Strengthening Hispanic Families Via NIDA

Recruitment. Participants were recruited according to eligibility criteria, in close
collaboration with community partners. Specifically, health and mental health care centers,
as well as community organizations and churches were targeted for recruitment activities.
Recruitment also consisted of snowball recruitment from participants exposed to the
intervention.

General Description of the Intervention. The Parent Management Training-Oregon model
(GenerationPMTO) intervention is delivered primarily to parents in order to strengthen
parenting skills in a safe learning environment that empower parents to implement these
skills at home. The development of the original GenerationPMTO Spanish manual was conducted
by Dr. Domenech-Rodriguez according to a comprehensive model of cultural adaptation research.

The intervention consisted of GenerationPMTO and culturally-focused sessions. The
GenerationPMTO-focused sessions are detailed in the core treatment manual and have been
translated into Spanish utilizing a rigorous process of translation and consultation with
Hispanic scholars. Culturally-focused sessions integrated content from three sources. First,
we informed sessions according to relevant literature focused on biculturalism. We also
informed the intervention by addressing specific cultural themes that were identified as
salient in our qualitative studies, which correspond to existing literature on risk and
protective factors associated with Hispanic youth. Finally, parents were invited to reflect
on additional cultural values and experiences that they consider relevant to their parenting
efforts.

With regard to content of individual sessions, module 1 addressed issues associated with
immigration, Hispanic culture, and bicultural frameworks. Module 2 addressed issues
associated with parenting and biculturalism. Modules 3-6 covered the GenerationPMTO core
components as they apply to adolescent populations. Module 7 consists of an in-person session
to refine and troubleshoot parenting skills that parents may consider particularly
challenging. To enhance the cultural relevance of GenerationPMTO components, we will present
all GenerationPMTO parenting skills according to bicultural frameworks, a strategy highly
effective the R34 study.

Modules 8-9 reinforced issues of biculturalism having exposed parents to all PMTO core
components. A strong focus on biculturalism is particularly relevant as empirical research
has demonstrated that the promotion of biculturalism constitutes an effective protective
factor for Hispanic youth in first generation Hispanic families.

Randomization. The individual family was the unit of computer-derived randomization, with
PTMO-control balance sought for (a) gender of target youth, and (b) time of recruitment.
Assessments. Data collection was completed after recruitment (T1) and upon intervention
completion (T2).

Intervention Delivery. The intervention was delivered in a major faith-based organization as
this site was the preferred site selected by Latino/a parents. In addition to the parenting
intervention, a strong advocacy approach was implemented to address various needs of parents
(e.g., referral to job training programs or immigration services).

Analyses. Tests of the primary hypothesis will involve fitting of the more assumption-laden
subject-specific multivariate response model to Likelihood of Youth Substance Use (LYUS)
sub-scale values, followed by fitting of the somewhat more conservative Generalized
Estimating Equations (GEE) marginal model with the advantage of fewer assumptions.Our papers
will report crude and covariate-adjusted efficacy estimates from both models, allowing
readers to draw inferences based on either or both approaches. These same models are used to
test the secondary efficacy hypotheses about program impact on parenting skill levels, youth
internalizing/externalizing behaviors, and parent stress levels.

Parent Inclusion Criteria:

- 18 years or older.

- Living in a one or two-parent family household.

- At least one parent self-identifies as foreign-born and first generation Hispanic/a
immigrant, with one or more US-born 12-14 year old children in middle school.

- Spanish speaking.

- Provide written consent to participate in a parenting intervention trial.

- Have access to phone service in home and have home-based internet access.

- Report a combined annual family income is equal or lower than federal income
guidelines for families eligible to receive federal welfare assistance.

Youth inclusion criteria:

- Age 12-14 years old.

- Attending middle school.

- Self-identified as Hispanic or Latino.

- English-, or Spanish-speaking, or bilingual.

- Parent report at least one externalizing problem behavior.

Parent Exclusion Criteria:

- Child Protective Services involvement due to confirmed child abuse or neglect

- History of diagnosis with any severe psychiatric disorder.

Focal Youth exclusion criteria:

- Hispanic validated version of Bird et al. screening test at 'high' level of problem
behaviors.

- One or more of the DSM-IV-TR conduct or oppositional defiant or substance use
disorders

- Documented sexual abuse.