Table 4: Universal Prevention Programs
Name of Program,Source / Overall Program Description
(Includes setting, target
population, & format) / Family Support
Components / Study Design
& Sample / Outcomes
1. Center for Improvement of Child Caring Effective Black Parenting Program (EBPP)
Sources:
Study Sources:
Study 1:
Myers et al. (1992) / Program Delivery: Various community settings (e.g. schools, churches, mosques)
Target Population: Targeting African American families (parents and children between 2 and 12 years of age)
Goals: To prevent behavioral and emotional problems among children, to encourage healthy development and self esteem, to decrease risk of delinquency and substance abuse, and to reduce the risk of child abuse.
Program Focus: EBPP is based upon a cognitive behavioral framework that provides information and parenting strategies. The child is not directly seen.
The program is either offered as a 15-week class that meets in a group format for three hours each week, or as a group seminar that meets for one day.
The program is delivered by a professional team consisting of mental health providers and Black educators. / Informational: Education about African American values, single parenting, and preventing substance use.
Instructional: Parenting strategies coupled with African cultural components (e.g. proverbs). / Study #1: Quasi-experimental. Two cohorts of parents were assigned to EBPP (n=109) or a control condition (n=64). Pre/post and 1- year follow-up data was collected (follow-up data was only collected on the first cohort). / Child: Significant improvement in child behaviors (e.g. decreases in hyperactivity among cohort I youth, delinquency among cohort II youth).
Parent: Significant reductions in parental rejection (cohort I) greater use of praise, decreased physical punishment (among cohort II parents)
Results for both child and parent outcomes were maintained at follow-up.
Other: Significant improvement in family relationships from pre to post.
2. COPEing with Toddler Behavior (CWTB)
Sources:
Niccols (2004)
Niccols (2009)
Study Sources:
Study #1: Niccols (2004)
Study #2: Niccols (2009) / Program Delivery: Various settings.
Target Population: Targeting parents of early age children between 12 and 36 months of age.
Goals: To prevent the onset of behavioral problems and enhance the relationship between parent and child
Program Focus: CWTB is a skills-based program for parents of young children. The child is not directly seen.
The program was originally offered in a 3-week format that expanded into a 8-week class meeting in a group format for two hours each week. Groups of between 10-25 parents break into groups of between 4-6, and view videotapes of parents who deliberately make mistakes in parenting. Parents both discuss the errors in their small groups and then as a larger group, and generate alternate parenting behaviors.
The program is delivered by professionals (providers with mental health and early childhood educational specialists). / Informational: Content around normal developmental behaviors
Instructional: Parenting strategies (e.g. positive strategies including praise and positive reinforcement, time out and limit setting to decrease negative behaviors)
Instrumental: Transportation, free parking and childcare, food / Study #1: Pilotstudy (pre, post, and follow-up) of the three-session course.
90 families participated, 48 provided data at all three time points
Study #2: RCT of 79 mothers into either the intervention or WLC. Pre/post/1 month follow-up. / Child: Reductions in problematic behavior (small to medium ES)
Parent: Increased knowledge about parenting children; reduction in disturbed interactions between parent and child and parental distress; high parent satisfaction
Child: Reductions in problematic child behaviors, improvements in positive behavior significant for condition (in favor of intervention group) at follow-up; no significant difference between groups for negative behaviors, or across time points within groups
Parent: Significantly greater improvements in parent/child interaction, including compliance and positive parenting; improvements in parental depression and overreactivity in comparison to WLC over time; no significant impact of group upon laxness over time. ES for both groups on parental measures were small; high parent satisfaction
3. Dare to be You (DTBY)
Sources:
Miller-Heyl et al. (1998)
Study Sources:
Study #1:
Miller-Heyl et al. (1998) / Program Delivery: Delivered in schools and the community.
Target Population: Targeting families of preschool children (between 2 and 5), elementary-school youth (5-7/8), and middle school children (ages 11/12-14).
Goals: To prevent the onset of mental health and substance abuse problems.
Program Focus: DARE, which stands for Decision-making, Assertiveness, Responsibility, and Esteem,
was originally developed as a universal prevention program that has also been used with high-risk families.
a. The preschool program consists of 10-12 weekly meetings over 3-4 months; child and parents are in separate groups, and then participate together on an activity. Parent components target skill-building (e.g. parental stress reduction and family management skills, child components aim to enhance cognitive, problem solving, communication skills); family meal and activities encourage parent/child interaction/enhancement of parent/child relationship.
b. The Bridges program (for youth 5-8 years) meets for 11 weeks over 3-4 months for two hours/session. The focus is also on skill acquisition, and includes fostering relationship between teachers and parents; activities are provided for siblings.
c. Care to Wait for Families with Youth (for 11-14 year olds) adapts the DTBY model for middle school students by also including content around safe sexual practices/abstinence. It consists of 11 weekly meetings over 3-4 months. Afterschool programs for youth in kindergarten through 12th grade are also available.
The program is delivered by trained professionals. / Informational: Information about child development (preschool)
Instructional: Strategies to manage stress, problem-solving communication, and decision making skills (preschool), parental monitoring and communication skills (Care to Wait)
Emotional: Encourages the development of a supportive environment and network.
Instrumental: Family meal (preschool and Bridges), childcare (children’s program for siblings). / Study #1: RCT: Low SES families of children 2-5 years of age randomly assigned to the preschool DTBY program (n=496) or a no-treatment control group (n=301). Two-year follow-up.
No published studies of Bridges or the Care to Wait for Families with Youth programs. / Child: Oppositional behaviors decreased, developmental levels increased among youth in the DTBY condition; no changes in social competence or dependency due to the intervention.
Parent: Significant improvements in self-esteem and self-efficacy comparative to the control group. Effects were maintained over time; minimal impact upon locus of control over time. Significant improvement in parenting (e.g. decreases in harsh punishment, use of effective discipline), and self-appraisals. Satisfaction with support from others improved over time.
4. Early Home Based Intervention
Sources:
Cheng et al. (2007)
Study Sources:
Study #1:
Cheng et al. (2007) / Program Delivery: Home setting.
Target Population: Targeting families of infants between 5 and 9 months of age.
Goals: To prevent behavior problems. The child is not directly seen.
Program Focus: Based in Japan, the program consists of home visits occurring on a monthly basis for five months, approximately one hour each visit.
Delivered by professionals-nurses. / Informational: (SAU): information about caretaking, nutrition, child’s health.
Instructional: Facilitator models ways to interact with child/to enhance sensitivity to child.
Emotional: Discussion of caretaking and observation of mother/child interaction coupled with praise and positive reinforcement, and affirmation. / Study #1: RCT of 95 mother/child pairs assigned to the intervention + services as usual (SAU) or SAU (e.g. parenting education, information on caring for an infant, including nutrition and health, general check-ups, mental health treatment if needed). Two-year follow-up. / Child: The intervention did not have a significant effect upon problem behaviors.
Other: Only mothers in the intervention group who had a troubled relationship with their child evidenced improvements in the quality of their relationship.
5. Family School Partnership (FSP)
Sources:
Bradshaw et al. (2009)
Ialongo et al. (2001)
Study Sources:
Study #1: Ialongo et al. (2001)
Study #2: Bradshaw et al. (2009) / Program Delivery: School setting.
Target Population: Targeting first grade students and their families.
Goals: To prevent academic difficulties and aggression among school-aged children through parent involvement in their child’s education and parenting strategies. To enhance parent/teacher communication. The child is not directly seen.
Program Focus: FSP aims to enhance the child’s success in school through enhancing parental involvement in their child’s education and teaching parents parenting strategies. Additional components (e.g. a voicemail system, assignments) encourage communication between parents, teachers, and mental health professionals.
Delivered by a professional team of a mental health provider (psychologist, social worker) and teacher. / Instructional: Five of the seven workshops focus on parenting strategies; the other two teach parents to be involved in reading and math with their child and review strategies to involve them in their child’s education. / Study #1: Randomized block design (three classrooms across nine schools were randomly assigned to either a) a classroom-centered intervention, b) FSP, or c) a control group. Teachers and children randomly assigned, equal genders per groups.
Assessed both immediately and at five years follow-up.
Study #2: RCT to a) a classroom-centered intervention (child only), b) FSP, or c) a control group. Sample consisted of 678 primarily ethnic minority children and their families. Followed from the first grade to the age of 19 (assessed during grades 1-3 and 6-12) / Child: At five-year follow-up, both intervention groups were associated with lower conduct problems (reported by teachers) and were less likely to have a conduct disorder diagnosis than youth in the control group (however, this relationship was only significant for the classroom curriculum (CC) group). Additionally, children who received the CC had significantly lower rates of school suspensions comparative to the control group; for children whose families received FSP, this relationship was only significant among the girls.
Parent: No significant intervention effects upon parenting (e.g. monitoring, discipline), but there were significant intervention effects concerning greater reinforcing activities and decreased rejection.
Other: At five-year follow-up, the CC group had significantly lower rates of mental health service use, and teacher-reported need for mental health services than the other groups.
Child: Marginally significant impact of FSP on reading (overall sample only) and math performance (for both the overall sample and among boys). No significant impact of FSP upon academic performance (teacher rated) from the 6th to 12th grades.
Other: No significant effect of FSP upon use of special education, graduation from high school, or attending college.
6. FRIENDS
Sources:
Barrett et al. (2005)
Lowry-Webster et al. (2001)
Study Sources:
Study #1:
Lowry-Webster et al. (2001)
Study #2: Barrett et al. (2005) / Program Delivery: School setting.
Target Population: Targeting children between 10-13 years of age and their families.
Goals: To prevent the onset of depression and anxiety among children. Children and their parents are seen separately in groups.
Program Focus: An Australian, CBT-based child and parent treatment program that has been adapted as a universal prevention program. The FRIENDS program (an acronym for the strategies, which consist of Feeling Worried, Relax and feel good, Inner thoughts, Explore plans, Nice work so reward yourself, Don’t forget to practice, and Stay calm, you know how to cope now).
The caregiver skills component is three to four, 2-hour sessions: sessions present an overview of the child’s program, and teaches parenting skills and anxiety reduction skills for parents to use to reduce their own anxiety.
The child’s component is based upon the Coping Koala Group Workbook (Barrett, 1995) and Coping Cat (Kendall, 1990).
.
Delivered by a variety of professionals, including trained teachers (Lowry et al., 2001) and mental health providers (e.g. psychologist, doctoral students) (Barrett et al., 2005). / Informational: Education about anxiety symptoms, cognitive, learned, and physiological facets of anxiety.
Instructional: Parenting techniques (use of positive reinforcement and praise, mild punishment techniques to decrease negative behaviors); skills to reduce anxiety; communication, problem-solving skills; skills to support partners. / Study #1:RCT
Sample: 594 youth randomly assigned by class to either FRIENDS or a comparison group.
Study #2: Seven schools (692 youth in the sixth and ninth grades) were randomly assigned to either FRIENDS or a monitoring condition. 12-month Follow-up data collected. / Child: Youth in the intervention group reported decreased symptoms of anxiety across risk levels compared to the comparison group at posttest. Depression decreased among intervention youth in the high anxiety group only.
Child: Significant decreases in anxiety and depression at post among moderate and high-risk youth. At follow-up, intervention youth evidenced greater improvements in anxiety. Sixth grade youth evidenced significant reductions in anxiety compared to ninth grade children at post; at follow up, improvements were equal across both age groups.
7. Home-based intervention
Sources:
AronenArajarvi (2000)
AronenKurkela (1996)
Study Sources:
Study #1: Aronen & Kurkela (1996)
Study #2: Aronen & Arajarvi (2000) / Program Delivery: Home based.
Target Population: Targeting pregnant women.
Goals: To prevent future mental health.
Program Focus: To reduce adverse mental health outcomes among youth by providing parents with education about the child’s development and parenting strategies in order to enhance the relationship between parent and child and improve parenting and attitudes toward the child.
Delivered by professionals-nurses who visit mothers approximately 10 times yearly (every four to six weeks) until the child turned five. The child is not directly seen. / Informational: About child development, family risks.
Instructional: Parenting strategies. / Study #1: A sample of every 8th family who was selected from maternity wards was assigned as either high or low risk and assigned to either the intervention or a control group. 15-year follow-up.
Study #2: Same study as above; 20-year follow-up. / Child: Children in the intervention group evidenced greater reductions in overall symptoms (both parent and child report); the intervention was associated with significantly greater decreases in internalizing than externalizing symptoms. The intervention was associated with better mental health at follow-up than the control group.
Child: The intervention group had significantly fewer symptoms (e.g. internalizing, attention problems) in comparison to the control group at follow-up. The intervention was more effective among high-risk youth, and reduced risks associated with adverse mental health outcomes.
8. Linking the Interests of Families and Teachers (LIFT)
Sources:
Eddy et al. (2000)
Reid et al. (1999)
Study Sources:
Study #1:
Reid et al. (1999)
Study #2:
Eddy et al. (2000)
Study #3:
DeGarmo et al. (2009) / Program Delivery: School setting.
Target Population: Targeting 1st and 5th graders and their families.
Goals: To reduce delinquency and antisocial behaviors by improving the child’s relations with parents, peers, and teachers.
Program Focus: The program consists of a 10-week child component to reduce problematic behaviors and enhance problem solving and social skills. Children participate in a classroom component two times a week for one hour to learn and practice skills, which they practice on the playground (the modified Good Behavior Game) (Dolan et al., 1993). Parents are seen in a group setting once a week for six weeks to learn parenting strategies.
Delivered by a professional team with varied educational backgrounds (ranging from trainers with doctoral degrees to persons without a college degree). / Informational: Normal child development.
Instructional: Parent strategies, problem-solving, negotiation skills to help their child problem solve.
Instrumental: Free childcare. / Studies #1 and #2:
Four schools in high risk areas for crime were randomized to LIFT or control ($2,000 provided) per year; within each school, the first or fifth grade class was randomly assigned to the study. Post (Reid et al., 199) and three year follow-up (Eddy et al., 2000).
Study #3: RCT involving 351 youth from six schools who were randomized to either LIFT or a control condition. / Child: Children in the LIFT condition were less aggressive towards peers, and engaged in more positive behaviors based upon teacher reports than the control groups at posttest. LIFT had the greatest impact among children with the most severe problem behaviors at pretest.
At follow-up, youth in the LIFT groups evidenced longer delays in substance use debuts, arrests, and involvement with antisocial peers.
Parent: Parents in the LIFT groups exhibited decreased aversive behavior towards their child than parents in the control group at posttest. High satisfaction at posttest.
Other: Teacher satisfaction was high.
Child: LIFT was associated with a decreased risk of tobacco and alcohol use (marginal effect upon initiating substance use) in comparison to control youth. Although girls had higher tobacco and drug use compared to boys, LIFT had a greater impact upon escalation of drug use among females.
9. Resourceful Adolescent Program-Family (RAP-F)
Sources:
Harnett & Dadds (2004)
Shochet et al. (2001)
Study Sources:
Study #1: Shochet et al. (2001)
Study #2: / Program Delivery: School setting.
Target Population: Targeting adolescents 12-15/16 years of age and their families.
Goals: RAP-Family aims improve the parent/child relationship.
Program Focus: Based upon CBT and Interpersonal Psychotherapy, RAP-Family is a three-session adjunctive program for parents that is added onto the RAP-Adolescent Program, which consists of 11, 40-50 minute sessions.
Separate groups for adolescents and parents.
Delivered by a professional team (e.g., psychologists); Harnett & Dadd (2004) studied program when delivered by school personnel (teachers). / Informational:
Adolescent development
Instructional: Managing conflict in the family, stress management, parenting strategies (e.g. to enhance theiradolescent’s self-esteem).
Instrumental: Food (dinner) / Study #1: 260 youth assigned to RAP-A, RAP-Family, or Adolescent Watch. 10 month follow-up
Study #2: Not stated. / Child: In comparison to the control group, youth in both RAP-A and RAP-F evidenced significantly less symptoms of depression and hopelessness at posttest and follow-up.