The purpose of this pilot project, funded by the Pan American Health Organization (PAHO), the Swedish International Development Cooperation Agency (SIDA), and the Norwegian Agency for Development Cooperation (NORAD), is to improve the health and development of adolescents and to prevent high-risk behaviours associated with ill health (including sexually transmitted infections (STIs) and HIV/AIDS). El Salvador, the Dominican Republic, Honduras, Nicaragua, and Guatemala began participating as pilot countries in 2002 for this 2-year initiative. Organisers hope that, by the end of the programme, young people within participating families:
  • will choose adequate companions.
  • will show a greater ability to resist peer pressure.
  • will not begin to use drugs or will diminish their consumption of these substances.
  • will present safe sexual behaviour patterns (abstinence or use of condoms).
PAHO, SIDA, and NORAD also hope that, drawing on the interpersonal training they have received through the Strong Families curriculum, participating parents:
  • will increase their knowledge and capacity to resolve conflicts with their adolescent children.
  • will develop their capacity to demonstrate affection, while at the same time establishing clear behavioural rules.
  • will increase both their ability to monitor the routine behaviour and the capacity to listen to and understand the specific problems of their adolescent children.
Main Communication Strategies
"Strong Families: Family Orientation to Prevent Risk Behavior among Youth in Latin America and the Caribbean" works by strengthening parents' capacity to express love and set clear limits, and by improving youth capacity to better communicate with their parents and make healthy decisions. Interpersonal training sessions, enhanced by printed materials and video, are tools used to improve parent-child communication in support of good health.

The Strong Families curriculum has been developed as an adaptation and translation of the The Iowa Strengthening Families Program (ISFP) (this programme is now called "The Strengthening Families Program: For Parents and Youth (SFP 10-14)"). This programme includes seven 2-hour sessions for parents and youth, who attend separate skill-building groups for the first hour and spend the second hour together in supervised family activities. Youth sessions focus on strengthening goal setting, dealing with stress and strong emotions, communication skills, increasing responsible behaviour, and improving skills to deal with peer pressure. Parents discuss the importance of nurturing their youth while, at the same time, setting rules, monitoring compliance, and applying appropriate discipline. Topics include making house rules, encouraging good behaviour, using consequences, building bridges, and protecting against substance abuse.

Four booster sessions are designed to be used 6 months to 1 year after the end of the first 7 sessions, in order to reinforce skills. Youth Booster sessions focus on making good friends, handling conflict, and reinforcing skills learned in the first 7 sessions. Parent Booster sessions focus on handling parents' stress, communicating when partners do not agree, and reinforcing earlier skills training.

Parents of all educational levels are addressed (printed materials for parents are written at an 8th-grade reading level). Videotapes portraying prosocial behaviours are used throughout the curriculum and are designed to be appropriate for multi-ethnic families.

The Strong Families programme is using and drawing on this programme, developing culturally appropriate, Spanish-language materials for the sessions. These scripts and videotapes are being tested at the country level. In 2003, El Salvador validated the model, which is now being scaled up to the national level. The process of creating a locally adapted curriculum - and then evaluating its effectiveness - will be carried out in each of the pilot countries.
Development Issues: 

Youth, Parent-Child Communication, Interpersonal Conflict, Health, HIV/AIDS.

Key Points: 

PAHO claims that the Strengthening Families curriculum "has wide evidence of effectiveness", but acknowledges that its effectiveness has only been demonstrated in the United States. Another barrier is the fact that limited funds constrain the possibility of developing programmes that can then be tailored to specific cultural environments in the region.

In 2003, PAHO's Adolescent Health and Development Program (FCH/CA-ADH) developed a conceptual framework and strategies for a plan of action based on a life cycle approach in step with the rest of the Child and Adolescent Health (FCH/CA) Unit, as well as with adolescent determinants of health. The FCH/CA-ADH Plan of Action for 2003-2006 responds to the needs of adolescents and youth of both genders and different age groups between the ages of 10 and 24, and focuses on the most vulnerable adolescent populations in priority countries. The plan also seeks to address current and emerging needs in adolescent health, particularly in the areas of violence, teen pregnancy, STIs, and HIV/AIDS.

Partner Text: 



Letter sent from Sylvia Singleton to The Communication Initiative on March 15 2004; and the PAHO website; and the Strengthening Families Program website.