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1.
Prev Sci ; 2020 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-31927654

RESUMO

There is a need to optimize the fit between psychosocial interventions with known efficacy and the demands of real-word service delivery settings. However, adaptation of evidence-based interventions (EBI) raises questions about whether effectiveness can be retained. This randomized controlled trial (RCT) evaluated a streamlined package of cognitive, behavior, and social skills training strategies known to prevent and reduce anxiety symptom and disorder escalation in youth. A total of 109 youth (Mage = 9.72; 68% girls; 54% Latinx) at risk based on high anxiety were randomized to the streamlined prevention and early intervention (SPEI) (n = 59) or control (n = 50) and were assessed at pretest, posttest, and 12-month follow-up. A main objective was to determine whether our redesign could be delivered by community providers, with acceptable levels of fidelity, quality, and impact. In terms of process evaluation results, there was high protocol fidelity, excellent clinical process skills, few protocol adaptations, and high satisfaction with the SPEI. In terms of outcomes, there were no significant main or moderated effects of the SPEI at the immediate posttest. However, at the follow-up, youth in the SPEI reported greater self-efficacy for managing anxiety-provoking situations, greater social skills, and fewer negative cognitive errors relative to controls. Collectively, findings suggest that the redesigned SPEI might be an attractive and efficient solution for service delivery settings.

2.
J Clin Child Adolesc Psychol ; : 1-15, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910050

RESUMO

Objective: A population-level, randomized controlled trial was conducted to test the effectiveness of a parent recruitment package for increasing initial engagement into a school-based parenting program and to identify strategies responsible for effects.Method: Participants were caregivers of kindergarten- to third-grade students (N = 1,276) attending one of five schools serving ethnically diverse families living in mostly low-income, urban conditions. First, families were randomly assigned to be recruited for research surveys or not, and then to a parenting program recruitment condition: 1) Engagement-as-usual (EAU) informational flyer; 2) EAU + testimonial booklet; 3) EAU + teacher endorsement; 4) EAU + recruitment call; or 5) all strategies (full package). Caregivers were offered a free parenting program at their child's school. Primary dependent variables were parenting program enrollment and attending at least one session (initiation). Exploratory analyses were conducted on program completion, attendance across sessions, homework completion, and in-session participation.Results: In the population-level sample, enrollment and initiation were higher for the full package compared to all other conditions except the recruitment call condition. Enrollment, initiation, and program completion were higher for the recruitment call and full package conditions compared to the EAU condition. In the subsample of initiators, parents in the full package condition attended fewer parenting sessions than in the EAU condition. Controlling for attendance across sessions, there were no condition effects on homework completion or in-session participation.Conclusions: The recruitment call can increase the public health impact of evidence-based parenting programs by improving enrollment, initiation, and program completion.

3.
J Abnorm Child Psychol ; 48(3): 407-417, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31749064

RESUMO

The current study compared the effectiveness of a school-clinician administered cognitive behavioral treatment (CBT) to treatment as usual (TAU) at post-treatment (i.e., after 12 weeks) and at a 1 year follow-up. Sixty-two school-based clinicians (37 in CBT; 25 in TAU) and 216 students (148 students in CBT; 68 in TAU) participated. Students were ages 6-18 (mean age 10.87; 64% Caucasian & 29% African American; 48.6% female) and all met DSM-IV diagnostic criteria for a primary anxiety disorder. Independent evaluators (IEs) assessed clinical improvement, global functioning, and loss of anxiety diagnoses; children and parents completed measures of anxiety symptoms. At post-treatment, no significant treatment main effects emerged on the primary outcome; 42% and 37% of youth were classified as treatment responders in CBT and TAU respectively. However, parent-report of child anxiety showed greater improvements in CBT relative to TAU (d = .29). Moderation analyses at post-treatment indicated that older youth, those with social phobia and more severe anxiety at baseline were more likely to be treatment responders in CBT compared to TAU. At the 1 year follow-up, treatment gains were maintained but no treatment group differences or moderators emerged. CBT and TAU for pediatric anxiety disorders, when delivered by school clinicians were generally similar in effectiveness for lowering anxiety and improving functioning at both post-treatment (on all but the parent measure and for specific subgroups) and 1 year follow-up. Implications for disseminating CBT in the school setting are discussed.

4.
J Clin Child Adolesc Psychol ; 49(1): 60-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30644774

RESUMO

This study presents findings from a randomized effectiveness trial of the New Beginnings Program (NBP), which has demonstrated efficacy in 2 prior randomized efficacy trials. Family courts in 4 counties facilitated recruitment of divorcing and separating parents, and providers in community agencies delivered the program. Participants were 830 parents of children ages 3-18 who were randomized to receive either the 10-session NBP or an active 2-session comparison condition in which parents learned about the same parenting skills but did not complete home practice of these skills. Parents were ethnically diverse (59.4% non-Hispanic White, 31.4% Hispanic, 9.2% other race or ethnicity). Multiple rater assessments of parenting, interparental conflict, and child mental health problems were conducted at pretest, posttest, and 10-month follow-up. The results indicated positive moderated effects of the NBP as compared with the active control condition to strengthen parenting at posttest and to reduce child mental health problems at posttest and 10 months. Many of these moderated effects showed positive benefits for non-Hispanic White families but not for Hispanic families. The findings indicate support for the effectiveness of the NBP when delivered by community-based agencies but also indicate the need for further adaptations to make the program effective for Hispanic parents.

5.
Dev Psychopathol ; 31(5): 1695-1713, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31535609

RESUMO

Exposure to high levels of postdivorce interparental conflict is a well-documented risk factor for the development of psychopathology, and there is strong evidence of a subpopulation of families for which conflict persists for many years after divorce. However, existing studies have not elucidated differential trajectories of conflict within families over time, nor have they assessed the risk posed by conflict trajectories for development of psychopathology or evaluated potential protective effects of children's coping to mitigate such risk. We used growth mixture modeling to identify longitudinal trajectories of child-reported conflict over a period of six to eight years following divorce in a sample of 240 children. We related the trajectories to children's mental health problems, substance use, and risky sexual behaviors and assessed how children's coping prospectively predicted psychopathology in the different conflict trajectories. We identified three distinct trajectories of conflict; youth in two high-conflict trajectories showed deleterious effects on measures of psychopathology at baseline and the six-year follow-up. We found both main effects of coping and coping by conflict trajectory interaction effects in predicting problem outcomes at the six-year follow-up. The study supports the notion that improving youth's general capacity to cope adaptively is a potentially modifiable protective factor for all children facing parental divorce and that children in families with high levels of postdivorce conflict are a particularly appropriate group to target for coping-focused preventive interventions.

6.
Sch Psychol ; 34(4): 386-397, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31294596

RESUMO

Parental academic involvement is critical in promoting children's long-term academic success and may be especially impactful during middle school. However, longitudinal research is lacking for Mexican-origin youth and has focused mostly on mothers. Mexican-origin mothers and fathers reported their academic involvement during seventh grade, and we examined the moderating role of adolescents' reports of parental acceptance and harsh parenting in the association between parental academic involvement and 12th grade academic outcomes (N = 720 families). We also examined whether these associations were similar for girls and boys. Mothers' academic involvement predicted boys' grade point average (GPA) and preparation for postsecondary education for girls and boys. Mothers' and fathers' academic involvement were not associated with girls' GPA. Significant interactions between fathers' academic involvement and parenting were observed. Fathers' academic involvement positively predicted girls' preparation for postsecondary education, but only if their daughters perceived them to have lower levels of harshness parenting. Fathers' involvement was negatively linked with daughters' preparation for postsecondary education if they perceived higher levels of harshness from fathers. Conversely, fathers' academic involvement was positively linked with boys' preparation for postsecondary education if their sons perceived their fathers to have higher or average levels of harshness harshness. Patterns between father- son dyads replicated for a marginal interaction predicting boys' GPA. Parental academic involvement may be crucial for Latino adolescents, and parents may uniquely combine their parenting strategies to yield optimal academic outcomes for their girls and boys. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Instituições Acadêmicas , Adolescente , Adulto , Feminino , Humanos , Masculino , Modelos Psicológicos , Fatores Sexuais
7.
J Fam Psychol ; 33(6): 690-703, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31318261

RESUMO

Despite widespread acknowledgment that "frequent, continuing, and meaningful" (Pruett & DiFonzo, 2014) time with both parents is beneficial for children from divorced or separated families, and that interparental conflict (IPC) is associated with increased child mental health problems, the joint effects of parenting time (PT), parenting quality (PQ), and IPC on children's mental health problems are less clear. The current study integrates two theoretical models in multiple mediator analyses to test indirect effects of mothers' and fathers' PQ and IPC to explain the association between PT and children's mental health problems within the same model. Participants were children aged 9-18 years (N = 141) who had one or both parents participate in a randomized comparative effectiveness trial of a court-based prevention program for high-conflict divorcing or separating families. Data were collected at pretest and 9-month follow-up. Analyses revealed an indirect effect in which fathers' PQ mediated the association between PT and child internalizing problems both concurrently and 9 months later. There were no significant indirect effects involving IPC. Analyses indicated a significant quadratic relation between PT and fathers' PQ, suggesting that although more PT is associated with better father-child relationships, there is a point beyond which more time is not related to a better relationship. We discuss the study findings, research limitations, and implications for public policy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Divórcio/psicologia , Conflito Familiar/psicologia , Transtornos do Neurodesenvolvimento/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Adolescente , Adulto , Criança , Divórcio/estatística & dados numéricos , Feminino , Humanos , Masculino , Tempo
8.
J Divorce Remarriage ; 60(4): 283-300, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31217674

RESUMO

This study examined whether the New Beginnings Program (NBP), a parenting-focused preventive intervention designed to reduce children's post-divorce mental health problems, affected attitudes toward divorce and marriage in young adults whose mothers had participated 15 years earlier. Participants (M = 25.6 years; 50% female; 88% Caucasian) were from 240 families that had participated in a randomized experimental trial (NBP vs. literature control). Analyses of covariance showed that program effects on both types of attitudes were moderated by gender. Males in the NBP reported more positive attitudes toward marriage and less favorable attitudes toward divorce than males in the literature control.

10.
J Fam Psychol ; 33(5): 499-510, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30730180

RESUMO

Parenting time, interparental conflict, and the quality of parenting a child experiences in the postdivorce family environment have complex relations with child adjustment outcomes. Using person-centered latent profile analyses, the present study examined (a) separate profiles of mothers' (N = 472) and fathers' (N = 353) parenting time, interparental conflict, and quality of parenting following divorce; and (b) associations of mother and father profiles with concurrent child outcomes (48% female, 3- to 18-years-old) as well as child outcomes 3 and 10 months later. Mother and father profiles were primarily differentiated by levels of parenting time and quality of parenting, respectively. Mother and father profiles defined by greater parenting time and lower quality parenting were associated with the poorest child outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Divórcio/psicologia , Conflito Familiar/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Adolescente , Adulto , Arizona , Criança , Pré-Escolar , Divórcio/estatística & dados numéricos , Feminino , Humanos , Masculino
12.
Prev Sci ; 20(1): 41-55, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29968007

RESUMO

Nuanced understanding of adolescents' interpersonal relationships with family and peers is important for developing more personalized interventions that prevent problem behaviors and adjustment issues. We used latent profile analysis (LPA) to classify a community sample of 784 adolescents with respect to their observed relationship dynamics with friends and family using videotaped observations and five-minute audiotaped speech samples collected at ages 16-17. The resulting latent classes served to predict behavioral and emotional health in early adulthood. The LPA of the video- and audio-coded observational variables revealed a three-class model: (1) the healthy relationship group (n = 587), representing low levels of deviant and drug use talk with friends and positive, noncoercive relationship with parents; (2) the disaffected group (n = 90), representing high levels of drug use talk with friends and negativity about their parent(s) in the five-minute speech sample; and (3) the antisocial group (n = 107), representing high levels of deviant talk, drug use talk, coercive joining with friends, and coerciveness in family interactions. In contrast to the healthy relationship group, the disaffected group showed elevated risk for substance use problems and depression and the antisocial group showed higher risk for substance use problems and committing violent crimes in early adulthood. Outcome differences between disaffected and antisocial groups were mostly nonsignificant. We discuss the viability of applying these findings to tailoring and personalizing family-based interventions with adolescents to address key dynamics in the family and friendship relationships to prevent adult substance use problems, depression, and violence.


Assuntos
Adaptação Psicológica , Família , Amigos , Relações Interpessoais , Psicologia do Adolescente , Adolescente , Adulto , Transtorno da Personalidade Antissocial , Depressão , Humanos , Observação , Autorrelato , Transtornos Relacionados ao Uso de Substâncias , Adulto Jovem
13.
Dev Psychopathol ; 30(5): 1611-1627, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30451140

RESUMO

Growth mixture modeling with a sample of 749 Mexican heritage families identified parallel trajectories of adolescents' and their mothers' heritage cultural values and parallel trajectories of adolescents' and their fathers' heritage cultural values from Grades 5 to 10. Parallel trajectory profiles were then used to test cultural gap-distress theory that predicts increased parent-adolescent conflict and adolescent psychopathology over time when adolescents become less aligned with Mexican heritage values compared to their parents. Six similar parallel profiles were identified for the mother-youth and father-youth dyads, but only one of the six was consistent with the hypothesized problem gap pattern in which adolescents' values were declining over time to become more discrepant from their parents. When compared to families in the other trajectory groups as a whole, mothers in the mother-adolescent problem gap trajectory group reported higher levels of mother-adolescent conflict in the 10th grade that accounted for subsequent increases in internalizing and externalizing symptoms assessed in 12th grade. Although the findings provided some support for cultural gap-distress predictions, they were not replicated with adolescent report of conflict nor with the father-adolescent trajectory group analyses. Exploratory pairwise comparisons between all six mother-adolescent trajectory groups revealed additional differences that qualified and extended these findings.


Assuntos
Conflito Familiar/psicologia , Relação entre Gerações/etnologia , Transtornos Mentais/psicologia , Americanos Mexicanos/psicologia , Relações Pais-Filho/etnologia , Valores Sociais/etnologia , Adolescente , Comportamento do Adolescente , Adulto , Criança , Conflito Familiar/etnologia , Pai , Feminino , Humanos , Masculino , Transtornos Mentais/etnologia , Mães , Pais , Teoria Psicológica , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia
14.
Dev Psychopathol ; 30(5): 1571-1587, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30295207

RESUMO

Scarce research has examined stress responsivity among Latino youths, and no studies have focused on the role of acculturation in shaping cortisol stress response in this population. This study assessed Mexican American adolescents' Mexican and Anglo cultural orientations and examined prospective associations between their patterns of bicultural orientation and hypothalamic-pituitary-adrenal cortisol reactivity to an adapted Trier Social Stress Test. The sample included 264 youths from a longitudinal birth cohort study who completed the Trier Social Stress Test and provided saliva samples at age 14. The youths completed assessments of cultural orientation at age 12, and family conflict and familism at age 14. Analyses testing the interactive effects of Anglo and Mexican orientation showed significant associations with cortisol responsivity, including the reactivity slope, peak levels, and recovery, but these associations were not mediated by family conflict nor familism values. Findings revealed that bicultural youth (high on both Anglo and Mexican orientations) showed an expected pattern of high cortisol responsivity, which may be adaptive in the context of a strong acute stressor, whereas individuals endorsing only high levels of Anglo orientation had a blunted cortisol response. Findings are discussed in relation to research on biculturalism and the trade-offs and potential recalibration of a contextually responsive hypothalamic-pituitary-adrenal axis for acculturating adolescents.


Assuntos
Aculturação , Conflito Familiar/psicologia , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Americanos Mexicanos/psicologia , Sistema Hipófise-Suprarrenal/metabolismo , Estresse Psicológico/metabolismo , Adolescente , Criança , Estudos de Coortes , Conflito Familiar/etnologia , Relações Familiares , Feminino , Hispano-Americanos , Humanos , Masculino , Estudos Prospectivos , Saliva/metabolismo , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia
15.
J Consult Clin Psychol ; 86(10): 845-855, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30265043

RESUMO

OBJECTIVE: Effects are reported of the Family Bereavement Program (FBP) on the mental health of bereaved youth and their surviving parent 15 years following the program. METHOD: On-hundred and 56 families (244 children ages 8-16; 54% male; 67% Non-Hispanic White) were randomly assigned to receive either the FBP (N = 90) or a literature control condition (N = 66). At the 15-year follow-up 80% of the youth and 76% of the bereaved parents were reinterviewed. Mental health problems and service use were self-reported by young adults and their parents. Key informants reported on mental health problems of young adults. RESULTS: Young adults in the FBP reported significantly less use of mental health services and of psychiatric medication than controls. Key informants reported significantly lower mental health problems for young adults who were in FBP as compared with controls and for those who were younger lower internalizing and externalizing problems for those in the FBP as compared with controls. Bereaved parents reported a significantly lower rate of alcoholism and less use of support groups than controls. CONCLUSIONS: The results provided evidence that FBP led to lower mental health problems and less service use by bereaved young adults and their parents as compared with controls. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Luto , Transtornos Mentais/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Morte Parental/psicologia , Pais/psicologia , Avaliação de Programas e Projetos de Saúde , Psicoterapia/métodos , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Adulto Jovem
16.
Child Youth Care Forum ; 47(3): 363-376, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30034206

RESUMO

Background: Offspring of anxious parents are at increased risk for developing anxiety disorders. There is a need to identify which youth are at greatest risk for disorder onset in this population. Objective: This study prospectively examined several theory-based family and parent characteristics (e. g., family conflict, parental over-control, parental psychopathology) as predictors of anxiety disorder onset in children whose parents were clinically anxious. Methods: Families were enrolled in a randomized controlled trial evaluating a familybased preventative intervention, relative to an information monitoring control condition, for offspring of anxious parents (N= 136; child mean age 8.69 years; 55% female; 85% Caucasian). Family and parent measures were collected using multiple informants and an observational task at baseline, post-intervention, and at a six and 12 month followup. Child anxiety disorder diagnosis was determined by independent evaluators using the Anxiety Disorders Interview Schedule for Children. Results: Results indicated that none of the baseline family or parent variables examined predicted the onset of an anxiety disorder in children over the one year follow-up period. Conclusions: Findings raise questions about the short-term risk associated with family and parent factors in anxiety disorder development in this high risk population.

17.
Eval Health Prof ; 41(2): 290-320, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29635949

RESUMO

We used a multigroup propensity score approach to evaluate a randomized effectiveness trial of the New Beginnings Program (NBP), an intervention targeting divorced or separated families. Two features of effectiveness trials, high nonattendance rates and inclusion of an active control, make program effects harder to detect. To estimate program effects based on actual intervention participation, we created a synthetic inactive control comprised of nonattenders and assessed the impact of attending the NBP or active control relative to no intervention (inactive control). We estimated propensity scores using generalized boosted models and applied inverse probability of treatment weighting for the comparisons. Relative to the inactive control, NBP strengthened parenting quality as well as reduced child exposure to interparental conflict, parent psychological distress, and child internalizing problems. Some effects were moderated by parent gender, parent ethnicity, or child age. On the other hand, the effects of active versus inactive control were minimal for parenting and in the unexpected direction for child internalizing problems. Findings from the propensity score approach complement and enhance the interpretation of findings from the intention-to-treat approach.


Assuntos
Divórcio , Poder Familiar , Pais/educação , Adolescente , Fatores Etários , Criança , Pré-Escolar , Grupos Étnicos , Humanos , Relações Pais-Filho , Pontuação de Propensão , Fatores Sexuais , Fatores Socioeconômicos , Estresse Psicológico/prevenção & controle
18.
JAMA Psychiatry ; 75(5): 429-437, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29562080

RESUMO

Importance: Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking, particularly for US Latino populations. Objective: To test whether a universal middle school prevention program can reduce the frequency of alcohol misuse and rates of alcohol use disorder 5 years after implementation with a Mexican American sample. Design, Setting, and Participants: A previous randomized clinical trial was conducted with 516 Mexican American 7th graders and at least 1 parent who identified as having Mexican origin. Three annual cohorts of families were recruited from rosters of 4 middle schools and randomized to the 9-session Bridges/Puentes family-focused group intervention or a workshop control condition. Recruitment, screening, pretest, and randomization occurred in the same academic year for each cohort: 2003-2004, 2004-2005, and 2005-2006. Data acquisition for the follow-up assessments of late-adolescent alcohol misuse and abuse, which were not included in the initial randomized clinical trial, was conducted from September 2009 to September 2014; analysis was conducted between August 2016 and July 2017. In this assessment, 420 children (81.4%) of the sample were included, when the majority were in their final year of high school. Interventions: The 9-session Bridges/Puentes intervention integrated youth, parent, and family intervention sessions that were delivered in the spring semester at each school, with separate groups for English-dominant vs Spanish-dominant families. The control workshop was offered during the same semester at each school, also in English and Spanish. Main Outcomes and Measures: Primary outcomes were diagnostic assessment of lifetime alcohol use disorder in the 12th grade, 5 years after the intervention, based on the Diagnostic Interview Schedule for Children and past-year frequency of alcohol use, binge drinking, and drunkenness based on the 2001 Youth Risk Behavior Survey. Results: Of the 420 participants, 215 (51.2%) were girls (mean [SD] age, 17.9 [0.62] years). The intervention reduced the likelihood of having an alcohol use disorder (ß = -.93; SE, 0.47; P = .047; odds ratio, 0.39). Intervention associations with past-year alcohol use frequency, binge drinking, and drunkenness were moderated by baseline substance use. The intervention reduced the frequency of alcohol use (ß = -.51; SE, 0.24; P = .04; Cohen d = 0.43) and drunkenness (ß = -.51; SE, 0.26; P = .049; Cohen d = 0.41) among youth who reported any previous substance use at baseline (T1 initiators) but not among those who had not initiated any substance use (T1 abstainers) at baseline. For past-year binge drinking, the intervention finding did not reach statistical significance among T1 initiators (ß = -.40; SE, 0.23; P = .09) or T1 abstainers (ß = .23; SE, 0.14; P = .11). Conclusions and Relevance: Study results support an association between a universal middle school intervention and alcohol misuse and alcohol use disorders among Mexican American high school students and implementation of universal middle school interventions to reach Latino communities.


Assuntos
Alcoolismo/prevenção & controle , Americanos Mexicanos/psicologia , Serviços de Saúde Escolar , Adolescente , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Alcoolismo/reabilitação , Estudos Transversais , Características Culturais , Feminino , Seguimentos , Humanos , Masculino , Fatores de Risco , Sudoeste dos Estados Unidos
19.
Prev Sci ; 19(5): 674-684, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-28444518

RESUMO

The public health impact of evidence-based, preventive parenting interventions has been severely constrained by low rates of participation when interventions are delivered under natural conditions. It is critical that prevention scientists develop effective and feasible parent engagement methods. This study tested video-based methods for engaging parents into an evidence-based program for divorcing parents. Three alternative versions of a video were created to test the incremental effectiveness of different theory-based engagement strategies based on social influence and health behavior models. A randomized controlled trial was conducted to compare the three experimental videos versus two control conditions, an information-only brochure and an information-only video. Participants were attendees at brief, court-mandated parent information programs (PIPs) for divorcing or never married, litigating parents. Of the 1123 eligible parents, 61% were female and 13% were never married to the child's other parent. Randomization to one of five conditions was conducted at the PIP class level, blocking on facilitator. All participants completed a 15-item, empirically validated risk index and an invitation form. Results of regression analyses indicated that the most streamlined version, the core principles video, significantly increased parents' interest in participating in the parenting intervention, enrollment during a follow-up call, and initiation (i.e., attending at least one session) compared to one or the other control conditions. Findings suggest that videos based on social influence and health behavior theories could provide an effective and feasible method for increasing parent engagement, which would help maximize the public health benefits of evidence-based parenting interventions.


Assuntos
Divórcio , Poder Familiar , Pais , Medicina Preventiva/métodos , Gravação em Vídeo
20.
Prev Sci ; 19(Suppl 1): 27-37, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-26786469

RESUMO

We examined attendance trajectory profiles among 335 Mexican-American families participating in an 11-week universal intervention to explore if heterogeneity in attendance and thus dosage was associated with intervention response, defined as pre-to-2-year post (T2) reductions in child report of internalizing symptoms. We estimated trajectories accounting for the influence of baseline covariates, selected based on the Health Belief Model (HBM) and Latino family research, to understand covariate associations with trajectories. Results supported six attendance trajectory groups: non-attenders (NA), early dropouts-low internalizing (EDO-LI), early dropouts-high internalizing (EDO-HI), mid-program dropouts (MPDO), sustained attenders-low internalizing (SA-LI), and sustained attenders-high internalizing (SA-HI). All groups except EDO-HI showed significant pre-to-post change on child report of internalizing; however, trajectory groups reflecting more attendance did not have greater pre-to-post change. Nonetheless, child report of internalizing differentiated two subgroups of sustained attenders and two subgroups of early dropouts. These results suggest heterogeneity among families with similar patterns of attendance and highlight the importance of modeling this heterogeneity. Although life stress was a barrier to participation, there was minimal support for the HBM. Cultural influences, acculturation, and familism, played a more prominent role in distinguishing trajectories. As expected, the EDO-HI group was less acculturated than both sustained attender groups and reported weaker familism values than the SA-HI group. However, unexpectedly, the SA-LI group had lower familism than the EDO-LI group. The results suggest that the influence of culture on participation is nuanced and may depend on child symptomatology.


Assuntos
Depressão , Hispano-Americanos/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Aculturação , Adulto , Idoso , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estresse Psicológico , Adulto Jovem
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