of a Family-Based Substance Abuse Prevention Program
in Rural Communities
Published in The Journal of Primary Prevention, Vol 18, No. 3, 1998
Parents' results. Significant effects were found for three of the nine parent measures. Parent graduates had significantly higher family cohesion scores at the six-week posttest (M = .75) than they did at the pretest (M = .66), t(53) = 2.89, p < .006. This effect did not last until the 10-week follow-up.
Significant effects for the age parents thought it was "O.K. to drink alcohol" were also found. At the posttest (M = 20-55) and at the 10-week follow-up (M = 21.09), parents reported a higher age than they did at the pretest (M = 20.10), t(40) = 2.42, p < .02 and t(34) = 2.13, p < .04, respectively.
Sigrlificant effects were also found for the curriculum questions, which assessed knowledge of key program concepts. At the posttest (M = .62) and 10-week follow-up (M = .64) parents had significantly higher scores than they did at the pretest (M = -43), t(47) = 5.64, p < .001 and t(34) = 5.16, p < .001, respectively.
The Families In Action program is a unique prevention program because it focuses on a multitude of domains as a means of preventing ATOD abuse. Specifically, the individual, family, school, peer and the community domains were incorporated into the FIA program. By including both students and parents in the program and teaching them comparable skills, changes can begin to occur within the family unit, which then facilitate positive changes in the adolescent toward school, peers, and substance use.
The program provides general life skills for both parents and students. Parents and students learn new communication skills which enable them to better handle conflicts and decisions in their personal lives. Students learn to use these new skills in parent, school, and peer interactions. Parents are taught to use their new life skills with their children, spouse, and co-workers.
The results indicated several positive program findings for students and parents. Girl and boy program graduates were more willing to seek counseling services at the follow-up. Program participation was more beneficial for boys than for girls. Boy graduates had higher school and peer attachment, more appropriate attitudes about alcohol, and believed that alcohol should be consumed at an older age as compared to boy nonparticipants. Teachers and professionals in the program area were interviewed regarding their perspective on why the program had stronger effects for boys than for girls. They noted that middle/junior high school girls often date older boys who are in high school. It is possible that some of the girls taking the program were too developmentally advanced for this particular program. The focus of the program was on preventing the initiation of ATOD use and some of the girls may have already been involved with older boys who are using substances. Another possibility is that boys related to the characters in the video segment of the program more than girls did. Students taking the program have commented that the boy characters in the video were "cool" while one of the primary girl characters was perceived as being "whiny." The gender effect should be interpreted with caution because in a second cohort all program effects were significant for both boys and girls (Abbey, Pilgrim, Hendrickson, & Lorenz, in preparation). One possible explanation for the non-replication of the gender effect is that program staff made additional efforts to engage girl participants. Thus, the program became more appropriate for both genders. In addition, the second cohort recruited higher functioning students.
Parents who graduated from the program reported an increase in activities at their child"s school and an increase in talking with counselors as compared to nonparticipants. Although these were small effects, program staff view these as important and promising. It is unrelistic to expec tthat a six-week program can completely turn around lifetime habits and beliefs about parenting,communication, and discipline. If program participantion makes parents more willing to seek out additional sources of information, support, and advice and to become more involved in their childÕs school, over time these families may experience additional positive changes. Follow-ups of three to five years may be necessary to identify the full impact of this type of program on family dynamics and ATOD use.
Some short-term program effects were found for parent graduates only: greater curriculum knowledge, higher family cohesion and an increase in the age considered appropriate for alcohol consumption. It is possible that if the program was of longer duration or if a booster session was provided the following year, that these short-term effects would have persisted. At the conclusion of the program, participants frequently stated that they wished it would continue longer. However, when program staff tried to arrange for on-going parent support groups, these were poorly attended. Finding ways to encourage busy families to make a long-term committment to family development is a challenge for all voluntary programs. As noted in the previous paragraph, it may be unrealistic to expect this program alone to change families unless it encourages them to seek out additional services.
There are several aspects of the study design which encourage caution in interperting and generalizing the results. Participants were not randomly assigned to conditions so initial differences between groups may have affected the findings, although analyses were conducted controlling for baseline differences between groups on the outcome measures and demographic variables. Although families from all socioeconomic backgrounds participated in the study, on average, those that chose to participate were more "needy" than those who chose not to participate in the program. owever, such pre-existing differences between groups makes it more difficult to find significant results (Cook & Campbell, 1979). In addition, program participants completed the questionnaire more times than did nonparticipants so there may have been a testing effect (Cook & Campbell, 1979). There was, however, at least a four month gap between the 10-week and the one-eyar follow-up so it is unlikely that participants remembered the ir previous responses. This program was conducted in a rural, primarily Caucasian, low-income area in the Midwest. Analyses of an additional cohort of data from this program also show a number of significant program effects (Abbey et al., in preparation). Replication of the program is also needed with other populations in order to determine the generalizability of the results.
Given these cautions about the need for replication, this study's findings have a number of implications for substance abuse prevention programming. Primary prevention programs benefit from strengthening youths' attachment to parents, school staff, and prosocial peers before students are at the age where experimentation with alcohol, tobacco, and other drugs is common. In the communities where this program was examined, it is very common for parents to provide youth with alcohol for their parties. Changing such a community norm is not easy and takes many years. By providing youth and their parents with a peer group that had signed a "zero tolerance" pledge, the FIA program created a positive peer group for families uncomfortable with underage alcohol consumption.
Some practical issues associated with conducting prevention programs in a rural community involve the large geographic distances between people, the lack of transportation, and the lack of recreational activities for youth. A strong sense of self-reliance and privacy also made it difficult for many people to attend a parenting program; they seemed to feel that they should be able to handle any difficulties themselves. Also, in a rural community there is less anonymity from others than in an urban area. Occasionally, people would opt out of the program once they heard about who else had registered because they did not like or want to associate with them. These issues can also arise in urban and suburban areas, however, they appear to be more salient in small towns.
Parents and youth reported enjoying both the times during the program when they were apart and the times when they were together. Each age group had some issues it wanted to discuss and work through without being heard by the other generation. Each age group also enjoyed the opportunity to begin practicing some of the skills with each other in the safety of the group. The opportunity to come back each week and discuss with the group leader and each other what had worked at home and what had not was also viewed as beneficial. There are many programs designed to teach parenting skills to parents; the FIA program is unique in its emphasis on teaching the same skills to parents and youth. Changing communication and discipline styles should be more effective when the entire family understands the process. As one girl graduate reported: "We have all learned how to communicate better and therefore we get along better."
It is very difficult to get families to make a commitment to parent education. This program was successful because of its focus on community involvement and ownership. As one Superintendent of schools stated: "Seeing school personnel, agency professionals, parents and children working together toward better communication and school/home relationships is gratifying." Schools were given a great deal of control in determining how the program would be staffed and when it would be offered. Community groups were informed about the rogram and asked to help support it. Store owners, teachers, and program graduates proudly wore FIA T-shirts in order to advertise the program and show their support. All the group leaders and childcare workers were hired from the community. Replication in another community might look somewhat different, because other communities may have different needs. What is important is to involve the community from the start in the planning and implementation of prevention programming.