The Influence of the Competences of the Professionals in Charge of Family Evidence-Based Programmes on Internalizing and Externalizing Symptoms in Adolescents.

This study analyses the influence of trainers' intrapersonal and group management competences on the effectiveness of the Universal Strengthening Families Program 11-14 (SFP 11-14). More specifically, it assesses the effect of these competences on internalizing and externalizing symptoms in adolescents. The analysed data is made up of ratings given by the 174 mothers participating in SFP 11-14. The results confirm the effectiveness of SFP 11-14 in reducing internalizing and externalizing symptoms in adolescents. Using linear regression models, evidence is provided of the influence of the trainers' expertise, in terms of their competences, in improving internalizing symptoms in adolescents (through a reduction in levels of anxiety, depression, and somatization and in the global internalization scale). Emphasis is placed on how trainer competences can impact on the effectiveness of evidence-based programmes, stressing that this should be taken into account by the public authorities and other stakeholders in the assessment and design of family evidence-based programmes.

Evaluation of Distress and Risk Perception Associated with COVID-19 in Vulnerable Groups.

Preventive behavior developed by the population is essential in the face of the risk of coronavirus infection (COVID-19). However, preventive measures will depend on the risk perception acquired. In addition, lockdown can directly affect mental health, provoking distress. Distress could affect risk perception. This study's objective was to analyze whether experiencing distress had an influence on risk perception with respect to vulnerable groups. The sample consisted of 806 participants. The study was conducted during the first week of lockdown declared by the Spanish Government. The Brief Symptom Inventory BSI-18 and a risk perception questionnaire about vulnerable groups was administered. The study revealed the appearance of distress in 9.6% of the sample (85.7% women). Experiencing distress influenced risk perception. This study's main contribution is the link between experiencing distress and the risk perception with respect to vulnerable groups. Risk perception is relevant since it can influence how the population faces the pandemic. Transmission of accurate information could help to minimize the effect of certain cognitive biases that affect risk perception and foster preventive behavior.

Measurement of Typhim Vi IgG as a Diagnostic Tool to Determine Anti-polysaccharide Antibody Production Deficiency in Children.

Background: The assessment of specific polysaccharide antibody production plays a pivotal role in the diagnosis of humoral primary immunodeficiencies (PID). The response to 23-valent pneumococcal vaccine (PPV) remains the gold standard for the diagnosis of polysaccharide antibodies. However, in Spain, the interpretation of pure polysaccharide 23-valent immunization is hampered by the high endemicity of pneumococcal disease and the generalization of the 13-valent adjuvant pneumococcal vaccination. Specific Typhim Vi vaccination (TV) immunoglobulin G IgG response to immunization is useful in adult PID, but there is no data regarding children. Objectives: To evaluate the clinical utility of TV IgG production as a diagnostic tool to determine anti-polysaccharide antibody production deficiency in children, when the response to PPV is unclear and isolated determination of serotypes is unfeasible. Methods: We conducted a single-institution prospective observational study on 61 children with recurrent infections. Baseline specific antibodies against PPV and TV were evaluated. In 28 children (46%), the response to the production of antibodies confirmed a clinical suspicion of humoral PID, and they were therefore immunized with 23-valent pneumococcal vaccine and Typhim Vi. Both specific antibody responses were measured by ELISA (The Binding Site Group Ltd, Birmingham, UK) using previously published cut-offs. Results: Seventy percent of the 61 children displayed baseline PPV IgG > 27 mg/L, whereas only 8% showed TV IgG > 28 U/mL (p < 0.0001). Twenty-one of 28 children (75%) achieved a 3-fold increase in post-vaccination TV IgG levels, whereas only 3% achieved a 4-fold increase in PPV IgG post vaccination, mainly due to high baseline PPV IgG titers. When we classified children according to their response to TV as responders or non-responders and compared this with the well-known clinical warning signs of the Jeffrey Modell Foundation. The proportions of children with history of pneumonia and the need for intravenous antibiotics were significantly higher in TV IgG non-responders than in TV IgG responders (p = 0.02 and p = 0.01, respectively). Conclusion: Response to TV can be considered an ancillary diagnostic tool to determine polysaccharide antibodies in children, particularly when isolated determination of pneumococcal serotypes is not feasible. TV provides a useful asset for clinicians in the era of conjugate PPV vaccination, with clinical relevance. Further research is warranted for validation.

An Integrated Analysis of the Impact of Spanish Family Support Programmes with Informed Evidence / Un análisis integrado del impacto de los programas españoles de apoyo familiar basados en la evidencia

A description is made of the quality of Spanish family support programmes, based on their impact, dissemination, scaling up in communities, and sustainability; 57 implemented programmes with informed evidence were selected by EurofamNet. Most of the programmes were shown to make a positive impact, using quantitative methodologies, and they were manualized, while about half of them defined the core contents and included professional training. From a cluster analysis of programmes with scaling up, those with a high and moderate level of systematization were identified, based on the existence of defined core contents, implementation conditions, institutional support, professional training, and reports of findings. The highly systematized programmes were characterized by a greater use of mixed methodologies, their scientific dissemination through different means, and their inclusion in services. A programme quality analysis is proposed, taking an integrated approach that relates the programme’s impact with its design, implementation, and evaluation of sustainability.(AU)

En este trabajo se presenta una descripción de la calidad de los programas españoles de apoyo a las familias, basándose en su impacto, difusión, diseminación institucional y sostenibilidad. En el marco de EurofamNet se seleccionaron 57 programas implementados con evidencia fundamentada. La mayoría de los programas mostraron un impacto positivo utilizando metodologías cuantitativas y estaban manualizados, mientras que cerca de la mitad de ellos definían los contenidos clave e incluían la formación de los profesionales. A partir de un análisis de conglomerados se identificaron los que tenían un nivel de sistematización alto y moderado, definidos los contenidos clave y las condiciones de implementación, apoyo institucional, formación profesional e informes de resultados. Los programas con alto nivel de sistematización se caracterizaron por un mayor uso de metodologías mixtas, su difusión científica a través de diferentes medios y su inclusión en las instituciones. Se propone un análisis de la calidad de los programas, con un enfoque integrado que relacione el impacto del programa con su diseño, implementación y la evaluación de la sostenibilidad.(AU)

Niveles de riesgo en adolescentes en consumo de tabaco y en actitudes hacia el consumo de drogas después de la intervención preventiva “Programa de Competencia Familiar” / Risk levels among adolescents in tobacco use and in substance use attitudes after the preventive intervention “Family Competence Program”

Introducción: el Programa de Competencia Familiar Universal (PCF-U) es un programa preventivo basado en la evidencia para familias con hijos entre 11 y 14 años. Los objetivos son la reducción o prevención del consumo, la promoción de las relaciones familiares, la promoción de las habilidades parentales y un aumento de las habilidades sociales y personales de los hijos.Método: Diseño cuasi-experimental con grupo control. La muestra final son 305 padres y 262 hijos. La evaluación incluye el Cuestionario sobre Actitudes hacia las Drogas. La evaluación también contiene preguntas sobre el consumo de tabaco y alcohol. Se lleva a cabo un análisis de conglomerados sobre el consumo de tabaco y sobre las actitudes hacia el consumo de drogas.Resultados: el consumo de tabaco desciende después de la intervención. El estadístico sobre las declaraciones sobre consumo de alcohol no es fiable. En actitudes hacia las drogas, la predisposiciónhacia el consumo desciende después de la intervención, pero no es significativa. Las creencias normativas y erróneas cambian, pero no de manera significativa. Sobre los conglomerados, se identificantres niveles de riesgo, 4.7% de los adolescentes pertenecerían al riesgo alto, 24.3% pertenecerían al riesgo medio/medio-bajo y 70.9% pertenecerían al riesgo bajo. Discusión: los resultados generales del PCF-U 11-14 presentados en otros estudios muestran buenos resultados en parentalidad y habilidades familiares. Sin embargo, en consumo de tabaco y alcohol y en actitudes hacia las drogas, sólo el consumo de tabaco tiene un cambio significativo. Quizás el programa es limitado para niveles de riesgo medio y alto. (AU)

Introduction: Universal Family Competence Program is an evidence-based drug preventive intervention in Spain, working with families with children between 11 and 14 years old. Their objectives arereduction or prevention of substance use, promotion of family relationships, promotion of parenting skills, and increase of children personal and social skills. Method: Cuasi-experimental design with control group. Final sample of this study was 305 parents and 262 children. Evaluation instrument includes the Questionnaire about Drug Attitudes, measuring readiness towards substance use, wrong beliefs and normative beliefs. The instrument also contains questions about tobacco and alcohol use. Cluster analysis on tobacco and alcohol use, and drug attitudes is calculated.Results: tobacco use descends after program intervention. Declarations on alcohol use are not reliable. On drug attitudes, readiness towards substance use descends after intervention, but it is notsignificant. Wrong beliefs on drugs decrease, but not in a significant way. Normative beliefs increase, nevertheless not significantly. Regarding cluster analysis, according to their responses to tobacco use and drug attitudes, it is possible to identify three levels of risk. 4.7% of the adolescents interviewed would belong to the high risk level, 24.3% would belong to the middle or middle down level and70.9% would belong to the low risk level.Discussion: general results of the PCF-U 11-14 show good results in family and parenting skills (investigated elsewhere). Nevertheless, when it takes to tobacco and alcohol use and to drug attitudes, only tobacco use results are significant. The program might be slightly short for high and medium risk levels. (AU)

Género y cambio de actitudes ante el consumo de drogas. Los efectos del Programa de Competencia Familiar con adolescentes (12-14 años) / Gender and Attitude Change in Drug Abuse. Effects of the Family Competence Program with Adolescents (12-14 years)

Resumen Las actitudes en la adolescencia hacia el consumo de drogas son muy relevantes para entender el consumo real. Además, hay que incorporar perspectivas de explicación diferenciadas por género. En este estudio se analiza el cambio de actitudes en el largo plazo después de participar en un programa de prevención familiar basado en la evidencia, el Programa de Competencia Familiar (PCF). A partir de una muestra de 78 adolescentes que han participado en el programa, además de un grupo de control, se mide la evolución de las actitudes hacia el consumo mediante el Cuestionario de Actitudes hacia las Drogas (CAD), cuestionario validado y utilizado como referencia por el Plan Nacional Sobre Drogas español. Se llevan a cabo tres procesos de medición separados por género: al inicio de la aplicación del PCF, al final de la aplicación (Post 1) y un seguimiento a los 24 meses (Post 2). Los principales resultados indican que se consiguen diferencias significativas en la disminución de la disponibilidad hacia el consumo, y en en la reducción de las creencias erróneas al final del programa, aunque no a largo plazo, tanto en chicos como en chicas. En cuanto a las creencias correctas o protectoras, estas se mantienen consistentes a lo largo del tiempo en ambos sexos.

Abstract Attitudes towards drug abuse are relevant to understand real abuse. Furthermore, explanations by gender should be also incorporated. In the current study, it is analyzed the attitudinal change in the long-term after participating in an evidence-based family prevention program, the Family Competence Program (FCP). With a population sample of 78 adolescents that have participated in the program, and a control group, it is measured the evolution of the attitudes towards consumption using the Drugs Attitudes Questionnaire, validated questionnaire and used as a reference by the Spanish National Plan Against Drugs. Three measurement processes are undertaken, differentiated by gender: at the beginning of the FCP application, at the end of the application (Post 1) and a 24-month follow-up (Post 2). Main results indicate that significant differences are achieved in availability for consumption and in wrong beliefs, at the end of the program, but not in the long term, both in girls and boys. Regarding protective beliefs, these are consistent along time in both genders.

Quality of implementation in an evidence-based family prevention program: "The Family Competence Program" / La calidad de la implementación en un programa de prevención familiar basado en la evidencia: el "Programa de competencia familiar"

Family prevention programs need to be evidence-based in order to guarantee the success of their implementation. The Family Competence Program (FCP), a Spanish cultural adaptation of the Strengthening Families Program (SFP), has developed different measures and processes to gauge the quality of the implementation. This article is dedicated specifically to two of these measures: the evaluation of the facilitators and the assessment of the family engagement techniques. For evaluating the facilitators, a Delphi technique with experts and professionals is undertaken. For assessing the family techniques, both self-evaluation of trainers and evaluation by families are used. Finding underpin that, in the case of facilitators, is important that, after to skills and experience, they need to understand the theory of change of the program. In the case of family engagement techniques, more detailed, comprehensive talks, discussions and group activities lead to better family engagement outcomes

Los programas de prevención familiar deben ser basados en la evidencia para garantizar el éxito de la implementación. El Programa de competencia familiar (PCF), adaptación cultural española del Strengthening families program (SFP), ha desarrollado diferentes medidas y procesos para determinar la calidad de la implementación. Este artículo está dedicado específicamente a 2 de estas medidas: la evaluación del papel de los formadores y la evaluación de las técnicas de implicación familiar. Para la evaluación del rol de los formadores, se lleva a cabo una técnica Delphi con expertos y profesionales. Para evaluar las técnicas familiares, se utiliza tanto la autoevaluación de los formadores como la evaluación de las familias. Los principales resultados y conclusiones indican que, en el caso de los formadores, junto a las habilidades personales y la experiencia, es importante que entiendan la teoría de cambio del programa. En el caso de las técnicas de implicación familiar, las explicaciones, debates y actividades de grupo más detalladas comportan mejores resultados en la implicación familiar