The Family to Family program: a structural intervention with implications for the prevention of HIV/AIDS and other community epidemics

Objectives: To describe a case study of a community-based intervention loca ted in the Harlem community of New York City, one of the oldest African-Ame rican communities in the United States. Although not specifically designed to prevent HIV infection, the program, 'Family to Family', exemplifies a 's tructural intervention' that was created to strengthen family functioning a nd to strengthen the bonds that connect families to each other. By fosterin g strong relationships within and between families in a community with high rates of violence, drug abuse, and HIV infection, the program seeks to imp rove the quality of neighborhood life and influence the social determinants of individual risk behavior. Social capital: Family to Family was created specifically to develop the 's ocial capital' that is available to children and families in the Harlem com munity. Social capital refers to resources that result from social relation ships, and that enhance an individual's or a group's ability to function an d achieve a given set of goals and objectives. In addition to fostering clo ser relation ships between children and their parents, this program also wo rks to help participating families develop closer relationships with other participating families and with Columbia University student and faculty vol unteers. Finally, Family to Family is sustained through the efforts of volu nteers; it receives no grant support and is entirely self-supporting. Conclusions: Family to Family has the potential to change the social dynami cs that promote HIV risk behavior in communities such as Harlem. Should it prove successful in improving the relationships between families and childr en, and in increasing the social capital available to all of its participan ts, it may become an important asset to public health prevention specialist s concerned about preventing the spread of HIV. (C) 2000 Lippincott William s & Wilkins.