Adapting a Multi-Risk Prevention Intervention for Latino Families to Enhance the Prevention of HIV and Substance Abuse

Purpose: A comprehensive approach to preventing negative behavioral health outcomes in youth is becoming increasingly emphasized (IOM, 2009). Many Latino youth are at increased risk for substance abuse, mental health concerns, unsafe sexual practices and HIV (Prado et al., 2006), and these outcomes have been empirically connected to individual, family and community-based stressors, including acculturation (Cervantes, Fisher, Cordova & Kilp, in press; IOM, 2009). Despite this knowledge, there is a lack of evidence-based approaches that target these outcomes by reducing stress in Latino families in a culturally relevant manner (Cervantes, Kappos, Duenas & Arellano, 2003).

The current presentation discusses the process of and findings from an NIH-funded adaptation of Familia Adelante (FA) with 131 Latino families at 3 national study sites. FA is a twelve-session multi-risk reduction curriculum for Latino youth and their families (Cervantes, Goldbach & Santos, in press). The present work adapted FA through the use of expert feedback and community based participatory research (CBPR) methods.

Methods: The initial study included groups of middle school youth (n=153) and their parents (n=149) held separately but concurrently. Pre, Post and 6-month follow-up measures were collected, using previously normed instruments (Padilla, 1987; Conners, et al, 1998). Based upon results, a curriculum adaptation to strengthen HIV and drug prevention messaging was proposed to NIH using a two-phase approach. First, a panel of HIV/SA expert consultants provided extensive feedback. After integration of adaptations, CBPR methods were implemented, using focus groups of diverse Latino families across the U.S. (N=131). Qualitative data was recorded and coded using thematic analysis strategies. Further adaptations were made to the curriculum, and a final set of expert reviews were conducted prior to finalization.

Results: Based upon a review of the current literature and the use of expert consultants, significant changes were made to the FA curriculum. These changes fell under three broad categories: content, culture and comprehensiveness. Content related to the linking of module activities directly to empirical research, as well as addition of mixed-methods approaches to learning (such as group activities and guest speakers). Cultural adaptations were made to reflect new issues facing Latino families (for example, immigration reform). Comprehensiveness was addressed through adding additional life stressors recommended by youth (for example, eating disorders and bullying).

Implications: FA is a prevention program developed to address the unique needs and risk factors found among Latino families. Few prevention programs exist for Latino families, and even fewer address multiple risk outcomes through family-based programming. Based upon findings from the current study, a larger randomized trial has been proposed to explore the impact of adaptations on behavioral health outcomes.