Preventing Internalizing Symptoms Among Hispanic Adolescents: A Synthesis Across Familias Unidas Trials

被引:50
作者
Perrino, Tatiana [1 ]
Pantin, Hilda [2 ]
Prado, Guillermo [2 ]
Huang, Shi [2 ]
Brincks, Ahnalee [2 ]
Howe, George [3 ]
Beardslee, William [4 ]
Sandler, Irwin [5 ]
Brown, C. Hendricks [6 ,7 ]
机构
[1] Univ Miami, Miller Sch Med, Dept Publ Hlth Sci, Miami, FL 33136 USA
[2] Univ Miami, Miller Sch Med, Dept Publ Hlth Sci, Miami, FL 33136 USA
[3] George Washington Univ, Dept Psychol, Washington, DC 20052 USA
[4] Childrens Hosp Boston, Dept Psychiat, Boston, MA 02215 USA
[5] Arizona State Univ, Dept Psychol, Tempe, AZ 85287 USA
[6] Northwestern Univ, Dept Psychiat & Behav Sci, Feinberg Sch Med, Chicago, IL 60611 USA
[7] Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA
关键词
Adolescent; Internalizing symptoms; Family; Integrative data analyses (IDA); CENTERED INTERVENTION; CHILDREN; DEPRESSION; MEDIATORS; OUTCOMES; PROGRAM; EFFICACY; IMPACT;
D O I
10.1007/s11121-013-0448-9
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often underpowered to address moderation and mediation, an issue addressed in this paper. This synthesis study combined individual-level, longitudinal data from 721 adolescents across 3 randomized clinical trials of Familias Unidas, a family-focused prevention intervention for Hispanic youth. Using integrative data analysis (IDA) methods applied to trials, the study examined intervention moderation and mediation effects on internalizing symptoms. Baseline internalizing symptoms were a significant moderator of the intervention's effects on internalizing symptoms, while baseline externalizing symptoms did not moderate intervention effects. Baseline parent-adolescent communication, a modifiable risk factor and hypothesized mechanism by which the intervention works, significantly moderated the intervention's effects. Specifically, the intervention was more efficacious in its impact on internalizing symptoms for youth with lower initial levels of parent-adolescent communication compared to those with higher communication levels. Moderated mediation analyses showed that parent-adolescent communication changes mediated the intervention's effects on internalizing symptoms, with stronger effects for those with poorer baseline communication. Results suggest a potential benefit of identifying youth risks prior to interventions, and targeting specific modifiable mediators that lead to reductions of internalizing problems of adolescents. Findings also highlight advantages of utilizing data from combined trials and IDA for examining intervention moderators and mediators.
引用
收藏
页码:917 / 928
页数:12
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