Family-based Prevention Programs Research Articles

Qualitative Assessment on the Impact of Family-Based Drug Prevention Program by the National Anti-Drugs Agency in Malaysia

Family-based prevention programs aim to prevent youth from falling victim to substance abuse issues by focusing on what families can offer. This study attempts to evaluate the effectiveness of the Family on Alert (FoA) program conducted by NADA. A qualitative method was utilized involving focus group discussions with key informants from NADA in the state of Selangor, Kedah, Johor, Sabah, and the Federal Territory of Kuala Lumpur. NVivo software was used to analyze the qualitative data. Generally, the FoA program implemented by NADA has positively impacted the participants, particularly in increasing the awareness, knowledge, and attitude among parents in preventing drug abuse among adolescents in Malaysia.

Familial aggregation of traffic risky behaviours among pedestrians: a cross-sectional study in northwestern Iran

ObjectiveThis study aims to assess the familial aggregation of traffic risky behaviours among pedestrians and describe the sociodemographic profile of pedestrians in northwestern Iran.MethodsA cross-sectional study was conducted among 933...

Using Mobile Technology for Family-Based Prevention in Families with Low Incomes: Lessons from a Randomized Controlled Trial of a Childhood Obesity Prevention Program

Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure. All participants attended in-class nutrition education classes (Eating Smart · Being Active) as part of the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington State (classes were offered in English and Spanish). Participants in this analysis were 168 parents from a larger cluster randomized controlled trial who had been randomly assigned to also receive a newly developed, mobile-based version of an efficacious, feeding-focused, childhood obesity prevention program. Results showed that despite high levels of in-person attendance (70%), participants only accessed 47% of the videos (online content). Older parents and parents of girls showed higher levels of in-person attendance; currently employed parents showed lower levels. Online engagement varied as a function of ethnicity and acculturation: non-Hispanic parents accessed the most videos, low-acculturated Hispanic parents accessed the second most, and highly acculturated Hispanic parents accessed the least. In contrast, low-acculturated Hispanic parents showed the highest in-person attendance. For all but one outcome, significant online program effects were found only for parents who accessed at least half of the videos. Implications for mobile-based, family-based prevention programs for parents with low incomes are considered.ClinicalTrials.gov Identifier: NCT03170700; Registration Date: March 08, 2017.

Hispanic adolescents' internalizing symptoms and positive family functioning: A bidirectional examination of associations over time.

Open communication with parents, defined as perceived ease of adolescent-parent disclosure, and family support are components of positive family functioning linked with fewer adolescent internalizing symptoms. However, relatively little is known about bidirectional pathways over time. Even less is known about bidirectional pathways for Hispanic adolescents or about the role of adolescent and parent gender. Therefore, this study examined bidirectional pathways between positive family functioning and adolescent internalizing symptoms over time in a sample of Hispanic middle school adolescents (N = 340; 51% female, Mage = 13.27 years, SD = .77), who completed surveys in the fall of 2016 (Time 1) and the spring of 2017 (Time 2; N = 284; 52% female). Results indicated that positive family functioning, including open communication with mothers and fathers, predicted fewer depressive symptoms for girls, but not for boys. Open communication with fathers predicted fewer anxiety symptoms for girls and boys. Girls' depressive symptoms, but not boys', predicted decreases in open communication with fathers. Boys' depressive symptoms predicted less family support. Unexpectedly, boys' anxiety symptoms predicted increased family support. These findings highlight gendered pathways linking family functioning and internalizing symptoms in Hispanic adolescents over time, including the relative importance of open communication with fathers. Gendered findings emphasize the utility of family-based prevention and early intervention programs targeting internalizing symptoms, especially for Hispanic girls. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implications of built and social environments on the academic success among African American youth: testing Strong African American Families intervention effects on parental academic racial socialization.

Studies exploring widening academic disparities have highlighted the role of racialized school settings, which have given way to incidents of discrimination and unfair treatment for students of color, disproportionately affecting African American youth. Research also shows that family-based preventive interventions may avert negative outcomes for this population through the promotion of protective socialization practices. Consequently, the current study tests the efficacy of a culturally tailored preventive family-based program to foster induced changes in academic promotive parenting practices that prepare youth to advance academically by navigating negative race-related experiences in school settings. Data collected over four time periods from the Strong African American Families (SAAF) efficacy trial (Murry and Brody, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling analyses demonstrated that the SAAF program was associated with positive intervention induced changes in parental academic race-related socialization, which in turn, was indirectly associated with reduced school compromising behaviors through the enhancement of racial pride. While discrimination compromised academic success, our findings highlight the protective nature of racial pride in dissuading academic failure and school dropout through the promotion of academic success. This study confirms that a family-based prevention program holds promise to address academic disparities through the enhancement of parenting and youth protective processes that buffer youth from succumbing to racialized social environments such as schools. Implications for research, educational policy, and preventive interventions are discussed.

A new tool to capture dimensions of family dinners in relation to adolescent health and risk-related outcomes: The ‘Family Dinner Index’

There is a strong association between family meals and child and adolescent health. To systematically understand the associations between family meals with a variety of health and risk outcomes, we developed and conducted a validation study of child- and parent-versions of the Family Dinner Index (FDI; FDI-C/FDI-P). We validated the measures with a national sample of 2,090 parent–child dyads. Using factor analysis, we reduced the initial FDIs each to eight items representing communication, enjoyment, and digital distractions; the FDI-C also included meal logistics and the FDI-P, family bonding. Using multivariable log-binomial regression models, we examined the relationships between FDI scores and substance use, violence, weight perception, weight control intention, and health indicators. Children who scored ≥21 on the FDI-C had a significantly lower average prevalence of a ‘negative outcome’ composite, as well as a lower prevalence of each of the individual behaviors. Children of parents who scored ≥24 on the FDI-P had a significantly lower average prevalence of the ‘negative outcome’ composite, as well as a lower prevalence of substance use indicators, negative weight perception and intentions to lose weight, less than daily fruit and vegetable consumption, and not meeting guidelines for physical activity. The FDI measures provide support for face and content validity, as well as concurrent criterion validity and construct validity. Further validation with these measures using a longitudinal design will allow for the establishment of predictive validity. Currently, the FDI measures may help researchers and practitioners identify points of emphasis for tailoring family-based prevention programs accordingly.

Family, mental health, and placement outcomes of a low-cost preventive intervention for youth in foster care

This study assessed secondary outcomes of Connecting, a low-cost, self-directed, family-based prevention program for families with youth placed in their care by state child welfare agencies. Families caring for youth aged 11 to 15 years within Washington State were recruited and randomly assigned into either the Connecting program (n = 110) or a treatment-as-usual control condition (n = 110). The program included a 10-week sequence of self-directed family activities and DVDs with video clips. Survey data were collected from caregivers and youth at baseline, immediately post-intervention, and at 12 and 24 months post-intervention; placement data was collected from the child welfare department as well. Intention-to-treat analyses focused on 5 classes of secondary outcomes at 24 months post-intervention: caregiver-youth bonding, family climate, youth risk behavior attitudes, youth mental health, and placement stability. There were no intervention effects in the full sample. In subgroup analyses, among older youth (ages 16–17) but not younger youth (ages 13–15), the Connecting condition (vs. controls) yielded more frequent caregiver-reported bonding communication, bonding activities, warmth, and positive interactions, as well as less favorable youth attitudes towards early initiation of sexual behavior and substance use, and fewer youth self-injurious thoughts. Consistent with the social development model, the divergent outcomes between younger and older youth suggests Connecting’s driving mechanisms involve social processes that undergo critical shifts between early and mid-adolescence. Overall, the Connecting program showed promise in older youth for long-term promotion of caregiver-youth bonding, healthy behaviors, and mental health, but did not demonstrate long-term efficacy in facilitating stable or permanent placement of youth in care.

The Strong African American Families Program: Disrupting the Negative Consequences of Racial Discrimination Through Culturally Tailored, Family-Based Prevention

Racism continues to be a major source of stress for African Americans and can impair psychological functioning. Adolescents experiencing discrimination may engage in self-soothing, but risky behaviors, which leave them at risk for negative life trajectories. Black pride has been identified as a key factor in explaining the heterogeneity in responses to discrimination. Racial socialization, strategies parents use to promote Black pride and protect youth from discrimination, is an important focus of family-based prevention programs serving African American families. This study tests the efficacy of a culturally tailored preventive intervention for rural African American families to disrupt the negative consequences of discrimination on adolescent psychological functioning. Four waves of data from the Strong African American Families (SAAF) efficacy trial (Murry & Brody in Journal of Marital & Family Therapy 30(3):271-283, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling was used to test study hypotheses. Adolescent experiences with discrimination at age 15 predicted concurrent psychological functioning and multiple risk behaviors at age 16, including sexual risk behavior, substance use problems, academic failure, and juvenile justice involvement. Mediation analyses demonstrated that psychological functioning was a significant mediator of these relations. The SAAF program was associated with increases in racial socialization, which in turn fostered gains in adolescent Black pride. Black pride was indirectly associated with reduced risk behavior through adolescent psychological functioning, but Black pride did not moderate the effect of discrimination on psychological functioning. This study confirms that family-based prevention can support African American adolescent mental health in the context of discrimination. However, more emphasis on reducing exposure to discrimination is needed.

Neighborhood disadvantage is associated with biological aging: Intervention-induced enhancement of couple functioning confers resilience.

The accelerated pace of biological aging predicts mortality and morbidity later in life. The current study examines whether a change in supportive couple functioning buffers accelerated aging associated with stressful community environments among Black Americans who live in rural, Southern, disadvantaged neighborhoods. We examined 348 Black American middle-aged adults assigned randomly to receive the Protecting Strong African American Families (ProSAAF) intervention or a control condition. The program was designed to enhance supportive couple functioning among Black Americans. We used DunedinPoAm to quantify the methylation pace of aging and employed the Area Deprivation Index at the census block group level to measure neighborhood disadvantage. Neighborhood disadvantage was associated with the accelerated pace of aging. Further, participation in ProSAAF enhanced supportive couple functioning, and improvement in couple functioning protected participants from the harmful effects of neighborhood disadvantage on the accelerated pace of aging. These findings supported mediated moderation and suggested that family-based prevention programs that enhance couple support may decrease the erosive effects of neighborhood disadvantage and improve prospects for healthy aging among rural, Southern, Black Americans living in difficult circumstances. This may provide a supplemental strategy for decreasing health disparities due to neighborhood disadvantage by enhancing family systems.

Internet Addiction: The Role of Parental Care and Mental Health in Adolescence.

Internet addiction in adolescence is a social issue which is being increasingly discussed worldwide. Hence, deepening the knowledge of its development is necessary to prevent short- and long-term negative outcomes. This study involving 266 adolescents (mean age = 16.1 years, SD = 1.4) aimed at analyzing the relationship between quality of parental care, Internet addiction and adolescents’ mental health, by means of the following self-report tools: the Parental Bonding Instrument, the Internet Addiction Test, and the Strengths and Difficulties Questionnaire. The findings, collected through structural equation model analyses, showed that perceived care from both father and mother had significant indirect effects on Internet addiction problems through adolescents’ mental health problems. Furthermore, Internet addiction problems were demonstrated to be negatively associated with maternal care but not with paternal care. The study provides empirical support to the need of family-based prevention and intervention programs to take care of Internet addiction.

Predictors of Engagement and Attendance of a Family-Based Prevention Program for Underage Drinking in Mexico.

Underage drinking represents a major global health problem. Given the crisis that underage drinking represents, Tomando Buenas Decisiones, a family-based prevention program, was adapted and piloted in Mexico based on the existing Guiding Good Choices program. Although family-based interventions in the USA are promising for preventing underage drinking, little is known about how adapted versions of these interventions may work in low-middle income countries, such as in Latin America. The present study examined whether baseline individual, familial, and cultural factors predict participants' engagement and attendance in an adapted program for preventing underage drinking in Zacatecas, Mexico. The study was conducted with a sample of 178 parents who participated in the adapted program and were employed at local private companies. Latent growth curve modeling was used to analyze (a) change in engagement, (b) predictors of engagement, and (c) predictors of attendance. Results indicated that perceived engagement evidenced a significant linear increase throughout the intervention. Participants' familism values, such as perceived family as referents and family support, at baseline predicted both initial levels of and change in engagement. Perceived familial obligation also predicted change in engagement. Attendance was negatively predicted by male gender, by perceived stress, and by perceived familial obligations among women only. Poor family management, and perceived familial obligations among men, positively predicted attendance. Our findings have important implications for the conceptualization of engagement and attendance in family-based preventive interventions for underage drinking among Hispanics. Researchers interested in implementing interventions in Latin America can use these findings to better comprehend how and for whom adapted family-based preventive interventions work.

Development and Implementation of Businesses That Care in Zacatecas, Mexico.

As part of the Global Smart Drinking Goals campaign launched in 2018 in 6 “City Pilots” around the world, the Businesses That Care (BTC; Empresas Que se Cuidan in Spanish) prevention system was developed and implemented in Zacatecas, Mexico. BTC is a private business sector adaptation of the Communities That Care prevention system. BTC is designed to address underage alcohol use through a combination of a company-led prevention system, an adapted family-based prevention program with parents employed at participating companies, and environmental prevention strategies for company employees. BTC was designed to be congruent with other health and safety efforts in the region (e.g., media campaign, road safety, and school prevention efforts). This study presents the feasibility and adoption of the BTC system in Zacatecas. Process implementation measures indicated successful participant recruitment, retention, and adherence to intervention protocols. The first 4 stages of BTC implementation were completed within 14 months, with Stage 5 being interrupted by the COVID-19 pandemic. BTC Prevention Committee members, made up of employees from BTC participating companies, received 9 out of 10 BTC trainings/workshops during this time. Results provide evidence of the acceptability and feasibility for private companies to implement a prevention system approach for reducing youth alcohol use.

Selective Reporting of Results in a Systematic Review: A Critique of Ballester et al. (2021)

ABSTRACT Ballester et al.’s (2021) Ballester and colleagues' review of family-based drug prevention programs has at least two fundamental methodological problems that bring its results, and the conclusions drawn from these, into question. The first problem concerns the use of brief narrative summaries of the results from each paper that do not always accurately describe the results reported. The second problem concerns the failure to adequately describe the assessment of various forms of bias present in each of the papers reviewed. These problems are illustrated by examining the way in which Ballester et al. assessed potential outcome reporting bias in the seven papers from evaluations of the Strengthening Families Program 10–14 (SFP 10–14) included in their review and the manner in which they selectively highlight positive results from these papers in their narrative summaries while ignoring results that support the null hypothesis of no effect.

Protective parenting behavior buffers the impact of racial discrimination on depression among Black youth.

The adverse impact of racial discrimination on youth, and particularly its impact on the development of depressive symptoms, has prompted attention regarding the potential for family processes to protect youth from these erosive effects. Evidence from non-experimental studies indicates that protective parenting behavior (PPB) which occurs naturally in many Black families can buffer youth from the negative impact of racial discrimination. Of interest is whether "constructed resilience" developed through family-centered prevention programming can add to this protective buffering. The current paper examines the impact of constructed resilience in the form of increased protective parenting using 295 families randomly assigned either to a control condition or to the Protecting Strong African American Families (ProSAAF) program, a family-based prevention program previously shown to enhance protective parenting. We found that baseline racial discrimination was predictive of change in youths' depressive symptoms across the pre-post study period. Second, we found that parents participating in ProSAAF, relative to those randomly assigned to the control group, significantly improved in their use of an intervention targeting PPB. Third, we found a significant effect of change in PPB on the association of discrimination with change in depressive symptoms. Finally, we found that ProSAAF participation buffered the impact of racial discrimination on change in depressive symptoms through change in PPB. Results provide experimental support for constructed resilience in the form of change in PPB and call for increased attention to the development of family-based intervention programs to protect Black youth from the pernicious effects of racial discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Online Adaptation and Outcomes of a Family-Based Intervention Addressing Substance Use Disorders

Purpose: This article compares outcomes of a family-based prevention program from its original in-person mode to an online mode in response to the COVID-19 pandemic. Celebrating Families!™ is designed to improve parenting skills, family functioning, and family relationships to break the cycle of substance use problems. Method: This mixed-methods, quasi-experimental study compared outcomes of in-person and online treatment conditions and content analysis of open-ended responses to a satisfaction survey. Results: Both groups showed improvement in outcomes, with moderate effect sizes and high satisfaction. Average scores of the online groups were generally lower than the in-person scores. Qualitative data yielded participants’ accounts of improvements in parenting behaviors, family relationships, coping skills, and knowledge insights. Conclusions: Despite the contexts of COVID-19, findings provided evidence that such relational group interventions can be feasibly administered online and can effect changes required to break the cycle of substance use problems and adverse family experiences.

Universal Family Drug Prevention Programs. A Systematic Review

ABSTRACT Purpose: This study offers a response to certain recent doubts that have been cast on universal programs’ preventive capacity. The main objective of this paper is to review effective universal family programs in order to carry out a cultural adaptation of SFP 10–14 for the Spanish population. Method: For this purpose, a systematic review was conducted of different databases and evidence-based practices. An analysis was made of the methodologies used in the identified programs, based on standardized criteria. A risk of bias assessment was performed. Results/Discussion: Nineteen studies were identified that report findings on the prevention of substance use, relating to 7 universal family-based prevention programs. Positive outcomes have been achieved by universal family-based substance prevention programs reported in studies with good methodological groundings. Universal prevention programs have become a key preventive tool in social contexts.

Socio-economically deprived families’ routes to family-based addiction prevention services

Abstract Background Families living in poor socio-economic circumstances, already confronted with social and health inequalities, are often not reached by family-based addiction prevention programmes. Besides quantitative models and health literacy approaches, qualitative research is lacking that could shed light on the exact circumstances and processes that lead to hindered addiction prevention service uptake by these families. Drawing on the concept of 'candidacy', we aimed to reconstruct how socio-economically deprived parents and their (pre-)adolescent children in German-speaking Switzerland identify their candidacy for family-based addiction prevention services. Methods Following grounded theory, we collected and analysed data in an iterative-cyclical manner using theoretical sampling and theoretical coding techniques. Sixteen families with children aged 10-14 years were interviewed in depth (parent/s and one child separately). All but one family lived below the at-risk-of poverty threshold. Results Families' modes of recognising and handling problems in everyday life were found to be core phenomena that structure the process towards (non-)identification of candidacy for family-based addiction prevention services. Further, thematic relevance of addiction prevention, past experience with offers, integration in systems of assistance (social welfare, etc.), strategies to protect the family, and parents' search movements for support were important for families' identification of candidacy. Conclusions Socio-economically deprived families are not a homogeneous group. They differ in modes of problem construction and handling in everyday life; this differently opens up or closes routes to family-based addiction prevention services. Policy and practice should build on a bundle of diverse strategies for outreach to these vulnerable families. Key messages Our qualitative study adds scientific knowledge to a better understanding of socio-economically deprived families’ complex routes to family-based addiction prevention services. Results provide evidence that policy and practice should build on a bundle of diverse strategies to reach these vulnerable families. Equity in access to services can thus be improved.

The Social Ecology of Parental Monitoring: Parent-Child Dynamics in a High-Risk Peruvian Neighborhood.

While parental monitoring is understood to protect adolescents from engaging in risk behaviors, little is known about how the family dynamics involved in parental monitoring differ across sociocultural contexts. We sought to gain an in-depth understanding of parent-child relationship dynamics and parental knowledge of adolescents' activities in an urban Peruvian neighborhood with high levels of crime and adolescent substance use. We conducted 15 in-depth interviews and two focus groups with adolescents and 12 in-depth interviews with mothers sampled from a secondary school in Callao, Peru. Our findings emphasize the importance of parent-child confianza (trust) as a foundation for parental awareness of adolescents' lives and activities. Participants in our sample characterized confianza as encouraging adolescent disclosure and shaping how parental solicitation and rules were interpreted by adolescents. Participants described how confianza was rooted in features of the parent-child relationship, including shared parent-child time, parental affection, adolescent perceptions of parents' ability to give good advice, and awareness of how parents would react to delicate topics. Participants linked these family dynamics, in turn, to economic hardship, parental feelings of sacrifice and stress, perceptions of neighborhood risk, and gender norms limiting fathers' involvement in caregiving. Results have implications for the planning and adaptation of family-based prevention programs for use in high-risk contexts in Latin America.

Can We Uncouple Neighborhood Disadvantage and Delinquent Behaviors? An Experimental Test of Family Resilience Guided by the Social Disorganization Theory of Delinquent Behaviors.

Although the influence of neighborhood disadvantage on youth development of delinquent behavior is well established, findings from this research have yet to inform the development of family-centered prevention programming to protect youth from these erosive effects.The current paper examines the role of family integration in buffering the impact of social disadvantage in a sample of N=298 families randomly assigned either to a control condition or to a family-based prevention program previously shown to enhance marriage and parenting. We first confirmed that neighborhood concentrated disadvantage predicted change in delinquent behaviors across the course of the study. Additionally, replicating prior work, parents participating in the Protecting Strong African American Families (ProSAAF) program, relative to those randomly assigned to the control group, significantly improved their use of effective communication strategies with each other and reduced ineffective conflict in front of youth. This resulted in a significant indirect effect of ProSAAF on change in youth delinquent behaviors. Furthermore, using mediated moderation analysis, the study tested the buffering effect of greater family integration, showing that experimentally produced change in interparental communication skills and the resulting reduction in youth exposure to parental conflict buffered the effect of neighborhood disadvantage on change in youth delinquent behaviors, supporting a mediated moderation model in which family environments buffer neighborhood effects.

Short-Term Effects of an Obesity Prevention Program Among Low-Income Hispanic Families With Preschoolers

To assess the short-term effects of an obesity prevention program promoting eating self-regulation and healthy food preferences in low-income Hispanic children. Randomized controlled trial with pretest, posttest, and 6- and 12-month assessments. Head Start and similar early learning institutions in Houston, TX, and Pasco, WA. A total of 255 families with preschoolers randomized into prevention (n = 136) and control (n = 119) groups. Multicomponent family-based prevention program. Fourteen waves lasted 7 weeks each with 8-10 mother-child dyads in each group. Parent assessments included feeding practices, styles, and knowledge. Child assessments included child eating self-regulation, willingness to try new foods, and parent report of child fruit and vegetable preferences. Parent and child heights and weights were measured. Multilevel analyses were employed to consider the nested nature of the data: time points within families within waves. The program had predicted effects on parental feeding practices, styles, and knowledge in the pre- to post-comparisons. Effects on child eating behavior were minimal; only the number of different vegetables tried showed significant pre-post differences. Short-term effects of this prevention program highlight the importance of family-focused feeding approaches to combating child overweight and obesity.