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Strengthening Families Programme 10-14

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Evidence rating: 3+
Cost rating: 1

Strengthening Families Programme 10–14 is a parenting and family strengthening programme for families with children aged between 10 and 14. It can be implemented as a universal programme or targeted at high-risk adolescents.

Strengthening Families Programme 10–14 is based on the biopsychosocial model and other empirically based family risk and protective factor models. As such, the programme targets the enhancements of family protective processes and aims to reduce family risk. 

The programme consists of seven weekly sessions lasting two hours each. During the programme, families learn how to communicate effectively as well as specific skills such as parental limit setting and child resistance to peer pressure.

EIF Programme Assessment

Evidence rating: 3+
Level 3 indicates evidence of efficacy. This means the programme can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome. This programme does not receive a rating of 4 as it has not yet replicated its results in another rigorously conducted study, where at least one study indicates long-term impacts, and at least one uses measures independent of study participants.
Cost rating: 1
A rating of 1 indicates that a programme has a low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of less than €125. This figure is based on an analysis of UK costs and a conversion rate of 1.19.

What does the plus mean?

The plus rating indicates that this programme has evidence from at least one level 3 study, along with evidence from other studies rated 2 or better.

Child outcomes

This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Supporting children's mental health and wellbeing

Reduced rate of increase in internalising symptoms

based on study 1d

  • Statement: Improvement on the Anxiety-Depression index from the Child Behaviour Checklist (self-report)
  • Score: 0
  • Timeframe: Between 1 and 6 years later
  • Long term: 1

Preventing risky sexual behaviour & teen pregnancy

Reduced substance use during sex

based on study 1e

  • Statement: 5.6-percentage point reduction in proportion of participants who have used substances during sex (measured using a self-report measure)
  • Score: 2
  • Timeframe: 10 years later
  • Long term: 1

Reduced number of sexual partners in past year

based on study 1e

  • Statement: 7.3-percentage point reduction in proportion of participants who have had more than one sexual partner in the past year (measured using a self-report measure)
  • Score: 1
  • Timeframe: 10 years later
  • Long term: 1

Reduced sexually transmitted diseases

based on study 1e

  • Statement: 2.5-percentage point reduction in proportion of participants who have had sexually transmitted diseases (measured using a self-report measure)
  • Score: 15
  • Timeframe: 10 years later
  • Long term: 1

Enhancing school achievement & employment

Improved academic success

based on study 1c

  • Statement: Improvement on a 9-point scale of grades received at school (child and parent report)
  • Score: 0
  • Timeframe: 6 years later
  • Long term: 1

Preventing crime, violence and antisocial behaviour

Reduced aggression and hostility

based on study 1b

  • Statement: 0.48-point improvement on the Observer Index of Aggressive and Hostile Behavior (consists of subscales from the Iowa Family Interaction Rating Scales - expert observation of behaviour)
  • Score: 13
  • Timeframe: 4 years later
  • Long term: 1

Reduced aggressive and destructive conduct

based on study 1b

  • Statement: 0.22-point improvement on the Adolescent Report of Aggressive and Hostile Behaviours in Interactions (self-report)
  • Score: 14
  • Timeframe: 4 years later
  • Long term: 1

Preventing substance abuse

Reduced alcohol initiation

based on study 1a

  • Statement: 0.23-point improvement on the alcohol initiation index (self-report)
  • Score: 10
  • Timeframe: A year later
  • Long term: 1

based on study 1a

  • Statement: 0.65-point improvement on the alcohol initiation index (self-report)
  • Score: 15
  • Timeframe: 2 years later
  • Long term: 1

Reduced monthly polysubstance use

based on study 1d

  • Statement: Improvement on a polysubstance use scale of past month use of alcohol, cigarettes, and other substances
  • Score: 0
  • Timeframe: Between 1 and 6 years later
  • Long term: 1

This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Who is it for?

The best available evidence for this programme relates to the following age-groups:

Preadolescents Adolescents

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Secondary school
  • Community centre
  • Out-patient health setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Universal

Where has it been implemented?

  • Argentina
  • Bolivia
  • Brazil
  • Canada
  • Chile
  • Colombia
  • Costa Rica
  • Dominican Republic
  • Ecuador
  • El Salvador
  • Guatemala
  • Honduras
  • Mexico
  • Nicaragua
  • Panama
  • Paraguay
  • Peru
  • South Africa
  • United Kingdom
  • United States

Ireland provision

This programme has not been implemented in Ireland.

Ireland evaluation

This programme’s best evidence does not include evaluation conducted in Ireland.

About the programme

What happens during the delivery?

How is it delivered?

Strengthening Families Programme 10–14 is delivered by three trained facilitators (one lead practitioner and two co-practitioners) to family groups of between eight and 12 families. The programme consists of seven weekly sessions lasting two hours each.


What happens during the intervention?

  • During the first hour, the parents and children attend separate sessions on a related family skill (e.g. family communication or peer-refusal skills for substance misuse).
  • These sessions make use of an instructional video that provides the basis for a group discussion and practice activities.
  • During the second hour, the parents and children are reunited to review and practise skills and competencies together.

What are the implementation requirements?

Who can deliver it?

  • The facilitators who deliver this programme are a lead facilitator with NFQ-6 level qualifications and two co-facilitators with NFQ-5 level qualifications.


What are the training requirements?

Three days' training by certified master trainers is required. Booster training of practitioners is recommended.


How are the practitioners supervised?

  • It is recommended that facilitators are supervised by one host-agency supervisor (qualified to NFQ-6 level), who is also a certified facilitator.


What are the systems for maintaining fidelity?

  • A certification training where the research is presented, activities are modeled, and practice sessions are encouraged.
  • A comprehensive manual with detailed lesson plans.
  • Fidelity observations throughout the seven weeks of programming.

Is there a licensing requirement?

There is no licence required to run this programme.


How does it work? (Theory of Change)

How does it work?

  • Young people’s behavioural problems and substance misuse is linked to risk and protective factors within the family system. Key risks include poor family communication and ineffective parenting strategies. Key protective processes include improved family problem solving skills and strengthened family bonds.
  • Parents and young people learn strategies for identifying and reducing the risks within their family system, while at the same time increasing the protective factors. These strategies include more effective parenting practices (including limit setting) and communication.
  • In the short term, parenting practices, family communication and young people’s attitudes improve.
  • In the longer term, young people are less likely to be involved in substance misuse or antisocial behaviour and are more likely to do better in school.

Intended outcomes

  • Achieving in all areas of learning and development
  • Active and healthy, physical and mental wellbeing
  • Active and healthy, physical and mental wellbeing
  • Active and healthy, physical and mental wellbeing
  • Safe and protected from harm

Contact details

Cathy Hockaday
Strengthening Families 10-14
hockaday@iastate.edu

www.extension.iastate.edu/sfp10-14


About the evidence

The most rigorous evidence for Strengthening Families Programme 10–14 is from an RCT which was conducted in the United States. This is a rigorously conducted (level 3) study, which has identified a statistically significant positive impact on a number of child outcomes. A programme receives the same rating as its most robust study, and so this programme receives a level 3 overall.

Study 1a

Citation:Spoth et al. (1999)
Design:RCT
Country:United States
Sample:446 families of children in 6th grade (average age 11 years) at baseline
Timing:1 year follow-up and 2 year follow-up
Child outcomes:
    Other outcomes:
      Study rating:3

      Spoth, R., Redmond, C. & Lepper, H. (1999). Alcohol initiation outcomes of universal family-focused preventive interventions: One- and two-year follow-ups of a controlled study. Journal of Studies on Alcohol, 13, 103-111

      Study design and sample

      This study is a rigorously conducted RCT, involving random assignment of 22 schools to the Iowa Strengthening Families Program (ISFP) (11 schools), a rural population application of the Strengthening Families Program, or a minimal contact control condition (11 schools). 11 additional schools were assigned to a second intervention condition, which is not described in detail here.  Stratified randomisation was used to ensure balance across the groups on school size and the proportion of lower income students. 

      This study was conducted in the USA, with a sample of 446 families of 6-graders. The average age of the young people in the sample was 11.3 years. Among ISFP and control group families who completed the pretest, there was an average of 3.1 children and in just over half of the families (52%), the target child was a girl. Representative of the study region, 86% of the families were dual-parent families. Nearly all study parents completed high school (98% of mothers and 95% of fathers), and more than half (54% of mothers and 49% of fathers) reported some post-high-school education. Average ages of study parents were 37.2 years for mothers and 39.4 years for fathers; nearly all (98%) were white.

      Measures

      • The likelihood that the young adolescent would refuse a peer alcohol offer, and general resistance to peer pressure, were measured at post-test and 1.5 years follow-up using the Young Adolescent Substance Refusal and Substance Resistance Measure (parent report and child self-report). 
      • Parenting behaviours directly targeted by the intervention were measured at post-test and 1.5 years follow-up using the intervention targeted parenting behaviors measure (parent-report).
      • Alcohol initiation was measured at 1 and 2 year follow up using self-reported frequencies of alcohol use behaviours. The sum of these were used to create the Alcohol Initiation Index (child self-report). 

      Findings

      This study identified statistically significant positive impact on a number of child outcomes. This includes lower Alcohol Initiation Index scores at both 1 and 2 year follow-up.

      Note: Findings listed in this ‘About the evidence' section are based on measures judged to be valid and reliable. We have included a number of findings from across the follow-up time period, reflecting a range of outcome areas.

      Study 1b

      Citation:Spoth et al. (2000)
      Design:RCT
      Country:United States
      Sample:446 families of children in 6th grade at baseline
      Timing:4 year follow-up
      Child outcomes:
        Other outcomes:
          Study rating:3

          Spoth, R. L., Redmond, C., & Shin, C. (2000). Reducing adolescents' aggressive and hostile behaviors. Archives of Pediatric and Adolescent Medicine, 154, 1248-1257

          Spoth et al., 2000 describe additional outcomes from study 1a above. In this case, several outcomes were measured, including:

          • At 4-year follow up, aggressive and hostile behaviour was measured using the Observer Index of Aggressive and Hostile behavior, which consists of subscales from the Iowa Family Interaction Rating Scales (expert observation of behaviour).
          • At 4-year follow up, adolescent aggressive and hostile behaviours in parent-adolescent interactions were measured using the parent-adolescent report of aggressive and hostile behaviours, based on the self-report portion of the Iowa Youth and Family Rating Scales on Perceptions of Hostility/Warmth (parent-report and child self-report).

          This study identified statistically significant positive impact on a number of child outcomes. This includes reduced aggression and hostility and reduced aggressive and destructive conduct.

          Study 1c

          Citation:Spoth et al. (2008)
          Design:RCT
          Country:United States
          Sample:446 families of children in 6th grade at baseline
          Timing:6-year follow-up
          Child outcomes:
            Other outcomes:
              Study rating:3

              Spoth, R., Randall, G. K., & Shin, C. (2008). Increasing school success through partnership-based family competency training: Experimental study of long-term outcomes. School Psychology Quarterly, 23(1), 70.

              Spoth et al., 2008 describe additional outcomes from study 1a above. In this case, several outcomes were measured, including:

              • At 6-year follow up, academic success was measured by asking mother, father and students to report which grades the student typically gets in school (parent report and child self-report).

              This study identified statistically significant positive impact on a child outcome. This was improved academic success.

              Study 1d

              Citation:Trudeau et al. (2007)
              Design:RCT
              Country:United States
              Sample:446 families of children in 6th grade at baseline
              Timing:1–6 year follow-up (change over time)
              Child outcomes:
                Other outcomes:
                  Study rating:3

                  Trudeau, L., Spoth, R., Randall, G. K., & Azevedo, K. (2007). Longitudinal effects of a universal family-focused intervention on growth patterns of adolescent internalizing symptoms and polysubstance use: Gender comparisons. Journal of Youth and Adolescence, 36, 725-740

                  Trudeau et al., 2007 describe additional outcomes from study 1a above.  In this case, several outcomes were measured, including:

                  • At 1–6 year follow-up (change over time), internalising symptoms were measured using the Anxiety- Depression Index from the Child Behavior Checklist—Youth Self Report (child self-report).
                  • At 1–6 year follow-up (change over time), poly-substance use was measured through self-report questions which were summed to create a scale from ‘‘0’’ (no past month use) to ‘‘6’’ (past month use of all substance categories) (child self-report).

                  This study identified statistically significant positive impact on a number of child outcomes.  This includes lower rate of increase across time on internalising symptoms and lower overall level and a lower rate of increase in monthly polysubstance.

                  Study 1e

                  Citation:Spoth et al. (2014)
                  Design:RCT
                  Country:United States
                  Sample:446 families of children in 6th grade at baseline
                  Timing:10 year follow-up
                  Child outcomes:
                    Other outcomes:
                      Study rating:3

                      Spoth, R., Clair, S., & Trudeau, L. (2014). Universal family-focused intervention with young adolescents: Effects on health-risking sexual behaviors and STDs among young adults. Prevention Science 15 (Supplement 1), S47-S58

                      Spoth et al., 2014 describe additional outcomes from study 1a above.  In this case, several outcomes were measured, including:

                      • At 10 year follow-up, health risking sexual behaviours were measured by asking young adults self-report questions relating to:
                        • Number of sexual partners in past year (young adult self-report)
                        • Condom use in past year (young adult self-report)
                        • Substance use and sex (young adult self-report)
                        • Lifetime sexually transmitted diseases (young adult self-report)

                      This study identified statistically significant positive impact on a number of child outcomes.  This includes reduced health-risking sexual behaviours (indirect effects) (lower rates of substance use during sex and lower past year number of partners) and lower lifetime sexually transmitted diseases.

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