Effects of a Preventive Intervention for Mexican Origin Adolescents

预防性干预对墨西哥裔青少年的影响

• 批准号: 7501381
• 负责人: Nancy A. Gonzales
• 金额: $ 57.99万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-27 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7501381
• 关键词: Accounting; Acculturation; Address; Adolescence; Adolescent; Alcohol or Other Drugs use; Analysis of Variance; Behavior; Caregivers; Control Groups; Dependence; Diagnosis; Disease; Distal; Education; Educational workshop; Enrollment; Family; Family Process; Family Relationship; Gender; General Population; Goals; Growth; Healthy People 2010; Individual; Intervention; Language; Latino; Linguistics; Logistic Regressions; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Mexican; Minority Groups; Modeling; National Institute of Drug Abuse; National Institute of Mental Health; Numbers; Other Minority; Outcome; Parenting behavior; Parents; Pregnancy; Pregnancy in Adolescence; Prevention; Preventive Intervention; Public Health; Randomized; Rate; Recruitment Activity; Reporter; Reporting; Request for Applications; Research; Resources; Risk; Risk Behaviors; Sampling; Schools; Science; Student Dropouts; Substance Use Disorder; Substance abuse problem; Symptoms; Testing; Week; Work; Youth; base; coping; deviant; efficacy trial; externalizing behavior; follow-up; health disparity; high risk sexual behavior; high school; minority health; peer; prevent; programs; success; therapy design

DESCRIPTION (provided by applicant): The proposed project is a follow-up of 516 Mexican origin (MO) adolescents and their caregivers who participated in an experimental trial of the Bridges to High School Program / Puentes a la Secundaria (Puentes) in 7th grade. Puentes is a culturally competent, family-focused intervention that targeted several putative mediators based on empirical evidence that they account for significant disparities in mental health and substance use disorders for MO youth. Families were recruited from school rosters at 4 middle schools to receive the 9-week Puentes program or a 1-session control group workshop. Stratified recruitment was used to select random samples for separate English and Spanish versions of the program. The program was implemented with high levels of fidelity and multiple-reporter assessments were used to posttest and one-year program effects (8th grade). Positive posttest effects were found for each of the individual and family competencies targeted as proximal mediators and for a number of distal mediators, including substance use, school disorderly conduct, and parent report of internalizing and externalizing behaviors, hypothesized to predict long-term program effects on diagnosed disorders in late high school and emerging adulthood (EA). Program effects were moderated by baseline levels of functioning indicating generally stronger effects for adolescents and families with worse functioning at baseline, and by language, indicating differential effects on the basis of family acculturation. Posttest changes on proximal mediators led to significant reductions in substance use, deviant peer association, internalizing and externalizing in 8th grade. The current application proposes two assessments at 5 and 7 years posttest to address the following specific aims: 1) Examine Puentes effects on mental health and substance use trajectories and disorders; 2) Examine Puentes effects on risky behaviors (e.g., risky sexual behavior, school dropout) and success in EA adaptive functioning; 3) Examine whether program effects are mediated by the putative mediators targeted in the intervention; and 4) Examine whether program effects are moderated by baseline levels of risk, adolescent gender, and family linguistic acculturation. Analysis of covariance, mixed-model analysis of variance, logistic regression and latent growth curve modeling will be used to test the aims. The proposed continuation addresses a significant gap in prevention science and health disparities research by testing whether a family-focused intervention delivered in early adolescence can prevent mental health and substance use disorders in late high school and emerging adulthood that have significant public health burden for MOs in the U.S. The proposed research has important public health significance and is consistent with the goal of Healthy People 2010, to eliminate minority health disparities (DHHS, 2005) and with NIMH priorities to develop culturally appropriate and effective preventive interventions (NIMH, 1998).

描述（由申请人提供）：拟议的项目是对516名墨西哥裔（MO）青少年及其照顾者的跟踪调查，这些青少年参加了七年级的“通往高中的桥梁计划”/“Puentes a la Secundaria”（Puentes）的实验试验。Puentes是一项具有文化能力、以家庭为中心的干预措施，针对几个假定的中介因素，根据经验证据，这些因素说明了MO青年在精神健康和物质使用障碍方面的显著差异。从4所中学的学校名册中招募家庭，接受为期9周的Puentes项目或为期1次的对照组讲习班。分层招募是用来选择随机样本，分别为英语和西班牙语版本的程序。该计划以高水平的保真度实施，多报告者评估用于后测和一年的计划效果（8年级）。积极的后测试效应被发现针对每个个人和家庭能力作为近端介质和一些远端介质，包括物质使用，学校无序行为，内化和外化行为的父母报告，假设预测长期项目对高中晚期和成年早期诊断障碍的影响。项目的效果被基线功能水平所调节，这表明对基线功能较差的青少年和家庭的影响一般较强，而语言则表明在家庭文化适应的基础上有不同的影响。近端中介因子的测试后改变导致八年级学生物质使用、异常同伴交往、内化和外化的显著降低。目前的申请建议在测试后5年和7年进行两次评估，以解决以下具体目标：1)检查Puentes对精神健康和物质使用轨迹和障碍的影响；2)检查Puentes对风险行为（如危险性行为、辍学）和EA适应功能成功的影响；3)检查项目效果是否由干预中假定的目标中介介导；4)检查项目效果是否受到基线风险水平、青少年性别和家庭语言文化适应的调节。将使用协方差分析、混合模型方差分析、逻辑回归和潜在增长曲线模型来检验目标。通过测试青春期早期以家庭为中心的干预是否可以预防高中后期和成年初期的精神健康和物质使用障碍，从而解决了预防科学和健康差异研究中的一个重大差距，这对美国的mo来说是一个重大的公共卫生负担。消除少数民族的健康差距（卫生与公众服务部，2005年），并按照国家卫生健康研究所的优先事项，制定文化上适当和有效的预防干预措施（国家卫生健康研究所，1998年）。