Coping Together is a family strengthening intervention for families in the United States, adapted from Tuko Pamoja, the intervention developed and tested through our work in Kenya. It is a direct example of reciprocal innovation, an approach developed in a low-resource global setting brought to a United States community context.
In Coping Together, small groups of five or six families meet with trained lay facilitators from the community for eight sessions held virtually or in-person. Everyone in the family comes together, following a family systems approach in which the family is engaged as a whole. It is built for any families, but especially those facing multiple complex stressors. Families build communication, coping, problem-solving, and conflict resolution skills through interactive sessions including discussion, guided practice, and arts-based activities. Sessions use real-world examples to apply skills to daily life. Families create a shared family vision and goals to keep coping together after the program ends.
“Mainly the communication. I think that was our biggest piece, [before] not having the time to talk and not understanding each other. Once you get the communication piece down, at least for us, everything else falls in place.”
The work began in the first year of the COVID-19 pandemic, alongside a survey of 961 families across the southern United States. We then developed and tested the program with TRY, Together for Resilient Youth, in Durham, North Carolina. In a pilot with 18 families, community health workers delivered the sessions by videoconference. Families described positive changes in family functioning, relationship quality, and individual well-being, and their accounts supported our hypothesized pathway, in which improved communication provides the foundation for increased hope, problem solving, and coping. In the pre-post survey, small changes suggested improvements in family relationships. Results did not show evidence of immediate changes in mental health, though this group of families did not report high rates of mental health symptoms at the beginning. Results suggest Coping Together could fill a critical gap for addressing challenges in family relationships that can make a big difference in the lives of children and the adults who care for them.
Caminando Juntos
Caminando Juntos, "Walking Together," is the Spanish-language version of Coping Together, adapted for Latine immigrant families through extensive formative research with community organizations and parents themselves. Listening sessions surfaced the cultural strengths, contextual stressors, and specific needs to build into the program. We then adapted, translated, and prototyped the adapted components with community members. The first formal pilot studies of Caminando Juntos took place in Durham, North Carolina and Milwaukee, Wisconsin, with iterative feedback shaping revisions along the way. Bilingual facilitators delivered the program virtually, with results demonstrating high family engagement and overall high feasibility and acceptability. The findings support moving Caminando Juntos into wider delivery alongside the English-language Coping Together program.
With both an English and a Spanish version now developed and pilot tested, Coping Together is positioned for broader community roll-out and school-based implementation, alongside larger-scale evaluation.
Key Publications
Puffer, E. S., Johnson, S. L., Quick, K. N., Rieder, A. D., Mansoor, M., Proeschold-Bell, R. J., et al. (2022). Family strengthening in the context of COVID-19: Adapting a community-based intervention from Kenya to the United States. Prevention Science, 25(2), 267–278.
Johnson, S. L., Rieder, A. D., Rasmussen, J. M., Mansoor, M., Quick, K. N., Proeschold-Bell, R. J., et al. (2024). A pilot study of the Coping Together virtual family intervention: Exploring changes in family functioning and individual well-being. Research on Child and Adolescent Psychopathology, 52, 1047–1062.
Puffer, E. S., Mansoor, M., Rieder, A. D., Johnson, S. L., Quick, K. N., Rasmussen, J. M., et al. (2025). Embedding positive emotions activities in a family-strengthening intervention to enhance receptivity and engagement. Journal of Prevention and Health Promotion, 6(2), 301–334.
Johnson, S. L., Quick, K. N., Rieder, A. D., Rasmussen, J. D., Sanyal, A., Green, E. P., Duerr, E., Nagy, G. A., & Puffer, E. S. (2024). Social vulnerability, COVID-19, racial violence, and depressive symptoms: A cross-sectional study in the southern United States. Journal of Racial and Ethnic Health Disparities, 11(6), 3794–3806.
If you are interested in partnering on implementation or research related to Coping Together and Caminando Juntos, please reach out to Eve Puffer at eve.puffer@duke.edu.