The feasibility of using a parenting programme for the prevention of unintentional home injuries in the under-fives: a cluster randomised controlled trial

Mytton, Julie; Ingram, Jenny; Manns, Sarah; Stevens, Tony; Mulvaney, Caroline; Blair, Peter S; Powell, Jane; Potter, Barbara; Towner, Elizabeth; Emond, Alan; Deave, Toity; Thomas, James; Kendrick, Denise; Stewart‐Brown, Sarah

doi:10.3310/hta18030

Cited by 16 publications

(12 citation statements)

References 33 publications

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“…These included the practical guide by Ritzwoller et al 93 to costing behavioural interventions and methods used in other behavioural interventions such as the Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) programme, 94 A Stop Smoking In Schools Trial (ASSIST) 95 and the First-aid Advice and Safety Training (FAST) parent programme. 96 In keeping with both Hollingworth et al 95 and Mytton et al, 96 resources were categorised according to the stage at which they were used in the research process: planning and preparation for delivery (stage 1) or delivery itself (stage 2).…”

Section: Intervention Resource Use and Costsmentioning

confidence: 99%

“…density of alcohol outlets, opening hours and local marketing), and actions such as industry-driven corporate social responsibility initiatives, marketing and packaging regulations and community-based initiatives may complement or disrupt school-based actions. [93][94][95][96][97] There is also increasing interest in schools as environments for health promotion through actions that modify the physical and social environment. 98 Interventions and curricula, such as STAMPP, are therefore not being delivered in isolation, and, although study design characteristics such as randomisation control for internal biases, there is a need to better understand how interventions complement each other, the dynamic interplay between intervention components at different levels (e.g.…”

Section: Further Researchmentioning

confidence: 99%

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Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial

Sumnall

Agus²,

Cole

et al. 2017

Public Health Res

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BackgroundAlcohol use in young people remains a public health concern, with adverse impacts on outcomes such as health, well-being, education and relationships.ObjectivesTo assess the effectiveness and cost-effectiveness of a combined classroom curriculum and parental intervention on self-reported alcohol use [heavy episodic drinking (HED)] and alcohol-related harms (indicators such as getting into fights after drinking, poorer school performance and trouble with friends and family).DesignA two-arm, cluster randomised controlled trial with schools as the unit of randomisation.SettingA total of 105 post-primary schools in Northern Ireland (NI) and Glasgow/Inverclyde Educational Authority areas.ParticipantsA total of 12,738 male and female secondary school students (intervention delivered when students were in school year 9 in NI or S2 in Scotland in the academic year 2012–13 and aged 12–13 years) were randomised. Randomisation and baseline (T0) surveys took place when children were in school year 8 or S1. Schools were randomised (1 : 1) by an independent statistician to the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) or to education as normal (EAN). All schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational).InterventionsSTAMPP combined a school-based alcohol harm reduction curriculum [an adapted version of the School Health and Alcohol Harm Reduction Project (SHAHRP)] and a brief parental intervention designed to support parents in setting family rules around drinking. The classroom component comprised two phases delivered over 2 years, and the parental component comprised a standardised presentation delivered by a trained facilitator at specially arranged parent evenings on school premises. This was followed up a few weeks later by an information leaflet mailed to all intervention pupils’ parents highlighting the main points of the evening.Main outcome measures(1) Self-reported HED (defined as self-reported consumption of ≥ 6 units in a single episode in the previous 30 days for male students and ≥ 4.5 units for female students) assessed at 33 months from baseline (T3); and (2) the number of self-reported harms (harms caused by own drinking) assessed at T3.Data sourcesSelf-completed pupil questionnaires.ResultsAt final follow-up (T3), data were available for 5160 intervention and 5073 control pupils for the HED outcome, and for 5234 intervention and 5146 control pupils for the self-reported harms outcome. The intervention reduced self-reported HED compared with EAN (p < 0.001), but did not reduce self-reported harms associated with own drinking. The odds ratio for the intervention effect on HED was 0.596 (standard error 0.0596, 95% confidence interval 0.490 to 0.725). The mean cost of delivery per school was £818 and the mean cost per individual was £15. There were no clear cost savings in terms of service utilisation associated with the intervention. The process evaluation showed that the classroom component engaged and was enjoyed by pupils, and was valued by teachers. Schools, students, intervention trainers and delivery staff (teachers) were not blind to study condition. Data collection was undertaken by a team of researchers that included the trial manager and research assistants, some of whom were not blinded to study condition. Data analysis of primary and secondary outcomes was undertaken by the trial statistician, who was blinded to the study condition.LimitationsAlthough the classroom component was largely delivered as intended, there was very low attendance at the parent/carer event; however, all intervention pupils’ parents/carers received an intervention leaflet.ConclusionsThe results of this trial provide some support for the effectiveness and cost-effectiveness of STAMPP in reducing heavy episodic (binge) drinking, but not in reducing self-reported alcohol-related harms, in young people over a 33-month follow-up period. As there was low uptake of the parental component, it is uncertain whether or not the intervention effect was accounted for by the classroom component alone.Trial registrationCurrent Controlled Trials ISRCTN47028486.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 2. See the NIHR Journals Library website for further project information. The Public Health Agency of NI and Education Boards of Glasgow/Inverclyde provided some intervention costs. Diageo provided funds to print some workbooks. The remaining intervention costs were internally funded.

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Section: Intervention Resource Use and Costsmentioning

confidence: 99%

Section: Further Researchmentioning

confidence: 99%

Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial

Sumnall

Agus²,

Cole

et al. 2017

Public Health Res

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“…These included the practical guide to costing behavioural interventions of Ritzwoller et al 132 and methods used in other behavioural interventions such as the Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) programme, 133 A Stop Smoking In Schools Trial (ASSIST) 134 and the First-aid Advice and Safety Training (FAST) parent programme. 135 In keeping with both ASSIST and FAST trials, costs were categorised according to the stage at which they were incurred in the research process: planning and preparation for delivery (stage 1) and delivery itself (stage 2).…”

Section: Methodsmentioning

confidence: 99%

Increasing boys’ and girls’ intentions to avoid teenage pregnancy: a cluster randomised controlled feasibility trial of an interactive video drama-based intervention in post-primary schools in Northern Ireland

et al. 2017

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BackgroundAdolescent men have a vital yet neglected role in reducing unintended teenage pregnancy (UTP). There is a need for gender-sensitive educational interventions.ObjectivesTo determine the value and feasibility of conducting an effectiveness trial of theIf I Were JackRelationship and Sexuality Education (RSE) intervention in a convenience quota sample of post-primary schools in Northern Ireland. Secondary objectives were to assess acceptability to schools, pupils (male/female, aged 14–15 years) and parents/guardians; to identify optimal delivery structures and systems; to establish participation rates and reach, including equality of engagement of different socioeconomic and religious types; to assess trial recruitment and retention rates; to assess variation in normal RSE practice; to refine survey instruments; to assess differences in outcomes for male and female pupils; to identify potential effect sizes that might be detected in an effectiveness trial and estimate appropriate sample size for that trial; and to identify costs of delivery and pilot methods for assessing cost-effectiveness.DesignCluster randomised Phase II feasibility trial with an embedded process and economic evaluation.InterventionA teacher-delivered classroom-based RSE resource – an interactive video drama (IVD) with classroom materials, teacher training and an information session for parents – to immerse young people in a hypothetical scenario of Jack, a teenager whose girlfriend is unintentionally pregnant. It addresses gender inequalities in RSE by focusing on young men and is designed to increase intentions to avoid UTP by encouraging young people to delay sexual intercourse and to use contraception consistently in sexual relationships.Main outcome measuresAbstinence from sexual intercourse (delaying initiation of sex or returning to abstinence) or avoidance of unprotected sexual intercourse (consistent correct use of contraception). Secondary outcomes included Knowledge, Attitudes, Skills and Intentions.ResultsThe intervention proved acceptable to schools, pupils and parents, as evidenced through positive process evaluation. One minor refinement to the parental component was required, namely the replacement of the teacher-led face-to-face information session for parents by online videos designed to deliver the intervention to parents/guardians into their home. School recruitment was successful (target 25%, achieved 38%). No school dropped out. Pupil retention was successful (target 85%, achieved 93%). The between-group difference in incidence of unprotected sex of 1.3% (95% confidence interval 0.55% to 2.2%) by 9 months demonstrated an effect size consistent with those reported to have had meaningful impact on UTP rates (resulting in an achievable sample size of 66 schools at Phase III). Survey instruments showed high acceptability and reliability of measures (Cronbach’s alpha: 0.5–0.7). Economic evaluation at Phase III is feasible because it was possible to (1) identify costs of deliveringIf I Were Jack(mean cost per pupil, including training of teachers, was calculated as £13.66); and (2) develop a framework for assessing cost-effectiveness.ConclusionTrial methods were appropriate, and recruitment and retention of schools and pupils was satisfactory, successfully demonstrating all criteria for progression to a main trial. The perceived value of culture- and gender-sensitive public health interventions has been highlighted.Future workProgression to a Phase III effectiveness trial.Trial registrationCurrent Controlled Trials ISRCTN99459996.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 1. See the NIHR Journals Library website for further project information.

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“…Delivering universal services, these practitioners have very high potential reach [25] and are well placed to approach pregnant women, new parents and families about participation in research. However, where health visitors and community midwives have been involved in participant recruitment, disappointing recruitment and limited representativeness of the study sample has been a concern [26][27][28][29]. There is very little previous research exploring the experiences of these community health professionals in research, with only one study looking at barriers to community midwives identifying potential participants in a speci c randomised controlled trial (RCT) [35] and none that we have found looking at the experiences of health visitors.…”

Section: Introductionmentioning

confidence: 99%

Breaking through the barriers to recruit research participants in community settings: a qualitative exploration using the Theoretical Domains Framework and Behaviour Change Wheel

Rose¹,

Akister²,

Maxton³

et al. 2020

Preprint

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Background Recruitment of pregnant or postnatal women and young families into health research is a challenge. Community midwives and health visitors are well placed to invite service users to participate, but evidence suggests that they do not always invite all potentially eligible service users. Our aim was to use the Theoretical Domains Framework to explore health visitors’ and community midwives’ perceived barriers and enablers to approaching service users about participation in research and to use the Behaviour Change Wheel to suggest theory-based strategies to improve future recruitment. Methods Health visitors and community midwives working in four NHS Trusts and one community partnership in England were invited to complete an anonymous, online survey. The sample comprised health visitors (n=39) and community midwives (n=22). Qualitative data from open-ended questions about recruitment behaviour informed by the Theoretical Domains Framework were analysed using directed content analysis and inductive coding to identify salient Theoretical Domains Framework domains and specific barriers and enablers. Strategies to address these barriers and enablers were identified using the Behaviour Change Wheel. Results Six key Theoretical Domains Framework domains were identified as salient to service user approach: (a) environmental context and resources; (b) social/professional role and identity; (c) social influences; (d) goals; (e) beliefs about capabilities; (f) knowledge. Intervention strategies were identified to address specific barriers (insufficient time and staff capacity, inadequate study materials, rejection of the study’s relevance to practitioners’ role, negative influence of researchers and managers, and competing priorities) and to leverage specific enablers (additional staff resource, the relevance of service user approach to professional role, positive influence of team members, managers and researchers, and a belief in the link between service user approach and improvements in healthcare). Conclusions This study provides new insights into why community midwives and health visitors do, and do not, invite service users to participate in research. Using the Theoretical Domains Framework and the Behaviour Change Wheel we identified that resourcing and social support for staff together with education and communication about the health benefits of approaching service users about research participation are key to improving research recruitment involving these health professionals.

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The feasibility of using a parenting programme for the prevention of unintentional home injuries in the under-fives: a cluster randomised controlled trial

Cited by 16 publications

References 33 publications

Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial

Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial

Increasing boys’ and girls’ intentions to avoid teenage pregnancy: a cluster randomised controlled feasibility trial of an interactive video drama-based intervention in post-primary schools in Northern Ireland

Breaking through the barriers to recruit research participants in community settings: a qualitative exploration using the Theoretical Domains Framework and Behaviour Change Wheel

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