Preventing internalizing symptoms among Hispanic adolescents: a synthesis across Familias Unidas trials

Tatiana Perrino, Hilda Pantin, Guillermo Prado, Shi Huang, Ahnalee Brincks, George Howe, William Beardslee, Irwin Sandler, C. Hendricks Brown

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often underpowered to address moderation and mediation, an issue addressed in this paper. This synthesis study combined individual-level, longitudinal data from 721 adolescents across 3 randomized clinical trials of Familias Unidas, a family-focused prevention intervention for Hispanic youth. Using integrative data analysis (IDA) methods applied to trials, the study examined intervention moderation and mediation effects on internalizing symptoms. Baseline internalizing symptoms were a significant moderator of the intervention's effects on internalizing symptoms, while baseline externalizing symptoms did not moderate intervention effects. Baseline parent-adolescent communication, a modifiable risk factor and hypothesized mechanism by which the intervention works, significantly moderated the intervention's effects. Specifically, the intervention was more efficacious in its impact on internalizing symptoms for youth with lower initial levels of parent-adolescent communication compared to those with higher communication levels. Moderated mediation analyses showed that parent-adolescent communication changes mediated the intervention's effects on internalizing symptoms, with stronger effects for those with poorer baseline communication. Results suggest a potential benefit of identifying youth risks prior to interventions, and targeting specific modifiable mediators that lead to reductions of internalizing problems of adolescents. Findings also highlight advantages of utilizing data from combined trials and IDA for examining intervention moderators and mediators.

Original languageEnglish (US)
Pages (from-to)917-928
Number of pages12
JournalPrevention science : the official journal of the Society for Prevention Research
Volume15
Issue number6
DOIs
StatePublished - Dec 1 2014

Fingerprint

Hispanic Americans
Communication
Randomized Controlled Trials
Depression

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Preventing internalizing symptoms among Hispanic adolescents : a synthesis across Familias Unidas trials. / Perrino, Tatiana; Pantin, Hilda; Prado, Guillermo; Huang, Shi; Brincks, Ahnalee; Howe, George; Beardslee, William; Sandler, Irwin; Brown, C. Hendricks.

In: Prevention science : the official journal of the Society for Prevention Research, Vol. 15, No. 6, 01.12.2014, p. 917-928.

Research output: Contribution to journalArticle

Perrino, Tatiana ; Pantin, Hilda ; Prado, Guillermo ; Huang, Shi ; Brincks, Ahnalee ; Howe, George ; Beardslee, William ; Sandler, Irwin ; Brown, C. Hendricks. / Preventing internalizing symptoms among Hispanic adolescents : a synthesis across Familias Unidas trials. In: Prevention science : the official journal of the Society for Prevention Research. 2014 ; Vol. 15, No. 6. pp. 917-928.
@article{b2528a59169c4651b31df9efa7a59d0f,
title = "Preventing internalizing symptoms among Hispanic adolescents: a synthesis across Familias Unidas trials",
abstract = "Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often underpowered to address moderation and mediation, an issue addressed in this paper. This synthesis study combined individual-level, longitudinal data from 721 adolescents across 3 randomized clinical trials of Familias Unidas, a family-focused prevention intervention for Hispanic youth. Using integrative data analysis (IDA) methods applied to trials, the study examined intervention moderation and mediation effects on internalizing symptoms. Baseline internalizing symptoms were a significant moderator of the intervention's effects on internalizing symptoms, while baseline externalizing symptoms did not moderate intervention effects. Baseline parent-adolescent communication, a modifiable risk factor and hypothesized mechanism by which the intervention works, significantly moderated the intervention's effects. Specifically, the intervention was more efficacious in its impact on internalizing symptoms for youth with lower initial levels of parent-adolescent communication compared to those with higher communication levels. Moderated mediation analyses showed that parent-adolescent communication changes mediated the intervention's effects on internalizing symptoms, with stronger effects for those with poorer baseline communication. Results suggest a potential benefit of identifying youth risks prior to interventions, and targeting specific modifiable mediators that lead to reductions of internalizing problems of adolescents. Findings also highlight advantages of utilizing data from combined trials and IDA for examining intervention moderators and mediators.",
author = "Tatiana Perrino and Hilda Pantin and Guillermo Prado and Shi Huang and Ahnalee Brincks and George Howe and William Beardslee and Irwin Sandler and Brown, {C. Hendricks}",
year = "2014",
month = "12",
day = "1",
doi = "10.1007/s11121-013-0448-9",
language = "English (US)",
volume = "15",
pages = "917--928",
journal = "Prevention Science",
issn = "1389-4986",
publisher = "Springer New York",
number = "6",

}

TY - JOUR

T1 - Preventing internalizing symptoms among Hispanic adolescents

T2 - a synthesis across Familias Unidas trials

AU - Perrino, Tatiana

AU - Pantin, Hilda

AU - Prado, Guillermo

AU - Huang, Shi

AU - Brincks, Ahnalee

AU - Howe, George

AU - Beardslee, William

AU - Sandler, Irwin

AU - Brown, C. Hendricks

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often underpowered to address moderation and mediation, an issue addressed in this paper. This synthesis study combined individual-level, longitudinal data from 721 adolescents across 3 randomized clinical trials of Familias Unidas, a family-focused prevention intervention for Hispanic youth. Using integrative data analysis (IDA) methods applied to trials, the study examined intervention moderation and mediation effects on internalizing symptoms. Baseline internalizing symptoms were a significant moderator of the intervention's effects on internalizing symptoms, while baseline externalizing symptoms did not moderate intervention effects. Baseline parent-adolescent communication, a modifiable risk factor and hypothesized mechanism by which the intervention works, significantly moderated the intervention's effects. Specifically, the intervention was more efficacious in its impact on internalizing symptoms for youth with lower initial levels of parent-adolescent communication compared to those with higher communication levels. Moderated mediation analyses showed that parent-adolescent communication changes mediated the intervention's effects on internalizing symptoms, with stronger effects for those with poorer baseline communication. Results suggest a potential benefit of identifying youth risks prior to interventions, and targeting specific modifiable mediators that lead to reductions of internalizing problems of adolescents. Findings also highlight advantages of utilizing data from combined trials and IDA for examining intervention moderators and mediators.

AB - Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often underpowered to address moderation and mediation, an issue addressed in this paper. This synthesis study combined individual-level, longitudinal data from 721 adolescents across 3 randomized clinical trials of Familias Unidas, a family-focused prevention intervention for Hispanic youth. Using integrative data analysis (IDA) methods applied to trials, the study examined intervention moderation and mediation effects on internalizing symptoms. Baseline internalizing symptoms were a significant moderator of the intervention's effects on internalizing symptoms, while baseline externalizing symptoms did not moderate intervention effects. Baseline parent-adolescent communication, a modifiable risk factor and hypothesized mechanism by which the intervention works, significantly moderated the intervention's effects. Specifically, the intervention was more efficacious in its impact on internalizing symptoms for youth with lower initial levels of parent-adolescent communication compared to those with higher communication levels. Moderated mediation analyses showed that parent-adolescent communication changes mediated the intervention's effects on internalizing symptoms, with stronger effects for those with poorer baseline communication. Results suggest a potential benefit of identifying youth risks prior to interventions, and targeting specific modifiable mediators that lead to reductions of internalizing problems of adolescents. Findings also highlight advantages of utilizing data from combined trials and IDA for examining intervention moderators and mediators.

UR - http://www.scopus.com/inward/record.url?scp=84964315409&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964315409&partnerID=8YFLogxK

U2 - 10.1007/s11121-013-0448-9

DO - 10.1007/s11121-013-0448-9

M3 - Article

C2 - 24390684

AN - SCOPUS:84891406727

VL - 15

SP - 917

EP - 928

JO - Prevention Science

JF - Prevention Science

SN - 1389-4986

IS - 6

ER -