Abstract
Research reveals a linear association between prevention program dose and outcomes; that is, families receive the most benefits when they attend a sufficient number of program sessions. Ensuring participants receive an effective dose of prevention is a persistent challenge for the widespread implementation of family-centered prevention programs. We investigated factors associated with an effective dose of the Strong African American Families (SAAF) substance use prevention program. Dose-related factors included socioeconomic disadvantage, caregiver depression, family disorganization, youth risk for problem behavior, and community risk. Notably, SAAF includes an ecologically appropriate curriculum and a comprehensive set of engagement procedures, which decrease the influence of these factors on attendance. The sample consisted of 252 African American youth and their caregivers from eight rural counties in South Georgia who had been randomly assigned to receive the SAAF substance use prevention program, a seven-session family skills training program. We operationalized an effective dose of SAAF, per recent research, as attendance in at least 5 of 7 sessions. Logistic structural equation modeling revealed no evidence of the tested factors reducing dose. Family disorganization, however, was associated positively with an effective dose, controlling for all other factors. Families with more disorganization were more likely to receive an effective dose of the program. Findings suggest that ecologically sensitive engagement protocols and curricula may obviate the influence of common risk factors and foster participation among those who most perceive a need for the program.
Similar content being viewed by others
Change history
29 January 2022
The journal title in the running head was published as ‘The Journal of Primary Prevention’. This has been corrected as ‘Journal of Prevention’
References
Baker, C. N., Arnold, D. H., & Meagher, S. (2010). Enrollment and attendance in a parent training prevention program for conduct problems. Prevention Science, 12(2), 126–138. https://doi.org/10.1007/s11121-010-0187-0
Barrera, M., Berkel, C., & Castro, F. G. (2017). Directions for the advancement of culturally adapted preventive interventions: Local adaptations, engagement, and sustainability. Prevention Science, 18(6), 640–648. https://doi.org/10.1007/s11121-016-0705-9
Becker, K. D., Brandt, N. E., & Buckingham, S. L. (2015). Engaging youth and families in school mental health services. Child and Adolescent Psychiatric Clinics, 24, 385–398. https://doi.org/10.1016/j.chc.2014.11.002
Brody, G. H., Murry, V. M., Chen, Y. F., Kogan, S. M., & Brown, A. C. (2006a). Effects of family risk factors on dosage and efficacy of a family-centered preventive intervention for rural African Americans. Prevention Science, 7(3), 281–291. https://doi.org/10.1007/s11121-006-0032-7
Brody, G. H., Murry, V. M., Gerrard, M., Gibbons, F. X., Molgaard, V., McNair, L., Brown, A. C., Wills, T. A., Spoth, R. L., Luo, Z., Chen, Y. F., & Neubaum-Carlan, E. (2004). The strong African American families program: Translating research into prevention programming. Child Development, 75, 900–917. https://doi.org/10.1111/j.1467-8624.2004.00713.x
Brody, G. H., Murry, V. M., McBride, V., Kogan, S. M., Gerrard, M., Gibbons, F. X., Molgaard, V., Brown, A. C., Anderson, T., Chen, Y. F., Lou, Z., & Wills, T. A. (2006b). The strong African American families program: A cluster-randomized prevention trial of long-term effects and a mediational model. Journal of Consulting and Clinical Psychology, 74(2), 356. https://doi.org/10.1037/0022-006X.74.2.356
Bronfenbrenner, U. (1979). The ecology of human development. Harvard University Press.
Brown, T. A. (2015). Confirmatory factor analysis for applied research. Guilford publications.
Coatsworth, J. D., Pantin, H., & Szapocznik, J. (2002). Familias unidas: A family-centered ecodevelopmental intervention to reduce risk for problem behavior among Hispanic adolescents. Clinical Child and Family Psychology Review, 5(2), 113–132. https://doi.org/10.1023/A:1015420503275
Dishion, T. J., Kavanagh, K., Schneiger, A., Nelson, S., & Kaufman, N. K. (2002). Preventing early adolescent substance use: A family-centered strategy for the public middle school. Prevention Science, 3(3), 191–201. https://doi.org/10.1023/A:1019994500301.pdf.
Dishion, T. J., & Stormshak, E. A. (2007). Intervening in children’s lives: An ecological, family-centered approach to mental health care. American Psychological Association. https://doi.org/10.1037/11485-000
Eisner, M., & Meidert, U. (2011). Stages of parental engagement in a universal parent training program. Journal of Primary Prevention, 32, 83–93. https://doi.org/10.1007/s10935-011-0238-8
Endendijk, J. J., Groeneveld, M. G., van der Pol, L. D., van Berkel, S. R., Hallers-Haalboom, E. T., Bakermans-Kranenburg, M. J., & Mesman, J. (2017). Gender differences in child aggression: Relations with gender-differentiated parenting and parents’ gender-role stereotypes. Child Development, 88(1), 299–316. https://doi.org/10.1111/cdev.12589
Fleming, C. B., Mason, W. A., Haggerty, K. P., Thompson, R. W., Fernandez, K., Casey-Goldstein, M., & Oats, R. G. (2015). Predictors of participation in parenting workshops for improving adolescent behavioral and mental health: Results from the common sense parenting trial. The Journal of Primary Prevention, 36(2), 105–118. https://doi.org/10.1007/s10935-015-0386-3
Forehand, R., Brody, G. H., Armistead, L., Dorsey, S., Morse, E., Morse, P. S., & Stock, M. (2000). The role of community risks and resources in the psychosocial adjustment of at-risk children: An examination across two community contexts and two informants. Behavior Therapy, 31(3), 395–414. https://doi.org/10.1016/S0005-7894(00)80022-2
Frick, P. J., & Morris, A. S. (2004). Temperament and developmental pathways to conduct problems. Journal of Clinical Child and Adolescent Psychology, 33(1), 54–68. https://doi.org/10.1207/S15374424JCCP3301_6
Gonzales, N. A., Dumka, L. E., Millsap, R. E., Gottschall, A., McClain, D. B., Wong, J. J., German, M., Mauricio, A. M., Wheeler, L., Carpentier, F. D., & Kim, S. Y. (2012). Randomized trial of a broad preventive intervention for Mexican American adolescents. Journal of Consulting and Clinical Psychology, 80(1), 1. https://doi.org/10.1037/a0026063
Gorman-Smith, D., Tolan, P. H., Henry, D. B., Leventhal, A., Schoeny, M., Lutovsky, K., & Quintana, E. (2002). Predictors of participation in a family-focused preventive intervention for substance use. Psychology of Addictive Behaviors. https://doi.org/10.1037/0893-164X.16.4S.S55
Haggerty, K. P., Fleming, C. B., Lonczak, H. S., Oxford, M. L., Harachi, T. W., & Catalano, R. F. (2002). Predictors of participation in parenting workshops. The Journal of Primary Prevention, 22, 375–387. https://doi.org/10.1023/A:1015227623145
Heinrichs, N., Bertram, H., Kuschel, A., & Hahlweg, K. (2005). Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: Barriers to research and program participation. Prevention Science, 6(4), 275–286. https://doi.org/10.1007/s11121-005-0006-1
Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19(5), 629–645. https://doi.org/10.1007/s10826-009-9350-2
Joe, G. W., Broome, K. M., Rowan-Szal, G. A., & Simpson, D. D. (2002). Measuring patient attributes and engagement in treatment. Journal of Substance Abuse Treatment, 22(4), 183–196. https://doi.org/10.1016/s0740-5472(02)00232-5
Kogan, S. M., Bae, D., Lei, M.-K., & Brody, G. H. (2019). Family-centered alcohol use prevention for African American adolescents: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 87(12), 1085. https://doi.org/10.1037/ccp0000448
Kogan, S. M., Lei, M.-K., Brody, G. H., Futris, T. G., Sperr, M., & Anderson, T. (2016). Implementing family-centered prevention in rural African American communities: A randomized effectiveness trial of the strong African American families program. Prevention Science, 17(2), 248–258. https://doi.org/10.1007/s11121-015-0614-3
Kogan, S. M., Yu, T., Allen, K. A., & Brody, G. H. (2015). Racial microstressors, racial self-concept, and depressive symptoms among male African Americans during the transition to adulthood. Journal of Youth and Adolescence, 44(4), 898–909. https://doi.org/10.1007/s10964-014-0199-3
Kumpfer, K. L., Alvarado, R., Smith, P., & Bellamy, N. (2002). Cultural sensitivity and adaptation in family-based prevention interventions. Prevention Science, 3(3), 241–246. https://doi.org/10.1023/A:1019902902119
Lionetti, F., Keijsers, L., Dellagiulia, A., & Pastore, M. (2016). Evidence of factorial validity of parental knowledge, control and solicitation, and adolescent disclosure scales: When the ordered nature of Likert scales matters. Frontiers in Psychology, 7, 941. https://doi.org/10.3389/fpsyg.2016.00941
Matheny, A. P., Jr., Wachs, T. D., Ludwig, J. L., & Phillips, K. (1995). Bringing order out of chaos: Psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology, 16(3), 429–444. https://doi.org/10.1016/0193-3973(95)90028-4
Mendez, J. L., Carpenter, J. L., LaForett, D. R., & Cohen, J. S. (2009). Parental engagement and barriers to participation in a community-based preventive intervention. American Journal of Community Psychology, 44(1–2), 1–14. https://doi.org/10.1007/s10464-009-9252-x
Miller, T. R., Levy, D. T., Spicer, R. S., & Taylor, D. M. (2006). Societal costs of underage drinking. Journal of Studies on Alcohol, 67(4), 519–528. https://doi.org/10.15288/jsa.2006.67.519
Muthén, L., & Muthén, B. (1998-2017). Mplus. The comprehensive modelling program for applied researchers: user's guide, 5.
Perrino, T., Coatsworth, J. D., Briones, E., Pantin, H., & Szapocznik, J. (2001). Initial engagement in parent-centered preventive interventions: A family systems perspective. Journal of Primary Prevention, 22(1), 21–44. https://doi.org/10.1023/A:1011036130341
Prado, G., Pantin, H., Schwartz, S. J., Lupei, N. S., & Szapocznik, J. (2006). Predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families. Journal of Pediatric Psychology, 31(9), 874–890. https://doi.org/10.1093/jpepsy/jsj046
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128(2), 330. https://doi.org/10.1037/0033-2909.128.2.330
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019818801500203
Rowbotham, S., Conte, K., & Hawe, P. (2019). Variation in the operationalisation of dose in implementation of health promotion interventions: Insights and recommendations from a scoping review. Implementation Science, 14(1), 1–12. https://doi.org/10.1186/s13012-019-0899-x
Spoth, R. L., Redmond, C., Kahn, J. H., & Shin, C. (1997). A prospective validation study of inclination, belief, and context predictors of family-focused prevention involvement. Family Process, 36(4), 403–429. https://doi.org/10.1111/j.1545-5300.1997.00403.x
Spoth, R., Redmond, C., Shin, C., Greenberg, M., Clair, S., & Feinberg, M. (2007). Substance-use outcomes at 18 months past baseline: The PROSPER community–university partnership trial. American Journal of Preventive Medicine, 32(5), 395–402. https://doi.org/10.1016/j.amepre.2007.01.014
Thoemmes, F., MacKinnon, D. P., & Reiser, M. R. (2010). Power analysis for complex mediational designs using Monte Carlo methods. Structural Equation Modeling, 17(3), 510–534. https://doi.org/10.1080/10705511.2010.489379
Van Ryzin, M. J., Kumpfer, K. L., Fosco, G. M., & Greenberg, M. T. (2015). Family-based prevention programs for children and adolescents: Theory, research, and large-scale dissemination. Psychology Press.
Whittaker, K. A., & Cowley, S. (2012). An effective programme is not enough: A review of factors associated with poor attendance and engagement with parenting support programmes. Children & Society, 26(2), 138–149. https://doi.org/10.1111/j.1099-0860.2010.00333.x
Wills, T. A. (1986). Stress and coping in early adolescence: Relationships to substance use in urban school samples. Health Psychology, 5(6), 503. https://doi.org/10.1037/0278-6133.5.6.503
Funding
This research was supported by Award Number R01 AA021774 from the National Institute on Alcohol Abuse and Alcoholism and Award Number P30 DA027827 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse or the National Institutes of Health.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
All authors have approved this manuscript and its submission to The Journal of Primary Prevention. This manuscript is not being considered by any other journal and has not been published elsewhere.
Consent to Participate
We obtained written informed consent from all individual participants included in the study over 18 years of age. We obtained written informed consent from the legal guardians of participants under 18 years of age. We obtained written informed assent from participants under 18 years of age.
Informed Consent
This manuscript is original research that was approved by the University of Georgia IRB. This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments and follows established APA guidelines for informed consent.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Reck, A.J., Tracy, Q. & Kogan, S.M. Predicting Receipt of an Effective Dose of a Family-Centered Preventive Intervention for African American Youth. J Primary Prevent 43, 67–82 (2022). https://doi.org/10.1007/s10935-021-00655-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10935-021-00655-y