Results

1. Parental Involvement in School-Based Alcohol Prevention: Exploratory Trial of the Kids, Adults Together (KAT) Programme in South East Wales, UK Dr. J. Segrott1, Prof. M. Hickman2, Dr. S. Murphy, Dr. R. Playle3, R. Cannings-John3, H. Reed1, A. Flicker1, H. Rothwell1, Prof. L. Moore1 • Methods • RCT with embedded process evaluation includes • assessment of: • intervention feasibility and implementation; • intervention participation and reach; • trial recruitment and retention. • Introduction • Involvement of families in prevention programmes is important because family relationships and functioning are key influences on children’s • behaviour. • Young people in the • UK have one of the • highest levels of • alcohol misuse in • Europe 2;3 and early • prevention is a priority. • School-based programmes have had limited success in engaging families45 • In a pilot study conducted in two primary schools, The Kids, Adults Together (KAT) programme attracted 40-50 adult family members to family evenings. The Social Development Model6 explained how it might reduce alcohol misuse through improving family communication7. • Therefore an exploratory trial of KAT has been conducted in South East Wales, UK, to test the value and feasibility of an effectiveness trial. Figure 1: KAT programme components Conclusions KAT achieved high rates of parental participation which compare well with other such interventions, e.g. Blueprint (England) 8 Family Links nurturing Programme (South Wales ) 9 and Unplugged (European international EU-DAP study) 5;10. KAT can involve parents from all socioeconomic groups, although some scope remains for achieving a more equal balance of participation . The unusually high rate of parental participation combined with high rates of pupil participation suggest that any future effectiveness trial would have a low risk of implementation failure. Recruitment and data collection procedures for the exploratory trial were adequate and acceptable. The trial has enabled us to identify aspects which could be improved to increase efficiency in any effectiveness trial. The importance of involving parents as research participants in any future study needs careful consideration because significant resources would be needed to improve recruitment and retention rates achieved in the current study. Figure 2: KAT study design Figure 3: Schools were stratified by size and free school meal (FSM) entitlement and these variables were used to balance the randomisation. • Results Feasibility: Many teachers spoke positively about how KAT was easily integrated into their school week and curriculum.The delivery of KAT appeared to be facilitated by its strong links with the PSE and science curriculum, which also helped to build the structure and substance of KAT. Some schools felt KAT made curriculum topics become more interesting to pupils. • Intervention participation rates: • Of pupils who provided information at follow-up (n=158) • 94% did all (71%) or part (23%) of the KAT classwork • 60% attended the KAT events • 50% said that members of their family had attended the • KAT family event • Head teachers were surprised and pleased at numbers of families • who attended the KAT events. Trial participation rates: Literature cited Foxcroft DR, Tsertsvadze A. Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews. Perspectives in Public Health 2012;132:128-134. (2) Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C et al. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. 2012. Copenhagen, WHO Regional Office for Europe. Health Policy for Children and Adolescents, No. 6. Ref Type: Report (3) Hibell B, Guttormsson U, Ahlstrom S, Balakireva O, Bjarnason T, Kokkevi A et al. The 2007 ESPAD Report: Substance Use Among Students in 35 European Countries. 2009. Stockholm, The Swedish Council for Information on Alcohol and Other Drugs (CAN). Ref Type: Report (4) van derKreeft P, Wiborg G, Galanti MR et al. 'Unplugged': A new European school programme against substance abuse. Drugs EduPrevPol 2009;16:167-181. (5) Faggiano F, Vigna-Taglianti F, Burkhart G et al. The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial. Drug and Alcohol Dependence 2010;108:56-64. (6) Catalano RF, Hawkins JD. The Social Development Model: A Theory of Antisocial Behavior. In: Hawkins JD, ed. Delinquency and Crime: Current Theories. Cambridge: Cambridge University Press; 1996;149-197. (7) Rothwell H, Segrott J. Preventing alcohol misuse in young people aged 9-11 years through promoting family communication: an exploratory evaluation of the Kids, Adults Together (KAT) Programme. BMC Public Health 2011;11:810. (8) Blueprint Evaluation Team. Blueprint drugs education: the response of pupils and parents to the programme. 2009. University of Stirling. Ref Type: Report (9) Simkiss DE, Snooks HA, Stallard N et al. Measuring the impact and costs of a universal group based parenting programme: protocol and implementation of a trial. BMC Public Health 2010;10. (10) Faggiano F, Richardson C, Bohrn K, Galanti MR. A cluster randomized controlled trial of school-based prevention of tobacco, alcohol and drug use: The EU-Dap design and study population. Preventive Medicine 2007;44:170-173. Figure 4: The schools with higher free school meal rates had higher participation rates Next steps Criteria relating to feasibility of implementing KAT and more extensive evaluation in a larger sample of schools have been developed as a basis for a decision on whether to seek further funding and support for an effectiveness trial. Figure 6: High rates of pupil participation could have been improved if researchers had returned to collect data from absentees. Parental participation rates were low. The total population was conservatively estimated at 418. Fifty-three (13%) were recruited and of these, only 27 (6%) went on to complete interviews.. Figure 5: . . but within schools, more affluent families were more likely to participate Acknowledgements DECIPHer is a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council (RES-590-28-0005), Medical Research Council, the Welsh Government and the Wellcome Trust (WT087640MA), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This poster presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Further information Dr. Jeremy Segrott Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD +44 (0)29 20 870184 http://bit.ly/10Oaek4 http://www.drjeremysegrott.weebly.com @DrJeremySegrott 1Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University 2School of Social and Community Medicine, Bristol University 3South East Wales Trials Unit (SEWTU), School of Medicine, Cardiff University