Progress 09/01/23 to 08/31/24

Outputs
Target Audience:Through implementation of Familias Fuertes or SFP 10-14, we aim to serve Latine families in the rural San Luis Valley region. As universal programs, Familias Fuertes and SFP 10-14 target all families, not only those "at-risk," and support both parents and youth. These programs specifically serve parents of youth who are 10-14 years old. Also, our culturally adapted training and technical assistance objective aims to support local prevention providers ensure high quality program implementation, fidelity, evaluation, and sustainability. These training and technical assistance resources and events serve SFP 10-14 and Familias Fuertes facilitators and coordinators, local PROSPER team members, and other prevention delivery system personnel in the region. Changes/Problems:In April 2023, Dr. Edwin approved a change from solely Familias Fuertes implementation to a blend of Familias Fuertes and SFP 10-14 implementations, still with the target audience of Latine families. As a reminder, under Objective 1, we proposed to implement Familias Fuertes, a culturally adapted version of the evidence-based Strengthening Families Program 10-14. In addition to being delivered in Spanish, this program offers other cultural adaptations for Latine communities and includes videos in Spanish that incorporate these adaptations. Unfortunately, the feedback we've received from our local community is that the program materials and videos are not very good, and the Spanish dialect is very different. Also, we have heard that some local families prefer the program in English, especially if that means higher-quality resources and videos. We had a meeting to troubleshoot these items with Familias Fuertes and SFP 10-14 head trainers/program managers, AnaMaria Martinez and Cathy Hockaday. In addition to AnaMaria helping our Familias Fuertes facilitators with more direct T/TA, they reminded us that the core elements of both programs are the same and encouraged us to follow the community's desire for SFP 10-14 or Familias Fuertes if allowed by our funders. Based on Dr. Lewis' approval, our partners in the SLV began selecting and implementing Familias Fuertes vs. SFP 10-14 based on local families' interests. What opportunities for training and professional development has the project provided? Six technical assistance materials (research-to-practice tools) were adapted for local prevention practitioners and one research-to-practice tool was created to highlight how to make cultural adaptations to programs serving Latine communities. One Strengthening Families Program 10-14 (SFP 10-14) facilitator training was held in August 2023, where a total of 6 facilitators were trained. One Youth Mental Health First Aid training was hosted for 15 attendees. In year 2, three learning community events occurred with topics including supporting participants' mental health needs, sustaining SFP 10-14, and how to implement SFP 10-14 virtually. Regular tailored coaching was offered to local coordinators of the SFP 10-14 and/or Familias Fuertes program, where best practices and resources around family recruitment, implementation, evaluation, and coordination were shared; grant logistics and questions were discussed; and local issues and challenges were troubleshooted. How have the results been disseminated to communities of interest? Pre/post evaluation results were shared with our local coordinator in March 2024. These results reflected the data captured in the first 7 implementations of SFP 10-14/Familias Fuertes in the SLV. The results of our iterative feedback from the SLV Advisory Board resulted in seven translated, adapted research-to-practice tools. These tools or "results" were disseminated to local SFP 10-14 and Familias Fuertes facilitators and coordinators and prevention practitioners. The CSU Team co-presented with Rio Grande Public Health (one of the partner SFP 10-14 facilitators in the region) at the 2024 Colorado Shared Risk and Protective Factor Conference about the SFP 10-14/Familias Fuertes effort in the region, including this project. What do you plan to do during the next reporting period to accomplish the goals?Originally, we reported all deliverables were met for this project. Since submitting our request for a no-cost extension, we learned that the local coordinator had incorrectly reported families served. Regardless, we only have 10 more families left to serve to meet our deliverables, and originally, we planned on implementing more cohorts in our no-cost extension anyway. In this no-cost extension, we will implement three more cohorts of Familias Fuertes or Strengthening Families 10-14 (SFP 10-14) in Colorado's San Luis Valley and serve at least 10 more families. Additionally, we will continue to build technical assistance materials for local and state prevention practitioners, focused on increasing the knowledge and skills of local prevention practitioners in conducting evaluation activities.

Impacts
What was accomplished under these goals? Familias Fuertes Implementation in San Luis Valley (SLV) Due to an approved project change (see "Major changes/problems" section below), the San Luis Valley (SLV) Local Coordinator (LC) implemented cohorts of either Familias Fuertes or Strengthening Families Program 10-14 (SFP 10-14) based on families' preference and needs. To continue to build the local facilitator network, a SFP 10-14 training was hosted in August 2023 (6 trained). This effort aligned with a state grant that initiated a local PROSPER team and programs (SFP 10-14 and LST). Through this adjacent effort, which occurred in partnership with our CSU Team and the LC (served as PROSPER member), an SFP 10-14 training was hosted June 2023 (17 trained, also noted in 2021-46100-35478 REEport 2022-2023), a recertification training took place in September 2023 (2 trained), and a Familias Fuertes training occurred July 2023 (1 trained). A close partnership was formed between the SLV LC, PROSPER Local Team Leader, and Extension Juntos 4-H Youth Development Specialist. To coordinate implementations across the region, the CSU Team and these individuals would meet regularly. During these meetings and Implementation Team meetings between CSU and the lead organization, resources were shared to help with family recruitment, implementation, evaluation, and coordination; grant logistics and questions were discussed; and local issues were addressed. Additionally, tailored technical assistance (TA) was provided by CSU's technical assistance provider (TAP) to the LC through meetings, numerous emails, texts, and phone calls. Program materials for 5 cohorts were mailed to local partners to help sustain the program. To recruit facilitators and families, the LC used word of mouth within her network of partners, posted advertisements, handed out flyers, and posted in newsletters. More than 40 individuals or organizations were contacted for family recruitment, implementation, and sustainability purposes. These representatives primarily included public health professionals, school personnel, families, and CSU Extension. During year 2, 9 SFP 10-14/Familias Fuertes implementations were completed, serving 42 families (62 families total). Pre- and post-surveys were conducted for nearly all implementations; 2 implementations were missing either a pre or post-test and were not included in the analysis. About half of participating caregivers completed both a pre and post-test (n = 28); another 31 had only a pre or post-test. Caregivers with matched pre and post-tests from the SLV primarily showed trending improvements in parenting skills and behaviors, including non-statistically significant increases in Parent's Expectations on Substances (d = .22), Parental Monitoring (d = .14), Relationship Quality (d = .33), and Family Problem Solving (d = .25). Two measures showed maintenance or little change, including Positive Parenting Behaviors (d = .05) and Expectations and Rules (d = -.02). Lastly, one showed a non-statistically significant decrease: Goals Communication (d = .20). Additionally, 32 youth had matching pre/post-tests; another 25 had at least a pre or post-test. Youth from the SLV primarily showed trending improvements in their ratings, including Family Problem Solving (d = .38), Stress Coping (d = .28), Family Communication (d = .29), Peer Pressure Refusal Skills (d = .32), and their rating of Substance Use Rules (d = .20). Two areas showed small non-significant decreases, including Relationship Quality (d = -.16) and youth's ratings of Parent's Expectations (d = -.11). While initial assessment of this data primarily shows promise for program effectiveness, interpretability of these results is limited due to the small sample size of matched participants. Additional evaluation is necessary. Note: In statistics, an 'effect size' shows the magnitude (i.e., how large) of an effect is shown in the data, and in this case, the effect size is represented by Cohen's d statistic. Here are a common set of benchmarks for interpreting effect sizes: small effect (d between .2-.5), moderate effect (d between .5-.8), and large effect (d larger than .8). Nine fidelity checks were completed (3 per cohort and session type - youth, parent, or family), and these data were used as a coaching tool for FF/SFP 10-14 facilitators in TA and/or pre-session meetings. A virtual site visit was conducted in January 2023 prior to the first FF cohort to provide proactive and empowering support for the new LC and program facilitators. Culturally Adapted RTP Tools & Technical Assistance (T/TA) The SLV Advisory Board (AB) for our culturally adapted T/TA continued to work alongside our team in Year 2. Our CSU team translated and our SLV AB provided feedback on 6 research-to-practice (RTP) tools from English to Spanish: Fidelity, Adapting EBPs Part 1, Adapting EBPs Part 2, Cultural Adaptations Part 1, Cultural Adaptations Part 2, and Program Sustainability. Also, our team finished developing the new research-to-practice tool about the unique challenges of Latine immigrant communities face when adapting and implementing evidence-based prevention programs. The English version of this tool was posted to our website: Cultural Adaptations for Latino/a Communities. Also, the translated versions of all tools were posted to our website: Fidelidad, Adaptando EBPs Parte 1, Adaptación de EBPs Parte 2, Adaptaciones Culturales Parte 1, Adaptaciones Culturales Parte 2, Programas Sostenibles, and Adaptaciones Culturales - Comunidades Latinos/as. They were distributed to 96 individuals, which included SFP 10-14 & Familias Fuertes facilitators, coordinators, and leaders; PROSPER stakeholders; prevention advisory board members; and county and regional Extension Specialists. Lastly, these tools were discussed and shared during a PROSPER State Management Team (SMT), an SFP 10-14/Familias Fuertes Learning Community event, and an Implementation Team meeting. After completing the adaptations of these tools and creating the Latine specific research-to-practice tool, our CSU team began to create research-to-practice tools on process evaluation, outcome evaluation, and dissemination of evaluation results. In working with our community partners, we learned that program evaluation was an area local providers wanted more support in. Outlines for each of these tools were developed, and our team plans to continue working on these tools in a no-cost extension. The SLV Advisory Board also provided feedback on considerations for local program implementation and TA activities (e.g., learning communities, trainings, etc.). We used this feedback when scheduling learning community events and to support our local coordinator in planning program logistics. During Year 2, 3 learning communities occurred with topics including supporting participants' mental health needs, sustaining SFP 10-14, and how to implement SFP 10-14 virtually. When possible, the Program Manager and Head Trainer for SFP 10-14 was a guest facilitator to help answer attendee questions. According to post-survey results, nearly 85% of respondents reported "A Lot" or "Quite a Bit" when indicating to what extent the learning community addressed topics that would be useful in their role as a SFP 10-14/Familias Fuertes facilitator. Additionally, about 86% "A Lot" or "Quite a Bit" regarding the extent to which the learning community improved their knowledge around SFP 10-14 or FF implementation. Additionally, in response to a mental health crisis that occurred during an implementation of SFP 10-14, CSU provided additional support, training, and technical assistance, which included developing protocols and resources to ensure clear communication between host sites and facilitators, training for SFP 10-14 facilitators in Youth Mental Health First Aid (15 attendees), and direct guidance from the SFP 10-14 Program Manager during a learning community event.

Publications

Progress 09/01/22 to 08/31/23

Outputs
Target Audience:Through implementation of Familias Fuertes or SFP 10-14, we aim to serve Latine families in the rural San Luis Valley region. As universal programs, Familias Fuertes and SFP 10-14 target all families, not only those "at-risk," and support both parents and youth. These programs specifically serve parents of youth who are 10-14 years old. Also, our culturally adapted training and technical assistance objective aims to support local prevention providers ensure high quality program implementation, fidelity, evaluation, and sustainability. These training and technical assistance resources and events serve SFP 10-14 and Familias Fuertes facilitators and coordinators, local PROSPER team members, and other prevention delivery system personnel in the region. Changes/Problems:In April 2023, Dr. Edwin approved a change from solely Familias Fuertes implementation to a blend of Familias Fuertes and SFP 10-14 implementations, still with the target audience of Latine families. As a reminder, under Objective 1, we proposed to implement Familias Fuertes, a culturally adapted version of the evidence-based Strengthening Families Program 10-14. In addition to being delivered in Spanish, this program offers other cultural adaptations for Latine communities and includes videos in Spanish that incorporate these adaptations. Unfortunately, the feedback we've received from our local community is that the program materials and videos are not very good, and the Spanish dialect is very different. Also, we have heard that some local families prefer the program in English, especially if that means higher-quality resources and videos. We had meeting to troubleshoot these items with Familias Fuertes and SFP 10-14 head trainers/program managers, AnaMaria Martinez and Cathy Hockaday. In addition to AnaMaria helping our Familias Fuertes facilitators with more direct T/TA, they reminded us that the core elements of both programs are the same and encouraged us to follow the community's desire for SFP 10-14 or Familias Fuertes if allowed by our funders. Based on Dr. Lewis' approval, our partners in the SLV began selecting and implementing Familias Fuertes vs. SFP 10-14 based on local families' interests. What opportunities for training and professional development has the project provided? A SFP 10-14 facilitator training was held in November 2022 in Alamosa. A total of 17 individuals were trained, and 2 people were recertified. In November 2022, 5 people were trained as Familias Fuertes facilitators. In year 1, three learning community events were conducted and had representatives present from across the state, including the SLV, northeast, northwest, and southeast regions. Individualized coaching was offered to local coordinators of the SFP 10-14 and/or Familias Fuertes program. During the first year, the CSU team (Project Manager and/or TA provider) met with the local Familias Fuertes coordinator, the local grant coordinator, and/or other local prevention representatives as an "Implementation Team" 13 times. These meetings were vital in coordinating other SLV efforts around prevention (e.g., CSU Extension programs, local PROSPER Team, etc.). During these meetings, best practices and resources around family recruitment, implementation, evaluation, and coordination were shared; grant logistics and questions were discussed; and local issues and challenges were troubleshooted. Additionally, tailored TA was provided by CSU's technical assistance provider to the SLV Local Familias Fuertes Coordinator totaling 20 meetings and numerous as needed emails, texts, and phone calls. Program materials, facilitator manuals, and SFP 10-14 USBs were purchased and sent to the local community to facilitate grant-funded implementations and sustain the program over time. How have the results been disseminated to communities of interest? Our team provided coaching to local facilitators on program evaluation processes, including fidelity checks. We have assisted communities in planning fidelity checks and encouraged coordinators to use these data as a coaching tool with facilitators. Additionally, our TAP virtually completed two fidelity checks in June 2023 for a local SFP 10-14 implementation. These data were feedback to the local coordinator to share with their facilitator team. Post-learning community surveys and advisory board feedback have been used as a process improvement mechanism to ensure high quality facilitation and success of future learning community events. Although data were not directly shared with the communities, these data directly informed our work with the SLV. We are finishing the incorporation of advisory board feedback into our research-to-practice tools. Once done, we will share these tools with the advisory board again for one more review before sending to the larger prevention practitioner community. What do you plan to do during the next reporting period to accomplish the goals?During year 2 of the grant period, we plan to complete the remaining 6 implementations and serve 52 more families. Through this grant and supplementary funding, extensive local capacity has been built around Familias Fuertes and SFP 10-14. In addition to our hired local coordinator for the grant, there are 4 more people serving in a coordinator role locally. Also, on top of the training funded by RHSE, two other SFP 10-14 trainings were conducted locally, resulting in 34 trained SFP 10-14 facilitators and 8 trained Familias Fuertes facilitators in the SLV. Many implementations are planned and already occurring in this area for year 2. As such, we are confident we will make significant progress toward this deliverable in the next year. Further, we plan to finish the adaptations to our research-to-practice tools, post them on our website, and disseminate them to prevention practitioners in the SLV. We will continue hosting learning community events amongst SFP 10-14 and Familias Fuertes facilitators and support implementers with technical assistance.

Impacts
What was accomplished under these goals? Familias Fuertes Implementation in San Luis Valley (SLV) The SLV Local Familias Fuertes Coordinator (LC) was hired by the lead organization (LO) in October 2022, and the first Strengthening Families Program 10-14 (SFP 10-14, step 1 of Familias Fuertes training) training was hosted November 2022. During this training, 17 people were certified, and 2 individuals were recertified. Following the SFP 10-14 facilitator training, 5 people completed the virtual Familias Fuertes (FF) training. Also, this training was delivered in "Spanglish" so that 4 of CSU's staff/students could attend and learn more about the adaptations Familias Fuertes incorporates. This year, the CSU Project Manager (PM) and/or Technical Assistance Provider (TAP) met with the LC, the local grant coordinator, and/or other local prevention representatives as an "Implementation Team" 13 times to coordinate regional prevention efforts (e.g., CSU Extension programs, local PROSPER Team, etc.). During these meetings, best practices and resources around family recruitment, implementation, evaluation, and coordination were shared; grant logistics and questions were discussed; and local issues and challenges were troubleshooted. Additionally, tailored technical assistance (TA) was provided by CSU's TAP to the LC through 20 meetings and numerous emails, texts, and phone calls. Program materials, facilitator manuals, and SFP 10-14 USBs were purchased and sent to the local community to facilitate grant-funded implementations and sustain the program. To recruit facilitators and families, the LO used word of mouth within their network of partners, posted advertisements, handed out flyers, and posted in newsletters. Over 40 individuals or organizations were contacted for recruitment, implementation, and sustainability purposes. These representatives primarily included school personnel, families, and CSU Extension. Due to an approved project change (see "Describe major changes/problems..." section below), the LO took a hybrid approach to implementation - implementing cohorts of Familias Fuertes or SFP 10-14 based on families' preference and needs. During year 1, 3 implementations were completed, serving 20 families (24 parents, 24 youth): February - March 2023 (in-person; Center, CO), May - June 2023 (virtual), and June - July 2023 (virtual). Pre- and post-surveys were conducted during all implementations. In the SLV, 17 parents completed both the pre and post-test, and showed a slight increase in their average scores (M1 = 3.18, M2 = 3.3). Additionally, 14 matched youth completed both the pre and pos- test, and scores generally stayed the same or slightly improved. Youth remained about the same in theirCaregiver scores (M1 = 3.2, M2 = 3.18), an increase in Future Orientation (M1 = 3.37, M2 = 3.54), and an increase in their Resistance to Peer Pressure scores (M1 = 3.17, 3.42) from pre to post test. While initial assessment of this data shows promise for program effectiveness, interpretability of these results is limited due to the small sample size of matched participants. Additional evaluation is essential. Nine fidelity checks were completed (3 per cohort and session type - youth, parent, or family), and these data were used as a coaching tool for FF/SFP 10-14 facilitators in TA and/or pre-session meetings. A virtual site visit was conducted in January 2023 prior to the first FF cohort to provide proactive and empowering support for the new LC and program facilitators. Lastly, as a sustainability initiative through auxiliary funding, CSU is supporting Rio Grande Public Health as they establish a local PROSPER team in the SLV. We have connected the LC with the local team leader, and she participates on this team. In addition to the local team meetings and support, our TAP convenes a meeting between the LC and local team leader monthly to ensure cohesion between these efforts. As such, the local team and CSU's TAP are helping ensure high quality implementation and sustainability of FF or SFP 10-14 for Latine families locally. Culturally Adapted RTP Tools & Technical Assistance An advisory board (AB) was established to provide a local rural, Latine perspective to our prevention efforts, namely our research-to-practice tools and TA activities. To recruit members, we worked with the local MTSS team (SLV Multi-Tiered Systems of Support team) to discuss the role of the AB and recruit members. Interested members completed a Google Form, which included fields on demographics, employer/title, and prevention experience. 6 individuals completed the form, and only 3 became active members. The 3 AB members self-reported as Latine or Hispanic, had varying degrees of post-secondary education, were 100% female, and all worked in the local school district. Their prevention experience ranged from none to Positive Behavioral Interventions and Supports (PBIS), prevention-based trainings, and work with higher risk youth. Six previously developed research-to-practice tools were sent to the AB: Fidelity, Adapting EBPs Part 1, Adapting EBPs Part 2, Cultural Adaptations Part 1, Cultural Adaptations Part 2, and Program Sustainability. We asked for feedback on adaptations necessary to be relevant for prevention practitioners in the San Luis Valley, which is largely Latine/Hispanic and rural. A feedback form was created for each tool that went page-by-page asking for recommendations and culminated with items that asked about the usability of the tool, likelihood of sharing the tool, whether the tool should be translated into Spanish, general tool feedback, and considerations when hosting programs, trainings, and events in the SLV. Once submitted, the CSU team would review feedback and strategize how to incorporate AB member ideas. The primary feedback from AB members was to translate each tool into Spanish. Other recommendations included changing an image that represents diversity, rewording a definition to use less technical jargon, and adding prompting questions to further promote a concept. Ultimately, there were less edits to these tools than our team anticipated, which we suspect is due to the generalizability of our tools. Our team is currently translating these tools and incorporating this feedback into both the Spanish and English versions. Also, the AB also provided feedback on considerations for local program implementation and TA activities (e.g., learning communities, trainings, etc.). We used this feedback when scheduling learning community events and to support our LC in coordinating program times and garnering donations for meals, snacks, and incentives for families. This year, 3 learning community events were conducted (also listed in RHSE 21 REEport due to overlapping efforts), with program coordinators/facilitators present from across the state. According to post-learning community survey results, 75% of respondents reported "a lot" when indicating to what extent the learning community addressed topics that would be useful in their role as a SFP 10-14/Familias Fuertes facilitator. Additionally, 37.5% reported "quite a bit" and 37.5% reported "a lot" regarding the extent to which the learning community improved their knowledge around SFP 10-14 or FF implementation. Lastly, noting the unique challenges of Latine immigrant communities face when adapting and implementing evidence-based prevention programs, we created a tool specific to this subpopulation. Within this almost finalized tool, we discuss the "why" behind cultural adaptations to EBPs, surface and deep structure adaptations, Latine cultural drivers to adaptations, and example adaptations that do not impact the program's theory of change. This tool is in the final stages of development and will be reviewed by an AB member before finalized, posted to our website, and disseminated.

Publications