Program

Mar 14, 2007

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.

DESCRIPTION OF PROGRAM

Target population: Hispanic children ages
11 to 16 and their parents

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.

EVALUATION(S) OF PROGRAM

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.

Evaluated population: Children ages 11 to
16 enrolled in Migrant Education Programs in San Diego County
and their parents

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.

SOURCES FOR MORE INFORMATION

References

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.

KEYWORDS: Middle Childhood (6-11), Adolescence
(12-17), Children, Community-based, Substance Use, Tobacco Use, Alcohol Use,
Skills Training, Education, Home-Based, Immigrant, Migrant, Parent-Child
Communication, High-Risk, Hispanic or Latino.

Program
information last updated 3/14/07