Universality of Effects: An Examination of the Comparability of Long-Term Family Intervention Effects on Substance Use Across Risk-Related Subgroups

Abstract

This study extends earlier investigation of family risk-related moderation of two brief, family-focused preventive interventions. It examines effects on the trajectories of substance initiation over a period of six years after a pretest assessment, evaluating whether effects were comparable across higher- and lower-risk subgroups. The two interventions, designed for general-population families of adolescents, were the seven-session Iowa Strengthening Families Program (ISFP) and the five-session Preparing for the Drug Free Years program (PDFY). Thirty-three rural public schools were randomly assigned to either the ISFP, the PDFY, or a minimal contact control condition. Curvilinear growth curve analyses were used to evaluate the universality of intervention effectiveness by testing for risk moderation of intervention effects on school-level substance use trajectories of initiation of alcohol and illicit substance use. Results were most consistent with the interpretation that both interventions provided comparable benefits for both outcome measures, regardless of family risk status. Findings are discussed in terms of their implications for implementing universal preventive interventions in general populations.

Substance-Use Outcomes at 18 Months Past Baseline

“…18,19 This pattern of findings across studies is important in that it counters the common speculation that universal interventions often benefit only those in the general population at lower risk. 10 The present findings highlight how universal strategies can provide an avenue for reaching at least some higher-risk youth, while avoiding iatrogenic effects sometimes observed when high-risk youth are grouped together for intervention.…”

“…Across a wide range of risk-related variables examined in earlier studies, [17][18][19] very few significant risk moderation effects have been found, but when observed, they have indicated greater benefit to higher-risk subgroups. [17][18][19] Risk moderation effects are defined as those occurring when one risk-related subsample of intervention group participants shows significantly stronger effects than another. Thus, it also was hypothesized that there would be either no evidence of risk moderation or, if observed, risk moderation would favor the higherrisk subsample.…”

Historical Change in the Link between Adolescent Deviance Proneness and Marijuana Use, 1979–2004

“…gender, ethnicity, and locale groups) (Bierman et al, 2007;Kumpfer, Alvarado, Smith, & Bellamy, 2002;Spoth, Shin, Guyll, Redmond, & Azevedo, 2006). Therefore, a critical question in effective dissemination of externalizing risk-focused substance use prevention programs is whether deviance proneness is a risk factor for marijuana use across all demographic groups at a population level.…”

Selectieve en geïndiceerde preventie van problematisch middelengebruik bij jongeren

“…Het Strengthening Families programma is sindsdien niet meer onderzocht onder kinderen van ouders met een middelenprobleem. Wel is de effectiviteit van het universele preventieprogramma onderzocht voor subgroepen die geclassificeerd werden als relatief hoog of laag risico, op basis van onder andere de aanwezigheid van internaliserende of externaliserende problematiek onder de ouders (Spoth, Shin, Guyll, Redmond, & Azevedo, 2006). Hieruit bleek dat het Strengthening Familiesprogramma gedurende zes jaar na de interventie in beide groepen effectief was in het verhogen van de leeftijd waarop kinderen voor het eerst alcohol gebruikten.…”