Building cultural competence: A systematic evaluation of the effectiveness of culturally sensitive interventions with ethnic minority youth

Growing diversity within the US population accentuates the need for the development and implementation of culturally competent services in the field of child welfare. Despite this, few studies exist that examine the effectiveness of culturally sensitive interventions (CSIs) with ethnic minority populations, who are considerably more at risk of developing psychosocial problems including substance and alcohol abuse, delinquency, low academic achievement, and poor self-esteem. With the demand for evidence-based practice it is imperative that we examine the effectiveness of CSIs designed to prevent and treat youth problems. The main goal of this review was to systematically analyze the methodology of recent CSI research with populations of ethnic minority youth in order to evaluate each intervention's ability to adhere to existing standards of evidence-based practice. The fifteen CSI studies examined in this review illustrate progress in their attempt to adhere to the methodological rigor required of evidence-based practice. This review encourages the field of child welfare to position itself analogously with and embrace the movement toward building cultural competence by further investigating the effectiveness of culturally-sensitive interventions with ethnic minority youth.     

Dose-Response Assessment of Airborne Methyl Isothiocyanate (MITC) Following a Metam Sodium Spill

A tank car derailment in northern California in 1991 spilled metam sodium into the Sacramento River, and released its breakdown product, methyl isothiocyanate (MITC), into the air. This paper describes the risk evaluation process used. Over 240 individuals reported symptoms such as eye and throat irritation, dizziness, and shortness of breath. Reference exposure levels (RELs) for 1 hr were developed for MITC and compared to exposure concentrations. Ocular irritation in cats was the most sensitive endpoint reported. The no observed adverse effect level (NOAEL), divided by an uncertainty factor (UF) of 100, produced an REL of 0.5 ppb of MITC in air to prevent discomfort. An REL to prevent disability was estimated to be 40 ppb. An REL to prevent life-threatening injury was estimated to be 150 ppb. Measured MITC levels ranged from 0.2-37 ppb and estimated peak levels ranged from 140-1600 ppb. The usefulness of RELs for emergency planning is discussed.     

Gender and income in pharmacy: human capital and gender stratification theories revisited

This is a case study of gender and earnings in pharmacy--a profession characterized by its rapid recruitment of female practitioners. We try to account for disparities in earnings between male and female pharmacists in Ontario with the aid of human capital theory and gender stratification theory. Data is drawn from a random sample of 463 Ontario pharmacists. We find a consistent sex gap in earnings regardless of occupational level of practitioners (i.e. owner, manager or employee) and net of such factors as hours worked, commitment to work, hours devoted to childcare, absences from the labour market, and years since graduation. Instead, the main reason why women in pharmacy earn less than males is because they remain employees throughout their careers. However, we are less successful at identifying the additional factors responsible for the depressed earnings of female practitioners. We discuss our findings in light of the claims of gender stratification and human capital theory.     

Alcohol and drug use of inter-city versus rural school age children

The purpose of this study of seventy-nine children was to determine: 1) the prevalence and type of substance use in inter-city and rural eight to twelve-year-old children; and 2) the relationships between child substance use, self-esteem, peer substance use, and family climate. The conceptual framework for the study was a modification of Kumpfer and Turner's Social Ecology Model (1991). Nineteen percent of the children had used alcohol or drugs. Thirty-three percent of the children acknowledged having friends who used substances. Inter-city children reported more alcohol and marijuana use, while the rural children reported more use of inhalants. The responses of both inter-city and rural children also indicated that there were problems with substance use and family violence in the home. Self-esteem and affiliation with drug using peers were significantly correlated with substance use of the child.     

Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients

Food insufficiency is a significant problem in the United States, and poor African American women with children are at especially high risk. An inadequate household food supply can potentially affect the well-being of household members, but it is difficult to distinguish the effects of food insufficiency from risk factors for poor health that are also common among the food insufficient, such as poverty. We examined food insufficiency and physical and mental health among African American and white women (n = 676) who were welfare recipients in 1997. Controlling for common risk factors, women who reported food insufficiency in both 1997 and 1998 were more likely to report fair or poor health at the later date. Food insufficiency in 1998 was significantly associated with meeting the diagnostic screening criteria for recent major depression. Food insufficiency at both times and in 1998 only was related to women's sense of mastery. These findings add to growing evidence that household food insufficiency is associated with poor physical and mental health.     

Role sequencing: does order matter for mental health?

Role sequencing refers to the ordering of social roles. According to the normative order hypothesis, adults who follow a certain sequencing of their social roles will be better adjusted than their peers who follow other life course patterns. The normative order is defined as first entering the paid labor force, getting married, and later having children. This study tests this hypothesis by analyzing retrospective life history data from three subsamples of adults who completed the 1987--1988 National Survey of Families and Households: (1) married, working parents; (2) divorced, working parents; and (3) married, unemployed parents. The findings indicate significant race/ethnic (black/white), gender, and cohort differences in the type of role sequencing patterns that are conducive to positive mental health. For example, African Americans who work first, then have children, and later get married report better mental health than their peers who followed the normative order White men and women seem to benefit from following the normative course of role transitions. Among women, however, the psychological benefits of following typical life course patterns are especially evident among those born during the baby boom.     

A study of the relationship between protective behaviors and drinking consequences among undergraduate college students

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses.     

The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 +/- 40 to 141 +/- 53 W (p < .01); dynamic balance increased 48%, from 22.3 +/- 7.9 to 33.1 +/- 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 +/- 1.32 to 6.54 +/- 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.