Methods: The study was conducted from 2007 to 2010. Asian-American adolescent girls aged 11-14 and their mothers recruited from 19 states via postings on craigslist.org and flyers sent to social service agencies. A total of 108 dyads consented and were randomized to either intervention (n = 56) or control arm (n = 52). Intervention-arm dyads completed a 9-module session online, and control-arm dyads received no intervention. Guided by family interaction theory, the prevention program aimed to enhance the quality of girls' relationships with their mothers, and teach girls skills to avoid substance use. Specifically, the program focused on enhancing mother-daughter attachment, improving mother-daughter communication, and increasing maternal monitoring, while helping mothers establish appropriate family rules against substance use, and promoting girls' mood management, refusal skills, and self-efficacy. All participants completed pretest and two annual follow-up measures. Intervention-arm participants also received one annual booster session between the two follow-up measurements.
Results: At the time of enrollment, girls had an average age of 13.14 (SD = 0.96) years and mothers had an average of 40.10 (SD = 7.09) years. At two-year follow-up, 93 of the 108 dyads (86.1%) were retained in the study. Data were analyzed for intent-to-treat methods with the last observation carried forward using all 108 dyads (56 intervention and 52 control). Between-arm and across-measurement differences were analyzed by a repeated-measures general linear model (GLM). Time by intervention interaction results indicated that relative to control-arm girls, intervention-arm girls reported higher levels of mother-daughter closeness (p = .0001), greater mother-daughter communication (p = .048), more maternal monitoring (p =. 018), and enhanced family rules again substance use (p = .01) at 2-year follow up. Intervention-arm girls also reported stronger self-efficacy (p = .015), greater refusal skills (p = .005), and lower intention in using substances in the future (p = .01). As to substance use, intervention-arm girls reported significantly fewer instances of using alcohol (p = .036), marijuana (p = .041), and prescription drugs for nonmedical purposes (p = .045) compared to their control-arm counterparts. The intervention, however, did not exert effects on girls' cigarette use over time.
Discussion and conclusions: This study results suggest that a family-oriented intervention can provide protection and reduce substance use risks for young Asian American girls. Although the intervention was not expressly developed for Asian American girls, it shows modest effects in improving parent-child relationships, increasing girls' skills, and most important, preventing girls' substance use. Further controlled trials are needed to replicate our findings. Studies that test the relative efficacy between a generic intervention and a culturally-specific intervention will be meaningful to this underserved population.
