Adapting and Testing the Feasibility and Acceptability of Familias Unidas in Chile

Introduction: Substance use and sexual risk taking among Hispanic youth are serious concerns both in the U.S. and in Latin America. Unfortunately, unlike in the U.S., preventive interventions implemented in Latin American are generally not adapted for the new context/population or evaluated. Familias Unidas is a family-centered intervention found to be efficacious and effective in reducing substance use and sexual risk behaviors in Hispanic youth living in the U.S. The effects of Familias Unidas on substance use and sexual risk behaviors in the U.S. have been partially mediated by improvements in family functioning.  The goal of the proposed study was to adapt Familias Unidas for the Chilean adolescent population and to evaluate the feasibility and acceptability of delivering the adapted Familias Unidas in this new context.

Methods: The developers of the Familias Unidas intervention and the staff of the San José de Maipo Foundation in Chile met over a two day period in Miami, FL and then over a 5-day period in Chile to discuss whether to what extent adaptations had to be made to the Familias Unidas intervention. After adaptions were made, a pilot test of 42 families was conducted to assess the feasibility and acceptability of delivering Familias Unidas in three communities in Chile. A non-experimental design with baseline and post-baseline assessments were conducted.  

Results:  Adaptations to the intervention discussed and made during the two working meetings between the intervention developers and the Chilean team consisted of surface level adaptations (e.g., language idiosyncrasies). These adaptations were made prior to beginning the pilot study.  Participants enrolled in the study consisted of 42 Chilean youth (M age= 13.31; SD= 1.137) and their primary care givers (M age= 39.07; SD= 6.964).  Primary caregivers were mostly mothers (78.6 %). The average session attendance of the intervention is 8.9 (SD = 2.678) and the average fidelity is 4.84 on a scale ranging from 0 to 7, with 7 indicating perfect fidelity. Additionally, although not statistically significant, preliminary results show moderate improvements in family functioning between baseline and 3-months post baseline assessments. 

Conclusions: This study demonstrates the feasibility of implementing an evidence-based family intervention developed for Hispanic youth in the U.S. in Latin America. Results suggest that it is possible to implement Familias Unidas with high fidelity with only four days of training.  Moreover, the results suggests that moderate effect sizes similar to those in the U.S. can be observed. The San José de Maipo Foundation is currently planning to conduct a powered randomized controlled trial of Familias Unidas.