Six-Year Intervention Outcomes for Adolescent Children of Parents With the Human Immunodeficiency Virus

Division of Adult Psychiatry, University of California, Los Angeles, Los Ángeles, California, United States
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 09/2004; 158(8):742-8. DOI: 10.1001/archpedi.158.8.742
Source: PubMed


Having a parent with the human immunodeficiency virus has a significant negative impact on an adolescent child's adjustment.
To assess the adjustment of adolescent children to having a parent with the human immunodeficiency virus over 6 years, following the delivery of a coping skills intervention.
A randomized controlled trial with repeated evaluations that was analyzed with an intention-to-treat analysis. A skill-based intervention was delivered in 3 modules over 24 sessions, with the third module being delivered only if parents died.
A representative sample of parents with the human immunodeficiency virus (n = 307) and their adolescent children (n = 423) was recruited from the Division of AIDS Services in New York City; 51.5% (n = 158) of the parents died.
Employment and school enrollment, receiving public welfare support, early parenthood, mental health symptoms, and the quality of romantic relationships.
Over 6 years, significantly more adolescents in the intervention condition than the control condition were employed or in school (82.58% vs 68.94%), were less likely to receive public welfare payments (25.66% vs 36.65%), were less likely to have psychosomatic symptoms (mean, 0.24 vs 0.31), were more likely to report better problem-solving and conflict resolution skills in their romantic relationships (mean score, 4.38 vs 4.20), expected to have a partner with a good job (mean, 4.57 vs 4.19), and expected to be married when parenting (mean, 3.05 vs 2.40). With marginal significance, the percentage of parents in the intervention condition (34.6%) was less than in the control condition (44.1%).
Physicians must consider the psychosocial consequences of illness-related challenges on children and provide interventions.

Download full-text


Available from: Mary Jane Rotheram-Borus, Nov 07, 2014
  • Source
    • "First, studies highly varied in a number of ways. Intervention duration ranged from a single 1-h session (Winters and Leitten 2007; Winters et al. 2012) to over 30 sessions (Catalano et al. 1999; Rotheram-Borus et al. 2004; 2012), and boosters were added between follow-up measures in a number of studies (Fang and Schinke 2013; Furr-Holden et al. 2004; Spoth et al. 2002). Follow-up times ranged from 2 months (McGillicuddy et al. 2001) to 15 years (Haggerty et al. 2008; Wolchik et al. 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: In order to quantify the effectiveness of family interventions in preventing and reducing adolescent illicit drug use, we conducted a systematic review and meta-analysis of randomized controlled trials. We searched the Cochrane Database of Systematic Reviews, Educational Research Information Centre (ERIC), MEDLINE, Embase, and PsycINFO for studies published between 1995 and 2013. Results were described separately for different outcomes (marijuana vs. other illicit drugs) and intervention types (universal, selective, and indicated prevention). Meta-analyses were performed when data were sufficient (e.g., marijuana and other illicit drug initiation in universal samples), using random effect models. Otherwise, we provided narrative reviews (e.g., regarding selective and indicated prevention). Thirty-nine papers describing 22 RCTs were eligible for inclusion. Universal family interventions targeting parent-child dyads are likely to be effective in preventing (OR 0.72; 95 % CI 0.56, 0.94) and reducing adolescent marijuana use, but not in preventing other illicit drugs (OR 0.90; 95 % CI 0.60, 1.34). Among high-risk groups, there is no clear evidence for the effectiveness of family interventions in preventing and reducing illicit drug use and drug disorders. The three small RCTs among substance-(ab)using adolescents gave some indication that programs might reduce the frequency of illicit drug use. Family interventions targeting parent-child dyads are likely to be effective in preventing and reducing adolescent marijuana use in general populations, but no evidence for other illicit drug use was found. We underline the need to strengthen the evidence base with more trials, especially among at-risk populations.
    Full-text · Article · May 2015 · Clinical Child and Family Psychology Review
  • Source
    • "FOCUS (Families OverComing Under Stress) is an example of a family-centered preventive intervention specifically adapted to promote resilience in military and veteran families. As a trauma-informed preventive intervention, FOCUS adapted core components from existing evidencedbased family preventive interventions (Beardslee, Gladstone, Wright, & Cooper, 2003; Rotheram-Borus, Lee, Lin, & Lester, 2004) for at-risk families shown to have psychological health and family functioning benefits in a rigorous randomized control trial with longitudinal follow-up (Beardslee et al., 2003; Rotheram-Borus et al., 2004). The FOCUS intervention for military and veteran families is designed for culturally diverse, single-parent, and dual-parent families contending with challenges encountered during predeployment, deployment, reintegration, and long-term postdeployment. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although current research recognizes robust interdependence among family members, it is not yet evident that such principles have fully integrated into existing systems of care for military and veteran families. Such gaps can create disadvantages in delivering effective support, prevention, and treatment, while including families may yield significant advantages. This article highlights theoretical frameworks and empirical evidence that illustrate the relevance of systemic approaches to supporting service members, veterans, and their families. We discuss examples of family-centered approaches already in place and identify gaps in existing systems of care.
    Full-text · Article · Jan 2013
  • Source
    • "The first intervention, Project TALK (Teens and Adults Learning to Communicate), is a manualized, family-centered, prevention intervention developed to promote positive psychological adjustment in adolescents affected by parental illness (Lester et al. 2008; Rotheram-Borus et al. 2001, 2004, 2006). Project TALK contributed a proven model for a modularized prevention intervention, as well as the implementation of cognitive-behavioral skills delivered in a prevention framework across the family system. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In this paper, we report on the development and dissemination of a preventive intervention, Families OverComing Under Stress (FOCUS), an eight-session family-centered intervention for families facing the impact of wartime deployments. Specific attention is given to the challenges of rapidly deploying a prevention program across diverse sites, as well as to key elements of implementation success. FOCUS, developed by a UCLA-Harvard team, was disseminated through a large-scale demonstration project funded by the United States Bureau of Navy Medicine and Surgery (BUMED) beginning in 2008 at 7 installations and expanding to 14 installations by 2010. Data are presented to describe the range of services offered, as well as initial intervention outcomes. It proved possible to develop the intervention rapidly and to deploy it consistently and effectively.
    Full-text · Article · Jul 2011 · Prevention Science
Show more