Abstract
The programme addresses alcohol and other drug use and related risk behaviours that affect adolescents and youngsters within the recreational context, a model that has become hegemonic and that has a huge impact on the lifestyles of our adolescents. FERYA/EPOPS facilitates that families become aware of the impact that this model has on the health of their children and encourages families to contribute to its transformation by working at community and environmental level.
To empower and capacitate leaders of family organization to actively involve them in the development of environmental/community actions to prevent the risk that affect adolescents.
Empowerment and capacity trainings (8 hours) are conducted for leaders/representatives of family organizations. Once trained, actions are deployed at local/regional level, and regular meetings held to support and monitor the actions carried out by the local team.
Three methods were used: an empowerment and self-efficacy questionnaire, focus groups, and community readiness assessment interviews. The experimental groups showed higher individual and community self-efficacy, social activism and intention to carry out preventive actions in the long-term than the control groups.
Evaluation results suggest that empowerment of family organisations to promote community- based initiatives in the prevention of alcohol and substance use can be long-term effective.
Intervention details
The target population is adolescents (13 -19 years of age) with a special focus on minors (<18 years).
The strategic target group of the intervention is leaders of family organizations to actively involve their organizations and the families that participated in them in the prevention of risk that affect their children within the nightlife recreational context. The programme is also aimed at professionals working with families, such as teachers, psychologists, pedagogues, social workers, practitioners and other professionals within the prevention field.
Development of preventive actions led by Family Organisations and undertaken in the different community fields (young people organizations, educational communities, family and neighbourhood associations, professionals of prevention, industry representatives, policy makers, and other stakeholders).
Workshops to actively engage leaders/representatives of Family Organizations in the design and deployment of activities, community mobilization, coproduction and dissemination of newsletters, interactive media, internal evaluation, dissemination at national and international level, synergistic work with community- based platforms (POQIB).
The work undertaken at the POQIB, where main industry organizations are represented, has led to advocacy campaigns to engage main municipalities in the deployment of strategies to restrict alcohol use by youngsters and the promotion of a healthy leisure time. As a result, limited hours for the sale of alcohol are in place on nightlife activities (music events) and a guide has been produced to facilitate the management of municipal festivities under preventive criteria -http://www.caib.es/sites/padib/ca/archivopub.do?ctrl=MCRST352ZI320720&i….
Family Organizations, and their network of entities, have also played a key role at political level participating in the regulation of the gambling industry opening times (up until now they were open 24 hours/day). Apart from the problems associated with gambling, these shops have bars with low alcohol prices that attract minors and act as after-hours when the recreational nightlife venues close.
The FERYA/EPOPS programme is based on a set of intertwined theoretical models. The central model is the Ecological Systems Theory, by Bronfenbrenner (1981) which converges with the Social Learning Theory proposed by Miller and Dollar, further developed by Bandura, which considers human behaviour as the result of the continuous interaction between cognitive, behavioural, and environmental factors (Bandura, 1969), which constitutes the foundation for the Social Development Model (Catalano and Hawkins, 1996) and the Theory of Reasoned Action (Ajzen and Fishbein, 1980). The ecological perspective is combined with the components of the organizational empowerment, developed by Peterson and Zimmerman (2004), on the three proposed stages: intraorganisational (internal components of the organisation), interorganisational (connections and relationships between organisations) and extra-organisational (influence exerted by the organization and its network among the community, through public policies and the promotion of social changes).
Evaluation details
The entire process of developing and implementing the FERYA programme in the Balearic Islands, the actions undertaken, and the different outcomes obtained have been assessed. More specifically, the piloting of the programme in Coimbra (Portugal) was also assessed between 2017-2019. However, by the time this report is delivered, another type of evaluation is being carried out, focusing on the impact of the intervention and the development of a logic model.
For the Workshops, impact evaluations were carried out on the empowerment of organizations and leadership. In addition to continuous process evaluations (satisfaction, social relevance) especially qualitative but also quantitative data.
The preventive actions carried out in the territories generate case studies with the aim of assessing the mechanisms of action of the program, facilitators and barriers to achieving its results.
And an interrupted time series evaluation is being planned. There is still in the selection of the indicators phase and articulation with Health, Security and Youth Services to determine on access to data.
During the implementation of EPOPS Project, a process evaluation was undertaken, and two reports were prepared and delivered (an interim and a final report). The evaluation collected information on: number of interviews, questionnaires and focus groups undertaken, as well as target and number of participants in each; presentations undertaken both at national and international level; project dissemination efforts; programme changes, adaptations in the programme modules, number of workshops carried out, issues found and how they were overcome; follow-up of the webpage maintenance; number and nature of the interventions undertaken within Parents Organisations and other agents within the community (e.g., Civil Society Organisations, administration stakeholders, policy makers); participants' engagement; sustainability of the programme.
For the outcome evaluation, the assessment was undertaken at three different time points: i. at baseline, during workshops conducted before the intervention was implemented, in both experimental and control conditions (T0); ii. three months after the implementation of the intervention (T1); and iii. one year after the intervention (T2).
In Spain, a total of 59 parents took part in the baseline assessment, 36 belonging to the experimental groups, and 23 to the control group. In Portugal, a total of 54 parents participated in the baseline assessments, 37 belonging to the experimental groups and 17 to the control groups. In Spain, all parents belonging to the first experimental group who took part in the first follow-up assessment (T1) also took part at T2. Further, all control group parents took part in the follow-up assessment at T1, but about a third did not take part at T2. In Portugal on the other hand, participation in all groups decreased considerably at each further assessment point. Regarding general self-efficacy, the differences between the experimental and the control group were quite marked at baseline and T1, with the former group having higher values; regarding individual and community self-efficacy, the differences between the experimental and the control group were maintained across all assessment points, with the values for the former group being higher than for the latter; community intervention self-efficacy was higher in the experimental than the control group across all assessment points, in fact, a slight increase was observed for the experimental group between T1 and T2, while a constant decrease was observed for the control group; regarding intention to carry out initiatives, the experimental group indicated intending taking part in community actions more often than the control group, except for the difference between T1 and T2 where both groups obtained similar results; finally, regarding social activism, the experimental group went down at T1 and then up again at T2, while that in the control group gradually decreased over time. Therefore, although generally, empowerment scores were higher for the experimental group than the control group, this experience highlights the importance to not only assess the effectiveness of a programme quantitatively but through the use of a multicomponent methodology.
Apart from the quantitative results obtained through the empowerment questionnaire, a total of 24 telephone interviews were completed at T0, 12 each in Spain and Portugal. At the end of the interviews, the participants were invited to take part in focus group discussions, during which empowerment at different levels (individual, inter- intra- and extra-organizational) was assessed. At T1, five face-to-face interviews were conducted in each country after the focus group discussions. Participants in both countries and at both assessment time-points generally agreed that alcohol consumption of children and adolescents is a public health issue that needs to be addressed. The issue of cultural acceptance of alcohol consumption among young people was raised by participants at both assessment points and, together with the aspects of lack of knowledge/awareness about the extent of the problem, and the concern with nightlife and leisure styles.
Three experimental FGs (2 in Spain, 1 in Portugal) and three control FGs (1 in Spain, 2 in Portugal) were also conducted. Participants in the experimental groups consisted of families attending the programme, Parent Organisation Leaders and administration stakeholders, whereas the control group was formed by parents that did not attend any FERYA workshops nor were linked to an involved Parent Organisation.
Participants were asked about factors influencing individual empowerment, factors influencing their ability to have a role in the community, factors contributing to their knowledge and skills regarding community prevention and influence, and examples of preventive actions undertaken. In general, the results showed that, while experimental group provided ideas and thoughts regarding how to act to prevent substance use in nighlife and other leisure spaces, and had also learned from previous actions and accumulated experiences based on concrete examples, control group participants did not have similar experiences to fall back on.
In conclusion, the results of the FERYA program demonstrate the complexity involved in evaluating community-based programs and the importance of using mixed-methods. The complexity does not only apply to the challenges faced when conducting longitudinal assessments but also concerns the assessment and interpretation of measures collected using quantitative methods (e.g., self-efficacy). By using mixed- methods, it was possible to depict the level of empowerment for each experimental and control groups, something which would have been difficult if only quantitative methods were used.
Design and assessment of an empowerment measurement tool to evaluate parents self-efficacy when engaging in community and environmental actions Lloret, D; Gervilla, E; Juan, M; Castaño, Y; Pischke, C; Samkange-Zeeb, F; and Mendes, F. (2020) Community Intervention Self-Efficacy Scale for Parent Leaders (CONNECTED): Parents’ Empowerment to Prevent Adolescent Alcohol Use. International Journal of Environmental Research and Public Health, 17 (13) doi: https://doi.org/10.3390/ijerph17134812
Community Readiness Assessment. Qualitative research carried out during the external evaluation of the project (2017-2019), showed that empowered families (in Spain) had better knowledge on the problem and where more critical when discussing interventions to prevent it than those recently engaged (Portugal) https://ferya.es/_wp/wp-content/uploads/2020/01/D4.6_Scientific_report_…
Environmental report. A compilation of case studies to illustrate the preventive actions carried out by the participating family organizations and their results https://ferya.es/_wp/wp-content/uploads/2020/01/D1. 10_Environmental_report.pdf
