This study used data from a sample of 6th to 12th grade students (N = 48,641, 51% female), nested in 192 schools, to determine if the influence of family-based protective factors varied across different school contexts. Hierarchical logistic regression models were used to examine the effects of individual-level family protective factors, relative to school-level aggregates of the same factors, on recent (past 30 days) use of cigarettes, alcohol, and marijuana. Cross-level interactions indicated that the effect of the student's level of family protection, relative to other students in their school, differed depending on the aggregated school level of family protection. The results suggested that the benefit of belonging to a well-functioning family was more influential for students attending schools characterized by higher-than-average aggregated levels of protection compared to students attending schools of lower-than-average protection. Thus, family-level factors offered less protection for students in relatively high-risk school contexts. These results were consistent with a protective-reactive interaction and suggest that a thorough understanding of adolescent substance use must consider the complex interplay among adolescents, their families, and their social environments.

Despite the public health burden of adolescent substance use, delinquency, and other problem behavior, few comprehensive models of disseminating evidence-based prevention programs to communities have demonstrated positive youth outcomes at a population level, capacity to maintain program fidelity, and sustainability. We examined whether the Communities That Care (CTC; Hawkins and Catalano 1992) model had a positive impact on risk/protective factors and academic and behavioral outcomes among adolescents in a quasi-experimental effectiveness study. We conducted a longitudinal study of CTC in Pennsylvania utilizing biannual surveillance data collected through anonymous in-school student surveys. We utilized multilevel models to examine CTC impact on change in risk/protective factors, grades, delinquency, and substance use over time. Youth in CTC communities demonstrated less growth in delinquency, but not substance use, than youth in non-CTC communities. Levels of risk factors increased more slowly, and protective factors and academic performance decreased more slowly, among CTC community grade-cohorts that were exposed to evidence-based, universal prevention programs than comparison grade cohorts. Community coalitions can affect adolescent risk and protective behaviors at a population level when evidence-based programs are utilized. CTC represents an effective model for disseminating such programs.

PURPOSE: Improving the health of women before pregnancy is an important strategy for reducing adverse pregnancy outcomes for mother and child. This paper reports the first pretest-posttest results from a randomized trial of a unique, multidimensional, small group format intervention, Strong Healthy Women, designed to improve the health behaviors and health status of preconceptional and interconceptional women. METHODS: Nonpregnant pre- and interconceptional women ages 18-35 were recruited in 15 low-income rural communities in Central Pennsylvania (n = 692). Women were randomized in a ratio of 2-to-1 to intervention and control groups; participants received a baseline and follow-up health risk assessment at 14 weeks and completed questionnaires to assess behavioral variables. The analytic sample for this report consists of 362 women who completed both risk assessments. Outcomes include measures of attitudinal and health-related behavior change. MAIN FINDINGS: Women in the intervention group were significantly more likely than controls to report higher self-efficacy for eating healthy food and to perceive higher preconceptional control of birth outcomes; greater intent to eat healthy foods and be more physically active; and greater frequency of reading food labels, physical activity consistent with recommended levels, and daily use of a multivitamin with folic acid. Significant dose effects were found: Each additional intervention session attended was associated with higher perceived internal preconceptional control of birth outcomes, reading food labels, engaging in relaxation exercise or meditation for stress management, and daily use of a multivitamin with folic acid. CONCLUSIONS: The attitudinal and behavior changes attributable to the intervention were related primarily to nutrition and physical activity. These results show that these topics can be successfully addressed with pre- and interconceptional women outside the clinical setting in community-based interventions.

The predictors and correlates of positive functioning among community prevention teams have been examined in a number of research studies; however, the role of personality has been neglected. In this study, we examined whether team member and leader personality dimensions assessed at the time of team formation predicted local prevention team functioning 2.5-3.5 years later. Participants were 159 prevention team members in 14 communities participating in the PROSPER study of prevention program dissemination. Three aspects of personality, aggregated at the team level, were examined as predictors: Openness to Experience, Conscientiousness, and Agreeableness. A series of multivariate regression analyses were performed that accounted for the interdependency of five categories of team functioning. Results showed that average team member Openness was negatively, and Conscientiousness was positively linked to team functioning. The findings have implications for decisions about the level and nature of technical assistance support provided to community prevention teams.

Both the organizational studies literature and the community psychology literature discuss the importance of readiness when implementing change. Although each area emphasizes different characteristics, several common themes are present within the literature. The current study integrates and applies organizational and community psychology literature in evaluating community readiness in the context of a school-community-university collaborative prevention model. Results demonstrate (a) that there is substantial agreement between members of community prevention teams on the level of readiness of a community;(b) that readiness is a cohesive, but multidimensional, construct related to hypothesized community and individual characteristics; and (c) that there is small to moderate agreement between members of prevention teams and their "agency directors." These results support the notion that clear "theories of change" need to be formulated before deciding how to assess community readiness, as assessments will vary due to several factors: the type of respondent, the level in which analyses are conducted, and the specific community domain (i.e., school, workplace collaboration, collaboration experience) investigated.

PURPOSE: To compare the relative influence of risk and protective factors across several domains on adolescent substance use in a large sample of youth. METHODS: Cross-sectional survey data were collected from students in grades 6, 8, 10, and 12 in Pennsylvania (N = 91,778). Generalized linear mixed models were estimated for each grade level to examine associations among indices of three risk factors (individual, peer, and family) and three protective factors (family, school, and community) and both recent and lifetime substance use. RESULTS: The risk factors were stronger predictors of substance use outcomes compared with the protective factors, regardless of grade level or substance use type. In particular, the individual and peer risk factors were strongly related to lifetime and recent use of cigarettes, alcohol, and marijuana. Among the protective factors, the strongest associations with substance use were found in the community domain. Several age-related differences in the associations were also found, suggesting that family and community factors were more salient among younger adolescents whereas peer and school factors were stronger among older adolescents. CONCLUSIONS: These findings provide support for the social development model (SDM), which proposes that adolescent substance use is associated with factors across multiple spheres of influence. Age-related differences in these associations suggest that effective interventions to reduce adolescent substance use may need to emphasize different domains of risk and protective factors at different stages of adolescent development.

BACKGROUND: After many years in which evaluations had generally not found the coalition approach to be effective, the community-coalition approach has recently been shown to produce a public health impact if best practices are utilized. The next challenge is to foster sustainability among coalitions in order to achieve long-term public health outcomes. This study examined the level of and predictors of sustainability among Communities That Care (CTC) sites in Pennsylvania. METHODS: Board functioning and the funding of 110 CTC sites were assessed through the reports of board members, staff, and technical-assistance providers from 2003 through 2006; data were analyzed in 2007. RESULTS: Ninety percent of CTC coalitions continued after the 3-year initial funding period, with 3%-8% of sites terminating each year thereafter. Approximately two thirds of CTC sites continued to operate 4 years after the termination of the original 3-year implementation grant. Many of the sites attracted funding at a level equivalent to or greater than the initial grant. Overall coalition functioning, as reported by either board members or technical-assistance providers, along with planning for sustainability, predicted both survival and post-launch funding. CONCLUSIONS: Evidence suggests that board functioning predicts survival, at least in part independently of its influence on funding; and that planning for sustainability predicts sustainability, at least in part independently of overall coalition functioning.

PURPOSE: To facilitate research on adolescent risk and protection regarding behavior problems, and to facilitate community decision-making regarding resource allocation for intervention programs, by creating a reduced set of coherent aggregate indices of adolescent risk and protection. METHODS: We examined the 31 risk and protective factor scales in the Communities That Care Youth Survey (CTC-YS). Data came from two waves of the CTC-YS administered to sixth through 12th graders in Pennsylvania (2001 n = 43,842; 2003 n =101,988). Factor analysis and calculation of internal reliability were used to create aggregate indices of risk/protective factor domains. Correlations of aggregate indices with each other and with problem behaviors (antisocial behavior, substance use) were examined. RESULTS: Theory and empirical results led to the creation of seven coherent indices: Community Cohesion, Family Cohesion, Family Risk, School Support for Prosocial Activities, Antisocial Peer Domain, Attitudes toward Risky Behavior, Risky Behavioral Tendencies. Four scales were not included in the aggregate index (Religiosity, Academic Performance, Personal Transitions and Mobility, and Early Initiation of Drug Use and Antisocial Behavior). The indices were related to each other and to adolescent problem behaviors (antisocial behavior and substance use) in expected ways. Results were consistent across waves of data. CONCLUSIONS: The construction of theoretically meaningful and empirically defensible aggregate measures of adolescent risk and protective factors is possible, although analyses of other data sets and further discussion are warranted. The use of aggregate indices by researchers and communities is recommended as a way to facilitate research and decision-making.

Community coalition prevention models often select interventions based on the types of risk factors (outcome predictors) that are elevated. Variances and correlations between predictors and targeted behaviors also may vary between communities and provide information to improve the selection of interventions. Community differences in risk factor levels and correlations between predictors and problem behaviors were examined using a child self-report computer assessment (ALEXSA(c); prevention.psu.edu/people/ALEXSA.htm). Three school-based subsamples of children were studied. Means, prevalences, and correlations differed significantly between samples. Discussion addresses developmental considerations and illustrates how correlations between predictors and problem behaviors might improve the selection of interventions. This study is preliminary and should be replicated with larger community samples, more indicated/selected sample, and in more communities.

BACKGROUND: Little is known about the interplay of genotypes and malleable risk factors in influencing adolescent psychiatric symptoms and disorders. Information on these processes is crucial in designing programs for the prevention of psychiatric disorders. OBJECTIVE: To assess whether latent genetic factors and measured parent-child relationships interact (G x E) in predicting adolescent antisocial behavior and depression. DESIGN: We characterized risk of antisocial behavior and depression in adolescents by means of a genetically informed design. We used in-home questionnaire and observational measures of adolescent outcomes and environmental moderators (parenting), and a latent variable behavior genetic analytic model. SETTING: A nationally distributed sample recruited from random-digit dialing and national market panels. PARTICIPANTS: A total of 720 families with at least 2 children, 9 through 18 years old, stratified by genetic relatedness (monozygotic and dizygotic twins, full biological siblings in nondivorced and stepfamilies, and half-siblings and biologically unrelated siblings in stepfamilies). MAIN OUTCOME MEASURES: Antisocial behavior and depressive symptoms. RESULTS: There was an interaction of genotype and both parental negativity and low warmth predicting overall antisocial behavior, as well as aggressive and nonaggressive forms of antisocial behavior, but not depression. Genetic influence was greater for adolescent antisocial behavior when parenting was more negative or less warm. Genotype-environment correlation was partialled out in the analysis and thus did not account for the results. CONCLUSION: This study demonstrates, on the basis of careful measurement and appropriate analytic methods, that a continuous measure of parenting in the normative range moderates the influence of genotype on antisocial behavior.

The transition to parenthood is often associated with a decline in couple relationship adjustment. Couples (n = 71) expecting their first child were randomly assigned to either:(a) Becoming a Parent (BAP), a maternal parenting education program; or (b) Couple CARE for Parents (CCP), a couple relationship and parenting education program. Couples were assessed pre-intervention (last trimester of pregnancy), post-intervention (5 months postpartum), and follow-up (12 months postpartum). Relative to BAP, CCP reduced negative couple communication from pre- to post-intervention, and prevented erosion of relationship adjustment and self-regulation in women but not men from pre-intervention to follow-up. Mean parenting stress reflected positive adjustment to parenthood with no differences between BAP and CCP. CCP shows promise as a brief program that can enhance couple communication and women's adjustment to parenthood.

PURPOSE: The purpose of this integrative review is to systematically and critically synthesize nursing scholarship on parents' perspectives of the parent-child relationship during infancy. CONCLUSION: Research has shown that the process of establishing the parent-child relationship is highly individualized and complex. Numerous barriers and facilitators influencing this relationship have been identified that are relevant to nursing. PRACTICE IMPLICATIONS: Nurses have an important opportunity to positively affect the developing parent-infant relationship. Screening parents for depression and providing parents with resources and support are key nursing interventions supporting the parent-infant relationship.

The purpose of the present study was to conduct a test of acceptability of a new model for family-focused drug prevention programs for families of early adolescents. An existing evidence-based behavioral intervention, the Strengthening Families Program: For Parents and Youth 10-14 (SFP), was adapted to include concepts and activities related to mindfulness and mindful parenting (an extension of mindfulness to the interpersonal domain of parent-child relationships). The foundation for this innovative intervention approach stems from research on the effects of mind-body treatments involving mindfulness meditation and the function of stress and coping in relation to parenting and parent well-being. One group of families participated in a seven-week pilot of this mindfulness-enhanced version of SFP. Results of a mixed-method implementation evaluation suggest that the new intervention activities were generally feasible to deliver, acceptable to participants, and perceived to yield positive benefits for family functioning and parent psychological well-being. The next phase of this research will involve curriculum refinement based upon results of this initial study, and a larger pilot efficacy trial will be conducted.

Although existing family preservation program research has focused on identifying the components of effective treatment, we remain far from fully developing empirically supported interventions (Barth, Chamberlain, Reid, Rolls, Hurlburt, Farmer, James, McCabe,& Kohl, 2005; Dufour, Chamberland,& Trocme, 2003). The current longitudinal study expands existing efforts to understand the active ingredients of effective interventions by learning from parents who experienced a family preservation intervention themselves. The current study reports on the reflections of 35 parents who child protection social workers referred to family preservation programs. In contrast to a focus on intervention components, parents related the helpful interventions they received to the effectiveness of intervention processes -- namely, to the quality of the relationships they had with their individual family preservation workers and with service teams at the programs they attended. Parents identified that workers in effective programs used specific relational skills to recreate a nurturing family environment that fostered parent engagement and change throughout the process of intervention.

This paper introduces a model of "mindful parenting" as a framework whereby parents intentionally bring moment-to-moment awareness to the parent-child relationship. This is done by developing the qualities of listening with full attention when interacting with their children, cultivating emotional awareness and self-regulation in parenting, and bringing compassion and nonjudgmental acceptance to their parenting interactions. First, we briefly outline the theoretical and empirical literature on mindfulness and mindfulness-based interventions. Next, we present an operational definition of mindful parenting as an extension of mindfulness to the social context of parent-child relationships. We discuss the implications of mindful parenting for the quality of parent-child relationships, particularly across the transition to adolescence, and we review the literature on the application of mindfulness in parenting interventions. We close with a synopsis of our own efforts to integrate mindfulness-based intervention techniques and mindful parenting into a well-established, evidence-based family prevention program and our recommendations for future research on mindful parenting interventions.

This study investigated whether a psycho-educational program with modest dosage (eight sessions), delivered in a universal framework through childbirth education programs and targeting the coparenting relationship would have a positive impact on observed family interaction and child behavior at 6-month follow-up (child age 1 year). One hundred sixty-nine couples, randomized to intervention and control conditions, participated in videotaped family observation tasks at pretest (during pregnancy) and at child age 1 year (2003-2007). Coparenting, parenting, couple relationship, and child self-regulatory behaviors were coded by teams of raters. Intent-to-treat analyses of program effects controlled for age, education, and social desirability. Evidence of significant (p < 0.05) program effects at follow-up emerged in all four domains. Effect sizes ranged from 0.28 to 1.01. Targeting the coparenting relationship at the transition to parenthood represents an effective, non-stigmatizing means of promoting parenting quality and child adjustment.

Parent-child relationships, known as attachments, underpin the emotional health and wellbeing of infants. Difficulties within this relationship can have far-reaching consequences for both parents and children. Health visitors within public health teams have a unique opportunity to support this relationship at an early stage. This paper describes the first stage of a study to develop a parent to infant attachment-screening tool. The aim of this stage was to develop items for inclusion in the tool, using parent focus groups to draw out relevant terminologies for aspects of the attachment relationship. Set in community venues within a primary care trust, a purposive maximum variation sample of 10 parents took part in three separate focus groups. Transcripts rich in parental descriptions of the parent-child relationship were recorded, transcribed and analysed. During the next stage of the study, a further focus group will develop the scaling of the items within the tool, which takes the form of a parent-completed questionnaire. Future stages will focus on piloting and validation of the tool, as well as testing for parental acceptability, internal consistency and reliability.

Participation rates in parenting programs are typically low, severely limiting the public health significance of these interventions. We examined predictors of parenting program enrollment and retention in a sample of 325 divorced mothers. Predictors included intervention timing and maternal reports of child, parent, family, and sociocultural risk factors. In multivariate analyses, child maladjustment and family income-to-needs positively predicted enrollment, and higher maternal education and recruitment near the time of the divorce predicted retention. Findings have implications for the optimal timing of preventive parenting programs for divorcing families and point to the importance of examining predictors of enrollment and retention simultaneously. Editors' Strategic Implications: Parent education researchers and practitioners may find the authors' application of the Health Belief Model to be a useful organizing framework for improving engagement and retention.

Factors that influence the prognosis for recovery in psychosocial risk families: The role of child resilience. This study analyses the indicators, such as child resilience, that influence prognosis for recovery in psychosocial risk families, by examining the combination that better discriminates between a favourable prognosis and an unfavourable one. For this purpose, the evaluation of the prognosis of 418 cases of children and their families (224 two-parents and 194 one-parent) were examined through the Psychosocial Risk Profile of the Family, which was filled in by professionals from social services. The impact level on development, the temporality of the problem, and parents' attitudes about the intervention, their children and the service affected the prognosis of both families. Child resilience selectively influenced the favourable prognosis in two-parent families whereas the risk level affected the unfavourable prognosis in one-parent families. Child resilience was only related to those risk indicators which reflect more continuity of the problem and an accumulation of negative life events, but also to some compensatory factors such as the parents' expectations of the child's future that reflect parental competence.

This study investigated the impact of parents' observed conflict behavior on subsequent child attachment security, both as a main effect and as moderated by parents' romantic attachment. Participants were 80 heterosexual couples involving men from the Oregon Youth Study and their first-born children. The authors used hierarchical linear modeling to predict child security with each parent. Interparental psychological aggression predicted lower child security with father, regardless of romantic attachment. If the father was insecure, interparental positive engagement predicted lower child security with him. If either the mother or father was avoidant, interparental withdrawal did not predict lower child security, though it did for more secure parents. Results are discussed in terms of implications of attachment-(in)congruent behavior for parents' emotional availability.(PsycINFO Database Record (c) 2008 APA, all rights reserved).