Effectiveness of the Strengthening Families Programme in the UK at preventing substance misuse in 10–14 year-olds: a pragmatic randomised controlled trial

Segrott, J. et al. (2022) Effectiveness of the Strengthening Families Programme in the UK at preventing substance misuse in 10–14 year-olds: a pragmatic randomised controlled trial. BMJ Open, 12(2), e049647. (doi: 10.1136/bmjopen-2021-049647) (PMID:35190414)

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Abstract

Objectives: The Strengthening Families Programme 10–14 (SFP10-14) is a USA-developed universal group-based intervention aiming to prevent substance misuse by strengthening protective factors within the family. This study evaluated a proportionate universal implementation of the adapted UK version (SFP10-14UK) which brought together families identified as likely/not likely to experience/present challenges within a group setting. Design: Pragmatic cluster-randomised controlled effectiveness trial, with families as the unit of randomisation and embedded process and economic evaluations. Setting: The study took place in seven counties of Wales, UK. Participants: 715 families (919 parents/carers, 931 young people) were randomised. Interventions: Families randomised to the intervention arm received the SFP10-14 comprising seven weekly sessions. Families in intervention and control arms received existing services as normal. Outcome measures: Primary outcomes were the number of occasions young people reported drinking alcohol in the last 30 days; and drunkenness during the same period, dichotomised as ‘never’ and ‘1–2 times or more’. Secondary outcomes examined alcohol/tobacco/substance behaviours including: cannabis use; weekly smoking (validated by salivary cotinine measures); age of alcohol initiation; frequency of drinking >5 drinks in a row; frequency of different types of alcoholic drinks; alcohol-related problems. Retention: primary analysis included 746 young people (80.1%) (alcohol consumption) and 732 young people (78.6%) (drunkenness). Results: There was no evidence of statistically significant between-group differences 2 years after randomisation for primary outcomes (young people’s alcohol consumption in the last 30 days adjusted OR=1.11, 95% CI 0.72 to 1.71, p=0.646; drunkenness in the last 30 days adjusted OR=1.46, 95% CI 0.83 to 2.55, p=0.185). There were no statistically significant between-group differences for other substance use outcomes, or those relating to well-being/stress, and emotional/behavioural problems. Conclusions: Previous evidence of effectiveness was not replicated. Findings highlight the importance of evaluating interventions when they are adapted for new settings. Trial registration number: ISRCTN63550893.

Item Type:Articles
Additional Information:Funding of £2.1 M from the National Prevention Research Initiative, managed by the Medical Research Council – award G0802128, included c.£650 k implementation costs. The NPRI funding partners are Alzheimer’s Research Trust; Alzheimer’s Society; Biotechnology and Biological Sciences Research Council; British Heart Foundation; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Engineering and Physical Sciences Research Council; Health & Social Care Research & Development Office for Northern Ireland; Medical Research Council; The Stroke Association; Welsh Government; and World Cancer Research Fund. A representative from the study funders was a member of the trial’s Independent Trial Steering Committee. The Welsh Government provided c.£675 k of partnership funding, to cover the cost of implementation in three trial areas, and the associated training and support provided by the Cardiff Strengthening Families Programme team. Further support from Welsh Government provided £208k to cover programme delivery in six trial sites from August 2011-July 2012. The Cardiff Strengthening Families Programme team also provided financial support for programme delivery and trial recruitment in schools. At the time of the study DECIPHer was 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. DECIPHer funding has supported JSe and JH’s input into the trial. The centre is now funded by Welsh Government through Health and Care Research Wales. DECIPHer funding has supported JSe and JH’s input into the trial. LM is supported by the Medical Research Council (MC_UU_12017/14) and Chief Scientist Office (SPHSU14). The Centre for Trials Research is funded by Health & Care Research Wales and Cancer Research UK.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Moore, Professor Laurence
Authors: Segrott, J., Gillespie, D., Lau, M., Holliday, J., Murphy, S., Foxcroft, D., Hood, K., Scourfield, J., Phillips, C., Roberts, Z., Rothwell, H., Hurlow, C., and Moore, L.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:21 February 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in BMJ Open 12(2): e049647
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
3048231Complexity in healthSharon SimpsonMedical Research Council (MRC)MC_UU_00022/1HW - MRC/CSO Social and Public Health Sciences Unit
3048231Complexity in healthSharon SimpsonChief Scientist Office (CSO)SPHSU16HW - MRC/CSO Social and Public Health Sciences Unit