Mediation in a family-directed program for prevention of adolescent tobacco and alcohol use

Background. Family Matters is a universal intervention designed to prevent adolescent tobacco and alcohol use through involvement of family members an d by targeting family risk factors for tobacco and alcohol use. Previously reported findings suggest that the program reduced the prevalence of both a dolescent smoking and drinking in the 12 months after program completion. T his paper reports analyses conducted to identify the mediators through whic h the program influenced adolescent smoking and drinking. Methods. One thousand fourteen adolescents ages 12 to 14 years and their fa milies, identified by random-digit dialing, were entered into a randomized trial. Adolescents and their parents provided data by telephone for measuri ng mediator and behavioral variables at baseline, 3 months, and 12 months a fter program completion. Repeated-measures logistic regression with general ized estimating equations was used to assess mediation processes. Results. The program resulted in statistically significant changes in sever al substance-specific aspects of the family, such as rule setting about tob acco and alcohol use. However, the intermediate family effects did not acco unt for the program effects on adolescent behavior. Conclusions. The variables hypothesized to explain program effects were not identified by direct empirical examination. (C) 2001 American Health Found ation and Academic Press.