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Strengthening Families Program
Intervention:
The Strengthening Families Program (SFP) is a family skills program originally developed and tested in 1983 with 6- to 12-year-old children of parents in substance abuse treatment. The goals of SFP are to increase family strengths and resilience and reduce risk factors for problem behaviors in high-risk children, including behavioral, emotional, academic, and social problems. SFP builds on protective factors by improving family relationships, parenting skills, and the youth’s social and life skills. SFP is based on cognitive–behavioral social learning theory and family systems theory.
Since its initial development and use in 1983, culturally modified and age-adapted versions (for 3- to 5-year-old preschoolers and 6- to 12-year-old elementary school children) have been developed and used with high-risk families of diverse backgrounds from various community settings. SFP has also been used as a universal primary prevention intervention with families in schools, churches, and communities.
SFP is a parenting and family skills training program that consists of 14 consecutive weekly skill-building sessions. Parents and children work separately in training sessions and then participate together in a session practicing the skills they learned earlier. Two booster sessions are available for use at 6 months to 1 year after the primary course. Children’s sessions concentrate on setting goals, dealing with stress and emotions, communication skills, responsible behavior, and how to deal with peer pressure. Parent sessions concentrate on setting rules, nurturing, monitoring compliance, and applying appropriate discipline.
Evaluation Methodology:
Study 1
Spoth and colleagues (2002) used a two-group design with random assignment of 22 rural schools in a Midwestern state which were assigned to intervention and minimal-contact control groups. School selection was based on program eligibility and community population of fewer than 8,500. Schools were blocked on size and proportion of lower-income families and then randomly assigned to groups.
The intervention group families (n=238) received the seven-session Strengthening Families Program (SFP). There were 208 control-group families.
The families were representative of the region and had an average of 3.1 children; 86 percent were two-parent families. Nearly all parents (98 percent of mothers and 95 percent of fathers) completed high school, and about half reported some post–high school education. Average ages of study parents were 37.2 years for mothers and 39.4 years for fathers. Nearly all parents (97.8 percent) were white. Of the 238 families admitted to the study, 79 percent completed the posttest (SFP=189; control=186) and 68 percent completed the 1-year follow-up (SFP=161; control=156).
Two major outcome measures were used. The Young Adolescent Substance Refusal and Substance Resistance measure consisted of four young-adolescent self-reported items and three parent-reported items that measured the likelihood that the young adolescent would refuse a peer alcohol offer, along with items that measured the youth’s response to a specific peer pressure situation. The Intervention-Targeted Parenting Behaviors, a measure of parenting behaviors directly targeted by the SFP program, included 13 parent self-reported items that assessed application of substance-related rules and consequences, positive involvement with the target child, communication, and anger or conflict management. In the case of dual-parent families, mother and father scores were averaged.
The study also included an implementation adherence measure completed by observers three or four times for each team of program implementers. For each of the three program components (youth, parent, family), 25 percent to 50 percent of the total number of observations were checked by a second observer.
Interrater reliability on the adherence measure was calculated, and the intervention group was divided into higher- and lower-adherence groups. Multilevel (mixed model) analyses of covariance were used to account for the nested design of the study (families clustered within schools) and to test for intervention outcome effects in the total sample as well as with the higher- and lower-adherence subgroups.
Study 2
Gottfredson and colleagues (2006) examined intervention fidelity and effectiveness of the SFP using a four-group experimental design with a sample of 715 predominately African American families in an urban setting. Families were recruited at local events by five organizations in the Washington, D.C., area. One site was a prerelease center for incarcerated parents; the other agencies recruited from the community. Some 1,400 families from high-risk neighborhoods were approached, and 715 (51 percent) were enrolled. Eligible families had a child between the ages of 7 and 11 years and were able to read, speak, and understand English. Participating parents were predominately African American (75 percent) and female (94 percent), and more than half (52 percent) reported a combined family annual income of less than $20,000.
Eligible families were randomly assigned to one of four conditions: child skills training (CT) only (n=176), parent skills training (PT) only (n=177), parent and child skills training plus family skills training (FT; n=188), and minimal treatment (MT) control group (n=174).The FT treatment group received the fourteen 3-hour sessions of the SFP that includes a) 1 hour of preclass activities, b) 1 hour of parents’ skills training and a simultaneous children’s skill training class, and c) 1 hour of family skills training conducted in two multifamily groups, each lead by two group leaders. The other two intervention groups received either the parent training or the child training component of the SFP but not all three components. Pretests and posttests were administered in small groups of parents and children before interventions began and again approximately 1 week after the intervention ended. The overall attrition rate from pretest to posttest was 30 percent, a rate similar to other studies of the SFP.
Three different outcome surveys were derived from previous tests constructed from standardized scales before this study: a 56-item survey for younger children ages 7 and 8; a 138-item survey for older children (ages 9 through 11), and a 195-item survey for parents. Content of the surveys, which included both parent and child reports, consisted of child problem behaviors, child risk and protective factors, and family factors.
The parent- and child-reported outcomes were analyzed with analysis of covariance that included a dummy variable to account for the various sites and pretest scores as covariates in each analysis.
Evaluation Outcome:
While study 1 produced some evidence that indicates the program’s effectiveness, the study assessed only parent-reported outcomes. Study 2 included both parent- and student-reported outcomes. Although both sources of data produced reasonably reliable measurement in study 2, parent and child reports of similar behaviors were not highly correlated, and parent reports generated more positive effects than child reports. Overall, the child reports yielded important new information about potential negative effects of the family skills training condition.
Study 1
Adherence to SFP Intervention
Among the intervention schools from the Spoth and colleagues (2002) study, eight schools were classified as higher adherence, and three schools were deemed lower adherence.
Parenting Skills
Targeted parenting behaviors of the total Strengthening Families Program (SFP) intervention group were more improved than those of control families at both posttest (p<.001) and at 1½ years postbaseline follow-up (p<.01).
At posttest, targeted parenting skills families attending either the higher adherence (p<.001) or lower adherence (p<.05) SFP intervention were significantly improved, compared with control families. However, only families in the higher adherence intervention group improved significantly, compared with control youth, at the 1½-year follow-up (p<.01).
Youth Substance Refusal/Resistance Skills
At baseline there were no significant differences on the measure of youth substance refusal/resistance skills between the total intervention and the control groups. At the 1½ years postbaseline follow-up, there was a marginally significant difference (p<.10) between scores of the higher adherence intervention and the control groups.
Study 2
Negative Peer Associations
Gottfredson and colleagues (2006) reported a statistically significant negative effect on child reports of negative peer associations for children of families assigned to the SFP intervention group.
Child Problem Behavior
No statistically significant effect was found for the SFP intervention.
Child Risk and Protective Factors
No statistically significant effect was found for the SFP intervention.
Family Factors
No statistically significant effect was found for the SFP intervention.
Other Information:
References:
Aktan, Georgia B., Karol L. Kumpfer, and Christopher W. Turner. 1996. “Effectiveness of a Family Skills Training Program for Substance Use Prevention With Inner City African-American Families.”
Substance Use and Misuse
31(2):157–75.
Fox, Danielle Polizzi, Denise C. Gottfredson, Karol L. Kumpfer, and Penny D. Beatty. 2004. “Challenges in Disseminating Model Programs: A Qualitative Analysis of the Strengthening WDC Families Project.”
Clinical Child and Family Psychology Review
7(3):165–76.
Gottfredson, Denise C., Karol L. Kumpfer, Danielle Polizzi Fox, David Wilson, Veronica Puryear, Penny D. Beatty, and Myriam Vilmenay. 2006. “Strengthening Washington, DC, Families Project: A Randomized Effectiveness Trial of Family-Based Prevention.”
Prevention Science
4:1007–11.
Kumpfer, Karol L. 1998. “Selective Prevention Interventions: The Strengthening Families Program.” In Rebecca S. Ashery, Elizabeth E. Robertson, and Karol L. Kumpfer (eds.).
Drug Abuse Prevention Through Family Intervention.
NIDA Research Monograph Series No. 177: U.S. Department of Health and Human Services Pub. No. 99–4135.
Kumpfer, Karol L., and Rose Alvarado. 2003. “Family Strengthening Approaches for the Prevention of Youth Problem Behaviors.”
American Psychologist
58(6/7):457–65.
Kumpfer, Karol L., Rose Alvarado, Paula Smith, and Nikki Bellamy. 2002. “Cultural Sensitivity in Universal Family-Based Prevention Interventions.”
Prevention Science
3(3):241–44.
Kumpfer, Karol L., Rose Alvarado, Connie Tait, and Charles W. Turner. 2002. “Effectiveness of School-Based Family and Children’s Skills Training for Substance Abuse Prevention Among 6- to 8-Year-Old Rural Children.”
Psychology of Addictive Behaviors
16(4):65–71.
Kumpfer, Karol L., Rose Alvarado, Henry O. Whiteside, and Connie Tait. 2005. “The Strengthening Families Program (SFP): An Evidence-Based, Multicultural Family Skills Training Program.” In José Szapocznik, Patrick H. Tolan, and Soledad Sambrano (eds.).
Preventing Substance Abuse.
Washington, DC: American Psychological Association Books, 3–14.
Spoth, Richard L., Max Guyll, Linda Trudeau, and Catherine J. Goldberg–Lillehoj. 2002. “Two Studies of Proximal Outcomes and Implementation Quality of Universal Preventive Interventions in a Community–University Collaboration Context.”
Journal of Community Psychology
30(5):499–518.
Program Specification:
New Rating:
No Effects
Re-reviewed Date:
June 2011
Program Type:
Alcohol and Drug Therapy / Education
Conflict Resolution / Interpersonal Skills
Family Therapy
Parent Training
Ethnicity:
American Indian or Alaska Native
Asian
African American
Hispanic or Latino (of any race)
White
Gender:
Both
Age:
3
-
16
Target Settings:
Rural
Suburban
Urban
Problem Behaviors:
Alcohol,Tobacco and Other Drug Use
Delinquency
Family Functioning
Risk & Protective Factors:
Risk
Protective
Additional Information:
SAMHSA: NREPP
OJJDP/CSAP: Strengthen Families
NIDA: Preventing Drug Abuse
Status:
Program is in operation at this time.
Performance Measures:
Suggested OJJDP Performance Measures for the Program Types(s):
Delinquency Prevention
Family Therapy
Logic Model:
PDF
Performance Matrix:
PDF
Mental Health Services
Family Therapy
Logic Model:
PDF
Performance Matrix:
PDF
Delinquency Prevention
Parent Training
Logic Model:
PDF
Performance Matrix:
PDF
Mental Health Services
Parent Training
Logic Model:
PDF
Performance Matrix:
PDF
Contact Information: