Family-based prevention against substance abuse and behavioral problems: culture-sensitive adaptation process for the modification of the US-American Strengthening Families Program 10–14 to German conditions

Aim: The Strengthening Families Program 10–14 (SFP 10–14) was developed in 1993 at the Iowa State University as a universal family-based prevention program against substance abuse and behavioral problems in youth aged 10 to 14 years. Its effectiveness in delaying the initiation of tobacco, alcohol and cannabis use, in decreasing the average amount consumed and in reducing adolescents’ problem behavior in school and at home has been repeatedly evaluated in randomized-controlled studies in the US. While there is a well-established system of school- and community-based prevention in Germany, there is a lack of family-based prevention. This situation would be improved by the cultural adaptation and evaluation of SFP 10–14 in Germany. Subjects and methods: Focus group meetings were held with experts from family assistance and drug prevention, as well as with parents of children within the ages of the target group, in three geographically different cities in Germany (Hamburg, Schwerin and Munich). Group members were presented the original version of the material from the US (teaching manuals and DVDs), as well as an already adapted version from the UK. Group members developed criteria in a group discussion process necessary for the adaptation of the material to the German culture. Following the newly defined criteria, new teaching DVDs and manuals were produced. Results: As a result of the focus groups meetings, several aspects concerning the adaptation of the material had to be considered. Four aspects were especially important: (1) application to the regional social structures in Germany, within the target group (risk population: migration background, socioeconomic status, family structure), (2) adaptation to the German language (colloquial language, idiomatic expressions, non-verbal language), (3) consideration of culturally dependent norms about parents’ and children’s role model behavior, as well as the problem definition for behavior that is supposed to be addressed (family, school, peer group) and (4) the program’s adequate incorporation into the conditions of the local support system. Conclusions: Neither of the two existing SFP versions (US and UK version) could serve as a matrix for the German version, extensive adaptations were necessary. Results from the adaptation process carried out earlier in the UK with the original material from the US were helpful in this process. The German version of the program (Familien stärken) will be evaluated for a target group that consists of families with low socioeconomic status. This randomized-controlled multicenter study will be carried out in different German cities (Hamburg, Hanover, Schwerin, Rostock and Munich) between 2010 and 2013