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Effectiveness of the Strengthening Families Programme in the UK at preventing substance misuse in 10-14 year-olds: a

Jeremy Segrott^1,2, David Gillespie³, Mandy Lau³

¹Centre for Trials Research, Cardiff University, Cardiff, UK SegrottJ@cardiff.ac.uk.

|February 22, 2022

Insights

The Strengthening Families Programme 10-14 (SFP10-14) did not significantly reduce alcohol consumption or drunkenness in UK youth. This universal prevention program

Area of Science:

Public Health
Family Studies
Substance Abuse Prevention

Background:

The Strengthening Families Programme 10-14 (SFP10-14) is a US-developed universal, group-based intervention designed to prevent substance misuse by enhancing family protective factors.
An adapted UK version (SFP10-14UK) was implemented universally, bringing together families identified as likely or unlikely to face challenges.

Purpose of the Study:

To evaluate the effectiveness of the adapted UK version of the Strengthening Families Programme 10-14 (SFP10-14UK) in preventing substance misuse among young people.
To assess the impact of SFP10-14UK on alcohol consumption, drunkenness, and other substance use behaviors.

Main Methods:

A pragmatic cluster-randomised controlled effectiveness trial was conducted in seven counties of Wales, UK.
715 families, comprising 919 parents/carers and 931 young people, were randomized.
Intervention families received seven weekly sessions of SFP10-14UK, while control families received existing services.

Main Results:

No statistically significant differences were found between intervention and control groups for primary outcomes (alcohol consumption and drunkenness) at 2-year follow-up.
Secondary outcomes, including other substance use, well-being, stress, and emotional/behavioral problems, also showed no significant group differences.
Retention rates for the primary analysis were 80.1% for alcohol consumption and 78.6% for drunkenness.

Conclusions:

The previously observed effectiveness of the Strengthening Families Programme was not replicated in this UK implementation.
Findings underscore the critical need to evaluate interventions rigorously when adapted for new cultural and contextual settings.
Further research may be needed to understand factors influencing the program's effectiveness in diverse populations.

Read full analysis

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.Cite Now.

Keywords:

community child health public health substance misuse

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