Attendance Patterns and Links to Non-Response on Child Report of Internalizing among Mexican-Americans Randomized to a Universal Preventive Intervention
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We examined attendance trajectory profiles among 335 Mexican-American families participating in an 11-week universal intervention to explore if heterogeneity in attendance and thus dosage was associated with intervention response, defined as pre-to-2-year post (T2) reductions in child report of internalizing symptoms. We estimated trajectories accounting for the influence of baseline covariates, selected based on the Health Belief Model (HBM) and Latino family research, to understand covariate associations with trajectories. Results supported six attendance trajectory groups: non-attenders (NA), early dropouts-low internalizing (EDO-LI), early dropouts-high internalizing (EDO-HI), mid-program dropouts (MPDO), sustained attenders-low internalizing (SA-LI), and sustained attenders-high internalizing (SA-HI). All groups except EDO-HI showed significant pre-to-post change on child report of internalizing; however, trajectory groups reflecting more attendance did not have greater pre-to-post change. Nonetheless, child report of internalizing differentiated two subgroups of sustained attenders and two subgroups of early dropouts. These results suggest heterogeneity among families with similar patterns of attendance and highlight the importance of modeling this heterogeneity. Although life stress was a barrier to participation, there was minimal support for the HBM. Cultural influences, acculturation, and familism, played a more prominent role in distinguishing trajectories. As expected, the EDO-HI group was less acculturated than both sustained attender groups and reported weaker familism values than the SA-HI group. However, unexpectedly, the SA-LI group had lower familism than the EDO-LI group. The results suggest that the influence of culture on participation is nuanced and may depend on child symptomatology.
KeywordsUniversal intervention Mexican-American Attendance patterns Internalizing Non-response
This study was supported by the National Institute of Mental Health grant MH064707.
Compliance with Ethical Standards
Development and evaluation of the Bridges to High School program (Bridges), including the data collected and used in this study, were supported by the National Institute of Mental Health grant MH64707.
Conflict of Interest
Drs. Gonzales and Dumka are the developers of the Bridges program; Dr. Mauricio was involved in implementation of the Bridges program during its efficacy trial; Drs. Tein and Millsap were involved in the evaluation of the efficacy of the Bridges program. The authors declare that they have no other conflicts of interest.
All study procedures and measures were reviewed and approved by the Arizona State University Institutional Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all participants in this study and assent was obtained from minors included in the study.
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