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Factors associated with the implementation of the Familias Unidas intervention in a type 3 translational trial

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

This study highlights how Familias Unidas, a Hispanic-specific, evidence-based, family centered preventive intervention, progressed from intervention development (type 1 translation; T1) through rigorous evaluation (T2) and examines the role of intervention fidelity—adherence and competence—in a T3 trial. Effects of participant, provider, and organizational variables on direct (observational) and indirect (self-reported) fidelity were examined as were effects of fidelity. Two structural equation models were estimated using data from 367 Hispanic parent-adolescent dyads randomized to Familias Unidas. Facilitator perceptions of parental involvement in schools, school performance grade, and school socioeconomic status predicted indirect adherence ratings, which were positively related to adolescent substance use. Facilitator openness to evidence-based practices was associated with indirect competence ratings, school performance grade and size were associated with direct competence ratings, and direct competence ratings were negatively associated with substance use. Findings highlight unique contributions of direct and indirect fidelity ratings in the implementation of Familias Unidas.

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Acknowledgments

This was an investigator-initiated study funded by the National Institute on Drug Abuse (R01 DA025192 to Guillermo Prado, PhD; P30 DA027828 to C. Hendricks Brown) and the National Institute on Alcohol Abuse and Alcoholism (R01 DA025192S1 to Guillermo Prado, PhD). The funders played no role in the study design, data collection, analysis, interpretation, writing of the paper or decision to submit the paper for publication. The researchers were independent from the funders. All authors had full access to all data and can take responsibility for the integrity of the data and accuracy of data analysis.

Conflict of interests

The authors declare that they have no competing interests.

Compliance with ethical standards

All procedures for this study, including the informed consent process, were performed in accordance with ethical standards and protection for human subjects.

Author information

Authors and Affiliations

  1. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA

    Sara M. St. George, Denise C. Vidot & Guillermo Prado

  2. Department of Biostatistics, Vanderbilt University, Nashville, TN, USA

    Shi Huang

  3. Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Justin D. Smith & C. Hendricks Brown

Authors
  1. Sara M. St. George
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  2. Shi Huang
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  3. Denise C. Vidot
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  4. Justin D. Smith
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  5. C. Hendricks Brown
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  6. Guillermo Prado
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Corresponding author

Correspondence to Sara M. St. George.

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Implications

Practice: Community practitioners should learn more about factors found to facilitate or impede the translation of evidence-based interventions (EBIs) and use observational methods for monitoring intervention fidelity.

Research: Researchers should exercise caution when using self-reported measures to monitor intervention fidelity and should further examine resource-efficient observational methods.

Policy: Policy makers should facilitate the process of bringing preventive EBIs to scale and ensure they are appropriately implemented through the use of observational methods for monitoring fidelity.

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St. George, S.M., Huang, S., Vidot, D.C. et al. Factors associated with the implementation of the Familias Unidas intervention in a type 3 translational trial. Behav. Med. Pract. Policy Res. 6, 105–114 (2016). https://doi.org/10.1007/s13142-015-0344-x

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  • DOI: https://doi.org/10.1007/s13142-015-0344-x

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