Preventing Internalizing Symptoms Among Hispanic Adolescents: A Synthesis Across Familias Unidas Trials
Open accessAbstract
Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often underpowered to address moderation and mediation, an issue addressed in this paper. This synthesis study combined individual-level, longitudinal data from 721 adolescents across 3 randomized clinical trials of Familias Unidas, a family-focused prevention intervention for Hispanic youth. Using integrative data analysis (IDA) methods applied to trials, the study examined intervention moderation and mediation effects on internalizing symptoms. Baseline internalizing symptoms were a significant moderator of the intervention's effects on internalizing symptoms, while baseline externalizing symptoms did not moderate intervention effects. Baseline parent-adolescent communication, a modifiable risk factor and hypothesized mechanism by which the intervention works, significantly moderated the intervention's effects. Specifically, the intervention was more efficacious in its impact on internalizing symptoms for youth with lower initial levels of parent-adolescent communication compared to those with higher communication levels. Moderated mediation analyses showed that parent-adolescent communication changes mediated the intervention's effects on internalizing symptoms, with stronger effects for those with poorer baseline communication. Results suggest a potential benefit of identifying youth risks prior to interventions, and targeting specific modifiable mediators that lead to reductions of internalizing problems of adolescents. Findings also highlight advantages of utilizing data from combined trials and IDA for examining intervention moderators and mediators.
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Familias Unidas has been shown to have its strongest effect with Hispanic families with poor parent-child communication.
“Familias Unidas has been shown to have its strongest effect with Hispanic families with poor parent-child communication [24, 25]”
From “Scaling-out” evidence-based interventions to new populations or new health care delivery systems (2017) · cites this paper as [24]
Improvement in the parent-child relationship through parenting interventions has been shown to relate to lower drug abuse, HIV sex risk behavior, and internalizing behavioral symptoms for adolescents.
“As one example, improvement in the parent-child relationship through parenting interventions has been shown to relate to lower drug abuse, HIV sex risk behavior, and internalizing behavioral symptoms for adolescents [24, 44–46].”
From “Scaling-out” evidence-based interventions to new populations or new health care delivery systems (2017) · cites this paper as [24]
Perrino and colleagues found that the theoretical mediator of parent-child communication was impacted only when its baseline measure was low.
“They found that the theoretical mediator of parent-child communication was impacted only when its baseline measure was low.”
From “Scaling-out” evidence-based interventions to new populations or new health care delivery systems (2017) · cites this paper as [24]
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- Authors
- Perrino, T., Pantin, H., Prado, G., Huang, S., Brincks, A., Howe, G., Beardslee, W., Sandler, I., & Brown, C. H.
- Affiliations
- University of Miami (US)
- George Washington University (US)
- Boston Children's Hospital (US)
- Arizona State University (US)
- Northwestern University (US)
- Corresponding author
- Perrino, Tatiana
- ORCID
- Venue
- Prevention Science
- Published
- 2014-01-05
- Volume
- 15
- Issue
- 6
- Pages
- 917-928
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC4082758
- OpenAlex
- W2078402699
- Cited by
- 66
- References
- 39
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 14 · 2015: 6 · 2014: 2 · 2013: 1
- FWCI
- 11.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH61143, R01MH040859)
- National Institute on Drug Abuse (R01DA017462, R01DA025894)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Psychosocial Factors Impacting Youth
- Keywords
- internalizing problems, adolescent depression, Latino youth, family-focused prevention, parent-adolescent communication, modifiable risk factors, integrative data analysis
- MeSH terms
- Adolescent, Data Interpretation, Statistical, Depression, Female, Hispanic or Latino, Humans, Longitudinal Studies, Male, Parent-Child Relations, Regression Analysis, Randomized Controlled Trials as Topic, Checklist
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