OBJECTIVE: The purpose of this study was to better understand facilitators', parents', and teachers' experiences, attitudes, and perceived impact of the international alcohol prevention program "Effekt" and its delivery to help explain its ineffectiveness in Estonia.
METHOD: One focus group with program facilitators (n = 8, 7 women) and individual interviews with seventh grade teachers (n = 12, 11 women) and parents (n = 24, all women) were carried out. The semi-structured interview schedules sought to explore participants' attitudes toward the program, delivery process, impact, participation barriers, and facilitators and long-term implementation. Interviews were transcribed, and data analysis was guided by the thematic analysis method.
RESULTS: Participants identified both positive and negative elements regarding program delivery that are broken down into three main themes: perceived value of the program, perception of low participation rates, and long-term perspective. Perceived value of the program: Participants perceived the program to be effective from the parents' perspective, but they considered its effect on children questionable. Perception of low participation rates: The perception of low participation rates was considered as the main factor reducing the program's impact. This was potentially influenced by factors such as a weak engagement process, lack of perceived relevance, infrequent meetings, and parents not attending school meetings. Long-term perspective: Most participants supported the idea of implementing the program with some adjustments, such as involving children, tailoring the content, and increasing the engagement of teachers.
CONCLUSIONS: Limited engagement, low perceived relevance, practical issues, and impractical format were perceived as major contributors to the ineffectiveness of the program. Taking these and other identified factors into account may help inform future prevention programs targeting parents.