Bauman KE, Foshee VA, Ennett ST, Pemberton M, Hicks KA, King TS, Koch GG . (2001). The influence of a family program on adolescent tobacco and alcohol use. American Journal of Public Health, 91, 604-610.
|Program Title||Family Matters|
|Purpose||Designed to promote tobacco use prevention among middle school children. (2001)|
|Program Focus||Tobacco Use Prevention|
|Age||Adolescents (11-18 years), Adults (40-65 years), Older Adults (65+ years), Young Adults (19-39 years)|
|Race/Ethnicity||Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin|
|Setting||Clinical, Community, Home-based, Rural, School-based, Suburban, Urban/Inner City|
|Funded by||NIDA (Grant number(s): DA08125)|
|User Reviews||(Be the first to write a review for this program)|
Family Matters is a family-oriented program designed to prevent adolescents 12-14 years of age from using tobacco and alcohol. The intervention is designed to influence population-level prevalence and can be implemented with large numbers of geographically dispersed families. The program encourages communication among family members and focuses on general family characteristics (e.g., supervision and communication skills) and substance-specific characteristics (e.g., family rules for tobacco and alcohol use and media/peer influences).
The program involves successive mailings of four booklets to families, each beginning with identification of the topics for the booklet and then proceeding in order with a question-and-answer section about the main substantive content of the booklet, a description of the suggested activities, a summary of the main considerations of the booklet, and a preview of the next part of the program. Booklet 1, "Why Families Matter", motivates the family to participate and become engaged by demonstrating the negative consequences to the family from adolescent substance use. Booklet 2 , "Helping Families Matter to Teens", focuses on general family characteristics known or believed to influence adolescents that are not specific to alcohol and tobacco use, such as supervision, support, communication skills, attachment, time spent together, educational achievement, conflict reduction, and how well adolescence is understood. Booklet 3, "Alcohol and Tobacco Rules are Family Matters", is concerned with tobacco and alcohol-specific variables that originate in the family and predict adolescent drug use. Booklet 4 is "Non-Family Influences That Matter", which considers variables that originate outside the family that can influence adolescent use.
Family members are asked to read the booklets and complete the activities intended to reinforce their content. Two weeks later, health educators contact the parent by telephone to confirm that the booklet was received, to arrange for sending another copy if not received, to determine if the booklet has been read and activities completed, to encourage family participation, to answer questions, and to assess the parent's satisfaction and other reactions to the booklet. A new booklet is mailed when the health educator determines that the prior booklet has been completed.
Family Matters was evaluated using a randomized experimental design. A national probability sample of families with children aged 12-14 years living throughout the contiguous United States was selected based on random-digit dialing. Adolescent-parent pairs were matched by date and time of baseline completion, and then the pairs were allocated randomly either to receive the Family Matters intervention or to serve as controls, who did not receive booklets or health educator calls.
Data were obtained through telephone surveys at baseline and at 3 and 12 months after completion of the intervention. Adolescents were asked "How much have you ever smoked cigarettes in your life?" Response categories were "none at all, not even a puff", "1 or 2 puffs but not a whole cigarette", "1 to 5 whole cigarettes", "6 to 20 whole cigarettes", and "more than 20 whole cigarettes." Categories were collapsed to never used (first response category) and had used (all other categories). Adolescents also were asked "How much alcohol have you ever had in your life?" Response categories were "none at all, not even a sip", "1 or 2 sips but not a whole drink", "3 or more sips but never a whole drink at one time", "1 to 5 whole drinks", "6 to 20 whole drinks", and "more than 20 whole drinks." Categories were collapsed to never used (first response category) and had used (all other categories). To assess the overall prevalence of smoking and drinking, both baseline users and nonusers were included in the analyses. Only the adolescents classified at baseline as nonusers were included in analyses assessing onset of cigarette smoking.
Of the 1,135 adolescent-parent pairs who completed the 3-month follow-up, the 12-month follow-up, or both, 78.0% were non-Hispanic White, the average age was 13.9 years (SD=0.9), and 50.7% were female.
Effects on Smoking
- Smoking onset was reduced among adolescents who reported being nonusers at the start of the program. At 12-month follow-up, 16.4% fewer program participants (31% versus 25.9%) had initiated smoking compared with an adolescent control group (p=.037). Results were significantly stronger among non-Hispanic White adolescents than among adolescents of other ethnicity.
Figure 1: Nonusers Who Began Cigarette Use
- Self-reported smoking also was reduced among both users and nonusers, after adjusting for demographic variables and use rates at the start of the program (p=.014).
Figure 2: Lifetime Cigarette Use Among All Participants
Effects on Alcohol Use
- Self-reported alcohol use was reduced among both users and nonusers, after adjusting for use rates at the start of the program and demographic variables (p=.022).
Figure 3: Lifetime Alcohol Use Among All Participants
Bauman, Karl E., Ennett, Susan E., Foshee, Vangie A., Pemberton, Michael, & Hicks, Katherine. (2001). Correlates of participation in a family-directed tobacco and alcohol prevention program for adolescents. Health Education & Behavior, 28(4), 440-461.
Bauman, Karl E., Foshee, Vangie A., Ennett, Susan T., Hicks, Katherine A., & Pemberton, Michael. (2001). Family Matters: A family-directed program designed to prevent adolescent tobacco and alcohol use. Health Promotion Practice, 2 (1), 81-96.
Ennett, Susan T., Bauman, Karl E., Foshee, Vangie A., Pemberton, Michael, & Hicks, Katherine A. (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 (1), 48-62.
Ennett, Susan T., Bauman, Karl E., Pemberton, Michael, Foshee, Vangie A., Chuang, Ying-Chih, King, Tonya S., & Koch, Gary G. (2001). Mediation in a family-directed program for prevention of adolescent tobacco and alcohol use. Preventive Medicine, 33 , 333-346.
Bauman, Karl E., Ennett, Susan T., Foshee, Vangie A., Pemberton, Michael, King, Tonya S., & Koch, Gary G. (2000). Influence of a family-directed program on adolescent cigarette and alcohol cessation. Prevention Science, 1 (4), 227-237.
Chuang, Y.-C., Ennett, S. T., Bauman, K. E., & Foshee, V. (2005). Neighborhood influences on adolescent cigarette and alcohol use: Mediating effects through parent and peer behaviors. Journal of Health and Social Behavior, 46 , 187-204.
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