Computer Assisted Family Intervention to Treat Self-Harm Disparities in Latinas and Sexual/Gender Minority Youth

Santisteban, Daniel

Abstract

Project 2 Suicide is the second leading cause of death in youth ages 10-24 and self-harm, which includes nonfatal suicide attempts (SA) and non-suicidal self-injury (NSSI) are prevalent and are risk factors for future suicide attempts and suicide completion. Self-harm behavior is a disparity for Latinas as well as for sexual/gender minority youth. This study seeks to refine and test the efficacy of a computer assisted culturally informed and flexible/adaptive intervention (CA CIFFTA) to address this disparity and to reduce the logistical barriers that may contribute to underutilization of treatment. We focus the research on Latinas and Latino LGBT youth (both males and females) because both groups show significantly higher risk for self-harm behaviors and can experience unique stressors (e.g., trauma, minority status, family-related stress, and marginalization) that if addressed using a tailored and adaptive intervention, can contribute to health disparities. We seek to refine the multicomponent CA CIFFTA treatment so that it includes new psycho-educational modules designed to serve sexual/gender minority youth. CIFFTA was designed to address the full continuum of unique culture-related stressor (e.g., acculturation, immigration, discrimination due to race, ethnicity), family conflict and substance use, and will be enhanced to address unique life stressors (e.g., family and peer rejection due to LGBT lifestyle, exposure to trauma, and marginalization), and clinical profiles (e.g., depression, emotion dysregulation). The study investigates the efficacy of a hybrid intervention (face to face and web-based interventions) delivered to both adolescents and parents when compared to treatment as usual. The adaptive framework allows the treatment to be systematically tailored to the unique needs of the adolescent/family. The use of technology helps to avoid some of the logistical barriers to service utilization and makes the intervention more engaging. The intervention will be refined (content and technology) and then pilot tested with 100 Latino adolescents 12-18 years of age and their families. Analyses will investigate: 1) the efficacy of the intervention compared to Treatment As Usual, 2) the linkages between co-existing problem areas (e.g., self-harm, risky sexual behavior, substance use) to see if there is evidence for a syndemic; and 3) the relationship of culture- related variables (e.g., acculturation, familism, and Hispanic Stress) to the key factors hypothesized to contribute to self-harm behavior (i.e., depression, family conflict, substance use, and emotion dysregulation). The study will utilize a number of measures that are shared across CLaRO studies and will serve as a context for the mentoring of a young investigator (Dr. Gattamorta) who is seeking to advance her program of research on family process among Latino gender/minority youth.