Effects of a Preventive Intervention for Mexican Origin Adolescents

点击翻译按钮获取中文摘要

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).