Parenting Clinical Trial
Official title:
Strengthening Hispanic Families Via NIDA Prevention Science
The proposed specific aims of this K01 pilot study were:
1. Develop a culturally adapted and web-enhanced version of the Parent Management
Training-the Oregon model (GenerationPMTO) intervention for first generation Hispanic
families with youth.
2. Implement a small randomized controlled trial (RCT) with the culturally adapted and
web-enhanced version of the GenerationPMTO intervention.
3. Systematically examine the implementation feasibility (i.e., rates of engagement,
retention, and cultural acceptability) and initial efficacy of the adapted intervention
(i.e., reduced parental stress and depression, increased quality of parenting skills,
reduced levels of internalizing and externalizing behaviors in youth, and reduced
adolescent substance use likelihood).
Recruitment. Participants were recruited according to eligibility criteria, in close
collaboration with community partners. Specifically, health and mental health care centers,
as well as community organizations and churches were targeted for recruitment activities.
Recruitment also consisted of snowball recruitment from participants exposed to the
intervention.
General Description of the Intervention. The Parent Management Training-Oregon model
(GenerationPMTO) intervention is delivered primarily to parents in order to strengthen
parenting skills in a safe learning environment that empower parents to implement these
skills at home. The development of the original GenerationPMTO Spanish manual was conducted
by Dr. Domenech-Rodriguez according to a comprehensive model of cultural adaptation research.
The intervention consisted of GenerationPMTO and culturally-focused sessions. The
GenerationPMTO-focused sessions are detailed in the core treatment manual and have been
translated into Spanish utilizing a rigorous process of translation and consultation with
Hispanic scholars. Culturally-focused sessions integrated content from three sources. First,
we informed sessions according to relevant literature focused on biculturalism. We also
informed the intervention by addressing specific cultural themes that were identified as
salient in our qualitative studies, which correspond to existing literature on risk and
protective factors associated with Hispanic youth. Finally, parents were invited to reflect
on additional cultural values and experiences that they consider relevant to their parenting
efforts.
With regard to content of individual sessions, module 1 addressed issues associated with
immigration, Hispanic culture, and bicultural frameworks. Module 2 addressed issues
associated with parenting and biculturalism. Modules 3-6 covered the GenerationPMTO core
components as they apply to adolescent populations. Module 7 consists of an in-person session
to refine and troubleshoot parenting skills that parents may consider particularly
challenging. To enhance the cultural relevance of GenerationPMTO components, we will present
all GenerationPMTO parenting skills according to bicultural frameworks, a strategy highly
effective the R34 study.
Modules 8-9 reinforced issues of biculturalism having exposed parents to all PMTO core
components. A strong focus on biculturalism is particularly relevant as empirical research
has demonstrated that the promotion of biculturalism constitutes an effective protective
factor for Hispanic youth in first generation Hispanic families.
Randomization. The individual family was the unit of computer-derived randomization, with
PTMO-control balance sought for (a) gender of target youth, and (b) time of recruitment.
Assessments. Data collection was completed after recruitment (T1) and upon intervention
completion (T2).
Intervention Delivery. The intervention was delivered in a major faith-based organization as
this site was the preferred site selected by Latino/a parents. In addition to the parenting
intervention, a strong advocacy approach was implemented to address various needs of parents
(e.g., referral to job training programs or immigration services).
Analyses. Tests of the primary hypothesis will involve fitting of the more assumption-laden
subject-specific multivariate response model to Likelihood of Youth Substance Use (LYUS)
sub-scale values, followed by fitting of the somewhat more conservative Generalized
Estimating Equations (GEE) marginal model with the advantage of fewer assumptions.Our papers
will report crude and covariate-adjusted efficacy estimates from both models, allowing
readers to draw inferences based on either or both approaches. These same models are used to
test the secondary efficacy hypotheses about program impact on parenting skill levels, youth
internalizing/externalizing behaviors, and parent stress levels.
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