Guadalupe A. Bacio

Ecodevelopmental and Intrapersonal Moderators of a Family Based Preventive Intervention for Hispanic Youth: A Latent Profile Analysis

Hispanic adolescents are disproportionately affected by externalizing disorders, substance use and HIV infection. Despite these health inequities, few interventions have been found to be efficacious for this population, and even fewer studies have examined whether the effects of such interventions vary as a function of ecodevelopmental and intrapersonal risk subgroups. The aim of this study was to determine whether and to what extent the effects of Familias Unidas, an evidence-based preventive intervention, vary by ecodevelopmental and intrapersonal risk subgroups. Data from 213 Hispanic adolescents (mean age = 13.8, SD = 0.76) who were enrolled in a randomized clinical trial evaluating the relative efficacy of Familias Unidas on externalizing disorders, substance use, and unprotected sexual behavior were analyzed. The results showed that Familias Unidas was efficacious over time, in terms of both externalizing disorders and substance use, for Hispanic youth with high family ecodevelopmental risk (e.g., poor parent-adolescent communication), but not with youth with moderate ecodevelopmental or low ecodevelopmental risk. The results suggest that classifying adolescents based on their family ecodevelopmental risk may be an especially effective strategy for examining moderators of family-based preventive interventions such as Familias Unidas. Moreover, these results suggest that Familias Unidas should potentially be targeted toward youth with high family ecodevelopmental risk. The utility of the methods presented in this article to other prevention scientists, including genetic, neurobiological and environmental scientists, is discussed.

Differences in quit attempts between non-Hispanic Black and White daily smokers: The role of smoking motives

INTRODUCTION The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking. METHODS This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n=155) and non-Hispanic White (n=159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke. RESULTS As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores in these subscales mediated the relationship between race and quit attempts. CONCLUSIONS In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke.

Determinants of Problem Drinking and Depression among Latino Day Laborers

Little is known about alcohol misuse and depression among Latino day laborers despite the fact that they encounter multiple stressors (e.g., job instability, unsafe work environments). A structural equation model tested the relationships among laborer stress, social support, health status, current alcohol misuse, and depression. A sample of 89 male, urban Latino day laborers completed measures assessing these constructs in 2011. Stress was negatively related to physical health status, which was associated with depression. Findings suggest that stressors specific to being a day laborer resulting from their work and living conditions generate and maintain health disparities in this vulnerable population.

Ecodevelopmental predictors of early initiation of alcohol, tobacco, and drug use among Hispanic adolescents

The purpose of this cross-sectional study was to test the transactional relationships of risk and protective factors that influence initiation of alcohol, tobacco, and drug use among Hispanic youth. Ecodevelopmental theory was used to identify factors at multiple ecological levels with a focus on four school-level characteristics (i.e. school socioeconomic status, school climate, school acculturation, and school ethnic composition). A sample of 741 Hispanic adolescents (M age=13.9, SD=.67) and their caregivers were recruited from 18 participating middle schools in Miami-Dade County, FL. Structural equation modeling was used to test the hypothesized ecodevelopmental model of early substance use, accounting for school clustering effects. Results provided strong support for the model (CFI=.95; RMSEA=.03). School SES was indirectly related to the likelihood of starting substance use through perceived peer use norms (β=.03, p<.02). Similarly, school climate had an indirect effect on substance use initiation through family functioning and perceptions of peer use norms (β=-.03, p<.01). Neither school ethnic composition nor school acculturation had indirect effects on initiation of substance use. Results highlight the importance of the interplay of risk and protective factors at multiple ecological levels that impact early substance use initiation. Further, findings underscore the key role of school level characteristics on the initiation of substance use and present opportunities for intervention.

Alcohol Use Following an Alcohol Challenge and a Brief Intervention among Alcohol‐Dependent Individuals

BACKGROUND AND OBJECTIVES The study examined the effects of an alcohol challenge on naturalistic drinking among alcohol-dependent individuals and explored brief motivational interviewing (MI) as a potential intervention for these participants. METHOD Alcohol-dependent individuals (n = 32, eight females) completed the intake assessment, alcohol challenge, one MI session, and 1-month follow-up (87.5% retention) where they completed measures of drinking and motivation for change. RESULTS As expected, multilevel mixed models revealed that drinking did not increase post-alcohol challenge. Participants reported a reduction in ambivalence, drinking days, and a trend towards fewer total drinks between the MI and 1-month follow-up. CONCLUSIONS Consistent with other studies, the alcohol challenge did not worsen alcohol use. Results support further investigation of brief MI for alcohol-dependent participants in alcohol challenges. SCIENTIFIC SIGNIFICANCE Alcohol administration to alcohol-dependent participants appears to not exacerbate naturalistic drinking. MI may be a feasible intervention for non-treatment seeking alcohol-dependent participants in alcohol challenge studies.

Effects of sex composition on group processes in alcohol prevention groups for teens.

Although most alcohol and other drug prevention programs for adolescents are offered in group settings, little is known about the possible effects of sex composition on group processes and mechanisms of change. Using the Group Actor-Partner Interdependence Model framework, we examined how the sex constellation of adolescent prevention group members influenced youth satisfaction, engagement, and endorsement of healthy behavior during group. Participants in Project Options (N = 379; 61.8% girls; Mage = 16.1; SD = 1.4), a voluntary school-based alcohol prevention program, completed measures of satisfaction at each prevention session and observers rated engagement and change talk for each group. When analyses were oriented toward girls, their personal satisfaction, group-rated satisfaction, and group-level engagement were positively related to having more girls in the group. Similarly, in boys, personal satisfaction, satisfaction of the group as a whole, and engagement in groups improved when groups were composed of more girls. Statements supportive of healthy alcohol/drug-related decision making were unrelated to group composition. The findings suggest that the composition of girls and boys in groups has differential effects on some group processes. This avenue of research has merit for understanding the mechanisms associated with satisfaction and engagement in adolescent substance use prevention programs.

Modeling Alcohol Use Disorder Severity: An Integrative Structural Equation Modeling Approach

Background: Alcohol dependence is a complex psychological disorder whose phenomenology changes as the disorder progresses. Neuroscience has provided a variety of theories and evidence for the development, maintenance, and severity of addiction; however, clinically, it has been difficult to evaluate alcohol use disorder (AUD) severity. Objective: This study seeks to evaluate and validate a data-driven approach to capturing alcohol severity in a community sample. Method: Participants were non-treatment seeking problem drinkers (n = 283). A structural equation modeling approach was used to (a) verify the latent factor structure of the indices of AUD severity; and (b) test the relationship between the AUD severity factor and measures of alcohol use, affective symptoms, and motivation to change drinking. Results: The model was found to fit well, with all chosen indices of AUD severity loading significantly and positively onto the severity factor. In addition, the paths from the alcohol use, motivation, and affective factors accounted for 68% of the variance in AUD severity. Greater AUD severity was associated with greater alcohol use, increased affective symptoms, and higher motivation to change. Conclusion: Unlike the categorical diagnostic criteria, the AUD severity factor is comprised of multiple quantitative dimensions of impairment observed across the progression of the disorder. The AUD severity factor was validated by testing it in relation to other outcomes such as alcohol use, affective symptoms, and motivation for change. Clinically, this approach to AUD severity can be used to inform treatment planning and ultimately to improve outcomes.

Family Factors: Immigrant Families and Intergenerational Considerations

This chapter emphasizes the importance of paying special attention to the family context for immigrant youth. Some key considerations for immigrant families, including separation and reunification, cultural and language brokering, acculturative gaps, and family conflict, are described. Case vignettes are used to illuminate these experiences, in order to bring empirical findings to life and reflect the kinds of circumstances which practitioners may encounter in their work with immigrant families.

Patterns of Drinking Initiation Among Latino Youths: Cognitive and Contextual Explanations of the Immigrant Paradox

ABSTRACT This study examined the immigrant paradox in drinking initiation among Latino youths and tested contextual (i.e., family, peer) and cognitive (i.e., alcohol expectancies, risk-taking) explanations of this pattern. A sample of 129 first- and second-generation (73%) youths completed the study. The estimated odds of starting to drink were 2.5 (95% confidence interval [CI]: 1.10–5.9) times higher for second-generation teens compared to first-generation youths. Negative expectancy valuations and perceptions of peer substance use simultaneously explained the generational increase in drinking initiation. Addressing these tractable mechanisms represents opportunities to delay initiation and help reduce emerging disparities among Latino youth.