Strategies for involving parents of high-risk youth in drug prevention: A three-year longitudinal study in boys & girls clubs
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STRATEGIES FOR INVOLVINGPARENTS OF HIGH-RISK YOUTHIN DRUG PREVENTION:A THREE-YEAR LONGITUDINALSTUDY IN BOYS & GIRLS CLUBS
Tena L. St. Pierre and D. Lynne KaltreiderPennsylvania State University, University Park
Involving parents of high-risk youth in community-based interventionprograms is extremely challenging. This article presents six groups ofstrategies for recruiting and retaining parents of high-risk youth in a parentinvolvement program called the Family Advocacy Network (FAN Club). TheFAN Club program accompanied a drug prevention program for the parentsearly adolescent children who were members of Boys & Girls Clubs. Strategiespresented are based on a longitudinal study that found positive programeffects for youth in Boys & Girls Clubs that offered the FAN Club with thethree-year youth drug prevention program and monthly youth activities.Strategies are: (1) identify the right person to lead the program; (2) clearlyconvey the purpose of the program; (3) build relationships of mutual trust,respect, and equality; (4) create parent ownership and group bonding;(5) provide easy access, incentives, and reminders; and (6) be flexible butpersistent. q 1997 John Wiley & Sons, Inc.
The governments latest National Household Survey on Drug Abuse indicated that theuse of drugs, particularly marijuana, among our nations youth has increased dramati-
A R T I C L E
JOURNAL OF COMMUNITY PSYCHOLOGY, Vol. 25, No. 5, 473485 (1997) 1997 John Wiley & Sons, Inc. CCC 0090-4392/97/050473-13
Tena L. St. Pierre is an associate professor in the Department of Agricultural and Extension Education, andSenior Research Associate at the Institute for Policy Research and Evaluation, The Pennsylvania State Univer-sity, University Park, PA 16802. D. Lynne Kaltreider is a research associate at the Institute for Policy Researchand Evaluation, The Pennsylvania State University, University Park, PA 16802.This research was funded by a grant from the Center for Substance Abuse Prevention, Substance Abuse andMental Health Services Administration, Public Health Service, Department of Health and Human Services,Grant No. 1H86SPO1383.Correspondence concerning this article should be sent to Tena L. St. Pierre, N253 Burrowes Building, ThePennsylvania State University, University Park, PA 16802.
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cally (Substance Abuse and Mental Health Services Administration, 1996). These find-ings have led communities across the United States to refocus their attention on the Waron Drugs and the need for effective strategies that prevent young people from startingto use drugs.
The upsurge of teen drug use clearly calls for the development and evaluation of in-novative prevention strategies that build on theory and prior research. Over the lastdecade, a growing body of research has identified risk factors for drug abuse that existin youths environments. In particular, the family environment has been shown to exerta powerful influence on adolescents potential drug use. Poor bonding between childrenand parents (Brook, Brook, Gordon, Whiteman, & Cohen, 1990), low parental involve-ment in activities with children (Kandel & Andrews, 1987), maternal isolation (Werner& Smith, 1982), poor family management practices (Coombs & Landsverk, 1988), andfamily history and parental approval of drug use (Hawkins, 1988) put youth at risk. Fur-thermore, the risk for youth drug use is increased when youths families are economi-cally disadvantaged (West, 1982; West & Farrington, 1979). Given the tremendous influ-ence the family environment has on young people, prevention researchers stronglyadvocate the involvement of parents in drug prevention programs for youth (DeMarsh& Kumpfer, 1986; Hawkins, Catalano, & Miller, 1992).
However, identifying and effectively implementing appropriate prevention programsfor parents of youth exposed to these risks is extremely challenging. A multitude of gen-eral family life skills programs and some parenting programs directed specifically towardthe prevention of youth drug use exist, but most were designed for middle-class Whiteparents. Most follow structured curricula, are often offered in weekly sessions, and in-volve didactic material, role-playing, discussions, and homework, strategies not appro-priate for high-risk families (DeMarsh & Kumpfer, 1986; Alvy, 1988).
Moreover, published evaluations of parent programs specifically designed to preventor reduce drug use by high-risk youth are rare (DeMarsh & Kumpfer, 1986). These eval-uations have been fraught with problems including: (1) high attrition (DeMarsh &Kumpfer, 1986); (2) small sample size (Klein & Swisher, 1983; Klitzner, Gruenewald, &Bamberger, 1990); (3) selection bias (DeMarsh & Kumpfer, 1986; Albert, Simpson, andEaglesham, 1983); (4) inability to secure and maintain control groups (Lorion & Ross,1992); and (5) lack of longitudinal designs (Lorion & Ross, 1992).
There are probably few well-designed and evaluated parent programs with high-riskfamilies because attracting and retaining parents is hardest among low-income popula-tions (Chilman, 1973; Halpern, 1990). Researchers shy away from such programs due tothe tremendous methodological challenges of evaluating preventive interventions incommunity settings with high-risk populations (Van Hasselt et al., 1993). Everyday stres-sors in low-income families environments such as poverty, poor housing, and unem-ployment make it difficult for programs to recruit and retain parents (Chilman, 1973).It is well documented that parent participation by low-income parents is typically low (Co-hen & Rice, 1995; DeMarsh & Kumpfer, 1986; Miller & Prinz, 1990) and that attemptingto involve low-income parents requires continuous labor-intensive efforts difficult to sus-tain over time by program staff (Ruch-Ross, 1992).
In this article, we discuss strategies used to recruit and retain parents of high-riskyouth in a parent involvement program offered with a youth drug prevention programimplemented in four Boys & Girls Clubs in different states. We believe that these strate-gies were integral to involving youths parents in the program and that parent partici-pation greatly contributed to the positive outcome results for youth. Below is a descrip-
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tion of the study and the outcome evaluation results, the parent involvement program,and a discussion of strategies to involve parents that were learned through our experi-ences conducting the multi-year prevention study.
The longitudinal study tested the incremental impact of a three-year youth drug pre-vention program with monthly youth activities and a parent involvement program (FANClub Group) relative to: (1) the three-year drug prevention program with monthly youthactivities but without parent involvement (Prevention Plus Group); (2) the three-yeardrug prevention program alone (Prevention Only Group); and (3) no program (Con-trol Group).
Sixteen Boys & Girls Clubs from eight different states in the East, South, and Mid-west participated in the study. Matched on as many socioeconomic and demographiccharacteristics as possible, four clubs were selected to participate in each of the fourstudy groups described above.
Participating clubs were located in what the Annie E. Casey Foundation terms se-verely distressed neighborhoods. According to the Foundation (1994), a neighborhoodis considered severely distressed if it meets at least four of five indicators. Average per-centages on four of these indicators for the census tracts in which the 16 clubs were lo-cated were: (1) incomes below poverty level above 27.5% (study clubs, 34%); (2) publicassistance recipients above 17% (study clubs, 20%); (3) female-headed households above39.6% (study clubs, 43%); and (4) high school dropouts above 23.3% (study clubs, 48%).
The 16 clubs also were located in high-risk neighborhoods with high crime rates and,in most cases, where the selling and using of drugs was prevalent. Fifty-eight percent ofyouth participants reported on the delayed posttest that many or most people in theirneighborhoods were using illegal drugs, and 61% indicated they had personally seen co-caine, crack, or other illegal drugs sold in their neighborhoods. Seventy-eight percentsaid they had been offered illegal drugs, half of them three or more times. Sixty per-cent said it would be easy to get marijuana, and 49% said it would be easy for them toget other illegal drugs.
Three hundred youth (96 in FAN Club; 64 in Prevention Plus; 84 in Prevention Only;and 56 in control) participated in all seven testing occasions over the 36-month study.Participants were 28% White; 54% Black; 14% Hispanic; and 4% Black Hispanic. Sixty-four percent were male, 36% were female, and the average age at baseline was 11.35years.
Results from the youth self-report questionnaire indicated positive program effectsfor youth in Boys & Girls Clubs that offered the three-year youth prevention programwith monthly youth activities and the FAN Club parent program. Over the 36 months,the FAN Club group reported increasing ability to refuse alcohol, marijuana, and ciga-rettes, and increasing negative attitudes toward using marijuana. In contrast, the no-program control group of Boys & Girls Clubs showed decreasing ability to refuse alco-hol, marijuana, and cigarettes, increasing favorable attitudes toward marijuana use, andthe least knowledge of any of the groups. For the most part, the other two interventiongroups held fairly constant over the 36 months on their ability to refuse alcohol, mari-juana, and cigarettes, and their attitudes toward marijuana use. (See St. Pierre, Mark,Kaltreider, & Aikin, 1997, for a detailed description of the studys outcome evaluationand the youth prevention program.)
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THE PARENT INVOLVEMENT PROGRAM
The parent involvement program, called the Family Advocacy Network or FAN Club forshort, was designed to strengthen high-risk families by creating a bond between programyouth and their parents, reducing maternal isolation, providing opportunities for fami-lies to participate in pleasurable activities together, assisting parents to influence theirchildren to lead drug-free lives, and providing social and instrumental support. Basedon the family support-resource model (Weissbourd & Kagan, 1989), the FAN Club wasdesigned to focus on families strengths rather than deficits, to inspire parental confi-dence and competence, to respond to family cultural preferences and values, to take adevelopmental view of parents, to be flexible and responsive to parental needs, to en-courage voluntary participation by parents, and to include parents as partners in theplanning and implementation of the program.
The FAN Clubs four developmental categories of parent involvement activities wereadapted from Landerholm and Karrs (1988) typology for involving parents in earlychildhood intervention programs. This approach focuses on the development of supportsystems for families and creating a match between parent needs and involvement op-portunities. By offering a developmental continuum of activities, parents can participateat their level of readiness. Some parents may be experiencing a great deal of stress whichcan affect the parents ability to function and to be a good parent. High family stress canaffect the child ( Jeremy & Bernstein, 1984) but having support and resources can re-duce the stress (Bristol, 1983; Dyson & Fewell, 1986; Gabel & Kotsch, 1981).
Many FAN Club families experienced high levels of stress in their daily lives and lowlevels of support. Many were socially isolated, had few friends, no phone, no transporta-tion, and no job. Offering a flexible program with developmental categories of activitiesprovided opportunities for families to participate according to their needs and wants.The program was geared to meet the needs of the parents rather than expecting parentsto meet the needs of the program.
A full-time FAN Club Coordinator and a part-time Parent Assistant (from the targetpopulation) were hired to conduct the FAN Club program (The FAN Club Coordinatoralso conducted the youth prevention programs.) Based at the Boys & Girls Club, FANClub activities fell broadly into four categories that fit the developmental needs of pro-gram parents.
Basic Support Activities helped families cope with daily life or with particular crises.This support was offered by the FAN Club Coordinator on a one-to-one basis to parents.At times, the support was necessary before a family was ready to participate in more struc-tured FAN Club activities at the Boys & Girls Club. Examples of basic support activitiesby FAN Club Coordinators included accompanying parents to appointments with socialservice agencies, assisting parents in dealings with their childrens school, giving supportto parents whose spouse or children were involved with the criminal justice system, help-ing a parent through crises by linking them with appropriate helping networks and shel-ters, providing transportation to parents for medical or court appointments, and visitinga parent in the hospital. FAN Club Coordinators became familiar with families needsand routinely made home visits to see how families were doing.
Parent Support Activities were regularly scheduled social activities that parents select-ed and participated in as a group. Though mostly social, these activities provided op-portunities for parents to give and receive support that many otherwise did not have be-cause of being socially isolated. Some activities were offered to parents only; others were
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open to parents and children. Examples of parent support activities were potluck din-ners, attending one anothers churches, bingo, picnics, crafts projects, pool parties,meeting for coffee, ice cream socials, movies, bowling, and skating.
Educational Program Activities, also selected by FAN Club parents, were designed toprovide education, knowledge, or enrichment experiences. Examples included speakersto discuss parenting, culturally appropriate events such as Black History programs, APuerto Rican Culture parade and Puerto Rican Heritage Night, AIDS programs, gangprevention workshops, health fairs, and the Boys & Girls Club of Americas drug pre-vention parent program, Keep SMART.
Leadership Activities were those which parents voluntarily took a major role in plan-ning and implementing. These included monthly FAN Club planning meetings, fundrais-ing, volunteering in the Boys & Girls Club programs (including the summer lunch pro-gram and club-wide dinners), visiting local nursing homes, and prevention programgraduations.
Level of Parent Involvement
As noted, FAN Club parents selected and helped implement a variety of family and par-ent activities each month. The FAN Club Coordina...