STRIVE

Developers

Norweeta G. Milburn, Ph.D.

 
Program Summary
Support to Reunite, Involve and Value Each Other (STRIVE) is a five-session family-based intervention intended to reduce sexual risk behaviors, substance use, and delinquency among youth who have recently run away from home. 
 
The intervention requires participation from both the adolescent and at least one parent. It is delivered to individual families in a community-based setting or in the family's home by a trained specialist.
Intended Population
The program was designed for and evaluated with newly homeless youth ages 12 to 17.
Program Setting

The program was designed for and evaluated in community-based organizations and homes.

Contact and Availability Information

Nancy Gonzalez-Caro, MPH
Evidence-Based Product Specialist
ETR
100 Enterprise Way, Suite G300
Scotts Valley, CA 95066
Ph: 800-321-4407 x237
Website: http://www.etr.org/ebi/programs/strive/

Dr. Norweeta Milburn
UCLA Nathanson Family Resilience Center
760 Westwood Plaza, Rm A8-153
Los Angeles, CA 90095
Ph: 310-794-3773
Email: nmilburn@mednet.ucla.edu
Website: http://nfrc.ucla.edu/STRIVE

Sample of curriculum available for review prior to purchase
Yes
Adaptation guidelines or kit available
Yes
Languages available
English
Program Core Components
Category Component Core Component Component present Notes Lesson number(s) / activities where present
Content Graduating from high school No
Content Anatomy/physiology No
Content Other
Content Volunteering/civic engagement No
Content Spirituality No
Content Morals/values No
Content Identity development No
Content Social support/capital No
Content Social influence/actual vs. perceived social norms No
Content Social competence No
Content Parenting skills Yes (both versions) All sessions are intended to strengthen family connections and build positive relationships by giving parents skills for communicating with their teen and handling conflicts
Content Normative beliefs No
Content Leadership No
Content Gender roles No
Content Gender identity No
Content Cultural values No
Content Connections with trusted adults Yes (both versions) All sessions are intended to strengthen family connections and build positive relationships
Content Conflict resolution/social problem solving Yes (both versions) Session 1, Task 9; Session 2, Task 9; Session 4, Task 5
Content Communication skills No
Content Child development No
Content Boundary setting/refusal skills No
Content Substance use cessation No
Content Substance use - Other drugs No
Content Substance use - Alcohol No
Content Substance use - Abstinence No
Content Brain development and substance use No
Content Vocational/skills training No
Content Supplemental academic services No
Content School engagement No
Content College preparation No
Content Alternative schooling No
Content Self-regulation Yes (both versions) Session 1, Task 8; then use of the Feeling Thermometer throughout the sessions
Content Self-esteem Yes (both versions) Session 1, Task 7, Task 8
Content Self-efficacy/empowerment No
Content Resilience Yes (both versions) Session 1, Task 9
Content Sexual health No
Content STIs - Treatment No
Content STIs - Screening No
Content STIs - Prevention No
Content STIs - Information No
Content Sexual risk reduction Optional A video on risks of HIV for homeless youth is assigned as homework.
Content Sexual risk discontinuation Optional A video on risks of HIV for homeless youth is assigned as homework.
Content Personal vulnerability Yes (both versions) Session 1 establishes positive atmosphere; participants are rewarded for sharing authentically throughout
Content Sexual orientation No
Content Maternal health No
Content Contraception - Condoms No
Content Contraception - Long-acting reversible contraceptives No
Content Contraception - Other No
Content Contraception - Pills, patches, rings, and shots No
Content Reproduction No
Program Objectives
STRIVE seeks to improve the stability and quality of residential life, reduce the number of runaway episodes, and minimize HIV-related sexual and substance use risk behaviors among recently homeless adolescents. The intervention is designed to improve family functioning, reduce family conflict, and build problem solving, negotiation, and coping skills.
Program Content

STRIVE is grounded in cognitive-behavioral and family systems theories and stresses the importance of establishing a positive family climate to reduce the risk of chronic homelessness and associated adolescent risk behaviors. The specific topics covered by each session are:

  • Session 1: Participants are encouraged to create a positive family atmosphere and to make a commitment to the program and not running away from home. Families learn how to anticipate, identify, and plan for situations and events that may trigger the adolescent to run away.
  • Session 2: Participants learn and practice problem-solving skills. Families are encouraged to develop a positive family environment by prioritizing problems and solving them as a team.
  • Session 3: Participants learn how to analyze and frame problems, and how to articulate the intentions behind their behaviors. The session also provides factual information about HIV risk among runaway and homeless youth.
  • Session 4: This session focuses on coping and negotiation skills. Families learn strategies to cope with stressful situations and how to negotiate solutions. They practice applying these skills to their real-world problems.
  • Session 5: In this session, families apply what they have learned in prior sessions to solve an ongoing family conflict. The facilitator observes the discussion and provides feedback on the process.
Program Methods
The program is delivered to each family individually through a series of interactive, semi-structured tasks.
Program Structure and Timeline
The five STRIVE sessions are delivered weekly and last between 1.5 to 2 hours. Facilitators can work with up to two youth and their families per day if the intervention is delivered in the home, and more than two per day if families come to the facilitator's location.
Staffing
Facilitators should have experience working with at-risk adolescents. A degree such as a B.A., B.S., or M.F.T. are recommended, but not required.
Program Materials and Resources
Core intervention materials consist of:
  • Implementation manual
  • Evaluation assessments
  • Monitoring tools
  • Recruitment and retention materials
Additional Needs for Implementation
Necessary materials and equipment are described in the intervention manual.
Fidelity
Guidelines are provided in the manual for the key issues to be covered in each of the five intervention sessions. Other materials related to fidelity and adaptation can be found here:
http://www.etr.org/ebi/programs/strive/
Staff Training
A minimum of three full days of training is required. Training is set up through Dr. Milburn, and is provided by trainers with advanced degrees (M.S.W., Ph.D., or Psy.D.) who helped develop the intervention. Training can be provided at UCLA or onsite at the implementer's location.
Technical Assistance and Ongoing Support
Assistance via phone and telehealth supervision can be provided by the trainers.
 
ETR can also provide in-person and web- or phone-based technical assistance before, during and/or after program implementation. TA is tailored to the needs of the site and is designed to support quality assurance, trouble-shoot adaptation issues, and boost implementation.
 
ETR provides evaluation support for EBI implementation as well. Services address process and outcome evaluation and include assistance with evaluation planning, instrument design and development, implementation fidelity, data management and analysis, performance measurement, continuous quality improvement (CQI) protocols, and effective tools and strategies for reporting results.
Allowable Adaptations
The program can be adapted for other at-risk populations and is currently being adapted for adolescents who are re-entering the community from the juvenile justice system.
Reviewed Studies
Citation High-Quality Randomized Trial Moderate-Quality Randomized Trial Moderate-Quality Quasi-experiment Low Study Rating Did Not Meet Eligibility Criteria

Milburn et al. 2012

 		✓
Study Characteristics
Citation Setting Majority Age Group Majority Racial/Ethnic Group Gender Sample Size

Milburn et al. 2012

 		After school 14 to 17 Hispanic or Latinx of any race Youth of any gender 151
Study Findings

Evidence by Outcome Domain and Study

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Milburn et al. 2012

 		Indeterminate evidence Potentially favorable evidence Indeterminate evidence n.a. n.a.
Detailed Findings
Citation Details

Milburn et al. 2012

 		The program was evaluated using a randomized controlled trial involving newly homeless adolescents in Los Angeles and San Bernardino Counties, California. Study participants were recruited on a rolling basis over a three-year period through community-based organizations and study flyers and advertisements. About half were randomly assigned to receive the STRIVE intervention and half were assigned to a control group that received only referral services. Surveys were administered before the intervention (baseline) and at follow-ups conducted 3, 6, and 12 months after the intervention.

The study found that twelve months after the intervention, adolescents participating in the intervention reported having significantly fewer sexual partners in the previous three months. The study found no statistically significant program impacts on measures of vaginal or anal sex or unprotected sex in the previous three months. Findings from the three- and six-month follow-ups were not considered for the review because they did not meet the review evidence standards. Specifically, both the three- and six-month follow-ups had a high rate of sample attrition, and the study did not establish baseline equivalence for the remaining sample members.

The study also examined program impacts on measures of substance use and delinquent behaviors. Findings for these outcomes were not considered for this review because the outcomes fell outside the scope of the review.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.