Predicting Receipt of an Effective Dose of a Family-Centered Preventive Intervention for African American Youth

Research reveals a linear association between prevention program dose and outcomes; that is, families receive the most benefits when they attend a sufficient number of program sessions. Ensuring participants receive an effective dose of prevention is a persistent challenge for the widespread implementation of family-centered prevention programs. We investigated factors associated with an effective dose of the Strong African American Families (SAAF) substance use prevention program. Dose-related factors included socioeconomic disadvantage, caregiver depression, family disorganization, youth risk for problem behavior, and community risk. Notably, SAAF includes an ecologically appropriate curriculum and a comprehensive set of engagement procedures, which decrease the influence of these factors on attendance. The sample consisted of 252 African American youth and their caregivers from eight rural counties in South Georgia who had been randomly assigned to receive the SAAF substance use prevention program, a seven-session family skills training program. We operationalized an effective dose of SAAF, per recent research, as attendance in at least 5 of 7 sessions. Logistic structural equation modeling revealed no evidence of the tested factors reducing dose. Family disorganization, however, was associated positively with an effective dose, controlling for all other factors. Families with more disorganization were more likely to receive an effective dose of the program. Findings suggest that ecologically sensitive engagement protocols and curricula may obviate the influence of common risk factors and foster participation among those who most perceive a need for the program.