Cleve Redmond

Direct and indirect latent-variable parenting outcomes of two universal family-focused preventive interventions: Extending a public health-oriented research base.

Recent literature underscores the need for studies of family-based preventive interventions oriented toward public health objectives. This article illustrates a program evaluation approach for the study of family intervention outcomes in general populations. Thirty-three rural schools were randomly assigned to 1 of 3 conditions: the Preparing for the Drug-Free Years Program (PDFY), the Iowa Strengthening Families Program (ISFP), and a minimal-contact control group. Self-report and observational data collected from 523 families were used to develop measurement models of 3 latent parenting constructs that included measurement method effects. Analyses were conducted to ensure initial and attrition-related group equivalencies and to assess school effects. Structural equation models of the hypothesized sequence of direct and indirect effects for both PDFY and ISFP were then fit to the data. All hypothesized effects were significant for both interventions. The discussion addresses the potential public health benefits of evaluation research on universal preventive interventions.

PROSPER Community–University Partnership Model for Public Education Systems: Capacity-Building for Evidence-Based, Competence-Building Prevention

This paper presents a model to guide capacity-building in state public education systems for delivery of evidence-based family and youth interventions—interventions that are designed to bolster youth competencies, learning, and positive development overall. Central to this effort is a linking capacity agents framework that builds upon longstanding state public education infrastructures, and a partnership model called PROSPER or PROmoting School–community–university Partnerships to Enhance Resilience. The paper presents an overview of the evolving partnership model and summarizes positive results of its implementation over a 12-year period in an ongoing project.

Research on Family Engagement in Preventive Interventions: Toward Improved Use of Scientific Findings in Primary Prevention Practice

Effective strategies for family engagement are essential in the implementation of models directed toward the application of research findings to primary prevention practice. Although there has been limited investigation of family engagement in preventive interventions for general populations, the research has yielded several preliminary findings that warrant further study. Notably, families in eligible general populations can differ to a significant degree in intervention preferences and beliefs that influence their motivation to engage in interventions or in intervention evaluations. Also, a number of stable family member characteristics, such as internalizing/externalizing problems, have not been predictive of family engagement. Educational attainment has been predictive, but the differences between participants and nonparticipations have tended to be small. In addition, there are several common barriers to engagement, including family scheduling conflicts, that place practical limits on participation levels and need to be carefully addressed through engagement techniques. Collectively, findings from the literature suggest directions for the development of effective engagement strategies; also, they underscore the value of family engagement research in science-based prevention practices.

Barriers to Participation in Family Skills Preventive Interventions and Their Evaluations: A Replication and Extension

BARRIERS TO PARTICIPATION IN FAMILY SKILLS PREVENTIVE INTERVENTIONS AND THEIR EVALUATIONS A REPLICATION AND EXTENSION* Richard Spoth, Cleve Redmond, Cathy Hockaday, and Chung Yeol Shin** This study extends a line of programmatic research on families who decline participation in intervention and assessment components of family focused prevention projects. Parents responding to a brief telephone interview (N = 459) identified the most important of 28 barriers concerning project assessments, intervention-related time demands and logistic requirements, beliefs and attitudes about interventions, and family member influences. Results demonstrated that several time-related factors, logistic requirements, and family member influences were important barriers. Findings also showed that sociodemographic factors were associated with unfavorable attitudes about interventions and their assessments. Implications for the development of ef fective recruitment strategies and for future research are presented. This article addresses several issues raised by the literature on barriers to participation in preventive interventions. The literature indicates the importance of gathering data specific to the type of intervention and the type of consumer population targeted by the intervention because barriers can vary with different interventions and can also vary among consumer groups (Carter, Elward, Malmgren, Martin, & Larson, 1991; Lutz, 1989; Pirie et al., 1986; Spoth & Redmond, 1993a, 1993b, 1994, Vernon, Laville, & Jackson, 1990; Wilson, 1990). In addition, this literature suggests that it is important to gather detailed information on a variety of barriers related to practical concerns (e.g., time demands and logistic requirements), social influences (e.g., family member preferences), and attitudinal factors (e.g., perceived intervention efficacy). Nonetheless, there has been a dearth of research directed toward these barriers to participation in a particular intervention of interest-family skills preventive interventions-offered to a particular consumer population of interest, namely, rural families. Further, there has been limited research on barriers to family preventive interventions that are embedded in an evaluation project. There are additional participation barriers to interventions that are being offered as part of an evaluation study (e.g., anticipated invasions of privacy) and these barriers also warrant further study (Coie et al., 1991; Orden, Dyer, & Lui, 1990; Spoth & Molgaard, 1993). To address the issues raised in the relevant barriers literature, the study reported in this article gathered detailed information on a comprehensive set of research-based barriers to participation in assessment and intervention components of a family skills preventive intervention evaluation project. It also examined the relationship between these barriers and parent sociodemographic characteristics. A key interest was the barriers data that can be used to guide the development of effective recruitment strategies, such as data concerning scheduling conflicts or time demands, perceived invasions of privacy, perceived susceptibility to child problem behaviors, and spousal influences. In an earlier retrospective study of participation barriers (Spoth & Redmond, 1993b), data were collected from nonparticipants during a recruitment telephone interview and via a subsequent mail survey. Data were obtained from parents representing 167 families who refused to participate in a family-focused prevention program evaluation study. Parents from refusing families responded to an open-ended interviewer question about their familys decision not to participate in the study. Ninetyseven (59%) of these parents also responded to a brief mail survey concerning 10 reasons for refusal, using a yes/no response format. The present study incorporated a number of substantive and methodological improvements over the previous study. …

Brief Family Intervention Effects on Adolescent Substance Initiation: School-Level Growth Curve Analyses 6 Years Following Baseline

This study examines the effects of 2 brief family-focused interventions on the trajectories of substance initiation over a period of 6 years following a baseline assessment. The 2 interventions, designed for general-population families of adolescents, were the 7-session Iowa Strengthening Families Program (ISFP) (Molgaard & Spoth, 2001) and the 5-session Preparing for the Drug Free Years Program (PDFY) (Catalano, Kosterman, Haggerty, Hawkins, & Spoth, 1999). Thirty-three rural public schools were randomly assigned to the ISFP, the PDFY, or a minimal-contact control condition. The authors evaluated the curvilinear growth observed in school-level measures of initiation using a logistic growth curve analysis. Alcohol and tobacco composite use indices--as well as lifetime use of alcohol, cigarettes, and marijuana--and lifetime drunkenness, were examined. Significant intervention-control differences were observed, indicating favorable delays in initiation in the intervention groups.

Assessing a public health approach to delay onset and progression of adolescent substance use: latent transition and log-linear analyses of longitudinal family preventive intervention outcomes.

This study examined the effects of the Iowa Strengthening Families Program (ISFP) and the Preparing for the Drug-Free Years program (PDFY) on young adolescent transitions from nonuse of substances to initiation and progression of substance use. Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents. Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses. Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up. Also at this follow-up, the PDFY showed effects on delayed progression of use among those previously reporting initiation.

Engaging families in longitudinal preventive intervention research: Discrete-time survival analysis of socioeconomic and social–emotional risk factors.

This study examined whether family risk factors predicted attrition in a prevention research project that incorporated procedures to increase retention in assessment and intervention activities. Analyses used data from 667 rural families collected over 4 waves and consisted of (a) young adolescent and parent reports of internalizing and externalizing problems, (b) observer ratings of distress in parent-child interactions, and (c) family socioeconomic status (SES). Analyses failed to identify any risk factors as significant predictors of intervention participation. Only SES was found to be significant as a predictor of assessment attrition. This SES result appeared to reflect an association between lower educational attainment and an increased likelihood of attrition.

Toward Dissemination of Evidence-Based Family Interventions: Maintenance of Community-Based Partnership Recruitment Results and Associated Factors

A major challenge in the dissemination of evidence-based family interventions (EBFIs) designed to reduce youth substance use and other problem behaviors is effective and sustainable community-based recruitment. This understudied topic is addressed by a preliminary study of 14 community-university partnership teams randomly assigned to an intervention condition in which teams attempted sustained implementation of EBFIs with two cohorts of middle school families. This report describes attendance rates of recruited families maintained over time and across both cohorts, along with exploratory analyses of factors associated with those rates. When compared with community-based recruitment rates in the literature, particularly for multisession interventions, relatively high rates were observed; they averaged 17% across cohorts. Community team functioning (e.g., production of quality team promotional materials) and technical assistance (TA) variables (e.g., effective collaboration with TA, frequency of TA requests) were associated with higher recruitment rates, even after controlling for community and school district contextual influences. Results support the community-university partnership model for recruitment that was implemented in the study.

Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation.

In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY.

Modeling Factors Influencing Enrollment in Family-Focused Preventive Intervention Research

The reported study tests an extension of a previously supported model of family context and health belief predictors of parental inclination to enroll in preventive interventions. The extended model addresses limitations in the prior investigation; it examines the role of intervention-related beliefs and inclinations on actual enrollment in a skills training intervention research project. Model testing was conducted with a sample of 635 parents of 6th graders who completed a prospective participation factor survey and were recruited for an intervention research project 6 months later. The model fit was strong and all but one of the primary hypothesized effects were supported. Notably, both stated inclination to enroll in an intervention and in the research project had significant positive effects on actual project enrollment occurring 6 months later. Perceived intervention benefits and barriers had significant effects on both types of stated inclination to enroll. Examination of modification indices for the model suggested an additional path linking educational attainment with actual enrollment.