The Adelante project: Realities, challenges and successes in addressing health disparities among central American immigrant youth.
The Adelante project: Realities, challenges and successes in addressing health disparities among central American immigrant youth.
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Adelante项目：解决中美洲移民青年健康差距的现实、挑战和成功。
DOI：
10.1037/cdp0000368
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发表时间：
2022-07
影响因子：
3.3
通讯作者：
Gonzalez A
中科院分区：
文献类型：
--
作者：
Edberg MC;Cleary SD;Andrade EL;Evans WD;Quinteros-Grady L;Alvayero RD;Gonzalez A
The Adelante intervention, implemented between 2013–2018, addressed an important syndemic health disparity for Central American immigrant youth approaching or in high school -- the co-occurrence of substance abuse, sex risk (pregnancy, STIs, HIV), and interpersonal violence. Adelante was implemented and evaluated by the Avance Center for the Advancement of Immigrant/Refugee Health, which built on a university-community partnership that has been in place since 2005. Using a tailored, ecological positive youth development (PYD) approach, Adelante employed intervention strategies across ecological levels, including individual, family, peer, and community levels, with the use of social marketing and digital media strategies to link activities under one aspirational identity and support community engagement. Using a Community Based Participatory Research (CBPR) approach with multiple community partners involved in the effort, the research assessed changes in co-occurring behavioral outcomes and tested hypotheses concerning relationships between PYD mediators and these outcomes. Multiple methods were used in collaboration with partners to assess intervention inputs and outcomes – detailed implementation process records; pre-post surveys to assess changes in PYD assets, risk behavior knowledge, and prevention skills; a community survey in the intervention and comparison communities (total n=3600) at baseline and two follow-up waves; surveys of a high risk cohort (n=238) at baseline and follow-up, and social marketing campaign surveys (n=1,549) at baseline with two follow-up waves. Analysis showed multiple improvements in PYD mediators and risk behavior outcomes, including an overall 70% increase in knowledge and a 15% increase in prevention skills. Preliminary analysis of risk behavior outcomes demonstrated, for example, a significant, inverse effect on reported sexual activity (past 3 months) for both Adelante intervention community and cohort samples. In addition, self-reported exposure to the social marketing campaign was associated with positive effects on multiple outcomes, including drug use risk and violence attitudes, and improvement in violence/sexual risk behavior outcomes in the intervention vs. comparison community. There are few models in the literature that provide a roadmap for how to address multiple, related health conditions in marginalized, immigrant communities, even as most health disparities are associated with complex social ecologies. The Adelante intervention adds a useful model of this nature to the evidence base, and provides support for the ecological approach to positive youth development with respect to such communities. The Adelante project was a collaboration between a university-based center and multiple community organizations to address the co-occurrence of substance use, sex risk and violence among Central American immigrant youth in a marginalized community setting. The multilevel intervention was designed to increase resilience assets in youth, parents, and community organizations to improve the environment for youth to succeed and avoid risk behavior. Results from this preliminary study show that the model was effective in building resilience across multiple dimensions, changing attitudes about violence and sex risk, and in changing some self-reported risk behaviors.
影响因子：
4.4
作者：
Evans WD;Andrade EL;Barrett ND;Cleary SD;Snider J;Edberg M
通讯作者：
Edberg M