Testing the Effectiveness of the Strong African American Families Program: A Randomized, Community Based Prevention Trial

Introduction: The Strong African American Families (SAAF) program is a family-based, alcohol preventive intervention for rural African American youth. It consists of 7 weekly meetings with separate, concurrent sessions for parents and youth, followed by a joint parent–youth session. A randomized prevention trial supported SAAF’s efficacy. The effectiveness of SAAF as implemented by a community-based agency, however, is unknown.  To address this need, we evaluated SAAF as implemented by the University of Georgia Cooperative Extension (CE). Local CE offices provided logistical and infrastructure support and hired a SAAF Coordinator, who organized family recruitment and program delivery using a detailed implementation manual and routine technical assistance. In this presentation, we describe the implementation system’s design and effectiveness as evinced by adherence to program delivery protocols, family recruitment rates, program attendance, and SAAF effects on substance use vulnerability and mediating processes.

Methods: Rural African American families (N = 472) with an 11-year-old were assigned randomly to either SAAF or a wait--list control. Families participated in audio computer-assisted self-interviews in their homes at baseline and at a delayed posttest 9 months later. We assessed targeted substance vulnerability outcomes and intervention-targeted mediators. Wait-list participants were invited to attend SAAF 1 year after baseline.

Results: Program implementation activities yielded high levels of engagement. Of the 667 families screened for participation, 550 took part in the project (82%). Local CE SAAF Coordinators organized the training of 34 community members to deliver the program and the implementation of 36 groups in 8 rural Georgia counties. Mean family attendance was 4.0 sessions. Adherence assessments indicated that a mean of 86% (SD = 10.42) of SAAF activities were delivered. SAAF and the control group were equivalent on demographic characteristics and program outcomes at baseline. Effectiveness analyses revealed that assignment to SAAF compared to the wait list resulted in reduced vulnerability to substance use (β =-.095, p = .017) as indicated by measures of attitudes and intentions. Consistent with the program’s causal model, intervention-targeted change in youth self-regulation mediated the association between assignment to SAAF and substance use vulnerability, indirect effects = -.041, 95% CI (-.079, -.003).

Conclusions: The SAAF effectiveness trial demonstrated effects similar to those found in a highly controlled prevention trial. The effects were achieved by implementing a dissemination model centered on designated prevention coordinators’ working with extensive technical assistance.