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Mahadevan J, Gautam M, Benegal V. Mental health and well-being for the prevention of substance use disorders. Indian J Psychiatry 2024; 66:S272-S282. [PMID: 38445279 PMCID: PMC10911324 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_716_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 03/07/2024] Open
Affiliation(s)
- Jayant Mahadevan
- Department of Psychiatry, Centre for Addiction Medicine, NIMHANS, Bangalore, Karnataka, India E-mail:
| | - Manaswi Gautam
- Consultant Psychiatrist, Gautam Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Vivek Benegal
- Department of Psychiatry, Centre for Addiction Medicine, NIMHANS, Bangalore, Karnataka, India E-mail:
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Zhang J, Hanson AN, Piehler TF, Ha T. Coercive Parent-Adolescent Interactions Predict Substance use and Antisocial Behaviors Through Early Adulthood: A Dynamic Systems Perspective. Res Child Adolesc Psychopathol 2024; 52:141-154. [PMID: 37458901 DOI: 10.1007/s10802-023-01102-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 01/14/2024]
Abstract
This study revisits the association between coercive parent-adolescent interactions and adolescent externalizing behaviors. Specifically, we investigate the moment-to-moment coercive exchanges between parents and adolescents and how these dynamic processes map to the long-term development of substance use and antisocial behavior from middle adolescence to early adulthood. We collected videotaped observations with 794 adolescents (ages 16-17 years) and their parents during interactions and coded their real-time behavioral exchanges. State Space Grid analyses were used to measure the proportion of time in which each parent-adolescent dyad engaged in the Dyadic Coercion region as an indicator of rigidity in dyadic coercion. We also measured adolescents' substance use and antisocial behavior at ages 16-17, ages 18-19, and ages 21-22. The enduring impact of parent-adolescent coercive interaction on substance use and antisocial behavior was tested using categorical latent growth curve models and path models. Adolescents with more coercive interactions with parents showed higher rates of increase in alcohol use and higher levels of antisocial behavior through early adulthood. The findings highlight the unique contribution of using intensive data to understand coercive interactions on a micro-timescale and how these dynamics influence long-term development in externalizing behaviors. Implications for intervention studies are discussed.
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Affiliation(s)
- Jingchen Zhang
- Department of Family Social Science, University of Minnesota - Twin Cities, 290 McNeal Hall, 1985 Buford Avenue, St. Paul, MN, 55108, USA.
| | - Alexandra N Hanson
- Department of Family Social Science, University of Minnesota - Twin Cities, 290 McNeal Hall, 1985 Buford Avenue, St. Paul, MN, 55108, USA
| | - Timothy F Piehler
- Department of Family Social Science, University of Minnesota - Twin Cities, 290 McNeal Hall, 1985 Buford Avenue, St. Paul, MN, 55108, USA
| | - Thao Ha
- Department of Psychology, Arizona State University, Tempe, USA
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Li Y, Maina G, Mousavian G, Fang Y, Twum-Antwi B, Sherstobitoff J, Amoyaw J, Pandey M. Family-based Interventions of Preventing Substance Use Among Immigrant Youth: A Scoping Review. SUBSTANCE USE : RESEARCH AND TREATMENT 2024; 18:29768357241244680. [PMID: 38707894 PMCID: PMC11069246 DOI: 10.1177/29768357241244680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 03/15/2024] [Indexed: 05/07/2024]
Abstract
Introduction Immigrant youth face heightened risks of substance use due to the stress associated with immigration and acculturation. While parental intervention can have a preventative impact on substance use, parents need to be well-informed about substance use and effective interventions that can prevent substance use among immigrant youth. Such interventions ought to be culturally sensitive, family-based, and targeted at the specific substances that are prevalent in a given context. Identifying and curating interventions that can empower parents in addressing substance use can help mitigate the risks that immigrant youth may face. Methods This scoping review aimed to identify the types, characteristics, and effectiveness of family-based substance use intervention programs. Based on Arksay and O'Malley's guidelines, interventions included in the review must have met the following criteria: (a) was a family-based intervention aiming to prevent substance use; (b) targeted immigrant teens aged 12 to 17 years old; (c) was published in English; (d) originated from Australia, Canada, New Zealand, or the United States. The pinch table was used to synthesize included articles, after which studies were compared and categorized, and cross-cutting categories were identified. Results After screening 4551 searched literature, 13 studies that utilized family-based interventions were included in the review. All interventions were face-to-face programs, and most interventions involved parents and youth as participants. Eco-developmental theory and active learning strategies were used by multiple interventions. Given immigrant families were target stakeholders, both deep structure and surface structure cultural adaptations were utilized. Interventions increased parents' knowledge and skills regarding substance use prevention and delayed substance use initiation among youth. Conclusion From the review, it was evident that parents are an essential element in any program aiming to prevent or reduce children's substance use. Besides information about substance use prevention, the curriculum also involves parenting and communication skills for parents to understand the protective effects of family. Effective family-based interventions for immigrant youth require attention to parenting and immigration stress, while also considering cultural adaptation. Future directions and limitations are also discussed.
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Affiliation(s)
- Yiyan Li
- College of Nursing, University of Saskatchewan, Prince Albert, SK, Canada
| | - Geoffrey Maina
- College of Nursing, University of Saskatchewan, Prince Albert, SK, Canada
| | - Ghazal Mousavian
- College of Graduate and Postdoctoral Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yiting Fang
- College of Nursing, University of Saskatchewan, Prince Albert, SK, Canada
| | - Barbara Twum-Antwi
- College of Nursing, University of Saskatchewan, Prince Albert, SK, Canada
| | | | - Jonathan Amoyaw
- Department of Sociology and Social Anthropology, Dalhousie University, Halifax, NS, Canada
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Dziak JJ, Almirall D, Dempsey W, Stanger C, Nahum-Shani I. SMART Binary: New Sample Size Planning Resources for SMART Studies with Binary Outcome Measurements. MULTIVARIATE BEHAVIORAL RESEARCH 2024; 59:1-16. [PMID: 37459401 PMCID: PMC10792389 DOI: 10.1080/00273171.2023.2229079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Sequential Multiple-Assignment Randomized Trials (SMARTs) play an increasingly important role in psychological and behavioral health research. This experimental approach enables researchers to answer scientific questions about how to sequence and match interventions to the unique, changing needs of individuals. A variety of sample size planning resources for SMART studies have been developed, enabling researchers to plan SMARTs for addressing different types of scientific questions. However, relatively limited attention has been given to planning SMARTs with binary (dichotomous) outcomes, which often require higher sample sizes relative to continuous outcomes. Existing resources for estimating sample size requirements for SMARTs with binary outcomes do not consider the potential to improve power by including a baseline measurement and/or multiple repeated outcome measurements. The current paper addresses this issue by providing sample size planning simulation procedures and approximate formulas for two-wave repeated measures binary outcomes (i.e., two measurement times for the outcome variable, before and after intervention delivery). The simulation results agree well with the formulas. We also discuss how to use simulations to calculate power for studies with more than two outcome measurement occasions. Results show that having at least one repeated measurement of the outcome can substantially improve power under certain conditions.
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Affiliation(s)
- John J. Dziak
- Institute for Health Research and Policy, University of Illinois at Chicago
| | | | | | - Catherine Stanger
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College
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Connell AM, Seidman S, Ha T, Stormshak E, Westling E, Wilson M, Shaw D. Long-term Effects of the Family Check-Up on Suicidality in Childhood and Adolescence: Integrative Data Analysis of Three Randomized Trials. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1558-1568. [PMID: 35476247 PMCID: PMC9606146 DOI: 10.1007/s11121-022-01370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
This study employed integrative data analysis techniques to examine the long-term effects of the family check-up (FCU) on changes in youth suicide risk using three randomized prevention trials, including one trial initiated in early childhood and two initiated in early adolescence. Data were harmonized across studies using moderated nonlinear factor analysis, and intervention effects were tested using an autoregressive latent trajectory model examining changes in suicide risk across long-term follow-up. Across trials, significant long-term effects of the FCU on reductions in suicide risk were observed, although differences between intervention and control group trajectories declined over time. No moderation of intervention effects was observed by youth gender or race/ethnicity or across samples. While results offer further support for the benefits of the FCU for suicide risk reduction, they also suggest that such effects may wane over time, underscoring the need for continued development of the FCU to enhance longer-term durability of effects on suicide-related behaviors.
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Affiliation(s)
| | | | - Thao Ha
- Arizona State University, Tempe, USA
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Dalton H, Day J, Handley T, Booth A, Hayes A, Perkins D. Making Connections that Count - a Case Study of the Family Referral Service in Schools Program on the Central Coast, New South Wales, Australia. Int J Integr Care 2023; 23:7. [PMID: 36819618 PMCID: PMC9912907 DOI: 10.5334/ijic.6998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction Adverse childhood experiences (ACEs) are associated with health and social problems in later life, with an early intervention highly desirable for better outcomes. Description The Family-Referral-Services-In-Schools (FRSIS) is an early-intervention case management program for children and families with complex unmet needs, providing access to family support, housing, mental health care, and/or drug and alcohol services. The in-school trial setting was aimed at improving service uptake which was low in its community counterpart. Discussion FRSIS was a well-regarded intervention that reduced barriers to access for vulnerable families. The school setting and non-government agency service provision led to increased acceptability and trust. The program reached 5% of the student population. Support was tailored to family need, which was often complex and involved both children and caregivers. Initially, the multi-agency partnership and governance oversight group championed the service and enabled the pilot to be established, however funding uncertainty and competing priorities saw leadership support ebb away despite operational success. Conclusion The FRSIS model breaks down numerous barriers to accessing care for vulnerable families by its generalist nature and tailored approach and represents a high-trust approach to brokering appropriate care. Consistency in leadership support was a missed opportunity for program sustainability.
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Affiliation(s)
- Hazel Dalton
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Healthy Minds Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jamin Day
- School of Humanities, Creative Industries, and Social Sciences, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
| | - Tonelle Handley
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Angela Booth
- University Library, University of Newcastle, Callaghan, NSW, Australia
| | - Alan Hayes
- Macquarie University, Macquarie Park, NSW, Australia
| | - David Perkins
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mental Health Policy Unit, Health Services Research Institute, University of Canberra, Canberra, ACT, Australia
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The Family Check-up Intervention Moderates Polygenic Influences on Long-Term Alcohol Outcomes: Results from a Randomized Intervention Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:975-985. [PMID: 31175564 DOI: 10.1007/s11121-019-01024-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Alcohol problems are influenced by both genetic and environmental factors. Evidence from twin models and measured gene-environment interaction studies has demonstrated that the importance of genetic influences changes as a function of the environment. Research has also shown that family-centered interventions may protect genetically susceptible youth from developing substance use problems. In this study, we brought large-scale gene identification findings into an intervention study to examine gene-by-intervention effects. Using genome-wide polygenic scores derived from an independent genome-wide association study of adult alcohol dependence, we examined whether an adolescent family-centered intervention would moderate the effect of genetic risk for alcohol dependence on lifetime alcohol dependence in young adulthood, approximately 15 years after the start of intervention, among European American (N = 271; 48.3% in the intervention condition) and African American individuals (N = 192; 51.6% in the intervention condition). We found that among European American individuals, the intervention moderated the association between alcohol dependence polygenic scores and lifetime alcohol dependence diagnosis in young adulthood. Among participants in the control condition, higher alcohol dependence polygenic scores were associated with a greater likelihood of receiving an alcohol dependence diagnosis; in contrast, among participants in the intervention condition, there was no association between alcohol dependence polygenic scores and alcohol dependence diagnosis. No moderation effect was found among African Americans. These results demonstrate that modifying environments of genetically vulnerable youth could reduce the likelihood of developing alcohol dependence and underscore the significance of environmentally focused prevention and intervention efforts.
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Bergman P, Dudovitz RN, Dosanjh KK, Wong MD. Engaging Parents to Prevent Adolescent Substance Use: A Randomized Controlled Trial. Am J Public Health 2019; 109:1455-1461. [PMID: 31415193 DOI: 10.2105/ajph.2019.305240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To test whether providing information to parents about their child's academic performance and behavior in school will lead to lower rates of adolescent substance use.Methods. We performed a randomized controlled trial in Los Angeles, California. We enrolled 318 seventh graders and their parents in 2014 and collected data through 2016. Half of the participants had parents with income less than $15 000, and 81% were Latino. During this intervention, Linking Information and Families Together, we sent parents weekly text messages, telephone calls, or e-mails about missed assignments, grades, and behavior. Parents reported their monitoring and parenting self-efficacy; students reported their use and intentions to use alcohol, marijuana, and other drugs.Results. By the end of eighth grade, lifetime use of alcohol or marijuana was 18.2% in the control group and 10.2% in the intervention group (P = .02). Parenting self-efficacy, parent-child relationship, and student's grades were similar between groups.Conclusions. The intervention successfully reduced adolescent alcohol and marijuana initiation between grades 7 and 8. The intervention cost $15 per student per year but could be automated, reducing the marginal cost toward zero. The intervention holds promise as a scalable and innovative approach to reducing substance use.Trial Registration. ClinicalTrials.gov Identifier: NCT02129153.
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Affiliation(s)
- Peter Bergman
- Peter Bergman is with Teachers College, Columbia University, New York, NY. Rebecca N. Dudovitz, Kulwant K. Dosanjh, and Mitchell D. Wong are with the David Geffen School of Medicine, University of California, Los Angeles
| | - Rebecca N Dudovitz
- Peter Bergman is with Teachers College, Columbia University, New York, NY. Rebecca N. Dudovitz, Kulwant K. Dosanjh, and Mitchell D. Wong are with the David Geffen School of Medicine, University of California, Los Angeles
| | - Kulwant K Dosanjh
- Peter Bergman is with Teachers College, Columbia University, New York, NY. Rebecca N. Dudovitz, Kulwant K. Dosanjh, and Mitchell D. Wong are with the David Geffen School of Medicine, University of California, Los Angeles
| | - Mitchell D Wong
- Peter Bergman is with Teachers College, Columbia University, New York, NY. Rebecca N. Dudovitz, Kulwant K. Dosanjh, and Mitchell D. Wong are with the David Geffen School of Medicine, University of California, Los Angeles
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Gilligan C, Wolfenden L, Foxcroft DR, Williams AJ, Kingsland M, Hodder RK, Stockings E, McFadyen T, Tindall J, Sherker S, Rae J, Wiggers J. Family-based prevention programmes for alcohol use in young people. Cochrane Database Syst Rev 2019; 3:CD012287. [PMID: 30888061 PMCID: PMC6423557 DOI: 10.1002/14651858.cd012287.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alcohol use in young people is a risk factor for a range of short- and long-term harms and is a cause of concern for health services, policy-makers, youth workers, teachers, and parents. OBJECTIVES To assess the effectiveness of universal, selective, and indicated family-based prevention programmes in preventing alcohol use or problem drinking in school-aged children (up to 18 years of age).Specifically, on these outcomes, the review aimed:• to assess the effectiveness of universal family-based prevention programmes for all children up to 18 years ('universal interventions');• to assess the effectiveness of selective family-based prevention programmes for children up to 18 years at elevated risk of alcohol use or problem drinking ('selective interventions'); and• to assess the effectiveness of indicated family-based prevention programmes for children up to 18 years who are currently consuming alcohol, or who have initiated use or regular use ('indicated interventions'). SEARCH METHODS We identified relevant evidence from the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, MEDLINE (Ovid 1966 to June 2018), Embase (1988 to June 2018), Education Resource Information Center (ERIC; EBSCOhost; 1966 to June 2018), PsycINFO (Ovid 1806 to June 2018), and Google Scholar. We also searched clinical trial registers and handsearched references of topic-related systematic reviews and the included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster RCTs (C-RCTs) involving the parents of school-aged children who were part of the general population with no known risk factors (universal interventions), were at elevated risk of alcohol use or problem drinking (selective interventions), or were already consuming alcohol (indicated interventions). Psychosocial or educational interventions involving parents with or without involvement of children were compared with no intervention, or with alternate (e.g. child only) interventions, allowing experimental isolation of parent components. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 46 studies (39,822 participants), with 27 classified as universal, 12 as selective, and seven as indicated. We performed meta-analyses according to outcome, including studies reporting on the prevalence, frequency, or volume of alcohol use. The overall quality of evidence was low or very low, and there was high, unexplained heterogeneity.Upon comparing any family intervention to no intervention/standard care, we found no intervention effect on the prevalence (standardised mean difference (SMD) 0.00, 95% confidence interval (CI) -0.08 to 0.08; studies = 12; participants = 7490; I² = 57%; low-quality evidence) or frequency (SMD -0.31, 95% CI -0.83 to 0.21; studies = 8; participants = 1835; I² = 96%; very low-quality evidence) of alcohol use in comparison with no intervention/standard care. The effect of any parent/family interventions on alcohol consumption volume compared with no intervention/standard care was very small (SMD -0.14, 95% CI -0.27 to 0.00; studies = 5; participants = 1825; I² = 42%; low-quality evidence).When comparing parent/family and adolescent interventions versus interventions with young people alone, we found no difference in alcohol use prevalence (SMD -0.39, 95% CI -0.91 to 0.14; studies = 4; participants = 5640; I² = 99%; very low-quality evidence) or frequency (SMD -0.16, 95% CI -0.42 to 0.09; studies = 4; participants = 915; I² = 73%; very low-quality evidence). For this comparison, no trials reporting on the volume of alcohol use could be pooled in meta-analysis.In general, the results remained consistent in separate subgroup analyses of universal, selective, and indicated interventions. No adverse effects were reported. AUTHORS' CONCLUSIONS The results of this review indicate that there are no clear benefits of family-based programmes for alcohol use among young people. Patterns differ slightly across outcomes, but overall, the variation, heterogeneity, and number of analyses performed preclude any conclusions about intervention effects. Additional independent studies are required to strengthen the evidence and clarify the marginal effects observed.
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Affiliation(s)
- Conor Gilligan
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - David R Foxcroft
- Oxford Brookes UniversityDepartment of Psychology, Social Work and Public HealthMarston Road, Jack Straws LaneMarstonOxfordEnglandUKOX3 0FL
| | - Amanda J Williams
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Emily Stockings
- University of New South WalesNational Drug and Alcohol Research Centre (NDARC)SydneyAustralia
| | - Tameka‐Rae McFadyen
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Jenny Tindall
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Shauna Sherker
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Alcohol and Drug FoundationProgram Development and EvaluationLevel 12, 607 Bourke StreetMelbourneVictoriaAustralia3000
| | - Julie Rae
- Alcohol and Drug FoundationProgram Development and EvaluationLevel 12, 607 Bourke StreetMelbourneVictoriaAustralia3000
| | - John Wiggers
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
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Dishion TJ, Mun CJ, Ha T, Tein JY. Observed Family and Friendship Dynamics in Adolescence: a Latent Profile Approach to Identifying "Mesosystem" Adaptation for Intervention Tailoring. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 20:41-55. [PMID: 29968007 PMCID: PMC6951801 DOI: 10.1007/s11121-018-0927-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Nuanced understanding of adolescents' interpersonal relationships with family and peers is important for developing more personalized interventions that prevent problem behaviors and adjustment issues. We used latent profile analysis (LPA) to classify a community sample of 784 adolescents with respect to their observed relationship dynamics with friends and family using videotaped observations and five-minute audiotaped speech samples collected at ages 16-17. The resulting latent classes served to predict behavioral and emotional health in early adulthood. The LPA of the video- and audio-coded observational variables revealed a three-class model: (1) the healthy relationship group (n = 587), representing low levels of deviant and drug use talk with friends and positive, noncoercive relationship with parents; (2) the disaffected group (n = 90), representing high levels of drug use talk with friends and negativity about their parent(s) in the five-minute speech sample; and (3) the antisocial group (n = 107), representing high levels of deviant talk, drug use talk, coercive joining with friends, and coerciveness in family interactions. In contrast to the healthy relationship group, the disaffected group showed elevated risk for substance use problems and depression and the antisocial group showed higher risk for substance use problems and committing violent crimes in early adulthood. Outcome differences between disaffected and antisocial groups were mostly nonsignificant. We discuss the viability of applying these findings to tailoring and personalizing family-based interventions with adolescents to address key dynamics in the family and friendship relationships to prevent adult substance use problems, depression, and violence.
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Affiliation(s)
- Thomas J Dishion
- REACH Institute, Arizona State University, Tempe, AZ, USA
- Oregon Research Institute, Eugene, OR, USA
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Chung Jung Mun
- Department of Psychology, Arizona State University, Tempe, AZ, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - Thao Ha
- REACH Institute, Arizona State University, Tempe, AZ, USA
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- REACH Institute, Arizona State University, Tempe, AZ, USA
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Gonzales NA, Jensen M, Tein JY, Wong JJ, Dumka LE, Mauricio AM. Effect of Middle School Interventions on Alcohol Misuse and Abuse in Mexican American High School Adolescents: Five-Year Follow-up of a Randomized Clinical Trial. JAMA Psychiatry 2018; 75:429-437. [PMID: 29562080 PMCID: PMC5875338 DOI: 10.1001/jamapsychiatry.2018.0058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
IMPORTANCE Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking, particularly for US Latino populations. OBJECTIVE To test whether a universal middle school prevention program can reduce the frequency of alcohol misuse and rates of alcohol use disorder 5 years after implementation with a Mexican American sample. DESIGN, SETTING, AND PARTICIPANTS A previous randomized clinical trial was conducted with 516 Mexican American 7th graders and at least 1 parent who identified as having Mexican origin. Three annual cohorts of families were recruited from rosters of 4 middle schools and randomized to the 9-session Bridges/Puentes family-focused group intervention or a workshop control condition. Recruitment, screening, pretest, and randomization occurred in the same academic year for each cohort: 2003-2004, 2004-2005, and 2005-2006. Data acquisition for the follow-up assessments of late-adolescent alcohol misuse and abuse, which were not included in the initial randomized clinical trial, was conducted from September 2009 to September 2014; analysis was conducted between August 2016 and July 2017. In this assessment, 420 children (81.4%) of the sample were included, when the majority were in their final year of high school. INTERVENTIONS The 9-session Bridges/Puentes intervention integrated youth, parent, and family intervention sessions that were delivered in the spring semester at each school, with separate groups for English-dominant vs Spanish-dominant families. The control workshop was offered during the same semester at each school, also in English and Spanish. MAIN OUTCOMES AND MEASURES Primary outcomes were diagnostic assessment of lifetime alcohol use disorder in the 12th grade, 5 years after the intervention, based on the Diagnostic Interview Schedule for Children and past-year frequency of alcohol use, binge drinking, and drunkenness based on the 2001 Youth Risk Behavior Survey. RESULTS Of the 420 participants, 215 (51.2%) were girls (mean [SD] age, 17.9 [0.62] years). The intervention reduced the likelihood of having an alcohol use disorder (β = -.93; SE, 0.47; P = .047; odds ratio, 0.39). Intervention associations with past-year alcohol use frequency, binge drinking, and drunkenness were moderated by baseline substance use. The intervention reduced the frequency of alcohol use (β = -.51; SE, 0.24; P = .04; Cohen d = 0.43) and drunkenness (β = -.51; SE, 0.26; P = .049; Cohen d = 0.41) among youth who reported any previous substance use at baseline (T1 initiators) but not among those who had not initiated any substance use (T1 abstainers) at baseline. For past-year binge drinking, the intervention finding did not reach statistical significance among T1 initiators (β = -.40; SE, 0.23; P = .09) or T1 abstainers (β = .23; SE, 0.14; P = .11). CONCLUSIONS AND RELEVANCE Study results support an association between a universal middle school intervention and alcohol misuse and alcohol use disorders among Mexican American high school students and implementation of universal middle school interventions to reach Latino communities.
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Affiliation(s)
- Nancy A. Gonzales
- Department of Psychology and REACH Institute, Arizona State University, Tempe
| | - Michaeline Jensen
- Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill
| | - Jenn Yun Tein
- Department of Psychology and REACH Institute, Arizona State University, Tempe
| | - Jessie J. Wong
- Center on Primary Care and Outcomes Research, Stanford University, Stanford, California,Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Larry E. Dumka
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe
| | - Anne Marie Mauricio
- Department of Psychology and REACH Institute, Arizona State University, Tempe
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Otten R, Mun CJ, Dishion TJ. The social exigencies of the gateway progression to the use of illicit drugs from adolescence into adulthood. Addict Behav 2017; 73:144-150. [PMID: 28511099 PMCID: PMC6946384 DOI: 10.1016/j.addbeh.2017.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 04/07/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is limited empirical integration between peer clustering theory and the Gateway framework. The goal of the present study was to test the hypothesis that friendship associations partly predict gateway escalations in the use of drugs from adolescence to adulthood. METHOD This longitudinal study analyzed 3 waves of data from a community sample of 711 male and female participants without a history of illicit drug use reporting drug use at age 17, 22, and 27. Substance use assessments including tobacco, alcohol, cannabis, onset and abuse/dependence tendency of illicit drugs other than cannabis (i.e., cocaine, methamphetamine, and opiates), and friends' reported use of illicit drugs. Structural equation modeling was used to test the hypothesized model. RESULTS Participants' cannabis use level at age 17 was positively associated with perceived friends' drug use at age 22, which in turn predicted participants' onset of illicit drug use between ages 22 and 27. Moreover, progression of tobacco use throughout age 17 to 22 was associated with an increased onset of illicit drug use between ages 22 and 27. Apart for an effect of cannabis use at age 22 on abuse and dependence tendency to various drugs at age 28, results were similar. CONCLUSIONS During this period of development, the availability and selection of drug-using friends contributes to the progression to potentially more rewarding and damaging illicit drugs. These findings suggest the need to attend to the peer ecology in prevention and support the common practice of using abstaining peers in treatment for drug dependence.
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Affiliation(s)
- Roy Otten
- Pluryn, Research & Development, Nijmegen, The Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; ASU REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA.
| | - Chung Jung Mun
- ASU REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Thomas J Dishion
- ASU REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA; Oregon Research Institute, Eugene, OR, USA
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Smolkowski K, Seeley JR, Gau JM, Dishion TJ, Stormshak EA, Moore KJ, Falkenstein CA, Fosco GM, Garbacz SA. Effectiveness evaluation of the Positive Family Support intervention: A three-tiered public health delivery model for middle schools. J Sch Psychol 2017. [PMID: 28646972 DOI: 10.1016/j.jsp.2017.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article presents the results of an evaluation of Positive Family Support, an ecological family intervention and treatment approach to parent supports and family management training developed from a history of basic and translational research. This effectiveness trial, with 41 public middle schools randomly assigned to intervention or control, examined student-, teacher-, and parent-reported outcomes, as well as math and reading scores and school attendance. Multilevel analyses suggested that for students at risk for behavior problems, immediate-intervention schools outperformed control schools on parent-reported negative school contacts for students at risk for behavior problems. Implementation, however, was hampered by several challenges, including school funding cuts, lack of staff time to provide parenting supports, and staff turnover. Given that preventive interventions are generally cost effective, it is critical that researchers continue their efforts to refine these interventions and find ways to support schools' implementation of evidence-based programs that can reduce problem behavior. This article is part of a special issue "Parental Engagement in School-Based Interventions".
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Affiliation(s)
- Keith Smolkowski
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, United States.
| | - John R Seeley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, United States
| | - Jeffery M Gau
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, United States
| | - Tom J Dishion
- Arizona State University, 950 S. McAllister, Tempe, AZ 85287, United States
| | - Elizabeth A Stormshak
- University of Oregon, Prevention Science Institute, 1600 Millrace Dr. Ste. 106, Eugene, OR 97403-6217, United States
| | - Kevin J Moore
- University of Oregon, Prevention Science Institute, 1600 Millrace Dr. Ste. 106, Eugene, OR 97403-6217, United States
| | - Corrina A Falkenstein
- University of Oregon, Prevention Science Institute, 1600 Millrace Dr. Ste. 106, Eugene, OR 97403-6217, United States
| | - Gregory M Fosco
- Pennsylvania State University, 226 Health and Human Development Bldg., University Park, PA 16802, United States
| | - S Andrew Garbacz
- University of Wisconsin-Madison, Department of Educational Psychology, United States
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Dishion T, Forgatch M, Chamberlain P, Pelham WE. The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change. Behav Ther 2016; 47:812-837. [PMID: 27993335 PMCID: PMC5389456 DOI: 10.1016/j.beth.2016.02.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/15/2015] [Accepted: 02/03/2016] [Indexed: 11/18/2022]
Abstract
This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children's adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training-Oregon model), and family attenuation and dissolution (Treatment Foster Care-Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements.
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Affiliation(s)
| | - Marion Forgatch
- Implementation Sciences International Inc., and Oregon Social Learning Center
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