In 1999, the University of Georgia’s Center for Family Research began developing and testing a family-based alcohol prevention program targeted at rural African-American 11- and 12-year-olds and their primary caregivers.
Building on two decades of scientific research showing how low-income, rural, African-American families overcome economic hardship, racism and a lack of social services to raise successful adolescents, researchers at the University of Georgia and Iowa State University designed a seven-week program to help African-American preteens make healthy choices as they enter adolescence.
During weekly meetings that began with a shared meal, SAAF (pronounced “safe”) participants met in groups of three to 12 families, along with African-American facilitators. Parents and preteens met separately with their own facilitators for the first hour, and then reassembled for a joint session during the second hour. Facilitators emphasized participants’ strengths and successes. The sessions used activities and games to model personal responsibility, discipline, trust, goal-setting, resisting peer pressure and family engagement. SAAF also placed a strong emphasis on cultural sensitivity and enhancing families’ racial pride.
The center has just begun marketing SAAF for use outside of Georgia, where about 20 communities have implemented the model program. Denver recently began using the program with juvenile offenders and their families.
What They Looked For
According to Gene Brody, director of the Center for Family Research, SAAF was developed in response to data published in the 1990s showing that alcohol and drug use was becoming at least as prevalent among African-American youth in rural Southern communities as it was among those in inner cities.
“When we examined the availability of prevention programming to deter alcohol and drug use in Southern rural communities, we found there weren’t many,” Brody said. “And there weren’t any programs designed specifically for African-Americans living in [those] communities. A lot of prevention programs are not based on research with the population they’re trying to target.”
SAAF was designed precisely for those youth, whose “pervasive poverty, lack of mental health resources and a historical mistrust of service systems” made it likely that they would turn early and often to drugs, alcohol and risky sexual behaviors if those issues weren’t addressed in their families or communities, according to the evaluation study. The study, “Long-Term Effects of the Strong African American Families Program on Youths’ Conduct Problems,” appears in the October 2008 issue of Journal of Adolescent Health.
“The essence of the program is to try to enhance [positive] parenting processes, as well as the self-regulatory abilities of adolescents,” Brody said.
Companion studies of SAAF have shown that, compared with the control group, fewer SAAF youths initiate alcohol consumption and drug use over time, and that once initiated, the frequency of those behaviors among the SAAF group increases more slowly.
But Brody and his colleagues hypothesized that the positive effects of the program might take root so deeply in youths that the changes were likely to manifest themselves in other ways as well.
For example, Brody said, “We found in our epidemiological research that for African-American adolescents, one of the strongest predictors of alcohol and drug use was racial discrimination. So in the SAAF, we teach parents strategies for teaching their children how to deal with racial discrimination, and become resilient to it.”
“The risk factors that predict alcohol and drug use are similar to risk factors that predict conduct and behavioral problems,” Brody said. “So while the original trial was designed to examine whether the SAAF program deterred alcohol use, we decided … to analyze whether the program was also able to deter the development of conduct problems.”
To minimize study contamination within the small, rural Georgia communities targeted in the project, randomization occurred at the county level. The nine counties involved in the study were randomly assigned to either the SAAF program or to the control group. Community liaisons – African-American community leaders recruited to assist with the study – contacted the families of public school students identified for participation.
Slightly more than half of the preteens in the study were girls. Fifty-four percent of caregivers were single; 36 percent were married and living with their spouses, while the remaining caregivers had other living arrangements. The mothers’ average age was 38; the fathers’ was 40. Eighty percent of the parents had completed high school. Median family income was just over $20,000.
Mean attendance was 4.7 of the seven sessions. Control families received mailed leaflets on adolescent development and stress management.
Families from both groups underwent assessment at pretest, post-test (eight months) and follow-up (29 months). Adults received $75 for participating; youths received $25. Trained African-American field researchers administered computer-based, self-report questionnaires privately and separately to caregivers and to youths in the family homes.
Youths answered questions concerning instances of their own risk behaviors involving truancy, theft and substance use, and on the percentages of their friends who engaged in such behaviors. They also rated their self-esteem; their ability to set, sustain and achieve goals; and negative attitudes they had about drinking and sexual activity.
Caregivers rated youths’ distractibility, carelessness and need for supervision. They completed surveys that assessed communications with their children about drugs, alcohol and sex, child management practices, the amount of nurturing they gave their children, and racial socialization. Finally, caregivers reported on their child’s academic engagement and competence.
More than nine in 10 of the 667 family units completed all of the assessments through follow-up at 29 months, when the youths were approaching age 14.
What They Found
Researchers found that, compared with the control group, youths participating in the SAAF program were 54 percent less likely to be engaged in conduct problems at the 29-month follow-up.
They also confirmed that the effects of the intervention were stronger for those youths at greatest risk for conduct problems, even if they were participating alongside youths with fewer risk factors.
SAAF youths who hung out more frequently with deviance-prone peers (as of the pre-test) were 62 percent less likely than youths in the control group to be engaged in conduct problems at follow-up. Participating youths with poor self-control at pre-test were 74 percent less likely to be engaged in conduct problems at follow-up. This is particularly important, because SAAF is designed as a universal intervention program for all rural African-American families, regardless of the number of risk factors they have.