The Promoting Strong African American Families Program: A Randomized Controlled Trial of Program Effects on Couple, Coparenting, Parenting, and Health Outcomes

Introduction

Two-parent African American families living in the rural southeastern United States encounter a range of economic and contextual stressors that cascade through families, undermining adults’ emotional well-being, couple relationships, and parenting practices (Barton & Bryant, 2016; Conger et al., 2002). Although the influence of economic distress on family relationships and youth development is well established, findings from this research have yet to inform the development of family-centered prevention programming. In response, the Protecting Strong African American Families (ProSAAF) program was developed to meet the needs of two-parent African American families residing in the impoverished rural South. The current study presents results on program efficacy, engagement, and costs from a randomized controlled trial.

Methods

Participants were 346 rural African American couples with a pre- or early-adolescent child. In-home assessments occurred at baseline and two follow-up waves (mean of 9.4 and 17 months from baseline, respectively). Outcomes measures were: relationship satisfaction, relationship confidence, effective communication, spousal support, coparenting, parental monitoring, and self-reported health. Data were analyzed using growth curves and path analysis. For intervention families (n = 172), a trained African American facilitator visited families’ home for 6 sessions on an approximate weekly basis. Two booster sessions were also conducted.

Results

Compared to couples in the control condition, ProSAAF couples reported improved change over time in effective communication (men[m]: B = .12; p < .01; women[w]: B = .13; p < .01), relationship satisfaction (m: B = .09; p < .01; w: B = .10; p < .01), relationship confidence (m: B = .07; p < .01; w: B = .05; p < .05), spousal support (m: B = .08; p < .01; w: B = .07; p < .05), coparenting (m: B = .14; p < .05; w: B = .19; p < .01), and intervention-targeting parenting (m: B = .12; p < .01; w: B = .04; p = .11). ProSAAF participation had an indirect effect (IE) on changes in self-reported health through improved couple functioning (m: IE = 0.072, 95% Confidence Interval (CI) = .008, .188; w: IE = 0.064; 95% CI = .010, .183). For attendance, 81% (n = 139) of families assigned to the intervention completed all six sessions; 19% (n = 32) of families completed 3 or fewer sessions. Mean program costs were $1664 per family (range $651 – $3174).

Conclusion

Results demonstrate the efficacy of a prevention program for low-income African Americans couples rearing a child in early adolescence. Of note, program effects were found in multiple dimensions of the family system. Results inform the ongoing debate surrounding prevention programs for low-income, ethnic minority families.