Haitian youth in Miami/Dade County who become part of the juvenile justice system have not received culturally appropriate remediating or rehabilitative attention by that system. This study will modify a specific variety of intervention, the Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) for appropriateness in Miami's Haitian cultural contexts. Based on our prior studies from more than two decades of research among Haitian communities in Florida family-based interventions that integrate individually-oriented approaches for youth are better suited to the Haitian American sociocultural context. This study will develop and implement a culturally specific, integrated family and individual-based, drug use, sexual risk and delinquency risk reduction program for Haitian adolescents aged 13-17 in Miami-Dade County. First, instruments for the intervention will be pretested with 10 Haitian youth and their families and then refined based on cultural acceptability interviews and focus group data. Second, we will conduct a pilot randomized trial with 88 at-risk Haitian youth and their families to analyze 80 (because of estimated attrition). We will test the CIFFTA model against the Standard of Care (SOC) currently being offered by the Miami-Dade's Juvenile Service Department (J- DAP) to Haitian adolescents in their diversionary program. Primary study outcomes include: sustained abstinence in substance use; family functioning; sexual risk behavior; and conduct disorder. Secondary outcomes includes: reduce rates in recidivism and peer/gang involvement. The results of the study will be used to modify the intervention content and delivery format which will provide the foundation for the development of a full RO1 CIFFTA study in the future. Ethnographic methods will be used to collect process data along with outcome data at baseline and follow-up points after CIFFTA completion, to complement analysis of outcomes, monitor the intervention of the trial and form a context for interpreting its primary effects. Research activities proposed here will include recruitment of Haitian families whose youths are in the J-DAP program, participant observation in households of recruited families, modification of CIFFTA for use in Haitian families, implementation of a pilot intervention in a limited number of youth and their families, process and outcome evaluation of those interventions, analysis of data resulting from these activities, and design of an intervention to be applied on a larger scale after completion of the present project.
In order to develop culturally appropriate intervention strategies for Haitian young people who are arrested and receive intervention from the County's juvenile justice system, the investigators propose to conduct a formative study of youth and families in that system. The study will modify a specific variety of intervention, the Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA), for appropriateness in Miami's Haitian cultural contexts and conduct a pilot randomized trial with 88 at- risk Haitian youth and their families (to analyze 80 because of estimated attrition) against a standard of care for Haitian juvenile. The goal of the pilot study is to obtain preliminary data on CIFFTA's feasibility, cultural acceptability and efficacy.