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A Feasibility Trial of an Online-Only, Family-Centered Preventive Intervention for Hispanics: e-Familias Unidas

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Abstract

We piloted the preventive intervention e-Familias Unidas, delivered exclusively through the Internet to maximize reach and sustainability. This program is an adaptation of an evidence-based, family-centered intervention that aims to prevent Hispanic adolescent drug use and risky sexual behavior through improving family functioning. The purpose of this feasibility trial was to: (1) explore the use of Facebook and a trusted community champion in the online recruitment of Hispanic parents of adolescents, (2) test an online-only assessment and randomization protocol, (3) pilot intervention delivery via e-familiasunidas.com, and (4) assess pre-post changes in family functioning. We tracked participant recruitment and enrollment via Facebook analytics and REDCap. Intervention completion was tracked via our website. We conducted an ANCOVA to test for between group (e-Familias Unidas vs. control) differences post-intervention. Recruitment lasted for a total of 10 weeks and was divided into three phases, with each phase systematically assessing which strategies maximized recruitment and enrollment. Overall, 93 Hispanic parents enrolled in the study. Of those randomized to the intervention group (n = 46), 70% were engaged and watched an average of 5.4 out of the 12 online videos. We found that participants recruited through a community champion, versus Facebook advertisements, had higher rates of enrollment and intervention completion. There was a significant improvement in parent-adolescent communication for parents who received e-Familias Unidas compared to those in the control group (n = 47). This pilot trial demonstrated it is feasible to recruit, assess, and deliver e-Familias Unidas to Hispanic parents through an online-only platform. Our findings highlight the promise of an online platform to optimize the reach of preventive interventions for underserved populations, to more effectively target participants, and to disseminate sustainable evidence-based interventions. We discuss lessons learned and recommendations for future research.

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Notes

  1. Facebook advertisements directed participants to the study. Facebook page promotion directed participants to our public Facebook page, which had information on how to enroll in the study, parenting tips, and other Familias Unidas-related materials.

  2. Screenshots of advertisements and Facebook Page can be found in Appendix A.

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Acknowledgements

We would like to thank our community partner and the participants.

Funding

This research was funded by a research award to Dr. Hilda Pantin from the Department of Public Health Sciences at the University of Miami Miller School of Medicine. The videos adapted for use in this study were funded by the Centers for Disease Control and Prevention grant # U01PS000671 (PI: Yannine Estrada).

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Correspondence to Lourdes M. Rojas.

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Conflict of Interest

The authors declare they have no conflict of interest.

Ethical Approval

All procedures in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Appendix 1: Facebook Advertisements and Page Promotion

Appendix 1: Facebook Advertisements and Page Promotion

See Figs. 2, 3, 4, 5, 6, 7, 8 and 9.

Fig. 2
figure 2

Stock photo utilized in Phase 1. Top caption translates to: “Is it difficult to communicate with your adolescent? Are you Hispanic? Do you have a kid between the ages of 12 and 16 years of age?” Caption in the photo translates to: “Imagine if being a parent was easier…” Bottom caption translates to: “Reduce the stress of being a parent… See if you qualify for the free program, e-Familias”

Fig. 3
figure 3

Stock photo utilized in Phase 1. For translation of captions, see Fig. 2

Fig. 4
figure 4

Stock photo utilized in Phase 1. For translation of captions, see Fig. 2

Fig. 5
figure 5

Telenovela clip utilized in Phases 1 and 2. Telenovela clip depicting a mother scolding her son for not doing his homework and getting home late. Ad was used in Week 3–6. Top caption translates to: “Is it difficult to communicate with your adolescent?” Caption in the photo translates to: “e-Familias Unidas may help you…” Bottom caption translates to: “Reduce the stress of being a parent… See if you qualify for the free program, e-Familias Unidas”. Note. In Phase 2, we added “A chance to earn $60” to the caption

Fig. 6
figure 6

Telenovela clip, which outperformed other stock photos and videos, utilized in Phases 1 and 2. Telenovela clip depicting a mother interrupting her suave son as he’s about to kiss his girlfriend. Ad was used in weeks 3–6. Top caption translates to: “Are you Hispanic? Do you have a kid between the ages of 12 and 16?” Caption in the photo translates to: “e-Familias Unidas may help you…” Bottom caption translates to: “Reduce the stress of being a parent… See if you qualify for the free program, e-Familias Unidas”. Note. In Phase 2, we added “A chance to earn $60” to the caption

Fig. 7
figure 7

Facebook page promotion utilized in Phase 1. Top caption translation: “E-Familias Unidas is a family-centered intervention to prevent the consumption of…”

Fig. 8
figure 8

Trailer of Telenovela, Talk Show, Interactive Activities, and Web Page. Trailer of telenovela clips and talk show to explain the program. Top caption translation: “If you are interested in seeing more of e-Familias Unidas, click the link to participate.” Note. In Phase 2, we added “A chance to earn $60” to the caption

Fig. 9
figure 9

Advice to Parents Post on Facebook Page. Top caption translation: “Our advice of the day! To learn more about how e-Familias Unidas can help you and to participate in e-Familias Unidas, click the following link.” Advice #1 translation: “To have better communication, it is important to find the appropriate moment and place to have a conversation”

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Rojas, L.M., Bahamon, M., Lebron, C. et al. A Feasibility Trial of an Online-Only, Family-Centered Preventive Intervention for Hispanics: e-Familias Unidas. J Primary Prevent 42, 97–124 (2021). https://doi.org/10.1007/s10935-020-00620-1

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