BOX 6-5

Adolescent Transitions Program: A Multilevel School-Based Parenting Intervention

The Adolescent Transitions Program (ATP) is a multilevel, adaptive parenting intervention designed to reach parents through middle schools (Dishion and Kavanagh, 2003; Dishion, Kavanagh, et al., 2003). The first randomized controlled trial of the original ATP compared the impact of four alternative approaches. A version that combined parent and teen elements was shown to improve parent–child relations and reduce family conflict. A parent focus–only version reduced school behavior problems and tobacco use and also had a short-term effect on the incidence of aggressive and delinquent behaviors (Andrews and Dishion, 1995).

A second randomized controlled trial in eight small Oregon communities conducted by Irvine, Biglan, and colleagues (1999) evaluated the effectiveness of ATP when delivered by staff who were not mental health professionals. ATP participants showed a number of significant improvements.

A more recent version of the program, the Ecological Approach to Family Intervention and Treatment (EcoFIT), consists of parenting information provided through a Family Resource Center, along with parent–child homework interactions that encourage effective family management (Dishion and Stormshak, 2007; Dishion, Kavanagh, et al., 2003). Multiethnic students (58.6 percent minority) and their families in each school were randomly assigned to this intervention or a control condition (Dishion, Kavanagh, et al., 2002). Intervention parents maintained their monitoring practices, which had a preventive effect on substance use. In a longer-term follow-up, Connell, Dishion, and colleagues (2007) found that, relative to randomized matched controls, adolescents in the participating families had lower rates of growth in tobacco, alcohol, and marijuana use; lower rates of arrest; and a lower likelihood of being diagnosed with a substance use disorder.

Aos, Lieb, and colleagues (2004) report ATP as a program whose benefits exceed its costs.

Two HIV prevention interventions have been tested in multiple trials. Trials of the Chicago HIV Prevention and Adolescent Mental Health project, a family-based, universal HIV prevention program targeting youth in fourth and fifth grades, showed a number of benefits, such as enhanced family decision making, improved caregiver monitoring, and fewer disruptive difficulties with children (McKay, Chasse, et al., 2004; McBride, Baptiste, et al., 2007; Paikoff, Traube, and McKay, 2007). Familias Unidas, which targets Hispanic immigrant parents and their children, was found to increase parental involvement and improve communication and support, and resulted in fewer adolescent behavior problems (Pantin, Coatsworth, et al., 2003).

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