Reducing Alcohol, Tobacco, and Drug Use Among Latino Immigrant Youth: A Preliminary Test of the ¡Unidos Se Puede! Program ABSTRACT Adolescent alcohol, tobacco, and other drug (ATOD) use is a major public health concern, with rates for Latino middle school youth higher than other ethnic groups. One well-established precursor of adolescent ATOD use is psychosocial stress. Among Latino immigrant youth, stress related to migration is associated with ATOD use, depressive symptoms, and anti-social behavior, even after accounting for indicators of socio-economic status. Although several programs have been developed to address Latino ATOD use, they rely on bilingual professionals with a master’s degree or higher to field the program. Latino families are increasingly locating themselves in new settlement areas that lack bilingual ATOD counselors equipped to provide appropriate prevention or treatment. This suggests that health disparities will widen without novel and effective ATOD use interventions targeting young Latino adolescents. Unidos is a positive youth development program that works with Latino parents and their adolescent children to delay or reduce ATOD use by increasing parental involvement in their child’s schooling and youth academic achievement. Because Unidos can be delivered by community-based “promotoras” rather than masters level clinicians, it addresses the implementation, scalability and sustainability problems associated with existing ATOD prevention programs. Initial evaluations of Unidos’ impact on strengthening Latino adolescents’ ability to succeed are positive, but its impact on reducing ATOD use has not been evaluated. The proposed project examines the preliminary efficacy of Unidos to decrease ATOD use among Latino youth in new settlement areas. The goals of this efficacy trial will be achieved by accomplishing two specific aims: (1) Evaluate the potential of the intervention to delay the initiation into or reduce ATOD use among Latino youth who are 1st to 2nd generation immigrants; and (2) Evaluate the intervention’s ability to strengthen known protective factors against ATOD use among adolescents–specifically child personal agency and parent-child, peer, and school relationships. To accomplish these aims, we propose an attention placebo randomized control trial. For this trial, we will recruit a sample of youth and their parents (N=120 dyads) from a random sample of Latino 7th graders in Tulsa Public Schools. Those meeting the inclusion/exclusion criteria and agreeing to participate will provide baseline data before being randomly assigned to either the treatment or control condition (n=60 dyads each). Participants will be followed for 32 months post-baseline, during which time we will collect psychosocial measures annually near the end of each of three school years (7th, 8th, and 9th grades). The two primary hypotheses that will be tested are: (1) Youth in the Unidos program will delay initiation of ATOD use compared to youth in a control group; and (2) Youth in the Unidos program will have less ATOD use compared to youth in a control group.

This project has important public health implications. If effective, the study will provide preliminary evidence of a psychosocial intervention that reduces ATOD use among an understudied immigrant population and holds potential to address the implementation, scalability and sustainability problems associated with existing ATOD prevention programs targeting Latino immigrant youth in new settlement areas.