Felner R D, Brand S, Mulhall K E, Counter B, Millman J B, Fried J
Center for Prevention Research and Development, Institute for Government and Public Affairs, University of Illinois, 1002 W. Nevada St., 61801, Urbana, IL.
J Prim Prev. 1994 Dec;15(2):123-46. doi: 10.1007/BF02197143.
A partnership between corporate worksites, a community-based prevention agency, and families in those worksites is described. Its primary goals were the reduction of family risk and enhancement of family protective factors that predispose children and youth to substance abuse and related social and emotional difficulties. A related goal of the program is to reduce family stress levels and attitudes that may influence the parents' levels of risk for substance abuse and related disorder. The program delivery strategy is conceived of as part of the necessart efforts of prevention programs to reach target populations in host settings in which they may naturally participate, thereby reducing obstacles and barriers to participation that often impede prevention efforts. Evaluation revealed that the program was generally better able to retain parents for a fairly lengthy period, and with high rates of attendance. Program attendance was also not affected by parental background characteristics that, in other delivery approaches, are often associated with poor attendance and high drop-out levels. Results also indicated that levels of program exposure (dosage) do make a significant difference in the efficacy of such efforts as those parents in the program who participated in higher percentages and numbers of sessions (i.e. more than 80% of sessions) showed both short-term and longer-term (i.e. across 18 month follow-ups) gains in their ratings of the target child's behavior problems and strengths, substance abuse resistance related knowledge and attitudes, reduced parental stress, depression and irritability, and increased utilization of social support. By contrast, parents who received a low program exposure exhibited a more restricted set of short-term gains. The findings are discussed in terms of their importance for consideration of program dosage for prevention programs, and the need to attend to the context in which programming is offered as it may facilitate or impede efforts to provide levels of dosage and fidelity to create enduring impacts.
本文描述了企业工作场所、社区预防机构与这些工作场所中的家庭之间的合作关系。其主要目标是降低家庭风险，增强家庭保护因素，这些因素会使儿童和青少年易患药物滥用及相关的社会和情感问题。该项目的一个相关目标是降低家庭压力水平和可能影响父母药物滥用及相关障碍风险水平的态度。项目实施策略被视为预防项目必要努力的一部分，以便在目标人群可能自然参与的所在环境中接触到他们，从而减少通常会阻碍预防工作的参与障碍。评估显示，该项目总体上更能让家长在相当长的一段时间内持续参与，且出勤率很高。项目参与率也不受家长背景特征的影响，而在其他实施方式中，这些特征往往与低出勤率和高辍学率相关。结果还表明，项目接触程度（剂量）确实对这类努力的效果有显著影响，因为参与项目的家长中，参加课程百分比和数量较高（即超过80% 的课程）的家长在对目标儿童的行为问题和优点、药物滥用抵抗相关知识和态度的评分上，以及在减少家长压力、抑郁和易怒情绪以及增加社会支持利用方面，都显示出短期和长期（即18个月随访期间）的改善。相比之下，项目接触程度低的家长所表现出的短期改善则较为有限。本文从这些发现对于预防项目剂量考量的重要性，以及关注项目实施背景的必要性方面进行了讨论，因为项目实施背景可能会促进或阻碍提供剂量水平和保真度以产生持久影响的努力。
