Program Goals/Target Population
Sembrando Salud is a culturally sensitive, community-based tobacco- and alcohol-use prevention program specifically adapted for migrant Hispanic adolescents and their families. The program is designed to improve parent–child communication skills as a way of improving and maintaining healthy decision-making. Designed for youths 11 to 16 years old, the 8-week curriculum for adolescents and their families is delivered by bilingual/bicultural college students in classrooms and meeting rooms in school-based settings during evening hours.
Sembrando Salud is a mix of interactive teaching methods, including videos, demonstrations, skill practice, group discussions led by a leader, and role-playing. The program develops new behavioral skills, such as communicating with peers and adults and refusing alcohol and tobacco offers. The program includes three central components: 1) information about the health effects of using tobacco and drinking alcohol, 2) social influences on tobacco/alcohol use, and 3) training in refusal skills. Further, adolescents are exposed to how problems can be identified and analyzed, solutions generated, and decisions made, implemented, and evaluated. There is an additional emphasis on developing parental support for the healthy discussions and behaviors of adolescents through enhanced parent–child communications. Parental communication skills—such as listening, confirmation, and reassurance—also are developed.
The curriculum and group sessions were tailored to migrant Hispanic audiences. All sessions were taught by bilingual, bicultural Mexican American group leaders, who were sensitive to the values and norms of the cultures and could move between the languages during the presentation of the material for greater comprehension. Many of the role-plays were adapted from experiences common to migrant Hispanic adolescents living in the United States. For instance, issues of familismo and respeto were incorporated into the curriculum so adolescents could learn tobacco and alcohol refusal skills without disrespecting their elders.
11 to 16
Overall, the results from the study by Elder and colleagues (2002) indicated that the Sembrando Salud program made little impact on the measured outcomes, except for measures of the perceived effects of tobacco use.
The rates of smoking in the past 30 days started low and remained low through the 2-year follow-up period. At baseline, 3.0 percent of the treatment group reported smoking in the past 30 days, compared with 3.1 percent of the attention-control group. By the 2-year follow-up, 2.9 percent of the treatment group and 3.5 percent of the attention-control group reported smoking in the past 30 days. There were no significant differences between the groups.
Susceptibility to Smoking
The number of youths in the treatment group who were considered susceptible to smoking dropped by nearly 50 percent from the immediate postintervention period to the 2-year follow-up period. The number of youths in the attention-control group susceptible to smoking also dropped 40 percent during this same period. The overall reduction in the number of youths considered susceptible to smoking was statistically significant. However, the difference between the groups was not statistically significant.
The rates of reported drinking in the past 30 days for the treatment and attention-control groups dropped from the baseline to the 2-year follow-up. The rates for drinking in the treatment group went from 7.9 percent to 6.8 percent, while the rates in the attention-control group went from 7.2 percent to 5.3 percent. Again, there were no significant differences between the groups, and the overall reduction was not statistically significant.
Susceptibility to Drinking
The number of youths in the treatment group who were considered susceptible to drinking dropped by about 25 percent from the baseline period to the 2-year follow-up period. In the attention-control group, the number of youths dropped by almost 50 percent during this same period. However, the overall reduction was not statistically significant, and there were no significant differences between the groups.
Parent–Child Communication and Attitudes
The results of communication with parents, tobacco peer norms, and tobacco self-standards were similar for the treatment and attention-control groups. The average scores on these measures tended to increase from baseline to the 2-year follow-up for both groups. There were no significant differences between the groups.
The program appeared to have short-term effects only on the perceived effects of tobacco use. The treatment group had significantly higher average scores on measures of the perceived effects of tobacco use, compared with the attention-control group, from the 1-year follow-up to the 2-year follow-up.
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