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Guide
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Sembrando Salud
OVERVIEW
Sembrando Salud (SS) is a community-based tobacco and alcohol prevention program. The program targets high risk adolescents who would not typically receive similar prevention programs, in this case low-income Hispanic students. The culturally sensitive intervention is designed to provide children with the information and skills to make healthy decisions regarding alcohol and tobacco use. One of the central components of SS is including parents and families in the decision-making process by encouraging communication. The impact of SS was evaluated in comparison to a similar educational intervention on first aid and home safety. Results show that SS helps improve the targeted outcome of parent-child communication, as reported by adolescents and by parents, in households with fewer children.
Sembrando Salud is an alcohol and tobacco prevention program that strives to improve healthy decision-making skills among adolescents. The intervention consists of eight weekly two-hour sessions where adolescents meet in small groups. Sessions usually take place during the evenings at school or at other community-based organizations. Sessions are run by trained group leaders, all of whom are bilingual Mexican-Americans. Group leaders have been trained over ten weekly sessions and are monitored throughout the intervention to ensure consistency and quality of program implementation.
Each session is comprised of an overview and brief review of lessons learned in the previous sessions. The review is then followed by a group leader presentation on new material. Presentations involve a variety of techniques such as group discussion, demonstrations, skills practice, role-playing and behavioral modeling. After the presentations, students are given the opportunity to demonstrate and practice skills. Finally, sessions conclude with homework assignments. Parents are asked to participate in the first, second and eighth session with their child. These sessions involve both separate and joint parent-child activities.
Although the format of each session is fairly consistent, the content varies from week to week. Topics addressed in the eight sessions include information about the health effects of alcohol and tobacco; social influences (e.g., media, peers) on alcohol and tobacco use; refusal skills; problem-solving and decision making skills; communication skills; and developing parental support of healthy decisions.
Finally, participants are offered SS “dollars” throughout the program to encourage attendance, participation and completion of homework assignments. Upon completion of the intervention, groups pool their SS dollars in exchange for program paraphernalia.
Litrownik, A.J., Elder, J.P., Campbell, N.R., Ayala, G.X., Slymen, D.J., Parra-Medina, D., Zavala, F.B., & Lovato, C.Y. (2000). Evaluation of a tobacco and alcohol use prevention program for Hispanic migrant adolescents: Promoting the protective factor of parent-child communication. Preventive Medicine, 31, 124-133.
Approach: Based on eligibility criteria, twenty-five schools were selected to participate in the Sembrando Salud evaluation. Of those eligible, 22 schools representing 15 districts ultimately agreed to participate. Schools were pre-randomized to either the tobacco/alcohol prevention treatment or an attention-control group. A total of 660 families agreed to participate (n=367 treatment; n=293 control). These families were then organized into groups of three to fifteen to receive either the treatment or control intervention program. Thirty-seven groups received the tobacco/alcohol prevention program while thirty-three received the control intervention program.
The control intervention followed the exact same format and utilized the same techniques as that of Sembrando Salud described previously. The only difference between the programs was the content. Participants in the control intervention received information pertaining to first aid and home safety. Topics included emergency preparation, skills on approaching emergency victims, and general household safety concerns.
Trained bilingual assistants completed baseline surveys prior to both interventions. Assessments took approximately one hour per family and were administered to families at school or at home. Families were given the option of choosing a Spanish- or English-language survey. All parents elected the Spanish language survey; 79 percent of adolescents did as well. Post-assessments were conducted using the same surveys and methods within a two-month period after all interventions had been completed. Families were offered a $10 dollar incentive for completion of both assessments. There was a 96 percent retention rate in the study and attrition was similar across groups.
Measures on the survey assessed demographic characteristics and acculturation. The primary outcome measures included communication with parents (adolescent-report) and communication with children (parent-report).
Results: Parent-reported communication with children was significantly better among participants in the SS treatment group (p=.016). Similarly, adolescent-reported communication with parents was also found to be significantly higher among SS participants when compared to those in the control intervention group (p=.048). The impact of the intervention, however, was moderated by household size. As household size increased, communication was found to decrease. Furthermore, analyses of the communication measures indicated that adolescent and parent reported-communication were significantly related (p<.001). The effect size was 0.1 in smaller households.
Limitations to the evaluation include the relative difficulty of engaging the target population. Approximately 60 percent of eligible children did not participate in the study. Furthermore, the follow-up only assessed the short-term impact of SS, as it was conducted within two months of program completion. Finally, outcome measures did not capture actual tobacco or alcohol utilization or decision-making practices, two of the primary goals of the program. The evaluation did, however, specifically choose to focus on parent-child communication, due to its association with youth substance use and abuse.
Link to program curriculum: http://behavioralhealth.sdsu.edu/passedprojects/sembrandosalud.html
Litrownik, A.J., Elder, J.P., Campbell, N.R., Ayala, G.X., Slymen, D.J., Parra-Medina, D., Zavala, F.B., & Lovato, C.Y. (2000). Evaluation of a tobacco and alcohol use prevention program for Hispanic migrant adolescents: Promoting the protective factor of parent-child communication. Preventive Medicine, 31, 124-133.
Program categorized in this guide according to the following:
Evaluated participant ages: 11-16
Program age ranges in the Guide: 6-11, 12-14, 15-21
Program components: clinic-based, provider-based, or miscellaneous; parent or family component; school-based
Measured outcomes: social and emotional health and development; behavioral problems
Program information last updated 3/14/07
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© Child Trends 2004 |