This study examined the role of maternal parenting stress in the relation between intimate partner violence (IPV) and children's emotional and behavioral problems among 139 African American children between the ages of 8 and 12 years. Structural equation modeling was used to investigate a mediational model examining maternal reports of IPV and parenting stress and both mother and child reports of child adjustment. Results suggest that parenting stress helps explain the link between IPV and child emotional and behavioral problems. Findings from this study highlight the importance of parenting stress in outcomes of children from low-income African American families who experience IPV.
E-supervision has a potential role in addressing speech-language personnel shortages in rural and difficult to staff school districts. The purposes of this article are twofold: to determine how e-supervision might support graduate speech-language pathologist (SLP) interns placed in rural, remote, and difficult to staff public school districts; and, to investigate interns’ perceptions of in-person supervision compared to e-supervision. The study used a mixed methodology approach and collected data from surveys, supervision documents and records, and interviews. The results showed the use of e-supervision allowed graduate SLP interns to be adequately supervised across a variety of clients and professional activities in a manner that was similar to in-person supervision. Further, e-supervision was perceived as a more convenient and less stressful supervision format when compared to in-person supervision. Other findings are discussed and implications and limitations provided.
Background
African American (AA) adults are 60% more likely to be diagnosed with diabetes mellitus (DM) and experience more complications than non-Hispanic White adults. Cognitive behavioral therapy (CBT) has shown to be an effective modality for helping patients improve health behaviors and regulate emotional states. Motivational interviewing (MI) addresses participant engagement and motivation. Therefore, MI was combined with CBT as an approach to the process of learning using CBT skills to promote healthy lifestyle choices. We aimed to assess the effects of a culturally tailored CBT/MI intervention on glycemic control in AA participants and understand their perspectives, attitudes, and experiences while participating in this intervention.
Methods
Using a randomized, parallel design pilot study (web-based group vs in-person group), 20 participants aged ≥ 18 years, identifying as AA and having a glycosylated hemoglobin (HbA1c) > 8%, were recruited. A CBT/MI intervention was administered in six sessions over 3 months. Participants completed baseline and follow-up assessments on measures for diabetes control (HbA1c), self-efficacy, generalized anxiety, depression, perceived stress, health-related quality of life, and cognitive ability. Post-CBT/MI intervention focus groups were conducted to determine patient perspectives regarding the intervention.
Results
Fourteen participants completed the study, their mean HbA1c improved from 10.0 to 8.9% (t(26) = 0.5, p-value = 0.06). The Diabetes Distress Scale demonstrated decreased distress overall (t(26) = 2.6; p-value = 0.02). The Generalized Anxiety Disorder Scale demonstrated decreased generalized anxiety for all participants (t(26) = 2.2; p = 0.04). Themes identified in focus groups included (1) intervention group social support through information sharing, (2) mental health and personal identities in diabetes understanding and management, and (3) receptivity to CBT/MI intervention positively impacts self-efficacy through improved health literacy.
Conclusion
This group-based, culturally tailored CBT/MI intervention for type 2 DM care was positively received by AA participants and helped improve diabetes control, as demonstrated by the change in HbA1c. There were additional benefits of social support through group interactions and a stronger sense of self-efficacy due to health education. A comprehensive treatment plan using a CBT/MI intervention may be useful in promoting healthy diabetes self-management.
Trial registration
ClinicalTrials.gov, NCT03562767. Registered on 19 June 2018
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