The proposed study's overarching goal is to reduce the ethnic disparities in illicit drug use, cigarette use, and HIV between Hispanic and non-Hispanic youth. This goal will be accomplished by four aims:
AIM 1 is to evaluate the effectiveness of Familias Unidas, relative to Community Practice (i.e., standard prevention services), in preventing illicit drug use;
AIM 2 is to evaluate the effectiveness of Familias Unidas, relative to Community Control, in preventing cigarette use;
AIM 3 is to evaluate the effectiveness of Familias Unidas, relative to Community Control, in preventing unprotected sexual behavior;
and AIM 4 is to assess the extent to which family functioning mediates the effects of the intervention on illicit drug use, cigarette use, and unprotected sexual behavior. Twenty four middle schools with a total sample of 744 Hispanic adolescents from a wide geographic area of Miami-Dade County will be randomized using a block design to one of two conditions: Familias Unidas or Community Practice. The Familias Unidas intervention has been evaluated and found to be efficacious in two separate randomized controlled trials. In the first study (Pantin et al., 2003), Familias Unidas was shown to be efficacious relative to a no intervention control condition in increasing family functioning and reducing behavior problems (Prado et al., 2006), risk factors for youth illicit drug use and unprotected sex. In the second randomized controlled trial (Prado et al., in press), Familias Unidas was found to be efficacious, relative to two attention control conditions, in preventing cigarette use and illicit drug use. Familias Unidas was also found to be efficacious relative to both of the control conditions in preventing/reducing unprotected sexual behavior at last sexual intercourse. Finally, family functioning was found to mediate the effects of intervention condition on the outcomes. Hierarchical Linear Modeling (HLM) will be used to test: (H1) Familias Unidas will be more effective than Community Practice in reducing illicit drug use over time;(H2) Familias Unidas will be more effective than Community Practice in reducing cigarette use over time;and (H3) Familias Unidas will be more effective than Community Practice in reducing unprotected sexual behavior over time. Additionally HLM will be used to determine whether (H1a) the effect of Familias Unidas on illicit drug use will be partially mediated by family functioning;(H2a) the effect of Familias Unidas on cigarette use will be partially mediated by family functioning and (H3a) the effect of Familias Unidas on unprotected sexual behavior will be partially mediated by family functioning.

Public Health Relevance

The objective of the proposed study is to reduce illicit drug use, cigarette use, and unsafe sexual behavior health disparities in Hispanic populations. The knowledge expected to be gained from this study will aid in the development of effective interventions to reduce drug use, cigarette use, unprotected sexual behavior, and HIV in Hispanic adolescents.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA025192-04
Application #
8212157
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Crump, Aria
Project Start
2008-12-15
Project End
2013-11-30
Budget Start
2011-12-01
Budget End
2012-11-30
Support Year
4
Fiscal Year
2012
Total Cost
$754,291
Indirect Cost
$252,051
Name
University of Miami School of Medicine
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Cordova, David; Huang, Shi; Lally, Meghan et al. (2014) Do parent-adolescent discrepancies in family functioning increase the risk of Hispanic adolescent HIV risk behaviors? Fam Process 53:348-63
Prado, Guillermo; Lightfoot, Marguerita; Brown, C Hendricks (2013) Macro-level approaches to HIV prevention among ethnic minority youth: state of the science, opportunities, and challenges. Am Psychol 68:286-99
Brody, Gene H; Beach, Steven R H; Hill, Karl G et al. (2013) Using genetically informed, randomized prevention trials to test etiological hypotheses about child and adolescent drug use and psychopathology. Am J Public Health 103 Suppl 1:S19-24
Brown, C Hendricks; Mohr, David C; Gallo, Carlos G et al. (2013) A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs. J Acquir Immune Defic Syndr 63 Suppl 1:S72-84
Prado, Guillermo; Pantin, Hilda (2011) Reducing Substance Use and HIV Health Disparities among Hispanic Youth in the U.S.A.: The Familias Unidas Program of Research. Interv Psicosoc 20:63-73
Prado, Guillermo J; Schwartz, Seth J; Maldonado-Molina, Mildred et al. (2009) Ecodevelopmental x intrapersonal risk: substance use and sexual behavior in Hispanic adolescents. Health Educ Behav 36:45-61
Brown, C Hendricks; Ten Have, Thomas R; Jo, Booil et al. (2009) Adaptive designs for randomized trials in public health. Annu Rev Public Health 30:1-25