Effectiveness of a Culturally Adapted Strengthening Families Program 12–16 Years for High-Risk Irish Families
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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.
To promote wide-scale implementation and positive outcomes in Ireland, a unique model of inter-agency collaboration was developed plus guidelines for cultural adaptation with fidelity.
250 high-risk youth and families were recruited to complete SFP and its parent questionnaire. A quasi-experimental 2 group pre- and post-test design was employed where the norms were the comparison group. A 2 × 2 analysis of variance (ANOVA) generated the outcome tables including p values and Cohen’s d effect sizes. Evaluation feedback was used to improve outcomes the next year.
All 21 measured outcomes had statistically significant positive results. Larger effect sizes were found for the Irish families than the USA families (d = 0.57 vs. 0.48 for youth outcomes, d = 0.73 vs. 0.65 for parenting and d = 0.76 vs. 0.70 for family outcomes). Overt and covert aggression, criminality and depression decreased more in Irish youth, but the USA youth improved more in social skills.
This study suggests that SFP 12–16 is quite effective in reducing behavioural health problems in Irish adolescents, improving family relationships and reducing substance abuse. Additionally, the Irish interagency collaboration model is a viable solution to recruitment, retention and staffing in rural communities where finding five skilled professionals to implement SFP can be difficult.
KeywordsFamily skills training Parenting Ireland Risk behaviours Prevention of delinquency and substance abuse Cultural adaptation
Conflict of interest
Karol Kumpfer, Ph.D, is an experimental and developmental psychologist, University of Utah full professor and the program developer of all of the SFP age versions. She was the Substance Abuse and Mental Health Services Administration (SAMHSA) Director of the Center for Substance Abuse Prevention in Washington, DC until 2000 and then CDC Coordinating Scientist evaluating evidence-based substance abuse approaches for the Centers for Disease Control and Prevention (CDC) Guide to Community Preventive Services until 2005. About half of the eight SFP RCTs were conducted on her federal National Institutes of Health (NIH) research grants. Two years ago the sales of all of the SFP CDs and the evaluations that supported her graduate students were transferred from the university to Lutra Group, Inc. Hence, she does have a potential conflict of interest now because her husband, Dr. Henry Whiteside, is president of Lutra Group. Also she conducts some of the training workshops and evaluations for Lutra Group including those for a few of the sites in Ireland. Robert O’Driscoll is an addiction counselor with the Irish Health Service Executive South Drug and Alcohol Services. He was the site coordinator on the pilot SFP program and is also an accredited SFP Ireland group leader trainer. He has been involved in a number of implementations and evaluations and has trained SFP group leaders across Ireland. He has also consulted with numerous implementers on how best to deliver SFP in marginalized communities where it is most needed. Jing Xie, M.S., is a doctoral student of Dr. Kumpfer’s who works for Lutra Group in the summer and entered most of the Ireland data and worked on writing the individual Ireland agency evaluation reports conducted annually. Keely Cofrin Allen, Ph.D. is an independent biostatistician and psychologist who directs the biostatistics division for the Utah State Department of Health. She maintains the SFP SPSS normative database and conducts most of the SFP data analyses including all of those for the Ireland agencies. She is responsible for the integrity of the data and the reported data analysis.
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