Abstract
Underage drinking is a major global health problem. Given the crisis that underage drinking represents, Tomando Buenas Decisiones (TBD), a family-based prevention program based on the existing Guiding Good Choices program, was adapted and piloted in Northern Mexico. Although family-based interventions in the U.S. are efficacious for preventing underage drinking, little is known about how their adapted versions work in low-middle income countries, such as in Latin America. In light of this, the current dissertation: (1) explored the malleability, and session-specific mean-level changes in etiologic factors targeted by TBD; (2) examined whether baseline individual, familial, and cultural factors predicted participants’ engagement and attendance during program delivery; and (3) tested the effects of TBD for reducing family risk for underage drinking in Zacatecas, Mexico. Findings suggest that TBD helped families develop protection against and reduce the risk of alcohol use in their children. Also, that participants’ engagement significantly increased throughout the intervention. Moreover, different familism subscales predicted both participants’ engagement and attendance. However, pre-intervention individual and familial characteristics such as perceived stress, sex (i.e., male), and poor family management only predicted attendance. Finally, results indicated that TBD was efficacious in reducing family conflict, poor family management, and general family risk relative to our wait-listed comparison group at post-intervention and 3-months post-intervention. This dissertation provides support for further rigorous evaluation and dissemination of the TBD program for Hispanic families. These findings can be used to comprehend better how and for whom adapted family-based preventive interventions work in Latin America.