Integrating Culture, Science, and Social Justice: A Program of Prevention Parenting Research with Latino/a Immigrants Informed By Social Work Principles

Background and Purpose: Latino/a immigrants are negatively impacted by widespread mental health disparities throughout the United States (US). These challenges have been augmented by a recent anti-immigration climate, which has exacerbated various forms of discrimination against this population. The purpose of this presentation is to describe an NIMH-funded program of prevention research, focused on the cultural adaptation and dissemination of an evidence-based parenting intervention for low-income Latino/a immigrant families. A special focus will be given to illustrate how community-based participatory research approaches (CBPR) have guided this program of research, particularly as it refers to the research team engaging in a continuing decision-making process to address scientific rigor, as well as cultural and contextual relevance.

 

Methods: This program of research is grounded on a 2-year qualitative study aimed at learning from the life experiences and parenting needs of the target immigrant population (n=83). This formative phase facilitated the cultural adaptation of the efficacious intervention known as Parent Management Training, the Oregon Model (GenerationPMTO^R). Thus, the qualitative study informed the implementation of a randomized controlled trial (RCT) with 103 Latino/a immigrant families with children ages 4-12 (n = 189 parents). The primary objective of this RCT was to empirically test the differential efficacy of PMTO by allocating participants to one of three conditions: (a) a culturally adapted version of PMTO (exclusive focus on parenting), (b) a culturally-enhanced version of PMTO (focus on parenting, biculturalism, immigration challenges, and discrimination), and (c) a wait-list control condition. A multilevel modeling approach was utilized to analyze parenting and child adaptation outcomes.

Results: Empirical findings indicated high implementation feasibility of both adapted interventions, with an overall 86% retention rate of families, including 84% of fathers. Participants’ qualitative reports also indicated high satisfaction with both adapted interventions. HLM analyses showed statistically significant improvements on parenting skills in both adapted interventions at 6-month follow-up, when compared to the control condition (p < .05, d = 0.52 to 1.12). Analyses also indicated that the culturally enhanced parenting intervention, in which cultural and contextual issues (e.g., discrimination) were overtly addressed, had the most robust impact on internalizing and externalizing child outcomes (p < .05, d = -.90 to -1.00). However,  the impact reported by parents on child externalizing behaviors differed according to gender, with fathers reporting the highest levels of improvement.

Conclusions and Implications: Data demonstrated the importance of adhering to the original PMTO core components to ensure intervention efficacy. Culturally adaptation was also critical, as the highest level of impact on child outcomes was observed in the adapted intervention with an overt focus on cultural and contextual issues (e.g., discrimination). These findings will be discussed according to CBPR principles and major premises of the Grand Challenges for Social Work Initiative. Specifically, lessons from this program of research indicate that Latino/a immigrant communities can benefit from culturally relevant and efficacious parenting interventions, particularly if they are delivered by overtly addressing the experiences of discrimination and injustice to which these populations are exposed in the US context.