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Prevention Science

, Volume 19, Issue 5, pp 630–641 | Cite as

Predictors of Participation in an eHealth, Family-Based Preventive Intervention for Hispanic Youth

  • Tatiana Perrino
  • Yannine Estrada
  • Shi Huang
  • Sara St. George
  • Hilda Pantin
  • Miguel Ángel Cano
  • Tae Kyoung Lee
  • Guillermo Prado
Article

Abstract

The Familias Unidas intervention is an efficacious family-based preventive intervention for reducing substance use and other health risks among Hispanic youth. A current randomized controlled trial (RCT) is examining this intervention’s efficacy when delivered via the Internet (eHealth). eHealth interventions can overcome logistical barriers to participation, yet there is limited information about the feasibility of these interventions, especially among ethnic minorities. This paper examines participation and predictors of participation in the eHealth Familias Unidas intervention in a sample of 113 Hispanic families whose adolescent had behavioral problems. Analyses examined multidimensional ways of characterizing participation, including the following: (1) total intervention participation, (2) initial engagement (participating in at least one of the first three intervention sessions), (3) completing the pre-recorded, eHealth parent group sessions, and (4) participating in the live, facilitator-led, eHealth family sessions. Participation in this eHealth intervention was comparable to, and in most cases higher than, previous, face-to-face Familias Unidas interventions. High levels of baseline family stress were associated with lower initial engagement and lower family session participation. Greater parental Hispanicism was associated with more participation in eHealth parent group sessions and across the total intervention. Higher levels of baseline effective parenting, in other words less intervention need, were significantly associated with lower levels of total intervention participation and lower levels of family session participation. Implications for preventive interventions delivered via Internet are discussed.

Keywords

Adolescent Prevention Family Hispanic Participation Engagement Internet 

Notes

Compliance with Ethical Standards

Funding

This study involved analyses of data from a randomized controlled trial funded by the Centers for Disease Control and Prevention, Grant No. U01PS003316-Yannine Estrada, Principal Investigator.

Conflict of Interest

Authors Hilda Pantin and Guillermo Prado are the developers of the Familias Unidas intervention, which is the subject of this paper’s analyses.

Ethical Approval

This study was approved by the University of Miami’s Human Subjects Research Board and the Miami- Dade County Schools’ Research Board. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from parents of all youth in this trial. Voluntary informed assent was obtained from all youth in this trial.

Supplementary material

11121_2016_711_MOESM1_ESM.docx (28 kb)
ESM 1 (DOCX 27 kb)

References

  1. Baydar, N., Reid, M. J., & Webster-Stratton, C. (2003). The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Development, 74, 1433–1453.CrossRefPubMedGoogle Scholar
  2. Bennett, G. G., & Glasgow, R. E. (2009). The delivery of public health interventions via the Internet: Actualizing their potential. Annual Review of Public Health, 30, 273–292.CrossRefPubMedGoogle Scholar
  3. Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness-of-fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–600.CrossRefGoogle Scholar
  4. Berdahl, T. A., & Stone, R. A. T. (2009). Examining Latino differences in mental healthcare use: The roles of acculturation and attitudes towards healthcare. Community Mental Health Journal, 45, 393–403.CrossRefPubMedGoogle Scholar
  5. Berkel, C., Mauricio, A. M., Schoenfelder, E., & Sandler, I. N. (2011). Putting the pieces together: An integrated model of program implementation. Prevention Science, 12, 23–33.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Brody, G. H., Murry, V. M., Chen, Y. F., Kogan, S. M., & Brown, A. C. (2006). Effects of family risk factors on dosage and efficacy of a family-centered preventive intervention for rural African Americans. Prevention Science, 7, 281–291.CrossRefPubMedGoogle Scholar
  7. Brouwer, W., Kroeze, W., Crutzen, R., de Nooijer, J., de Vries, N. K., … & Oenema, A. (2011). Which intervention characteristics are related to more exposure to internet-delivered healthy lifestyle promotion interventions? Journal of Medical Internet Research, 13, e2.Google Scholar
  8. Byrne, B. M. (2001). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Mahwah: Lawrence Erlbaum Associates.Google Scholar
  9. Cervantes, R. C., Padilla, A. M., & Salgado de Snyder, N. (1991). The Hispanic Stress Inventory: A culturally relevant approach to psychosocial assessment. Psychological Assessment, 3, 438–447.CrossRefGoogle Scholar
  10. Conger, R. D., Patterson, G. R., & Ge, X. (1995). It takes two to replicate: A meditational model for the impact of parents’ stress on adolescent adjustment. Child Development, 66, 80–97.CrossRefPubMedGoogle Scholar
  11. Cordova, D., Huang, S., Lally, M., Estrada, Y., & Prado, G. (2014). Do parent–adolescent discrepancies increase the risk of Hispanic adolescent HIV risk behaviors? Family Process, 53, 348–363.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Cunningham, C. E., Boyle, M., Offord, D., Racine, Y., Hundert, J., Secord, M., & McDonald, J. (2000). Tri-ministry study: Correlates of school-based parenting course utilization. Journal of Consulting and Clinical Psychology, 68, 928–933.CrossRefPubMedGoogle Scholar
  13. Danaher, B. G., & Seeley, J. R. (2009). Methodological issues in research on web-based behavioral interventions. Annals of Behavioral Medicine, 38, 28–39.CrossRefPubMedGoogle Scholar
  14. Dillman Carpentier, F. R., Mauricio, A. M., Gonzales, N. A., Millsap, R. E., Meza, C. M., Dumka, L. E., German, M., & Genalo, M. T. (2007). Engaging Mexican origin families in a school-based preventive intervention. Journal of Primary Prevention, 28, 521–546.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Estrada, Y., Rosen, A., Huang, S., Tapia, M., Sutton, M., Willis, L., et al. (2015). Efficacy of a brief intervention to reduce substance use and human immunodeficiency virus infection risk among Latino youth. Journal of Adolescent Health. doi: 10.1016/j.jadohealth.2015.07.006.
  16. Eysenbach, G. (2005). The law of attrition. Journal of Medical Internet Research, 7, e11.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Fernandez, M. A., & Eyberg, S. M. (2009). Predicting treatment and follow-up attrition in parent–child interaction therapy. Journal of Abnormal Psychology, 37, 431–441.Google Scholar
  18. Frantz, I., Stemmler, M., Hahlweg, K., Pluck, J., & Heinrichs, N. (2015). Experiences in disseminating evidence-based prevention programs in a real-world setting. Prevention Science, 16, 789–800.CrossRefPubMedGoogle Scholar
  19. Guo, X., Suarez-Morales, L., Schwartz, S. J., & Szapocznik, J. (2009). Some evidence for multidimensional biculturalism: Confirmatory factor analysis and measurement invariance analysis on the Bicultural Involvement Questionnaire-Short Version. Psychological Assessment, 21, 22–31.CrossRefPubMedGoogle Scholar
  20. Kline, R. B. (1998). Principles and practice of structural equation modeling. NY: Guilford Press.Google Scholar
  21. Knapp, C., Madden, V., Wang, H., Slover, P., & Shenkman, E. (2011). Internet use and eHealth literacy of low-income parents whose children have special health care needs. Journal of Medical Internet Research, 13, e75.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Mendez, J. L., Carpenter, J. L., LaForett, D. R., & Cohen, J. S. (2009). Parental engagement and barriers to participation in a community-based preventive intervention. American Journal of Community Psychology, 44, 1–14.CrossRefPubMedGoogle Scholar
  23. Mohr, D. C., Cuijpers, P., & Lehman, K. (2011). Supportive accountability: A model for providing human support to enhance adherence to eHealth interventions. Journal of Medical Internet Research, 13, E30.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Muthén, L.K. & Muthén, B.O. (1998–2012). Mplus user’s guide. Seventh edition. Los Angeles: Muthén & Muthén.Google Scholar
  25. Pantin, H. (1996). Ecodevelopmental measures of support and conflict for Hispanic youth and families. Miami: University of Miami School of Medicine.Google Scholar
  26. Pantin, H., Prado, G., Lopez, B., Huang, S., Tapia, M. I., Schwartz, S. J., et al. (2009). A randomized controlled trial of familias unidas for hispanic adolescents with behavior problems. Psychosomatic Medicine, 71, 987–995.Google Scholar
  27. Perrino, T., Coatsworth, J. D., Briones, E., Pantin, H., & Szapocznik, S. (2001). Initial engagement into parent-centered preventive interventions: A family systems perspective. Journal of Primary Prevention, 22, 21–44.CrossRefGoogle Scholar
  28. Prado, G., & Pantin, H. (2011). Reducing substance use and HIV health disparities among Hispanic youth in the U.S.A.: The Familias Unidas program of research. Psychosocial Interventions, 20, 63–73.CrossRefGoogle Scholar
  29. Prado, G., Pantin, H., Schwartz, S. J., Lupei, N. S., & Szapocznik, J. (2006). Predictors of engagement and retention into a parent centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families. Journal of Pediatric Psychology, 31, 874–890.CrossRefPubMedGoogle Scholar
  30. Prado, G., Pantin, H., Briones, E., Schwartz, S., Feaster, D., Huang, S., … Szapocznik, J. (2007). A randomized controlled trial of a parent-centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75, 914–26.Google Scholar
  31. Prado, G., Cordova, D., Huang, S., Estrada, Y., Rosen, A., Bacio, G.A., … McCollister, K. (2012). The efficacy of Familias Unidas on drug and alcohol outcomes for Hispanic delinquent youth: Main effects and interaction effects by parental stress and social support. Drug and Alcohol Dependence, 125S, S18-25.Google Scholar
  32. Prado, G., Pantin, H., & Estrada, Y. (2015). Integrating evidence-based interventions for adolescents in primary care. American Journal of Preventive Medicine, 48, 488–490.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Quay, H. C., & Peterson, D. R. (1993). The Revised Behavior Problem Checklist: Manual. Odessa: Psychological Assessment Resources.Google Scholar
  34. Rainie, L., Duggan, M., & Page, D. (2015). Americans’ internet access: 2000–2015. Washington, DC: Pew Research Center.Google Scholar
  35. Salas-Wright, C.P., Vaughn, M.G., Schwartz, S.J., & Córdova, D. (2015). An “immigrant paradox” for adolescent externalizing behavior? Evidence from a national sample. Social Psychiatry and Psychiatric Epidemiology, 51,27–37.Google Scholar
  36. Sanders, M. R., Baker, S., & Turner, K. M. (2012). A randomized controlled trial evaluating the efficacy of Triple P Online with parents of children with early-onset conduct problems. Behavior Research and Therapy, 50, 675–684.CrossRefGoogle Scholar
  37. Sandler, I. N., Schoenfelder, E. N., Wolchik, S. A., & MacKinnon, D. P. (2011). Long-term impact of prevention programs to promote effective parenting: Lasting effects but uncertain processes. Annual Review of Psychology, 62, 299–329.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Santisteban, D. A., Dillon, F., Mena, M. P., Estrada, Y., & Vaughan, E. L. (2005). Psychiatric, family and ethnicity-related factors that can impact treatment utilization among Hispanic substance abusing adolescents. Journal of Social Work Practice in the Addictions, 5, 133–155.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Santisteban, D. A., Coatsworth, J. D., Briones, E., Kurtines, W., & Szapocznik, J. (2012). Beyond acculturation: An investigation of the relationship of familism and parenting to behavior problems in Hispanic youth. Family Process, 51, 470–482.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Sourander, A., McGrath, P.J., Ristkari, T., Cunningham, C., Huttunen, J., … & Unruh, A. (2016). Internet-assisted parent training intervention for disruptive behavior in 4-year-old children: A randomized clinical trial. JAMA Psychiatry, 73, 378–87.Google Scholar
  41. Spoth, R., Goldberg, C., & Redmond, C. (1999). Engaging families in longitudinal preventive intervention research: Discrete-time survival analysis of socioeconomic and social-emotional risk factors. Journal of Consulting and Clinical Psychology, 67, 157–163.CrossRefPubMedGoogle Scholar
  42. Spoth, R., Rohrbach, L.A., Greenberg, M., Leaf, P., Brown, C.H., … & Society for Preventon Research Type 2 Translational Task Force Members and Contributing Authors. (2013). Addressing core challenges for the next generation of type 2 translation research and systems: The translation science to population impact framework. Prevention Science, 14, 319–51.Google Scholar
  43. Szapocznik, J., & Coatsworth, J. D. (1999). An ecodevelopmental framework for the influences on drug abuse: A developmental model of risk and protection. In M. D. Glantz & C. R. Hartel (Eds.), Drug abuse: Origins & interventions (pp. 331–336). Washington: APA.CrossRefGoogle Scholar
  44. Szapocznik, J., Kurtines, W., & Fernandez, T. (1980). Bicultural involvement and adjustment in Hispanic-American youths. International Journal of Intercultural Relations, 4, 353–365.CrossRefGoogle Scholar
  45. Szapocznik, J., Prado, G., Burlew, A. K., Williams, R. A., & Santisteban, D. A. (2007). Drug abuse in African American and Hispanic adolescents: Culture, development, and behavior. Annual Review of Clinical Psychology, 3, 77–105.CrossRefPubMedGoogle Scholar
  46. Tolan, P. H., Gorman-Smith, D., Huesmann, L. R., & Zelli, A. (1997). Assessment of family relationship characteristics: A measure to explain risk for antisocial behavior and depression among urban youth. Psychological Assessment, 9, 212–223.CrossRefGoogle Scholar
  47. Winslow, E. B., Bonds, D., Wolchik, S., Sandler, I., & Braver, S. (2009). Predictors of enrollment and retention in a preventive parenting intervention for divorced families. Primary Prevention, 30, 151–172.CrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2016

Authors and Affiliations

  • Tatiana Perrino
    • 1
  • Yannine Estrada
    • 1
  • Shi Huang
    • 2
  • Sara St. George
    • 1
  • Hilda Pantin
    • 1
  • Miguel Ángel Cano
    • 3
  • Tae Kyoung Lee
    • 1
  • Guillermo Prado
    • 1
  1. 1.Department of Public Health SciencesUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Department of BiostatisticsVanderbilt UniversityNashvilleUSA
  3. 3.Department of Epidemiology, Robert Stempel College of Public Health & Social WorkFlorida International UniversityMiamiUSA

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