Waiting room (Xchange prevention registry)
About the Xchange waiting room
This section comprises interventions that the board didn't accept yet for inclusion in Xchange but could be re-assessed with additional information and possibly included in the future. The requirements to be able to evaluate an intervention in Xchange are that the focus of the intervention is directed at results related to substance use/violence/crime, that there is a published peer-reviewed study of acceptable quality with a control group, a quasi-experimental design or interrupted time series and that the intended results of the intervention are specifically measured.
List of interventions in the waiting room
Mantente REAL - (keepin’ it REAL)
Country of origin: USA
Age group: 11-14 years old
Target group: Young people aged 11-14 years old
Programme setting(s): School
Reason for being in the waiting room: Methodological concerns about critical areas of the main study.
Mantente REAL is a universal, school-based prevention programme designed for adolescents aged 12-14 to prevent the use of alcohol, tobacco, and other drugs. It focuses on teaching skills to resist peer pressure related to drug use and other personal and social skills critical for the psychological and psychosocial development of adolescents. Mantente REAL is a culturally Spanish-adapted version of the “Keepin´ it real” program developed in the United States. The programme consists of twelve lessons delivered by teachers and incorporates videos that showcase visual models of behaviour. These models are used to facilitate role-play scenarios and decision-making exercises to manage risky situations and seek support when necessary. The stories presented are based on real experiences of teenagers and adapted to the Spanish context.
Overview of results from the European studies
Cutrín et al. (2021) conducted an RCT to evaluate the effectiveness of Mantente Real. A two-arm study was conducted with parallel groups: one group received the intervention (n=410), and the other group was taught the usual curriculum (n=524). However, there was no detailed explanation of how the random sequence was generated. A pre-test was administered before the start of the programme, and a post-test four months after. However, the post-test was administered very close to the end of the programme, making it difficult to assess the real long-term effect of the intervention. The authors noted that they measured outcomes related to alcohol, tobacco and marihuana, however, data for tobacco and other drug use were not published, making it difficult to fully assess the programme’s effectiveness and safety across all intended outcomes.
References
Cutrín, O., Kulis, S., Maneiro, L., MacFadden, I., Navas, M. P., Alarcón, D., Gómez-Fraguela, J. A., Villalba, C., & Marsiglia, F. F. (2021). Effectiveness of the Mantente REAL program for preventing alcohol use in Spanish adolescents. Psychosocial Intervention, 30(3), 113–122. https://doi.org/10.5093/pi2020a19
Cutrín, O., Mac Fadden, I., Ayers, S. L., Kulis, S. S., Gómez-Fraguela, J. A., & Marsiglia, F. F. (2020). Applicability of the theory of planned Behavior for predicting alcohol use in Spanish early adolescents. International Journal of Environmental Research and Public Health, 17(22), 8539. https://doi.org/10.3390/ijerph17228539
Strengthening Families 6-11 (SFP, Utah version)
Country of origin: USA
Age group: 6-11 years old
Target group: Young people aged 6- 11 years and their families
Programme setting(s): Community, Family
Reason for being in the waiting room: No studies of acceptable quality with an appropriate design fulfil all the criteria to be included in the review process. The current studies are quasi-experimental with inadequate or no control group, and the study by Lasbeur and Pelat (2023) is not peer-reviewed as it is an internal report.
The Strengthening Families Programme was developed by Karol Kumpfer for children ages 6-11 in the 1990s and is commonly referred to as the Utah version. It’s composed of 14 weekly sessions, each lasting hours, in which during the first hour parents and children are separated, and during the second hour, they work together on the practical application of what they learned. Parents are taught skills such as positive reinforcement, communication, stress and emotional management, conflict resolution, and non-violent discipline, while children’s psychosocial, problem-solving and coping skills are developed.
Overview of results from the European studies
A quasi-experimental evaluation was conducted with the Utah version in Portugal (Magalhães et al., 2015). This study lacked an equivalent control group for comparison, did not include substance use-related outcomes, and did not provide an attrition analysis.
A study in France, conducted by Santé publique France between 2017 and 2019 in 19 cities, assessed the effectiveness of the Family and Parenting Support Programme (PSFP). The control group received a minimal parenting information intervention. Repeated measures were taken before the intervention (T0), 1 month after the intervention (T1) and at 6 months follow-up (T2). Significant improvements were noted in child hyperactivity, behavioural problems, well-being, parental involvement and mental health at T1. At 6-month follow-up (between T0 and T2), significant effects persisted only for behavioural problems and child well-being (Lasbeur & Pelat, 2023). However, the study did not provide details on allocation methods, differential attrition, and the 6-month follow-up period was too short to assess long-term intervention effects.
The evaluation of the implementation in Spain (Orte et al., 2013 & 2015) was not included here because of significant drop-out at follow-up, the lack of ITT and attrition analysis, the fact that the sample size is considered to be limited for inferential analysis and because it remains unclear what the adaptation from the original intervention consisted of.
References
Lasbeur, L., & Pelat, C. (2023). Évaluation de l’efficacité du programme de soutien aux familles et à la parentalité 6-11 ans, en comparaison avec une intervention minimale de parentalité. Santé publique.
Kumpfer, K. L., & Magalhães, C. (2018). Strengthening families program: An evidence-based family intervention for parents of high-risk children and adolescents. Journal of Child & Adolescent Substance Abuse, 27(3), 174-179.
Magalhães, Cátia CA, & Kumpfer, K.L. (2015). Effectiveness of culturally adapted Strengthening Families Programme 6-11 years among Portuguese families. Journal of Children's Services.
Orte, C., Ballester, L., & March, M. X. (2013). The Family Competence Approach, An Experience Of Socio-Educational Work With Families. Pedagogía Social. Revista Interuniversitaria, núm. 21, enero-junio, 2013, pp. 13-37 Sociedad
Orte, C., Ballester, L., March, M. X., Amer, J., Vives, M., & Pozo, R. (2015). The Strengthening Families Programme in Spain: a long-term evaluation. Journal of Children's Services.
Reason for exclusion: A high drop-out rate without attrition analysis, a small sample size limiting inferential analysis, unclear adaptation details, and no observed link between family vulnerability and outcomes at the two-year follow-up.
