Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA.
Prev Sci. 2013 Jun;14(3):290-9. doi: 10.1007/s11121-012-0326-x.
Hispanic adolescents are disproportionately affected by externalizing disorders, substance use and HIV infection. Despite these health inequities, few interventions have been found to be efficacious for this population, and even fewer studies have examined whether the effects of such interventions vary as a function of ecodevelopmental and intrapersonal risk subgroups. The aim of this study was to determine whether and to what extent the effects of Familias Unidas, an evidence-based preventive intervention, vary by ecodevelopmental and intrapersonal risk subgroups. Data from 213 Hispanic adolescents (mean age = 13.8, SD = 0.76) who were enrolled in a randomized clinical trial evaluating the relative efficacy of Familias Unidas on externalizing disorders, substance use, and unprotected sexual behavior were analyzed. The results showed that Familias Unidas was efficacious over time, in terms of both externalizing disorders and substance use, for Hispanic youth with high family ecodevelopmental risk (e.g., poor parent-adolescent communication), but not with youth with moderate ecodevelopmental or low ecodevelopmental risk. The results suggest that classifying adolescents based on their family ecodevelopmental risk may be an especially effective strategy for examining moderators of family-based preventive interventions such as Familias Unidas. Moreover, these results suggest that Familias Unidas should potentially be targeted toward youth with high family ecodevelopmental risk. The utility of the methods presented in this article to other prevention scientists, including genetic, neurobiological and environmental scientists, is discussed.
西班牙裔青少年受到外化障碍、物质使用和 HIV 感染的影响不成比例。尽管存在这些健康不平等，但很少有干预措施被证明对这一人群有效，更少的研究检查了这些干预措施的效果是否因生态发展和个体内在风险亚组而有所不同。本研究旨在确定 Familias Unidas（一种基于证据的预防干预措施）是否以及在何种程度上因生态发展和个体内在风险亚组而有所不同。这项研究的数据来自 213 名西班牙裔青少年（平均年龄为 13.8 岁，标准差为 0.76），他们参加了一项随机临床试验，评估 Familias Unidas 对外化障碍、物质使用和无保护性行为的相对疗效。结果表明， Familias Unidas 随着时间的推移在减少外化障碍和物质使用方面对具有高家庭生态发展风险（例如，父母与青少年沟通不良）的西班牙裔青年是有效的，但对具有中等或低生态发展风险的青年则不然。结果表明，根据家庭生态发展风险对青少年进行分类可能是检验基于家庭的预防干预措施（如 Familias Unidas）的调节因素的一种特别有效的策略。此外，这些结果表明 Familias Unidas 可能应该针对具有高家庭生态发展风险的青年。本文提出的方法对其他预防科学家（包括遗传、神经生物学和环境科学家）的效用也进行了讨论。
