The Strong African American Families Program: a cluster-randomized prevention trial of long-term effects and a mediational model.

The Strong African American Families Program, a universal preventive intervention to deter alcohol use among rural African American adolescents, was evaluated in a cluster-randomized prevention trial. This 7-week family skills training program is based on a contextual model in which intervention effects on youth protective factors lead to changes in alcohol use. African American 11-year-olds and their primary caregivers from 9 rural communities (N = 332 families) were randomly selected for study participation. Communities were randomized to prevention and control conditions. Intent-to-treat analyses indicated that fewer prevention than control adolescents initiated alcohol use; those who did evinced slower increases in use over time. Intervention-induced changes in youth protective factors mediated the effect of group assignment on long-term changes in use.

The strong African American families program: prevention of youths' high-risk behavior and a test of a model of change.

In this study, the efficacy of the Strong African American Families Program (SAAF) was tested. The trial, which included 332 families, indicated that families who participated in SAAF experienced increases over time in regulated, communicative parenting; increases in targeted parenting behaviors, according to youths' reports; and low rates of high-risk behavior initiation among youths. Changes in regulated, communicative parenting mediated the intervention's impact on youths' recognition of changes in parenting, which in turn was linked to changes in youths' high-risk behavior.

Longitudinal direct and indirect pathways linking older sibling competence to the development of younger sibling competence.

A 4-wave longitudinal model tested direct and indirect links between older sibling (OS; M = 11.7 years) and younger sibling (YS; M = 9.2 years) competence in 152 rural African American families. Data were collected at 1-year intervals. At each wave, different teachers assessed OS competence, YS competence, and YS self-regulation. Mothers reported their own psychological functioning; mothers and YSs reported parenting practices toward the YS. OS competence was stable across time and was linked with positive changes in mothers' psychological functioning from Wave 1 to Wave 2. Mothers' Wave 2 psychological functioning was associated with involved-supportive parenting of the YS at Wave 3. OS Wave 2 competence and Wave 3 parenting were indirectly linked with Wave 4 YS competence, through Wave 3 YS self-regulation. Structural equation modeling controlled for Wave 1 YS competence; thus, the model accounted for change in YS competence across 3 years.

Buffering Effects of a Family-Based Intervention for African American Emerging Adults.

This study focused on the buffering effects of Adults in the Making (AIM), a family-centered preventive intervention, on the link between life stress and increases in risk behaviors among 347 rural, southern African Americans as they left high school. Of the families, 174 were assigned to the prevention condition and 173 to a control condition. Emerging adults reported risk behaviors at pretest, posttest (7 months after pretest), and long-term follow-up (10 months after posttest). A significant Life stress × Prevention condition interaction emerged: Increases in risk behaviors were significantly greater among emerging adults in the control condition who experienced high stress levels than among those in the prevention condition who experienced equally high stress levels.

Long-term effects of the strong African American families program on youths' alcohol use.

OBJECTIVE: This report extends earlier accounts by addressing the effects of the Strong African American Families (SAAF) program across 65 months. Two hypotheses were tested: (a) Rural African American youths randomly assigned to participate in SAAF would demonstrate lower rates of alcohol use than would control youths more than 5 years later, and (b) SAAF's effects on deterring the onset of alcohol use in early adolescence would carry forward to mediate the program's long-term effects. METHOD: African American youths in rural Georgia (mean age at pretest = 10.8 years) were assigned randomly to the SAAF group (n = 369) or to a control group (n = 298). Past-month alcohol use was assessed at pretest and at 9, 18, 29, 53, and 65 months after pretest. RESULTS: SAAF participants increased their alcohol use at a slower rate than did adolescents in the control condition across the follow-up assessments. At the 65-month assessment, SAAF participants reported having drunk alcohol half as often as did youths in the control group. Consistent with the second hypothesis, SAAF's effects on deterring initiation carried forward to account for its effects on alcohol use across time. CONCLUSIONS: Training in protective parenting processes and self-regulatory skills during preadolescence may contribute to a self-sustaining trajectory of disinterest in and avoidance of alcohol use during adolescence when peers begin to model and sanction it.

Parenting moderates a genetic vulnerability factor in longitudinal increases in youths' substance use.

The authors used a longitudinal, prospective design to investigate a moderation effect in the association between a genetic vulnerability factor, a variable nucleotide repeat polymorphism in the promoter region of 5HTT (5-HTTLPR), and increases in youths' substance use. The primary study hypothesis predicted that involved-supportive parenting would attenuate the link between the 5-HTTLPR polymorphism and longitudinal increases in substance use. African American youths residing in rural Georgia (N = 253, mean age = 11.5 years) provided 4 waves of data on their own substance use; the mothers of the youths provided data on their own parenting practices. Genetic data were obtained from youths via saliva samples. Latent growth curve modeling indicated that 5-HTTLPR status (presence of 1 or 2 copies of the s allele) was linked with increases in substance use over time; however, this association was greatly reduced when youths received high levels of involved-supportive parenting. This study demonstrates that parenting processes have the potential to ameliorate genetic risk.

Psychological functioning, support for self-management, and glycemic control among rural African American adults with diabetes mellitus type 2.

OBJECTIVE: To test a contextual-ecological model of factors relevant for glycemic control in an understudied and vulnerable population of persons with diabetes mellitus Type 2. DESIGN: Rural African American adults (40-65 years old, n = 200) with Type 2 diabetes and 200 adult support persons whom the adults with diabetes nominated were interviewed in their homes. Adults with diabetes and support persons reported their own psychological functioning, which included depressive symptoms, self-esteem levels, and optimism levels as well as the quality of their relationship with one another. Adults with diabetes reported the extent and quality of the instrumental and emotional support they received from their support persons. RESULTS: Structural equation modeling indicated that psychological functioning among the adults with diabetes and support persons was associated with the latter's provision of support for diabetes self-management. Support, in turn, was linked indirectly with glycemic control as assessed via glycosylated hemoglobin levels, through promotion of glucose monitoring. CONCLUSION: Targeting sources of support in patients' immediate social contexts is important to the improvement of self-care and deterring of morbidity among rural African Americans with Type 2 diabetes.

Effects of family risk factors on dosage and efficacy of a family-centered preventive intervention for rural African Americans.

This study was designed to test hypotheses about family risk factors and their links to dosage and efficacy of a family-centered preventive intervention. Participants were 172 families with an 11 year-old child randomly assigned to the intervention condition in the Strong African American Families Program (SAAF). Two family risk factors, ratio of adults to children in the household and youth unconventionality, were negatively related to dosage, defined as number of intervention sessions attended. Dosage, in turn, was associated with changes in targeted parenting behavior across the 7 months between pretest and posttest. The effect of family risk factors on the link between program dosage and changes in parenting behavior was stronger for families experiencing more risks. The results highlight the need for engagement strategies for recruiting and retaining high-risk families in preventive interventions.

Longitudinal links among parenting, self-presentations to peers, and the development of externalizing and internalizing symptoms in African American siblings.

A longitudinal model that linked involved-supportive parenting and siblings' ability-camouflaging self-presentations to peers with the development of externalizing and internalizing symptoms was tested with 152 pairs of first- and second-born African American siblings (mean ages 12.7 years and 10.2 years at the first wave of data collection). Three waves of data were collected at 1-year intervals. Teachers assessed siblings' externalizing symptoms, internalizing symptoms, and academic competence; siblings reported their own self-presentations and desire for peer acceptance; and mothers and siblings provided multiinformant assessments of involved-supportive parenting. Involved-supportive parenting at Wave 1 was linked with peer-directed self-presentations at Wave 2. Wave 2 self-presentations were linked indirectly with changes from Wave 1 to Wave 3 in externalizing and internalizing symptoms through their association with academic competence.

Longitudinal pathways to competence and psychological adjustment among African American children living in rural single-parent households.

A three-wave model linking maternal functioning to child competence and psychological adjustment was tested with 150 African American families living in the rural South. The children were 11 years old at Wave 1. Structural equation modeling indicated that maternal education and per capita income were linked with maternal psychological functioning (self-esteem, optimism, depression) at Wave 1, which forecast mothers' competence-promoting parenting 1 year later at Wave 2. Competence-promoting parenting forecast child cognitive competence, social competence, and psychological adjustment 1 year later at Wave 3, indirectly through child self-regulation. The data were reanalyzed controlling for Wave 1 child competence and adjustment. All paths remained significant, indicating that the model accounted for change in child competence and adjustment across 2 years.

Protective longitudinal paths linking child competence to behavioral problems among African American siblings.

A 4-wave longitudinal design was used to examine protective links from child competence to behavioral problems in first- (M=10.97 years) and second- (M=8.27 years) born rural African American children. At 1-year intervals, teachers assessed child behavioral problems, mothers reported their psychological functioning, and both mothers and children reported parenting practices. Structural equation modeling indicated that child competence was linked with residualized positive changes in mothers' psychological functioning from Wave 1 to Wave 2. Mothers' psychological functioning and child competence at Wave 2 forecast involved-supportive parenting at Wave 3, which was associated negatively with externalizing and internalizing problems at Wave 4. The importance of replicating processes leading to outcomes among children in the same study is discussed.

The Strong African American Families Program: translating research into prevention programming.

A randomized prevention trial contrasted families who took part in the Strong African American Families Program (SAAF), a preventive intervention for rural African American mothers and their 11-year-olds, with control families. SAAF is based on a contextual model positing that regulated, communicative parenting causes changes in factors protecting youths from early alcohol use and sexual activity. Parenting variables included involvement-vigilance, racial socialization, communication about sex, and clear expectations for alcohol use. Youth protective factors included negative attitudes about early alcohol use and sexual activity, negative images of drinking youths, resistance efficacy, a goal-directed future orientation, and acceptance of parental influence. Intervention-induced changes in parenting mediated the effect of intervention group influences on changes in protective factors over a 7-month period.