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Intervention IP-090: Familias Unidas Program

Summary

Familias Unidas is an evidence-based, parent-centered intervention delivered by non-research personnel to reduce risky adolescent behaviors. In a randomized trial, 746 Hispanic eighth graders received either Familias Unidas or prevention as usual within a pubic school system. Familias Unidas was more effective in preventing drug use and condomless sex from increasing 30 months after baseline relative to prevention as usual. Familias Unidas also improved family functioning.

Overview

Purpose of Intervention:

To reduce health disparities associated with adolescent drug use and sexual risk behaviors among Hispanics

Intervention Type:

Research-Tested — Interventions with strong methodological rigor that have demonstrated short-term or long-term positive effects on one or more targeted health outcomes to improve minority health and/or health disparities through quantitative measures; Studies have a control or comparison group and are published in a peer-review journal; No pilot, demonstration or feasibility studies.

Intervention Details

Intervention was Primarily Driven, Led, or Managed by:

Academic/Clinical Researchers Only

Citations:

  • Estrada Y, Lee TK, Huang S, Tapia MI, Velázquez MR, Martinez MJ, Pantin H, Ocasio MA, Vidot DC, Molleda L, Villamar J, Stepanenko BA, Brown CH, Prado G. Parent-Centered Prevention of Risky Behaviors Among Hispanic Youths in Florida. American journal of public health. 2017 Apr;107(4):607-613. Epub 2017 Feb 16. PubMedExternal Web Site Policy PubMed CentralExternal Web Site Policy DOIExternal Web Site Policy
    Relevance: Main Intervention, Post-Intervention Outcomes
  • Prado G, Cordova D, Huang S, Estrada Y, Rosen A, Bacio GA, Leon Jimenez G, Pantin H, Brown CH, Velazquez MR, Villamar J, Freitas D, Tapia MI, McCollister K. The efficacy of Familias Unidas on drug and alcohol outcomes for Hispanic delinquent youth: main effects and interaction effects by parental stress and social support. Drug and alcohol dependence. 2012 Sep;125 Suppl 1(Suppl 1):S18-25. Epub 2012 Jul 7. PubMedExternal Web Site Policy PubMed CentralExternal Web Site Policy DOIExternal Web Site Policy
    Relevance: Post-Intervention Outcomes
  • Prado G, Fernandez A, St George SM, Lee TK, Lebron C, Tapia MI, Velazquez MR, Messiah SE. Results of a Family-Based Intervention Promoting Healthy Weight Strategies in Overweight Hispanic Adolescents and Parents: An RCT. American journal of preventive medicine. 2020 Nov;59(5):658-668. Epub 2020 Oct 1. PubMedExternal Web Site Policy PubMed CentralExternal Web Site Policy DOIExternal Web Site Policy
    Relevance: Post-Intervention Outcomes
Adaptation of Another Research-based Intervention:

Yes

Name of Original Intervention:

1.) Familias Unidas for Health and Wellness 2.) eHealth Familias Unidas

Name of Original Intervention Author:

Guillermo Prado is the developer (contact person Dr. Maria Tapia). Affiliation: University of Miami. Email: gprado@miami.edu; m.tapia1@med.miami.edu.

URL to original Intervention:

None available

Citations:

  • Estrada Y, Lee TK, Wagstaff R, M Rojas L, Tapia MI, Velázquez MR, Sardinas K, Pantin H, Sutton MY, Prado G. eHealth Familias Unidas: Efficacy Trial of an Evidence-Based Intervention Adapted for Use on the Internet with Hispanic Families. Prevention science : the official journal of the Society for Prevention Research. 2019 Jan;20(1):68-77. PubMedExternal Web Site Policy DOIExternal Web Site Policy
Intervention Primary Outcomes were comparable to the original:

Yes

Contact Information

Primary Contact Name:

Maria Tapia

Primary Contact Affiliation:

University of Miami

Intervention URL:

https://www.sonhs.miami.edu/research/familias-unidas

Primary Contact Email:

m.tapia1@med.miami.edu

Primary Contact Phone Number:

305-243-2341

Results

Intentions

Improve minority health or the health of other populations with health disparities (e.g. rural populations, populations with low SES, and sexual and gender minorities)

Intervention Primary Outcome:

Drug use, sexual risk behaviors

Intervention Secondary Outcome:

Family functioning

Key Findings:

In an effectiveness trial, Familias Unidas was effective in preventing drug use from increasing and prevented greater increases in sex without a condom 30 months after baseline, relative to prevention as usual. Familias Unidas also had a positive impact on family functioning and parental monitoring of peers at six months after baseline.

Statistical Method Used:

Across multiple trials, we use longitudinal growth curve models to analyze the direct effects of the intervention on study outcomes across time. The comparability of study conditions is determined and statistically addressed as needed. Probit distribution is used to take into account count variables and to test for intervention effects on binary outcomes.

Was statistical method used to analyze data from original Intervention comparable to the original:

Yes

Evaluations and Assessments

Were Any of the Following Assessments Conducted (Economic Evaluation, Needs Assessment, Process Evaluation)?:

No

Demographic and Implementation Description

Diseases, Disorders, or Conditions:

Substance Use/Abuse, Sexually Transmitted Infections and HIV/AIDS, Teen-age Pregnancy/Birth

Race/Ethnicity:

Hispanic or Latino

Populations with Health Disparities:

Racial and Ethnic Minority Populations, Underserved Rural Communities

Age:

Adolescents (10 - 17 years), Young Adults (18 - 39 years), Middle-Aged Adults (40 - 64 years), Older Adults (65+ years)

Socio-demographics / Population Characteristics

Community Type:

Rural, Suburban, Urban / Inner City

Other Populations with Health Disparities:

Unspecified

Gender Identity:

Female, Male

Sexual Orientation:

Unspecified

Geographic Location:

Florida

Socio-Economic Status:

Unspecified

Minority Health and Health Disparities Research Framework

Levels of Influence
Individual Interpersonal Community Societal
Determinant Types Biological
Behavioral ✔ ✔
Physical / Built Environment
Sociocultural Environment ✔ ✔
Health Care System

Community Involvement

The community's role in different areas of the Intervention (Choices are "No Role", "Participation", and "Leadership"):

Design:

Participation

Dissemination:

Participation

Evaluation:

Participation

Implementation:

Participation

Outreach:

Participation

Planning :

Participation

Recruitment:

Participation

Sustainability:

Participation

Characteristics and Implementation

Intervention Focus Area:

Behavior Change

Disease Continuum:

Primary Prevention

Delivery Setting:

Schools / Colleges

Mode of Delivery:

In-person

Who delivered the Intervention?:

Researchers, school social workers/mental health professionals and community mental health professionals

Conceptual Framework

Intervention Theory:

Social Cognitive / Social Learning Theory, Eco-developmental theory

Intervention Framework:

Social Ecological Model

Implementation

Intervention Study Design:

Individual Randomized Controlled Trial/Comparative (requires random assignment, a control/comparison group, and pre and post intervention outcome assessments), Pilot, feasibility, or demonstration study design

Targeted Intervention Sample Size:

746

Actual Intervention Sample Size:

746

Start Year:

2010

End Year:

2014

Intervention Exposures

Duration of Intervention/How Long it Lasted:

1-3 months

Frequency of Intervention Delivery:

Weekly

Number of Sessions/Meetings/Visits/Interactions:

More than 10 Sessions

Average Length of Each Session/Meeting/Visit/Interaction:

1-2 Hours

Format of Delivery:

Dyad/Group of two (e.g. participant & partner; mother & child), Group (e.g. Community leaders)

Highest Reading Level of Intervention Materials Provided to Participants:

Grade 8-9

Adaptations and Modifications

Were modifications made?
Intervention Elements Modified
Content

Yes
Context

Yes
Implementation

No
Funding

No
Organization

No
Providers

Yes
Sociopolitical

No
Stages of Occurrence Yes

Modification Details

Explanation
Content

Adding Elements, Shortening

For the online adaptation, live parent group sessions were modified to pre-recorded video sessions. Further, we added a telenovela series and interactive exercises.
Context

Format, Personnel

The intervention was delivered online instead of in person.
Providers

None

Online intervention was delivered by non research staff.
Stages of Occurrence

Other

At the effectiveness stage.

Impact, Lessons, Components

Produced an impact or change beyond the primary or secondary outcome:

Yes

Impact on family functioning, internalizing/externalizing symptoms in certain trials, suicidal ideation

Essential Aspects for Success:

Facilitators must have the ability to engage and connect with participants. It is important to account for cultural variables that are important in Hispanic culture and how that impacts the family.

Intervention Impact:

Impact on family functioning, internalizing/externalizing symptoms in certain trials, suicidal ideation

Lessons Learned

Key Lessons Learned and/or Things That Could be Changed or Done Differently:

It is important to evaluate the readiness of the agency delivering the intervention including things such as recruitment sources, availability of Spanish speaking facilitators.

Insights Gained During Implementation

Insight Category Insight Description
Cost of Implementing or Sustaining Currently we have an ongoing study that will examine the sustainment of the online adaptation of Familias Unidas
Equipment / Technologies For the online adaptation, important to gauge comfort with technology--not only for families but for facilitators as well and address accordingly.
Training / Technical Assistance During COVID we learned that is possible to train and deliver the intervention via the Internet.
Staffing Agencies need to be able to have Spanish speaking culturally informed facilitators.

Intervention Components

Intervention Has Multiple Components:

Yes

Assessed Each Unique Contribution:

No

Products, Materials, and Funding

Please contact researcher for additional materials that are not publicly available.

Expertise, Partnerships, and Funding Sources
Used for Implementation Needed for Sustainability
Expertise

Community mobilization, community organization/coalition building

 Yes Yes
Partnerships

Health care facilities (local clinics)

 Yes Yes
Funding Sources

Public funding (e.g., federal, state or local government)

 Yes Yes

Product/Material/Tools

Tailored For Language Language(s) if other than English Material
Outreach/Recruitment Tools

None currently used

No

Outreach/Recruitment Tools are not currently used.
Participant Educational Tools

Not currently using, agency specific

No

Participant Educational Tools are not currently used.
Measurement Tools

Agency specific

No

Measurement Tools are available by contacting the researcher.

Implementation Materials and Products

Material
Implementation/Delivery Materials

Tools not publicly available

 https://www.sonhs.miami.edu/research/familias-unidas/index.html 

Session outline

Attachment available for request at the bottom of the page.
Implementation/Output Materials
No Implementation/Output Materials provided.

Articles Related to Submitted Intervention

Article
Reports/Monographs
No Reports/Monographs provided.
Additional Articles

Adaptations

Attachment available for request at the bottom of the page.

Adaptations

Attachment available for request at the bottom of the page.

Materials Available for Request

  • Table A - Session outline.docx
  • eHealth Familias Unidas Primary Care.pdf
  • Ehealth Main Outcome-Estrada.pdf
  • Ehealth Main Outcome-Estrada.pdf