An Application of the Complier Average Causal Effect Analysis to Examine the Effects of a Family Intervention in Reducing Illicit Drug Use among High‐Risk Hispanic Adolescents

The Complier Average Causal Effect (CACE) method has been increasingly used in prevention research to provide more accurate causal intervention effect estimates in the presence of noncompliance. The purpose of this study was to provide an applied demonstration of the CACE analytic approach to evaluate the relative effects of a family‐based prevention intervention, Familias Unidas, in preventing/reducing illicit drug use for those participants who received the intended dosage. This study is a secondary data analysis of a randomized controlled trial designed to evaluate the relative efficacy of Familias Unidas with high‐risk Hispanic youth. A total of 242 high‐risk Hispanic youth aged 12–17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at baseline, 6 months and 12 months postbaseline. CACE models were estimated with a finite growth mixture model. Predictors of engagement were included in the CACE model. Findings indicate that, relative to the intent‐to‐treat (ITT) analytic approach, the CACE analytic approach yielded stronger intervention effects among both initially engaged and overall engaged participants. The CACE analytic approach may be particularly helpful for studies involving parent/family‐centered interventions given that participants may not receive the intended dosage. Future studies should consider implementing the CACE analysis in addition to ITT analysis when examining the effects of family‐based prevention programs to determine whether, and the extent to which, the CACE analysis has more power to uncover intervention effects.     

The Before Baby Relationship Checkup: A Couples-Based Intervention to Reduce Relationship Risk Factors for Perinatal Mood and Anxiety Disorders

Relationship conflict and lack of partner support are risk factors for perinatal mood and anxiety disorders. An intervention to strengthen couples’ relationships before birth may reduce relationship risk factors for perinatal mood and anxiety disorders, though no research has explored this to date. The aims of this Stage 1 open-series non-experimental proof of concept study were to adapt the ‘Marriage Checkup’, an evidence-based intervention for relationship distress, as a preventative intervention for perinatal mood and anxiety disorders and to assess its feasibility and acceptability. Pregnant women receiving care at a university-based obstetric practice, and their partners, were recruited. Ten couples participated in the Before Baby Relationship Checkup, a personalized relationship health service offered in the obstetric clinic. Quantitative and qualitative data gathered suggests the intervention is feasible to implement in an obstetric setting, and acceptable to perinatal couples. Specific adaptations to the Marriage Checkup for perinatal couples are warranted and further testing is needed to evaluate efficacy.

     

Do the effects of a family intervention on alcohol and drug use vary by nativity status?

To examine whether the intervention effects of Familias Unidas, compared to community practice, on Hispanic adolescent alcohol and drug use varies by nativity status (i.e., U.S.-born and foreign-born). A total of 213 eighth grade Hispanic adolescents with behavior problems and their primary caregivers were assigned randomly to one of two conditions: Familias Unidas or Community Control. Participants were assessed at baseline and at 6, 18, and 30 months post baseline. Results showed that, the effects of Familias Unidas on alcohol use was moderated by nativity status. Specifically, Familias Unidas was efficacious in preventing/reducing alcohol use for U.S.-born youth, but not foreign-born. No moderating effects were found for drug use. These findings suggest that prevention interventions may be more efficacious in preventing/reducing alcohol use among certain Hispanic adolescent subgroups. (PsycINFO Database Record (c) 2012 APA, all rights reserved).