Outcomes of a Culturally Adapted Behavioral Health Prevention Program

Introduction: Behavioral health disparities continue to negatively impact ethnic and racial minority populations, especially for Latinos (e.g., Alegria et al., 2011; Lara et al., 2005; Napoles & Stuart, 2018). To reduce disparities, behavioral health programs must be effective in reaching and influencing subcultural groups. While there are a plethora of curriculum-based family prevention programs that claim to be culturally appropriate for use with minority families, there exist few programs that adequately address the needs of Latino families living in the U.S. (e.g., Cervantes et al., 2011; Chapman & Perreira, 2005; Maldonado-Molina, 2006). Many prevention programs have been culturally adapted to varying degrees. This study focuses on one such program, Familias Unidas (FU). The objectives of the study were to: (1) assess improvements in family functioning after participation in FU and (2) explore whether level of acculturation would affect these outcomes.

Methods: Families were administered a pre and posttest measuring parenting skills, protective factors, and parent-child relationships. Participants included 372 individuals (youth = 197, parents = 175). Youth ranged in age from 10 – 18. In terms of acculturation, the sample was equally divided among low acculturation (51%) and high acculturation (49%).

A categorical variable of acculturation (low/high) served as the independent variable in all statistical analyses. Dependent variables included posttest scores on several subscales. Pretest scores served as covariates. Paired sample t-tests were run to assess differences from pretest to posttest. Three separate MANCOVAs were used to assess differences between low and high acculturated families on aforementioned variables.

Results: Paired sample t-tests revealed significant desired results. Both parents and youth had significantly improved from pretest on the target variables. Familias Unidas had a positive effect on parent-child interaction t (134) = 2.94: p < .01 and less conflict t (88) = -2.15: p < .05. Parents reported an increase in parenting skills t (131) = 2.83: p < .01. Youth who participated in the program reported decreased engagement in sexual risk behaviors and an increase in their ability to refuse sexual activity t (176) = 1.99: p < .05. Youth also had a significant decrease in aggressive and hostile behaviors t (155) = 2.07: p < .05.

Pretest to posttest group differences were examined using three separate one-way MANCOVAs. One focused on differences in youth outcomes, another on differences in parent outcomes and the last one on differences in the relationship between youth and parent from pretest to posttest. However, the MANCOVAs produced no significant results.

Conclusion: The findings did not substantiate the hypothesis that acculturation would affect differences in family functioning after participation in FU, suggesting that this prevention program can be equally applicable to Latino families regardless of their level of acculturation. Possible explanations for this finding include: inadequate measure of acculturation, the issues addressed in FU cut across cultural lines, and/or FU facilitators made additional cultural adaptations.