Family-Centered Prevention during the Emerging Adult Years to Reduce Risk and Support Healthy Adult Adjustment

Introduction

Developmental research over the past 30 years has converged on a clear model that predicts the trajectory of risk associated with problem behavior from early childhood to the adult years. Early contextual risks predict a pattern of problem behavior in childhood that is exacerbated over time by limited parenting skills and poor family management at home. Family-centered prevention at critical junctures can prevent future behavior problems and reduce risk.

Although many studies have documented parental influence on adolescent substance use, it is surprising that far fewer studies have examined these connections after youth leave high school or provided interventions during this time period that focus on family relationships. Despite the evidence, few studies have followed youth and families into the adult years, and no study has focused on delivering family-centered interventions as youth transition from adolescence to adulthood, a time period known for increases in risk behavior.

Methods

Our sample includes 593 ethnically diverse youth recruited for a school-based, family-centered intervention to prevent problem behavior during middle school. The families were randomly assigned to receive the Family Check-Up or middle school as usual. We continue to follow this sample into adulthood, when we provided a young adult version of the Family Check-Up. Data on risk behavior and parenting were collected at 7 time points from middle school to the young adult years.

Results

When we examined long-term outcomes at age 19–21 associated with the intervention, we found that many of the early effects of the intervention were maintained into the young adult years. Using ITT analyses, we found that young adults showed a reduction in deviant peer affiliation and reductions in family conflict when compared with the control group, with modest effect sizes (ES; p < .05, ES = .27 and .22, respectively). We also found that males who received the intervention showed reductions in tobacco use (p < .05, ES = .25). Furthermore, analyses suggest that these results were maintained after administration of the young adult version of the FCU. Our data suggest that males in the treatment group used alcohol and drugs less frequently at follow-up than did those who were not offered the young adult version of the FCU, a medium effect (p < .05, ES = .42).

Conclusions

These results highlight the efficacy of family-centered prevention in emerging adulthood and provide support for continued research on interventions that aim to reduce risk during the young adult years.