Brittany Rhoades Cooper’s research while affiliated with Washington State University and other places

Strengthening Families Program for Parents and Youth 10–14 years old is an evidence-based and family-focused prevention program to reduce negative youth outcomes by increasing family protective factors. This program has been widely disseminated with positive results across diverse geographic and demographic communities. However, the onset of the COVID-19 pandemic in February 2020 resulted in an abrupt halt of in-person prevention programming. Guided by the Framework for Reporting Adaptations and Modifications – Expanded (FRAME), the current study reviews the process used to develop a virtual adaptation during the COVID-19 pandemic. To minimize disruptions to program delivery, an interdisciplinary team at Washington State University adapted the program from an in-person to a virtual delivery format, virtually trained facilitators in the new format, and implemented the virtual program seven times between 2021 and 2022. Evaluation findings suggest the virtual adaptation was successful as evidenced by high retention among families, promising outcomes of caregivers and youth, and satisfaction of facilitators and participants with the virtual format. Using online platforms to develop, scale-up, and deliver family prevention programs may improve dissemination and increase access during public health emergencies and beyond.

Prior research suggests that technical assistance which includes one-on-one, individualized support, guidance, and assistance is necessary to promote high-quality implementation of evidence-based interventions. However, this area lacks measures. This paper uses a mixed methods and community-engaged approach to develop and then evaluate a standardized measure of the collaborative working relationship between technical assistance providers and coalitions/coalition leaders. For measure development, researchers interviewed eight coalition leaders and eight coalition technical assistance providers about their experience providing or receiving technical assistance, using a human-centered design approach. A heat-mapping technique used with the interview data identified 11 themes related to the provision of high-quality technical assistance. Researchers then created survey items through an iterative process. After multiple rounds of revision and feedback with coalition leaders and coalition and technical assistance researchers, the reliability of seven of the constructs was piloted with 52 coalition leaders. The seven constructs included the following: competence and autonomy support, responsiveness, authentic and meaningful participation, co-creation, trust and rapport, compliance, and negative interactions. Researchers used Cronbach’s Alphas and correlational analyses to further refine the scales. Empirical results mapped well onto prior theoretical work and suggested that the collaborative working relationship is a multi-dimensional construct. This research moves prevention research methods and measurement development into a more community-engaged, stakeholder-involved approach.

Caregiver and teen engagement in prevention programs is critical for positive outcomes, but barriers may reduce participation for those who may benefit most. Self-directed programs can reduce some barriers, but little research exists on predictors of engagement in these programs, especially those aimed at college-age youth and their caregivers. This paper describes engagement in a self-administered, paper handbook-based preventive intervention for students leaving home for their first year of college. Data are from the First Years Away from Home randomized controlled trial study. We measured four engagement outcomes: caregiver-reported initiation, caregiver- and student-reported dose, and caregiver-reported student engagement. Aim 1 was to describe caregiver and student engagement in the intervention; Aim 2 was to examine four categories of engagement predictors measured at baseline: sociodemographic, student, and caregiver factors, and caregiver–student relationship quality. Caregivers and students reported engaging with intervention materials, with 80% of caregivers and 77% of students reporting some handbook use. Most caregivers reported students as moderately to highly engaged. Some positive predictors of engagement outcomes included a positive caregiver–student relationship, greater student well-being, and caregiver disapproval of substance use. However, some were less engaged: risk factors for lower engagement included minoritized ethnicity status, student substance use, first-generation college student status, and students with poorer well-being and less positive relationships with their caregiver. Future work should examine ways to better engage families of students who may be entering college with higher levels of risk when creating and implementing interventions aimed at this developmental period.

First-year college students are at increased risk for anxiety, depression, and high-risk alcohol use relative to older students. Parents often provide support through communication. We examined several aspects of daily parent-student communication, including quantity, mode, initiation, and content (e.g., perceived support, parental advice, topics discussed), between 367 first-year parent-student dyads (across a 7-day period) and tested for differences by gender, first-generation status, and race-ethnicity. Multilevel models examined between- and within-person associations between communication variables and how the student felt about their relationship with their parent the following day. Results showed students communicated frequently with parents (74% of days) across a variety of modalities, especially via text message, with important demographic differences observed. Any and more communication, perceived support, student honesty, parental advice, and discussing friendships were associated with increased positive feelings about the parent-student relationship the following day at the within-person level. Implications for future research and programming are discussed.

The research-practice gap between evidence-based intervention efficacy and its uptake in real-world contexts remains a central challenge for prevention and implementation science. Providing technical assistance (TA) is considered a crucial support mechanism that can help narrow the gap. However, empirical measurement of TA strategies and their variation is often lacking. The current study unpacks the black box of TA, highlighting different TA strategies, amounts, and their relation to intervention characteristics. First, we qualitatively categorized interactions between TA providers and implementers. Second, we explored how characteristics of implementing organizations and the intervention related to variations in the amount of TA delivered. Using data spanning six years, we analyzed over 10,000 encounters between TA providers and implementers. Content analysis yielded four distinct strategies: Consultation (27.2%), Coordination Logistics (24.5%), Monitoring (16.5%), and Resource Delivery (28.2%). Organizations with prior experience required less monitoring and resource delivery. Additionally, characteristics of the intervention were significantly associated with the amount of consultation, monitoring, coordination logistics, and resource delivery provided. The specific features of the intervention showed significant variation in their relation to TA strategies. These findings provide initial insights into the implications of intervention characteristics in determining how much of which TA strategies are needed to support implementations in real-world settings.

Background The long-term effectiveness of Head Start remains a topic of debate. Previous research with families of children enrolling in Head Start at three years of age has shown patterns of familial risk moderate the short-term effects of Head Start suggesting some children benefit more than others. However, we know little about patterns of risk that moderate Head Start’s effectiveness for children who first enroll in Head Start at four-year-old and even less about risk factors that moderate the long-term effectiveness of Head Start. Objective In the current study, we sought to address these gaps by examining differential treatment effects of Head Start on elementary school outcomes for subgroups of children who first enrolled in Head Start at age four. Methods Latent class analysis (LCA) was used to identify subgroups of children from the four-year-old cohort of the Head Start Impact Study (N = 2,108) based on family risk variables in preschool (e.g., maternal depression). Weighted regression analyses were then conducted to assess if the effects of Head Start on end of pre-kindergarten, kindergarten, 1st, and 3rd grade academic and social-emotional outcomes varied by latent class membership. Results While a subsample of children attending Head Start experienced sustained benefits, others had worse outcomes in elementary school, and predominantly any initial benefits of Head Start were not sustained into elementary school. Conclusion Irrespective of patterns of familial risk, initial benefits gained via Head Start for children first enrolling in at four-years of age typically fade out during elementary school.

Background In order to achieve wide-scale impact in community settings, programs must be sustained. Theory and empirical evidence suggest that intervention characteristics, organizational context, capacity for program implementation, and processes related to implementation are associated with continued program delivery. However, few studies examine how combinations of these factors work together in different settings to influence program sustainment. Methods Using scales specified in the Program Sustainability Assessment Tool (PSAT), the current cross-sectional study aims to identify the necessary and sufficient conditions for the sustainment of the Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14). Staff ( n = 59) at SFP 10-14 implementation sites across Washington State completed an online survey reporting on their current level of SFP 10-14 sustainment. They also completed PSAT, with eight scales designed to assess conditions that consistently produce sustainment. Data were analyzed using qualitative comparative analysis. Results Environmental support was the only necessary condition for sustainment success. Four solutions sufficient to achieve sustainment were also identified. These included the combined presence of (1) environmental support, organizational capacity, and funding stability; (2) environmental support, organizational capacity, communication, and program evaluation, in the absence of strategic planning; (3) environmental support, organizational capacity, program evaluation, and partnerships, in the absence of strategic planning; and (4) environmental support, communication, partnerships, and funding stability, in the absence of program evaluation. Conclusions Environmental support in combination with organizational capacity appeared to most consistently produce sustainment of SFP 10-14 programs in Washington State. Program providers will benefit from a focusing on enhancing those conditions to increase program sustainment.

Background: Co-use of cannabis and tobacco is common and increases negative behavioral, physical and mental health consequences. This study aimed to describe latent profiles of youth internalizing and externalizing problems, sensation seeking, and family environment in the US and their relationships with substance co-use. Methods: Data come from the Population Assessment of Tobacco Health (PATH). Using latent profile analysis with a distal outcome, we conducted a secondary data analysis examining relationships between latent profiles and the distal outcome of cannabis/tobacco use and co-use one year later. Participants were a nationally representative sample of youth ages 12-17 (N = 13,651). Results: We identified five youth subgroups: (1;11%) Family Risk, (2;32%) Family Protection with Very Low Internalizing, (3;21%) Family Protection with High Youth Risk, (4;24%) Family Protection with Moderate Youth Risk, (5;12%) Family Risk with High Youth Risk. Relationships between group membership and tobacco/cannabis outcomes, one year later, indicated that the least likely tobacco/cannabis users were the Family Protection with Very Low Internalizing class (no lifetime use probability (PR)=0.86, standard error (SE)=0.007; no 30-day use PR = 0.96, SE = 0.004). In contrast, the Family Risk with High Youth Risk class had the highest probability of both co-use (lifetime co-use PR = 0.33; SE = 0.014; 30-day co-use PR = 0.10; SE = 0.010) and single substance use (probability of lifetime single substance use PR = 0.30; SE = 0.013; 30-day single substance use PR = 0.24; SE = 0.014). Conclusions: A "protective but reactive" risk buffering pattern effect of family factors on youth factors was observed in that the lowest rates of co-use were observed in the three classes with family protection. These findings highlight the need for interventions addressing multiple domains and focusing on youth and family risk factors.

Abstract Background Adolescents often use substances such as tobacco and cannabis. Co-use of these substances can lead to physical, mental, and psychosocial difficulties beyond that which would be anticipated by simple additivity of their individual effects. Methods We aimed to examine the mediating role of age at first use of cannabis or tobacco (AU) between youth factors of internalizing, externalizing, and sensation seeking and two co-use outcomes (lifetime; last 30 days). Path analytic modeling using data from youth age 12–17 who had tried cannabis or tobacco at least once in their lives and participated in the Population Assessment of Tobacco Health (PATH) waves one and two (collected 2013–2015; n=3,847; approximately 46% female) study allowed us to examine these relationships. Results The lifetime use model indicated significant direct (internalizing (B = 0.18), externalizing (B = 0.30), sensation seeking (B = 0.15)) and indirect relationships (internalizing (B = 0.18), externalizing (B = 0.33), sensation seeking (B = 0.10)) between each of the three youth factors, the mediator (AU) and the lifetime co-use outcome (p