Preventing alcohol misuse in young people

During 2006/7, members of a number of multi-agency groups in Gwent felt dissatisfied that existing initiatives to reduce alcohol misuse by young people had been unable to influence what children learned about alcohol in the family environment.  Gwent Police led work to  identify a school-based Australian programme which had involved parents as well as children in activities aimed at reducing substance misuse and convened a multi-agency group which adapted the programme for Welsh primary schools, calling the new version KAT.

KAT aims to prevent later alcohol misuse among young people by strengthening positive family communication and attachment.  Children take part in KAT activities during normal lesson time and prepare work for a family event to which their parents are invited.  Children are given a “goody bag” to take home, the contents of which include a DVD produced by Gwent police depicting a family drama triggered by alcohol misuse.  Parents and children are asked to watch and discuss the DVD together.

The developer of KAT and DECIPHer researchers met through PHIRN, the Public Health Improvement Research Network, and agreed to collaborate in conducting a pilot study of KAT in two primary schools during 2008-9. The development of KAT was exciting for researchers because although early prevention programmes are likely to be more effective when they involve parents as well as children, many interventions experience significant challenges when trying to recruit parents.  By working closely with Gwent police and school staff, researchers identified a theoretical basis for the programme and high rates of acceptability among parents, pupils and school staff.  The KAT events in both schools were attended by large numbers of parents.

Based on these results, DECIPHer made a successful application for funds from the National Institute for Health Research to conduct an exploratory trial of KAT, to assess the value and feasibility of a full effectiveness trial.  The application was strengthened by commitment from the Welsh Government and Gwent Police to cover the costs of programme delivery, and their support of a randomised design to test KAT’s feasibility.

The exploratory trial began in 2012.  During recruitment, the Newport Healthy Schools team provided valuable advice on the design of recruitment materials for schools, and accompanied the research team on visits to interested schools.  Questionnaires for children were developed with the help of pupils at a school in Penarth whose feedback increased the acceptability and clarity of the questions.

A stakeholder group which included representatives of Welsh Government, Public Health Wales, Alcohol Concern Cymru, the Welsh Network of Healthy Schools Scheme, and the original developer of KAT, helped to identify criteria used to decide whether to proceed to a full effectiveness trial of KAT and provided valuable input on how the results would align with current policy/practice priorities.

Although it was not feasible to proceed to an effectiveness trial of KAT, the methods used to engage parents/carers could be embedded within other prevention programmes.  DECIPHer plans to build on its strong links with policy makers in school-based health promotion, parenting, and education to explore how parental involvement could be increased by using knowledge gained through the KAT collaboration.