Familias Unidas

About This Program

Target Population: The parents of Hispanic adolescents between 12-16 years old and the adolescents

For children/adolescents ages: 12 – 16

For parents/caregivers of children ages: 12 – 16

Program Overview

Familias Unidas is a family-centered drug use and sexual risk behavior prevention intervention for Hispanic youth and their families. Familias Unidas was specifically developed for Hispanics. It helps empower parents to speak with their adolescents about how to prevent drug use and sexual risk behaviors. Familias Unidas is a multilevel intervention that targets risk (e.g., poor adolescent communication) and protective factors (e.g., parental involvement) at the family, peer, and, school level. Familias Unidas has been adapted for use on the Internet and is currently being tested for obesity prevention, and delivery in primary care settings.

Program Goals

The goals of Familias Unidas are:

  • Prevent drug use and sexual risk behaviors in adolescents
  • Improve family functioning
  • Improve parent-adolescent communication
  • Improve positive parenting
  • Improve parental investment
  • Improve parental monitoring of peers

Essential Components

The essential components of Familias Unidas include:

  • Consists of 8 multiparent group sessions and 4 family sessions with the adolescent that aim to develop effective parenting skills
  • Developed for the parents of Hispanic adolescents and the adolescents
  • 2-hour session multiparent groups with 12 to 15 parents
  • Sessions delivered in school and community settings
  • Designed to increase parents’ understanding of their role in protecting their adolescent from risk behaviors such as substance use and unsafe sexual behavior through group sessions, and to facilitate parental investment in the adolescent’s worlds as well
  • Skills learned in the parent group sessions applied in the family sessions, with guidance from a facilitator
  • Delivered by a trained facilitator and co-facilitator
  • Facilitators trained in engagement and joining skills that optimize program participation
  • Utilizes a participatory approach to deliver program content, including how to help parents communicate

Program Delivery

Child/Adolescent Services

Familias Unidas directly provides services to children/adolescents and addresses the following:

  • Potential drug use, sexual risk behaviors, conduct problems, and internalizing symptoms

Parent/Caregiver Services

Familias Unidas directly provides services to parents/caregivers and addresses the following:

  • Disinterest in adolescent, poor parent-adolescent communication, poor behavior management, poor family functioning

Recommended Intensity:

The parent group sessions are 2 hours in duration for a total of 8 sessions. The family sessions are approximately one hour for a total of 4 sessions. There is a session (either a parent group or a family session) every week.

Recommended Duration:

12 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • School

Homework

Familias Unidas includes a homework component:

The program has 3 homework assignments designed to reinforce program content and to help guide parents in helping adolescents develop prosocial peers and to connect with adolescents’ friends parents.

Languages

Familias Unidas has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • A large enough room to accommodate 12-15 parents is needed in order to conduct the parent group sessions.
  • A small room is needed to conduct the family sessions.
  • A/V equipment is needed to play intervention skills videos.
  • A computer is needed to display information on drug use and sexual risk behaviors.

Education and Training

Prerequisite/Minimum Provider Qualifications

• A minimum of a Bachelor’s degree is necessary to deliver the intervention.

Education and Training Resources

There is a manual that describes how to implement this program , and there is training available for this program.

Pantin et al. FamiliasUnidas. Manual is not published. Manual is accessed through program contact

Training Contact:
  • Yannine Estrada
    phone: (305) 243-6614
Training is obtained:

Onsite and it involves didactic instruction, role plays, and video review of previous FamiliasUnidas sessions.

Number of days/hours:

Training consists on 3-4 days of training, depending on the number of facilitators being trained.

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Familias Unidas.

Formal Support for Implementation

There is formal support available for implementation of Familias Unidas as listed below:

Provision of guidance on intervention implementation, supervision during implementation phase, data analyses, and fidelity ratings.

Supervision will take place with up to 12 facilitators and includes case reviews, discussion of clinical issues, troubleshooting of retention, and feedback based on fidelity ratings. A total of 24 hours of supervision (twelve 2-hour supervision sessions) will be provided. UM raters will complete observational fidelity measures to evaluate whether the intervention is being delivered as designed. This includes assessment of group processes as well as intervention content.

Fidelity Measures

There are fidelity measures for Familias Unidas as listed below:

Study developed fidelity measures that evaluate facilitator adherence to the intervention are used. Measures have been developed to access fidelity for the group sessions and for the family sessions. Training on how to evaluate fidelity is provided. Training is conducted using previous Familias Unidas intervention videos. Fidelity is measured based both on process and content of sessions. Fidelity measures help to identify and rate core prescribed intervention components delivered by the facilitator.

Implementation Guides or Manuals

There are no implementation guides or manuals for Familias Unidas.

Research on How to Implement the Program

Research has not been conducted on how to implement Familias Unidas.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

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

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

Population:

  • Age — Children: 10-14 years (Mean=12.40 years); Adults: Not specified
  • Race/Ethnicity — 100% Hispanic
  • Gender — Children: 102 Male and 76 Female; Adults: Not specified
  • 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 comparison groups, outcomes, measures, notable limitations)
This paper reports a test of the efficacy of Familias Unidas in promoting protection against and reducing risk for adolescent behavior problems. Upon completing the baseline assessment, the families 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 showed 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. 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 postintervention follow-up: 3 months.

Pantin, H., Prado, G., Lopez, B., Huang, S., Tapia, M. I., Schwartz, S. J., ...Branchini, J. (2009). A randomized controlled trial of Familias Unidas for Hispanic adolescents with behavior problems. Psychosomatic Medicine, 71(9), 987-995. doi: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 comparison groups, outcomes, measures, notable limitations)
The present study evaluated 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 Diagnostic Interview Schedule for Children (DISC), and the Parent–Adolescent Communication Scale. Results showed that Familias Unidas was efficacious in reducing substance use, sexual risk behaviors, and externalizing disorders in this at-risk population. The effects of the intervention were partially mediated by improvements in family functioning. Additionally, substance use rates increased for youth in both conditions—increases in substance use in the Community Control condition were substantially greater than those in Familias Unidas. Sexually active adolescents in Familias Unidas reported having been significantly more likely to use condoms during the past 90 days than their counterparts in the Community Control condition. Finally, the incidence of externalizing disorders was substantially greater for youth in Community Control (61%) than for youth in Familias Unidas (32%). Limitations include present sample was not representative of the U.S. Hispanic population and results should not be generalized to all Hispanic adolescents, self-selection biases, and reliance on self-report measures.

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

Prado, G., Cordova, D., Huang, S., Estrada, Y., Rosen, A., Bacio, G. A.,...Villamar, J. (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, S18-S25. doi10.1016/j.drugalcdep.2012.06.011

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

Population:

  • Age — Children: 12-17 years (Mean=14.7 years), Adults: Mean=40.0 years
  • Race/Ethnicity — 100% Hispanic
  • Gender — Children: 156 Male and 86 Female, Adults: 186 Female and 27 Male
  • 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 comparison groups, outcomes, measures, notable limitations)
This study examined 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 showed 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, and results should not be generalized to all Hispanic adolescents, 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 because data on these factors were not collected as part of this study, and control condition was not used in this study.

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

Prado, G., Pantin, H., Huang, S., Cordova, D., Tapia, M. I., Velazquez, M. R., ...Jimenez, G. L. (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.

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

Population:

  • Age — Children: 12-17 years (Mean=14.7); Caregivers: Mean=40.0 years
  • Race/Ethnicity — 100% Hispanic
  • Gender — Children: 156 Male and 86 Female; Caregivers: 186 Female and 27 Male
  • 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 comparison groups, outcomes, measures, notable limitations)
This study utilizes population from Prado, et al. (2012). This study examined 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 showed 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 and results should not be generalized to all Hispanic adolescents, reliance on self-report measures, and control condition was not used in this study.

Length of postintervention follow-up: Approximately 3 months.

Estrada, Y., Lee, T. K., Huang, S., Tapia, M. I., Velázquez, M. R., Martinez, M. J., ...Villamar, J. (2017). Parent-centered prevention of risky behaviors among Hispanic youths in Florida. American Journal of Public Health, 107(4), 607-613.

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 Latino students and their families.

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

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined 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 indicated 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 postintervention follow-up: 1 year.

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., ...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.

The present study evaluated 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 showed 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. Since this study reported on Familias Unidas combined with another intervention, this study was not used in the rating/review process.

Additional References

Prado, G., & Pantin, H. (2011). Reducing substance use and HIV health disparities among Hispanic youth in the USA: The Familias Unidas Program of research. Psychosocial Intervention, 20, 63-73. doi:10.5093/in2011v20n1a6

Contact Information

Yannine Estrada, PhD
Agency/Affiliation: University of Miami
Website: www.familias-unidas.info
Email:
Phone: (305) 243-6614

Date Research Evidence Last Reviewed by CEBC: June 2019

Date Program Content Last Reviewed by Program Staff: July 2019

Date Program Originally Loaded onto CEBC: July 2019