This application proposes to conduct a Stage II randomized trial to test Culturally Informed &Flexible Family-Based Treatment for Adolescents (CIFFTA) a treatment developed as part of a Stage I treatment development effort and showing very promising preliminary findings. Drug use rate are highest among Hispanic middle school youth and to date there are few if any treatments that have been proven effective with substance abusing Hispanic adolescents. Further treatment for Hispanic youth and families is complicated by the fact that these families often differ from mainstream drug users in values, beliefs and behaviors that can directly impact engagement, retention, and efficacy/effectiveness of drug treatment. Our efforts to develop and fully test a more powerful treatment that can address these issues began with a Stage 1 study that: 1) led to the development of a flexible manual that allows treatment tailoring to the unique family characteristics, 2) showed highly promising feasibility and acceptability indicators (Santisteban and Mena, in press) and 3) showed highly promising preliminary outcomes on both drug use and family-level hypothesized mediators (Santisteban et al., unpublished manuscript). This application proposes a Stage II randomized trial with 220 Hispanic youngsters'ages 14-17 meeting criteria for drug abuse and their families. The study will test the treatment's efficacy compared to a control condition, in impacting drug use, risky sexual behavior, and hypothesized mechanisms (family functioning and therapeutic alliance) of change, in a larger and more rigorous trial. The study also includes a test of the dose-response relationship and exploration of moderators of treatment outcome. This application responds to a Program Announcement (PA-07-111) that outlines as areas of interest """"""""...women, minorities, families, couples, specific cultural groups, adolescents..."""""""" The Stage II trial focuses on a treatment designed to boost the treatment effects by building in a flexible tailoring process to better address the specific needs of: 1) adolescents, 2) minorities and a special cultural group - Hispanics, via a treatment that works with 3) couples and families.

Public Health Relevance

Should this line of research continue to be successful, it will contribute to the field: 1) a highly innovative and effective treatment for Hispanic drug abusing adolescents, 2) a better understanding of the mechanisms of change in family therapy with drug abusing adolescents, and 3) a framework for flexible and tailored treatment that can be used to better address the unique needs of other special populations.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Chambers, Jessica Campbell
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University of Miami Coral Gables
Schools of Nursing
Coral Gables
United States
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Gattamorta, Karina A; Varela, Alberto; McCabe, Brian E et al. (2017) Psychiatric Symptoms, Parental Attachment, and Reasons for Use as Correlates of Heavy Substance Use Among Treatment-Seeking Hispanic Adolescents. Subst Use Misuse 52:392-400
Gattamorta, Karina A; Mena, Maite P; Ainsley, Jordan B et al. (2017) The Comorbidity of Psychiatric and Substance Use Disorders Among Hispanic Adolescents. J Dual Diagn 13:254-263
Santisteban, Daniel A; Czaja, Sara J; Nair, Sankaran N et al. (2017) Computer Informed and Flexible Family-Based Treatment for Adolescents: A Randomized Clinical Trial for at-Risk Racial/Ethnic Minority Adolescents. Behav Ther 48:474-489
Gattamorta, Karina A; McCabe, Brian E; Mena, Maite P et al. (2016) A Latent Profile Analysis Investigating Factors Impacting Latino Adolescents' Attendance in Treatment. Couns Psychol 44:871-894
Stanforth, Evan T; McCabe, Brian E; Mena, Maite P et al. (2016) Structure of Problem Recognition Questionnaire with Hispanic/Latino Adolescents. J Subst Abuse Treat 71:36-40
Santisteban, Daniel A; Mena, Maite P; Muir, Joan et al. (2015) The efficacy of two adolescent substance abuse treatments and the impact of comorbid depression: results of a small randomized controlled trial. Psychiatr Rehabil J 38:55-64
McCabe, Brian E; Santisteban, Daniel A; Mena, Maite P et al. (2013) Engagement, retention, and abstinence for three types of opioid users in Florida. Subst Use Misuse 48:623-34
Santisteban, Daniel A; Mena, Maite P; Abalo, Clara (2012) Bridging Diversity and Family Systems: Culturally Informed and Flexible Family Based Treatment for Hispanic Adolescents. Couple Family Psychol 2:246-263
Santisteban, Daniel A; Coatsworth, J Douglas; Briones, Ervin et al. (2012) Beyond acculturation: an investigation of the relationship of familism and parenting to behavior problems in Hispanic youth. Fam Process 51:470-82
Santisteban, Daniel A; Mena, Maite P; McCabe, Brian E (2011) Preliminary results for an adaptive family treatment for drug abuse in Hispanic youth. J Fam Psychol 25:610-4