Preventing alcohol misuse in young people aged 9-11 years through promoting family communication: an exploratory evaluation of the Kids, Adults Together (KAT) Programme

Abstract

BackgroundAlcohol misuse by young people is an important public health issue, and has led to the development of a range of prevention interventions. Evidence concerning the most effective approaches to intervention design and implementation is limited. Parental involvement in school-based interventions is important, but many programmes fail to recruit large numbers of parents. This paper reports findings from an exploratory evaluation of a new alcohol misuse prevention programme - Kids, Adults Together (KAT), which comprised a classroom component, engagement with parents through a fun evening for families with children aged 9-11 years, and a DVD. The evaluation aimed to establish the programme's theoretical basis, explore implementation processes and acceptability, and identify plausible precursors of the intended long-term outcomes.MethodsDocumentary analysis and interviews with key personnel examined the programme's development. Classroom preparation and KAT family events in two schools were observed. Focus groups with children, and interviews with parents who attended KAT family events were held immediately after programme delivery, and again after three months. Interviews with head teachers and with teachers who delivered the classroom preparation were conducted. Follow-up interviews with programme personnel were undertaken. Questionnaires were sent to parents of all children involved in classroom preparation.ResultsKAT achieved high levels of acceptability and involvement among both children and parents. Main perceived impacts of the programme were increased pro-social communication within families (including discussions about harmful parental alcohol consumption), heightened knowledge and awareness of the effects of alcohol consumption and key legal and health issues, and changes in parental drinking behaviours.ConclusionsKAT demonstrated promise as a prevention intervention, primarily through its impact on knowledge and communication processes within families, and its ability to engage with large numbers of parents. A key programme mechanism was the classroom preparation's facilitation of parental involvement in the family fun evening. The programme also incorporated features identified in the literature as likely to increase effectiveness, including a focus on harm reduction, interactive delivery, and targeting primary-school-age children. Further research is needed to test and develop programme theory through implementation in different school contexts, and to examine potential longer-term impacts, and the feasibility of large scale delivery.

Preventing alcohol misuse in young people: an exploratory cluster randomised controlled trial of the Kids, Adults Together (KAT) programme

“…Our findings, and those of our previous evaluation of KAT's implementation, 90 suggest that the quality and completeness of delivery of the intervention does depend to a large extent on the commitment and enthusiasm of individual teaching staff. A key issue here is perhaps the need to ensure that programmes such as KAT, which have a primary focus on health and well-being, can demonstrate how they might address educational outcomes for pupils, and thus help teachers to deliver their core role as educators.…”

“…Findings from the evaluation at the development stage were promising, 90 but questions remained about the acceptability and feasibility of KAT across a larger number of schools; its reach across social groups; and its effectiveness in preventing alcohol misuse. In line with the Medical Research Council (MRC) evaluation framework for complex interventions, 35 it was, therefore, appropriate to move forward to an exploratory trial, the aim of which was to further develop and evaluate KAT in a larger number of schools in order to determine the value and feasibility of conducting a definitive effectiveness trial.…”

“…The first pilot study 90 theorised the function of each KAT component using Valente's framework of exposure, knowledge and attitudes, and practice. 107 There was evidence that each component had set off family communication which could mediate later drinking behaviour through parental regulatory practices ( Figure 3).…”

“…88 A shorter approach is supported by evidence that brief interventions can be as effective as longer interventions in older adolescents. 89 An evaluation at the development stage 90 found that KAT had important features previously identified in more effective interventions. Interactive delivery methods are used throughout, and it is based in primary schools, where most children have not yet become regular drinkers.…”

Exploratory trial of a school-based alcohol prevention intervention with a family component

“…A non-controlled study (Rothwell and Segrott, 2011) found that KAT achieved high rates of family engagement and acceptability which could be explained by the Social Development Model (SDM) (Catalano and Hawkins, 1996), and that there was the potential to evaluate KAT's effectiveness using an RCT design. The aim of the current study was to assess the value and feasibility of conducting a cluster RCT of KAT.…”