title: Reducing Internalizing Symptoms Among High-Risk, Hispanic Adolescents: Mediators of a Preventive Family Intervention.
abstract: Familias Unidas is a family-focused preventive intervention that has been found to reduce drug use and sexual risk behaviors among Hispanic adolescents. In some trials, Familias Unidas has also been found to be efficacious in reducing adolescent internalizing symptoms (i.e., depressive and anxiety symptoms), even though the intervention did not specifically target internalizing symptoms. This study examines potential mediators or mechanisms by which Familias Unidas influences internalizing symptoms, specifically the role of intervention-targeted improvements in parent-adolescent communication and reductions in youth externalizing behaviors. A total of 213 Hispanic eighth grade students with a history of externalizing behavior problems and their primary caregivers were recruited from the public school system. Participants, with a mean age of 13.8 years, were randomized into the Familias Unidas intervention or community practice control condition and assessed at baseline, 6, 18, and 30 months post-baseline. A cascading mediation model was tested in which the Familias Unidas intervention was hypothesized to decrease adolescent internalizing symptoms through two mediators: improvements in parent-adolescent communication leading to decreases in externalizing behaviors. Findings show that the intervention had significant direct effects on youth internalizing symptoms at 30 months post-baseline. In addition, the cascading mediation model was supported in which the Familias Unidas intervention predicted significant improvements in parent-adolescent communication at 6 months, subsequently decreasing externalizing behaviors at 18 months, and ultimately reducing youth internalizing symptoms at 30 months post-baseline. Implications for prevention interventions are discussed.
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street (R-669), Miami, FL, USA. tperrino@med.miami.edu.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Perrino
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street (R-669), Miami, FL, USA.
authors.forename: Ahnalee
authors.initials: A
authors.lastname: Brincks
authors.affiliation: Department of Psychology, George Washington University, Washington, DC, USA.
authors.forename: George
authors.initials: G
authors.lastname: Howe
authors.affiliation: Department of Psychiatry and Behavioral Sciences and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: C Hendricks
authors.initials: CH
authors.lastname: Brown
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street (R-669), Miami, FL, USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Prado
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street (R-669), Miami, FL, USA.
authors.forename: Hilda
authors.initials: H
authors.lastname: Pantin
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005431:Florida; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000517:prevention & control*
keywords: Adolescent; Family; Hispanic; Internalizing symptoms; Prevention