Familias Unidas' Impact on Suicide Ideation and Behaviors Among Hispanic Adolescents: Preliminary Results from an Effectiveness Trial

Introduction: Suicide is the third leading cause of death among adolescents in the United States. Literature suggests that adolescents who engage in health risk behaviors, such as drug use, are at a higher risk of engaging in suicidal behavior than their peers. On the contrary, parenting style/family functioning has been found to be protective of such health risks and suicidal behaviors among adolescents. Familias Unidas is a family-centered, evidence-based intervention shown to be efficacious at preventing and reducing problem behaviors, such as drug use and risky sexual behaviors in Hispanic adolescents. The purpose of this study is to examine the relative impact of Familias Unidas on suicidal ideation and attempts among Hispanic adolescents. This study also examines mediators of intervention effectiveness as well as moderators. Methods: Data are from an ongoing effectiveness trial of Familias Unidas in middle schools across Miami-Dade County. Hispanic 8th graders (N=746; 52% male; 13.8 years old [SD: 0.67]) and their primary caregivers were randomly assigned to one of two study conditions: Familias Unidas or Community Practice.  The intervention is delivered through parent group sessions and family visits in which parents develop skills to improve family functioning. Participants were assessed at baseline, 6-, 18-, and 30-months post baseline. DISC Predictive Scales (DPS) were administered to adolescents via QDS to determine suicide ideation (ever) and attempt (in last year). Analysis of a partial dataset of quality assured data was conducted.  Comparisons between Familias Unidas and the Control group were examined at baseline and 6-month follow-up to determine short-term impact of intervention on suicidal behaviors.  Gender and drug use were examined as potential moderators of intervention effectiveness.  Results:  Nine percent (95% CI= 7.3% to 11.6%) of adolescents in the sample reported suicide ideation; 6% (95% CI=4.1% to 7.7%) reported an attempt in the last year. The prevalence of suicidal ideation among females was 11% compared to 7.7% in males. At baseline, 8.6% of the adolescents reported substance use in the last 90-days. The prevalence of suicidal ideation among adolescents who used substance was 16.4% compared to 8.6% in those who didn’t report substance use. Preliminary analyses showed that adjusting for baseline, youth randomized to Community Practice were 110% more likely to reported suicide ideation (OR=2.1), and 196% more likely to reported an attempt (OR=2.96) than youth randomized to Familias Unidas. Conclusions: Preliminary results suggest that Familias Unidas reduces suicidal behaviors among Hispanic adolescents at 6-month follow-up. Future work will examine the trajectory over the duration of the trial and pay special attention to the role parenting style and family functioning as potential moderators of the intervention effectiveness.