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This study examined combinations of warmth and hostility in mother-father-adolescent triadic relationships when adolescents were in 6th grade and associations with adolescent middle school substance initiation. We conducted a latent profile analysis with a sample of 687 two-parent families (52.4% of adolescents were female, mean age = 11.27 at 6th grade). These analyses revealed five profiles of triadic relationships, labeled as: cohesive families (46%, high warmth and low hostility in all three dyads), compensatory families (24%, low interparental warmth but high parent-adolescent warmth), disengaged families (13%, average to low warmth and hostility in three dyads), distressed families (9%, high hostility and low warmth in all three dyads), and conflictual families (8%, high hostility and average warmth in all three dyads). There were significant differences across triadic relationship profiles in rate of alcohol initiation during middle school. Specifically, adolescents in distressed families and conflictual families initiated alcohol at higher rates than adolescents in other types of families. Cohesive families and compensatory families initiated alcohol at the lowest rates among all five types of families. Similar patterns appeared for drunkenness and cigarettes. Implications for family-based interventions to decrease adolescent substance use and future research directions are discussed.

Prior studies have found that parents' perceptions of control over their lives and their social support may both be important for parenting behaviors. Yet, few studies have examined their unique and interacting influence on parenting behaviors during early adolescence. This longitudinal study of rural parents in two-parent families (N = 636) investigated (a) whether perceived control and social support when their youth were in sixth grade were independently or interactively associated with changes in parenting behaviors (discipline, standard setting) and parent-child warmth and hostility 6 months later and (b) if these linkages differed by parent gender. We also investigated the interactive links between perceived control, social support, and parenting. Specifically, we tested if parents' perceived control moderated the linkages between social support and parenting and if these linkages differed by parent gender. Greater perceived control predicted more increases in parents' consistent discipline and standard setting, whereas greater social support predicted increases in parent-child warmth and decreases in parent-child hostility. Parental perceived control moderated the effect of social support on parental warmth: For mothers only, social support was significantly linked to parent-child warmth only when mothers had low (but not high) perceived self-control. The discussion focuses on reasons why perceived control and social support may have associations with different aspects of parenting and why these might differ for mothers and fathers., (© 2017 Family Process Institute.)

Although interparental conflict (IPC) has been linked directly and indirectly (via adolescents' appraisals) with a wide range of adolescent outcomes, little is known about the implications of IPC and related adolescent threat appraisals for substance use. Drawing on the cognitive-contextual framework, we test competing hypotheses about how IPC may impact adolescent substance use outcomes, specifically testing whether (a) threat appraisals are directly related to escalation in alcohol and tobacco use over adolescence, or (b) threat appraisals are indirectly associated with substance use through their impact on adolescent internalizing problems. Family data from 768 2-caregiver families were analyzed for this study. Adolescents (53% female) were followed on 7 occasions starting in the fall of 6th grade (mean age = 11.3 years) through the spring of 11th grade. IPC and family demographic data were collected from parents. Youth provided data on their appraisals of conflict, internalizing problems, and substance use. Using longitudinal growth curve models, findings supported threat appraisals as a direct risk factor for escalating cigarette use, but not escalating alcohol use, during adolescence. In the alcohol trajectory model, IPC was a direct predictor of increases in alcohol use over time. These findings indicate that high levels of threat appraisals are a specific and direct risk for greater increases in cigarette use over the course of adolescence and that IPC confers risk for increasing rates of alcohol use over adolescence. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Seeking to reduce problematic peer influence is a prominent theme of programs to prevent adolescent problem behavior. To support the refinement of this aspect of prevention programming, we examined peer influence and selection processes for three problem behaviors (delinquency, alcohol use, and smoking). We assessed not only the overall strengths of these peer processes, but also their consistency versus variability across settings. We used dynamic stochastic actor-based models to analyze five waves of friendship network data across sixth through ninth grades for a large sample of U.S. adolescents. Our sample included two successive grade cohorts of youth in 26 school districts participating in the PROSPER study, yielding 51 longitudinal social networks based on respondents' friendship nominations. For all three self-reported antisocial behaviors, we found evidence of both peer influence and selection processes tied to antisocial behavior. There was little reliable variance in these processes across the networks, suggesting that the statistical imprecision of the peer influence and selection estimates in previous studies likely accounts for inconsistencies in results. Adolescent friendship networks play a strong role in shaping problem behavior, but problem behaviors also inform friendship choices. In addition to preferring friends with similar levels of problem behavior, adolescents tend to choose friends who engage in problem behaviors, thus creating broader diffusion.

This study is a longitudinal investigation of the Promoting School-community-university Partnerships to Enhance Resilience (PROSPER) partnership model designed to evaluate the level of sustainability funding by community prevention teams, including which factors impact teams' generation of sustainable funding. Community teams were responsible for choosing, implementing with quality, and sustaining evidence-based programs (EBPs) intended to reduce substance misuse and promote positive youth and family development. Fourteen US rural communities and small towns were studied. Data were collected from PROSPER community team members (N = 164) and prevention coordinators (N = 10) over a 5-year period. Global and specific aspects of team functioning were assessed over six waves. Outcome measures were the total funds (cash and in-kind) raised to implement prevention programs. All 14 community teams were sustained for the first 5 years. However, there was substantial variability in the amount of funds raised, and these differences were predicted by earlier and concurrent team functioning and by team sustainability planning. Given the sufficient infrastructure and ongoing technical assistance provided by the PROSPER partnership model, local sustainability of EBPs is achievable.

Community coalitions have been promoted as a strategy to help overcome challenges to the dissemination and implementation of evidence-based prevention programs. This paper explores the characteristics of coalitions that enable the provision of implementation support for prevention programs in general and for the implementation of evidence-based prevention programs with fidelity. Longitudinal cross-lagged panel models were used to study 74 Communities That Care (CTC) coalitions in Pennsylvania. These analyses provide evidence of a unidirectional influence of coalition functioning on the provision of implementation support. Coalition member knowledge of the CTC model best predicted the coalition's provision of support for evidence-based program implementation with fidelity. Implications for developing and testing innovative methods for delivering training and technical assistance to enhance coalition member knowledge are discussed.

The transition to parenthood involves many stressors that can have implications for the couple relationship as well as the developmental environment of the child. Scholars and policymakers have recognized the potential for interventions that can help couples navigate these stressors to improve parenting and coparenting strategies. Such evidence-based programs are scarcely available, however, and little is known about the resources necessary to carry out these programs. This study examines the costs and resources necessary to implement Family Foundations, a program that addresses the multifaceted issues facing first-time parents through a series of pre- and post-natal classes. Costs were determined using a 6-step analytic process and are based on the first implementation of the program carried out through a five-year demonstration project. This assessment demonstrates how overall costs change across years as new cohorts of families are introduced, and how cost breakdowns differ by category as needs shift from training group leaders to sustaining program services. Information from this cost analysis helps clarify how the program could be made more efficient in subsequent implementations. We also consider how results may be used in future research examining economic benefits of participation in the program., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objectives: We test the hypothesis that an evidence-based preventive intervention will change adolescent friendship networks to reduce the potential for peer influence toward antisocial behavior. Altering adolescents' friendship networks in this way is a promising avenue for achieving setting-level prevention benefits such as expanding the reach and durability of program effects., Methods: Beginning in 2002, the Promoting School-University Partnerships to Enhance Resilience (PROSPER) randomized control trial assigned two entire sixth-grade cohorts of 14 rural and small town school districts in Iowa and Pennsylvania to receive the intervention and of 14 to control. A family-based intervention was offered in sixth grade and a school-based intervention was provided in seventh grade. More than 11,000 respondents provided five waves of data on friendship networks, attitudes, and behavior in sixth through ninth grade. Antisocial influence potential was measured by the association between network centrality and problem behavior for each of 256 networks (time, grade cohort, and school specific)., Results: The intervention had a beneficial impact on antisocial influence potential of adolescents' friendship networks, with p < .05 for both of the primary composite measures., Conclusions: Current evidence-based preventive interventions can alter adolescents' friendship networks in ways that reduce the potential for peer influence toward antisocial behavior., (Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Analyses of program engagement can provide critical insight into how program involvement leads to outcomes. This study examines the relation between participant engagement and program outcomes in Family Foundations (FF), a universal preventive intervention designed to help couples manage the transition to parenthood by improving coparenting relationship quality. Previous intent-to-treat outcome analyses from a randomized trial indicate FF improves parental adjustment, interparental relationships, and parenting. Analyses for the current study use the same sample, and yield statistically reliable relations between participant engagement and interparental relationships but not parental adjustment or parenting. Discussion considers implications for FF and the difficulties researchers face when examining the relation between engagement and outcomes in preventive interventions.

Objective: Although studies have demonstrated that an adolescent's parents and friends both influence adolescent substance use, it is not known whether the parenting experienced by one's friends also affects one's own use. Drawing on conceptions of shared parenting and the tenets of coercion theory, we investigated the extent to which three domains of parenting behaviors (parental knowledge, inductive reasoning, and consistent discipline) influenced the alcohol, cigarette, and marijuana use of not only their own adolescent children but also of members of their adolescents' friendship groups., Method: Analyses of friendship nominations within each of two successive ninth-grade cohorts in 27 Iowa and Pennsylvania schools (N = 7,439 students, 53.6% female) were used to identify 897 friendship groups. Hierarchical logistic regression models were used to examine prospective associations between 9th-grade friendship group-level parenting behaviors and adolescent self-reported alcohol, cigarette, and marijuana use in 10th grade., Results: Adolescent substance use in 10th grade was significantly related to parenting behaviors of friends' parents, after controlling for adolescents' reports of their own substance use and their own parents' behaviors at the 9th grade level. These associations were particularly strong for parents' knowledge about their children and use of inconsistent discipline strategies. Significant interaction effects indicated that these relationships were strongest when adolescents received positive parenting at home. Some, but not all, of the main effects of friends' parents' parenting became nonsignificant after friends' substance use in ninth grade was included in the model., Conclusions: The findings suggest that the parenting style in adolescents' friends' homes plays an important role in determining adolescent substance use. Implications of the joint contribution of parents and peers for prevention and intervention are discussed.

Purpose: To investigate the long-term (6- and 12-month) effects of the Strong Healthy Women intervention on health-related behaviors, weight and body mass index (BMI), and weight gain during pregnancy. Strong Healthy Women is a small-group behavioral intervention for pre- and interconceptional women designed to modify key risk factors for adverse pregnancy outcomes; pretest-posttest findings from a randomized, controlled trial have been previously reported. The following questions are addressed: 1) were significant pretest-posttest changes in health-related behaviors (previously reported) maintained over the 12-month follow-up period; 2) did the intervention impact weight and BMI over the 12-month follow-up period; and 3) did the intervention impact pregnancy weight gain for those who gave birth during the follow-up period?, Methods: Data are from 6- and 12-month follow-up telephone interviews of women in the original trial of the Strong Healthy Women intervention (n = 362) and from birth records for singleton births (n = 45) during the 12-month follow-up period. Repeated measures regression was used to evaluate intervention effects., Main Findings: At the 12-month follow-up, participants in the Strong Healthy Women intervention were significantly more likely than controls to use a daily multivitamin with folic acid and to have lower weight and BMI. The intervention's effect on reading food labels for nutritional values dropped off between the 6- and 12-month follow-up. Among those who gave birth to singletons during the follow-up period, women who participated in the intervention had lower average pregnancy weight gain compared with controls. Although the intervention effect was no longer significant when controlling for pre-pregnancy obesity, the adjusted means show a trend toward lower weight gain in the intervention group., Conclusion: These findings provide important evidence that the Strong Healthy Women behavior change intervention is effective in modifying important risk factors for adverse pregnancy outcomes and may improve an important pregnancy outcome, weight gain during pregnancy. Because the intervention seems to help women manage their weight in the months after the intervention and during pregnancy, it may be an effective obesity prevention strategy for women before, during, and after the transition to motherhood., (Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)

This study investigated the ability of a psychosocial prevention program implemented through childbirth education programs to enhance the coparental and couple relationship, parental mental health, the parent-child relationship, and child outcomes. A sample of 169 heterosexual, adult couples expecting their first child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of eight classes delivered before and after birth, which was designed as a universal prevention program (i.e., applicable to all couples, not just those at high risk). Intent-to-treat analyses utilizing data collected from child age 6 months through 3 years indicated significant program effects on parental stress and self-efficacy, coparenting, harsh parenting, and children's emotional adjustment among all families, and maternal depression among cohabiting couples. Among families of boys, program effects were found for child behavior problems and couple relationship quality. These results indicate that a universal prevention approach at the transition to parenthood focused on enhancing family relationships can have a significant and substantial positive impact on parent and child well-being.

This study examines how aspects of coalition functioning predict a coalition's ability to promote high-quality implementation of evidence-based programs (EBPs). The study involved 62 Communities That Care (CTC) coalitions in Pennsylvania measured annually from 2003 to 2007. Findings indicate that the communities with higher levels of poverty and longer existing coalitions are related to lower support for high-quality EBP implementation. Several aspects of coalition functioning-including higher levels of funding; leadership strength; board efficiency; strong internal and external relationships; and fidelity to the CTC model-significantly predicted support for high-quality EBP implementation. Earlier measurements of coalition functioning (2003-2004 and 2005-2006) predicted EBP implementation (2007) more strongly than concurrent coalition assessments (2007). The discussion focuses on how coalitions and technical assistance providers can improve coalition support for the implementation of EBPs.

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.

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.

The current study investigated how individual risk factors interact with social contextual-level protective factors to predict problematic substance use among a sample of 12th-grade students (n = 8,879, 53% female). Results suggested six latent classes of substance use: (1) Non-Users; (2) Alcohol Experimenters; (3) Alcohol, Tobacco, and Other Drug (ATOD) Experimenters; (4) Current Smokers; (5) Binge Drinkers; and (6) Heavy Users. Binary logistic regression models provided evidence that individual risk, family, school, and community protective factors were associated with membership in the substance use latent classes. However, the significance of interaction terms suggested that these protective influences differed according to the level of individual risk. Adolescents with high levels of individual risk benefited less from a positive family or neighborhood context than adolescents with low levels of individual risk. These findings suggest that the individual risk factors may undermine the protective effect of parental supervision, discipline, and other family factors, as well as protective aspects of cohesive neighborhoods, among these adolescents. Multi-component and adaptive intervention efforts that account for different levels of ATOD use involvement, as well as distinct profiles of risk and protection, are likely to be most effective in preventing problematic substance use.

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.

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.

This study examined the impact of on-site and off-site technical assistance (TA) dosage on the functioning of Communities That Care prevention boards in Pennsylvania. Data on board functioning were collected over three years from board member and TA providers. Results of path models indicated little overall impact of TA dosage on board functioning the subsequent year. However, on-site TA dosage did appear to influence board functioning for younger boards and for boards who were relatively better functioning. In addition, the stability of board functioning and off-site TA was moderate to strong, the stability of on-site TA dosage was low, and poor functioning sites did not receive more TA in the following year. EDITORS' STRATEGIC IMPLICATIONS: This paper is one of the first quantitative examinations of the impact of TA on community-based prevention or health promotion coalitions. The authors provide a number of implications for further study with respect to TA. Thus, it should be valuable to researchers and practitioners involved in the development and implementation of such community-based efforts.

Community coalitions (CCs) have labored with some difficulty to demonstrate empirical evidence of effectiveness in preventing a wide range of adolescent problem behaviors. Training and technical assistance (TA) have been identified as important elements in promoting improved functioning of CCs. A reliable, valid, and inexpensive method to assess functioning of CCs has been developed and is tested in this article in the context of Pennsylvania's Communities That Care (CTC) model. A CC Web-based questionnaire was developed and administered to more than 79 communities (867 participants) and the validity and reliability were assessed through multiple means, including the use of a companion TA implementation feedback questionnaire completed by TAs assigned to each of the sites. Results indicated adequate to good psychometric properties on internal reliability of the Web-based questionnaire, moderate construct validity across different reports of functioning, and relative stability throughout the course of 1 year. Implications for a variety of community prevention coalitions interested in a relatively low-cost, user friendly, and suitable methodology for evaluating coalition functioning are discussed. In addition, areas of application for future research including linking coalition functioning with the quality and nature of technical assistance, levels of risk and protective factors, and large data sets of youth risk factor and problem behavior data are highlighted.

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.

The relationships between community coalition processes during initial 3-year state seed funding and markers of sustainability post-funding were investigated in 20 Communities That Care (CTC) sites in Pennsylvania. Coalition processes were assessed using interviews with coalition members, ratings from the research team and ratings from state technical consultants. We found members' knowledge of prevention, coalition internal functioning, and fidelity to the CTC model during early coalition functioning predictive of later sustained coalition board activity. Findings suggest domains of early coalition functioning that may be important for understanding and promoting sustainability.

This paper examined whether community readiness, prevention knowledge, coalition functioning, and barriers are linked to perceived effectiveness of community prevention coalitions. Interviews were conducted with 203 key leaders in Communities That Care (CTC) prevention boards in 21 Pennsylvania communities. Community-level means for the reliable self-report measures were utilized separately and in combination with research staff ratings, state technical assistant staff ratings, and other data. The results indicated that the strong link between readiness and perceived effectiveness was mediated by internal coalition functioning. The extent of CTC linkage with outside community entities was not linked to perceived effectiveness. The study concludes that community readiness is an important condition for success of a prevention coalition, and exerts effects mainly through the quality of the coalition's internal functioning. Member turnover and infighting appear to be important factors related to internal functioning. Linkage with outside entities may be more important for coalition models where the coalition is more dependent on local institutions for resources.