ABSTRACT

Objective

To examine the associations between sociodemographic characteristics, perceived barriers to treatment, clinical impairment, and youth treatment engagement.

Method

Participants included 196 families (youth: ages 12 to 18; 64.3% cis-gender female; 23.5% Black, 60.7% White, and 12.2% Mixed/Other race; 41.3% Hispanic or Latinx ethnicity) recruited as part of a comparative effectiveness trial for adolescent anxiety and depression. Self-report measures of sociodemographic characteristics and caregiver perceived barriers were completed at intake. Youth clinical impairment was assessed at baseline via clinical interview. Measures of engagement were collected throughout treatment, including initiation status, session attendance, and termination status. Relationships were examined using analyses of variances and hierarchal linear and logistic modeling.

Results

Perceived barriers did not differ by sociodemographic characteristics. Greater perceived stressors and obstacles predicted fewer sessions attended and a lower likelihood of successful termination. Youth of caregivers with an advanced degree and those with caregivers who were employed part time attended more sessions and were more likely to initiate and terminate treatment successfully compared to youth with caregivers of a lower education level or student or unemployed status. At higher levels of youth clinical impairment, greater perceived treatment demands and issues predicted reduced likelihood of treatment initiation.

Conclusions

Perceived barriers, sociodemographic characteristics, and clinical impairment were all associated with levels of engagement in the treatment process. Baseline and continued assessment of perceived and experienced barriers to treatment may promote individualized strategies for families identified as at-risk for reduced engagement.

中文翻译：

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青少年的治疗参与：社会人口特征、护理人员感知的障碍和临床障碍的关联

摘要

客观的

研究社会人口特征、感知的治疗障碍、临床损伤和青少年治疗参与度之间的关联。

方法

参与者包括 196 个家庭（青少年：12 至 18 岁；64.3% 顺性别女性；23.5% 黑人，60.7% 白人，12.2% 混血/其他种族；41.3% 西班牙裔或拉丁裔），作为比较有效性试验的一部分而招募用于青少年焦虑和抑郁。在入学时完成了社会人口特征和护理人员感知障碍的自我报告测量。通过临床访谈对青少年临床损伤进行基线评估。在整个治疗过程中收集参与度指标，包括开始状态、会议出席率和终止状态。使用方差分析以及分层线性和逻辑模型来检查关系。

结果

感知到的障碍并不因社会人口特征而有所不同。感知到的压力源和障碍越大，参加的会议就越少，成功终止的可能性也就越低。与护理人员教育水平较低、学生或失业状态的青少年相比，拥有高等学位的护理人员和兼职护理人员的青少年参加了更多的疗程，并且更有可能成功开始和终止治疗。在青少年临床损伤程度较高的情况下，感知到的治疗需求和问题越多，则预示着开始治疗的可能性就会降低。

结论

感知到的障碍、社会人口特征和临床障碍都与治疗过程的参与程度相关。对感知和经历的治疗障碍进行基线和持续评估可能会促进针对参与度降低风险的家庭制定个性化策略。