This study addressed 5 research questions about the role of implementation (dosage and fidelity) and process (alliance with the provider, and satisfaction/engagement with the intervention) characteristics in explaining effects on parenting characteristics targeted by a selective family-focused violence prevention program for high-risk, socially influential, middle school youth. The intervention was part of a multisite trial involving random assignment of 37 schools to 4 conditions: (a) a universal intervention composed of a student social-cognitive curriculum and teacher training, (b) this selective intervention, (c) a condition combining these two interventions, and (d) a no-intervention control condition. The present study uses data from 334 participating families who attended at least 1 intervention session at which process measures of alliance with the provider and satisfaction with the intervention were administered. Although parent and child alliance with the provider and satisfaction with the program increased over the course of the intervention, these process characteristics were not associated with higher levels of intervention attendance. Higher intervention dosage was associated with more positive change in the parenting characteristics targeted by the intervention. Process characteristics had mixed positive and negative effects that were limited to a single outcome. Within structured, manualized, family-focused preventive efforts, as contrasted with less structured therapeutic interventions, these findings suggest that monitoring and improving program dosage may have stronger effects on parenting practices than improving therapeutic alliance or engagement in the intervention.

This supplement highlights the efforts of Morehouse School of Medicine's Prevention Research Center and its partners to reduce the disparities experienced by African American women for breast and cervical cancer in Georgia, North Carolina and South Carolina. The project (entitled the Southeastern U.S. Collaborative CEED, or SUCCEED) is supported by a Centers for Disease Control and Prevention (CDC) grant to establish a Center of Excellence in the Elimination of Disparities (CEED). This introductory paper provides an overview describing the project's goals and core components and closes by introducing the adjoining papers that describe in more detail these components. The program components for SUCCEED include providing training and technical assistance for implementing evidence-based interventions for breast and cervical cancer; supporting capacity-building and sustainability efforts for community-based organizations; promoting the establishment of new empowered community coalitions and providing advocacy training to cancer advocates in order to affect health systems and policies.

This study reports the findings of a multisite randomized trial evaluating the separate and combined effects of 2 school-based approaches to reduce violence among early adolescents. A total of 37 schools at 4 sites were randomized to 4 conditions: (1) a universal intervention that involved implementing a student curriculum and teacher training with 6th-grade students and teachers, (2) a selective intervention in which a family intervention was implemented with a subset of 6th-grade students exhibiting high levels of aggression and social influence, (3) a combined intervention condition, and (4) a no-intervention control condition. Analyses of multiple waves of data from 2 cohorts of students at each school (N = 5,581) within the grade targeted by the interventions revealed a complex pattern. There was some evidence to suggest that the universal intervention was associated with increases in aggression and reductions in victimization; however, these effects were moderated by preintervention risk. In contrast, the selective intervention was associated with decreases in aggression but no changes in victimization. These findings have important implications for efforts to develop effective violence prevention programs.

Two studies were conducted to explore the degree to which single- and multiple-risk profiles were evident in samples of African American early adolescents in low-income inner-city, rural, and suburban schools. Study 1 examined early adolescent risk status (i.e., single, multiple) in relation to later adjustment in a representative sample (70% European American, 30% African American). Youth who experienced a single risk in early adolescence had moderately increased levels of school dropout and criminal arrests, whereas youth with multiple risks (i.e., combination of 2 or more risks) had significantly increased levels of school dropout, criminal arrests, and teen parenthood. Study 2 examined the extent to which single- and multiple-risk profiles were evident in cross-sectional samples of African American youth from low-income inner-city and rural areas. About one fourth of both the inner-city and rural samples of African American youth were composed of youth in the single-risk category. A significantly greater proportion of boys in the inner-city sample (20%) than boys in the rural sample (13%) experienced multiple risks. Girls across the rural and inner-city samples did not differ in terms of risk. Overall, more than 60% of African American youth in these two low-income samples did not evidence risk for later adjustment problems. Implications for research and intervention are discussed.

Two studies were conducted to explore the degree to which single- and multiple-risk profiles were evident in samples of African American early adolescents in low-income inner-city, rural, and suburban schools. Study 1 examined early adolescent risk status (i.e., single, multiple) in relation to later adjustment in a representative sample (70% European American, 30% African American). Youth who experienced a single risk in early adolescence had moderately increased levels of school dropout and criminal arrests, whereas youth with multiple risks (i.e., combination of 2 or more risks) had significantly increased levels of school dropout, criminal arrests, and teen parenthood. Study 2 examined the extent to which single- and multiple-risk profiles were evident in cross-sectional samples of African American youth from low-income inner-city and rural areas. About one fourth of both the inner-city and rural samples of African American youth were composed of youth in the single-risk category. A significantly greater proportion of boys in the inner-city sample (20%) than boys in the rural sample (13%) experienced multiple risks. Girls across the rural and inner-city samples did not differ in terms of risk. Overall, more than 60% of African American youth in these two low-income samples did not evidence risk for later adjustment problems. Implications for research and intervention are discussed.

This paper reports on the social relations of rural African American early adolescents and the initial impact of a multilevel universal intervention program aimed at enhancing the productive school engagement of at-risk youth. Students' school social relations were assessed with social cognitive mapping procedures that yield information on peer group membership and social network centrality (i.e., prominence in the social structure). Risk status was determined by cluster analysis of teacher ratings of students' adjustment on multiple dimensions including aggression, academic competence, and popularity. Four subgroups were identified: Model, Aggressive, Troubled, and Below Average. Differences among clusters were found in network centrality and patterns of peer affiliations. In addition, boys in the Below Average and Troubled configurations showed an increase in social prominence after the initial intervention phase.

Conducted a qualitative investigation to identify the perceptions of risk factors for violence in a sample of inner-city African American youth. Using ethnographic analyses, themes emerging from these data included concerns about the reciprocity between drugs and violence, familial quality of life issues, gender differences in the experience of violence and risk for violence, community safety concerns, and fears about managing peer relationships specific to violence. These data are interpreted relative to the risk factors the violence prevention literature has identified among youth residing in urban environments. Findings are discussed in terms of their potential contribution to generating hypotheses for the development of theory and effective violence prevention practice.

This paper reviews research which discusses the risk and protective functions that families and other caregivers provide in influencing the development of aggressive behavior in youth. Currently, there is an emphasis on providing violence prevention programs in the school environment, typically with little parental or caregiver involvement. By enhancing the role of families and caregivers in youth violence prevention programs, we assert that an unique opportunity exists to both address specific risk factors for violence while enhancing the protective features of the family. Relatedly, the risk literature on youth violence indicates that the most influential risk factors (i.e., the family, community, and peers) have their principle impact on youth aggression outside the school. We suggest a shift in the focus of violence prevention programming that is more inclusive of families as both a risk and protective agent. In support of this position, relevant theory and reviews of exemplary family-involved programs are offered. Challenges to involving youth caregivers are identified and recommendations for overcoming those challenges suggested. Last, recommendations for future research and public policy in the prevention of youth violence are offered.

Phinney's (1992) Multigroup Ethnic Identity Measure (MEIM) was administered to 118 African American children between the ages of 8 and 12 years who lived in an impoverished inner-city neighborhood. This study examined the scale's reliability in measuring feelings of ethnic affirmation and belonging, ethnic behaviors, and ethnic knowledge in a sample of urban children. Results of the reliability analyses were mixed, and indicated that the constructs of ethnic behavior and identity achievement were less stable in this population. Potential implications of differences in cognitive development and social experiences between younger children and adolescents as well as contextualfactors such as socioeconomic status are considered in the discussion of the results.