Family Intervention to Prevent Depression and Substance Use Among Adolescents of Depressed Parents

Parental depression places offspring at elevated risk for multiple, co-occurring problems. The purpose of this study was to develop and preliminarily evaluate Project Hope, a family intervention for the prevention of both depression and substance use among adolescent-aged children (M?=?13.9?years) of depressed parents. The program was created by blending two empirically supported interventions: one for depression and another for substance use. Thirty families were randomly assigned to either Project Hope (n?=?16) or a wait-list control condition (n?=?14). Pretests, posttests (n?=?29), and 5-month follow-ups (n?=?28) were conducted separately with parents and youth via phone interviews. Questions asked about the family depression experience, family interactions, family management, coping, adolescent substance use beliefs and refusal skills, adolescent depression, and adolescent substance use. Project Hope was fully developed, manualized, and implemented with a small sample of targeted families. Engagement in the program was relatively high. Preliminary outcome analyses were conducted using 2 (Group) ×3 (Time) analyses of covariance. Results provided some evidence for significant improvements among intervention compared to control participants in indicators of the family depression experience, family management, and coping, and a statistically significant decrease from pretest to posttest in alcohol quantity for intervention compared to control youth. Next steps for this program of research are discussed.     

中国控烟状况与干预对策

目前国内控烟文献从人群吸烟状况及吸烟影响因素、控烟干预策略及其效果、控烟能力等多角度,探讨了我国的烟草控制问题.在综合已有有效地控烟策略基础上,提出加强控烟教育和宣传、发挥医务人员在控烟中的表率作用、综合使用各种措施控烟等针对性建议,对中国长期有效的控烟具有深远意义.     

The Effects of Parental Tobacco and Marijuana Use and Personality Attributes on Child Rearing in African-American and Puerto Rican Young Adults

We assessed the effect of the interrelationship of mothers’ and fathers’ tobacco and marijuana use with their personality attributes on some of their child rearing behaviors. We used a longitudinal design to analyze the data of 258 males and females who were seen four times over a 13-year period from early adolescence through young adult parenthood. Thirty-one percent of the multiple regression analyses revealed significant interactions between the effect of tobacco or marijuana use and a personality attribute on child rearing. The majority of these significant interactions suggested that protective personality characteristics were offset by substance use risks resulting in less adequate child rearing. If these results are substantiated in an experimental intervention, it suggests that having resilient personality attributes does not protect against the negative effects of tobacco or marijuana use on child rearing.     

Evaluating the Effectiveness of an Abduction Prevention Program for Young Adults With Intellectual Disabilities

The purpose of this study was to evaluate the effectiveness of behavioral skills training (BST) and in situ training (IST) for teaching abduction prevention skills to young adults with intellectual disabilities. Four individuals, ages 18–24, participated. Five BST sessions were conducted for each participant. Following BST, in situ assessments took place at the participants’ school to assess acquisition of the skills. The data show that none of the participants reached criterion level following BST although some of the participants improved their score from baseline. IST was then implemented with two of the participants achieving criterion level and two participants exhibiting two of the three safety skills.     

Family Protection and Prevention of Alcohol Use Among Hispanic Youth at High Risk

Research regarding prevention strategies for Hispanic youth stress the importance of family interventions because of the particular importance of family as a protective factor within the Hispanic community. Starting in 1995, the Center for Substance Abuse Prevention conducted the National Cross-Site Evaluation of High Risk Youth Programs, a 5-year drug and alcohol prevention study with a sample of approximately 10,500 youth, including nearly 3,000 Hispanic youth. Youth were surveyed regarding their alcohol use patterns and risk and protective factors, with several measures of family relationships, including family connectedness, family supervision, and parental attitudes toward their child's alcohol use. Analyses indicate that family factors are highly linked to alcohol use among Hispanics, particularly among Hispanic females. Longitudinal growth curve analyses indicate that improving the connections that young Hispanic females have to their parents can have positive long-term effects on delaying or reducing their alcohol use. This evaluation was conducted under the direction of Dr. Soledad Sambrano, Ph.D. of the Center for Substance Abuse Prevention under contract #2777-95-5002 with EMT Associates, Inc. and ORC Macro. The views expressed herein represent the opinions and analyses of the individual authors and may not necessarily reflect the opinions, official policy, or position of the U.S. Department of Health and Human Services, the Public Health Service, the Substance Abuse and Mental Health Service Administration, or the Center for Substance Abuse Prevention.     

青少年感觉寻求与烟酒使用的关系:一个有中介的调节模型

在生态系统理论和社会学习理论基础上提出一个有中介的调节模型,探讨青少年感觉寻求与烟酒使用的关系,以及压力性生活事件的调节效应和结交不良同伴的中介效应。被试为660名青少年,研究工具包括青少年感觉寻求量表、压力性生活事件量表、不良同伴问卷和烟酒使用问卷。结果显示:(1)青少年感觉寻求是烟酒使用的风险因素。(2)压力性生活事件对感觉寻求与烟酒使用之间的关系具有风险增强的调节效应。(3)这种调节效应以结交不良同伴为中介变量。因此,青少年感觉寻求与烟酒使用之间既存在调节效应又存在中介效应。     

Community Mobilization and Community-Based Participatory Research to Prevent Youth Violence Among Asian and Immigrant Populations

Many community mobilization activities for youth violence prevention involve the researchers assisting communities in identifying, adapting, and/or tailoring evidence-based programs to fit the community needs, population, and cultural and social contexts. This article describes a slightly different framework in which the collaborative research/evaluation project emerged from the community mobilization activities. As will be discussed, this collaborative, sustained partnership was possible in the context of the Center on Culture, Immigration and Youth Violence Prevention's (UC Berkeley ACE) community mobilization activities that brought the issue of youth violence, particularly among immigrant and minority populations, to the forefront of many of the community partners' agendas. The East Bay Asian Youth Center (EBAYC) was one of the partners that came to the table, which facilitated the community-based engagement/mobilization. UC Berkeley ACE collaborated with EBAYC to evaluate an after-school program and an alternative probation program serving a diverse youth and immigrant population, including African Americans, Asians, and Hispanics. This article describes UC Berkeley ACE's community mobilization activity and the collaborative partnership with EBAYC, discusses how the evaluations incorporated community-based principles in design and practice, and presents some findings from the evaluations.     

Youth Action Research for Prevention: A Multi-level Intervention Designed to Increase Efficacy and Empowerment Among Urban Youth

Youth Action Research for Prevention (YARP), a federally funded research and demonstration intervention, utilizes youth empowerment as the cornerstone of a multi-level intervention designed to reduce and/or delay onset of drug and sex risk, while increasing individual and collective efficacy and educational expectations. The intervention, located in Hartford Connecticut, served 114 African-Caribbean and Latino high school youth in a community education setting and a matched comparison group of 202 youth from 2001 to 2004. The strategy used in YARP begins with individuals, forges group identity and cohesion, trains youth as a group to use research to understand their community better (formative community ethnography), and then engages them in using the research for social action at multiple levels in community settings (policy, school-based, parental etc.) Engagement in community activism has, in turn, an effect on individual and collective efficacy and individual behavioral change. This approach is unique insofar as it differs from multilevel interventions that create approaches to attack multiple levels simultaneously. We describe the YARP intervention and employ qualitative and quantitative data from the quasi-experimental evaluation study design to assess the way in which the YARP approach empowered individual youth and groups of youth (youth networks) to engage in social action in their schools, communities and at the policy level, which in turn affected their attitudes and behaviors.     

Triple P-Positive Parenting Program: Towards an Empirically Validated Multilevel Parenting and Family Support Strategy for the Prevention of Behavior and Emotional Problems in Children

This paper outlines the theoretical and empirical foundations of a unique multilevel parenting and family support strategy designed to reduce the prevalence of behavioral and emotional problems in preadolescent children. The program known as Triple P-Positive Parenting Program is a multilevel system of family intervention, which provides five levels of intervention of increasing strength. These interventions include a universal population-level media information campaign targeting all parents, two levels of brief primary care consultations targeting mild behavior problems, and two more intensive parent training and family intervention programs for children at risk for more severe behavioral problems. The program aims to determine the minimally sufficient intervention a parent requires in order to deflect a child away from a trajectory towards more serious problems. The self-regulation of parental skill is a central construct in the program. The program uses flexible delivery modalities (including individual face-to-face, group, telephone assisted, and self-directed programs) to tailor the strength of the intervention to the requirements of individual families. Its multidisciplinary, preventive and community-wide focus gives the program wide reach, permitting the targeting of destigmatized access points through primary care services for families who are reluctant to participate in parenting skills programs. The available empirical evidence supporting the efficacy of the program is discussed and its implications for research on dissemination are discussed.     

Usability of a Smartphone Application to Support the Prevention and Early Intervention of Anxiety in Youth

Mental, emotional, and behavioral disorders are common in youth with anxiety problems being among the most prevalent, typically failing to spontaneously remit, and placing some youth at risk for additional difficulties. Mobile health (mHealth) might be a novel avenue to strengthen prevention efforts for child anxiety, since program effects are generally small. However, although a significant number of mHealth tools have been developed, few have been evaluated in terms of usability (or even clinical effectiveness). Usability testing is the first level of evaluation in responsible mHealth efforts as it is one of the main barriers to usage and adoption. As such, the objective of this research was to evaluate the usability of a smartphone application (app) corresponding to an indicated prevention and early intervention targeting youth anxiety. To accomplish this, 132 children (M_age = 9.65, 63% girls) and 45 service providers (M_age = 29.13, 87% female) rated our app along five established dimensions of usability (ease of use, ease of learning, quality of support information, satisfaction, and stigma). Findings showed that the app was highly and positively rated by youth and providers, with some variations (lower ratings when errors occurred). Path analyses also showed that system understanding was significantly related to greater system satisfaction, but that such relation occurred through the quality of support information offered by the app. Together, this has research and clinical implications as it highlights avenues for advancing youth care via mHealth usability evaluation, including prior to establishing effectiveness.     

School Climate and Implementation of a Preventive Intervention

Although there has been wide dissemination of research-based psychosocial prevention programs, a similarly strong research base to guide program implementation has been lacking. Program implementation has been particularly difficult for schools, due partly to insufficient understanding of how school ecologies interact with these programs. This study examined the effects of multiple dimensions of school climate on level and rate of change in implementation of a violence prevention intervention across three school years. Using multi-level modeling, the study found that teacher-reported support between staff and among teachers and students predicted higher average levels of implementation. Teacher-reported administrative leadership predicted greater growth in implementation across 3 years. Findings offer implications for an ecological model of program implementation that considers school-level contextual effects on adoption and sustainability of new programs in schools. The Metropolitan Area Child Study Research Group is a collaboration of (in alphabetical order) Leonard Eron, University of Michigan; Nancy Guerra, University of California, Riverside; David Henry, University of Illinois at Chicago; L. Rowell Huesmann, University of Michigan; Patrick Tolan, University of Illinois at Chicago; and Richard VanAcker, University of Illinois at Chicago.     

Analysis of an Alcohol Use Prevention Program for Undergraduate Students

The authors analyzed data from an online alcohol abuse prevention test. Results showed no statistically significant difference between students charged with university alcohol‐related offenses and those who had not been charged. Implications for counselors and suggestions for future research are discussed.     

Be a Mom: Formative Evaluation of a Web-Based Psychological Intervention to Prevent Postpartum Depression

A formative evaluation (consisting of two phases: a scoping literature review and a focus group with mental health professionals) was conducted to inform the design of a web-based intervention to prevent postpartum depression, in terms of its characteristics and content: the Be a Mom program. The results showed that the web-based intervention should be short-term, delivered postnatally, and grounded in cognitive-behavior therapy principles. Moreover, the intervention should include weekly sessions targeting basic contents: motherhood changes, reorganizations and emotional experience; cognitions, self-criticism, and self-compassion; parenting values, social support, and assertive communication skills; couple relationship, negotiation and conflict resolution skills; and postpartum depression signs and professional help-seeking. These results may improve the Be a Mom’s adequacy, implementation success, and effectiveness.     

Development of a Brief Group CBT Intervention to Reduce COVID-19 Related Distress Among School-Age Youth

School-aged youth have been significantly impacted by the COVID-19 pandemic. The effects of the pandemic will likely have long-standing effects on the well-being of youth, and access to mental health care is even more critical during this time. For the past 5 years, TRAILS (Transforming Research into Action to Improve the Lives of Students) has been working throughout the state to increase utilization of evidence-based mental health practices among K-12 school mental health professionals (SMHPs). By leveraging SMHPs who are widely accessible to students, TRAILS seeks to improve youth access to effective mental health care and reduce current mental health inequities. In March 2020, TRAILS responded to the COVID-19 pandemic by developing a group manual designed to be delivered virtually by SMHPs to help students develop effective coping skills to mitigate the impact of COVID-19. TRAILS focuses on promoting use of CBT and mindfulness, as these skills are ideally suited for school-based delivery, and thus the new manual, Coping with COVID-19 (CC-19), was grounded in these modalities. This article will describe the design, development, and deployment of the CC-19 program to address the mental health needs of students in the context of the pandemic. Early acceptability and penetration data will also be discussed.     

Illicit Drug Use,Cognitive Distortions,and Suicidal Ideation Among Homeless Youth: Results From a Randomized Controlled Trial

Illicit drug use and cognitive distortions confer significant risks to youth suicidal thoughts and behaviors. However, there has been limited evidence regarding the efficacy of suicide prevention interventions with homeless youth, especially studies testing whether such interventions can reduce the risk for suicidal ideation associated with illicit drug use. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a drop-in center. Youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their illicit drug use, cognitive distortions, and suicidal ideation 4 times over 9 months. A multiple-group multilevel structural equation model showed that higher illicit drug use at baseline predicted a slower reduction in cognitive distortions and suicidal ideation in the TAU group. These associations were not found in the CTSP + TAU group, suggesting an interruption of such risk from illicit drug use. Findings suggest that CTSP can reduce the risk of illicit drug use as a treatment barrier towards cognitive distortions and suicidal ideation among homeless youth, with implications to improve treatment efforts and to reduce premature mortality in a vulnerable population.     

Analysis of An Intervention to Reduce or Prevent Secondary Conditions for People with Spinal Cord Injuries

People with acute spinal cord injuries (SCI) are at risk for developing secondary conditions such as pressure sores, urinary tract infections, pain, weight gain and deconditioning, and depression. This study analyzed the effectiveness of an Internet assessment and feedback tool in determining secondary condition risk for this population based on individual responses to a knowledge and behavioral questionnaire. Seventy-one people with newly-diagnosed SCI who were treated at one of five Model Spinal Cord Injury Systems Centers were randomly assigned to either an experimental condition in which they received computerized feedback and one-on-one consultations based on their online questionnaire answers, or to a control condition in which they received no feedback until the study's completion. One year after the initial assessment, the online questionnaire was re-administered to all participants as a post-test. Three times between the pre- and post-test assessments researchers telephoned participants to administer phone surveys probing secondary condition development. Results indicate there were significant differences among race groups and between complete and incomplete injury status for pressure sore occurrence. This study represents a new era of interactive technology in health promotion that can serve as a basis for future research to decrease secondary condition risk for people with SCI.     

Maternal Coping Skills as a Moderator Between Depression and Stressful Life Events: Effects on Children's Behavioral Problems in an Intervention Program

In this study, I report secondary analyses using data from the Infant Health and Development Program (IHDP). The IHDP included parent-targeted as well as child-targeted components as an integral part of early intervention programs. I examined three questions: (1) Do the IHDP early intervention services enhance adaptive maternal coping skills? (2) Do maternal coping skills moderate the relationship between stressful life events and maternal depression? (3) Are maternal coping skills associated with children's behavioral scores? Mothers in the treatment group have more adaptive coping skills than follow-up only mothers, and these effects are moderated by maternal characteristics. Adaptive coping skills moderate the effects of negative life events on maternal depression. Adaptive maternal coping skills are significantly associated with fewer behavioral problems for children at age three. These effects are moderated by the intervention. Implications for early intervention programs are discussed.     

青少年的气质与烟酒使用:交互效应检验

考察气质(意志控制、愤怒挫折、感觉寻求)对青少年烟酒使用的主效应,气质与教养方式(权威、专制、纵容)对烟酒使用的交互效应以及气质间的交互效应.采用随机整群抽样的方法,选取660名青少年为被试,匿名完成气质问卷、教养方式问卷和烟酒使用问卷.结果显示:(1)在控制了性别、年龄、社会经济地位后,气质对青少年烟酒使用具有预测作用,低意志控制、高愤怒挫折、高感觉寻求正向预测烟酒使用;(2)教养方式调节部分气质因素与烟酒使用的关系,具体为:权威和专制教养缓冲感觉寻求的风险作用,符合风险缓冲模型;纵容教养增强感觉寻求的风险作用,符合风险增强模型;(3)气质内部在影响青少年烟酒使用时也存在交互作用,愤怒挫折增强感觉寻求的风险作用,符合风险增强模型.因此,烟酒使用是气质与教养方式及气质间交互作用的产物.     

How Culture Impacts the Dissemination and Implementation of Innovation: A Case Study of the Families and Schools Together Program (FAST) for Preventing Violence with Immigrant Latino Youth

We consider how culture impacts the translation of research into practice, focusing on the culture of the client and the culture of the agency implementing selected programs. We build on lessons learned from a pilot study of an evidence-based family-school partnership, Families and Schools Together (FAST), to prevent youth violence with low-income, immigrant Latino families in Southern California. We examine the impact of cultural characteristics on the translation of this innovation into practice at the community level, relying on an interactive systems framework developed recently by Wandersman and colleagues (2008, American Journal of Community Psychology, 41(3–4), in press) discussed in this issue. As we point out, the culture of the client and the culture of the agency can facilitate or impede connections within and across these interactive systems.