Abstract
Background: Parenting adolescents poses challenges that are exacerbated by immigration. Aqui Para Ti [Here for You] (APT) is a clinic-based, healthy youth development program that provides family-centered care for Latino youth and their families who are mostly immigrants from Mexico and Latin America.
Objectives: To present the APT model of care and report the experiences of youth and their parents.
Subjects: APT patients between 11 and 24 years (n=30) and parents (n=15). Most youth patients were female, between 11 and 17 years, and from Mexico. Most parents were female, 40 years or younger, and from Mexico.
Methods: Youth participants completed a survey and participated in an individual semi-structured interview, and parent participants attended focus groups. Descriptive statistics summarized survey data. Interviews and focus groups were transcribed and analyzed in Spanish using content analysis by two independent coders. Quantitative and qualitative findings were integrated using side-by-side comparisons. Researchers not involved in the coding process contributed with the interpretation of the findings.
Results: Youth and parents were satisfied with the services received at APT. Youth felt listened to by their providers (100%), felt they could trust them (100%) and valued comprehensive care. Eighty-seven percent reported that their experiences at APT were better than at other clinics. Parents valued the family parallel care, confidentiality, family-centeredness, and the cultural inclusivity of the APT services.
Conclusion: Patients and parents were satisfied with the services offered at APT. Family parallel care could be a positive alternative to deliver confidential and family-centered services to immigrant families.
References
1. Bacallao ML, Smokowski PR. The costs of getting ahead: Mexican family system changes after immigration. Fam Relat 2007;56:52–66.10.1111/j.1741-3729.2007.00439.xSearch in Google Scholar
2. Qin DB. Doing well vs. feeling well: understanding family dynamics and the psychological adjustment of Chinese immigrant adolescents. J Youth Adolesc 2008;37:22–35.10.1007/s10964-007-9220-4Search in Google Scholar
3. Kwak K. Adolescents and their parents: a review of intergenerational family relations for immigrant and non-immigrant families. Hum Dev 2003;46:115–36.10.1159/000068581Search in Google Scholar
4. Sawyer SM, Afifi RA, Bearinger LH, Blakemore SJ, Dick B, et al. Adolescence: a foundation for future health. Lancet 2012;379:1630–40.10.1016/S0140-6736(12)60072-5Search in Google Scholar
5. Svetaz MV, Garcia-Huidobro D, Allen ML. Parents and family matter: strategies for developing family-centered adolescent care within primary care practices. Prim Care 2014;41:489–506.10.1016/j.pop.2014.05.004Search in Google Scholar
6. Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, et al. Adolescence and the social determinants of health. Lancet 2012;379:1641–52.10.1016/S0140-6736(12)60149-4Search in Google Scholar
7. United States Census Bureau. Demographic Analysis 2010: Sensitivity Analysis of the Foreign-Born Migration Component. Available at: http://www.census.gov/population/www/documentation/twps0098/twps0098.pdf.Search in Google Scholar
8. United States Census Bureau. The Hispanic Population: 2010. Available at: https://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf.Search in Google Scholar
9. Miranda AO, Bilot JM, Peluso PR, Berman K, Van Meek LG. Latino families: The relevance of the connection among acculturation, family dynamics, and health for family counseling research and practice. Fam J 2006;14:268–73.10.1177/1066480706287805Search in Google Scholar
10. Dempsey AF, Singer DD, Clark SJ, Davis MM. Adolescent preventive health care: what do parents want? J Pediatr 2009;155:689–94.10.1016/j.jpeds.2009.05.029Search in Google Scholar PubMed
11. Duncan RE, Vandeleur M, Derks A, Sawyer S. Confidentiality with adolescents in the medical setting: what do parents think? J Adolesc Health 2011;49:428–30.10.1016/j.jadohealth.2011.02.006Search in Google Scholar PubMed
12. Berlan ED, Bravender T. Confidentiality, consent, and caring for the adolescent patient. Curr Opin Pediatr 2009;21:450–6.10.1097/MOP.0b013e32832ce009Search in Google Scholar PubMed
13. Cheng TL, Savageau JA, Sattler AL, DeWitt TG. Confidentiality in health care: a survey of knowledge, perceptions, and attitudes among high school students. J Am Med Assoc 1993;269:1404–7.10.1001/jama.1993.03500110072038Search in Google Scholar
14. Kapphahn CJ, Wilson KM, Klein JD. Adolescent girls’ and boys’ preferences for provider gender and confidentiality in their health care. J Adolesc Health 1999;25:131–42.10.1016/S1054-139X(99)00050-6Search in Google Scholar
15. Edman JC, Adams SH, Park MJ, Irwin Jr CE. Who gets confidential care? Disparities in a national sample of adolescents. J Adolesc Health 2010;46:393–5.10.1016/j.jadohealth.2009.09.003Search in Google Scholar
16. Svetaz MV, Landrieu MJ, Allen ML, Shlafer RJ. Aqui Para TI [Here for You]: a decade supporting Latino families and bridging the science of health equity and positive youth development. J Adolesc Health 2013;52(Supplement 1):S98.10.1016/j.jadohealth.2012.10.231Search in Google Scholar
17. Elster AB, Kuznets NJ. Guidelines for adolescent preventive services. Baltimore, MD: American Medical Association, 1994.Search in Google Scholar
18. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988;8:77–100.10.1016/0272-7358(88)90050-5Search in Google Scholar
19. Resnick MD. Protective factors, resiliency, and healthy youth development. Adolesc Med State Art Rev 2000;11:157–64.Search in Google Scholar
20. Chase R, Clement D. West Side community health assessment. Saint Paul, MN: Research Center, 2000:44.Search in Google Scholar
21. Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood) 2008;27:759–69.10.1377/hlthaff.27.3.759Search in Google Scholar
22. Clark VLP, Creswell JW. Designing and conducting mixed methods research. Thousand Oakes, CA: Sage, 2011:488.Search in Google Scholar
23. Rea LM, Parker RA. Designing and conducting survey research: a comprehensive guide, 3rd ed. San Francisco, CA: John Wiley & Sons, 2005:304.Search in Google Scholar
24. Weber RP. Basic content analysis. Thousand Oakes, CA: Sage, 1990:96.10.4135/9781412983488Search in Google Scholar
25. Alford S. Best Practices for youth-friendly clinical services. Available at: http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=1347&Itemid=177.Search in Google Scholar
26. Tebb K, Hernandez LK, Shafer MA, Chang F, Eyre SL, et al. Understanding the Attitudes of Latino Parents Toward Confidential Health Services for Teens. J Adolesc Health 2012;50:572–7.10.1016/j.jadohealth.2011.10.008Search in Google Scholar
27. Silow-Carroll S, Alteras T, Stepnick L. Patient-centered Care for Underserved Populations: Definition and Best Practices (pp. 1–43). Washington, DC: Economic and Social Research Institute, 2006:43.Search in Google Scholar
28. Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong 2nd O. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep 2003;118:293–302.10.1016/S0033-3549(04)50253-4Search in Google Scholar
29. Derose KP, Bahney BW, Lurie N, Escarce JJ. Immigrants and health care access, quality, and cost. Med Care Res Rev 2009;66:355–408.10.1177/1077558708330425Search in Google Scholar PubMed
30. Leduc N, Proulx M. Patterns of health services utilization by recent immigrants. J Immigr Health 2004;6:15–27.10.1023/B:JOIH.0000014639.49245.ccSearch in Google Scholar
31. Byczkowski TL, Kollar LM, Britto MT. Family experiences with outpatient care: Do adolescents and parents have the same perceptions? J Adolesc Health 2010;47:92–8.10.1016/j.jadohealth.2009.12.005Search in Google Scholar PubMed
32. Finkelstein MA. Volunteer satisfaction and volunteer action: A functional approach. Soc Behav Pers 2008;36:9–18.10.2224/sbp.2008.36.1.9Search in Google Scholar
33. Kvale S. Doing interviews. Thousand Oakes, CA: Sage, 2008:160.10.4135/9781849208963Search in Google Scholar
34. Huddy L, Billig J, Bracciodieta J, Hoeffler L, Moynihan PJ, et al. The effect of interviewer gender on the survey response. Political Behav 1997;19:197–220.10.1023/A:1024882714254Search in Google Scholar
©2016 by De Gruyter
