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Intervention Summary

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Family Wellness: Survival Skills for Healthy Families

Family Wellness: Survival Skills for Healthy Families is a psychoeducational program designed to help families (including children ages 8 and up) strengthen their connection with each other and reinforce healthy ways of interacting. The program aims to improve family members' communication, conflict resolution, problem-solving, disciplinary, and cooperation skills.

Trained instructors deliver the six-session Family Wellness curriculum to families in a variety of formats (i.e., 1- to 3-hour classes held weekly, biweekly, or monthly; daylong workshop; weekend retreat), using interactive techniques (e.g., visuals, role-play, sculpts, continua, group activities). The sessions focus on three main areas: (1) parenting (e.g., parents as leaders, parents as models, children in healthy families, dealing with change), (2) family functioning (e.g., passing on parental values, communication skills, stepfamily and extended family issues), and (3) couples and relationships (e.g., signs of a healthy relationship, domestic violence, commitment, conflict resolution and money management). Children participate in the parenting and family functioning sessions; however, the couples and relationships sessions are for adults only.

Instructors may be professionals or laypeople; however, they must complete a 3-day training before delivering the program. Upon completion of the training, instructors are certified for 3 years.

In the study reviewed for this summary, the curriculum was delivered through 1- to 3-hour classes held weekly over a 12-week period.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes Review Date: December 2012
1: Communication skills
2: Conflict resolution skills
3: Problem-solving skills
4: Disciplinary skills
5: Cooperation skills
Outcome Categories Family/relationships
Social functioning
Ages 18-25 (Young adult)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Other community settings
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History Since 1980, more than 12,000 instructors in all 50 States and Puerto Rico, as well as in Australia, Germany, Italy, Japan, Singapore, South Korea, and Taiwan, have received training in Family Wellness. Over 1,000,000 families have received the program in settings such as schools, churches, mental health agencies, military groups, social services, criminal justice systems, refugee groups, foster and adoptive settings, community organizations, and universities.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations The following programs are adaptations of Family Wellness: Survival Skills for Healthy Families:

  • The Strongest Link: The Couple, for couples (available in English and Spanish)
  • Skills and Strengths for Families Affected by Domestic Violence, for families and adults who want to prevent domestic violence
  • The Wellness Way for Stepfamilies, for stepfamilies
  • Survival Skills for Healthy Christian Families, for Christian families
  • A Map For Marriage: Before You Say "I Do," for couples considering marriage
  • Dads for Life: Fathering for Family Wellness, for fathers
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal

Quality of Research
Review Date: December 2012

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Montañez, M. (2011, December). Family Wellness: Strengthening familial dynamics among underserved populations. Evidence from a quasi-experimental research design employing an intervention and control group. Las Cruces, NM: New Mexico State University.

Supplementary Materials

Family Wellness Evaluation Instrument

Information on reliability, validity, and intervention fidelity

Outcomes

Outcome 1: Communication skills
Description of Measures Communication skills were assessed with the Family Wellness Evaluation Instrument, which contains 48 items pertaining to communication, conflict resolution, stress and change, problem solving, disciplinary skills, cohesion skills, family dynamics, couple skills, and domestic violence. The instrument was administered once, after the intervention, to measure preintervention results retrospectively and postintervention results. Using a scale ranging from 0 (never true) to 10 (always true), participants responded to each item (e.g., "When I want or need something, I tell my partner about it," "When I ask a family member to do something, I tell them when I need it to be done"). Higher scores indicate better skills.
Key Findings A study was conducted with families (parents and children) who were (1) recruited from community referrals and advertising for participation in the intervention group, which received Family Wellness, or (2) recruited at a neighborhood grocery and general store for participation in the control group, which did not receive services. Parents in both groups were assessed after the 12-week intervention.

From pre- to postintervention, parents in the intervention group had a greater increase in scores for communication skills compared with parents in the control group (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.0 (0.0-4.0 scale)
Outcome 2: Conflict resolution skills
Description of Measures Conflict resolution skills were assessed with the Family Wellness Evaluation Instrument, which contains 48 items pertaining to communication, conflict resolution, stress and change, problem solving, disciplinary skills, cohesion skills, family dynamics, couple skills, and domestic violence. The instrument was administered once, after the intervention, to measure preintervention results retrospectively and postintervention results. Using a scale ranging from 0 (never true) to 10 (always true), participants responded to each item (e.g., "'If an argument with a family member gets too heated, I know how to ask for a 'time out' to calm down," "When there is a disagreement in the family, either my partner or I call for a family meeting to work things out"). Higher scores indicate better skills.
Key Findings A study was conducted with families (parents and children) who were (1) recruited from community referrals and advertising for participation in the intervention group, which received Family Wellness, or (2) recruited at a neighborhood grocery and general store for participation in the control group, which did not receive services. Parents in both groups were assessed after the 12-week intervention.

From pre- to postintervention, parents in the intervention group had a greater increase in scores for conflict resolution skills compared with parents in the control group (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.0 (0.0-4.0 scale)
Outcome 3: Problem-solving skills
Description of Measures Problem-solving skills were assessed with the Family Wellness Evaluation Instrument, which contains 48 items pertaining to communication, conflict resolution, stress and change, problem solving, disciplinary skills, cohesion skills, family dynamics, couple skills, and domestic violence. The instrument was administered once, after the intervention, to measure preintervention results retrospectively and postintervention results. Using a scale ranging from 0 (never true) to 10 (always true), participants responded to each item (e.g., "When my partner talks to me about a problem, I let them know what I think they said," "Before I work on a problem, I make sure I know what I want the results to look like"). Higher scores indicate better skills.
Key Findings A study was conducted with families (parents and children) who were (1) recruited from community referrals and advertising for participation in the intervention group, which received Family Wellness, or (2) recruited at a neighborhood grocery and general store for participation in the control group, which did not receive services. Parents in both groups were assessed after the 12-week intervention.

From pre- to postintervention, parents in the intervention group had a greater increase in scores for problem-solving skills compared with parents in the control group (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.0 (0.0-4.0 scale)
Outcome 4: Disciplinary skills
Description of Measures Disciplinary skills were assessed with the Family Wellness Evaluation Instrument, which contains 48 items pertaining to communication, conflict resolution, stress and change, problem solving, disciplinary skills, cohesion skills, family dynamics, couple skills, and domestic violence. The instrument was administered once, after the intervention, to measure preintervention results retrospectively and postintervention results. Using a scale ranging from 0 (never true) to 10 (always true), participants responded to each item (e.g., "When children follow the rules in our family, they are given extra privileges," "When children do not follow the rules in our family, they are given consequences"). Higher scores indicate better skills.
Key Findings A study was conducted with families (parents and children) who were (1) recruited from community referrals and advertising for participation in the intervention group, which received Family Wellness, or (2) recruited at a neighborhood grocery and general store for participation in the control group, which did not receive services. Parents in both groups were assessed after the 12-week intervention.

From pre- to postintervention, parents in the intervention group had a greater increase in scores for disciplinary skills compared with parents in the control group (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.0 (0.0-4.0 scale)
Outcome 5: Cooperation skills
Description of Measures Cooperation skills were assessed with the Family Wellness Evaluation Instrument, which contains 48 items pertaining to communication, conflict resolution, stress and change, problem solving, disciplinary skills, cohesion skills, family dynamics, couple skills, and domestic violence. The instrument was administered once, after the intervention, to measure preintervention results retrospectively and postintervention results. Using a scale ranging from 0 (never true) to 10 (always true), participants responded to each item (e.g., "My partner and I work together well as a team," "Even when things are going bad, I still want to be with my partner"). Higher scores indicate better skills.
Key Findings A study was conducted with families (parents and children) who were (1) recruited from community referrals and advertising for participation in the intervention group, which received Family Wellness, or (2) recruited at a neighborhood grocery and general store for participation in the control group, which did not receive services. Parents in both groups were assessed after the 12-week intervention.

From pre- to postintervention, parents in the intervention group had a greater increase in scores for cooperation skills compared with parents in the control group (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.0 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult)
26-55 (Adult)
72.2% Female
27.8% Male
77.1% Hispanic or Latino
18.5% White
1.5% Black or African American
1.5% Race/ethnicity unspecified
1% American Indian or Alaska Native
0.5% Asian

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Communication skills 2.0 2.0 2.0 1.5 2.0 2.5 2.0
2: Conflict resolution skills 2.0 2.0 2.0 1.5 2.0 2.5 2.0
3: Problem-solving skills 2.0 2.0 2.0 1.5 2.0 2.5 2.0
4: Disciplinary skills 2.0 2.0 2.0 1.5 2.0 2.5 2.0
5: Cooperation skills 2.0 2.0 2.0 1.5 2.0 2.5 2.0

Study Strengths

The measure had evidence of acceptable reliability. A validation process that included content experts was used to establish face validity of the measure, and questions were stated in English and Spanish, thus minimizing misinterpretation. Considerable effort went into training and supervision to maintain intervention fidelity. An appropriate sample size was used.

Study Weaknesses

Although intervention fidelity was discussed in the study, no evidence was provided to support whether the intervention was implemented as intended. Attrition and missing data were difficult to assess because of a lack of corresponding numbers for different categories of data. No procedures for handling missing data were described. Despite explanations of similarity between the intervention and control groups, there appear to be gender differences and differences in the length of the parents' current relationship. Covariates were not discussed. There was no discussion concerning the conduct of more sophisticated analyses to control for group differences.

Readiness for Dissemination
Review Date: December 2012

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Creighton, F., & Doub, G. (2000). Family Wellness instructor manual. Scotts Valley, CA: Family Wellness Associates.

Creighton, F. P., Doub, G. T., & Scott, V. M. (2001). Family Wellness: Survival Skills for Healthy Families: Family workbook. Salida, CA: Family Wellness Associates.

Family Wellness Associates. (n.d.). Family Wellness evaluation instrument. Salida, CA: Author.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: PowerPoint presentation version 3 [CD-ROM]. Salida, CA: Author.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: Session 1: Parents in healthy families [DVD]. Santa Cruz, CA: Impact Duplication.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: Session 2: Children in healthy families [DVD]. Santa Cruz, CA: Impact Duplication.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: Session 3: Adult relationships [DVD]. Santa Cruz, CA: Impact Duplication.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: Session 4: Change in healthy families [DVD]. Santa Cruz, CA: Impact Duplication.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: Session 5: Solving family problems [DVD]. Santa Cruz, CA: Impact Duplication.

Family Wellness Associates. (n.d.). Survival Skills for Healthy Families: Session 6: Sex, drugs, and you [DVD]. Santa Cruz, CA: Impact Duplication.

Family Wellness Associates. (n.d.). Survival Skills manual handouts [CD-ROM]. Salida, CA: Author.

Family Wellness Associates. (n.d.). You're the coach: How to teach family wellness skills to families [DVD]. Salida, CA: Author.

Family Wellness Associates Product Catalog

Program Web site, http://www.familywellness.com

Scott, V., Doub, G., & Runnels, P. (1999). Raising a loving family: Learn how to create the family life you want. Salida, CA: Family Wellness Associates.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.8 3.8 3.6 3.7

Dissemination Strengths

The instructor manual thoroughly describes the theory and rationale behind the program and all program materials. Several supplemental materials are available to support implementation. Instructors are required to attend training before they implement the program, and an advanced training is required for recertification. The training provides instructors with information on the session content, as well as coaching theory and practice and presentation skills. A training DVD package is also available, which demonstrates instructor skills for each of the six sessions. The program Web site is easy to navigate and provides information on program materials and trainings. It also contains an "Instructor Corner," which implementers can use to provide input and share tips and recommendations. Research findings that describe the types of evaluation methods used and anticipated outcomes of successful implementation are also available. Several tools are provided to support quality assurance.

Dissemination Weaknesses

Laypeople and clinicians likely enter the required instructor training with a large variation in general intervention skills; however, there is no specific support protocol in place to address this variation and ensure that posttraining skill is standardized. On-site consultation is intended for groups of eight or more participants, which may limit availability to some implementers in small sites. Little guidance is provided on the use of outcome monitoring tools to support quality assurance.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Family workbook $15 each Yes
CD-ROM with PowerPoint presentations $45 each No
You're the Coach (DVD) $75 each No
Survival Skills DVD series (sessions 1-6) $50 per session or $199 for set of 6 sessions No
Raising a Loving Family (book) $10 each No
3-day, on-site Instructor Training with certification (includes instructor manual, CD-ROM with handouts, and a family workbook)
  • $650 per participant for 2 or more participants or for participants from nonprofit organizations, military, schools, or local government
  • $750 per participant
Yes
Recertification through 1-day, off-site Advanced Instructor Training
  • $125 for participants from nonprofit organizations, military, schools, or local government
  • $150 per participant
Yes, one recertification option is required every 3 years
Recertification through sample session video review Free Yes, one recertification option is required every 3 years
1-day, on-site consultation $1,500 for groups of 8 or more participants, plus travel expenses No
Phone or email consultation Free No
Replications

Selected citations are presented below. An asterisk indicates that the document was reviewed for Quality of Research.

Chicagoland Healthy Marriage Initiative: First Year Highlights

Keith Research and Evaluation. (2007, November). An independent program evaluation of Santa Clara County's Family Wellness program: Survival Skills for Healthy Families. Austin, TX: Author.

La Hoz, A. E., & Garcia, M. C. (n.d.). Stories of success: Why does healthy relationship education work for Latino couples? Analysis of focus groups.

Manning, W. D., Trella, D., Lyons, H., Gulbis, A., & du Toit, N. (2007). Healthy relationships and healthy marriages: Final report. Bowling Green, OH: Center for Family and Demographic Research.

Ooms, T. (2007, March). Adapting healthy marriage programs for disadvantaged and culturally diverse populations: What are the issues? (Couples and Marriage Series, Policy Brief No. 10). Washington, DC: Center for Law and Social Policy.

Philliber Research Associates. (2006, October). St. Louis Healthy Marriage Coalition--Evaluation report. Saint Louis, MO: Author.

Contact Information

To learn more about implementation, contact:
Ana Morante, LMFT, CFLE
(408) 250-2261
a3fam@hotmail.com

To learn more about research, contact:
Marcel Montañez, Ph.D., LMHC
(575) 646-5078
marcel@nmsu.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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