PROTEGO - a selective intervention programme for the prevention of tobacco, alcohol and other drug use in the family
At a glance
Country of origin
- Spain
Level(s) of intervention
- Selective prevention
PROTEGO is a selective intervention programme for the prevention of tobacco, alcohol and other drug use in the family. It is a based on the improvement of the educational skills of families through the application of a group intervention. It consists of eight two-hour sessions for groups of 12 to 15 parents of children and adolescents aged 9 to 13 years. It focuses on developing and enhancing parenting skills, addressing risk factors and family protection through educational activities. It aims to strengthen the bonds between parents and children, and to define and clarify the family´s position on substance use.
Links to this programme in other registries
Implementation Experiences
Read the experiences of people who have implemented this programme.
Contact details
Jaume Larriba
Technical Director
PDS – Promoción y Desarrollo Social, asociación
C/ Provenza, 79 bajos 3a - 08029 Barcelona (Spain)
Phone ++(34) 934 307 170 – ++(34) 678 505 102 |
Fax ++(34)934 390 773
Email: jlarriba[a]pdsweb.org
Name of organisation: 'P.D.S. – Promoció i Desenvoluapment Social (P.D.S. - Promoción y Desarrollo Social-)'
Street address: Provença street 79, ground flour 3.
Postal code: 08029
City: Barcelona
Country: Spain
Website: www.pdsweb.org
E-mail: aduran[a]pdsweb.org
Overview of results from the European studies
Studies overview
The programme has been evaluated in one quasi-experimental study in Spain and one pre-post study with 12 months follow-up without control group. The quasi-experimental study was conducted among families (n=259) served by social services or specialised units in 12 territories, less than 12 months after the intervention (parents with problems of addiction were excluded). The study showed small but significant effects on communication skills, conflict management and cohesion, and family bonding among parents moderated by implementation and participation. There were no outcome measures related to substance use (only parents were evaluated). There was no difference in cohesion, family bonding and family communication.
The longitudinal study was conducted between 12 and 16 months after the pre-test, and 10 – 14 months after the post-test. The study showed statistically significant differences; it showed that all the measures were positive, except for behavioural monitoring, indicating that most outcomes were maintained. Family positioning on drugs increased over time.
Countries where evaluated
- Spain
Characteristics
Protective factor(s) addressed
- Family: attachment to and support from parents
- Family: parent involvement in learning/education
- Individual and peers: Problem solving skills
Risk factor(s) addressed
- Family: family management problems
- Family: parental attitudes favourable to alcohol/drug use
Outcomes targeted
- Positive relationships
- Relations with parents
- Other behaviour outcomes
Description of programme
Implementation Experiences
Implementation Experiences
Spain
Contact details
Jaume Larriba-Montull
jlarriba[a]pdsweb.org
Main obstacles
With respect to individual professionals
The main obstacles for professionals are related to the selection, recruitment and retention of participants and their training of professionals for this purpose. Protego is a selective family prevention programme (aimed mainly at parents lacking skills required to manage challenges and difficulties related to their children’s education). This means that a large proportion of the target population that may benefit from participation in the programme is unaware of the benefits that it can bring and is often reluctant to participate. Therefore, the professionals in charge of recruiting participants (usually social service professionals) must manage such resistance. In addition, these professionals sometimes also have difficulty in determining whether or not an individual meets the requirements for inclusion in the programme or, by contrast, presents criteria for exclusion from participation in the programme.
With respect to social context
The main difficulties are related to some of the characteristics of the people to whom the programme is addressed: external locus of control, low awareness of need and/or low level of commitment to the education of children. In addition, participants also often have difficulties finding care for their children during the programme sessions and it can be difficult finding suitable times for parental participation.
With respect to organisational and economic context
Protego is a selective prevention programme aimed at parents with a low level of commitment to their children’s education and/or with few educational skills and who face difficulties related to family management. This, in addition to the fact that recruitment is usually done through social services, means that potential participants often have a low or very low socioeconomic status. This can sometimes lead to difficulties in attending programme sessions, especially for people living in rural areas and/or in remote areas that are poorly connected to the place where programme sessions are held (due to transport difficulties or cost). The working conditions of these people can also be an obstacle, since often, if they have a job, they have to work variable or unpredictable shifts.
Other obstacles may stem from a lack of interest and/or real political commitment to investing efforts in a programme such as this, which, while proven to be effective, requires significant effort and resources and is targeted at, by their very nature and needs, small groups, as opposed to being a universal prevention intervention.
How they overcame the obstacles
With respect to individual professionals
Training and guidance are provided to the professionals in charge of recruiting participants. In this regard, in the latest revised version of the programme manual the section devoted to providing guidance for the recruitment and retention of participants has been expanded. Such aspects are also included in the training plan for the implementation of the programme. In addition, orientation sessions are usually held with professionals prior to the recruitment of participants in the locations in which the programme is implemented.
With respect to social context
Motivational strategies were used, facilitating as much as possible childcare needs so that parents could participate in the programme and a very flexible schedule for application of the programme was offered.
With respect to organisational and economic context
The involvement and collaboration of grass-roots local professionals were sought, since they understand the needs of the people who can benefit from the intervention.
When possible, additional incentives for participants were provided, such as transport facilities and/or aids.
Promoting the coordination of the contents worked on in the programme with the services that are charged to recruit the participating families, to contribute by this way to consolidate the changes brought about by the implementation of the programme.
Lessons learnt
With respect to individual professionals
An important lesson learnt, as demonstrated by the programme evaluation study, is that difficulties in the recruitment and retention of participants can be overcome (at least at acceptable levels) and are not a real impediment to the implementation of the programme, provided that the guidelines and suggestions for addressing these obstacles provided in both the programme manual and the training programme for its implementation are rigorously followed.
With respect to social context
The importance of using appropriate strategies to address participants’ motivation and the fact that this is key to their recruitment were recognised. Once the programme has started, the use of motivational strategies, social support and adapting schedules, while still important, is less important than the use of motivational strategies for participant recruitment, as the gains derived from participation in the programme reinforce its importance: participation becomes motivating per se as the programme progresses.
With respect to organisational and economic context
After overcoming the initial difficulties, and once the programme has been implemented in a community, the intervention is often repeated and the programme is well accepted in the community. Such consolidation occurs because the people involved usually appreciate that the benefits and positive aspects of programme implementation outweigh the efforts required for implementation. The programme also contributes to overcoming social inequality by helping to empower disadvantaged families in the education of their children.
Another important aspect to bear in mind is that Protego generally targets people who need to make important changes to their educational habits. The evaluation of the programme has shown its capacity to bring about and sustain such changes in the medium term. However, while most participants experience positive changes in their children’s educational habits and patterns after the implementation of the programme, such changes should continue to be reinforced and supported to expand and consolidate them. To this end — given that Protego is a selective intervention programme, whose participants are referred by different social and community care services and resources — these services and resources constitute a very useful tool for giving continuity to the changes brought about by the application of the programme. For all of these reasons, it is advisable to strengthen the articulation of the contents of the programme with the derivative services in order to consolidate the changes brought about by application. To this end, a registration and assessment form for participants is included as an annex to facilitate feedback to the professionals who referred participants to the programme.
Strengths
There is a programme manual. Following evaluation of the initial version of the manual, there is now a revised and updated version, which incorporates improvements based on the evaluation. The manual contains support materials and tools for the process evaluation of the sessions carried out. It includes a training plan for professionals. The programme was designed with sustainability in mind. It has proven to be effective and capable of promoting lasting changes in the participating families.
Weaknesses
It requires trained and motivated resources (staff/professionals), structure (infrastructure and logistics) and well trained professionals. This requires a relatively high level of investment in terms of both resources and cost, especially in the initial stages.
Opportunities
The growing interest in parent education issues and the fight against social inequality may encourage the use of the programme.
Threats
The high number of other interventions, aimed at other family profiles (universal prevention interventions), that are shorter and require fewer resources and less investment, even though not adequate or shown to be not effective in populations with higher levels of exposure to risk factors (selective programmes), may pose a threat by competing with more appropriate but more demanding interventions, such as Protego.
Recommendations
With respect to individual professionals
It is very important to provide training for the professionals involved in the programme, to guarantee both the adequate and the faithful application of the programme and to ensure a good recruitment and retention process for participants.
It is also important to promote interactivity, making the implementation of the programme practical, dynamic and participatory, and to encourage learning by all.
It is important that, during the implementation of the programme sessions, even if a managerial approach is adopted, active listening is practised, mutual support is encouraged and the strengths of the participants are highlighted (so that they develop skills but also perceive personal self-efficacy).
It is also important to encourage the participating families to apply the knowledge and skills acquired in the programme sessions in a real context in order to generalise the learning and verify its validity in the natural environment. For this purpose, each session of the programme includes a section on homework and a section on reviewing homework.
With respect to social context
It is important to ensure that the programme is interwoven with the social and community care services and resources of the territory and that it has the support of professionals from these services.
It may also be important to adapt the examples and exercises of the programme sessions to the characteristics of the local reality.
With respect to organisational and economic context
It is necessary to provide the necessary resources (for recruitment of participants, training of professionals, implementation of programme sessions, monitoring and evaluation, incentives and motivation of participants, etc.).
