Effects of Preference on Outcomes of Preventive Interventions among Ethnically Diverse Adolescents At-Risk of Depression.

Patient-centered care includes efforts to align treatment with patient preferences to improve outcomes and has not been studied in adolescent depression prevention. Within a school-based randomized trial, we examined the effects of offering a preference between two evidence-based preventive interventions for youth at risk of depression, Learning to BREATHE (L2B) and Interpersonal Therapy-Adolescent Skills Training. We examined the effects of 3 preference factors (assignment condition [preference vs. random], receipt of preferred program, and baseline program preference) on outcomes in a diverse sample of 111 adolescents (M age = 15.18 years, SD = .86): 81 (73%) girls, 45 (41%) White, 40 (36%) Asian American, 8 (7%) Latinx, 1 (1%) African American, and 17 (15%) multiracial or other race/ethnicity. Findings revealed little evidence that receiving a preferred intervention or being given a choice of interventions was linked to greater improvement or initial engagement. Further, analyses did not indicate that adolescents with baseline indications for a specific intervention would benefit more from that intervention; rather, adolescents with generally lower baseline functioning improved more regardless of the intervention received. However, receipt of L2B and a baseline preference for L2B were associated with greater improvements in about half of the outcomes examined, with effect sizes ranging from R 2 = 0.04 to 0.14. There was little support for the need to match interventions to adolescent preferences in school-based prevention efforts. Rather, the more scalable mindfulness-based intervention had stronger effects than the interpersonal intervention and may hold promise for diverse adolescents.

Prospective relations between parent-adolescent acculturation conflict and mental health symptoms among Vietnamese American adolescents.

OBJECTIVES: Intergenerational acculturation conflict in immigrant families has been implicated as a risk factor for adolescent maladjustment. However, the directionality and specific family related mediators of this association have not been identified. The present study prospectively examined relations between adolescent reports of perceived acculturation conflict and internalizing and externalizing mental health symptoms. Perceived parent-adolescent relationship strain and perceived parental psychological control were examined as potential mediators. METHOD: Survey measures were administered to 375 Vietnamese American adolescents (48.8% males; M = 15.55 years, SD = .59) at 3 time points over 6 months. RESULTS: Using cross-lagged path analysis, perceived acculturation conflict predicted externalizing symptoms, whereas internalizing symptoms predicted perceived acculturation conflict. Perceived maternal psychological control mediated the association between perceived acculturation conflict and later externalizing symptoms, whereas maternal psychological control, parental unresponsiveness, and unmet parent expectations mediated the association between internalizing symptoms and later acculturation conflict. CONCLUSION: Culturally competent enhancement of parental sensitivity and responsiveness might be targeted as a modifiable protective factor in family-based preventive interventions for at-risk immigrant families. (PsycINFO Database Record