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Intervention Summary

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SAFEChildren

Schools And Families Educating Children (SAFEChildren) is a family-focused preventive intervention designed to increase academic achievement and decrease risk for later drug abuse and associated problems such as aggression, school failure, and low social competence. SAFEChildren targets 1st-grade children and their families living in inner-city neighborhoods. The intervention has two components. The first component is a multiple-family group approach that focuses on parenting skills, family relationships, understanding and managing developmental and situational challenges, increasing parental support, skills and issues in engaging as a parent with the school, and managing issues such as neighborhood problems (e.g., violence). Families participate in 20 weekly sessions (2 to 2.5 hours each) led by a trained, professional family group leader. Each session includes a review of the previous week's homework, discussion about a focused topic, and in-session role-plays and activities. The second component is a reading tutoring program for the child. Tutoring is provided twice weekly (one 30-minute and one 20-minute session) over 20 weeks, using a modified version of the Wallach program. Each tutoring session involves segments on phonics, sound and word activities, and reading books.

Descriptive Information

Areas of Interest Mental health promotion
Substance abuse prevention
Outcomes Review Date: October 2007
1: Reading achievement
2: Child problem behaviors
3: Parenting practices
4: Parental involvement in child's education
Outcome Categories Education
Social functioning
Violence
Ages 6-12 (Childhood)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities Black or African American
Hispanic or Latino
Settings School
Other community settings
Geographic Locations Urban
Implementation History Since 1997 approximately 550 families have participated in the SAFEChildren program.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations Parent group handouts and process and fidelity measures are available in Spanish.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Selective

Quality of Research
Review Date: October 2007

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

Gorman-Smith, D., Tolan, P. H., Henry, D. B., Leventhal, A., Schoeny, M., Lutovsky, K., & Quintana, E. (2002). Predictors of participation in a family-focused preventive intervention for substance use. Psychology of Addictive Behaviors, 16(Suppl. 4), S55-S64.  Pub Med icon

Tolan, P., Gorman-Smith, D., & Henry, D. (2000). Promoting academic and social competence among urban youth: The SAFEChildren Project. Final grant report submitted to the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention.

Tolan, P., Gorman-Smith, D., & Henry, D. (2004). Supporting families in a high-risk setting: Proximal effects of the SAFEChildren preventive intervention. Journal of Consulting and Clinical Psychology, 72(5), 855-869.  Pub Med icon

Supplementary Materials

Gorman-Smith, D., Tolan, P., Henry, D. B., Quintana, E., Lutovsky, K., & Leventhal, A. (2007). Schools and Families Educating Children: A preventive intervention for early elementary school children. In P. H. Tolan, J. Szapocznik, & S. Sambrano (Eds.), Preventing youth substance abuse: Science-based programs for children and adolescents (pp. 113-135). Washington, DC: American Psychological Association.

Outcomes

Outcome 1: Reading achievement
Description of Measures Children's reading achievement was measured using the Woodcock Diagnostic Reading Battery (WDRB), a comprehensive set of individually administered tests that measure important dimensions of reading achievement and closely related abilities. Four subscales of the battery were administered: letter-word identification, word attack, passage comprehension, and incomplete words. Results from each subscale were combined for a total reading score.
Key Findings One study analyzed the growth trajectories in reading achievement from the end of kindergarten to the middle of 2nd grade for both intervention and nonintervention children. Children who received the intervention improved in overall reading ability at a more rapid rate for the reading composite (p < .01) than those who did not receive the intervention. When the reading composite results were converted to grade-equivalent scores, the intervention participants were 0.44 grade-equivalent years ahead of the control participants by the middle of 2nd grade. In addition, the intervention participants were somewhat above the national average for mid-2nd-grade reading skills (grade equivalent = 2.9 level achievement, school month = 2.6), while the control participants were slightly below the national average (grade equivalent = 2.4, school month = 2.6). The slope effect size was very small (Cohen's d = 0.17).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.6 (0.0-4.0 scale)
Outcome 2: Child problem behaviors
Description of Measures Teachers and parents provided ratings of the child's aggression, hyperactivity, and concentration problems using subscales of the Teacher Observations of Classroom Adaptation--Revised (TOCA-R) and Parent Observations of Classroom Adaptation--Revised (POCA-R). In this structured interview, teachers and parents report observations of the child's behaviors that may affect adaptation to school. Higher scores reflect higher levels of aggression, hyperactivity, and problems with concentration. Parent and teacher ratings were combined for each of the subscales.
Key Findings Among families designated as high risk (those with less adequate parenting skills and family relationship quality at pretest), there was a decrease over time in aggression among children who received the SAFEChildren intervention, whereas there was essentially no change among children who did not receive the intervention (p < .05). In addition, SAFEChildren participants showed an improvement in concentration (p < .05) relative to those who did not receive the intervention. The slope effect sizes were very small (Cohen's d = 0.12 and 0.13, respectively).

Among high-risk children (having high levels of problem behaviors at pretest), SAFEChildren participants showed a decrease in aggression, whereas those who did not receive the intervention had a slight increase in aggression (p < .05). The slope effect size was very small (Cohen's d = 0.10).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.6 (0.0-4.0 scale)
Outcome 3: Parenting practices
Description of Measures Parents completed the Parenting Practices Questionnaire, a 46-item self-report scale that measures two primary constructs, discipline practices and monitoring. Higher scores represent more effective or better parenting practices.
Key Findings Among families designated as high risk (those with less adequate parenting skills and family relationship quality at pretest), there was a significantly greater improvement in parental monitoring among those who received the SAFEChildren intervention than among those who did not receive the intervention (p < .05). The slope effect size was very small (Cohen's d = 0.14).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.6 (0.0-4.0 scale)
Outcome 4: Parental involvement in child's education
Description of Measures Parents completed the Fast Track Parent Involvement Scales, a self-report measure of parental involvement in their child's education that contains three subscales: parent endorsement of school, parent involvement, and quality of relationship with the teacher. Higher scores on these composites indicate greater parental involvement in school.
Key Findings Among families with high-risk children (having high levels of problem behaviors at pretest), those who received the SAFEChildren intervention showed a slight increase in parental involvement in the child's education, whereas families who did not receive the intervention showed a substantial decrease (p < .05). The slope effect size was very small (Cohen's d = 0.14).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.6 (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 6-12 (Childhood)
26-55 (Adult)
51% Male
49% Female
57.5% Hispanic or Latino
42.5% Black or African American

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: Reading achievement 4.0 4.0 3.8 3.5 3.0 3.5 3.6
2: Child problem behaviors 4.0 4.0 3.8 3.5 3.0 3.5 3.6
3: Parenting practices 4.0 4.0 3.8 3.5 3.0 3.5 3.6
4: Parental involvement in child's education 4.0 4.0 3.8 3.5 3.0 3.5 3.6

Study Strengths

The measures used are well established and have good psychometric properties. The methods used to ensure intervention fidelity are noteworthy. When data were missing, this was addressed with growth curve modeling. The retention was good for this type of study. Appropriate analyses were used.

Study Weaknesses

The researchers employed an unbalanced design favoring the intervention group (55% were randomly assigned to the intervention condition, and 45% were randomly assigned to the control condition), which somewhat limits the confidence in these findings. The large number of measures employed raises the possibility of colinearity in the absence of a discussion of the statistical power of the multiple measures.

Readiness for Dissemination
Review Date: October 2007

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.

Forms and handouts:

  • Description of process and fidelity protocol
  • Description of training and technical support
  • Family Group Sessions: Parent Process Measure
  • Family Group Sessions: Process Measure--Interventionist Form
  • Family intervention handouts
  • Letter-Writing Sheets
  • Reading Response Sheet
  • Tutoring flash cards

Program Web site, http://www.psych.uic.edu/fcrg/safe.html

SAFEChildren family intervention manual. (2006).

Woo, S., Gorman-Smith, D., Gay, F., Schoeny, M., Tolan, P. H., & Henry, D. B. (n.d.). SAFEChildren tutoring manual. Revised for 7th and 8th grade student tutors. Chicago, IL: Authors.

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
3.0 2.3 3.0 2.8

Dissemination Strengths

Implementation materials are thorough, coherent, and easy to follow. The family intervention manual includes specific guidance for family recruitment and engagement. Training and technical assistance are available upon request. Excellent fidelity and process instruments are available to support quality assurance.

Dissemination Weaknesses

Little information is provided on organization-level implementation or tutor and leader qualifications. No formal training curriculum has been developed to supplement the intervention materials. No substantive guidance is provided on how new implementation sites use the information collected from quality assurance instruments.

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 intervention manual $50 each Yes
Tutoring manual $20 each Yes
Set of reproducible tutoring materials $75 each Yes
Basic 3-day, on-site training $3,000 per site for up to 10 participants No
Intensive 5-day, on-site training $6,500 per site for up to 10 participants No
Initial 1.5-day consultation $2,500 per site No
Phone consultation $250 per hour No
Fidelity and process measures Included with manuals No

Additional Information

Group leaders are usually hired to work half-time at a salary commensurate with a master's of social work and 4-6 years of postdegree experience. College students can serve as tutors; approximately 2 hours should be budgeted for each tutee per week, which allows for both preparation and travel time.

Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation, contact:
Department of Psychiatry
(312) 413-1090
fcrg@psych.uic.edu

To learn more about research, contact:
Patrick Tolan, Ph.D.
(434) 243-9551
pht6t@virginia.edu

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

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