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在非法药物使用、吸烟使用和艾滋病毒方面的种族差异。这一目标将通过四个目标来实现：目标1是评价家庭与社区做法（即标准预防服务）相比在预防非法药物使用方面的效力；目标2是评价家庭控制相对于社区控制在预防卷烟使用方面的有效性；目标3是评价家庭控制相对于社区控制在预防无保护的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干预对非法药物使用、吸烟使用和无保护的性行为的影响。来自迈阿密-戴德县广泛地理区域的24所中学的744名西班牙裔青少年将使用块设计随机分配到两个条件之一：家庭或社区实践。在两个独立的随机对照试验中，对familas Unidas干预措施进行了评估，并发现其有效。在第一项研究中（Pantin et al., 2003）， familas Unidas被证明在增加家庭功能和减少行为问题（Prado et al., 2006），青少年非法药物使用和无保护性行为的危险因素方面，相对于无干预控制条件是有效的。在第二项随机对照试验中（普拉多等人，出版中），发现在两种注意力控制条件下，家庭在预防吸烟和非法药物使用方面是有效的。研究还发现，在预防/减少无保护的性行为和最后性交方面，联合用药相对于两种对照条件都是有效的。最后，我们发现家庭功能在干预条件对结果的影响中起中介作用。将使用层次线性模型（HLM）来检验：（H1）随着时间的推移，家庭联盟在减少非法药物使用方面将比社区实践更有效；（H2）随着时间的推移，家庭行动将比社区行动更有效地减少卷烟使用；（H3）随着时间的推移，家庭合作将比社区实践更有效地减少无保护的性行为。此外，HLM将用于确定（H1a）家庭对非法药物使用的影响是否部分由家庭功能介导；（H2a）家庭烟草对卷烟使用的影响将部分由家庭功能介导；（H3a）家庭烟草对无保护的性行为的影响将部分由家庭功能介导。公共卫生相关性：拟议研究的目的是减少西班牙裔人群中非法药物使用、吸烟使用和不安全性行为的健康差异。预计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.