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Evidence-based Family Interventions for Dissemination to States Dr. Karol Kumpfer Professor Dept of Health Promotion and Education University of Utah. Strong Families are the Backbone of a Strong Community. Accepting responsibility makes a family: Physical necessities Emotional support
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Evidence-based Family Interventions for Dissemination to States Dr. Karol KumpferProfessorDept of Health Promotion and EducationUniversity of Utah
Strong Families are the Backbone of a Strong Community • Accepting responsibility makes a family: • Physical necessities • Emotional support • Learning opportunities • Moral guidance • Building skills and resilience • When families fail,society pays the price
What State Policy Makers Need to Know • Family interventions 9 times more more effective than individual interventions with youth. • Family has the greatest impact on children’s later health problems. • How can we get practitioners to adopt evidence-based practices?
What are the Major Family Risk Factors?(Kumpfer & DeMarsh, 1985, Chassin, et al., 2004) • Family conflict • Lack of love, care, & support • Lack of supervision or discipline • Lack of family rituals • Low expectations for school success • Lack of communication • Sexual or physical abuse
How do Family Environmental Risks Interact with Biological Risk Factors? 1.Genetically Inherited Risks in Type II Alcoholic Families (Schuckit, 1997) • Difficult Temperament • Hyperactivity or Rapid Tempo • Autonomic Hyperactivity • Rapid Brain Wave 2. Decreased Verbal IQ 3. Rapid Metabolism of Alcohol 4.Fetal Alcohol & Drug Syndrome
What Family Dynamics Support the Development of Family Protective Factors? • Family Attachment • Love and Care • Family Organization • Routines and Traditions • Supervision and Guidance • Good Communication • Family Fun
Self-Control F = .21 M= .27 Academic Self-Efficacy Normed Fit Index F: = .90 M: = .92 F = .19 M= .16 F = .71 M= .71 F = .88 M= .88 F = .43 M= .36 Family Bonding Family and Peer Norms Family Supervision No Substance Use F = .62 M= .55 Social and Community Prevention Environment Female: (n=5,488) Male: (n=3,023) F = .12 M= .17 Primary Protective Factors (Kumpfer, Whiteside, & Turner, 2003)
What Supports the Development of Resilience In Children and Families?(Kumpfer & Franklin, in press; Masten, et al., in press; Luthar, et al., in press) • Caring and Empathetic • Wise and Insightful • Happy and Optimistic • Intelligent and Competent • High Self-esteem • Direction, Mission and Purpose in Life • Determination and Perseverance
Effect Sizes (ES) for Family-based Prevention (Tobler & Kumpfer, 2000) • Youth Only Interventions .10 • Parenting Skills Training .31 • Family Therapy .45 • Family Skills Training .82 • In-home Family Support 1.62 • Mean ES Family Interventions .96
Evidence-based Family Interventions(see www.strengtheningfamilies.org) • 7 Exemplary I (replicated parenting and family programs: • Incredible Years (3-10 years) • Helping the Non-compliant Child (3-7 years) • Strengthening Families (3-16 years) • Guiding Good Choices (PFDY) 8-14 years) • Functional Family Therapy (10-18) • Multisystemic Therapy (10-18) • Treatment Foster Care (12-18)
Strengthening Families Program • NIDA (1982-1986) research and 15 SFP replications found positive results: • Improved parenting knowledge & skills • Improved family relationships • Improved children’s social skills and behavior
SFP 6-12 NIDA RCT on Component Outcomes (Kumpfer & DeMarsh, 1986) • Parent Training: increases parenting skills and decreases children’s conduct disorders and decreased family conflict • Children’s Skills Training: Increased children’s social skills • Family Skills Training: Increased family cohesion and organization • Reduced parent & child alcohol/drug use
SFP: An Evidence-based Practice • NIDA Red Book • OJJDP Strengthening America’s Families • CSAP Model Program • CMHS Model Program • ONDCP Model Program • International Cochrane Collaboration Reviews (Foxcroft et al., 2003)
Factors Effecting Effective Implementation of Evidence-based Models? • MONEY: Evidence based programs cost a little more but deliver real results (more cost-effective). • Federal and state government earmarks for funding for Evidence-based Programs increase implementation dramatically. • Congress earmarked 13.5 million for EB family programs to 142 communities per year in 1998 and drug use came down. • New Jersey legislature earmarks 1.8 million for SFP in 55 communities • Virginia legislature also earmarked funds.
Other Factors Impacting Wide-scale Dissemination • Training and Technical Assistance Systems needed (Developers have, CSAP did support, Texas developed own, but also need universities to support) • Culturally Adapted Versions help increase recruitment and retention 40%. • Referral Systems to get high risk families to attend (judges to court order families with criminal drug charges or child protective services orders).
Questions and Contacts Phone: (801) 582-1652 Fax: (801) 581-5872 kkumpfer@xmission.com www.strengtheningfamilies.org (801) 583-4601