Saving a seat at the table for community members: co-creating an attachment-based intervention for low-income Latinx parent-youth dyads using a promotor/a model

Published: February 4, 2022
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Evidence for the effectiveness of attachment-based interventions in improving youth’s socioemotional health increases each year, yet potential for scalability of existing programs is limited. Available programs may have lower acceptability within low-income immigrant communities. Co-designing and implementing interventions with trained community workers (Promotors) offers an appealing solution to multiple challenges, but community workers must have high investment in the program for this to be a workable solution. This study examines the experiences of promotors involved in the co-creation and delivery of an attachmentbased intervention program for low-income Latinx youth (ages 8 to 17) and their mothers. Promotors (N=8) completed surveys, reporting on the experiences of each therapy group in terms of group dynamic (e.g., promotors’ connectedness to each group, perceived program relevance). Following the completion of the intervention study, promotors participated in interviews in which they described their experiences in co-creating the intervention, delivering the intervention to the community, and their recommendations for improving the intervention. Overall, promotors perceived group dynamics as positive, though the mother groups were evaluated as significantly higher in quality (e.g., lower conflict) than the youth groups. Interviews revealed that promotors enjoyed the cocreation process and identified important areas for improvements for the intervention (incorporation of more visuals, creation of agelimited groups, reducing number of youth sessions) and evaluation (reduction in length, modification of language). Integrating input from promotors in the process of co-creating and implementing an intervention can benefit every member of the community from the program participants to the providers themselves.

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Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A Psychological study of the strange situation. Lawrence Erlbaum. DOI: https://doi.org/10.1037/t28248-000
Alhusen, J. L., Hayat, M. J., & Gross, D. (2013). A longitudinal study of maternal attachment and infant developmental outcomes. Archives of Women’s Mental Health, 16, 521-529. doi:10.1007/s00737-013-0357-8. DOI: https://doi.org/10.1007/s00737-013-0357-8
Arredondo, E. M., Dumbauld, J., Milla, M., Madanat, H., Coronado, G. D., Haughton, J., Garcia-Bigley, F., Ramers, C., Nodora, J., Bharti, B., Lopez, G., Diaz, M., Marquez, J., & Gupta, S. (2021). A promotor-led pilot study to increase colorectal cancer screening in Latinos: The Juntos Contra el Cáncer program. Health Promotion Practice, 22(4), 491-501. DOI: https://doi.org/10.1177/1524839920912240
Ayón, C. (2020). State-level immigration policy context and health: How are Latinx immigrant parents faring? Social Work Research, 44(2), 110-122. DOI: https://doi.org/10.1093/swr/svaa003
Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129(2), 195-215. DOI: https://doi.org/10.1037/0033-2909.129.2.195
Barnett, M. L., Gonzalez, A., Miranda, J., Chavira, D. A., & Lau, A. S. (2018). Mobilizing community health workers to address mental health disparities for underserved populations: A systematic review. Administration and Policy in Mental Health, 45(2), 195-211. doi:10.1007/s10488-017-0815-0. DOI: https://doi.org/10.1007/s10488-017-0815-0
Barnett, M., Miranda, J., Kia-Keating, M., Saldana, L., Landsverk, J., & Lau, A. S. (2019). Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol. BMJ Open, 9(7), e028988. doi:10.1136/bmjopen-2019-028988. DOI: https://doi.org/10.1136/bmjopen-2019-028988
Beijersbergen, M. D., Juffer, F., Bakermans-Kranenburg, M., & van IJzendoorn, M. H. (2012). Remaining or becoming secure: Parental sensitive support predicts attachment continuity from infancy to adolescence in a longitudinal adoption study. Developmental Psychology, 48(5), 1277-1282. doi:10.1037/a0027442. DOI: https://doi.org/10.1037/a0027442
Borelli, J. L., Cervantes, B. R, Hecht, H. K., Marquez, C., DePrado, R., Torres, G., Robles, A., Chirinos, N., Leal, F., Montiel, G. I., Pedroza, M., & Guerra, N. (2021). Barreras y soluciones: Lessons learned from integrating research-based clinical techniques into a community agency serving low-income Latinx immigrant families. Family Process. [In press]. DOI: https://doi.org/10.1111/famp.12712
Borelli, J. L., Yates, T. M., Hecht, H. K., Cervantes, B. R., Russo, L. N., Arreola, J., Leal, F., Torres, G., & Guerra, N. (2021). Confía en mí, confío en ti: Applying developmental theory to mitigate sociocultural risk in Latinx families. Development and Psychopathology, 33(2), 581-597. doi:10.1017/S0954579420001364. DOI: https://doi.org/10.1017/S0954579420001364
Bowlby, J. (1973). Attachment and loss, Vol. 2: Separation. New York: Basic Books.
Bracho, A., Lee, G., Giraldo, G. P., & De Prado, R. M. (2016). Recruiting from the heart, training the brain: The work of Latino Health Access. Hesperian Foundation.
Braun, V., & Clarke, V. (2012). Thematic analysis. In H. Cooper, P. M. Camic, D. L. Long, A. T. Panter, Bruckner, T. A., Scheffler, R. M., Shen, G., Yoon, J., Chisholm, D., Morris, J., Fulton, B. D., Dal Poz, M. R., & Saxena, S. (2011). The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bulletin of the World Health Organization, 89(3), 184-194. doi:10.2471/BLT.10.082784. DOI: https://doi.org/10.2471/BLT.10.082784
Campos, B., & Kim, H. S. (2017). Incorporating the cultural diversity of family and close relationships into the study of health. American Psychologist, 72, 543-554. doi:10.1037/amp0000122. DOI: https://doi.org/10.1037/amp0000122
Campos, B., Ullman, J. B., Aguilera, A., & Dunkel Schetter, C. (2014). Familism and psychological health: The intervening role of closeness and social support. Cultural Diversity and Ethnic Minority Psychology, 20(2), 191-201. doi:10.1037/a0034094. DOI: https://doi.org/10.1037/a0034094
Cardoso, J. B., Brabeck, K., Capps, R., Chen, T., Giraldo-Santiago, N., Huertas, A., & Mayorga, N. A. (2021). Immigration enforcement fear and anxiety in Latinx high school students: The indirect effect of perceived discrimination. Journal of Adolescent Health, 68(5), 961-968. doi:10.1016/j.jadohealth.2020.08.019. DOI: https://doi.org/10.1016/j.jadohealth.2020.08.019
Campbell, J. L., Quincy, C., Osserman, J., & Pedersen, O. (2013). Coding in-depth semistructured interviews: Problems of unitization and intercoder reliability and agreement. Sociological Methods and Research, 42, 294-320. doi:10.1177/0049124113500475. DOI: https://doi.org/10.1177/0049124113500475
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development & Psychopathology, 18(3), 623-649. doi:10.1017/s0954579406060329. DOI: https://doi.org/10.1017/S0954579406060329
Dagnino, P., Perez, C., Gomez, A., Gloger, S., & Krause, M. (2017). Depression and attachment: How do personality styles and social support influence this relation? Research in Psychotherapy: Psychopathology, Process and Outcome, 20, 53-62. DOI: https://doi.org/10.4081/ripppo.2017.237
Del Villano, N., Cecere, C., Sapuppo, W., Sannino, A., Perrella, R., Bisogno, S., & Caviglia, G. (2014). Working memory abilities, attachment relationships an learning process in children of primary school age: An empirical research. Research in Psychotherapy: Psychopathology, Process and Outcome, 17(1), 21-32. doi:10.4081/ripppo.2014.134. DOI: https://doi.org/10.4081/ripppo.2014.134
D’Onofrio, E., Pace, C. S., & Cavanna, D. (2015). Qualitative research in adolescent psychotherapy: attachment and reflective functioning as psychotherapy outcomes of an adolescent with anorexia nervosa. Research in Psychotherapy: Psychopathology, Process and Outcome, 18(2), 93-101. doi:10.4081/ripppo.2015.181. DOI: https://doi.org/10.4081/ripppo.2015.181
Diamond, G. S., Wintersteen, M. B., Brown, G. K., Diamond, G. M., Gallop, R., Shelef, K., & Levy, S. (2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 49(2), 122-131. doi:10.1016/j.jaac.2009.11.002. DOI: https://doi.org/10.1016/j.jaac.2009.11.002
Dozier, M., & Kristin, B. (2017). Attachment and biobehavioral catch-up: Addressing the needs of infants and toddlers exposed to inadequate or problematic caregiving. Current Opinion in Psychology, 15(3), 111-117. doi:10.1016/j.copsyc.2017.03.003. DOI: https://doi.org/10.1016/j.copsyc.2017.03.003
Elder, J. P., Ayala, G. X., Parra-Medina, D., & Talavera, G. A. (2009). Health communication in the Latino community: issues and approaches. Annual Review of Public Health, 30, 227-251. doi:10.1146/annurev.publhealth.031308.100300. DOI: https://doi.org/10.1146/annurev.publhealth.031308.100300
Falbe, J., Friedman, L. E., Sokal-Gutierrez, K., Thompson, H. R., Tantoco, N. K., & Madsen, K. A. (2017). ‘She gave me the confidence to open up’: Bridging communication by promotoras in a childhood obesity intervention for Latino families. Health Education & Behavior, 44(5), 728-737. doi:10.1177/1090198117727323. DOI: https://doi.org/10.1177/1090198117727323
Ford, J. D., Fallot, R. D., & Harris, M. (2009). Group therapy. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 415-440). The Guilford Press.
Hahn, H., Oransky, M., Epstein, C., Smith Stover, C., & Marans, S. (2015). Findings of an early intervention to address children’s traumatic stress implemented in the child advocacy center setting following sexual abuse. Journal of Child & Adolescent Trauma, 9(1), 55-66. doi:10.1007/s40653-015-0059-7. DOI: https://doi.org/10.1007/s40653-015-0059-7
Held, M. L., Nulu, S., Faulkner, M., & Gerlach, B. (2020). Climate of fear: Provider perceptions of Latinx immigrant service utilization. Journal of Racial and Ethnic Health DisParities, 1-12. doi:10.1007/s40615-020-00714-w. DOI: https://doi.org/10.1007/s40615-020-00714-w
Hoeft, K. S., Rios, S. M., Guzman, E. P., & Barker, J. C. (2015). Using community participation to assess acceptability of ‘Contra Caries’, a theory-based, promotora-led oral health education program for rural Latino parents: a mixed methods study. BMC Oral Health, 15(1), 1-11. DOI: https://doi.org/10.1186/s12903-015-0089-4
Infante, A., Knudson, A., & Brown, A. (2011). Promising practices for rural community health worker programs. Walsh Center for Rural Health Analysis. Available from: https://www.norc.org/PDFs/Walsh%20Center/Rural%20Evaluation%20Briefs/Rural%20Evaluation%20Brief_March2011_Yseries_1.pdf
Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173-202. doi:10.1146/annurev.publhealth.19.1.173. DOI: https://doi.org/10.1146/annurev.publhealth.19.1.173
Kakuma, R., Minas, H., van Ginneken, N., Dal Poz, M. R., Desiraju, K., Morris, J. E., Saxena, S., & Scheffler, R. M. (2011). Human resources for mental health care: current situation and strategies for action. Lancet, 378(9803), 1654-1663. doi:10.1016/S0140-6736(11)61093-3. DOI: https://doi.org/10.1016/S0140-6736(11)61093-3
Kataoka, S., Novins, D. K., & DeCarlo Santiago, C. (2010). The practice of evidence-based treatments in ethnic minority youth. Child and Adolescent Psychiatric Clinics of North America, 19(4), 775-789. doi:10.1016/j.chc.2010.07.008. DOI: https://doi.org/10.1016/j.chc.2010.07.008
Kerns, K. A., & Brumariu, L. E. (2014). Is insecure parent–child attachment a risk factor for the development of anxiety in childhood or adolescence? Child Development Perspectives, 8(1), 12-17. doi:10.1111/cdep.12054. DOI: https://doi.org/10.1111/cdep.12054
Kerns, K. A., Mathews, B. L., Koehn, A. J., Williams, C. T., & Siener-Cieslam S. (2015). Assessing both safe haven and secure base support in parent-child relationships. Attachment and Human Development, 17(4), 337-353. doi:10.1080/14616734.2015.1042487. DOI: https://doi.org/10.1080/14616734.2015.1042487
Kia-Keating, M., Santacrose, D. E., Liu, S. R., & Adams, J. (2017). Using community-based participatory research and human-centered design to address violence-related health disparities among Latino/a youth. Family & Community Health, 40(2), 160-169. doi:10.1097/FCH.0000000000000145. DOI: https://doi.org/10.1097/FCH.0000000000000145
LeBreeton, J. M. & Senter, J. L. (2007). Answers to 20 questions about interrater reliability and interrater agreement. Organizational Research Methods, 11(4), 815-852. doi:10.1177/1094428106296642. DOI: https://doi.org/10.1177/1094428106296642
Lee, J., Hong, J., Zhou, Y., & Robles, G. (2020). The Relationships between loneliness, social support, and resilience among Latinx immigrants in the United States. Clinical Social Work Journal, 48(1), 99-109. doi:10.1007/s10615-019-00728-w. DOI: https://doi.org/10.1007/s10615-019-00728-w
Liu, S. R., Kia-Keating, M., & Nylund-Gibson, K. (2018). Patterns of adversity and pathways to health among White, Black, and Latinx youth. Child Abuse & Neglect, 86, 89-99. doi:10.1016/j.chiabu.2018.09.007. DOI: https://doi.org/10.1016/j.chiabu.2018.09.007
Martin, M. Y. (2005). Community health advisors effectively promote cancer screening. Ethnicity & Disease, 15, S14-S16.
Messias, D. K., Parra-Medina, D., Sharpe, P. A., Treviño, L., Koskan, A. M., & Morales-Campos, D. (2013). Promotoras de Salud: roles, responsibilities, and contributions in a multisite community-based randomized controlled trial. Hispanic Health Care International: The Official Journal of the National Association of Hispanic Nurses, 11(2), 62-71. doi:10.1891/1540-4153.11.2.62. DOI: https://doi.org/10.1891/1540-4153.11.2.62
Moretti, M. M., Obsuth, I., Craig, S. G., & Bartoo, T. (2015). An attachment-based intervention for parents of adolescents at risk: Mechanisms of change. Attachment & Human Development, 17(2), 119-135. doi:10.1080/14616734.2015.1006383. DOI: https://doi.org/10.1080/14616734.2015.1006383
Pace, C. S., D’Onofrio, E., Guerriero, V., & Zavattini, G. C. (2016). A proposal for a brief-term post-adoption intervention in the attachment-perspective: A single case study with a late-adopted child and his adoptive mother. Research in Psychotherapy: Psychopathology, Process and Outcome, 19(1), 31-40. doi:10.4081/ripppo.2016.197. DOI: https://doi.org/10.4081/ripppo.2016.197
Rastogi, M., Massey-Hastings, N., & Wieling, E. (2012). Barriers to seeking mental health services in the latino/a community: A qualitative analysis. Journal of Systemic Therapies, 31(4), 1-17. doi:10.1521/jsyt.2012.31.4.1. DOI: https://doi.org/10.1521/jsyt.2012.31.4.1
Rhodes, S. D., Foley, K. L., Zometa, C. S., & Bloom, F. R. (2007). Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review. American journal of Preventive Medicine, 33(5), 418-427. doi:10.1016/j.amepre.2007.07.023. DOI: https://doi.org/10.1016/j.amepre.2007.07.023
Rindskopf, D., & Sher, K. J. (Eds.), APA handbook of research methods in Psychology, Vol. 2. Research designs: Quantitative, qualitative, neuropsychological, and biological (pp. 57-71). American Psychological Association, doi:10.1037/13620-004. DOI: https://doi.org/10.1037/13620-004
Roelofs, J., Meestersm, C., ter Huurne, M., Bamelis, L., & Muris, P. (2006). On the links between attachment style, parental rearing behaviours, and internalizing and externalizing problems in non-clinical children. Journal of Child and Family Studies, 15(3), 331-344. doi:10.1007/s10826-006-9025-1. DOI: https://doi.org/10.1007/s10826-006-9025-1
Ryan, R., O’Farrelly, C., & Ramchandani, P. (2017). Parenting and child mental health. London Journal Of Primary Care, 9(6), 86-94. doi:10.1080/17571472.2017.1361630. DOI: https://doi.org/10.1080/17571472.2017.1361630
Shepherd-Banigan, M., Hohl, S. D., Vaughan, C., Ibarra, G., Carosso, E., & Thompson, B. (2014). ‘The promotora explained everything’: Participant experiences during a household-level diabetes education program. The Science of Diabetes Self-Management and Care, 40(4), 507-515. doi:10.1177/0145721714531338. DOI: https://doi.org/10.1177/0145721714531338
Singla, D. R., Kohrt, B. A., Murray, L. K., Anand, A., Chorpita, B. F., & Patel, V. (2017). Psychological treatments for the world: Lessons from low- and middle-income Countries. Annual Review of Clinical Psychology, 13, 149-181. doi:10.1146/annurev-clinpsy-032816-045217. DOI: https://doi.org/10.1146/annurev-clinpsy-032816-045217
Steele, M., Steele, H., Bate, J., Knafo, H., Kinsey, M., Bonuck, K., Meisner, P., & Murphy, A. (2014). Looking from the outside in: the use of video in attachment-based interventions. Attachment & Human Development, 16(4), 402-415. doi:10.1080/14616734.2014.912491. DOI: https://doi.org/10.1080/14616734.2014.912491
Sternberg, R. M., Nápoles, A. M., Gregorich, S., & Stewart, A. L. (2019). Mentes positivas en acción: Feasibility study of a promotor-delivered cognitive behavioral stress management program for low-income Spanish-speaking Latinas. Health Equity, 3(1), 155-161. doi:10.1089/heq.2019.0012. DOI: https://doi.org/10.1089/heq.2019.0012
Tran, A. N., Ornelas, I. J., Perez, G., Green, M. A., Lyn, M., & Corbie-Smith, G. (2014). Evaluation of Amigas Latinas Motivando el Alma (ALMA): a pilot promotora intervention focused on stress and coping among immigrant Latinas. Journal of Immigrant and Minority Health, 16(2), 280-289. doi:10.1007/s10903-012-9735-y. DOI: https://doi.org/10.1007/s10903-012-9735-y
Thomas, R., Abell, B., Webb, H. J., Avdagic, E., & Zimmer-Gembeck, M. J. (2017). Parent-child interaction therapy: A meta-analysis. Pediatrics, 140(3), e20170352. doi:10.1542/peds.2017-0352. DOI: https://doi.org/10.1542/peds.2017-0352
Thomas, R., & Zimmer-Gembeck, M. J. (2007). Behavioral outcomes of parent-child interaction therapy and triple p-positive parenting program: A review and meta-analysis. Journal of Abnormal Child Psychology, 35(3), 475-495. doi:10.1007/s10802-007-9104-9. DOI: https://doi.org/10.1007/s10802-007-9104-9
Villarruel, A. M., Jemmott, L. S., Jemmott, J. B., & Eakin, B. L. (2006). Recruitment and retention of Latino adolescents to a research study: lessons learned from a randomized clinical trial. Journal for Specialists in Pediatric Nursing, 11(4). 244-250. doi:10.1111/j.1744-6155.2006.00076.x. DOI: https://doi.org/10.1111/j.1744-6155.2006.00076.x
Waitzkin, H., Getrich, C., Heying, S., Rodríguez, L., Parmar, A., Willging, C., Yager, J., & Santos, R. (2011). Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression. Journal of Community Health, 36(2), 316-331. doi:10.1007/s10900-010-9313-y. DOI: https://doi.org/10.1007/s10900-010-9313-y
Francisca Leal, Latino Health Access

Francisca Leal is an administrator at Latino Health Access.

How to Cite

Borelli, J. L., Russo, L. N., Arreola, J., Cervantes, B. R., Marquez, C. M., Montiel, G., Avalos, V., Carballo, J., Garcia, J., Bhatt, I., Torres, G., Leal, F., & Guerra, N. (2022). Saving a seat at the table for community members: co-creating an attachment-based intervention for low-income Latinx parent-youth dyads using a promotor/a model. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1). https://doi.org/10.4081/ripppo.2022.598