Skip to main content
Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2005 Sep;82(Suppl 3):iii92–iii102. doi: 10.1093/jurban/jti067

Methodological challenges in designing efficacious drug abuse and HIV preventive interventions for hispanic adolescent subgroups

Hilda Pantin 1,, Guillermo Prado 1, Seth J Schwartz 1, Summer Sullivan 1
PMCID: PMC3455903  PMID: 15933335

Abstract

This article focuses on designing and evaluating drug abuse and HIV prevention interventions for subgroups of Hispanic adolescents. It describes the need for preventive interventions designed or adapted specifically for Hispanic adolescents and offers a rationale for subgrouping Hispanic adolescents based on risk and protective factor profiles rather than demographic indices. This subgrouping method is based on intrapersonal and ecodevelopmental domains of risk and protection. Finally, the article presents methods for designing, adapting, and evaluating “flexible” interventions for use with Hispanic adolescent subgroups.

Keywords: Drug abuse, Hispanic adolescents, HIV, Preventive interventions

Full Text

The Full Text of this article is available as a PDF (100.3 KB).

Footnotes

Hilda Pantin and Guillermo Prado contributed equally to this work.

References

  • 1.Ramirez RR, Cruz GP. The Hispanic Population in the United States: March 2002: Population Characteristics. Washington, DC: U.S. Census Bureau; 2003. pp. 20–545. [Google Scholar]
  • 2.Johnston L, O’Malley P, Bachman J. National Survey Results on Drug Use From the Monitoring the Future Study, 1975–1995, Volume I: Secondary School Students. Rockville, MD: National Institute on Drug Abuse; 1996. [Google Scholar]
  • 3.HIV/AIDS Surveillance Report. Atlanta, GA: CDC-P Division of HIV/AIDS Prevention; 2003. pp. 14–14. [Google Scholar]
  • 4.Centers for Disease Control and Prevention Surveillance summaries. MMWR Morb Mortal Wkly Rep. 2004;53:SS–2. [Google Scholar]
  • 5.Canino G, Shrout P, Alegria M, et al. Methodological challenges in assessing children’s mental health services utilization: cross cultural considerations. Ment Health Serv Res. 2002;4:97–105. doi: 10.1023/A:1015252217154. [DOI] [PubMed] [Google Scholar]
  • 6.Wallace JM, Muroff JR. Preventing substance abuse among African American children and youth: race differences in risk factor exposure and vulnerability. J Prim Prev. 2002;22:235–261. doi: 10.1023/A:1013617721016. [DOI] [Google Scholar]
  • 7.Vega W, Aguilar-Gaxiola S, Andrade L, et al. Prevalence and age of onset for drug use in seven international sites: results from the International Consortium of Psychiatric Epidemiology. Drug Alcohol Depend. 2002;68:285–297. doi: 10.1016/S0376-8716(02)00224-7. [DOI] [PubMed] [Google Scholar]
  • 8.Centers for Disease Control and Prevention. Human immunodeficiency virus (HIV) deaths by race/ethnicity and specified origin: United States and Puerto Rico, 1999. Available at: http://www.cdc.gov/NCHS/data/hpdata2010/chcsummit.pdf. Accessed August 10, 2004.
  • 9.Vega WA, Amaro H. Latino. outlook: good health, uncertain prognosis. Annu Rev Public Health. 1994;15:39–67. doi: 10.1146/annurev.pu.15.050194.000351. [DOI] [PubMed] [Google Scholar]
  • 10.Amaro H. National strategic plan on Hispanic drug abuse research. In: Amaro H, Cortes DE, editors. National Strategic Plan on Hispanic Drug Abuse Research: From Molecule to the Community. Boston: Northeastern University Institute on Urban Research; 2003. [Google Scholar]
  • 11.Griffin KW, Botvin GJ, Nichols TR, Doyle MM. Effectiveness of a universal drug abuse prevention intervention approach for youth at high risk for substance use initiation. Prev Med. 2003;36:1–7. doi: 10.1006/pmed.2002.1133. [DOI] [PubMed] [Google Scholar]
  • 12.Jemmott JB, Jemmott LS, Fong GT. Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention. Am J Public Health. 1992;82:372–377. doi: 10.2105/ajph.82.3.372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.McKay M, Chase K, Paikoff R, et al. Family-level impact of the CHAMP family program: a community collaborative effort to support urban families and reduce youth HIV exposure. Fam Process. 2004;43:79–93. doi: 10.1111/j.1545-5300.2004.04301007.x. [DOI] [PubMed] [Google Scholar]
  • 14.Rotheram-Borus MJ, Koopman C, Haignere C, Davies M. Reducing HIV sexual risk behaviors among runaway adolescents. JAMA. 1991;266:1237–1241. doi: 10.1001/jama.266.9.1237. [DOI] [PubMed] [Google Scholar]
  • 15.DiClemente RJ, Wingood GM, Harrington KF, et al. Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial. JAMA. 2004;292:171–179. doi: 10.1001/jama.292.2.171. [DOI] [PubMed] [Google Scholar]
  • 16.Gonzalez-Castro F, Barrera M, Pantin H, et al. Prevention research with Hispanic populations. In: Amaro H, Cortes DE, et al., editors. National Strategic Plan on Hispanic Drug Abuse Research: From Molecule to the Community. Boston: Northeastern University Institute on Urban Research; 2003. [Google Scholar]
  • 17.Krauss BJ, Godfrey C, Yee D, et al. Saving our children from a silent epidemic: the PATH program for children and adolescents. In: Pequegnat W, Szapocznik J, et al., editors. Working with Families in the Era of HIV/AIDS. Thousand Oaks, CA: Sage; 2000. pp. 89–112. [Google Scholar]
  • 18.Castro FG, Barrera M, Martinez CR. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5:41–45. doi: 10.1023/B:PREV.0000013980.12412.cd. [DOI] [PubMed] [Google Scholar]
  • 19.Kumpfer KL, Alvarado R, Smith P, Bellamy N. Cultural sensitivity and adaptation in family-based prevention interventions. Prev Sci. 2002;3:241–246. doi: 10.1023/A:1019902902119. [DOI] [PubMed] [Google Scholar]
  • 20.Prado G, Pantin H, Schwartz S, Lupei N, Szapocznik J. Predictors of engagement and retention in a family-centered substance abuse and HIV preventive intervention for Hispanic adolescents. J Pediatr Psychol. In press. [DOI] [PubMed]
  • 21.Barrera M, Jr, Castro FG, Biglan A. Ethnicity, substance use, and development: exemplars for exploring group differences and similarities. Dev Psychopathol. 1999;11:805–822. doi: 10.1017/S0954579499002333. [DOI] [PubMed] [Google Scholar]
  • 22.Villarruel AM, Gallegos EC, Cherry CJ, Duran MR. La uniendo de fronteras: collaboration to develop HIV prevention strategies for Mexican and Latino youth. J Transcult Nurs. 2003;14:193–206. doi: 10.1177/1043659603014003006. [DOI] [PubMed] [Google Scholar]
  • 23.Pantin H, Schwartz S, Sullivan S, Prado G, Szapocznik J. Ecodevelopmental HIV prevention programs for Hispanic adolescents. Am J Orthopsychiatry. 2004;74:545–558. doi: 10.1037/0002-9432.74.4.545. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Szapocznik J, Coatsworth JD. An ecodevelopmental framework for organizing the influences on drug abuse: a developmental model for risk and prevention. In: Glantz M, Hartel CR, editors. Drug Abuse: Origins and Interventions. Washington, DC: American Psychological Association; 1999. [Google Scholar]
  • 25.Collins LM, Murphy SA, Bierman KL. A conceptual framework for adaptive preventive interventions. Prev Sci. 2004;5:185–196. doi: 10.1023/B:PREV.0000037641.26017.00. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Szapocznik J, Feaster DJ, Mitrani VB, et al. Structural Ecosystems Therapy for HIV-seropositive African American women: effects on psychological distress, family hassles. and family support. J Consult Clin Psychol. 2004;72:288–303. doi: 10.1037/0022-006X.72.2.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Gil AG, Vega WA, Biafora F. Temporal influences of family structure and family risk factors on drug use initiation in a multiethnic sample of adolescent boys. J Youth Adolesc. 1998;27:373–393. doi: 10.1023/A:1022807221074. [DOI] [Google Scholar]
  • 28.Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol Bull. 1992;112:64–105. doi: 10.1037/0033-2909.112.1.64. [DOI] [PubMed] [Google Scholar]
  • 29.Ajzen I, Fishbein M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice Hall; 1980. [Google Scholar]
  • 30.O’Leary A, Maibach E, Ambrose TK, Jemmott JB, Celentano DD. Social cognitive predictors of sexual risk behavior change among STD clinic patients. AIDS Behav. 2000;4:309–316. doi: 10.1023/A:1026474804172. [DOI] [Google Scholar]
  • 31.Barkin SL, Smith KS, DuRant RH. Social skills and attitudes associated with substance use behaviors among young adolescents. J Adolesc Health. 2002;30:448–454. doi: 10.1016/S1054-139X(01)00405-0. [DOI] [PubMed] [Google Scholar]
  • 32.Sutherland I, Shepherd JP. Adolescents’ beliefs about future substance use: a comparison of current users and non-users of cigarettes, alcohol and illicit drugs. J Adolesc. 2002;25:169–181. doi: 10.1006/jado.2002.0459. [DOI] [PubMed] [Google Scholar]
  • 33.Hadjicostandi J, Cheurprakobkit S. Drugs and substances: views from a Latino community. Am J Drug Alcohol Abuse. 2002;28:693–710. doi: 10.1081/ADA-120015877. [DOI] [PubMed] [Google Scholar]
  • 34.Jemmott JB, Jemmott LS, Fong GT. Abstinence and safer sex HIV risk reduction interventions for African-American adolescents: a randomized controlled trial. JAMA. 1998;279:1529–1536. doi: 10.1001/jama.279.19.1529. [DOI] [PubMed] [Google Scholar]
  • 35.DiClemente RJ, Durbin M, Siegel D. Determinants of condom use among junior high school students in a minority, inner-city school district. Pediatrics. 1992;89:197–201. [PubMed] [Google Scholar]
  • 36.Garbarino J, Abramowitz RH. The Ecology of Human Development. In: Garbarino J, editor. Children and Families in the Social Environment. New York, NY: Aldine de Gruyter; 1992. [Google Scholar]
  • 37.Coatsworth JD, Pantin H, Szapocznik J. Familias Unidas: a family-centered ecodevelopmental intervention to reduce risk for problem. behavior among Hispanic adolescents. Clin Child Fam Psychol Rev. 2002;5:113–132. doi: 10.1023/A:1015420503275. [DOI] [PubMed] [Google Scholar]
  • 38.O’Sullivan L, Jaramillo B, Moreau D, Meyer-Bahlburg H. Mother-daughter communication about sexuality in a clinical sample of Hispanic adolescent girls. Hisp J Behav Sci. 1999;21:447–469. [Google Scholar]
  • 39.Mason CA, Cauce AM, Gonzalez N, Hiraga Y. Neither too sweet nor too sour: problem peers, maternal control and problem behavior in African American adolescents. Child Dev. 1996;67:2115–2130. [PubMed] [Google Scholar]
  • 40.Patterson G, Stouthamer-Loeber M. The correlation of family management practices and delinquency. Child Dev. 1984;55:299–1307. doi: 10.2307/1129999. [DOI] [PubMed] [Google Scholar]
  • 41.Perkins DF, Luster T, Villarruel FA, Small S. An ecological, risk factor examination of adolescent’s sexual activity in three ethnic groups. J Marriage Fam. 1998;60:660–673. doi: 10.2307/353536. [DOI] [Google Scholar]
  • 42.Felix-Ortiz M, Fernandez A, Newcomb MD. The role of intergenerational discrepancy of cultural orientation in drug use among Latina adolescents. Subst Use Misuse. 1998;33:967–994. doi: 10.3109/10826089809056251. [DOI] [PubMed] [Google Scholar]
  • 43.Vega WA, Gil AG. A model for explaining drug use behavior among Hispanic adolescents. Drugs Soc. 1998;14:57–74. [Google Scholar]
  • 44.Ford K, Norris A. Urban Hispanic adolescents and young adults: relationship of acculturation to sexual behavior. J Sex Res. 1993;30:316–323. doi: 10.1080/00224499309551718. [DOI] [Google Scholar]
  • 45.Newcomb MD, Wyatt GE, Romero GJ. Acculturation, sexual risk taking, and HIV health promotion among Latinas. J Couns Psychol. 1998;45:454–467. doi: 10.1037/0022-0167.45.4.454. [DOI] [Google Scholar]
  • 46.Kaplan CP, Napoles-Springer A, Stewart SL, Perez-Stable E. Smoking acquisition among adolescents and young Latinas: the role of socioenvironmental and personal factors. Addict Behav. 2001;26:531–550. doi: 10.1016/S0306-4603(00)00143-X. [DOI] [PubMed] [Google Scholar]
  • 47.King KM, Chassin L. Mediating and moderated effects of adolescent behavioral undercontrol and parenting in the prediction of drug use disorders in emerging adulthood. Psychol Addict Behav. 2004;18:239–249. doi: 10.1037/0893-164X.18.3.239. [DOI] [PubMed] [Google Scholar]
  • 48.Musher-Eizenman DR, Holub SC, Arnett M. Attitude and peer influences on adolescent substance use. The moderating effect of age, sex, and substance. J Drug Educ. 2003;33:1–23. doi: 10.2190/YED0-BQA8-5RVX-95JB. [DOI] [PubMed] [Google Scholar]
  • 49.Boone TL, Lefkowitz ES. Safer sex and the health belief model: considering the contributions of peer norms and socialization factors. J Psychol Hum Sex. 2004;16:51–68. doi: 10.1300/J056v16n01_04. [DOI] [Google Scholar]
  • 50.Blum RW, McNeely C, Nonnemaker J. Vulnerability, risk and protection. J Adolesc Health. 2002;31S:28–39. doi: 10.1016/S1054-139X(02)00411-1. [DOI] [PubMed] [Google Scholar]
  • 51.Masten AS, Coatsworth JD. The development of competence in favorable and unfavorable environments: lessons from research on successful children. Am Psychol. 1998;53:205–220. doi: 10.1037/0003-066X.53.2.205. [DOI] [PubMed] [Google Scholar]
  • 52.Chassin L, Pitts SC, DeLucia C, Todd M. A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression. J Abnorm Psychol. 1999;108:106–119. doi: 10.1037/0021-843X.108.1.106. [DOI] [PubMed] [Google Scholar]
  • 53.Tang CSK, Wong CSY, Schwarzer R. Psychosocial differences between occasional and regular adolescent users of marijuana and heroin. J Youth Adolesc. 1996;25:219–239. doi: 10.1007/BF01537345. [DOI] [Google Scholar]
  • 54.Shedler J, Block J. Adolescent drug use and psychological health: a longitudinal inquiry. Am Psychol. 1990;45:612–630. doi: 10.1037/0003-066X.45.5.612. [DOI] [PubMed] [Google Scholar]
  • 55.Epstein JA, Griffin KW, Botvin GJ. Positive impact of competence skills and psychological wellness in protecting inner-city adolescents from alcohol use. Prev Sci. 2002;3:95–104. doi: 10.1023/A:1015479216401. [DOI] [PubMed] [Google Scholar]
  • 56.Szapocznik J, Santisteban D, Rio A, et al. Family effectiveness training: an intervention to prevent drug abuse and problem behaviors in Hispanic adolescents. Hisp J Behav Sci. 1989;11:4–27. [Google Scholar]
  • 57.Milligan GW. Clustering validation: results and implications for analyses. In: Arabie P, Hubert LJ, DeSoto G, editors. Clustering and Classification. River Edge, NJ: World Scientific; 1996. pp. 341–375. [Google Scholar]
  • 58.Nunnally JC, Bernstein IH. Psychometric Theory. New York, NY: McGraw-Hill; 1994. [Google Scholar]
  • 59.Muthén B. Statistical and substantive checking in growth mixture modeling. Psychol Methods. 2003;8:369–377. doi: 10.1037/1082-989X.8.3.369. [DOI] [PubMed] [Google Scholar]
  • 60.Muthén B, Brown C, Masyn K, Jo B, Khoo ST, Yang CC. General growth mixture modeling for randomized preventive interventions. Biostatistics. 2002;3:459–475. doi: 10.1093/biostatistics/3.4.459. [DOI] [PubMed] [Google Scholar]
  • 61.Raudenbush SW, Bryk AS. Hierarchical Linear Models. Applications and Data Analysis Methods. 2nd ed. Thousand Oaks, CA: Sage; 2002. [Google Scholar]
  • 62.Duncan TE, Ducan SC, Strycker LA, Li F, Alpert A. An Introduction to Latent Variable Growth Curve Modeling: Concepts, Issues, and Applications. Mahwah, NJ: Lawrence Erlbaum Associates; 1999. [Google Scholar]
  • 63.Delucchi K, Bostrom A. Small sample longitudinal clinical trials with missing data: a comparison of analytic methods. Psychol Methods. 1999;4:158–172. doi: 10.1037/1082-989X.4.2.158. [DOI] [Google Scholar]
  • 64.Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: getting started and moving on from Stage I. Clin Psychol Sci Pract. 2001;8:133–142. doi: 10.1093/clipsy/8.2.133. [DOI] [Google Scholar]

Articles from Journal of Urban Health : Bulletin of the New York Academy of Medicine are provided here courtesy of New York Academy of Medicine

RESOURCES