How Do Family-Focused Prevention Programs Work? A Review of Mediating Mechanisms Associated with Reductions in Youth Antisocial Behaviors.

The development and evaluation of family-focused preventive interventions has grown significantly in recent decades, but the degree to which these interventions produce anticipated improvements in the family environment, and the extent to which such changes are associated with reductions in youth antisocial behaviors (ASB), is unclear. This article seeks to answer these questions by reviewing evidence from tests of mediation conducted in evaluations of family-focused interventions. Interventions are drawn from family-focused interventions rated as Model Plus, Model, or Promising on the Blueprints for Healthy Youth Development Web site ( http://www.colorado.edu/cspv/blueprints/ ) based on evidence of their effectiveness in reducing child externalizing behaviors, substance use, and/or delinquency. Of the 19 such interventions listed on Blueprints, seven programs (37 %) were evaluated using mediation analyses which met study criteria. Two-thirds (67 %) of these analyses indicated significant improvements in the targeted family processes for intervention versus control group participants. Over half (62 %) of all tests of mediation were statistically significant and indicated that improvements in the family environment were associated with reductions in ASB. The results support prior theoretical and empirical literature identifying the family as an important context for preventing ASB and promoting healthy youth development. The findings also provide information that can be used to refine current family-focused interventions in order to increase their efficiency and potency, and to develop new interventions in order to expand the number and types of families who can benefit from such services.