Randomized trial of a broad preventive intervention for Mexican American adolescents.

Abstract

Objective This randomized trial of a family-focused preventive intervention for Mexican American (MA) adolescents evaluated intervention effects on adolescent substance use, internalizing and externalizing symptoms, and school discipline and grade records in 8th grade, one year after completion of the intervention. The study also examined hypothesized mediators and moderators of intervention effects. Method Stratified by language of program delivery (English vs. Spanish), the trial included a sample of 516 MA adolescents (50.8% female; M =12.3 years, SD=.54) and at least one caregiver that were randomized to receive a low dosage control group workshop or the 9-week group intervention that included parenting, adolescent coping, and conjoint family sessions. Results Positive program effects were found on all five outcomes at one-year posttest, but varied depending on whether adolescents, parents, or teachers reported on the outcome. Intervention effects were mediated by posttest changes in effective parenting, adolescent coping efficacy, adolescent school engagement, and family cohesion. The majority of direct and mediated effects were moderated by language, with a larger number of significant effects for families that participated in Spanish. Intervention effects also were moderated by baseline levels of mediators and outcomes, with the majority showing stronger effects for families with poorer functioning at baseline. Conclusion Findings support the efficacy of the intervention to decrease multiple problem outcomes for MA adolescents, but also demonstrate differential effects for parents and adolescents receiving the intervention in Spanish vs. English, and depending on their baseline levels of functioning.

Participation Patterns Among Mexican–American Parents Enrolled in a Universal Intervention and Their Association with Child Externalizing Outcomes

“…We also expected more acculturated caregivers to participate at higher rates due to more accepting values about receiving services. Perhaps our data did not support this hypothesis because Bridges was developed and adapted through an iterative process of piloting and redesign to ensure the program was congruent with the values and preferences of Mexican American families (Gonzales et al, 2012a). We included both familism and acculturation in the model because we expected that parents in trajectory groups with higher rates of attendance would be highly acculturated but also have stronger familism values.…”

“…Participants were 292 primary female caregivers (FCG) from families recruited for the Bridges' randomized clinical trial (RCT) that were randomly assigned to the treatment condition and attended at least one session (Gonzales et al, 2012a). Of the 542 families in the RCT, 353 were assigned to treatment; 83% (292) of FCGs from these families attended 1 or more sessions.…”

“…Bridges is a family-focused, skills-based universal intervention that reduces problem behaviors and academic disengagement following the middle school transition (Gonzales et al, 2012a). Bridges' design was guided by an ecodevelopmental framework (Szapocznik & Coatsworth, 1999) that recognizes youth need to adapt to multiple contexts (e.g., families, schools) and unique cultural factors (e.g., acculturation).…”

“…We offered Bridges in English and Spanish and families chose the language of participation. Across four schools and three cohorts, there were 23 intervention groups (English, n= 11; Spanish, n = 12) and no school or cohort effects (Gonzales et al, 2012a).…”

Effective Parenting Interventions to Reduce Youth Substance Use: A Systematic Review

“…by guest on April 27, 2019 www.aappublications.org/news Downloaded from preventing or reducing use of 2 substances at <12 months, 10, 21, 27 2 at 12 to 24 months, 14,20 4 at 24 to 48 months, 15,25,26,28 and 2 at >48 months. 7,18 In terms of preventing all 3 substances, 1 study showed efficacy at <12 months, 18 2 at 12 to 24 months, 18, 25 1 at 24 to 48 months, 18 and none at >48 months.…”