"Learning together, growing with family": The implementation and evaluation of a family support programme

We examined the quality of the programme implementation and their influence on the programme results in a sample of 425 parents and 138 facilitators and 53 collaborating bodies of CaixaProinfancia in 12 Spanish cities.

Table 1 shows that participants were mainly composed of at risk families mothers (87%) and were mothers (86%) with a mean age of 37 years, and with a mean of 2.4 children, the majority with a two-parent family situation in 54.7%. The majority of the mothers have a basic education (58%) and are unemployed (62%). It is important to note the large proportion of participants coming from immigrant families and their geographic distribution (46.2%). The greatest percentage comes from the Northern African region, followed by South America, and in smaller proportion from the European Union itself and Asian regions.

There were 138 facilitators, over 61 groups, with an average age of 36.4 (4.2). The majority had more than 6 years of experience. All had graduate degrees; just over one third (39%) were social educators, 17.6% were social workers, 16.4% were psychologists, and 26.8% had degrees in pedagogy (teaching). All facilitators had attended the initial training workshop.

Quality of Implementation Scale. The quality of implementation process was examined using a questionnaire elaborated ad hoc based on Byrne (2010) . The objective was to assess the conditions in which the programme was implemented to contribute to its development and improvement in future trials. Consisted of 23 items with a response scale ranging from 0 to 4 ( 0. Not at all; 1. A little; 2. Some; 3. Plenty; 4. A lot ). To obtain the factor model we used the structural equation exploratory model ( Asparouhov & Muthén, 2009 ) using MPLUS6 that combines the exploratory factor analysis and the confirmatory factor analysis, the RMSEA index for the sample was 0.026. The resulting model includes 6 factors: (1) Prior steps to the beginning of the programme (4 items; vg., “The programme has been advertised”, “the programme has been officially inaugurated”), (2) Fidelity (4 items; vg., “Fidelity with respect to content and methodology is adequate”), (3) Programme organization (3 items; vg., “the best schedule for the meetings has been sought according to the groups”), (4) Facilities to the participants (5 items; vg., “Volunteers have been taken care of young children during the sessions”, “Some refreshments and coffee breaks have been arranged for the families during the sessions”), (5) Quality of the group facilitator (4 items; vg., “Facilitators have been stable during the program”), and (6) Coordination to other services (3 items; vg., “Facilitators have collaborated with the professional team and the coordinator”). Reliability was adequate ( α = 0.650 for the Prior steps scale, α = 0.610 for the Fidelity scale, α = 0.876 for the Programme organization scale, α = 0.867 for the Facilities to the participants scale, α = 0.674 for the Quality of the group facilitator scale and α = 0.791 for the Coordination to other services scale.

Identification of Family Educational Practices scale (PEF) (short version) (Alonso & Román, 2003 ). The scale explores in a scale of 54 items, (0–5 frequency scale) the reported use of educational practices most frequently used by families across three hypothetical family situations. The styles examined are Authoritarian (low affect, low sensitivity, imposing), Inductive or Balanced (democratic, affective, communicative, clear rules, flexible control), and Permissive (indulgence, lack of demands and control, affective expressions). We used the parent version for this study. Reliability was adequate ( α = 0.85 for the authoritarian scale, α = 0.85 for the inductive scale and α = 0.83 for the permissive scale).

Parental Sense of Competence (PSOC) (Johnston & Mash, 1989; Spanish version by Menéndez, Jiménez, & Hidalgo, 2011 ). This is a self-report scale of perceived self-efficacy and satisfaction in the parental role. It is a 16-item self-report questionnaire rated on a 6-point Likert scale (1 = strongly disagree; 6 = strongly agree). The PSOC provides two subscales: parents’ self-efficacy ( α = .77), and satisfaction in the parenting role ( α = .78). Higher mean scores for the subscales indicate more self-efficacy and satisfaction with the parental role.

Parental attendance rate. This was recorded on an individual basis by the facilitator. At the end of the programme each participant's rate of attendance was computed as a percentage of the total sessions assisted.

There are two essential elements in the focus group technique: the list of questions to trigger off the discourse and selection of the participating people to pick up their perception, attitude or feeling about a specific subject responding to the objective of the investigation. Literal transcriptions were made of the contents of the focus groups (one per collaborating entity, 20 in total) with the professionals that had animated the groups. For the analysis of the content of the focus groups we used the Atlas Ti 6.2 computer program. Prior to the analysis of the textual information, some initial categories of reference were selected based on the literature. In the first stage of textual analysis paragraphs, fragments and significant quotes in the transcription documents of the discussion groups were selected. The second stage, consisted of the construction of the empirical categories extracted and their relevance which respect to the initial categories of reference.

Table 2 shows the average values of the implementation factors. In general, the values indicate a medium-high level of the quality of implementation, but they are especially high with respect to the quality of the group facilitator and the organization of the programme, followed by coordination with other services and the individual support facilities offered to participants and, finally, by adherence to programme contents and methodology and prior organization steps.

Table 3 shows the pre-test and post-test comparisons on Child-rearing practices and Parental competence. Repeated measured ANOVA analyses were performed on pre– post measures for each of the factors involved in the outcome dimensions (Child-rearing practices and Parental competences). Significant positive results were obtained after the programme in Inductive and Permissive parenting, with increases scores in the former and decreases scores in the latter. Satisfaction and Efficacy also significantly increased after the programme.

With regard to the parental attendance in percentage the average rate of attendance was 80% of the sessions (minimum 70% and maximum 85%) what means a drop-out rate quite low given the poor psychosocial conditions of the families and motivated by personal and family circumstances.

In order to determine which factors from the implementation process are those that most determine an improvement in the exercise of positive parenting after the programme, linear regression analyses has been performed. To that end, changes in parental education practices, parent efficacy and level of attendance of participants were analyzed as a function of the six factors of the implementation scale (Prior organization, Fidelity, Programme organization, Facilities to the participants, Quality of the group facilitator and Coordination with other services). Linear regression analyses were applied for the changes in Child-rearing practices and Parental sense of competence, as predicted by the six implementation measures Change scores for each factor of the outcome measures were calculated by subtracting the pre-test score from the post-test score, so that a higher score indicated an increase in the factor and a low score a reduction of the factor. All the variables included in the regression models were standardized ( Tabachnick & Fidell, 2007 ). To interpret the global significance of the model, we examined the statistic F, the values for the Adjusted R 2 (AdjR 2 ), as well as the specific contribution of each variable to the total variance explained by the model through the significance and the value of the squared semi-partial correlation (rs 2 ). All analyses were conducted using the SPSS 18.0 statistical software assuming a confidence level of 95% for Type I error.

The models were only significant for Permissive and Inductive practices as well as for parental Efficacy and Assistance to the programme. The model of Permissive practices accounted for 47% of variance ( Table 4 ). The results showed that Fidelity, Programme Organization, Facilities provided to the participants and Positive qualities of the facilitator predicted a reduction in permissive practices. The variables that contributed most to the model was the Programme Organization (rs 2 = .29) and Facilities provided to the participants (rs 2 = .15). The model of Inductive practices accounted for 36% of variance ( Table 4 ). The results showed that Fidelity, Facilities provided to the participants and Positive qualities of the facilitator predicted an increase in inductive practices. The variable that contributed most to the model was the Facilities provided (rs 2 = .15), closely followed by the rest.

The model of parental Efficacy accounted for 23% of variance ( Table 5 ). The results showed that Fidelity, and Positive qualities of the facilitator predicted an increase in the perception of self-efficacy. The variable that contributed most to the model was the Positive qualities of the facilitator (rs 2 = .11). Finally, the model of programme assistance accounted for 28% of variance ( Table 5 ). The results showed that Prior steps taken, Fidelity, Programme Organization, and Facilities provided to the participants predicted an increase in parental assistance to the programme. The variable that contributed most to the model was the performing of preparatory actions prior to the starting of the programme (rs 2 = .14).

Here we draw on facilitators’ comments on the elements that influence in the selection and attraction of the families as well as the strategies of motivation and forming groups, as they are the preparatory steps in the implementation process. We include some examples of transcriptions from the professionals’ discourse that illustrate the elements analyzed. Regarding the elements that have influenced in attracting the families the facilitators mentioned some of the strategies that had good results:

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  Pre-selection of families: In accordance with the inclusion and exclusion criteria of the families, the social workers of the centre and/or centres in the same network pre-selected families that could benefit from the programme. This “first” list of families served to begin the process of group formation.

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  Individual interview: After making the pre-selection, the attention in an in-person, individual interview helps families to better understand the proposal of participating in the groups. It is especially relevant when the programme is offered by a co-ordinating organization to families from other organizations. From the discussion groups, we acknowledged the importance of having the first presentation of the programme be given by a professional known to the family and then having a presentation (individual or collective) by the group facilitators. Typically, the referrer of the family or the professional who knows the family should make this first contact.

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  Group presentation meetings: These can be held after pre-selecting and contacting the families individually, but there are also cases in which an open meeting is held for all interested families. This strategy seems to show that the programme is on offer as another resource; in the centres that have many editions, the programme has “caught on,” and individualized recruitment is no longer necessary.

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    For the first session, we called an open meeting at the school, and many families came. We explained the programme to them, gave a PowerPoint presentation, played a video of the families from last year with music, trying to motivate them, too.

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    We usually present the programme, hold a joint meeting, and explain the schedule, what we are going to do, and to whom it is for. We give them the example of a family that has already come to the programme, or we even invite a family that has already done the programme to come.

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  Families who inform families: As a result of the gradual consolidation of the programme, a new recruitment strategy has appeared that consists of inviting families who have already completed the programme to come and explain their experience. The “experienced” families benefit because their sense of usefulness in helping other families strengthens their own family bonds, and the “new” families benefit because the visit helps them see the resource being offered more clearly.

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    We also showed them a bit of the work from last year; a mother from last year came and talked about her experience so the people in the room could see people from their social environment, who had attended the programme.

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    The truth is, it works, and it helps them. Besides, they also get asked about it on the street, what did they do last year, etc. They all know each other, these are neighbourhoods that are in touch with each other on the street, so they tell each other about it. I think it is also very important that they are in touch.

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    The first year is always the most difficult for recruitment and acceptance, but after that, the same families [who participate] advertise the programme.

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  With regard to motivation and predisposition, one of the most notable aspects in selecting families is the level of motivation that they have to participate. The professionals consider the level of motivation and involvement of the families to be key factors to carry on the programme. Motivation is understood as not being static or a constituent part of the family but rather as a key element to take into account and stimulate in the recruitment phase.

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    In our case, since we have already been doing workshops for 3 years, we were very clear that the families we were going to contact were going to be families whom we had contacted before, who are part of the association, and who had a reference and predisposition to be able to carry out a process of change and, above all, reinforce the positive parenting.

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    To phrase it positively: We think that you are capable of changing things, that you want to change things, that this is definitely going to help you, that it will offer you tools that maybe you do not know about or that you use in different ways, etc. To give positive strength to everything we think they are capable of doing.

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  The child age plays an important role for group forming. The range age initially considered to form groups was children from 6 to 12 years old. However, since the 2012/13 edition of the programme (taking into account the recommendations from the previous evaluative report from 2011/12), the child groups have been formed to be more homogeneous in age. In the focal group facilitators recommended to form more homogeneous age groups (6–8 or 8–12 years old). Despite this recommendation, in some instances, it has been impossible to form these groupings, which has caused difficulties in adapting the activities for age groups with the broad range of 6–12 years of age.

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  Finally, the level at which the families function in the language were also used as an important factor to form groups. Faced with the linguistic impossibility of holding programme sessions in a normalized manner, in some groups, external resources have been used to overcome the language barrier, allowing families who could benefit from the content (but who do not know the language) to participate in a satisfactory manner.

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    We have made the selection taking certain criteria into account but, above all, the language issue, so that they are able to understand each other since that limits us a lot.

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    In our case, since all of the families were foreigners with little knowledge of Spanish, an educator native to that country participated.