Strengthening Families Research Articles

Preventing Internalizing and Externalizing Symptoms in Adolescents Through a Short Prevention Programme: An Analysis of the Effectiveness of the Universal Strengthening Families Program 11-14

In recent years, there has been a growth in the number of evidence-based programmes designed to act directly on the factors that predispose or precipitate the onset of disorders or symptoms, rather than designing specific interventions to deal with each particular problem or disorder. The development of the Universal Strengthening Families Programme 11-14 (SFP 11-14) is one such example, where parents and adolescents are trained through the acquisition of strategic skills. The aim of this study is to assess the effectiveness of SFP 11-14 in tackling internalizing and externalizing symptoms in adolescents from 11 to 14 years old. A quasi-experimental design was used with a control group, based on pre-test and post-test assessments and a follow-up. 289 adolescents and 353 parents took part, with 16 experimental groups and 17 control groups. From an analysis of variance and post-hoc Tukey-B tests, the effectiveness of SFP 11-14 in dealing with internalizing and externalizing symptoms was explored, confirming the efficacy of its short multicomponent (6-session) structure at the evaluation point (post-test1) and 6-month follow-up (post-test2). The results confirm that short preventive multicomponent programmes can prevent externalizing and internalizing symptoms in early adolescence. Improved family dynamics and relationships act as protective factors against possible mental disorders and against internalizing and externalizing symptoms. However, in future research, a specific assessment should be made of the effectiveness of each component in order to reinforce the more productive input, as well as conducting longitudinal evaluations so as to confirm long-term outcomes.

Child Sexual Abuse Prevention Program: Reference to the Indonesian Government

Background: Child Sexual Abuse (CSA) was a global problem widespread in many countries. Komisi Perlindungan Anak Indonesia or Indonesian Children Protection Commission (KPAI) recorded as many as 1.880 children become victims of sexual abuse such as rape, fornication, sodomy and paedophilia. The Government of Indonesia become made become efforts both national and international scale, but there is no effective and applicable program that has been implemented. Objective: The purpose of this article was to analyse the programs had been implemented to prevent sexual violence against children. Method: This article was a literature study by examining 38 articles related to the program against child abuse. The researcher was looking for reference sources from the Science Direct, Sage pub and Google Scholar online become. The keywords used were Child Sex Abuse Prevention Program, Parenting Program, Parent Training, Parent Intervention, Maltreatment, Violence, and Violence Prevention. Result: In children, programs that had been implemented include C-SAPE; IGEL; Train the trainer; BST; A program for minorities in Australia; Cool and Safe. For parents, the programs that had been applied include ACT-RSK; Triple-P; RETHINK; The Incredible Years Parents, Teachers, and Children Training Series; PACE; The Making Choices and Strong Families; The African Migrant Parenting; Strengthening Families; 123 Magic; PDEP and FAST. Conclusion: The sexual violence prevention program for children that can be implemented by the Indonesian government was using teaching methods based on school curricula that can be delivered by teachers. For parent, the program that could be implemented by the Indonesian government was using positive parenting methods that focus on preventing sexual violence against children and delivered by expert facilitators. To reach children and families with different cultural backgrounds, the Indonesian government could adapt sexual violence prevention programs for the Australian minorities and The African Migrant Parenting.

Barriers and Facilitators in the Strengthening Families Program (SFP 10-14) Implementation Process in Northeast Brazil: A Retrospective Qualitative Study.

This study analyzed contextual barriers and facilitators in the implementation of Strengthening Families Program (SFP 10–14), Brazilian version, a family-based preventive program focused on the prevention of risk behaviors for adolescent health. SFP 10–14 was implemented between 2016 and 2017 for socioeconomically vulnerable families in four Northeast Brazilian states as a tool of the National Drug Policy. A retrospective qualitative study was carried out in which 26 implementation agents participated. Data from 16 individual interviews and two group interviews were analyzed through content analysis. The most recurrent barriers were the group facilitators’ working conditions, weak municipal administration, precarious infrastructure, inadequate group facilitator training methodologies, low adherence of managers and professionals, and funding scarcity. The conditions highlighted as favorable to the implementation were proper intersectoral coordination, engagement of involved actors, awareness of public agency administrators, municipal management efficacy, and efficient family recruitment strategies. Favorable political contexts, engagement of implementation agents, and intersectoral implementation strategies were identified as central to the success of the implementation of SFP 10–14, especially in the adoption of the intervention, community mobilization, and intervention delivery stages. Further studies should combine contexts, mechanisms, and results for a broad understanding of the effectiveness of this intervention in the public sector.

Exploring the short-term effects of the Strengthening Families Program on Brazilian adolescents: a pre-experimental study

Background Substance abuse and violence are among the primary health concerns regarding Brazilian adolescents. This study sought to explore the short-term effects of the Strengthening Families Program (SFP 10-14), a preventive program for families with adolescents, adapted to Brazil. Methods A pre-experimental design was used, with a pretest and 10-12-month follow-up evaluation. A qualitative study was carried out using in-depth interviews held one to three months after the intervention to examine the use of skills learned. The sample included 126 adolescents (pre-test and follow-up comparison) and 23 adolescents (interviews) between 10 and 14 years of age from low-income families residing in northeastern Brazil. Results The comparison between pretest and follow-up showed an increase in learning self-efficacy and school absence without parental permission. Null effects were found on the consumption of alcohol in the last month; episodes of binge drinking in the last month; antisocial behavior; parenting practices regarding emotional support factors, intrusiveness, and behavior supervision; future time perspective; doing homework; grade repetition; school grades; school dropout; and satisfaction with one's relationship with school. The majority of the interviewed adolescents reported applying the learned skills during family interaction and with friends. Conclusion Mixed results were found on short-term effects of the Strengthening Families Program for Brazilian adolescents. Future studies should examine the contexts and mechanisms linked to such results.

Delivering the Strengthening Families Program to Native American Families During COVID-19: Lessons & Next Steps

The COVID-19 pandemic (COVID) of 2020 has forced adaptation for all Americans. Programs that serve Native American children and families are particularly critical during this time due to the disproportionate risks and disparities faced by this population. The objective of this qualitative evaluation is to gather adult participant feedback on strengths and needed changes with a telehealth adaptation of the Strengthening Families Program. This evaluation builds on previous knowledge of SFP group leadership which suggests that supportive helping relationships paired with dynamic flexibility are facilitators of effective family engagement. Participant feedback suggests that caregiver’s felt comfort, care, and genuine concern. In addition all participants noticed a difference in their families’ communication and relationships. Although tragic and challenging, the COVID-19 pandemic, forced a spotlight on barriers (limited internet access, social services, and food resources) that were needed to sustain participation and increase resilience among Native American residents in this mid-western state. The individualized planning and checking in on every level which started out as a “how do we replicated this service” became about building resilience strategies for Native American families in this critical time in history.

Assessing multidimensional sustainability: Lessons from Brazil’s social protection programs

Examining linkages among multiple sustainable development outcomes is key for understanding sustainability transitions. Yet rigorous evidence on social and environmental outcomes of sustainable development policies remains scarce. We conduct a national-level analysis of Brazil's flagship social protection program, Zero Hunger (ZH), which aims to reduce food insecurity and poverty. Using data from rural municipalities across Brazil and quasi-experimental causal inference techniques, we assess relationships between social protection investment and outcomes related to sustainable development goals (SDGs): "no poverty" (SDG 1), "zero hunger" (SDG 2), and "health and well being" (SDG 3). We also assess potential perverse outcomes arising from agricultural development impacting "climate action" (SDG 13) and "life on land" (SDG 15) via clearance of natural vegetation. Despite increasing daily per capita protein and kilocalorie production, summed ZH investment did not alleviate child malnutrition or infant mortality and negligibly influenced multidimensional poverty. Higher investment increased natural vegetation cover in some biomes but increased losses in the Cerrado and especially the Pampa. Effects varied substantially across subprograms. Conditional cash transfer (Bolsa Familia [BF]) was mainly associated with nonbeneficial impacts but increased protein production and improved educational participation in some states. The National Program to Strengthen Family Farming (PRONAF) was typically associated with increased food production (protein and calories), multidimensional poverty alleviation, and changes in natural vegetation. Our results inform policy development by highlighting successful elements of Brazil's ZH program, variable outcomes across divergent food security dimensions, and synergies and trade-offs between sustainable development goals, including environmental protection.

Condições de acesso à linha do Pronaf Agroecologia no Território da Cantuquiriguaçu/PR

Com a instituição do Programa Nacional de Fortalecimento da Agricultura Familiar em 1995, os recursos financeiros voltados para a agricultura familiar passaram a ter um canal de acesso antes inexistente. Dentre os subprogramas do Pronaf está a linha voltada para a agroecologia, instituída a partir da safra 2003/2004, cujo acesso é baixo. Neste contexto o artigo aqui apresentado resulta de uma pesquisa que busca analisar limites e potencialidades no acesso dos agricultores familiares à linha do Pronaf Agroecologia no Território da Cidadania da Cantuquiriguaçu/PR. Foi utilizado instrumental descritivo exploratório, via um estudo de casos coletando dados junto a agricultores familiares e com agentes de instituições financeiras, buscando confrontar e comparar as respostas sobre a inexistência de acesso ao subprograma na região. Os resultados indicam que os agricultores familiares entrevistados, têm interesse em acessar os recursos, mas por desconhecimento, dificuldades quanto às exigências, receio quanto ao endividamento e taxas de juros, isto não acontece. No caso das instituições financeiras o que se observou é de que a linha não é atraente em termos financeiros para ser disponibilizada. Consequentemente não há um conhecimento apurado sobre como funciona e constata-se a necessidade de que a assistência técnica seja mais efetiva no sentido de instruir, orientar e auxiliar os agricultores familiares a apresentar projetos viáveis junto às instituições financeiras. Superar estes limites pode ser um meio de usufruir das potencialidades da produção agroecológica, tão importante e necessária para a sustentabilidade social, ambiental e econômica.

Report on the Toronto International Program to Strengthen Family Medicine and Primary Care

筆者らは2019年6月，トロント国際家庭医療研修プログラム（Toronto International Program to Strengthen Family Medicine and Primary Care）に参加し，家庭医療の重要なエッセンスを学んだ．長い歴史を持つカナダの家庭医療を土台に，患者レベル・地域レベル・国際レベルで各層において日本の家庭医療の課題を考察する事ができた．

Modelos teóricos utilizados por enfermeiros para avaliação da família: reflexão teórica

Objetivo: identificar a produção científica no período de 10 anos completos, a partir da implementação da Atenção Básica no Brasil, sobre os modelos teóricos utilizados e que influenciaram os enfermeiros na avaliação de famílias no brasil e no mundo. Métodos: Trata-se de um estudo teórico-reflexivo, construído com base na leitura crítica da avaliação dos modelos familiares pelos profissionais de enfermagem, em estudos científicos, que referenciam as avaliações familiares como fatores preditores na melhora significativa no cuidado direto ao paciente. Essa construção teórica aproxima-se da abordagem qualitativa, tendo em vista a interpretação e análise dos elementos teóricos obtidos por meio de uma revisão integrativa. Resultados: Foram utilizados 20 artigos e encontrados 19 modelos. Os Modelos Calgary, o APGAR de família e o Genograma e Ecomapa são mais comumente utilizados na prática clínica do enfermeiro. Considerações Finais: A utilização de modelos teóricos de avaliação propicia melhoria na qualidade do cuidado dispensado bem como a sistematização da assistência, a integração da família e suas relações no cuidar promovendo um fortalecimento familiar.

Realistic expectations: exploring the sustainability of graduation outcomes in a program for children affected by HIV in Kenya’s Northern Arid Lands

ABSTRACT Orphans and vulnerable children (OVC) programs in high HIV prevalence contexts are shifting toward ‘graduation’ approaches to facilitate outcome-focused programming, but little is known about the sustainability of participant outcomes post-graduation. We conducted a qualitative follow-up study to 4Children’s quantitative tracer study of the APHIAplus IMARISHA program in Kenya examining the sustainability of graduation benchmarks nine months after graduation. Our analysis examined effective intervention sequencing, graduation benchmarks, and characteristics linked to household-level backsliding, with a focus on the role of economic capacity-building interventions. We conducted 59 in-depth interviews with IMARISHA participants and four key informant interviews with program implementers. High levels of backsliding among tracer study participants demonstrate a misalignment between interventions received and expected outcomes as measured by benchmarks. Our analysis identified several barriers to sustaining program gains, including constraints on the availability or intensity of interventions, ongoing dependency on program resources, and weak execution of the graduation process. No pattern emerged to explain the most effective sequence of interventions, and no intervention could be described as most important to sustainability, but greater participation across interventions was linked to improved outcomes. We recommend longer-term economic capacity-building paired with ‘family strengthening’ interventions addressing internal household social issues to improve sustainability.

Understanding the Effects of Involuntary Migration on Family Relationships: Meaning Construction by Parents and Service Providers

In this paper, we explore the meanings constructed of involuntary migration processes and influences on family relationships and interactions. We draw from qualitative interview data with 30 Syrian and Iraqi refugee parents (13 females and 17 males) currently living in Canada, as well as survey data from professionals working with newly arrived refugee families in a Canadian context. Refugee parents reflect on the impact of pre-migration, in transit, and post-migration circumstances and experiences on their family relationships. These men and women tell stories of their responses to and the effects of difficult experiences initiating and accompanying their involuntary migration from war zones, and post-migration settlement. To complement this interview data, we also surveyed group facilitators working in the same local community with refugee families (including parents, teens, and younger children) in Journey Home, a cultural adaptation of the Strengthening Families Program (SFP 8–11, 12–16), identifying and addressing early risk factors leading to potential involvement of criminal justice and child protection services. These professionals reflect on what they have heard and observed, in these groups, about parents, teens, and children’s experiences of involuntary migration and resettlement and effects on family interactions. They also reflect on what aspects of their own prior experience and professional/academic training aid them in their work. These reflections by both refugee family members and service providers are both similar and different. They highlight the challenges and resiliencies of family life in the face of involuntary migration, the conditions that enhance family well-being and effective professional supports.

Does a mindfulness-augmented version of the German Strengthening Families Program reduce substance use in adolescents? Study protocol for a randomized controlled trial

BackgroundMindfulness training (MT) for parents of adolescents has been shown to improve mental health and stress-related outcomes in individuals and their families. Studies of MT among young people are mainly delivered in educational or clinical settings, and there is a need for controlled studies on both parent-directed and adolescent-directed approaches. It is unclear whether MT has preventive effects for substance use outcomes. The primary objective of this trial is to evaluate the effectiveness of family-based MT targeting both adolescents and their parents to prevent adolescent substance use and enhance neurobehavioral self-regulation skills that play a major role in addiction development and mental health.Methods/designThe trial design is a superiority, two-arm, randomized controlled trial in which families will participate either in the full curriculum of the evidence-based Strengthening Families Program 10–14 (SFP 10–14, German adaptation) or in a mindfulness-enhanced version of this program (SFP-Mind). Both seven-session interventions are highly structured and will each be delivered over a period of approximately 7 weeks. The experimental intervention SFP-Mind is a modified version of the SFP 10–14 in which some elements were eliminated or changed to enable the inclusion of additional parent-directed and adolescent-directed mindfulness components. The primary outcome is adolescent self-reported alcohol use based on an alcohol initiation index at 18-month follow-up. Dispositional mindfulness, impulsivity, and emotion regulation will be included as secondary outcomes and potential mechanisms of action. The study will recruit and randomize 216 adolescents, aged 10–14 years, and their parents who will be followed up for 18 months.DiscussionThis trial aims to evaluate the effectiveness of SFP-Mind for family-based prevention of substance use and promoting mental health in adolescence.Trial registrationGerman Register of Clinical Studies, DRKS00015678. Registered on 25 February 2019.

Evaluation of the Prevention Program: “Strong Families: Love and Limits” in Colombia

“Strong Families” is a program developed by PAHO/WHO aimed at preventing risk behaviors in adolescents, and it is based on the Strengthening Families Program of Iowa. The objective of this study was to evaluate the effectiveness of this program in Colombia. For this, a quasi-experimental study involving 376 families was carried out. The families that underwent the intervention attended between five and seven sessions. The groups were evaluated before the intervention and 12 and 18 months later. Intervened parents showed significant changes in parenting after the intervention. No changes were observed with respect to risk behaviors in adolescents undergoing survey and control. It is suggested to review the program to put more emphasis on the prevention of risk behaviors and to refine the proposed instruments to measure these behaviors.

Local Adaptations to Implement the Strengthening Families Program in Northeastern Brazil

Local adaptations can promote user engagement and sustainability in the preventive program. The objective of this study is to evaluate local adaptations of the Strengthening Families Program (SFP) (10-14) for Brazilian families. Data were collected from semi-structured interviews of 42 facilitators who implemented the program. The directed content analysis was the analysis method used. The findings revealed that most facilitators did not make any additions (83.3%), while 50% reported discarding activities, largely due to the lack of time (31.6%). Adaptations were made by 73.2% of the interviewees, which most commonly (32%) addressed examples and linguistic features. Suggestions were made by 58.94% of the interviewees and focused on improving the support systems and delivery of the intervention, as well as the intervention itself to customize it to the socioeconomic and educational conditions of the target group. It was concluded that adaptations to the SFP (10-14) materials and procedures, and improvements in political support and organizational capacity are needed for its implementation.

A Policy Discussion on Maternity Waiting Home in Zambia to Achieve Its Vision 2030 on Maternal and Perinatal Mortality

Maternal and child health, with a focus on perinatal health, remains an area of focus for developing countries. Zambia has identified maternal and child health as an area of concentration in its 2030 vision agenda, with the goal of achieving less than 180 maternal deaths per 100, 000 live births by 2030. So far, interventions executed by the government include improving birthing space and providing higher quality services such as emergency obstetric care, post-abortion care and encouraging community level advocacy by safe motherhood action groups. However, the high perinatal and maternal mortality rate in Zambia is associated with the low accessibility to quality obstetric care as a result of delays in decision to seek care, delays in reaching care centers, and delays in receiving care. Consequently, Maternal Waiting Homes (MWH) has been identified as a tool for reducing maternal and perinatal mortality. It is currently being used in Zambia but there is limited data on the operation and its impact. The evidence on MWH for this paper was based on the aggregate review of numerous studies. These identified MWH as an effective, equitable and cost-effective intervention but without concrete evidence of its acceptance. The effectiveness is highly dependent on its strength to promptly identify and refer high-risk pregnant women to skilled obstetric care. In addition, other non-medical interventions including strengthening family planning program at the grassroots level and integration of community mobilization in the MWH program with service quality improvement were recognized as successful. However, the utilization of MWHS has been low in most low- and middle-income countries (LMICs). This paper also describes potential implications of the MWHs on the political, economic, and social and development sectors of the country. In all, it recommends the upgrading and strengthening of MWH and its health system in Zambia, alongside integration of other suggested interventions.

Feasibility of the Strengthening Families Program for Brazilian Families: A Mixed Method Study

Abstract The objective of this study was to examine the feasibility (limited effectiveness, acceptability and practicality) of the Strengthening Families Program, a universal preventive intervention, for Brazilian families. A pre-experimental study was carried out, with pre-test, post-test, 6- and 10-12-month follow-ups. 74 adolescents and their parents participated. Scales on academic, parenting, and health outcomes were applied to adolescents at the four assessment times. Direct observation of implementation fidelity and families engagement in the intervention and telephone interviews with facilitators were used to investigate acceptability and practicality. The results show significant increase in parental supervision and learning self-efficacy. High levels of fidelity and parent/guardian engagement as well as moderate levels of adolescent engagement were found. The facilitators found the intervention had acceptable goals, but procedures excessively structured and unsuitable for families with low educational level. Practical implications are discussed.

The unequal allocation of PRONAF resources: which factors determine the intensity of the program across Brazil?

Abstract The family farming sector in Brazil is an important player in the country’s economy, especially in poor rural areas., The government has created the National Program for Strengthening Family Agriculture (PRONAF) to stimulate the development of family farming in Brazil. It a credit program that offers loans at a subsidized interest rate. Previous studies have shown that wealthier farmers and more developed regions have more access to subsidized credit. Due to this apparently unequal allocation of PRONAF resources, the study aims to analyze, through econometric regressions and interviews with specialists, the underlying determinants for the unequal credit allocation across the municipalities in Brazil. Results indicate that wealth and knowledge of farmers are significant determinants of loan size, whereas municipalities that represent a high risk have received significantly fewer resources from PRONAF per household head. Thereby, we can conclude that PRONAF’s operations are not fulfilling their pro-poor objectives of targeting poor farmers and municipalities. Progress in infrastructure and institutions to reduce risks, enhancement of farmers’ qualifications and organization, better access to markets and agroindustry, and improvements in rural extension services are found to be essential to increasing the access to PRONAF’s credit.

Strategies for Family Engagement in Evidence-Based Programmes: A Meta-Synthesis of Systematic Reviews from a Social Casework Approach

This paper explores the role of social work practice in youth risk prevention through evidence-based interventions, such as the Strengthening Families Programme. It begins by analysing the aetiology of social work practice in prevention and the theories that aim to explain social work practice as one of the most important disciplines for meeting the skill development requirements of risk prevention. Research has shown that evidence-based interventions applied at the family level can delay the onset of substance use. Various studies have backed working with these kinds of systems to ensure the effectiveness of interventions aimed at reducing substance abuse; however, family participation has also been shown to be one of the disadvantages of this kind of intervention. For this reason, the main goal of the present research is to identify the most effective strategies for engaging families in the context of social casework. We present a meta-synthesis of two systematic exploratory reviews of scholarly articles concerning family involvement, adherence, and findings that lead to achieving coupling. We discuss the family factors that social workers should consider in order to ensure that different members of family systems commit to building supportive relationships.

Thinking out of the box

ABSTRACTNever has the phrase 'thinking out of the box' resonated more appropriately for the field of child welfare than now. With the passage of the Strengthening Families Act and the re-conceptionalization of child welfare by the Children's Bureau toward primary prevention, it is an exciting and propitious time for thinking more broadly and unconventionally about how to best provide child welfare services to children and families through a diverse, skilled, and committed workforce. Developing the workforce needed for a prevention based child welfare system for the future while addressing the workforce challenges of the present will be challenging but also presents another opportunity for 'out of the box' thinking.

Can better parenting be achieved through short prevention programs? The challenge of universal prevention through Strengthening Families Program 11–14

AbstractWith the increase in substance use by young people in recent years' there has been a growth in evidence‐based programs aimed at preventing this problem. This study aims to assess possible changes in family and parental dynamics among families taking part in a short (6‐session) universal program. These changes might act as protective factors for families in preventing substance use. A quasi‐experimental design was used' with pretest and posttest evaluations. The participating schools meeting the inclusion criteria were randomly assigned to the experimental or control group. The sample was made up of 16 experimental groups and 17 control groups' with the participation of 353 parents and 289 youths. The results confirm the strengthening of the families by improving the following key components of parenting: resilience' involvement' family conflicts' and positive parenting. Reinforcing parenting skills through a short program is a good strategy to take' ensuring high levels of adherence (86.40% retention of the initial sample). Hence future universal prevention programs must not just set their sights on high levels of effectiveness' but also on efficiency.