Short-term effects of the Strengthening Families Program (SFP 10-14) in Brazil: a randomized controlled trial

Abstract

Abstract This study discloses the evaluation of the short-term effect of the Strengthening Families Program (SFP 10-14), adapted as Famílias Fortes (Strong Families) in Brazil, on preventing adolescent drug use and improving parenting behaviors. Methods: A two-arm, parallel cluster randomized controlled trial was conducted in 60 Social Assistance Reference Centers (SARC) in 12 Brazilian municipalities. In each city, the SARC were randomly assigned to the intervention or control group. Eight hundred five families participated in the study, each contributing data from one parent/guardian and one adolescent for a total of 1,610 participants. Data collection occurred before the implementation of the intervention, and 6 months after baseline collection. Data were analyzed using multilevel mixed-effects modeling with repeated measuresin two different paradigms: Intention to Treat (ITT) and Per protocol (PP). The study was registered in the Brazilian Ministry of Health Register of Clinical Trials (REBEC), under protocol number RBR-5hz9g6z. Results: Considering the ITT paradigm, the program reduced the chance of parents/guardians being classified as negligent by 60% (95%CI 0.21; 0.78); increased the use of nonviolent discipline by caregivers (Coef 0.33, 95%CI 0.01; 0.64) and decreased the chance of adults exposing adolescents to their drunken episodes by 80% (95%CI 0.06; 0.54). No program effects were observed on outcomes related to adolescent drug use. Similar results were observed in the PP paradigm. Conclusion: The positive results on family outcomes suggest preventive potential of the program in the Brazilian population. Long-term evaluations need to be conducted to verify if the program will also achieve the drug use reduction goals that were not found in the short term.