GMI_ALC: Developing a teacher training programme for a Group Motivational Interviewing intervention to prevent alcohol misuse in secondary schools

Encouraging young people to develop healthy lifestyle habits and reduce unhealthy or risky behaviours is important for improving health across the life course. Alcohol use during adolescence has been shown to track into later adulthood and so may increase the likelihood of long-term harms to health. Although there have been reductions in adolescent alcohol use over the past decade, it is still a public health priority to prevent young people from initiating alcohol use and to reduce existing alcohol use. Young people begin to experiment with alcohol as young as 13 years old so interventions to reduce alcohol are needed during this period of young adolescence. In secondary school, adolescents usually receive a form of personal and social education [PSE] to provide them with the knowledge and skills for healthy living. However, there is a lack of evidence as to the most effective educational approaches to support healthily behaviours, although motivational interviewing shows some potential.

This study will explore the use of a new approach to PSE, which is based on Group Motivational Interviewing [GMI], with a focus on alcohol use. We have developed a GMI intervention in collaboration with students and teachers that can be used in a typical PSE session. The intervention encourages students to interact with each other and share their experiences in order to reflect on their personal motivations for and against alcohol use. It also encourages students to make responsible and well-informed decisions. Our initial work suggests that students value these learning opportunities and that the GMI intervention is an acceptable approach to alcohol education in secondary schools. However, in this initial work, the intervention was delivered by highly skilled and experienced facilitators. It would be unsustainable for schools to attempt to deliver the intervention in this way in the long-term.

As part of this study, we will build on our initial work to explore what resources and skills teachers need in order to be able to deliver the intervention, and in collaboration with teachers, students and other stakeholders we will develop a training package for teacher delivery of the intervention. Following this, we will test the training package with a small number of teachers, and will evaluate how acceptable the package is to them. We will also evaluate the delivery of the intervention by the trained teachers to Year 8 students. We will interview the trained teachers to find out how feasible they think delivering the intervention is, and we will run focus groups with students who received the intervention to find out what they think about it as well. Following these evaluations we will work with teachers, students and other stakeholders to finalise the intervention design. This research will not tell us whether the intervention is effective in reducing or preventing alcohol use, but it supports the development of the intervention which could then be evaluated in the future.

Aim: To develop a Group Motivational Interviewing [GMI] teacher training programme to support the Personal and Social Education [PSE] curriculum in preventing alcohol misuse in young people.

Design: Multi-phase participatory action-research.

Setting: Four secondary schools in Wales (purposively sampled by size and Free School Meal entitlement).

Target population: Students aged 12-13 years old (Y8).

Objectives: This study will build on preliminary development1 of a GMI alcohol misuse curriculum intervention. 1) To co-produce a feasible and acceptable teacher training programme for sustainable delivery of the GMI intervention via a stakeholder action group; 2) To deliver GMI training to teachers who have a responsibility for delivering PSE; 3) To undertake in-depth field testing of the training to assess fidelity of delivery of the GMI intervention by trained teachers, explore intervention feasibility and acceptability, and identify mechanisms of action. 4) Present results to a stakeholder group to finalise training format and intervention logic model for future evaluation.

Research Questions:
1) What are the core components of a PSE GMI training intervention for teachers?
2) Is this training feasible to deliver and acceptable to teachers?
3) Is the delivery of the GMI session by trained teachers consistent with MI principles and what are the key mechanisms of action?
4) Is the GMI session delivered by trained teachers acceptable to students and teachers?

Data sources: Consultation with stakeholder action group (RQ1); interviews with secondary school teachers (n=12) and trainers (n=2) (RQ2, RQ3, RQ4); structured observation (n=12) (RQ3); focus groups with students (n=8) (RQ4).

Public involvement & Engagement: Stakeholder action group to comprise secondary school teachers, students, public health practitioners from Health Promoting School Schemes, and Motivational Interviewing [MI] trainers.