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

Abstract

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 paper examines participation and predictors of participation in the eHealth Familias Unidas intervention in a sample of 113 Hispanic families whose adolescent had behavioral problems. Analyses examined multidimensional ways of characterizing participation, including the following: (1) total intervention participation, (2) initial engagement (participating in at least one of the first three intervention sessions), (3) completing the pre-recorded, eHealth parent group sessions, and (4) participating in the live, facilitator-led, eHealth family sessions. 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 family stress were associated with lower initial engagement and lower family session participation. Greater parental Hispanicism was associated with more participation in eHealth parent group sessions and across the total intervention. Higher levels of baseline effective parenting, in other words less intervention need, were significantly associated with lower levels of total intervention participation and lower levels of family session participation. Implications for preventive interventions delivered via Internet are discussed.

Principles of Precision Prevention Science for Improving Recruitment and Retention of Participants

“…For example, Mauricio found Latina mothers were more likely to drop out early or have declining attendance compared to other participating mothers (though there were no ethnicity differences for participating fathers). Perrino et al (2016) found associations between greater parental Hispanicism and higher participation in family-based interventions designed for Hispanic youth.…”

“…Instead, a complex mixture of individual factors (both mutable and more stable), provider, program, and community-level factors synergistically may affect enrollment, engagement, and retention (McCurdy and Daro 2001). While papers in this special issue acknowledge the importance of all of these factors, none of the papers in this special issue empirically test factors at levels other than the individual, with the exception of Perrino et al's (2016) examination of facilitator experience. We posit in this commentary that taking a broader lens on the factors that may predict participant enrollment, engagement, satisfaction, and retention may better identify critical factors in the design and optimization of prevention programs.…”

“…When participant motivation is cultivated, increases in participation and engagement are evident . Families with greater needs may have stronger motivations to participate and remain in the program (Perrino et al 2016;Smith et al 2017). A family's readiness to change may also be an important factor.…”

“…Evidence examining culturally adapted programs supports higher recruitment and retention of families (Kumpfer and Alvarado 1995;Kumpfer et al 2002). Articles in this special issue found evidence that race and ethnicity were related to participant engagement and retention (Mauricio et al 2017;Perrino et al 2016). For example, Mauricio found Latina mothers were more likely to drop out early or have declining attendance compared to other participating mothers (though there were no ethnicity differences for participating fathers).…”

Preventive Parenting Interventions: Advancing Conceptualizations of Participation and Enhancing Reach

“…These papers contribute to translation science by addressing the questions, Bwho will come if you build it?^, Bwhy do people come? ', and Bif they do come, how should we measure it?^A bout the Contributing Articles A diverse set of programs are represented by the studies in this issue, including an online, interactive program (i.e., Pathways for African American Success, Murry et al this issue), an e-health intervention with self-paced online and virtual components (Familias Unidas, Perrino et al 2016), group-based, multi-family, in-person programs (Strengthening Families Program, Coatsworth, Hemady, and George, this issue; New Beginnings Program, Berkel et al 2016;Mauricio et al 2017;) and a brief, in-person program that is intended to be tailored and adapted for individual families (i.e., Family Check-Up, Smith et al 2016). Some of these programs include a child and parent or family component (i.e., Pathways for African American Success, Familias Unidas, and Strengthening Families Program), and others only include a parent component (i.e., New Beginnings Program and Family Check-Up).…”