RCT of Fostering Healthy Futures for Preteens: Substance Use-Related Outcomes for Youth in Out-Of-Home Care

This study examined whether Fostering Healthy Futures for Preteens (FHF-P), a 9-month community-based mentoring and skills training program for children in out-of-home care, reduced risk factors for substance use.

A randomized controlled trial enrolled 270 participants aged 9-11 years who were placed in out-of-home care over the prior year. Participants were 47.4% female, 48.9% Hispanic, 47.8% White, 36.7% American Indian, and 24.8% Black. Interviews, which contained questions about positive and negative appraisals of substance use as well as affiliations with deviant and positive friends, were conducted at baseline (T1), 6-months post intervention (T2), and 1.5 years post intervention (T3). An exploratory analysis examined substance use and related problems among a subset of participants (n = 47) interviewed in young adulthood (T4); the rate of substance use was too low to examine these outcomes at earlier timepoints.

FHF-P participants, relative to controls, had greater prosocial friend affiliation at T2; at T3, they had less deviant friend affiliation and 65% lower odds of friends using substances. When examined within sex, significant intervention effects were only observed in the female subgroup. Although there were no group differences in substance use or related problems at T4, a significant interaction between baseline substance use and intervention status suggested that early substance use predicted later substance use and related problems only for the control group.

FHF-P had positive impacts on salient risk and protective factors for substance use and buffered the impact of early risk on young adult problematic substance use in a high-risk population.