Strengthening Families Research Articles

Quality of implementation in an evidence-based family prevention program: “The Family Competence Program”

Family prevention programs need to be evidence-based in order to guarantee the success of their implementation. The Family Competence Program (FCP), a Spanish cultural adaptation of the Strengthening Families Program (SFP), has developed different measures and processes to gauge the quality of the implementation. This article is dedicated specifically to two of these measures: the evaluation of the facilitators and the assessment of the family engagement techniques. For evaluating the facilitators, a Delphi technique with experts and professionals is undertaken. For assessing the family techniques, both self-evaluation of trainers and evaluation by families are used. Finding underpin that, in the case of facilitators, is important that, after to skills and experience, they need to understand the theory of change of the program. In the case of family engagement techniques, more detailed, comprehensive talks, discussions and group activities lead to better family engagement outcomes.

Universal Prevention Exposure as a Moderator of the Community Context: Findings from the PROSPER Project.

This study examined how participation in a universal family skills-building program may interact with community risks and resources to produce youth outcomes. Prior research has noted community-level variability in risk and protective factors, but thus far no study has examined the role that participation on a community-wide intervention may play in moderating the effects of community risks or resources. The study included 14 communities (seven in Iowa, seven in Pennsylvania) that implemented a family focused evidence-based program as part of the PROSPER project. Community level variables included both risk factors (percent of low income families, the availability of alcohol and tobacco, norms regarding adolescent substance use, incidence of drug-related crimes) and community resources (proactive school leadership, availability of youth-serving organizations, and student involvement in youth activities). The proximal youth and family outcomes included youth perceptions of their parents' management skills, parent-child activities, and family cohesion. Results indicated that the Strengthening Families Program:10-14 may have moderated the impact of the community risks and resources on community-level youth outcomes; risk levels meaningfully associated with community-level change in program participants, though these results varied somewhat by outcome. Generally, higher levels of resources also meaningfully associated with more positive change after participating in the family-focused intervention. These results suggest that the effect of some evidence-based programs may be even stronger in some communities than others; more research in this area is needed.

The Strengthening Families Program 10–14 in Panama: Parents’ perceptions of cultural fit.

Parenting interventions are recommended strategies for preventing emotional and behavioral problems in adolescents. Little is known, however, about the cultural fit of these interventions outside high-income English speaking countries. This is one of the first studies to explore parental perceptions of cultural fit of a well-known American parenting intervention, the Strengthening Families Program 10–14, in low-resource communities in Panama. A qualitative methodology was used with the aim of exploring parents’ perception and recollection of the intervention. Thirty Panamanian parents of adolescents aged 10 to 14 years old who received the intervention between 2010 and 2011 were interviewed in 2012. We were not seeking to assess efficacy of the intervention, but to use the methodology to examine cultural fit. Parents’ narratives were analyzed through thematic analysis. They talked about communication, resilience, community-specific concerns such as perceiving their world as dangerous, and concerns commonly experienced by most parents worldwide such as being worried for children’s academic performance. Findings can be used to inform adaptations to the intervention if disseminated cross-culturally. This participant-driven approach offers a methodology that can be replicated in real-world service delivery settings to explore the cultural fit of interventions with ethnically diverse populations inside the United States or overseas.

Adaptations in a Community-Based Family Intervention: Replication of Two Coding Schemes.

Although program adaptation is a reality in community-based implementations of evidence-based programs, much of the discussion about adaptation remains theoretical. The primary aim of this study was to replicate two coding systems to examine adaptations in large-scale, community-based disseminations of the Strengthening Families Program for Parents and Youth 10-14, a family-based substance use prevention program. Our second aim was to explore intersections between various dimensions of facilitator-reported adaptations from these two coding systems. Our results indicate that only a few types of adaptations and a few reasons accounted for a majority (over 70%) of all reported adaptations. We also found that most adaptations were logistical, reactive, and not aligned with program's goals. In many ways, our findings replicate those of the original studies, suggesting the two coding systems are robust even when applied to self-reported data collected from community-based implementations. Our findings on the associations between adaptation dimensions can inform future studies assessing the relationship between adaptations and program outcomes. Studies of local adaptations, like the present one, should help researchers, program developers, and policymakers better understand the issues faced by implementers and guide efforts related to program development, transferability, and sustainability.

Engaging and Training Professionals to Implement Family Strengthening Programs: Lessons Learned

Child welfare professionals (CWPs) who attended the Healthy Relationship and Marriage Education Training delivered by Extension educators in Georgia participated in focus groups 6 months post-training to investigate what elements of the training influenced their implementation of the concepts and their recommendations for future trainings. The findings revealed three elements that influenced implementation: relevant content, interactive training, and trainer attributes. CWPs made recommendations concerning content/curriculum format, field implementation, and training methods. Conclusions included recommendations for both CWPs and Extension educators. As an unexpected outcome, results suggested that qualitative evaluation may reinforce and strengthen partnerships between Extension and other agencies.

Diffusion of Intervention Effects: The Impact of a Family-Based Substance Use Prevention Program on Friends of Participants

PurposeWe tested whether effects of the Strengthening Families Program for Youth 10–14 (SFP10-14) diffused from intervention participants to their friends. We also tested which program effects on participants accounted for diffusion. MethodsData are from 5,449 students (51% female; mean initial age = 12.3 years) in the PROmoting School-community-university Partnerships to Enhance Resilience community intervention trial (2001–2006) who did not participate in SFP10-14 (i.e., nonparticipants). At each of five waves, students identified up to seven friends and self-reported past month drunkenness and cigarette use, substance use attitudes, parenting practices, and unsupervised time spent with friends. We computed two measures of indirect exposure to SFP10-14: total number of SFP-attending friends at each wave and cumulative proportion of SFP-attending friends averaged across the current and all previous post-intervention waves. ResultsThree years post-intervention, the odds of getting drunk (odds ratio = 1.4) and using cigarettes (odds ratio = 2.7) were higher among nonparticipants with zero SFP-attending friends compared with nonparticipants with three or more SFP-attending friends. Multilevel analyses also provided evidence of diffusion: nonparticipants with a higher cumulative proportion of SFP-attending friends at a given wave were less likely than their peers to use drugs at that wave. Effects from SFP10-14 primarily diffused through friendship networks by reducing the amount of unstructured socializing (unsupervised time that nonparticipants spent with friends), changing friends' substance use attitudes, and then changing nonparticipants' own substance use attitudes. ConclusionsProgram developers should consider and test how interventions may facilitate diffusion to extend program reach and promote program sustainability.

Relações entre o nível socioeconômico e qualidade de vida na agricultura familiar da Amazônia.

Os agricultores familiares detém um número significativo na produção do campo e na região norte do Brasil não é diferente. A qualidade de vida dos agricultores é relativizada pelo crédito rural disponível pelo governo federal Programa Nacional de Fortalecimento da Agricultura Familiar (PRONAF) e pelo governo do Estado de Roraima Fundo de Desenvolvimento Econômico e Social do Estado de Roraima/Agencia de Fomento do Estado de Roraima (FUNDER/AFERR), a tecnologia empregada no campo que em âmbito nacional é apoiado pela Empresa Brasileira de Pesquisa Agropecuária – (EMBRAPA) e a mão de obra cuja caracterização é essencialmente familiar, mas que não descaracteriza como agricultura familiar se houver um número inferior de mão de obra não familiar. Utilizado como método o estudo de caso, utilizando estudos estatísticos, pode ser analisado as informações coletadas obtendo-se resultados que podem ser mensurado a qualidade de vida dos agricultores da região amazônica, mas especifico no Município de Mucajaí. Nota-se o quão importante é a necessidade do estudo da qualidade de vida dos agricultores familiares, pois pode ser visto que em sua maioria são analfabetos, muitos não recebem assistência técnica e pouco conhecem sobre as linhas de crédito rural e tem dificuldades de aquisição devido às exigências.

Medical-Legal Strategies to Improve Infant Health Care: A Randomized Trial.

Changes in health care delivery create opportunities to improve systems to better meet the needs of low-income families while achieving quality benchmarks. Families of healthy newborns receiving primary care at a single large urban safety-net hospital participated. Intervention families were randomly assigned a family specialist who provided support until the 6-month routine health care visit. The Developmental Understanding and Legal Collaboration for Everyone (DULCE) intervention is based on the Strengthening Families approach and incorporated components of the Healthy Steps and Medical-Legal Partnership models. Medical record reviews determined use of preventive and emergency care. Surveys conducted at baseline, postintervention (6 months), and follow-up (12 months) were used to determine hardship and attainment of concrete supports. Three hundred thirty families participated in the study. At baseline, 73% of families reported economic hardships. Intervention parents had an average of 14 contacts with the family specialist, and 5 hours of total contact time. Intervention infants were more likely to have completed their 6-month immunization schedule by age 7 months (77% vs 63%, P < .005) and by 8 months (88% vs 77%, P < .01). Intervention infants were more likely to have 5 or more routine preventive care visits by age 1 year (78% vs 67%, P < .01) and were less likely to have visited the emergency department by age 6 months (37% vs 49.7%, P < .03). The DULCE intervention accelerated access to concrete resources (P = .029). Assignment to the Project DULCE intervention led to improvements in preventive health care delivery and utilization and accelerated access to concrete supports among low-income families.

A AGRICULTURA FAMILIAR E AS POLÍTICAS PÚBLICAS : AVALIAÇÃO DOS MUNICÍPIOS DE GUAPOREMA, SÃO TOMÉ, TAPEJARA E TUNEIRAS DO OESTE - PR

This research aims an assessment of the main public policies for family farming in Brazil in the governments of President Luiz Inacio Lula da Silva (2003-2006 and 2004-2010) and President Dilma Roussef (2011-2014), re-elected for the term 2015-2018. Among the policies we include: the National Program for Strengthening Family Farming – PRONAF; the Food Acquisition Program - PAA; the National School Feeding Program – PNAE; the National Policy on Technical Assistance and Rural Extension – PNATER; the National Program for Rural Housing– PNHR. We aim to evaluate the reproduction, or not, from these policies in the municipalities of Guaporema, Sao Tome, Tapejara and Tuneiras do Oeste - PR. As analysis methodology we adopted critical/dialectical perspective, and as an investigation methodology we used Quant/Quali perspective, seeking information from primary quantitative and qualitative data, and secondary data from censuses, statistical and research already conducted. In this way we performed theoretical/statistical surveys, and interviews with public representatives of the municipalities surveyed. The results showed that in the four cities there is the presence of these public policies, and that in general they have met the objectives of strengthening family farming, improving people’s living conditions on the rural area, promotion of associations and organizations of farmers, motivation of the permanence of families in rural areas, among other achievements. However, it is also evident the limitations and challenges to overcome in front of each of these actions, especially the extend expansion of programs and compliance with the specificities of the participating groups

Effectiveness of culturally adapted Strengthening Families Programme 6-11 years among Portuguese families

Purpose – The purpose of this paper is to compare the outcomes from the Portuguese Strengthening Families Programme (SFP) with those from other countries to see if they are equally effective despite the new context. SFP was selected for cultural adaptation because comparative effectiveness reviews find that SFP is the most effective parenting and family intervention (Foxcroft et al., 2003, 2012). Standardised cultural adaptations of SFP have resulted in successful outcomes in 35 countries. Design/methodology/approach – The outcomes for the SFP six to 11 years Portuguese families (n=41) were compared to the SFP six to 11 years international norms (n=1,600) using a quasi-experimental, non-equivalent control two group pre- and post-test design. A 2×2 ANOVA generated the outcome tables including p-values and Cohen’s d effect sizes. Standardised test scales were used and measured 21 parenting, family and child risk and protective factors. Findings – Statistically significant positive results (p &lt; 0.05) were found for 16 or 76.2 per cent of the 21 outcomes measured for Portuguese families. The Portuguese effect sizes were similar to the SFP international norms for improvements in the five parenting scales (d=0.61 vs 0.65), five family scales (d=0.68 vs 0.70) and seven children’s scales (d=0.48 vs 0.48) despite these norms having larger effect sizes than the USA norms. Hence, the cultural adaptation did not diminish the outcomes and SFP Portuguese families can benefit substantially from SFP participation. Originality/value – A Portuguese culturally adapted version of SFP had never been developed or evaluated; hence, this paper reports original findings.

Is the Strengthening Families Programme feasible in Europe?

Purpose – The purpose of this paper is to provide insights into the potential of technology transfer in prevention interventions. It argues that contextual factors are more identifiable and more malleable than the cliché of “culture” as a barrier to implementation might suggest. The key question is how various contextual factors impact on programme implementation and effectiveness in the different cultures of a multifaceted continent such as Europe, and how successful programmes adapt to various contexts. Design/methodology/approach – Using a questionnaire survey, input was collected from people involved in the adaptation and implementation of the Strengthening Families Programme (SFP) in several European countries. Findings – The publications and experiences of the SFP implementers and evaluators in most of the European countries where it was introduced suggest that the programme is both feasible and effective (where outcomes are available). To achieve this, however, the implementers spent a considerable amount of time and effort to prepare, pre-test and consult with their target populations in order to adjust SFP to culture and context. This paper suggests restricting the use of “culture” to a set of norms and values, and to distinguish this from “context” which describes social and political organisation. Even though both condition each other, it is helpful to address culture and context separately when adapting prevention programmes. Research limitations/implications – Outcome data were not available for all implementations of SFP and some very recent ones in Austria, France and Italy could not be included in the questionnaire survey. Practical implications – An examination of social capital might help implementers to anticipate resistance from the target population that seems to emanate from history, culture and context. The level of trust of others and institutions and the willingness to co-operate with them can heavily influence the readiness of drug prevention service planners, commissioners and providers, as well as the target population, to adopt interventions and other behaviours. Programmes seem to have key principles that make them effective and that should not be modified in an adaptation: a particular example is the programme protocol. Other aspects, such as wording, pictures and the content of examples used to illustrate some issues do have to be modified and are essential for an intervention to be well-accepted and understood. In some programmes, the effective principles – so-called “kernels” – are identifiable although, overall, prevention research still strives to identify them. Social implications – Implementing complex programmes that require the cooperation of many stakeholders might increase social capital in the communities involved. Originality/value – The paper examines the common belief among many European prevention professionals that programmes from abroad, particularly from North America, cannot be implemented in Europe.

The Strengthening Families Programme in Spain: a long-term evaluation

Purpose – The purpose of this paper is to first assess the long-term effects of the adaptation of the American Strengthening Families Programme in Spain (known as the Programa de Competencia Familiar, translated into English as the Family Competence Programme (FCP)). The second aim is to identify family typologies and family changes regarding family competence over time. The paper’s initial hypothesis is that families have different behaviours and take advantage of the FCP in different ways. Design/methodology/approach – Monitored applications of the FCP were conducted using a quasi-experimental design consisting of a control group and pre-test, post-test and two-year follow-up assessments. The sample was made up of 136 families who took part in the programme and another 18 who participated in the control groups. Validated instruments were applied to assess the methodological processes and the family assessments. A cluster analysis was undertaken to identify different family typologies and their evolution in relation to the FCP goals. Findings – The FCP shows effective and consistent results over time for families in a variety of difficult situations, with important result maintenance. The longitudinal analysis (i.e. the two-year follow-up) demonstrates that the majority of changes identified (using the factors under consideration) maintained their relevance for most of the families, producing positive change. Originality/value – There is little long-term evaluation or longitudinal analysis of family prevention programmes that are evidence-based and include cognitive-emotional content. This paper analyses the long-term evaluation of family prevention programmes and identifies the ways in which families change over time.

Protective factors among Latino families involved with child welfare: A review of Spanish protective factor research on child maltreatment prevention in seven countries

This article analyzes the panorama of published Spanish-language literature addressing protective factors and their role in the prevention of child maltreatment in Latino families. To our knowledge, this is the first time that the use of protective factors in English-language literature has been compared to their counterparts the Strengthening Families (SF) approach and Protective Factors Survey (PFS) frames our research process, which used reviewed literature to identify the presence of protective factors in seven Spanish-speaking countries: Chile, Colombia, Cuba, Mexico, Spain, Venezuela and the United States. Our findings shed light on the importance of family functioning in Spanish-language studies to date and validate the inclusion of family functioning as a protective factor in the PFS. Implications for policy and practice are discussed.

Participation and Motivation in Obesity Treatment – A Qualitative Study of Teenagers' and Parents' Perceptions

Aim: The aim was to describe teenagers’ and parents’ perceptions of participation in treatment and their view of motivation within the context of obesity treatment. Methods: Qualitative interviews were conducted with 10 families (10 teenagers, aged 13 to 18 years and 6 parents) taking part in a family-based treatment model for childhood obesity. Data from interviews were processed with a phenomenographic analytic method. Results: The categories motivation promotion, motivation demotion, conditions for participation and supportive treatment interventions outline participants’ views on motivation and participation in the treatment of overweight/obesity. Motivation and opportunity for involvement in treatment is of great importance for parents and teenagers. Motivation was described as an important and necessary driving force for changing lifestyle behaviour. Conclusions: Future treatment interventions need to focus on further strengthening families’ participation and supporting motivation based on the experiences and suggestions that emerged in this study. For the health care sector, it is a challenge to develop comprehensive models that take families’ conditions into account and to involve them in the design of childhood obesity treatment.

Civil Society and the Gender Politics of Economic Competitiveness in Malaysia

Malaysian government planning and policy-making have increasingly come to recognise the role of women and the household in the promotion of a number of strategies aimed at enhancing economic competitiveness. Government planning documents emphasise the need to boost women's labour market participation, increase women's levels of entrepreneurship, and the need to strengthen and support the family unit—developments that can be understood in terms of a market-building agenda in which women's labour and the household are viewed as untapped resources in the struggle to maintain international competitiveness. This article explores an important dimension of this policy turn: the role of civil society in both promoting and resisting this market-building agenda. The paper focuses in particular on two case studies: religious non-governmental organisations involved in implementing ‘family strengthening’ programmes and civil society engagements with the issue of women's representation on corporate boards.

Family Drug Court, Targeted Parent Training and Family Reunification: Did this Enhanced Service Strategy Make A Difference?

AbstractThis article reports findings from an evaluation of reunification outcomes for children and families who participated in a family drug court (FDC) that incorporated the use of two innovative evidence‐based parenting programs. In addition to comprehensive FDC services, families participated in the Strengthening Families Program and Celebrating Families!TM programs in a sequential format. Data analyses were conducted on a sample of 214 children whose child welfare cases were adjudicated through the FDC and 418 matched comparison cases. Entry‐cohort survival analysis results indicated that families receiving FDC services were more than twice as likely to reunify in a 45 month observation window.

A Virginia Wounded Warrior and School of Social Work Partnership: The “MISSION: Healthy Relationships” Project and Student Engagement

Postdeployment family reintegration and relationship breakdown among combat veterans has received considerable attention from the Department of Defense and the media. Social interventions have been developed as a family strengthening strategy. In this article, we present a university–Wounded Warrior partnership where a relationship enhancement program was delivered in a weekend retreat format. The program was provided by a faculty member and a master’s of social work (MSW) alumnus who was an employee of the Wounded Warrior program. Doctoral and MSW students who were research assistants, interns, and volunteers were involved in (1) program management, including recruitment and registration of participants; (2) co-facilitation of intervention activities; and (3) evaluation research, specifically interviewing participants and transcription of interviews.

EVALUATION OF ALL BABIES CRY, A SECOND GENERATION UNIVERSAL ABUSIVE HEAD TRAUMA PREVENTION PROGRAM.

Child maltreatment results in significant individual, family, and societal costs. This study assessed the efficacy of All Babies Cry (ABC), a media-based infant maltreatment prevention program, using a mixed-method, quasi-experimental staged evaluation design. ABC's messaging, designed and tested through a series of focus groups, provides strategies for reducing parental stress and soothing infants. Participants (n = 423) were first-time parents, 70% fathers, recruited at two hospitals. The first 211 were controls; the next 212 received ABC. Participants were interviewed 3 times: at baseline in hospital, and by telephone 5 weeks (n = 359; 85%) and 17 weeks (n = 326; 77%) later. Researchers measured parents' perceptions, intentions, and use of strategies to calm crying and manage caregiver stress. Outcomes were based on the Strengthening Families Model and the Theory of Planned Behavior. The intervention was well received, appears effective in improving mediators of behavior, and may change parental behavior.

“The love that I was missing”: Exploring the lived experience of motherhood among teen mothers in foster care

The present study employed Interpretative Phenomenological Analysis (IPA) to explore the experiences and meaning of motherhood among teen mothers in foster care. Through a series of 18 in-depth, semi-structured interviews exploring experiences of both being mothered and mothering, the six young women in this study shared their stories of living the reality of becoming mothers under extremely challenging circumstances and doing their best to thrive. Themes of darkness and despair, (e.g., substance abuse, poverty, and child maltreatment) glimpses of light in the darkness (e.g., relationships with their partner's family), and new beginnings (e.g., identity as mother) emerged as characteristic of their experience. Implications for practice, policy, and research in the areas of teen pregnancy prevention and support for family strengthening are offered.

Family Strengthening Programs: Where Do We Go From Here?

Family Strengthening Programs: Where Do We Go From Here?