participants, we propose that asset accumulation occurs in 3 stages. In the first stage (reallocation), current resource inflows exceed current outflows. To do this, people reallocate resources from consumption or leisure. In the second stage (conversion), people may convert resources from liquid to illiquid forms. In the third stage (maintenance), people resist temptations to dissave. We theorize that people adopt psychological and behavioral strategies to achieve these objectives. Putting psychological and behavioral strategies together with the stages of reallocation, conversion, and maintenance results in 6 strategy groups. We provide real-world examples of each strategy group and discuss implications for encouraging account ownership among the unbanked, improving asset-accumulation programs, and improving financial education.     

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community

ABSTRACT

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.     

The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation

ABSTRACT

One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale’s implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.     

Does Prior Banking Experience Matter? Differences of the Banked and Unbanked in Individual Development Accounts

Using data from the 4-year American Dream Demonstration, this study compares saving performance and program participation of banked (n = 1,538) and unbanked participants (n = 466) enrolled in 14 IDA programs. The study shows banked participants had $2.74 higher average monthly net deposit (p < 0.05); 5% higher deposit frequency (p < 0.001); and 42% less odds of drop out than unbanked participants (p < 0.001). Moreover, program characteristics such as financial education, monthly saving targets, peer group meetings, and direct deposit are important predictors of program performances. Individual characteristics such as race/ethnicity, home ownership, and income are significantly associated with program performance.