Behavioral Effects of a Brief Parent-Child Group Prevention Strategy for School-Referred Bicultural Youth

Background:  This pilot study examined the behavioral effects of a brief manualized prevention protocol with a sample of school-referred children and parents from a minority ethnic/linguistic or occupational culture. Common developmental risk factors included biculturality, residential instability, parental absence/ambiguous parental absence, parental health/behavioral health issues, health disparities, violence exposure, limited English proficiency, and social isolation. While there are a number of interventions to sustain resilience and prevent academic difficulty and developmental psychopathology among children living in adversity, there is a shortage of evidence-based prevention programs for bicultural groups, including distinct high-risk occupational cultures such as the military and occupations typically performed by immigrant labor forces in the United States. Thus, the development and pilot-testing of a brief prevention strategy aimed to prevent onset of adjustment disorder, acute stress disorder, and post-traumatic stress disorder in this population of school-age children was warranted.

Methods: Data were collected using a pre/post quasi-experimental design. A brief, 12-session (1.5 hours) concurrent parent/youth group preventive intervention was developed by participatory action and systematic review research methods within a resilience theoretical framework to maintain or improve pre-test levels of resilience in parents and reduce symptoms triggering school referral which are precursors of developmental psychopathology. The convenience sample of school-referred bicultural families (N = 34) had been evaluated by social work clinicians using the Diagnostic Interview Schedule for Children to rule out target disorders. Parent mean age and education was 37.5 and 11.6 years, children mean age was 10.3, and mean annual family income was $37, 342.  Occupations included house cleaning/janitorial, lawn care, mechanic, painter/construction, disabled veteran, police/firefighter Reservist/veteran, and active duty enlisted.

The Resilience Scale for Adults (RSA) and the Child Behavior Checklist for ages 6-18 (CBCL) were administered to parents in English (39.4%) and Spanish (60.6%) at two time points as part of the prevention strategy pilot study.  The RSA is a 33-item valid and reliable measure assessing protective factors at the personal, family, and social levels. This study reports on the CBCL Syndrome Scales consisting of 113 items which are valid and reliable measures of clinical symptoms in children. Multivariate statistical analyses (paired sample t-tests, multiple regression, and repeated measures) were performed using SPSS 21.0 to examine behavioral effects of the prevention strategy for parents and youth.

Results:  Parents and children completed an average of 7.2 sessions.  Parent RSA scores increased from pretest to posttest (pretest mean = 158.3; post-test mean = 176.9), but not at a significant level (t= -1.65; p = .13).  Child CBCL scale scores did significantly decrease from pretest to posttest (t = 4.8; p < .0001), with no significant association with number of sessions completed (B = .98; p = .66) nor school level (F = .35; p = .58).

Implications: Findings suggest that a brief, culturally competent parent-child prevention strategy is feasible/non-harmful and may be useful in reducing precursor symptoms associated with onset of stress and trauma conditions in bicultural youth. Future studies should test the protocol with larger samples and triangulation of measures.