A family-based intervention to promote protection against, and reduce risk for, behavior problems, illicit drug use, alcohol use, cigarette use, and unsafe sexual behavior in Hispanic youth and adolescents.
- Illicit Drug Use
- Sexual Risk Behaviors
- Alcohol Prevention and Treatment
- Drug Prevention/Treatment
- Parent Training
- Community (e.g., religious, recreation)
Continuum of Intervention
- Selective Prevention (Elevated Risk)
- Early Adolescence (12-14) - Middle School
- Late Adolescence (15-18) - High School
- Male and Female
- Hispanic or Latino
- : Inconclusive Evidence
- : Promising
- : Promising
- : 3.8-3.9
Program Information Contact
1425 NW 10th Avenue
Miami, FL 33136
- Hilda Pantin, PhD
- University of Miami
Brief Description of the Program
Familias Unidas™ Preventive Intervention is a multilevel family-based intervention designed to prevent problem behaviors in Hispanic adolescents. The program engages Hispanic immigrant parents in an empowerment process in which they first build a strong parent-support network and then use the network to increase knowledge of culturally relevant parenting, strengthen parenting skills, and then apply these new skills in a series of activities designed to reduce risks frequently found in poor, urban environments. The program is designed to prevent conduct disorders; use of illicit drugs, alcohol, and cigarettes; and risky sexual behaviors by improving family functioning.
The program is also influenced by culturally specific models developed for Hispanic populations in the United States, and is delivered primarily through multi-parent groups, which aim to develop effective parenting skills, and family visits, during which parents are encouraged to apply those skills while interacting with their adolescent. The multi-parent groups, led by a trained facilitator, meet in 8 to 9 weekly 2-hour sessions for the duration of the intervention. Each group has 10 to 15 parents, with at least 1 parent from each participating family. Sessions include problem posing and participatory exercises. Group discussions aim to increase parents' understanding of their role in protecting their adolescent from harm and to facilitate parental investment. The program also includes 4 to 10 1-hour family visits.
See: Full Description
Pantin et al., 2003
- Familias Unidas demonstrated a steady decline in behavior problems across all data collection points, but at 12 months (3 months after intervention) the treatment and control groups looked similar.
- There was no significant Time x Condition interaction on School Bonding/Academic Achievement.
Pantin et al., 2009
- Relative to a control group, Familias Unidas had a lower rate of increase in substance use at 30 months post-baseline.
- Increased level of condom use among sexually active youth from 6 to 30 months post-baseline.
- Overall prevalence of externalizing behavior, although growth model showed no significant difference.
- No significant difference in engaging in sexual intercourse.
Prado, Pantin et al., 2012: Among participants who reported having had sex in the past 90 days
- Reduction in inconsistent condom use during vaginal (39%) and anal (60%) intercourse, relative to controls.
- Reduction in the number of days (.40 days) of having unprotected sex while under the influence of drugs or alcohol.
- Lower numbers of sexual partners.
Prado, Cordova et al., 2012
- Reduction in reported illicit drug use from 29.1% at baseline to 22.5% at 9-month follow-up, relative to community practice whose use increased from 23.1% at baseline to 31.3%.
- Reduction in the percentage of adolescents with an alcohol dependence diagnosis from 15.8% to 5.4%, relative to community practice whose diagnosis increased from 6.6% to 8.1%.
- No change in the proportion of youth having had sex under the influence of alcohol or drugs from baseline to 9-month follow-up. Community practice's proportion of youth having had sex while under the influence of alcohol or drugs increased from 12.5% to 34.9%.
Estrada et al., 2015
- Significantly lowered sexual initiation rate relative to the control group
- Significantly improved adolescent-reported positive parenting scores at 6-month follow-up
Estrada et al., 2017
- Significantly less frequent drug use in past 90 days compared with control group
- Significantly improved condom use in the last 90 days compared with control group
Molleda et al., 2016
- Significant reduction in conduct problems at three months
Significant Program Effects on Risk and Protective Factors:
- Familias Unidas increased parental investment more than the control condition (Pantin et al., 2003)
- Greater improvements in family functioning (e.g., parent-adolescent communication, positive parenting, and parental monitoring of peers) (Pantin et al., 2009; Prado, Pantin et el., 2012).
- Changes in family functioning partially mediated the effects of the intervention condition on substance use (Prado et al., 2007; Pantin et al., 2009).
- Parental monitoring of peers and overall family functioning (Estrada et al., 2017)
- Parent-adolescent communication (Molleda et al., 2016)
Familias Unidas™ Preventive Intervention is a Hispanic-specific program, and as such targets Hispanic immigrant families with adolescent children.
Risk and Protective Factors
- Individual: Early initiation of antisocial behavior, Substance use*
- Family: Low socioeconomic status, Neglectful parenting*, Poor family management*
- School: Low school commitment and attachment
- Family: Attachment to parents*, Parent social support
*Risk/Protective Factor was significantly impacted by the program.
Training and Technical Assistance
The Familias Unidas training includes four full days of in-depth training on the program. During the four-day period, facilitators are trained on 32-hours of program content via program review (i.e., overview of Familias Unidas, rationale, theoretical framework, intervention activities and strategies), role-plays and open discussion regarding the applicability of program content to schools, community prevention/treatment centers and other community settings serving Hispanic adolescents and families. Moreover, goals and outcomes for each group session and family visit are well defined in terms of clinical processes, materials needed, and intervention strategies. The fourth day of training requires that training participants present an assigned segment of the program to the group as though implementing those activities with families. Facilitators must complete the full four-day training, in order to become a certified Familias Unidas-Facilitator. Technical assistance is available during all phases of program adoption (e.g., organizing the training) and implementation (e.g., recruitment, evaluation) to ensure program success.
Training Certification Process
The Familias Unidas Training process involves an individual’s transition from facilitator to trainer. After a Familias Unidas facilitator has implemented Familias Unidas with a three-person implementation team at least six times, he/she is eligible to participate in the Training-of-Trainer (TOT) process. The cost for participating in a TOT is $3,500, plus the cost of travel to a four-day Training-of-Facilitators (TOF). This price includes a site visit conducted by a master trainer to observe the new trainer as he/she implements their first TOF with their agency.
During this facilitator training, the Trainer in Training (TT) operates as part of the standard training team. Details regarding the TOT process are outlined below.
Steps for Becoming a Familias Unidas Trainer:
Contact the University of Miami’s Center for Family Studies. Once aware of the interest, the Familias Unidas team will inform the agency and potential Trainer in Training (TT) of upcoming TOFs. The TT is expected to participate in the TOF as the critical part of their TOT process. The TOT occurs at a designated TOF. The trainer in training (TT) operates as part of the training team during the TOF. This is a core component of the TOT. As part of the training team, the TT will participate in:
- Conference calls that occur prior to the TOF in order to assign diverse program components for the training, discuss the overall structure of the training, and review clinical processes that will be discussed and specific activities that will occur or be discussed during the training.
- Pre-training meeting that occurs the day before TOF Day #1. This is a face-to-face meeting to orient the TT to the materials, structure and general culture of Familias Unidas TOFs. The meeting will also allow for the TT to help set up and get oriented to the training venue prior to the training.
- Debriefing meetings happen on each of the four training days. The TOT debriefing will provide constructive feedback that addresses TT strengths and areas for improvement in the training process. The TT is asked to provide feedback that can contribute to a better TOT and TOF.
Brief Evaluation Methodology
Familias Unidas™ Preventive Intervention has been evaluated in four randomly controlled studies. The first study (Pantin et al., 2003) was a mixed-model design using random assignment to either the treatment or a no-treatment control group. A total of 167 Hispanic families of 6th and 7th grade students from three South Florida public schools were stratified by grade within each school and randomly assigned to intervention and no-intervention control conditions.
The second study evaluated the efficacy of Familias Unidas combined with Parent-Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention, in preventing adolescent substance use and unsafe sexual behavior (Prado et al., 2007). Adolescents and their families from three Florida middle schools were randomly assigned to one of three conditions: Familias Unidas Plus PATH, English for Speakers of Other Languages (ESOL) plus PATH, or ESOL plus HeartPower! for Hispanics (HEART).
The third study (Pantin et al., 2009) randomly assigned 213 8th grade students at-risk for problem behaviors in three Florida middle schools to treatment or control. Control families received three referrals to agencies in their catchment area that serve youth with behavior problems. Assessments were completed at baseline, and at 6, 18, and 30 months post-baseline.
The fourth study (Prado, Cordova et al., 2012; Prado, Pantin et al., 2012) randomly assigned 242 delinquent Hispanic adolescents (age 12-17 years) to either the Familias Unidas intervention (N=120) or a community practice control group (N=122). The intervention sought to reduce past 90-day substance use, alcohol and marijuana dependence, and risky sexual behavior among adolescents and to improve family functioning. Assessments were conducted at baseline, posttest (6 months post baseline), and 9-month follow-up (one year post baseline).
The fifth study (Estrada et al., 2015) randomly assigned 160 ninth-grade Hispanic students to either a shortened 6-week Familias Unidas intervention condition (N=72), or a community-practice control group (N=82). Assessments were completed at baseline, and at 6, 12, and 24 months postintervention.
The sixth study (Estrada et al. 2017) randomly assigned 746 eighth-grade Hispanic students to either a 3-month Familias Unidas intervention (N=376) or a prevention-as-usual control group (N=370). The authors assessed past 90-day substance use and risky sexual behavior at baseline, post-test, three, fifteen, and twenty-seven months afterward. A supplemental study (Vidot et al., 2016) explored the role of parent-adolescent communication on suicide thoughts and attempts.
The seventh study (Molleda et al., 2016) randomly assigned 239 families from two schools in Ecuador to the 3-month Familias Unidas intervention (N=129) or Community Practice control group (N=110). Data were collected at baseline and at the conclusion of the three-month program. The authors assessed parent reports of adolescent conduct problems and family functioning (parent-adolescent communication and parental monitoring of peers).
Peer Implementation Sites
467 Creamery Way
Exton, Pa. 19341
Estrada, Y., Rosen, A., Huang, S., Tapia, M., Sutton, M., Willis, L., ... Prado, G. (2015). Efficacy of a brief intervention to reduce substance abuse and human immunodeficiency virus infection risk among Latino youth. Journal of Adolescent Health, 57, 651-657.
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, 189-201.
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, 987-995.
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 abuse and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75, 914- 926.
Prado, G., Cordova, D., Huang, S., Estrada, Y., Rosen, A., Bacio, G. A., ... 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 (Suppl 1), S18-S25.
Prado, G., Pantin, H., Huang, S., Cordova, D., Tapia, M. I., Velasquez, M. R., ... Estrada, Y. (2012). Effects of a family intervention in reducing HIV risk behaviors among high-risk Hispanic adolescents: A randomized controlled trial. Archive of Pediatric and Adolescents Medicine, 166 (2), 127-133.