Program Profile: Family Matters

This is a family-based program designed to prevent and reduce tobacco and alcohol use among children between the ages of 12 and 14. The program is rated Ineffective here were no statistically significant differences found between treatment group youth and control group youth in tobacco and alcohol use at the 12-month follow up.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

Family Matters is a preventative, family-oriented program designed for families with children between the ages of 12 and 14. The overall goal of the program is to prevent the onset and reduce the prevalence of alcohol and tobacco use in adolescents. Family Matters is based on research that shows that family characteristics, such as parental marital conflict or child neglect, are related to adolescent substance use (Ashery et al. 1998).

Program Components

The program is delivered through four booklets mailed to the home and through follow-up telephone calls by health educators. The booklets contain lessons and activities designed to motivate families to participate in the program and encourage families to consider characteristics related to adolescent substance use. Booklet content covers communication skills, parenting styles, attachment and time together, educational encouragement, conflict resolution, availability of tobacco and alcohol in the home, family rules about child use of tobacco and alcohol, and insights into peer and media influences.

The four booklets are successively mailed home to parents, along with token participation incentives of a Family Matters–imprinted pencil, button, balloon, or magnet. After each mailing, health educators phone parents to encourage them to complete the book and any included parent–child activities. The health educators also answer questions from parents. The booklets are delivered in the following order:

• Why Families Matter describes the program and encourages participation.
• Helping Families Matter to Teens considers general family factors that influence adolescent alcohol and tobacco use, such as communication skills and parenting styles.
• Alcohol and Tobacco Rules Are Family Matters emphasizes behavior-specific factors that families can influence, including the availability of tobacco and alcohol in the home and family rules about child substance use.
• Nonfamily Influences That Matter deals with nonfamily influences on adolescent substance use, such as the media and friends who use. It also reviews the main points of the program.

Key Personnel

The program contact is usually the adolescent’s mother or mother surrogate, who is asked to participate in the program and to involve additional adult family members. In addition to reading the booklet, adult family members are asked to complete activities with the adolescent on such key program content areas as communication skills and rule setting. Some of the reading material and activities are for adult family members only; other parts of the program are for the adult family members and the adolescent.

The health educators conduct follow-up calls after each booklet is completed, but never interact directly with the adolescent. These educators can be recruited from within the implementing organization or surrounding community (e.g., school nurses, teachers, college students, and business professionals). They may be either paid staff or volunteers.

Study

Bauman and colleagues (2002) evaluated Family Matters using a randomized experimental design to assess the prevalence of cigarette and alcohol use. At baseline, parent–child pairs (all children ages 12 to 14) were selected throughout the United States by random-digit dialing and then interviewed by telephone. Initially, 64,811 phone numbers were selected to represent all residential phone numbers in the contiguous United States, of which 2,395 were estimated to be in households with both an eligible adolescent and parent. A total of 1,326, or 55.4 percent, of the pairs completed the 15-minute baseline telephone interview. Ultimately, 1,316 subjects made up the final sample, as 9 asked to be withdrawn and 1 was lost to follow-up. The adolescents–parent pairs were then randomly allocated either to receive Family Matters or to serve as controls. The Family Matters intervention group (n = 531) received successive mailings of four booklets to their homes, followed by phone contact from the health educators. The control group (n = 604) received no intervention.

Of the entire sample, 78 percent were non-Hispanic white (the ethnicity of the remaining 22 percent was not provided). The average age of the adolescent participants was 13.9 years, and 59.7 percent were female. In 96 percent of the sample, the mother or a mother surrogate was the contact interviewed at baseline. Regarding the education of the parents, 36.2 percent had a high school education or less, 33.2 percent had some college education, and 32.0 percent had graduated from college or higher. At the initial interview, 27.0 percent of the adolescents reported using cigarettes at some point in the past, and 63.4 percent reported using alcohol. The treatment and control groups did not differ on baseline characteristics. Of the 1,198 pairs eligible for Family Matters, 549 (45.8 percent) began the program, and 407 (34.0 percent) completed it. At 3- and 12-month points after the program was completed, participants were called for a follow-up interview. Of these 1,316 subjects, 1,135 (86.2 percent) completed either one or both of the follow-up interviews.

Adolescent alcohol use was assessed with the question, “How much alcohol have you ever had in your life?” Tobacco use was assessed with the question, “How much have you ever smoked cigarettes in your life?” Generalized estimating equations (GEE) methods were used to allow the inclusion of adolescents who completed one or both of the follow-up phone interviews. No subgroup analyses were conducted.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Ashery, Rebecca S., Elizabeth B. Robertson, and Karol L. Kumpfer. 1998. “Drug Abuse Prevention Through Family Interventions.” Rockville, Md: U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse.

Bauman, Karl E., Susan T. Ennett, Vangie Ann Foshee, Michael R. Pemberton, and Katherine A. Hicks. 2001. “Correlates of Participation in a Family-Directed Tobacco and Alcohol Prevention Program for Adolescents.” Health Education and Behavior 28(4):440–61.

Bauman Karl E., Susan T. Ennett, Vangie Ann Foshee, Michael R. Pemberton, Tonya S. King, and Gary G. Koch. 2000. “Influence of a Family-Directed Program on Adolescent Cigarette and Alcohol Cessation.” Prevention Science 1(4):227–37.

Bauman Karl E., Susan T. Ennett, Vangie Ann Foshee, Michael R. Pemberton, Tonya S. King, and Gary G. Koch. 2002. “Influence of a Family Program on Adolescent Smoking and Drinking Prevalence.” Prevention Science 3:35–42.

Bauman, Karl E., Vangie Ann Foshee, Susan T. Ennett, Katherine A. Hicks, and Michael R. Pemberton. 2001. “Family Matters: A Family-Directed Program Designed to Prevent Adolescent Tobacco and Alcohol Use.” Health Promotion Practice 2(1):81–96.

Bauman, Karl E., Vangie Ann Foshee, Susan T. Ennett, Michael R. Pemberton, Katherine A. Hicks, Tonya S. King, and Gary G. Koch. 2001. “Influence of a Family Program on Adolescent Tobacco and Alcohol Use.” American Journal of Public Health 91(4):604–10.

Ennett, Susan T., Karl E. Bauman, Vangie Ann Foshee, Michael R. Pemberton, and Katherine A. Hicks. 2001. “Parent–Child Communication About Adolescent Tobacco and Alcohol Use: What Do Parents Say and Does It Affect Youth Behavior?” Journal of Marriage and the Family 63:48–62.

Ennett, Susan T., Karl E. Bauman, Michael R. Pemberton, Vangie Ann Foshee, Ying–Chih Chuang, Tonya S. King, and Gary G. Koch. 2001. “Mediation in a Family-Directed Program for Prevention of Adolescent Tobacco and Alcohol Use.” Preventive Medicine 33(4):333–46.