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Strong African American Families Program

Blueprints Program Rating: Promising

A 7-week interactive educational program for African American parents and their early adolescent children that includes separate weekly parent and child skills-building followed by a family session to reduce adolescent substance use, conduct problems, and sexual involvement.

  • Alcohol
  • Close Relationships with Parents
  • Delinquency and Criminal Behavior
  • Truancy - School Attendance

    Program Type

    • Alcohol Prevention and Treatment
    • Drug Prevention/Treatment
    • Family Therapy
    • Parent Training
    • Skills Training

    Program Setting

    • Community (e.g., religious, recreation)
    • School

    Continuum of Intervention

    • Universal Prevention (Entire Population)

    A 7-week interactive educational program for African American parents and their early adolescent children that includes separate weekly parent and child skills-building followed by a family session to reduce adolescent substance use, conduct problems, and sexual involvement.

      Population Demographics

      African American parents and their early adolescent children, however, evaluations only include 11- and 12-year-old children.

      Age

      • Late Childhood (5-11) - K/Elementary

      Gender

      • Male and Female

      Race/Ethnicity

      • African American

      Race/Ethnicity/Gender Details

      This program was developed for use among rural African American families.

      Risk Factors: Affiliating with deviant peers, increases in the rates of substance use in rural communities, limited recreational and occupational resources, limited access to mental health services.

      Protective Factors: Negative attitudes about alcohol and sex, goal-directed future orientation, resistance efficacy, acceptance of parental influence and negative images of drinkers, and strong racial identity.

      • Individual
      • Peer
      • School
      • Family
      • Neighborhood/Community
      Risk Factors
      • Individual: Early initiation of drug use, Favorable attitudes towards antisocial behavior, Favorable attitudes towards drug use*, Substance use
      • Peer: Interaction with antisocial peers, Peer substance use
      • Family: Family conflict/violence, Low socioeconomic status, Parent stress, Parental attitudes favorable to antisocial behavior, Parental attitudes favorable to drug use, Poor family management*
      • School: Low school commitment and attachment
      • Neighborhood/Community: Community disorganization, Extreme economic disadvantage, Laws and norms favorable to drug use/crime, Perceived availability of drugs
      Protective Factors
      • Individual: Clear standards for behavior*, Perceived risk of drug use, Problem solving skills, Prosocial behavior, Prosocial involvement, Refusal skills*
      • Family: Attachment to parents*, Opportunities for prosocial involvement with parents, Parent social support, Parental involvement in education

      *Risk/Protective Factor was significantly impacted by the program.

      See also: Strong African American Families Program Logic Model (PDF)

      The Strong African American Families (SAAF) program is a 7-week interactive educational program for African American parents and their early adolescent children, age 11. The intervention program is based on an empirical model of the processes linked to psychological adjustment, substance use and high-risk behavior in rural African American youth. Early adolescence is the period in which children gain increasing control over their behavior, begin forming friendships based on similarities and common interests, and develop attitudes toward substances and substance use. The attitudes and behaviors that they develop during this time influence their achievement motivation, academic performance and friendship selections, which in turn lead them toward or away from substance use. The SAAF program is designed to strengthen positive family interactions and to enhance parents’ efforts to help their children establish and reach positive goals during this critical transition between childhood and adolescence.

      The Strong African American Families (SAAF) project is a 7-week interactive educational program for African American parents and their early adolescent children, age 11. The intervention program is based on an empirical model of the processes linked to psychological adjustment, substance use and high-risk behavior in rural African American youth. Early adolescence is the period in which children gain increasing control over their behavior, begin forming friendships based on similarities and common interests, and develop attitudes toward substances and substance use. The attitudes and behaviors that they develop during this time influence their achievement motivation, academic performance and friendship selections, which in turn lead them toward or away from substance use. The SAAF program is designed to strengthen positive family interactions and to enhance parents’ efforts to help their children establish and reach positive goals during this critical transition between childhood and adolescence.

      The SAAF curriculum is based on data collected in two other studies, Families In It Together (FIIT) and the Family and Community Health Study (FACHS). These studies survey large numbers of African American families residing in rural areas about the kinds of things that parents and children do that foster competence. The SAAF program targets the following predictors of child competence: (1) family routines, parent-child relationship quality, no-nonsense discipline, monitoring and communication, parental involvement with the child’s school, racial socialization; (2) goal setting, self-regulation, resistance skill development; and (3) the cognitive antecedents of adolescent risk behavior, including the formation of prototypes of drinking youths and willingness to drink in risk-conducive situations.

      The SAAF includes a curriculum organized around seven sessions. Each session includes three modules - Caregiver, Youth, and Family. SAAF modules are an hour each. Parent and youth meet separately for their modules that occur simultaneously. During the second hour, everyone comes together for a group meeting with all of the families. Thus, all parents and youths receive a total of 14 hours of prevention training. All of the Caregiver modules, two of the Youth modules and one Family module utilize DVDs to facilitate content delivery. An optional component of the SAAF sessions includes the provision of meals prior to the start of each series of modules. This allows for a communal experience among families and rapport building between the facilitators and the families.

      The SAAF curriculum is designed to help parents/caregivers learn nurturing skills that support their children; enhance parents' abilities to discipline their youth and promote independence as children transition to adolescence; give youth a healthy future orientation and an increased appreciation of their parents/caregivers; and to teach youth skills for dealing with temptation and peer pressure. Facilitators are African American community members who are trained to teach the SAAF curriculum. One facilitator leads the Parent/Caregiver Sessions, while two facilitators share the responsibility of leading the Youth Sessions. All three facilitators lead Family Sessions.

      The aims of the program include (1) facilitating the development of a supportive and structured family environment that promotes positive parent-child relationships, (2) enhancing parental engagement in parenting that involves high levels of monitoring and support, strong communication about risk behavior such as substance use and sex, and racial socialization, and (3) preparing youth to resist substance use and other risk behavior by maintaining a future orientation, enhancing risk behavior resistance skills, and accepting parental influences. Ultimately, the program's goal is to delay the onset and lower the rate of substance use in rural African American youth.

      The Strong African American Families Program was conceived and designed using an approach that is consistent with recommendations presented in reports issued by the Institute of Medicine and the National Institute of Mental Health. Both reports described a three-phase preventive intervention cycle, which begins with the definition of a target problem. The second phase involves the review and application of developmental, epidemiological, and longitudinal research to derive an etiological model of the problem's development and the protective factors involved in that process. In the third phase the theoretical model for an intervention is constructed, preferably based on research conducted with populations similar to those who will receive the preventive intervention.

      The SAAF program development followed many aspects of the reports, as well as building on other family-centered intervention programs (The Strengthening Families Program for Parents and Youth 10-14) that have been shown to enhance parent and youth competence and inhibit young people's use of alcohol and other substances, delinquent activity, and other problem behaviors. The basic premise of the SAAF program is that regulated, communicative home environments are characterized by four practices: involved-vigilant parenting (high levels of monitoring and control as well as high levels of emotional and instrumental support); clearly articulated parental expectations for alcohol use (this creates a parent-child relationship that promotes discussions about these types of issues); communication about sex (provides information to the youth and promotes the youths' internalization of their parents' norms regarding sexual behavior) and racial socialization (included as previous research suggests that racism contributes to substance use and compromises psychological functioning among African American youth). The theories relevant to the SAAF program are social control theory; social development theory; problem behavior theory; the prototype/willingness model of adolescent risk behavior and self-control theory.

      • Skill Oriented
      • Social Control
      • Social Learning

      The first study was a cluster randomized prevention trial which included assignment of families to a treatment or control group. Participants (African American mothers and their 11-year-old children) were recruited from nine rural counties in Georgia. Of the nine counties, two were small and contiguous; these counties were combined into a single population unit, yielding a total of eight county-units. The eight county-units were then randomly assigned to either the control or intervention conditions, resulting in the assignment of four county-units to each condition. Schools in these units provided lists of 11-year-old students, from which 521 families were selected randomly. Of these families, 332 completed pretests. The final sample included 150 families in the control counties and 172 families in the intervention counties. The intervention group began the 7-week prevention sessions and the control (during the same 7-week period that the intervention families participated in the prevention sessions) families received three leaflets via postal mail. One described various aspects of development in early adolescence, another dealt with stress management, and the third provided suggestions for encouraging children to exercise. Families in both groups complete a pre-test one month before the SAAF program begins, a post-test three months after the sessions end, and a long-term follow-up (completed by youths only), thus producing a 7-month interval between pre- and post-test and a 29-month interval between the pre-test and the long-term follow-up.

      Study 2 (Futris & Kogan 2014; Kogan et al. 2016) was a randomized control trial with recruitment taking place in 8 rural, impoverished Georgia counties over a 5 year span. Participants (n=465) were African American children in 5th and 6th grade and their parents. Participant families were randomly assigned to the intervention group (n=242) or a waitlist control group (n=223) that gained access to the program after 12 months. Assessments occurred at baseline and at posttest, 3 months after program completion.

      Study 1

      After participating in the SAAF program, parents engaged in more regulated, communicative parenting than parents in the control group. Youth who participated in the SAAF program reported higher levels of protective factors than youth who did not participate. Regulated, communicative parenting and youth protective factors actually declined in control families from pre- to post-test, while they increased in the intervention families. These results suggest that the SAAF program may have derailed potential declines in these two factors during the 7-month assessment period. Changes in the targeted youth protective factors were mediated through the SAAF program's effects on their caregiver's communication and parenting behaviors.

      At post-test and the 29 month follow-up, new alcohol user proportions were significantly lower among SAAF adolescents than control adolescents.

      Assignment to the SAAF condition was associated with a significantly slower rate of increase in alcohol use and conduct problems (theft, truancy, suspension) across the 29 months between the pre-test and the long-term follow-up. When pre-test levels of alcohol use, gender, and the primary caregivers' educational attainment were controlled, participation in SAAF still predicted lower rates of growth in alcohol use among participating adolescents.

      At 65 months, youths who participated in SAAF reported drinking half as often during the past month than did similar youths in the control condition.

      Mediational Analyses: Changes in youth alcohol use from the pre-test to the long-term follow-up were mediated through SAAF's enhancement of youth protective processes from pre- to post-test. Program-induced changes in parenting led to an increase in self-pride, which was associated with peer orientation, sexual risk intentions, and behavior at the 29-month follow-up.

      Study 2 (Futris & Kogan 2014; Kogan et al. 2016)

      At posttest (three months after program completion), compared to waitlist control participants, intervention children showed significant improvements in youth risk behavior vulnerability, youth self-regulatory processes, and parenting practices.

      Study 1

      Compared to control group students, SAAF students reported:

      • Fewer conduct problems (theft, truancy, suspension) across the 29 months between the pre-test and the long-term follow-up.
      • Significantly lower new alcohol user proportions at both the post-test and through the 29 month follow-up.
      • Significantly slower rate of increase in alcohol use through the 65 month follow-up.

      Significant Program Effects on Risk and Protective Factors:

      • Greater positive changes in regulated, communicative parenting (involved-vigilant parenting, racial socialization, communication about sex, and establishment of clear parental expectations).
      • Greater positive changes in all youth protective factors (negative attitudes about alcohol and sex, goal-directed future orientation, resistance efficacy, acceptance of parental influence and negative images of drinkers).

      Study 2 (Futris & Kogan 2014; Kogan et al. 2016)

      Significant Program Effects on Risk and Protective Factors:

      • Youth risk behavior vulnerability
      • Youth self-regulatory processes
      • Positive parenting

      Program effects on risk and protective factors (Futris & Kogan, 2014; Kogan et al., 2016) were mediated through self-regulatory processes, which were affected directly by program participation and indirectly via program effects on positive parenting.

      Cohen’s d ranged from .17-.32, indicating small program effects on risk and protective factors (Futris & Kogan 2014; Kogan et al. 2016).

      The participants were all recruited from rural Georgia, most of whom worked but were still below or near the poverty level. Future research would want to include more geographic (inner-city/urban sites and locations other than Georgia) and socioeconomic (a broader income range) diversity to improve the generalizability of the results. The program was particularly effective in reducing conduct problems for higher risk youth (those with low self-control and greater affiliation with delinquency peers).

      Study 1

      • Randomization was done at the county level, but analysis was conducted at the individual level.
      • Families were nested in counties and there were so few counties included (8) that there were not enough to conduct a multilevel analysis in order to detect county-level influences on intervention effectiveness.
      • Treatment and control groups were not equivalent on two of the individual-level variables.

      Study 2 (Futris & Kogan 2014; Kogan et al. 2016)

      • No behavioral outcome measure
      • No posttest effects on behavioral outcomes
      • One baseline group demographic difference
      • Some scale reliabilities were poor

      • Blueprints: Promising
      • Crime Solutions: Effective
      • OJJDP Model Programs: Effective
      • SAMHSA: 3.6-3.8

      Western Tidewater Community Services Board
      5268 Godwin Blvd.
      Suffolk, VA 23434
      (757)714-9670
      Contact: Brandon Rodgers
      brodgers@wtcsb.org

      Amachi Pittsburgh
      100 West Station Square Drive, Suite 621
      Pittsburgh, PA 15219
      (412)281-1288, ext. 208
      Contact: Fred Hill
      fhill@amachipgh.org

      Evelyn K. Davis Center for Working Families
      801 University Avenue, Unit 3
      Des Moines, IA 50314
      (515)697-7700
      Contact: Jonathan R. Douglas, PhD
      Jrdouglas3@dmacc.edu

      Brody, G., Kogan, S., Chen, Y., & McBride-Murry, V. (2008). Long-term effects of the Strong African American Families program on youths' conduct problems. Journal of Adolescent Health, 43, 474-481.

      Brody, G., McBride-Murry, V., Gerrard, G., Gibbons, F., Molgaard, V., McNair, L., ... Neubaum-Carlan, E. (2004) The Strong African American Families Program: Translating research into prevention programming, Child Development, 75(3), 900-917.

      Brody, G. H., Murry, V. M., Kogan, S. M., Brown, A. C., Anderson, T., Chen, Y., ... Wills, T. A. (2006). 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, 356-366.

      Brody, G. H., Murry, V. M., Gerrard, M., Gibbons, F. X., McNair, L., Brown, A. C., ... Chen, Y. (2006). The Strong African American Families Program: Prevention of youths' high-risk behavior and a test of model change. Journal of Family Psychology, 20, 1-11.

      Gerrard, M., Gibbons, F. X., Brody, G. H., Murry, V. M., Cleveland, M. J., & Wills, T. A. (2006). A theory-based dual-focus alcohol intervention for preadolescents: The Strong African American Families Program. Psychology of Addictive Behaviors, 20, 185-195.

      Murry, V. M., Berkel, C., Brody, G. H., Gibbons, M., & Gibbons, F. X. (2007). The Strong African American Families program: Longitudinal pathways to sexual risk reduction. Journal of Adolescent Health, 41, 333-342.

      Tracy N. Anderson
      Assistant Director
      Center for Family Research
      University of Georgia
      1095 College Station Road
      Athens, GA 30602-4527
      Phone: (706) 425-2992
      E-mail: tnander@uga.edu

      Study 1

      Brody, G., Kogan, S., Chen, Y., & McBride-Murry, V. (2008). Long-term effects of the Strong African American Families program on youths' conduct problems. Journal of Adolescent Health, 43, 474-481.

      Brody, G., McBride-Murry, V., Gerrard, G., Gibbons, F., Molgaard, V., McNair, L., ... Neubaum-Carlan, E. (2004) The Strong African American Families Program: Translating research into prevention programming, Child Development, 75(3), 900-917.

      Brody, G. H., Murry, V. M., Kogan, S. M., Brown, A. C., Anderson, T., Chen, Y., ... Wills, T. A. (2006). 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, 356-366.

      Brody, G. H., Murry, V. M., Gerrard, M., Gibbons, F. X., McNair, L., Brown, A. C., ... Chen, Y. (2006). The Strong African American Families Program: Prevention of youths' high-risk behavior and a test of model change. Journal of Family Psychology, 20, 1-11.

      Gerrard, M., Gibbons, F. X., Brody, G. H., Murry, V. M., Cleveland, M. J., & Wills, T. A. (2006). A theory-based dual-focus alcohol intervention for preadolescents: The Strong African American Families Program. Psychology of Addictive Behaviors, 20, 185-195.

      Murry, V. M., Berkel, C., Brody, G. H., Gibbons, M., & Gibbons, F. X. (2007). The Strong African American Families program: Longitudinal pathways to sexual risk reduction. Journal of Adolescent Health, 41, 333-342.

      Brody, G., Kogan, S., Chen, Y., & McBride-Murry, V. (2008). Long-term effects of the Strong African American Families program on youths' conduct problems. Journal of Adolescent Health, 43, 474-481.

      Brody, G., McBride-Murry, V., Gerrard, G., Gibbons, F., Molgaard, V., McNair, L., ... Neubaum-Carlan, E. (2004) The Strong African American Families Program: Translating research into prevention programming, Child Development, 75 (3), 900-917.

      Brody, G. H., Murry, V. M., Kogan, S. M., Brown, A. C., Anderson, T., Chen, Y., ... Wills, T. A. (2006). 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, 356-366.

      Brody, G. H., Murry, V. M., Gerrard, M., Gibbons, F. X., McNair, L., Brown, A. C., ... Chen, Y. (2006). The Strong African American Families Program: Prevention of youths' high-risk behavior and a test of model change. Journal of Family Psychology, 20, 1-11.

      Gerrard, M., Gibbons, F. X., Brody, G. H., Murry, V. M., Cleveland, M. J., & Wills, T. A. (2006). A theory-based dual-focus alcohol intervention for preadolescents: The Strong African American Families Program. Psychology of Addictive Behaviors, 20, 185-195.

      Murry, V. M., Berkel, C., Brody, G. H., Gibbons, M., & Gibbons, F. X. (2007). The Strong African American Families program: Longitudinal pathways to sexual risk reduction. Journal of Adolescent Health, 41, 333-342.

      Evaluation Methodology

      Design: The study was a cluster randomized prevention trial which included assignment of families to a treatment or control group. Participants (African American mothers and their 11-year-old children) were recruited from nine rural counties in Georgia. In these counties, families live in small towns and communities in which poverty rates are among the highest in the nation and unemployment rates are above the national average. Of the nine counties, two were small and contiguous; these counties were combined into a single population unit, yielding a total of eight county-units. The eight county-units were then randomly assigned to either the control or intervention conditions, resulting in the assignment of four county-units to each condition. Schools in these units provided lists of 11-year-old students, from which 521 families were selected randomly. Of these families, 332 completed pretests (the authors state that the recruitment rate of 64% exceeds rates commonly reported for problematic and high-risk behavior prevention trails). The final sample included 150 families in the control counties and 172 families in the intervention counties.

      The intervention group began the 7-week prevention sessions and the control families received three leaflets via postal mail during the same 7-week period that the intervention families participated in the prevention sessions. One leaflet described various aspects of development in early adolescence, another dealt with stress management, and the third provided suggestions for encouraging children to exercise. Families in both groups completed a pre-test one month before the SAAF program began, a post-test three months after the sessions ended, and a long-term follow-up (completed by youths only), thus producing a 7-month interval between pre- and post-test and a 29-month interval between the pre-test and the long-term follow-up.

      Treatment and control groups were equivalent at the County level, so equivalence was also analyzed at the individual level. Tests of sample equivalence at the individual level indicated no differences across the prevention and control conditions for family sociodemographic characteristics. Group pretest equivalence on all study variables revealed that the groups differed (scores were higher in the control group than in the prevention group) on two measures: mothers' reports of communication about sex and youths' reports of negative attitudes toward alcohol and sexual activity. The researchers controlled for this in the final analyses. Sample attrition was very low; the pre-test, post-test and long-term follow-up were completed by 92% of the participants. The study employed an intent-to-treat analysis, which included all families from intervention counties who completed the pretest regardless of the number of sessions they actually attended. This included 24 families and 22 youths who did not attend any prevention sessions but who completed the pre-test, post-test, and the long-term follow-up.

      65-month follow-up: Of the recruited families, 85% completed pretest, posttest and four long-term follow-up assessments, the last of which took place 5.4 years after the pretest. To preserve the random nature of the group assignments, the analyses included all families in the intervention condition who completed all assignments regardless of the number of prevention sessions they actually attended, thereby adhering to the intent-to-treat principle.

      Sample: The families who completed the posttest had an average of 2.7 children. In 53.6% of these families, the target child was a girl. Of the mothers in the families, 33.1% were single, 23.0% were married and living with their husbands, 33.9% were married but separated from their husbands, and 7% were living with partners to whom they were not married. Of the two-parent families, 93.0% included both of the targeted child's biological parents. The mothers' mean age was 38.1 years, and the fathers' mean age was 39.4 years. A majority of the mothers, 78.7%, had completed high school. The families' median household income was $1,655.00 per month.

      Measures:
      Primary Caregivers' Intervention Targeted Behaviors: Four indicators of primary caregivers' intervention targeted behaviors were included: involved-vigilant parenting (19 Likert scale items that measured parental behaviors concerning involvement, inductive discipline, consistent discipline and monitoring), adaptive racial socialization (assessed using the Racial Socialization Scale, a 15 item scale that measures specific racial socialization behaviors), communication about sex (assessed using The Parental Communication About Sex Scale, which measures specific topics about reproduction/pregnancy, menstruation, sexually transmitted diseases and HIV/AIDS) and clear communication of expectations about alcohol use (assessed using two items that asked if parents had expressed how they feel about alcohol/drugs and if they set norms concerning this behavior in their home).

      Prototype Images and Similarity: (Gerrard et al., 2006) At both the pre- and 3-month post-test, images of alcohol-drinking youth were introduced with a lead-in question asking participants to think about youth who drink. Following this lead-in question were six adjectives (popular, selfish, smart, cool, unattractive, and dull) followed by a 5-point Likert scale for each. Participants were asked to indicate, for example, how popular the alcohol-drinking youth were from 1 (not at all) to five (very) on the Likert scale. Similarity to drinkers was also assessed using the question: "How much are you like (similar to) the type of [girl/boy] ages 11, 12, or 13 who drink alcohol?" Responses were given on a 5-point Likert scale again ranging from 1 (not at all) to 5 (very). Similarity and favorability were then used as two indicators of the prototype construct.

      Parental Monitoring: (Gerrard et al., 2006) Parental monitoring of child behavior was assessed with a two-item scale ("How often do you know where your child is when he or she is away from home?" and "In the course of a day, how often do you know where your child is?"), each measured on 5-point Likert scales.

      Nurturant-Involved Parenting: (Gerrard et al., 2006) This measure included nine items that assessed the frequency of parental involvement and inductive discipline.

      Intervention-Targeted Youth Protective Factors: The outcome indicators consisted of five variables: future-oriented goals (5 items, which measure the youths ability to set, sustain and achieve goals for the future), resistance efficacy (youths presented with scenarios, three items), negative images of drinkers (youths introduced with lead-in statements, 9 items), acceptance of parental alcohol influences (youths questioned about their parents' thoughts about alcohol use), and negative attitudes toward alcohol use and sexual activity (assessed using Jessor and Jessors' four-item scale that measures youths' negative attitudes toward drinking and sexual activity).

      Youth Alcohol Use: (Brody et al., 2006) Youths completed post-test and long-term follow-up assessments of their alcohol use via an alcohol composite index. The index consisted of three items, two concerning lifetime behavior and one concerning recent use. Youths were asked (a) if they had ever in their lives consumed an entire alcoholic drink, (b) if they had consumed an entire alcoholic drink during the past month, and (c) if they had ever drunk three or more alcoholic drinks at one time (binge drinking).

      Alcohol Willingness: (Gerrard et al., 2006) The alcohol-willingness measures began with a description of a hypothetical scenario: "Suppose you were with a group of kids and there was some alcohol that you could have if you wanted. How willing would you be to do the following things?" Three items that assessed willingness to drink followed this statement- "have one drink," "drink more than one drink," and "get drunk"- each rated on a four-point Likert scale.

      Alcohol Intentions: (Gerrard et al., 2006) Two items with 4-point Likert scales assessed intentions to use alcohol in the next year: "Do you intend to drink alcohol in the next year?" and "How likely is it that you will drink alcohol in the next year?"

      Conduct Problems (Brody et al., 2008). Five questions from the National Youth Survey concerning past year frequency of engaging in disruptive behaviors involving theft, truancy, and suspension from school.

      Analysis: The effectiveness of the intervention program is tested using structural equation modeling (SEM), which can be applied to the evaluation of models that include hypothesized sequences of intervention effects on proximal and distal outcomes. SEM also allows simultaneous examination of intervention effects on interrelated constructs, such as targeted parenting behaviors and youth protective factors, while controlling measurement error. The SEM analyses addressed differences between groups at posttest after controlling for pretest levels of the targeted parent or youth variables. Lastly, the SEM analyses were replicated using multilevel ANCOVAs to determine whether the inclusion of county-level effects would change those results. Alcohol use initiation was analyzed using z -tests to compare the proportions of SAAF adolescents who reported initiating alcohol use since pre-testing (new user proportions) to those of adolescents in the control condition. Latent growth models were specified to test the effects of the intervention on alcohol use among adolescents.

      Outcomes

      Posttest:
      Prevention Effects: The analyses revealed that involved-vigilant parenting, racial socialization, communication about sex and establishment of clear parental expectations loaded significantly and positively on the latent construct of intervention-targeted communicative parenting behavior. There were also significant factor loading for all youth protective factors (negative attitudes about alcohol and sex, goal-directed future orientation, resistance efficacy, acceptance of parental influence and negative images of drinkers).

      Compared to control group families, SAAF reported significantly greater changes from pre-posttest in regulated, communicative parenting and youth protective factors. The SEM analyses were replicated using multilevel ANCOVAs to determine whether the inclusion of county-level effects would change those results. The results revealed that the SAAF families showed significantly greater positive changes in the intervention-targeted parent and youth behaviors than the control group families.

      Alcohol Use: At posttest, new alcohol user proportions were significantly lower among SAAF adolescents than control adolescents.

      Mediational Analyses: The analyses revealed that all conditions were met for mediation (group assignment associated with parenting behavior; group assignment associated with youth protective factors; mediator associated with changes in youth protective factors and impact of group on youth outcomes was not significant in the presence of the mediator), indicating that changes in youth protective factors and youth's views of parenting were mediated through intervention-induced changes in regulated, communicative parenting. A supplemental analysis determined that involved-vigilant parenting, racial socialization, communication about sex and clear expectation about alcohol use were the specific parenting behaviors associated with changes in the youth protective factors. Finally, intervention-induced changes in regulated, communicative parenting were linked to changes in youth's assessments of parental behavior, which, in turn, were associated with lower initiation rates of risk behaviors across the 7 months that separated the pre- and posttest.

      Long-term:
      Intervention Efficacy Model: (Brody et al., 2006) At the long-term follow-up, new alcohol user proportions were significantly lower among SAAF adolescents than control adolescents. In addition, alcohol use demonstrated the predicted linear growth over time with participants varying significantly around the mean rate of growth. Assignment to the SAAF condition was associated with a significantly slower rate of increase in alcohol use across the 29 months between the pre-test and the long-term follow-up. SAAF participants experienced 17.4% less growth in alcohol use for each unit increase among the control group. When pre-test levels of alcohol use, gender, and the primary caregivers' educational attainment were controlled, participation in SAAF still predicted lower rates of growth in alcohol use among participating adolescents.

      Mediational Analyses: Assignment to the SAAF condition was associated with an increase in youth protective factors at post-test when pre-test levels were controlled. Assignment to the SAAF condition also predicted lower levels of alcohol use at the long-term follow-up when pre-test levels were controlled. The mediator (post-test youth protective factors with pre-test levels controlled) was associated with decreases from pre-test to the long-term follow-up in youth alcohol use. Finally, the impact of group assignment on levels of alcohol use at the long-term follow-up was not significant in the presence of the mediator. Thus, it was determined that changes in youth alcohol use from the pre-test to the long-term follow-up were mediated through SAAF's enhancement of youth protective processes from pre- to post-test.

      Program participation led to an increase in the use of intervention-targeted parenting practices with pre-test levels controlled. This increase in parenting practices, in turn, was associated with an increase in adolescents' self-pride with pre-test levels. The increase in self-pride was inversely associated with peer orientation which, in turn, was associated with intent to engage in sexual activity. Finally, intent was associated with engagement in sexual risk behavior. Thus, consistent with the distal mediational hypotheses, program-induced changes in parenting led to an increase in self-pride, which was associated with peer orientation, sexual risk intentions, and behavior at the 29-month follow-up.

      Path Analysis: (Gerrard et al., 2006) The first SEM specified a direct path from the intervention to the 24-month follow up consumption as well as direct paths from pre-test parenting behavior and the children's alcohol consumption, intentions, willingness, and prototypes to follow-up consumption. In spite of relatively stable consumption from pre-test to follow-up, youths in the intervention group reported significantly smaller increases in drinking between pretest and follow-up than did those in the control group.

      A second (full) SEM was designed to simultaneously test the hypothesized mediation of the intervention effects through the social reaction and reasoned/intention processes. Thus, two indirect pathways from intervention to follow-up alcohol consumption were added to the first model: (a) the social reaction path and (b) the reasoned/intention path. Paths between pre-/post-test pairs of each mediator were included in this model. The direct path from intervention to follow-up alcohol consumption was no longer significant in this model and was therefore dropped. In spite of the significant reaction between change in willingness and change in intentions, the increase in the favorability of risk prototypes that typically occurs between ages 11 and 13 was smaller in the intervention group than in the control group. This change, in turn, was associated with a smaller increase in willingness to drink. Finally, these changes in willingness were associated with less escalation of drinking between pre-test and the follow-up. The intervention also had a direct effect on post-test parenting behavior, such that parents in the intervention group reported a greater increase in targeted parenting behaviors than did the control parents. As expected, these increases were associated with changes in adolescents' intentions to drink, and there was a marginal path from change in intention to change in consumption.

      Summary: This model provided evidence that both the social reaction and the reasoned/intention pathways mediated the intervention effects on alcohol consumption. As would be expected with children of this age, the relation between willingness to drink and changes in alcohol consumption was stronger than that between intentions to drink and these changes, but the difference was not significant.

      Impact on Conduct Problems (Brody et al., 2008). This intent to treat analysis included a larger sample size (than mentioned above) of 667 African American primary caregivers and their 11 year old children. No significant experimental condition x attrition interaction effects emerged. Negative binomial regression was used to test the study hypotheses. SAAF had a significant intervention effect on conduct problems across the 29 months from pretest to long-term follow-up, controlling for pretest levels. It reduced youths' chances of engaging in conduct problems by 54% relative to the control group. Additionally, these effects were most pronounced for youth who, at pretest, had lower self-control and more affiliation with deviance-prone peers. Thus, those with the highest risk benefited most from the intervention.

      65-month follow-up (Brody et al., 2010). Assignment to the SAAF condition was associated with a significantly slower rate of increase in alcohol use across the 65 months separating the first and sixth assessments. Youths who took part in SAAF drank an average of .68 times in the past month, whereas youths in the control group drank an average of 1.41 times (twice as often) during the same time period.

      Evaluation Methodology

      Design:

      Recruitment: Participants were recruited over the span of 5 years from school lists of African American 5th and 6th grade students in 8 impoverished rural counties in Georgia. A total of 465 families were recruited during this time. Eligibility requirements included the presence in the family of a youth 11 or 12 years of age at pretest who self-identified as African American; caregiver self-identification as African American was not required.

      Assignment: Families were randomly assigned to either the intervention group (n=242) or a wait-list control group (n=223) that would receive the program after a 12-month waiting period.

      Attrition: Assessments occurred at baseline and posttest, three months after program completion. At posttest there was an overall retention rate of 89.5%.

      Sample:

      Child participants ranged from 10-13 years in age, averaging 11.49 years at baseline, and were evenly split by gender (51% male). Primary caregivers were predominantly female (95.9%) ranging in age from 22-81 years, with a baseline average of 37.11 years. Most caregivers were a biological parent of the participant child (89.9%) and most lived in a single-parent household (61.6). More than half were below the poverty line (57.4%).

      Measures:

      Assessments occurred at baseline and at posttest, three months after program completion (6 months after pretest).

      Intervention-targeted parenting was assessed with both parent and youth reports on a nine-item involved/vigilant parenting scale, which assessed caregivers’ use of monitoring, consistent discipline, and positive parenting practices. Internal consistency was relatively low (α=.62-.63). Parents and youth also completed a nine-item scale assessing parental discussion with the youth regarding expectations regarding risky behavior such as alcohol use (α=.94-.95). Parents also reported on relationship harmony and distress (e.g., “your child is easy to get along with”) using the Interaction Behavior Questionnaire (α=.90).

      Intervention-targeted self-regulatory processes were assessed with youth self-reports on a four-item anger control scale (α=.84), a seven-item scale indexed behavioral self-control (α=.70), and a resistance efficacy measure that presents hypothetical scenarios where youth are offered alcohol, cigarettes, or marijuana to examine behavioral intentions (α=.72-.74).

      Risk behavior vulnerability was assessed with the Tolerance for Deviance scale (α=.86-.87) as well as a 13-item inventory on intentions to use substances and engage in sexual activity (α=.86-.88) and a 12-item measure reporting on affiliations with risk-taking peers (α=.80-.81).

      Parent-reported youth self-control was assessed by asking “how often does your child… work toward a goal, think ahead of time about the consequences of his/her actions.”

      Parent depressive symptoms were assessed with a 20-item depressive symptoms measure. Reliability was not reported.

      Analysis:

      The effects of the program at posttest were evaluated with structural equation modeling, controlling for baseline levels of risk behavior vulnerability, intervention-targeted parenting, and youth self-regulatory processes. Complier-average causal effect modeling was used to identify and compare latent groups of compliers within both groups. Multilevel analysis was used to account for clustering by county.

      Intent-to-Treat: All available data were used in analyses.

      Outcomes

      Implementation Fidelity:

      All sessions were recorded and adherence checks were performed on six sessions (28%) for each 7-week program. Mean session coverage was 84.5% and did not vary significantly by site or implementation year.

      Baseline Equivalence:

      Families assigned to the intervention group were experiencing slightly (but significantly) more economic hardship than control group participants. Otherwise the groups were equivalent on demographic and outcome measures.

      Differential Attrition:

      Tests revealed no significant differences between program completers and attriters, though baseline-by-condition attrition was not examined.

      Posttest:

      At posttest, compared to control participants, intervention youth showed significant improvements in youth risk behavior vulnerability, youth self-regulatory processes, and parenting practices.

      Video

      https://cfr.uga.edu/saaf-programs/saaf/