Publication Date

2016-11-10

Availability

Open access

Embargo Period

2016-11-10

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Epidemiology (Medicine)

Date of Defense

2016-10-17

First Committee Member

Tatiana Perrino

Second Committee Member

Guillermo Prado

Third Committee Member

Seth Schwartz

Fourth Committee Member

Daniel Feaster

Fifth Committee Member

Mildred Maldonado-Molina

Abstract

Hispanic youth are often at greater risk for developing mental, emotional, and behavioral (MEB) problems, such as substance use, sexual risk behaviors, and internalizing and externalizing symptoms, compared to non-Hispanic white youth. Socio-ecological risk and protective factors, including family, school, peer, and acculturation factors, have been shown to be associated individually with a variety of MEB problems. This study examines the clustering of these risk and protective factors and evaluates whether there are specific subgroups of Hispanic adolescents, who are at greater risk for a variety of MEB problems. Data come from two randomized controlled trials, and were collected at baseline, when adolescents were in eighth grade, and then 6, 18, and 30 months post-baseline. Cross-sectional analyses included 959 participants, whereas longitudinal analyses utilized the 474 control group participants to evaluate associations in the absence of intervention. Using latent class analysis, three subgroups (Low, Medium, and High Socio-Ecological Risk) were identified based on socio-ecological risk and protective factors. Results indicated that adolescents in the higher socio-ecological risk subgroups reported significantly higher MEB problems at both baseline and 30 months post-baseline. Furthermore, the majority of adolescents remained in the same socio-ecological risk group across time points. Those who remained in the Low Socio-Ecological Risk group reported significantly lower MEB problems at 30 months post-baseline compared to those who remained in the High or Medium Socio-Ecological Risk groups. These results highlight the stability and impact of the clustering of socio-ecological risk and protective factors on MEB problems and support previous literature in finding the importance of these factors during early adolescence. Implications include the importance of screening youth for multiple risk and protective factors during early adolescence, as well as examining similar socio-ecological risk subgroups as potential moderators of the effects of preventive interventions.

Keywords

Hispanic; adolescents; latent class analysis; risk factors; health behaviors

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