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The coronavirus disease 2019 pandemic and activism against structural racism heightened awareness of racial-ethnic disparities and disproportionate burden among the underserved. The opioid crisis further compounds these phenomena, increasing vulnerability for substance use disorders (SUD). Community-based participatory research can facilitate multidisciplinary collaboration, yet literature on these approaches to prevent and reduce SUD and associated stigma remains limited.Discrimination, stigma, and multiple crises with health care and systemic barriers increasingly marginalize the underserved, specifically around SUD. The Detroit Area Mental Health Leadership Team (DAMHLT, since 2015), aims to optimize SUD prevention, enhance resiliency and advocacy to advance knowledge on SUD research and influence community-level research and practice.DAMHLT's approach on bidirectionality, community level access to real-time epidemiological data, advocacy (i.e., institutional responsiveness) and dissemination may be translational to other partnerships.As we move through an ever-changing pandemic, DAMHLT's lessons learned can inform partnership dynamics and public health strategies such as hesitancy on public health response.

Emerging adulthood has been described as a difficult stage in life and may be particularly stressful for Hispanic emerging adults who are disproportionately exposed to adversity and chronic sociocultural stressors. To better prevent and treat depressive disorders among Hispanic emerging adults, more research is needed to identify and understand modifiable determinants that can help this population enhance their capacity to offset and recover from adversity and sociocultural stressors. As such, this study aimed to (1) examine the association between resilience and depressive symptoms among Hispanic emerging adults, and (2) examine the extent to which intrapersonal resources (e.g., mindfulness, distress tolerance, emotion regulation strategies) and interpersonal resources (e.g., family cohesion, social support) moderate the association between resilience and depressive symptoms. To examine these aims, 200 Hispanic emerging adults (ages 18-25) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey, and data were analyzed using hierarchical multiple regression and moderation analyses. Findings from the hierarchical multiple regression indicate that higher resilience was associated with lower depressive symptoms. Findings from the moderation analyses indicate that family cohesion, social support, and emotion regulation strategies (e.g., cognitive reappraisal and expressive suppression) functioned as moderators; however, mindfulness and distress tolerance were not significant moderators. Findings from this study add to the limited literature on resilience among Hispanics that have used validated measures of resilience. Furthermore, we advance our understanding of who may benefit most from higher resilience based on levels of intrapersonal and interpersonal resources.

Background The Acculturative Process and Context Framework (Ward & Geeraert, 2016) proposes that acculturative stressors influence psychological well-being over time. In fact, extant literature has linked bicultural stress with psychological functioning; yet, no studies have explored the causal dominance of bicultural stress. The purpose of the present study was to evaluate the directionality of prospective relations among bicultural stress and psychosocial functioning (i.e., depressive symptoms, hopefulness, and self-esteem) in Latinx immigrant adolescents across 5 waves. Method There were 303 Latinx adolescents who were recruited for this study from Los Angeles and Miami and were assessed across 5 waves at 6-month intervals. Adolescents were 14.50 years old on average (SD = .88) and 53.16% were male. Adolescents reported living in the United States for 2.07 years on average (SD = 1.87). A Random-Intercept Cross-Lagged Panel Model (RI-CLPM) was used to examine the between- and within-person relations among bicultural stress, depressive symptoms, hopefulness, and self-esteem in a comprehensive model. Results The comprehensive RI-CLPM including bicultural stress, depressive symptoms, hopefulness, and self-esteem exhibited excellent model fit. Between-person, trait-like relations among constructs ranged from small to large, as expected. Within-person, cross-lagged estimates among constructs were overall inconsistent, with some evidence that, within individuals, self-esteem influences later hopefulness. Conclusion Findings from this study indicate that the RI-CLPM is an effective strategy to examine bicultural stress and well-being processes among adolescents. There is a need for further research examining bicultural stress among Latinx immigrant youth, particularly within prevention and intervention studies. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Ethnic identity formation is a central developmental task that can become challenging when adolescents face a salient stressor, such as ethnic discrimination. Although ethnic identity and experiences with ethnic discrimination are thought to be associated, the temporal order of these constructs is unclear. In the current study, we examined (a) the rejection-identification model and (b) the identification-attribution model in a longitudinal, cross-lagged model among 302 Hispanic immigrant adolescents (Mage = 14.51, SD = .88 at baseline; 46.7% female) living in Miami (n = 152) and Los Angeles (n = 150). Results support the identification-attribution model such that adolescents who reported higher levels of ethnic identity exploration reported higher levels of perceived discrimination 1 year later. Conversely, adolescents who reported higher levels of ethnic identity belonging reported less subsequent perceived discrimination. Findings suggest that ethnic identity formation may affect the recognition of ethnic discrimination among Hispanic immigrant adolescents. (PsycINFO Database Record

Bimanual tasks involve the coordination of both arms, which often offers redundancy in the ways a task can be completed. The distribution of control across limbs is often considered from the perspective of handedness. In this context, although there are differences across dominant and nondominant arms during reaching control ( Sainburg 2002 ), previous studies have shown that the brain tends to favor the dominant arm when performing bimanual tasks ( Salimpour and Shadmehr 2014 ). However, biomechanical factors known to influence planning and control in unimanual tasks may also generate limb asymmetries in force generation, but their influence on bimanual control has remained unexplored. We investigated this issue in a series of experiments in which participants were instructed to generate a 20-N force with both arms, with or without perturbation of the target force during the trial. We modeled the task in the framework of optimal feedback control of a two-link model with six human-like muscles groups. The biomechanical model predicted a differential contribution of each arm dependent on the orientation of the target force and joint configuration that was quantitatively matched by the participants’ behavior, regardless of handedness. Responses to visual perturbations were strongly influenced by the perturbation direction, such that online corrections also reflected an optimal use of limb biomechanics. These results show that the nervous system takes biomechanical constraints into account when optimizing the distribution of forces generated across limbs during both movement planning and feedback control of a bimanual task. NEW & NOTEWORTHY Here, we studied a bimanual force production task to examine the effects of biomechanical constraints on the distribution of control across limbs. Our findings show that the central nervous system optimizes the distribution of force across the two arms according to the joint configuration of the upper limbs. We further show that the underlying mechanisms influence both movement planning and online corrective responses to sudden changes in the target force.

Complex Regional Pain Syndrome (CRPS) is characterized by pain, motor and inflammatory symptoms usually affecting one limb. Cognitive difficulties have been reported to affect patients’ ability to represent, perceive and use their affected limb. It is debated whether these difficulties result from deficits in controlling goal-directed movements in space or from a learned strategy to protect the affected limb. In order to dissociate the two hypotheses, patients with upper-limb CRPS were asked to move with their unaffected hand towards visual targets projected at different positions on a horizontal semi-reflexive mirror. By means of a robotic handle placed below the screen, they were asked to move a cursor, to reach and cross lines at their estimated midpoint. In some of the stimulation series, the affected hand was placed below the mirror so that some lines appeared projected onto that hand. Vision of the hands and the robotic handle was preserved or prevented by opening or closing a shutter below the mirror. Lines were displayed on the mirror according to which part of the body was affected (ispi- vs. contralateral) and the actual position of the affected hand (inside vs. outside the workspace). Comparatively to control participants, CRPS patients generally biased their estimation by bisecting the lines towards their left side, irrelative of which part of the body was affected and the position of the affected hand, both in ipsi- and contralateral space, with only a few exceptions. Our results are in line with previous studies having described a visuospatial deficit in CRPS patients and discard the explanation of observed symptoms in terms of learned nonuse strategies, as only the unaffected hand was used to perform the task. It is suggested that CRPS patients can display difficulties to perform tasks requesting visuo-motor coordination, reflecting the complex cortical reorganization occurring in CRPS., SCOPUS: ar.j, info:eu-repo/semantics/published

Author(s): Cordova, David; Mendoza Lua, Frania; Munoz-Velazquez, Jaime; Street, Katie; Bauermeister, Jose A; Fessler, Kathryn; Adelman, Nicole; Youth Leadership Council; Neilands, Torsten B; Boyer, Cherrie B | Abstract: BackgroundDrug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention.MethodEmploying community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis.ResultsAmong eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans.ConclusionsFindings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.

Human Immunodeficiency Virus (HIV)/sexually transmitted infection (STI) risk behaviors among adolescents remain significant public health concerns. Shifts in policy and advances in technology provide opportunities for researchers and clinicians to deliver and evaluate mobile-health (mHealth) prevention programs in primary care, however, research is limited. This study assessed the usability and acceptability of Storytelling 4 Empowerment-a mHealth HIV/STI and drug abuse preventive intervention app-among adolescents in primary care. Informed by principles of community-based participatory research, we recruited a purposive sample of 30 adolescents from a youth-centered community health care clinic in Southeast Michigan. The study sample is primarily African American and female. Adolescents who participated in the Storytelling 4 Empowerment intervention assessed its usability and acceptability, and self-reported their HIV/STI risk behaviors. We used a multiple-methods approach. Adolescents reported high acceptability of the content, process, and format of Storytelling 4 Empowerment, as evidenced by qualitative data and mean scores from the Session Evaluation Form for the HIV/STI and Alcohol/Drug content, overall Storytelling 4 Empowerment intervention, and Client Satisfaction Questionnaire-8. Findings indicate that Storytelling 4 Empowerment is acceptable among adolescents in primary care. A next step is to examine the effect of Storytelling 4 Empowerment on adolescent sexual risk and drug use behaviors and HIV/STI testing.

We examined the effects of family functioning trajectories on sexual risk behaviors and STI in adolescents. A sample of 850 predominantly (80%) Black adolescents from Michigan, United States, was assessed at baseline, 12, 24, and 36 months postbaseline. Adolescents were from working-class families with a mean age of 14.9 years (SD = .64, Range = 13.9 to 16.9) at baseline. Participants completed measures of family functioning at each time point. At 36 months postbaseline, levels of sexual risk behaviors, including sex initiation, unprotected sex, and alcohol or drug use before last sexual intercourse, and STIs were assessed. Latent class growth analysis (LCGA) yielded 4-class solutions for family conflict and parent support. Adolescents with high or increasing family conflict trajectories, and low or decreasing family support trajectories, were at relatively greater risk of sexual risk behaviors and STIs. Yet, the additional trajectories differ across outcomes highlighting the complexities of the role of family functioning on sexual risk behaviors and STIs over time. Multiple Group LCGA indicate some findings vary as a function of gender. (PsycINFO Database Record

Drawing from a theory of bicultural family functioning two models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement six months post-baseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms one year post-baseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning, (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS, (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS.

Background Preventing and reducing substance use disorders, sexually transmitted infections (STIs)/HIV, and teen pregnancy, and the associated risk behaviors (ie, substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among the youth. Mobile health (mHealth) apps may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated efficacy in reducing substance use or sexual risk behaviors or improving the uptake of STI/HIV testing among the youth, particularly in clinic settings. Objective This small-scale study aimed to examine the feasibility of conducting a pilot randomized controlled trial (RCT). We evaluated the effects of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, on the potential mechanisms by which behavior change occurs, namely clinician-youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy. We also assessed the ability to measure targeted outcomes of past 30-day substance use (ie, alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use before sex, as well as the uptake of STI/HIV testing. Methods Employing community-based participatory research principles, 50 youths aged 13 to 21 years were recruited from a youth-centered community health clinic in Southeast Michigan, randomized sequentially to either S4E or enhanced usual practice, and assessed at baseline, immediately postintervention, and 30 days postintervention. S4E consists of 3 modules, including alcohol and drug use, tobacco, and STI/HIV. Results Relative to youth in the enhanced usual practice group, S4E participants demonstrated higher youth-clinician risk communication (mean 3.22, SD 1.67) and increases in prevention knowledge (∆ score mean 0.36, SD 0.51) and self-efficacy (∆ score mean 0.16, SD 0.47). In addition, youth in the S4E group showed reductions in the proportions of past 30-day overall substance use (Cohen h=0.71, 95% CI 0.15 to 1.27), as well as past 30-day alcohol (Cohen h=0.71, 95% CI 0.15 to 1.27), tobacco (Cohen h=0.17, 95% CI −0.39 to 0.73), and drug use (Cohen h=1.28, 95% CI 0.72 to 1.84). The results also suggest a reduction in the proportion of youths who reported past 30-day condomless sex (Cohen h=0.18, 95% CI −0.38 to 0.74) and alcohol use before sex (Cohen h=0.44, 95% CI −0.12 to 1.00). Finally, the findings also demonstrated an increase in the proportion of youths who reported STI/HIV testing over time (Cohen h=0.16, 95% CI −0.39 to 0.72). Conclusions The findings suggest the feasibility of a small-scale pilot RCT. S4E demonstrated shifts in the hypothesized direction, reducing substance use, sexual risk behaviors, and improving the uptake of STI/HIV testing among youth in a clinic setting. The findings suggest that a larger RCT may be warranted. Trial Registration ClinicalTrails.gov NCT03855410, https://clinicaltrials.gov/ct2/show/NCT03855410.

Despite policy changes related to the use and distribution of marijuana in cities and states across the country, few studies have examined changes in disapproval and use of marijuana among American youth.To examine trends in disapproval and use of marijuana among adolescents and young adults in the United States.We employed nationally representative data spanning the period of 2002-2013. Analyses were based on self-reported measurements from 105,903 younger adolescents (aged 12-14); 110,949 older adolescents (aged 15-17); and 221,976 young adults (aged 18-25).Between 2002 and 2013 the proportion of adolescents aged 12-14 reporting "strong disapproval" of marijuana use initiation increased significantly from 74.4-78.9%. Concurrently, a significant decrease in past 12-month marijuana use (OR = 0.98, 95% CI = 0.97-0.99) was observed among younger adolescents. No significant trend was observed for marijuana use disapproval among adolescents aged 15-17 between 2002 and 2013. Yet a significant (OR = 0.99, 95% CI = 0.98-0.99) decrease in the past 12-month marijuana use was observed (2002 = 26.2%, 2013 = 21.9%) among this group. Among young adults (aged 18-25), a substantial decrease - from 40.5% in 2002 to 22.6% in 2013 - was observed in the proportion reporting "strong disapproval" of marijuana use initiation; however, increases in the past 12-month use were relatively small among young adults (Δ = 2.21) but statistically significant (OR = 1.02, 95% = 1.01-1.02).Changes are underway in the perception and use of marijuana among American youth. However, changes differ in important ways among youth from distinct developmental subgroups.

We sought to determine the extent to which initial levels and over-time trajectories of cultural stressors (discrimination, negative context of reception, and bicultural stress) predicted well-being, internalizing symptoms, conduct problems, and health risk behaviors among recently immigrated Hispanic adolescents. Addressing this research objective involved creating a latent factor for cultural stressors, establishing invariance for this factor over time, estimating a growth curve for this factor over time, and examining the effects of initial levels (intercepts) and trajectories (slopes) of cultural stressors on adolescent outcomes.A sample of 302 recently immigrated Hispanic adolescents in Miami (median of 1 year in the United States at baseline) and Los Angeles (median of 3 years in the United States at baseline) was recruited from public schools and assessed six times over a 3-year period.Perceived discrimination, context of reception, and bicultural stress loaded onto a latent factor at each of the first five timepoints. A growth curve conducted on this factor over the first five timepoints significantly predicted lower self-esteem and optimism, more depressive symptoms, greater aggressive behavior and rule breaking, and increased likelihood of drunkenness and marijuana use.The present results may be important in designing interventions for Hispanic immigrant children and adolescents, including those within the present wave of unaccompanied child migrants. Results indicate targeting cultural stressors in interventions may have potential to improve well-being and decrease externalizing behaviors and substance use within this population.

This study examined longitudinal effects of adolescent and parent cultural stress on adolescent and parent emotional well-being and health behaviors via trajectories of adolescent and parent family functioning. Recent immigrant Latino adolescents (Mage = 14.51) and parents (Mage = 41.09; N = 302) completed measures of these constructs. Latent growth modeling indicated that adolescent and parent family functioning remained stable over time. Early levels of family functioning predicted adolescent and parent outcomes. Baseline adolescent cultural stress predicted lower positive adolescent and parent family functioning. Latent class growth analyses produced a two-class solution for family functioning. Adolescents and parents in the low family functioning class reported low family functioning over time. Adolescents and parents in the high family functioning class experienced increases in family functioning.

Introduction There is a critical need for the most current information available on the prevalence of substance use disorders (SUD) among immigrants vis-a-vis that of individuals born in the United States (US). We report the prevalence of SUDs among immigrants from major world regions and top immigrant-sending countries, and assess key moderators (i.e., age, gender, family income, age of migration, time in US) of the relationship between immigrant status and SUD risk. Method The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012–2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and SUD risk. Results Immigrants were found to be substantially less likely than US-born individuals to be diagnosed with a past-year or lifetime SUD, including alcohol, cannabis, cocaine, and opioid use disorders. These findings held across major world region and among immigrants from the top-ten immigrant sending nations, and across differences in age, gender, family income, age of migration, and time spent in the US. Conclusions Results from the present study provide up-to-date and cogent evidence that immigrants use alcohol and drugs, and meet criteria for SUDs, at far lower rates than do US-born individuals. Moreover, we provide new evidence that the protective effect of nativity holds for immigrants from an array of global regions and sending countries, and across key demographic and migration-related differences.

Hispanic immigrant youth engage in increased health risk behaviors, such as alcohol misuse, due in part to being confronted with acculturative stress in addition to facing major normative developmental challenges, such as identity consolidation (Berry et al. in Appl Psychol 55:303-332, 2006). Using a developmental psychopathology framework, in the present study we examined the effect of bicultural stress on alcohol misuse among immigrated Hispanic adolescents, indirectly through trajectories of identity formation and alcohol expectancies. Our sample consisted of 302 recently immigrated Hispanic adolescents (53 % male; Mage = 14.5 at baseline) who were interviewed every 6 months for 3 years. Bivariate growth curve modeling was used to examine the influence of initial early bicultural stress on later alcohol misuse via change in identity development (i.e., coherence and confusion) and subsequent growth in cognitive alcohol expectancies. Findings revealed that initial levels and growth of identity coherence were not significantly associated with either bicultural stress or tension reduction (TR) alcohol expectancies. Multiple mediation analyses indicated that the effect of bicultural stress at time 1 on the frequency of being drunk at time 6 was mediated via high initial levels of identity confusion, followed by growth in risky TR expectancies (T4-T6). A developmental approach to the genesis of alcohol use problems in immigrant youth is discussed.

Recent research suggests that acculturation is a multifaceted construct with implications for substance use among Hispanics. However, few, if any, studies examining profiles of acculturation have been conducted using national samples. Moreover, no cluster-based studies have examined how acculturation relates to discrimination and substance use disorders among Hispanics in the United States.The present study, employing Wave 2 data on Hispanics (n = 6,359) from the National Epidemiologic Survey of Alcohol and Related Conditions, aims to address these gaps. We use latent profile analysis to identify profiles of acculturation among Hispanics in the United States and, in turn, examine the relationships between membership in these profiles and experiences of discrimination and the prevalence of substance use disorders.A five-class solution was the optimal modeling of the data. Classes were identified as Class 1: Spanish-dominant/strongly separated (17 %), Class 2: Spanish-dominant/separated (18 %), Class 3: bilingual/bicultural (33 %), Class 4: English-dominant/bicultural (16 %), and Class 5: English-dominant/assimilated (16 %). Bilingual/bicultural Hispanics (Class 3) reported the highest prevalence of discrimination (31 %). Spanish-language dominant Hispanics (Classes 1 and 2) reported the lowest prevalence of substance use disorders. Significant differences in the prevalence of substance use disorders were observed between the bilingual/bicultural (Class 3) and English-dominant/assimilated classes (Class 5), but no differences were noted between the two English-dominant classes (Classes 4 and 5).Study findings indicate that acculturation is heterogeneous in its expression among Hispanics and suggest that Hispanics who maintain their Spanish-language capacity are at a substantially lower risk for a variety of substance use disorders.

The Complier Average Causal Effect (CACE) method has been increasingly used in prevention research to provide more accurate causal intervention effect estimates in the presence of noncompliance. The purpose of this study was to provide an applied demonstration of the CACE analytic approach to evaluate the relative effects of a family-based prevention intervention, Familias Unidas, in preventing/reducing illicit drug use for those participants who received the intended dosage. This study is a secondary data analysis of a randomized controlled trial designed to evaluate the relative efficacy of Familias Unidas with high-risk Hispanic youth. A total of 242 high-risk Hispanic youth aged 12-17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at baseline, 6 months and 12 months postbaseline. CACE models were estimated with a finite growth mixture model. Predictors of engagement were included in the CACE model. Findings indicate that, relative to the intent-to-treat (ITT) analytic approach, the CACE analytic approach yielded stronger intervention effects among both initially engaged and overall engaged participants. The CACE analytic approach may be particularly helpful for studies involving parent/family-centered interventions given that participants may not receive the intended dosage. Future studies should consider implementing the CACE analysis in addition to ITT analysis when examining the effects of family-based prevention programs to determine whether, and the extent to which, the CACE analysis has more power to uncover intervention effects.

The present study was designed to examine trajectories of personal identity coherence and confusion among Hispanic recent-immigrant adolescents, as well as the effects of these trajectories on psychosocial and risk-taking outcomes. Personal identity is extremely important in anchoring young immigrants during a time of acute cultural change. A sample of 302 recently immigrated (5 years or less in the United States at baseline) Hispanic adolescents (Mage = 14.51 years at baseline; SD = 0.88 years, range 14–17) from Miami and Los Angeles (47 % girls) completed measures of personal identity coherence and confusion at the first five waves of a six-wave longitudinal study; and reported on positive psychosocial functioning, depressive symptoms, and externalizing problems at baseline and at Time 6. Results indicated that identity coherence increased linearly across time, but that there were no significant changes in confusion over time and no individual differences in confusion trajectories. Higher baseline levels of, and improvements in, coherence predicted higher levels of self-esteem, optimism, and prosocial behavior at the final study timepoint. Higher baseline levels of confusion predicted lower self-esteem, greater depressive symptoms, more aggressive behavior, and more rule breaking at the final study timepoint. These results are discussed in terms of the importance of personal identity for Hispanic immigrant adolescents, and in terms of implications for intervention.

Parent-adolescent discrepancies in family functioning play an important role in HIV risk behaviors among adolescents, yet longitudinal research with recent immigrant Hispanic families remains limited. This study tested the effects of trajectories of parent-adolescent family functioning discrepancies on HIV risk behaviors among recent-immigrant Hispanic adolescents. Additionally, we examined whether and to what extent trajectories of parent-adolescent family functioning discrepancies vary as a function of gender. We assessed family functioning of 302 Hispanic adolescents (47 % female) and their parent (70 % female) at six time points over a three-year period and computed latent discrepancy scores between parent and adolescent reports at each timepoint. Additionally, adolescents completed measures of sexual risk behaviors and alcohol use. We conducted a confirmatory factor analysis to determine the feasibility of collapsing parent and adolescent reported family functioning indicators onto a single latent discrepancy variable, tested model invariance over time, and conducted growth mixture modeling (GMM). GMM yielded a three-class solution for discrepancies: High-Increasing, High-Stable, and Low-Stable. Relative to the Low-Stable class, parent-adolescent dyads in the High-Increasing and High-Stable classes were at greater risk for adolescents reporting sexual debut at time 6. Additionally, the High-Stable class was at greater risk, relative to the Low-Stable class, in terms of adolescent lifetime alcohol use at 30 months post-baseline. Multiple group GMM indicated that trajectories of parent-adolescent family functioning trajectories did not vary by gender. Implications for future research and practice are discussed.

The static coefficient of friction (µstatic) plays an important role in dexterous object manipulation. Minimal normal force (i.e., grip force) needed to avoid dropping an object is determined by the tangential force at the fingertip-object contact and the frictional properties of the skin-object contact. Although frequently assumed to be constant for all levels of normal force (NF, the force normal to the contact), µ static actually varies nonlinearly with NF and increases at low NF levels. No method is currently available to measure the relationship between µstatic and NF easily. Therefore, we propose a new method allowing the simple and reliable measurement of the fingertip µstatic at different NF levels, as well as an algorithm for determining µstatic from measured forces and torques. Our method is based on active, back-and-forth movements of a subject's finger on the surface of a fixed six-axis force and torque sensor. µstatic is computed as the ratio of the tangential to the normal force at slip onset. A negative power law captures the relationship between µstatic and NF. Our method allows the continuous estimation of µstatic as a function of NF during dexterous manipulation, based on the relationship between µstatic and NF measured before manipulation.

Hispanic problem behavior youth are at an increased risk of engaging in HIV risk behaviors, including low condom use. However, relatively little research has examined factors that affect condom use in this population. Although research indicates that family processes, such as higher levels of family functioning and open parent–adolescent communication about sex, and condom use attitudes, norms, and control beliefs as depicted by the theory of planned behavior have an effect on condom use behaviors, the combination of the two factors has received minimal attention. The purpose of this study was to examine the effect of family functioning on condom use intentions and behaviors through communication about sex and condom use attitudes, parental norms, and control beliefs. A cross-sectional study of 171 predominately male (73.1%) sexually active Hispanic problem behavior adolescents (mean age = 14.88 years) was conducted. Structural equation modeling was used to test the study hypothesis. Findings largely support the overall model and suggest that family functioning had an indirect effect on condom use intention and behavior through communication about sex, condom use attitudes, and control beliefs. Family functioning, however, did not have an indirect effect on condom use intention and behavior through communication about sex and parental norms. Implications for prevention science and future research are discussed.

Recent decades have witnessed a rise in the number of immigrant children in the United States (US) and concomitant concerns regarding externalizing behaviors such as crime, violence, and drug misuse by immigrant adolescents. The objective of the present study was to systematically compare the prevalence of externalizing behaviors and migration-related factors among immigrant and US-born adolescents in the US. Data on 12 to 17 year olds (Weighted N in thousands = 25,057) from the National Survey on Drug Use and Health (NSDUH) R-DAS between 2002 and 2009 were used. The R-DAS online analytic software was employed. Prevalence estimates and 95 % confidence intervals were calculated adjusting for the complex survey sampling design. Compared to their US-born counterparts, immigrant adolescents—particularly those between the ages of 15 and 17 years—are significantly less likely to be involved in externalizing behaviors. In addition, later age of arrival and fewer years spent in the US were associated with reduced odds of externalizing behavior. Supplementary analyses indicate that the link between nativity and externalizing behavior may be primarily driven by differences between US-born and immigrant youth who self-identify as non-Hispanic black or Hispanic. Immigrant adolescents are also more likely to report cohesive parental relationships, positive school engagement, and disapproving views with respect to adolescent substance use. This study extends prior research on the “immigrant paradox” to externalizing behavior among adolescents using a nationally representative data source. Findings highlight the importance of examining age, age of arrival, duration, and race/ethnicity in the study of nativity and externalizing.

Substance use behaviors do not occur in isolation of one another and are not static over time. As adolescents age into early adulthood, there may be dynamic changes in their substance use behaviors, and these changes may be influenced by family and school factors. The current study uses Latent Transition Analysis to examine these changes by measuring transitions among different substance use profiles based on past 30-day alcohol, tobacco and marijuana use, and by estimating associations with demographic, family and school factors. Data were from youth (n = 850; 80 % African American, 17 % white, 3 % mixed race, 50 % female and 50 % male) in grade 10 (Time 1), with 24- (Time 2) and 48-month (Time 3) follow-ups. Substance use profiles included Non-users (54 %), Alcohol and Marijuana Users (20 %), and Alcohol, Tobacco and Marijuana Users (26 %). There were considerable transitions among profiles from Time 1 to Time 2, and fewer transitions from Time 2 to Time 3. At Time 1, African American race and positive school attitudes were negatively associated with being an Alcohol and Marijuana User, and being an Alcohol, Tobacco and Marijuana User. Family conflict, parental school involvement, female gender and African American race were associated with transitions among substance use profiles. Implications are discussed for a better understanding of transitions in substance use profiles, and for promoting maintenance of non-use and transitions from substance using profiles to non-use.

The present study was designed to examine acculturative changes, and their effects on mental health and family functioning, in recent-immigrant Hispanic adolescents. A sample of 302 Hispanic adolescents was assessed five times over a 2½-year period. Participants completed measures of Hispanic and U.S. practices, collectivist and individualist values, and ethnic and U.S. identity at each time point. Baseline and Time 5 levels of mental health and family functioning were also assessed. Latent class growth analyses produced two-class solutions for practices, values, and identifications. Adolescents who increased over time in practices and values reported the most adaptive mental health and family functioning. Adolescents who did not change in any acculturation domain reported the least favorable mental health and family functioning.

We sought to examine latent classes of family functioning and parent support trajectories during high school and whether these trajectories are associated with an increased risk of substance use and misuse among urban youth. A total of 850 adolescents (Mage = 15.1 years) were included in this study, assessed at baseline, 12-, 24-, and 36-months postbaseline, and completed self-report measures on past 30-day alcohol and marijuana use, binge drinking, and measures of family functioning and parent support. Latent class growth analysis revealed that trajectories of high family functioning and parent support are associated with a decreased risk of marijuana use. Findings may be helpful to inform family-based preventive interventions.

In the family-based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent–adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent–adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent–adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent–adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90-day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family-based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families.

A growing number of studies have examined the "immigrant paradox" with respect to the use of licit and illicit substances in the United States. However, there remains a need for a comprehensive examination of the multigenerational and global links between immigration and substance use disorders among adults in the United States.The present study, using data from the National Epidemiologic Survey on Alcohol and Related Conditions, aimed to address these gaps by comparing the prevalence of substance use disorders of first-generation (n = 3,338) and second-generation (n = 2,515) immigrants with native-born American adults (n = 15,733) in the United States. We also examined the prevalence of substance use disorders among first-generation emigrants from Asia, Africa, Europe, and Latin America in contrast to second-generation and native-born Americans.The prevalence of substance use disorders was highest among native-born Americans, slightly lower among second-generation immigrants, and markedly lower among first-generation immigrants. Adjusted risk ratios were largest among individuals who immigrated during adolescence (ages 12-17 years) and adulthood (age 18 years or older). Results were consistent among emigrants from major world regions.Consistent with a broad body of literature examining the links between the immigrant paradox and health outcomes, results suggest that nativity and age at arrival are significant factors related to substance use disorders among first- and second-generation immigrants in the United States.

Although Black adolescents have reported a lower prevalence of substance use relative to non-Hispanic Whites, Black youth are disproportionately affected by adverse social outcomes. Social scientists have highlighted that using a framework that includes perceived peer prejudice and teacher discrimination as social determinants of adolescent risk behaviors is essential to fully understanding substance use behaviors in adolescents. However, this area of research remains underdeveloped. This study examined whether and to what extent perceived peer prejudice and teacher discrimination affect binge drinking and marijuana use by Black (n = 514) and non-Hispanic White (n = 2,818) adolescents using data from the National Longitudinal Study of Adolescent Health, Wave 2, Public Use dataset. Findings suggest that peer prejudice increased the risk of substance use in non-Hispanic White youth only, whereas experiences of teacher discrimination increased the risk of substance use in both Black and non-Hispanic White youth. The study’s limitations are noted, and implications for future research are discussed.

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 towards 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.

a b s t r a c t Introduction: Drug and alcohol use disproportionately affect Hispanic youth. Despite these disparities, few empirically supported preventive interventions are available to ameliorate this public health con- cern among Hispanic youth. This study examined the effects of Familias Unidas, relative to Community Practice, in reducing past 90-day substance use, alcohol and marijuana dependence, and having sex while under the influence of alcohol or drugs. Additionally, this study explored whether Familias Unidas' effects varied by environmental context, namely parental stress and social support for parents. Methods: A total of 242 delinquent Hispanic youth aged 12-17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at three time points. Results: Familias Unidas was efficacious in reducing past 90-day substance use, illicit drug use, and in reducing the proportion of youth with an alcohol dependence diagnosis, relative to Community Practice. Results also showed a reduction in the proportion of youth who reported having sex while under the influence of alcohol or drugs. No differences between conditions were observed in past 90-day alcohol use or marijuana dependence. Intervention effects on illicit drug use and alcohol dependence varied by environmental context. For example, Familias Unidas was most efficacious for adolescents with parents exhibiting high stress and lower levels of social support. Conclusions: Familias Unidas was efficacious in reducing some drug and alcohol related outcomes. The findings also support the concept of targeting family-based interventions, such as Familias Unidas, for adolescents with parents exhibiting high stress and low levels of social support.

The present study examined the relationship between Berry’s acculturation typology and HIV risk behaviors and whether family functioning mediated any such effects. A total of 235 high risk Hispanic adolescents were categorized into one of Berry’s four acculturation typologies through the use of cut-off scores on measures of Hispanicism and Americanism. Structural equation modeling was used to examine the effects of acculturation typology on HIV risk behaviors and the indirect effects of acculturation typology on HIV risk behaviors through family functioning. Acculturation typology was related to HIV risk behaviors. Family functioning partially mediated the effects of acculturation typology on the HIV risk behavior outcomes. These findings suggest that both Americanism and Hispanicism play an important role in the etiology of HIV risk behaviors among Hispanic youth and that both, along with family functioning, are important to consider when designing preventive interventions for this population.

Underage drinking and drug use in the Unites States (U.S.) constitute major public health concerns (National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2010; National Institute on Drug Abuse [NIDA], 2009). Underage drinking and drug use are associated with a myriad of significant developmental, social, behavioral and health problems (Komro & Toomey 2002; Spoth, Greenberg, & Turrisi, 2008). Although alcohol use and dangerous patterns of drinking and drug use are widespread among all adolescents in the U.S., Hispanic adolescents are disproportionately affected by both alcohol and drug use. For example, findings from the Monitoring the Future study reveal that Hispanic 8th and 10th graders’ use of both alcohol and drugs (with the exception of amphetamines) was higher than both non-Hispanic white and Black 8th and 10th graders, respectively (Johnston et al., 2010). This is particularly alarming for two reasons: 1) Hispanics constitute the largest and fastest growing ethnic group in the U.S. and are a youthful population with 39% under 19 years old (Marotta & Garcia, 2003), and 2) research has indicated that the early onset of alcohol and drug use is strongly associated with future abuse and dependence (Amaro & Cortes, 2003; NIAAA, 2010). In spite of this, few culturally-specific interventions have been found to be efficacious in preventing and reducing alcohol and drug use among Hispanic adolescents (Szapocznik, Prado, Burlew, Williams, & Santisteban, 2007). One intervention is Familias Unidas (Prado et al., 2007; Pantin et al., 2009). Familias Unidas is a Hispanic-specific, family-based, substance use (including alcohol and drugs) preventive intervention (Pantin et al., 2009; Prado et al., 2007). Familias Unidas is guided by ecodevelopmental theory (Szapocznik & Coatsworth, 1999) and informed by culturally specific models developed for Hispanic populations in the U.S. (Szapocznik & Kurtines, 1993; Szapocznik & Williams, 2000). Consistent with Hispanic cultural values, Familias Unidas places parents in positions of leadership and expertise in helping to prevent alcohol and drug use in youth by increasing positive parenting, family support of the adolescent, parental involvement, general parent-adolescent communication and parent-adolescent communication regarding substance use (Pantin, et al., 2004). Furthermore, Hispanic youth tend to acculturate faster as compared to their parents, and thereby creates stressors within the family, which in turn might affect family functioning. Thus, Familias Unidas aims to increase parental knowledge with respect to U.S. cultural norms, which in turn might help ameliorate family functioning, including improved parent-adolescent communication with regard to differences in cultural perspectives (Prado & Pantin, 2011). Familias Unidas has demonstrated overall efficacy in preventing and reducing alcohol and drug use among Hispanic youth (Pantin et al., 2009; Prado et al., 2007). However, although little is known with respect to the efficacy of family-based interventions to prevent/reduce alcohol and drug use among Hispanic adolescents, even less is known with regard to which interventions are efficacious with which Hispanic subgroups (Castro et al., 2006). Thus, to tailor interventions aimed to maximize efficacy in Hispanic populations, there remains the need to examine moderating factors such as nativity status, which has been shown to moderate intervention effects in other interventions (Martinez & Eddy, 2005). Therefore, the purpose of this study was to investigate whether the effects of Familias Unidas (Prado et al., 2007; Prado & Pantin, 2011), as compared to community practice, on Hispanic adolescent alcohol and drug use varies by nativity status (i.e., U.S.-born and foreign-born). Acculturation is a bi-dimensional process whereby the attitudes and/or behaviors of people from their culture of origin are modified as a result of contact with the host culture (Berry, 2003). Research examining the effects of acculturation on alcohol and drug use among Hispanics in the U.S. has shown mixed findings (Lara, Gamboa, Kahramanian, Morales, & Bautista, 2005). Whereas some research has demonstrated that higher levels of acculturation are associated with increased risk of alcohol and drug use (Caetano, Ramisetty-Mikler, Rodriguez, 2009; Vega & Gil, 1998), other studies show no effects (e.g., Epstein, Doyle, & Botvin, 2003). The difference in findings has been partly attributed to the fact that different proxies have been used to measure acculturation (Lara et al., 2005). Although a number of proxies have been used to measure acculturation in Hispanic populations (Lara et al., 2005), nativity status in particular has been utilized in alcohol and drug research (Caetano et al., 2009; Vega & Gil, 1998). Thus, nativity status is not acculturation in and of itself, but rather one proxy by which acculturation is generally operationalized (Lopez-Class, Castro, & Ramirez, 2011; Schwartz, Unger, Zamboanga, & Szapocznik, 2010). Nativity status as a proxy of acculturation assumes that the acculturation phenomenon can be estimated by the amount of exposure one has to the mainstream culture (Lara et al., 2005). In fact, nativity status has been identified as one potential important proxy of acculturation by which differential effects of prevention interventions occur among Hispanic youth (Martinez & Eddy, 2005). For example, in a study evaluating a family intervention, Martinez and Eddy (2005) found stronger intervention effects on depression for U.S.-born Hispanic adolescents, relative to foreign-born participants. The current study was a secondary analysis on the efficacy of Familias Unidas in preventing/reducing alcohol and drug use in Hispanic adolescents (Pantin et al., 2009). Specifically, the primary goal of this study was to examine whether the effects of Familias Unidas, as compared to community practice, on Hispanic adolescent alcohol and drug use varies by nativity status (i.e., U.S.-born and foreign-born). Because previous research has shown stronger intervention effects for relatively higher family risk groups (Pantin et al., 2009; Prado & Pantin, 2011; Prado et al., 2007) and U.S.-born adolescents on other outcomes (Martinez & Eddy, 2005), we expect that, relative to community practice, Familias Unidas will be more efficacious at reducing/preventing both alcohol and drug use for U.S.-born adolescents.

Objective To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. Design Randomized controlled trial. Setting Miami–Dade County Public School System and Miami–Dade County's Department of Juvenile Services, Florida. Participants A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention. Intervention Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants). Main Outcome Measures Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures. Results Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting. Conclusion These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents. Trial Registration clinicaltrials.gov Identifier: NCT01257022

A 2-phase study was conducted to develop a culturally informed measure of psychosocial stress for adolescents: the Hispanic Stress Inventory--Adolescent Version (HSI-A). Phase 1 involved item development through the collection of open-ended focus group interview data (n = 170) from a heterogeneous sample of Hispanic youths residing in the southwest and northeast United States. In Phase 2, we examined the psychometric properties of the HSI-A (n = 1,651), which involved the use of factor analytic procedures to determine the underlying scale structure of the HSI-A for foreign-born and U.S.-born participants in an aggregated analytic approach. An 8-factor solution was established, with factors that include Family Economic Stress, Acculturation-Gap Stress, Culture and Educational Stress, Immigration-Related Stress, Discrimination Stress, Family Immigration Stress, Community and Gang-Related Stress, and Family and Drug-Related Stress. Concurrent, related validity estimates were calculated to determine relations between HSI-A and other measures of child psychopathology and behavioral and emotional disturbances. HSI-A total stress appraisal scores were significantly correlated with both the Children's Depression Inventory and the Youth Self Report (p.001). Reliability estimates for the HSI-A were conducted, and they yielded high reliability coefficients for most factor subscales, with the HSI-A total stress appraisal score reliability alpha at .92.

Despite the unique and challenging circumstances confronting Latino immigrant families, debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Following the grounded theory approach, the current qualitative investigation utilized focus group interviews with 83 Latino immigrant parents to explore the relevance of culturally adapting an evidence-based parenting intervention to be disseminated within this population. Findings from this study indicate that Latino immigrant parents want to participate in a culturally adapted parenting intervention as long as it is culturally relevant, respectful, and responsive to their life experiences. Research results also suggest that the parenting skills participants seek to enhance are among those commonly targeted by evidence-based parenting interventions. This study contributes to the cultural adaptation/fidelity balance debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance, as well as high fidelity to the core components that have established efficacy for evidence-based parenting interventions.