Pablo Montero-Zamora
Pablo Montero-Zamora, PhD, Postdoctoral Fellow, University of Texas at Austin, Austin, TX, Eric C. Brown, PhD, Associate Professor, University of Miami, Miami, FL, Chris Ringwalt, DrPH, Senior Scientist, Pacific Institute for Research and Evaluation, Chapel Hill, NC, Seth Schwartz, PhD, Professor, University of Texas at Austin, Austin, TX, Guillermo Prado, PhD, Dean, Graduate School, University of Miami, Miami, FL and Jorge Alberto Ortiz Garcia, PhD, Professor, Universidad Autonoma de Zacatecas, Zacatecas, ZT, Mexico
Introduction: Youth alcohol use (AU) is a major global health problem. Tomando Buenas Decisiones (TBD), an adapted family-based prevention program (FBP) based on the existing Guiding Good Choices program, was piloted, and tested in Zacatecas, Mexico. We examined the effects of the TBD program on reducing family risk for youth AU.
Methods: We used a quasi-experimental design comprising a sample of 268 parents with children 8 to 16 years. All participants were working actively in one of five Zacatecan private companies. Inverse probability weighting based on intervention status, along with censoring propensity scores, was used to estimate the difference in risk levels between intervention participants and wait-listed controls. Latent growth curve modeling was used to analyze the intervention impact on three first-order risk factors (i.e., positive attitudes for drug use, family conflict, poor family management) and a combined measure of general family risk (i.e., a second-order factor using the three first-order risk factors) at baseline, post-intervention, and 3-month follow-up.
Results: Relative to wait-listed controls, the TBD program was efficacious in reducing positive attitudes for drug use, family conflict, poor family management, and general family risk levels. Specifically, positive attitudes for drug use were associated with the second largest post-intervention effect (Δ = -.595, p <. 001, d = .824), followed by family conflict (Δ = -.479, p <. 001, d = .784), and general family risk (Δ = -.263, p <. 001, d = .725). Regarding long-term intervention effects at 3-month follow-up, we found a reduction in all but one study outcome (i.e., positive attitudes for drug use). General family risk was associated with the greatest 3-month post-intervention effect (Δ = -.221, p <.001, d = .649), followed by poor family management (Δ = -.309, p <.001, d = .536), and family conflict (Δ = -.479, p = .014, d = .784).
Conclusions: Demonstrating that FBPs can reduce family risks for youth AU is crucial given that these family risks may play a central role in prevention strategies targeting the drivers of premature death in countries like Mexico. Findings from this study address a gap in establishing efficacious preventive interventions for youth AU in Latin America. We anticipate that our study’s findings could help inform prevention efforts to reduce leading youth alcohol-related harms such as drunk driving, and domestic violence among Mexican adolescents and their families.
*Accepted for the 2022 NIDA International Poster Session at the Society for Prevention Research (SPR) conference.