Familias Unidas: Preventing Drug Abuse and HIV in Hispanic First Offenders
Condition: Substance Use; Unsafe Sexual Behavior
MeSH terms: Substance-Related Disorders
Study type: Interventional
Phase: Phase 2

Summary: 
      The main goal of the proposed study is to evaluate the efficacy of Familias Unidas (United
      Families), a family-based, ecodevelopmental intervention found to be previously efficacious
      in preventing and reducing behavior problems, illicit drug use, and unsafe sexual behavior in
      non-delinquent Hispanic adolescents (Pantin et al., 2003; Prado, Pantin, Briones et al.,
      2007).

      The study hypotheses are as follows:

      Hypothesis 1. Familias Unidas will be more efficacious than Treatment as Usual in preventing
      drug use among Hispanic first offending adolescents or those who are at risk for committing a
      first time offense over time.

      Hypothesis 1a. The effect of Familias Unidas on drug use will be partially mediated by
      improvements in family functioning.

      Hypothesis 2. Familias Unidas will be more efficacious than Treatment as Usual in preventing
      unsafe sexual behavior among Hispanic first offending adolescents or those who are at risk
      for committing a first time offense over time.

      Hypothesis 2a. The effect of Familias Unidas on unsafe sexual behavior will be partially
      mediated by improvements in family functioning.

      Hypothesis 3. Familias Unidas will be more efficacious than Treatment as Usual in preventing
      subsequent criminal offenses among Hispanic first offending adolescents or in preventing a
      first time offense for those at risk for committing a first time offense over time.

      Hypothesis 3a. The effect of Familias Unidas on subsequent criminal offenses will be mediated
      by family functioning.
    

Detailed description: 
      Familias Unidas aims to prevent drug use and unprotected sexual behavior by increasing family
      functioning. A sample of 240 Hispanic adolescent first offenders or those at risk of becoming
      first offenders (age range 12 to 17) and 240 primary caregivers will be randomized to one of
      two conditions: Familias Unidas or Treatment as Usual. The investigators do not expect any
      risks to participants for participating in this study; however, participants may feel
      embarrassed by some of the content or feel fatigued as a result of completing the
      assessments. Also, depending on which group participants are assigned to, they may be less
      likely to use drugs and practice unsafe sexual behaviors and more likely to function better
      as families.

      The proposed study will be guided by four aims. AIM 1 is to evaluate the efficacy of Familias
      Unidas, relative to Treatment as Usual in preventing illicit drug use in a sample of Hispanic
      youth first offenders or those at high risk of committing a first offense; AIM 2 is to
      evaluate the efficacy of Familias Unidas, relative to Treatment as Usual in preventing unsafe
      sexual behavior; AIM 3 is to evaluate the efficacy of Familias Unidas, relative to Treatment
      as Usual in preventing a first offense or reducing the number of subsequent criminal offenses
      ; and AIM 4 is to assess the extent to which family functioning mediates the effects of the
      intervention on illicit drug use, unsafe sexual behavior, and first or subsequent criminal
      offenses.

      Compared to non-Hispanic whites, Hispanic adolescents are highly vulnerable to drug use and
      HIV infection. Hispanic adolescents between the ages of 13 to 19 are five times more likely
      to be infected with HIV than are same-aged non-Hispanic Whites (CDC-P, 2006). Compared to
      non-Hispanic whites and to African Americans, Hispanic 8th graders report the highest
      lifetime, annual, and 30-day prevalence rates of alcohol, cigarette, and licit or illicit
      drug use (with the exception of amphetamines; Johnston et al., 2008). Hispanic adolescents
      also have higher rates of unprotected sex at last intercourse (CDC-P, 2007) than non-Hispanic
      whites or African Americans. Drug use and unsafe sexual behavior are risks for HIV infection.
      Hispanics are also a youthful population, with more than one-third under the age of 18
      (Marotta & Garcia, 2003). Preventing drug use and HIV in Hispanics, and particularly among
      Hispanic youth at elevated risk for drug use and unsafe sexual behavior, such as Hispanics in
      the criminal justice setting or those at risk of entering the criminal justice system
      (Telpin, 2003), is therefore of vital importance.
    

Intervention name(s): Familias Unidas
Intervention type(s): Behavioral
Intervention description(s): There will be 8 group sessions and 4 family visits. During the group sessions, the facilitator offers support for parents and gently corrects maladaptive interactions between parents and adolescents. During family visits, facilitators assist families in practicing skills and restructuring family interactions. The parent group sessions focus on parental investment in the adolescent's worlds (e.g., peer and school worlds), family communication, family support, behavior management/positive parenting, parental monitoring, adolescent substance use, and adolescent unsafe sex and HIV.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Prevention; HIV; Substance use; Hispanic; Adolescents; Unsafe sexual behavior; Behavioral intervention