Family Matters

About This Program

Target Population: Parents of adolescents 12-14 years of age

For parents/caregivers of children ages: 12 – 14

Program Overview

Family Matters is a family-directed program to reduce tobacco and alcohol use among adolescents. Families with adolescents aged 12 to 14 are targeted because at these ages, many have not yet used the substances. The program features four successively mailed booklets and follow-up telephone contacts by health educators. Booklet 1 focuses on motivating families to participate in the program. Booklet 2 focuses on general family characteristics known or believed to influence adolescent drug use that are not specific to drug behavior. Booklet 3 addresses tobacco and alcohol-specific risk factors. Booklet 4 addresses substance use risk factors outside the family. A health educator contacts a parent by telephone after each booklet to encourage participation by all family members, answer questions, and record information. The adolescent is reached through family members and is never contacted directly by the health educator. The program and all related materials may be downloaded for free from the website: http://familymatters.sph.unc.edu.

Program Goals

The goals of Family Matters are:

  • Prevent tobacco and alcohol use among adolescents aged 12 to 14 years old in the general population
  • Reduce tobacco and alcohol use among adolescents aged 12 to 14 years old in the general population

Essential Components

The essential components of Family Matters are:

  • Program content guided by theory and empirical findings
  • 4 program booklets that are mailed to families:
    • Booklet 1, Why Families Matter:
      • Focuses on motivating families to participate in the program:
        • Among other things, adult family members are asked to identify and discuss possible consequences to the family if the adolescent used tobacco or alcohol. From the Health Belief Model, families are expected to be motivated if they feel susceptible to their child's substance use.
        • Adult family members are informed that children from all types of families use tobacco and alcohol and that their child may do so. From social learning theory, families are expected to be motivated if they feel they can exert control over their child's behavior.
        • Adult family members are told about family influences on children and, for illustration of their own influence, are encouraged to discuss their similarities with the adolescent.
    • Booklet 2, Helping Families Matter to Teens:
      • Focuses on general family characteristics known or believed to influence adolescent drug use that are not specific to drug behavior such as:
        • Supervision
        • Support
        • Communication skills
        • Attachment
        • Time spent together
        • Educational achievement
        • Conflict reduction
        • How well adolescence is understood
      • These characteristics are central to theories of socialization, social control, social development, and family interaction.
      • Among other things, adults are asked to:
        • List behaviors that reflect normal changes in adolescents
        • Practice communication skills with their child
        • Plan special times to be together
    • Booklet 3, Alcohol and Tobacco Rules are Family Matters:
      • Addresses tobacco and alcohol-specific risk factors, largely encompassed by social learning theory, that originate in the family and predict adolescent drug use.
      • Adults are asked to:
        • List things they do that might inadvertently encourage their child's use of tobacco or alcohol
        • Identify rules that might influence their child's use
        • Consider ways to monitor use
      • Adult family members and the adolescent then meet to agree on rules and sanctions related to adolescent tobacco or alcohol use.
    • Booklet 4, Non-Family Influences that Matter:
      • Based largely on social inoculation theory, the content considers variables that originate largely outside the family that may influence adolescent use.
      • The adult and adolescent consider what the adolescent can do to resist peer and media pressures for use.
      • In one activity, the parent and adolescent practice responses to a friend offering alcohol and tobacco, and in another, they watch favorite television shows to discuss these shows tobacco- and alcohol-related messages.
  • The number of activities that must be completed by the family for the booklet to be considered complete is specified in the Health Educator Guidebook.
  • A health educator contacts a parent by telephone after each booklet to:
    • Check on the completion of the activities in the book (multiple calls will be made until the booklet is complete)
    • Encourage participation by all family members
    • Answer questions
    • Record information about program participation. Phone scripts are provided in the Health Educator Guidebook.

Program Delivery

Parent/Caregiver Services

Family Matters directly provides services to parents/caregivers and addresses the following:

  • Parents of adolescents 12-14 years of age

Recommended Intensity:

Multiple phone calls will typically be needed to assess booklet completion. On average, families spend 4.5 hours to complete each booklet including the activities the booklet specifies. Once each booklet is complete, there is a substantive 15-minute phone contact between the health educator and family.

Recommended Duration:

Because successive booklets are mailed only after completion of the last booklet, the length varies. It can take one to 12 months for a family to complete all 4 booklets.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Foster/Kinship Care

Homework

This program does not include a homework component.

Resources Needed to Run Program

The typical resources for implementing the program are:

All program materials are available for free on the Family Matters website: http://familymatters.sph.unc.edu. The provider is responsible for printing copies of the booklets and mailing them to program recipients, staffing the health educators, and providing any resource needs of the health educators (space, phone).

Education and Training

Prerequisite/Minimum Provider Qualifications

It is recommended that Health Educators have a Bachelor or Master’s degree in health education or public health. However, the Health Educators can have less education if necessary for staffing purposes.

Education and Training Resources

There is a manual that describes how to implement this program , and there is training available for this program.

Bauman, K. E. (2005). Family Matters, Health Educator Guidebook. Accessible online: http://familymatters.sph.unc.edu

Training Contact:
Training is obtained:

Contact Katherine Hicks at the above email address. She will travel to the organization’s site to provide training.

Number of days/hours:

Typically, a day or day and a half training that is tailored by Katherine Hick’s to the organization’s needs.

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Family Matters.

Formal Support for Implementation

There is no formal support available for implementation of Family Matters.

Fidelity Measures

There are no fidelity measures for Family Matters.

Implementation Guides or Manuals

There are no implementation guides or manuals for Family Matters.

Implementation Cost

There are implementation costs for Family Matters as listed below:

Information on the cost of implementing the program in the randomized trial is provided in:

  • Bauman, K. E., Foshee, V. A., Ennett, S. T., Hicks, K. A., & Pemberton, M. (2001). Family Matters: A family-directed program designed to prevent adolescent tobacco and alcohol use. (2001). Health Promotion Practice, 2(1), 81-96.

Research on How to Implement the Program

Research has not been conducted on how to implement Family Matters.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., King, T. S., & Koch, G. G. (2000). Influence of a family-directed program on adolescent cigarette and alcohol cessation. Prevention Science, 1(4), 227-237. doi:10.1023/A:1026503313188

Type of Study: Randomized controlled trial
Number of Participants: 1,326 (parent-adolescent pairs)

Population:

  • Age — Parents: Not specified; Adolescents: 12-14 years
  • Race/Ethnicity — Parents: Not specified; Adolescents: 73.4% Non-Hispanic White, 12.5% Non-Hispanic Black, 9.2% Hispanic, and 4.9% Other
  • Gender — Parents: Not specified; Adolescents: 51% Female and 49% Male
  • Status — Participants were families contacted via telephone to participate.

Location/Institution: United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This paper reports the findings of research designed to determine whether Family Matters reduced use of cigarettes or alcohol by users. As baseline interviews were completed, parent-adolescent pairs were matched by date and time of completion and then allocated randomly to either receive Family Matters or to serve as controls. Measures utilized include questions about alcohol and cigarette use. Results indicate no statistically significant program effects were observed for cessation or decrease in smoking and drinking by users. Limitations include all data were collected by telephone, only subsample of users was included, use of project-developed measures without established psychometrics, and attrition.

Length of postintervention follow-up: 3 and 12 months.

Bauman, K. E., Foshee, V. A., Ennett, S. T., Pemberton, M., Hicks, K. A., King, T. S., & Koch, G. G. (2001). The influence of a family program on adolescent tobacco and alcohol use. American Journal of Public Health, 91(4), 604-610. doi:10.2105/ajph.91.4.604

Type of Study: Randomized controlled trial (Secondary data analysis)
Number of Participants: 1,326 (parent-adolescent pairs)

Population:

  • Age — Parents: Not specified; Adolescents: 12-14 years
  • Race/Ethnicity — Parents: Not specified; Adolescents: 73.4% Non-Hispanic White, 12.5% Non-Hispanic Black, 9.2% Hispanic, and 4.9% Other
  • Gender — Parents: Not specified; Adolescents: 51% Female and 49% Male
  • Status — Participants were families contacted via telephone to participate.

Location/Institution: United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Same population as in Bauman et al. (2000). This paper reports the findings of the effectiveness of Family Matters in preventing adolescent tobacco and alcohol use in a general population. As baseline interviews were completed, parent-adolescent pairs were matched by date and time of completion and then allocated randomly to either receive Family Matters or to serve as controls. Measures utilized include questions about alcohol and cigarette use. Results indicate families who received the Family Matters intervention that smoking onset was reduced at 1 year, with a 25.0% reduction for non-Hispanic Whites but no statistically significant program effect for other races/ethnicities. There were no statistically significant program effects for smokeless tobacco or alcohol use onset. Limitations include not all families eligible for the study completed interviews at all data collection points, attrition may have been increased by reliance on the telephone for data collection, and use of project-developed measures without established psychometrics.

Length of postintervention follow-up: 3 and 12 months.

Ennett, S. T., Bauman, K. E., Pemberton, M., Foshee, V. A., Chuang, Y. C., King, T. S., & Koch, G. G. (2001). Mediation in a family-directed program for prevention of adolescent tobacco and alcohol use. Preventive Medicine, 33(4), 333-346. doi:10.1006/pmed.2001.0892

Type of Study: Randomized controlled trial (Secondary data analysis)
Number of Participants: 1,014 (parent-adolescent pairs)

Population:

  • Age — Parents: Mean=40.4 years; Adolescents: Mean=13.9 years
  • Race/Ethnicity — Parents: Not specified; Adolescents: 78% Non-Hispanic White, 9.9% Non-Hispanic Black, 7.6% Hispanic, and 4.5% Other
  • Gender — Parents: Not specified; Adolescent: 50.7% Female
  • Status — Participants were families contacted via telephone to participate.

Location/Institution: United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Uses population from Bauman, et al. (2000). This study examined the Family Matters program impact on adolescent smoking and drinking. As baseline interviews were completed, parent-adolescent pairs were matched by date and time of completion and then allocated randomly to either receive Family Matters or to serve as controls. Measures utilized include questions about alcohol and cigarette use. Results indicate participation in the Family Matters program resulted in statistically significant changes in several substance-specific aspects of the family, such as rule setting about tobacco and alcohol use. However, the immediate family effects did not account for the program effects on adolescent behavior. Limitations include reliance on self-reported measures and use of project-developed measures without established psychometrics.

Length of postintervention follow-up: 3 and 12 months.

Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., King, T. S., & Koch, G. G. (2002). Influence of a family program on adolescent smoking and drinking prevalence. Prevention Science, 3(1), 35-42.

Type of Study: Randomized controlled trial (Secondary data analysis)
Number of Participants: 1,135 (parent-adolescent pairs)

Population:

  • Age — Parents: Mean=40.4 years, Adolescents: Mean=13.9 years
  • Race/Ethnicity — Parents: Not specified; Adolescents: 78% Non-Hispanic White, 9.9% Non-Hispanic Black, 7.6% Hispanic, and 4.5% Other
  • Gender — Parents: Not specified; Adolescent: 50.7% Female
  • Status — Participants were families contacted via telephone to participate.

Location/Institution: United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Uses population from Bauman et al. (2000). This study examined the Family Matters program effect on reducing adolescent drinking and smoking. As baseline interviews were completed, parent-adolescent pairs were matched by date and time of completion and then allocated randomly to either receive Family Matters or to serve as controls. Measures utilized include questions about alcohol and cigarette use. Results indicate participation in the Family Matters program significantly reduced the prevalence of smoking cigarettes and drinking alcohol among adolescents. Limitations include reliance on self-reported measures and use of project-developed measures without established psychometrics.

Length of postintervention follow-up: 3 and 12 months.

Additional References

Bauman, K. E., Foshee, V. A., Ennett, S. T., Hicks, K., & Pemberton, M. (2001). Family Matters: A family-directed program designed to prevent adolescent tobacco and alcohol use. Health Promotion Practice, 2(1), 81-96. doi:10.1177/152483990100200112

Contact Information

Susan T. Ennett, MSPH, PhD
Agency/Affiliation: UNC-Chapel Hill
Email:

Date Research Evidence Last Reviewed by CEBC: April 2019

Date Program Content Last Reviewed by Program Staff: July 2019

Date Program Originally Loaded onto CEBC: July 2019