A Family-Oriented, Web-Based Intervention for Preventing Substance Use Among Asian American Girls: A Randomized-Controlled Trial

Background and Purpose: Notwithstanding their popular image as members of a model minority group, Asian-American adolescent girls face increasing risks for drug abuse. National data indicate that the binge drinking rate of Asian-American adolescent girls rose from 14.8% to 33.6% in 1 year (Hahm, Lahiff, & Guterman, 2004). Furthermore, Asian-American sexual minority girls were more likely than their male counterparts to use a broad range of harmful substances (Hahm, Wong, Huang, Ozonoff, & Lee, 2008).

Efforts invested in developing and testing substance use prevention programs for Asian-American adolescent girls have been scarce. Asian youth are nearly always excluded from the treatment outcome literature (Huey & Polo, 2008). Recognizing the need to include adequate numbers of Asian Americans in clinical trials, we tested a family-based, gender-specific program with a sample of Asian-American adolescent girls and their mothers, and evaluated the program's outcomes on girls' substance use, psychological states, parent-child communication, parental monitoring, and family rules against substance use.

Methods: The study used a two-group randomized experimental design. Participants were 108 Asian-American mother-daughter dyads recruited from 19 states having significant Asian populations. All participants completed baseline measures, and intervention-arm dyads (n = 56) completed a 9-session prevention program that aimed to prevent substance use among young adolescent girls, while control-arm dyads (n = 52) received no intervention. The intervention targeted risk and protective factors related to substance use among young adolescent girls, including normative beliefs, self-efficacy, refusal skills, body esteem, mood management, parent-child communication, parental monitoring, and family rules against substance use. All participants then completed two annual follow-up data collections consisting of measures identical to baseline measures. Intervention-arm participants received an annual booster session between the two follow-up measurements.

Results: Ninety-six mother-daughter pairs (50 intervention and 46 control) completed both 1-year, and 2-year follow-up measures. At baseline, girls had a mean age of 13.1 years (SD = 0.96), and their mothers' mean age was 39.6 years (SD = 6.20). Repeated-measures general linear analytic models were used to analyze time X intervention interaction effects. Results showed that at 2-year follow-up, relative to control-group girls, intervention-arm girls reported more positive outcomes on 30-day alcohol use (p < .02), marijuana use (p < .05), prescription drug misuse (p < .05), and intentions to use tobacco, alcohol, and drugs in the future (p < .001). Intervention-arm girls also reported more improvements on self-efficacy (p < .01), refusal skills (p < .01), parent-child communication (p < .0001), parental monitoring (p < .01), and family rules against substance use (p < .001). No intervention X time interaction effects were found on normative beliefs, body esteem, and mood management.

Conclusions and Implications: A family-oriented, web-based substance use prevention program was efficacious in changing Asian-American girls' risk and protective factors and girls' substance use behavior. Moreover, the problem effects were sustainable two years post intervention. Future work should replicate and strengthen the program with a larger sample. Study findings should stimulate further exploration of gender-specific prevention approaches and interventions that employ interactive technology and new media with Asian Americans.