Steven Hoffman

Short-Term Effects on Substance Use of the Keepin' It REAL Pilot Prevention Program: Linguistically Adapted for Youth in Jalisco, Mexico

This article presents the short-term effects of a pilot study of keepin’it REAL (Manténte REAL) conducted in central Mexico by a binational team of investigators. This middle school-based model program for preventing substance use was adapted for Mexico linguistically but not culturally. Two Guadalajara public middle schools were recruited and randomly assigned to either implement the prevention program or serve as a control site. The program was implemented in the treatment site by the students’ regular teachers, who were trained by the research team. Seventh graders in ten classrooms in the treatment and control schools (N = 432) completed a pretest and posttest survey in Spanish similar to the survey utilized in the original efficacy trial of keepin’it REAL in the US. T-tests and OLS regressions were conducted to determine the effects of the intervention on substance use outcomes. Differences between treatment and control groups in frequency of use of alcohol and tobacco, the two substances of choice in this sample, were significant and in the desired direction. Differences in amount of use were also in the preferred direction but were not significant for alcohol and only marginally significant for tobacco. When the sample was split by gender, statistically significant treatment effects remained for females but were not observed among males. Effects of the linguistically adapted version of keepin’it REAL appears to be driven by the change in female use; however, the difference in male and female outcomes was not statistically significant. Implications for cultural adaptation and prevention in Mexico are discussed from a communication competency perspective. The promising results of the pilot study suggest that the linguistic adaptation was effective, but that a comprehensive cultural adaptation of keepin’it REAL in partnership with Mexican investigators and communities may be warranted.

Family teacher and parent perceptions of youth needs and preparedness for transition upon discharge from residential care

Summary The purpose of this study was to compare parent (N = 51) and family teacher (N = 102) ratings of perceptions of aftercare for youth reintegrating into the home and community settings following a stay in residential care. Findings The results show large differences between treatment providers and parents as to the level of youth preparedness for transition. Applications Youth leaving residential care facilities struggle to maintain the gains they make during their time in treatment. Understanding what residential care providers and parents of youth perceive to be most important for youth during this transition period is essential to the youth’s long-term success.

Health Literacy among Youth in Guatemala City

Health literacy (HL) is recognized as an important health construct that is correlated with various health-related outcomes, but outside of the United States there is limited HL research available, particularly among youth. This study looked at the HL and harmful health behavior (i.e., substance use) of 210 youth across 10 schools in Guatemala City. Based on results from the Newest Vital Sign (NVS) HL assessment, fewer than one third of youth sampled had adequate HL. Training/education to improve adolescent HL is needed in Guatemala City, and the unique skillset of social workers could be an idea method of reaching at-risk youth.

Health Literacy in High-Risk Youth: A Descriptive Study of Children in Residential Care

Although previous studies have demonstrated that children in out-of-home care present with elevated levels of mental and physical health, educational, and behavioral problems, little is known about youths ability to manage health care needs or access health information and support. This study evaluates the health literacy skills of 229 youth served in a residential setting. Results revealed that the majority of youth demonstrated some level of risk, and anywhere from one-quarter to one-third demonstrated significant health literacy deficits suggesting a need for additional research and treatment intervention. Implications, study limitations, and recommendations for practice and future research are discussed.

Understanding the gendered patterns of substance use initiation among adolescents living in rural, central Mexico

BACKGROUND Little is known about the age of initiation and gender differences in substance use among adolescents in rural, central Mexico. METHODS The cross-sectional data were collected from students enrolled in the Videobachillerato (VIBA) (video high school) programme in Guanajuato, Mexico. Questionnaires asked students about the age at which they had used alcohol, cigarettes, or cannabis for the first time. Kaplan-Meier Survival Functions were used to estimate if males and females were significantly different in their cumulative probabilities of initiating substances over time. RESULTS On average, alcohol is initiated at 14.7 years of age, cigarettes at 15.1 years of age, and cannabis at 16.5 years of age. Over time, males had a significantly higher probability of initiating alcohol (Kaplan-Meier Failure Curve: X(2)=26.35, p<0.001), cigarettes (Kaplan-Meier Failure Curve: X(2)=41.90, p<0.001), and cannabis (Kaplan-Meier Failure Curve: X(2)=38.01, p<0.001) compared to females. CONCLUSIONS These results highlight the gendered patterns of substance use initiation among adolescents in rural, central Mexico and underscore the need for gendered substance use prevention interventions with these adolescents. By putting forth efforts to understand substance use initiation patterns of adolescents living in rural, central Mexico, culturally specific and efficacious prevention efforts can be tailor-made to create lasting differences.

Suicidal Ideation and Migration Aspirations among Youth in Central Mexico

Over the past 100 years the state of Guanajuato has consistently been one of the highest migrant sending states in Mexico. Youth living in high migratory states such as Guanajuato are heavily influenced by the expectation that they will travel to the US, and research has shown that those who do not migrate may be looked down upon by members of their community. This secondary analysis looks at the connection between suicidal ideation and migration aspirations among a group of adolescents living in Guanajuato, Mexico. Data were originally collected in 2007 as part of a comprehensive health survey of youth attending an alternative high schooling program. Regression analyses show that suicidal ideation predicts intentions to migrate among both males and females, while other factors differentially influence the adolescents by gender. The results indicate that suicidal ideation may be associated with migration aspirations among Mexican youth living in high migratory communities. Study limitations and implications are discussed.

Confirmatory factor analysis of the Warwick-Edinburgh Mental Wellbeing Scale among youth in Mexico

The internal structure of the Warwick-Edinburgh Mental Wellbeing Scale was evaluated using confirmatory factor analysis for a sample of youth living in Michoacán, Mexico. While the chi-square test of model fit suggested misfit to the data, the alternative fit indices and standardized factor loadings supported the conclusion that the items are adequate and reliable indicators of a single underlying latent factor. The utilization of this strengths-based mental health instrument could help circumvent some of the negativity and stigma inherent in traditional mental health assessments.