E-health reduced Hispanic youth drug use

A culturally tailored online family program in pediatric primary care reduced drug use among Hispanic adolescents.
*Randomized clinical trial; Level 2 evidence (OCEBM).

Citation

Estrada Y, Lozano A, Graefe B, et al. A Primary Care E-Health Family Intervention for Risk Behaviors in Hispanic Youths. JAMA Network Open. 2026;9(10):e2637908. doi:10.1001/jamanetworkopen.2026.37908

Background

Hispanic adolescents experience important disparities in substance use and sexual risk behaviors. Family-based prevention programs can help, but access is limited; primary care and online delivery may improve reach.

Patients

456 Hispanic adolescent-parent dyads from 15 South Florida pediatric clinics; adolescents were 12 to 16 years old. Exclusions included planned relocation, inability to understand content, or no broadband internet.

Intervention

Eight online parent group sessions plus 4 live guided family sessions over about 12 weeks.

Control

Treatment as usual: standard clinic care and study assessments only.

Outcome

Drug use in the past 90 days, condom use, sexually transmitted infections, alcohol and hard drug initiation, and family functioning. Infection data collection stopped during the pandemic.

Follow-up Period

36 months.

Results

Outcome Finding
Past 90-day drug use trajectory (primary) Lower with intervention: incidence rate ratio 0.50 (95% CI 0.43 to 0.58)
Alcohol initiation Lower with intervention; Cramer V 0.10 (CI not reported)
Hard drug initiation Lower with intervention; Cramer V 0.10 (CI not reported)

Intention-to-treat analyses were used. Condom use and overall family functioning did not significantly improve. Number needed to treat could not be calculated because event rates were not reported.

Limitations

Single-region sample, self-reported behaviors, low baseline risk behavior rates, and pandemic disruption limit certainty. Baseline drug use was higher in controls, which may bias apparent benefit.

Funding

NIH funded; author owns Familias Unidas trademark/copyright, royalties possible.

Clinical Application

Consider culturally tailored online family prevention for Hispanic adolescents in primary care; evidence supports substance-use prevention, not sexual-risk reduction.