Partnerships in Prevention Science Institute, Iowa State University, ISU Research Park, Building 2, Suite 2400, 2625 North Loop Drive, Ames, IA 50010, USA.
J Youth Adolesc. 2012 Jun;41(6):788-801. doi: 10.1007/s10964-011-9735-6. Epub 2011 Dec 10.
This study examined the mediated and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed in young adulthood. Sixth grade students (N=446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age 21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-targeted outcomes and the related potential public-health impact of scaling up these interventions.
本研究考察了一项普遍针对家庭的预防干预措施的中介和调节效应，该干预措施在青少年早期实施，对成年早期评估的内化症状产生影响。1993 年，来自 22 个中西部农村学区的六年级学生（N=446；52%为女性；98%为白人）及其家庭被随机分配到实验组和对照组。接受爱荷华强化家庭计划（ISFP）和对照组的学生在七个时间点（前测到成年早期-21 岁）进行自我报告问卷调查。结果表明，青少年内化症状的增长因素（6-12 年级）受 ISFP 条件和风险状况（定义为早期物质使用开始）的预测。发现风险状况对条件效应的调节作用，高风险青少年从 ISFP 中获益更多。结果还支持了这样一种假设，即 ISFP 对成年早期内化症状的影响是通过青少年内化症状的增长因素来介导的；然而，风险调节在成年早期仅略微显著。年轻人内化症状的临床或亚临床水平的相对降低率为 28%，这表明在没有提供干预的学区，每 100 名表现出内化症状的临床或亚临床水平的年轻人中，在提供中学预防计划的学区，可能只有 72 名年轻人表现出这些水平的症状。这些发现强调了以家庭为中心的普遍干预措施的积极影响如何扩展到非目标结果，以及扩大这些干预措施的相关潜在公共卫生影响。
