Program

Feb 12, 2010

OVERVIEW

Guiding Good Choices, called GGC in the rest of this summary, is a skills training program designed to decrease a child’s likelihood of using drugs and alcohol. The program uses a multimedia approach to teach parents how to interact effectively with their children. GGC consists of five workshops that emphasize child, parent and family practices that help discourage and prevent adolescent substance use. Findings from two studies are presented below. An early random assignment study examined the program’s effects on parenting skills and parent-child interactions and demonstrated mixed, largely positive, findings depending on whether the parent was a mother or father and his/her communication skills at the start of the program. A larger school-level random assignment study tested the program’s impacts on children’s substance use and depressive symptoms, showing positive results for both.

DESCRIPTION OF PROGRAM

Target population: Children ages 8-14

Guiding Good Choices strives to reduce adolescent substance use by altering the ways in which families interact and communicate about risky behaviors. GGC consists of five 2-hour sessions for parents, one of which children also attend. Each session is dedicated to improving a certain skill. The first session provides an overview of the program and presents information on risk factors that lead to substance use among adolescents. Session two introduces ways in which to develop family policies and expectations for children. Children attend the third session with their parents. In this session, peer resistance and avoidance skills are taught. Session four stresses conflict management and expressing feelings in a constructive manner. The fifth and final session covers child and family interactions as well as parents’ rewards and feedback for children’s behavior. Each session concludes with a homework assignment that is to be completed by the family.

Session leaders are selected based on previous experience and the ability to conduct group activities. Three months before the program begins, leaders receive three days of training. Leaders also receive a one-day booster session two weeks before GGC begins. Leaders are organized in teams of two to conduct the GGC program sessions. Intervention participants are divided into sections so that the workshops are not too large.

EVALUATION(S) OF PROGRAM

Mason, W. A., Kosterman, R., Hawkins, J. D., Haggerty, K. P., Spoth, R., & Redmond, C. (2007). Influence of a family-focused substance use preventive intervention on growth in adolescent depressive symptoms. Journal of Research on Adolescence, 17(3), 541-564.

Evaluated Population: Rural adolescent sixth-graders (N=332) from 33 schools in a Midwestern state were evaluated and followed through the twelfth grade. Only one child per family was recruited for the study. The average age of the selected children was 11.35 years. Most families were two-parent (86 percent), had a girl as the selected child (52 percent), and were white (over 95 percent). The families’ median household income was $32,000 in 1993, and most mothers (61 percent) and fathers (58 percent) reported having some education past high school.

Approach:  This article tested GGC’s potential to reduce depressive symptoms among adolescents. Schools were randomly assigned to one of three conditions: the GGC condition, the Iowa Strengthening Families Condition (not discussed here), and the control condition.

Pre-test and post-test took place in grade six while four follow-up measurements occurred each year until grade 12. Variables measured were self-report adolescent depressive symptoms using the Child Behavior Checklist – Youth Self-Report and self-report multiple substance use. The other variables taken into account at baseline were maternal depression, parent education, and child gender.

Results: The authors found that the intervention decreased multiple substance use over time. They also found that although depressive symptoms among both treatment and control adolescents rose over the 6 years of the study, they rose more slowly among the GGC group. The authors calculated that GGC reduced the rate of feelings of worthlessness by 28%. In other words, for every 100 12th graders who had feelings of worthlessness in the general population, 28 fewer (or 72) would have them in the GGC group. Compared to girls, boys’ depressive symptoms were lower overall and increased at a slower rate than girls.

 

Rueter, M., Conger, R., & Ramisetty-Mikler, S. (1999). Assessing the benefits of a parenting skills training program: A theoretical approach to predicting direct and moderating effects. Family Relations, 48(1), 67-77.

Evaluated population: Six economically disadvantaged school districts in a Midwestern state were identified to participate in the study. GGC staff sent a letter and brochure explaining the program to those families with 6th or 7th graders, as identified by the schools. Of the 387 eligible families, 85 program-group families and 90 control-group families completed the post-test and thus had data for evaluation.

At pretest (N=209), two-parent families made up 89.5 percent of the families in the study. Only 3.0 percent of the couples were cohabiting. Remaining parents were divorced, separated or widowed. The median age for mothers was 39 while fathers reported a slightly older median age of 41. The average family had 2 or 3 children and reported a median family per capita income of approximately $6,800 per family member.

Approach: Families were randomly assigned to either a treatment condition (n=103) or a control condition (n=106). Families in the control group were put on a wait list and could receive the GGC program after the evaluation was completed. During the assessment, participating family members completed questionnaires and checklists identifying family practices and conflicts. Afterwards, they took part in family tasks, which measured general family interactions and problem-solving behaviors. Home visits lasted approximately 2 ½ to 3 hours. After the visit was completed, participants were given a second questionnaire to fill out and a postage-paid envelope in which they could send it back.

Data were collected during home visits, during which family interactions were observed and videotaped and family members completed questionnaires on family practices, financial concerns, marital difficulties, and family conflicts.

Trained observers who were unaware of program assignment assessed the videos. Observers received 200 hours of training initially and then 4 hours per week in additional training. Videos, questionnaires, and reports were evaluated measuring parental communication, parental negativity and quality of the parent-child relationship.

Results: Fathers who participated in the GGC program reported significantly better outcomes for paternal communication skills, parent-child relationship quality and parental negativity than the control group. Mothers in the GGC program reported significantly better outcomes for maternal communication skills only.

Furthermore, fathers with already stronger communication skills at baseline showed greater gains in those skills at post-test compared with fathers who had weaker skills at baseline. However, for mothers, weak communication skills at baseline were associated with greater gains in those skills. For marital difficulties, fathers had no subgroup impacts like they did with communication skills, though mothers did. Mothers reporting more marital difficulties showed greater gains in communication skills and relationship quality than those reporting stronger marriages. Mothers did not gain more or less in any post-test measure based on financial concerns, while fathers did. Fathers with fewer financial concerns showed greater gains in reduced negativity and relationship quality than those with more financial concerns.

Kosterman, R., Hawkins, D., Spoth, R., Haggerty, K. & Zhu, K. (1997). Effects of a preventive parent-training intervention on observed family interactions: Proximal outcomes from Preparing for the Drug Free Years. Journal of Community Psychology, 25(4), 337-352.

Evaluated population: See previous summary, Rueter, M., Conger, R., & Ramisetty-Mikler, S. (1999).

Approach: Families were randomly assigned to GGC (N=103) or to a wait-list control group (N=106).

Assessments were conducted as they were in the previous two evaluations using home visits, questionnaires and videotaped interaction tasks.

There were two tasks that the parents were recorded participating in with the child. Task 1 is a general interaction task involving reading and discussing questions given to them. Task 2 is a problem-solving task where the family attempts to resolve an issue that they identified as the most important.

This evaluation assessed proactive communication, negative parent-child interactions and quality of the parent-child relationship. Proactive communication includes the extent to which a parent is appropriately assertive, responsive and reasonable with the child.

Results: GGC had a significant impact on improving proactive communication skills for mothers in both the general interaction and problem-solving tasks and for fathers in the problem-solving task. Although the intervention decreased negative interactions, the results were only significant for mothers in the general interaction task. Finally, GGC reported a moderate impact on the quality of the parent-child relationship; fathers in the treatment group reported significantly higher quality relationships than their control group counterparts for the problem-solving task and for mothers in the general interaction task.

Park, J., Kosterman, R., Hawkins, J.D., Haggerty, K.P., Duncan, T.E., Duncan, S.C., & Spoth, R. (2000). Effects of the “Preparing for the Drug Free Years” curriculum on growth in alcohol use and risk for alcohol use in early adolescence. Prevention Science, 1(3). 125-138.

Evaluated population: The program identified 33 rural schools in 19 economically disadvantages counties in a Midwestern state.

In the original sample of 424 families, 82 percent of the parents were married. Each family had, on average, three children and the average age of the target child was 11.3 years. The mean age of the parents was 36.9 for mothers and 39.6 for fathers. Almost all families were white. The median annual per capita income for a five person family was $37,500.

Approach: Of 33 schools, 11 were randomly assigned to the control condition, 11 to the GGC treatment group and 11 to a second intervention study which will not be discussed here. This resulted in 217 families in the treatment group and 207 in the control group. Families in the control group received four brochures in the mail on adolescent development and were put on the wait list for the GGC program.

Data were collected at pretest, approximately two months before GGC was implemented. Posttest data were collected nine months after program completion and follow-up data were collected 1, 2, and 3.5 years later. Data were collected in the same manner as the previous evaluation with home visits, questionnaires and videotaped interaction tasks.

Families were evaluated according to parents’ norms toward drug and alcohol use, family management skills, family conflict, refusal skills and alcohol use.

Results: Although immediate impacts on alcohol use were not found, the GGC group reported significantly less growth in alcohol use over time from pre-test through the 3.5 year follow-up.

Parents in the GGC treatment group enhanced or maintained their norms against substance use significantly more than the control group. With regard to family management, the evaluation found only moderate improvement among the GGC group. Additionally, the evaluation did not find any significant outcomes on measures of family conflict or refusal skills.

 SOURCES FOR MORE INFORMATION

Link to program curriculum: http://www.drp.org/prevention-programs/search-by-age/

References

Kosterman, R., Hawkins, D., Spoth, R., Haggerty, K. & Zhu, K. (1997). Effects of a preventive parent-training intervention on observed family interactions: Proximal outcomes from Preparing for the Drug Free Years. Journal of Community Psychology, 25(4), 337-352.

Mason, W. A., Kosterman, R., Hawkins, J. D., Haggerty, K. P., Spoth, R., & Redmond, C. (2007). Influence of a family-focused substance use preventive intervention on growth in adolescent depressive symptoms. Journal of Research on Adolescence, 17(3), 541-564.

Park, J., Kosterman, R., Hawkins, J.D., Haggerty, K.P., Duncan, T.E., Duncan, S.C., & Spoth, R. (2000). Effects of the “Preparing for the Drug Free Years” curriculum on growth in alcohol use and risk for alcohol use in early adolescence. Prevention Science, 1(3). 125-138.

Rueter, M., Conger, R., & Ramisetty-Mikler, S. (1999). Assessing the benefits of a parenting skills training program: A theoretical approach to predicting direct and moderating effects. Family Relations, 48(1), 67-77.

Program categorized in this guide according to the following:

Evaluated participant ages: 6th and 7th grade / Program age ranges in the Guide:  6-11, 12-14

Program components: clinic-based, provider-based, or miscellaneous; parent or family component, community/media campaign

Measured outcomes: social and emotional health and development; physical health; behavioral problems

KEYWORDS: Middle School, Children (3-11), Adolescents (12-17),  Rural and/or Small Towns, Manual is Available, Clinic/Provider-based, Parent/Family Component, Depression/Mood Disorders, Alcohol Use, Marijuana/Illicit/Prescription Drugs, Skills Training.

Program information last updated 2/12/10              

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