Beyond effectiveness of the Strengthening Families Program (10-14): a scoping RE-AIM-based review

A scoping review, based on the RE-AIM framework, was conducted to analyze evidence of reach, effectiveness, adoption, implementation, and maintenance of the Strengthening Families Program (10-14), a preventive family-based substance abuse program for adolescents. Sixty-five articles were included. The results disclosed that effectiveness, implementation, and maintenance at the individual-level were the most evaluated aspects, while reach, maintenance at the setting-level, and adoption were the least investigated aspects. Positive effects on drug abuse prevention and protective parenting factors were found in the U.S. studies. Likewise, Latin American studies have shown the improvement of parenting practices. However, European studies have produced mixed results, with predominantly null effects on substance abuse. The implementation quality was high. There is no available evidence of adoption and maintenance at the setting-level by the organizations that implemented it. New studies must examine the reach, adoption, and sustainability of the program to lay foundations for its future use as an instrument of public policies.

The Influence of the Competences of the Professionals in Charge of Family Evidence-Based Programmes on Internalizing and Externalizing Symptoms in Adolescents

This study analyses the influence of trainers' intrapersonal and group management competences on the effectiveness of the Universal Strengthening Families Program 11-14 (SFP 11-14). More specifically, it assesses the effect of these competences on internalizing and externalizing symptoms in adolescents. The analysed data is made up of ratings given by the 174 mothers participating in SFP 11-14. The results confirm the effectiveness of SFP 11-14 in reducing internalizing and externalizing symptoms in adolescents. Using linear regression models, evidence is provided of the influence of the trainers' expertise, in terms of their competences, in improving internalizing symptoms in adolescents (through a reduction in levels of anxiety, depression, and somatization and in the global internalization scale). Emphasis is placed on how trainer competences can impact on the effectiveness of evidence-based programmes, stressing that this should be taken into account by the public authorities and other stakeholders in the assessment and design of family evidence-based programmes.

Establishing the Effectiveness of Enhanced Implementation Methods in Preventative Behavioral Health

Background: More than 20 million Americans ages 12 and older have a past-year substance use disorder. Majority-minority cities, including Flint, MI, suffer disproportionately from higher rates of substance use and are less likely to have access to evidence-based prevention and treatment interventions relative to predominately White and wealthier cities. Thus, identifying approaches that can improve implementation of evidence-based substance use practices is a critical public health goal. In the current report, we provide a detailed protocol for the implementation and evaluation of the Strengthening Flint Families initiative, a community-based implementation study of a multi-level behavioral health intervention that includes peer recovery coaching, the Strengthening Families Program, and a multimedia campaign. Our goal is to improve family resilience and reduce behavioral health disparities in the Flint community, as an example of how this could be done in other communities. Our overall strategy includes community-informed implementation enhancements to increase adoption and sustainment of evidence-based behavioral health services. Methods: This project has 4 phases that align with study aims- 1) a systematic assessment of behavioral health organizations in the Flint Area to understand organizational needs and strengths in Flint; 2) tailoring implementation strategies for one individual-level evidence-based practice, peer recovery coaching, and one family-level evidence-based program, the Strengthening Families Program; 3) building capacity and promoting sustainability; and 4) evaluating primary (implementation) and secondary (effectiveness) outcomes. Implementation outcomes are derived from the RE-AIM framework and effectiveness outcomes will be assessed at the individual, family, and community levels. Discussion: Understanding and addressing the behavioral health organizational needs, strengths, and barriers to program adoption and referral in Flint offers great promise to strengthen the behavioral health network of providers serving Flint residents. Moreover, understanding barriers to accessing and implementing behavioral health services in low-resource communities may prove to be a valuable tool for discovering the most effective implementation methods tailored to specific organizations. These evidence informed approaches may prove useful for cities outside of Flint.