Preventing Health Disparities in Hispantic Youth: Changing trajectories

防止西班牙裔青年的健康差异：改变轨迹

• 批准号: 7314914
• 负责人: DANIEL A. SANTISTEBAN
• 金额: --
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7314914
• 关键词: ARHGEF5 gene; Acculturation; Address; Adolescent; Adoption; Age; Age-Years; Alcohol or Other Drugs use; Attention deficit hyperactivity disorder; Behavior; Behavioral; Centers of Research Excellence; Characteristics; Child; Clinical; Cluster Analysis; Communities; Competence; Condition; Conduct Disorder; Conflict (Psychology); Cultural Characteristics; Data; Dependency; Depressive disorder; Development; Diagnostic; Discrimination; Disease; Disruption; Drug usage; Educational process of instructing; Effectiveness of Interventions; Family; Family Practice; Family psychotherapy; Functional disorder; Funding; Future; HIV; Health; Hispanics; Immigration; Individual; Influentials; Intervention; Knowledge; Link; Literature; Manuals; Measures; Mental Depression; Mental disorders; Modeling; Moods; National Center on Minority Health and Health Disparities; Outcome; Parenting behavior; Parents; Peer Group; Pharmaceutical Preparations; Problem behavior; Procedures; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Research; Research Design; Risk; Risk Factors; Sampling; Schools; Sexually Transmitted Diseases; Stress; Substance abuse problem; Symptoms; Testing; Time; Training; Treatment Efficacy; Treatment outcome; United States National Institutes of Health; Youth; adolescent drug use; base; design; health disparity; indicated prevention; innovation; interpersonal conflict; juvenile justice system; knowledge base; prevent; psychoeducational; response; skills; stressor; therapy development

The proposed study is submitted as part of a P60 entitled "NCMHD Center for Culturally-Tailored Hispanic Health Disparities Research", in response to the NIH RFA-MD-06-002: Establishing Comprehensive NCMHD Research Centers of Excellence (El Centra). This study seeks to investigate the efficacy and mechanisms of a highly promising and culturally informed family-based intervention for preventing the emergence of two important health disparities in Hispanic youth - drug use and HIV/STIs. Indicated prevention of these specific disparities will be accomplished by identifying youth who already show serious child psychiatric, behavioral, and family risk factors (i.e., conduct disorder, attention deficit hyperactivity disorder, depressive disorders, and maladaptive family functioning) for these disparities and providing treatment to significantly modify these problems. In Hispanic youth and families we will also target the acculturation-related stressors that have been shown to place youth at risk for deteriorating health. The Culturally Informed Family Treatment for Adolescents (CIFTA) model to be tested integrates cultural and individually-based enhancements (e.g., modules on immigration stressors and individual skills development) with family treatment, to better address the youth and family's treatment needs. The culture-based enhancements are critical because the stresses of acculturation and discrimination compound the typical risk factors and family disruptions that can contribute to the deteriorating behavior in Hispanic youth. The flexible manual design is also innovative and helps to tailor interventions to the needs of Hispanic youth and families. This study will: 1) refine/adapt the CIFTA treatment manual to the unique clinical and developmental characteristics of youth 11-14 years of age, 2) implement a randomized clinical trial with 200 Hispanic youth, testing the efficacy of CIFTA compared to a community treatment as usual condition in reducing symptoms of CD, ADHD, DD, and family risk factors, 3) investigate the relationship of CIFTA's hypothesized mechanisms of treatment change to outcome, 4) test the ability of CIFTA to prevent health disparities over a period of 20 months post baseline, and 5) empirically identify subtypes of profiles on acculturation and immigration-related factors and link these to treatment outcomes. The results of this study have the potential to advance the knowledge base relevant to Hispanics by providing data from a fully Hispanic sample, on such important issues as outcome findings, mechanisms of change, and sub-types of culturally-related profiles that can impact treatment response.

拟议的研究是作为p60的一部分提交的，标题为“ NCMHD文化量的西班牙裔中心 健康差异研究”，响应NIH RFA-MD-06-002：建立全面的NCMHD 卓越研究中心（El Centra）。 这项研究旨在研究高度有希望和文化的功效和机制 知情的基于家庭的干预措施，以防止出现两个重要的健康差异 西班牙裔青年 - 吸毒和艾滋病毒/性传播疾病。指出预防这些特定差异将是 通过确定已经表现出严重儿童精神病，行为和家庭风险的年轻人来完成 因素（即行为障碍，注意力缺陷多动障碍，抑郁症和适应不良的因素 家庭功能）对于这些差异，并提供治疗以显着修改这些问题。在 西班牙裔青年和家庭，我们还将针对与文化相关的压力源 使青年有恶化的健康风险。青少年的文化知情家庭待遇 （CIFTA）要测试的模型整合了基于文化和个体的增强功能（例如，模块上的模块 移民压力源和个人技能发展）通过家庭治疗，以更好地解决年轻人 和家庭的治疗需求。基于文化的增强至关重要，因为 适应和歧视使典型的风险因素和家庭中断造成了贡献 西班牙裔青年的行为恶化。灵活的手动设计也是创新的，有助于 量身定制西班牙裔青年和家庭需求的干预措施。这项研究将：1）完善/适应Cifta 治疗手册，涉及11-14岁的青年独特的临床和发育特征，2） 与200名西班牙裔青年一起实施随机临床试验，与A相比，CIFTA的功效 像往常的社区治疗减少CD，ADHD，DD和家庭风险因素的症状一样，3） 研究CIFTA假设的治疗机制变化与结果的关系，4）测试 CIFTA在基准后20个月内预防健康差异的能力，以及5） 确定有关适应和移民相关因素的概况的亚型，并将其与治疗联系起来 结果。 这项研究的结果有可能提高与西班牙裔有关的知识基础 从完全西班牙裔样本中提供数据，诸如结果结果，机制 变化和与文化有关的特征的子类型，可能会影响治疗反应。