Hispanic Adolescents Research Articles

Child disclosure, parental solicitation, and adjustment problems: Parental support as a mediator.

Little is known about how perceived parental solicitation and child disclosure are negatively associated with early adolescent adjustment problems and/or if these associations are consistent across race/ethnic groups. This study used data from 209 early adolescents to examine perceived parental support as a mediator in the associations between perceived parental solicitation and child disclosure and subsequent adjustment problems, while also examining race/ethnic group differences across non-Hispanic White and Hispanic early adolescents using multi-group path analyses. Perceived parent support did not mediate the associations between child disclosure and perceived parental solicitation and subsequent adjustment problems. However, child disclosure was directly associated with subsequent conduct problems for Hispanic adolescents. Child disclosure and perceived parental solicitation may positively influence the parent-adolescent relationship by increasing parental support but may not entirely help in reducing the prevalence of adjustment problems. Child disclosure may be particularly beneficial for Hispanic early adolescents in reducing adjustment problems.

Nonsuicidal Self-Injury Among African American and Hispanic Adolescents and Young Adults: a Systematic Review.

While African American and Hispanic adolescents and young adults living in the USA are exposed to myriad stressors that may increase their risk for mental health difficulties, few studies have examined nonsuicidal self-injury (NSSI) among these youth. The purpose of this systematic review was to critically examine and synthesize current literature on NSSI among these understudied youth. Using multiple search terms related to NSSI, race/ethnicity, and developmental stage, electronic literature searches of PubMed, PsychINFO, and Google Scholar databases retrieved 3036 relevant articles published in the English language between 2000 and 2018; manual reference checks yielded an additional 17 articles. Ultimately, a total of 52 full-text studies were assessed for eligibility, and 15 articles were included in the present review. Although the majority of studies reported higher prevalence of NSSI among non-Hispanic White youth, evidence suggests that African American males are also at high risk of engaging in self-harm. Emotional dysregulation emerged as a common risk factor, while social support and feelings of connection were protective for some African American and Hispanic youth. Although racism and discrimination were not linked to NSSI in the reviewed studies, this remains an important area of future research for prevention and intervention efforts.

P113 Relationship Between Acculturation and Diet Quality Among Hispanic Adolescents

<h3>Background</h3> Acculturation is a dynamic and complex process that adopts elements of the dominant culture, which include food, attitudes, beliefs, languages, art, music, rituals, and faith/religion. This melting pot vs. salad bowl framework may impact health. The melting pot advocates for assimilation into 1 dominant culture whereas the salad bowl encourages distinctions that contribute to unique aspects of every group. The salad bowl approach to health suggests that health promotion and disease prevention are broad goals that coincide with identity and heritage. <h3>Objective</h3> To determine whether there is a relationship between level of acculturation and diet quality among first- and second-generation Hispanic adolescents in the United States. <h3>Study Design, Setting, Participants</h3> We utilized the 2015-2016 National Health and Nutrition Examination Survey (NHANES) sample, consisting of 447 Hispanic adolescents ages 12 to 19 (46.5% male, 53.5% female) in the US. Diet quality from the Healthy Eating Index (HEI) was measured using 2-day food records. <h3>Measurable Outcome/Analysis</h3> Data was cleaned and analyzed using SAS version 4.0. Level of acculturation was scored via NHANES content of generational items for parental citizenship status and language items for frequency of native language spoken at home. HEI was scored as poor (0 to 49), moderate (50 to 79), and good (80 to 100). Multiple logistic regression measured acculturation vs. diet quality, and controlled for gender, age, and income. The Tukey test confirmed findings. <h3>Results</h3> Gender and income had no influence on HEI whereas older age groups were associated with higher HEI scores (<i>P</i> < .008). Level of acculturation was associated with HEI (<i>P</i> < .05). Among adolescents with poor diet quality, 38% with high acculturation had poor diet quality compared to 20.4% with medium acculturation and 6.8% with low acculturation (<i>P</i> < .009). <h3>Conclusions</h3> Findings suggest that Americanized Hispanic adolescents consume more standard American foods and fewer meals prepared at home. Future investigations should explore the impact of acculturation on diet quality among other ethnicities and evaluate culturally appropriate interventions in the US.

Family Mealtime Communication in Single- and Dual-Headed Households Among Hispanic Adolescents With Overweight and Obesity

ObjectiveTo investigate the association of adolescent self-report of family mealtime communication on obesity-related behaviors in single- and dual-parent households and by sex in a sample of overweight and obese Hispanic adolescents. DesignCross-sectional analysis of a randomized control trial SettingEighteen middle schools in Miami-Dade County, Florida. ParticipantsTwo-hundred and eighty Hispanic seventh- and eighth-grade students Main Outcome MeasuresPhysical activity, fruit and vegetable intake, and added sugar intake. AnalysisStructural equation modeling. ResultsThe findings indicate that mealtime communication was associated with fruit and vegetable consumption in boys (β = .30; P = .001; 95% confidence interval [CI], 0.52–2.68) and physical activity in girls (β = .26; P = .010; 95% CI, 0.16–1.30). Moreover, a single-parent household was associated with dietary consumption in boys (fruit and vegetable intake [β= .18; P = .039; 95% CI, 0.02–2.60] but had a moderating effect on fruit and vegetable consumption in girls (β = .21; P = .015; 95% CI, 0.14–2.19). Conclusions and ImplicationsFamily mealtime communication may impact dietary and physical activity outcomes in Hispanic adolescents with overweight and obesity, but differentially across gender and household parent makeup. These findings, together with the prevalence of single parents, point to the importance of targeting Hispanic single parents as agents of change to promote healthy lifestyle behaviors in their children via positive mealtime interactions.

Associations between network-level acculturation, individual-level acculturation, and substance use among Hispanic adolescents

Acculturation is associated with substance use behaviors in Hispanic adolescents. However, there is limited research determining whether the individual’s friends’ acculturation patterns also influence substance use. Tenth-grade students (N = 970) participated in Project RED, a study of substance use and social networks among Hispanic youth in Southern California. Acculturation and substance use data from both the respondent and their nominated friends were regressed on lifetime cigarette use, marijuana use, and alcohol use controlling for sibling substance use, sex, depressive symptoms, and network measures. Respondent’s Hispanic orientation was significantly associated with lower odds of both cigarette and marijuana use, whereas respondent’s friends’ US orientation was associated with higher odds of cigarette use. When controlling for network-level acculturation, individual-level U.S. orientation was not associated with substance use. Participants who nominated more friends had lower odds of cigarette use. Among this sample of Hispanic adolescents, affiliating with U.S.-oriented friends was associated with a higher risk for smoking. Substance use prevention efforts should consider encouraging Hispanic youth to maintain their cultural heritage and foster friendship groups that support abstinence and promote Hispanic and bicultural identity.

1274-P: Prevalence of Addictive-Like Eating in Hispanic Adolescents with Obesity Seeking Weight Management Treatment

Background: There is a growing body of literature exploring food addiction (FA) in adolescents with obesity and how it impacts treatment outcomes. Several studies have evaluated the prevalence of FA in youth with obesity as measured by the Yale Food Addiction Scale for children (YFAS-c) and rates vary from 4-22%. The rates of obesity in Hispanic youth is reported to be higher than in other ethnic groups however there is a paucity of literature exploring the prevalence of FA in this population. Due to our geographic location and our majority Hispanic patient population, we examined 1) the prevalence of FA in Hispanic adolescents with obesity and 2) the association between FA and demographic characteristics. Methods: Baseline data from a RCT on behavioral weight management interventions was used. Participants who self-identified as Hispanic, were 14-18 years of age, and with a BMI &amp;gt;95th% met criteria. Fisher’s exact test was used to assess the differences between adolescents with positive and negative YFAS-c scores and demographic characteristics. Results: In a sample of 59 Hispanic youth, 29% met criteria for FA. There was no significant difference in age, gender, or household income between adolescents with positive YFAS-c at baseline compared to those with negative scores. Conclusions: Hispanic youth with obesity have higher rates of FA than previous prevalence reports. This information is essential to consider prior to implementation of a weight management program as it may impact adherence, retention, and ultimately weight outcomes. Baseline behavioral phenotyping may be a strategy to ensure adolescents are receiving the services they require in conjunction with participation in a weight management program. These findings can help inform providers of the importance of screening for FA prior to intervention administration and possibly modifying the intervention content to address addictive like eating behaviors. Disclosure J. Gonzalez: None. C. Fink: None. C. Wee: None. E. Hegedus: None. K. Lopez: None. A. Vidmar: None. Funding eHealth International (CHLA 000193)

Growing Leaders: Testing Learning Modules that Foster Belongingness and Growth Mindsets about Leadership among Adolescents

Adolescence is a period of identity formation, and in particular a time for the development of beliefs regarding who can be a leader. Given that such beliefs are informed by what adolescents see and what those around them believe, adolescents who are part of racial minority groups are more likely to form opinions that they are less able to lead relative to adolescents who are part of majority groups. With our research, we designed learning modules that we delivered during interactive workshops led by research team members from underrepresented groups. In these modules, we discussed systemic racism, programs created to combat inequality, the increasing representation of Black and Hispanic people and women in various high-status positions, and ways to foster and benefit from a growth mindset, for middle and high school students. Results suggested the learning modules increased feelings of belongingness in leadership after the workshop for underrepresented Black and Hispanic adolescents in addition to White and Asian adolescents. We also showed significant increases in beliefs that one can grow leadership abilities for all adolescents; this effect was larger for White and Asian adolescents. We discuss the implications for mitigating the perpetuation of underrepresentation in leadership.

Perspectives on Integrated Behavioral Health in pediatric care with immigrant children and adolescents in a Federally Qualified Health Center in Texas.

The world's displaced population has reached a record high. Immigration is under the global lens and part of the public debate more than ever. The existing data on mental health disorders among displaced youth are alarming, and children and adolescents are disproportionately impacted by forces outside their control. In the United States, the recent border crisis has exponentially increased the needs for accessible mental health services for immigrant children, adolescents, and their families. As a result, implementation of integrated solutions for primary and behavioral health care has grown. In this article, we explore the application of an integrated model, the Primary Care Behavioral Health Consultation Model (PCBH) with Hispanic and Latino immigrant children and adolescents and their families in a Federally Qualified Health Center in Houston, Texas. PCBH holds great promise for increasing access to mental health services for immigrant and refugee populations.

Sex behaviours and family sexuality communication among Hispanic adolescents

ABSTRACT This study compared the extent to which Hispanic teenagers talk with mothers, fathers and extended family members about risks of sex, protection and relational sex, as well as the role of teenagers’ gender on the association between sexuality communication and risky sexual behaviours. The analysis is based upon 474 Hispanic young people’s responses to a school-based survey recruited from six New England high schools. We (1) calculated descriptive statistics and tests of difference by teenagers’ gender, and (2) ran logistic regression models for engaging in three different risky sexual behaviors separately by gender. There were significant gender differences in teenagers’ talk with mothers and fathers, but not with extended family members. There was consistent ‘gender matching’ between teenagers and the extended family member they talked to. The content of sexuality communication, the family member the teenager talked to and the gender of the teenager all contributed to whether communication was protective for teenagers’ sexual behaviour. There are substantial differences in the types of sexuality communication Hispanic teenagers have with different family members, which are closely tied to teenager’s and the family member’s gender. Results suggest that one size does not fit all when it comes to family communication about sex and sexuality.

Emotional Maltreatment and Adolescent Depression: Mediating Mechanisms and Demographic Considerations in a Child Welfare Sample.

Emotional maltreatment is a risk factor for adolescent depression. Yet, it remains unclear whether commissions and omissions of emotional maltreatment (a) confer vulnerability via distinct mechanisms and (b) demonstrate similar risk across adolescent subpopulations. The present, multiwave study examined whether school engagement and peer relationships explain the depressive effects of distinct emotional maltreatment subtypes in an at-risk child welfare sample (N=657; ages 11-14, AgeMean =12.49). The findings indicated that commission subtypes of emotional maltreatment predicted increasing depressive symptoms via increasing peer relationship problems, especially for girls. Meanwhile, decreasing school engagement was a depressogenic risk pathway for Hispanic adolescents reporting omission subtypes of emotional maltreatment. The results emphasize the importance of distinguish between emotional maltreatment subtypes to identify specific risk pathways for adolescent depression.

Adolescent Physical Activity Disparities by Parent Nativity Status: the Role of Social Support, Family Structure, and Economic Hardship

In this cross-sectional study, we examine disparities in physical activity (PA) rates, a determinant of obesity risk, by exploring the impact of household economic hardship, social support, and family structure on adolescent physical activity levels. We assess whether these factors have a different impact on PA stratified by parental nativity status (Hispanic adolescents of foreign- and native-born caregivers compared with whites). The sample included 1927 white and Hispanic 15-year-olds of foreign-born (outside of USA) and native US-born caregivers from the Fragile Families and Child Wellbeing Study. We assessed whether economic hardship, family/friend encouragement for PA, married/cohabiting caregivers, and having a resident grandparent was associated with frequency of PA in the past week, while controlling for age, education, and child's sex. We examined the interaction effects of parent nativity on economic hardship and family support. Results indicate disproportionately higher PA levels for white adolescents compared with Hispanic adolescents of foreign-born caregivers (B = -0.41, SE = 0.19, p = 0.03), for adolescents with more family/friend encouragement (B = 0.81, SE = 0.10, p < 0.001), and for adolescents in cohabiting households (B = 0.28, SE = 0.14, p = 0.04); support and hardship factors did not vary by nativity status. Researchers and practitioners should address differences among ethnic/generational subgroups and family/friend supports that may improve adolescent PA levels, particularly among Hispanic adolescent subgroups. Physical activity levels continue to be dismal especially for racial/ethnic minority groups, which puts them at further risk of consequences of physical inactivity, including life-long complications associated with being an obese adolescent.

Racial/Ethnic Differences in Illicit Substance Use: A Temporal-Ordered Test of General Strain Theory

This longitudinal study applied general strain theory to elaborate specific stressful events’ lagged effects on risk of illicit substance use among non-Hispanic White, non-Hispanic Black, and Hispanic adolescents, and relatedly evaluated the moderating role of race/ethnicity in explaining illicit use. Data were drawn from five waves representing 9 years (2002–2010) of the 1997 National Longitudinal Survey of Youth (NLSY), totaling 16,868 person-waves, and we engaged temporal ordering and generalized estimating equations (GEE) for panel data in STATA for data analysis. Results showed specific events affected risk of illicit substance use differentially across racial/ethnic groups. Strains commonly encountered in disorganized spaces affected non-Hispanic White’s risk. Measured strains did not affect non-Hispanic Black respondents and findings for Hispanic respondents point to the family as a possible strain. Results indicated legal drug use and depression increased risk of illicit use greatly. Race/ethnicity’s role in illicit use’s associations with several variables illustrates differential implications for racial/ethnic groups in policy and preventive interventions.

Social Media Use and Externalizing Behaviors During Early Adolescence

A primary goal of this study was to examine adolescents’ use of the most commonly used social media apps in the United States. An additional goal was to examine the relationship between social media use and adolescent externalizing behaviors. The moderating influences of gender and race/ethnicity also were assessed. The sample included 1,072 adolescents ( M age = 12.74 years, SD = 0.67, 51% girls; 64% White). Participating adolescents completed a survey in school. Most of the adolescents did not use Facebook or Twitter. However, the majority of adolescents used Instagram and Snapchat, and girls were more likely to use these social media apps than were boys. Adolescents who regularly used social media reported more delinquent behavior and poorer behavioral conduct in comparison with nonusers. In addition, boys who used Facebook regularly and Hispanic adolescents who used Instagram regularly were at an elevated risk for delinquent behaviors and poorer behavioral conduct.

Disparities in Sleep Health among Adolescents: The Role of Sex, Age, and Migration.

Background. Disparities in sleep disturbances have been described in adults; nevertheless, among adolescents, data have yielded conflicting results. Therefore, analyses of our cohort study of 500 urban, normally developed Hispanic adolescents (10–18 years), aim to determine if rates of sleep debt differ between: (a) male and female adolescents, (b) US-born Hispanics and first-generation immigrant ethnic counterparts, and (c) specific activities that these teens trade for sleep. Participants’ weekday and weekend sleep patterns, along with the reasons for sleeping less than the recommended hours were recorded. Standardized surveys were used to gather information regarding sociodemographics, migration, acculturation, and medical history. Using the criteria set forth by the National Sleep Foundation, analyses indicated that sleep deprivation is a pervasive problem, with 75% in the preadolescents and 45% of the late adolescents exhibiting sleep problems. Females slept on average at least one hour less per day than their male counterparts (7 vs. 8 hours). The sleep problems were rooted in several overlapping causes, including use of technology, video games, studying, and employment. Nevertheless, reasons for sleep loss differed by gender and by immigrant status. Multivariable adjusted logistic regression analyses showed that females, US-born teens, and preadolescents had higher odds of being sleep deprived. Pediatricians and sleep experts should be aware of gender-specific causes and responses of sleep problems. Cultural ecological frameworks need to be considered, and clearly indicate that findings may not generalize to youth from other cultural backgrounds.

Authoritative Parenting Behaviors and Marijuana Use Based on Age Among a National Sample of Hispanic Adolescents.

Although numerous prevention efforts have been implemented, marijuana remains the most commonly used illicit substance among Hispanic adolescents nationwide. We sought to determine the influence authoritative parenting behaviors have on lifetime, past year, and past month marijuana use among Hispanic adolescents overall, and then based on age (i.e., 12-13, 14-15, and 16-17years). We conducted a secondary analysis of the 2012 National Survey on Drug Use and Health (N = 3457). We performed a series of logistic regression analyses. Nearly one-fifth (19.5%) of Hispanic participants reported lifetime marijuana use, 14.5% reported past year use, and 7.5% reported past month use. Results indicated that Hispanic adolescents who are at significantly increased risk for reporting lifetime, past year, and past month marijuana use, were those who reported that their parents seldom or never performed the following behaviors: (1) checked if their homework was done, (2) helped them with their homework, (3) limited the amount of TV they watched, (4) told them they did a good job, and (5) told them they were proud of them. There were no relationships between adolescents' lifetime, past year, or past month marijuana use and whether their parents made their youth do chores or limited their time out on a school night. Regarding age, while results indicated that most authoritative parenting behaviors have a significant effect against marijuana use, the protective effect diminished with age, with the exception of the relationship between adolescents' past month marijuana use and whether their parents checked to see if their homework was done. Substance use prevention programs for this population should start in early adolescence and involve and educate parents on adopting authoritative parenting behaviors.

Using the Theory of Triadic Influence to Examine Correlates of Positive Drug Expectancies Among Hispanic Adolescents

Using the Theory of Triadic Influence to Examine Correlates of Positive Drug Expectancies Among Hispanic Adolescents

Gender Differences in Socio-ecological Determinants of Alcohol Use Among Hispanic Adolescents.

Compared to other racial groups, Hispanic/Latino(a) adolescents experience higher rates of alcohol (ab)use and alcohol-related problems. Evidence suggests there are gender differences in alcohol use patterns indicating the likelihood of gender differences in how various determinants influence alcohol use among the genders. Assessing the mechanisms that contribute to Hispanic adolescents' alcohol use requires an understanding of the multidimensional social and environmental processes that operate together to impact their alcohol use. In this study, we examined socio-ecological determinants of Hispanic adolescent alcohol use by gender. Data from 10th grade Hispanic/Latino(a) students (N=781) from four high schools in Los Angeles were used to examine associations between socio-ecological characteristics and adolescent alcohol use by gender. Overall, 37.5% of participants reported past 30-day alcohol use. Among boys, alcohol use was associated with intrapersonal (not qualifying for reduced lunch), interpersonal (mother's education and peer drinking), and institutional (alcohol-prone school club membership) determinants. Among girls, alcohol use was associated with intrapersonal (academic achievement) and interpersonal (parent and peer alcohol use behavior) determinants. Prevention and intervention efforts need to take into consideration the gender differences in social-ecological risk and protective factors when designing educational or intervention programs and services targeted at Hispanic adolescents. This is crucial to addressing multi-component factors that influence their substance use behavior.

Beyond insurance: race-based disparities in the use of metabolic and bariatric surgery for the management of severe pediatric obesity.

It is unknown whether previously noted racial disparities in the use of metabolic and bariatric surgery (MBS) for the management of pediatric obesity could be mitigated by accounting for primary insurance. To examine utilization of pediatric MBS across race and insurance in the United States. Retrospective cross-sectional study. The National Inpatient Sample was used to identify patients 12 to 19 years old undergoing MBS from 2015 to 2016, and these data were combined with national estimates of pediatric obesity obtained from the 2015 to 2016 National Health and Nutrition Examination Survey. Severe obesity was defined as class III obesity, or class II obesity plus hypertension, dyslipidemia, or type 2 diabetes. A total of 1,659,507 (5.0%) adolescents with severe obesity were identified, consisting of 35.0% female, 38.0% white, and 45.0% privately insured adolescents. Over the same time period, 2535 MBS procedures were performed. Most surgical patients were female (77.5%), white (52.8%), and privately insured (57.5%). Black and Hispanic adolescents were less likely to undergo MBS than whites (odds ratio .50, .46, respectively; P < .001 both), despite adjusting for primary insurance. White adolescents covered by Medicaid were significantly more likely to undergo MBS than their privately insured counterparts (odds ratio 1.66; P < .001), while the opposite was true for black and Hispanic adolescents (odds ratio .29, .75, respectively; P < .001 both). Pediatric obesity disproportionately affects racial minorities, yet MBS is most often performed on white adolescents. Medicaid insurance further decreases the use of MBS among nonwhite adolescents, while paradoxically increasing it for whites, suggesting expansion of government-sponsored insurance alone is unlikely to eliminate this race-based disparity.

Maintaining and attaining educational expectations: A two-cohort longitudinal study of Hispanic youth.

Hispanic adolescents have high expectations for their own educational attainment, but educational attainment outcomes for Hispanic young adults are relatively low on average. Limited scholarship links Hispanic adolescents' educational expectations with attainment in adulthood. Using a longitudinal within-group approach, the authors examined changes in Hispanic adolescents' educational expectations from 10th to 12th grade as well as the discrepancy between educational expectations and later attainment in 2 cohorts (N = 1,372 and N = 1,521). Based on national surveys approximately 12 years apart (NELS:88 and ELS:02), expectations of a college degree became more common for Hispanic adolescents. Most Hispanic young adults attained less education than they expected, and this expectations-attainment gap grew over time, consistent with U.S. national trends. Parent education was positively associated with attaining expectations, and family income became more important for attaining expectations over time. Consistent with the immigrant paradox and immigrant optimism hypothesis, second-generation youth came closer to attaining their expectations than third- or higher-generation youth of equal positioning. Educational expectations and attainment patterns also varied by cohort: for instance, immigrants in the more recent cohort had an absolute disadvantage in terms of attaining their expectations compared with their other-generation counterparts. Finally, parental involvement in education (e.g., parents' educational aspirations) was associated with educational expectations and attainment outcomes. This study advances knowledge of factors that contribute to maintaining and attaining educational expectations for Hispanic youth and how these factors have changed over time. Study results inform efforts to support Hispanic adolescents' and young adults' educational potential. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Pediatric-Inspired Regimens Are Associated with Better Outcomes When Compared with Hypercvad in Hispanic Adolescents and Young Adults with Acute Lymphoblastic Leukemia

Background Acute lymphoblastic leukemia (ALL) is frequent in Mexico, representing 51% of acute leukemia in adults. Hispanic ethnicity is associated with high-risk features and poor outcomes. We previously reported a multicenter experience in Mexico, where the majority of our ALL-patients (67%) were adolescents and young adults (AYA), mostly treated with HyperCVAD and with poor outcomes: 3-year overall survival (OS) of 25.7%. Many groups have demonstrated better outcomes with pediatric-inspired regimens (PIR) in the AYA-group, with long term OS &gt; 60%. In 2016-2017 we changed the standard of care from HyperCVAD to PIR in two of the centers from the previously mentioned study. Methods We included AYA-patients with the diagnosis of Philadelphia-negative ALL treated with PIR (ALL-BFM 90 or CALGB 10403) between March 2016 and June 2019 in two centers in Mexico City. Both regimens were modified from the original: we used E. Coli asparaginase instead of pegaspargase and mercaptopurine instead of thioguanine. We compared these patients with our common historic database of patients with the same characteristics diagnosed between February 2009 and June 2015, treated with HyperCVAD. Hyperleukocytosis was defined as a white blood cell count &gt; 30 x103/mcL for B-cell ALL and &gt; 100 x103/mcL for T-cell ALL. Patients with t(v;11q23), hypodyploid or complex karyotype were considered high-risk. Baseline characteristics of both groups were compared with Chi-square or Mann-Whitney U test. We estimate OS by Kaplan-Meier method and compared groups by log-rank test. Multivariate Cox proportional hazards regression was used to evaluate independent prognostic factors associated with OS. Results We compared 73 patients treated with PIR with a control group of 137 patients treated with HyperCVAD. The patients treated with PIR received either ALL-BFM 90 (N=46) or CALGB 10403(N=27). The median follow-up was 49.8, 23.3 and 12.7 months for HyperCVAD, ALL-BFM 90 and CALGB 10403 respectively. Patients treated with PIR were slightly older than those in the control group (median 24 vs. 20 years, p=0.005) and presented with high-risk karyotype more frequently (31.9% vs. 12.2%, p=0.042). Most of the patients were B-cell ALL (91.8% for PIR and 95.6% for HyperCVAD; p=0.349). Comparing PIR vs. HyperCVAD, there were no differences in the proportion of patients with hyperleukocytosis (33.3% vs. 25.0%, p=0.128) or obesity (24.7% vs. 16.4%, p=0.192). The induction related mortality was 5.7% for the entire group with a trend that favors PIR (1.4% vs. 8.0%, p=0.061). In patients treated with PIR, the 4-week complete remission (CR) rate was higher (79.5% vs. 64.2%, p=0.027) and the relapse rate was lower (41.5% vs. 60.0%, p=0.027). Patients treated with PIR were more frequently treated with allogeneic stem-cell transplant (alloSCT) in first CR: 19.2% vs. 7.3%, p=0.017. The median OS was significantly higher with PIR than with HyperCVAD, with a median of 19.0 months (3.3-25.4 months) vs. 11.1 months (7.3-14.8 months), and a 18-month OS of 53% vs. 33%, p=0.017. When comparing the two different PIR (ALL-BFM 90 vs. CALGB 10403), the patients treated with ALL-BFM 90 had more frequently high-risk karyotypes (46% vs. 10.5%, p=0.012). Both regimens were associated with similar 4-week CR rate (78.3% vs. 81.5%, p=1). OS was higher with the CALGB 10403 with an 18 month-OS of 79% vs. 42% with the ALL-BFM 90 (p=0.044). When adjusted for high-risk karyotype, the benefit on OS was no longer significant. In the multivariate analysis for OS, the independent significant prognostic factors were: treatment with a PIR (HR 0.428, 95% CI 0.221-0.826, p=0.011), alloSCT in first CR (HR 0.316, 95% CI 0.106-0.938, p=0.038) and high-risk karyotype (HR 2.695 95% CI 1.272-5.560, p=0.009). Discussion Although different groups have shown the benefit of PIR in the AYA-patients, the MD Anderson group couldn´t found any benefit from using the augmented BFM when compared to HyperCVAD. In our experience, the outcomes with HyperCVAD are poor in this group. In this report, the treatment with PIR was associated with a higher CR rate, lower relapse rate and better OS when compared with our historical HyperCVAD in AYA-patients. The benefit on survival was independent of other risk factors or alloHSCT. The main limitation of the study is the comparison with a historical group. However, given the general trend to treat these patients with RIP, a prospective randomized study in this regard is unlikely. Disclosures Demichelis: Abbvie: Speakers Bureau; AMGEN: Research Funding, Speakers Bureau; Celgene: Speakers Bureau; Novartis: Research Funding, Speakers Bureau; Shire: Speakers Bureau.