Barbara Lopez

A Randomized Controlled Trial of a Parent-Centered Intervention in Preventing Substance Use and HIV Risk Behaviors in Hispanic Adolescents

The present study evaluated the efficacy of Familias Unidas + Parent-Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention, in preventing adolescent substance use and unsafe sexual behavior. Two hundred sixty-six 8th-grade Hispanic adolescents and their primary caregivers were randomly assigned to 1 of 3 conditions: Familias Unidas + PATH, English for Speakers of Other Languages (ESOL) + PATH, and ESOL + HeartPower! for Hispanics (HEART). Participants were assessed at baseline and at 6, 12, 24, and 36 months postbaseline. Results showed that (a) Familias Unidas + PATH was efficacious in preventing and reducing cigarette use relative to both control conditions; (b) Familias Unidas + PATH was efficacious, relative to ESOL + HEART, in reducing illicit drug use; and (c) Familias Unidas + PATH was efficacious, relative to ESOL + PATH, in reducing unsafe sexual behavior. The effects of Familias Unidas + PATH on these distal outcomes were partially mediated by improvements in family functioning. These findings suggest that strengthening the family system, rather than targeting specific health behaviors, may be most efficacious in preventing and/or reducing cigarette smoking, illicit drug use, and unsafe sex in Hispanic adolescents.

A randomized controlled trial of Familias Unidas for Hispanic adolescents with behavior problems.

Objective: To evaluate the efficacy of Familias Unidas, a Hispanic-specific, parent-centered intervention, in preventing/reducing adolescent substance use, unsafe sexual behavior, and externalizing disorders. Methods: A total of 213 8th grade Hispanic adolescents with behavior problems and their primary caregivers were assigned randomly to one of two conditions: Familias Unidas or Community Control. Participants were assessed at baseline and at 6, 18, and 30 months post baseline. Results: Results showed that, relative to a Community Control condition, Familias Unidas was efficacious in preventing or reducing externalizing disorders, preventing and reducing substance use, and in reducing unsafe sexual behavior. The effects of Familias Unidas on these outcomes were partially mediated by improvements in family functioning. Conclusions: These findings suggest that parent-centered intervention is an efficacious strategy for preventing/reducing specific health risk behaviors in Hispanic adolescents with behavior problems.

The Impact of Acculturative Stress and Daily Hassles on Pre-adolescent Psychological Adjustment: Examining Anxiety Symptoms

Acculturative stress in relation to anxiety symptoms has not been examined empirically in young Hispanic populations. The present study, conducted with 138 pre-adolescent Hispanic youngsters, investigated this relationship. The findings suggested that acculturative stress was related to physiological, concentration, and worrisome symptoms of anxiety. After decomposing acculturative stress, it became evident that perceived discrimination accounted for a large proportion of the variance in the relationship between acculturative stress and anxiety. Immigration-related stress was mostly associated with worry symptoms. Finally, total daily hassles were an independent predictor of concentration and physiological anxiety symptoms. Implications for prevention interventions and future research are discussed.

Ecodevelopmental × Intrapersonal Risk: Substance Use and Sexual Behavior in Hispanic Adolescents

Hispanic adolescents are a rapidly growing population and are highly vulnerable to substance abuse and HIV infection. Many interventions implemented thus far have been “one size fits all” models that deliver the same dosage and sequence of modules to all participants. To more effectively prevent substance use and HIV in Hispanic adolescents, different risk profiles must be considered. This studys purpose is to use intrapersonal and ecodevelopmental risk processes to identify Hispanic adolescent subgroups and to compare substance use rates and sexual behavior by risk subgroup. The results indicate that a larger proportion with high ecodevelopmental risk (irrespective of the intrapersonal risk for substance use) report lifetime and past 90-day cigarette and illicit drug use. In contrast, a larger proportion with high intrapersonal risk for unsafe sex (irrespective of ecodevelopmental risk) report early sex initiation and sexually transmitted disease incidence. Implications for intervention development are discussed in terms of these Hispanic adolescent subgroups.

Correlates of Early Alcohol and Drug Use in Hispanic Adolescents: Examining the Role of ADHD with Comorbid Conduct Disorder, Family, School, and Peers

This study examined correlates of early adolescent alcohol and drug use in a community sample of 217 eighth-grade adolescents with behavior problems and from Hispanic/Latino immigrant families. Structural equation modeling was used to examine relationships of multiple contexts (e.g., family, school, and peers) to alcohol and drug use. Results suggest that conduct disorder in youth with high levels of hyperactivity symptoms, poor school functioning, and peer alcohol and drug use was directly related to early adolescent alcohol and drug use. Attention deficit/hyperactivity disorder with comorbid conduct disorder and family functioning was indirectly related to early alcohol and drug use through poor school functioning and through peer alcohol and drug use. Results are discussed in terms of possible targets for interventions to prevent alcohol and drug use in Hispanic adolescents.

School, Family, and Peer Factors and Their Association with Substance Use in Hispanic Adolescents

The purpose of the present study was to examine how relationships among family, school, and peer factors relate to likelihood of substance use in Hispanic adolescents. Results indicated that only perceived peer substance use was directly related to adolescents’ own substance use. A significant interaction was found between parental monitoring and peer use vis-à-vis substance use, which suggests that the relationship between parental monitoring and the adolescents’ own use was significantly stronger among youth who reported that more of their friends used substances. Implications of these results for the design of substance use preventive interventions are discussed. Editors’ Strategic Implications: This research is promising both in terms of the implications for targets of prevention programming and for the application of ecodevelopmental theory, which might guide similar efforts with different cultural groups.

Adolescent Neurological Development and its Implications for Adolescent Substance Use Prevention

Recent technological advancements have facilitated the study of adolescent neurological development and its implications for adolescent decision-making and behavior. This article reviews findings from the adolescent neurodevelopment and substance use prevention literatures. It also discusses how findings from these two distinct areas of adolescent development can complement each other and be used to build more developmentally appropriate interventions for preventing adolescent substance use. Specifically, a combination of child-centered and family-based strategies is advocated based on extant neurological and prevention literature. Editors’ strategic implications: Researchers are encouraged to take up the authors’ challenge and study the links between adolescent neurological development/decision making ability and the long term efficacy of comprehensive interventions for preventing adolescent substance use.

Parent-centered intervention: A practical approach for preventing drug abuse in hispanic adolescents

Objective: The objective of the present article is to review and discuss Familias Unidas, an empirically supported, family-based, culturally specific drug abuse and HIV prevention intervention for Hispanic immigrant adolescents and their families. Method: The authors focus on engagement and retention as well as on intervention delivery. Conclusions: The present article serves as a guide for social workers and mental health practitioners in carrying out effective family-based adolescent substance use and HIV preventive interventions. Recommendations for and challenges to implementing the intervention in practice-based settings are discussed.

The prevalence of erectile dysfunction in heart failure patients by race and ethnicity

Erectile dysfunction (ED) is a common problem in male patients with heart failure (HF). However, no study was found that estimates the prevalence of ED by US ethnic groups with HF. We conducted an observational, cross-sectional study of patients enrolled in a HF disease management program in two sites Louisiana (N=329; 178 white, 99 black) and Florida (N=52; Hispanic). All male patients with an ejection fraction ⩽40% were included. The Sexual Health Inventory for Men was used to estimate the prevalence of ED. Overall prevalence of ED was 89% and ED severity did not vary by race/ethnic group. Race/ethnic group differences were found for age, New York Heart Association functional classification, and blood pressure. Hispanic patients had the lowest unadjusted and adjusted prevalence rate of ED (81, 85%) compared to Black (90, 95%) and White (91, 92%) patients. There is a high prevalence of ED in Hispanic, Black and White ethnic groups with HF.

The Prevalence of Peripheral Arterial Disease in Patients With Heart Failure by Race and Ethnicity

More than 5 million people live with heart failure (HF) in the United States, and this number is expected to rise due to several factors including increased life expectancy brought about by medical therapy and the aging of the population. HF and peripheral arterial disease (PAD) share many risk factors. A review of the literature reveals several studies supporting a higher prevalence of HF in patients with PAD than in those without PAD. However, no study was found that estimates the prevalence of PAD in patients with HF. Moreover, the prevalence of PAD by US race/ethnic groups with HF has not been studied. The authors conducted a cross-sectional multicenter study of patients enrolled in an HF disease management program in Louisiana (n=330) and Florida (n=464). All patients with an ejection fraction <or=40% and a measured ankle-brachial index (ABI) were included in the study. PAD was defined as an ABI <0.9. The overall prevalence of PAD was 17.1%. The prevalence of PAD was 25.9% for white, 13.4% for Hispanic, and 13.7% for black patients. White patients had a higher prevalence of PAD than black or Hispanic patients (P<.001). Routine ABI measurements in these groups would enhance efforts to detect subclinical PAD.