Pantin, H., Coatsworth, J. D., Feaster, D. J., Newman, F. L., Briones, E., Prado, G., Schwartz, S., & Szapocznik, J. (2003). Familias Unidas: The efficacy of an intervention to promote parental investment in Hispanic immigrant families. Prevention Science, 4(3), 189-201. https://doi.org/10.5093/in2011v20n1a6

Type of Study: Randomized controlled trial
Number of Participants: 178 families

Population:

• Age — 10-14 years (Mean=12.40 years)
• Race/Ethnicity — 100% Hispanic
• Gender — 102 Male and 76 Female
• Status — Participants were Hispanic adolescents in 6th to 8th grade and their primary caregivers.

Location/Institution: Three middle schools in low-income areas of Miami, South Florida

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to report a test of the efficacy of Familias Unidas in promoting protection against and reducing risk for adolescent behavior problems. Participants were stratified by adolescents’ school and grade and were randomly assigned to either the Familias Unidas intervention or to the no-intervention control condition. Measures utilized include the Parenting Practices Scale, the Social Support Appraisal Scale, Revised Behavior Problem Checklist, the Conners-Wells Self-Report Scale, the Interpersonal Competence Inventory, the Behavior Scale Part I, the School Attitudes/Bonding Scale, the Adolescent Competence Scale, the Interpersonal Competence Scale, and the Piers–Harris Children’s Self-Concept Scale. Results indicate that Familias Unidas was efficacious in increasing parental investment and decreasing adolescent behavior problems, but that it did not significantly impact adolescent school bonding/academic achievement. Summer-vacation rates of adolescent behavior problems were six times higher in the control condition than in the intervention condition. Furthermore, change in parental investment during the intervention was predictive of subsequent levels of adolescent behavior problems. Limitations include the exclusive use of questionnaire measures may have introduced bias into the results, the results may have been compromised by the low enrollment rate, the stratified randomization procedure utilized to assign participants to conditions may have created the possibility of contamination, and length of follow-up.

Length of controlled postintervention follow-up: 3 months.

Pantin, H., Prado, G., Lopez, B., Huang, S., Tapia, M. I., Schwartz, S. J., Sabillon, E., Brown, H., & Branchini, J. (2009). A randomized controlled trial of Familias Unidas for Hispanic adolescents with behavior problems. Psychosomatic Medicine, 71(9), 987–995. https://doi.org/10.1097/PSY.0b013e3181bb2913

Type of Study: Randomized controlled trial
Number of Participants: 213 families

Population:

• Age — Children: Mean=13.8 years; Adults: Mean=40.0 years
• Race/Ethnicity — 100% Hispanic
• Gender — Children: 136 Male and 77 Female; Adults: 186 Female and 27 Male
• Status — Participants were 8th-grade Hispanic adolescents with behavior problems and their primary caregivers.

Location/Institution: A single urban low-income school district in Miami-Dade County, Florida.

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of Familias Unidas in preventing/reducing adolescent substance use, unsafe sexual behavior, and externalizing disorders. Participants were randomly assigned to one of two conditions: Familias Unidas or community control. Measures utilized include the Parenting Practices Scale, the Family Relations Scale, the Diagnostic Interview Schedule for Children (DISC), the Parent–Adolescent Communication Scale, the Parent Relationship with Peer Group Scale, and the Sexual Behavior Instrument. Results indicate that, relative to a community control condition, Familias Unidas was efficacious in preventing or reducing externalizing disorders, preventing and reducing substance use, and in reducing unsafe sexual behavior. The effects of Familias Unidas on these outcomes were partially mediated by improvements in family functioning. Limitations include present sample was not representative of the U.S. Hispanic population, self-selection biases, and reliance on self-report measures.

Length of controlled postintervention follow-up: Approximately 3, 15, and 27 months.

Prado, G., Cordova, D., Huang, S., Estrada, Y., Rosen, A., Bacio, G. A., Jimenez, G. L., Pantin, H., Brown, C. H., Velasquez, M.-R., Villamar, J., Frietas, D., Tapia, M., & 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, 125(1), S18–S25. https://doi.org/10.1016/j.drugalcdep.2012.06.011

Type of Study: Randomized controlled trial
Number of Participants: 242 families

Population:

• Age — 12-17 years (Mean=14.7 years)
• Race/Ethnicity — 100% Hispanic
• Gender — 156 Male and 86 Female
• Status — Participants were delinquent Hispanic youth.

Location/Institution: Miami-Dade Countys' Department of Juvenile Services and the Miami-Dade County Public School system (MDCP-S)

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the effects of Familias Unidas, relative to Community Practice, in reducing past 90-day substance use, alcohol and marijuana dependence, and having sex while under the influence of alcohol or drugs. Participants were randomly assigned to Familias Unidas or Community Practice. Measures utilized include the Hispanic Stress Inventory, the Social Provisions Scale and the Diagnostic Interview Schedule for Children (DISC). Results indicate that Familias Unidas was efficacious in reducing past 90-day substance use, illicit drug use, and in reducing the proportion of youth with an alcohol dependence diagnosis, relative to Community Practice. Results also showed a reduction in the proportion of youth who reported having sex while under the influence of alcohol or drugs. No differences between conditions were observed in past 90-day alcohol use or marijuana dependence. Intervention effects on illicit drug use and alcohol dependence varied by environmental context. For example, Familias Unidas was most efficacious for adolescents with parents exhibiting high stress and lower levels of social support. Limitations include present sample was not representative of the U.S. Hispanic population; no data were collected on binge drinking; did not collect in depth data on those families who decided not to participate; the exact role of physical, emotional, and sexual abuse cannot be determined; and an attention-control condition was not used.

Length of controlled postintervention follow-up: 6 and 12 months.

Prado, G., Pantin, H., Huang, S., Cordova, D., Tapia, M. I., Velazquez, M.-R., Calfee, M., Malcolm, S., Arzon, M., Villamar, J., Jimenez, G. L., Cano, N., Brown, H., & Estrada, Y (2012). Effects of a family intervention in reducing HIV risk behaviors among high-risk Hispanic adolescents: A randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 166(2), 127–133. https://doi.org/10.1001/archpediatrics.2011.189

Type of Study: Randomized controlled trial
Number of Participants: 242 families

Population:

• Age — 12-17 years (Mean=14.7 years)
• Race/Ethnicity — 100% Hispanic
• Gender — 156 Male and 86 Female
• Status — Participants were delinquent Hispanic youth.

Location/Institution: Miami-Dade County's Department of Juvenile Services and the Miami-Dade County Public School system (MDCP-S)

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the sample from Prado et al. (2012). The purpose of the study was to examine the efficacy of Familias Unidas, to reduce human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. Participants were randomly assigned to Familias Unidas or community practice. Measures utilized include the Hispanic Stress Inventory, the Social Provisions Scale, Audio-CASI System, and the Diagnostic Interview Schedule for Children (DISC). Results indicate that compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent–adolescent communication and positive parenting. Limitations include present sample was not representative of the U.S. Hispanic population, reliance on self-report measures, and an attention-control condition was not used in this study.

Length of controlled postintervention follow-up: Approximately 3 months.

Estrada, Y., Lee, T. K., Huang, S., Tapia, M. I., Velázquez, M.-R., Martinez, M. J., Pantin, H., Ocasio, M. A., Vidot, D. C., Molleda, L., Villamar, J., Stepaneko, B. A., Brown, C. H., & Prado, G. (2017). Parent-centered prevention of risky behaviors among Hispanic youths in Florida. American Journal of Public Health, 107(4), 607–613. https://doi.org/10.2105/AJPH.2017.303653

Type of Study: Randomized controlled trial
Number of Participants: 746 families

Population:

• Age — Children: 12-16 years; Adults: Mean=41.0 years
• Race/Ethnicity — 100% Hispanic
• Gender — Children: 52% Male; Adults: 83% Female
• Status — Participants were middle school Hispanic students and their families.

Location/Institution: Miami–Dade County Public School (MDCPS)

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Familias Unidas in preventing substance use (alcohol, illicit drugs) and sex without a condom among Hispanic adolescents. Participants were randomly assigned to Familias Unidas or prevention as usual by using stratified randomization within schools. Measures utilized include the Parent Relationship with Peer Group Scale, the Family Relations Scale and the Parenting Practices Scale. Results indicate that Familias Unidas was effective in preventing drug use from increasing and prevented greater increases in sex without a condom 30 months after baseline, relative to prevention as usual. Familias Unidas also had a positive impact on family functioning and parental monitoring of peers at 6 months after baseline.  Limitations include reliance on self-report measures, sample is not representative of the entire United States nor of all Hispanics, and did not collect information for the prevention-as-usual group such as the length of the control condition or whether youths participated.

Length of controlled postintervention follow-up: 3, 15, and 27 months.

Lee, T. K., Estrada, Y., Soares, M. H., Ahumada, M. S., Molina, M. C., Bahamon, M. M., & Prado, G. (2019). Efficacy of a family-based intervention on parent-adolescent discrepancies in positive parenting and substance use among Hispanic youth. Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 64(4), 494–501. https://doi.org/10.1016/j.jadohealth.2018.10.002

Type of Study: Randomized controlled trial
Number of Participants: 746 adolescents and their primary caregivers

Population:

• Age — Adolescents: Mean=13.9 years; Parents: Mean=41.0 years
• Race/Ethnicity — 100% Hispanic
• Gender — Adolescents: 52% Male; Parents: 83% Female
• Status — Participants were eighth graders and their primary caregivers. 

Location/Institution: 18 middle schools within the Miami-Dade County Public School System (MDCPS), located in South Florida

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the sample from Estrada et al. (2017). The purpose of the study was to investigate the moderating and mediating roles of positive parenting discrepancy trajectories on the association between condition effect (i.e., Familias Unidas vs. prevention as usual condition) and substance use among Hispanic youth. Participants were randomly assigned to two conditions: Familias Unidas or prevention as usual. Measures utilized include the positive parenting subscale of the Parenting Practices Scale, and items from Monitoring the Future Survey. Results indicate that, relative to prevention as usual, Familias Unidas reduced positive parenting discrepancies across time, when parent reports were higher than adolescent reports at baseline; this in turn, predicted substance use at 30 months postbaseline. Limitations include all assessments consisted of self-report measures, the study did not incorporate other informant reports, did not collect data such as dosage or whether adolescents in the prevention as usual group actually received an intervention, and study consisted of family living in South Florida which is demographically different from other Hispanic areas in the nation.

Length of controlled postintervention follow-up: 3, 15, and 27 months.

Brincks, A., Perrino, T., Howe, G., Estrada, Y., Robles, N., & Prado, G. (2021). Familias Unidas prevents youth internalizing symptoms: A baseline target moderated mediation (BTMM) study. Prevention Science. Advance online publication. https://doi.org/10.1007/s11121-021-01247-2

Type of Study: Randomized controlled trial
Number of Participants: 746 adolescent-parent dyads

Population:

• Age — Adolescents: Mean=13.8 years; Parents: Mean=41 years
• Race/Ethnicity — 100% Hispanic
• Gender — Adolescents: 48% Female; Parents: 83% Female
• Status — Participants were eighth grade adolescents of Hispanic origin.

Location/Institution: Miami–Dade County Public School system

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the sample from Estrada et al. (2017). The purpose of the study was to examine the effects of the Familias Unidas preventive intervention on reducing internalizing symptoms with a universal sample of Hispanic youth in a real-world school setting. Participants were recruited and randomized to Familias Unidas or a control condition. Measures utilized include the Youth Self-Report, the Family Relations Scale, the Parenting Practices Scale, the Hispanic Stress Inventory, and the Social Provisions Scale. Results indicate that Familias Unidas decreased youth internalizing symptoms through improvements in family functioning in some models, but there was no evidence of moderation by baseline level of family functioning. There was some evidence of mediation through increasing social support for parents for those intervention parents presenting with lower baseline support. However, there was no evidence of mediation through parent stress. Post hoc analyses suggest a possible cascading of effects where improvements in support for parents strengthened parental monitoring of youth and ultimately reduced youth internalizing symptoms. Limitations include use of self-reported measures and lack of random assignment to the level of the mediator.

Length of controlled postintervention follow-up: 3, 15, and 27 months.

Ocasio, M. A., Lozano, A., Lee, T. K., Feaster, D. J., Carrico, A., & Prado, G. (2021). Efficacy of a family-based intervention for HIV prevention with Hispanic adolescents with same gender sexual behaviors. Prevention Science, 23(1), 119–129. https://doi.org/10.1007/s11121-021-01272-1

Type of Study: Randomized controlled trial
Number of Participants: 194

Population:

• Age — Familias Unidas: Mean=14.32 years; Control: Mean=14.16 years
• Race/Ethnicity — 100% Hispanic
• Gender — Familias Unidas: 76% Male and 25% Female; Control: 71% Male and 29% Female
• Status — Participants were Hispanic adolescents with same gender sexual behaviors.

Location/Institution: Miami-Dade County Public School System

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to assess the relative efficacy of a general, family-based intervention (Familias Unidas) on improving substance and condom use outcomes among Hispanic adolescents with same gender sexual behaviors. Data across five distinct trials of Familias Unidas were synthesized. Participants were randomized either to Familias Unidas or control condition. Results indicate that Familias Unidas did not impact substance use but significantly reduced condomless sex postintervention relative to the control condition. Hypothesized mediators did not explain this effect. Post hoc analyses indicated that the effect was significant in studies that recruited based on prior risk but not studies that recruited universal samples. Limitations include low power to detect effects, lack of standardized measures, and gender identities and sexualities were conflated in analyses.

Length of controlled postintervention follow-up: Varied by study.

The following studies were not included in rating Familias Unidas on the Scientific Rating Scale...

Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., Huang, S., Sullivan, S., Tapia, M. I., Sabillon, E., Lopez, B., & 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(6), 914–926. https://doi.org/10.1037/0022-006X.75.6.914

The purpose of the study was to evaluate the efficacy of Familias Unidas + Parent–Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention in preventing adolescent substance use and unsafe sexual behavior. Participants were randomly assigned to 1 of 3 conditions: Familias Unidas + PATH, English for Speakers of Other Languages (ESOL) + PATH, and ESOL + HeartPower! for Hispanics (HEART). Measures utilized include the Bicultural Involvement Questionnaire— Revised, the Family Relations Scale, and the Parent–Adolescent Communication Scale. Results indicate that (a) Familias Unidas+ PATH was efficacious in preventing and reducing cigarette use relative to both control conditions; (b) Familias Unidas + PATH was efficacious, relative to ESOL + HEART, in reducing illicit drug use; and (c) Familias Unidas + PATH was efficacious, relative to ESOL + PATH, in reducing unsafe sexual behavior. Limitations include lack of control group, present sample was not representative of the U.S. Hispanic population and results should not be generalized to all Hispanic adolescents, reliance on self-report measures, and study does not report findings on Familias Unidas alone. Note: Since this study reported on Familias Unidas combined with another intervention, this study was not used in the rating/review process.