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Paulsson Do U, Stenhammar C, Edlund B, Westerling R. Health communication with parents and teachers and unhealthy behaviours in 15- to 16-year-old Swedes. Health Psychol Behav Med 2017. [DOI: 10.1080/21642850.2017.1316666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Ulrica Paulsson Do
- Department of Public Health and Caring Sciences, Section for Sociomedical Epidemiological Research, Uppsala University, Uppsala, Sweden
| | - Christina Stenhammar
- Department of Public Health and Caring Sciences, Section for Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Birgitta Edlund
- Department of Public Health and Caring Sciences, Section for Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ragnar Westerling
- Department of Public Health and Caring Sciences, Section for Sociomedical Epidemiological Research, Uppsala University, Uppsala, Sweden
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52
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Gaete J, Araya R. Individual and contextual factors associated with tobacco, alcohol, and cannabis use among Chilean adolescents: A multilevel study. J Adolesc 2017; 56:166-178. [PMID: 28259098 DOI: 10.1016/j.adolescence.2017.02.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 12/21/2022]
Abstract
We studied the association between individual and contextual variables and the use of tobacco, alcohol, or cannabis in the last 30 days preceding the study, considering the hierarchical nature of students nested in schools. We used the 7th Chilean National School Survey of Substance Use (2007) covering 45,273 students (aged 12-21 years old) along with information from 1465 schools provided by the Chilean Ministry of Education. Multilevel univariable and multivariable logistic regression models were performed. We found a significant intra-class correlation within schools for all substances in the study. Common (e.g., availability of pocket money, more time spent with friends, poor parental monitoring, poor school bonding, bullying others, and lower risk perception of substance use) and unique predictors (e.g., school achievement on national tests) were identified. These findings may help in planning and conducting preventive interventions to reduce substance use.
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Affiliation(s)
- Jorge Gaete
- Departamento de Salud Pública y Epidemiología, Facultad de Medicina, Universidad de los Andes, Santiago, Chile; Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Ricardo Araya
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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53
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Mapping risk factors for substance use: Introducing the YouthMap12. Addict Behav 2017; 65:40-50. [PMID: 27723510 DOI: 10.1016/j.addbeh.2016.09.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/09/2016] [Accepted: 09/21/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND In adolescence, psychological problems and regular use of alcohol, cigarettes, cannabis and other drugs (AOD) tend to cluster together, strongly indicating that certain groups of young people are at elevated risk of developing a problematic use of AOD. OBJECTIVE The aim of the present study was to develop an easy-to-implement screening instrument to identify subgroups of young people with different psychological problems at risk of problem use of AOD. METHOD 3589 randomly selected young Danes between 15 and 25years of age, from a national survey (n=2702) and a municipality survey (n=887), answered a 12-item questionnaire (YouthMap12) with 6 items identifying externalizing problems (EP6) and 6 items identifying internalizing problems (IP6). Latent class analysis (LCA) was used to characterize groups at risk, and associations were estimated between EP6 and IP6 and regular use of AOD, and between latent class membership and regular use of AOD. RESULTS LCA identified 6 classes with varying degrees of externalizing and internalizing problems: 70% of youth were in the low problem score class, and the remaining 30% were at various levels of risk. Regular use of cigarettes, cannabis and alcohol was strongly associated with classes characterized by externalizing problems, while over-the-counter and prescription medicine was strongly associated with classes characterized by internalizing problems. CONCLUSIONS Youth at risk of problem use of AOD can be identified using a simple and easily administered instrument.
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Bühler A, Schulze K, Rustler C, Scheifhacken S, Schweizer I, Bonse-Rohmann M. Tobacco prevention and reduction with nursing students: A non-randomized controlled feasibility study. NURSE EDUCATION TODAY 2017; 48:48-54. [PMID: 27710824 DOI: 10.1016/j.nedt.2016.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/29/2016] [Accepted: 09/19/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Prevalence of tobacco use among nurses and nursing students is disproportionally high in Germany. However, from a public health perspective they are considered to be an important group for delivering smoking cessation interventions. As delivery of tobacco-related treatment depends on own smoking status, smoking prevention and cessation among the nursing professions is indicative for improving nurse and public health. OBJECTIVE To evaluate the feasibility and effects of a comprehensive tobacco prevention and reduction program on psychosocial and environmental factors related to smoking behavior of nursing students. METHODS Between 2014 and 2015, a non-randomized, controlled feasibility study was conducted in 12 schools of nursing with 397 nursing students in Germany. Students in the intervention group received a program (ASTRA) consisting of an introductory session, steering committee workshop, stress prevention lessons, evidence-based smoking cessation intervention, and action project. Six months after baseline assessment, change in smoking-related protective and risk factors was determined. Secondary endpoints included smoking behavior. RESULTS The program was implemented in total in 5 of 7 intervention schools. About one third of smoking nursing students participated in a cessation intervention. The program seems to do better than a minimal intervention booklet in four primary outcomes: perceived descriptive, subjective, and injunctive norms towards smoking and nursing as well as perceived social support. As anticipated, there was no change in smoking behavior. CONCLUSIONS The applied approach is feasible and able to improve important smoking-related norm perceptions of student nurses and perception of social support. However, additional context measures to influence the settings of nursing education currently rather supporting smoking seem to be necessary in order to promote smoking cessation among nursing students and to scale up implementation of the program.
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Affiliation(s)
- Anneke Bühler
- IFT Institut für Therapieforschung, München, Parzivalstr. 25, D-80804, München, Germany.
| | - Katrin Schulze
- IFT Institut für Therapieforschung, München, Parzivalstr. 25, D-80804, München, Germany.
| | - Christa Rustler
- Deutsches Netzwerk rauchfreie Krankenhäuser (DNrfK), Pettenkoferstrasse 16-18, D-10247, Berlin, Germany.
| | - Sabine Scheifhacken
- Deutsches Netzwerk rauchfreie Krankenhäuser (DNrfK), Pettenkoferstrasse 16-18, D-10247, Berlin, Germany.
| | - Ines Schweizer
- Hochschule Esslingen, Flandernstr. 101, D-73732 Esslingen a.N., Germany.
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55
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Hanley Santos G, Coomber R. The risk environment of anabolic-androgenic steroid users in the UK: Examining motivations, practices and accounts of use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 40:35-43. [PMID: 27955960 DOI: 10.1016/j.drugpo.2016.11.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 10/21/2016] [Accepted: 11/14/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The numbers using illicit anabolic-androgenic steroids are a cause of concern for those seeking to reduce health harms. Using the 'risk environment' as a conceptual framework to better comprehend how steroid users' practices and perspectives impact on health risks, this paper examines steroid user motivations, patterns of use, and the ways in which these practices are accounted for. METHODS As part of a wider mixed-method study into performance and image enhancing drug (PIED) use and supply in one mid-sized city in South West England, qualitative interviews were undertaken with 22 steroid users. Participants were recruited from a local safer injecting service, rather than bodybuilding gyms, in order to access a wider cross-section of steroid users. A limitation of this approach is potential sample bias towards those showing more health optimising behaviours. RESULTS The research findings highlight that patterns of steroid use varied according to motivation for use, experience and knowledge gained. Most reported having had little or no knowledge on steroids prior to use, with first use being based on information gained from fellow users or suppliers-sometimes inaccurate or incomplete. In accounting for their practices, many users differentiated themselves from other groups of steroid users-for example, older users expressed concern over patterns of use of younger and (what they saw as) inexperienced steroid users. Implicit in these accounts were intimations that the 'other' group engaged in riskier behaviour than they did. CONCLUSION Examining social contexts of use and user beliefs and motivations is vital to understanding how 'risk' behaviours are experienced so that this, in turn, informs harm reduction strategies. This paper examines the ways in which use of steroids is socially situated and the implications of this for policy and practice.
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Affiliation(s)
- Gisella Hanley Santos
- School of Law, Criminology and Government, Plymouth University, Drake Circus, Plymouth PL4 8AA, UK.
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Mt Gravatt Campus, Queensland 4122, Australia
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56
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Shackleton N, Hale D, Bonell C, Viner RM. Intraclass correlation values for adolescent health outcomes in secondary schools in 21 European countries. SSM Popul Health 2016; 2:217-225. [PMID: 29349141 PMCID: PMC5757888 DOI: 10.1016/j.ssmph.2016.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cluster randomised controlled trials (CRCTs) are increasingly used to evaluate the effectiveness of interventions for improving health. A key feature of CRCTs is that individuals in clusters are often more alike than individuals in different clusters, irrespective of treatment. This similarity within clusters needs to be taken into account when planning CRCTs to obtain adequate sample sizes, and when analysing clustered data to obtain correct estimates. METHODS Nationally representative data from 15 to 16 year olds were analysed, from 21 of the 35 countries that participated in the 2007 European School Survey Project on Alcohol and Other Drugs. Within country school level intra-class correlation coefficients (ICCs) were calculated for substance use (self-reported alcohol use, regular alcohol use, binge drinking, any smoking, regular smoking, and illicit drug use) and psychosocial health (depressive mood and self-esteem). Unadjusted and adjusted ICCs are presented. ICCs are adjusted for student sex and socioeconomic status. RESULTS ICCs ranged from 0.01 to 0.21, with the highest (0.21) reported for regular smoking. Within country school level ICCs varied substantially across health outcomes, and among countries for the same health outcomes. Estimated ICCs were consistently higher for substance use (range 0.01-0.21), than for psychosocial health (range 0.01-0.07). Within country ICCs for health outcomes varied by changes in the measurement of particular health outcomes, for example the ICCs for regular smoking (range 0.06-0.21) were higher than those for having smoked at all in the last month (range 0.03-0.17). CONCLUSIONS For school level ICCs to be effectively utilised in informing sample size requirements for CRCTs and adjusting estimates from meta-analyses, the school level ICCs need to be both country and outcome specific.
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Affiliation(s)
- N Shackleton
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
- General and Adolescent Paediatrics, Population, Policy & Practice Programme, Institute of Child Health, University College London, United Kingdom
| | - D Hale
- General and Adolescent Paediatrics, Population, Policy & Practice Programme, Institute of Child Health, University College London, United Kingdom
| | - C Bonell
- Department of Social Science, Institute of Education, University College London, United Kingdom
| | - R M Viner
- General and Adolescent Paediatrics, Population, Policy & Practice Programme, Institute of Child Health, University College London, United Kingdom
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Wexler L, Poudel-Tandukar K, Rataj S, Trout L, Poudel KC, Woods M, Chachamovich E. Preliminary Evaluation of a School-Based Youth Leadership and Prevention Program in Rural Alaska Native Communities. SCHOOL MENTAL HEALTH 2016; 9:172-183. [DOI: 10.1007/s12310-016-9203-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fitzgerald N, Angus K, Emslie C, Shipton D, Bauld L. Gender differences in the impact of population-level alcohol policy interventions: evidence synthesis of systematic reviews. Addiction 2016; 111:1735-47. [PMID: 27177685 DOI: 10.1111/add.13452] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/19/2016] [Accepted: 05/09/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Consistent review-level evidence supports the effectiveness of population-level alcohol policies in reducing alcohol-related harms. Such policies interact with well-established social, cultural and biological differences in how men and women perceive, relate to and use alcohol, and with wider inequalities, in ways which may give rise to gender differences in policy effectiveness. This paper aimed to examine the extent to which gender-specific data and analyses were considered in, and are available from, systematic reviews of population-level alcohol policy interventions, and where possible, to conduct a narrative synthesis of relevant data. METHODS A prior systematic 'review of reviews' of population level alcohol interventions 2002-2012 was updated to May 2014, all gender-relevant data extracted, and the level and quality of gender reporting assessed. A narrative synthesis of extracted findings was conducted. RESULTS Sixty-three systematic reviews, covering ten policy areas, were included. Five reviews (8%) consistently provided information on baseline participation by gender for each individual study in the review and twenty-nine (46%) reported some gender-specific information on the impact of the policies under consideration. Specific findings include evidence of possible gender differences in the impact of and exposure to alcohol marketing, and a failure to consider potential unintended consequences and harm to others in most reviews. CONCLUSIONS Gender is poorly reported in systematic reviews of population-level interventions to reduce alcohol-related harm, hindering assessment of the intended and unintended effects of such policies on women and men.
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Affiliation(s)
- Niamh Fitzgerald
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, School of Health Sciences, University of Stirling, Stirling, UK.
| | - Kathryn Angus
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, School of Health Sciences, University of Stirling, Stirling, UK
| | - Carol Emslie
- Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Linda Bauld
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, School of Health Sciences, University of Stirling, Stirling, UK
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59
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Das JK, Salam RA, Arshad A, Finkelstein Y, Bhutta ZA. Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews. J Adolesc Health 2016; 59:S61-S75. [PMID: 27664597 PMCID: PMC5026681 DOI: 10.1016/j.jadohealth.2016.06.021] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/21/2016] [Accepted: 06/24/2016] [Indexed: 01/08/2023]
Abstract
Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. We conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. We report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. Our overview findings suggest that among smoking/tobacco interventions, school-based prevention programs and family-based intensive interventions typically addressing family functioning are effective in reducing smoking. Mass media campaigns are also effective given that these were of reasonable intensity over extensive periods of time. Among interventions for alcohol use, school-based alcohol prevention interventions have been associated with reduced frequency of drinking, while family-based interventions have a small but persistent effect on alcohol misuse among adolescents. For drug abuse, school-based interventions based on a combination of social competence and social influence approaches have shown protective effects against drugs and cannabis use. Among the interventions targeting combined substance abuse, school-based primary prevention programs are effective. Evidence from Internet-based interventions, policy initiatives, and incentives appears to be mixed and needs further research. Future research should focus on evaluating the effectiveness of specific interventions components with standardized intervention and outcome measures. Various delivery platforms, including digital platforms and policy initiative, have the potential to improve substance abuse outcomes among adolescents; however, these require further research.
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Affiliation(s)
- Jai K Das
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ahmed Arshad
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Yaron Finkelstein
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
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Rathmann K, Moor I, Kunst AE, Dragano N, Pförtner TK, Elgar FJ, Hurrelmann K, Kannas L, Baška T, Richter M. Is educational differentiation associated with smoking and smoking inequalities in adolescence? A multilevel analysis across 27 European and North American countries. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:1005-1025. [PMID: 27214054 DOI: 10.1111/1467-9566.12420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study aims to determine whether educational differentiation (i.e. early and long tracking to different school types) relate to socioeconomic inequalities in adolescent smoking. Data were collected from the WHO-Collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, which included 48,025 15-year-old students (Nboys = 23,008, Ngirls = 25,017) from 27 European and North American countries. Socioeconomic position was measured using the HBSC family affluence scale. Educational differentiation was determined by the number of different school types, age of selection, and length of differentiated curriculum at the country-level. We used multilevel logistic regression to assess the association of daily smoking and early smoking initiation predicted by family affluence, educational differentiation, and their interactions. Socioeconomic inequalities in both smoking outcomes were larger in countries that are characterised by a lower degree of educational differentiation (e.g. Canada, Scandinavia and the United Kingdom) than in countries with higher levels of educational differentiation (e.g. Austria, Belgium, Hungary and The Netherlands). This study found that high educational differentiation does not relate to greater relative inequalities in smoking. Features of educational systems are important to consider as they are related to overall prevalence in smoking and smoking inequalities in adolescence.
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Affiliation(s)
- Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
| | - Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
| | - Anton E Kunst
- Department of Public Health, AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nico Dragano
- Institute of Medical Sociology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and the Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | | | - Lasse Kannas
- Faculty of Sport and Health Sciences, Department of Health Sciences, University of Jyväskylä, Finland
| | - Tibor Baška
- Department of Public Health, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
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King KA, Vidourek RA, Merianos AL, Bartsch LA. Psychosocial Factors Associated with Alcohol Use Among Hispanic Youth. J Immigr Minor Health 2016; 19:1035-1041. [PMID: 27557680 DOI: 10.1007/s10903-016-0485-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined whether authoritarian parenting, school experiences, depression, legal involvement and social norms predicted recent alcohol use and binge drinking among a national sample of Hispanic youth. A secondary data analysis of the National Survey on Drug Use and Health was performed (N = 3457). Unadjusted odds ratios were computed via univariate logistic regression analyses and significant variables were retained and included in the multivariable logistic regression analyses. Results indicated that in the past 30 days, 13.8 % of Hispanic youth drank alcohol and 8.0 % binge drank. Hispanic youth at highest risk for alcohol use were 16-17 years of age, experienced authoritarian parenting, lacked positive school experiences, had legal problems, and felt that most students at their school drank alcohol. Results should be considered when developing and implementing alcohol prevention efforts for Hispanic youth. Multiple approaches integrating family, school, and peers are needed to reduce use.
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Affiliation(s)
- Keith A King
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Rebecca A Vidourek
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Ashley L Merianos
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Lauren A Bartsch
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA.
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Andersen S, Rod MH, Ersbøll AK, Stock C, Johansen C, Holmberg T, Zinckernagel L, Ingholt L, Sørensen BB, Tolstrup JS. Effects of a settings-based intervention to promote student wellbeing and reduce smoking in vocational schools: A non-randomized controlled study. Soc Sci Med 2016; 161:195-203. [PMID: 27319278 DOI: 10.1016/j.socscimed.2016.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 06/06/2016] [Accepted: 06/09/2016] [Indexed: 11/17/2022]
Abstract
RATIONALE School dropout and health risk behavior such as cigarette smoking represent major problems among students attending upper secondary vocational education. Modifications to the social environment may promote educational attainment as well as health and wellbeing of young people. However, there is a need for more evidence-based intervention programs. OBJECTIVE The aim of this study was to assess the effectiveness of an intervention targeting the socio-environmental setting at vocational schools on student wellbeing and smoking. METHODS We conducted a non-randomized controlled trial of 5794 students (mean age 21 years; 81% male) in 10 (four intervention and six comparison) large vocational schools in Denmark. The intervention involved changes in everyday school practices focusing on four themes: (i) introduction activities, (ii) daily class meetings, (iii) scheduled breaks and (iv) pleasant non-smoking environment. Outcomes were student wellbeing (four subscales: school connectedness, student support, teacher relatedness, positive valuing of the profession) and daily smoking measured at 10-week follow-up. RESULTS We found statistically significant between-group difference in school connectedness, but not in student support, teacher relatedness and valuing the profession. The intervention had no effect on daily smoking. However, we found a statistically significant interaction between baseline smoking status and condition. This interaction suggested that baseline occasional smokers in the intervention group had significantly reduced odds ratio (OR) of becoming a daily smoker compared to baseline occasional smokers in the control group (8% versus 16%; OR = 0.44). CONCLUSION The positive effects on school connectedness and in preventing occasional smokers becoming daily smokers indicate that it is possible to tackle school-related wellbeing and smoking in a high risk population through settings-based interventions.
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Affiliation(s)
- Susan Andersen
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Morten Hulvej Rod
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Annette Kjær Ersbøll
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Christiane Stock
- Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg, Denmark.
| | - Christoffer Johansen
- The Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
| | - Teresa Holmberg
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Line Zinckernagel
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Liselotte Ingholt
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Betina Bang Sørensen
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
| | - Janne Schurmann Tolstrup
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen, Denmark.
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Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C, Kakuma R, Kennedy E, Mahon J, McGovern T, Mokdad AH, Patel V, Petroni S, Reavley N, Taiwo K, Waldfogel J, Wickremarathne D, Barroso C, Bhutta Z, Fatusi AO, Mattoo A, Diers J, Fang J, Ferguson J, Ssewamala F, Viner RM. Our future: a Lancet commission on adolescent health and wellbeing. Lancet 2016; 387:2423-78. [PMID: 27174304 PMCID: PMC5832967 DOI: 10.1016/s0140-6736(16)00579-1] [Citation(s) in RCA: 1755] [Impact Index Per Article: 219.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia.
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Columbia University, New York, NY, USA
| | - John S Santelli
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David A Ross
- World Health Organization, Geneva, Switzerland; London School of Hygiene & Tropical Medicine, London, UK
| | - Rima Afifi
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia; University of Oregon, Eugene, OR, USA
| | - Monika Arora
- Public Health Foundation of India, New Delhi, India
| | - Peter Azzopardi
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
| | | | | | - Ritsuko Kakuma
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Terry McGovern
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ali H Mokdad
- Institute of Health Metrics and Evaluation, University of Washinton, Seattle, WA, USA
| | - Vikram Patel
- London School of Hygiene & Tropical Medicine, London, UK; Public Health Foundation of India, New Delhi, India
| | - Suzanne Petroni
- International Centre for Research on Women, Washington, DC, USA
| | - Nicola Reavley
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Jane Waldfogel
- School of Social Work, Columbia University, New York, NY, USA
| | | | | | - Zulfiqar Bhutta
- University of Toronto, Toronto, ON, Canada; Aga Khan University, Karachi, Pakistan
| | | | - Amitabh Mattoo
- Australia India Centre, University of Melbourne, Melbourne, VIC, Australia; Jawaharlal Nehru University, New Delhi, India
| | | | - Jing Fang
- Kunming Medical University, Kunming, China
| | - Jane Ferguson
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Russell M Viner
- Institute of Child Health, University College London, London, UK
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Gaete J, Ortúzar C, Zitko P, Montgomery A, Araya R. Influence of school-related factors on smoking among Chilean adolescents: a cross-sectional multilevel study. BMC Pediatr 2016; 16:79. [PMID: 27282769 PMCID: PMC4901418 DOI: 10.1186/s12887-016-0612-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent tobacco smoking is a major health concern in Chile. Schools may be able to influence adolescent behaviour regarding smoking; however, this topic has received limited research attention in Latin-American countries. Moreover, the prevalence of cigarette smoking varies between schools, and some of this variability may be explained by school factors. This article examines the inter-school variability in student smoking in a large sample of Chilean schools and identifies the school- and student-level characteristics associated with cigarette smoking. METHODS This cross-sectional study used self-reported student-level data from 45,273 students from 1462 schools and official data from these schools provided by the Chilean Ministry of Education (2007). Student smoking behaviour was used as an outcome, and individual-level and school-level features were used as explanatory variables. Logistic multilevel modelling was used to analyse the data. RESULTS The mean prevalence of smoking in the 1462 schools was 39.9 %. The null model indicated that 8 % of the variance in smoking behaviour was explained by schools; and in the final model, controlled by individual- and school-level variables, the variance explained by schools dropped to 2.4 %. The main school-level variables explaining the school influence were school bonding, school truancy and school achievement. CONCLUSIONS This is the first study to examine the extent to which student smoking varies between Chilean schools and to identify some of the school factors associated with this inter-school variability. Although most variation in smoking prevalence lies between students within schools, there is sufficient between-school variation to be of interest to educators and policy makers.
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Affiliation(s)
- Jorge Gaete
- Department of Public Health and Epidemiology, Faculty of Medicine, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, Santiago, Chile.
- Department of Population Health, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, United Kingdom.
| | - Catalina Ortúzar
- Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, San Joaquín, Santiago, Chile
| | - Pedro Zitko
- Unidad de Estudios Asistenciales, Complejo Asistencial Barros Luco, José Miguel Carrera 3604, San Miguel, Santiago, Chile
| | - Alan Montgomery
- Medical Statistics and Clinical Trials, Nottingham Clinical Trials Unit, University of Nottingham, C Floor, South Block, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom
| | - Ricardo Araya
- Department of Population Health, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, United Kingdom
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Vaughan EL, Martinez S, Escobar OS, Denton LK. School Factors and Alcohol Use: The Moderating Effect of Nativity in a National Sample of Latino Adolescents. Subst Use Misuse 2016; 51:742-51. [PMID: 27070949 DOI: 10.3109/10826084.2016.1155603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND School is an important developmental context for adolescents and may be related to adolescent alcohol use. Less is known as to whether the relationships between school factors and alcohol use differ between Latino youth born outside of the United States versus those born in the United States. OBJECTIVE The aim of this study is to test nativity as a moderator of the relationship between school factors and alcohol use among Latino adolescents. METHODS This study used data from Waves I and II of the National Longitudinal Study of Adolescent Health (Add Health) to test nativity as a moderator of the relationship between school factors and alcohol use in a subsample of Latino adolescents. RESULTS Results found that during adolescence, nativity moderates the relationship between school connectedness and Wave I alcohol use. For those born outside of the United States, school connectedness was not related to alcohol use. Significant main effects emerged for grades in school and truancy. Better grades were associated with less alcohol use, while truancy was associated with greater alcohol use. The longitudinal relationships between school factors and Wave II alcohol use were not statistically significant. CONCLUSIONS School connectedness is a contemporaneous risk factor for alcohol use among those born in the United States. Prevention efforts that address school contextual factors may be important for all Latino students to reduce engagement in alcohol use and optimize well-being.
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Affiliation(s)
- Ellen L Vaughan
- a Department of Counseling and Educational Psychology , Indiana University , Bloomington , Indiana , USA
| | - Sylvia Martinez
- b Educational Leadership and Policy Studies, Indiana University , Bloomington , Indiana , USA
| | - Oscar S Escobar
- a Department of Counseling and Educational Psychology , Indiana University , Bloomington , Indiana , USA
| | - Lisa K Denton
- c Department of Psychology, State University of New York at Fredonia , Fredonia , New York , USA
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Shackleton N, Jamal F, Viner R, Dickson K, Hinds K, Patton G, Bonell C. Systematic review of reviews of observational studies of school-level effects on sexual health, violence and substance use. Health Place 2016; 39:168-76. [PMID: 27126364 DOI: 10.1016/j.healthplace.2016.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/24/2016] [Accepted: 04/05/2016] [Indexed: 01/08/2023]
Abstract
For three decades there have been reports that the quality of schools affects student health. The literature is diverse and reviews have addressed different aspects of how the school environment may affect health. This paper is the first to synthesise this evidence using a review of reviews focusing on substance-use, violence and sexual-health. Twelve databases were searched. Eleven included reviews were quality-assessed and synthesised narratively. There is strong evidence that schools' success in engaging students is associated with reduced substance use. There is little evidence that tobacco-control policies and school sexual-health clinics on their own are associated with better outcomes.
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Affiliation(s)
- Nichola Shackleton
- University College London Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Farah Jamal
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
| | - Russell Viner
- University College London Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Kelly Dickson
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
| | - Kate Hinds
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
| | - George Patton
- School Of Paediatrics, Royal Children's Hospital, University of Melbourne, Level 5, 161 Barry Street, Parkville, 3010 VIC, Australia.
| | - Chris Bonell
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
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School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews. J Adolesc Health 2016; 58:382-396. [PMID: 27013271 DOI: 10.1016/j.jadohealth.2015.12.017] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/09/2015] [Accepted: 12/10/2015] [Indexed: 01/08/2023]
Abstract
PURPOSE Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches. METHODS We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively. RESULTS We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective. CONCLUSIONS There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying.
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Giannotta F, Weichold K. Evaluation of a Life Skills Program to Prevent Adolescent Alcohol Use in Two European Countries: One-Year Follow-Up. CHILD & YOUTH CARE FORUM 2016. [DOI: 10.1007/s10566-016-9349-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Glaser DB, Roberts KJ, Grosskopf NA, Basch CH. An Evaluation of the Effectiveness of School-Based Breastfeeding Education. J Hum Lact 2016; 32:46-52. [PMID: 26173810 DOI: 10.1177/0890334415595040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 06/15/2015] [Indexed: 11/16/2022]
Abstract
School-based interventions aimed at modifying the knowledge, attitudes, social norms, and intended future practice regarding breastfeeding may be an effective way of improving breastfeeding rates. A systematic review of relevant literature was conducted to identify scientifically rigorous studies on school-based interventions and promotion activities that focus on breastfeeding. Of the 1990 citations reviewed, only 6 empirical articles on school-based interventions to promote breastfeeding were found and these interventions vary greatly in terms of format, duration, outcome measures, and significance of the results. Overall, these studies demonstrated positive effects on perceptions and attitudes toward breastfeeding and increased behavioral intention of breastfeeding later in life. School-based breastfeeding promotion programs hold promise for increasing knowledge of breastfeeding and support for breastfeeding, promoting positive attitudes, creating a culture where breastfeeding is the norm, and increasing future intentions to breastfeed.
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Affiliation(s)
- Debra B Glaser
- School of Health Sciences & Professional Programs, York College of The City University of New York, Jamaica, NY, USA
| | - Katherine J Roberts
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Nicholas A Grosskopf
- School of Health Sciences & Professional Programs, York College of The City University of New York, Jamaica, NY, USA
| | - Corey H Basch
- Department of Public Health, William Paterson University, Wayne, NJ, USA
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Authoritative School Climate and High School Student Risk Behavior: A Cross-sectional Multi-level Analysis of Student Self-Reports. J Youth Adolesc 2016; 45:2246-2259. [PMID: 26781806 DOI: 10.1007/s10964-016-0424-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
Many adolescents engage in risk behaviors such as substance use and aggression that jeopardize their healthy development. This study tested the hypothesis that an authoritative school climate characterized by strict but fair discipline and supportive teacher-student relationships is conducive to lower risk behavior for high school students. Multilevel logistic regression models were used to analyze cross-sectional, student-report survey data from a statewide sample of 47,888 students (50.6 % female) in 319 high schools. The students included ninth (26.6 %), tenth (25.5 %), eleventh (24.1 %) and twelfth (23.8 %) grade with a racial/ethnic breakdown of 52.2 % White, 18.0 % Black, 13.1 % Hispanic, 5.9 % Asian, and 10.8 % reporting another or two or more race/ethnicities. Schools with an authoritative school climate had lower levels of student-reported alcohol and marijuana use; bullying, fighting, and weapon carrying at school; interest in gang membership; and suicidal thoughts and behavior. These results controlled for demographic variables of student gender, race, grade, and parent education level as well as school size, percentage of minority students, and percentage of low income students. Overall, these findings add new evidence that an authoritative school climate is associated with positive student outcomes.
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Wang LJ, Lu SF, Chong MY, Chou WJ, Hsieh YL, Tsai TN, Chen C, Lee YH. A family-oriented therapy program for youths with substance abuse: long-term outcomes related to relapse and academic or social status. Neuropsychiatr Dis Treat 2016; 12:699-706. [PMID: 27099500 PMCID: PMC4820190 DOI: 10.2147/ndt.s105199] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The abuse of illegal substances by youths in Taiwan has become a major public health issue. This study explores the outcomes (relapse rate and academic or social status) of a family-oriented therapy program conducted for substance-using youths who were referred by a judge to participate in it. METHODS The present study includes 121 participants categorized into three groups: 36 youths underwent a weekly ten-session outpatient motivational enhancement psychotherapy (MEP) group program; 41 youths participated in a program that combined the aforementioned MEP program with an additional weekly ten-session parenting skill training (PST) program for their guardians (MEP + PST group); and 44 adolescents who received standard supervision by the court served as the control group. All participants were followed-up for a maximum of 2 years. RESULTS Of the 121 participants (mean age: 16.1±1.1 years), 33.1% relapsed into substance use during the follow-up period. The probability of relapse did not differ significantly between the MEP group (36.1%) and the control group (40.9%), but the youths in the MEP + PST group (22.0%) were at a lower risk of relapse than the control group participants (adjusted hazard ratio =0.48, 95% confidence interval [CI] =0.21-1.09). By the end of the study follow-up period, participants in both the MEP group and the MEP + PST group were more likely to be attending school (MEP group: adjusted odds ratio [aOR] =6.61, 95% CI =1.60-27.35; MEP + PST group: aOR =8.57, 95% CI =1.94-37.82) or employed (MEP group: aOR =7.75, 95% CI =1.95-30.75; MEP + PST group: aOR =7.27, 95% CI =1.76-29.97), when compared to the control group. CONCLUSION This study revealed that a family-oriented treatment approach may be a more effective option for preventing youths' relapsing into substance abuse. In comparison to individuals who received standard supervision by the court, those who received MEP experienced a better school attendance or social outcome over the follow-up period.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shing-Fang Lu
- Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Lian Hsieh
- Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tung-Ning Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Hsuan Lee
- Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Pförtner TK, Rathmann K, Moor I, Kunst AE, Richter M. [Social inequalities in adolescent smoking: A cross-national perspective of the role of individual and macro-structural factors]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 59:206-16. [PMID: 26631012 DOI: 10.1007/s00103-015-2280-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In an EU-funded project, we examined on the basis of international comparative analyses which factors were associated with and contributed to socioeconomic inequalities in adolescent smoking. This paper presents the results obtained and discusses their implications for policy and research. METHODS Analyses were based on the "Health Behaviour in School-aged Children (HBSC)" study in 2006 and included more than 50,000 adolescents from 37 countries. The focus was on the association between family affluence and weekly smoking (regularly, at least once a week) among adolescents. Explanatory variables at the individual level refer to psychosocial resources and burdens of school, family, and peers. At the country level, national income, various tobacco control policies, and an index of external differentiation of the educational system were used. RESULTS The psychosocial factors of school and family explained many of the inequalities in the smoking behavior of adolescents. In an international comparison, socioeconomic inequalities in smoking were stronger in richer countries. Absolute smoking rates were lower and inequalities in smoking smaller for boys in countries with higher tobacco prices. On the other hand, educational systems with higher degrees of external differentiation showed lower inequalities in smoking beahviour by girls, and relatively higher rates of smoking (for boys and girls). Stronger inequalities in smoking behaviour were demonstrated in countries with a greater range of preventative measures for tobacco dependence (for boys) and with higher levels of government spending on tobacco control (for girls). CONCLUSION Experiences in richer countries revealed that tobacco control needs to be strengthened for socially disadvantaged adolescents. The reduction of smoking prevalence and socioeconomic inequalities in smoking behavior should be based not only on a strengthening of psychosocial resources in the family and at school, but also on an increase in tobacco prices.
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Affiliation(s)
- Timo-Kolja Pförtner
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Eupener Straße 129, 50933, Köln, Deutschland.
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
| | - Katharina Rathmann
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Irene Moor
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Anton E Kunst
- Department of Public Health, AMC, University of Amsterdam, Amsterdam, Niederlande
| | - Matthias Richter
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Moderation, mediation - or even both? School climate and the association between peer and adolescent alcohol use. Addict Behav 2015; 51:120-6. [PMID: 26255636 DOI: 10.1016/j.addbeh.2015.07.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/02/2015] [Accepted: 07/24/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Ample studies discuss the enhancing effects of peer drinking on student alcohol use. In addition, there is vast research on school climate impact on student alcohol use. Though these two areas are intertwined for most young adolescents, it is heretofore not completely clear, in what way these characteristics functionally interact and affect drinking behavior. METHODS In a longitudinal study, we analyzed a sample of 2490 German adolescents (Mage=13.32, SD=0.57, range=8-13) from 5th (fall 2010) to 8th (fall 2013) grade. We discerned mediating (class climate) and moderating (school organization variables) functions of school on the association between peer and adolescent alcohol use, and finally combined them in direct effect moderated mediation models for a variety of outcomes (lifetime alcohol use, frequency and amount of drinking, binge drinking), adjusting for possible confounders. RESULTS Class climate mediated a small significant part of the association between peer and adolescent alcohol use (1.8-2.4%), with the exception of lifetime drinking. Student-teacher ratio and percentage of at-risk students significantly moderated the peer-adolescent association, with the latter having an enhancing and the first having a buffering effect. CONCLUSIONS School life serves as an important context of adolescent development and as such, seems to have direct and indirect effects on behavior and health. Future research should pay attention to differentiating effects of school climate and include both forms of operationalization when analyzing school effects on student behavior.
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Diseth Å, Samdal O. Classroom Achievement Goal Structure, School Engagement, and Substance Use Among 10thGrade Students in Norway. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/21683603.2015.1084250] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tomczyk S, Hanewinkel R, Isensee B. Multiple substance use patterns in adolescents-A multilevel latent class analysis. Drug Alcohol Depend 2015; 155:208-14. [PMID: 26233485 DOI: 10.1016/j.drugalcdep.2015.07.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Multiple substance use among adolescents is associated with a number of negative consequences. Therefore, we aim to investigate multiple substance use patterns among young adolescents and identify possible multilevel predictors. METHODS We analyzed a longitudinal sample of 2490 German students (51% male; Mage=13.32, SD=0.57) at 45 schools in four German states (Bremen, Hesse, North Rhine-Westphalia, Schleswig-Holstein), who completed two assessments in fall, 2010 and fall, 2013. We conducted multilevel latent class analysis for follow-up data on a variety of outcomes, and tested our final 3-class-model for possible baseline predictors. Follow-up substance use measures included lifetime use, current use, and amount of substance for cigarettes and alcohol. Baseline covariates comprised age, gender, socio-economic status, bullying, victimization, peer and parental use, type of school, and health certification of school. RESULTS We identified three latent classes: non-users (n=1541; 61.9%), experimenters (n=722; 29.0%), and multiusers (n=227; 9.1%). Experimental consumption was predicted by higher baseline age (OR=1.71; 1.31-2.24), paternal drinking (OR=2.89; 1.23-6.79), and school type (OR=2.57; 1.83-3.61), while multiuse was predicted by peer smoking (OR=2.94; 1.80-4.80) and drinking (OR=2.13; 1.32-3.44), maternal drinking (OR=6.26; 2.02-19.43), bullying (OR=1.69; 1.15-2.48), higher age (OR=1.92; 1.40-2.62), and school type (OR=4.76; 2.75-8.24) compared to the non-users class. CONCLUSIONS Prevention and further research on multiple substance use need to concentrate on social influence models and behavior-related interventions, especially at schools without a college-preparatory track.
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Affiliation(s)
- Samuel Tomczyk
- Institute for Therapy and Health Research (IFT-Nord), Harmsstraße 2, Kiel 24114, Germany.
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research (IFT-Nord), Harmsstraße 2, Kiel 24114, Germany
| | - Barbara Isensee
- Institute for Therapy and Health Research (IFT-Nord), Harmsstraße 2, Kiel 24114, Germany
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Graber R, de Visser R, Abraham C, Memon A, Hart A, Hunt K. Staying in the 'sweet spot': A resilience-based analysis of the lived experience of low-risk drinking and abstention among British youth. Psychol Health 2015; 31:79-99. [PMID: 26155742 PMCID: PMC4673561 DOI: 10.1080/08870446.2015.1070852] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study was to understand how and why young people drink less or not at all when with their peers. Understanding the subjective experiences of moderate or non-drinkers may help identify protective processes facilitating resilience to cultural norm and influences that encourage excessive alcohol consumption among young people. DESIGN Semi-structured interviews were conducted with 25 moderate- or non-drinkers aged 17-25 years (13 young women) living in South East England. Interviews explored recent experiences of social situations and encounters that did or did not involve alcohol. Transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS Analysis identified six conceptually coherent themes clustering within a superordinate theme of a healthy experience of moderate alcohol use or abstention: 'the sweet spot'. These themes were: feeling good in the body, feeling like you can be who you are, feeling like you belong, making a free choice, enjoying the moment, and feeling safe and secure. CONCLUSIONS This resilience-based analysis showed how non-drinking and moderate-drinking may be experienced as a positive and proactive choice. Understanding the subjective experiences of young people may aid development of specific, realistic interventions to promote moderate drinking and abstention among young people in drinking cultures.
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Affiliation(s)
- Rebecca Graber
- a School of Psychology , University of Sussex , Falmer , UK
| | | | | | - Anjum Memon
- c Division of Primary Care and Public Health, Brighton and Sussex Medical School , University of Brighton , Falmer , UK
| | - Angie Hart
- d Community University Partnership Programme, University of Brighton , Falmer , UK
| | - Kate Hunt
- e MRC/CSO Social and Public Health Sciences Unit , University of Glasgow , Glasgow , UK
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School Climate: a Review of the Construct, Measurement, and Impact on Student Outcomes. EDUCATIONAL PSYCHOLOGY REVIEW 2015. [DOI: 10.1007/s10648-015-9319-1] [Citation(s) in RCA: 408] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Andersen S, Tolstrup JS, Rod MH, Ersbøll AK, Sørensen BB, Holmberg T, Johansen C, Stock C, Laursen B, Zinckernagel L, Øllgaard AL, Ingholt L. Shaping the Social: design of a settings-based intervention study to improve well-being and reduce smoking and dropout in Danish vocational schools. BMC Public Health 2015; 15:568. [PMID: 26088693 PMCID: PMC4474364 DOI: 10.1186/s12889-015-1936-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 06/12/2015] [Indexed: 11/15/2022] Open
Abstract
Background The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here. Methods/design The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011–2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73 % and 81 % of eligible students, and 22 % of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period. Discussion Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention. Trials registration ISRCTN57822968. Date of registration: 16/01/2013
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Affiliation(s)
- Susan Andersen
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Janne Schurmann Tolstrup
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Morten Hulvej Rod
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Betina Bang Sørensen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Teresa Holmberg
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Christoffer Johansen
- The Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark.
| | - Christiane Stock
- Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700, Esbjerg, Denmark.
| | - Bjarne Laursen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Line Zinckernagel
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Anne Louise Øllgaard
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Liselotte Ingholt
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
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Duff P, Muldoon K, Toma O, Richardson CG. Examining the influence of community belonging on marijuana use among youth living in British Columbia, Canada. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2014.896953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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80
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Abstract
Schools provide an ideal setting for screening, brief interventions, and outpatient treatment for substance use disorders (SUD). Individual treatment for SUD is effective at decreasing substance use as well as substance-related harm. In some contexts, rather than being helpful, group interventions can result in harm to participants; therefore, individual treatment may be preferred. Early interventions for adolescents who are using alcohol and other drugs (AOD) are generally effective in decreasing frequency and quantity of AOD use as well as decreasing risky behaviors.
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81
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Hale DR, Patalay P, Fitzgerald-Yau N, Hargreaves DS, Bond L, Görzig A, Wolpert M, Stansfeld SA, Viner RM. School-level variation in health outcomes in adolescence: analysis of three longitudinal studies in England. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 15:600-10. [PMID: 23793374 DOI: 10.1007/s11121-013-0414-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
School factors are associated with many health outcomes in adolescence. However, previous studies report inconsistent findings regarding the degree of school-level variation for health outcomes, particularly for risk behaviours. This study uses data from three large longitudinal studies in England to investigate school-level variation in a range of health indicators. Participants were drawn from the Longitudinal Study of Young People in England, the Me and My School Study and the Research with East London Adolescent Community Health Survey. Outcome variables included risk behaviours (smoking, alcohol/cannabis use, sexual behaviour), behavioural difficulties and victimisation, obesity and physical activity, mental and emotional health, and educational attainment. Multi-level models were used to calculate the proportion of variance in outcomes explained at school level, expressed as intraclass correlations (ICCs) adjusted for gender, ethnicity and socio-economic status of the participants. ICCs for health outcomes ranged from nearly nil to .28 and were almost uniformly lower than for attainment (.17-.23). Most adjusted ICCs were smaller than unadjusted values, suggesting that school-level variation partly reflects differences in pupil demographics. School-level variation was highest for risk behaviours. ICCs were largely comparable across datasets, as well as across years within datasets, suggesting that school-level variation in health remains fairly constant across adolescence. School-level variation in health outcomes remains significant after adjustment for individual demographic differences between schools, confirming likely effects for school environment. Variance is highest for risk behaviours, supporting the utility of school environment interventions for these outcomes.
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Affiliation(s)
- Daniel R Hale
- General and Adolescent Pediatrics, Institute of Child Health, UCL, 30 Guilford St, London, WC1N 1EH, UK,
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82
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Abstract
OBJECTIVE To assess effectiveness of school-based smoking prevention curricula keeping children never-smokers. DESIGN Systematic review, meta-analysis. DATA MEDLINE (1966+), EMBASE (1974+), Cinahl, PsycINFO (1967+), ERIC (1982+), Cochrane CENTRAL, Health Star, Dissertation Abstracts, conference proceedings. DATA SYNTHESIS pooled analyses, fixed-effects models, adjusted ORs. Risk of bias assessed with Cochrane Risk of Bias tool. SETTING 50 randomised controlled trials (RCTs) of school-based smoking curricula. PARTICIPANTS Never-smokers age 5-18 (n=143,495); follow-up ≥6 months; all countries; no date/language limitations. INTERVENTIONS Information, social influences, social competence, combined social influences/competence and multimodal curricula. OUTCOME MEASURE Remaining a never-smoker at follow-up. RESULTS Pooling all curricula, trials with follow-up ≤1 year showed no statistically significant differences compared with controls (OR 0.91 (0.82 to 1.01)), though trials of combined social competence/social influences curricula had a significant effect on smoking prevention (7 trials, OR 0.59 (95% CI 0.41 to 0.85)). Pooling all trials with longest follow-up showed an overall significant effect in favour of the interventions (OR 0.88 (0.82 to 0.95)), as did the social competence (OR 0.65 (0.43 to 0.96)) and combined social competence/social influences curricula (OR 0.60 (0.43 to 0.83)). No effect for information, social influences or multimodal curricula. Principal findings were not sensitive to inclusion of booster sessions in curricula or to whether they were peer-led or adult-led. Differentiation into tobacco-only or multifocal curricula had a similar effect on the primary findings. Few trials assessed outcomes by gender: there were significant effects for females at both follow-up periods, but not for males. CONCLUSIONS RCTs of baseline never-smokers at longest follow-up found an overall significant effect with average 12% reduction in starting smoking compared with controls, but no effect for all trials pooled at ≤1 year. However, combined social competence/social influences curricula showed a significant effect at both follow-up periods. SYSTEMATIC REVIEW REGISTRATION Cochrane Tobacco Review Group CD001293.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, Canada
| | - Julie McLellan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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83
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Han Y, Kim H, Ma J. School bonds and the onset of substance use among Korean youth: an examination of social control theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2923-40. [PMID: 25761170 PMCID: PMC4377943 DOI: 10.3390/ijerph120302923] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 11/25/2022]
Abstract
This study examined the association between school bonds and the onset of substance use among adolescents in South Korea. Based on Hirschi’s social control theory, this study tested the roles of teacher attachment, educational aspiration, extracurricular activities, and rule internalization—four elements of social bonds within the school setting—in delayed initiation of alcohol drinking and cigarette smoking. Discrete-time logistic regression was used to analyze five waves of the Korea Youth Panel Survey (N = 3449 at baseline), a nationally representative sample of Korean youth. Stronger teacher attachment, higher educational aspiration, and higher rule internalization were correlated with delayed onset of alcohol drinking and cigarette smoking. On the other hand, participation in school extracurricular activities was positively associated with the onset of alcohol drinking, but not statistically significantly linked with the onset of cigarette smoking. These findings suggest that early prevention strategies for youth substance use should specifically target school-related factors that represent social bonds developed among youth.
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Affiliation(s)
- Yoonsun Han
- Department of Child Psychology and Education, Sungkyunkwan University, 25-2 Sungkyunkwan-ro, Jongno-gu, Seoul, 110-745, Korea.
| | - Heejoo Kim
- Department of Child Psychology and Education, Sungkyunkwan University, 25-2 Sungkyunkwan-ro, Jongno-gu, Seoul, 110-745, Korea.
| | - Julie Ma
- School of Social Work, Michigan State University, 254 Baker Hall, East Lansing, MI 48824, USA.
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84
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Tanner-Smith EE, Fisher BW. Visible School Security Measures and Student Academic Performance, Attendance, and Postsecondary Aspirations. J Youth Adolesc 2015; 45:195-210. [PMID: 25722253 DOI: 10.1007/s10964-015-0265-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/21/2015] [Indexed: 11/28/2022]
Abstract
Many U.S. schools use visible security measures (security cameras, metal detectors, security personnel) in an effort to keep schools safe and promote adolescents' academic success. This study examined how different patterns of visible security utilization were associated with U.S. middle and high school students' academic performance, attendance, and postsecondary educational aspirations. The data for this study came from two large national surveys--the School Crime Supplement to the National Crime Victimization Survey (N = 38,707 students; 51% male, 77% White, MAge = 14.72) and the School Survey on Crime and Safety (N = 10,340 schools; average student composition of 50% male, 57% White). The results provided no evidence that visible security measures had consistent beneficial effects on adolescents' academic outcomes; some security utilization patterns had modest detrimental effects on adolescents' academic outcomes, particularly the heavy surveillance patterns observed in a small subset of high schools serving predominantly low socioeconomic students. The findings of this study provide no evidence that visible security measures have any sizeable effects on academic performance, attendance, or postsecondary aspirations among U.S. middle and high school students.
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Affiliation(s)
- Emily E Tanner-Smith
- Department of Human and Organizational Development, Peabody Research Institute, Vanderbilt University, Box 0181 GPC, 230 Appleton Place, Nashville, TN, 37203, USA.
| | - Benjamin W Fisher
- Department of Human and Organizational Development, Vanderbilt University, Peabody #90, 230 Appleton Place, Nashville, TN, 37203, USA
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85
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King KA, Vidourek RA, Merianos AL, Bartsch LA. Predictors of Recent Marijuana Use and Past Year Marijuana Use Among a National Sample of Hispanic Youth. Subst Use Misuse 2015; 50:1395-405. [PMID: 26444054 DOI: 10.3109/10826084.2015.1013136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Marijuana use rates remain higher among Hispanic youth compared to youth from other ethnic groups. OBJECTIVES The purpose of the study was to examine if sex, age, authoritarian parenting, perceived school experiences, lifetime depression, legal involvement, and perceived social norms of marijuana use predicted recent marijuana use and past year marijuana use among Hispanic youth. METHODS The participants of this study were a nationwide sample of Hispanic youth (n = 3,457) in the United States. A secondary data analysis of the 2012 National Survey on Drug Use and Health was performed. Unadjusted odds ratios were computed via univariate logistic regression analyses and all statistically significant variables were retained and included in the final multiple logistic regression analyses. Recent marijuana use was operationally defined as use within the past 30 days, and marijuana use in the past year was defined as use within the past year. RESULTS Results indicated that 7.5% of Hispanic youth used within the past month and 14.5% of Hispanic youth used within the past year. Results revealed that significant predictors for recent use were age, authoritarian parenting, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Predictors for past year were age, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. CONCLUSIONS/IMPORTANCE Findings from this study can be used to address the public health problem of marijuana use among Hispanic youth that is ultimately contributing to health disparities among this ethnic group nationwide. Recommendations for future studies are included.
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Affiliation(s)
- Keith A King
- a Health Promotion and Education, University of Cincinnati , Cincinnati , Ohio , USA
| | - Rebecca A Vidourek
- a Health Promotion and Education, University of Cincinnati , Cincinnati , Ohio , USA
| | - Ashley L Merianos
- a Health Promotion and Education, University of Cincinnati , Cincinnati , Ohio , USA
| | - Lauren A Bartsch
- a Health Promotion and Education, University of Cincinnati , Cincinnati , Ohio , USA
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86
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Jamal F, Langford R, Daniels P, Thomas J, Harden A, Bonell C. Consulting with young people to inform systematic reviews: an example from a review on the effects of schools on health. Health Expect 2014; 18:3225-35. [PMID: 25470115 DOI: 10.1111/hex.12312] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There has been increasing interest in involving the public in systematic reviews as they provide a shortcut to the evidence and arguably have greater influence over policy decisions and ultimately people's lives. Case examples of this involvement are rare, especially for reviews focused on children and young people. This study describes the process and impact of consulting with a young people's advisory group to inform decision making in a systematic review on the effects of schools and school environment interventions on children and young people's health. METHODS Consultations were conducted with a pre-existing group of young people brought together to advise on public health research. Their views were sought at two key stages: (i) at the beginning when general views relating to the policy problem under study were elicited; and (ii) half-way through to advise on how to focus the review on key priorities. RESULTS Young people's involvement in our review ensured that the scope of our review was appropriate and that issues which were important to young people were considered. The group was especially valuable in terms of prioritizing in a relevant and meaningful way. A crucial additional impact of involvement was young people providing 'early signals' of key themes for the synthesis.
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Affiliation(s)
- Farah Jamal
- Institute for Health and Human Development, UH250, Stratford Campus, University of East London, London, UK
| | - Rebecca Langford
- University of Bristol, School of Social and Community Medicine, Bristol, UK
| | - Philip Daniels
- Public Health Registrar Office, West Midlands Deanery, Birmingham, UK
| | - James Thomas
- Institute of Education, University of London, London, UK
| | - Angela Harden
- Institute for Health and Human Development, UH250, Stratford Campus, University of East London, London, UK
| | - Chris Bonell
- Institute of Education, University of London, London, UK
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87
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Coppo A, Galanti MR, Giordano L, Buscemi D, Bremberg S, Faggiano F. School policies for preventing smoking among young people. Cochrane Database Syst Rev 2014; 2014:CD009990. [PMID: 25342250 PMCID: PMC6486025 DOI: 10.1002/14651858.cd009990.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND School tobacco policies (STPs) might prove to be a promising strategy to prevent smoking initiation among adolescents, as there is evidence that the school environment can influence young people to smoke. STPs are cheap, relatively easy to implement and have a wide reach, but it is not clear whether this approach is effective in preventing smoking uptake. OBJECTIVES To assess the effectiveness of policies aiming to prevent smoking initiation among students by regulating smoking in schools. SEARCH METHODS We searched seven electronic bibliographic databases, including the Cochrane Tobacco Addiction Group specialized register, MEDLINE, EMBASE, PsycINFO and ERIC. We also searched the grey literature and ongoing trials resources. The most recent search was performed in May 2014. SELECTION CRITERIA We included cluster-randomised controlled trials (c-RCTs) in which primary and secondary schools were randomised to receive different levels of smoking policy or no intervention. Non-randomised controlled trials, interrupted time series and controlled before-after studies would also have been eligible. Cross-sectional studies were not formally included but we describe their findings and use them to generate hypotheses to inform future research. DATA COLLECTION AND ANALYSIS We independently assessed studies for inclusion in the review, and present a narrative synthesis, as the studies are too limited in quality to undertake a formal meta-analysis. MAIN RESULTS We found only one study which was eligible for inclusion in the review. It was judged to be at high risk of bias. The study compared two 'middle schools' from two different regions in China. The experimental conditions included the introduction of a tobacco policy, environmental changes, and communication activities, while the control condition was no intervention. After a year's follow-up the study found no differences in smoking prevalence between intervention and control schools. We also described 24 observational studies, the results of which we considered for hypothesis generation. In these, policy exposure was mainly described using face-to-face interviews with school staff members, and the outcome evaluation was performed using self-administered questionnaires. Most studies reported no differences in students' smoking prevalence between schools with formal STPs when compared with schools without policies. In the majority of studies in schools with highly enforced policies, smoking bans extended to outdoor spaces, involving teachers and including sanctions for transgressions, with assistance to quit for smokers plus support by prevention programmes, there was no significant difference in smoking prevalence when compared to schools adopting weaker or no policies. AUTHORS' CONCLUSIONS Despite a comprehensive literature search, and rigorous evaluation of studies, we found no evidence to support STPs. The absence of reliable evidence for the effectiveness of STPs is a concern in public health. We need well-designed randomised controlled trials or quasi-experimental studies to evaluate the effectiveness of school tobacco policies.
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Affiliation(s)
- Alessandro Coppo
- Università del Piemonte OrientaleDepartment of Translational MedicineNovaraItaly
| | | | - Livia Giordano
- CPO Piemonte, AOU San Giovanni Battista HospitalCenter for Oncological PreventionVia San Francesco da paola 31TurinPiedmontItaly10123
| | - Daria Buscemi
- Università del Piemonte OrientaleDepartment of Translational MedicineNovaraItaly
| | - Sven Bremberg
- Karolinska InstitutetDepartment of Public Health SciencesStockholmSweden
| | - Fabrizio Faggiano
- Università del Piemonte OrientaleDepartment of Translational MedicineNovaraItaly
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88
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Eisenberg ME, Toumbourou JW, Catalano RF, Hemphill SA. Social norms in the development of adolescent substance use: a longitudinal analysis of the International Youth Development Study. J Youth Adolesc 2014; 43:1486-97. [PMID: 24633850 PMCID: PMC4130778 DOI: 10.1007/s10964-014-0111-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 02/28/2014] [Indexed: 11/26/2022]
Abstract
Identifying specific aspects of peer social norms that influence adolescent substance use may assist international prevention efforts. This study examines two aggregated measures of social norms in the school setting and their predictive association with substance (alcohol, tobacco and marijuana) use 2 years later in a large cross-national population-based cohort of adolescents. The primary hypothesis is that in Grade 7 both "injunctive" school norms (where students associate substance use with "coolness") and "descriptive" norms (where student substance use is common) will predict Grade 9 substance use. Data come from the International Youth Development Study, including 2,248 students (51.2% female) in the US and Australia attending 121 schools in Grade 7. Independent variables included injunctive norms (aggregating measures of school-wide coolness ratings of each substance use) and descriptive norms (aggregating the prevalence of school substance use) in Grade 7. Dependent variables included binge drinking and current use of alcohol, tobacco and marijuana in Grade 9. Associations between each type of school-wide social norm and substance use behaviors in Grade 9 were tested using multilevel logistic regression, adjusting for covariates. In unadjusted models, both injunctive and descriptive norms each significantly predicted subsequent substance use. In fully adjusted models, injunctive norms were no longer significantly associated with Grade 9 use, but descriptive norms remained significantly associated with tobacco and marijuana use in the expected direction. The findings identify descriptive social norms in the school context as a particularly important area to address in adolescent substance use prevention efforts.
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Affiliation(s)
- Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA,
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89
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Andrade FH. Co-occurrences between adolescent substance use and academic performance: school context influences a multilevel-longitudinal perspective. J Adolesc 2014; 37:953-63. [PMID: 25057764 PMCID: PMC4142206 DOI: 10.1016/j.adolescence.2014.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 06/19/2014] [Accepted: 06/22/2014] [Indexed: 11/25/2022]
Abstract
A growing body of literature has linked substance use and academic performance exploring substance use as a predictor of academic performance or vice versa. This study uses a different approach conceptualizing substance use and academic performance as parallel outcomes and exploring two topics: its multilevel-longitudinal association and school contextual effects on both outcomes. Using multilevel Confirmatory Factor Analysis and multilevel-longitudinal analyses, the empirical estimates relied on 7843 students nested in 114 schools (Add Health study). The main finding suggests that the correlation between substance use and academic performance was positive at the school level in contraposition to the negative relationship at the individual level. Additional findings suggest a positive effect of a school risk factor on substance use and a positive effect of academic pressure on academic performance. These findings represent a contribution to our understanding of how schools could affect the relationship between academic performance and substance use.
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Affiliation(s)
- Fernando H Andrade
- School of Social Work, University of Michigan, 2846 Verle Av., Ann Arbor, MI 48109, USA.
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90
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Lima-Serrano M, Lima-Rodríguez JS. Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review. GACETA SANITARIA 2014; 28:411-7. [PMID: 24923204 DOI: 10.1016/j.gaceta.2014.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 05/01/2014] [Accepted: 05/07/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion. METHODS The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool. RESULTS Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents' and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable. CONCLUSIONS This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed.
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Affiliation(s)
- Marta Lima-Serrano
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, España
| | - Joaquín S Lima-Rodríguez
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, España.
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91
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Substance Use Prevalence According to Public High School Types in Istanbul. ADDICTIVE DISORDERS & THEIR TREATMENT 2014. [DOI: 10.1097/adt.0b013e31829111b6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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92
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Berg L, Rostila M, Saarela J, Hjern A. Parental death during childhood and subsequent school performance. Pediatrics 2014; 133:682-9. [PMID: 24616354 DOI: 10.1542/peds.2013-2771] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Parental death during childhood has been linked to increased mortality and mental health problems in adulthood. School failure may be an important mediator in this trajectory. We investigated the association between parental death before age 15 years and school performance at age 15 to 16 years, taking into account potentially contributing factors such as family socioeconomic position (SEP) and parental substance abuse, mental health problems, and criminality. METHODS This was a register-based national cohort study of 772,117 subjects born in Sweden between 1973 and 1981. Linear and logistic regression models were used to analyze school performance as mean grades (scale: 1-5; SD: 0.70) and school failure (finished school with incomplete grades). Results are presented as β-coefficients and odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Parental death was associated with lower grades (ORs: -0.21 [95% CI: -0.23 to -0.20] and -0.17 [95% CI: -0.19 to -0.15]) for paternal and maternal deaths, respectively. Adjustment for SEP and parental psychosocial factors weakened the associations, but the results remained statistically significant. Unadjusted ORs of school failure were 2.04 (95% CI: 1.92 to 2.17) and 1.51 (95% CI: 1.35 to 1.69) for paternal and maternal deaths. In fully adjusted models, ORs were 1.40 (95% CI: 1.31 to 1.49) and 1.18 (95% CI: 1.05 to 1.32). The higher crude impact of death due to external causes (ie, accident, violence, suicide) (OR: -0.27 [90% CI: -0.28 to -0.26]), compared with natural deaths (OR: -0.16 [95% CI: -0.17 to -0.15]), was not seen after adjustment for SEP and psychosocial situation of the family. CONCLUSIONS Parental death during childhood was associated with lower grades and school failure. Much of the effect, especially for deaths by external causes, was associated with socially adverse childhood exposures.
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Affiliation(s)
- Lisa Berg
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
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93
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Hale DR, Fitzgerald-Yau N, Viner RM. A systematic review of effective interventions for reducing multiple health risk behaviors in adolescence. Am J Public Health 2014; 104:e19-41. [PMID: 24625172 DOI: 10.2105/ajph.2014.301874] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We systematically searched 9 biomedical and social science databases (1980-2012) for primary and secondary interventions that prevented or reduced 2 or more adolescent health risk behaviors (tobacco use, alcohol use, illicit drug use, risky sexual behavior, aggressive acts). We identified 44 randomized controlled trials of universal or selective interventions and were effective for multiple health risk behaviors. Most were school based, conducted in the United States, and effective for multiple forms of substance use. Effects were small, in line with findings for other universal prevention programs. In some studies, effects for more than 1 health risk behavior only emerged at long-term follow-up. Integrated prevention programs are feasible and effective and may be more efficient than discrete prevention strategies.
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Affiliation(s)
- Daniel R Hale
- The authors are with the General and Adolescent Paediatrics Unit, Institute of Child Health, University College London, UK
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94
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Jackson N, Denny S, Sheridan J, Fleming T, Clark T, Teevale T, Ameratunga S. Predictors of drinking patterns in adolescence: a latent class analysis. Drug Alcohol Depend 2014; 135:133-9. [PMID: 24373625 DOI: 10.1016/j.drugalcdep.2013.11.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/21/2013] [Accepted: 11/29/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Uni-dimensional measures of alcohol consumption may be unable to fully capture the complexity of adolescent drinking and experience of alcohol-related harms. Latent class analysis provides an empirical method to understand different adolescent drinking patterns. METHODS Latent class analysis was used to create typologies of drinking among the 5018 current drinkers in the national Youth '07 survey. Determinants of drinking patterns were identified using multinomial logistic regression. RESULTS Four latent classes were identified, demonstrating an overall increase in risk of alcohol-related outcomes from increasing consumption. One class strongly deviated from this pattern, having moderate consumption patterns but disproportionately high levels of alcohol-related problems. Multinomial logistic regression found that the strongest predictors of belonging to high-risk drinking typologies were having a positive attitude to regular alcohol use, buying own alcohol, peers using alcohol, and obtaining alcohol from friends and/or other adults. Other significant predictors included being male, having a strong connection to friends, having parents with a low level of knowledge of their daily activities and poor connection to school. Class membership also varied by ethnicity. CONCLUSION The latent class approach demonstrated variability in alcohol-related harms across groups of students with different drinking patterns. Longitudinal studies are necessary to determine the causes of this variability in order to inform the development of targeted policy and preventative interventions. Legislative controls, such as increasing the legal purchase age and reducing the commercial availability of alcohol, will continue to be important strategies for reducing harm in young people.
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Affiliation(s)
- Nicki Jackson
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand.
| | - Simon Denny
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Janie Sheridan
- Centre for Addiction Research, The University of Auckland, Auckland, New Zealand
| | - Terry Fleming
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Terryann Clark
- School of Nursing, The University of Auckland, Auckland, New Zealand
| | - Tasileta Teevale
- Department of Pacific Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
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95
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Andrade FH. Can the school context moderate the protective effect of parental support on adolescents' alcohol trajectories in urban Chicago? Drug Alcohol Depend 2013; 133:330-7. [PMID: 23891034 PMCID: PMC3818413 DOI: 10.1016/j.drugalcdep.2013.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/20/2013] [Accepted: 06/07/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Research explaining school effects on alcohol use is scare. This study examined the interactive effect between family support and school characteristics (size, poverty, and sector) on adolescents' alcohol use trajectories in Chicago. METHODS Longitudinal and multilevel data were from the Project of Human Development in Chicago Neighborhoods and the Common Core of Data (National Center for Educational Statistics). The sample consisted of 2205 adolescents in 558 schools. A three-level hierarchical linear model was used to estimate multilevel growth curve models and school effects on alcohol trajectories. RESULTS In addition to the strong relationship between parental support and alcohol trajectories; the results also found school effects on the average baseline of alcohol use and the rates of change across time. Interestingly, high levels of parental support were more effective in preventing alcohol use in public schools, while adolescents attending private schools with low levels of parental support were more likely to consume alcohol. Similarly, students attending public schools with higher rates of poverty who enjoy higher levels of parental support were less likely to consume alcohol compared to students with lower parental support attending lower rates of schools poverty. CONCLUSION Key findings highlight the importance of the interaction between parental support and school characteristics meaning that protective factors provided by parents could be reinforced or diminished by the school context.
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Affiliation(s)
- Fernando H. Andrade
- University of Michigan SSW. 1080 S. University, Ann Arbor, MI 48109, Rm B660
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96
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Bonell CP, Fletcher A, Jamal F, Wells H, Harden A, Murphy S, Thomas J. Theories of how the school environment impacts on student health: systematic review and synthesis. Health Place 2013; 24:242-9. [PMID: 24177419 DOI: 10.1016/j.healthplace.2013.09.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 10/26/2022]
Abstract
Public-health interventions informed by theory can be more effective but complex interventions often use insufficiently complex theories. We systematically reviewed theories of how school environments influence health. We included 37 reports drawing on 24 theories. Narrative synthesis summarised and categorised theories. We then produced an integrated theory of school environment influences on student health. This integrated theory could inform complex interventions such as health promoting schools programmes. Using systematic reviews to develop theories of change might be useful for other types of 'complex' public-health interventions addressing risks at the individual and community levels.
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Affiliation(s)
- C P Bonell
- Department of Childhood, Families and Health, Institute of Education, University of London, 20 Bedford Way, London WC1H 0AL, UK.
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97
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Population-level interventions to reduce alcohol-related harm: an overview of systematic reviews. Prev Med 2013; 57:278-96. [PMID: 23811528 DOI: 10.1016/j.ypmed.2013.06.019] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 05/23/2013] [Accepted: 06/17/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To analyse available review-level evidence on the effectiveness of population-level interventions in non-clinical settings to reduce alcohol consumption or related health or social harm. METHOD Health, social policy and specialist review databases between 2002 and 2012 were searched for systematic reviews of the effectiveness of population-level alcohol interventions on consumption or alcohol-related health or social outcomes. Data were extracted on review research aim, inclusion criteria, outcome indicators, results, conclusions and limitations. Reviews were quality-assessed using AMSTAR criteria. A narrative synthesis was conducted overall and by policy area. RESULTS Fifty-two reviews were included from ten policy areas. There is good evidence for policies and interventions to limit alcohol sale availability, to reduce drink-driving, to increase alcohol price or taxation. There is mixed evidence for family- and community-level interventions, school-based interventions, and interventions in the alcohol server setting and the mass media. There is weak evidence for workplace interventions and for interventions targeting illicit alcohol sales. There is evidence of the ineffectiveness of interventions in higher education settings. CONCLUSION There is a pattern of support from the evidence base for regulatory or statutory enforcement interventions over local non-regulatory approaches targeting specific population groups.
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98
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The investigation of tramadol dependence with no history of substance abuse: a cross-sectional survey of spontaneously reported cases in Guangzhou City, China. BIOMED RESEARCH INTERNATIONAL 2013; 2013:283425. [PMID: 24151592 PMCID: PMC3787562 DOI: 10.1155/2013/283425] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/14/2013] [Accepted: 08/14/2013] [Indexed: 11/17/2022]
Abstract
The study was to survey and assess the drug dependence and abuse potential of tramadol with no history of substance abuse. Subjects of tramadol dependence with no prior history of substance abuse were surveyed by interview. Physical dependence of tramadol was assessed using 10 items opiate withdrawal scale (OWS), and psychological dependence was assessed by Addiction Research Center Inventory-Chinese Version (ARCI-CV). Twenty-three male subjects (the median age was 23.4 ± 4.1 years) referred to the addiction unit in Medical Hospital of Guangzhou with tramadol abuse problems were included in this cross-sectional study. The control group included 87 heroin addicts, 60 methamphetamine (MA) abusers, and 50 healthy men. The scores of OWS of tramadol were 0.83-2.30; the mean scores of identifying euphoric effects-MBG, sedative effects-PCAG, and psychotomimetic effects-LSD of ARCI were 8.96 ± 3.08, 6.52 ± 3.25, and 6.65 ± 2.50, respectively, F = 4.927, P < 0.001. Scores of MBG scale in tramadol did not differ from those in heroin and MA groups (P > 0.05) but were higher than those in healthy men (P < 0.05). Tramadol with no history of substance abuse has a clear risk of producing high abuse potential under the long-term infrequent abuse and the high doses.
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99
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Yuan C, Lv J, VanderWeele TJ. An assessment of health behavior peer effects in Peking University dormitories: a randomized cluster-assignment design for interference. PLoS One 2013; 8:e75009. [PMID: 24040377 PMCID: PMC3767642 DOI: 10.1371/journal.pone.0075009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 08/09/2013] [Indexed: 11/18/2022] Open
Abstract
Background Relatively little is known about the peer influence in health behaviors within university dormitory rooms. Moreover, in China, the problem of unhealthy behaviors among university students has not yet been sufficiently recognized. We thus investigated health behavior peer influence in Peking University dormitories utilizing a randomized cluster-assignment design. Methods Study design: Cross-sectional in-dormitory survey. Study population: Current students from Peking University Health Science Center from April to June, 2009. Measurement: Self-reported questionnaire on health behaviors: physical activity (including bicycling), dietary intake and tobacco use. Results Use of bicycle, moderate-intensity exercise, frequency of sweet food and soybean milk intake, frequency of roasted/baked/toasted food intake were behaviors significantly or marginally significantly affected by peer influence. Conclusion Health behavior peer effects exist within dormitory rooms among university students. This could provide guidance on room assignment, or inform intervention programs. Examining these may demand attention from university administrators and policy makers.
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Affiliation(s)
- Changzheng Yuan
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
- * E-mail:
| | - Tyler J. VanderWeele
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, United States of America
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100
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Gauffin K, Vinnerljung B, Fridell M, Hesse M, Hjern A. Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study. Addiction 2013; 108:1441-9. [PMID: 23489245 DOI: 10.1111/add.12169] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 09/03/2012] [Accepted: 02/21/2013] [Indexed: 12/20/2022]
Abstract
AIM To investigate whether socio-economic status (SES) in childhood and school failure at 15 years of age predict illicit drug abuse in youth and young adulthood. DESIGN, SETTING AND PARTICIPANTS Register study in a Swedish national cohort born 1973-88 (n = 1,405,763), followed from age 16 to 20-35 years. Cox regression analyses were used to calculate hazard ratios (HR) for any indication of drug abuse. MEASUREMENTS Our outcomes were hospital admissions, death and criminality associated with illicit drug abuse. Data on socio-demographics, school grades and parental psychosocial problems were collected from censuses (1985 and 1990) and national registers. School failure was defined as having mean school grades from the final year in primary school lower than -1 standard deviation and/or no grades in core subjects. FINDINGS School failure was a strong predictor of illicit drug abuse with an HR of 5.87 (95% CI: 5.76-5.99) after adjustment for age and sex. Childhood SES was associated with illicit drug abuse later in life in a stepwise manner. The lowest stratum had a HR of 2.28 (95% CI: 2.20-2.37) compared with the highest stratum as the reference, when adjusted for other socio-demographic variables. In the fully adjusted model, the effect of SES was greatly attenuated to an HR of 1.23 (95% CI: 1.19-1.28) in the lowest SES category, while the effect of school failure remained high with an HR of 4.22 (95% CI: 4.13-4.31). CONCLUSIONS School failure and childhood socio-economic status predict illicit drug abuse independently in youth and young adults in Sweden.
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Affiliation(s)
- Karl Gauffin
- Centre for Health Equity Studies, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
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