Family Matters

OVERVIEW

The goal of the Family Matters program is to prevent tobacco and alcohol use in adolescents, primarily those between the ages of 12 and 14 years. The program provides parents of adolescents with information about parenting and substance use prevention. Experimental, random-assignment studies of the Family Matters program have found that it is effective in decreasing and preventing cigarette use and, to a smaller degree, reducing alcohol use and onset.

DESCRIPTION OF PROGRAM

Target population: Adolescents aged 12-14

The Family Matters program is a theory-driven program that works with both adolescents and their parents to prevent the use of tobacco and alcohol. Parents are mailed four instructional booklets, which contain information for parents and activities for parents to work on with their children. Parents and adolescents receive information about normal adolescent development, predictors of adolescent substance use, the influence that the family, peers, and the media can have, and how to take action to prevent substance use. Parents are contacted by health educators by phone after they receive each mailing. On average, parent-adolescent pairs spend 4.5 hours working on the curriculum and parents spend 1 hour of time speaking with the health educator. The program takes families on average 234.9 days to complete. Throughout the program, parents identify normal and risky behaviors in their adolescent and are asked to identify factors which may be encouraging alcohol or tobacco use. Then, families lay out family expectations and rules relating to alcohol and tobacco. In 2000, the cost of replicating the program, omitting all research expenses, was estimated at $140.42 per eligible participant.

EVALUATION(S) OF PROGRAM

Study 1: Bauman, K. E., Foshee, V. A., Ennett, S. T., Pemberton, M., Hicks, K. A., King, T. S., & Koch, G. G. (2001). The influence of a family program on adolescent tobacco and alcohol use. American Journal of Public Health, 91(4), 604-610.

Evaluated population: 1,135 families who had adolescents ages 12-14 in their households were analyzed in this study. The authors note that non-Hispanic whites (78%), two-parent households, and college-educated mothers (32%) were slightly over-represented.

Approach: 64,811 residential telephone numbers were sampled in a Random Digit Dial (RDD) procedure, in order to obtain a nationally-representative U.S. sample. Households with adolescents ages 12-14 (N=2,395; 3.7%) were contacted. If there was more than one adolescent in the household, one was selected at random for the study and the other was omitted from the study. Eligible matched pairs (N=1,316) were randomly assigned to the treatment group or the control group. The analytic sample included 1,135 pairs (86%) that completed one or both follow-ups.

Families were then contacted 3 months and 12 months after the conclusion of the program for follow-up data collection. Control group participants were contacted during the same periods as their matched counterparts in the treatment condition. At the 3-month and 12-month follow-up, adolescents reported if they had ever smoked cigarettes, drank alcohol, or used smokeless tobacco.

Results: Family Matters reduced smoking initiation rates, with 16.4% fewer initiators in the treatment group than in the control group at the 1-year follow up (small effect size of 0.15). The greatest impact on smoking initiation was concentrated among non-Hispanic whites, with 25% fewer initiators in the treatment group than in the control group at the 1-year follow up (small effect size of 0.25). The program did not have any impact on adolescent drinking or smokeless tobacco use at either the 3 or 12 month follow-up.

Study 2: Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., King, T. S., & Koch, G. G. (2002). Influence of a family program on adolescent smoking and drinking prevalence. Prevention Science, 3(1), 35-42.

Evaluated population: This study is an extension of the study described in Study 2. However, the sample includes adolescents who were smoking Thus, 1316 adolescents participated in this study.

Approach: The approaches to sample selection, treatment assignment, and data collection are the same as described in Study 2. Drinking and smoking status was assessed via self-report items asking how often the adolescents had used alcohol or cigarettes in their lifetimes. The analyses conducted in this study included adolescents who were smoking or drinking at the time of baseline data collection and adolescents who were not.

Results: Compared with the control group adolescents, Family Matters adolescents smoked less often at both 3 and 12 month follow-up periods (small effect sizes .19 and .17 respectively). Likewise, they drank less often than control group adolescents at both follow-up periods (effect sizes .32 and .12 respectively). Demographic characteristics did not modify program impact. The authors note that these analyses provide stronger evidence that the program affects both smoking and alcohol use than their previous studies because this study has greater statistical power.

Study 3: Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., Kling, T. S., & Koch, G. G. (2000). Influence of a family-directed program on adolescent cigarette and alcohol cessation. Prevention Science, 1(4), 227-237.

Evaluated Population: This study evaluated a subsample of 12- to 14-year old adolescents and their parents (N=288 pairs) who were selected from the nationally representative population of U.S. households described in Study 2. Pairs with an adolescent who reported cigarette use or alcohol use at baseline were selected, in order to examine cessation.

Approach: The approaches to treatment assignment and data collection were the same as described in Study 2. This study analyzed a subgroup from the sample described in Study 2, focusing on adolescents who reported smoking or drinking at the time of the baseline measure (N=288 pairs). At baseline and at follow-up, adolescents reported the number of days in the past 30 days they had drank alcohol or smoked cigarettes.

Results: The program had no impacts on smoking or alcohol cessation and did not decrease the number of days the adolescent had used cigarettes or alcohol in the past 30 days. The researchers note that their analyses were limited because of the small sample sizes and non-availability of medical testing for the presence of alcohol and cigarette use.

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://familymatters.sph.unc.edu/Program_materials.htm

References

Study 1: Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., King, T. S., & Koch, G. G. (2002). Influence of a family program on adolescent smoking and drinking prevalence. Prevention Science, 3(1), 35-42.

Study 2: Bauman, K. E., Foshee, V. A., Ennett, S. T., Pemberton, M., Hicks, K. A., King, T. S., & Koch, G. G. (2001). The influence of a family program on adolescent tobacco and alcohol use. American Journal of Public Health, 91(4), 604-610.

Study 3: Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., King, T. S., & Koch, G. G. (2000). Influence of a family-directed program on adolescent cigarette and alcohol cessation. Prevention Science, 1(4), 227-237.

Program categorized in this guide according to the following:

Evaluated participant ages: 12-14

Program age ranges in the Guide: adolescence

Program components: clinic-based, provider-based, or miscellaneous; parent or family component

Measured outcomes: physical health, smoking, alcohol use

KEYWORDS: Adolescence (12-17), Clinic-based, Home-based, Substance Use, Tobacco Use, Alcohol Use, White or Caucasian, Hispanic or Latino, Black or African American, Life Skills Training, Community or Media Campaign, Parent Education, Manual, Cost

Program information last updated 8/19/09

		© Child Trends 2004