Brittany L. Rhoades

Feasibility and Preliminary Outcomes of a School-Based Mindfulness Intervention for Urban Youth

Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper reports findings from a pilot randomized controlled trial assessing the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention. Four urban public schools were randomized to an intervention or wait-list control condition (n = 97 fourth and fifth graders, 60.8% female). It was hypothesized that the 12-week intervention would reduce involuntary stress responses and improve mental health outcomes and social adjustment. Stress responses, depressive symptoms, and peer relations were assessed at baseline and post-intervention. Findings suggest the intervention was attractive to students, teachers, and school administrators and that it had a positive impact on problematic responses to stress including rumination, intrusive thoughts, and emotional arousal.

Latent Class Analysis: An Alternative Perspective on Subgroup Analysis in Prevention and Treatment

The overall goal of this study is to introduce latent class analysis (LCA) as an alternative approach to latent subgroup analysis. Traditionally, subgroup analysis aims to determine whether individuals respond differently to a treatment based on one or more measured characteristics. LCA provides a way to identify a small set of underlying subgroups characterized by multiple dimensions which could, in turn, be used to examine differential treatment effects. This approach can help to address methodological challenges that arise in subgroup analysis, including a high Type I error rate, low statistical power, and limitations in examining higher-order interactions. An empirical example draws on N = 1,900 adolescents from the National Longitudinal Survey of Adolescent Health. Six characteristics (household poverty, single-parent status, peer cigarette use, peer alcohol use, neighborhood unemployment, and neighborhood poverty) are used to identify five latent subgroups: Low Risk, Peer Risk, Economic Risk, Household & Peer Risk, and Multi-Contextual Risk. Two approaches for examining differential treatment effects are demonstrated using a simulated outcome: 1) a classify-analyze approach and, 2) a model-based approach based on a reparameterization of the LCA with covariates model. Such approaches can facilitate targeting future intervention resources to subgroups that promise to show the maximum treatment response.

Demographic and Familial Predictors of Early Executive Function Development: Contribution of a Person-Centered Perspective.

Executive function (EF) skills are integral components of young childrens growing competence, but little is known about the role of early family context and experiences in their development. We examined how demographic and familial risks during infancy predicted EF competence at 36months of age in a large, predominantly low-income sample of nonurban families from Pennsylvania and North Carolina in the United States. Using latent class analysis, six ecological risk profiles best captured the diverse experiences of these families. Profiles with various combinations of family structure, income, and psychosocial risks were differentially related to EF. Much of the influence of early risks on later EF appears to be transmitted through quality of parent-child interactions during infancy. Findings suggest that early family environments may prove to be especially fruitful contexts for the promotion of EF development.

Modeling the interplay of multilevel risk factors for future academic and behavior problems: A person-centered approach

This study identified profiles of 13 risk factors across child, family, school, and neighborhood domains in a diverse sample of children in kindergarten from four US locations (n = 750; 45% minority). It then examined the relation of those early risk profiles to externalizing problems, school failure, and low academic achievement in Grade 5. A person-centered approach, latent class analysis, revealed four unique risk profiles, which varied considerably across urban African American, urban White, and rural White children. Profiles characterized by several risks that cut across multiple domains conferred the highest risk for negative outcomes. Compared to a variable-centered approach, such as a cumulative risk index, these findings provide a more nuanced understanding of the early precursors to negative outcomes. For example, results suggested that urban children in single-parent homes that have few other risk factors (i.e., show at least average parenting warmth and consistency and report relatively low stress and high social support) are at quite low risk for externalizing problems, but at relatively high risk for poor grades and low academic achievement. These findings provide important information for refining and targeting preventive interventions to groups of children who share particular constellations of risk factors.

Why do high school seniors drink? Implications for a targeted approach to intervention.

The transition from high school to college provides a potentially critical window to intervene and reduce risky behavior among adolescents. Understanding the motivations (e.g., social, coping, enhancement) behind high school seniors’ alcohol use could provide one important avenue to reducing risky drinking behaviors. In the present study, latent class analysis was used to examine the relationship between different patterns of drinking motivations and behaviors in a sample of 12th graders (N = 1,877) from the 2004 Monitoring the Future survey. Unlike previous variable-centered analyses, this person-centered approach identifies types of motivations that cluster together within individuals and relates membership in these profiles to drinking behaviors. Results suggest four profiles of drinking motivations for both boys and girls, including Experimenters, Thrill-seekers, Multi-reasoners, and Relaxers. Early initiation of alcohol use, past year drunkenness, and drinking before 4 p.m. were associated with greater odds of membership in the Multi-reasoners class as compared to the Experimenters class. Although the strength of these relationships varied for boys and girls, findings were similar across gender suggesting that the riskiest drinking behavior was related to membership in the Multi-reasoners class. These findings can be used to inform prevention programming. Specifically, targeted interventions that tailor program content to the distinct drinking motivation profiles described above may prove to be effective in reducing risky drinking behavior among high school seniors.

The Role of a State-Level Prevention Support System in Promoting High-Quality Implementation and Sustainability of Evidence-Based Programs

Although numerous evidence-based programs (EBPs) have been proven effective in research trials and are being widely promoted through federal, state, and philanthropic dollars, few have been “scaled up” in a manner likely to have a measurable impact on today’s critical social problems. The Interactive Systems Framework for Dissemination and Implementation (ISF) explicates three systems that are critical in addressing the barriers that prevent these programs from having their intended public health impact. In this article we describe the relevance of these systems in a real-world context with a specific focus on the Prevention Support System (PSS). We expand on the ISF model by presenting funders and policy-makers as active and engaged stakeholders, and demonstrate how a state-level PSS has used empirical evidence to inform general and program-specific capacity-building and support interactions among researchers, funders, and practitioners in Pennsylvania. By embracing this expanded ISF framework as a conceptual model for the wide-scale dissemination and support of EBPs, and recognizing the need for a distinct state-level PSS, Pennsylvania has created an infrastructure to effectively address the primary barriers to moving from lists of EBPs to achieving population-level public health improvement.

Early Risk for Problem Behavior and Substance Use: Targeted Interventions for the Promotion of Inhibitory Control

Central to many neurocognitive models of childhood problem behavior is inhibitory control, which Kochanska and colleagues refer to as effortful impulse control (Kochanska et al., Child Development 67:490–507, 1996). Inhibitory control is defined here to include active processes of inhibition, effortful or willful control of emotions, thoughts, and actions, as well as self-regulation of both approach and avoidance (Rothbart, Temperament in childhood 59–73, 1989). Inhibitory control has also been considered a central component of executive cognitive function (ECF), which includes a variety of neurocognitive skills necessary for problem-solving and goal directed behaviors. This chapter has three primary objectives. First, we discuss research on brain development and neurocognition (ECF) relevant to childhood and adolescent problem behaviors including substance use. We expand our focus from substance use to early childhood behavior problems in general (e.g., conduct problems, attention deficit hyperactivity disorder (ADHD)) due to common neurological correlates, as well as putative relationships between childhood conduct problems and adolescent substance misuse (Clark et al., Drug and Alcohol Dependence 77:13–21, 2005). Next, we review the growing number of public health interventions that measure and/or target ECF, while highlighting those that specifically target inhibitory control. Finally, we discuss the implications and research directions for the future development and implementation of substance misuse interventions.