Effects of a Preventive Intervention for Mexican Origin Adolescents

描述（由申请人提供）：拟议的项目是516墨西哥裔（MO）青少年和他们的照顾者谁参加了桥梁高中计划/ Puentes a la Secundaria（Puentes）在7年级的实验性试验的后续行动。Puentes是一个文化上有能力的，以家庭为重点的干预措施，针对几个假定的调解人的基础上，经验证据表明，他们占显着的差异，心理健康和物质使用障碍的MO青年。从4所中学的学校名册中招募家庭，接受为期9周的Puentes计划或1次控制组研讨会。分层招募被用来选择随机样本的单独的英语和西班牙语版本的程序。该计划的实施具有高水平的保真度和多个报告者的评估被用来后测和一年的计划效果（8年级）。积极的后测效果被发现为每个个人和家庭的能力为目标的近端介质和一些远端介质，包括物质使用，学校无序的行为，和父母报告的内化和外化行为，假设预测长期计划的影响，在高中后期和成年初显期（EA）诊断的疾病。程序的影响是温和的基线水平的功能，表明一般较强的影响，青少年和家庭在基线功能较差，并通过语言，家庭文化适应的基础上，表明差异的影响。近端介质的后测变化导致物质使用，越轨同伴交往，内化和外化在8年级显着减少。本申请提出了测试后5年和7年的两项评估，以解决以下具体目标：1）检查Puentes对心理健康和物质使用轨迹和障碍的影响; 2）检查Puentes对危险行为的影响（例如，风险性行为，辍学）和成功的EA适应功能; 3）检查程序的影响是否介导的假定调解人的干预目标;和4）检查程序的影响是否缓和的基线水平的风险，青少年性别，和家庭语言的文化适应。将使用协方差分析、混合模型方差分析、逻辑回归和潜在生长曲线建模来检验目标。拟议的继续解决预防科学和健康差距研究的一个重大差距，通过测试是否一个家庭-在青春期早期提供的重点干预可以预防高中后期和成年期出现的心理健康和物质使用障碍，这些障碍对美国的MO有重大的公共卫生负担。拟议的研究具有重要的公共卫生意义，并与健康人的目标一致2010年，以消除少数群体健康差距（卫生和人口健康部，2005年），并与国家卫生研究所优先制定文化上适当和有效的预防干预措施（国家卫生研究所，1998年）。

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).