Early Intervention Programs Research Articles

Effects of child abuse and neglect on executive functions among children diagnosed with learning disabilities or attention deficit and hyperactivity disorder

BackgroundStudying cognitive deficits due to abuse and neglect in vulnerable children with neurodevelopmental disorders can fuel the battle to save them. We aimed to assess effects of child abuse and neglect on executive functions (EF) among children diagnosed with attention deficit and hyperactivity disorder (ADHD) and specific learning disorders (SLD). Three hundred forty drug-naive children were divided into four groups according to their diagnosis. They have all been through history taking, clinical interview, assessment of exposure to abuse or neglect, Barkley Deficit in Executive Functioning Scale-Children and Adolescents (BDEFS-CA), and Conners and intelligence quotient (IQ) test.ResultsChildren with ADHD or SLD were significantly exposed to abuse and neglect showing significant executive dysfunctions. The mostly affected domains with abuse among ADHD were emotion regulation with effect size (ES): 0.576, self-restraint ES: 0.38 and self-motivation ES: 0.256, abuse was significantly associated with lower social class 63.6% ES: 0.377 while neglect was significantly associated with parents’ marital status of being divorced 92% ES: 0.621. Abuse and neglect were significantly associated with emotion regulation executive dysfunction with OR 23.5 and 22.8 respectively.ConclusionExecutive dysfunctions are significantly related to exposure to abuse and neglect. The most affected domains were emotion regulation and self-restraint executive functions. Also, we concluded that prevalence of abuse and neglect to be significantly higher in lower social class than average and higher classes and in divorced parents than married ones. Health education and early intervention programs should be directed more specifically to the more vulnerable children diagnosed with neurodevelopmental disorders and of lower social class or of divorced parents.

Pilot of an early intervention programme for low-risk persons who use drugs in the Philippines

Objective: The aim of this study was to pilot and evaluate the feasibility of an early intervention programme for low-risk drug users in the Philippines. Design: The early intervention consists of three sessions delivered by paraprofessionals focusing on stress, wellbeing, substance use, family and drug use and communication skills. The study was conducted in two phases. In the pilot phase, a randomised controlled trial design was used. In the second phase, a larger field cohort evaluation study design was implemented. Setting: The randomised controlled trial in the first phase was undertaken in four local government units (LGUs). The second phase took place in 13 LGUs in three island clusters in the Philippines. Methods: In the first phase, 42 low-risk users from three urban and one rural community were randomly assigned to treatment and wait-control groups. In the second phase, 744 low-risk users undertook the programme. In both phases, the pretest and posttest measured recovery skills, life skills, quality of life, perceived family support, wellbeing and intent to use drugs. Results: In the first phase, analysis of variance with repeated measures revealed significant differences in pretest and posttest scores in recovery skills and quality of life of participants compared to those who did not participate in the programmes. In the second phase, paired-sample t-test revealed significant improvements in terms of recovery skills, life skills, quality of life, perceived family support, wellbeing and intent to use drugs. Path analysis provided support for the programme’s theory of change. Facilitators perceived the programme to be effective and easy to implement. Conclusions: The study suggests that an early intervention focusing on mental health and substance use delivered by paraprofessionals may be a viable means to reduce drug use and improve mental health in countries such as the Philippines that have little resources and scarce mental health professionals.

Effect of an early intervention program for oral and written language on the reasoning ability of students at risk of learning disabilities

The relationship of certain cognitive processes with oral and written language is frequently studied, however, there is not enough research that tries to clarify the directionality of these relationships, especially in students with learning difficulties. The aim of this study is to analyze the effect of an early intervention program for oral and written language on reasoning in pupils at risk of presenting learning disabilities. The program aims to prioritize and systematize the teaching of oral and written language through the ordinary school curriculum, through five instructional components: alphabetic principle, awareness phonology, reading and writing fluency, vocabulary, and text comprehension. A total of 53 girls and boys at risk of presenting learning difficulties have participated, from four to six years of age. A mixed and longitudinal research design with repeated measures has been followed, with four phases of evaluation and three of intervention, two groups of pupils (instructed vs. not instructed) and three study variables (reasoning, classification and seriation). The evaluation of these variables has been through test of classification and seriation, with adequate validity and reliability. The instructed group has obtained better scores in reasoning, classification and seriation than the non-instructed group throughout the application of the program. The efficacy of early, systematic and planned intervention of oral and written language is highlighted as a way to improve certain cognitive abilities in subjects at risk of learning difficulties.

Early developmental support for preterm infants based on exploratory behaviors: A parallel randomized controlled study.

Preterm infants are at high risk for developmental disabilities, and their parents are at increased risk for high stress. Early intervention programs are applied to reduce these adverse outcomes. The primary aim is to compare the efficacy of the novel Explorer Baby early intervention program for the holistic development of preterm infants. The second objective was to compare the stress levels of their mothers. Randomized clinical trial with 38 weeks-6 months corrected age preterm infants at low risk for cerebral palsy, randomly assigned to experimental (Explorer Baby) or active control neurodevelopmental therapy (NDT) groups. Fifty-seven infants were enrolled in the study, and 51 (26 Explorer Baby, 25 NDT) completed it. Bayley III was used as a primary outcome before, during, and after the intervention. When we compared the changes between the groups before and after therapy, no significant differences were found in any of the primary or secondary outcomes (between-group comparisons). When comparing the changes in both groups before and after therapy (in-group comparison), the Explorer Baby group demonstrated significant improvements in cognitive (Hedges' g=.83) and explorative language skills (Hedges' g=.65), whereas the NDT group showed improved parent-child dysfunctional interaction (Hedges' g=2.66) between T0-T1 and T0-T2. The Explorer Baby early intervention program may be a preferred option to support premature infants without brain injury, as it shows greater skill acquisition than NDT, although not statistically significant. Both methods are safe as they support premature babies without negatively affecting mothers' overall stress levels.

A Framework for the Design of Inclusive Community-Based Early Childhood Intervention Programs

In this article, a framework for the creation of a fully inclusive and comprehensive early childhood intervention system is described. Although aspirational at this time, the potential for developmental science, intervention science, and implementation science to be integrated to maximize the effectiveness of early intervention systems is presented in the context of the Developmental Systems Approach. This framework guides a practice model emphasizing a family-centered problem-solving process that focuses on supporting well-characterized family patterns of interaction that contribute to children's development. Discussed as well is the ability of such an integrated system to be compatible with and incorporate principles and practices from a human rights perspective; all designed to support family and child goals. The transformational potential of this framework for organizing inclusive community-based early childhood programs is considered.

Cerebral visual impairment and effect of phase-wise stimulation strategies-An interim analysis.

Cerebral visual impairment (CVI) is an overarching term, defined as a brain-based visual impairment with onset in childhood, unexplained by an ocular disorder and associated with unique visual and behavioral characteristics. Good vision and awareness of visual function in a child are highly essential as neuroplasticity is maximum in the first three years of life and response to intervention is utmost in this period. Awareness is lacking regarding CVI, and the diagnosis is largely missed. This can be easily addressed if a structured approach is employed. This study aims to evaluate the etiology and radiological correlation with the severity of CVI and outcome after structured intervention in children with CVI. Prospective-interventional study. Children attending the Child Development Centre (CDC) of a tertiary care hospital in North Karnataka and diagnosed with CVI in the age group of six months to 12 years and meeting the sampling criteria were screened and enrolled consecutively after obtaining parental consent/assent. Statistical analysis used is nonparametric test with SPSS software. Age showed a significant association with the phase of CVI. Perinatal insult was associated significantly with the severity of CVI. Magnetic resonance imaging (MRI) findings did not hamper the recovery of CVI. Enrolment in early intervention programs tailored according to child's specific needs should be encouraged, with stress on ophthalmic screening of preterm and high-risk babies with perinatal hypoxia and history of convulsions, as early as six months.

Hispanic adolescents' internalizing symptoms and positive family functioning: A bidirectional examination of associations over time.

Open communication with parents, defined as perceived ease of adolescent-parent disclosure, and family support are components of positive family functioning linked with fewer adolescent internalizing symptoms. However, relatively little is known about bidirectional pathways over time. Even less is known about bidirectional pathways for Hispanic adolescents or about the role of adolescent and parent gender. Therefore, this study examined bidirectional pathways between positive family functioning and adolescent internalizing symptoms over time in a sample of Hispanic middle school adolescents (N = 340; 51% female, Mage = 13.27 years, SD = .77), who completed surveys in the fall of 2016 (Time 1) and the spring of 2017 (Time 2; N = 284; 52% female). Results indicated that positive family functioning, including open communication with mothers and fathers, predicted fewer depressive symptoms for girls, but not for boys. Open communication with fathers predicted fewer anxiety symptoms for girls and boys. Girls' depressive symptoms, but not boys', predicted decreases in open communication with fathers. Boys' depressive symptoms predicted less family support. Unexpectedly, boys' anxiety symptoms predicted increased family support. These findings highlight gendered pathways linking family functioning and internalizing symptoms in Hispanic adolescents over time, including the relative importance of open communication with fathers. Gendered findings emphasize the utility of family-based prevention and early intervention programs targeting internalizing symptoms, especially for Hispanic girls. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-stigma and quality of life among people with psychosis: The protective role of religion.

The quality of life in people with psychosis has been consistently demonstrated to be lower than those without, with self-stigma contributing greatly to this impairment. Hence, it is imperative to address this gap in order to facilitate recovery-oriented and other outcomes. This study investigates the potential of religiosity in moderating the effects of self-stigma on quality of life among those with psychosis. Adults with psychosis (n = 99) were recruited from the Early Psychosis Intervention Programme in Singapore from 2018 to 2021, and administered the self-report Religious Commitment Index, Internalized Stigma of Mental Illness scale, and Abbreviated World Health Organization Quality of Life instrument. Linear regression analyses were conducted and the interaction between self-stigma and religious commitment scores calculated to investigate the moderation effects of religiosity on the relationship between stigma and quality of life. Preliminary regression analyses revealed a significant association between sex and psychological quality of life. After controlling for sex, religiosity was found to moderate the relationship between self-stigma and psychological quality of life. The results of the study demonstrate the potential of religiosity in buffering the effects of self-stigma on quality of life. This reveals an area that can be easily targeted and addressed in treatment programs to improve outcomes beyond the clinical setting among people living with psychosis, to facilitate their recovery journey and beyond.

Carious status and socio-behavioral risk factors among 12 year-old children in South-Central region in Romania

BackgroundRegular screenings at children population level are necessary in order to assess communities’ need for education, prevention, as well as early detection and intervention programs The study aims to assess dental caries experience and oral health-related behaviors among Romania children from the South and Central region.MethodsThe cross-sectional study conducted in 2019–2020 is part of the national survey “Romanian Oral Health Survey”, under the endorsement of the World Health Organization (WHO). The stratified, randomized and representative sample included 98 children of 12 years of age. The assessment included a clinical examination, using International Caries Detection and Assessment System (ICDAS) and the Oral Health Questionnaire for Children recommended by the World Health Organization.ResultsResults revealed that the frequency of caries-free children among 12 year-olds was 36.7% and the mean DMFT was 2.89. Regarding the oral health-related habits, 38.8% of children brushed twice daily; the consumption of sugary foods multiple times per day has been frequently met and 11.2% at the age of 12 never visited the dental office.ConclusionsThe findings revealed that caries prevalence was high and behaviors negatively influence oral health. The presented data are of utmost importance for Romanian policy makers to promote oral health education among children, to support consistent preventive oral health campaigns and to stimulate dental attendance, irrespective of children’ living areas or gender.

Prevention of caries and obesity in children with immigrant background in Norway- a study protocol for a cluster randomized controlled trial

BackgroundImmigrants are known to experience greater socioeconomic stress and poorer well-being and to suffer more from lifestyle- and diet-related disorders than native populations. There is also evidence that children of immigrant parents are at greater risk of diverse health problems than their host country cohorts. The aim of this study is to apply and evaluate the efficacy of an early life intervention program among parents/children with immigrant background to prevent childhood caries and obesity, thereby improving the children’s general health, oral health, and quality of life.MethodsThis is a study protocol for a cluster randomized controlled intervention follow-up study. In phase I of the study, the primary care health centers in the municipality of Bergen, Norway were randomly allocated to intervention or control groups. The intervention was carried out using the motivational interviewing technique and the common risk factor approach. The intervention group received guidance on diet/oral hygiene and the control group received standard care information. Parental knowledge and children at age 3 and 5 years old will be assessed in a prospective phase II follow-up study compared to native Norwegian controls. The primary outcome will be evaluation of change on parental oral health related knowledge and attitudes. The secondary outcome will assess the impact of the intervention on children’s caries -, body mass index- and oral health related quality of life.DiscussionCollaboration between dental public health and primary health care personnel on the common risk approach motivational intervention offers opportunities to address key dietary behaviors that may prevent obesity and dental caries. Providing sustainable preventive measures decreases the burden of diseases and consequently reduces health inequalities, particularly among at-risk children.Trial RegistrationThe study is registered as a clinical trial (ClinicalTrials.gov Identifier: NCT05758454: 7 March 2023). Ethical approval has already been granted by the Regional Ethical Committee (REK) (2015/ 27,639 /REK vest) and Sikt – Norwegian Agency for Shared Services in Education and Research (Reference number 778825).

Parenting stress and autistic children's emotional problems relate to family-school partnerships and parent mental health.

Dimensions of family-school partnerships, including parent-teacher relationship quality and family educational involvement, are associated with positive outcomes for youth. Family-school partnerships are important for autistic youth, who may particularly benefit from cross-setting supports. Coordinated family-school partnerships may help maximize child outcomes. This study investigated the extent to which child behavioral and physical health (emotional, behavioral, and medical problems) and parent mental health (parenting stress, parent mental health history, and parent depressive symptoms) were associated with parent-teacher relationship quality and family involvement in a sample of 68 families of school-aged autistic children. Families were recruited through invitation letters disseminated at local early intervention and early childhood programs. Children in the sample were primarily boys, primarily White, and approximately 8 years old. Results suggest that (a) child emotional problems and parenting stress were negatively associated with parent-teacher relationship quality (large effects) and (b) parent history of mental health problems was negatively associated with family involvement (large effect). Intervention recommendations and future research directions are discussed. For example, it would be helpful for future research to include the perspectives of ethnically diverse samples when examining family-school partnerships among families with autistic children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Predictors of poor neurodevelopmental outcomes of very preterm and very low birth weight infants.

Despite recent improvements, premature infants remain at high risk for long-term morbidity and poorer neurodevelopment, particularly very preterm (VP) and very low birth weight (VLBW). The aim of this study was to describe neurodevelopmental outcomes at two years and identify potential predictors of worse performance. In a retrospective cohort, a two-years' neurodevelopmental evaluation was analyzed. Multivariable regressions were used to study the association of perinatal history with neurodevelopmental outcomes. Subjects included VP and/or VLBW born at a Portuguese III-level perinatal center between 2011-2017. Milestones outcomes were assessed using the Griffiths' Mental Development Scales. One hundred seventy-seven infants were included. Two-years milestones were not achieved in 18.6% in language domain and 7.3% in motor function, 4.5% wore glasses and 1.1% auditory prosthesis/cochlear implant. Almost 30% needed intervention, 18.6% occupational therapy, 16.4% physiotherapy and 13.6% speech therapy. Griffiths' Mental Development Scales was performed in 139, with a mean global quotient of 98.3 and hearing/speech as the least quoted scale. Global development delay (GDD) was present in 14.8% and cerebral palsy in 2.8%. Multivariate analysis by logistic regression adjusted to gestational age, birth weight and confounding variables, revealed a statistically significant association between GDD and hydrocephalus with shunt/reservoir (OR:19.01), retinopathy of prematurity stage ≥2 (OR:7.86) and neonatal sepsis (OR:3.34). Consistent with recent studies, preterm are at increased risk of neurodevelopmental impairment, mainly due to GDD and language delay, rather than cerebral palsy. In this population, hydrocephalus, retinopathy of prematurity and neonatal sepsis were strongly associated with poorer outcomes. Insight into these factors is essential to refer patients for specific early intervention programs.

Effect of Personality Traits and Emotion Regulation Strategies on Risky Behaviors in Adolescents.

The current study investigated the effects of personality traits and emotion regulation strategies on high-risk behaviors among adolescents (N = 1,572). This study used a cross-sectional and correlational research design. Multiple linear regression was used for analysis. A 1-unit increase in extraversion and neuroticism led to a 0.391- and 0.365-unit increase in high-risk behaviors, respectively. However, a 1-unit increase in agreeableness and conscientiousness led to a 0.307- and 0.365-unit decrease in high-risk behaviors, respectively (p < 0.05). A 1-unit increase in external and internal dysfunctional emotion regulation strategies led to a 1.34- and 0.548-unit increase in high-risk behaviors, respectively. However, a 1-unit increase in internal functional emotion regulation strategies led to a 0.641-unit decrease in high-risk behaviors (p < 0.05). Regression analysis showed that age, school type, sex, grade level, father's educational level, father's child-rearing style, and school performance were associated with more high-risk behaviors (p < 0.05). There were correlations between some personality traits, emotion regulation strategies, sociodemographic characteristics, and high-risk behaviors. Early intervention programs targeting dysfunctional personality traits and emotion regulation skills in adolescence may prevent the development of risky behaviors in adulthood. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 23-36.].

Mental health disorder as a risk factor for domestic violence experienced by school children

PurposeDomestic violence is a universal social concern, and its implication on children’s mental health is a global health predicament. Although the aftereffect of domestic violence on the mental health of women is well researched, mental health disorders of children in terms of attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), general anxiety disorder (GAD), separation anxiety disorder (AD) and mood disorder (MD) on account of domestic violence is rarely investigated. Hence, the purpose of the study is to investigate the impact of exposure to domestic violence on children’s mental health.Design/methodology/approachTo examine the correlation between domestic violence and mental health among children, in a survey of public primary schools in Ekiti State, Nigeria, the authors employed 664 pupils with simple random techniques. The Multidimensional Domestic Violence Scale assessed the participants’ exposure to domestic violence. The Child & Youth Mental Health General Screening Questionnaire was used to examine respondents’ mental health.FindingsThe results revealed a high incidence of domestic violence among children. It also showed a substantial correlation between domestic violence and the mental health of primary school pupils. Children living with domestic violence experience significantly increased rates of ADHD, ODD, AD, GAD and MD as forms of mental health disorders.Research limitations/implicationsGiven the unpleasantness of this social issue affecting the well-being of children globally, it is imperative to engage in intervention and prevention packages that will assist the victims, perpetrators, parents, teachers, schools and other stakeholders. Introducing counselling services into the primary school curriculum will assist victims and those at risk develop self-confidence that will enable them to report their violators. Although counselors do not diagnose, early detection of victims would assist in early intervention where counselors can use different techniques and approaches to help such victims to resolve all forms of cognitive distortions that can lead to mental health disorders. Counselling services can help in providing referral opportunities to victims or “at risk children,” rehabilitation and follow-up services for victims of domestic violence.Practical implicationsGovernment organizations should also reintroduce health-care services where clinical psychologists will be available in primary schools to provide psychological services to meet the needs of the victims.Originality/valueConclusively, the study presents evidence that children who witness domestic violence face a significant risk of developing mental health disorders. The findings highlight the potential harm that domestic violence can inflict on children’s mental well-being. Mental health conditions such as ADHD, CD, ODD, GAD, AD and MD are commonly observed in these children. It recommends establishing early intervention programs for children witnessing domestic violence in schools and communities and programs to detect and address mental health issues promptly.

Disparities in treatment and survival in early-stage hepatocellular carcinoma in California.

Curative intent therapy is the standard of care for early-stage hepatocellular carcinoma (HCC). However, these therapies are under-utilized, with several treatment and survival disparities. We sought to demonstrate whether the type of facility and distance from treatment center (with transplant capabilities) contributed to disparities in curative-intent treatment and survival for early-stage HCC in California. We performed a retrospective analysis of the California Cancer Registry for patients diagnosed with stage I or II primary HCC between 2005 and 2017. Primary and secondary outcomes were receipt of treatment and overall survival, respectively. Multivariable logistic regression and Multivariable Cox proportional hazards regression were used to evaluate associations. Of 19 059 patients with early-stage HCC, only 36% (6778) received curative-intent treatment. Compared to Non-Hispanic White patients, Hispanic patients were less likely, and Asian/Pacific Islander patients were more likely to receive curative-intent treatment. Our results showed that rural residence, public insurance, lower neighborhood SES, and care at non-National Cancer Institute-designated cancer center were associated with not receiving treatment and decreased survival. Although multiple factors influence receipt of treatment for early-HCC, our findings suggest that early intervention programs should target travel barriers and access to specialist care to help improve oncologic outcomes.

The experiences of parents in an early-intervention program for young people with borderline personality disorder features.

Previous research demonstrates that parents' communication skills may contribute to the development and maintenance of their young person's borderline personality disorder (BPD). Carers of people with BPD also experience their own psychosocial stressors and feel unsupported. Consequently, Dialectical Behavior Therapy for adolescents (DBT-A) invites parents to partake in group therapy alongside their young person. Despite this involvement, little research exists examining parents' perspective of engaging in a DBT-A program, and specifically whether they experience their own benefits and changes from being part of the program. To examine this, the current study interviews 34 parents who engaged in an early intervention DBT-A program. Thematic analysis resulted in seven key themes and 16 subthemes beginning with parents' expectations of the program, followed by the key elements of the program that facilitated change, and the actual changes and benefits attributed to these elements. Overall, parents were surprised by their own gains from the program, and how the skills they learned facilitated personal development that improved family communication and functioning with their young person and more broadly. This study addresses the gap in understanding the parent perspective with clinical implications for the benefits of involving parents in therapy more generally.

Digitalization in mental health care. New opportunities for specialists and patients

Digitalization – is one of the most promising trends of the healthcare system transformation, including mental health care. Telemedicine opportunities allow to improve health care system, to resolve the problem of the qualified specialist’s deficit and provide the remote territories with appropriate medical care, it also provides education possibilities for the mental health specialists from all over Russia offering continual training opportunities. Digital technologies can help substantially improve the science data collection in the field of mental health, remote access ensures patient enrollment from the different regions of the country, it allows to make the measures in the typical patient’s environment, data accumulated with the help of digital assistants open the new possibilities in the study of mental disorders. Digital behavior and behavior in the digital environment became the new research objectives in the field of mental health. Problem internet use with the behavior addiction development is in the research focus of the researchers aimed to elaborate early intervention and prevention programs. The use of the computerized programs, gamification, VR and mobile apps possibilities should become the essential part of the medical care provision in the field of mental health with the hybrid models implementation where the patient will have the option to choose individualized treatment program with the optimal ratio between digital and classic treatments options. Digital technologies should take their place in the prevention and mental health sustenance in the nearest future.

Rabies in chozna ‘Potus flavus’: a warning of a potential threat to public and animal health

We reported an outbreak of wild rabies in Potus flavus (choznas), a carnivorous mammal associated with insectivorous bats in Kosñipata, Cusco, Peru, from February 2021 to October 2022. Eight human exposures were reported, with aggressive attacks resulting in injuries. The outbreak prompted a public health response and raised concerns about zoonotic diseases due to habitat fragmentation and urbanization. The study involved antigenic and genetic characterization of the virus in the affected animals, revealing similarities with variants in non-hematophagous bats. This outbreak marked the first time rabies had been reported in choznas in the region, highlighting the need for early intervention programs and wildlife protection. Pre-exposure rabies vaccinations were administered to residents, and community surveillance was established to control the outbreak. The study emphasizes the importance of continuous surveillance and education to prevent rabies transmission from choznas to humans and other animals, as their role as potential secondary transmitters of the virus warrants further investigation.

Predictors for runaway behavior in adolescents in South Korea: national data from a comprehensive survey of adolescents.

Runaway behavior is reported to impede the growth, mental health development, and social adjustment of adolescents. Exposure to harmful media causes problematic behaviors in adolescents, sometimes inducing them to run away from home. This study examined the factors influencing adolescents' runaway behavior. Utilizing the data of 11,354 adolescents from the Survey of Media Usage and Harmful Environment among Adolescents, a hierarchical logistic regression analysis was conducted using the SPSS 24.0 program. The significant predictors of runaway behavior were the grade of the adolescent, deviant behaviors (drinking, smoking), autonomous control ability, relationship with family, and harmful media (p < 0.001). This regression model explained 13.1% of the variance in runaway behavior. A significant outcome of this study is that harmful media was identified as one of the factors affecting adolescents' runaway behavior. Adjusted OR and 95% CI of harmful media was 1.23 (1.10-1.38). This study showed that individual, family, social factors, and harmful media influence adolescents' runaway behavior. The results emphasize the importance of health teachers and the need for early intervention programs, for the identification and prevention of risk factors for adolescents' runaway behavior.

Preliminary Effects of a Guided Self-Change Intervention on Perceived Risk and Self-Efficacy in University Students Engaging in Cannabis or Alcohol Misuse.

Guided Self-Change (GSC) is a Motivational Interviewing (MI)-based early intervention program, infused with Cognitive Behavioral Therapy (CBT), for individuals with substance use problems. In this study, we implemented a 4-session GSC program with the innovative addition of mindfulness-based techniques at a minority-serving institution to reduce substance use and negative consequences among self-referred university students. We investigated processes that may be associated with behavior change, including perceived risk of use and self-efficacy ratings among university students who reported their primary substance of choice was cannabis (n = 18) or alcohol (n = 18). The sample of 36 participants (Mage = 24.4, SDage = 5, range 18-37) mostly identified as female (58.3%), then male (41.7%); 52.8% identified as Hispanic/Latine, 22.2% as Black or African American, and 19.5% as a sexual minority. Among cannabis primary using students, results indicated that the perceived risk of weekly cannabis use, confidence to change, and readiness to change showed statistically significant increases from pre- to post-assessment. Among alcohol primary using students, confidence to change and readiness to change showed statistically significant increases from pre- to post-assessments. All results yielded large effect sizes, which may be inflated due to the small sample size. Findings suggest that over the course of participation in a brief, 4-session targeted GSC program, there were significant increases in perceived risk and self-efficacy among minority university students who engage in primary cannabis or primary alcohol use.