Skip to main content

Advertisement

SpringerLink
Log in

Children with Elevated Psychosocial Risk Load Benefit Most from a Family-Based Preventive Intervention: Exploratory Differential Analyses from the German “Strengthening Families Program 10–14” Adaptation Trial

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

While the effectiveness of substance use prevention programs such as the Strengthening Families Program 10–14 (SFP) has been demonstrated in the USA, European SFP adaptations have not replicated these sizable effects. Following the rationale of the risk moderation hypothesis positing that elevated risk groups may benefit more from a preventive intervention than lower-risk groups, we reanalyzed evaluation data from a randomized controlled trial testing the adapted German version of SFP (SFP-D). We hypothesized a differential impact of risk status on intervention results. The study employed a minimal control condition. Of the N = 292 participating children, 73.5% qualified as at-risk because they lived in a deprived urban district, and 26.5% qualified as high risk because they additionally scored as “difficult” in the German Strengths and Difficulty Questionnaire (parents’ reports using gender- and age-specific German norms). Outcomes were children’s self-reports on substance use, mental health, family functioning, and quality of life. Data were analyzed with repeated measures linear mixed models and relative risk analyses. The high-risk group in the SFP-D condition achieved the best results compared with all other groups, especially in mental health and quality of life. Relative risk analyses on tobacco [alcohol] abstinence showed that an additional percentage of 29.8% [16.0%] of high-risk children in nonabstinent controls would have remained abstinent if they had participated in SFP-D. We conclude that risk load influences the impact of substance use prevention programs and discuss to what extent differential analyses can add value to prevention research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Allen, D., Coombes, L., & Foxcroft, D. R. (2007). Cultural accommodation of the Strengthening Families Programme 10–14: UK phase I study. Health Education Research, 22, 547–560.

    Article  PubMed  Google Scholar 

  • Altendorfer-Kling, U., Ardelt-Gattinger, E., & Thun-Hohenstein, L. (2007). Der Selbstbeurteilungsbogen des SDQ anhand einer österreichischen Feldstichprobe. [The self-report version of the Strengths and Difficulties questionnaire in an Austrian field sample]. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 35, 265–271.

    Article  PubMed  Google Scholar 

  • Baldus, C., Thomsen, M., Sack, P.-M., Bröning, S., Arnaud, N. Daubmann, A., & Thomasius, R. (2016). Evaluation of a German version of the Strengthening Families Programme 10–14. European Journal of Public Health of Public Health, 1–7. [Advance Access published July 3, 2016]. doi:10.1093/eurpub/ckw082

  • Bröning, S., Kumpfer, K., Kruse, K., Sack, P. M., Schaunig-Busch, I., Ruths, S., et al. (2012). Selective prevention programs for children from substance-affected families: A comprehensive systematic review. Substance Abuse Treatment, Prevention, and Policy, 7, 23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bröning, S., Sack, P. M., Thomsen, M., Stolle, M., Wendell, A., Stappenbeck, J., & Thomasius, R. (2014). Implementing and evaluating the German adaptation of the “Strengthening Families Program 10-14”—A randomized-controlled multicentre study. BMC Public Health, 14, 83.

    Article  PubMed  PubMed Central  Google Scholar 

  • Burkhart, G., & Simon, R. (2015). Prevention strategies and basics. In N. El-Guebaly, G. Carrà, & M. Galanter (Eds.), Textbook of addiction treatment: International perspectives (Vol. 1, pp. 115–141). Italia: Springer-Verlag.

    Chapter  Google Scholar 

  • Calafat, A., Garcia, F., Juan, M., Becoña, E., & Fernández-Hermida, J. R. (2014). Which parenting style is more protective against adolescent substance use? Evidence within the European context. Drug and Alcohol Dependence, 138, 185–192.

    Article  PubMed  Google Scholar 

  • Chassin, L., Sher, K. J., Hussong, A., & Curran, P. (2013). The developmental psychopathology of alcohol use and alcohol disorders: Research achievements and future directions. Development and Psychopathology, 25, 1567–1584.

    Article  PubMed  PubMed Central  Google Scholar 

  • Connell, A. M., & Frye, A. A. (2006). Growth mixture modelling in developmental psychology: Overview and demonstration of heterogeneity in developmental trajectories of adolescent antisocial behaviour. Infant and Child Development, 15, 609–621.

    Article  Google Scholar 

  • Conrod, P. J., O’Leary-Barrett, M., Newton, N., Topper, L., Castellanos-Ryan, N., Mackie, C., & Girard, A. (2013). Effectiveness of a selective, personality-targeted prevention program for adolescent alcohol use and misuse: A cluster randomized controlled trial. JAMA Psychiatry, 70, 334–342.

    Article  PubMed  Google Scholar 

  • Dawson-McClure, S. R., Sandler, I. N., Wolchik, S. A., & Millsap, R. E. (2004). Risk as a moderator of the effects of prevention programs for children from divorced families: A six-year longitudinal study. Journal of Abnormal Child Psychology, 32, 175–190.

    Article  PubMed  Google Scholar 

  • Degenhardt, L., Stockings, E., Patton, G., Hall, W. D., & Lynskey, M. (2016). The increasing global health priority of substance use in young people. The Lancet Psychiatry, 3, 251–264.

    Article  PubMed  Google Scholar 

  • DeWit, D. J., Adlaf, E. M., Offord, D. R., & Ogborne, A. C. (2014). Age at first alcohol use: A risk factor for the development of alcohol disorders. American Journal of Psychiatry, 157, 745–750.

    Article  Google Scholar 

  • du Prel, J. B., Hommel, G., Röhrig, B., & Blettner, M. (2009). Confidence interval or p-value? Part 4 of a series on evaluation of scientific publications. Deutsches Ärzteblatt International, 106, 335–339.

    PubMed  PubMed Central  Google Scholar 

  • Fairlie, A. M., Wood, M. D., & Laird, R. D. (2012). Prospective protective effect of parents on peer influences and college alcohol involvement. Psychology of Addictive Behaviors, 26, 30.

    Article  PubMed  Google Scholar 

  • Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.

    Article  PubMed  Google Scholar 

  • Foxcroft, D. R., & Tsertsvadze, A. (2012). Universal school-based prevention programs for alcohol misuse in young people. [Cochrane Review]. Evidence-Based Child Health, 7, 450–575.

    Article  Google Scholar 

  • Glaser, R. R., Horn, M. L. V., Arthur, M. W., Hawkins, J. D., & Catalano, R. F. (2005). Measurement properties of the Communities That Care® Youth Survey across demographic groups. Journal of Quantitative Criminology, 21, 73–102.

    Article  Google Scholar 

  • Goodman, A. (2010). Substance use and common child mental health problems: Examining longitudinal associations in a British sample. Addiction, 105, 1484–1496.

    Article  PubMed  Google Scholar 

  • Heck, R. H., Thomas, S. L., & Tabata, L. N. (2013). Multilevel and longitudinal modeling with IBM SPSS. London: Routledge.

    Google Scholar 

  • Kellam, S. G., Mackenzie, A. C., Brown, C. H., Poduska, J. M., Wang, W., Petras, H., & Wilcox, H. C. (2011). The Good Behavior Game and the future of prevention and treatment. Addiction Science and Clinical Practice, 6, 73–84.

    PubMed  PubMed Central  Google Scholar 

  • Kirillova, G., Reynolds, M., Kirisci, L., Mosovsky, S., Ridenour, T., Tarter, R., & Vanyukov, M. (2014). Familiality of addiction and its developmental mechanisms in girls. Drug and Alcohol Dependence, 143, 213–218.

    Article  PubMed  PubMed Central  Google Scholar 

  • Koning, I. M., Verdurmen, J. E., Engels, R. C., van den Eijnden, R. J., & Vollebergh, W. A. (2012). Differential impact of a Dutch alcohol prevention program targeting adolescents and parents separately and simultaneously: Low self-control and lenient parenting at baseline predict effectiveness. Prevention Science, 13, 278–287.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883.

    Article  PubMed  Google Scholar 

  • Kumpfer, K. L., Maghalhães, C., Xie, J., & Kanse, S. (2016). Cultural and gender adaptations of evidence-based family interventions. In M. J. Van Ryzin, K. L. Kumpfer, G. M. Fosco, & M. T. Greenberg (Eds.), Family-based prevention programs for children and adolescents. Theory, research, and large-scale dissemination (pp. 256–281). London: Psychology Press.

    Google Scholar 

  • Luthar, S. S., & Eisenberg, N. (2017). Resilient adaptation among at-risk children: Harnessing science toward maximizing salutary environments. Child Development, 88, 337–349.

    Article  PubMed  Google Scholar 

  • Meeus, W. (2017). Adolescent psychosocial development: A review of longitudinal models and research. Developmental Psychology, 52, 1969–1993.

    Article  Google Scholar 

  • Meier, M. H., Hall, W., Caspi, A., Belsky, D. W., Cerdá, M., Harrington, H. L., et al. (2016). Which adolescents develop persistent substance dependence in adulthood? Using population-representative longitudinal data to inform universal risk assessment. Psychological Medicine, 46, 877–889.

    Article  CAS  PubMed  Google Scholar 

  • Miettunen, J., Murray, G. K., Jones, P. B., Mäki, P., Ebeling, H., Taanila, A., et al. (2014). Longitudinal associations between childhood and adulthood externalizing and internalizing psychopathology and adolescent substance use. Psychological Medicine, 44, 1727–1738.

    Article  CAS  PubMed  Google Scholar 

  • Molgaard, V., & Spoth, R. (2001). The Strengthening Families Program for young adolescents: Overview and outcomes. Residential Treatment for Children & Youth, 18, 15–29. doi:10.1300/J007v18n03_03.

    Article  Google Scholar 

  • Morris, A. S., Robinson, L. R., Hays-Grudo, J., Claussen, A. H., Hartwig, S. A., & Treat, A. E. (2017). Targeting parenting in early childhood: A public health approach to improve outcomes for children living in poverty. Child Development, 88, 388–397.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention: Principles of effective prevention programs. American Psychologist, 58, 449–456.

    Article  PubMed  Google Scholar 

  • Okulicz-Kozaryn, K., & Foxcroft, D. R. (2012). Effectiveness of the Strengthening Families Programme 10–14 in Poland for the prevention of alcohol and drug misuse: Protocol for a randomized controlled trial. BMC Public Health, 12, 319.

    Article  PubMed  PubMed Central  Google Scholar 

  • Olson, D. H. (2008). FACES IV manual. Minneapolis: Life Innovations.

    Google Scholar 

  • Pérez, J. M. E., Díaz, S. A. H., Villa, R. S., Hermida, J. R. F., Crespo, J. L. C., & Rodríguez, O. G. (2010). Family-based drug use prevention: The "familias que funcionan" program. Psychology in Spain, 14, 1–7.

    Google Scholar 

  • Segrott, J., Holliday, J., Rothwell, H., Foxcroft, D., Murphy, S., Scourfield, J., Hood, K., & Moore, L. (2014). Cultural adaptation and intervention integrity: A response to Skärstrand, Sundell and Andréasson. The European Journal of Public Health, 24, 354–355.

    Article  PubMed  PubMed Central  Google Scholar 

  • Skärstrand, E., Sundell, K., & Andréasson, S. (2014). Evaluation of a Swedish version of the Strengthening Families Programme. The European Journal of Public Health, 24, 578–584.

    Article  PubMed  Google Scholar 

  • Smit, E., Verdurmen, J., Monshouwer, K., & Smit, F. (2008). Family interventions and their effect on adolescent alcohol use in general populations: A meta-analysis of randomized controlled trials. Drug and Alcohol Dependence, 97, 195–206.

    Article  PubMed  Google Scholar 

  • Spoth, R., Redmond, C., Shin, C., & Azevedo, K. (2004). Brief family intervention effects on adolescent substance initiation: School-level growth curve analyses 6 years following baseline. Journal of Consulting and Clinical Psychology, 72, 535–542.

    Article  PubMed  Google Scholar 

  • Spoth, R., Shin, C., Guyll, M., Redmond, C., & Azevedo, K. (2006). Universality of effects: An examination of the comparability of long-term family intervention effects on substance use across risk-related subgroups. Prevention Science, 7, 209–224.

    Article  PubMed  Google Scholar 

  • Spoth, R., Trudeau, L., Redmond, C., & Shin, C. (2014). Replication RCT of early universal prevention effects on young adult substance misuse. Journal of Consulting and Clinical Psychology, 82, 949–963.

    Article  PubMed  PubMed Central  Google Scholar 

  • Spoth, R., Trudeau, L., Shin, C., Ralston, E., Redmond, C., Greenberg, M., & Feinberg, M. (2013). Longitudinal effects of universal preventive intervention on prescription drug misuse: Three randomized controlled trials with late adolescents and young adults. American Journal of Public Health, 103, 665–672.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stevens, J. P. (2002). Applied multivariate statistics for the social sciences (4th ed.). Mahwah: L. Earlbaum.

    Google Scholar 

  • Stockings, E., Hall, W. D., Lynskey, M., Morley, K. I., Reavley, N., Strang, J., Patton, G., & Degenhardt, L. (2016). Prevention, early intervention, harm reduction, and treatment of substance use in young people. The Lancet Psychiatry, 3, 280–296.

    Article  PubMed  Google Scholar 

  • Stolle, M., Stappenbeck, J., Wendell, A., & Thomasius, R. (2011). Family-based prevention against substance abuse and behavioral problems: Culture-sensitive adaptation process for the modification of the US-American Strengthening Families Program 10–14 to German conditions. Journal of Public Health, 19, 389–395.

    Article  Google Scholar 

  • Stronski, S. M., Ireland, M., Michaud, P. A., Narring, F., & Resnick, M. D. (2000). Protective correlates of stages in adolescent substance use: A Swiss National Study. Journal of Adolescent Health, 26, 420–427.

    Article  CAS  PubMed  Google Scholar 

  • Sullivan, G. M., & Feinn, R. (2012). Using effect size—Or why the p value is not enough. Journal of Graduate Medical Education, 4, 279–282.

    Article  PubMed  PubMed Central  Google Scholar 

  • Toumbourou, J. W., Stockwell, T., Neighbors, C., Marlatt, G. A., Sturge, J., & Rehm, J. (2007). Interventions to reduce harm associated with adolescent substance use. The Lancet, 369, 1391–1401.

    Article  CAS  Google Scholar 

  • Van Ryzin, M. J., Roseth, C. J., Fosco, G. M., Lee, Y. K., & Chen, I. C. (2016). A component-centered meta-analysis of family-based prevention programs for adolescent substance use. Clinical Psychology Review, 45, 72–80.

    Article  PubMed  PubMed Central  Google Scholar 

  • Velleman, R., Templeton, L., Reuber, D., Klein, M., & Moesgen, D. (2008). Domestic abuse experienced by young people living in families with alcohol problems: Results from a cross-European study. Child Abuse Review, 17, 387–409.

    Article  Google Scholar 

  • Verdurmen, J. E., Koning, I. M., Vollebergh, W. A., van den Eijnden, R. J., & Engels, R. C. (2014). Risk moderation of a parent and student preventive alcohol intervention by adolescent and family factors: A cluster randomized trial. Preventive Medicine, 60, 88–94.

    Article  PubMed  Google Scholar 

  • Vigna-Taglianti, F. D., Galanti, M. R., Burkhart, G., Caria, M. P., Vadrucci, S., & Faggiano, F. (2014). “Unplugged,” a European school-based program for substance use prevention among adolescents: Overview of results from the EU-Dap trial. New Directions for Youth Development, 141, 67–82.

    Article  Google Scholar 

  • Weiss, M., Schmucker, M., & Lösel, F. (2015). Meta-Analyse zur Wirkung familienbezogener Präventionsmaßnahmen in Deutschland. [Meta-analytic review of family-based prevention programs in Germany]. Zeitschrift für Klinische Psychologie und Psychotherapie, 44, 27–44.

    Article  Google Scholar 

  • Woerner, W., Becker, A., & Rothenberger, A. (2004). Normative data and scale properties of the German parent SDQ. [Suppl. 2]. European Child & Adolescent Psychiatry, 13, II3–II10. doi:10.1007/s00787-004-2002-6.

    Google Scholar 

Download references

Acknowledgements

We would like to thank our student assistants (Ninja Deierling and Sarah Kupsa) as well as the former project staff Martin Stolle, Astrid Wendell, and Julian Stappenbeck for their support throughout the study. We also would like to thank our cooperating partners, all of them nongovernment organizations: (1) Hamburg: Jugend hilft Jugend e.V., (2) München: Condrobs e.V., (3) Hannover: Step Hannover GmbH, (4) Schwerin: VSP GmbH, (5) München: “Keine Macht den Drogen e.V”, and Ulm: “Förderverein für suchtgefährdete Kinder und Jugendliche e.V. (FSKJ)”.

Author information

Authors and Affiliations

  1. German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany

    Sonja Bröning, Christiane Baldus, Monika Thomsen, Peter-Michael Sack, Nicolas Arnaud & Rainer Thomasius

  2. Medical School Hamburg (MSH), Hamburg, Germany

    Sonja Bröning

Authors
  1. Sonja Bröning
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christiane Baldus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Monika Thomsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter-Michael Sack
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicolas Arnaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rainer Thomasius
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sonja Bröning.

Ethics declarations

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

This work was funded by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF) Grant 01EL0810 awarded to Rainer Thomasius.

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures were approved by the ethics committee of the Chamber of Physicians of Hamburg.

Informed Consent of Study Participants

Informed consent was obtained from all individual participants included in the study.

Electronic Supplementary Material

Appendix 1

(DOCX 18 kb)

Appendix 2

(DOCX 13 kb)

Appendix 3

(DOCX 37 kb)

Appendix 4

(DOCX 35 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bröning, S., Baldus, C., Thomsen, M. et al. Children with Elevated Psychosocial Risk Load Benefit Most from a Family-Based Preventive Intervention: Exploratory Differential Analyses from the German “Strengthening Families Program 10–14” Adaptation Trial. Prev Sci 18, 932–942 (2017). https://doi.org/10.1007/s11121-017-0797-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-017-0797-x

Keywords

Search

Navigation