Bridging Disciplinary Boundaries (January 11 - 14, 2007)

This study evaluated the efficacy of the Entre Dos Mundos/Between Two Worlds violence prevention program for Latino adolescents. Without prevention and intervention services, research data suggest that many Latino adolescents and adults are at risk for alcohol and drug use, aggressive behavior, and mental health problems (CDC, 2004; Gonzales, et al, 2002). This heightened risk for antisocial behavior and psychopathology has been linked to acculturation stressors that many Latinos experience while trying to adapt to life in the U.S.

Entre Dos Mundos is an eight-session prevention program that uses a multiple-family group format. Bringing groups of adolescents and parents together to discuss acculturation stressors and challenges provides the opportunity to intervene in problematic parent-adolescent relationship processes and builds social support. Each session is devoted to a theme that has been empirically linked to acculturation stress (handling cultural conflicts in the family, coping with racial discrimination, navigating within U.S. schools). Psychodramatic action methods and behavioral rehearsals are used to optimize skills training exercises.

Methods

Using a pretest-posttest experimental trial to compare implementation formats, we randomly assigned 41 Latino families to Entre Dos Mundos action-oriented skills training groups and 45 to unstructured Entre Dos Mundos support groups using the same session themes. Latino families with foreign-born adolescents ages 12 to 18 were assigned to these two conditions. Pretest score was entered as the first step in a stepwise multiple regression equation. Family income, parent education, and time since immigration were entered in the second, third, and fourth steps, followed by intervention condition in the fifth step and attendance in the sixth step. An interaction term for attendance-by-pretest score was entered in the final step and dropped if it was not statistically significant.

Results

We found no significant differences between the intervention delivery methods; both groups showed improvements in the desired directions. However, there were statistically significant dosage effects from pretest to posttest. Controlling for pretest scores, family income, parent education, and time spent living in the U.S., parents who attended more group sessions reported significant decreases in their adolescent child's aggression, oppositional defiant behavior, ADHD, and attention problems. Further, parents who attended more intervention sessions reported significant gains in family adaptability, bicultural support, and bicultural identity integration. Relative to low dosage parents, the high dosage participants had a large treatment effect size (.6 to .9) for bicultural support, adolescent aggression, family adaptability, bicultural identity integration, and adolescent oppositional defiant behavior. The effect size for adolescent attention problems and ADHD was moderate (.4 to .5).

Implications for practice

This study showed that program dosage is more important than implementation format for Entre Dos Mundos/Between Two Worlds violence prevention. It was the amount of exposure to the EDM curriculum and the parents' investment in regularly coming to the groups that was the critical ingredient for program success.