Effectiveness of culturally adapted substance use interventions for Latino adolescents : a systematic review and meta-analysis
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Cultural factors have been shown to have a moderating effect on substance use, thus an increasing number of substance use interventions with Latino adolescents seek to incorporate culture in an attempt to positively impact outcomes. Research on the effectiveness of culturally adapted substance use interventions, however, has produced a body of ambiguous evidence. The purpose of this systematic review is to examine the characteristics and effects of culturally adapted substance use interventions with Latino adolescents on substance use outcomes. The research question guiding this study is: What are the effects of culturally adapted interventions on substance use outcomes with Latino adolescents? A systematic search of thirteen electronic databases, five research registers, five research affiliated websites, reference lists, and a comprehensive gray literature search were undertaken to locate randomized (RCT) or quasi-experimental (QED) studies conducted between 1990 and December 2014 examining substance use outcomes of culturally adapted interventions with Latino adolescents. The search yielded 35,842 titles and abstracts, and the full texts of 108 articles were screened for inclusion. The final sample included 10 studies (7 RCT and 3 QED). Program participants were comprised of 56.5% males; 74.2% were U.S. born; and their mean age was 13.13 years. Meta-analytic results suggest significant effects of moderate magnitude on substance use outcomes at posttest (g=0.328; 95% CI 0.015 to 0.640, p<0.04), and an overall positive and moderate effect at follow-up (g=0.516; 95% CI 0.149 to 0.883, p<.006). Homogeneity analysis revealed the effect size distribution was highly heterogeneous at posttest and follow-up, indicating significant variance in magnitude of effects across studies. Moderator analysis revealed differences in mean effects on study and intervention characteristics. The risk of bias assessment revealed that most studies were at high risk for performance bias and selection bias. While culturally adapted substance use interventions demonstrated positive impacts on substance use overall, there was significant variability across studies. These findings emphasize the need for rigorously conducted studies to better discern the benefits of utilizing culturally adapted interventions for reducing substance use among Hispanic adolescents.