A culturally tailored family intervention program significantly reduced current drug use and risky sexual behaviors in high-risk Hispanic youth, in a randomized trial of more than 200 teens.

Data from the Monitoring the Future survey showed high rates of problem behavior in Hispanic youth, said Guillermo Prado, Ph.D., of the division of epidemiology and population health sciences at the University of Miami. He and his colleagues hypothesized that a family-centered intervention (called Familias Unidas) could reduce these behaviors.

The multiparent group intervention focused on positive parenting, communication with teens about sex, and family support. “Part of the group session is dedicated to helping the parents create social support networks,” similar to what they might have had in their countries of origin, he said. “We hypothesized that our family intervention would have an impact and that the results would be mediated by improvements in family function.”

The researchers recruited 242 Hispanic delinquent youth and their families from the juvenile justice system or the Miami–Dade County Public Schools system. The youth were randomized to either Familias Unidas (120) or a community practice program that served as a control (122). The average age of the participants was 15 years, and 35% were foreign born. The average household income ranged from $15,000 to $19,000 annually.

Overall, teens in the intervention group showed a significant drop in reported illicit drug use, compared with the controls, Dr. Prado reported at the annual meeting of the Society for Prevention Research.

Approximately 30% of teens in the intervention group were using drugs at baseline, but this number dropped to 20% at 6 months, followed by a leveling off of drug use, compared with steady increases in the control group over time.

Alcohol dependence was not a formal diagnosis, Dr. Prado noted. However, the trajectory for alcohol dependence among controls was very flat; while the intervention group showed a decrease from 15% at baseline to 5% by 12 months’ follow-up. The lack of impact of the intervention on current alcohol use (as opposed to dependence) was an interesting finding, he said.

“In Hispanic culture, alcohol use is considered more normative,” and parents are less likely to notice teens’ alcohol consumption until there are signs of alcohol dependence, which might explain this finding, he said.

With respect to the percentage of youth who have sex while under the influence of alcohol or drugs, there was a significant increase in the control group over time, compared with a steady level in the intervention group.

On further analysis, “our family-based intervention is most efficacious for families who report high family risk (such as poor communication and low parental involvement),” Dr. Prado noted.

Data from a post hoc analysis suggests that the effectiveness of Familias Unidas varies by parental environmental exposure, including levels of immigration stress and levels of social support, which could be areas for future research, he noted.

Dr. Prado said he had no relevant financial conflicts.