Announcement of a special issue of the Journal of Primary Prevention

Announcement of a special issue of the Journal of Primary Prevention     

Leadership and team effectiveness in community coalitions for the prevention of alcohol and other drug abuse

Comprehensive community coalitions or partnerships are increasinglybeing developed in this country to coordinate and expand alcoholand other drug (AOD) abuse prevention services. While case studyevidence suggests that some coalitions are effective, thereis very little theory development or empirical research on factorscontributing to successful coalitions. This paper presents atheoretical model of coalition team effectiveness hypothesizingthat an empowering style of leadership increases member satisfactionand perceptions of team efficacy which ultimately increasesteam effectiveness. This theoretical model was pilot testedin an exploratory study using preliminary, small sample data(N = 65) from the first year evaluation of an AOD preventioncoalition. The exploratory research strategy employed factoranalysis and multiple regression analysis to test the relationshipof coalition members' process data (i.e. perceptions of teamleader's style, team efficacy and member satisfaction) to outcomedata (i.e. team members' AOD knowledge and use and team effectivenessin developing fundable plans). The results supported the proposedmodel and suggest that further model testing employing largersamples, more diverse community teams, and more sophisticateddata analyses (structural equation modeling or path analysis)could lead to information useful in training team leaders anddeveloping more effective coalitions.     

Determining the efficacy of a resiliency training approach in adults with type 2 diabetes

PURPOSE: The purpose of this randomized clinical study was to test the efficacy of a resiliency training approach for people with diabetes who have previously received standard diabetes self-education. METHODS: A single-blinded, randomized design was employed with repeated measures (baseline, 3 months, 6 months) with 67 participants assigned to either treatment as usual (n = 37) or the resiliency classes (n = 30). Outcome variables included physiological measures (glycosylated hemoglobin, waist measurement, eating and exercise habits) and psychosocial measures (self-efficacy, locus of control, social support, and purpose in life). RESULTS: Analyses of variance indicated that the intervention group had higher levels of resiliency as reported by knowing positive ways of coping with diabetes-related stress, knowing enough about themselves to make right diabetes choices, having fun in life, eating healthier, and increasing physical activity compared with the control group at 3 months (P < .05). Glycosylated hemoglobin and waist measurement improved but not significantly. CONCLUSIONS: Interventions to foster resilience among people with diabetes have the potential to make an important contribution to increasing positive life outcomes. Diabetes educators using the resiliency approach in tandem with standard diabetes education programs can assist their patients to become more self-directed in their diabetes care.     

A Wakeup Call to the Prevention Field: Are Prevention Programs for Substance Use Effective for Girls?

Substance misuse in adolescent girls has increased dramatically since 1992. This article reviews trends in use rates and etiological theories tested by gender that suggest that family protective factors have more influence on girls. Next, a literature review reveals that few prevention programs have published their outcomes by gender or developed gender-specific programs. Nationwide community coalition results found positive effects on boys but increased drug use in young girls. The most effective programs are family focused targeting family bonding, supervision, and communication. Recent gender-specific prevention programs with positive results address stress, depression, social assertiveness, and body image. The authors recommend additional research testing programs by gender and also gender-specific versus generic versions of evidence-based programs to determine how to improve prevention program effectiveness for girls.     

Cultural Sensitivity and Adaptation in Family-Based Prevention Interventions

Because of the substantial impact of families on the developmental trajectories of children, family interventions should be a critical ingredient in comprehensive prevention programs. Very few family interventions have been adapted to be culturally sensitive for different ethnic groups. This paper examines the research literature on whether culturally adapting family interventions improves retention and outcome effectiveness. Because of limited research on the topic, the prevention research field is divided on the issue. Factors to consider for cultural adaptations of family-focused prevention are presented. Five research studies testing the effectiveness of the generic version of the Strengthening Families Program (SFP) compared to culturally-adapted versions for African Americans, Hispanic, Asian/Pacific Islander, and American Indian families suggest that cultural adaptations made by practitioners that reduce dosage or eliminate critical core content can increase retention by up to 40%, but reduce positive outcomes. Recommendations include the need for additional research on culturally-sensitive family interventions.     

Announcement of a special issue of The Journal of Primary Prevention

Announcement of a special issue of The Journal of Primary Prevention     

Effectiveness of a Culturally Adapted Strengthening Families Program 12–16?Years for High-Risk Irish Families

Background  

Evidence-based programs (EBPs) targeting effective family skills are the most cost effective for improving adolescent behavioural health. Cochrane Reviews have found the Strengthening Families Program (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaptation processes resulted in successful outcomes in several countries.     

The Strengthening Washington D.C. Families Project: A Randomized Effectiveness Trial of Family-Based Prevention

The Strengthening Washington DC Families Project (SWFP) examined implementation fidelity and effectiveness when a selective, evidence-based prevention program was implemented with a sample of 715 predominantly African American families across multiple settings in an urban area. Using a true experimental design, this study reports on the differential effectiveness of four conditions (child skills training only, parent skills training only, parent and child skills training plus family skills training, and minimal treatment controls) in reducing child antisocial behavior and its precursors. Major challenges with recruitment and retention of participants and uneven program coverage were documented. No statistically significant positive effects for any of the program conditions were observed, and a statistically significant negative effect on child reports of Negative Peer Associations was observed for children of families assigned to the family skills training condition. Two marginally significant findings were observed: Child's positive adjustment favored families assigned to family skills training condition relative to minimal treatment and child training only, and family supervision and bonding was lower for children in family skills training than in the other three conditions. Hypotheses about potential explanations for the weaker than expected effects of this program are offered, as are thoughts about the infrastructure necessary to successfully implement family strengthening programs and the future of prevention science.     

Parenting skills and family support programs for drug-abusing mothers

Children born to drug-using mothers can suffer from fetal alcohol or drug syndrome (FAS/FDS) or fetal alcohol or drug effect (FAE/FDE). Such children have a greater likelihood of developing acute or chronic physical, cognitive and behavioral problems. In-utero exposure to tobacco, alcohol or drugs impact on the developing fetus and, after birth, the family environment and family system exert effects on the infants and children of substance-abusing parents. Evidence-based prevention and maternal drug treatment programs focus on enhancing parental childcaring abilities, supporting parent-child attachment and encouraging family support systems to improve children's health and cognitive outcomes. FAS/FDS prevention programs, as well as selective and indicated prenatal and postnatal interventions, can improve the support given both to mother and to child, and evidence-based, in-home parenting and family-skills-training approaches are particularly useful.