Accolade
for SFP 10-14 from Cochrane review
The Strengthening Families Programme (SFP 10-14)
received a boost when Professor
David Foxcroft and colleagues
singled it out as the most promising "effective intervention
over the longer-term for the primary prevention of alcohol misuse."*
It was a considerable accolade because the comment came in a
Cochrane review, the scrupulously scientific series created by
the international Cochrane collaboration The same work was later
published in the journal, Addition.**
Conclusions of Cochrane
Review
Problems in Reviewed Studies
Poor Quality
- Lack of suitable control groups
- Non random allocation or non-equivalent groups
- Lack of pretest information
- High levels of attrition
- Inappropriate analysis
- Poor quality presentation
- Intention to treat issues
Little Evidence of Intervention Effectiveness
- Small effect sizes
- Partial effectiveness not repeated over the long term
- Evidence base does not support continued use
To get to this point Foxcroft's team examined over 6000 reports
of studies of psychosocial or educational interventions intended
to prevent alcohol use or misuse by young people. Just 56 were
acceptably rigorous and relevant to be included in the review
and just three reported alcohol use or misuse reductions which
persistent over a follow-up period of at least three years.
That left the Strengthening Families Programme (SFP 10-14),
the latest study of which*** featured a "strong design, and ...
a consistent pattern of effectiveness across the three drinking
behaviour variables they reported." Unusually, its effectiveness
"seemed to increase over time, reflecting the developmentally
orientated ... model on which the intervention is based." What
David Foxcroft added was a reanalysis accounting for children
who could not be re-interviewed at the tenth-grade (age 15-16)
follow-up by assuming that they had behaved similarly to children
whose families had not been offered any intervention at all.
The resulting estimate was that for every nine children whose
families had been offered the Strengthening Families Programme
(SFP 10-14), one was prevented from beginning to drink, to drink
without permission or for the first time getting drunk, the last
two being statistically significant. This may not seem spectacular
but it was around twice as good as the estimate for the other
two programmes and more consistent across all the drinking measures.
It wa enough to persuade Professor Foxcroft to call for "a
project to translate, develop and pilot the Strengthening Families
Programme (SFP 10-14) in the United Kingdom."****
Disappointing results from school-based
programmes have encouraged interest in family interventions.
The one with the best track record is the US Strengthening
Families Programme (SFP 10-14), approach now being tried
in Britain.
~David Foxcroft, Oxford Brookes University
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