Mentoring Youth at High Risk: The Perspectives of Professional Mentors

Background

Youth mentoring programs rely largely on volunteers, but youth facing significant risks may be poor candidates for volunteer-based interventions. Full-time “professional” mentors in highly structured programs may be better suited to partner effectively with such youth and their families, but few studies examine professional mentoring interventions. Because of mentoring’s inherent flexibility, mentors’ role conceptualizations can profoundly influence the nature of their work. Serving as a professional mentor may have important implications for how mentors conceptualize and perform their role.

Objective

This qualitative study examined the role conceptions of professional mentors serving at-risk youth.

Methods

Semi-structured interviews with mentors were transcribed, coded, and subjected to thematic analysis.

Results

Mentors described the importance of “professionalism” in prioritizing mentoring, expending considerable effort, and performing difficult or unpleasant tasks. They reported that serving multiple children full-time enabled them to rapidly build expertise, that credibility and authority granted them because of their professional status facilitated their work across multiple key contexts, and that their expertise and long-term commitment facilitated the development of deep relationships. Mentors perceived their role as highly challenging but reported high self-efficacy. They described high multifaceted organizational support, a community for youth, and an individualized child focus.

Conclusions

A mentoring model delivered by experienced professional mentors may hold promise for working with youth at high risk. The role conceptualizations of mentors and the organizational culture within which mentors work may be important in helping youth succeed.     

Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap

Dissemination and implementation science (DI) has evolved as a major research model for children's mental health in response to a long-standing call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an overemphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children's healthy development and for utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation's mental health burden by supporting the needs and values of families and communities within their own unique social ecologies.     

Bisphenol A (BPA) daily intakes in the United States: estimates from the 2003-2004 NHANES urinary BPA data

Investigations into human exposure to bisphenol A (BPA) have, for the most part, assessed intake based on food consumption estimates combined with measurements or estimates of BPA in foods. In this study, nationally representative data on urinary levels of BPA in the United States (US) from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) were used to estimate daily intake of BPA, assuming steady-state excretion. Distributions of intakes for the US population were determined for (i) all NHANES participants with urinary BPA data; (ii) participants by the following age groups: 6-11 years, 12-19 years, 20-39 years, 40-59 years, and 60+ years; and (iii) participants by gender. On the basis of the NHANES urinary BPA data and the assumptions described in this paper, daily BPA intakes for male participants are statistically significantly higher than for female participants, and there are statistically significant differences in daily BPA intakes according to age groups, with the oldest group having the lowest estimated intakes. Median intake was approximately three orders of magnitude below health-based guidance values of 50 microg/kg-day.     

Derivation of biomonitoring equivalent (BE) values for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds: a screening tool for interpretation of biomonitoring data in a risk assessment context

Recent efforts by the U.S. Centers for Disease Control and Prevention and other researchers have resulted in a growing database of measured concentrations of dioxins and related compounds in blood samples taken from the general population. However, few tools exist to assist in the interpretation of the measured values in a health risk context. Biomonitoring equivalent (BE) values are defined as the concentration or range of concentrations of a chemical or its metabolite in a biological medium (blood, urine, or other medium) that is consistent with an existing health-based exposure guideline, and are derived by integrating available data on pharmacokinetics with existing chemical risk assessments This study reviews available health based exposure guidance values for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds from a variety of agencies including the World Health Organization Joint Expert Committee on Food Additives (JECFA), the European Commission Scientific Committee on Foods (ECSCF), the United Kingdom Committee on Toxicology (UKCOT), and the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) to estimate corresponding BE values for dioxin-like compounds in blood on a serum lipid-adjusted basis. Based on data from the animal studies underlying the exposure guidance values, a serum lipid-adjusted dioxin toxicity equivalent (TEQ) concentration of approximately 15 ppt is consistent with the ATSDR minimal risk level (MRL) for dioxins. Serum lipid-adjusted TEQ concentrations of approximately 31 to 74 ppt are consistent with the tolerable intakes estimated by the other three agencies. These values may be used as screening tools for evaluation of biomonitoring data for dioxins in the context of existing risk assessments and for prioritization of the potential need for additional risk assessment efforts for dioxins.     

A qualitative study to explore paraprofessionals’ role in school‐based prevention and early intervention mental health services

This study explored the role of paraprofessionals within a school‐based prevention and early intervention program to promote children's engagement in learning and positive parenting practices. Study aims were designed to understand how paraprofessionals perceive their role in high‐need communities and how they define their work within schools. Two focus groups were conducted with school family liaisons (SFLs) during the 2015–2016 school year. Transcribed audio recordings were coded using thematic analysis wherein 2 authors coded independently, followed by audited discussion and final consensus codes. SFLs acknowledged the importance of serving high‐need communities and relationship building was central to their role. They leveraged contextual knowledge (culture, language, and neighborhood) to engage parents, allowing them to serve as effective advocates for parents/families in the school setting. Findings support the importance of paraprofessionals in prevention‐focused services and highlight how leveraging shared experiences and prioritizing relationship building facilitates their work as advocates within schools.     

Estimates of exposures to perchlorate from consumption of human milk, dairy milk, and water, and comparison to current reference dose

To develop an enforceable drinking water standard from a health-based reference dose, sources of exposure and relevant exposure factors across the U.S. population must be considered. Human exposures, expressed as an estimated daily exposure, can be used to evaluate the health protectiveness of a range of potential regulatory values, thus providing a scientific foundation on which decisions can be based. Recent evidence points to detectable levels of perchlorate in milk and other foods. The purpose of this article is to estimate human exposure to perchlorate from ingestion of drinking water, human milk, and dairy milk. Drinking-water exposure was based on a range of possible regulatory values, derived from the recently established reference dose. Exposure to perchlorate from the consumption of milk was based on exploratory Food and Drug Administration dairy milk data, and on additional published perchlorate concentrations in dairy and human milk samples. This effort is exploratory in nature due to the limited data available at this time. However, it is anticipated that these exposure estimates and comparison with the current reference dose will stimulate dialogue and research that will advance the risk assessment for perchlorate.     

Comparing United States and Canadian population exposures from National Biomonitoring Surveys: bisphenol A intake as a case study

The Centers for Disease Control and Prevention provides biomonitoring data in the United States as part of the National Health and Nutrition Examination Survey (NHANES). Recently, Statistics Canada initiated a similar survey - the Canadian Health Measures Survey (CHMS). Comparison of US and Canadian biomonitoring data can generate hypotheses regarding human exposures from environmental media and consumer products. To ensure that such comparisons are scientifically meaningful, it is essential to first evaluate aspects of the surveys' methods that can impact comparability of data. We examined CHMS and NHANES methodologies, using bisphenol A (BPA) as a case study, to evaluate whether survey differences exist that would hinder our ability to compare chemical concentrations between countries. We explored methods associated with participant selection, urine sampling, and analytical methods. BPA intakes were also estimated to address body weight differences between countries. Differences in survey methods were identified but are unlikely to have substantial impacts on inter-survey comparisons of BPA intakes. BPA intakes for both countries are below health-based guidance values set by the US, Canada and the European Food Safety Authority. We recommend that before comparing biomonitoring data between surveys, a thorough review of methodologic aspects that might impact biomonitoring results be conducted.