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

描述(由申请者提供)：这项拟议的研究的总体目标是减少拉美裔和非拉美裔青年在非法药物使用、香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：目的1是相对于社区实践(即标准预防服务)评价Familias Unidas在预防非法药物使用方面的效力；目标2是评价Familias Unidas相对于社区控制在预防吸烟方面的效力；目标3是评价Familias Unidas相对于社区控制在预防无保护的性行为方面的效力；以及AIM 4是评估家庭功能在多大程度上调解非法药物使用、吸烟和无保护的性行为的干预效果。来自迈阿密-戴德县广泛地理区域的24所中学，总共744名拉美裔青少年的样本将被随机分成两种情况之一：家庭式，Unidas或社区实践。在两个单独的随机对照试验中，对Familias Unidas干预措施进行了评估，发现是有效的。在第一项研究中(Pantin等人，2003年)，与无干预控制条件相比，Familias Unidas被证明在增加家庭功能和减少行为问题、青少年非法药物使用的风险因素和无保护的性行为方面是有效的(Prado等人，2006年)。在第二个随机对照试验中(Prado等人，正在出版)，Familias Unidas被发现，相对于两种注意力控制条件，在防止吸烟和非法药物使用方面是有效的。与这两种控制条件相比，家庭统一也被发现在预防/减少最后性交时无保护的性行为方面有效。最后，家庭功能被发现在干预条件对结果的影响中起中介作用。将使用分层线性模型检验：(1)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；(2)随着时间的推移，家庭联盟在减少香烟使用方面将比社区实践更有效；(H3)随着时间的推移，家庭联盟在减少无保护措施的性行为方面将比社区实践更有效。此外，HLM将用于确定：(H1a)家庭联盟对非法药物使用的影响是否将部分由家庭功能调节；(H2a)家庭联盟对香烟使用的影响是否将部分由家庭功能调节；(H3a)家庭联盟对无保护性行为的影响是否将部分由家庭功能调节。公共卫生相关性：这项拟议研究的目标是减少拉美裔人口中非法药物使用、香烟使用和不安全性行为的健康差距。预计从这项研究中获得的知识将有助于开发有效的干预措施，以减少拉美裔青少年的药物使用、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.