Child and Parent Voices on a Community-Based Prevention Program (FAST) Melodie Fearnow-Kenney, Patricia Hill, and Nicole Gore Abstract Families and Schools Together (FAST) is a collaborative program involving schools, families, and community-based partners in efforts to prevent sub- stance use, juvenile delinquency, school failure, child abuse and neglect, mental health problems, and violence. Although evaluated extensively, there remains a dearth of qualitative data on child and parent perceptions of the FAST pro- gram. The present study helps to fill that gap with the implementation and evaluation of the FAST program using two school communities in Central Virginia. Qualitative data were collected via child focus groups and parent open-ended survey responses. Data were analyzed using a process called Con- cept Mapping. The results of this research are used to identify key strengths of the program components as well as potential adjustments to implementation arising from the views of child and parent participants. Particular attention is paid to the one-on-one “special play” as viewed from the target and non-target child. Relevance of these findings to the implementation and evaluation of other school–community programs are discussed. Key Words: prevention, children, Families and Schools Together, parents, com- munity, FAST program, voices, participants, family perspectives, qualitative Introduction Families and Schools Together (FAST) is a community-based, multifamily support program which begins with eight weeks of family sessions and then School Community Journal, 2016, Vol. 26, No. 1 223 Available at http://www.schoolcommunitynetwork.org/SCJ.aspx SCHOOL COMMUNITY JOURNAL transitions into a two-year follow up segment called FASTWORKS (McDon- ald et al., 1997). The program involves families of children ages five to twelve who request participation or have been identified by their schools as being at risk for academic failure and social problems. Developed in 1988 by Dr. Lynn McDonald, FAST is based on well-known theories of family systems, child development, and risk resiliency. The primary goals of the program are to en- hance family functioning, prevent substance abuse by the child and family, expand social relationships, increase parent involvement in school, improve parent–child relationships, prevent school failure, and improve child behavior (McDonald, Frank, & Price, 2006). FAST is backed by more than 15 years of evaluative research and has received recognition as an effective program from national organizations such as the Office of Juvenile Justice and Delinquency Prevention (OJJDP, n.d.) and the Substance Abuse and Mental Health Services Administration (SAMHSA, 2003). FAST has earned the designation of an effective program due to years of research documenting its effectiveness across diverse populations. Recent stud- ies have found it to be adaptable and effective with diverse cultural and ethnic groups such as European (McDonald, FitzRoy, Fuchs, Fooken, & Klasen, 2012), immigrant Latino (Guerra & Knox, 2008), low-income urban La- tino (McDonald, Moberg, et al., 2006), and American Indian families and children (Kratochwill, McDonald, Levin, Bear-Tibbetts, & Demaray, 2004). The latest FAST evaluations have demonstrated program effects on important outcomes, namely, prevention of child aggressive behavior (Guerra & Knox, 2008; Knox, Guerra, Williams, & Toro, 2011), promotion of child prosocial behavior (Crozier, Rokutani, Russett, Godwin, & Banks, 2010), enhancement of parent–child communication (Knox et al., 2011), and reduction of family stress (Ackley & Cullen, 2010). Evaluations of FAST, however, have not all demonstrated program suc- cess across all outcomes. For example, Knox and colleagues (2011) found no differences in aggression between FAST and control group children. Layz- er, Goodson, Creps, Werner, and Bernstein (2001) observed no differences in teachers’ report of positive changes in children who participated in FAST as compared to those in a control group, despite the fact that FAST parents reported improved behavior. In addition, there were few significant differenc- es between FAST and control families in the year following completion of the program (Layzer et al., 2001). Moberg and colleagues (2003) conducted a two-year randomized trial of FAST and observed significant improvements in academic outcomes but few other significant differences between the FAST and control children. 224 CHILD & PARENT VOICES ON FAST When proven preventive interventions fail to produce anticipated program effects, evaluators often examine issues related to fidelity of implementation and consumer (participant) experience (e.g., Olds, Sadler, & Kitzman, 2007). Fidelity has been defined as the degree to which programs are implemented as program developers intended (e.g., Fagan et al., 2011). Programs differ in terms of how much of the program can be adapted and still retain a high de- gree of effectiveness. According to the program developers (McDonald et al., 2012), 60% of FAST can be adapted. Core components make up only 40% of the group processes, lending a fair amount of room for local adaptations. FAST teams are actually encouraged by the developers to adapt the program to the needs of the community they are serving as one way of respecting the cultural values of the participants. Therefore, a need exists for a systematic method of determining which, if any, adaptations should be made by FAST teams. A few recent evaluations have attempted to address this need by collecting qualitative program feedback from FAST parents. Knox and colleagues (Knox et al., 2011) conducted two parent focus groups in which FAST parents re- ported, after participation in FAST, that they were better able to relate to and communicate with their children, and they saw improved behavior particu- larly among their older children. Similarly, Ackley and Cullen (2010) used the open-ended parent comments provided as part of the FAST, Inc. Evaluation Report as evidence of consumer satisfaction. With the exception of these two publications, there remains a dearth of research on parent perspectives of the FAST program, and there is no research on the FAST process and outcomes from the voice of child participants. The scarcity of qualitative data on child and parent perceptions of the FAST program exists despite evidence to suggest that the success of a program de- pends in large part on the degree to which parents’ and children’s concerns and motivations are integrated into the implementation design (Olds et al., 2007). The current study contributes to the FAST research base by being the first to assess and analyze the child, as well as parent, perspectives of the program from two community implementations. The first aim of this paper is to examine child qualitative feedback on the FAST program. The authors have particular interest in child perceptions re- garding the “special play” that is a core component of the FAST program. During “special play,” a designated target child participates in one-on-one, parent-mediated play, while the non-target children engage in supervised free- play (McDonald et al., 1997). The play period lasts 15 minutes, and parents are instructed to focus on child-initiated play without directing or criticizing. Parents are encouraged to continue “special play” between FAST sessions and over the next 2 years. It was hypothesized that non-target siblings would have 225 SCHOOL COMMUNITY JOURNAL negative reactions to not being the “special play” child and may feel jealous of the special time that the target child experiences with the parent. Therefore, child focus group interviews were conducted separately with target and non- target children. These qualitative data are expected to provide valuable insight on the child FAST experience that can be used to make adaptations to the FAST sessions and potentially impact outcomes of all participating children. A second aim of this paper is to summarize the qualitative data that is typi- cally collected at the end of a FAST cycle as “parent comments” on the Kids FAST evaluation questionnaire (McDonald & Creer, 2012, 2013). Parents are asked to rate their satisfaction with the FAST program and experience with the FAST target child. These data provide important information about unmea- sured outcomes and ideas for future program implementation from the parent perspective. Method Participants Participants were children and parents/grandparents from two communities near Richmond, Virginia. Nine families participated in the FAST program at an elementary school in an urban community. Eleven families participated at a second school that is located in a rural community. Demographic characteris- tics of evaluation participants are presented in Table 1. Some families were not in attendance when focus groups and questionnaires were conducted; there- fore, the values in Table 1 reflect a subset of program participants at each site. Table 1. Demographic Characteristics of Participants Group Gender Age Ethnicity Mean: 8.08 Target (“Special 38.5% (5) male 100% African Mode: 8.00 Play”) Children 61.5% (8) female American Range: 6–11 Mean: 9.67 Non-Target 55.6% (5) male 100% African Mode: 8.00 Children 44.4% (4) female American Range: 7–13 69% African Amer. 25% (4) male Mean: 37.85 6.3% Amer. Indian/ Parents/ 62.5% (10) female Mode: ≤ 32 Alaskan Native Guardians 12.5% (2) missing Range: ≤ 32 – ≥ 32 12.5% Caucasian/ White 226 CHILD & PARENT VOICES ON FAST Design and Procedure Child Procedures and Parent Consent All questions, consent forms, and procedures for this study were approved by a review committee of the sponsoring community organization and the partnering school. The evaluator and FAST coordinators worked together to develop focus group guidelines and eight questions with prompts for the child focus groups. At the beginning of each FAST cycle, the evaluator met with parents at both sites to discuss the child focus group questions and procedures. Parents were able to ask questions and provide parental consent for their chil- dren to participate via written consent. Although the children at each site did not meet the evaluator at that time, they saw her interacting with the FAST coordinators and parents. At the last session of the FAST cycle, the evaluator conducted two separate child focus groups at each community site: one for the target/“special play” children and one for the non-target children. Focus groups were selected as the data collection strategy for two important reasons: (1) to minimize any child discomfort related to meeting alone with an unknown adult, and (2) to maximize child interactions which can lead to rich data (Horowitz et al., 2003; Stafstrom, Havlena, & Krezinski, 2012). Focus groups were held in a class- room or cafeteria of the school that hosted the FAST program the children were attending; thus, the environment was familiar to them. The evaluator and introduction to the focus groups were presented to the children by the FAST facilitators who had worked with the children during the FAST cycle. The eval- uator/focus group facilitator was well trained in focus group methods and had more than 20 years of experience interacting with diverse groups of children in school and community programs. Children were asked to provide feedback on the FAST program in their own words. Several steps were taken to prevent socially desirable responses, in- cluding: (1) explanation regarding the confidentiality of responses, (2) use of focus group questions that illicit both positive and negative valuations of the program/experiences, (3) assurance that “there are no right or wrong answers,” and (4) validation of all child responses, positive or negative. The child focus group questions mirror the open-ended questions completed by parents on the adult evaluation survey. The evaluator took notes and audio recorded the focus groups, which each took about 30 minutes to complete. Audio recordings were deleted after transcription. The questions with prompts were: 1. What did you like most about FAST? What do you enjoy most that in- volves the entire family? 227 SCHOOL COMMUNITY JOURNAL 2. What did you like least about FAST? What did you not like? 3. What would you change about the program if we were to start over? What would you add to the program? What would you take out? 4. Do you ever think about FAST on non-FAST days? When? Can you give examples? 5. Has being in FAST changed anything between you and your family? Can you give examples of things that have changed? 6. Has being in FAST changed anything related to your friends? Has it changed how you make friends or how you communicate with friends? 7. What did you think of the “special play” time? 8. Can you tell me anything that happened in your life as a result of partici- pating in FAST? Adult Procedures At the end of each FAST cycle, parents completed a questionnaire that is part of the Kids FAST evaluation (McDonald & Creer, 2012, 2013). In addi- tion to ratings on targeted program outcomes, parents provided open-ended feedback on program impact and what they enjoyed most and least about FAST. The questions are listed below: 1. What has been most valuable about your FAST experience? 2. What kind of changes have you seen in your FAST child since attending FAST? 3. Has the FAST program and/or team helped you? Please explain. 4. Has being in FAST changed your relationship in any way with the following? -FAST child -Spouse/partner -School personnel -Other FAST parents -Community agencies/organizations 5. What did you most enjoy about FAST? 6. What did you enjoy least about FAST? Two additional questions asked about what the participant’s child enjoyed most and least about FAST, but because the children answered these questions for themselves, the parent responses are not presented here. Analyses The procedure used to analyze and organize the children’s focus group data and the open-ended parent feedback is known as Concept Mapping. This methodology is often used by social scientists and others to interpret qualita- tive input from multiple participants (Trochim, Cabrera, Milstein, Gallagher, 228 CHILD & PARENT VOICES ON FAST & Leischow, 2006; Trochim, Marcus, Mâsse, Moser, & Weld, 2008). The re- sulting “maps” provide a framework or structure for guiding action planning or, in this case, informing program developers and implementers of program components that seem to be working and those in need of revision or adapta- tion for a particular target group (e.g., school or community). Transcripts of the children’s focus groups and the parent open-ended feedback were reviewed by the evaluation team (i.e., evaluator and FAST coordinators), and responses were sorted into groups corresponding to the questions asked of the children and parents. Similar ideas or feedback were combined and given a descriptive label. A concept map (graphic illustration) was created for each of the three groups (i.e., target children, non-target children, and parents) to structure the concepts within the questions/categories. Relationships between concepts were represented with connecting arrows, and responses receiving multiple en- dorsements are presented in bold. Despite the urban/rural differences between the two FAST sites, qualitative feedback across the two sites was very similar. Therefore, the results presented are collapsed over sites as is recommended by the FAST developers (McDonald et al., 1997). The concept maps for target children, non-target children, and parents are presented in Figures 1–3. Results Target (“Special Play”) Children Insights from the two groups of target children are depicted in Figure 1. Target children reported enjoying most aspects of the FAST program includ- ing gym/outside time, the dinners, spending time with family, the “special play” time, songs, and playing games. A few children reported not liking the “Hello” song, having to go home, “having to stop playing with [siblings] be- cause of the ‘special play’ time,” and “having to go to the library and not go to the gym.” Suggested changes to the program were to add more free time to play with friends, increase the length of the program (i.e., the time of each session), and add more interesting songs. Improvements in parent/family re- lationships included being closer to family, better communication, getting along better, and doing more things together. Improvements in relationships with friends included better communication, respecting others, having more friends, choosing friends more wisely, and being able to speak up to bullies. “I am happy that I am playing with so many kids.” Changes in their lives as a re- sult of participating in FAST were making better decisions, knowing how to control anger, getting smarter/better grades, being closer to family, and being happier. “Me and my family are closer.” 229 SCHOOL COMMUNITY JOURNAL Figure 1. Target child concept map. Non-Target Children As illustrated in Figure 2, non-target children enjoyed being active/playing, getting help with homework, having fun conversations, playing games with their families, and talking about feelings. They did not like when the FAST routine had to be changed, and a few did not like having to do homework while attending a FAST session (because a parent said they must do it). Rec- ommended changes were to make the program longer, provide healthier foods, and allow for more free time with parents to play games. Most non-target children reported having closer relationships with parents since participating in FAST, communicating more and better with family members, and treating family members better. Since participating in FAST, non-target children reported being better at identifying friends, being a good friend, and communicating better. They felt they had a more positive attitude and handled conflict better as a result of the FAST program. They also reported having more friends, including friends they made through FAST. 230 CHILD & PARENT VOICES ON FAST When discussion turned to the “special play,” non-target child feedback was conflicted. Younger siblings stated that the “special play was not fair,” and “I was upset and mad that my brother got to go in there [for “special play”] with my mom.” Some reported dissatisfaction with not being able to play with the sibling because she/he had to leave a game or activity to attend the “special play” time: “I wanted to play with my brother, but he had to leave.” However, older non-target children, especially those who reported being the target child in previous FAST cycles, stated that “special play is fair because she [sibling] is younger.” They also explained that it was the younger sibling’s turn because “I had special play before.” Figure 2. Non-target child concept map. Parents Overall themes identified from parent open-ended responses on the Kids FAST evaluation questionnaire (McDonald & Creer, 2012, 2013) are depicted in Figure 3. Parents enjoyed spending quality time with family members, the parent-only component, developing friendships with other parents, and “spe- cial play.” “The most valuable experience was [that] FAST helped me make time to read my kids’ story books to them and to listen to them more than be- fore.” Parents were less fond of having the same session routine every week, and 231 2 S 3 C 2 H O O L C O M M U N I T Y J O U R N A L Figure 3. Parents concept map.