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Right arrow Adolescent Medicine

PEDIATRICS Vol. 111 No. 1 January 2003, pp. e32-e38

ELECTRONIC ARTICLE

Sustaining and Broadening Intervention Impact: A Longitudinal Randomized Trial of 3 Adolescent Risk Reduction Approaches

Ying Wu, PhD*, Bonita F. Stanton, MD*, Jennifer Galbraith§, Linda Kaljee, PhD§, Lesley Cottrell, PhD*, Xiaoming Li, PhD*, Carole V. Harris, PhD{ddagger}, Dawn D’Alessandri, MPH* and James M. Burns, MD*

* Departments of Pediatrics
{ddagger} Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, West Virginia
§ Department of Pediatrics, University of Maryland, Baltimore, Maryland

--> Objective. To determine whether the addition of a parental monitoring intervention (Informed Parents and Children Together [ImPACT]) alone or with "boosters" could enhance (either broaden or sustain or both) the effect of a small group, face-to-face adolescent risk reduction intervention Focus on Kids (FOK).

Methods. A longitudinal, randomized, community-based cohort study was conducted of 35 low-income, community-based, in-town settings. A total of 817 black youths aged 12 to 16 years at baseline were studied. After completion of baseline measures, youths were randomized to receive a face-to-face intervention alone (FOK only), a face-to-face intervention and a parental monitoring intervention (FOK plus ImPACT), or both of the above plus boosters (FOK plus ImPACT plus boosters). Risk and protective behaviors were assessed at 6 and 12 months after intervention.

Results. At 6 months’ follow-up, youths in families that were assigned to FOK plus ImPACT reported significantly lower rates of sexual intercourse, sex without a condom, alcohol use, and cigarette use and marginally lower rates of "risky sexual behavior" compared with youths in families that were assigned to FOK only. At 12 months after intervention, rates of alcohol and marijuana use were significantly lower and cigarette use and overall risk intention were marginally lower among FOK plus ImPACT youths compared with FOK only youths. With regard to the boosters delivered at 7 and 10 months, 2 risk behaviors—use of crack/cocaine and drug selling—were significantly lower among the youths who were assigned to receive the additional boosters compared with youths without the boosters. The rates of the other risk behaviors and intentions did not differ significantly.

Conclusions. The results of this randomized, controlled trial indicate that the inclusion of a parental monitoring intervention affords additional protection from involvement in adolescent risk behaviors 6 and 12 months later compared with the provision of an intervention that targets adolescents only. At the same time, the results of the present study do not provide sufficient evidence that booster sessions further improve targeted behaviors enough to include them in a combined parent and youth intervention.

Key Words: adolescents • parenting • HIV • risk behavior

Abbreviations: HIV, human immunodeficiency virus • FOK, Focus on Kids • ImPACT, Informed Parents and Children Together

Received for publication Jun 24, 2002; Accepted Aug 28, 2002.




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