Biomedical subjects

José Szapocznik

Publications and source records attributed to José Szapocznik.

At least 19 recordsLinked to original sources

PubMed2006

The prevention of HIV transmission in Hispanic adolescents.

This article reviews the state of the science in HIV prevention for Hispanic adolescents. The article discusses the importance of preventing HIV in Hispanic adolescents. Literature is reviewed in three broad areas: (1) the prevalence rates of drug and alcohol misuse, sexual practices, and HIV infection; (2) risk and protective factors for drug and alcohol misuse and unprotected sex (in general and specifically for Hispanics); and (3) the state of HIV prevention intervention development and evaluation targeting Hispanic youth. Seven specific recommendations are advanced in areas that have the potential to further the field of HIV prevention for Hispanic adolescents.

Adolescent↗

PubMed2006

Outpatient drug abuse treatment for Hispanic adolescents.

The objective of this article is to review the state of the science in evidence-based drug abuse treatments for Hispanic adolescents, highlight scientific opportunities, and offer recommendations to further the field of drug abuse treatment for this population. The article is divided into seven sections: boundaries for this review, drug abuse and associated problems, behavioral treatment, cultural issues in hispanic adolescent behavioral drug abuse treatment, pharmacological treatment, gender differences in treatment, and scientific opportunities/recommendations. Although only one treatment approach, Brief Strategic Family Therapy, has been empirically shown to be efficacious in treating Hispanic adolescent drug abusers, with some modifications other treatments may also have the potential to be efficacious with Hispanic adolescents. Family-based approaches, which typically appear to be most efficacious with adolescents in general, may also have the greatest potential to treat drug abuse in Hispanic adolescents.

Adolescent↗

PubMed2006

NATIVITY AND YEARS IN THE RECEIVING CULTURE AS MARKERS OF ACCULTURATION IN ETHNIC ENCLAVES.

The current study was conducted to ascertain the validity of two commonly used markers of acculturation (nativity and years in the receiving culture) in an enclave context. Relationships between these markers and a bidimensional measure of acculturation were examined in a convenience sample of Hispanic immigrant adolescents and their caregivers in Miami. Nativity was examined using adolescent-reported data; approximately half of the youth were U.S.-born and half foreign-born, but all of the caregivers were foreign-born. Years in the receiving culture was examined using both adolescent and caregiver data. Results indicated that nativity was significantly associated with adoption of receiving-culture practices, with a small to moderate effect size. Years in the receiving culture was significantly associated with adoption of receiving-culture practices only for adolescent girls and for female caregivers who immigrated as youth. Neither nativity nor years in the receiving culture explained even moderate amounts of variance in retention or loss of culture-of-origin practices.

Journal Article↗

PubMed2006

Patterns of retention in a preventive intervention with ethnic minority families.

This study examined socio-demographic, child, and family-level correlates of retention patterns among parent participants of Familias Unidas/SEPI (Coatsworth, Pantin, & Szapocznik, 2002), a randomized, controlled trial of a family-focused preventive intervention. The current study's aim was to identify variables that could be used to classify ethnic minority (African American and Hispanic) caregivers (N = 143) into their known patterns of retention across 30 sessions of the intervention. Person-centered analyses identified three broad attendance pattern groups: (a) non-attenders; (b) variable-attenders; (c) consistent-high-attenders. Subgroups of the variable-attender group included: (a) dropouts; (b) variable-low-attenders; (c) variable-high-attenders. Four socio-demographic indicators were significant discriminators of the broad retention patterns. Three family-level factors were significant discriminators of the variable-attender subgroups. Additional significant mean/rate differences among retention pattern groups on correlates are reported. Implications for how retention is examined in preventive interventions and for developing intervention strategies for improving retention rates are discussed.

Adult↗

PubMed2006

The impact of the built environment on children's school conduct grades: the role of diversity of use in a Hispanic neighborhood.

A population-based study examined the relationship between diversity of use of the built environment and teacher reports of children's grades. Diversity of use of the built environment (i.e., proportion of a block that is residential, institutional, commercial and vacant) was assessed for all 403 city blocks in East Little Havana, Miami-a Hispanic neighborhood. Cluster analysis identified three block-types, based on diversity of use: Residential, Mixed-Use, and Commercial. Cross-classified hierarchical linear modeling was used to examine the impact of diversity of use, school, gender, and year-in-school on academic and conduct grades for 2857 public school children who lived in these blocks. Contrary to popular belief, mixed-use blocks were associated with optimal outcomes. Specifically, follow-up analyses found that a youth living on a residential block had a 74% greater odds of being in the lowest 10% of conduct grades (conduct GPA <2.17) than a youth living on a mixed-use block. In fact, an analysis of the population attributable fraction suggests that if the risk associated with residential blocks could be reduced to the level of risk associated with mixed-use blocks, a 38% reduction in Conduct GPAs <2.17 could be achieved in the total population. These findings suggest that public policy targeting the built environment may be a mechanism for community-based interventions to enhance children's classroom conduct, and potentially related sequelae.

Achievement↗

PubMed2006

Retaining ethnic minority parents in a preventive intervention: the quality of group process.

This study examined relations between group process variables and retention of ethnic minority (African American and Hispanic) caregivers in a family-focused preventive intervention. Data from the Familias Unidas/SEPI project (Coatsworth, Pantin, & Szapocznik, 2002), a randomized, controlled intervention trial, were used to cluster participants according to their patterns of retention over 30 intervention sessions. These person-centered analyses identified three broad patterns: (a) dropouts; (b) variable-attenders; and (c) consistent-high-attenders. Two subgroups of the variable-attender group were also identified: (a) intermittent-attenders, and (b) continual-attenders. Discriminant Function Analysis (DFA) with follow-up Analysis of Variance tested for differences among the three main retention groups on facilitator ratings of participants' general level of participation, leadership, positive alliance with the group, and negative alliance with the group during the first half of the intervention. Leadership and positive alliance significantly discriminated the broad retention patterns. Mean level of participation was not significantly different across retention groups. Results of DFA and ANOVA analyses using leadership, alliance, and participation variables from the first and second halves of the intervention indicated only leadership and positive alliance during the second half of the intervention discriminated continual-attenders from intermittent-attenders. EDITORS' STRATEGIC IMPLICATIONS: The authors describe a promising approach to studying facilitators' assessments of client involvement in a family-focused preventive intervention. The quality of the participants' behavior during sessions, rather than their absolute levels of participation, predicted their pattern of retention in the program. Future comparisons of facilitator and parent views may prove helpful.

Adolescent↗

PubMed2006

Cultural differences in adolescent drug abuse.

This chapter describes the epidemiology of drug use among adolescents from different racial and ethnic groups. Second, it addresses the cultural variables prevalent in each of these groups and their relevance in the delivery of clinical care. Third, it describes the risks and protective factors for adolescent drug use and their interface with culture and the screening tools available for the pediatrician. Finally, we present the treatment and model programs of prevention that were tested specifically with ethnic groups ranked by the National Registry of Evidence-Based Programs.

Adolescent↗

PubMed2006

Needs and scientific opportunities for research on substance abuse treatment among Hispanic adults.

The results of a focused search of the literature on empirical studies of substance abuse treatment outcomes with Hispanic adults are reviewed. Also provided are key research opportunities and recommendations on substance abuse treatment for Hispanics. The paper is divided into two major sections: the first focuses on behavioral drug treatment studies on Hispanic adults, and the second identifies published original articles in pharmacotherapy, namely that more empirical research is needed to determine which treatments are efficacious with Hispanic populations. For treatment modalities not associated with promising effect sizes with Hispanic samples, cultural modifications may be needed to improve the compatibility of the treatment with Hispanic culture. For those treatments found to have promising effect sizes with various Hispanic subgroups, with Hispanics at different levels of acculturation, and with Hispanics from various socioeconomic backgrounds. The authors stress the need for theory-driven interventions to be developed specifically for well-characterized Hispanic subgroups (e.g., suburban middle-income Puerto Ricans living in the Northeast).

Adult↗

PubMed2006

Brief strategic family therapy: lessons learned in efficacy research and challenges to blending research and practice.

In this article, we present key lessons that we have learned from (1) a long program of research on an empirically supported treatment, brief strategic family therapy (BSFT), and (2) our ongoing research and training efforts related to transporting BSFT to the front lines of practice. After briefly presenting the rationale for working with the family when addressing behavior problems and substance abuse in adolescent populations, particularly among Hispanic adolescents, we summarize key findings from our 30-year program of research. The article closes by identifying barriers to the widespread adoption of empirically supported treatments and by presenting current work within the National Institute on Drug Abuse's Clinical Trials Network that attempts to address these barriers and obstacles.

Adolescent↗

PubMed2006

Differential Predictors of African American and Hispanic Parent Retention in a Family-Focused Preventive Intervention.

Similarities and differences in predictors of retention/attendance patterns between African American and Hispanic parent participants (N = 143) from a family-focused preventive intervention were examined. Three broad retention pattern groups, nonattenders, variable attenders, and consistent high attenders, and 2 subgroups of the variable attendance group, decreasing low attenders and decreasing high attenders, were identified. In subgroup analyses, 3 significant discriminant functions were evident: 1 function classified Hispanic parents' retention patterns using sociodemographic indicators (e.g., educational attainment, household income) and 2 functions discriminated Hispanic and African American parents' patterns using family-level predictors (e.g., multiple caregivers attending the intervention, perceived barriers to participation). Implications are discussed in terms of strategies for improving methods of retaining participants in family-centered interventions conducted with ethnic minority families.

Journal Article↗

PubMed2006

Hispanic caregivers of adults with mental retardation: importance of family functioning.

Our aim in this study was to validate a stress-process model for Hispanic caregivers of adults with mental retardation that incorporates family functioning. The model postulates that maladaptive adult behaviors are related to poorer family relationships and higher levels of family burden, which in turn is related to caregiver psychological distress and self-reported health. The 153 Hispanic caregivers were interviewed in their homes with structured interviews and self-report measures. We analyzed cross-sectional data using structural equation modeling. The hypothesized model provided an excellent fit to the data. Also, family relationships mediated the relationship between maladaptive adult behaviors and family burden, and higher levels of family burden were related to greater caregiver distress. Acculturation was negatively related to caregiver distress.

Acculturation↗

PubMed2005

Family Functioning, Identity, and Problem Behavior in Hispanic Immigrant Early Adolescents.

The present study investigated the role of identity in the relationship between family functioning and behavior problems in a sample of Hispanic immigrant early adolescents and their families. The sample consisted of 181 Hispanic immigrant adolescents (92 males, 89 females) and their participating caregivers (who were mostly mothers). Identity was measured using adolescent reports, whereas family functioning and early adolescent behavior problems were measured using both adolescent and parent reports. Correlational analyses indicated that previously obtained relationships among family functioning, identity, and behavior problems were replicated in the present sample. Structural equation models indicated that 20% of the relationship between family functioning and behavior problems operated indirectly through identity, and identity confusion partially mediates the relationship between family functioning and early adolescent behavior problems. Implications for intervention are discussed.

Journal Article↗

PubMed2005

Predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families.

OBJECTIVE: This study examined predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families. The influence of retention on changes in adolescent HIV-risk attitudes was also examined. METHODS: Participants in this study were 91 Hispanic adolescents and their primary parents. Structural equation modeling was used to identify (a) predictors of initial engagement, (b) the effects of group processes on retention, and (c) the effects of retention on change HIV-risk attitudes in adolescents. RESULTS: Although some participant characteristics predicted engagement, the parent-facilitator relationship quality at the initial contact was found to be the strongest predictor of engagement. Furthermore, within-group processes such as group cohesion positively predicted retention. Finally, parent retention predicted decreases in adolescent HIV-risk attitudes. CONCLUSIONS: The results may have important implications for engagement and retention in parent-centered interventions, as well as for reducing risks for HIV transmission in Hispanic adolescents. Implications for services research are also discussed.

Adolescent↗

PubMed2005

A PERSON-CENTERED AND ECOLOGICAL INVESTIGATION OF ACCULTURATION STRATEGIES IN HISPANIC IMMIGRANT YOUTH.

Understanding the processes of acculturation in ethnic minority populations is one of the central tasks of crosscultural research. Addressing challenges of theory, methods, and application in acculturation research requires ongoing advancements in methods and theoretical and model development. The current study was designed to explain a person-centered approach to investigating acculturation and biculturalism and to illustrate this method with a sample of 315 Hispanic youth. Pattern analyses of the Hispanicism and Americanism scores from the Bicultural Involvement Scale yielded four distinct acculturation types, including one characterized by moderate scores on both scales. Relations between acculturation types and indicators of individual, family, and peer adaptation were tested. Results indicated that bicultural youth tended to show the most adaptive pattern of functioning across multiple sociocultural domains. Assimilated youth did not show as strongly negative a pattern as has been reported elsewhere. Implications and benefits of a person-centered approach are discussed.

Journal Article↗

PubMed2005

Concordance among biological, interview, and self-report measures of drug use among African American and Hispanic adolescents referred for drug abuse treatment.

This study examined the concordance among urine assays, interview measures, and self-report measures of marijuana and cocaine use among 190 drug-abusing/dependent African American and Hispanic adolescents and their families at 3 assessment points of an 18-month randomized clinical trial study. Results demonstrated concordance among urine assays, a calendar method self-report measure (Timeline Follow Back [TLFB]), and a noncalendar method self-report measure (Adolescent Drug Abuse Diagnosis Scale). Diagnostic criteria of marijuana and cocaine abuse/dependence from a clinical structured interview (Diagnostic Interview Schedule for Children [DISC]) also converged, albeit weakly, with self-report measures. Adolescent and parent reports on DISC marijuana abuse/dependence diagnostic criteria were related; however, collateral findings for DISC cocaine abuse/dependence diagnostic criteria were equivocal. Differences in concordance among biological and self-report cocaine use measures were found for baseline TLFB assessments among African American participants. Implications for future use and refinement of adolescent drug use assessments are discussed.

Adolescent↗

PubMed2004

Religious involvement, coping, social support, and psychological distress in HIV-seropositive African American mothers.

This study used a cross-sectional design to examine the role of religious involvement within a stress-process framework. Participants were 252 urban, low-income HIV-seropositive African American mothers. The relationships among religious involvement, stress, coping responses, social support, and psychological distress were examined using structural equation modeling. The number of stressors reported by the mother was related to greater religious involvement, which in turn was negatively related to psychological distress. Furthermore, the results suggest that social support, active coping, and avoidant coping responses mediated the relationship between religious involvement and psychological distress. According to the present results, interventions to attenuate psychological distress in HIV-seropositive African American mothers might focus on increasing social support, promoting active coping, and decreasing avoidant coping. The present findings suggest that this may be accomplished, in part, by promoting involvement in religious institutions and practices. However, in light of the cross-sectional design used in the present study, and given that religion may have both positive and negative consequences, further research is needed to determine the extent to which promoting religiosity may increase or alleviate distress.

Adaptation, Psychological↗

PubMed2004

Ecodevelopmental HIV prevention programs for Hispanic adolescents.

The purpose of this article is to illustrate how an ecodevelopmental perspective on risk and protection can be applied to the study and prevention of unsafe sexual behavior in Hispanic immigrant adolescents. Special attention is given to culturally based ecodevelopmental risk and protective processes that may influence unsafe sexual behavior among Hispanic adolescents. Principles for designing prevention programs to offset these risks are offered on the basis of an ecodevelopmental HIV prevention program that has been developed and is currently being tested.

Adolescent↗

PubMed2004

A program of research with Hispanic and African American families: three decades of intervention development and testing influenced by the changing cultural context of Miami.

In this article we summarize work with poor, inner-city Hispanic and African American families conducted at the University of Miami Center for Family Studies. We elucidate ways in which this research program has paralleled the treatment development paradigm and has been responsive to changes in local demographics. Specific cultural issues pertaining to Hispanics and African Americans are discussed in light of treatment development and implementation. Future directions and challenges for working with poor, inner-city minority families are addressed.

Black or African American↗