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IMPACT OF THE DARE TO BE YOU FAMILY SUPPORT PROGRAM: COLLABORATIVE REPLICATION IN RURAL COUNTIES David MacPhee, Jan Miller-Hey, and Jan Carroll Colorado State University

Rural families often have unmet needs for services to strengthen family functioning and promote optimal youth development. Community needs assessments conducted at 2 rural sites led to a community-university collaboration that implemented the DARE to be You (DTBY) program for families and youth aged 9 years at one site and aged 13 years at the second site. Families in the DTBY intervention, in contrast to a matched comparison group, evinced significantly greater gains in parent self-efficacy, effective child-rearing practices (i.e., more democratic and less coercive), and positive parent-child relationships. As well, changes to community assets were documented in the form of increased human services to strengthen families. The results are discussed in terms of the utility of community–university partnerships to help strengthen rural families and C 2014 Wiley Periodicals, Inc. promote community social capital.

Families who live in rural areas, compared to those in cities, are at elevated risk for mental health problems (Spoth & Redmond, 1996), as are rural adolescents (Curtis, Waters, & Brindis, 2011; Hartley, Bird, & Dempsey, 1999). These higher rates of distress and depression may be due in part to the greater prevalence of poverty and lower education in rural areas (Ferriss, 2006; Jensen, McLaughlin & Slack, 2003). As well, rurality is associated with sociocultural stressors such as less availability of resources in the community (Kelleher,

This research was supported by a grant from NIFA, Children, Youth and Families at Risk (CYFAR), U.S. Department of Agriculture. For information about the DARE to be You Program, visit http://www.coopext.colostate.edu/DTBY/ Please address correspondence to: David MacPhee, Department of Human Development & Family Studies, Colorado State University 1570, Fort Collins, CO 80523. E-mail: [email protected]

JOURNAL OF COMMUNITY PSYCHOLOGY, Vol. 42, No. 6, 707–722 (2014) Published online in Wiley Online Library (wileyonlinelibrary.com/journal/jcop). C 2014 Wiley Periodicals, Inc. DOI: 10.1002/jcop.21647

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Vaughn, Hardin, Pope, & Farmer, 1992), loneliness that can be exacerbated by low population density (Woodward & Frank, 1988), and limited support to adolescents from their family systems (Conger, Conger, Matthews, & Elder, 1999). Support systems to promote family functioning and mental health also are in short supply in rural areas, which is why services for rural families and youth have been identified as a national priority (Mohatt, Bradley, & Adams, 2005; Spoth, 2007; Spoth & Redmond, 1996). In this study, we report on the impact of a family support program that involved collaboration between rural communities and university-based applied researchers. This collaboration was initiated to a great extent by the communities’ recognition that their families needed more support and their youth needed more opportunities for asset development. Consistent with recommendations for conducting rural prevention research (Spoth & Redmond, 1996), we targeted the family system as a means to promote youth development and reduce risk-taking behavior. Rural Youth: At Risk and Underserved Mental health service providers have largely ignored rural youth (Petti & Leviton, 1986). In part, this oversight can be attributed to the perception that urban youth face greater risks for mental health problems (Cutrona, Halvorson, & Russell, 1996). However, community surveys find that rates of emotional and behavioral problems are more similar than different between urban and rural youth, even when controlling for family income (Cutrona et al., 1996; Robbins, Dollard, Armstrong, Kutash, & Vergon, 2008). These surveys likely underestimate mental health issues among rural youth because more remote counties, where there are higher rates of problem behaviors, are underrepresented in such surveys (Kelleher et al., 1992). Rural residence and persistent poverty often coincide (Rural Policy Research Institute, 2013), and together they have serious and far-reaching effects on the well-being of rural youth (Conger, Elder, Lorenz, Simons, & Whitbeck, 1994; Cutrona et al., 1996). For example, low-income youth have as much as a 50% higher incidence of emotional and behavioral problems than children who are not poor (Brooks-Gunn & Duncan, 1997; Reijneveld et al., 2010). The linkage between rural poverty and youths’ mental health problems may be explained by poverty’s deleterious effects on family life: Caregivers who live below the federal poverty threshold experience higher rates of substance abuse, domestic violence, parental mental health problems, and maternal depression than families not receiving welfare (Knitzer, 2000). The presumption that family processes mediate poverty’s effects on youths’ mental health is supported by studies finding that behavior problems often abate when the family’s economic circumstances improve (Costello, Compton, Keeler, & Angold, 2003). Although rural youth and their families may have substantial needs for mental health and prevention services, multiple barriers often preclude these needs from being met. Rural families are more likely than those in urban areas to lack transportation, perceive mental health services as stigmatizing, and have a limited understanding of available services (Robbins et al., 2008; Starr, Campbell, & Herrick, 2002. Rural families also are less likely to have health insurance, may be reluctant to seek assistance because of values related to self-reliance (Cutrona et al., 1996), and have less access to mental health and support services (Petti & Leviton, 1986). In addition, a limited literature suggests that community-level factors are associated with youth assets (Kegler et al., 2005), and yet prevention resources are rarely directed to positive youth development in rural areas where asset development may be most needed. An overarching concern is the general Journal of Community Psychology DOI: 10.1002/jcop

DARE to be You in Rural Counties

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lack of focus on the mental health needs of rural children and their families (see Boydell, Pong, Volpe, Tilleczek, Wilson, & Lemieux 2006), meaning that their concerns often are unacknowledged and unmet (for an exception, see Hester, 2004). Family Interventions to Promote Youth Development and Resilience New interventions for rural families and youth typically focus on the family system (Cutrona et al., 1996; Spoth & Redmond, 1996), as does the one we describe. This emphasis is grounded in research-based models showing that family processes are partly responsible for the link between rural poverty (Conger, Ge, Elder, Lorenz, & Simons, 1994) or neighborhood characteristics (e.g., Leventhal & Brooks-Gunn, 2003) and youth outcomes. For example, a longitudinal study in rural Iowa showed economic stress to be associated with greater parental depression, more marital discord, and less effective child-rearing practices, with the latter being an especially potent mediator of adverse effects on adolescent adjustment (Conger et al., 1992). In contrast, effective parenting serves as a protective factor for risky adolescent behavior (Conger, Rueter, & Conger, 1994). Building on these results, Spoth and colleagues developed Project Family (Spoth & Redmond, 1996) and PROSPER (Redmond et al., 2009) for rural families, both of which focused on protective factors in the home–particularly effective child management–that reduced youths’ risk-taking attitudes and behaviors and enhanced their resilience through problem-solving skills and assertiveness. How should family-based prevention services be delivered in rural areas? In one interview study (Boydell et al., 2006), family members recommended that rural mental health services for children be delivered locally by professionals who are familiar with the area’s culture. Further, caregivers advocated for early intervention, health promotion and education, and parental support. Although innovative programs existed in some of the rural areas studied, the authors noted that they were uncommon and poorly funded. Others have advocated for stronger collaborations between family service providers in rural communities and applied researchers, such as through the Extension Service (Molgaard, 1997), to translate science into effective practice (Spoth, 2008). The emerging emphasis on rural community-university partnerships has several features (see Spoth, 2007). First, to promote social capital, programs should build on community strengths and enhance families’ competencies. Second, scientific knowledge and community actions should be integrated through close collaboration across multiple phases of the project. Third, factors related to effective partnerships need to be better understood to promote program sustainability. For instance, successful implementation of the familybased, rural PROSPER program was associated with community readiness, previous collaborations among community team members, and attitudes toward prevention (Greenberg, Feinberg, Meyer-Chilenski, Spoth, & Redmond, 2007). Finally, rigorous evaluations need to be conducted on outcomes that are relevant to the local community, although such evaluations are infrequent (Redmond et al., 2009) and not well-tailored to community service providers’ information needs (Gabriel, 2000). Given that little is known about evidence-based intervention services in rural settings (Spoth, 2007; Redmond et al., 2009), it is important to conduct effectiveness trials for families in at-risk rural communities. The principles of community-university collaboration described above guided the implementation of the DARE to be You (DTBY) program (Miller-Heyl, MacPhee, & Fritz, 2001) at two rural sites. For instance, as noted later, community needs assessments informed the program’s focus, and collaborations between service providers and applied researchers were implemented from the planning Journal of Community Psychology DOI: 10.1002/jcop

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stage to project completion. The collaboration employed a three-tier approach described by Redmond et al. (2009) that included community teams, a prevention coordinator through the Extension Service, and university applied researchers. Parent education and youth skill development were the foci, and the program coordinated educational support activities that connected community activities to local, state, and national resources. Also, as Gabriel (2000) noted, community buy-in is greater when there is an obvious relation between the intervention’s focus and the benefits that are assessed. Although problems facing our target communities’ youth were the initial impetus for the prevention program, research evidence led to selection of a family-based program. Consequently, we chose outcome measures related to healthy family functioning, not youth problem behaviors. The objectives of the DTBY project were as follows: (a) to enhance parental selfefficacy and decrease parental stress, so that parents had the personal resources to use effective rearing practices; (b) to increase parents’ use of effective child management strategies; (c) to strengthen parent-child relationships; and (d) to build community assets through training of community service providers. Objectives 1–3 were based on previous research showing that economically stressed families, particularly those in rural areas, are more likely to experience mental health problems and compromised rearing practices, which in turn elevate the risk for youth problem behaviors (Conger et al., 1992; Redmond et al., 2009). Objective 4 is grounded in the community–university partnership perspective (Spoth, 2007) that informed this study.

METHOD Needs Assessment and Community Readiness The intervention was delivered in two rural sites in the Rocky Mountain region. Initially, the sites were selected because they met the demographic criteria of a potential funder, and because families at each site experienced significant stressors that were likely to increase distress and punitive child-rearing practices. These family needs led the county Extension family and consumer agents to seek assistance from the state’s Director of Civic and Federal Engagement: The local Extension staff had previous experience with DTBY and were seeking resources to implement the evidence-based, family-strengthening program in their communities. The director worked with the Extension agents to conduct local needs assessments (described below) so that the program implementation could be tailored to those needs. The Extension agents at both sites were willing to guide the 5year program, and they were well connected with community organizations and agencies whose collaboration would be critical for success. Next, the director brought together (a) Extension agents and community stakeholders in each site, (b) the developer of DTBY, a program that has curricula for parents and their 4- to 15-year-old children, and (c) applied researchers from the state’s land grant university, who were familiar with community readiness assessment or evaluation of family support programs. This team evaluated community readiness and received funding to support delivery of the DTBY program. Site 1 included three adjacent agricultural counties with a total population of 31,500. Nearly a decade of drought has devastated the two major industries of farming and ranching. Because many farms and ranches have quit operating, this region has one of the highest rates of unemployment in the state and poverty rates of 32.4% to 48.1%. The rural landscape also means that many families are isolated and have limited support Journal of Community Psychology DOI: 10.1002/jcop


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services available to them. Stakeholders convened in a facilitated meeting to identify the immediate needs of children and youth in the three counties and discuss current and potential programs to address those needs. This structured needs assessment, using methods described by Finifter, Jensen, Wilson, and Koenig (2005), was facilitated by county Extension agents and included (a) public data related to potential audiences, (b) interviews with key informants, and (c) focus groups of parents, community volunteers, and human service providers. Elementary-school children were determined to be the population with the greatest need. Site 2 was a semirural county of 48,000 where the primary employers are the prison system and tourism. There are pockets of working poor, who are part of the service industry, and the poverty rate has increased as families try to meet basic needs with minimum wage jobs. The poverty rate in 2010 was 24.8%. Mobility, immigration, and drug use are common issues. The needs assessment process at this site, which was the same as at Site 1, concluded that although there are opportunities and supports for families with younger children and high school age children, middle schoolers’ needs were not met well. The Community Readiness Model (CRM; Edwards, Jumper-Thurman, Plested, Oetting, & Swanson, 2000) was used at each site in advance of implementing the DTBY program. This model assesses a community’s readiness to effectively implement a program based on six dimensions: existing prevention efforts, knowledge of prevention efforts, leadership, community climate, knowledge about the problem, and resources related to the problem. The model categorizes stakeholders’ input into nine stages of community readiness, ranging from “no awareness” of the issue (e.g., child maltreatment) to a high level of community ownership. An evaluator and Extension agents who were trained in the CRM conducted semistructured telephone interviews and focus groups with 41 human service staff members and volunteer mentors at the two sites. With assistance from the CRM’s developers, community readiness at both sites was categorized to be in the initiation stage: enough information is available to justify efforts, an action is incipient, staff training is underway, there is enthusiasm among stakeholders about the program, and there is modest involvement of community members in the efforts. “Initiation” is the precursor to the stabilization stage, the goals of which are training of community professionals (described below), networking between service providers, and evaluation of the program’s impact–all foci of the current study. Participants Intervention group. Families at each site were contacted through schools, human service agencies, youth organizations, churches, word of mouth, and distribution of flyers. Four cohorts of families were recruited into the DTBY program, described below. At Site 1, 37 participants completed baseline surveys; 30 participants completed baseline measures at Site 2. Participants were primarily mothers (77% in both sites) who were high schooleducated (mean [M] = 11.47 years at Site 1; M = 13.15 years at Site 2). The average age of the parents was similar at both sites (M = 39 years). Site 1 recruitment focused on families of children in middle childhood (M = 9.19 years), whereas Site 2 focused on families of youth in early adolescence (M = 13.31 years). Comparison group. A post hoc comparison group was selected from two earlier intervention trials that involved random assignment to DTBY or a control group; the latter group was the sampling frame for the present study. In these trials, randomization was by individual Journal of Community Psychology DOI: 10.1002/jcop

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family. Recruitment procedures were the same as at Sites 1 and 2. The comparison group families were from a rural county in the Four Corners area of Colorado (population = 25,400; 2010 poverty rate = 17.6%) that was several hundred miles from the intervention sites described above. Comparison families were group matched to the intervention group based on child age (± 1 year) and parent marital status. In all, 53 families were selected. Demographically, they were similar (p > .25) to the intervention group in terms of parent education level (M = 13.25), parent age (M = 36.88), and child age (M = 10.49 years). The sample of 120 provides a statistical power of .80 to detect a small effect size of d = .25. DTBY Program Community training. Each year, when DTBY facilitator trainings were scheduled, the site coordinators also invited community stakeholders to the 15-hour training. These stakeholders were typically staff of human service agencies who worked with families and youth in the local area. The community training covered the program theory that undergirded the family-based curriculum (described next), and it also focused on activities and applications that community organizations could use to meet local families’ needs and promote their strengths. As well, it was a venue for team building among agencies in each community. Family workshops. The DTBY program (Miller-Heyl et al., 2001) is an 11-week, 22- to 26-hour workshop series for parents of children and youth who may be struggling with personal and parenting issues. Activities focus on increasing parents’ and their children’s self-efficacy, self-responsibility, communication, and decision-making skills. Each 21/2-hour workshop began with a 30-minute meal and social time, and a parent–child activity (10–30 minutes) focusing on building the children’s self-concept, responsibility, or other key constructs. Parents then met together to learn new skills while children met separately for parallel workshops. Parent self-efficacy is bolstered through activities such as success sharing and learning how to cope with experiences that are deflating. Parents are taught how to make situational versus internal attributions as well as problem-solving skills to promote effectance and stress management. Multiple sessions are devoted to communication skills and effective, age-appropriate child-rearing strategies, all involving modeling and hands-on practice. The children’s curriculum is age-graded. For example, the elementary-age curriculum implemented at Site 1 had relatively more emphasis on communication, feelings, and prosocial skills, whereas Site 2 placed more emphasis on promoting healthy adolescent development, including skills to resist peer pressure, decision-making abilities, and role model awareness. Concepts were taught by means of hands-on activities, discussions, role-plays, worksheets, and homework. Details about the curriculum may be accessed through the National Registry of Evidence-based Programs and Practices website: http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=65. Implementation fidelity was promoted by requiring all facilitators to use a manual that provided detailed descriptions of adult and child activities. Previous evaluation results, replicated in numerous cultural settings, showed that DTBY significantly improved parents’ ability to create a nurturant, structured home environment and increased children’s developmental level while reducing problem behaviors. Parents were offered a $200 incentive for completion of the program and surveys. We believed it was important to offer such incentives given that dosage is a critical source of Journal of Community Psychology DOI: 10.1002/jcop


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variability in intervention outcomes (Spoth & Redmond, 2000), especially among highrisk families (Brody, Murry, Chen, Kogan, & Brown, 2006; Haggerty et al., 2002). Measures of Program Impact Parent self-efficacy. Parent self-efficacy is an important mediator of child-rearing practices (MacPhee, Fritz, & Miller-Heyl, 1996) and changes in parent self-efficacy are related to improved disciplinary practices (Miller-Heyl, MacPhee, & Fritz, 1998). Parent selfefficacy was measured with the six-item Competence subscale from the Self-Perceptions of the Parental Role (SPPR; MacPhee, Benson, & Bullock, 1986). Each item includes two contrasting statements, such as “Some parents often worry about how they’re doing as a parent BUT Other parents feel confident about their parenting abilities.” Parents endorse the statement that best represents their feelings, checking either sort of true for me or really true for me. Subscale means can range from 1 to 5, with higher scores reflecting greater confidence in parenting. The SPPR has high internal reliabilities (α = .78–.87; .75 in the current sample), convergent and factorial validity, and construct validity in terms of relations to difficult child behavior, punitive child-rearing practices, and social support (MacPhee et al., 1986). Parent-rearing practices. The Parent-Child Relationship Inventory (PCRI; Gerard, 1994) short form includes two scales measuring child-rearing practices: Democratic Control, with nine items assessing consistent control versus coercion, and child defiance; and Communication (seven items), with items that focus on the child’s willingness to selfdisclose, parent use of reasoning, and whether the parent is a good listener. Items are rated from 1 (strongly disagree) to 4 (strongly agree). Alpha (.80–.89) and test-retest (.76–.92) reliabilities are high in the standardization samples; α = .82-.84 in the present sample. The PCRI is uncorrelated with social desirability, is sensitive to the effects of parent training, and is related to other measures of efficacy and rearing practices. Parents also completed an eight-item measure of Coercion from the Behavior Checklist for Infants and Children (α = .76–.82, MacPhee, 1986; α = .79 in the current sample). The items, rated from 1 (strongly disagree) to 4 (strongly agree), focus on child defiance (e.g., “My child tries to see how much he/she can get away with”), parent power assertion (e.g., “I need to come down hard on my child when he/she acts up”), and relational conflict (e.g., “I feel like I’m in a battle of wills with my child”). This measure is strongly, inversely related to parent self-efficacy (MacPhee, 1986) and children’s social skills, and is positively correlated with parents’ use of harsh punishment and children’s aggression (Walker & MacPhee, 2011). Parent stress and satisfaction. The PCRI includes a nine-item Stress subscale (α = .71 in this sample) that taps into parents’ feelings of worry, being overburdened, stress, and lack of enjoyment. In terms of validity, this stress scale is significantly related to other measures of parenting stress and depression scales, and is sensitive to the effects of stress management interventions. Another PCRI subscale assesses Satisfaction with being a parent (α = .84 in the current sample); these 11 items ask parents about their feelings of rewards versus regrets in relation to the parental role. Parent-child relationship quality. Parents completed a 15-item measure of the quality of their relationship with the target child. Ten of the items were from the Parent-Adolescent Communication Scale (PACS; Barnes & Olson, 1992) with the highest factor loadings Journal of Community Psychology DOI: 10.1002/jcop

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in the standardization sample. These were combined with five items from the Dyadic Adjustment Scale (DAS; Spanier, 1976). All items were phrased in terms of “my child” (e.g., “My child and I confide in each other”) and were rated from 1 (strongly disagree) to 6 (strongly agree). The PACS assesses open communication and problems in family communication; the DAS measures relationship quality and satisfaction (e.g., argues and confides). In samples of 12- to 14-year-olds, their parents, and adolescent mothers, this 15item scale has alpha coefficients of .82 to .93 (.89 in the current sample) and is strongly related to measures of child problem behaviors, attachment security, and disciplinary practices. Perceptions of the Program Participant satisfaction. Parents’ views of DTBY were solicited with five items on the posttest. On three items, participants rated their satisfaction with the program (e.g., “I learned useful information in these workshops”) from 1 (strongly no) to 4 (strongly yes). Two openended questions asked about the best part of the workshops and what they would change about the workshops. The open-ended responses were content coded (see Weber, 1990) using themes identified in earlier DTBY program evaluations. Perceptions of community agencies. To gauge the impact of the DTBY program on the broader community, surveys were sent to all family service agencies in the two sites. The survey contained four open-ended questions: (a) What do you know about the DTBY program? (b) What do you see as the main strengths of the program? (c) What impact has DTBY had on the families served and on the broader community? and (d) What impact did staff training have on your agency’s staff, programming, and referrals? Of the 17 questionnaires sent, 13 (76%) were returned. Agencies’ knowledge of the program was coded as follows: four represented actual participation in the program (received training as a DTBY leader or had participated in a DTBY program), three equaled evidence of detailed knowledge of goals and concepts within the program, two reflected a basic understanding, one a vague notion of the program, and zero indicated no knowledge of the program. The average of all codable responses was 3.33, indicating that a majority of agencies had staff members who participated in the DTBY community training and/or participated in the DTBY program as a parent or staff member. Procedures described by Cresswell (2003) were used to code responses to the remaining questions. The first author identified specific categories or themes in the written responses. Two graduate students then used this template to independently code the responses (kappa = .92); the first author resolved disagreements. In addition, an external federal evaluator conducted interviews with six to nine stakeholders at each site who had participated in the DTBY community trainings. All participants in the community trainings were staff members in local human service agencies and schools. The evaluator’s report did not identify any themes beyond those found in the agency surveys, and so information from her report was used to supplement the content coding of the agency surveys. Procedure Parents completed measures at entry into the program and then 6 months later, 3 months after completion of the DTBY workshop series. The local program coordinator orally administered the measures to parents. Group testing was the norm, although individual Journal of Community Psychology DOI: 10.1002/jcop


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assessments were given when group testing could not be arranged. All procedures were approved by the university’s institutional review board. Group Equivalence and Attrition Preliminary analyses were conducted to determine whether the intervention and comparison groups were similar at baseline. Although the groups were similar demographically, they were not equivalent on several baseline measures of program impact. Using t tests, significant differences (p < .05) were observed in stress, satisfaction with the parental role, democratic control, and communication. A propensity score matching process (see Cook & Steiner, 2010; Luellen, Shadish, & Clark, 2005) was used to equate the groups statistically. The four variables on which the groups differed were entered into a binary logistic equation with group as the dependent variable. The resulting propensity score–which predicts group membership–was used as a covariate in analyses of intervention effects. Of the 67 intervention participants who enrolled in the program, 58 completed pretest and posttest surveys (13% attrition). All comparison parents had complete data. Differential attrition was assessed by comparing intervention caregivers who completed the 6-month follow-up to those who had not. Univariate analyses were conducted on nine demographic variables and the seven outcome variables measured at baseline. No significant differences were observed between those who completed posttests and those who did not. Plan of Analysis Repeated measures analyses of covariance, with group as the between-subjects factor, were used to assess differential change on the outcome measures between baseline and the follow-up. Although the covariate did show one significant interaction with time and group, involving change in democratic control, its inclusion did not alter the conclusions about intervention effects. In analyses of parent-reported behaviors, we focus on Group × Time interactions because these indicate differential changes in the intervention versus control groups over time. Post hoc analyses for site differences are noted if significant. Qualitative findings related to families’ and community agencies’ perceptions of the program are then described.

RESULTS Parent Attitudes and Skills Mean changes on the measures of program impact are reported in Table 1. In the domain of parent self-appraisals, a significant improvement in parent self-efficacy was observed in the intervention group, compared to no change in the comparison group. This differential change represents a medium effect size, ηp 2 = .07. No effects of the DTBY program were observed on satisfaction with the parental role. Although parental stress trended downward with time (p = .074), this change was not specific to the intervention group. Multiple effects of the DTBY program were observed in rearing practices as well as the quality of the parent–child relationship. First, use of democratic control–consistent, child-centered discipline–increased significantly, ηp 2 = .222; this change was mirrored by decreased use of coercion, ηp 2 = .14. Both effect sizes are considered to be large (Cohen, Journal of Community Psychology DOI: 10.1002/jcop

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Table 1. Program Impact on Parent Outcomes, by Group, Baseline to 6-Month Follow-Up Baseline

Parent self-efficacy Satisfaction with parent role Parental stress Democratic control Coercion Open communication Relationship quality

6 months

C

I

CI

I

FTxG (1,107)

3.51 (.81) 3.39 (.38) 2.42 (.43) 2.55 (.44) 2.22 (.36) 3.07 (.40) 4.13 (.79)

3.35 (.79) 2.90 (.49) 2.68 (.44) 2.42 (.47) 2.48 (.56) 2.64 (.73) 4.03 (.99)

3.50 (.85) 3.44 (.36) 2.33 (.49) 2.28 (.38) 2.24 (.20) 3.33 (.34) 4.08 (.98)

3.71 (.74) 2.96 (.51) 2.57 (.39) 2.65 (.46) 2.20 (.46) 2.67 (.68) 4.33 (.91)

8.42** n.s. n.s. 22.59** 11.36** n.s. 8.31**

Note. n.s. = nonsignificant; C = comparison group; I = intervention (DTBY) group. See text for explanation of significant treatment effects. *p < .05. **p < .01.

1992). The two intervention sites differed significantly from each other in the magnitude of change on these two outcome variables, with Site 2 showing large changes (d = .71) on both variables, whereas Site 1 showed a small increase (d = .32) in democratic control and a moderate decrease (d = .50) in coercion. Note that the two sites differed in children’s ages, family demographics, and facilitators who delivered the intervention, any one (or all) of which could explain such site differences. No intervention effects were detected on the measure of open communication. However, parent perceptions of the quality of the parent-child relationship improved in the DTBY group, compared to a slight decrease in the comparison group, a difference representing a large effect size, ηp 2 = .072. Perceptions of the Program Participant satisfaction. On the ratings of satisfaction with the program, the participants’ average was 3.78 or strongly satisfied, where 4 was “strongly yes.” When caregivers were asked about the best parts of the DTBY workshops, the most common response (56%) was building a support network with other parents, followed by learning new child-rearing techniques (38%), normalizing parenting issues (19%), and having a better understanding of children (19%). When asked about ways to improve the program, the most common response was “nothing” (43%); no suggestion was mentioned more than twice. Perceptions of community agencies. Human service agencies in each community were asked about the main strengths of DTBY, its impact on the broader community, and whether the community trainings were beneficial. With regard to the main strengths of DTBY, agency personnel mentioned the program’s content, especially the emphasis on involving families and gaining their commitment to improving family life (62%). As well, respondents described various positive outcomes as demonstrated by direct knowledge of family gains (92%). The benefits included enhanced parenting skills, improved family functioning, and the development of support systems. Several respondents also noted how the child participants were better able to express their feelings, improved in self-esteem, or decreased in problem behaviors (54%). Two individuals at one site said that the DTBY program filled a gap in their community given that few programs were available for families of children aged 6–12 years.

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The DTBY program was viewed as strengthening communities in several ways. First, the agencies said that their staff members incorporated many DTBY principles into the agency’s services (54%), such as Parents as Teachers and school services. Most (76%) of the agencies indicated that DTBY helped to strengthen collaborative relationships among agencies, in the form of referrals as well as through focused discussions of family needs. In addition, 38% of agency personnel said that DTBY helped to broaden the range of services available to families in the local community, and 23% said that DTBY helped to promote the idea that families have different strengths that they bring to the larger social system, as this quote captures: If together we strengthen our families, teach them new personal skills, it rubs off on the children in the families and communities, sets a positive example for our youth, teaches pride and self-worth to those who had none. . . . Their self-worth strengthens the families, teaches new ways to handle stress, and increases the possibility of successful marriages. Our kids are happier at home and therefore do better in school when they receive encouragement. I could go on and on. This is why I really liked the DTBY program. The common theme of agencies’ comments was that DTBY, by strengthening families within the community, played a significant role in reducing or preventing family problems. No agency reported any perceived problems or negative effects of the program, for either families or community efforts. The external evaluator who interviewed participants in the community trainings asserted: “Arguably the greatest impact of the program, outside of direct impact on families, has been the 15- to 20-hour DTBY training for community members and agencies. As the leader of . . . Build a Generation stated, ‘It was nothing less than brilliant’ to provide such a training to community partners.’” This training was perceived as essential to fostering agency buy in, getting family referrals, and aligning DTBY and other family agencies’ missions: Several partners talked about having worked with families for decades and this is the first training that opened their eyes to “new ways of thinking about family relationships” and how they have used this newfound knowledge to improve the way they provide services. The program also enhanced resources in the community by means of training local family members and professionals to facilitate DTBY sessions. As the evaluator noted: These professionals live and work locally and are part of other existing social service networks in the community. Thus, the knowledge and skills gained through their involvement with DTBY will continue to have ripple effects far beyond the tenure of the project.

DISCUSSION Rural communities have limited support services for families and youth (Spoth & Redmond, 1996), even though this population typically is burdened by greater economic stress and its repercussions, including mental health problems and family conflict Journal of Community Psychology DOI: 10.1002/jcop

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(Conger, Ge, et al., 1994). This gap between the need for versus availability of services to strengthen rural families animated the current project, as did a paucity of information about evidence-based intervention services in rural settings (Redmond et al., 2009). We therefore tested the effectiveness of the DTBY program (Miller-Heyl et al., 2001) for families in two rural sites. Consistent with appeals for community program evaluations to use more rigorous methods (e.g., Redmond et al., 2009), a matched comparison group was included and valid measures of family functioning–tied to outcomes valued by community stakeholders (Gabriel, 2000)–were employed. The DTBY program had the intended impact on participating families, with significant improvements observed in parents’ sense of competence, effective disciplinary practices, and parent–child relationships. These changes reflect the emphasis of DTBY’s curriculum on self-efficacy and authoritative child-rearing, processes that are also central to researchbased models of how rural poverty affects family functioning (Conger, Elder, et al., 1994). Furthermore, our results replicate findings from one of the few other interventions for rural families reported in the literature, in which Redmond and colleagues (Redmond et al., 2009; Spoth & Redmond, 1996) found significant long-term effects on effective child management practices and processes related to youth problem behavior. However, the DTBY program objective related to mitigating parent stress was not achieved. This objective was grounded in research-based models that accord stress a central role in mediating poverty’s effect on parenting (e.g., Magnuson & Duncan, 2002) and mental health (DeCarlo Santiago, Wadsworth, & Stump, 2011). The lack of program impact on stress invites at least two inferences. First, the DTBY curriculum may not have incorporated sufficient coverage of stress management to have the intended impact: less than 2 hours were devoted to this topic. Second, the fact that parental efficacy and rearing practices did change but stress did not suggests that parenting practices can improve regardless of stress level. The latter inference would be important to test in randomized trials, especially with vulnerable rural families. Conclusions drawn from this effectiveness trial’s positive outcomes are tempered by several limitations, notably the small sample size of both families and communities. Interventions for rural families may be more challenging to deliver because of transportation issues and time constraints (Spoth & Redmond, 1996), which likely affected our ability to recruit more participants. Consequently, our results need to be replicated in other rural areas, although it should be noted that DTBY was adopted in large part because of its previous success in rural, underserved areas (e.g., Miller-Heyl et al., 1998). An additional limitation is that outcomes were examined 6 months after enrollment, whereas it would be desirable to monitor the impact on families for 2 or more years. In terms of impact on the community, it would also be important to assess more systematically the community-level effects, including whether such changes were sustained over several years. One important feature of this intervention trial is that a partnership approach was adopted from the project’s inception. Several strands were woven together to create a stronger safety net for rural youth. First, the collaboration between service providers in rural communities and applied researchers at the land grant university established bidirectional communication about the communities’ youth development needs with the intervention team, which permitted the researchers to translate intervention science into effective practices tailored to those needs (see Spoth, 2008). This process was especially well suited to a partnership with the Extension Service (Molgaard, 1997). Second, several factors related to sustainability (see Greenberg et al., 2007) were building blocks of the program, including community readiness, existing collaborations among family service providers and schools, and positive attitudes toward prevention efforts. Finally, promotion Journal of Community Psychology DOI: 10.1002/jcop


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of rural communities’ social capital (see Spoth, 2007) was an explicit aim of the program, which was addressed by means of training community service providers. Did these trainings benefit the target communities? Although data were collected from a small (n = 13) sample of family service agencies, respondents were representative of agencies in these rural areas and the results were consistent across respondents and method of data collection (i.e., open-ended surveys and individual interviews). Among the ways DTBY promoted community strengths were as follows: (a) greater interagency collaboration involving both referrals and assessment of family needs, (b) more breadth of services available to rural families, (c) improved functioning among nontarget families (secondary effects) because agency staff infused best practices into services, and (d) enhanced support systems among families. The latter outcome was described, by participants and agency staff alike, as a key benefit for families living in rural areas where social isolation is common (Woodward & Frank, 1988). This outcome has been found in previous evaluations of DTBY that used quantitative measures of support satisfaction (see Miller-Heyl et al., 2001). This evaluation of DTBY illustrates how family-based interventions can be delivered effectively in rural areas by incorporating principles that are hallmarks of community psychology (Dalton, Elias, & Wandersman, 2001), notably collaboration, empowerment (or self-efficacy, a core element of DTBY), individual wellness, and an ecological perspective on change. It is hoped that more programs are implemented, to good effect, to meet the pressing but oft-ignored needs of rural families and youth (Cutrona et al., 1996). REFERENCES Barnes, H., & Olson, D. H. (1992). Parent-adolescent communication. In D. H. Olson et al. (Eds.), Family inventories. St Paul, MN: University of Minnesota. Boydell, K. M., Pong, R., Volpe, T., Tilleczek, K., Wilson, E., & Lemieux, S. (2006). Family perspectives on pathways to mental health care for children and youth in rural communities. Journal of Rural Health, 22, 182–188. doi:10.1111/j.1748-0361.2006.00029.x Brody, G. H., Murry, V. M., Chen, Y., Kogan, S. M., & Brown, A. C. (2006). Effects of family risk factors on dosage and efficacy of a family-centered preventive intervention for rural African Americans. Prevention Science, 7, 281–291. doi:10.1007/s11121-006-0032-7 Brooks-Gunn, J., & Duncan, G. (1997). The effects of poverty on children. The Future of Children, 7(2), 55–71. doi:10.2307/1602387 Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. doi:10.1037/00332909.112.1.155 Conger, R. D., Conger, K. J., Elder, G. H., Lorenz, F. O., Simons, R. L., & Whitbeck, L. B. (1992). A family process model of economic hardship and adjustment of early adolescent boys. Child Development, 63, 526–541. doi:10.2307/1131344 Conger, R. D., Conger, K. J., Matthews, L. S., & Elder, G. H. (1999). Pathways of economic influence on adolescent adjustment. American Journal of Community Psychology, 27, 519–541. doi:10.1023/A:1022133228206 Conger, R. D., Elder, G. H., Jr., Lorenz, F. O., Simons, R. L., & Whitbeck, L. B. (1994). Families in troubled times: Adapting to change in rural America. Hawthorne, NY: Aldine. Conger, R. D., Ge, X., Elder, G. H., Jr., Lorenz, F. O., & Simons, R. L. (1994). Economic stress, coercive family process, and developmental problems of adolescents. Child Development, 65, 541–561. doi:10.2307/1131401 Conger, R. D., Rueter, M. A., & Conger, K. J. (1994). The family context of adolescent vulnerability and resilience to alcohol use and abuse. Sociological Studies of Children, 6, 55–86. Journal of Community Psychology DOI: 10.1002/jcop

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