Correlates of voluntary HIV testing and counseling among middle aged and older Latinas

This study identifies and describes HIV Voluntary Counseling and Testing (VCT) of middle aged and older Latinas. The rate of new cases of HIV in people age 45 and older is rapidly increasing, with a 40.6% increase in the numbers of older Latinas infected with HIV between 1998 and 2002. Despite this increase, there is paucity of research on this population. This research seeks to address the gap through a secondary data analysis of Latina women. The aim of this study is twofold: (1) Develop and empirically test a multivariate model of VCT utilization for middle aged and older Latinas; (2) To test how the three individual components of the Andersen Behavioral Model impact VCT for middle aged and older Latinas. The study is organized around the three major domains of the Andersen Behavioral Model of service use that include: (a) predisposing factors; (b) enabling characteristics and (c) need. Logistic regression using structural equation modeling techniques were used to test multivariate relationships of variables on VCT for a sample of 135 middle age and older Latinas residing in Miami-Dade County, Florida. Over 60% of participants had been tested for HIV. Provider endorsement was found to he the strongest predictor of VCT (odds ration [OR] 6.38), followed by having a clinic as a regular source of healthcare (OR=3.88). Significant negative associations with VCT included self rated health status (OR=.592); Age (OR=.927); Spanish proficiency (OR=.927); number of sexual partners (OR=.613) and consumption of alcohol during sexual activity (.549). As this line of inquiry provides a critical glimpse into the VCT of older Latinas, recommendations for enhanced service provision and research will he offered.

Ethnic groups and institutions: A study of institutional engineering in four Central and Eastern European countries

The issue of institutional engineering has gained a renewed interest with the democratic transitions of the Central and Eastern European countries, as for some states it has become a matter of state survival. The four countries examined in the study – Macedonia, Slovakia, Romania and Bulgaria – exemplify the difficulty in establishing a stable democratic society in the context of the resurgence of national identity. The success of ethnonational minorities in achieving the desired policies affirming or expanding their rights as a group was conditioned upon the cohesion of the minority as well as the permissiveness of state institutions in terms of participation and representation of minority members. The Hungarian minorities in Slovakia and Romania, the Turkish minority in Bulgaria, and the Albanian minority in Macedonia, formed their political organizations to represent their interests. However, in some cases the divergence of strategies or goals between factions of the minority group seriously impeded its ability to obtain the desired concessions from the majority. The difficulty in the pursuit of policies favoring the expansion of minority rights was further exacerbated in some of the cases by the impermissiveness of political institutions. The political parties representing the interest of ethnonational minorities were allowed to participate in elections, although not without suspicions about their intent and even strong opposition from majority groups, but participation in elections and subsequent representation in legislative bodies did not translate into adoption of the desired policies. The ethnonational minorities' inability to effectively influence the decision-making process was the result of the inadequacy of democratic institutions to process these demands and channel them through the normal political process in the absence of majority desire to accommodate them. Despite the promise of democratic institutions to bring about a major overhaul of the policies of forceful assimilation and disregard for minority rights, the four cases analyzed in the study demonstrate that in effect ethnonational minorities continued to be at the mercy of the majority, especially if the minority was unable to position itself as a balancing actor.

The effect of group counseling on the self-esteem, attendance, and counselor utilization of immigrant Hispanic secondary limited English proficient students

As the population of the United States becomes more diverse and the immigrant Hispanic, limited English proficient (LEP) school age population continues to grow, understanding and addressing the needs of these students becomes a pressing question. The purpose of this study was to investigate the effects of group counseling, by a bilingual counselor, on the self-esteem, attendance and counselor utilization of Hispanic LEP high school students. The design for this study was a quasi-experimental design. The experimental and control groups consisted of one class from each of the four levels of English for Speakers of Other Languages (ESOL), I-IV. The counseling intervention, the independent variable, was delivered by a bilingual counselor once a week, for fifteen weeks.^ A total of 112 immigrant Hispanic LEP students selected from the total ESOL student population participated in the study. The experimental and control groups were administered the Culture Free Self Esteem Inventory (CFSEI) Form AD as a pretest and posttest. The Background Information Questionnaire (BIQ) was utilized to gather information on counselor utilization and demographic data. Attendance data were obtained from the students' computer records. At the conclusion of the study the differences between the experimental and control groups on the three dependent variables were compared.^ Statistical analyses of the data were done using SPSS statistical software. A multivariate analysis of variance (MANOVA) was utilized to determine if there were significant differences in the self-esteem scores, attendance and counselor utilization. Correlational analyses was utilized to determine if there was a relationship between English language proficiency and self-esteem and between acculturation level and self-esteem.^ The study results indicate that there were no significant differences in the self-esteem scores and attendance of the subjects in the experimental group at the completion of the group counseling treatment. Counselor utilization was statistically significant for the targeted population. A relationship was found between English language proficiency level and self-esteem scores for students in ESOL levels II, III and IV. No significant correlation was found between acculturation and self-esteem.^ Research on the dropout rates of LEP coupled with the results of this study show that students at the intermediate and advanced levels of ESOL (III and IV) exhibit more positive self-esteem and achieve higher graduation rates that levels I and II. LEP students at levels I and II, once they became familiar with the role and function of school counselors through group counseling, utilized their services. ^

Ethnic identification: Impact on HIV/AIDS risk among migrant and seasonal workers in South Florida

Migrant workers are one of the most rapidly growing populations in the United States (U.S.) and have been significantly affected by HIV/AIDS. More than 9 million people in the U.S., primarily concentrated in Texas, Florida, Washington, California, Oregon, and North Carolina, are migrant farm workers. High prevalence rates are also suspected among migrant worker communities where risky health behaviors appear to be common. Constant mobility, isolation, limited education, substandard housing, and poverty are some of the factors that migrant workers experience and in many cases increases their HIV risk. Recent studies have suggested that ethnic identity or the level of attachment with one's ethnic group may influence engagement in HIV risk behaviors, a fact that may be important in the development of interventions among ethnic minorities. This study assesses the relationship between ethnic identity and HIV risk behaviors in two different samples; one assesses this relationship at baseline with a total of 431 African American migrant and seasonal workers in Immokalee, Florida. The second analyzes changes in ethnic identity and HIV behaviors in a sample of 270 Hispanic and African American migrant and seasonal workers in Immokalee, Florida. Data from baseline and 6-month follow-up were used in the analyses presented. The results suggest that individuals with higher levels of ethnic identity report lower levels of engagement in some, but not all, of the risky behaviors examined. These findings point to a potentially protective role for ethnic identity among this sample.

Ethnic identity, self-esteem and academic factors in second -generation post-1970 Jamaican immigrants

Immigrants from Jamaica represent the largest number of migrants to the United States from the English speaking Caribbean. Research indicates that of all Caribbean immigrants they are most likely to retain the ethnic identity of their home country for the longest period of time. This dissertation explored the nature of ethnic identity and sought to determine its impact upon the additional variables of self-esteem and academic factors. A secondary analysis was carried out using data collected in the Spring of 1992 by Portes and Rumbaut on the children of immigrants attending the eighth and ninth grades in local schools in San Diego and southern Florida. A sample of 151 second-generation Jamaican immigrants was selected from the data set. ^ Six hypotheses yielded mixed results. Both parents who have a Jamaican ethnic identity present in the household are the best predictor Jamaican youth who retain a Jamaican ethnic identity. It was expected that ethnic identity would be a predictor of positive academic factors. The study showed that ethnic identity was not associated with one of the academic factors which were examined: help given with homework. ^ Neither family economic status nor parents' level of education played a significant role in the retention of Jamaican identity. Other findings were that there was no mean difference in the self-esteem scores of respondents who had similar ethnic identities to their parents and those who did not. There was also no difference found in the academic factors of either group. The study also showed that there was a small correlation between parent-child conflict and self-esteem. Specifically, the study found that the higher the conflict between youth and their parents, the lower the self-esteem of the youth. Finally it found that time lived in the U.S. was the best predictor of a higher GPA and it was also related to lower self-esteem. ^ Surprisingly, the study found that the relationship between ethnic identity and SES was the opposite of what was expected in that it found that SES was higher when there was no Jamaican identity. ^

Outdoor experiential team -building and the college adjustment and persistence of freshmen in learning communities

Student retention is a primary goal in all higher education institutions. Students who are more adjusted to college life are more likely to persist. The purpose of this research was to determine the effects of an outdoor experiential team-building program on the college adjustment of first-semester freshmen in learning communities at a diverse, urban university. The participants in this quasi-experimental study were first-semester freshmen enrolled in learning communities. A total of 123 students participated, with 61 students in the experimental group and 62 students in the comparison group. There were no significant differences between the two groups in relation to age, gender, or ethnicity. The students in the experimental group participated in the team-building program, which consisted of three events spaced three and four weeks apart. At the end of the semester, students in both the experimental and comparison groups completed the Student Adaptation to College Questionnaire (SACQ), a 67-item self-report survey. ^ Independent samples t-test of the SACQ scores (for attachment to the institution, social adjustment, and overall adaptation to college) between groups was done, and the analyses revealed no statistically significant differences. Chi-square analyses revealed no significant difference in the enrollment pattern between the two groups over a four-year period. Repeated measures ANOVAs revealed that from the first semester of enrollment to the second semester there was a significant drop in GPA for students from the comparison group and no such drop in GPA for students from the experimental group who had participated in at least two of the team building activities. A repeated measures ANOVA was conducted for the first year by semester and ethnicity. No ethnic differences were found, and no interaction was found by ethnicity and semester. ^ Should colleges and universities continue to utilize outdoor experiential team-building programs as a creative way to influence students' connection to the institution they should further investigate its value on students' adjustment to college. Future studies should also consider other variables influenced by team-building programs that affect students' college adjustment, such as collaborative learning. Faculty should be included in the planning process to increase their participation. ^

Ethnic and American identity development: A developmental systems approach

Given the role ethnic identity has as a protective factor against the effects of marginalization and discrimination (Umaña-Taylor, 2011), research longitudinally examining ethnic identity has become of increased importance. However, successful identity development must incorporate elements from both one's ethnic group and from the United States (Berry, 1980). Despite this, relatively few studies have jointly evaluated ethnic and American identity (Schwartz et al., 2012). The current dissertation, guided by three objectives, sought to address this and several other gaps in the literature. First, psychometric properties of the Multigroup Ethnic Identity Measure (MEIM) and the American Identity Measure (AIM) were evaluated. Secondly, the dissertation examined growth trends in recently immigrated Hispanic adolescents' and their caregivers' ethnic and American identity. Lastly, the relationship between adolescents' and caregivers' ethnic and American identity was evaluated. The study used an archival sample consisting of 301 recently immigrated Hispanic families collected from Miami (N = 151) and Los Angeles (N = 150). Consistent with previous research, results in Study 1 indicated a two-factor model reliably provided better fit than a one-factor model and established longitudinal invariance for the MEIM and the AIM. Results from Study 2 found significant growth in adolescents' American identity. While some differences were found across site and nationality, evidence suggested recently immigrated Hispanic adolescents were becoming more bicultural. Counterintuitively, results found a significant decline in caregivers' ethnic identity which future studies should further examine. Finally, results from Study 3, found several significant positive relationships between adolescents' and their caregivers' ethnic and American identity. Findings provided preliminary evidence for the importance of examining identity development within a systemic lens. Despite several limitations, these three studies represented a step forward in addressing the current gaps in the cultural identity literature. Implications for future investigation are discussed.

Effectiveness of peer counseling on high school students who failed two or more classes in a nine week quarter

The purpose of this study was to examine the effectiveness of peer counseling on high school students who have previously failed two or more classes in a nine week quarter.^ This study was constructed by comparing students who previously failed and were subsequently given peer counseling with a matched group of students who failed and did not receive peer counseling.^ To test the proposed research question, 324 students from a large urban school system were randomly chosen from a computer generated list of students who failed courses, matched on variables of number of classes failed, grade level and gender. One student from each matched pair was randomly placed in either the experimental or control group. 162 students from Group 1 (experimental) were assigned a peer counselor with their pair assigned to Group 2 (control). Group 1 received peer counseling at least 4 times during the third nine week academic quarter (Quarter 3) while Group 2 did not.^ The Grade Point Averages (GPA) for all students were collected both at the end of Quarter 2 and Quarter 3, at which time peer counseling was terminated. GPA's were also collected nine weeks after counseling was terminated.^ Results were determined by multiple regression, analysis of covariance and t-test. A level of significance was set at.05. There was significant increase in the GPA's of those counseled students immediately after peer counseling and also nine weeks after counseling was terminated, while the group not receiving peer counseling showed no increase. It was noted that there were significantly more school drop-outs from the non-counseled group than the counseled group. The number of classes failed, high school attended, grade level and gender were not found to be significant.^ The conclusion from this study was that peer counseling does impact significantly on the GPA's of students experiencing academic failure. Recommendations from this study were to implement and expand peer counseling programs with more failing students, continue counseling for longer than one quarter, include students in drop-out programs and students from different socio-economic and racial backgrounds, and conduct subsequent evaluation. ^

Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations, nurses and nurse students. The participants were randomly assigned to one of the two learning interventions, L1 or L2. Participants in L1 received a lecture, discussion and exploration of the forces impacting on advance directive behavior. Participants in L2 received the same intervention components with the additional component of group practice completing advance directives.^ Analysis of the data by chi-square and logistic regression did not support the hypotheses that the practice component would make a difference in the participants' facilitation of advance care planning with patients or in their own personal advance care planning activities. There were significant differences in post-intervention behavior between the nurse and nurse student groups. The nurses in the study did significantly more facilitation of advance care planning with patients and completed significantly more advance care documents than the nurse students post-intervention. However, the nurse students held more post-intervention family discussions than did the nurses. ^

Perceptions of family environment, body image and self-esteem of eating disordered and non-eating disordered women

This study explored the perceptions of family environment, body image and self esteem of women who suffer from anorexia nervosa, bulimia nervosa, and depression. Using a nonequivalent control group design, one hundred and fifty women with anorexia nervosa (n = 50), bulimia nervosa (n = 50), and depression (n = 50) were given the Family Environment Scale (FES) and the Eating Disorders Inventory-2 (EDI-2). The objectives of this study were to: (1) study how women with anorexia nervosa and bulimia nervosa perceive their family environment as measured by the FES; (2) compare and contrast perceptions of family environment of women with anorexia nervosa and bulimia nervosa with the control group; (3) compare and contrast perceived levels of self esteem and body image as measured by the EDI-2 of women with anorexia nervosa and bulimia nervosa with the control group; and (4) examine the perceived family environments of eating disordered and non-eating disordered women with regard to body image and self esteem. Results suggested, women who suffered from anorexia nervosa or bulimia nervosa scored significantly lower (p $<$.021) on the Expressiveness, Intellectual-Cultural Orientation, and Active-Recreational subscales of the FES. The results also indicated that women who suffered from bulimia nervosa scored significantly higher (p $<$.015) than women who suffered from anorexia nervosa on the Conflict and Independence subscales of the FES. The results of studying these three populations reflected that women who suffered from anorexia nervosa scored significantly different (p $<$.000) than women who suffered from bulimia nervosa on many of the subscales of the EDI-2. The findings of the study confirmed that women who suffered from anorexia nervosa or bulimia nervosa scored significantly different (p $<$.000) on the subscales of the EDI-2 compared to women who suffered from depression. It was also confirmed that a relationship does exist between perceptions of body image and self esteem and perceptions of family environment amongst women with anorexia nervosa and bulimia nervosa as compared to depressed women. The findings of the study indicated that women who suffered from anorexia nervosa tended to: be less expressive and independent; handle conflict less openly; have a greater drive for thinness; have greater body dissatisfaction; be more perfectionistic; and struggle more intensely with fears around maturity and social insecurity than did women who suffered from bulimia nervosa or depression. In addition, the findings of the study also suggested that women who suffered from bulimia nervosa tended to: be raised in homes where openly expressed anger is permitted amongst family members; have a lesser drive for thinness; have less body dissatisfaction; be less perfectionistic; and not struggle as intensely with fears around maturity and social insecurity as do women who suffered from anorexia nervosa, but more than women who suffer from depression. Treatment implications that may assist community college professors and counselors in meeting the special needs of this special group of women were also discussed. (Abstract shortened by UMI.) ^

Social and cultural influences in the formation of identity: A cross-national/cultural study

This multi-site, multi-ethnic/cultural study examined the effects of variation between ethnic/cultural groups and the effects of institutional variation within ethnic/cultural groups on identity formation. The participants were 892 late adolescent college students from six sites in 5 countries (Brazil, China, Costa Rica, US, and Sweden) representing different linguistic and ethnic/cultural traditions living in the context of varied social conditions. As hypothesized, there were significant differences in the proportion of identity statuses between sites in the Personal domain, $\chi\sp2$(20, N = 858) = 164.78, $p<.001,$ the Interpersonal domain, $\chi\sp2$(20, N = 858) = 145.69, $p<.001,$ and the World View domain, $\chi\sp2$(20, N = 858) = 120.89, $p<.001,$ but the distribution of the differences was more complex than expected. In addition, there were significant differences in Identity Satisfaction among sites, F(15, 2325) = 12.65, $p<.001.$ Further univariate analyses revealed that differences among sites were found on Identity Satisfaction in the personal, interpersonal and world view domain. The direction of the differences, however, were more complex than hypothesized.^ The second hypothesis was confirmed but only with the world view identity status and not for each of the six sites. Stepwise discriminant analyses showed that Identity status in the world view domain was predicted by Institutional Support in Nebraska, gender and Institutional Change in Brazil, and Institutional Access in China. Lastly and as hypothesized, some Institutional Attributes significantly predicted Overall Identity Satisfaction in all sites as revealed by multivariate regression analyses, except in Sweden, F (5, 79) =.660, p =.65. These findings extend the literature on identity formation not only by having investigated how culture influences the process of identity formation with samples representing different ethnic/cultural and linguistically different populations but also by empirically testing the role that social processes play in identity formation at the cross-cultural level. ^

A comparative analysis of school satisfaction and dropout risk of middle school students attending programs for students with emotional handicaps, severe emotional disturbance and general education students attending center schools and satellite schools

This study evaluated school satisfaction as an indicator of dropout risk of students with Emotional Handicaps (EH) and students with Severe Emotional Disturbance (SED). The students attended two different kinds of middle schools in a largely urban school district in South Florida. One hundred eight students in grade 8 (ages 13-16) participated in this study. Participants were administered the National Dropout Prevention Assessment (NDPA). Forty participants with EH and SED attended a special center school. Thirty-one participants with EH and SED attended satellite programs in a regular middle school. Thirty-seven general education participants attended the same regular middle school. Overall school satisfaction scores were generated, as well as three primary factors (school, environment and personal) and 16 subscales (school atmosphere, future income, difficulty level of classwork, teacher relationships, peer relationships, intrinsic interest in classwork, school hours, classwork stress, general attitude towards school, family influence, perceived opportunity for career, future goals, travel distance, leisure time, self-appraisal of performance, and self-esteem).^ Comparison of students with EH and SED revealed that both groups of students were rated at "low risk" of becoming dropouts on the Environmental factor and the Difficulty of Schoolwork subscale. Students with EH were rated at "caution risk" risk on the Travel Distance subscale. Students with SED were rated at "high risk" on this subscale.^ There were no significant differences in school satisfaction and dropout risk between different program delivery models. There were also no significant differences for category of students (EH, SED) by school type (center school, satellite program). All students were rated at "low risk" of dropping out of school.^ There were significant differences between general education students and students with EH and SED attending satellite programs. Students with EH and SED were rated at "caution risk" for dropping out on the Travel Distance and the Leisure Time subscales. Discussion of results, implications for practice and recommendations for further research are included. ^

Making Life Choices Program: A psychoeducational intervention for promoting critical cognitive and affective competencies in adolescents at-risk for problem behaviors

The long term goal of the work described is to contribute to the emerging literature of prevention science in general, and to school-based psychoeducational interventions in particular. The psychoeducational intervention reported in this study used a main effects prevention intervention model. The current study focused on promoting optimal cognitive and affective functioning. The goal of this intervention was to increase potential protective factors such as critical cognitive and communicative competencies (e.g., critical problem solving and decision making) and affective competencies (e.g., personal control and responsibility) in middle adolescents who have been identified by the school system as being at-risk for problem behaviors. The current psychoeducational intervention draws on an ongoing program of theory and research (Berman, Berman, Cass Lorente, Ferrer Wreder, Arrufat, & Kurtines 1996; Ferrer Wreder, 1996; Kurtines, Berman, Ittel, & Williamson, 1995) and extends it to include Freire's (1970) concept of transformative pedagogy in developing school-based psychoeducational programs that target troubled adolescents. The results of the quantitative and qualitative analyses indicated trends that were generally encouraging with respect to the effects of the intervention on increasing critical cognitive and affective competencies. ^

Understanding the cycle of violence: An examination of bully and victim social roles in early childhood

The purpose of this study was to assess the prevalence of bullying and victimization in a metropolitan area. A cross-sectional study with kindergarten (n = 127) and first grade (n = 126) children was conducted in two Miami-Dade County Public Schools and three private schools in the same area. Bullying and victimization behavior and social acceptance were assessed through peer nomination and the mental health outcomes of depression and anxiety were assessed through children's self-report. Teachers and parents also completed a social behavior scale for each child. Three areas of analyses were conducted pertaining to membership classification of social roles and the social acceptance and mental health outcomes associated with those roles, reporter agreement within the social roles, and the psychometric properties of the Childhood Social Behavior Scale. Results showed an overall negative pattern of adjustment for children identified as a member of any of the negative social roles. Also, the results support a new analytic approach to the investigation of social roles. The implication of these findings for early identification, social policy, and effective prevention strategies are discussed. ^