Publication Date

2019-04-13

Availability

Embargoed

Embargo Period

2021-04-12

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Public Health Sciences (Medicine)

Date of Defense

2019-04-01

First Committee Member

Hilda M. Pantin

Second Committee Member

Guillermo Prado

Third Committee Member

Eric C. Brown

Fourth Committee Member

Ahnalee Brincks

Abstract

Family-based, evidence-based interventions (EBIs) have been found to not only prevent adolescent mental and behavioral health problems, but also improve general family functioning. Unfortunately, family-based EBIs are resource intensive and not widely-disseminated for population-scale impact. The resources associated with implementing and disseminating EBIs must be efficiently allocated to families who are likely to benefit most. Yet, how do we predict who benefits most? Prevention scientists have hypothesized that identifying families based on baseline family functioning, the key modifiable determinant of family-based EBIs, may best predict who is likely to benefit most. In this dissertation, we applied this logic to an evidence-based, Hispanic-specific, family-centered preventive intervention, Familias Unidas. Utilizing a pooled data set of four completed efficacy and effectiveness trials of Familias Unidas (N=1445 Hispanic families), we conducted a series of secondary data analyses to fulfill three objectives: 1) confirm a parsimonious measure of family functioning for Hispanic parents at baseline, 2) identify whether heterogenous subgroups of parents who have similar family functioning characteristics at baseline exist, and 3) test whether the indirect effect of intervention on adolescent behavioral health outcomes (at follow-up) through family functioning (post-intervention) significantly differ by the defined subgroups from the second objective. We discuss the implications of our findings for screening and targeting of parents who are most likely to benefit from family-based preventive interventions.

Keywords

Family-based intervention; Adolescent Health; Minority Health; Prevention Science

Available for download on Monday, April 12, 2021

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