The Feasibility and Acceptability of Familias Unidas in Primary Care: A Pilot Study

Behavioral preventive interventions, including family-based interventions, have been found to be efficacious in preventing/reducing risk behaviors and promoting positive health behaviors among adolescents. Unfortunately, these evidence-based interventions have generally not been disseminated into community practice, where they can have a significant impact. With the passing of the Patient Protection and Affordable Care Act and the growing emphasis on prevention in healthcare, primary care is becoming an ideal setting in which to evaluate and disseminate efficacious/effective preventive interventions. To this end, our team has been examining the feasibility and acceptability of delivering an e-health adaptation of Familias Unidas, a family-centered intervention found to be efficacious and effective in reducing substance use and sexual risk behaviors in Hispanic adolescents.

Thirty three Hispanic youth (M age = 13.9; SD = 1.5) and their parents have been recruited from the waiting areas of two primary care clinics and randomly assigned to either e-health Familas Unidas or one of two control conditions.  90% of families meeting the eligibility criteria were enrolled in just three weeks without major challenges, speaking to the feasibility of enrolling families into a study evaluating the delivery of a family-centered intervention in primary care.  Participants randomized to e-health Familias Unidas have participated at high rates, with most families already completing more than 50% of the sessions (intervention activities are still ongoing). Thus far, ongoing qualitative data collection from study participants suggest that the intervention is highly acceptable. Similar qualitative data collected from clinic physicians and staff suggest that it is feasible to deliver an evidence-based preventive intervention within primary care without major disruption to clinic flow and without staff burnout. However, specific recommendations, such as the need for the researchers to provide an orientation to all clinic staff about the recruitment process have been made. Focus groups will be conducted to further assess the physicians and medical staff’s perspective on the feasibility of delivering e-health Familias Unidas in their clinic in the future.

In summary, primary care represents an important venue in which to integrate evidence-based preventive interventions.  As our healthcare system moves from one focused on “sick care” to one focused on “well care,” it is important to establish the effectiveness of preventive interventions in primary care settings. Studies such as the feasibility and acceptability study conducted by our team are yielding critical information necessary to pave the way for large-scale effectiveness and implementation studies in this setting.