08 SES 16 B, Role of education in relation to prevention issues
Adherence to treatment has become a key element in making interventions effective. There have been multiple attempts to define adherence (García del Castillo, García del Castillo-López, and López-Sánchez, 2014). From a medical perspective, it can be understood as the extent to what the user implements and takes into account the prescriptions made by the doctor based on the diagnosis (Sabaté, 2003). It is a multidimensional concept that comprises several elements, such as attendance, retention and participation.
Preventive and socio-educative interventions cannot be compared to medical treatments, however, there are possibilities to examine the adherence of a programme and understand it from the point of view of social and educative interventions.
Few studies in the literature report data on adherence, and those are incomplete, focusing only in variables such as the retention of participants (García del Castillo et al., 2014; Gearing et al., 2014), which is one of the three main aspects that comprise adherence.
The lack of participants’ adherence in preventive interventions has implications on their motivation and, mainly, on the results obtained through the intervention. In fact, the lack of adherence can seriously affect the whole programme, its effectiveness and credibility (Aarons, Hurlburt, and Horwitz, 2011; Allen, Linnan, and Emmons , 2012).
There are just a few studies in the literature that recognise the importance of examining the influence of the adherence variable on their interventions, therefore, there is very little or no record whatsoever of its effects in preventive interventions (the impact on preventive measures), which can be considered a weakness.
Guyll, Spoth and Cornish (2012) defend the comprehensive study of adherence due to the innumerable benefits associated with the actual implementation by participants of the intervention guidelines. These authors found that adherence to treatment improves the extent of prevention in health, increases the quality of life, improves motivation and retention of participants, and also has important implications regarding the costs-benefit analysis. Therefore, these and other authors maintain that the analysis of adherence to preventive strategies must be carried out systematically in studies.
Improving adherence is a frequent concern among technical managers and implementers, since lack of participation, abandonment, etc., pose a serious threat to the success of programs (Axford, Lehtonen, Tobin, Kaoukji, and Berry, 2012; Byrnes, Miller, Aalborg, Plasencia, and Keagy, 2010; Gearing et al., 2014; Spoth and Redmond, 2002).
The main objective of this study is to analyse the adherence to the family prevention programme “Programa de Competencia Familiar 11-14- Universal”, which is a six-sessions training programme for families (parents and children) to enhance the family dynamics, social skills and to prevent drug use and abuse in pre-adolescents. More specifically, in this study we analyse the retention level, the attendance level and the quality of the participation of the family members during the sessions and throughout the course, considering the differences found among sex and family profiles.
The study presented here is part of a wider research process regarding the validation of the “Programa de Competencia Familiar 11-14 Universal”, financed by the Spanish Government (EDU2016-79235-R). It follows a quasi-experimental design with both control and quasi-experimental groups, with pre-test and post-test measurement, as well as a follow-up (6 months after implementation). The study of the adherence to the programme was implemented following an observation design during each session of the programme. The three main components of adherence: recruitment, retention and the quality of participation was analysed using various instruments. The data was gathered in different stages of the programme. Stage 1 includes the recruitment of families, all the families that were interested in the programme could participate with the exception of some exclusion criteria such as being an active drug user. Stage 2 includes the programme implementation, during the sessions the participation was analysed by the trainer. After each session the trainer completed a check list and a 5-point rating scale about the attendance and participation of each family member. This instrument comprised the following categories: attendance, active participation during the activities, active participation empathy towards other’s comments, implementation of the techniques taught. It should also be noted that, variables such as duration of the sessions, environmental conditions of the rooms and logistical aspects are also gathered. The third stage includes the analysis of the retention level, based on the number of families that had attended most of the sessions and finished the programme. The final sample consisted of 165 families, who participated in the programme, with children aged between 11 and 14 years. The programme was implemented in sixteen schools and high schools from the Balearic Islands and Castilla y León.
This paper presents the preliminary results, as data is currently being examined. As to the retention levels, overall, the retention of families in the programme was quite high. Actually, 93,3% of the families that started the programme finished it. The preliminary data indicate that the retention level vary according to the geographical area where the programme was implemented, in the Balearic Islands was relatively higher (97,7%) than the retention level in Castilla y León (88%). Although those differences are not statistically significant (p>0.05). Likewise, it has been noted that the retention levels in primary education rise to 96,36% in families, whereas, in secondary education, even though, still high, there’s an 87,27% of families that finish the programme once it has started. It is important to highlight that these differences are not statistically significant (p>0.05). The results obtained about the quality of the participation are under analysis and will be presented during the conference, those results include the frequency of attendance of the families -parents and children-, their active participation during the sessions as well as the frequency in which they implemented on their own and at home the techniques that were promoted during the programme. These results will be presented by sex and family profile.
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health, 38(1), 4–23. Allen, J. D., Linnan, L. A., & Emmons, K. M. (2012). Fidelity and its relationship to impementation effectiveness, adaptation, and dissemination. In R. C. Brownson, G. A. Colditz, y E. K. Proctor (Eds.), Dissemination and implementation in health: Translating science to practice (pp. 281–304). New York: Oxford University Press. Byrnes, H. F., Miller, B. A., Aalborg, A. E., Plasencia, A. V., & Keagy, C. D. (2010). Implementation fidelity in adolescent family-based prevention programs: Relationship to family engagement. Health Education Research, 25(4), 531-541. doi:10.1093/her/cyq006 Gearing, R. E., Townsend, L., Elkins, J., El-Bassel, N., & Osterberg, L. (2014). Strategies to predict, measure, and improve psychosocial treatment adherence. Harvard Review of Psychiatry, 22(1), 31–45. doi.org/10.1097/HRP.10.1097/HRP.0000000000000005 Guyll, M, Spoth, R., & Cornish, M. (2012). Substance misuse prevention and economic analysis: challenges and opportunities regarding international utility. Substance use and misuse, 47, 8-9, 877. Sabaté, E. (Ed.). (2003). Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization. http://www. who.int/chp/knowledge/publications/adherence report/en/ Spoth, R. L., & Redmond, C. (2002). Project family prevention trials based in community-university partnerships: Toward scaled-up preventive interventions. Prevention Science, 3(3), 203-221. doi:10.1023/A:1019946617140
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