A Formative Evaluation of the Family Strengthening Program in the Treasure Valley

Family Advocates, a nonprofit organization serving families in the Treasure Valley in Idaho, offers the Family Strengthening Program. This is a 20-week program providing weekly meetings for families who need to develop strong family cohesion, resilience, and parenting skills to maintain healthy families. The program uses the Strengthening Families’ approach with an emphasis on the protective factors framework and provides incentives to participants for participation. A third-party evaluation team from a local university conducted a formative evaluation of the program to help improve its quality. The evaluation team used both goal-based and goal-free, needs-based evaluation approaches, and analyzed quantitative and qualitative data. This included survey data from past weekly sessions, Facebook alumni group communications, and group interviews and surveys with participants, graduates, volunteers, and staff. The triangulated data indicated that program participants were highly satisfied with the program and felt the program helped improve their protective factors. The data also revealed the parents’ perceptions regarding program incentives as well as their preference for learning in socialized contexts. Based on the formative evaluation results and considering the participants’ perceptions and experiences, the program amended their curriculum and incentive plans to better accommodate the participants’ needs

Benefits of Incorporating the Strengthening Families Program Into Family Drug Treatment Court Services

The opioid epidemic has become a public health crisis; it is important to understand practices Extension educators can use to support affected families. We explored the benefits of a parenting program delivered by Extension educators, the Strengthening Families Program (SFP), for families involved in family treatment court services. Data came from 41 parents who participated in SFP from 2014 to 2018. Findings from retrospective questionnaires showed increases in parental warmth, positive discipline, stress management, and family organization, as well as decreases in family conflict. Findings show the potential for SFP to support families as they work through challenges amid the opioid epidemic

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

Effectiveness of a culturally adapted strengthening families program 12-16 years for high-risk Irish families

ManuscriptBACKGROUND: Evidence-based programs (EBPs) targeting effective family skills are the most cost effective for improving adolescent behavioural health. Cochrane Reviews have found Strengthening Families Program (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaption processes resulted in successful outcomes in 26 countries. OBJECTIVE: To promote wide-scale implementation and positive outcomes in Ireland, a unique model of inter-agency collaboration was developed plus guidelines for cultural adaptation with fidelity. METHODS: 250 high-risk youth and families were recruited to complete SFP and its parent questionnaire. A quasi-experimental 2 group pre- and post-test design was employed where the norms were the comparison group. A 2 x 2 analysis of variance (ANOVA) generated the outcome tables including p-values and Cohen's d effect sizes. Evaluation feedback was used to improve outcomes the next year. RESULTS: All 21 measured outcomes had statistically significant positive results. Larger effect sizes were found for the Irish families than the USA families (d. = .57 vs. .48 for youth outcomes, d. = .73 vs. .65 for parenting and d. = .76 vs. .70 for family outcomes). Overt and covert aggression, criminality and depression decreased more in Irish youth, but the USA youth improved more in social skills. CONCLUSIONS: This study suggests that SFP 12-16 is quite effective in reducing behavioural health problems in Irish adolescents, improving family relationships and reducing substance abuse. Additionally, the Irish interagency collaboration model is a viable solution to recruitment, retention and staffing in rural communities where finding five skilled professionals to implement SFP can be difficult

Strengthening Family Practices for Latino Families

The study examined the effectiveness of a culturally-adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9–12 year old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto Rican families

Participation in Universal Prevention Programs

We analyze the decision to participate in community-based universal prevention programs through the framework of prospect theory, with family functionality, and related risk status, providing the reference point. We find that participation probability depends on the relative ratios of the weighting and valuation functions. Using data from the Strengthening Families Program and the Washington Healthy Youth Survey, we empirically test the implications of our model. We find that family functionality affects the participation decision in complex and, in some cases, non-linear ways. We discuss the implication of these findings for cost-effectiveness analysis, and suggest directions for further research.Prospect Theory, Treatment Outcomes, Risk Status

Doctor of Philosophy

dissertationThe purpose of this study was to compare the different delivery and dissemination methods for the Strengthening Families Program (SFP) by conducting a mixed method analysis (quantitative and qualitative study) amongst Asian Indian (AI) and non-Asian Indian (NAI) families residing in Utah. The study also examined the impact of the Computer Technology-Based Intervention (CBI) SFP 7-17 Years DVD Program on girls and boys enrolled in the program after the program completion. The dissertation was mainly divided into two parts. A quantitative section compared the effectiveness of the three different delivery methods of the Strengthening Families Program (SFP). The three delivery methods were compared among each other over the 21 SFP standardized outcomes. The research design consisted of a 2-repeated measure, 3-group quasi-experimental nonequivalent control group design (Chapter 2 and Chapter 4). Results of the quantitative section suggested that about 70% (15 out of 21) of the outcome effect sizes were larger for the CBI SFP 7-17 Years DVD Program as compared to the SFP norms. Gender analyses revealed that the program was equally effective among girls and boys enrolled in the program (Chapter 4). The second part of the dissertation is comprised of a qualitative research study. The aim of the qualitative research was to explore the views and perceptions about the newly developed CBI SFP 7-17 Years DVD Program among Asian Indian parents and to investigate the impact of the SFP DVD Program on the Asian Indian families residing in Utah (Chapter 3). Thematic analyses revealed that Asian Indian parents had improvement in parental involvement in their children's lives, parental monitoring, positive parenting, family cohesion, family communication, family organization, family strengths, and decrease in family conflicts. Parents also reported improvement in children concentration and social behavior and decrease in children depression. The overall alcohol and drug use among the parents showed reduction after the program completion

Effective Preventative Interventions of Substance Use

Substance use among adolescents remains a serious problem in most rural communities in part due to the well-documented failure of most prevention programs. Despite these challenges some prevention programs have been deemed both reliable and valid. Three such programs include the: Adolescent Transitions Program, Strengthening Families Program: For Parents and Youth 10-14, and Guiding Good Choices. This paper provides a systemic review of these three programs and offers suggestions to community leaders for successful program implementation

Viabilidade do Strengthening Families Program para Famílias Brasileiras: Um Estudo com Métodos Mistos

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.Este estudo teve por objetivo examinar a viabilidade (efetividade limitada, aceitabilidade e praticidade) do Strengthening Families Program, uma intervenção preventiva universal, para famílias brasileiras. Conduziu-se um estudo pré-experimental, com pré-teste, pós-teste, 6 e 10-12 meses de follow-up. Participaram 74 adolescentes e seus pais. Escalas sobre desfechos acadêmicos, parentais e saúde foram aplicadas nos adolescentes nos quatro tempos de avaliação. Observação direta da fidelidade da implementação e do engajamento familiar na intervenção e entrevistas por telefone com facilitadores foram usadas para investigar aceitabilidade e praticidade. Identificou-se aumento significativo em supervisão parental e autoeficácia para a aprendizagem. Altos níveis de fidelidade e engajamento parental foram encontrados, bem como engajamento moderado dos adolescentes. Os facilitadores consideraram a intervenção aceitável em suas metas, mas com procedimentos excessivamente estruturados e inadequados para famílias com baixo grau de instrução. Implicações práticas são discutidas

Prevention of alcohol and drug problems among adolescents : evaluating a Swedish version of the Strengthening families program

Alcohol and other drug use among adolescents is a persistent public health problem. Several methods have been developed and studied with the aim to prevent underage substance use. Strategies involving parents in preventive interventions have been promising, and one program in particular has been high-lighted; the Strengthening Families Program 10–14 (SFP 10-14). A culturally adapted version of the SFP to Swedish conditions was developed. The program was named Steg-för-Steg, and a randomized controlled trial was conducted to evaluate the effects of the program on adolescent alcohol and other drug use. This thesis is built around the planning, implementation and outcomes of this RCT with the aim to explore the role of parental programs in reducing problems with alcohol and other drug use among adolescents. This thesis is based on four papers. The first paper is a descriptive study of the planning, and development of the Steg-för-Steg program. In addition, a pilot study involving two 6th grade classes from two schools in Stockholm is presented. The three additional papers are based on a randomized controlled trial including 707 students and parents in 19 schools in Stockholm. Youth participation in the study required an active consent from their parents, hence the final study population consisted of 587 students, and all parents independent of their child’s participation or not. In paper II predictors of parental participation and retention in the Steg-för-Steg program is examined with multiple logistic regression analyses. The data is based on 441 parents of 6th graders from the intervention arm in the RCT. Paper III analyzes the effects of the Steg-för-Steg program on adolescent use of alcohol and other drugs. General Linear Model is used to examine being drunk lifetime, and norm-breaking behaviours in 587 students during four time points. In paper IV the effects of the Steg-för-Steg program on predictors of adolescent use of alcohol and other drugs is studied with univariate and multiple logistic regression analyses. Data is obtained from 587 students and their parents. Predictor variables were obtained in grade 7, and outcome variables in grade 9. The results from paper I show that it is possible to transport a family-based program from one country to another, especially if care is taken to adapt the program to local conditions without loosing program fidelity. Paper II shows that parents with a lower level of emotional warmth participated to a greater extent in the Steg-för-Steg program than those with higher level of warmth. In addition, a restrictive attitude towards youth and alcohol was related to participation. Retention in the program was associated with being born in Sweden, and having a low score on the warmth scale. In paper III results from the RCT shows that no effects of the Swedish version of the Strengthening Families Program were found on adolescent use of alcohol, tobacco, and illicit drugs. Finally, paper IV reveals that high parental knowledge, parents with a restrictive attitude towards youth and alcohol, and adolescents reporting a positive school climate were associated with a lower risk of alcohol and other drug use. Furthermore, youth with high norm-breaking behaviours, youth attending a school in an area with high socioeconomic status, and youth with parents born in Sweden were more likely to have used alcohol and other drugs. There was no association or impact from parental participation in the Swedish version of the Strengthening Families Program on risk or protective factors for adolescent substance use. Conclusion: While it is possible to transport a family program like the Strengthening Families Program from its American original to Sweden, and also that many parents can be recruited to participate in the program, no effects were found for the program, neither on substance use among the adolescents, nor on the risk and protective factors that the program aims to affect