Guiding Good Choices

Program Goals

Guiding Good Choices (GGC) promotes healthy, protective parent–child interactions and addresses children’s risk for early substance use.



Target Population

The program targets families of children in grades 4–8 (ages 9–14).



Program Activities

GGC is a multimedia family-competency training program. The program is delivered in five weekly sessions specifically designed to strengthen parents’ family management skills, parent–child bonding, and children’s peer-resistance skills. Children are required to attend one session, which concentrates on peer pressure. The other four sessions involve only parents and include instruction in four areas:

  • Identifying risk factors for adolescent substance use and creating strategies to enhance the family’s protective processes
  • Developing effective parenting skills, particularly those regarding substance use issues
  • Managing anger and family conflict
  • Providing opportunities for positive child involvement in family activities

Program Theory

GGC is based on the social development model, which theorizes that enhancing protective factors, such as prosocial bonding to family, school, peers and establishing clear standards or norms for behavior will decrease the likelihood that children will engage in problem behaviors.

Intervention ID: 
77
Ages: 
9 to 14
Rating: 
Effective
Evaluation: 

Study 1

Kosterman and colleagues (1997) assessed three specific parenting behaviors:


 

1.       The increase of proactive family communication

2.       The reduction of negative family interaction

3.       The improvement of observable relationship quality between parent and child



The study was conducted in six school districts in two economically stressed rural communities in the central Midwest, with 209 families completing the pretest assessment. The families were then randomly assigned into an intervention group (treatment) or a waitlist group (control). Videotaped observations of family interactions were conducted at the families’ homes both 2 months before and 2–9 weeks following the intervention. Before each interaction, parents and children completed an independent questionnaire designed to identify issues leading to disagreements within the family. Family interactions were scored across 60 different dimensions intended to measure individual characteristics, relationships, group interactions, and problem-solving.


 

An analysis of covariance was used to examine differences in posttest scores while controlling for differences in pretest scores. An intent-to-treat approach was used for analysis, so that all families in the treatment condition were included in the analysis regardless of their level of participation in the intervention.



Study 2

Spoth and colleagues (1999) evaluated a comprehensive test of GGC to assess the impact of the program on the initiation of substance use (alcohol or tobacco) and on the progression from one status to another status (e.g., from no-use to alcohol-only use). Schools were selected on the basis of free-lunch-program eligibility and community size (population 8,500 or fewer). Schools were assigned using a randomized block design, wherein blocks were formed on the basis of school size and the proportion of students residing in low-income neighborhoods. Within blocks, schools were assigned to GGC (n=221 families), a second intervention group (Iowa Strengthening Families Program, n=238) or a minimal contact control group (n=208).


 

Test participants consisted of families of sixth graders enrolled in 33 rural schools in 19 contiguous counties in a Midwestern State. All three groups were similar across sociodemographic characteristics, and families participating in the study were generally representative of the sampling frame (the mean level of education was 0.7 years higher for participants). The sample completing both pretests and posttests was composed primarily of dual-parent families (85.0 percent) and whites (98.6 percent). In 51 percent of the families, the target child for the intervention was female.


 

The analysis incorporated three waves of data collected over a 2.5-year period. Participants were tested 1-year post-implementation and 2-years post-implementation. Measures of lifetime and past-month use of substances (self-report) were used in a stage-sequential latent transition analysis model.



Study 3

In study 3, Spoth and colleagues (2009) analyzed data from the study 2 population. The follow-up period of 10 years allowed the researchers to follow participants into young adulthood, and data was collected at seven points in time over that period. The study used four measures of young adult substance use: frequency of drunkenness, alcohol-related problems, use of cigarettes, and use of illicit drugs. A fifth measure for polysubstance use was developed by dichotomizing answers for the previous measures and compiling them.


 

The primary analysis used an indirect effects model, which was designed to address issues related to the long follow-up period. The model compares case rates in the treatment and control conditions, which yields relative reduction rates—that is, the proportion of control condition cases that would have been prevented had those individuals received the intervention. The researchers hypothesized that program effects on problematic substance use in young adults would occur indirectly, that is through the program’s impact on the initiation of substance use. A hierarchical latent growth curve model was used to assess intervention effects on adolescent substance use initiation, which was then assessed for its effects on young adult substance use outcomes.

Outcomes: 

Study 1

Proactive Communication

Kosterman and colleagues (1997) found significant positive effects of the interaction on proactive communication. Mothers showed statistically significant increases in general family interactions, and mothers and fathers showed statistically significant increases in problem-solving interactions.



Negative Interactions with Children

The study found decreased negative interactions between mothers and their children. This effect was statistically significant. Although the fathers in the treatment group showed fewer negative interaction practices with their children than did fathers in the control group, the differences were not statistically significant.



Relationship Quality

The control group showed moderate improvements in relationship quality. For this dimension, only fathers in the treatment group demonstrated statistically significant improvements in their quality of relationship with their child during the problem-solving task. Mothers in the treatment group showed a higher quality of relationship during the general interaction task, but this difference from the control group mothers only approached significance.



Study 2

Initiation of substance use

Spoth and colleagues’ (1999) evaluation demonstrated positive effects for intervention parents and children. Compared with members of a control group, adolescents in the treatment group who had not initiated substance use by the 1-year follow-up were significantly less likely to have initiated use at the 2-year follow-up.



Progression in substance use

Adolescents in the treatment group who had initiated substance use by the 1-year follow-up were also significantly more likely than control group youths to have remained at their 1-year substance use status.



Study 3

Substance Use

Spoth and colleagues (2009) found that the intervention prevented significant numbers of individuals from engaging in problematic young adult substance use. Specifically, GGC could have prevented an estimated 9 percent of control group individuals from engaging in drunkenness, 11 percent from experiencing alcohol-related problems and cigarette use, and 16 percent from engaging in illicit drug use.