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TRANSCRIPT
GREAT Families1
Community-Based Multiple Family Groups to Prevent and Reduce Violent and
Aggressive Behavior: The GREAT Families Program
Emilie Phillips Smith1, Deborah Gorman-Smith2, William Quinn3, David Rabiner4,
Patrick Tolan2, Donna-Marie Winn4 and the Multi-site Violence Prevention Project 1,2,3,4,5
Word Count: 3,985 words
Abstract
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This paper describes the community-based family-focused component of the
GREAT Schools and Families project, a collaborative, targeted family and universal
school-based adolescent prevention program implemented in four sites with families in
diverse communities. This component includes the families of sixth-grade students
identified by teachers as aggressive and socially influential among their peers. The paper
describes the developmental-ecological conceptual framework and the program derived
from this model including multiple-family group meetings and the Home-School
Communication component. Approaches to recruitment, engagement, staff training and
socio-cultural sensitivity in work with families in predominantly poor and challenging
settings are described. The program involves collection of data using measures of fidelity
and processes that will facilitate examination of theoretical and programmatic processes
potentially mediating and moderating effects upon individual families. This course of
work could inform us about necessary approaches and procedures necessary to engage
and support families in efforts to reduce individual and school grade-level violence and
aggression.
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The purpose of this paper is to describe the family component of the GREAT
Schools and Families Program (Meyer et al., in press; Miller-Johnson et al., in press;
Orpinas, Horne, and the Multisite Violence Prevention Project, in press). This paper will
describe the theoretical background and conceptual framework of the program, the
driving goals and objectives of the curriculum, staff training and supervision, recruitment,
retention, and engagement, particularly of families from diverse racial-ethnic and
geographic backgrounds, and the assessment of critical program processes and fidelity.
A Developmental-Ecological Framework for Family-Based Prevention
The GREAT Families component is grounded in a developmental-ecological
model of child and family functioning that assumes that: (1) the family serves as the
primary support and socializing force for children; (2) the challenges families face and
often the ways they attempt to address them are dependent upon the age of the children;
(3) children and families live in communities and are also influenced by larger social,
cultural, and policy realities; and (4) strengthening families and family-focused
interventions are among the more powerful ways to effect positive child outcomes and
prevent violent and antisocial behavior.
A major tenet of developmental-ecological theory is that individual development
is influenced by the qualities of the social systems in which the family lives or
participates (Bronfenbrenner, 1986; 1995; Dishion & McMahon, 1998; Gorman-Smith,
Tolan, & Henry, 2000; Tolan & Gorman-Smith, 1997). Individual development is nested
within a series of social structures (Bronfenbrenner, 1986; Szapocznik & Coatsworth, in
press), beginning with family and peer systems, and, in turn, families and peers are nested
within larger social contexts, such as schools and neighborhoods. Potential risk factors
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include not only individual child behavioral problems, but also potential problems in
family functioning and increased risk owing to their social settings. However, there are
also strengths germane to the individual child, family, and social setting that could be
helpful in bolstering youth and families. Thus, this intervention focuses not only on risk
but also current and potential assets and strengths in the family, peer, school, and
neighborhood settings and the interactions between these social contexts.
Developmental-ecological theory also considers the impact of these systems
across development. Based upon prior work on developmental trajectories in violence
and aggression (Elliott, Huizinga, & Menard, 1989; Loeber, Wei, Stouthamer-Loeber,
Huizanga, & Thornberry, 1999; Tremblay et al., 1991; and Tremblay et al., 1995), the
GREAT Families intervention is aimed at interrupting a progression from early socially
unacceptable behavior to serious delinquency and violence by eliminating the function of
problem behaviors in families and the reinforcers of such behavior. The idea of
developmental-ecology also attends to multiple risk and protective factors in the lives of
young people and potential changes in the relative influence of family, peers, and
neighborhoods as young people grow and mature. Whereas parents are among the
earliest influences upon children, as children grow and develop, school, peers, and
community become increasingly important sources as well (Elliott et. al., 1989).
Overlaying the idea of developmental-ecological theory is the idea of context that
includes attention to the race, ethnicity, and social status of the individual in interaction
with prevailing cultural norms and actions of their own cultural group and larger social-
cultural systems (McLoyd and Ceballo, 1998; Ogbu, 1985). Research on parenting
across racial and ethnic groups has revealed both some practices that are common and
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effective across groups and some parenting practices that have been found to be more
uniquely effective among particular racial-ethnic groups. For example, research has
found that for Asian American and African American parents that stricter and more
parent-directed approaches, approaches referred to as more “authoritarian” are actually
related to positive child and adolescent adjustment whereas these practices are not related
to positive outcomes among European American children and youth (Deater-Deckard &
Dodge, 1997; Deater-Deckard, Dodge, Bates, & Pettit, 1996; Lamborn, Dornbusch, &
Steinberg, 1996; Murry, Smith, & Hill, 2001; Tolan & McKay, 1996). Understanding
parenting approaches that are found to be effective across and within particular racial-
ethnic contexts has very important implications for future prevention efforts.
Program Background and Rationale
The GREAT Families program is based upon a conceptual model that takes into
account various individual, family, school, and neighborhood influences (Figure 1). The
exogenous constructs in the model (i.e. parental, school, and neighborhood
characteristics) illustrate that various individual and contextual factors can influence
family cohesion, organization, and beliefs. Families that are more organized and
cohesive are likely more diligent in monitoring the youth and utilizing developmentally
appropriate disciplinary practices. These practices lead to the family being a catalyst of
change helping to influence the child’s peer relationships and neighborhood involvement
through better monitoring and discipline, and improve the school setting through better
relationships with school staff, all of which leads to less problem behavior and improved
competence and achievement.
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Past research has demonstrated that family relationships are important risk and
protective factors in children’s risk for violence and closely associated antisocial
behaviors (McCord, 1991; Patterson, Reid, & Dishion, 1992; Patterson, & Stouthamer-
Loeber, 1984). The empirical support for reducing risk for serious problems through
increasing family functioning promotes hope that much can be done to affect youth
antisocial and delinquent outcomes. Given the role of family, a number of family
programs have been developed and tested in a variety of settings, with families of
multiple racial-ethnic backgrounds, some demonstrating significant effects up to 3 years
following intervention (Alexander, Robbins, & Sexton, 2000; Davidson, Redner, Amdur,
& Mitchell, 1990; Henggeler, Schoenwald, Borduin, Rowland, Cunningham, 1998;
Sexton & Alexander, 2002; Spoth, Redmond, & Shin, 2001). Thus, there are likely some
important parenting and family intervention approaches that are effective across diverse
families and with families of children ranging from preschool to adolescence.
Multiple Family Groups as an Avenue for Change
There are a number of approaches and settings in which family–based
intervention can be conducted. Growing research shows more effectiveness among
approaches involving groups of families when compared to clinic-based approaches with
individual families (Cunningham & Bremner, & Boyle, 1995; Webster-Stratton, 1984).
Group-based family education also has the potential of developing a group of peer
families that may continue to provide family support after formal program termination.
Prior research has shown that multiple family groups can facilitate understanding, new
behavior in family members and the targeted family member, and facilitate
generalization of within-session training (Laquer, 1976). In a research review and
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synthesis of group-based family approaches, Barlow and Stewart-Brown (2000) highlight
the potential of group-based family education programs to reach a larger number of
families in a way that might also be more cost-effective.
Because of their supportive and normalizing functions, multiple family groups
can be attractive for prevention. Prior studies have shown efficacy of multiple family
groups for reducing risk for aggression and substance abuse (Kosterman, Hawkins,
Spoth, Haggerty, & Zhu, 1997; Litrownik et al., 2000.) Though some work has
demonstrated evidence of efficacy for reducing violence and aggression using rigorous
designs, more work is needed examining multiple family approaches and the theorized
processes with families of diverse racial, ethnic, and social backgrounds to examine if the
content and processes of program implementation are similar.
A Focus Upon Families of Aggressive and Influential Adolescents
Adolescence is an important developmental stage where many problem behaviors
emerge including substance use and abuse, early and unsafe sexual activity, and violence
and aggression (Elliott et al., 1989; Kann, 2001; Loeber, et al., 1999). Adolescence is
also marked by transitions in family relationships, needs regarding parenting, and the
importance of peer influences. However, when good family relationships prevail, even
during adolescence, young people are less susceptible to negative peer influences and
problem behavior (Elliott, Huizinga, & Menard, 1989; Patterson, Reid, & Dishion, 1992).
The GREAT Families Program is built upon the premise that a small minority of
youth perpetrates the overwhelming majority of violent and aggressive acts, both in and
around school. Longitudinal surveys indicate that 20 percent of the serious offenders
account for 75 to 90 percent of self-reported violent crimes (Elliott et al., 1989; Loeber et
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al., 1999). The intent is to intervene with those who are aggressive and influential. The
rationale is that reducing violence and aggression among the “unconventional leaders,”
young people who are popular, influential, and are also leaders in deviant behavior, will
lead to diminished support for violence and aggression among their peer groups (Miller-
Johnson, Costanzo, & Coie, in press).
Summary
In summary, the GREAT Families Program is built upon a developmental-
ecological perspective that views families as powerful sources in the lives of young
people, even as they grow and develop and peers begin to become increasingly important.
This perspective also recognizes that children and families live within social and cultural
contexts that also influence their approach to parenting. Nevertheless, family-based
prevention has been shown to be an efficacious approach to reducing violence and
delinquency.
This program uses a multiple family group approach in hopes of providing a
medium by which families can develop natural, sustainable sources of support for
effective parenting. It seeks to support positive parenting during an important
developmental transition, adolescence, when new challenges emerge for many families.
The program focuses on working with youth who are both aggressive and influential to
test the premise that influencing unconventional leaders may affect peer norms for
violence and aggression. The next section describes the family program in more detail.
The GREAT Families Program
Program Organization
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The family-focused intervention builds upon several prior prevention and
intervention studies conducted by the investigators collaborating in this multi-site project
(Conduct Problems Prevention Research Group, 2002; Dumas, Prinz, Smith, and
Laughlin, 1999; Gorman-Smith et al, in press-b; McCreary, Maffuid, & Stepter, 1998;
Quinn, 1999; Quinn, Sutphen, Michaels, & Gale, 1994; Sayger, Horne, Walker, &
Passmore, 1988; Tolan & McKay, 1996 ). This study tests the effects of promoting a
group of core parenting principles and family relationship skills identified by the
collaborative based upon previous family research:
1. Promoting home-school partnerships (McDonald et al., 1997; McDonald
& Sayger, 1998; Quinn, 1995; Smith et al., 1997);
2. Parental monitoring and supervision (Patterson, Reid, & Dishion, 1992);
3. Promoting care and respect through discipline and rules (Tolan & McKay,
1996);
4. Parent and child coping, self-control, and management skills (Fleischman,
Horne, & Arthur, 1983; McCreary et al., 1998);
5. Developing healthy, respectful, and effective family communication and
problem-solving skills (Alexander, Robbins, & Sexton, 2000; The
Conduct Problems Prevention Research Group, 2002).
6. Planning for the future (Kohl, Lengua, McMahon, & the Conduct
Problems Prevention Research Group, in press).
The GREAT Families program is comprised of fifteen weekly, two-hour manualized
sessions with groups of approximately four to six families held in community-based
settings that are comfortable and convenient for the family (The Multi-Site Violence
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Prevention Project, 2001; copy of manual available by request). The sessions correspond
to the six core constructs with each of the constructs being represented by two to three
sessions each. Topics of the family sessions include establishing family rules and roles,
good communication, handling emotions, choosing good friends, and connecting to the
community. Family sessions involve at least one parent or caregiver, the sixth-grade
youth, and school-age siblings in games, exercises, and some didactic information each
session. Families also have homework exercises for each session to be completed and
brought back to share. Extended family and friends who play supportive and child-
rearing roles are welcome to family group meetings with the intent of working with the
whole family if possible. However, family members who participate are asked to commit
to attend as consistently as possible. This effort recognizes the role of extended family
and friends in supportive and child-rearing capacities, particularly in some ethnic-
minority communities (Wilson et al., 1995). Transportation, meals, and child-care are
provided to support the families. Families can be compensated up to 225 dollars for
attending all 15 sessions.
The Home-School Communication Plan (HSCP), which is similar to the Daily
Report Card Programs (DuPaul, Guevrement, & Barkley, 1991), is designed to promote
regular communication between a child’s teacher(s) and parents about the child’s success
in achieving important academic and behavioral goals at school. The HSCP identifies a
uniform set of academic and behavioral goals that are expected to be relevant for all
students. These goals are 1) talking to teachers with respect; 2) behaving respectfully
with peers; and 3) completing assigned work. Families identify teachers they want to
help them in monitoring their child. One teacher per family completes the daily sheet
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indicating whether the child has succeeded in meeting their goals. The goal sheet with
the daily teacher report is sent home at the end of the week for parents to review.
Families are asked to bring their child’s goal sheet to the group meetings for a brief
review and discussion. The intent is to give parents a chance to share their child’s
success, and to receive suggestions for help.
Staff Recruitment, Training, and Supervision
Staff are hired for the intervention based on prior experience in family
intervention with the populations in this project and formal training in family systems
theory and related topics. Most have a master’s degree in psychology, social work, or
marital and family therapy. The staff includes equal proportions of males and females
(50%), 46% are African American, 33% Non- Hispanic White, and approximately 20%
Latino. Most are between 25 and 35 years of age.
The investigators and program coordinators at each site participate in a “train the
trainer’s meeting” and subsequently train site-based staff. Staff receive approximately 20
hours of training and preparation over multiple days. The training materials focus on
helping staff to understand an overview of violence and aggression, a developmental-
ecological family approach, the distinction between prevention and treatment, the role of
rigorous methodology and fidelity in intervention, strategies to promoting interactive and
involved group processes, and an understanding of their own racial-ethnic-social
backgrounds and the implications for their work with diverse children and families
(Tolan, 2002). Training emphasizes conceptual understanding, skills practice, and
clinical preparation. After the family group meetings begin, staff are involved in
approximately one hour of individual supervision per week, and attend a 1-2 hour group
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case discussion and staff meeting. These meetings also are accompanied by training that
revisits upcoming sessions. Coordinators observe family sessions for training and to
ensure fidelity. Weekly conference calls among the coordinators and investigators
facilitate cross-site consistency in program implementation and engages the coordinators
and investigators across sites in problem-solving emerging challenges.
The Process of Identifying, Recruiting and Engaging Families
This section describes the approaches implemented across the four sites in
identifying, recruiting, and engaging families.
Identification of Targeted Children and Families
Teachers nominate students for participation in the targeted intervention using
two criteria. First, teachers are asked to nominate students who have demonstrated a
pattern of aggressive and disruptive behavior in the classroom using definitions and
examples provided by program staff. Second, from that list, teachers rate each child on
social influence. Those students with both high aggression and social influence scores
are considered eligible for participation in the intervention.
Recruitment
The recruitment process is important because it is the initial phase of the
engagement. First, families are sent a letter outlining the program. Soon after letters are
sent (within 3-4 days), the intervention staff follow up by telephone or through a home
visit. Multiple phone calls and/or home visits are very likely for many families.
Although it is essential that the basic information outlined in the script is followed and
presented in the order approved, interventionists are encouraged to use their individual
style with a focus on developing a comfortable supportive relationship with families.
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During attempts to engage the family, interventionists are trained to keep the
following key issues in mind.
1) Describe the program as one that will be helpful to their child's school
performance and functioning with other children.
2) Understand that a primary goal is to establish rapport with the caregiver most
likely to mobilize the family to participate in the program though it is hoped
that all family members will participate.
3) Even though parents are informed that the program is 15 weeks long,
interventionists recognize that this commitment might prove difficult to make
immediately. Interventionists emphasize their willingness to be of assistance
in helping families attend the sessions regularly and working with the family
to address any barriers to participation along the way. With this in mind, all
four sites provide meals, childcare, and transportation to facilitate family
participation in addition to helping families find ways to resolve other
challenges to their participation.
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Engaging Families in the Intervention Program
Engaging and keeping families in the intervention program is one of the most
serious challenges in prevention research. (Gorman-Smith et al., in press- a; Prinz,
Smith, Dumas, Laughlin, White, Barrón, 2001; Quinn, 1999). Yet, families may differ in
their perception of the value of prevention activities. Because they do not perceive their
child as having problems with the kinds of behaviors targeted and they may not have
necessarily sought intervention themselves, families may not see the immediate value of
spending time in such activities. In addition many families with at-risk youth,
particularly those from lower socioeconomic backgrounds, may justifiably mistrust social
service or educational institutions and professionals. There may be serious concern about
the reason for interest in the family and whether the requests to participate are
trustworthy. A number of families may have been involved with previous research
projects and based upon these experiences may expect misleading, condescending and/or
insensitive requests. Even among those interested in participating, other demands may
compete for their time and energy.
Nonetheless, continuous family engagement is critical. One study has uncovered
two different patterns of involvement among participating families: families that were
immediately responsive and families that required extensive and intensive engagement
efforts (Gorman-Smith, et al., in press-a). Both types of families were eventually
involved and both were found to be engaged and enthusiastic. This study points to the
importance of persistence and problem-solving with families around barriers to
participation (e.g., schedule conflicts, child resistance, transportation).
The experience and skill of the interventionist is critical to family participation in
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the program (Patterson & Forgatch, 1985). Families are more likely to stay engaged when
interventionists 1) are assertive, positive, and empathetic when contacting families and
easily accessible after contact, 2) address barriers to participation directly, 3) can frame
difficulties as understandable, but also expect families to participate fully in the program,
4) stay focused on the practical in resolving participation dilemmas and 5) foster a
collaborative, mutually respectful atmosphere.
The Families Involved
The families who agreed to participate in the GREAT Families Program varied
both across sites and within sites though they shared some common characteristics (Table
1). Overall, the families were disproportionately poor. These families represented a
diversity of racial-ethnic backgrounds (though predominantly African American), family
structures, and geographic locales. Some families reside in urban Midwest areas while
others reside in more rural southeastern settings. Even within a site, some families might
reside in more suburban neighborhoods while others may reside in urban neighborhoods.
Implementing the multi-family program across these sites is a step towards examining the
implementation and generalizability of this approach in settings that have various
demands.
Sensitivity to Family Diversity in Prevention Programming
The GREAT Families program includes families from diverse racial, ethnic,
social, geographic, and cultural backgrounds. The project screens staff for their
experience and sensitivity in dealing with families like the ones who would participate in
the program. It is critical for potential staff to demonstrate their ability to recognize and
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discuss ways that cultural backgrounds relate to their own and the participants’ values
and beliefs about families, and to perceptions about the program.
Once hired, the project conducts training to help staff further explore their own
ability to interact effectively with families and discusses background readings about
family functioning and prevention approaches with African-American and Mexican-
American families (Murray, Smith, & Hill, 2001; Smith, Prinz, Dumas, & Laughlin,
2001, Stevenson, 2001; Szapocznik, Santisteban, Rio, Perez-Vidal, 1989; Tolan &
Gorman-Smith, 1997; Wright and Smith, 1998). These discussions are an important part
of training, supervision, and the intervention. To supplement the discussion of the reading
materials provided, exercises are conducted during training in which interventionists are
asked to reflect upon how they might be perceived by families (i.e., aspects of their
presentation and style that may help or hinder program participation), and role-play a
variety of scenarios to help staff practice and feel comfortable in handling the many ways
that families may raise issues of race and culture (i.e., accusations that the school
personnel are racist, not engaging in practices because they are in conflict with their
religious teachings or cultural values about families, etc.). The exploration of cultural
issues presents a potentially valuable activity for interventionists in their weekly group
and individual supervision sessions led by trained clinicians. Additionally, a “Cultural
Considerations Section” is integrated into the manualized sessions to help the
interventionists think about the ways that race, culture, and social status might interact
with the material in the family sessions. This might include thinking about gender and
family roles in Latino families or views of institutions and racism among African
American families. Interventionists who are conscious of these influences will be better
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equipped to help families find effective, realistic and culturally consonant ways of
handling challenges. It will also help facilitate for families the distinction of cultural
practices that represent strength and health promotion and those that are problematic. In
turn, interventionists will then be better equipped to foster problem- resolution and
recognize potential areas of strength and protective factors that they can help promote
among families.
Evaluating Process Aspects of the Intervention Effects
Examining whether the intervention was implemented as intended and
establishing the extent to which it is this intervention, as theoretically constructed, that is
reducing risk are important functions of process evaluation (Kazdin, 1999; Tolan &
Gorman-Smith, in press). This type of analysis moves beyond a “black box” conception
and measurement of intervention effects to provide valuable information about the
validity of the theory guiding the intervention (Kazdin, 1999). Another major purpose of
process evaluation is to document the fidelity or integrity of the intervention delivery;
that is whether the program was delivered as intended to the targeted recipients (Dumas,
Lynch, Laughlin, Smith, & Prinz, 2001; Moncher & Prinz, 1991; Rossi, Freeman, &
Lipsey, 1999). The fourth purpose of the process evaluation of the targeted intervention
is to examine the intervention processes that potentially moderate and mediate change.
Our hypothesis is that process characteristics such as perceived helpfulness of the
intervention provider and program, family participation/enthusiasm, and extent to which
the critical activities of each session are carried out will, at least partially, mediate the
extent of change in these targets, and therefore the preventive benefit of the intervention.
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The GREAT Families Program’s process and fidelity measurement strategy
sought to obtain reports about fidelity and process characteristics from at least two
sources (usually staff and participating parents and youth), repeated at four time points
over the course of the intervention, four data points for process measurement and four
data points of fidelity/program adherence data. Three analytic interests will be served by
these data: 1) examining systematic family change in the theorized direction during
intervention as expected; 2) assuring that the program was delivered as intended in what
was delivered and how it was delivered; and 3) examining the family (e.g. enthusiasm,
satisfaction with content), group (e.g. cohesiveness and mutual respect) and provider (e.g.
respect for families, relationship with families) characteristics related to and potentially
moderating program impact upon family functioning and youth violent and aggressive
behavior.
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Summary and Discussion
In summary, the GREAT Families program is designed to bolster the family as a
means of helping to interact more positively within multiple ecological settings in an
effort to positively impact youth behavioral and academic outcomes, recognizing the
socio-cultural contexts in which families, youth, peers, and schools develop. The family
program has already been piloted and is being implemented with two successive year
cohorts of youth and families in the four collaborating sites. Future work will examine
data from this portion of the GREAT Schools and Families program in efforts to share
what we have learned about approaches and efforts to promote positive outcomes for
children and families.
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Acknowledgements
1Centers for Disease Control and Prevention, Atlanta, GA 2University of Illinois-Chicago,
IL 3University of Georgia-Athens, GA 4Duke University-Durham, NC 5Virginia
Commonwealth Unviersity-Richmond, VA. Please address correspondence to Emilie
Phillips Smith, Division of Violence Prevention, CDC, 4770 Buford Highway, MS K-60,
Atlanta, GA 30341, [email protected].
The authors gratefully appreciate the valuable, diligent and persistent efforts of the site-based coordinators, Claire Hyman (Duke University), Alice Virgil (University of Chicago-Illinois), Lori Durham-Reaves (University of Georgia-Athens) and Cheryl Groce-Wright (Virginia Commonwealth University) and their contributions in developing and implementing this program. We would also like to acknowledge the innumerable parents, youth, teachers, principals, and school personnel and other staff without whom this work would not have been possible. This study was fund by the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, CDC Cooperative Agreements U81/CCU417759 (Duke University), U81/CCU517816 (University of Chicago-Illinois), U81/CCU417778 (University of Georgia) and U81/CCU317633 (Virginia Commonwealth University).
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Table 1 – Description of Participating Families
Respondent/Caregiver Frequency Percentage Mother 450 82%Father 29 5%Stepparent 6 1%Foster parent 5 1%Grandparent 41 8%Aunt/uncle 11 2%Other 6 1%
Marital Status Never Married 198 36%Married 175 32%Divorced 61 11%Separated 51 11%Co-habitating 31 5%Widowed 24 4%
Race-ethnicityAfrican American/Black
387 83%
American Indian/Native American
3 .65%
European American/White
60 13%
Hispanic/Latino (regardless of race)
82 15%
Highest Educational Level Completed
Some high school
181 32%
High school grad
208 38%
Some post-high school
93 17%
College graduate
45 8%
Post graduate education
11 2%
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Table (cont’d) – Description of Families
Income Frequency PercentageLess than 10,000
131 25%
10-19,999 141 26%20-29,999 93 17%30-39,999 69 13%40-49,999 34 6%50-59,999 19 4%60-69,999 14 3%70,000 and above
34 6%
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MODERATORS FAMILY PARENTING FAMILY OTHER SYSTEM CHILD FUNCTIONING LIFE STRESS SCHOOL CONDITIONS NEIGHBORHOODCHARACTERISTICS
PARENTAL DEPRESSION
PARENTS’ PARTNER VIOL.
SERVICE UTILIZATION
MARITAL STATUS
.
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COHESION
ORGANIZATION
BELIEFS
MONITORING
DISCIPLINEPRACTICE
FAMILY /NEIGHBORHOOD
RELATIONS
FAMILY/PEERRELATIONS
Family/School Relations
Social Competence
AGGRESSION/VIOLENCE
Academic Functioning