A Primary Care E-Health Family Intervention for Risk Behaviors in Hispanic Youths
8 affiliations
- 1School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
- 2Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
- 3now with College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida
- 4now with Department of Child Psychology and Education, Sungkyunkwan University, Seoul, South Korea
- 5now with the School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
- 6now with Florida International University, Miami
- 7Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida
- 8University of Miami Medical Group, Clinical Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida
Abstract
Importance: Culturally tailored, evidence-based family interventions that can be effectively delivered within pediatric primary care settings may provide a scalable approach for preventing risk behaviors among Hispanic adolescents.
Objective: To evaluate whether the online eHealth Familias Unidas Primary Care (eHealth FUPC) program reduced drug use and increased condom use in Hispanic youth and to examine family functioning as a mediator.
Design, Setting, and Participants: This randomized clinical trial included 5 follow-up visits across 36 months from April 18, 2017, to December 18, 2022, at 15 pediatric primary care clinics. Participants included Hispanic youth aged 12 to 16 years and a legal guardian. Data were analyzed from January 31, 2023, to August 21, 2024.
Intervention: Participants were randomized 1:1 to the intervention, consisting of 8 video group sessions for parents and 4 online, facilitator-guided family sessions for parents and adolescents for a total intervention duration of approximately 12 weeks. Interventionists included pediatric primary care personnel.
Main Outcomes and Measures: The co-primary outcomes were past 90-day drug use, condom use, and sexually transmitted infections (STIs). Secondary outcomes included initiation of alcohol use, initiation of hard drug use (ie, lysergic acid diethylamide, phencyclidine, ecstasy [MDMA], psilocybin mushrooms), and family functioning. STI was changed to a secondary outcome after data collection was discontinued because of the COVID-19 pandemic.
Results: A total of 456 dyads of adolescents (mean [SD] age, 13.9 [1.4] years; 241 [52.9%] female) and parents or caregivers (mean [SD] age, 43.2 [6.6] years; 424 [93.0%] female) were included in the primary intention-to-treat analyses (225 in the eHealth FUPC intervention and 231 in treatment as usual). A total of 356 families (78.1%) completed the final assessment. eHealth FUPC effects were found for past 90-day drug use trajectories (unstandardized b [SE] = −0.70 [0.70]; incidence rate ratio, 0.47; 95% CI, −0.84 to −0.55; P < .001), alcohol initiation (χ ² ₁ = 3.85; P = .05; Cramer V = 0.10), and hard drug use (χ ² ₁ = 4.14; P = .04; Cramer V = 0.10), with less initiation for eHealth FUPC. Intervention effects were not found for condom use, condom use trajectory, or family functioning.
Conclusions and Relevance: In this randomized clinical trial of the eHealth FUPC intervention, compared with treatment as usual, the experimental condition showed reduced drug use across time and prevented youths from initiating alcohol and hard drug use. No intervention effects were found for condom use. Whether behavioral preventive evidence-based interventions such as eHealth FUPC can be maintained in organizations such as primary care clinics should be further researched.
Trial Registration: ClinicalTrials.gov Identifier: NCT03009539
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BibTeX
@article{estrada2026primary,
title = {{A Primary Care E-Health Family Intervention for Risk Behaviors in Hispanic Youths}},
author = {Yannine Estrada and Alyssa Lozano and Beck Graefe and Tae Kyoung Lee and Elliott Mitrani and Padideh Lovan and Maria Isabel Tapia and Tatiana Perrino and Lourdes Q. Forster and Lisa Gwynn and Guillermo Prado},
journal = {JAMA Network Open},
year = {2026},
month = oct,
doi = {10.1001/jamanetworkopen.2026.37908},
url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855123},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A Primary Care E-Health Family Intervention for Risk Behaviors in Hispanic Youths
AU - Yannine Estrada
AU - Alyssa Lozano
AU - Beck Graefe
AU - Tae Kyoung Lee
AU - Elliott Mitrani
AU - Padideh Lovan
AU - Maria Isabel Tapia
AU - Tatiana Perrino
AU - Lourdes Q. Forster
AU - Lisa Gwynn
AU - Guillermo Prado
PY - 2026
DA - 2026/10/09
JO - JAMA Network Open
DO - 10.1001/jamanetworkopen.2026.37908
UR - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855123
AB - Importance: Culturally tailored, evidence-based family interventions that can be effectively delivered within pediatric primary care settings may provide a scalable approach for preventing risk behaviors among Hispanic adolescents. Objective: To evaluate whether the online eHealth Familias Unidas Primary Care (eHealth FUPC) program reduced drug use and increased condom use in Hispanic youth and to examine family functioning as a mediator. Design, Setting, and Participants: This randomized clinical trial included 5 follow-up visits across 36 months from April 18, 2017, to December 18, 2022, at 15 pediatric primary care clinics. Participants included Hispanic youth aged 12 to 16 years and a legal guardian. Data were analyzed from January 31, 2023, to August 21, 2024. Intervention: Participants were randomized 1:1 to the intervention, consisting of 8 video group sessions for parents and 4 online, facilitator-guided family sessions for parents and adolescents for a total intervention duration of approximately 12 weeks. Interventionists included pediatric primary care personnel. Main Outcomes and Measures: The co-primary outcomes were past 90-day drug use, condom use, and sexually transmitted infections (STIs). Secondary outcomes included initiation of alcohol use, initiation of hard drug use (ie, lysergic acid diethylamide, phencyclidine, ecstasy [MDMA], psilocybin mushrooms), and family functioning. STI was changed to a secondary outcome after data collection was discontinued because of the COVID-19 pandemic. Results: A total of 456 dyads of adolescents (mean [SD] age, 13.9 [1.4] years; 241 [52.9%] female) and parents or caregivers (mean [SD] age, 43.2 [6.6] years; 424 [93.0%] female) were included in the primary intention-to-treat analyses (225 in the eHealth FUPC intervention and 231 in treatment as usual). A total of 356 families (78.1%) completed the final assessment. eHealth FUPC effects were found for past 90-day drug use trajectories (unstandardized b [SE] = −0.70 [0.70]; incidence rate ratio, 0.47; 95% CI, −0.84 to −0.55; P < .001), alcohol initiation (χ ² ₁ = 3.85; P = .05; Cramer V = 0.10), and hard drug use (χ ² ₁ = 4.14; P = .04; Cramer V = 0.10), with less initiation for eHealth FUPC. Intervention effects were not found for condom use, condom use trajectory, or family functioning. Conclusions and Relevance: In this randomized clinical trial of the eHealth FUPC intervention, compared with treatment as usual, the experimental condition showed reduced drug use across time and prevented youths from initiating alcohol and hard drug use. No intervention effects were found for condom use. Whether behavioral preventive evidence-based interventions such as eHealth FUPC can be maintained in organizations such as primary care clinics should be further researched. Trial Registration: ClinicalTrials.gov Identifier: NCT03009539
SN - 2574-3805
ER -