Familias Unidas Stage III Study: Preventing Substance Abuse in Hispanic Youth

描述（由申请人提供）：拟议研究的总体目标是减少西班牙裔和非西班牙裔青年之间非法药物使用，吸烟和艾滋病毒的种族差异。这一目标将通过四个目标来实现：目标1是评估家庭联合会相对于社区实践的有效性（即，目标2是评估家庭联盟相对于社区控制在预防吸烟方面的有效性;目标3是评估家庭联盟相对于社区控制在预防无保护性行为方面的有效性;目标4是评估家庭联盟相对于社区控制在预防无保护性行为方面的有效性;目标5是评估家庭联盟相对于社区控制在预防无保护性行为方面的有效性。目的4是评估家庭功能在多大程度上介导了干预对非法药物使用、吸烟和无保护性行为的影响。来自迈阿密戴德县广泛地理区域的24所中学的744名西班牙裔青少年的总样本将使用区组设计随机分配到两个条件之一：Familias Unidas或社区实践。在两项独立的随机对照试验中，对家庭联合干预进行了评估，发现其有效。在第一项研究中（Pantin等人，2003），显示Familias Unidas相对于无干预控制条件在增加家庭功能和减少行为问题方面是有效的（普拉多等人，2006年），青年非法药物使用和无保护性行为的风险因素。在第二个随机对照试验中（普拉多等人，据发现，相对于两种注意力控制条件，Familias Unidas在预防吸烟和非法药物使用方面是有效的。还发现，相对于两种控制条件，Familias Unidas在预防/减少最后一次性交时的无保护性行为方面也是有效的。最后，家庭功能被认为是中介的干预条件对结果的影响。分层线性模型（HLM）将用于测试：（H1）随着时间的推移，Familias Unidas在减少非法药物使用方面比社区实践更有效;（H2）随着时间的推移，Familias Unidas在减少香烟使用方面比社区实践更有效;（H3）随着时间的推移，Familias Unidas在减少无保护性行为方面比社区实践更有效。此外，HLM还将用于确定（H1 a）Familias Unidas对非法药物使用的影响是否部分由家庭功能介导;（H2 a）Familias Unidas对香烟使用的影响是否部分由家庭功能介导;以及（H3 a）Familias Unidas对无保护性行为的影响是否部分由家庭功能介导。公共卫生相关性：这项研究的目的是减少西班牙裔人群中非法药物使用、吸烟和不安全性行为的健康差异。从这项研究中获得的知识将有助于制定有效的干预措施，以减少西班牙裔青少年的吸毒，吸烟，无保护的性行为和艾滋病毒。

DESCRIPTION (provided by applicant): 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.