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.

拟议的研究作为题为“NCMHD 文化定制西班牙裔中心”的 P60 的一部分提交 健康差异研究”，回应 NIH RFA-MD-06-002：建立综合 NCMHD 卓越研究中心（El Centra）。 本研究旨在调查一种极具前景和文化的功效和机制。 以家庭为基础的知情干预措施可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/性传播感染。将采取措施预防这些具体差异 通过识别已经表现出严重儿童精神、行为和家庭风险的青少年来完成 因素（即行为障碍、注意力缺陷多动障碍、抑郁症和适应不良） 家庭功能）解决这些差异，并提供治疗以显着改变这些问题。在 我们还将针对西班牙裔青年和家庭，针对与文化适应相关的压力源，这些压力源已被证明 使青少年面临健康恶化的风险。青少年的文化知情家庭治疗 待测试的（CIFTA）模型集成了文化和基于个人的增强功能（例如，模块 移民压力源和个人技能发展）与家庭待遇，以更好地解决年轻人的问题 以及家人的治疗需求。基于文化的增强至关重要，因为 文化适应和歧视加剧了典型的风险因素和家庭破裂，可能导致 西班牙裔年轻人日益恶化的行为。灵活的手动设计也具有创新性，有助于 根据西班牙裔青年和家庭的需求制定干预措施。本研究将： 1) 完善/调整 CIFTA 针对 11-14 岁青少年独特的临床和发育特征的治疗手册，2) 对 200 名西班牙裔青年实施一项随机临床试验，测试 CIFTA 与 照常社区治疗可减少 CD、ADHD、DD 症状和家庭危险因素，3) 研究 CIFTA 假设的治疗改变机制与结果的关系，4) 测试 CIFTA 在基线后 20 个月内防止健康差异的能力，以及 5) 凭经验 确定文化适应和移民相关因素的亚型，并将其与治疗联系起来 结果。 这项研究的结果有可能通过以下方式推进与西班牙裔相关的知识库： 提供来自完全西班牙裔样本的数据，涉及结果发现、治疗机制等重要问题 变化以及可能影响治疗反应的文化相关概况的子类型。