Outcomes for African-American VS. non African

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Strengthening Families Program:
Outcomes for African-American VS. non AfricanAmerican Families
By Aliesha L. Shaw
Mentor: Dr. Karol Kumpfer
Introduction
Over the past 10 years research into risk and resilience has increased significantly as
well as interventions to improve resilience to negative unhealthy behaviors, such as substance
abuse, risky sex, violence, and poor nutrition. However, little has been explored when it comes
specifically to African-Americans. This purpose of this research study is to examine the level of
resilience in African-Americans compared to non-African Americans who are participating in
the first prevention program designed specifically to increase resilience to unhealthy behaviors—
namely the Strengthening Families Program (Kumpfer & Whiteside, 2005). The authors will
explore baseline differences in the risk and protective factors associated with African-American
resilience, particularly in regards to substance abuse as compared to other non-African
Americans. People of different races/cultures tend to be raised in different environments and
therefore may be exposed to different risk and protective factors. Depending on the environment
in which one was raised, certain protective factors may have been stressed more than others
while certain risks may have been more prevalent than others. Even if people of different
races/cultures are exposed to the same risk and protective factors, it still isn’t clear if these
factors affect African-Americans differently than non African-Americans.
Resilience is generally defined as an individual’s ability to overcome adversities and
adapt successfully to varying situations (Masten, Best, & Garmezy, 1991). Resilience is
cultivated through risk and protective factors, which are variables that shift developmental
pathways (Reis, Colbert, & Hebert, 2005). Risk factors are those that increase vulnerability
towards negative outcomes and protective factors are those that increase the chance of positive
outcomes.
Protective factors seen most commonly in highly resilient individuals include personal
characteristics (self-esteem, independence, sense of humor, knowing boundaries and
expectations, positive values, positive outlook on life) and support systems (family support, role
models, positive network of friends, school support systems). Also, Richardson & associates
(1990) found the most important protective characteristics to be purpose in life and
determination.
Risk factors are those that increase vulnerability toward negative outcomes. Common
influential factors that increase risk include the lack of positive social networks, inconsistent role
models, and inconsistent values. Risk factors commonly associated with drug use among youth
have been found by Kumpfer & Bluth (2004) to include parental/sibling drug use, poor child
rearing, ineffective supervision of the child, ineffective discipline skills, negative parent/child
relationships, negative family environment, and family disorganization. An association with drug
using peers has been found to be the most predictive risk factor for drug use (Ary, Duncan,
Biglan, Metzler, Noell, & Smolkowski, 1999).
The goal of this study is to determine which factors increase African-Americans
vulnerability to destructive behaviors and which factors allow some African-American families
to become resilient and overcome adversity. Studies such as this are important because so little
is known about whether the predictors of deviant behavior, mainly observed in Euro-American
samples, predict in the same or different ways among African-American adolescents (Barnes,
Farrell, & Banerjee, 1994). Therefore, prevention efforts aimed at African-American youths have
had to assume that the risk factors associated with the general Euro-American population are also
relevant for African-American youths (Gillmore & associates, 1990).
Affirming cultural patterns derived from common heritages or experiences have proven
to protect some individuals against adversity (Fraser & Richman, 1999). These common cultural
patterns are generally referred to as racial identity. Past research suggests that racial identity &
socialization can serve as culturally unique protective factors in African-Americans, which have
been found to protect them against adverse environmental circumstances (Miller & MacIntosh,
1999). Brody and his associates (2004) found that the most effective approach to racial
socialization involves teaching about the realities of racial oppression while emphasizing the
possibility of achieving success in the face of these obstacles.
Because African-Americans are in the minority in this country they may learn that in
order to reach success in the mainstream they must include a degree of adherence to its values
and beliefs (Miller, & MacIntosh, 1999). At the same time, he or she must develop a sense of self
and connection within the African-American community. Due to this realization of having to live
in two different worlds, African-Americans may develop a skill of adaptability, which may serve
as a protective factor.
When examining resilience in African-Americans, special attention should be directed
towards the family unit, including extended family. The African-American family network is
characterized by diverse extended family structures involving blood-kin and non blood-kin
members (Wilson & Tolson, 1990). In the United States, the development of the extended family
can be traced from the time of slavery. The enslavement of Africans for labor led to the
disorganization of the family unit and created a situation in which children were often separated
from biological parents (Dodson, 1983). This separation required that children belonged to and
were the responsibility of the collective community (Martin & Martin, 1983).
Social scientists have long stressed the superiority of the traditional nuclear family unit in
a way that discounts the more complex extended family networks that are common in minority
families (Lyles & Carter, 1982). Contrary to popular belief, African-Americans may benefit
more from the presence of an extended family unit than from a traditional nuclear family.
The presence of an extended family network plays a significant role in protecting against the use
of drugs and other deviant behaviors in the African-American community by providing a
supportive social network.
Ford (1994) found that African-American youth that demonstrate resilience have an
internal locus of control, a positive sense of self, and feelings of empowerment. Ford also
identified resilient barriers including peer pressures and socio-psychological and contextual
factors such as racial identity, relationships with teachers and counselors, experiences of
discrimination, and peer relationships. When comparing coping strategies used by African
American and Euro-Americans, significant differences emerge. Chapman & Mullis (2000) found
that in contrast to their Caucasian peers, African Americans were more likely to utilize peer
networks, self-reliance, and spiritual supports.
Data collected from families participating in the Strengthening Families Program (SFP)
from many agencies nationwide will be analyzed in order to determine if there are differences in
the level of improvement from the pre-test to the post-test between African-American families
and non African-American families who participated in the Strengthening Families Program. In
addition, African-American families will be compared with non African-American families to
determine if there are any variations with regards to risk and protective factors measured at the
baseline.
The Strengthening Families Program, developed in 1982 by Dr. Karol Kumpfer and Dr.
Joseph DeMarsh, is a family skills training program designed to increase family resilience and
strength through the development of effective communication and conflict resolution skills. SFP
has been replicated and tested by independent researchers to include culturally adapted versions
of the program geared specifically towards both rural and urban African-American families
(Aktan, Kumpfer, & Turner, 1996). An additional goal of this study is to determine if the
positive results found in this more controlled research studies can be replicated when SFP is
implemented by community agencies without the strict controls on fidelity and quality of the
SFP delivery by the group leaders. In other words, how effective is the program when it is being
implemented as a health services program in the community rather than as a research study. It is
also possible that the results will be more impressive because the program is not being
implemented with real families by real practitioners who know their families and communities.
Although the implementations of these culturally adapted programs are very beneficial to the
African-American community, further research needs to be done to examine why some AfricanAmerican families are in such a need of these programs while others are not.
Theoretical Basis for Family Intervention
The theoretical basis for the content of the Strengthening Families Program and the
selection of the hypothesized outcome variables is the Social Ecology Model of Adolescent
Substance Abuse (CSAP, 2000; Kumpfer, Alvarado, & Whiteside, 2003). This theory of the
primary causes of drug abuse has been tested with two major databases, one data set including
about 1,800 high school students in Utah (Kumpfer & Turner, 1990/1991) and one national data
set including 8,500 high risk ethnic youth (CSAP, 2000 do I cite this?). The hypothesized causal
models were tested using LISREL software to produce competing structural equation models
(SEM) of a hypothesized etiological model of risk and protective factors within major areas of
family, school, peer and individual antecedents of drug use. The model integrates demographic
risk factors (ethnicity, age, gender, socioeconomic status, population density), psychosocial
environment (low risk communities), and biological factors (vulnerability to drug abuse, genetic
predisposition).
The Social Ecology Model predicts that programs centering the attention on adolescents
should address more than just peer relations. The SEM suggests that prevention approaches
should include interventions effective in improving family and school climate in youth, which
affects youth’s self-efficacy, school bonding and peer relations (Kumpfer & Turner, 1991). This
model combines risk and protective factors rather than risk factors only, to produce resiliency in
youth. It also pertains to drug use in general, both legal and illegal. By focusing on increasing
family cohesion, positive parental skills and positive social skills, youth will develop
conventional bonds choosing isolation from antisocial peer who pressures the youth’s use of
drugs. Whether youth choose positive or negative peers is influenced directly by the self-esteem,
or self-efficacy and school bonding (Kumpfer & Turner, 1991). In other words, school climate
and family climate, although being indirectly related to peers effects, predict increased
vulnerability to negative peers. “Youth are more likely to choose pro-social peers if they are
bonded to pro-social parents and they are involved in a pro-social school” (Kumpfer & Turner,
1991. p. 456). According to Kumpfer, Alvarado, Whiteside, (2003) whose study opens up the
SEM, by testing approximately 8500 children, suggests that the protective factors: parental
attitudes or family values, family and school bonding and community and neighborhood
environment influence youth in choosing their peers (parental attitude or family values
influences impact more in girls, and family and school bonding impacts in girls performance at
school. community and neighborhood environment has a greater influence in boys). These
factors are also highly influential in the impact peers have in youth and the youth decision of
drug use (Kumpfer, Alvarado, Whiteside, 2003). See Figure 1
Figure 1: Pathways to Substance Use: Gender Effects
The Strengthening Families Program also seeks to enhance resilience in parents, children,
and the family system as well. The Resilience Framework model (Kumpfer, 1999) is a
presumption specific to the resilience process. It corresponds to analyze the influences of the
child’s personal strengths, family dynamics and community context all together in one
model. According to the Resilience Framework model “Developmental trajectories can be
changed by active individual choices in which the child or advocates can help a child to
change environments. In this way a limited type of “free will” can occur within our
stimulus/response, deterministic world view” (p.5). This theory organizes the child’s
resilience characteristics into five major types of strengths: spiritual, cognitive, social,
emotional, and physical. Parents or caretakers should use processes of modeling, coaching,
teaching, advising, supporting, reinforcing, advocating, providing opportunities and
nurturance, and encouraging the attempt of reasonable challenges to increase children’s
resiliency strengths mentioned before (Kumpfer, 1999)
As for family dynamics, parental motivations these being direct or indirect can create
considerable impact in the child’s life. Children require balance in their lives, parental
overprotection is a threat to resiliency since children need to be exposed to risky environments
and learn to deal with diverse types of circumstances. As is discuss in the Resilience Process
Model (Richardson & associates, 1990), resiliency can only begin when there is a negative
disruption of the balance of an individual, it is assumed that when there is a failure, one learns
from the circumstances building strengths to not fail again with similar situations.
Theory of SFP Intervention
The intervention activities to improve parenting, family relationships, and children’s
behavioral and emotional outcomes, are based on cognitive behavioral therapy or skills training
methods (Bandura, 2000). SFP rationale is to teach and engage the youth, parent and family
with positive skills to be resilient to negative influences towards the youth’s drug use (Kumpfer
& DeMarsh, 1985). Currently there exists a division of theories that are based on social learning
principles and place an emphasis on cognitive variables. The Social Cognitive Theory (Bandura,
1989) states that there is an intermediary (human cognition) between stimulus and response,
placing individual control above conduct responses to an incentive. Hence, Bandura's SCT
places a heavy focus on cognitive concepts. His theory focuses on how children and adults
operate cognitively on their social experiences and how these cognitions then influence behavior
and development. SFP utilizes this theory when working with parents and children to learn skills
to persuade a change in their behavior to promote a positive health outcome.
Among the Social Cognitive processes most used in SFP is modeling and self efficacy.
Children can often be seen modeling their parents. Children will imitate adults and then
generalize. They will usually model a person of high status as opposed to a person of low status.
SFP involves the modeling process via facilitation of groups of parents and children, instructing
them with effective skills to promote positive parenting, problem solving, socialization,
communication and other positive components of a resilient family. SFP desires family
involvement in the youth’s life to strength positive environments thus youth can make the right
choices in situations when peer pressure is an issue.
Another important point in Bandura's theory is self-efficacy (Bandura, 1997); the idea
that people can or cannot perform the necessary behavior to change their environment. People
with high self-efficacy believe they have the ability to change their environment to effect a
change they desire. People with low self-efficacy believe that they are incapable of changing
their environment. The belief in one's self can boost the chances of achieving change. Selfefficacy is acquired and changed through four sources: 1) skills, 2) vicarious experiences, 3)
verbal persuasion, and 4) physiological stimulation (Bandura, 1997). There is a growing body of
evidence that human attainments and positive well-being require an optimistic sense of personal
efficacy (Bandura, 1989). This is because ordinary social realities are strewn with difficulties.
They are full of impediments, failures, adversities, setbacks, frustrations, and inequities. People
must have a robust sense of personal efficacy to sustain the perseverant effort needed to succeed
(Bandura, 1997).
The Strengthening Families Program Description.
SFP is unique as a prevention program because it includes three major components:
1) Children’s Social Skills and Resilience Building Program,
2) Parenting Skills Training Class, and
3) Family Relationship Enhancement Class.
In the first hour the parents and children meet separately in their groups, and in the second hour
they meet together in two multi-family practice sessions. The family sessions are preceded by a family
meal, and childcare for younger children (often contracted to native elders), transportation (by native
contractors), and graduation incentives ($50 in educational and food benefits) are provided to increase
recruitment and retentions of families, which averages about 70% to 85% or higher with mandated
parents. Cultural adaptations have been found to increase program recruitment and completion by 40%
(Kumpfer, Alvarado, Smith, & Bellamy, 2002).
The Strengthening Families Components.
The 14-session Strengthening Families Program includes three major components:
1. The Parent Training (PT) includes group building, teaching parents how to increase resilience
through dreams and goals in their youth, supportive communication, getting desired behaviors through
the use of humor and by increasing attention and reinforcements for wanted behavior and using
behavioral goal statements, differential attention, chore charts and spinners (pie charts with sections
representing rewards mutually decided upon that children may get if they complete all chores and a
spun arrow lands on it), and through communication training, problem solving, compliance requests,
principles of limit setting (time outs, punishment, over correction), generalization and maintenance, and
implementation of behavior programs for their children.
2. The Children’s Skills Training Program (CT) includes a rationale for the program,
communication of group rules, understanding feelings, social skills of attending, communicating and
ignoring, good behavior, problem solving, communication rules and practice, resisting peer pressure,
compliance with parental rules, understanding and handling emotions, sharing feelings and dealing
with criticism, handling anger, and resources for help and review. Only the 3 to 5 years attend this
program and the exercises are based on age-adaptations of SFP and Head Start materials.
3. The Family Skills Training (FT) provides additional information and a time for the families to
practice (with facilitator support and feedback) their skills in the Child’s Game (Forehand &
McMahon, 1981). Child’s Game is similar to a structured play therapy session with parents trained to
interact with their children in a non-punitive, non-controlling, and positive ways. By practicing Child’s
Game at the beginning of all 14 sessions and rewards for completion of Child’s Game at home, parents
develop home routines to increase therapeutic parent/child play. This play activity has been found to
reduce reactive attachment disorder (RAD) and improve parent/child bonding and attachment
(Erickson & Egeland, 1996), particularly if a parent, often a father, has been gone (working in the city,
military duty, jail or prison). Because father absence is common in Indian families, SFP Child’s Game
component is very important in meeting the objectives of improving father’s involvement in their
children’s lives and education.
Research has shown that there are processes which can increase resilience. According to
the Resilience Framework developed by Kumpfer (1999), parents can improve their children’s
resiliency characteristics by increasing their support in five areas: spiritual/motivation, cognitive,
behavioral, emotional, and physical. Also, Masten (1994) suggests parents can help increase their
children’s resilience by reducing environmental risk and vulnerability, reducing stressors and
pileup, increasing available resources, and mobilizing protective processes.
Research Questions
1) Do statistically significant differences exist within risk and protective factors between
African-American and non African-American families as measured by pre-test differences?
In other words, does race/ethnicity affect risk and protective factors and resilience?
2) Are there differences in the amount of improvement gained through participation in the
Strengthening Families Program between African-American families and non AfricanAmerican families?
Methods
Study Design. This secondary data analysis study will use a 2 x 2 quasi-experimental
design (2 ethnicities x 2 measures), namely a Post-hoc Statistical Design (Campbell & Stanley,
1979) to compare the pre-test to posttest change scores for two groups—African-American and
non African-American families in the same classes. The 364 participants will be assigned to
groups depending on their ethnicity.
Participant Characteristics. Subjects participating in this research consist primarily of
African-American (59%) single mother (49%) families recruited nationally from families who
completed the 14-session Strengthening Families Program from 77 agencies in New Jersey,
Virginia, New Mexico, Indiana, Maryland, Utah, and Washington. Participating families
reported a mean combined family annual income of $12,479.
The participants of the SFP program are anyone who is considered family to the target
child. Participants choose to enter the program freely. At the final session (session 14), the
facilitators obtain consent from the subjects to participate in the evaluation of the program. Once
the consent is accomplished, the evaluation forms are distributed to the parent/caregiver who is
interested in putting their input of program success in their family.
Families were recruited using newspaper ads, letters from schools, and posters in
apartment buildings, booths at the mall, presentations, newsletters, and word-of-mouth. All the
project staff was new and hired part-time or on contract just to implement the grant. Half-time
site coordinators were hired by the agencies to supervise the hourly contracted group leaders,
recruit the families, and implement the program.
Data Collection Methods. The 77 participating agencies were chosen from the SFP
National Database particularly by the ethnic group the subjects belong to. Since the base of the
research commits to evaluate outcomes for African-American families vs. other ethnic groups, a
site is qualified to participate in this study when at least one African-American family is
participating in the program implementation, this is, and that within a SFP family class there
must be African-American participants.
Power. Needs power or sample size is difficult to determine because it depends on
retention, program effect sizes by variable, and variance in the data, plus alpha reliability of the
outcome measures. We use proven SFP standardized instrument based on federally-approved
OMB Core Measures, which we have used successfully in prior studies. Prior studies in the
community using these measures have found that significant pre-test to post-test differences
range in effect size from moderate (d= 20) to very large (d >41). Hence we expect to have
relatively strong effect sizes for the outcome variables and should be able to detect statistically
significant changes with as few as 25 to 30 families. Hence, having 364 families should be
sufficient to detect moderate effect sizes in changes from pre-to post-test.
Instrument of Evaluation. This study utilized directly the Strengthening Families
Program (SFP) parent retrospective pre-test and post-test evaluation survey collected from 77
participating agencies in the nation. This standardized SFP Parent Interview Questionnaire
contains 195 self-report items, including a number of scales taken from standardized outcome
evaluation instruments and clinical diagnostic instruments. A retrospective pre-test done at posttest is being used in the national practice sites to reduce fear of research and “instrument”
calibration bias that occurs with lack of trust or knowledge of concepts being asked at the time of
pre-tests. In addition, no names or code numbers are needed as all the data is on one test form.
Parents are not immediately asked to disclose confidential parenting information on a regular
pre-test. After they trust the group leaders they are asked to participate in the research and
complete the testing at the post-test on Session 14. Use of the retrospective measure has been
found in parenting programs to increase validity of the outcomes. This measurement instrument
has been found to have high reliability and validity in prior studies.
To reduce testing burden, only sub-scales of selected Core Measures instruments were
used for evaluation. They match the hypothesized dependent variables and were used in the
construction of the testing batteries. Each of the program goals and objectives as listed above are
matched to the standardized testing scale or measure in the Table below:
Table 1. Outcome Variables & Measures
SFP Outcome Variables
Measures
Parent Immediate Change Objectives
1. Increase in positive parenting
2. Increase in parenting skills
3. Increase parental supervision
4. Increase parental efficacy
5. Increase in parental involvement
6. Decrease in substance use or misuse
1. Alabama Parenting Scale
2. SFP parenting skills
3. Alabama supervision
4. Alabama Parenting Scale
5. Alabama Parenting Scale
6. CSAP30-day use rates
Child Change Objectives
1. Increase in life and social skills
2. Improved grades
3. Reduced overt aggression
4. Reduced covert aggression
5. Reduced concentration problems (ADD)
6. reduced conduct disorders
7. Reduced hyperactivity
8. Reduced shyness
9. reduced depression
1. Gresham & Elliot Social Skills
2. Parent report
3. Kellam POCA scale
4. Kellam POCA scale
5. Kellam POCA scale
6. Kellam POCA scale
7. Kellam POCA scale
8. Kellam POCA scale
9. Kellam POCA scale
Family Change Objectives
1. Increase positive parent/child relationship
2. Reduce family conflict
3. Increase family organization and order
4. Increase family communication skills
5. Increase family strengths and resilience
1. Moos FES cohesion
2. FES family conflict
3. FES family organization
4. FES communication
5. Family Strengths
(Kumpfer & Dunst, 1997)
Description of Standardized Measures: The Family Strengths and Resilience
Assessment (12-items) is a brief 5-point checklist created by Karol Kumpfer and Carl Dunst for
the American Humane Association to improve measurement of outcomes in child abuse and
neglect cases. We have found this global scale to be very change sensitive and a good outcome
measure of positive changes in the family’s situation.
The parent alcohol and illicit drug use including age of first use and 30-day substance use
rates for tobacco, alcohol, marijuana, binge drinking, and other illicit drugs was measured using
the CSAP/GPRA drug use measures from the Monitoring the Future (Johnston, O’Malley, and
Bachman, 1998) and the National Household Survey (SAMHSA/OAS, 2000).
The risk and protective factor precursors of substance abuse include negative child
behaviors and lack of effective discipline methods. The negative child behaviors such as
children’s aggression, conduct disorders, and children’s depression is measured by the Kellam
Parent Observation of Children’s Activities (POCA), which is a modification of the Achenbach
and Edelbrock (1988) Child Behavior Checklist (CBCL). The POCA has a five-point scale and is
more change sensitive than the CBCL and the wording is simpler for low education families.
The children’s social and life skills will be measured by selected items from the Gresham
and Elliot Social Skills Scale (1990). The parent’s parenting efficacy and skills was measured by
the 10-item Kumpfer Parenting Skills. The family conflict, organization, communication and
cohesion are measured by (Moos Family Environment Scales, Moos, 1974).
Study Procedures: Because this research involves human data, the investigators
submitted a request for approval of the study to the IRB committee. Since the data already
existed (secondary data) this project was granted an IRB exemption. The data to be collected
refers specifically to the retrospective pre-post test questionnaire filled out by the
parent/caregiver who attended to a minimum of 70% length of the program. Most of the data
included in this project exists in a national SFP database of “de-classified” family data
maintained by Dr. Kumpfer (program developer), for SFP evaluation purposes.
The instrument is type survey and asks only for first name and initial of last name, this to
correlate other surveys asks to fill out such as the satisfaction survey. No data is gathered on
anyone who has not given his or her consent. The parent/caregiver only completes the evaluation
survey focusing on the target child previously identified. Only participants who were involved in
the program participated filling out the surveys. The data collected by the site included only SFP
parent-evaluation surveys, of families with a 6 to 11year old child who is high-risk for substance
use.
Data has been sent to the SFP National Database for about two years by community
agencies wanting their data analyzed for a program evaluation. Once the data was obtained from
the different sites, each was counted and coded by site to allow to organization and follow up of
the surveys and to protect subject’s identity. These non-identified data were entered into a SPSS
national spreadsheet kept in the computer system at SFP office including all the variables of the
questionnaire to be analyzed.
Concerning the methods of maintaining confidentiality and privacy of the participants,
while Protected Health Information (PHI) is included on these questionnaires such as parenting
practices, social and mental status, substance use, no identifying information has been sent by
agencies that would allow the University of Utah researchers to identify the individual clients.
Data Analysis: All outcome data was collected on the SFP questionnaire. After data
cleaning (removing any names, assuring readable marks, checking for missing data and random
markings) by the researchers, the data was entered into a computer for analysis on a network PC
using SPSS for Windows. For this study, only the de-identified (coded) parent pre- and post-test
quantitative data was used using SPSS program to be analyzed by Dr. Keeley Cofrin.
Outcome data analysis procedures to be used include a 2 x 2 analysis of variance
(ANOVA) by co-variants of ethnicity (African-American vs. non African-American families),
risk factor levels (high vs. low risk at baseline) and other factors to determine any significant
difference between the groups and the types of participants by the pre- to post test scores. A total
change score was calculated as well as summed scores for the parent, child and family outcomes.
The effect sizes of the outcomes were calculated using d statistics for the cluster variables and 18
individual outcome variables to determine if SFP is more or less effective for African-American
or non African-American families for family outcome variables as compared to school or peer
variables as hypothesized.
Results
Results of the within-groups 2 x 2 ANOVA, which determines the level of change from
the pre-test to the post-test within each group, suggests that African-American families (AA)
have slightly more statistically significant outcomes than non African-American families (non
AA). All 18 pre- to post-test SFP change outcomes were found to be statistically significant for
African-Americans (p < .05), except for hyperactivity reduction (p = .36). In contrast, 15 of the
18 outcome variables were found to be statistically significant in the non African-American
families (non-AA). Family conflict (p =.12), Overt aggression (p =.07), Criminal behavior (p
=.25), and hyperactivity (p =.36) were not found to be significant for non African-American
families.
In order to analyze the between-group interaction we performed 18 analyses, one for each
of the outcome variables listed in table 1, to determine if the two groups differ in the way they
change from the pre-test to post-test. No significant interaction effects were found between the
African-American group and the non African-American group, meaning that both the AA and
non-AA families benefit equally from SFP.
Parenting Outcomes
African-American families were found to be slightly lower in positive protective factors
at baseline, including positive parenting, parental involvement, parenting skills, and parental
supervision. However, parental efficacy was slightly higher in African-Americans at baseline.
Both groups produced levels of improvement from pre- to post-test that were found to be
significant (p= 0.00) with effect sizes of (d >.41), meaning both groups of families made major
positive changes.
Parenting Outcomes
African-
Positive
N
Pretest
Posttest
Change
F
Sig
ES
210
3.43
4.18
0.75
161.2
0.00
1.76
147
3.63
4.39
0.77
165.7
0.00
2.13
206
3.30
3.91
0.61
110
0.00
1.47
146
3.51
4.11
0.60
130
0.00
1.89
210
2.99
3.54
0.55
135.2
0.00
1.61
149
3.14
3.70
0.56
147.9
0.00
2.00
210
2.77
3.17
0.40
125
0.00
1.55
148
2.86
3.23
0.37
85.09
0.00
1.52
211
3.10
3.75
0.65
137.6
0.00
1.62
148
3.09
3.81
0.73
145
0.00
1.99
American
parenting
Non African
American
Parental
AfricanAmerican
Involvement
Non AfricanAmerican
Parental
AfricanAmerican
Supervision
Non AfricanAmerican
Parental
AfricanAmerican
Non African-
Skills
American
Parental
AfricanAmerican
Efficacy
Non AfricanAmerican
Table 3 Parenting outcomes for SFP. Note the changes between Pre and Post-test
Family Outcomes
African-Americans were significant in their levels of improvement from the pre-test to
the post-test in all five family outcomes with (p= .00). Whereas, non African-Americans were
significant (p= .00) in four of the five family outcomes. Non African-Americans did not show
significant results in the reduction of family conflict (p= .12). Both groups had very large effect
sizes of (d >.41), except for the family conflict outcome in which African-Americans reported (d
=.34) and non African-Americans reported (d = .26). The family organization scale is the only
close interaction effect with (p = .06). Both groups improve in family organization, but the nonAA families start with lower family organization so they increase more to about the same level
as the AA families, creating a small interaction effect.
Family Outcomes
Family
African-
N
Pretest
Posttest
Change
F
Sig
ES
209
2.50
3.48
0.98
243.6
0.00
2.16
146
2.34
3.51
1.17
257.9
0.00
2.67
209
3.33
4.02
0.68
129.5
0.00
1.58
147
3.37
4.15
0.78
136.9
0.00
1.94
210
2.95
3.77
0.81
198.5
0.00
1.95
148
3.08
3.94
0.85
268.6
0.00
2.70
208
2.37
2.27
0.10
6.15
0.12
0.34
145
2.60
2.53
0.07
2.43
0.01
0.26
212
3.21
3.75
0.85
236.0
0.00
2.12
144
3.20
3.81
0.85
253.2
0.00
2.66
American
Organization
Non African
American
Family
AfricanAmerican
Cohesion
Non AfricanAmerican
Family
AfricanAmerican
Communication
Non AfricanAmerican
Family
AfricanAmerican
Conflict
Non AfricanAmerican
Overall
African-
Family
American
Resilience
Non AfricanAmerican
Table 4 Family outcomes for SFP. Note the changes between Pre and Post-test
Children Outcomes
African-Americans showed significant results (p = .00) in all of the childrens outcomes
except for hyperactivity (p = .36). Non African-Americans showed significant results in all
outcomes except overt aggression (p = .07), criminal behavior (p = .25), and hyperactivity
(p = .36). Baseline results are similar for both groups in every category except for criminal
behavior, which African-Americans reported 1.22 and non African-Americans reported 1.12.
Childrens Outcomes
Overt
African-
N
Pretest
Posttest
Change
F
Sig
ES
212
2.11
1.94
0.17
19.72
0.00
0.61
148
2.15
2.07
0.08
3.28
0.07
0.30
208
2.06
1.85
0.21
25.52
0.00
0.70
142
2.09
1.83
0.26
41.00
0.00
1.08
215
2.91
3.34
0.43
138.9
0.00
1.61
147
2.86
3.29
0.42
90.38
0.00
1.57
204
1.22
1.11
0.10
9.08
0.00
0.42
136
1.12
1.09
0.03
1.34
0.25
0.20
204
2.67
2.63
0.04
0.83
0.36
0.13
137
2.74
2.70
0.04
0.83
0.36
0.16
210
3.56
3.81
0.25
70.13
0.00
1.16
142
3.66
3.92
0.26
47.82
0.00
1.16
214
2.40
1.98
0.42
66.05
0.00
1.11
143
2.43
2.06
0.36
47.72
0.00
1.16
American
Aggression
Non African
American
Covert
AfricanAmerican
Aggression
Non AfricanAmerican
Concentration
AfricanAmerican
Problems
Non AfricanAmerican
Criminal
AfricanAmerican
Behavior
Non AfricanAmerican
Child
AfricanAmerican
Hyperactivity
Non AfricanAmerican
Child
AfricanAmerican
Sociability
Non AfricanAmerican
Child
AfricanAmerican
Depression
Non AfricanAmerican
Table 5 Childrens outcomes for SFP. Note the changes between Pre and Post-test
Discussion
18% of African-American teens report using cigarettes, alcohol, or illegal drugs in the
last 30 days (SAMHSA, 2000). Alarming statistics such as these reinforce the immense need
society has for programs such as SFP which help to decrease risk factors and negative behaviors.
The primary goal of this research study is to determine if SFP works as well for AfricanAmerican families as it does for non African-American families. Analyses of family
strengthening programs are necessary in order to be confident that the programs with the greatest
positive outcomes are being used.
Before discussing how African-Americans respond to treatment and prevention
programs, the factors that put them at risk for needing such programs must first be addressed.
Possible risk factors were analyzed at the baseline in order to determine the risk level of AfricanAmerican families compared to non African-American families. The only difference found in
risk and resilience at the pre-test was that African-American families reported lower scores in
family conflict and higher scores in family organization than did non African-Americans. Lower
family conflict levels and higher family organization levels in African-Americans may be
connected with the role that extended families play in the African-American familial unit.
The presence of an extended family network plays a significant role in protecting against various
deviant behaviors in the African-American community by providing a supportive social network.
African-American families reported slightly lower positive parenting outcomes at the
baseline; however they seemed to increase as much as non African-Americans at the post-test.
One reason for the slightly lower outcomes could be due to the high number of single parents in
the African-American community.
The children's scales at pre-test all look very similar for both groups, except criminal
behavior which was slightly higher in African-American children. Interestingly, AfricanAmericans reported significant results (p = .00) from the pre-test to the post-test in criminal
behavior. Non African-American children did not have significant results (p =.25) from the pretest to the post-test in criminal behavior. Also, neither group showed significant improvement in
the area of hyperactivity. The reasons as to why hyperactivity outcomes were left largely
unchanged is unclear, further research needs to be done in order to understand how to better
improve hyperactivity results. Overall, African-American families appear to benefit slightly
more from SFP participation, but this could also because the sample size is larger for the
African-American families (N=215 families) compared to (N= 149 families) for the non AfricanAmerican families.
Other researchers have also found cultural variations in risk and protective factors.
Barnes, Farrell, & Banerjee (1994) investigated whether sociodemographic, family, and peer
influences on adolescent problem behaviors are the same or different for Black and White
adolescents. 14 variables were analyzed but only 2 variables out of the 14 were determined to be
significantly related to race, indicating that most of the same processes influence the
development of adolescent problem behaviors for both Black and White adolescents. The first
significant interaction shows there is a difference between how Blacks and Whites respond to
peer influence. Peer interactions were found to have a stronger influence on Whites than on
Blacks.
Barnes & associates found the second significant interaction to be between race and
religion. To cope with psychological and environmental stress, with little support from
traditional mental health resources, African-Americans have used the historically validated
extended social network within the African-American church (Lyles & Carter, 1982). As the
most independent and self-sufficient institution in the African-American community, the church
provides a wide range of social services directed toward strengthening families and enhancing
the development of children and youth (Hill, 1993). Because the African-American church is
considered to be the center of the community it is without question one of the most important
protective factors within the African-American community.
Though differences will be found, there are many commonalties between AfricanAmerican and non African-American families. The role ethnicity plays in substance abuse
resilience is not nearly as big as the role certain protective factors play, such as a strong family
network. In addition, those families who attended the most Family Strengthening sessions have
the highest levels of improvement, regardless of ethnicity.
The mistaken comparison of African-American families against Euro-American
standards has given little attention to the influence of racism and economic deprivation on
African-American families and has minimized their adaptive strengths (Lyles & Carter, 1982).
Most prevention programs are generic programs developed for popular American culture, which
is mainly influenced by Euro-American, middle class values (Kumpfer & associates, 2002).
Some researchers (Kumpfer & Alvarado, 1995; Turner, 2000) believe culturally-sensitive
programs are essential for the success of family-prevention programs. Therefore, strengthening,
prevention, and treatment programs have begun culturally adapting their programs to better suit
African-Americans, in hopes that they will be more beneficial than generic versions. Alterations
made to these culturally adapted versions include changing pictures to include more AfricanAmericans, adjusting vocabulary, hiring ethnically- matched staff, and adaptations to cultural
values and traditions. In order to be successful, therapists working with racial minorities must
become aware of the cultural history and sociocultural meanings of African-American family
functions, structures, and strengths (Lyles & Carter, 1982). These changes, though important,
have been shown to only increase African-American participant’s level of comfort and
understanding of the program but not their level of improvement.
A culturally adapted version of the SFP program was offered to program managers in this
trial, However they opted to use the generic form of the SFP program rather than the culturallyadapted African-American version because they felt that the differences between the two
versions were superficial (Kumpfer, Turner, Gottfredson, Wilson, & Alvarado 2002). The
original research plan called for the development of a culturally-sensitive African American
version of SFP to be developed with the input of local implementers in the early stages of the
project. According to Kumpfer & associates (2002), the project began using the available
materials, and was to migrate to the revised version when it became available. However, the
research staff were advised by the funding agency not to implement this new version because
doing so would introduce another study variable that would have to be treated as a factor in the
analysis, thereby reducing the study power to detect changes overall if the data had to be
analyzed separately for the two versions of the program. It is possible that some members of the
client population reject the generic version of the program being used as culturally inappropriate
and stop attending (Kumpfer, Alvarado, Smith, & Bellamy 2002).
Although an African-American SFP version was not used in this trial, Kumpfer &
associates (2002) have analyzed comparisons between African-American adapted versions of
SFP and generic versions of SFP. Their results show that there is an increase in the recruitment
and retention of African American participant’s but not their outcome or level of improvement.
In rural Alabama, results from a generic SFP version (implemented in the first two years) were
compared to results from an African-American SFP version (implemented in the last two years).
Retention of the African-American drug-abusing mothers who attended 12 of the 14 sessions
improved from 61% to 92% after cultural adaptations were made. However, outcomes remained
the same. In Detroit the generic version had slightly better outcomes for African-American drug
abusers in treatment. Once again, completion rates increased from 45% to 85% after cultural
adaptations were made.
One particular African-American adapted program is the Strong African American
Families Program (SAAFP). Using SFP as a foundation, SAAFP was developed specifically for
rural African American families. In fact, SAAFP is the only empirically based family-centered
intervention program designed to prevent alcohol and other substance use and early sexual
activity specifically among rural African American youth (Brody, Neubaum, Boyd, & Dufour,
1997).
In Contrast, some data suggest that multicultural prevention programs are just as effective
as cultural-specific prevention programs. NIDA-funded researchers compared a multicultural
version of a drug prevention program named “Keepin it R.E.A.L”--which included cultural
values from all of the groups participating in the program--to two culture-specific programs in
middle schools in Phoenix, Arizona. The goal of this study was to determine if messages
matched to the student’s culture are more effective than messages that are not culture-specific.
The multicultural version of the intervention program had the greatest positive impact on initial
substance use over the course of the study, compared to controls and to the culture-specific
versions.
In conclusion, research has shown that people of all ages and cultural backgrounds
respond better to family strengthening, prevention, and treatment programs when their own
cultural values are represented and images of themselves are shown throughout the message. In
order for strengthening and prevention programs to be the most beneficial to the AfricanAmerican community, they must target the three key elements that have shown to be significant
protective factors for African-Americans—extended family unit, African-American
church/spiritual source, and racial identity.
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