JMIR Publications

ABSTRACT

Background:

The Strengthening Families Program (SFP) is an evidence-based parent training and youth life skills and drug prevention program traditionally delivered in group settings. Families attend parent and youth classes conducted by trained facilitators. Recently, a two-disk Home-Use DVD series was created with the same SFP skills as the group classes for parents and youth to watch together at home. Additional lesson material was added that included healthy brain development, school success, anger management, harms of alcohol and drugs, and mindfulness. The SFP DVD reduces SFP delivery costs for agencies and logistic burdens to families. Creative applications of the DVD include holding SFP DVD Family Discussion Groups of multiple families and using SFP DVD video clips as part of a shorter, 10-week group class version for parents and youth.

Objective:

We used a non-inferiority trial to examine 3 different DVD implementation scenarios, contrasting target outcomes with an age-matched sample culled from a national norm database of families who completed a standard SFP 14-week class.

Methods:

The partial eta2 was used to compare effect sizes (ES) between the different delivery modalities for relevant programmatic outcomes. We adjusted the effect sizes by demographic measures to determine whether there are site-specific features influencing program outcomes.

Results:

For the unadjusted effect size comparisons, 13 of the 15 indicated that the Home-Use DVD outperformed Group Norms with an average .13 ES estimate difference across the comparisons (28% improvement in ES for DVD condition). Comparisons of the Home-Use DVD condition to the mixed DVD use conditions showed no discernable pattern where one condition consistently outperformed another. Adjusted ES still reinforced the superiority of the DVD conditions; however, there was some shrinkage in ES as expected with the inclusion of relevant covariates.

Conclusions:

The Home-Use DVD shows that it is possible to effectively deliver an affordable family-based intervention using alternative technology outside of the traditional group-based class format. In almost all of the comparisons, the DVD conditions outperformed the Group Norms, underscoring that low-cost DVDs or online viewing may provide a useful surrogate for costly group-based formats. Future studies may want to improve on the quasi-experimental design by examining programmatic differences based on delivery format using a randomized controlled trial, thus strengthening the causal framework regarding program effects. In addition, the assessment protocol relied on retrospective reporting, which, although this can limit response shift bias, does not separate data collection in time as with a true pre- and posttest design.