The proposed study is submitted as part of a P60 entitled 'NCMHD Center for Culturally-Tailored HispanicHealth Disparities Research', in response to the NIH RFA-MD-06-002: Establishing Comprehensive NCMHDResearch Centers of Excellence (El Centra).This study seeks to investigate the efficacy and mechanisms of a highly promising and culturallyinformed family-based intervention for preventing the emergence of two important health disparities inHispanic youth - drug use and HIV/STIs. Indicated prevention of these specific disparities will beaccomplished by identifying youth who already show serious child psychiatric, behavioral, and family riskfactors (i.e., conduct disorder, attention deficit hyperactivity disorder, depressive disorders, and maladaptivefamily functioning) for these disparities and providing treatment to significantly modify these problems. InHispanic youth and families we will also target the acculturation-related stressors that have been shown toplace youth at risk for deteriorating health. The Culturally Informed Family Treatment for Adolescents(CIFTA) model to be tested integrates cultural and individually-based enhancements (e.g., modules onimmigration stressors and individual skills development) with family treatment, to better address the youthand family's treatment needs. The culture-based enhancements are critical because the stresses ofacculturation and discrimination compound the typical risk factors and family disruptions that can contributeto the deteriorating behavior in Hispanic youth. The flexible manual design is also innovative and helps totailor interventions to the needs of Hispanic youth and families. This study will: 1) refine/adapt the CIFTAtreatment manual to the unique clinical and developmental characteristics of youth 11-14 years of age, 2)implement a randomized clinical trial with 200 Hispanic youth, testing the efficacy of CIFTA compared to acommunity treatment as usual condition in reducing symptoms of CD, ADHD, DD, and family risk factors, 3)investigate the relationship of CIFTA's hypothesized mechanisms of treatment change to outcome, 4) testthe ability of CIFTA to prevent health disparities over a period of 20 months post baseline, and 5) empiricallyidentify subtypes of profiles on acculturation and immigration-related factors and link these to treatmentoutcomes.The results of this study have the potential to advance the knowledge base relevant to Hispanics byproviding data from a fully Hispanic sample, on such important issues as outcome findings, mechanisms ofchange, and sub-types of culturally-related profiles that can impact treatment response.
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