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Immigrant Parents’ Perceptions of SchoolEnvironment and Children’s Mental Healthand BehaviorHAYLEY A. HAMILTON, PhDa LYSANDRA MARSHALL, MAb JOANNA A. RUMMENS, PhDc HAILE FENTA, PhDd LAURA SIMICH, PhDe

ABSTRACTBACKGROUND: Research has increasingly identified the perception of school environment as an influential factor inchildren’s lives. There has been sparse research attention, however, on the potential importance of parents’ perceptions ofschool environment on child adjustment. This study examined the relationship between parents’ perceptions of schoolenvironment and children’s emotional and behavioral problems.

METHODS: Data were derived from the New Canadian Children and Youth Study, a study of the children (aged 4-6 and 11-13)of immigrant parents. Analyses focused on a subsample of Mainland Chinese, Hong Kong Chinese, and Filipino immigrants in alarge metropolitan area.

RESULTS: Parental perception of school environment was negatively associated with physical aggression in children even aftercontrolling for child age and gender, parental characteristics, family functioning, and aspects of acculturation. In contrast,parental perception was not significantly related to symptoms of emotional distress in children. There were some ethnicdifferences in perception of school environment.

CONCLUSIONS: Parental perception of school environment is important to the well-being of the children of immigrantparents, and reinforces the relevance of initiatives to improve the dynamics between parents and schools.

Keywords: school environment; immigrants; mental health; behavior problems; parents.

Citation: Hamilton HA, Marshall L, Rummens JA, Fenta H, Simich L. Immigrant parents’ perceptions of school environmentand children’s mental health and behavior. J Sch Health. 2011; 81: 313-319.

Received on February 17, 2010Accepted on July 19, 2010

Much research on school environment has focusedon children’s perceptions of school environment,

with particular emphasis on its relationship withacademic outcomes1-3 and child adjustment.1,4-7

There has been sparse research attention to thepotential importance of parents’ perceptions ofschool environment on child adjustment. Broaderresearch indicating a relationship between caring andhealthy school environments and mental health,8,9

aAssistant Professor, University of Toronto, and Research Scientist, ([email protected]), Centre for Addiction & Mental Health, 455 Spadina Ave., Street 300, Toronto, ONM5S 2G8, Canada.bSenior Lecturer, ([email protected]), Departmant of Sociology & Criminology, University of the West of England Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY,UK.cAssistant Professor, University of Toronto, and Research Scientist, ([email protected]), Community Health Systems Resource Group, The Hospital for Sick Children, 555University Ave., Toronto, ON M5G 1X8, Canada.dAssistant Professor, University of Toronto, and ([email protected]), Research Development Consultant, Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ONM4T 1X3, Canada.eAssistant Professor, University of Toronto, and Affiliate Scientist, ([email protected]), Centre for Addiction & Mental Health, 455 Spadina Ave., Street 300, Toronto, ON M5S2G8, Canada.

Address correspondence to: Hayley A. Hamilton, Assistant Professor, University of Toronto, and Research Scientist, ([email protected]), Centre for Addiction & MentalHealth, 455 Spadina Ave., Street 300, Toronto, ON M5S 2G8, Canada.

however, suggests that negative parental perceptionof schools may impair children’s mental health. Thereis also research linking parental involvement in theirchildren’s schools and positive parental perceptionsof the school environment.10-14 Parental involvementhas been found to be positively associated with mentalhealth.15

Parental perception of school environment may beof particular importance to immigrants because schools

Journal of School Health • June 2011, Vol. 81, No. 6 • © 2011, American School Health Association • 313

are such an important aspect of family adaptation.Many family-school challenges have the potential tobe enhanced among immigrants because of factorsrelated to acculturation. Research suggests that eth-nic minority parents and immigrant parents are lessinvolved in schools.10,16 Among parents in general,negative perceptions of their children’s school mayoriginate from several factors, including a feeling thatthey are not welcome in the school and that involve-ment in school activities would be unappreciated.17

For immigrant parents, such negative perceptions maynot only be enhanced, but may also be an additionalsource of stress because of concerns about their chil-dren’s adaptation and their unfamiliarity with thenorms of an educational system that is new to them.For example, Carreon’s18 study of immigrant par-ents’ interactions with their children’s schools foundfeelings of exclusion from activities within schools,a sense that immigrant parents’ contributions werenot valued, and communication difficulties with officestaff.

Several factors related to acculturation may con-tribute to immigrant parents’ perceptions of their chil-dren’s school environment. Language, for example,may impact the level of parent-school contact and thequality of parent-teacher relationships. The length oftime since immigration may be important as recentimmigrants may have more difficulty adapting to newschool cultures and practices especially when normsgoverning parent-teacher relationships and expecta-tions of students are very different from those in theircountry of origin. A case in point is Wang’s19 observa-tion that in China, parents are focused and assertive inthe creation of opportunities to interact with teachersand schools, whereas immigrant Chinese parents inthe United States are relatively passive with regard tocontacts with schools and school personnel. Anotherfactor that may contribute to immigrant parents’ per-ceptions of school environment is the extent to whichparents are informed about school requirements andevents, the overall progress of students, and schoolpractices that signify respect for questions and sug-gestions from parents.20 In addition, parents may havedifferent ideas of what constitutes positive school envi-ronment, which might not match those of school per-sonnel. Immigrant parents’ ideas may originate in theirhome country thus influencing their perceptions ofthe school. Teachers who are unaware of the potentialinfluence of cultural dynamics on parental involve-ment may regard immigrant parents as ‘‘apathetic’’with regard to their children’s education.21 Such neg-ative beliefs by teachers could contribute to furtherdistancing by immigrant parents.22 Immigrant parents’perceptions of school environment may also reflectperceptions of the larger society and be a window intothe level of acculturative stress being experienced withrespect to schools, family, and other factors.

The objective of this study is to examine the rela-tionship between immigrant parents’ perceptions ofschool environment and child emotional and behav-ioral problems. In doing so, we aim to expand theresearch literature on perception of school envi-ronment by focusing on parents’—rather than chil-dren’s—perceptions. A focus on child emotional andbehavioral problems in immigrant families, whichhave been understudied with respect to school envi-ronment, will also add to the existing literature. Giventhe nature of this study, we also incorporate charac-teristics of the families that may affect child health,such as family functioning23-25 and level of emotionaldistress in parents.26,27 Given our earlier argumentthat factors related to acculturation or adaptation mayinfluence school perception, we also consider selectfactors related to adaptation.

METHODS

SubjectsThis study is based on a subset of data from the

first cycle of the New Canadian Children and YouthStudy (NCCYS), a study of children of immigrants inCanada.28 The survey covered a wide range of immi-gration and settlement experiences related to family,school, work, and peers, as well as health and behav-ior outcomes. Children of the NCCYS were either bornoutside of Canada or into families in which at least oneparent had immigrated to Canada within the 10-yearperiod before entry into this study. Children belongedto 1 of 2 age cohorts at the time of the first survey:4-6 or 11-13 years of age. Interviews were conductedin the respondents’ language of choice with the par-ent designated as the most knowledgeable about thechild (the birth mother in about 85% of cases) andwith children 11-13 years of age. Data on 4-6-year-oldchildren were based entirely on parental report. Thefirst cycle of interviews occurred over a 2-year period(2002-2004).28 This study of parental perception ofschool environment focuses on a subsample of HongKong Chinese, Filipino, and Mainland Chinese in theGreater Toronto Area (n = 533). The inclusion of these3 groups in the larger study was based on analyses ofCitizenship and Immigration Canada’s 1999 data onimmigrant landings. Analyses had indicated that these3 ethnic groups represented the largest group of immi-grants to enter Canada during the 10 years before thisstudy.28 The Greater Toronto Area has the highestproportion of foreign-born residents in Canada.29 Fur-ther details of this study design are available in Beiseret al.28

InstrumentsChild Emotional Distress. This measure was based

on parental responses to 8 questionnaire itemsderived from those used to form an Emotional

314 • Journal of School Health • June 2011, Vol. 81, No. 6 • © 2011, American School Health Association

Disorder/Anxiety Scale within the National Longitu-dinal Survey of Children and Youth (NLSCY)30 andthose used within the Ontario Child Health Study(OCHS).31 The 8 items were seems to be unhappy,sad, or depressed; not as happy as other children; toofearful or nervous; worried; cries a lot; appears mis-erable, unhappy, tearful, or distressed; nervous, high-strung, or tense; and has trouble enjoying him/herself.Responses of (1) never or not true, (2) sometimes orsomewhat true, or (3) often or very true were averagedto form the index. Internal consistency was adequate(Cronbach’s alpha = 0.75).

Child Physical Aggression. This measure was con-structed using parental responses to 6 items derivedfrom the NLSCY,30 with earlier origins in theOCHS31,32 and the Montreal Longitudinal Survey.33

The 6 items were gets into many fights; is angered orfights when accidentally hurt by someone; physicallyattacks people; threatens people; is cruel, bullies, or ismean to others; and kicks, bites, hits other children.Responses of (1) never or not true, (2) sometimes orsomewhat true, or (3) often or very true were aver-aged to form the measure. Internal consistency wasadequate (Cronbach’s alpha = 0.75).

Parental Perception of School Environment. Thismeasure was based on 6 items: getting good gradesis very important at this school; most children in thisschool enjoy being there; parents are made to feel wel-come in this school; children are very proud of theirschool; this school offers parents opportunities to beinvolved in school activities; and children are safe inthis school. Principal components factor analysis withvarimax rotation indicated that the 6 items loadedon a single factor. Response choices ranged from 1(strongly disagree) to 5 (strongly agree). Responses wereaveraged across items to form an index where higherscores reflect more positive perceptions of school envi-ronment. The measure had good internal consistency(Cronbach’s alpha = 0.74).

Family Dysfunction. This measure was based on asubscale of 12 items adapted from those developedby researchers at Chedoke-McMaster Hospital31 andfrom those used in the NLSCY.30 The 12 items werefamily willing to compromise when making plans;family members support each other in crises; familymembers cannot share feelings of sadness; all familymembers are accepted regardless of their character;family members express feelings to each other; lots ofbad feelings in family; family members feel acceptedfor what they are; decision-making a family problem;family able to decide on how to solve problems; familymembers do not get along well together; family mem-bers confide in each other; and drinking is a source oftension/disagreement in the family. Response choicesranged from 1 (strongly disagree) to 5 (strongly agree).Item responses were reverse coded as necessary suchthat higher scores indicate greater family dysfunction.

Responses were averaged across items to create adysfunction score. Internal consistency was adequate(Cronbach’s alpha of 0.73).

Parental Depression. Depressive symptoms in par-ents were assessed using a 16-item index measure.The items were developed to assess depressive symp-toms within Laotians, Cambodians, Vietnamese, andChinese, and incorporate both universal or neutral(etic) and culturally oriented (emic) items.34,35 Theparent respondent was asked to indicate the extent towhich he or she experienced the following symptomsover the past week: feeling unhappy; feeling sad; feel-ing discouraged; felt low and hopeless; felt remorseful;had more trouble concentrating than normal; thoughtsseemed mixed-up; loss of appetite; food seems taste-less and hard to swallow; suffered from poor digestion;spells of dizziness; shortness of breath; feeling sickly;feeling tired all the time; feeling weak all over; andhead feeling heavy. Response choices were (1) rarelyor none of the time, (2) some or a little of the time,(3) occasionally or a moderate amount of time, and(4) most or all of the time. Responses were averagedto form the index score. A test of internal consistencyindicated an adequate Cronbach’s alpha of 0.89.

Immigration and Ethnicity Variables. The measureyears since immigration reflects the number of years theparents have lived in Canada. It was constructed bysubtracting the year of survey interview from the yearof immigration. English fluency was based on parents’assessment of their own ability to speak English beforeimmigration. A binary variable was created to repre-sent those who reported speaking English fluently (1)and those who reported being less than fluent (0). Rela-tive living conditions was a 3-category measure reflectingparental response to a question that asked whethertheir living conditions became worse (1), better (2),or stayed about the same (3) after moving from theirprevious country of residence. Ethnicity of parent wasa 3-category measure representing Mainland Chinese,Hong Kong Chinese, and Filipino.

Additional controls were also included in analyses.Sex of child was measured as female (1) or male (0). Ageof child was a 2-category measure with age group 4-6coded as 1 and 11-13 coded as 0. Parental education wasmeasured as parents’ highest level of education beforeimmigration. For purposes of this analysis, educationwas constructed as a binary measure representing lessthan bachelor’s degree (1) and bachelor’s degree orhigher (0). Household income was based on parents’estimate of the total gross income of all householdmembers. Income was constructed as a binary mea-sure representing less than $25,000 (1) and $25,000or greater (0).

Data AnalysisAnalyses were conducted using ordinary least

squares regression within Stata 9.0.36 Analyses


included sample weights that were constructed accord-ing to population estimates (defined by age, ethnicity,and gender) for census subdivisions in which respon-dents lived. Population estimates were derived fromthe 2001 Canadian Census. Analyses were based onlog and square root transformations of emotional dis-tress and physical aggression, respectively, to accountfor skewed distribution. Missing cases represented lessthan 1% for education, English fluency, emotionaldistress, and physical aggression; 1.4% for relative liv-ing conditions; 1.7% for family dysfunction; 4.3% forincome; and 6.2% for school environment. Other vari-ables had complete data. Additional analyses whereinmissing cases were handled through multiple impu-tation within Stata yielded results that were substan-tively similar to the results presented here involvinglistwise deletion.

RESULTS

Descriptives are outlined in Table 1. The sampleconsisted of approximately 48% females and 52%males. Among the children, 59% were of the youngerage cohort (aged 4-6), 39% were in households withlower incomes (less than $25,000), 48% were livingin households reported to be better off than beforeimmigrating, and approximately 22% of children hadparents that spoke English fluently. The parents hadbeen in Canada 4.9 years on average.

The results of multiple regression analyses areprovided in Tables 2 and 3. The first model foreach outcome shows the results of the outcomeregressed on perception of school, with controls forage, sex, income, parental education and depres-sive symptoms, and family dysfunction. The secondmodel reflects additional adjustments for ethnicity

Table 1. Weighted Means and Percentages

Mean/Percent SD

School environment 3.94 0.47Child gender (female) 47.7% —Age 4-6 cohort 58.6% —Income <$25,000 39.0% —Parent education< bachelor’s degree 34.7% —Years since parent arrival in Canada 4.89 3.73Speak English fluently 21.7% —Ethnicity

Hong Kong Chinese 25.6% —Filipino 31.0% —Mainland Chinese 43.5% —

Relative living conditionBetter off than before 48.3% —Worse off than before 18.6% —Same as before 33.1% —

Parental depression 1.56 0.44Family dysfunction 2.11 0.36Emotion score 1.35 0.30Physical aggression 1.19 0.26

Table 2. Emotional Distress Symptoms Regressed on SchoolEnvironment‡

Model 1 Model 2

School environment −.032 (.012)∗∗ −.019 (.013)Child gender (female) −.006 (.011) −.005 (.011)Income <$25,000 −.018 (.011) −.018 (.012)Parent education< bachelor’s degree .027 (.011)∗ .011 (.014)Age 4-6 cohort .004 (.011) .007 (.011)Parental depression .084 (.013)∗∗∗ .085 (.014)∗∗∗Family dysfunction .034 (.016)∗ .029 (.016)†

Ethnicity (reference = mainland Chinese)Hong Kong Chinese — .024 (.019)Filipino — −.027 (.016)†

Years in Canada — −.251E-3 (.002)Speak English fluently — −.004 (.014)Relative living condition (reference = same as before)

Better off — .003 (.012)Worse off — −.005 (.017)

Constant .767 .731Adjusted R2 .132 .139

∗∗∗p < .001; ∗∗p < .01; ∗p < .05; †p < .10; n = 458.‡Unstandardized coefficients with standard errors in brackets.

and acculturation-related factors. Table 2 results forsymptoms of emotional distress indicate a significantrelationship between parental perception of schoolenvironment and reports of symptoms of emotionaldistress in children (model 1). Higher parental per-ception of school was associated with less emotionaldistress in children regardless of family dysfunction,parental depression, and select characteristics of thechild. This significant relationship, however, disap-pears after controlling for ethnicity, years in Canada,English fluency, and relative living conditions inmodel 2. A comparison of standardized coefficients(not provided in table) indicates that although parentaldepression had the strongest influence on emotionaldistress in children, ethnicity had the most influenceon the association between perception of school andemotional distress in children. The influence of eth-nicity indicates that perception of school environmentdiffers across the 3 ethnic groups. School perceptionwas significantly more positive among Filipinos rela-tive to the other 2 groups (t = −9.46, p < .001).

Although Hong Kong Chinese and Filipino werenot significantly different from Mainland Chinese asevident in Table 2, a Wald test indicated a significantdifference in the emotional distress of children of HongKong Chinese and Filipino parents (F[1, 444] = 8.56,p < .01). Children of Filipino parents had fewer symp-toms of emotional distress. The only other variable thatwas significantly related to child emotional distress inthe final model was parental depression, with greatersymptoms of parent depression associated with greatersymptoms of child emotional distress.

Table 3 results for child physical aggression indicatea significant relationship with parental perceptionof school environment (model 1). Higher parental


Table 3. Physical Aggression Regressed on SchoolEnvironment‡

Model 1 Model 2

School environment −.026 (.009)∗∗ −.021 (.009)∗Child gender (female) −.019 (.008)∗ −.018 (.008)∗Income <$25,000 −.010 (.008) −.008 (.009)Parent education< bachelor’s degree .016 (.008)† .001 (.010)Age 4-6 cohort .032 (.008)∗∗∗ .034 (.008)∗∗∗Parental depression .022 (.010)∗ .024 (.010)∗Family dysfunction .019 (.011) .018 (.011)Ethnicity (reference = mainland Chinese)

Hong Kong Chinese — .031 (.014)∗Filipino — .006 (.012)

Years in Canada — −.001 (.001)Speak English fluently — −.011 (.010)Relative living condition (reference = same as before)

Better off — −.002 (.009)Worse off — −.422E-3 (.012)

Constant 1.493 1.472Adjusted R2 .082 .085

∗∗∗p < .001; ∗∗p < .01; ∗p < .05; †p < .10; n = 458.‡Unstandardized coefficients with standard errors in brackets.

perception of school was associated with less physicalaggression in children. Adjusting for ethnicity, years inCanada, English fluency, and relative status in model2 reduced the association between school perceptionand physical aggression as evident by a 17% declinein the coefficient; however, the association remainedsignificant.

When compared with children of Mainland Chineseparents, children of Hong Kong Chinese parents weremore physically aggressive. A Wald test indicatedthat children of Hong Kong parents were also morephysically aggressive than those of Filipino parents(F[1, 444] = 4.02, p < .05). Being male, 4-6 years ofage, and residing with a parent with greater symptomsof depression were characteristics that were alsoassociated with greater physical aggression in children.

DISCUSSION

The importance of schools in the adaptation ofimmigrant families suggests that perception of schoolenvironment may be significantly associated withaspects of child behavior and emotional health. Theobjective of this study was to test this associationwith respect to parental perception of school envi-ronment and child emotional and behavioral prob-lems. The results indicated that parental perceptionof school environment was significantly and nega-tively associated with physical aggression in children.This association of higher school perception amongparents with less physical aggression among childrenremained significant even after controlling for selectcharacteristics of the children (gender and age), par-ents (education, depressive symptoms, and ethnicity),and family (income and level of dysfunction), as well as

factors related to acculturation (length of time in coun-try, language spoken, and relative living conditions).This finding with respect to parental perception is con-sistent with findings from research focused on childperception of school environment and its relationshipwith child behavior.1,4

In contrast to findings for physical aggression,results for emotional problems in children indicatedno significant association with parental perceptionof school environment after controlling for parentalethnicity. This finding is not consistent with studiesthat have shown higher child perception of schoolsto be associated with fewer emotional problems inchildren.5,7 Results for this study with regard toparental perception and child emotional problemswere due to differences between Filipino and otherethnic groups. Filipinos had more positive perceptionsof school environment. This may be due to betterrelationships between parents and schools, differentexpectations among Filipino parents, or differencesin the meaning of items that form the school envi-ronment scale. This suggests some importance toconsidering ethnic origins in investigating immigrantexperiences within schools. This is further reflectedin Hoover-Dempsey and Sandler’s suggestion that par-ents’ perceptions of their roles in the education of theirchildren may be affected by their ethnicity.37

LimitationsAlthough this study makes an important contri-

bution by establishing the importance of parentalperception of school environment, there are severallimitations that should be noted. The analysis wasbased on cross-sectional data and therefore the direc-tion of the relationship could not be determined—ie,whether parental perception influenced child emo-tional health and physical aggression or vice versa.Thus future studies utilizing longitudinal data are nec-essary to determine the direction of the relationshipand test the possible mechanisms through which therelationship occurs. Another limitation is that mea-sures of emotional distress and physical aggressionused in analyses were based on parental reports.Future research that incorporated responses from mul-tiple sources such as teachers and children themselveswould add to knowledge in this area. Future stud-ies should also consider incorporating both child andparental perceptions to compare their influence. Thiswas not feasible in this study because of the inclu-sion of a younger age group of children who didnot fit the criteria for self-reports. The survey alsofocused on 2 age groups of children (4-6 and 11-13)rather than children across an age continuum, thusit is unknown whether the results would apply, forexample, to individuals in middle childhood or ado-lescence. This study also focused on only one aspect of


school environment, but school structure (eg, physicalor organizational) and administrative or managementpractices are examples of other aspects of school envi-ronment. In addition, this study did not incorporateneighborhood or school contextual measures. Finally,the sample was restricted to specific Asian populationsand therefore the association between parental per-ception and child emotional and behavioral problemsmay differ for other population groups.

ConclusionInformation about immigrant children’s health is

critical for policies and programs in schools and withinsettlement and health services. The findings of thisstudy suggest that aspects of child behavior and emo-tional health may be more within the purview ofschool environments, via the parents’ interactions andperceptions, than we might assume. Identifying thecritical relationship between parents and schools offersan opportunity to strengthen social supports that helpparents adapt and in turn to promote child emotionalhealth and behavior. Enhancing school, settlement,and public health initiatives and increasing collabora-tion would appear to be desirable policy directions.

IMPLICATIONS FOR SCHOOL HEALTH

The findings suggest that immigrant parents’ per-ceptions of their children’s school environment is a sig-nificant component in the school-home dynamic thatmay influence aspects of child emotional health andbehavior. This suggests a need to develop or improveinitiatives for the newest immigrant parents with chil-dren in schools. Such initiatives could involve outreachto immigrant parents with the goal of enhancingthe well-being of children. Initiatives may focus onestablishing open lines of communication with newimmigrant parents so that their needs and concerns canbe addressed. Such communication would facilitateimprovements in parents’ relationships with teach-ers, principals, and other school personnel, and in thelonger term encourage the involvement of immigrantparents in school activities. Given that characteris-tics of immigrant parents and the extent to whichthey are informed of school activities might also influ-ence perception20 and that their beliefs about whatconstitutes positive school environment might differfrom those of school personnel,16 establishing greateropportunities for communication and the develop-ment of positive relationships may be particularlyimportant for child emotional and behavioral health.

Human Subjects Approval StatementThe Research Ethics Boards at the University of

Toronto and the Centre for Addiction and MentalHealth in Toronto, Ontario, Canada approved the pro-tocols for this study.

REFERENCES

1. Shochet IM, Dadds MR, Ham D, Montague R. School connect-edness is an underemphasized parameter in adolescent mentalhealth: results of a community prediction study. J Clin ChildAdolesc Psychol. 2006;35:170-179.

2. Anderman LH, Freeman TM, eds. Students’ Sense of Belonging inSchool. Oxford, UK: Elsevier; 2004:27-63.

3. Wehlage GG, Rutter RA, Smith GA, Lesko N, Fernandez RR.Reducing the Risk: Schools as Communities of Support. Philidelphia,PA: Falmer; 1989.

4. Anderman EM. School effects on psychological outcomesduring adolescence. J Educ Psychol. 2002;94:795-809.

5. Jacobson KC, Rowe DC. Genetic and environmental influenceson the relationship between family connectedness, schoolconnectedness and adolescent depressed mood: sex differences.Dev Psychol. 1999;35:926-939.

6. Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM,Jones J. Protecting adolescents from harm: findings from theNational Longitudinal Study on Adolescent Health. JAMA.1997;278:823-832.

7. Kuperminc GP, Leadbetter BJ, Blatt SJ. School social climateand individual differences to psychopathology among middleschool students. J Sch Psychol. 2001;39:141-159.

8. Resnick MD, Harris LJ, Blum RW. The impact of caring andconnectedness on adolescent health and well-being. J PaediatrChild Health. 1993;39:3-9.

9. Rudd RE, Walsh DC. Schools as healthful environments:prerequisite to comprehensive school health. Prev Med.1993;22:499-506.

10. Griffith J. The relation of school structure and social environ-ment to parent involvement in elementary schools. Elem Sch J.1998;99:53-80.

11. Christenson SL. The family-school partnership: an opportunityto promote the learning competence of all students. Sch PsychRev. 2004;33:83-104.

12. Simon BS. High school outreach and family involvement. SocPsychol Educ. 2004;7:185-209.

13. Lopez LC, Sanchez VV, Hamilton M. Immigrant and native-born Mexican-American parents’ involvement in a publicschool: a preliminary study. Psychol Rep. 2000;86:521-525.

14. Soodak LC, Erwin EJ. Valued member or tolerated participant:parents’ experiences in inclusive early childhood settings.J Assoc Pers Sev Handicaps. 2000;25:29-41.

15. Ma X. School experiences influence personal health andinterpersonal relationships of adolescents: the Canadian case.Sch Effectiveness Sch Improv. 2007;18(2):209-240.

16. Ramirez AYF. Dismay and disappointment: parental involve-ment of Latino immigrant parents. Urban Rev. 2003;35:93-110.

17. Fine M. (Ap)parent involvement: reflections on parents,power, and urban public schools. Teach Coll Rec. 1993;94:682-710.

18. Carreon GP, Drake C, Barton AC. The importance of presence:immigrant parents’ school engagement experiences. Am EducRes J. 2005;42:465-498.

19. Wang D. Family-school relations as social capital: Chineseparents in the United States. Sch Community J. 2008;18:119-146.

20. Green CL, Walker JMT, Hoover-Dempsey KV, Sandler HM.Parents’ motivations for involvement in children’s education:an empirical test of a theoretical model of parental involvement.J Educ Psychol. 2007;99:532-544.

21. Ariza EN. Actions speak louder than words—or do they?Debunking the myth of apathetic immigrant parents ineducation. Contemp Educ. 2000;71(3):36-38.

22. Dembo MH, Gibson S. Teachers’ sense of efficacy: an importantfactor in school achievement. Elem Sch J. 1985;86:173-184.


23. Samaniego RY, Gonzales NA. Multiple mediators of the effectsof acculturation status on delinquency for Mexican Americanadolescents. Am J Community Psychol. 1999;27:189-210.

24. Fleming JE, Offord DR. Epidemiology of childhood depressivedisorders: a critical review. J Am Acad Child Adolesc Psychiatry.1990;29:571-580.

25. Gil A, Wagner E, Vega W. Acculturation, familism and alcoholuse among Latino adolescent males: longitudinal relations.J Community Psychol. 2000;28:443-458.

26. Lieb R, Isensee B, Hofler M, Pfister H, Wittchen H-U. Parentalmajor depression and the risk of depression and other mentaldisorders in offspring: a prospective-longitudinal communitystudy. Arch Gen Psychiatry. 2002;59:365-374.

27. Weissman MM, Warner V, Wickramaratne P, Moreau D, Olf-son M. Offspring of depressed parents: 10 years later. Arch GenPsychiatry. 1997;54(10):932-940.

28. Beiser M, Hamilton H, Rummens JA, et al. Predictors ofemotional problems and physical aggression among Hong KongChinese, Mainland Chinese and Filipino immigrant children inCanada. Soc Psychiatry Psychiatr Epidemiol. 2010;45:1011-1021.

29. Chui T, Tran K, Maheux H. Immigration in Canada: A Portraitof the Foreign-Born Population, 2006 Census (Statistics Canada,Catalogue 97-557-XIE). Ottawa, ON: Statistics Canada; 2007.

30. Statistics Canada HRDC. National Longitudinal Survey of Children:Overview and Survey Instruments for 1994-1995; Data Collection Cycle1. Ottawa, ON: Ministry of Industry; 1995.

31. Boyle MH, Offord DR, Racine Y, Fleming JE, Szatmari P, San-ford M. Evaluation of the revised Ontario Child Health Studyscales. J Child Psychol Psychiatry. 1993;34:189-213.

32. Offord DR, Munroe-Blum H, Fleming JE, Boyle MH, Rae-Grant NI. Ontario Child Health Study: summary and selectedresults. Can J Psychiatry. 1989;34:483-491.

33. Tremblay RE, Desmarais-Gervais L, Gagnon C, Charlebois P.The Preschool Behavioural Questionnaire: stability of its factorstructure between cultures, sexes, ages and socioeconomicstatus. Int J Behav Dev. 1987;10:467-484.

34. Beiser M. Strangers at the Gate: The ‘Boat People’s’ First Ten Yearsin Canada. Toronto, ON: University of Toronto Press; 1999.

35. Beiser M, Fleming JA. Measuring psychiatric disorder amongsoutheast Asian refugees. Psychol Med. 1986;16:627-639.

36. StataCorp. Stata Statistical Software: Release 9.0. College Station,TX: StataCorp; 2005.

37. Hoover-Dempsey KV, Sandler HM. Why do parents becomeinvolved in their children’s education? Rev Educ Res. 1997;67:3-42.
