Evaluation of a Swedish version of the Strengthening Families Programme.
BACKGROUND
Adolescents' alcohol consumption is a public health concern in Sweden as well as in many other countries. Underage drinking is associated with increased risks of alcohol-related injuries, risky sexual behaviours and dependence later in life. Different strategies have been used in the effort to prevent this behaviour, and to postpone the onset of alcohol. The Strengthening Families Programme 10-14 (SFP 10-14) from the USA has been highlighted as one of the more effective prevention programmes. The aim of the present article was to evaluate the effectiveness of a culturally adapted Swedish version of the SFP 10-14.


METHODS
This was a cluster randomized controlled trial including 587 sixth-grade students (age 12) and their parents in 19 elementary schools in Stockholm. Schools were randomly assigned to either control (9 schools, 216 students) or to the family skills training intervention (10 schools, 371 students). The SFP Swedish version consisted of two parts with seven and five sessions, respectively, held separately for youths and parents except two joint family sessions. Measures of students' self-reported episodes of drunkenness, smoking, illicit drug use and other norm-breaking behaviours were collected at baseline (March 2003) and at three subsequent yearly surveys. Data were analysed using multilevel models with an intention-to-treat approach.


RESULTS
No preventive effects were found for smoking, alcohol and illicit drug use and other norm-breaking behaviours, nor did moderators affect the outcome.


CONCLUSIONS
The Swedish version of the SFP 10-14 was not effective in preventing youths' substance use in a Swedish context.
1 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden2 Department of Clinical Neuroscience, STAD, Stockholm Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden eva.skarstrand@sll.se.
Eva
E
Skärstrand
3 Department of Knowledge Based Policy and Guidance, National Board of Health and Welfare, Stockholm, Sweden.
Knut
K
Sundell
1 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Sven
S
Andréasson
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology / Q000517:prevention & control; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D015397:Program Evaluation; D012574:Schools; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013548:Sweden