A Review of Family-Based Programs to Prevent Youth Violence Among Latinos

Articles

Hispanic Journal of Behavioral Sciences32(1) 5 –36

© The Author(s) 2010Reprints and permission: http://www. sagepub.com/journalsPermissions.nav

DOI: 10.1177/0739986309353317http://hjbs.sagepub.com

A Review of Family-Based Programs to Prevent Youth Violence Among Latinos

Melinda S. Leidy,1 Nancy G. Guerra,1

and Rosa I. Toro1

Abstract

At present, there is limited evidence supporting the effectiveness of family-based intervention programs to prevent violence or related behavior pro-blems with Latino youth and families. Although progress has been made, a number of important issues remain. In this article, the authors review several of the more prominent interventions for Latino youth and families, highlighting how they were adapted to or developed for Latino culture. They begin by discussing cultural sensitivity and how it affects the design, implementation, and adaptation of youth violence prevention programs. Following this, the authors review and discuss programs adapted for Latino families followed by programs developed specifically for Latino families. They highlight four primary components of family-based programs that have been linked most frequently to prevention outcomes: (a) improving parental monitoring, (b) increasing family cohesion, (c) increasing networking across families, and (d) empowering families to access resources more effectively.

Keywords

youth violence prevention, Latinos, parent-child interventions, cultural sensitivity

1University of California, Riverside, CA, USA

Corresponding Author:Melinda S. Leidy, Department of Psychology, 900 University Avenue, Riverside, CA 92521 Email: [email protected]

at CALIFORNIA STATE UNIV FRESNO on February 18, 2015hjb.sagepub.comDownloaded from

http://hjb.sagepub.com/

6 Hispanic Journal of Behavioral Sciences 32(1)

Youth violence in the United States is a significant public health problem that results in injury and death. Although the impact of youth violence is not limited to specific ethnic groups, epidemiological data suggest that ethnic minority youth are particularly at risk (Centers for Disease Control and Prevention, 2008). His-torically, most official data on youth violence for different ethnic groups have been limited to Black, White, and Other, constraining our ability to understand fully patterns of youth violence beyond these groups. A notable shortcoming has been a limited focus on Latinos, in spite of the fact that they are the largest and fastest growing ethnic minority in the United States with more than 40 million individuals claiming Latino heritage (referring to individuals from Mexico, most of Central and South America, Cuba, the Dominican Republic, and Puerto Rico).

As greater efforts have been made to include Hispanic or Latino ethnic categories in surveys and official data, what is emerging is a pattern of high and disproportionate representation of Latino youth as perpetrators and vic-tims of violence (Anderson, 2002; Vega & Gil, 1999). For example, in the most recent data available from the Youth Risk Behavior Survey, 40% of Latino 9th to 12th graders reported that they had been in one or more physical fights in the past 12 months, compared with 31% of non-Latino White stu-dents (Centers for Disease Control and Prevention, 2007). Furthermore, in terms of loss of life, homicide is ranked as the second leading cause of death among Latino youth aged 10 to 24 years. Differences are particularly striking when comparing homicide rates for this age group between Latino males (approximately 20 per 100,000) and non-Latino White males (approximately 3 per 100,000; Centers for Disease Control and Prevention, 2008).

Given these high rates of youth violence and victimization, combined with the increasing population growth among Latinos, at this juncture it is impor-tant to examine carefully the evidence base for effective youth violence prevention programs among Latinos. Toward this end, the purpose of this article is to identify and examine family-based programs that have demonstrated some effectiveness in preventing or reducing violence (or hypothesized mediators of violence) for Latino children and youth, discussing how they were adapted or tailored to Latino culture. A secondary purpose is to highlight commonali-ties and differences across the underlying theories and principles that guided these programs as a template for future research and practice.

We focus on family-based programs for two reasons. First, because pro-grams that are adapted or designed for specific ethnic groups generally cannot be implemented in heterogeneous settings such as schools and youth service agencies, the majority of youth violence prevention research targeting Latino populations has been conducted with families. Second, a focus on families is consistent with the evidence base for youth violence prevention—family-based



Leidy et al. 7

programs are among the most effective preventive interventions, particularly with adolescents and more seriously violent youth (Lipsey & Wilson, 1998; Schaeffer & Borduin, 2005).

In the current article, the term family-based is defined broadly to include all programs that involve families as the primary prevention context or eco-logical setting. This includes efforts to enhance parenting skills and increase parental involvement, as well as more family systems–oriented programs directed at improving family functioning or the quality of the parent-child relationship. Within each of these areas, specific factors have been linked empirically to youth violence prevention across different ethnic groups, incl-uding adequate parental monitoring, consistent discipline, open family communication, positive family functioning, and warm relationships (Guerra & Leidy, 2008; Mirabal-Colón & Vélez, 2006; Pettit, Laird, Dodge, Bates, & Criss, 2001). Still, family-based prevention programs vary significantly in terms of their relative emphasis on different family mediators (e.g., some programs are designed to improve parental skills such as monitoring, while others are designed to enhance family communication). Thus, it is important to determine which components of family-based programs are most clearly related to prevention outcomes for Latinos.

To identify studies for inclusion in this review, we searched the scientific literature database (PsycINFO), using keywords, including parenting, Hispanic, Latino, parent-child relations, families, aggression, youth violence, antisocial behavior, interventions, and so on. We included behavioral outcomes such as aggression, externalizing behaviors, delinquency, and negative social behav-iors (i.e., coercive or antisocial behaviors) because these are clearly linked with youth violence and share a common etiology (Guerra & Knox, 2002). A few reviews of family-based programs for Latinos were located, and we searched references in these reviews for additional citations. In addition, e-mails were sent to lead authors on all articles identified for inclusion asking for any related reports or articles that were in press. We also searched websites that provide listings of evidence-based youth violence prevention programs, such as Blueprints at the Center for the Study and Prevention of Violence at the University of Colorado at Boulder.

The main criteria for selection were that the preventive intervention had to be published (or in press); identify and target Latino parents of children and adolescents aged 6 to 18 years; include youth violence, related behavioral problems, or family mediators of violence as an outcome; and provide at least a brief discussion of how issues of cultural sensitivity were addressed in program development and implementation. Although we had planned to include all identified prevention programs fitting our stated criteria with Latinos in the




sample, studies that were not designed or applied specifically to Latino fami-lies generally did not report the specific number of Latino participants and instead reported the overall number of ethnic minority participants in their study. Some studies also reported a small number of Latino participants but did not report results separately for Latino families or discuss cultural sensi-tivity. Thus, we discuss only preventive interventions that were either adapted to or were designed specifically for Latino families. Depending on their emphasis, some of the included programs targeted both parents and children, whereas other programs involved only parents.

As a result of this process, we identified 10 programs that met our target criteria and are the focus of this review. We acknowledge that even with our best efforts, the programs identified and selected are not exhaustive of the field. However, they do represent a range of youth violence prevention efforts to date with Latino families and provide a basis for summarizing the current evidence. They also allow us to consider carefully how cultural sensitivity bears on the design, implementation, and adaptation of youth violence pre-vention programs for Latino populations. With this in mind, we begin by first discussing the concept of cultural sensitivity in general and as specifically applied to youth violence prevention within Latino populations. We then examine prevention programs adapted to Latinos, followed by programs developed specifically for Latinos. We conclude with a discussion of how cultural sensitivity was incorporated into these programs, connections across the preventive interventions reviewed, and suggestions for future research.

Cultural Sensitivity and Preventive InterventionsThere are many different approaches to addressing issues of cultural sensitiv-ity in preventive interventions. A first step is to articulate clearly what is meant by cultural sensitivity. One of the most widely cited definitions, pro-vided by Resnicow, Soler, Braithwaite, Ahluwalia, and Butler (2000), is that cultural sensitivity is

the extent to which ethnic/cultural characteristics, experiences, norms, values, behavioral patterns, and beliefs of a target population as well as relevant historical, environmental, and social forces are incorporated in the design, delivery, and evaluation of targeted health promotion mate-rials and programs. (p. 272)

It is important to note that in this context, “culture” typically refers to ethnic heritage, in spite of many variants of cultural influences (e.g., religion,



Leidy et al. 9

socioeconomic status, and region within a country) that may also be infl-uencing behavior (Cohen, 2009).

A further distinction that is useful in reviewing preventive interventions involves the distinction between “surface structure” and “deep structure” (Castro, Barrera, & Martinez, 2004; Resnicow et al., 2000; Wright & Zimmerman, 2006). Surface structure as applied to ethnic heritage refers to the external character-istics of a culture included in an intervention—for example, food, language, and music familiar to and preferred by a specific ethnic group. Surface struc-ture refers to how well interventions “fit” a target population’s culture, experience, and behavioral patterns. Having a good fit with the culture gener-ally increases the receptivity, comprehension, or acceptance of the messages being delivered. In contrast, deep structure reflects how significant cultural values, beliefs, norms, and historical circumstances related to worldviews and lifestyles influence behavior differently across ethnic groups. This incor-porates understanding how individuals in a specific population perceive the cause, course, prevention, and treatment of a behavior. Deep structure also includes individuals’ perceptions of the determinants of the specific behavior, such as how religion, family, society, economics, and the government influence the target behavior.

In practice, these distinctions have been translated primarily into guide-lines for program implementation. That is, cultural sensitivity has been considered in terms of how it affects the receptivity of the target population to both the logistics of program delivery and the underlying premise on which the program is based (e.g., whether a particular style of discipline rec-ommended by the program is consistent with cultural beliefs). Less emphasis has been placed on whether the etiology of the targeted outcomes and appro-priate prevention responses may vary according to the specific practices and beliefs across ethnic groups. Many prevention programs are grounded in empir-ical risk research, developed with mainstream participants in mind, although studies may have found similar relations for targeted ethnic groups.

What often is missing is a specific focus based on cultural beliefs and practices within the participant group as they uniquely predict risk. For example, machismo (discussed in the next section) has long been highlighted as a particularly strong cultural belief among Latinos emphasizing male dominance (with obvious links to violence), yet it has rarely been studied specifically in studies of risk and prevention of youth violence.

Other unique predictors of risk may be linked to the particular conditions of subgroups within different cultural or ethnic populations. For example, recent immigrant parents in the United States often find that an imbalance of power results from their children learning English before they do—yet whether this




imbalance of power increases risk for violence has not been addressed empir-ically and is not considered in prevention programs based on extant research with nonimmigrant groups (Guerra & Knox, 2008; Pantin, Schwartz, Sullivan, Coatsworth, & Szapocznik, 2003). Of course, developers of pre-ventive interventions for Latinos based on risk research are constrained by the limited number of empirical studies focused exclusively on risk for vio-lence within Latino populations.

Culturally Sensitive Youth Violence Prevention for LatinosThe distinction between surface structure and deep structure provides a frame-work from which to examine how cultural sensitivity has been addressed in youth violence prevention programs for Latino families. A related issue is the extent to which variation within Latino subgroups affects the appropriateness and relevance of prevention programming. Because Latino families differ with respect to country of origin, generational status, time of stay in the United States, acculturation, assimilation, economic conditions, and so on, it is imp-ortant to specify commonalities and differences that can affect the design and implementation of youth violence prevention programs. In other words, what are the shared characteristics that cut across different subgroups and what fea-tures are more constrained by local circumstances?

Consistent with the distinction between surface structure and deep struc-ture, variation within Latino subgroups is linked most closely to surface structure characteristics that can be adjusted through a participatory process of program adaptation. For instance, recent immigrant populations are most likely to face the greatest challenges in adapting to a new environment in the United States (Pantin, Coatsworth et al., 2003). From the perspective of sur-face structure characteristics, preventive interventions for non-English speakers must be translated into Spanish, also being mindful of regional variations in dialect. Beyond this obvious task, the stressors of daily life for some recent immigrant Latino families may interfere with their ability to effectively parent their children or even take advantage of prevention programs (Guerra & Knox, 2008). This is particularly problematic in urban settings characterized by high levels of crime and violence, escalating housing costs, substandard living conditions, and poor transportation (Leyendecker & Lamb, 1999).

Beyond these surface structure characteristics, there are several core cultural values within Latino populations (and cutting across subgroups) that are often maintained across multiple generations. These represent deep structure charac-teristics that should be addressed in youth violence prevention programming



Leidy et al. 11

because they can affect both the causes and prevention of youth violence (alth-ough discussed earlier, few empirical studies to date have examined these relations), and how receptive participants will be to specific programs (Castro et al., 2004; Wright & Zimmerman, 2006). Among the cultural values most rel-evant for pan-Latino (i.e., across multiple subgroups) youth violence prevention programming are colectivismo, familismo, respeto, simpatía, personalismo, religiosidad, machismo, and marianismo (Mirabal-Colón & Vélez, 2006).

Colectivismo involves mutual empathy where the interests of the group are greater than the interests of the individual. This can be seen as contrary to the individualistic, competitive society in the United States. Colectivismo carries with it a sense of belonging that is connected to being part of a larger group. Familismo refers to the central role of the family in an individual’s life. Both the nuclear and extended family provides a strong support system that includes both material and emotional support. Respeto places great social worth and decision-making power on authority figures. This can be seen in attitudes and behaviors toward decisions of elders, parents, teachers, physi-cians, politicians, law enforcement personnel, and other higher-status positions (Mirabal-Colón & Vélez, 2006). Simpatía is the general tendency to avoid interpersonal conflict by emphasizing positive behaviors in agreeable situations and deemphasizing negative behaviors in conflictive circumstances (Triandis, Marin, Lisanky, & Betancourt, 1984). Similarly, personalismo emphasizes the valuing and building of interpersonal relation-ships, as well as an unspoken expected reciprocity between individuals (Santiago-Rivera, Arredondo & Gallardo-Cooper, 2002: Arredondo, 2006). Religiosidad, primarily Roman Catholicism, implies that an individual’s view of the world is heavily influenced by God’s will, the spirit world, mir-acles, and folk healing. Individuals see hardship, suffering, and death as inevitable and integral parts of life (Mirabal-Colón & Vélez, 2006).

Cultural values related to gender roles, although quite relevant for under-standing and preventing youth violence, typically have not been considered carefully in preventive interventions for Latino children and families. Specifi-cally, machismo stresses the man’s role as head of the household, powerful, strong, and in control. In adolescent male Latino youth, it is associated with a justification of violence by linking it to gender roles, sexuality and biology, in order to perpetuate heterosexual male dominance (Asencio, 1999). Recently, researchers have identified two dimensions of machismo: (a) traditional machismo, which is described as aggressive, sexist, chauvinistic, and hyper-masculine, and (b) caballerismo, which is described as nurturing, family centered and chivalrous (Arciniega, Anderson, Tovar-Blank, & Tracey, 2008). In contrast, marianismo, based on the Catholic ideal of the Virgin Mary,




emphasizes the woman’s role as mother, and honors the mother’s suffering and self-sacrifice for her children (Cauce & Domenech-Rodríguez, 2002). This distinction often exacerbates gender differences, with clearly defined roles for men (power and control) and women (submission and sacrifice).

Family-Level Preventive Interventions Adapted for LatinosGiven these important cultural influences and potential significance for youth violence prevention, it is important first to ask whether existing evidence-based programs have been successfully adapted for Latino families. From our literature searches, we identified six comprehensive family-level inter-ventions with a specific focus on youth violence prevention that have been adapted to Latinos and that have been found to have at least some significant preventive effects for youth violence and behavior problems. These interven-tions and related research studies are described in detail (with citations) in Table 1. They are (a) Schools and Homes in Partnership (SHIP), (b) Bridges to High School, (c) Parent Management Training (PMT), (d) Families and Schools Together (FAST), (e) Brief Strategic Family Therapy (BSFT), and (f) Structural Family Therapy (SFT). Let us now turn to a brief description of each program’s content and outcomes, followed by a discussion of how these interventions were adapted for Latino children and families.

Summary of Interventions and Outcomes for Programs Adapted to Latino Families

Schools and Homes in Partnership. The SHIP intervention provided parent training, social behavioral interventions, and a reading intervention over a 2-year period in order to reduce child behavioral problems for at-risk early elementary school children (grades K-3). For parent training, the intervention used 12 to 16 sessions of the Incredible Years parent training program for families. For social behavioral intervention, the program used a 1-month contingency management social skill program (CLASS; Hops & Walker, 1988) plus the 20-hour Dina Dinosaur social skills program for children (Webster-Stratton, 1992). For supplemental reading instruction, the program used Reading Mastery and Corrective Reading. In an evaluation study with a high percentage (59%) of Latino participants (of predominantly Mexican heritage), intervention children showed lower levels of parent-rated coercive and antisocial behavior than their control counterparts at posttest and at the 2-year follow-up (Barrera et al., 2002; Smolkowski et al., 2005). Program



Tabl

e 1.

Inte

rven

tions

Ada

pted

to

Latin

o Fa

mili

es

Inte

rven

tion/

Cita

tion

Scho

ols

and

Hom

es

in P

artn

ersh

ip

(SH

IP)/

Barr

era

et

al.

(200

2)

Scho

ols

and

Hom

es in

Pa

rtne

rshi

p (S

HIP

)/Sm

olko

wsk

i et a

l. (2

005)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Ris

k st

atus

: Chi

ldre

n w

ith e

ither

ag

gres

sive

or

read

ing

diffi

culti

esN

: 284

Age

: K-3

rd g

rade

rsEt

hnic

ity: 5

9%

Latin

o an

d 41

% E

urop

ean

Am

eric

anG

ende

r: 45

% g

irls

, 55

% b

oys

Risk

sta

tus:

Chi

ldre

n w

ith e

ither

ag

gres

sive

or

read

ing

diffi

culti

es

M

etho

d

Chi

ldre

n w

ere

recr

uite

d th

roug

h sc

hool

dist

rict

s an

d w

ere

scre

ened

for

aggr

essiv

e be

havi

or

or r

eadi

ng d

iffic

ultie

s. C

hild

ren

wer

e el

igib

le

if th

ey w

ere

abov

e th

e 95

th p

erce

ntile

on

the

teac

her’s

rat

ing

of

the

CBC

L ag

gres

sion

mea

sure

or

if th

ey

scor

ed in

the

low

est

5% o

f the

rea

ding

sco

re

dist

ribu

tion

in t

heir

gr

ade

leve

l at

thei

r sc

hool

. Tho

se w

ho m

et

the

crite

ria

for

at le

ast

one

of t

hese

are

as w

ere

rand

omly

ass

igne

d to

re

ceiv

e or

not

rec

eive

th

e in

terv

entio

n.Se

e ab

ove.

In

terv

entio

n D

escr

iptio

n

SHIP

focu

sed

on r

educ

ing

beha

vior

al

prob

lem

s du

ring

the

ear

ly e

lem

enta

ry

scho

ol y

ears

thr

ough

par

ent

trai

ning

, so

cial

ski

lls t

rain

ing,

and

a re

adin

g in

terv

entio

n. T

he c

ompr

ehen

sive

inte

rven

tion

cons

isted

of 3

com

pone

nts:

(a) P

aren

t tr

aini

ng t

hrou

gh t

he In

cred

ible

Ye

ars

Prog

ram

, whi

ch c

onsis

ted

of

12-1

6 gr

oup

sess

ions

and

vid

eo t

apes

; (b

) soc

ial b

ehav

ior

inte

rven

tions

usin

g th

e D

ina

Din

osau

r So

cial

Ski

lls p

rogr

am

for

child

ren,

whi

ch t

each

es c

ogni

tive

and

soci

al s

kills

in s

mal

l gro

ups,

and

the

Con

tinge

ncie

s fo

r Le

arni

ng A

cade

mic

So

cial

Ski

lls (C

LASS

), w

hich

aim

s to

re

duce

act

ing

out

beha

vior

s by

tea

chin

g an

d re

info

rcin

g ap

prop

riat

e cl

assr

oom

be

havi

or; a

nd (c

) sup

plem

enta

l rea

ding

in

stru

ctio

n. T

he in

terv

entio

n m

et w

eekl

y in

gro

ups

and

was

pro

vide

d ov

er a

2-

year

per

iod.

See

abov

e.

R

esul

ts

At

post

test

, chi

ldre

n in

th

e in

terv

entio

n gr

oup

disp

laye

d le

ss n

egat

ive

soci

al

beha

vior

s th

an c

ontr

ols

(F(1

, 193

) =

7.04

9; p

< .0

1).

At

the

end

of t

he 1

-yea

r fo

llow

-up,

child

ren

in t

he

inte

rven

tion

grou

p sh

owed

le

ss p

aren

t-ra

ted

coer

cive

(F

(1, 1

90) =

5.60

3; p

< .0

5)

and

antis

ocia

l beh

avio

r th

an

cont

rols

(F(

1,19

4) =

11.

078;

p <

.001

).

At t

he e

nd o

f the

2 y

ear

follo

w-

up, t

hose

in th

e in

terv

entio

n gr

oup

disp

layed

low

er le

vels

of p

aren

t rep

orte

d ch

ild

(con

tinue

d)

13



14

Tabl

e 1.

(co

ntin

ued)

Inte

rven

tion/

Cita

tion

Brid

ges

to H

igh

Scho

ol/G

onza

les,

Dum

ka,

Dea

rdor

ff, C

arte

r, an

d M

cCra

y (2

004)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

N: 3

29A

ge: K

-3rd

gra

ders

Ethn

icity

: 52%

La

tino

and

48%

Eur

opea

n A

mer

ican

Gen

der:

47%

gir

ls,

53%

boy

s

Ris

k st

atus

: U

nive

rsal

, fam

ilies

w

ith c

hild

ren

tran

sitin

g to

ju

nior

hig

h th

e fo

llow

ing

year

N: 2

2A

ge: 6

th g

rade

rs

(ave

rage

age

11

.55

year

)Et

hnic

ity: 4

.5%

A

fric

an A

mer

ican

, 4.

5% A

nglo

, 86

.5%

Mex

ican

A

mer

ican

, and

4.

5% o

ther

Met

hod

Chi

ldre

n an

d fa

mili

es

wer

e re

crui

ted

from

2

scho

ols.

Fam

ilies

w

ere

sele

cted

on

a ra

ndom

bas

is t

o be

co

ntac

ted

and

invi

ted

to p

artic

ipat

e. F

amili

es

mus

t ha

ve a

chi

ld

tran

sitio

ning

to

juni

or

high

the

follo

win

g ye

ar.

The

re w

as n

o co

ntro

l gr

oup.

Inte

rven

tion

Des

crip

tion

The

Bri

dges

to

Hig

h Sc

hool

inte

rven

tion

was

des

igne

d to

incr

ease

pro

tect

ive

fact

ors

and

redu

ce r

isk

fact

ors

asso

ciat

ed w

ith lo

w a

cade

mic

en

gage

men

t an

d m

enta

l hea

lth a

mon

g ur

ban

child

ren

tran

sitio

ning

to

juni

or

high

sch

ool. T

his

inte

rven

tion

brou

ght

fam

ilies

to

scho

ols

for

a 9-

sess

ion

prog

ram

tha

t co

nsis

ted

of (

a) p

aren

t sk

ills

trai

ning

aim

ed a

t in

crea

sing

pa

rent

s’ u

se o

f effe

ctiv

e pa

rent

ing

skill

s in

3 d

omai

ns—

app

ropr

iate

di

scip

line,

ade

quat

e m

onito

ring

, and

su

ppor

t; (b

) ado

lesc

ent

copi

ng s

kills

tr

aini

ng d

esig

ned

to in

crea

se

Res

ults

antis

ocia

l beh

avio

r (t

(985

) = -2

.06,

p <

.05)

, an

d co

erci

ve b

ehav

ior

(t(9

40) = -2

.39,

p <

.0

5).

Pare

nts

of b

oys

in t

he in

terv

entio

n gr

oup

also

exp

erie

nced

gr

eate

r de

clin

es in

use

of

coe

rciv

e di

scip

line

(t(9

32) = -2

.65,

p <

.01)

.A

t pos

ttes

t, ad

oles

cent

s sh

owed

incr

ease

d us

e of

ac

tive

(t = -3

.15;

p =

.003

) and

dist

ract

ive

copi

ng s

trat

egie

s (t =

-2.8

6; p =

.005

), de

crea

sed

depr

essiv

e sy

mpt

oms

(t =

2.32

; p =

.016

). A

t pos

ttes

t, ch

ange

s in

mot

hers

’ pa

rent

ing

skill

s em

erge

d,

spec

ifica

lly in

crea

sed

mon

itori

ng (

t = -

2.67

; p =

.008

), an

d de

crea

sed

inco

nsis

tent

dis

cipl

ine

(t

= 2

.91;

p =

.005

). M

ater

-na

l car

egiv

ers

repo

rted

(con

tinue

d)



15

Inte

rven

tion/

Cita

tion

Pare

nt M

anag

emen

t Tr

aini

ng (

PMT

)/M

artin

ez a

nd

Eddi

e (2

005)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Gen

der:

46%

gir

ls,

54%

boy

s

Ris

k st

atus

: U

nive

rsal

. C

hild

ren

who

w

ere

fore

ign

born

had

bee

n in

th

e U

nite

d St

ates

an

ave

rage

of 6

.56

year

s N

: 73

Age

: mid

dle

scho

oler

s, m

ean

age

12.7

4 ye

ars

Ethn

icity

: 100

%

Span

ish

spea

king

La

tinos

Met

hod

Rec

ruitm

ent

was

do

ne t

hrou

gh w

ord

of m

outh

and

dir

ect

cont

act.

Hal

f of t

he

fam

ilies

wer

e ra

ndom

ly

assi

gned

to

the

PMT

in

terv

entio

n co

nditi

on

and

half

of t

he

fam

ilies

to

the

cont

rol

cond

ition

. Par

ticip

ants

w

ere

split

by

nativ

ity

stat

us w

ith 5

0% o

f yo

uth

born

in t

he

Uni

ted

Stat

es a

nd 5

0%

wer

e fo

reig

n bo

rn.

Inte

rven

tion

Des

crip

tion

adol

esce

nts’

use

of a

dapt

ive

copi

ng

skill

s; an

d (c

) a fa

mily

str

engt

heni

ng

com

pone

nt a

imed

at

incr

easin

g fa

mily

co

hesio

n. T

he in

terv

entio

n in

clud

ed 9

gr

oup

sess

ions

and

an

indi

vidu

aliz

ed

hom

e vi

sit o

ver

10 w

eeks

. PM

T us

es d

idac

tic in

stru

ctio

n, m

odel

ing,

role

play

ing

and

hom

e pr

actic

e to

teac

h pa

rent

ing

skill

s in

enc

oura

gem

ent,

mon

itorin

g, di

scip

line,

and

prob

lem

so

lvin

g. T

he in

terv

entio

n gr

oup

com

prise

d 12

-15

pare

nts

per

grou

p. O

ne h

our

was

dev

oted

to a

mea

l an

d tim

e fo

r so

cial

inte

ract

ion

amon

g fa

mili

es to

bui

ld s

ocia

l sup

port

net

wor

ks.

The

rem

aini

ng ti

me

was

faci

litat

ed b

y th

e en

tran

ador

es o

r co

ache

s. Ea

ch w

eek

pare

nts

rece

ived

new

info

rmat

ion

abou

t th

e se

ssio

n to

pic

and

assig

ned

hom

e pr

actic

e ex

erci

ses

for

the

wee

k. C

onte

nt

for

each

ses

sion

was

Res

ults

incr

ease

d su

ppor

tive

pare

ntin

g (t

= -

1.99

; p =

.031

), de

crea

sed

inco

nsis

tent

dis

cipl

ine

(t =

2.4

0; p

= .0

24),

and

few

er a

dole

scen

t be

havi

or p

robl

ems

(t =

2.

84; p

= .0

05).

At

post

test

, the

inte

rven

tion

grou

p de

mon

stra

ted

incr

ease

d ef

fect

ive

pare

ntin

g (F

(1, 5

1) =

2.7

9;

p <.

05),

gene

ral p

aren

ting

(F(1

, 51)

= 3

.53;

p <

.05)

, an

d sk

ill e

ncou

rage

men

t (F

(1, 5

1) =

3.8

3; p

< .0

5)

amon

g pa

rent

s. R

esul

ts

also

rev

eale

d be

nefit

s in

ad

oles

cent

agg

ress

ion

(F(1

, 50)

= 5

.40;

p <

.05)

, ex

tern

aliz

ing

beha

vior

s (F

(1, 5

0) =

5.3

0; p

< .0

5),

and

likel

ihoo

d of

sm

okin

g

Tabl

e 1.

(co

ntin

ued)

(con

tinue

d)



16

Inte

rven

tion/

Cita

tion

Fam

ilies

and

Sch

ools

To

geth

er (

FAST

)/M

cDon

ald

et a

l. (2

006)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Gen

der:

56%

boy

s an

d 44

% g

irls

Ris

k st

atus

: U

nive

rsal

.N

: 130

chi

ldre

n (8

0 as

sign

ed t

o FA

ST,

50 a

ssig

ned

to

FAM

E)A

ge: 1

st t

o 4t

h gr

ader

sEt

hnic

ity: 1

00%

La

tino,

mos

t w

ere

Mex

ican

in o

rigi

n.G

ende

r: FA

ST—

54%

bo

ys, 4

6% g

irls

. FA

ME—

28%

boy

s, 72

% g

irls

Met

hod

Cla

ssro

oms

in 1

0 ur

ban

elem

enta

ry s

choo

ls

wer

e m

atch

ed b

y gr

ade

and

then

ra

ndom

ly a

ssig

ned

to

eith

er t

he t

reat

men

t (F

AST

) or

the

co

mpa

riso

n, F

amily

Ed

ucat

ion

(FA

ME)

. A

uni

vers

al r

ecru

itmen

t st

rate

gy w

as u

sed

by r

ecru

iting

all

fam

ilies

with

chi

ldre

n in

the

tre

atm

ent

or

com

pari

son

cond

ition

cl

assr

oom

s.

Inte

rven

tion

Des

crip

tion

deliv

ered

thr

ough

dis

cuss

ion

in e

ither

sm

all g

roup

s or

cou

ples

, as

wel

l as

thro

ugh

role

-pla

ys. D

urin

g th

e w

eek,

th

e en

tran

ador

es t

elep

hone

d ea

ch

pare

nt t

o re

view

the

pas

t se

ssio

n m

ater

ial,

chec

k on

the

ir p

rogr

ess

with

th

e ho

me

assi

gnm

ent,

offe

r su

ppor

t, an

d an

swer

que

stio

ns. T

he in

terv

entio

n co

nsis

ted

of 1

2 w

eekl

y gr

oup

sess

ions

th

at la

sted

2.5

hou

rs e

ach.

FAST

is a

n af

ter-

scho

ol, m

ultif

amily

su

ppor

t gr

oup

aim

ed a

t in

crea

sing

pa

rent

invo

lvem

ent

in s

choo

ls a

nd

impr

ovin

g ch

ild w

ell-b

eing

. Tea

ms

prov

ide

hom

e vi

sits

and

lead

wee

kly

mul

tifam

ily s

essi

ons

(with

5-1

5 fa

mili

es)

that

tak

e pl

ace

at s

choo

l. T

here

is n

o fo

rmal

cur

ricu

lum

or

inst

ruct

ion.

The

firs

t ho

ur is

a

mul

tifam

ily s

essi

on, w

here

par

ents

le

ad c

omm

unic

atio

n at

the

ir fa

mily

ta

ble

whi

le s

hari

ng a

mea

l, si

ngin

g gr

oup

song

s, an

d pl

ayin

g fa

mily

gam

es.

Dur

ing

the

seco

nd h

our,

part

icip

ants

se

para

te in

to p

eer

grou

ps w

ith t

he

child

ren

play

ing

toge

ther

and

the

pa

rent

s m

eetin

g in

sm

all g

roup

s. T

he

Res

ults

(F(1

, 50)

= 2

.85;

p <

.05)

. A

mar

ginal

decr

ease

in u

se

of a

lcoh

ol m

ariju

ana

and

othe

r dr

ugs

(F(1

, 50)

=

2.04

; p <

.10)

was

foun

d.

At

the

2-ye

ar fo

llow

-up,

re

sults

indi

cate

d th

at

teac

hers

rat

ed s

tude

nts

assi

gned

to

FAST

as

havi

ng s

igni

fican

tly

mor

e so

cial

ski

lls

(F =

4.4

5; p

< .0

5), l

ess

aggr

essi

ve b

ehav

ior

in

the

clas

sroo

m (

low

er

exte

rnal

izin

g be

havi

ors

over

all;

F =-

4.68

; p

< .0

1), a

nd b

ette

r ac

adem

ic p

erfo

rman

ce

(F =

3.0

6; p

< .0

5) t

han

thos

e as

sign

ed t

o FA

ME.

Tabl

e 1.

(co

ntin

ued)

(con

tinue

d)



17

Inte

rven

tion/

Cita

tion

Brie

f Str

ateg

ic

Fam

ily T

hera

py

(BSF

T)/

Sant

iste

ban

et a

l. (1

997)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Ris

k st

atus

: U

nive

rsal

N: 1

22A

ge: 1

2- t

o 14

-yea

r-ol

ds, m

ean

age

13.1

yea

rsEt

hnic

ity: 8

4% L

atin

o an

d 16

% A

fric

an

Am

eric

an. O

f the

La

tinos

47%

wer

e C

uban

Met

hod

Fam

ilies

wer

e as

signe

d to

a b

asic

one

-gro

up

pret

est/p

ostt

est/f

ollo

w-

up d

esig

n. Fa

mili

es w

ere

self-

refe

rred

or

refe

rred

by

a s

choo

l cou

nsel

or

and

met

1 o

r m

ore

of

the

follo

win

g cr

iteria

: ex

tern

aliz

ing

beha

vior

pr

oble

ms,

inte

rnal

izin

g be

havi

or p

robl

ems,

Inte

rven

tion

Des

crip

tion

final

15

min

utes

is s

pent

in

unin

terr

upte

d pl

ay b

etw

een

pare

nt

and

child

with

no

teac

hing

, bos

sing

, or

dire

ctin

g. Fa

mili

es in

the

FA

ST

cond

ition

wer

e of

fere

d 8

wee

kly

grou

p se

ssio

ns a

nd p

aren

t gr

adua

te-

led

mon

thly

mee

tings

for

2 ye

ars.

The

re w

ere

4 in

hom

e in

terv

iew

s: pr

eint

erve

ntio

n, p

ostin

terv

entio

n,

1 ye

ar p

ost,

and

2 ye

ars

post

. Fam

ilies

in

the

FA

ME

cond

ition

wer

e se

nt

8 w

eekl

y be

havi

oral

boo

klet

s w

ith

follo

w-u

p ph

one

calls

to

see

if th

ey h

ad

read

the

boo

klet

s an

d w

ere

invi

ted

to

a fo

rmal

lect

ure

on p

aren

ting.

The

aim

of B

SFT

is t

o re

duce

beh

avio

r pr

oble

ms

amon

g 12

- to

14-

year

-ol

ds a

nd im

prov

e fa

mily

func

tioni

ng.

BSFT

ass

umes

tha

t tr

ansf

orm

ing

the

way

s in

whi

ch t

he fa

mily

func

tions

w

ill p

rodu

ce r

educ

tions

in t

he t

een’

s pr

esen

ting

prob

lem

s. BS

FT is

a fl

exib

le

mod

el t

hat

is t

ailo

red

to t

he n

eeds

of

eac

h fa

mily

. The

the

rapi

st “

join

s”

the

fam

ily, “

diag

nose

s,” a

nd t

hen

“res

truc

ture

s.” In

mos

t ca

ses,

it

Res

ults

At

post

test

, ado

lesc

ents

w

ho r

ecei

ved

BSFT

sh

owed

sig

nific

ant

impr

ovem

ents

in

cond

uct

diso

rder

(F(

1,

121)

= 6

5.81

; p <

.000

), so

cial

ized

agg

ress

ion

(F(1

, 12

1) =

11.

99; p

<.0

01),

an

d fa

mily

func

tioni

ng

(F(1

, 121

) =

41.8

; p <

.000

). T

hose

alr

eady

usi

ng d

rugs

Tabl

e 1.

(co

ntin

ued)

(con

tinue

d)



18

Inte

rven

tion/

Cita

tion

Brie

f Str

ateg

ic

Fam

ily T

hera

py

(BSF

T)/

Sant

iste

-ba

n et

al.

(200

3)

Stru

ctur

al F

amily

T

hera

py (

SFT

) ve

rsus

Indi

vidu

al

Psyc

hody

nam

ic

Chi

ld T

hera

py

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Gen

der:

66%

boy

s an

d 34

% g

irls

Ris

k st

atus

: Uni

-ve

rsal

N: 1

26A

ge: 1

2-18

yea

rs,

mea

n ag

e 15

.6

year

sEt

hnic

ity: 5

1%

Cub

an, 1

4%

Nic

arag

uan,

10%

C

olom

bian

, 6%

Pu

erto

Ric

an,

3% P

eruv

ian,

2%

M

exic

an, a

nd

14%

oth

er L

atin

o na

tiona

litie

sG

ende

r: 75

% b

oys,

25%

gir

lsR

isk

stat

us:

Uni

vers

al. I

nitia

l as

sess

men

t: 32

% O

DD

, 30%

an

xiet

y di

sord

ers,

Met

hod

ac

adem

ic pr

oble

ms

(exc

ept l

earn

ing

disa

bilit

ies)

, initi

atio

n of

alc

ohol

or d

rug

use.

The

re

was

no

cont

rol g

roup

.Se

e ab

ove.

Fam

ilies

wer

e ra

ndom

ly a

ssig

ned

to

the

BSFT

or

a gr

oup

cont

rol (

GC

) co

nditi

on

Fam

ilies

wer

e re

crui

ted

thro

ugh

scho

ol

coun

selo

rs a

nd m

edia

ca

mpa

igns

on

Span

ish

tele

visi

on a

nd

Inte

rven

tion

Des

crip

tion

co

nsist

s of

12-

16 w

eekl

y fa

mily

ses

sions

th

at la

st 6

0-90

min

utes

and

tak

es p

lace

w

ithin

a 4

- to

6-m

onth

per

iod.

See

abov

e. G

C c

onsi

sted

of a

par

ticip

a-to

ry le

arni

ng g

roup

inte

rven

tion

in

whi

ch a

dole

scen

ts w

ere

led

by a

faci

li-ta

tor

and

wer

e en

cour

aged

to

disc

uss

and

solv

e pr

oble

ms

amon

g th

emse

lves

. O

nly

the

adol

esce

nt w

as in

volv

ed in

th

erap

y an

d ea

ch g

roup

con

sist

ed

of 4

-8 a

dole

scen

ts. T

he n

umbe

r of

se

ssio

ns r

ecei

ved

by a

ny g

iven

gro

up

part

icip

ant

in t

he G

C w

as b

etw

een

6 an

d 16

wee

kly

sess

ions

. Eac

h se

ssio

n la

sted

app

roxi

mat

ely

90 m

inut

es.

The

aim

of S

FT w

as t

o re

duce

pro

blem

be

havi

ors

in c

hild

ren

and

impr

ove

over

all f

amily

func

tioni

ng. W

ith S

FT,

fam

ilies

wer

e se

en c

onjo

intly

. Thi

s in

terv

entio

n em

phas

ized

mod

ifyin

g

Res

ults

show

ed d

ecre

ase

in d

rug

use

(t(2

2) =

2.1

1; p

< .0

5).

At

post

test

, ado

lesc

ents

w

ho r

ecei

ved

BSFT

sh

owed

sig

nific

antly

gr

eate

r pr

e- t

o po

stin

t-er

vent

ion

impr

ovem

ent

in p

aren

t re

port

s of

ado

-le

scen

t co

nduc

t pr

oble

ms

(t(5

2) =

3.7

6; p

< .0

1)an

d so

cial

ized

agg

ress

ion

(t(5

2) =

3.5

7; p

< .0

01)

adol

esce

nt r

epor

ts o

f m

ariju

ana

use,

(t(6

9) =

2.

64; p

< .0

2) a

nd a

do-

lesc

ent

repo

rts

of fa

mily

co

hesi

on, (

t(49

) =

3.13

; p <

.005

) tha

n th

ose

in t

he

grou

p co

ntro

l con

ditio

n.A

t po

stte

st, S

FT a

nd IP

CT

eq

ually

red

uced

chi

ld

emot

iona

l (t =

34.

70;

p <.

001)

, beh

avio

ral

prob

lem

s (t

= 4

7.14

;

Tabl

e 1.

(co

ntin

ued)

(con

tinue

d)



19

Inte

rven

tion/

Cita

tion

(IPC

T)/

Szap

oczn

ik,

Rio

, et

al. (

1989

)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

16

% c

ondu

ct

diso

rder

s, 12

%

adju

stm

ent

diso

rder

s, 10

%

othe

r di

sord

ers

N: 6

9A

ge: 6

-12

year

s, m

ean

age

9.2

year

sEt

hnic

ity: L

atin

o w

ith 8

0% C

uban

, 20

% o

ther

Gen

der:

100%

boy

s

Met

hod

radi

o. F

amili

es w

ere

rand

omly

ass

igne

d to

SFT

, IPC

T, o

r th

e co

ntro

l con

ditio

n. A

ll fa

mili

es w

ere

seen

and

ev

alua

ted

in t

he s

ame

sett

ing.

Boys

mus

t be

from

tw

o-pa

rent

fa

mili

es a

nd m

ust

have

liv

ed in

the

Uni

ted

Stat

es fo

r 3

or m

ore

year

s

Inte

rven

tion

Des

crip

tion

m

alad

aptiv

e pa

tter

ns o

f int

erac

tions

. W

ith IP

CT,

the

chi

ld w

as s

een

in a

pla

yroo

m. T

his

inte

rven

tion

emph

asiz

ed t

he e

xpre

ssio

n of

fe

elin

gs, l

imit

sett

ing,

tran

sfer

ence

in

terp

reta

tions

, and

insi

ght

as a

m

echa

nism

for

chan

ge. T

he c

ontr

ol

cond

ition

con

sist

ed o

f rec

reat

iona

l ac

tiviti

es, s

uch

as a

rts

and

craf

ts,

mus

ic, a

nd g

ames

. All

cond

ition

s la

sted

no

long

er t

han

6 m

onth

s an

d ha

d a

min

imum

of 1

2 an

d a

max

imum

of

24

cont

act

hour

s.

Res

ults

p <

.001

), an

d ps

ycho

dyna

mic

fu

nctio

ning

(t =

124

.7;

p <.

001)

. At

the

1-ye

ar

follo

w-u

p, t

hose

in t

he

BSFT

con

ditio

n sh

owed

si

gnifi

cant

impr

ovem

ent

in fa

mily

func

tioni

ng fr

om

pret

est

to fo

llow

-up

(t(2

2) =

2.2

6; p

< .0

5),

whi

le fa

mily

func

tioni

ng

in t

he IP

CT

gro

up

dete

rior

ated

(t(

20) =

2.03

; p <

.05)

.

Not

e: C

BCL =

Chi

ld B

ehav

ior

Che

cklis

t. O

DD

= o

ppos

ition

al d

efia

nt d

isor

der.

Tabl

e 1.

(co

ntin

ued)




effects did not vary by ethnicity of participants, suggesting that the program worked well for both Latino and non-Latino families.

Bridges to High School. The Bridges to High School intervention was designed to increase protective factors and reduce risk factors associated with low aca-demic engagement and mental health among urban children transitioning from elementary school to junior high school (Gonzales, Dumka, Deardorff, Carter, & McCray, 2004). The intervention focused on teaching effective parenting skills and increasing family cohesion as well as helping adolescents to improve their adaptive coping skills. Families participated in nine group sessions at their child’s school and received one individualized home visit. In an evalua-tion study with a predominantly Latino sample (86.5%) of Mexican descent, youth participants showed improved coping strategies as rated by self-reports and fewer parent-rated behavior problems at post-test (Gonzales et al., 2004). Adolescents also reported increased maternal parenting skills, specifically less inconsistent discipline and increased monitoring (Gonzales et al., 2004).

Parent Management Training. PMT is a well-known family intervention developed by researchers at the Oregon Social Learning Center (Forgatch & Martinez, 1999; Reid, Eddy, Fetrow, & Stoolmiller, 1999). An important emphasis is on effective parental monitoring and rewards for appropriate behaviors. Although initially evaluated with non-Latino White samples, in recent years it has been extended to more diverse ethnic groups including Latinos. The 12-week intervention includes weekly group sessions that pro-vide time for social networking and parenting information led by coaches or “entrenadores” (as adapted for Latino families). During the week, the entre-nadores also telephone each parent to review the past session material, offer support, answer questions, and check on their homework progress. In a recent evaluation with an entirely Latino sample (predominantly Mexican), the families that received the intervention showed increased effective parenting and parents reported decreased aggressive behavior among their adolescent children (Martinez & Eddy, 2005).

Families and Schools Together. FAST is an afterschool, multifamily support group aimed at increasing parent involvement in schools and improving child well-being (McDonald et al., 2006). FAST does not include a set curriculum, but instead allows families to come together, engage in supervised parent-child interactions, and build social networks. Families meet together and then separate into child and parent groups. Meetings are held once a week over the course of 8 weeks. Parent graduates of the program then lead monthly meet-ings for 2 years, FASTWORKS. In a recent study with an exclusively Latino sample (predominantly of Mexican descent), teachers rated FAST students as having significantly better social skills, less aggressive behavior, and better



Leidy et al. 21

academic skills than the control group (McDonald et al., 2006). However, in another study with a more marginalized, immigrant Mexican population, FAST resulted in higher levels of social cohesion but did not directly affect children’s aggressive behavior (Knox, Guerra, Williams, Toro & Leidy, 2009).

Brief Structural/Strategic Family Therapy. The aim of BSFT is to improve the level of family functioning in order to reduce behavior problems among adolescents (Santisteban et al., 1997). BSFT is a flexible model that is tai-lored to the needs of each family. It consists of 12 to 16 weekly family sessions over the course of 4 to 6 months where the interventionist creates an effective collaboration with the family, identifies interaction patterns that are central to the problem behaviors, and restructures family interactions by facilitating alternate family organizations and modifying family roles. In a recent study with an entirely Latino sample (with a high percentage of Cuban-born participants), BSFT was effective in reducing behavior problems (both parent-rated conduct disorder and aggression), and improving family func-tioning (Santisteban et al., 1997, 2003). In addition, those who were already using drugs prior to the intervention showed a decrease in drug use (Santisteban et al., 1997, 2003).

Structural Family Therapy. In SFT, families are seen conjointly, and sessions emphasize modifying maladaptive patterns of interactions among family mem-bers. In addition to enhancing family functioning, a goal of SFT is to reduce child problem behaviors. The intervention provides 12 to 24 contact hours over a maximum 6-month time period. In a study with boys from two-parent Latino families (predominantly from Cuba), Szapocznik, Rio, et al. (1989) compared SFT with Individual Psychodynamic Child Therapy (IPCT) and a control group. IPCT is a nondirective approach emphasizing insight, limit setting, and expres-sion of feelings. Both SFT and IPCT reduced mother-rated behavioral and emotional problems and improved psychodynamic ratings of child functioning as rated by a psychologist. However, at the 1-year follow up, families that were in the IPCT group deteriorated in their general family functioning over time, while SFT families demonstrated improved family functioning as rated by independent observers (Szapocznik, Rio, et al., 1989).

How Cultural Sensitivity Was Incorporated Into Interventions Adapted for LatinosAt the surface structure level, all of the interventions that were adapted to Latino families translated their materials into Spanish. Of course, this is the most basic level of adaptation that essentially is required for implementation with limited or non-English speakers. Beyond this, several programs also




employed bilingual facilitators from the target cultural group (SHIP, Bridges to High School, FAST, and SFT). Presumably, matching facilitators and clients based on cultural background enhances the effectiveness of communication, even in Spanish, because of shared nuances in dialogue. Furthermore, facilita-tors from similar cultural backgrounds should bring to their work a cultural perspective reflecting understanding of deep structure concerns.

The design and content of the interventions also specifically addressed deep structure characteristics relevant to Latino families. To begin with, cen-tering the intervention at the family level was compatible with the Latino cultural value of familismo. In addition, familismo was integrated into the interventions in other ways. For example, the Bridges to High School program worked at increasing family cohesion, and thus reducing parent-child con-flict. FAST engaged all family members in the intervention and valued their perspectives. Both BSFT and SFT are family-focused interventions that focus on correcting maladaptive patterns within the family and strengthening interpersonal relationships.

Personalismo, the cultural value of personal relationships, was integrated into all of the interventions by providing face-to-face interactions, as well as focusing on the importance of interpersonal relationships among family members. The cultural value, respeto, was integrated into SHIP, PMT, FAST, BSFT, and SFT by recognizing the difficulty parents have in maintaining their children’s respect and the hierarchical family structure due to the differ-ing rates of acculturation between parents and children. FAST modeled respeto to children by school staff being respectful toward their parents who have minimal English language skills. PMT focused on parental empower-ment as a way of increasing effective parenting. However, it is interesting to note that none of the interventions integrated the cultural values of religiosi-dad, machismo, or marianismo into their intervention.

In terms of the process of cultural adaptation, many programs were modified in a collaborative fashion with community “experts” assessing the appropriate-ness of different models for Latino families in general as well as for the target sample. For example, PMT consulted with community experts, trained inter-ventionists, and project staff to ensure that the core content and components of the intervention were both theoretically and operationally relevant to the Latino culture and the specific participant subgroup. PMT also then conduc-ted focus groups with the modified intervention to determine the saliency and cultural validity of the adapted intervention. In essence, a modified version of the PMT program was developed for Latino families, incorporating key compo-nents of the evidence-based program but also refining these components and addressing new issues to maximize cultural fit.



Leidy et al. 23

Family-Level Preventive Interventions Developed for Latinos

Four family-level preventive interventions were identified that were devel-oped specifically for Latino families with the aim of reducing youth violence and behavior problems. These interventions and related research studies are described in detail (with citations) in Table 2. They are (a) Padres Trabajando Por La Paz (PTP), (b) Familias Unidas, (c) Bicultural Effectiveness Training (BET), and (d) Family Effectiveness Training (FET). We turn to a brief descrip-tion of each of program content and outcomes, followed by a discussion of how programs were tailored to Latino families.

Summary of Interventions and Outcomes for Programs Designed for Latino Families

Padres Trabajando Por La Paz. PTP consisted of bilingual newsletters that incorporated role model stories that were theoretically derived to increase par-ental monitoring (Murray, Kelder, Parcel, Frankowski, & Orpinas, 1999). PTP was part of a pilot for the parent education component of a comprehensive violence prevention program for middle school children called Students for Peace project. This was evaluated by a randomized trial, with Latino parents (predominantly of Mexican descent) in the intervention group receiving four newsletters over a 2-week period, while those in the control condition did not receive the newsletters. Results revealed that children of parents in the inter-vention group reported a modest increase in parental monitoring behaviors posttest across baseline levels, whereas parents of control children who reported moderate to high levels of monitoring at pretest reported lower levels of parental monitoring posttest (Murray et al., 1999).

Familias Unidas. Familias Unidas is designed to bring together groups of recently immigrated Latino parents in order to empower them to take leader-ship in structuring their adolescent’s social ecology (Coatsworth, Pantin, & Szapocznik, 2002; Pantin, Coatsworth et al., 2003). Familias Unidas strives to assist parents in developing parenting skills to help them reduce risks and enhance protection in important developmental domains for adolescents such as schools, peers, and family. Five general techniques were used to promote changes within the family: problem posing and participatory exercises, group discussions, parent-adolescent activities, visits by the adolescents’ school counselors, and parent-adolescent discussions. Multiparent groups meet weekly over a 9-month period. In a recent study of Latino families from diverse backgrounds (Cuban, Central American, South American, and Puerto



Inte

rven

tion/

Cita

tion

Padr

es T

raba

jand

o po

r la

Paz

(P

TP)

/Mur

ray,

Kel

der,

Parc

el,

Fran

kow

ski,

and

Orp

inas

(19

99)

Fam

ilias

Uni

das/

Pant

in,

Coa

tsw

orth

, et

al.

(200

3)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Ris

k st

atus

: Chi

ld

repo

rted

m

oder

ate

aggr

essi

on.

N: 9

4A

ge: 8

th g

rade

rs,

mea

n ag

e of

the

in

terv

entio

n gr

oup

was

13.

79

year

sEt

hnic

ity: 1

00%

La

tino.

73.

7% o

f pa

rent

s w

ere

born

in M

exic

o,

23.7

% w

ere

born

in

the

Uni

ted

Stat

es, a

nd 2

.6%

w

ere

born

in

Cen

tral

Am

eric

a.G

ende

r: 63

% b

oys,

37%

gir

lsR

isk

stat

us: U

nive

rsal

N: 1

67A

ge: 6

th a

nd 7

th

grad

ers,

mea

n ag

e w

as 1

2.4

year

s

M

etho

d

Pare

nts

of 8

th g

rade

rs

from

the

Stu

dent

s fo

r Pe

ace

inte

rven

tion

wer

e ca

lled

by b

iling

ual

tele

phon

e in

terv

iew

ers.

Pare

nts

wer

e ra

ndom

ized

into

the

in

terv

entio

n co

nditi

on

at t

he c

oncl

usio

n of

th

e pr

etes

t in

terv

iew

s an

d 10

-12

wee

ks la

ter,

com

plet

ed t

he p

ostt

est

tele

phon

e in

terv

iew

Fam

ilies

wer

e re

crui

ted

from

3 p

ublic

sch

ools

. A

dole

scen

ts m

ust

have

no

hist

ory

of

psyc

hiat

ric

In

terv

entio

n D

escr

iptio

n

PTP

aim

ed t

o in

crea

se p

aren

tal

mon

itori

ng a

nd, t

hus,

redu

ce c

hild

pr

oble

m b

ehav

iors

. PT

P co

nsis

ted

of

bilin

gual

new

slet

ters

inco

rpor

atin

g ro

le m

odel

sto

ries

the

oret

ical

ly

deri

ved

to in

crea

se p

aren

tal

mon

itori

ng in

Lat

ino

pare

nts.

Four

ne

wsl

ette

rs w

ere

mai

led

to p

aren

ts

in t

he in

terv

entio

n gr

oup

over

2

wee

k in

terv

als

duri

ng t

he 3

rd a

nd 4

th

mon

ths

of t

he s

choo

l yea

r.

Fam

ilias

Uni

das

stri

ves

to a

ssis

t pa

rent

s in

dev

elop

ing

skill

s to

hel

p re

duce

the

ri

sks

and

enha

nce

prot

ectio

n fo

r th

eir

adol

esce

nt. F

ive

tech

niqu

es w

ere

used

: (a

) pr

oble

m p

osin

g an

d pa

rtic

ipat

ory

R

esul

ts

At

post

test

, par

ents

in t

he

inte

rven

tion

cond

ition

w

ho h

ad lo

wer

soc

ial

norm

s fo

r m

onito

ring

at

bas

elin

e re

port

ed

high

er n

orm

s af

ter

the

inte

rven

tion

than

pa

rent

s in

the

con

trol

co

nditi

on (

p =

.009

). C

hild

ren

of p

aren

ts in

th

e in

terv

entio

n gr

oup

repo

rted

slig

htly

hig

her

leve

ls o

f mon

itori

ng a

t po

stte

st a

cros

s ba

selin

e va

lues

, whe

reas

con

trol

ch

ildre

n w

ho r

epor

ted

mod

erat

e to

hig

h le

vels

of

mon

itori

ng a

t pr

etes

t re

port

ed lo

wer

leve

ls a

t po

stte

st (

p =

.04)

.

A m

ixed

mod

el a

naly

sis

of v

aria

nce

reve

aled

a

sign

ifica

nt t

ime ×

cond

ition

inte

ract

ion

on

pare

ntal

inve

stm

ent

Tabl

e 2.

Inte

rven

tions

Dev

elop

ed fo

r La

tino

Fam

ilies

(con

tinue

d)

24



Inte

rven

tion/

Cita

tion

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Ethn

icity

: 39%

C

uban

, 29%

C

entr

al

Am

eric

ans

and

17%

Sou

th

Am

eric

ans,

5%

Puer

to R

ican

s/D

omin

ican

sG

ende

r: 61

% b

oys,

39%

gir

ls

M

etho

d

ho

spita

lizat

ion

and

mus

t re

side

with

at

leas

t 1

Latin

o im

mig

rant

par

ent.

Fam

ilies

wer

e ra

ndom

ly a

ssig

ned

to

inte

rven

tion

and

no-

inte

rven

tion

cont

rol

cond

ition

s.

In

terv

entio

n D

escr

iptio

n

exer

cise

s, (b

) gr

oup

disc

ussi

ons

to

incr

ease

par

ents

’ und

erst

andi

ng

of t

heir

rol

e in

pro

tect

ing

thei

r ad

oles

cent

s fr

om h

arm

and

fa

cilit

ate

pare

ntal

inve

stm

ent

in

thei

r ad

oles

cent

s, (c

) ac

tiviti

es t

o al

low

par

ents

to

inte

ract

with

the

ir

adol

esce

nts’

pee

rs, (

d) v

isits

by

adol

esce

nts’

sch

ool c

ouns

elor

s, an

d (e

) a

hom

e-ba

sed

fam

ily s

essi

on w

ith

plan

ned

pare

nt-a

dole

scen

t di

scus

sion

s. T

he m

ultip

aren

t gr

oups

met

wee

kly

for

9 m

onth

s w

ith a

tra

ined

faci

litat

or.

Con

trol

fam

ilies

wer

e on

ly c

onta

cted

to

com

plet

e as

sess

men

ts.

R

esul

ts

(F

(4, 5

77) =

2.68

; p <

.0

4) a

nd a

dole

scen

t be

havi

or p

robl

ems

(F(3

, 42

4) =

4.2

5; p

< .0

06).

Spec

ifica

lly, t

he c

ontr

ol

cond

ition

exh

ibite

d m

ore

pare

ntal

inve

stm

ent

duri

ng t

he fi

rst

3 m

onth

s, bu

t th

en fl

atte

ned

out

and

bega

n to

dec

reas

e sh

arpl

y at

9 m

onth

s. T

he in

terv

entio

n gr

oup

evid

ence

d its

gre

ates

t in

crea

se in

par

enta

l in

vest

men

t be

twee

n 3

and

6 m

onth

s, w

ith a

m

ilder

dec

line

betw

een

9 an

d 12

mon

ths.

The

in

vent

ion

grou

p al

so

exhi

bite

d a

stea

dy d

eclin

e in

ado

lesc

ent

beha

vior

pr

oble

ms,

whi

le t

he

cont

rol g

roup

evi

denc

ed

a sh

arp

incr

ease

bet

wee

n 3

and

6 m

onth

s an

d th

en

decl

ined

. Thu

s, Fa

mili

as

Tabl

e 2.

(co

ntin

ued)

(con

tinue

d)

25



26

Inte

rven

tion/

Cita

tion

Bicu

ltura

l Ef

fect

iven

ess

Trai

ning

(BE

T)/

Szap

oczn

ik, R

io,

et a

l. (1

986)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Ris

k st

atus

: Cub

an

Am

eric

an

fam

ilies

who

had

im

mig

rate

d w

ithin

th

e la

st 2

0 ye

ars.

Hig

h nu

mbe

r of

ado

lesc

ent

cond

uct/

beha

vior

pr

oble

ms

N: 3

1A

ge: M

ean

age

of

adol

esce

nts

was

15

yea

rsEt

hnic

ity: 1

00%

of

pare

nts

wer

e C

uban

bor

n

M

etho

d

Part

icip

ants

wer

e re

crui

ted

thro

ugh

publ

ic s

ervi

ce

anno

unce

men

ts,

refe

rral

s fr

om t

he

scho

ol s

yste

m, j

uven

ile

cour

t, an

d ot

her

soci

al

serv

ice

agen

cies

. Pa

rtic

ipan

ts w

ere

rand

omly

ass

igne

d to

BET

and

SFT

co

nditi

ons.

In

terv

entio

n D

escr

iptio

n

BET

aim

s to

bri

ng a

bout

a r

educ

tion

in in

divi

dual

and

fam

ily d

ysfu

nctio

n w

hile

als

o m

oder

atin

g cu

ltura

l con

flict

. BE

T in

clud

es 2

cha

nge

stra

tegi

es: (

a)

deto

ur fa

mily

con

flict

by

plac

ing

the

focu

s of

bot

h th

e in

terg

ener

atio

nal

diffe

renc

es a

nd t

he c

ultu

ral

diffe

renc

es o

n th

e cu

lture

con

flict

, (b

) de

velo

pmen

t of

alli

ance

s in

ord

er

to b

ring

abo

ut n

ew c

ross

ed a

llian

ces

betw

een

fam

ily m

embe

rs a

nd c

ultu

res.

SFT

—fa

cilit

ator

wor

ks w

ith fa

mily

; fa

mily

ena

cts,

faci

litat

or r

estr

uctu

res.

Sim

ilar

but

SFT

is m

ore

proc

ess

orie

nted

and

may

use

any

con

tent

tha

t em

erge

s fr

om t

he fa

mily

. BET

use

s cu

lture

as

cont

ent.

Goa

l to

com

pare

R

esul

ts

Uni

das

incr

ease

d pa

rent

al in

vest

men

t an

d de

crea

sed

adol

esce

nt

beha

vior

pro

blem

s bu

t di

d no

t si

gnifi

cant

ly

affe

ct a

dole

scen

t sc

hool

bo

ndin

g/ac

adem

ic

achi

evem

ent

(F(4

, 576

) =

1.11

; p <

.35)

.A

t po

stte

st, b

oth

inte

rven

tion

grou

ps

show

ed d

ecre

ased

chi

ld

cond

uct

prob

lem

s (F

(1,

29) =

8.30

; p <

.01)

, in

adeq

uacy

-imm

atur

ity

(F(1

, 29)

= 6

.72;

p <

.0

2), a

nd s

ocia

lized

de

linqu

ency

(F(

1, 2

9) =

7.

48; p

< .0

1). F

amily

fu

nctio

ning

als

o im

prov

ed

(p <

.001

). T

hus,

BET

pr

oved

to

be e

ffect

ive.

Tabl

e 2.

(co

ntin

ued)

(con

tinue

d)



27

Inte

rven

tion/

Cita

tion

Fam

ily E

ffect

iven

ess

Trai

ning

(FE

T)/

Szap

oczn

ik,

Sant

iste

ban,

et

al.

(198

9)

Sam

ple

(Chi

ld

Cha

ract

eris

tics)

Gen

der:

48%

boy

s, 52

% g

irls

Ris

k st

atus

: Had

to

hav

e th

e po

tent

ial f

or

inte

rgen

erat

iona

l an

d in

terc

ultu

ral

conf

lict.

Ado

lesc

ents

who

w

ere

at r

isk

for

futu

re d

rug

use

N: 7

9A

ge: 6

-12

year

s, m

ean

age

9.44

ye

ars

Ethn

icity

: 100

%

Latin

o w

ith 7

6%

Cub

anG

ende

r: 71

% b

oys

29%

gir

ls

M

etho

d

Part

icip

ants

wer

e ra

ndom

ly a

ssig

ned

to a

m

inim

al c

onta

ct c

ontr

ol

grou

p an

d th

e Fa

mily

Ef

fect

iven

ess T

rain

ing

cond

ition

. All

fam

ilies

ha

d to

mee

t 2

crite

ria

for

the

Hig

h R

isk

Synd

rom

e (p

oten

tial

for

inte

rgen

erat

iona

l an

d in

terc

ultu

ral

conf

lict)

. Fam

ilies

wer

e al

so a

dmitt

ed if

the

y pr

esen

ted

two

or

mor

e of

the

follo

win

g pr

oble

ms:

mar

ital

prob

lem

s, a

mot

her

who

is d

epre

ssed

/w

ithdr

awn/

lone

ly, o

lder

si

blin

g w

ho is

a d

rug

abus

er, c

hild

age

d 6-

12

year

s sh

owin

g an

y si

gns

of s

ubst

ance

use

.

In

terv

entio

n D

escr

iptio

n

BET

(ne

w in

terv

entio

n) w

ith S

FT. B

oth

grou

ps r

ecei

ved

the

inte

rven

tion

over

12

ses

sion

s.FE

T a

ims

at c

orre

ctin

g m

alad

aptiv

e fa

mily

inte

ract

ion

patt

erns

. Did

actic

an

d in

terv

entio

n m

ater

ial w

as

pres

ente

d by

a fa

cilit

ator

in a

cl

assr

oom

-like

atm

osph

ere

to

the

entir

e fa

mily

. FET

con

tain

s 3

com

pone

nts:

a fa

mily

dev

elop

men

t co

mpo

nent

, a b

icul

tura

l effe

ctiv

enes

s tr

aini

ng c

ompo

nent

, and

a b

rief

st

rate

gic

fam

ily t

hera

py c

ompo

nent

. In

terv

entio

n co

nsis

ted

of 1

3 w

eekl

y se

ssio

ns t

hat

wer

e ap

prox

imat

ely

1.5-

2 ho

urs

long

. The

min

imum

con

tact

co

ntro

l con

ditio

n w

as t

old

to w

ait

13

wee

ks a

nd w

as c

onta

cted

an

aver

age

of 1

.9 t

imes

dur

ing

the

3 m

onth

w

aitin

g pe

riod

. Aft

er t

he c

ompl

etio

n of

the

inte

rven

tion

for

the

FET

gr

oup,

tho

se in

the

min

imum

con

tact

co

ntro

l con

ditio

n w

ere

offe

red

the

inte

rven

tion.

R

esul

ts

At

post

test

, fam

ilies

in t

he

FET

sho

wed

a s

igni

fican

tly

grea

ter

impr

ovem

ent

than

the

con

trol

fam

ilies

on

mea

sure

s of

str

uctu

ral

fam

ily fu

nctio

ning

(p <

.04)

, chi

ld s

elf-c

once

pt

(p <

.01)

, and

pro

blem

be

havi

ors,

spec

ifica

lly

cond

uct

prob

lem

s (p

<

.01)

and

per

sona

lity

prob

lem

s (p

< .0

4).

Tabl

e 2.

(co

ntin

ued)




Rican), parent and adolescent ratings showed increased parental investment and decreased adolescent behavior problems (Pantin, Coatsworth et al., 2003).

Bicultural Effectiveness Training. BET was created as an attempt to develop a culturally sensitive psychoeducational and relatively easy to implement intervention that would be as effective as traditional family therapy models in bringing about a reduction in individual and family dysfunction while also moderating cultural conflict. BET is delivered in 12 sessions to family groups. It emphasizes two change strategies. The first strategy is to temporarily detour family conflict by placing the focus of both intergenerational and cultural differences on culture conflict. The second strategy focuses on the develop-ment of alliances, which aims to bring about new crossed alliances between family members (Szapocznik et al., 1986). In a study with predominantly immigrant Cuban families comparing BET and SFT, both BET and SFT reduced parent-rated child conduct problems, inadequacy-immaturity, social-ized delinquency, and overall family functioning as rated by the whole family (Szapocznik et al., 1986).

Family Effectiveness Training. The goal of FET is to correct maladaptive family interactions to prevent drug use and behavior problems in adolescents (Szapocznik, Santisteban, et al., 1989). It strives to teach the family preven-tion strategies designed to strengthen the family to overcome future stressors such as intergenerational and intercultural conflicts successfully. FET contains three components: a family development component, a bicultural effectiveness training component, and a brief strategic family therapy component. The weekly intervention is delivered to the entire family over the course of 13 weeks. In a randomized trial comparing FET with a minimal contact control condition with predominantly Cuban participants, families in the FET condi-tion showed greater improvements in independent observer-rated family functioning, child-rated self-concept, and fewer mother-rated child behav-ior problems than those in the control condition (Szapocznik, Santisteban, et al., 1989).

How Cultural Sensitivity Was Incorporated Into Interventions Designed for LatinosIn terms of maximizing cultural sensitivity, the interventions described above designed specifically for Latino families had many common features with the adapted interventions described previously. First, all of the interventions were offered in Spanish. Furthermore, all of these interventions were selected, in part, in recognition of the importance of familismo and the viability of using families as an entry point for child behavior change. Many of the interventions



Leidy et al. 29

in both groups worked with the whole family, further validating the importance of the family unit within Latino culture. Given the importance of personalismo, both adapted and tailored programs emphasized face-to-face contact and the importance of personal relationships. This affects adapted programs because programs can be selected or modified to include more personal contact. The tailored programs can be specifically developed to rely on relationship build-ing as an integral conceptual foundation of the program. This was seen particularly in BET and FET.

Similarly, both the adapted programs and the programs specifically designed for Latino families addressed respeto and how this affects parents’ ability to maintain their children’s respect, particularly when acculturation is faster among youth. Although this concern was integrated into SHIP, PMT, FAST, BSFT, and SFT (the adapted programs), it was specifically targeted by some of the tailored programs. For example, BET was developed with a particular focus on responding to the problems caused by children’s more rapid accul-turation within the family system. However, consistent with the interventions adapted to Latino families, none of the interventions developed for Latino families mentioned integrating the cultural values of religiosidad, machismo, or marianismo into their intervention.

Some of the interventions made note of other precautions that were taken to ensure that the intervention was culturally sensitive. PTP used stories that represented Latino culture and integrated those into the intervention. PTP also noted that they gathered role model stories from the population about parental monitoring and adapted those stories for the newsletter. Thus, the stories were drawn from a Latino population (and a specific Puerto Rican subgroup), reflective of the values and characteristics of Latino families, such as familismo and respeto, as well as the local variations for the Puerto Rican group.

Conclusion and Future DirectionsIt is evident that preventive interventions with families of youth aged 6 to 18 years can be effective youth violence prevention strategies with Latino populations. In both the adapted and tailored programs, a focus on families provided a culturally appropriate and well-matched starting point for pan-Latino prevention programming—that is, programming relevant more generally for Latino populations regardless of subgroups. In addition to building on the concept of familismo or the importance of families, the core components of successful programs were also well-suited to the deep struc-ture cultural dimensions of colectivismo, respeto, simpatía, and personalismo described earlier.




Two clear examples of effective pan-Latino youth violence prevention programs are Familias Unidas and FAST. Familias Unidas was shown to be effective with a Latino sample that included Cubans, Central Americans, South Americans, and Puerto Ricans/Dominicans (Coatsworth et al., 2002). A primary emphasis was on building parenting skills to address the particular challenges of raising an adolescent child in general and as specifically linked to challenges faced by immigrant families. FAST also provides an additional example of how to reach a diverse group of families while being culturally sensitive. FAST does not have a specific set curriculum but rather uses parent-led groups, social time, and parent-child activities to help improve child outcomes (McDonald et al., 2006). This allows the intervention to adapt to the needs of each group, and thus, reach a larger, more diverse population. Therefore, if the target population was in fact immigrant families, it is likely that issues related to immigration and acculturation would be discussed in the parent-led groups. In contrast, a nonim-migrant group of families may raise different issues.

In addition to highlighting deep structure characteristics of effective pan-Latino programming, it is also important to consider whether effective prevention programs shared a common focus on specific family processes of relevance to youth violence. As noted earlier, family-focused programs cover a broad range of strategies bound primarily by using the family as the eco-logical context for prevention. The programs we discussed also ranged in emphasis and intensity.

A common feature across programs was a focus on improving participa-nts’ parenting skills, specifically parental monitoring (a robust correlate of youth violence). In some cases, this was taught via newsletters (PTP), but in most cases programs were more comprehensive. All of the programs included some mechanism to build alliances among families. A unique feature of some of the programs was a specific family therapy orientation (BSFT, SFT, BET, FET), with an emphasis on improving family interactions, reducing parent-child conflict, and empowering families to leverage resources. Because research studies did not compare parent training with family therapy, we cannot say whether one approach is recommended—rather, the extant literature suggests that a range of family-focused interventions can be effective with Latino families and that these programs reflect the theoretical underpinnings of effective family-based prevention programs that have been implemented more broadly (Tolan & Guerra, 1994).

From the studies discussed above, four primary areas of emphasis cut across effective family-based prevention programming with Latinos: (a) improving parental monitoring, (b) increasing family cohesion, (c) increasing network-ing across families, and (d) empowering families to access resources more



Leidy et al. 31

effectively. Monitoring and cohesion are cornerstones of many family-based prevention programs that have been effective in preventing youth violence across multiple ethnic and cultural groups. These principles are also consis-tent with many of the deep structure characteristics of Latino culture discussed previously emphasizing the importance of respeto, simpatía, and personal-ismo. Increasing networking and utilization of resources are important family strengths that have been addressed in related treatment programs not discussed in this article (e.g., Multisystemic Family Therapy; Henggeler, Schoenwald, Borduin, & Cunningham, 1998). They are also consistent with the cultural value of colectivismo. In addition to being relevant to both youth violence prevention and Latino cultural values, all of these dimensions of effective programming also are significant for families coping with stressors associated with immigration, economic disadvantage, and other types of marginalization, because the overarching theme is one of strengthening and empowering fami-lies to be more effective in daily life.

Of course, these commonalities and directions for pan-Latino programming should not mask the fact that surface structure adaptation (language, rituals, examples used) may need to be done within a narrow cultural context reflect-ing unique subgroup and local differences (Cohen, 2009). As illustrated in several of the programs reviewed, this can be done by consulting with community experts and project staff to determine relevance for the spe-cific participant subgroup as well as conducting focus groups with participants before, during, and after program implementation. The use of paraprofessional lay health workers from the community (entrenadores, promotoras) can also increase the match between program and participants (although there is very little research comparing this method of prevention with standard professional delivery). Just as the evidence-base suggests that family-focused preventive interventions are among the most effective youth violence prevention strate-gies, evidence-based guidelines for adaptation can enhance our ability to effectively translate research for Latino families and other cultural groups.

What is missing from the studies discussed above is a focus on other asp-ects of culture that may be uniquely linked to the etiology of youth violence (and prevention) among Latinos. As we mentioned, it is noteworthy that none of the preventive interventions addressed the role of machismo and marian-ismo. In part, this is due to a general tendency for risk research to be conducted with mainstream populations and then extended to different ethnic groups. Certainly, future research with Latinos should explore the role of these gender-linked constructs to both youth violence and family dynamics. Religiosidad also was not incorporated into prevention programming, in spite of the obvi-ous potential to bring families together for a common purpose. Rather, most




programs adapted to or developed specifically for Latinos emphasized the immigrant experience and adjustment to the unique conditions linked to rec-ent immigration. Perhaps the next generation of prevention programs will incorporate a wider range of deep structure cultural values, building on research that examines their relation with youth violence and highlighting their promise for pan-Latino prevention programming.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Funding

This research was supported by a cooperative agreement with the Centers for Disease Control and Prevention (Grant #5U49CE000734).

References

Anderson, R. (2002). Deaths: Leading causes for 2000. National Vital Statistics Report, 50, 16.

Arciniega, G. M., Anderson, T. C., Tovar-Blank, Z. G., & Tracey, T. J. G. (2008). Toward a fuller conception of machismo: Development of a traditional machismo and caballerismo scale. Journal of Counseling Psychology, 55, 19-33.

Arredondo, P. (2006). Multicultural competencies and family therapy strategies with Latino families. In R. L. Smith & R. E. Montilla (Eds.), Counseling and fam-ily therapy with Latino populations: Strategies that work (pp. 77-96). New York: Routledge.

Asencio, M. W. (1999). Machos and sluts: Gender, sexuality and violence among a cohort of Puerto Rican adolescents. Medical Anthropology Quarterly, 13, 107-126.

Barrera, M., Biglan, A., Taylor, T. K., Gunn, B. K., Smolkowski, K., Black, C., et al. (2002). Early elementary school intervention to reduce conduct problems: A ran-domized trial with Hispanic and non-Hispanic children. Prevention Science, 3, 83-94.

Castro, F. G., Barrera, M., & Martinez, C. R. (2004). The cultural adaptation of pre-vention interventions: Resolving tensions between fidelity and fit. Prevention Sci-ence, 5, 41-45.

Cauce, A. M., & Domenech-Rodríguez, M. (2002). Latino families: Myths and reali-ties. In J. M. Contreras, K. A. Kerns, & A. M. Neal-Barnett (Eds.), Latino chil-dren and families in the United States: Current research and future directions (pp. 3-25). Westport, CT: Praeger.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2007). Web-based Injury Statistics Query and Reporting System



Leidy et al. 33

(WISQARS). Retrieved October 15, 2009, from http://www.cdc.gov/injury/wisqars/index.html

Centers for Disease Control and Prevention. (2008). Youth Risk Behavior Survey. Retrieved September 4, 2008, from http://www.cdc.gov/HealthyYouth/yrbs/

Coatsworth, J. D., Pantin, H., & Szapocznik, J. (2002). Families Unidas: A family-centered ecodevelopmental intervention to reduce risk for problem behavior among Hispanic adolescents. Clinical Child and Family Psychology Review, 5, 113-132.

Cohen, A. B. (2009). Many forms of culture. American Psychologist, 64, 194-204.Forgatch, M. S., & Martinez, C. R., Jr. (1999). Parent management training: A pro-

gram linking basic research and practical application. Journal of the Norwegian Psychological Society, 36, 923-937.

Gonzales, N. A., Dumka, L. E., Deardorff, J., Carter, S. J., & McCray, A. (2004). Pre-venting poor mental health and school dropout of Mexican American adolescents following the transition to junior high school. Journal of Adolescent Research, 19, 113-131.

Guerra, N., & Leidy, M. S. (2008). Lessons learned: Recent advances in the preven-tion and treatment of childhood aggression. Advances in Child Development and Behavior, 36, 287-330.

Guerra, N. G., & Knox, L. (2002). Violence: Encyclopedia of crime and justice (pp. 1649-1655). New York: MacMillan.

Guerra, N. G., & Knox, L. (2008). The role of culture in the dissemination and imple-mentation of innovation. American Journal of Community Psychology, 41, 304-313.

Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents. New York: Guilford Press.

Hops, H., & Walker, H. M. (1988). CLASS: Contingencies for Learning Academic and Social Skills: A classroom behavior management program for children with acting-out behaviors. Delray Beach, FL: Educational Achievement Systems.

Knox, L., Guerra, N. G., Williams, K. R., Toro, R. I. & Leidy, M. S. (2009). Preventing youth violence among immigrant Latino youth: Families and schools together. Unpublished manuscript.

Leyendecker, B., & Lamb, M. E. (1999). Latino families. In M. E. Lamb (Ed.), Parent-ing and child development in “nontraditional” families (pp. 247-262). Mahwah, NJ: Lawrence Erlbaum.

Lipsey, M. W., & Wilson, D. (1998). Effective intervention for serious offenders: A synthesis of research. In R. Loeber & D. Farrington (Eds.), Serious and violent juvenile offenders (pp. 86-105). Thousand Oaks, CA: Sage.

Martinez, C. R., & Eddy, J. M. (2005). Effects of culturally adapted parent manage-ment training on Latino youth behavioral health outcomes. Journal of Consulting and Clinical Psychology, 73, 841-851.




McDonald, L., Moberg, D. P., Brown, R., Rodriguez-Espiricueta, I., Flores, N. I., Burke, M. P., et al. (2006). After-school multifamily groups: A randomized controlled trial involving low-income, urban, Latino children. Children & Schools, 28, 25-34.

Mirabal-Colón, B., & Vélez, C. N. (2006). Youth violence prevention among Latino youth. In N. G. Guerra & E. Phillips Smith (Eds.), Preventing youth violence in a multicultural society (pp.103-126). Washington, DC: American Psychological Association.

Murray, N. G., Kelder, S. H., Parcel, G. S., Frankowski, R., & Orpinas, P. (1999). Padres Trabajando por la Paz: A randomized trial of a parent education interven-tion to prevent violence among middle school children. Health Education, 14, 421-426.

Pantin, H., Coatsworth, J. D., Feaster, D. J., Newman, F. L., Briones, E., Prado, G., et al. (2003). Familias Unidas: The efficacy of an intervention to promote paren-tal investment in Hispanic immigrant families. Prevention Science, 4, 189-201.

Pantin, H., Schwartz, S. J., Sullivan, S., Coatsworth, J. D., & Szapocznik, J. (2003). Preventing substance abuse in Hispanic immigrant Adolescents: An ecodevelop-mental, parent-centered approach. Hispanic Journal of Behavioral Sciences, 25, 469-500.

Pettit, G. S., Laird, R. D., Dodge, K. A., Bates, J. E., & Criss, M. M. (2001). Ante-cedents and behavior-problem outcomes of parental monitoring and psychological control in early adolescence. Child Development, 72, 583-598.

Reid, J. B., Eddy, J. M., Fetrow, R. A., & Stoolmiller, M. (1999). Description and immediate impacts of a preventive intervention for conduct problems. American Journal of Community Psychology, 27, 483-517.

Resnicow, K., Soler, R., Braithwaite, R. L., Ahluwalia, J. S., & Butler, J. (2000). Cul-tural sensitivity in substance use prevention. Journal of Community Psychology, 28, 271-290.

Santiago-Rivera, A. L., Arredondo, P., & Gallardo-Cooper, M. (2002). Counseling Latinos and la familia. Thousand oaks, CA: Sage.

Santisteban, D. A., Coatsworth, J. D., Perez-Vidal, A., Kurtines, W. M., Schwartz, S. J., LaPerriere, A., et al. (2003). Efficacy of Brief Strategic Family Therapy in modify-ing Hispanic adolescent behavior problems and substance use. Journal of Family Psychology, 17, 121-133.

Santisteban, D. A., Coatsworth, J. D., Perez-Vidal, A., Mitrani, V., Jean-Gilles, M., & Szapocznik, J. (1997). Brief structural/strategic family therapy with African American and Hispanic high-risk youth. Journal of Community Psychology, 25, 453-471.

Schaeffer, C. M., & Borduin, C. M. (2005). Long-term follow-up to a randomized clinical trial of multisystemic therapy with serious and violent juvenile offenders. Journal of Consulting and Clinical Psychology, 73, 445-453.



Leidy et al. 35

Smolkowski, K., Biglan, A., Barrera, M., Taylor, T., Black, C., & Blair, J. (2005). Schools and Homes in Partnership (SHIP): Long-term effects of a preventive intervention focused on social behavior and readings skills in early elementary school. Prevention Science, 6, 113-125.

Szapocznik, J., Rio, A., Murray, E., Cohen, R., Scopetta, M., Rivas-Vasquez, A., et al. (1989). Structural family versus psychodynamic child therapy for problematic His-panic boys. Journal of Consulting and Clinical Psychology, 57, 571-578.

Szapocznik, J., Rio, A., Perez-Vidal, A., Kurtines, W., Hervis, O., & Santisteban, D. (1986). Bicultural effectiveness training (BET): An experimental test of an inter-vention modality for families experiencing intergenerational/intercultural conflict. Hispanic Journal of Behavioral Sciences, 8, 303-330.

Szapocznik, J., Santisteban, D., Rio, A., Perez-Vidal, A., Santisteban, D., & Kurtines W. M. (1989). Family effectiveness training: An intervention to prevent drug abuse and problem behaviors in Hispanic adolescents. Hispanic Journal of Behavioral Sci-ences, 11, 4-27.

Tolan, P. H., & Guerra, N. G. (1994). What works in preventing youth violence. Boul-der, CO: Center for the Study and Prevention of Violence.

Triandis, H. C., Marin, G., Lisanky, J., & Betancourt, H. (1984). Simpatía as a cul-tural script for Hispanics. Journal of Personality and Social Psychology, 47, 1363-1375.

Vega, W. A., & Gill, A. G. (1999). A model for explaining drug use behavior among Hispanic adolescents. Drugs & Society, 14, 57-74.

Webster-Stratton, C. (1992). The incredible years. A trouble shooting guide for par-ents of children aged 3-8. Toronto, Ontario, Canada: Umbrella Press.

Wright, J. C., & Zimmerman, M. A. (2006). Culturally sensitive interventions to pre-vent youth violence. In N. G. Guerra & E. Phillips Smith (Eds.), Preventing youth violence in a multicultural society (pp. 221-247). Washington, DC: American Psy-chological Association.

Bios

Melinda S. Leidy received her Ph.D in developmental psychology at the University of California, Riverside. Her research interests include how marital conflict and mari-tal satisfaction influence child social and behavioral outcomes. She is also interested in how acculturation influences family processes and child outcomes among immi-grant Latino families. She recently completed a postdoctoral research fellowship at the Southern California Academic Center of Excellence on Youth Violence Preven-tion at the University of California at Riverside where she worked on linking her past research related to family processes to the prevention of youth violence among Latino immigrant families. Currently, she is serving as a Congressional Fellow with the Soci-ety for Research in Child Development.




Nancy G. Guerra is a professor of psychology at the University of California at Riverside. She received her doctorate in human development and psychology from Harvard University. She is the author of several recent books on youth violence pre-vention and treatment of juvenile offenders. For the past 10 years, she has been the director and principal investigator for the Southern California Academic Center of Excellence on Youth Violence Prevention, funded by the Centers for Disease Control and Prevention. Her research interests focus on the development and evaluation of programs to promote positive youth development and prevent problem behaviors among at-risk adolescents. She also has been involved in several international research and development projects for the Inter-American Development Bank and the World Bank in Latin America and the Caribbean.

Rosa I. Toro is a fifth-year graduate student at the University of California, River-side, working with Dr. Nancy Guerra at Southern California Academic Center of Excellence on Youth Violence Prevention. Her research interests include intervention work within the realm of youth violence, family systems, minority populations, and preadolescent development. She has investigated the effects of household chaos in Latino family households. Currently, she is collaborating in the data analytic phase of an implementation of an intervention program, FAST (Families and Schools Together), that was done with Latino families in the Santa Ana, California area. One of her future research interest includes investigating the effect of acculturation gaps between par-ents and children and its utility in prevention work.



Documents

A Review of Family-Based Programs to Prevent Youth Violence Among Latinos