GREAT Families1

Community-Based Multiple Family Groups to Prevent and Reduce Violent and

Aggressive Behavior: The GREAT Families Program

Emilie Phillips Smith1, Deborah Gorman-Smith2, William Quinn3, David Rabiner4,

Patrick Tolan2, Donna-Marie Winn4 and the Multi-site Violence Prevention Project 1,2,3,4,5

Word Count: 3,985 words

Abstract

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This paper describes the community-based family-focused component of the

GREAT Schools and Families project, a collaborative, targeted family and universal

school-based adolescent prevention program implemented in four sites with families in

diverse communities. This component includes the families of sixth-grade students

identified by teachers as aggressive and socially influential among their peers. The paper

describes the developmental-ecological conceptual framework and the program derived

from this model including multiple-family group meetings and the Home-School

Communication component. Approaches to recruitment, engagement, staff training and

socio-cultural sensitivity in work with families in predominantly poor and challenging

settings are described. The program involves collection of data using measures of fidelity

and processes that will facilitate examination of theoretical and programmatic processes

potentially mediating and moderating effects upon individual families. This course of

work could inform us about necessary approaches and procedures necessary to engage

and support families in efforts to reduce individual and school grade-level violence and

aggression.

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The purpose of this paper is to describe the family component of the GREAT

Schools and Families Program (Meyer et al., in press; Miller-Johnson et al., in press;

Orpinas, Horne, and the Multisite Violence Prevention Project, in press). This paper will

describe the theoretical background and conceptual framework of the program, the

driving goals and objectives of the curriculum, staff training and supervision, recruitment,

retention, and engagement, particularly of families from diverse racial-ethnic and

geographic backgrounds, and the assessment of critical program processes and fidelity.

A Developmental-Ecological Framework for Family-Based Prevention

The GREAT Families component is grounded in a developmental-ecological

model of child and family functioning that assumes that: (1) the family serves as the

primary support and socializing force for children; (2) the challenges families face and

often the ways they attempt to address them are dependent upon the age of the children;

(3) children and families live in communities and are also influenced by larger social,

cultural, and policy realities; and (4) strengthening families and family-focused

interventions are among the more powerful ways to effect positive child outcomes and

prevent violent and antisocial behavior.

A major tenet of developmental-ecological theory is that individual development

is influenced by the qualities of the social systems in which the family lives or

participates (Bronfenbrenner, 1986; 1995; Dishion & McMahon, 1998; Gorman-Smith,

Tolan, & Henry, 2000; Tolan & Gorman-Smith, 1997). Individual development is nested

within a series of social structures (Bronfenbrenner, 1986; Szapocznik & Coatsworth, in

press), beginning with family and peer systems, and, in turn, families and peers are nested

within larger social contexts, such as schools and neighborhoods. Potential risk factors

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include not only individual child behavioral problems, but also potential problems in

family functioning and increased risk owing to their social settings. However, there are

also strengths germane to the individual child, family, and social setting that could be

helpful in bolstering youth and families. Thus, this intervention focuses not only on risk

but also current and potential assets and strengths in the family, peer, school, and

neighborhood settings and the interactions between these social contexts.

Developmental-ecological theory also considers the impact of these systems

across development. Based upon prior work on developmental trajectories in violence

and aggression (Elliott, Huizinga, & Menard, 1989; Loeber, Wei, Stouthamer-Loeber,

Huizanga, & Thornberry, 1999; Tremblay et al., 1991; and Tremblay et al., 1995), the

GREAT Families intervention is aimed at interrupting a progression from early socially

unacceptable behavior to serious delinquency and violence by eliminating the function of

problem behaviors in families and the reinforcers of such behavior. The idea of

developmental-ecology also attends to multiple risk and protective factors in the lives of

young people and potential changes in the relative influence of family, peers, and

neighborhoods as young people grow and mature. Whereas parents are among the

earliest influences upon children, as children grow and develop, school, peers, and

community become increasingly important sources as well (Elliott et. al., 1989).

Overlaying the idea of developmental-ecological theory is the idea of context that

includes attention to the race, ethnicity, and social status of the individual in interaction

with prevailing cultural norms and actions of their own cultural group and larger social-

cultural systems (McLoyd and Ceballo, 1998; Ogbu, 1985). Research on parenting

across racial and ethnic groups has revealed both some practices that are common and

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effective across groups and some parenting practices that have been found to be more

uniquely effective among particular racial-ethnic groups. For example, research has

found that for Asian American and African American parents that stricter and more

parent-directed approaches, approaches referred to as more “authoritarian” are actually

related to positive child and adolescent adjustment whereas these practices are not related

to positive outcomes among European American children and youth (Deater-Deckard &

Dodge, 1997; Deater-Deckard, Dodge, Bates, & Pettit, 1996; Lamborn, Dornbusch, &

Steinberg, 1996; Murry, Smith, & Hill, 2001; Tolan & McKay, 1996). Understanding

parenting approaches that are found to be effective across and within particular racial-

ethnic contexts has very important implications for future prevention efforts.

Program Background and Rationale

The GREAT Families program is based upon a conceptual model that takes into

account various individual, family, school, and neighborhood influences (Figure 1). The

exogenous constructs in the model (i.e. parental, school, and neighborhood

characteristics) illustrate that various individual and contextual factors can influence

family cohesion, organization, and beliefs. Families that are more organized and

cohesive are likely more diligent in monitoring the youth and utilizing developmentally

appropriate disciplinary practices. These practices lead to the family being a catalyst of

change helping to influence the child’s peer relationships and neighborhood involvement

through better monitoring and discipline, and improve the school setting through better

relationships with school staff, all of which leads to less problem behavior and improved

competence and achievement.

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Past research has demonstrated that family relationships are important risk and

protective factors in children’s risk for violence and closely associated antisocial

behaviors (McCord, 1991; Patterson, Reid, & Dishion, 1992; Patterson, & Stouthamer-

Loeber, 1984). The empirical support for reducing risk for serious problems through

increasing family functioning promotes hope that much can be done to affect youth

antisocial and delinquent outcomes. Given the role of family, a number of family

programs have been developed and tested in a variety of settings, with families of

multiple racial-ethnic backgrounds, some demonstrating significant effects up to 3 years

following intervention (Alexander, Robbins, & Sexton, 2000; Davidson, Redner, Amdur,

& Mitchell, 1990; Henggeler, Schoenwald, Borduin, Rowland, Cunningham, 1998;

Sexton & Alexander, 2002; Spoth, Redmond, & Shin, 2001). Thus, there are likely some

important parenting and family intervention approaches that are effective across diverse

families and with families of children ranging from preschool to adolescence.

Multiple Family Groups as an Avenue for Change

There are a number of approaches and settings in which family–based

intervention can be conducted. Growing research shows more effectiveness among

approaches involving groups of families when compared to clinic-based approaches with

individual families (Cunningham & Bremner, & Boyle, 1995; Webster-Stratton, 1984).

Group-based family education also has the potential of developing a group of peer

families that may continue to provide family support after formal program termination.

Prior research has shown that multiple family groups can facilitate understanding, new

behavior in family members and the targeted family member, and facilitate

generalization of within-session training (Laquer, 1976). In a research review and

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synthesis of group-based family approaches, Barlow and Stewart-Brown (2000) highlight

the potential of group-based family education programs to reach a larger number of

families in a way that might also be more cost-effective.

Because of their supportive and normalizing functions, multiple family groups

can be attractive for prevention. Prior studies have shown efficacy of multiple family

groups for reducing risk for aggression and substance abuse (Kosterman, Hawkins,

Spoth, Haggerty, & Zhu, 1997; Litrownik et al., 2000.) Though some work has

demonstrated evidence of efficacy for reducing violence and aggression using rigorous

designs, more work is needed examining multiple family approaches and the theorized

processes with families of diverse racial, ethnic, and social backgrounds to examine if the

content and processes of program implementation are similar.

A Focus Upon Families of Aggressive and Influential Adolescents

Adolescence is an important developmental stage where many problem behaviors

emerge including substance use and abuse, early and unsafe sexual activity, and violence

and aggression (Elliott et al., 1989; Kann, 2001; Loeber, et al., 1999). Adolescence is

also marked by transitions in family relationships, needs regarding parenting, and the

importance of peer influences. However, when good family relationships prevail, even

during adolescence, young people are less susceptible to negative peer influences and

problem behavior (Elliott, Huizinga, & Menard, 1989; Patterson, Reid, & Dishion, 1992).

The GREAT Families Program is built upon the premise that a small minority of

youth perpetrates the overwhelming majority of violent and aggressive acts, both in and

around school. Longitudinal surveys indicate that 20 percent of the serious offenders

account for 75 to 90 percent of self-reported violent crimes (Elliott et al., 1989; Loeber et

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al., 1999). The intent is to intervene with those who are aggressive and influential. The

rationale is that reducing violence and aggression among the “unconventional leaders,”

young people who are popular, influential, and are also leaders in deviant behavior, will

lead to diminished support for violence and aggression among their peer groups (Miller-

Johnson, Costanzo, & Coie, in press).

Summary

In summary, the GREAT Families Program is built upon a developmental-

ecological perspective that views families as powerful sources in the lives of young

people, even as they grow and develop and peers begin to become increasingly important.

This perspective also recognizes that children and families live within social and cultural

contexts that also influence their approach to parenting. Nevertheless, family-based

prevention has been shown to be an efficacious approach to reducing violence and

delinquency.

This program uses a multiple family group approach in hopes of providing a

medium by which families can develop natural, sustainable sources of support for

effective parenting. It seeks to support positive parenting during an important

developmental transition, adolescence, when new challenges emerge for many families.

The program focuses on working with youth who are both aggressive and influential to

test the premise that influencing unconventional leaders may affect peer norms for

violence and aggression. The next section describes the family program in more detail.

The GREAT Families Program

Program Organization

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The family-focused intervention builds upon several prior prevention and

intervention studies conducted by the investigators collaborating in this multi-site project

(Conduct Problems Prevention Research Group, 2002; Dumas, Prinz, Smith, and

Laughlin, 1999; Gorman-Smith et al, in press-b; McCreary, Maffuid, & Stepter, 1998;

Quinn, 1999; Quinn, Sutphen, Michaels, & Gale, 1994; Sayger, Horne, Walker, &

Passmore, 1988; Tolan & McKay, 1996 ). This study tests the effects of promoting a

group of core parenting principles and family relationship skills identified by the

collaborative based upon previous family research:

1. Promoting home-school partnerships (McDonald et al., 1997; McDonald

& Sayger, 1998; Quinn, 1995; Smith et al., 1997);

2. Parental monitoring and supervision (Patterson, Reid, & Dishion, 1992);

3. Promoting care and respect through discipline and rules (Tolan & McKay,

1996);

4. Parent and child coping, self-control, and management skills (Fleischman,

Horne, & Arthur, 1983; McCreary et al., 1998);

5. Developing healthy, respectful, and effective family communication and

problem-solving skills (Alexander, Robbins, & Sexton, 2000; The

Conduct Problems Prevention Research Group, 2002).

6. Planning for the future (Kohl, Lengua, McMahon, & the Conduct

Problems Prevention Research Group, in press).

The GREAT Families program is comprised of fifteen weekly, two-hour manualized

sessions with groups of approximately four to six families held in community-based

settings that are comfortable and convenient for the family (The Multi-Site Violence

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Prevention Project, 2001; copy of manual available by request). The sessions correspond

to the six core constructs with each of the constructs being represented by two to three

sessions each. Topics of the family sessions include establishing family rules and roles,

good communication, handling emotions, choosing good friends, and connecting to the

community. Family sessions involve at least one parent or caregiver, the sixth-grade

youth, and school-age siblings in games, exercises, and some didactic information each

session. Families also have homework exercises for each session to be completed and

brought back to share. Extended family and friends who play supportive and child-

rearing roles are welcome to family group meetings with the intent of working with the

whole family if possible. However, family members who participate are asked to commit

to attend as consistently as possible. This effort recognizes the role of extended family

and friends in supportive and child-rearing capacities, particularly in some ethnic-

minority communities (Wilson et al., 1995). Transportation, meals, and child-care are

provided to support the families. Families can be compensated up to 225 dollars for

attending all 15 sessions.

The Home-School Communication Plan (HSCP), which is similar to the Daily

Report Card Programs (DuPaul, Guevrement, & Barkley, 1991), is designed to promote

regular communication between a child’s teacher(s) and parents about the child’s success

in achieving important academic and behavioral goals at school. The HSCP identifies a

uniform set of academic and behavioral goals that are expected to be relevant for all

students. These goals are 1) talking to teachers with respect; 2) behaving respectfully

with peers; and 3) completing assigned work. Families identify teachers they want to

help them in monitoring their child. One teacher per family completes the daily sheet

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indicating whether the child has succeeded in meeting their goals. The goal sheet with

the daily teacher report is sent home at the end of the week for parents to review.

Families are asked to bring their child’s goal sheet to the group meetings for a brief

review and discussion. The intent is to give parents a chance to share their child’s

success, and to receive suggestions for help.

Staff Recruitment, Training, and Supervision

Staff are hired for the intervention based on prior experience in family

intervention with the populations in this project and formal training in family systems

theory and related topics. Most have a master’s degree in psychology, social work, or

marital and family therapy. The staff includes equal proportions of males and females

(50%), 46% are African American, 33% Non- Hispanic White, and approximately 20%

Latino. Most are between 25 and 35 years of age.

The investigators and program coordinators at each site participate in a “train the

trainer’s meeting” and subsequently train site-based staff. Staff receive approximately 20

hours of training and preparation over multiple days. The training materials focus on

helping staff to understand an overview of violence and aggression, a developmental-

ecological family approach, the distinction between prevention and treatment, the role of

rigorous methodology and fidelity in intervention, strategies to promoting interactive and

involved group processes, and an understanding of their own racial-ethnic-social

backgrounds and the implications for their work with diverse children and families

(Tolan, 2002). Training emphasizes conceptual understanding, skills practice, and

clinical preparation. After the family group meetings begin, staff are involved in

approximately one hour of individual supervision per week, and attend a 1-2 hour group

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case discussion and staff meeting. These meetings also are accompanied by training that

revisits upcoming sessions. Coordinators observe family sessions for training and to

ensure fidelity. Weekly conference calls among the coordinators and investigators

facilitate cross-site consistency in program implementation and engages the coordinators

and investigators across sites in problem-solving emerging challenges.

The Process of Identifying, Recruiting and Engaging Families

This section describes the approaches implemented across the four sites in

identifying, recruiting, and engaging families.

Identification of Targeted Children and Families

Teachers nominate students for participation in the targeted intervention using

two criteria. First, teachers are asked to nominate students who have demonstrated a

pattern of aggressive and disruptive behavior in the classroom using definitions and

examples provided by program staff. Second, from that list, teachers rate each child on

social influence. Those students with both high aggression and social influence scores

are considered eligible for participation in the intervention.

Recruitment

The recruitment process is important because it is the initial phase of the

engagement. First, families are sent a letter outlining the program. Soon after letters are

sent (within 3-4 days), the intervention staff follow up by telephone or through a home

visit. Multiple phone calls and/or home visits are very likely for many families.

Although it is essential that the basic information outlined in the script is followed and

presented in the order approved, interventionists are encouraged to use their individual

style with a focus on developing a comfortable supportive relationship with families.

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During attempts to engage the family, interventionists are trained to keep the

following key issues in mind.

1) Describe the program as one that will be helpful to their child's school

performance and functioning with other children.

2) Understand that a primary goal is to establish rapport with the caregiver most

likely to mobilize the family to participate in the program though it is hoped

that all family members will participate.

3) Even though parents are informed that the program is 15 weeks long,

interventionists recognize that this commitment might prove difficult to make

immediately. Interventionists emphasize their willingness to be of assistance

in helping families attend the sessions regularly and working with the family

to address any barriers to participation along the way. With this in mind, all

four sites provide meals, childcare, and transportation to facilitate family

participation in addition to helping families find ways to resolve other

challenges to their participation.

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Engaging Families in the Intervention Program

Engaging and keeping families in the intervention program is one of the most

serious challenges in prevention research. (Gorman-Smith et al., in press- a; Prinz,

Smith, Dumas, Laughlin, White, Barrón, 2001; Quinn, 1999). Yet, families may differ in

their perception of the value of prevention activities. Because they do not perceive their

child as having problems with the kinds of behaviors targeted and they may not have

necessarily sought intervention themselves, families may not see the immediate value of

spending time in such activities. In addition many families with at-risk youth,

particularly those from lower socioeconomic backgrounds, may justifiably mistrust social

service or educational institutions and professionals. There may be serious concern about

the reason for interest in the family and whether the requests to participate are

trustworthy. A number of families may have been involved with previous research

projects and based upon these experiences may expect misleading, condescending and/or

insensitive requests. Even among those interested in participating, other demands may

compete for their time and energy.

Nonetheless, continuous family engagement is critical. One study has uncovered

two different patterns of involvement among participating families: families that were

immediately responsive and families that required extensive and intensive engagement

efforts (Gorman-Smith, et al., in press-a). Both types of families were eventually

involved and both were found to be engaged and enthusiastic. This study points to the

importance of persistence and problem-solving with families around barriers to

participation (e.g., schedule conflicts, child resistance, transportation).

The experience and skill of the interventionist is critical to family participation in

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the program (Patterson & Forgatch, 1985). Families are more likely to stay engaged when

interventionists 1) are assertive, positive, and empathetic when contacting families and

easily accessible after contact, 2) address barriers to participation directly, 3) can frame

difficulties as understandable, but also expect families to participate fully in the program,

4) stay focused on the practical in resolving participation dilemmas and 5) foster a

collaborative, mutually respectful atmosphere.

The Families Involved

The families who agreed to participate in the GREAT Families Program varied

both across sites and within sites though they shared some common characteristics (Table

1). Overall, the families were disproportionately poor. These families represented a

diversity of racial-ethnic backgrounds (though predominantly African American), family

structures, and geographic locales. Some families reside in urban Midwest areas while

others reside in more rural southeastern settings. Even within a site, some families might

reside in more suburban neighborhoods while others may reside in urban neighborhoods.

Implementing the multi-family program across these sites is a step towards examining the

implementation and generalizability of this approach in settings that have various

demands.

Sensitivity to Family Diversity in Prevention Programming

The GREAT Families program includes families from diverse racial, ethnic,

social, geographic, and cultural backgrounds. The project screens staff for their

experience and sensitivity in dealing with families like the ones who would participate in

the program. It is critical for potential staff to demonstrate their ability to recognize and

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discuss ways that cultural backgrounds relate to their own and the participants’ values

and beliefs about families, and to perceptions about the program.

Once hired, the project conducts training to help staff further explore their own

ability to interact effectively with families and discusses background readings about

family functioning and prevention approaches with African-American and Mexican-

American families (Murray, Smith, & Hill, 2001; Smith, Prinz, Dumas, & Laughlin,

2001, Stevenson, 2001; Szapocznik, Santisteban, Rio, Perez-Vidal, 1989; Tolan &

Gorman-Smith, 1997; Wright and Smith, 1998). These discussions are an important part

of training, supervision, and the intervention. To supplement the discussion of the reading

materials provided, exercises are conducted during training in which interventionists are

asked to reflect upon how they might be perceived by families (i.e., aspects of their

presentation and style that may help or hinder program participation), and role-play a

variety of scenarios to help staff practice and feel comfortable in handling the many ways

that families may raise issues of race and culture (i.e., accusations that the school

personnel are racist, not engaging in practices because they are in conflict with their

religious teachings or cultural values about families, etc.). The exploration of cultural

issues presents a potentially valuable activity for interventionists in their weekly group

and individual supervision sessions led by trained clinicians. Additionally, a “Cultural

Considerations Section” is integrated into the manualized sessions to help the

interventionists think about the ways that race, culture, and social status might interact

with the material in the family sessions. This might include thinking about gender and

family roles in Latino families or views of institutions and racism among African

American families. Interventionists who are conscious of these influences will be better

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equipped to help families find effective, realistic and culturally consonant ways of

handling challenges. It will also help facilitate for families the distinction of cultural

practices that represent strength and health promotion and those that are problematic. In

turn, interventionists will then be better equipped to foster problem- resolution and

recognize potential areas of strength and protective factors that they can help promote

among families.

Evaluating Process Aspects of the Intervention Effects

Examining whether the intervention was implemented as intended and

establishing the extent to which it is this intervention, as theoretically constructed, that is

reducing risk are important functions of process evaluation (Kazdin, 1999; Tolan &

Gorman-Smith, in press). This type of analysis moves beyond a “black box” conception

and measurement of intervention effects to provide valuable information about the

validity of the theory guiding the intervention (Kazdin, 1999). Another major purpose of

process evaluation is to document the fidelity or integrity of the intervention delivery;

that is whether the program was delivered as intended to the targeted recipients (Dumas,

Lynch, Laughlin, Smith, & Prinz, 2001; Moncher & Prinz, 1991; Rossi, Freeman, &

Lipsey, 1999). The fourth purpose of the process evaluation of the targeted intervention

is to examine the intervention processes that potentially moderate and mediate change.

Our hypothesis is that process characteristics such as perceived helpfulness of the

intervention provider and program, family participation/enthusiasm, and extent to which

the critical activities of each session are carried out will, at least partially, mediate the

extent of change in these targets, and therefore the preventive benefit of the intervention.

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The GREAT Families Program’s process and fidelity measurement strategy

sought to obtain reports about fidelity and process characteristics from at least two

sources (usually staff and participating parents and youth), repeated at four time points

over the course of the intervention, four data points for process measurement and four

data points of fidelity/program adherence data. Three analytic interests will be served by

these data: 1) examining systematic family change in the theorized direction during

intervention as expected; 2) assuring that the program was delivered as intended in what

was delivered and how it was delivered; and 3) examining the family (e.g. enthusiasm,

satisfaction with content), group (e.g. cohesiveness and mutual respect) and provider (e.g.

respect for families, relationship with families) characteristics related to and potentially

moderating program impact upon family functioning and youth violent and aggressive

behavior.

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Summary and Discussion

In summary, the GREAT Families program is designed to bolster the family as a

means of helping to interact more positively within multiple ecological settings in an

effort to positively impact youth behavioral and academic outcomes, recognizing the

socio-cultural contexts in which families, youth, peers, and schools develop. The family

program has already been piloted and is being implemented with two successive year

cohorts of youth and families in the four collaborating sites. Future work will examine

data from this portion of the GREAT Schools and Families program in efforts to share

what we have learned about approaches and efforts to promote positive outcomes for

children and families.

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References

Alexander, J. F., Robbins, M. S., & Sexton, T. L. (2000). Family-based

interventions with older, at-risk youth: From promise to proof to practice. The Journal

of Primary Prevention, 21(2), 185-205.

Barlow, J., & Stewart-Brown, S. (2000). Behavior problems and group-based

parent education programs. Developmental and Behavioral Pediatrics, 21(5), 356-370.

Bronfenbrenner, Urie (1995). Developmental ecology through space and time: A

future perspective. In P. Moen and G. Elder (Eds) Examining lives in context:

Perspectives on the ecology of human development. (pp. 619-647).

Bronfenbrenner, Urie (1986). Ecology of the family as a context for human

development: Research perspectives. Developmental Psychology, 22(6), 723-742.

Conduct Problems Prevention Research Group (2002). Evaluation of the first 3

years of the Fast Track Prevention Trial with children at high risk for adolescent conduct

problems. Journal of Abnormal Child Psychology, 30(1), 19-35.

Cunningham, C. D., Bremner, R., & Boyle, M. (1995). Large group community-

based parenting programs for families of preschoolers at risk for disruptive behavior

disorders: Utilization, cost-effectiveness, and outcomes. Journal of Child Psychology

and Psychiatry, 36, 1141-1159.

Davidson, W. S., Redner, R., Amdur, R. L. and Mitchell, C. M. (1990) Troubled

Youth and Families. New York: Plenum.

Deater-Deckard, K., & Dodge, K. A. (1997). Externalizing behavior problems

and discipline revisited: Nonlinear effects and variation by culture, context, and gender.

Psychological Inquiry, 8(3), 161-175.

05/08/2023

GREAT Families21

Deater-Deckard, K., Dodge, K. A., Bates, J., & Pettit, G. S. (1996). Physical

discipline among African American and European American mothers: Links to

children’s externalizing behaviors. Developmental Psychology, 32(6), 1065-1072.

Dishion, T. J., & McMahon, R. J. (1998). Parental monitoring and the prevention

of child and adolescent problem behavior: A conceptual and empirical formulation.

Clinical Child and Family Psychology Review, 1(1), 61-75.

Dumas, J. E., Lynch, A. M., Laughlin, J. E., Smith, E. P., & Prinz, R. J. (2001).

Promoting intervention fidelity: Conceptual issues, methods, and preliminary results

from the EARLY ALLIANCE Prevention Trial. American Journal of Preventive

Medicine, 20, 38-47.

Dumas, J. E., Prinz, R. J., Smith, E. P. & Laughlin, J. (1999). The EARLY

ALLIANCE Prevention Trial: An integrated set of interventions to promote competence

and reduce risk for conduct disorder, substance abuse, and school failure. Clinical Child

and Family Psychology Review, 2(2), 37-53.

DuPaul, G. J., Guevremont, D. C., & Barkley, R. A. (1991). Attention-deficit

hyperactivity disorder. In R. J. Morris & T. R. Kratochwill (Eds.), The practice of child

therapy (2nd ed.) (pp. 115-144). New York: Pergamon Press.

Elliott, D. S., Huizinga, D. & Menard, S. (1989). Multiple-problem youth:

Delinquency, substance use, and mental health problems. New York: Springer-Verlag.

Fleischman, M., Horne, A., & Arther, J. (1983). Troubled families. Champaign,

IL: Research Press.

05/08/2023

GREAT Families22

Gorman-Smith, D., Tolan, P., Henry, D., Leventhal, A., Schoeny, M., Lutovsky,

K., & Quintana, E. (in press, a). Predictors of participation in family focused preventive-

interventions. Drug Issues.

Gorman-Smith, D., Tolan, P.H. Henry, D. B., Lutovsky, K., Quintana, E., &

Leventhal, A. (in press, b). Schools and Families Educating Children (SAFE Chilldren):

A Preventive Intervention for early elementary school children.

Gorman-Smith, D., Tolan, P. H., & Henry, D. B. (2000). A developmental-

ecological model of the relation of family functioning to patterns of delinquency.

Journal of Quantitiative Criminology, 16(2), 169-198.

Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., &

Cunningham, P. (1998). Multisystemic treatment of antisocial behavior in children and

adolescents. New York: Guilford.

Kann L. (2001). The Youth Risk Behavior Surveillance System: measuring

health-risk behaviors. American Journal of Health Behavior, 25(3):272-277.

Kazdin, A. E. (1999). Current (lack of) theory in child and adolescent therapy

research. Journal of Clinical Child Psychology, 28, 533-543.

Kohl, G.O., Lengua, L.J., McMahon, R.J., & The Conduct Problems

Prevention Research Group. (in press). Parent involvement in school:

Conceptualizing multiple dimensions and their relations with family and demographic

risk factors. Journal of School Psychology.

Kosterman, R., Hawkins, J. D., Spoth, R., Haggerty, K. P., & Zhu, K. (1997).

Effects of a preventive parent-training intervention on observed family interactions:

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Proximal outcomes from preparing for the drug free years. Journal of Community

Psychology, 25(4), 337-352.

Lamborn, S. D., Dornbusch, S., Steinberg, L. (1996). Ethnicity and community

context as moderators of the relations between family decision making and adolescent

adjustment. Child Development, 67(2), 283-301.

Laqueur, H. P. (1976) Multiple family therapy. In P.J. Guerin (Ed.), Family

therapy: Theory and practice (pp. 405-441). New York: Gardner Press.

Litrownik, A. J., Elder, J. P., Campbell, N. R., Zyala, G. X., Slymen, D. J., Parra-

Media, D. Zavala, F. B., & Lovatto C. Y. (2000). Evaluation of a tobacco and alcohol

use prevention program for Hispanic migrant adolescents: Promoting the protective

factor of parent-child communication. Preventive Medicine, 31, 124-133.

Loeber, R.; Wei, E.; Stouthamer-Loeber, M; Huizanga, D; Thornberry, T. P.

(1999). Behavioral antecedents to serious and violent offending: Joint analyses from the

Denver Youth Survey, Pittsburgh Youth Study and the Rochester Youth Development

Study. Studies on Crime & Crime Prevention, 8(2), 245-263.

McCord, J. (1991). Family relationships, juvenile delinquency, and adult

criminality. Criminology, 29, 297-417.

McCreary, M. L., Maffuid, J., Stepter, T. A. (1998). Bridges to effective

treatment: Family therapy and family psychoeducational interventions with maltreating

and substance-abusing families. In R. L. Hampton and V. Senatore, Vincent (Eds); et al.

Substance abuse, family violence, and child welfare: Bridging perspectives. Issues in

children's and families' lives, pp. 220-248.

05/08/2023

GREAT Families24

McDonald, L., & Sayger, T. V. (1998). Impact of a family and school based

prevention program on protective factors for high risk youth. Drugs & Society, 12(1-2,)

61-85.

McDonald, L., Billingham, S., Conrad, T., Morgan, A., Payton, E. (1997).

Families and Schools Together (FAST): Integrating community development with

clinical strategies. Families in Society, 78(2), 140-155.

McLoyd, V., and Ceballo, R. (1998). Conceptualizing and assessing economic

context: Issues in the study of race and child development. In V. McLoyd and L.

Steinberg (Eds) Studying minority adolescents: Conceptual, methodological, and

theoretical issues. New Jersey: LEA, pp. 251-278.

Meyer, A., Allison, K., Gay, F., Reese, L., & the Multi-site Violence Prevention

Project (manuscript submitted). The Student Component of the GREAT Schools and

Families Universal Program. American Journal of Preventive Medicine.

Miller, G. E., & Prinz, R. J. (1990). Enhancement of social learning family

interventions for childhood conduct disorder. Psychological Bulletin, 108, 291-307.

Miller-Johnson, S., Costanzo, P. R., Coie, J. D., Rose, M. R., Browne, D. C., &

Johnson, C. (in press). Peer social structure and risk-taking behaviors among African

American Early Adolescents. Journal of Youth and Adolescence.

Moncher, F. J. & Prinz, R. J. (1991). Treatment Fidelity in Outcome Studies.

Clinical Psychology Review, 11, 247-266.

Multi-site Violence Prevention Project (2001). GREAT Schools and Families:

Targeted Family Manual. Atlanta, GA: National Center for Injury Prevention and

Control, Centers for Disease Control and Prevention.

05/08/2023

GREAT Families25

Murray, V. M., Smith, E. P., & Hill, N. E. (2001). Race, ethnicity, and culture in

studies of families in context. Journal of Marriage and Family (Special Section: Race,

ethnicity, culture, and family processes), 63(4), 911-914.

Ogbu, J. U. (1985). A cultural ecology of competence among inner-city blacks.

In M. Spencer, G. K. Brookins, & W.R. Allen (Eds), Beginnings: The Social and

affective development of black children. Hillsdale, New Jersey: LEA, pp. 45-66.

Orpinas, P, Horne, A., & the Multi-site Violence Prevention Project (manuscript

submitted). The Teacher Program. American Journal of Preventive Medicine.

Patterson, G. R. & Forgatch, M. S. (1985). Therapist behavior as a determinant

for client non-compliance: A paradox for the behavior modifier. Journal of Consulting

and Clinical Psychology, 53, 846-851.

Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys. Eugene,

OR: Castalia.

Patterson, G. R., & Forgatch (1985). Predicting future clinical adjustment from

treatment outcome and process variables. Psychological Assessment, 7, 275-285.

Patterson, G. R. & Stouthamer-Loeber, M. (1984). The correlation of family

management practices and delinquency. Childhood Development, 55, 1299-1307.

Prinz, R. J., Smith, E. P., Dumas, J. E., Laughlin, J. E., White, D. W., & Barrón,

R. (2001). Recruitment and retention of participants in prevention trials involving

family-based interventions. American Journal of Preventive Medicine, 20, 31-37.

Quinn, W. H. (1999) The Family Solutions Program: A Collaboration of the

University of Georgia and the Athens/Clarke County Juvenile Court. In T. Chibuocs &

05/08/2023

GREAT Families26

R. Lerner (Eds.), Serving children and families through community-university

partnerships: Success stories (pp. 89-100). Boston: Kluwer.

Quinn, W.H. (1995) Expanding the focus of intervention: The importance of

family /community relations. (pp. 245-259). In P. Adams And K. Nelson (Eds).,

Reinventing Human Services:Community and family centered practice. New York:

Aldine de Gruyter.

Quinn, W. H., Sutphen, R., Michaels, M., & Gale, J. (1994). Juvenile offenders:

Characteristics of at-risk families and strategies for intervention. Journal of Addictions

and Offender Counseling, 15, 1, 2-23.

Rossi, P. H., Freeman, H. E., & Lipsey, M. W. (1999). Evaluation: A systematic

approach. (6th ed.) Thousand Oaks, CA: Sage.

Sayger, T. V., Horne, A. M., Walker, J. M. & Passmore, J. L. (1988). Social

learning family therapy with aggressive children: Treatment outcome and maintenance.

Journal of Family Psychology, 1, 261-285.

Sexton, T. L., & Alexander, J. F. (2002). Family-based empirically supported

interventions. The Counseling Psychologist, 30(2), 238-261.

Smith, E. P., Prinz, R. J., Dumas, J. E., Laughlin, J. (2001). Latent models of

family processes in African American Families: Relationships to Child Competence,

achievement, problem behavior. Journal of Marriage and Family 63, 967-980.

Smith, E.P., Connell, C., Wright, G., Sizer, M., Norman, J. M., Hurley, A., and

Walker, S. N. (1997). An ecological model for understanding home, school, and

community partnerships. Journal of Educational and Psychological Consultation, 8(4),

339-360.

05/08/2023

GREAT Families27

Spoth, R. L., Redmond, C., & Shin, C. (2001). Randomized trial of brief family

interventions for general populations: Adolescent substance use outcomes 4 years

following baseline. Journal of Consulting and Clinical Psychology, 69(4), 627-642.

Stevenson, H., Davis, G., Abdul-Kabir, S. (2001). Stickin’ To, Watchin’ Over, and

Getttin’ With: An African American Parent’s Guide to Discipline. Jossey-Bass.

Szapocznik, J. & Coatsworth, J. D. (in press). An eco-developmental framework

for organizing the influences on drug abuse: A developmental model of risk and

protection. In M. Glantz and C. R. Hartel (Eds.), Drug Abuse: Origins and

Interventions. Washington, DC: American Psychological Association.

Szapocznik, J., Santisteban, D., Rio, A., Perez-Vidal, A., et al., (1989). Family

effectiveness training: an intervention to prevent drug abuse and problem behaviors in

Hispanic adolescents. Hispanic Journal of Behavioral Sciences, 2(1), 4-27.

Tolan, P. H. (2002). Family-focused prevention research: Tough but tender with

family intervention research. In H. Liddle, J. Bray, D. Santesban & R. Levant (Eds.),

Family psychology intervention science (pp. 197-214). Washington, D.C.: American

Psychological Association.

Tolan, P. H., & Gorman-Smith, D. (1997). Families and the development of

urban children. In O. Reyes, J.J. Wlabergk, & R. P. Weissberg (Eds.), Interdisciplinary

perspectives on children and youth. Newbury Park: Sage.

Tolan, P. H., & Gorman-Smith, D. (in press) What violence prevention research

can tell us about developmental psychopathology. Developmental Psychopathlogy.

05/08/2023

GREAT Families28

Tremblay, R. E., Loeber, R. Gagnon, C. Charlebois, P., Larivee, S. & LeBlanc,

M. (1991). Disruptive boys with stable and unstable high fighting behavior patterns

during junior elementary-school. Journal of Abnormal Child Psychology, 19, 285-300.

Tremblay, R. E., Pagani-Kurtz, L., Masse, L. C., Vitaro, F. & Pihl, R. O. (1995).

A bimodal preventive intervention for disruptive kindergarten boys: Its impact through

mid-adolescence. Journal of Consulting and Clinical Psychology, 63, 560-568.

Webster-Stratton, C. (1984). Randomized trial of two parent education programs

for families with conduct-disordered children. Journal of Consulting and Clinical

Psychology, 52, 666-678.

Wilson, M. N., Greene-Bates, C., McKim, L., Simmons, F., Askew, T., Curry-El,

J., & Hinton, I. D. (1995). African American family life: The dynamics of interactions,

relationships, and roles. In M. N. Wilson (Ed.), African American family life: Its

structural and ecological aspects. New directions for child development (pp 5-21). San

Francisco, CA: Jossey-Bass.

Wright, G. & Smith, E. P. (1998). Home, School, and Community Partnerships:

Integrating Issues of Race, Culture, and Class. Clinical Child and Family Psychology

Review, 1(3), 145-162.

05/08/2023

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Acknowledgements

1Centers for Disease Control and Prevention, Atlanta, GA 2University of Illinois-Chicago,

IL 3University of Georgia-Athens, GA 4Duke University-Durham, NC 5Virginia

Commonwealth Unviersity-Richmond, VA. Please address correspondence to Emilie

Phillips Smith, Division of Violence Prevention, CDC, 4770 Buford Highway, MS K-60,

Atlanta, GA 30341, esmith1@cdc.gov.

The authors gratefully appreciate the valuable, diligent and persistent efforts of the site-based coordinators, Claire Hyman (Duke University), Alice Virgil (University of Chicago-Illinois), Lori Durham-Reaves (University of Georgia-Athens) and Cheryl Groce-Wright (Virginia Commonwealth University) and their contributions in developing and implementing this program. We would also like to acknowledge the innumerable parents, youth, teachers, principals, and school personnel and other staff without whom this work would not have been possible. This study was fund by the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, CDC Cooperative Agreements U81/CCU417759 (Duke University), U81/CCU517816 (University of Chicago-Illinois), U81/CCU417778 (University of Georgia) and U81/CCU317633 (Virginia Commonwealth University).

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Table 1 – Description of Participating Families

Respondent/Caregiver Frequency Percentage Mother 450 82%Father 29 5%Stepparent 6 1%Foster parent 5 1%Grandparent 41 8%Aunt/uncle 11 2%Other 6 1%

Marital Status Never Married 198 36%Married 175 32%Divorced 61 11%Separated 51 11%Co-habitating 31 5%Widowed 24 4%

Race-ethnicityAfrican American/Black

387 83%

American Indian/Native American

3 .65%

European American/White

60 13%

Hispanic/Latino (regardless of race)

82 15%

Highest Educational Level Completed

Some high school

181 32%

High school grad

208 38%

Some post-high school

93 17%

College graduate

45 8%

Post graduate education

11 2%

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Table (cont’d) – Description of Families

Income Frequency PercentageLess than 10,000

131 25%

10-19,999 141 26%20-29,999 93 17%30-39,999 69 13%40-49,999 34 6%50-59,999 19 4%60-69,999 14 3%70,000 and above

34 6%

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MODERATORS FAMILY PARENTING FAMILY OTHER SYSTEM CHILD FUNCTIONING LIFE STRESS SCHOOL CONDITIONS NEIGHBORHOODCHARACTERISTICS

PARENTAL DEPRESSION

PARENTS’ PARTNER VIOL.

SERVICE UTILIZATION

MARITAL STATUS

.

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COHESION

ORGANIZATION

BELIEFS

MONITORING

DISCIPLINEPRACTICE

FAMILY /NEIGHBORHOOD

RELATIONS

FAMILY/PEERRELATIONS

Family/School Relations

Social Competence

AGGRESSION/VIOLENCE

Academic Functioning