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Literature suggests that communication is a protective factor against high-risk sexual behavior. This study assessed the impact of a fourth-grade communication-centered life skills program on attitudes, norms, self-efficacy, behaviors, and intentions toward communication about difficult subjects. Participants included 1,581 low-income Mexican elementary-school children, divided into experimental and control groups. Teachers were trained to replicate the program as part of the school curriculum over 15 to 20 weeks. Students completed self-report questionnaires before and after the program. Multilevel analyses demonstrated the program's statistically significant positive impact on communication about attitudes, self-efficacy, intentions, and behavior; perception of sociocultural norms regarding communication transformed as a result of the program. Gender significantly predicted differences in communication: with respect to attitudes, self-efficacy, and intentions. The results show that early intervention programs targeting communication about difficult subjects can prevent risky sexual behavior and its consequences (e.g., HIV/AIDS) and influence perception of norms and gender roles.

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A growing body of literature indicates that ethnic differences exist in the rates of retention and engagement in mental health services, and that these disparities stem partly from the inability of services to fulfill the needs and expectations of ethnic minority populations, including Latinos. Increasing the involvement of Latinos in their own mental health treatment may be an important component for improving their care and increasing their participation in treatment. The Right Question Project (RQP) is an educational strategy that encourages active participation in decisions that are important to the individual by facilitating a person's ability to formulate effective questions and to engage others in an instructive dialogue and shared decision making. The purpose of this article is to describe how this strategy, developed by a community group, was adapted and tailored for use in a mental health setting, with the intention of shifting the level of the client's active involvement with their providers in order to improve attendance at scheduled appointments and retention in mental health care. The article highlights the advantages of using practical interventions that originate from the community to improve the quality of services available to Latinos. At the same time, it reveals challenges and limitations that shaped implementation decisions, especially in terms of cultural, socioeconomic, and systemic factors affecting Latino participants. Implications for mental health providers, trainees, and supervisors are discussed.

In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.