Preventing substance misuse: Randomised Controlled Trial of the Strengthening Families 10-14 Programme

Lead Research Organisation: Cardiff University
Department Name: Research and Commercial Division

Abstract

Misuse of alcohol, tobacco and illegal drugs by young people impacts on their health in the short and long term, and is also associated with anti-social behaviour, crime and drop out from school. Many risk and protective factors for substance misuse in young people are located in the family. The Strengthening Families 10-14 UK programme aims to strengthen areas of family life that protect against substance misuse (parenting, communication, and young people?s resilience skills). The study will identify whether the programme delays or reduces substance use, and collect information that will help in wider implementation of the programme if successful.

Technical Summary

Adolescent risk behaviour, including substance misuse (alcohol, tobacco and illegal drugs), anti-social behaviour and crime has a substantial impact on the UK economy and the health of its population. These behaviours are associated with morbidity and mortality among adolescents, poor education, social exclusion and health damaging behaviours, and poor health over the life course. They contribute substantially to social inequalities in health in adolescence and adulthood.

This research application is for a randomised controlled trial of a substance misuse prevention intervention ? the Strengthening Families Programme (SFP) 10-14 UK. The SFP10-14 for young people aged 10-14 years and their parents is a population-based universal prevention programme for alcohol, tobacco and drug misuse in young people. Research in the United States has found the SFP10-14 to be effective in delaying the onset of alcohol use, and reducing levels of smoking. In other studies, later onset of alcohol and drug use has been shown to be associated with reduced lifetime prevalence of alcohol and drug problems. US-based cost-benefit assessments have indicated that the SFP10-14 can be cost-effective at the population level for preventing alcohol misuse, other alcohol problems and also for tobacco use prevention. The SFP10-14 is thus a promising intervention and has recently been culturally adapted for use in the UK where it is gaining popularity. However, the current evidence base for the programme is derived exclusively from the US from just two trials conducted by the same research team, and there is a need to evaluate the SFP10-14?s effectiveness in a UK context, particularly in relation to the contrasting legislative frameworks and cultures surrounding alcohol in this country.

The proposed trial will take place in six local authority areas in Wales. Families who are referred to the programme will be screened for eligibility before being allocated to intervention/control groups. Key outcome measures (measured at 2 years) will include: number of occasions young people report ever having been really drunk; reported use of cannabis; weekly smoking; unauthorised absence from school; GCSE performance; and age of initiation of alcohol and tobacco consumption. A process evaluation of programme delivery will be undertaken to examine fidelity and acceptability of the intervention to participating families, and key changes in family functioning. Economic analysis will also be conducted to examine the cost effectiveness of the SFP10-14. Findings from the research will be used to directly inform policy and practice in the field of substance misuse prevention.
 
Description Submitted written and oral evidence to Advisory Panel on Substance Misuse Alcohol Sub Group 2011
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
 
Description Collaboration with Welsh Government during SFP Trial 
Organisation Government of Wales
Country United Kingdom 
Sector Public 
PI Contribution The RCT of the Strengthening Families Programme (G0802128) will provide important evidence for policy making. We have built strong relationships with key policy makers in Welsh Government to ensure that our findings can be translated into policy and practice. Welsh Government is currently seeking to ensure that funding for the SFP in trial areas is sustained until our results are available, and we are supporting them in this work (e.g. by liaising with programme delivery teams, and organising joint presentations with local authority funding bodies).
Collaborator Contribution We have benefitted greatly from strong support from Welsh Government since the beginning of the trial. This has included: financial support for programme delivery as part of the trial (£928k); high level policy support for the need to fund SFP delivery as part of an RCT; and advice on how best to disseminate our findings to maximise their impact on policy and practice.
Impact Partnership with Welsh Government during the trial built upon existing strong relationships with policy makers and an exploratory study of the SFP in Cardiff, key aspects of which were used to inform our current trial. One publication resulted from this initial work: Segrott, J. (2013) 'Recruitment and group composition strategies for family-based substance misuse prevention interventions: an exploratory evaluation'. Journal of Children's Services..
Start Year 2007
 
Description Conference Poster, European Society for Prevention Research Conference (Palma) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact The poster - on key findings from a process evaluation of a family-based substance misuse prevention programme (Strengthening Families Programme 10-14 - SFP10-14) was part of a poster session at the conference. Delegates asked questions about the evaluation findings, and the methods used to assess implementation fidelity. A number of people took away further written information about the evaluation and the RCT which it forms part of.

One of the organisations present at the conference has asked for additional information about the evaluation to help inform their work on developing international guidelines on the implementation of family-based prevention programmes.
Year(s) Of Engagement Activity 2014
URL http://euspr.org/wp-content/uploads/2014/02/5th-EUSPR-Conference-Bookletv2.pdf
 
Description Conference Poster, Society for Prevention Research Conference, Washington DC 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Conference delegates from a range of countries read the poster and asked questions about the evaluation design and results.

Discussion with a conference delegate from Washington State, US, identified the potential for a collaborative research project comparing data from our project with a similar study in the US on fidelity of programme implementation.
Year(s) Of Engagement Activity 2014
URL http://www.preventionresearch.org/2014-annual-meeting/
 
Description Conference Presentation, UKCRC Conference (Leeds) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Presented findings from a process evaluation of a family-based substance misuse prevention programme (SFP10-14)

Following the presentation, a delegate who attended the presentation asked me to be a co-applicant on a research grant application for a study evaluating the SFP10-14 programme.
Year(s) Of Engagement Activity 2014
 
Description Conference presentation Programme fidelity in a large pragmatic trial: findings from a process evaluation of the Strengthening Families Programme 10-14 UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Talk sparked questions and discussion

None
Year(s) Of Engagement Activity 2013
 
Description Conference presentation at European Society for Prevention Research 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The presentation - on the group composition, group dynamics and intervention implementation generated a large amount of interest, and several requests to present the work to research teams with an interest in this area.
Year(s) Of Engagement Activity 2016
URL http://euspr.org/euspr-2016/
 
Description J Segrott DECIPHer Symposium Nov 2012 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Poster Presentation
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact DECIPHer Symposium 16.11.12 Poster given by J.Segrott "Recruitment by local practitioners to a pragmatic effectiveness trial of the Strengthening Families Programme (SFP10-14) in Wales, UK"

N/A
Year(s) Of Engagement Activity 2012
 
Description J Segrott Welsh Assembly Presentation Oct 2012 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact This talk was given to members (AMs) of the Welsh Assembly and their research staff, and forms part of a series of talks aimed at highlighting the relevance and importance of research conducted at Cardiff University. The talk highlighted the importance of evaluating new interventions and the practical relevance of the SFP trial for assembly members and their staff.

N/A
Year(s) Of Engagement Activity 2012
 
Description JSe: Presentation of research findings from RCT of Strengthening Families Programme 10-14 to Wales National Parenting Coordinators' Network 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Key findings from the randomised controlled trial of the Strengthening Families Programme 10-14UK (SFP10-14UK) were presented to the Wales National Parenting Coordinators' Network. The presentation generated debate about the effectiveness of the programme, and how local services might respond to the findings from the trial. During the discussion we also identified opportunities to collaborate with the organisation hosting the network - Children in Wales, on future research in relation to parenting support.
Year(s) Of Engagement Activity 2015
 
Description JSe: Presentation of research findings from RCT of Strengthening Families Programme 10-14 to regional leads for each Area Planning Board across Wales 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Findings from the randomised controlled trial of the Strengthening Families Programme 10-14 UK (SFP10-14UK) were presented to the regional leads of the seven Area Planning Boards (APBs) across Wales. APBs are responsible for commissioning services in the field of substance misuse prevention such as SFP10-14UK. The presentation generated considerable discussion and questions about how the APBs might utilise the findings from the trial, and whether or not funding should continue to be provided for the programme.
Year(s) Of Engagement Activity 2015
 
Description JSe: Presentation to Dyfed Substance Misuse Area Planning Board, Carmarthen, UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Findings from the randomised controlled trial of the Strengthening Families Programme 10-14UK (SFP10-14UK) were presented to the APB Children, Young People & Families Sub Group of the Dyfed Substance Misuse Area Planning Board (APB). The APB is one of the key bodies responsible for commissioning of substance misuse services across the south west Wales region. The presentation generated a number of questions about the findings from the trial, particularly the merits of universal versus targeted approaches to the delivery of prevention interventions.
Year(s) Of Engagement Activity 2015
 
Description Member of the DWP and Dept of Health Expert Advisory Group for Work and Health Westminster 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Attendance at meetings, Presentation to Damian Green Secretary of State for Work and Pensions and Penny Mordaunt Minister for Disabled People
Year(s) Of Engagement Activity 2016,2017
URL https://www.gov.uk/government/consultations/work-health-and-disability-improving-lives/work-health-a...
 
Description Participant newsletters 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach Regional
Primary Audience Participants in your research and patient groups
Results and Impact Regular newsletters to trial participants to keep them informed on what is happening with the trial

N/A
Year(s) Of Engagement Activity 2010,2011,2012,2013
URL http://www.projectsfpcymru.co.uk
 
Description Professional's newsletters 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach Regional
Primary Audience Supporters
Results and Impact Regular newsletters to professionals with an interest in the trial (such as referrers or practitioners) to inform them of update regarding Project SFP Cymru

N/A
Year(s) Of Engagement Activity 2010,2011,2012,2013
 
Description SFP - National Eisteddfod 2010 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Segrott J. Rhaglen Cryfhau Teuluoedd/Strengthening Families Programme. Pafiliwn Prifysgol Caerdydd, Eisteddfodd Genedlaethol (Cardiff University Pavilion, National Eisteddfod) 2010

N/A
Year(s) Of Engagement Activity 2010