Predictors of Participation in an Ehealth, Family-Based Preventive Intervention for Hispanic Youth

Introduction: The Familias Unidas intervention is an efficacious family-based preventive intervention for reducing substance use and other health risks among Hispanic youth. A current randomized controlled trial (RCT) is examining this intervention’s efficacy when delivered via the Internet (eHealth). eHealth interventions can overcome logistical barriers to participation, yet there is limited information about the feasibility of these interventions, especially among ethnic minorities. This presentation examines participation rates and predictors of participation in the eHealth Familias Unidas intervention.

Methods: The sample consisted of 100 Hispanic families whose adolescent had behavioral problems. We first compare participation rates in eHealth and previous face-to-face Familias Unidas trials. Next, to explore factors associated with participation in eHealth Familias Unidas, analyses estimated four models using structural equation modeling with each of four participation dependent variables, including: 1) initial engagement (participating in at least 1 of the first 3 intervention sessions), 2) total intervention participation; 3) participating in the live, facilitator-led, eHealth family sessions, and 4) completing the pre-recorded, eHealth parent group sessions.

Results: Participation in this eHealth intervention was comparable to, and in most cases higher than, previous face-to-face Familias Unidas interventions. High levels of baseline effective parenting were significantly associated with lower levels of participation for all four attendance outcome variables. High levels of baseline family stress were associated with lower initial engagement only. High youth behavior problems at baseline were unrelated to initial engagement, but were related to less participation at eHealth family sessions, eHealth parent group sessions, and across the intervention. In terms of acculturation, higher levels of Hispanicism were not associated with initial engagement but were associated with greater participation in eHealth family sessions, eHealth group sessions, and total attendance.

Conclusions: Strong participation rates suggest that eHealth Familias Unidas is a feasible intervention for these Hispanic families. Analyses of factors associated with engagement and participation suggest that there are certain subgroups that require special attention to maximize participation. Implications for preventive interventions delivered via the Internet are discussed.