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Intervention Summary

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DARE to be You

DARE to be You (DTBY) is a multilevel prevention program that serves high-risk families with children 2 to 5 years old. Program objectives focus on children's developmental attainments and aspects of parenting that contribute to youth resilience to later substance abuse, including parental self-efficacy, effective child rearing, social support, and problem-solving skills. Families engage in parent-child workshops that focus on developing the parents' sense of competence and satisfaction with the parent role, providing knowledge of appropriate child management strategies, improving parents' and children's relationships with their families and peers, and contributing to child developmental advancement.

Descriptive Information

Areas of Interest Mental health promotion
Substance abuse prevention
Outcomes Review Date: November 2006
1: Parental self-efficacy
2: Use of harsh punishment
3: Child's developmental level
4: Satisfaction with social support system
Outcome Categories Family/relationships
Social functioning
Ages 0-5 (Early childhood)
18-25 (Young adult)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Other community settings
Geographic Locations Urban
Suburban
Rural and/or frontier
Tribal
Implementation History DTBY staff have implemented the program in 27 sites and provided training workshops for 85 other sites across the United States. The duration of implementation has ranged from 2 to 18 years, with an average of about 7 years. At least 45 sites have conducted evaluations.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations DTBY has been administered in multiple languages besides English including Spanish and Navajo; DTBY also has been used with Asian populations through the Asian Association of Salt Lake City, Utah. Replication training focuses on assisting local staff in adapting to their local ethnic groups.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Selective

Quality of Research
Review Date: November 2006

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Miller-Heyl, J., MacPhee, D., & Fritz, J. J. (1998). DARE to be You: A family-support, early prevention program. Journal of Primary Prevention, 18(3), 257-285.

Study 2

Head Start-University Partnership Grant DTBY Final Evaluation Report. (2000).

Supplementary Materials

DARE to be You Evaluation Protocol

DARE to be You Fidelity Instrument

MacPhee, D., & Fritz, J. (1995, March). Dare to be You Colorado Prevention Project: Final Evaluation Report.

Outcomes

Outcome 1: Parental self-efficacy
Description of Measures The outcome of parental self-efficacy included measures of self-efficacy, satisfaction and positive attitudes about being a parent, and the use of nurturing family management strategies. These outcomes were measured using two subscales of the Self-Perceptions of the Parental Role scale: self-perceived competence in the parental role, and satisfaction with the parental role. Parents filled out the questionnaire at pretest, immediately following the intevention, and 1 year later in one study and at 1 and 2 years later in a second study.
Key Findings In the first study, parents in the intervention group increased in parental self-efficacy and self-esteem when compared with parents in the control group, and these increases persisted for at least 2 years after the intervention (p < .01).

In a second study, parents in the intervention group increased in parental self-efficacy beliefs and the use of nurturant child-rearing practices when compared with parents in the control group at 1-year follow-up (p < .05).
Studies Measuring Outcome Study 1, Study 2
Study Designs Experimental
Quality of Research Rating 2.8 (0.0-4.0 scale)
Outcome 2: Use of harsh punishment
Description of Measures Use of harsh punishment was measured with the Parent-Child Relationship Inventory subscales on Limit Setting, Autonomy, and Communication. Parents also reported their use of various parenting practices and were asked open-ended questions regarding how they would handle problematic behavior they viewed in vignettes that were part of the intervention.
Key Findings In one study, the use of harsh punishment decreased and effective discipline and limit-setting increased in the intervention group when compared with the control group (p < .05); these changes persisted through the 2-year follow-up.

In a second study, parents in the intervention group exhibited statistically significant decreases in the use of harsh punishment over time. However, the parents in the control group also exhibited decreases in the use of harsh punishment, and differences between the intervention and control groups were not statistically significant.
Studies Measuring Outcome Study 1, Study 2
Study Designs Experimental
Quality of Research Rating 2.8 (0.0-4.0 scale)
Outcome 3: Child's developmental level
Description of Measures Developmental level was measured using the Normative Child Behavior Checklist for Infants and Children and a subset of items from the General Development Index of the Minnesota Child Development Inventory. These measures were filled out by caregivers (e.g., parents or grandparents).
Key Findings Children involved in DTBY programming had greater average increases than children in the control group at each data collection time point through the 2-year follow-up (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 2.7 (0.0-4.0 scale)
Outcome 4: Satisfaction with social support system
Description of Measures Social networks provide a variety of parenting advantages in terms of emotional and instrumental support (e.g., reassurance, babysitting, advice). The Social Network Questionnaire was used to assess network size, network membership, the frequency of contact with and closeness of network members, the number of people in the network, and satisfaction with support.
Key Findings Satisfaction with social networks increased between pretest and 1-year follow-up, with the intervention group increasing more than the control group (p < .04). The authors interpret this finding as a reframing of perceptions of existing social networks due to the DTBY intervention.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 2.8 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 0-5 (Early childhood)
18-25 (Young adult)
26-55 (Adult)
69.9% Female
15.4% Male
42.1% White
26.2% American Indian or Alaska Native
23% Hispanic or Latino
1.4% Race/ethnicity unspecified
Study 2 0-5 (Early childhood)
18-25 (Young adult)
26-55 (Adult)
71.5% Female
22.2% Male
48.9% White
27.4% American Indian or Alaska Native
11.5% Hispanic or Latino
4.8% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Parental self-efficacy 3.0 2.8 3.0 2.8 2.5 2.8 2.8
2: Use of harsh punishment 3.0 2.8 3.0 2.8 2.5 2.8 2.8
3: Child's developmental level 2.5 2.8 3.0 2.8 2.5 2.8 2.7
4: Satisfaction with social support system 3.0 2.5 2.5 3.0 2.5 3.0 2.8

Study Strengths

The measures were appropriate and well chosen, and the examination of instruments with regard to cultural relevance was a notable strength. Intervention fidelity measures appear to be adequate fidelity in terms of the intervention being manualized, log books being kept, etc. The choice of analytic techniques was appropriate given the state of the field at the time the study was conducted (more sophisticated techniques are available today).

Study Weaknesses

Attrition was an issue that may have biased the results. The authors discussed attrition, but they did not fully present how missing data were handled in the analyses. No power analysis was presented, but the analyses used were appropriate at the time the study was conducted. Despite the evidence presented regarding fidelity, the fidelity instrument was "home grown" and would benefit from greater detail of measuring the content of presentations. The manuscripts reviewed may have benefited from a more complete discussion of potentially confounding variables such as demand characteristics, regression to the mean, and the unspecified interventions that the control group might have received in the control group. The control group in the second study received no treatment at all, which may have biased the comparison. Differences between the control group members at pretest did not appear to be well accounted for, particularly as it connects to the study's findings. It is also unclear if the modest changes in outcomes are clinically significant.

Readiness for Dissemination
Review Date: November 2006

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

DARE to be You Web site, http://www.coopext.colostate.edu/DTBY/index.html

Martin, M., & Miller-Heyl, J. (1992). DARE to be You preschool activity guide. Fort Collins, CO: Authors.

Miller-Heyl, J. (1990). DARE to be You: Life skills and substance abuse prevention curriculum. Volume II: Class outline for early childhood (K-12) (2nd ed.). Fort Collins, CO: Author.

Miller-Heyl, J. (2000). DARE to be You Parent Training Guide (Spanish/English ed.). Fort Collins, CO: Author.

Miller-Heyl, J. (n.d.). Replication manual for the DARE to be You program for families of preschool youth, caregivers, and community. Fort Collins, CO: Author.

Miller-Heyl, J., MacPhee, D., & Fritz, J. (2001). DARE to be You: A systems approach to the early prevention of problem behaviors. New York: Kluwer Academic/Plenum.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.3 1.8 3.3 2.8

Dissemination Strengths

The implementation materials are well organized and tabbed for easy access. Both initial and follow-up trainings are offered to implementers. The high, medium, and low fidelity compliance options contained on the fidelity tool are outstanding and allow the rater to record with more specificity how closely each aspect of the program matches the original model. The evaluation protocol is comprehensive and includes process and outcome measures.

Dissemination Weaknesses

Little information on training content is provided. Implementers who wish to use many of the instruments must contact the various instrument developers directly for approval.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Implementation manuals Included in cost of training; additional manuals are $65 each Yes
Activity kit for children's program $225 No
20 hours of on-site training (includes evaluation manual with process and content instruments) $5,500 for up to 35 participants, plus travel expenses Yes (one training option is required)
20 hours of off-site training (includes evaluation manual with process and content instruments) $500 for the first participant, $250 for each additional participant from the same agency Yes (one training option is required)
Phone or email consultation (up to three calls or emails) Free No
Additional technical assistance $50 per hour No

Additional Information

Program costs for replication without research are $40,000 for 150 family members (not including siblings), or about $266 per person.

Replications

Selected citations are presented below. An asterisk indicates that the document was reviewed for Quality of Research.

* Miller-Heyl, J., MacPhee, D., & Fritz, J. J. (1998). DARE to be You: A family-support, early prevention program. Journal of Primary Prevention, 18(3), 257-285.

Contact Information

To learn more about implementation, contact:
Jan Miller-Heyl
(970) 565-3606
jan.miller-heyl@colostate.edu

Sue Sidinger
(970) 491-2666
sidinger@ext.colostate.edu

To learn more about research, contact:
David MacPhee
(970) 491-5503
david.macphee@colostate.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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