Methods: The current study is part of a larger effectiveness trial of the Bridges intervention. Our sample included 415 families randomized to Bridges: 41% were Spanish-speaking Hispanic, 22% English-speaking Hispanic, 16% Non-Hispanic White (NHW), 9% African-American, 7% Native American, and 5% another race/ethnicity. Income averaged $37,500. Group leaders attempted to contact parents assigned to Bridges to conduct a manualized engagement call; 82% of calls were completed. During the call, group leaders showed parents how Bridges would help meet their family goals and problem solved attendance obstacles.
Results: Mediation analyses showed that engagement call completion mediated the effects of sociocultural factors on initiation: household income; mediation effect (ab) = -.07, 95% CI [-.11, -.03], parent education; ab = -.10, 95% CI [-.18, -.04], and cultural group (NHW; ab = -1.07, 95% CI [-2.03, -.25], Native American; ab = -1.98, 95% CI [-2.14, -.35], English-speaking Hispanic; ab = -0.96, 90% CI [-1.92, -.01]). Also, the engagement call mediated the effects of parent-adolescent communication; ab = -.50, 90% CI [-.94, -.05], and parental positive reinforcement; ab = -.61, 90% CI [-1.20, -.02] on initiation.
Conclusions: Findings revealed that Spanish-speaking Hispanics, parents with lower income and education, and those with more parenting difficulties were more likely to complete the engagement call and consequently more likely to initiate. Thus, the engagement call helped reduce disparities in initiation for low-SES and high-need families, which suggests that using the engagement call could increase the public health impact of family-based interventions.