Long-term effects of a universal family intervention: Mediation through parent-adolescent conflict
Open accessAbstract
This randomized trial of a family-focused preventive intervention for Mexican American middle schoolers examined internalizing, externalizing, and substance use outcomes in late adolescence, 5 years after completing the intervention. Parent-adolescent conflict was tested as a mediator of these effects. The role of parent and adolescent acculturation in these pathways was also examined. There were 494 seventh-grade adolescents and their primary female caregivers randomized to receive either a 9-week multicomponent intervention or a brief workshop control group. Assessments were conducted at pretest, 2-year follow-up (9th grade), and 5-year follow-up (when most participants were in the 12th grade). The Bridges program significantly reduced mother-adolescent conflict measured in the 9th grade, with conflict mediating program effects on internalizing and externalizing symptoms, adolescent substance use, and diagnosed internalizing disorder in late adolescence. Mother and child acculturation were both significantly predictive of late adolescence outcomes. Contrary to hypotheses, neither mother nor child acculturation emerged as a significant predictor of mother-adolescent conflict, and the interaction of mother and adolescent acculturation was similarly not related to mother-adolescent conflict. Intervention effects were largely consistent across different levels of acculturation. These findings provide support for the efficacy of family-focused intervention during early adolescence, both in reducing mental health problems and substance use in the long term and in impacting parent-adolescent conflict processes that appear to play an important role in the development of later adjustment problems.
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In the Bridges program for Hispanic youth entering high school, reduced parent-child conflict at two years mediated the program's effects on internalizing, externalizing, and substance use problems five years after the program ended.
“an evaluation of the Bridges program for Hispanic youth in transition to high school found that the effects of the program to reduce conflict between parents and children at two years mediated program effects to reduce internalizing, externalizing, and substance use problems five years after the program ended (10).”
From Long-term effects of parenting-focused preventive interventions to promote resilience of children and adolescents (2015) · cites this paper as [10]
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Sandler, I., Ingram, A., Wolchik, S., Tein, J.-Y., & Winslow, E. (2015) · Child Development Perspectives · doi:10.1111/cdep.12126 · Cited by 191 · see citing works
“For example, an evaluation of the Bridges program for Hispanic youth in transition to high school found that the effects of the program to reduce conflict between parents and children at two years mediated program effects to reduce internalizing, externalizing, and substance use problems five years after the program e…”
BackgroundDelgado, M. Y., Nair, R. L., Updegraff, K. A., & Umaña‐Taylor, A. J. (2017) · Child Development · doi:10.1111/cdev.12969 · Cited by 45 · see citing works
“Research with ethnic minority youth suggests that ethnic discrimination (Greene, Way, & Pahl, 2006), parent-adolescent conflict (e.g., Jensen et al., 2014), and friendship intimacy (Way, Becker, & Greene, 2006) are salient in early adolescence.”
BackgroundPrado, G. J., Estrada, Y. A., Rojas, L. M., Bahamón, M., Pantin, H. M., Nagarsheth, M., Gwynn, L. A., Ofir, A. Y., Forster, L., Torres, N. S., et al. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.11.005 · Cited by 33 · see citing works
“Fortunately, research has documented that preventive interventions targeting family processes, such as parent-adolescent communication and parental monitoring of peers, are successful in reducing adolescent drug use and sexual risk behaviors for non-Hispanics and Hispanics alike (Jensen et al., 2014; Spoth, Randall, &…”
BackgroundExternalizing and internalizing pathways to Mexican American adolescents’ risk taking
Gonzales, N. A., Liu, Y., Jensen, M. R., Tein, J. Y., White, R. M. B., & Deardorff, J. (2017) · Development and Psychopathology · doi:10.1017/s0954579417000323 · Cited by 27 · see citing works
“Economic hardship was assessed by mother report using items from the four economic hardship subscales developed by Barrera, Caples, and Tein (2001) that were based on subscales originally used by Conger et al. (1991) and validated for Mexican Americans: inability to make ends meet (two items), not enough money for nec…”
MethodInfluentialSelf-citationUS Immigration Policy Stressors and Latinx Youth Mental Health
Roche, K. M., White, R. M. B., Partoví, R., Vaquera, E. G., & Little, T. D. (2024) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2024.1153 · Cited by 26 · see citing works
Prevention and Intervention Research With Latino Families: A Translational Approach
Stein, G. L., & Guzman, L. E. (2015) · Family Process · doi:10.1111/famp.12143 · Cited by 24 · see citing works
“For example, intervention effects demonstrated similar reductions in mother–child conflict across different levels of acculturation and these reductions resulted in fewer internalizing and externalizing symptoms (Jensen et al., 2014).”
Howe, G. W., Beach, S. R. H., Brody, G. H., & Wyman, P. A. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01911 · Cited by 22 · see citing works
Gonzales, N. A., Jensen, M. R., Tein, J. Y., Wong, J. J., Dumka, L. E., & Mauricio, A. M. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.0058 · Cited by 20 · see citing works
Self-citationPiñeros-Leaño, M., Parchment, T. M., & Calvo, R. (2022) · Children and Youth Services Review · doi:10.1016/j.childyouth.2022.106756 · Cited by 16 · see citing works
Familial Influences on Dating Violence Victimization Among Latino Youth
Reyes, H. L. M., Foshee, V. A., Klevens, J., Tharp, A. T., Chapman, M. V., Chen, M. S., & Ennett, S. T. (2016) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2016.1210270 · Cited by 16 · see citing works
“…number of family-based substance use and youth violence prevention programs that target family cohesion or general and acculturation-based family conflict that have been found to be effective for Latino adolescents (Jensen et al., 2014; Leidy et al., 2010; Pantin et al., 2009; Smith et al., 2014).”
BackgroundCulturally Adapted Preventive Interventions for Children and Adolescents
Gonzales, N. A., Lau, A. S., Murry, V. M., Piña, A., & Barrera, M. (2016) · Wiley eBooks · doi:10.1002/9781119125556.devpsy417 · Cited by 16 · see citing works
“…differences at immediate posttest, long-term follow-up showed similar improvements across groups on the quality of parent-child relationships (Jensen et al., 2014) and school engagement (Gonzales et al., 2014) following transition to high school (ninth grade), and these changes mediated…”
BackgroundSelf-citationPotential Mediators in Parenting and Family Intervention: Quality of Mediation Analyses
Patel, C. C., Fairchild, A. J., & Prinz, R. J. (2016) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-016-0221-2 · Cited by 15 · see citing works
“To this point, the more commonly tested putative mediators reflected both significant and nonsignificant results whether with preferred or Table 1 continued Study Sample size Temporal precedence Mediation approach Significance test of mediated effect Estimate reported Mediator model Overall model fit (SEM only) Est. o…”
InfluentialNavas, J. M. M., Taubner, S., Mota, C. P., Henriques, M. I. R. S., Saliba, A., Heinonen, E. O., Ramos, S., Moreno-Peral, P., Volkert, J., Adler, A., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.730921 · Cited by 12 · see citing works
Cultural differences in the parents & children interaction in Kuwait society
Al-Kandari, M. T., Al-Kandari, E. M., & Al‐Kandari, Y. Y. (2022) · Cogent Education · doi:10.1080/2331186x.2022.2122335 · Cited by 5 · see citing works
“Some empirical studies (e.g., Jensen et al., 2014; Ramírez García et al., 2010) showed how family played the role of a mediator.”
BackgroundThorslund, K., Hanse, J. J., & Axberg, U. (2017) · Scandinavian Journal of Public Health · doi:10.1177/1403494817705233 · Cited by 5 · see citing works
“[14] Jensen MR, Wong JJ, gonzales nA, et al.”
BackgroundPiña, A., & Gonzales, N. A. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.888668 · Cited by 6 · see citing works
Self-citationTsai, K. M., Perez‐Brena, N. J., Perez, V. M., & Camacho‐Thompson, D. E. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818872-9.00094-7 · Cited by 6 · see citing works
Haggerty, K. P., Barkan, S. E., Caouette, J. D., Skinner, M. L., & Hanson, K. G. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.106973 · Cited by 4 · see citing works
Hosseini, M. S., Esmaeili, A., & Sahebi, A. (2017) · Razavi International Journal of Medicine · doi:10.5812/rijm.13929 · Cited by 4 · see citing works
“Mothers feel they are incapable of any impact on their children’s behavior and that’s what Bandura (1968) calls the experience of lack of control and the reducing factor of self-efficacy (7).”
BackgroundEstimating Latent Baseline-by-Treatment Interactions in Statistical Mediation Analysis
González, O., Millechek, J. R., & Georgeson, A. R. (2023) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705511.2023.2193312 · Cited by 4 · see citing works
“…models (some with other covariates) have been used to evaluate interventions for drug use (e.g., MacKinnon, 2001), internalizing symptoms (e.g., Jensen et al., 2014; Perrino et al., 2014), depressive symptoms (e.g., Chaudoir et al., 2021), antisocial behavior (e.g., Smith et al., 2014), and…”
MethodAllen, J. B. H., Homel, R. J., McLaws, S., Evans-Whipp, T. J., Olsson, C. A., & the PRF Early Relational Health Network (2026) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-025-00553-3 · Cited by 3 · see citing works
Healthier Parents - Effects of Parent Training Programs on Mental Health
Löfgren, H. O., Padyab, M., Ghazinour, M., Nilsson, K., Petersen, S., & Hägglöf, B. (2017) · International Journal of Social Work and Human Services Practice · doi:10.13189/ijrh.2017.050204 · Cited by 3 · see citing works
“…levels of parental depression as well as reduced overall health and social service usage; however, this only applied in programs where parents participated without their children (Charles, Bywater, Edwards, Hutchings, & Zou, 2013), and it only applied in longitudinal studies (Jensen et al., 2014).”
BackgroundIntervenciones socioeducativas familiares en entornos escolares y comunitarios
Grau, M. A. G., Barrio, B. P., Fernández, J. A. A., & Socías, C. O. (2023) · Aula Abierta · doi:10.17811/rifie.52.2.2023.185-193 · Cited by 2 · see citing works
“…familia-escuela-comunidad refuerza los factores de protección a nivel preventivo (por ejemplo, en salud y/o conductas de riesgo como alimentación, hábitos de vida, consumo o conducta sexual) (Dishion et al., 2002; Epstein, 2011; Jensen et al., 2014; Orte y Ballester, 2018; Spoth et al., 2009).”
BackgroundSerra, V. Q., Grau, M. A. G., & Socías, C. O. (2022) · Estudios sobre Educación · doi:10.15581/004.42.008 · Cited by 2 · see citing works
Curlee, A. S., Tein, J., White, R. M. B., Carlo, G., Gonzales, N. A., & Knight, G. P. (2022) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000563 · Cited by 1 · see citing works
Self-citationRacial/Ethnic Variations in the Intergenerational Transmission of Adolescent Depression
Park, Y., Park, Y., Thor, P., Baiden, P., & Lee, S. (2024) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-024-02246-z · Cited by 1 · see citing works
“Our findings are supported by a number of studies that indicate a parent-child conflict has a disruptive effect on the general population [46, 47].”
Hernández-Caldentey, R., & Buelga, S. (2014)
Ndetei, D. M., Mutiso, V., Nyamai, P. K., & Musyimi, C. W. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05971-1
Paul, A., Laribee, A., Neudecker, M., Luca, S. M. D., & McVoy, M. K. (2025) · Hispanic Journal of Behavioral Sciences · doi:10.1177/07399863251350866
“…health outcomes such as short and long-term internalizing symptoms (anxiety/depression), internalizing symptom reduction were often more effective (Jensen et al., 2014; Perrino, Brincks, et al., 2016; Perrino, Pantin, et al., 2016) with more contradictory results for externalizing (oppositional,…”
InfluentialParental Beliefs Are Associated with Youth Response to Alcohol Intervention
Calihan, J. B., Minegishi, M., Levy, S., Stamoulis, C., & Weitzman, E. R. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2026.2637140
“Interventions that modify parenting behaviors effectively prevent adolescent substance use but have not been evaluated in families navigating youth chronic illness (Bo et al., 2018; Gilligan et al., 2019; Jensen et al., 2014; Kuntsche & Kuntsche, 2016; Newton et al., 2017; Soper et al., 2010).”
Pearce, N., CROSS, D. S., Francis, J., Sae-Koew, J. H., Godley, A. M., Attwell, C., Evans-Whipp, T. J., Allen, J. B. H., Homel, R. J., Olsson, C. A., et al. (2026) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-026-00567-5
“…all participants and therefore provides a conservative estimate of effects in real-life scenarios at the population level, by including all participants, regardless of how well they received the intervention (DeGue et al., 2021; Jensen et al., 2014; Leflot et al., 2013; Mageau et al., 2022 ).”
Connell, A. M., Epstein, M., McClaine, R. N., Satchell, K., Halvorson, M. A., & Mariscal, M. (2026) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.70221
Duran, Ş., & Özbay, Y. (2026) · Türk Psikolojik Danışma ve Rehberlik Dergisi · doi:10.17066/tpdrd.1650921
- Authors
- Jensen, M. R., Wong, J. J., Gonzales, N. A., Dumka, L. E., Millsap, R., & Coxe, S.
- Affiliations
- Arizona State University (US)
- Florida International University (US)
- Corresponding author
- Jensen, Michaeline R.
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2014-04-14
- Volume
- 43
- Issue
- 3
- Pages
- 415-427
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC4008685
- OpenAlex
- W2162574592
- Cited by
- 33
- References
- 76
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 6 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 2
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- This study was supported by the National Institute of Mental Health grant R01 MH64707.
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Sociology and Political Science › Psychosocial Factors Impacting Youth
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- parent-adolescent conflict, mediation, Mexican American adolescents, internalizing problems, externalizing problems, adolescent substance use, acculturation, mother-adolescent conflict, long-term intervention effects, preventive interventions, adolescent mental health
- MeSH terms
- Acculturation, Adaptation, Psychological, Adolescent, Child, Family Therapy, Female, Humans, Internal-External Control, Male, Mothers, Parent-Child Relations, Parents, Social Adjustment, Time Factors, Treatment Outcome, Negotiating, Mexican Americans, Substance-Related Disorders, Family Conflict
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