Strengthening Families Program Research Articles

Exploring Nonspecialist Preparedness to Deliver an Evidence-Based, Family Strengthening Intervention in Rwanda: A Qualitative Study.

Families in low- and middle-income countries (LMICs) face significant mental health and psychosocial care gaps. In recent years, researchers and practitioners have addressed these gaps by task-sharing evidence-based mental health and psychosocial support (MHPSS) interventions to nonspecialist community providers. Supervision and training approaches are intended to prepare nonspecialists to deliver evidence-based interventions with quality. However, there is still little research exploring nonspecialist experiences with training and supervision and how, if at all, their training and supervision experiences result in fidelity and competence in delivering the intervention. This qualitative study uses data from a cluster-randomized trial of a family strengthening and violence prevention program in Rwanda, known as Sugira Muryango. In semi-structured interviews, the nonspecialists provided examples of using skills such as rapport-building, empathy, and active listening to deliver Sugira Muryango effectively. Because nonspecialists were serving in their own communities, they found that it was easier to earn trust with friends and neighbors, and this facilitated effective delivery of Sugira Muryango. Nonspecialists discussed how training, monthly supervision, in-person monitoring visits, and the use of the manual and audio recorders equipped them to deliver Sugira Muryango with quality. Nonspecialists also provided examples of barriers to quality of delivery, including supervisor lack of availability, delayed compensation, and technology issues. Preparedness was consistent across gender; however, nonspecialists serving in a better-resourced district had previous experiences delivering evidence-based interventions and felt more prepared at the beginning of Sugira Muryango.

Short-term effects of the strengthening families Program (SFP 10–14) in Brazil: a cluster randomized controlled trial

IntroductionThis study reports the evaluation of the short-term effects of the Strengthening Families Program (SFP 10–14), adapted as Famílias Fortes (Strong Families) in Brazil, on preventing adolescent drug use and improving parenting behaviors.MethodsA two-arm, parallel cluster randomized controlled trial was conducted in 60 Social Assistance Reference Centers (SARC) from 12 Brazilian municipalities. In each city, the SARC were randomly assigned to the intervention or control group. A total of 805 families participated in the study, each contributing data from one parent or legal guardian and one adolescent totaling 1,610 participants. Data collection occurred before intervention implementation and 6 months after baseline collection. Data were analyzed using multilevel mixed-effects modeling with repeated measures in two different paradigms: Intention to Treat (ITT) and Per protocol (PP). The study was registered in the Brazilian Ministry of Health Register of Clinical Trials (REBEC), under protocol no. RBR-5hz9g6z.ResultsConsidering the ITT paradigm, the program reduced the chance of parents and legal guardians being classified as negligent by 60% (95%CI 0.21; 0.78), increased the use of nonviolent discipline by caregivers (Coef 0.33, 95%CI 0.01; 0.64) and decreased the chance of adults exposing adolescents to their drunken episodes by 80% (95%CI 0.06; 0.54). No program effects were observed on outcomes related to adolescent drug use. Similar results were found for the PP paradigm.ConclusionThe positive effects on family outcomes suggest preventive potential of the program among the Brazilian population. Long-term evaluations are necessary to verify if the program can also achieve the drug use reduction goals not observed in the short term.

“The program encourages people not to have a heavy heart”: a qualitative study of a family strengthening program in Kenya

ABSTRACT There are millions of street-connected children worldwide, with thousands estimated in Kenya. Many child-serving organizations, including Agape Children’s Ministry in Kenya, aim to remove children from the streets, and provide rehabilitation and family reintegration. This study aims to elucidate barriers and facilitators of Agape’s Family Strengthening Program (FSP) and elicit feedback. Twelve children, 12 caregivers, and 11 staff participated in interviews. Salient child/caregiver themes include: (1) spirituality/religion, (2) reflections on the FSP, (3) reflections on Agape, and (4) family functioning. Staff themes were similar. Results amplify the voices of the participants regarding provision of and participation in the FSP.

Menumbuhkan Kepedulian Sosial Dan Kerjasama Anak Melalui Metode Groupwork

Humans are social creatures who cannot live alone and need the help of others in every aspect of their lives. Good cooperation must be instilled in children from an early age so that they can develop and be able to function socially well in the future. Fostering social care and cooperation in children can be done in various ways even through games. Through games children are easier to learn. This activity was carried out as one of the mini projects of Field Work Practice 2 activities carried out at SOS Children's Villages Medan for the Family Strengthening Program. This activity was carried out at the Kwala Bekala Community. This Field Work Practice activity was carried out at the Kwala Bekala Community. This Field Work Practice activity was carried out for approximately 3 months. The method used in this study is the Groupwork method with general stages (1) Preparation, (2) Assessment, (3) Alternative Program Planning, (4) Action Plan Formulation, (5) Program Implementation, (6) Evaluation and Results of Change and (7) Termination.

Coparenting Profiles and Children's Socioemotional Outcomes in Unmarried Parents with Low-Income.

This study aimed to examine patterns of mother-father coparenting relationship quality and their associations with child empathy, emotional insecurity, and behavior problems in families with low income. Given the growing number of nonmarital births and the high risk of relationship dissolution among cohabiting couples living with low income, it is important to examine the coparenting relationships among racially diverse unmarried couples from low-income contexts. To date, little research has assessed patterns of coparenting relationships and their associations with child socioemotional outcomes among this population. Participants were 4,266 unmarried couples and their preschool-aged children from the Building Strong Families study. Latent profile analysis was conducted. Latent profile analysis of survey data from mothers and fathers revealed four coparenting patterns: Profile 1: low quality, more negative maternal coparenting perceptions (7.2%); Profile 2: moderate-high quality, high congruence, slightly more negative paternal coparenting perceptions (25.2%); Profile 3: low congruence, severely more negative maternal coparenting perceptions (11.8%); and Profile 4: mutual high-quality coparenting (55.8%). Children of parents with the mutual high-quality coparenting profile had the most positive outcomes according to maternal reports of child socioemotional development. Highly congruent and positive perceptions of the other parent as a coparent were found to be significant promotive factors for positive child socioemotional development. Family strengthening policies and programs for unmarried couples with low income should target and support the development of mutually satisfying, high-quality coparenting relationships, with the ultimate goal to improve developmental outcomes for young children in such families.

From evidence-based health prevention registers to best practices in implementation: how to succeed and tailor an effective prevention program?

Abstract The role of evidence-based prevention registers and “best practice portals”, aiming at health enhancing behaviour changes and reducing social inequalities, are even more important in the post COVID era. Evidence-based practices are interventions for which there is consistent scientific evidence asserting that they improve health outcomes for a specific population at time T in setting S. Adaptation and dissemination are the next challenges for decision-makers whereas there is no scientific consensus on a universal dissemination and adaptation model. Best practice portals should help to disseminate evidence-based interventions in health prevention. Therefore specific skills for adapting and implementing programs in local settings are needed. Models for dissemination remain complex for field practitioners and local stakeholders. Nevertheless, effective implementation can be achieved by supporting the local practitioners and stakeholders with scientific standards in prevention research including a delivery system, an organizational capacity, a support system and a strong training and technical assistance. In this workshop, we will briefly present: 1. The implementation of evidence-based interventions (Unplugged, ICAPS Intervention centred on adolescents’ physical activity and sedentary behavior) or experimented for adaptation (Panjo: Nurse-family partnership, PSFP: Strengthening Families Program, Good Behavior Game, MBCP: Mindfulness-based childbirth and parenting). 2. The lessons learned from the implementation of these interventions. The required conditions for dissemination include readiness assessment, affordability of training and manuals, targeted audience, materials, supportive training and assistance. Fidelity monitoring tools must be provided for field practitioners who face the dilemma to adapt evidence-based program respecting its unchangeable core components (fidelity vs. flexibility in adapting an evidence-based intervention).

Growing stronger together: Sharing a story of culturally responsive evaluation with indigenous families and communities

BackgroundGaps exist in understanding how to create and conduct culturally responsive evaluations. This information is particularly critical when working with evidence-based programs and when involving populations that have and continue to experience oppression and trauma. ObjectiveWe share our story of developing and carrying out a culturally responsive evaluation of an EBP, Strengthening Families Program (SFP), with Indigenous families. Participants and settingA collective storytelling approach was used based on reflections from the evaluation team and key implementation staff. MethodsWe used a collective storytelling approach, organizing the content around six previously identified principles of Indigenous research (Tsosie et al., 2022). ResultsEmerging themes, supported by quotes throughout, illustrate the importance of organizing the integration of culture into the evaluation through the six principles of Indigenous research: respect, relationship, relevance, reciprocity, responsibility, and representation. ConclusionWorking toward a culturally responsive evaluation allowed for the creation of more meaningful connections with Indigenous community partners and families. It also acknowledged insights that partners and families bring to the work and encouraged multi-directional learning to occur between evaluators, partners, and families.

Growing stronger together: Implementing the Strengthening Families Program with Indigenous communities

BackgroundChild welfare agencies commonly seek to use evidence-based programs (EBPs) for their demonstrated results. Challenges remain in adapting programs to fit for Indigenous populations. We suggest that relationality holds promise as a guide in the implementation of EBPs with Indigenous families and children. ObjectiveWe provide the story of a culturally integrated implementation of the EBP, Strengthening Families Program (SFP), with Indigenous families. Participants and settingInsights from the staff who implemented SFP, project leadership and a community steering committee were brought together to create the collective implementation story. MethodsA relational approach was used in thematic analysis with a focus on the three Rs - responsibility, respect, and reciprocity- that support Indigenous knowledge organization. ResultsFindings offer insight into cultural integrations in the implementation of SFP. The program centered Indigenous and community identities through meals, gifts, parenting practice examples and discussions tailored by each group of families and staff. Practices related to responsibility, respect and reciprocity each proved to be essential concepts in the relationship building among caregivers, children, SFP staff, project leadership, and community supporters that led to program success. ConclusionCultural integration created a space that reflected Indigenous knowledge relationality. It respected the uniqueness among groups of families who participated in the evidence-based SFP. Our story supports the importance of having Indigenous staff and group leaders to guide cultural integration in relationship with tribal communities.

The subjective perception of the happiness of older adult residents in Colombia.

Happiness is understood as the perception of subjective well-being, it can be a quality, a result, or a state characterized by well-being or satisfaction that every person wants to achieve. In older adults, this satisfaction is a sum of lifelong achievements and triumphs; However, some factors influence this ideal. Analyze demographic, family, social, personal, and health factors associated with the subjective perception of happiness in older adults, using data from a study conducted in five cities in Colombia, in order to make a theoretical contribution in the search for improvement of their physical, mental and social health. A quantitative, cross-sectional, analytical study was carried out, using primary source information, obtained with 2,506 surveys from voluntary participants aged 60 and over, who had no cognitive impairment, and who reside in urban areas but not in long-term centers. The variable happiness (classified as high or moderate/low) was used for: (1) A univariate explorative characterization of older adult, (2) a bivariate estimation of the relationships with the factors studied, and (3) a multivariate construction of profiles through multiple correspondences. 67.2% reported high happiness levels, with differences by city: Bucaramanga (81.6%), Pereira (74.7%), Santa Marta (67.4), Medellín (64%), and Pereira (48.7%). Happiness was explained by the absence of risk of depression and little hopelessness, strengthened psychological well-being, a perception of high quality of life, and living in a functional family. This study provided an overview of possible factors that can be enhanced and strengthened with public policies (structural determinant), community empowerment, family strengthening (intermediate determinant), and educational programs (proximal determinant). These aspects are included in the essential functions of public health, in favor of mental and social health in older adults.

Grounding evidence-based prevention within cultural context: promising effects of substance use prevention adapted for American Indian families

Background: Effective substance use prevention strategies are needed for American Indian (AI) youth, who face disproportionate risk for early substance use and consequently bear a disproportionate burden of health and developmental disparities related to early use. With few exceptions, significant advances in prevention science have largely excluded this population, leaving gaps in the evidence of effective practice. This paper builds on emerging efforts to address this gap, reporting first outcome findings from an evidence-based early substance use prevention program culturally adapted for young adolescents on a Northern Plains reservation. Methods: Using a community-based participatory approach, the Thiwáhe Gluwáš’akapi Program (TG, sacred home in which family is made strong) was developed by embedding cultural kinship teachings within the Strengthening Families Program for Parents and Youth 10-14 and aligning other elements of program content with local culture and context. Results: Results of pre and post comparisons of proximal program outcomes showed that youth reported significant improvements in parental communication about substance use, substance use resistance skills, stress management, family cohesion, and overall well-being. Adults reported improvements in a wide array of parenting behaviors and indicators of family dynamics. Conclusions: These findings provide an initial glimpse into the potential effects of the TG program and suggest that it holds promise for helping AI families address risks for youth substance use through positive impacts on modifiable risk and protective factors documented to influence early substance use.

Family listening/circle program: The experience of community action projects to promote family and community wellness in three tribal communities in New Mexico.

The Family Listening/Circle Program (FLCP) is a community-based participatory research (CBPR), culture-centered, intergenerational family strengthening program that was co-developed in partnership with the University of New Mexico's Center for Participatory Research (UNM-CPR) and three tribal communities (Pueblo of Jemez, Ramah Navajo, and Mescalero Apache) in New Mexico. The Family Listening/Circle Program brings together fourth and fifth graders, their parents, caregivers, and elders to reduce risky behaviors associated with the initiation of substance use among the youth, and to strengthen family communication and connectedness to culture and language as protective factors. The tribal research teams (TRTs) from each community worked with UNM-CPR to co-create, pilot, implement, and evaluate the tribally-specific FL/CP curricula centered in their own tribal histories, language, knowledge, visions, and actions for the future. A key component of the FL/CP involved the planning and completion of community action projects (CAPs) by participating families. During the final session of the program, the families present their community action projects on poster boards, with children leading the presentations. The TRTs and UNM team document narratives of what was shared and learned by the families. The CAPs provide an empowerment and community benefit focus based on Paulo Freire's philosophy that people can become agents of change if they identify and work on issues that are important to them. The community action projects are also centered in Indigenous values and practices of reciprocity, responsibility, and being active members of the community. The CAPs added unique contributions to the Family Listening/Circle Program as the participants' learnings were strengthened when they had the opportunity to give back to their communities. The CAPs were important to document as they illustrated the potential range of effectiveness with their capacity to empower participants to address challenges within their communities, strengthen cultural norms and values, and improve the wellbeing of community members.

The Brother–Sister Sibling Dyad as a Pathway to Gender-Based Violence Prevention: Engaging Male Siblings in Family-Strengthening Programs in Humanitarian Settings

Household violence poses a significant threat to the physical and mental health of adolescent girls. In conflict-affected communities, increased stresses to safety, security, health, and livelihoods may heighten this risk. While it is widely evidenced that the caregiver-child relationship can increase or protect against girls’ risk of violence, less is known about the role of male siblings. Sibling Support for Adolescent Girls in Emergencies (SSAGE) used whole-family support programming to synchronously engage adolescent girls, their male siblings, and their caregivers in conflict-affected communities in Jordan and Niger, using gender-transformative approaches to explore the impacts of gender norms, power, and violence and encourage support and emotional connection. We conducted qualitative research activities, including focus group discussions, participatory group activities, and in-depth, paired, and key informant interviews with 469 SSAGE participants and program facilitators to explore SSAGE’s impact on the male-female sibling dyad in both settings. The multi-stakeholder team used a collaborative thematic analysis approach to identify emergent themes. Findings suggest that the inclusion of male siblings in family strengthening programs may have a positive impact on factors related to girls’ protection, with research participants discussing decreased perpetration of physical and verbal violence by male siblings, increased equity in household labor between siblings, and improved trust and mutual support among siblings. These changes were facilitated by improved communication and interrogation of positive gender identities. In humanitarian settings, interventions that support more gender-transformative, egalitarian, and emotionally effective relationships between male-female siblings can work towards improving girls’ protective assets. More research on the impact of this relationship on girls’ experience of immediate and long-term experience of violence is needed. In settings where gender power dynamics among male-female siblings are less salient, other relationship dyads should be explored.

Efektivitas Home Visit dalam Program Penguatan Keluarga Oleh Sos Children’s Village Medan

Family strengthening program by SOS Children's Village Medan is one form of family level social intervention that aims to prevent conditions that resulting children being separated from their family, mainly from economic factors. In implementing, educators obliged to do home visits. Home visit means that educator carried out in the client's home. One of the village assisted by this program is the village of kwala bekala, where most of the clients work in the informal sector and spend their daily lives working outside their home, thus hinder the process of home visits. In fact, through home visits, educators will be able to explore problems and developments experienced by clients that will affect the termination process.The purpose of this study is to know the effectiveness of home visits in Family strengthening programs by SOS Children’s village. Techniques being used for data collection includes literature study, observation, interviews, and documentation. The data obtained in the field were analyzed qualitatively to obtain conclusions. The result of this study shows that home visits in this program have been effective, as measured by three approaches, namely, resource approach, the second approach is the process approach and lastly based on the target approach seen from the achievement of the home visit goal in this program.

An Evaluation of the Competences and Attitudes of the Providers of an Evidence-Based Family Prevention Program

Evidence-based family prevention programs have become more prevalent in recent years due to their effectiveness. However, they also pose a number of challenges, such as controlling for possible biases associated with the profile of the program provider. This study assesses whether the professionals in charge of implementing the Strengthening Families Program (SFP) have adequate competences, and whether significant groupings can be identified according to their competences and attitudes to evidence-based practice. It analyses what training and occupational factors might influence their competence levels and attitudes. Through a cross-sectional study, an evaluation was made of the professionals in charge of giving the SFP ( n = 177; 84.2% females; mean age: 38 years). They were found to have sufficient levels of suitable competences, particularly in terms of intrapersonal, interpersonal, and environment-related skills. From a K-means cluster analysis, significant groupings were identified, based on the professionals’ competences and attitudes to evidence-based practice. When the professionals in Cluster 2 (a higher level of competences and receptive attitudes) were compared with the other clusters, significant differences in two variables were found: (a) the receipt of prior training in the SFP and (b) specialization in family interventions. This finding is important because once the competences had been evaluated to control for possible biases, higher competence levels were shown to influence the program’s effectiveness. For this reason, it is important to identify possible factors that might foster better proficiency in the said skills. This could serve as a guideline for public health services, social agents, and institutions, offering them guidance on the type of competences and level of skills required by the professionals in charge of giving the program.

Pembentukan Kelompok Belajar Sebagai Strategi Untuk Meningkatkan Minat Belajar Siswa SD di Desa Binaan Sos Children Village Medan Kelurahan Kwala Bekala

Community service as a manifestation of one of the Tri Dharma of Higher Education carried out by Students of the Social Welfare Study Program, Faculty of Social and Political Sciences, the University of North Sumatra through Practicum II activities at SOS children's village medan, through the family strengthening program carried out in kwala bekala aimed at increasing the interest of students at the time of the pandemic, to increase their interest in learning through the formation of study groups. The method the author uses in this devotion program is community intervention by zastrow, which consists of: intake and contract, deals, planning/planning, intervention and formulation of programs, evaluations, and terminations. The results of the program can be seen from the attainment of the goals and impact students obtained during the program. Where students who participate in the program are able to follow the writer's well applied set of activities and are thus helpful in increasing their interest in learning. It is seen at the rate of their presence in group meetings each week and the results of weekly quizzes that show their willingness to repeat each home lesson.

Implementing a Child Mental Health Intervention in Child Welfare Services: Stakeholder Perspectives on Feasibility.

This pilot study integrated quantitative and qualitative data to examine the feasibility of implementing a modified version of a multiple family group behavioral parent training intervention (The 4Rs and 2Ss for Strengthening Families Program [4Rs and 2Ss]) in child welfare (CW) placement prevention services, from the perspectives of participating caregivers (n = 12) and CW staff (n = 12; i.e., 6 caseworkers, 4 supervisors, and 2 administrators). Quantitative surveys were administered to caregivers and CW staff followed by semi-structured interviews to examine the feasibility of implementing the modified 4Rs and 2Ss program, as well as factors impacting feasibility. Results indicated that quantitative benchmarks for high feasibility were met in all assessed areas (e.g., family recruitment, caseworker fidelity ratings, CW staff feasibility ratings) except for family attendance, which was markedly lower than desired. Factors facilitating feasibility included agency and research support, intervention ease-of-use, perceived benefits to existing CW practice, as well as logistical support (e.g., food, transportation, childcare) promoting attendance. Factors hindering feasibility included conflicts between research-based eligibility criteria and existing client population demographics, research-related processes resulting in delays, CW staff role conflicts, added workload burden, complex family issues, and power differentials inherent to CW services which complicated families' voluntary participation.

Evaluating facilitators’ challenges administering a program building on existing strengths in families facing difficulties

The primary objective of this study was to understand the challenges faced by 12 facilitators (9 women and 3 men) of the Strengthening Families Program (SFP) implemented in the Adélard-Dugré and Jean-Nicolet neighbourhoods of Trois-Rivières, Quebec. This objective was operationalized as the following question: How did facilitators manage to buy in to, and align themselves with, program principles while avoiding an expert stance and remaining focused on participating families’ strengths? This question has not been investigated before in connection with the SFP program. This study was conducted between 2011 and 2014, and relied on semi-annual group interviews. The results indicate that facilitators’ first step was to acknowledge their expectations. Once they had accomplished this, they were able to let go and distance themselves from an expert stance. This allowed them to recognize the benefits flowing from application of the program’s principles, and understand how they could repurpose their expertise for intervention with program participants. Facilitators also came to realize that they had developed strong relationships with the families and better understood the latter’s realities. Finally, this article explores the implications of the results, both for practice (in terms of program compliance) and research (in terms of program evaluation).

Protocol for a randomised controlled trial of a family strengthening program to prevent unhealthy weight gain among 5 to 11-year-old children from at-risk families: the Strong Families Trial

BackgroundObesity is an increasing health concern in Australia among adult and child populations alike and is often associated with other serious comorbidities. While the rise in the prevalence of childhood obesity has plateaued in high-income countries, it continues to increase among children from disadvantaged and culturally diverse backgrounds. The family environment of disadvantaged populations may increase the risk of childhood obesity through unhealthy eating and lifestyle practices. The Strong Families Trial aims to assess the effectiveness of a mixed behavioural and lifestyle intervention for parents and carers of at-risk populations, i.e. families from culturally diverse and disadvantaged backgrounds, in preventing unhealthy weight gain among children aged 5 to 11 years.MethodsEight hundred families from low socio-economic areas in Greater Western Sydney, NSW, and Melbourne, VIC, will be recruited and randomised into a lifestyle intervention or control group. The intervention comprises 90-minute weekly sessions for 6 weeks (plus two-booster sessions) of an integrated, evidence-based, parenting and lifestyle program that accounts for the influences of family functioning. Primary (anthropometric data) and secondary (family functioning, feeding related parenting, physical activity, consumption of healthy foods, health literacy, family and household costs) outcome measures will be assessed at baseline, immediately following the intervention, and 12 months post-intervention.DiscussionThis study will elucidate methods for engaging socially disadvantaged and culturally diverse groups in parenting programs concerned with child weight status.Trial RegistrationThis study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001019190). Registered 16 July 2019.

Examining mechanisms linking economic insecurity to interparental conflict among couples with low income.

The current study used the family stress model to test the mechanisms by which economic insecurity contributes to mothers' and fathers' mental health and couples' relationship functioning. Although low household income has been a focus of poverty research, material hardship-defined as everyday challenges related to making ends meet including difficulties paying for housing, utilities, food, or medical care-is common among American families. Participants were from the Building Strong Families project. Couples were racially diverse (43.52% Black; 28.88% Latinx; 17.29% White; 10.31% Other) and living with low income (N = 2,794). Economic insecurity included income poverty and material hardship. Bayesian mediation analysis was employed, taking advantage of the prior evidence base of the family stress model. Material hardship, but not income poverty, predicted higher levels of both maternal and paternal depressive symptoms. Only paternal depressive symptoms were linked with higher levels of destructive interparental conflict (i.e., moderate verbal aggression couples use that could be harmful to the partner relationship). Mediation analysis confirmed that material hardship operated primarily through paternal depressive symptoms in its association with destructive interparental conflict. The economic stress of meeting the daily material needs of the family sets the stage for parental mental health problems that carry over to destructive interparental conflict, especially through paternal depressive symptoms. Family-strengthening programs may want to consider interventions to address material hardship (e.g., comprehensive needs assessments, connections to community-based resources, parents' employment training) as part of their efforts to address parental mental health and couples' destructive conflict behaviors.

Using qualitative comparative analysis to uncover multiple pathways to program sustainment: implications for community-based youth substance misuse prevention

BackgroundIn order to achieve wide-scale impact in community settings, programs must be sustained. Theory and empirical evidence suggest that intervention characteristics, organizational context, capacity for program implementation, and processes related to implementation are associated with continued program delivery. However, few studies examine how combinations of these factors work together in different settings to influence program sustainment.MethodsUsing scales specified in the Program Sustainability Assessment Tool (PSAT), the current cross-sectional study aims to identify the necessary and sufficient conditions for the sustainment of the Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14). Staff (n = 59) at SFP 10-14 implementation sites across Washington State completed an online survey reporting on their current level of SFP 10-14 sustainment. They also completed PSAT, with eight scales designed to assess conditions that consistently produce sustainment. Data were analyzed using qualitative comparative analysis.ResultsEnvironmental support was the only necessary condition for sustainment success. Four solutions sufficient to achieve sustainment were also identified. These included the combined presence of (1) environmental support, organizational capacity, and funding stability; (2) environmental support, organizational capacity, communication, and program evaluation, in the absence of strategic planning; (3) environmental support, organizational capacity, program evaluation, and partnerships, in the absence of strategic planning; and (4) environmental support, communication, partnerships, and funding stability, in the absence of program evaluation.ConclusionsEnvironmental support in combination with organizational capacity appeared to most consistently produce sustainment of SFP 10-14 programs in Washington State. Program providers will benefit from a focusing on enhancing those conditions to increase program sustainment.