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Olaoye OA, Adejumobi AS, Ogundele TF, Akande MA. Effect of a context-specific health education intervention on knowledge of health risk behaviors among adolescents in Nigerian public and private secondary schools: a comparative study. Int J Adolesc Med Health 2024; 0:ijamh-2024-0062. [PMID: 39151416 DOI: 10.1515/ijamh-2024-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 07/18/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVES Health education programmes that utilizes multicomponent classroom teaching strategies have the potential to enhance knowledge, attitudes, and actions of adolescents concerning health risk behaviors (HRBs). This study assessed the effect of a school-based context-specific health education intervention (CsHEI) on knowledge of HRBs among in-school adolescents in public- and private-owned secondary schools in Nigeria. METHODS In-school adolescents were recruited into this quasi-experimental study using stratified random sampling from secondary schools in Ile-Ife, Osun-State, Nigeria. Knowledge of HRBs was assessed pre- and post-implementation of a CsHEI. The intervention was a four-week instructor-led health education class on HRBs, delivered over a 2-h class activity per week. Data was summarized using descriptive statistics as well as Inferential statistics. RESULTS With a mean age of 14.9 ± 1.56 years, a total of 145 females (54.3 %) and 122 males (45.7 %) participated in this study. Over 70 % of the participants had good knowledge of HRBs prior to the intervention with the pre-test mean general knowledge of HRB (t=-3.13, p=0.002) and knowledge of personal safety (t=-2.99, p=0.003) being significantly lower between students in public-schools compared to their private-school counterparts. Post-intervention, a significant improvement in participants' knowledge was observed in all HRB domains with over 90 % of participants having a good knowledge of HRBs. CONCLUSIONS The CsHEI improved knowledge of in-school adolescents in public- and private-owned secondary schools in Osun state, Nigeria in all domains of HRBs. Integrating the CsHEI with other health behavioral change strategies can mitigate prevalence of HRBs among adolescents, thereby improving health-outcomes and well-being of adolescents.
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Affiliation(s)
- Olumide Ayoola Olaoye
- Department of Medical Rehabilitation, College of Health Sciences, 54715 Obafemi Awolowo University , Ile-Ife, Nigeria
| | - Adeyemi S Adejumobi
- Department of Medical Rehabilitation, College of Health Sciences, 54715 Obafemi Awolowo University , Ile-Ife, Nigeria
| | - Tobi F Ogundele
- Department of Occupational Therapy, Federal Neuro Psychiatric Hospital Yaba, Yaba, Lagos, Nigeria
| | - Micheal A Akande
- Department of Occupational Therapy, University of Benin Teaching Hospital, Benin City, Edo, Nigeria
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Jensen MP, Krølner RF, Thygesen LC, Lund L, Andersen S. The Impact of Implementation Fidelity of a School-Based Multi-Component Smoking Prevention Intervention on Vocational Students' Smoking Behavior: A Cluster-Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01712-8. [PMID: 39093518 DOI: 10.1007/s11121-024-01712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Abstract
Preventing young people's cigarette smoking is a major public health priority, and smoking is especially prevalent in vocational schools. Well-enforced comprehensive school tobacco policies accompanied by preventive efforts show potential to reduce smoking, but the implementation process is crucial to achieve the intended effect. We investigate whether and how implementation fidelity of a multi-component smoking prevention intervention impacted student smoking outcomes after 4-5 months among students in Danish vocational education and training (national age range 15-65 years, mean 25.6) and preparatory basic education (national age range 15-25 years, mean 17.6) institutions using questionnaire data from a cluster-RCT. The intervention included a smoke-free school hours policy, educational curriculum, and class competition. We calculated an overall implementation fidelity measure combining staff-reported school-level delivery (fidelity) and student-reported receipt (participation, responsiveness), and used multilevel regression models to analyze associations with smoking outcomes (smoking daily, regularly, and during school hours). We supplemented the analysis with restricted cubic spline regression. Additionally, we stratified the analyses by school types and analyzed associations between implementation fidelity of the separate intervention components and smoking outcomes. High implementation was associated with lower odds of regular smoking (OR: 0.37, 95% CI: 0.18-0.78) and smoking during school hours, but not daily smoking, and these associations varied between the school settings. When analyzed separately, implementation fidelity of the components did not affect the outcomes significantly. Our findings underline the need to support the implementation process of school tobacco policy interventions to ensure the intended effects of reducing students' smoking.
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Affiliation(s)
- Marie Pil Jensen
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark.
| | - Rikke Fredenslund Krølner
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Lau Caspar Thygesen
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Lisbeth Lund
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Susan Andersen
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
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McGovern R, Balogun-Katung A, Artis B, Bareham B, Spencer L, Alderson H, Brown E, Brown J, Lingam R, McArdle P, Newham JJ, Wojciechowska A, Rankin J, Redgate S, Thomason P, Kaner E. The Effectiveness of Preventative Interventions to Reduce Mental Health Problems in at-risk Children and Young People: A Systematic Review of Reviews. JOURNAL OF PREVENTION (2022) 2024; 45:651-684. [PMID: 38884876 PMCID: PMC11271346 DOI: 10.1007/s10935-024-00785-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
Mental health problems are the leading cause of childhood disability worldwide, resulting in poor outcomes for children and young people that persist into adulthood. It is essential that those young people most at risk of developing mental health problems receive effective preventative interventions. Whilst there have been a number of systematic reviews which have examined the effectiveness of secondary prevention interventions for specific groups of children and young people, or to address identified mental health concerns, no review has engaged with the breadth of this literature. We conducted a systematic review of systematic reviews to map this complex field of secondary preventative interventions and identify effective interventions to prevent mental health problems in children and adolescents aged 3-17 years. The review protocol was registered on PROSPERO. We searched five electronic databases from inception to February 2023. The certainty of the evidence was appraised using the AMSTAR 2. We included 49 unique systematic reviews each including between 2 and 249 (mean 34) unique studies; the majority of which were reviews which included only or mostly randomised controlled trials (70%). The reviews examined selective interventions (defined as interventions which are delivered to sub-group populations of young people at increased risk of mental health problems) (n = 22), indicated interventions (defined as interventions which target young people who are found to have pre-clinical symptoms) (n = 15) or a synthesis of both (n = 12). The certainty of the evidence in the reviews was rated as high, (n = 12) moderate (n = 5), low (n = 9) and critically low (n = 23). We found evidence to support both selective and indicated interventions in a range of populations and settings, with most of this evidence available for children and young people in their mid-years (6-10 years) and early adolescence (11-13 years). There was a large body of evidence suggesting that resilience enhancing, cognitive behaviour therapy-based and psychoeducational interventions for children who experience adversity, or those with subclinical externalising problems may offer promise. Early selective interventions for a subpopulation of children and young people who have experienced adversity which combines risk reduction and resilience enhancing approaches directed at children and their families may be effective at reducing mental health problems.
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Affiliation(s)
- R McGovern
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Artis
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Bareham
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - E Brown
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - J Brown
- Children's Social Care, Newcastle City Council, Newcastle upon Tyne, UK
| | - R Lingam
- Population Child Health Research Group, School of Women and Children's Health, University New South Wales, Sydney, Australia
| | - P McArdle
- Child and Adolescent Mental Health Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - A Wojciechowska
- Disabilities Integrated Team at the Tees, Esk and Wear Valleys, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - S Redgate
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - P Thomason
- Children's Social Care, Gateshead Council, Tyne and Wear, UK
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
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Shi B, Li G, Wu S, Ge H, Zhang X, Chen S, Pan Y, He Q. Assessing the Effectiveness of eHealth Interventions to Manage Multiple Lifestyle Risk Behaviors Among Older Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e58174. [PMID: 39083787 PMCID: PMC11325121 DOI: 10.2196/58174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/24/2024] [Accepted: 06/01/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Developing adverse lifestyle behaviors increases the risk of a variety of chronic age-related diseases, including cardiovascular disease, obesity, and Alzheimer disease. There is limited evidence regarding the effectiveness of eHealth-based multiple health behavior change (MHBC) interventions to manage lifestyle risk behaviors. OBJECTIVE The purpose of this systematic evaluation was to assess the effectiveness of eHealth MHBC interventions in changing ≥2 major lifestyle risk behaviors in people aged ≥50 years. METHODS The literature search was conducted in 6 electronic databases-PubMed, Embase, Web of Science, Scopus, Cochrane Library, and SPORTDiscus-from inception to May 1, 2024. Eligible studies were randomized controlled trials of eHealth interventions targeting ≥2 of 6 behaviors of interest: alcohol use, smoking, diet, physical activity (PA), sedentary behavior, and sleep. RESULTS A total of 34 articles with 35 studies were included. eHealth-based MHBC interventions significantly increased smoking cessation rates (odds ratio 2.09, 95% CI 1.62-2.70; P<.001), fruit intake (standardized mean difference [SMD] 0.18, 95% CI 0.04-0.32; P=.01), vegetable intake (SMD 0.17, 95% CI 0.05-0.28; P=.003), self-reported total PA (SMD 0.22, 95% CI 0.02-0.43; P=.03), and objectively measured moderate to vigorous PA (SMD 0.25, 95% CI 0.09-0.41; P=.002); in addition, the interventions decreased fat intake (SMD -0.23, 95% CI -0.33 to -0.13; P<.001). No effects were observed for alcohol use, sedentary behavior, or sleep. A sensitivity analysis was conducted to test the robustness of the pooled results. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. CONCLUSIONS eHealth-based MHBC interventions may be a promising strategy to increase PA, improve diet, and reduce smoking among older adults. However, the effect sizes were small. Further high-quality, older adult-oriented research is needed to develop eHealth interventions that can change multiple behaviors. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42023444418; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023444418.
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Affiliation(s)
- Beibei Shi
- School of Physical Education, Shandong University, Jinan, China
| | - Guangkai Li
- School of Physical Education, Shandong University, Jinan, China
| | - Shuang Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Hongli Ge
- School of Physical Education, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yang Pan
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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Clune S, Ratnaike D, White V, Donaldson A, Randle E, O'Halloran P, Lewis V. What is known about population level programs designed to address gambling-related harm: rapid review of the evidence. Harm Reduct J 2024; 21:118. [PMID: 38890632 PMCID: PMC11184756 DOI: 10.1186/s12954-024-01032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level. METHODS The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems. RESULTS One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective. CONCLUSIONS Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.
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Affiliation(s)
- Samantha Clune
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia.
| | - Deepika Ratnaike
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Vanessa White
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Erica Randle
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Paul O'Halloran
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Virginia Lewis
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
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Arellano Spano M, Morris TT, Davies NM, Hughes A. Genetic associations of risk behaviours and educational achievement. Commun Biol 2024; 7:435. [PMID: 38600303 PMCID: PMC11006670 DOI: 10.1038/s42003-024-06091-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/22/2024] [Indexed: 04/12/2024] Open
Abstract
Risk behaviours are common in adolescent and persist into adulthood, people who engage in more risk behaviours are more likely to have lower educational attainment. We applied genetic causal inference methods to explore the causal relationship between adolescent risk behaviours and educational achievement. Risk behaviours were phenotypically associated with educational achievement at age 16 after adjusting for confounders (-0.11, 95%CI: -0.11, -0.09). Genomic-based restricted maximum likelihood (GREML) results indicated that both traits were heritable and have a shared genetic architecture (Riskh 2 = 0.18, 95% CI: -0.11,0.47; educationh 2 = 0.60, 95%CI: 0.50,0.70). Consistent with the phenotypic results, genetic variation associated with risk behaviour was negatively associated with education (r g = -0.51, 95%CI: -1.04,0.02). Lastly, the bidirectional MR results indicate that educational achievement or a closely related trait is likely to affect risk behaviours PGI (β=-1.04, 95% CI: -1.41, -0.67), but we found little evidence that the genetic variation associated with risk behaviours affected educational achievement (β=0.00, 95% CI: -0.24,0.24). The results suggest engagement in risk behaviour may be partly driven by educational achievement or a closely related trait.
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Affiliation(s)
- Michelle Arellano Spano
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, BS8 2BN, United Kingdom.
- Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, United Kingdom.
| | - Tim T Morris
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, United Kingdom
| | - Neil M Davies
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7NF, United Kingdom
- Department of Statistical Sciences, University College London, London, WC1E 6BT, United Kingdom
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Amanda Hughes
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, BS8 2BN, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, United Kingdom
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Lee CK, Liao LL. Feasibility of Intervention Program to Prevent Adolescent Health-Compromising Behaviors. J Sch Nurs 2024; 40:155-165. [PMID: 34661470 DOI: 10.1177/10598405211046198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Most people start experimenting with and/or initiating health-compromising behaviors and establishing behavioral patterns during adolescence. Possible selves and episodic future thinking have been used to foster behavioral changes. In this study, we aimed to (1) develop a program incorporating possible selves and episodic future thinking to decrease the risks associated with health-compromising behaviors, and (2) examine the feasibility and fidelity of implementing this intervention among Taiwanese adolescents. A novel combination of existing intervention approaches tailored for the Taiwanese context was applied to develop a school-based intervention, which we named the Future Mapping Master program. This program contains four core units: exploring the self, setting goals, developing strategies and problem solving, and understanding the threats of health-compromising behaviors. It includes daily episodic future thinking visualization exercises. The feasibility evaluation was conducted with 88 adolescents aged 12-14 years. Feedback from teachers and students supported the proposed program's feasibility and revealed favorable reactions to the intervention. The Future Mapping Master program is feasible and offers promising strategies for implementation in Taiwanese school settings.
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Affiliation(s)
- Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
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Tinner L, Kelly C, Caldwell D, Campbell R. Community mobilisation approaches to preventing adolescent multiple risk behaviour: a realist review. Syst Rev 2024; 13:75. [PMID: 38409098 PMCID: PMC10895861 DOI: 10.1186/s13643-024-02450-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/03/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Adolescent multiple risk behaviour (MRB) is a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, with systematic reviews reporting mixed evidence of effectiveness. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. There are gaps in the current literature, theory and implementation that would benefit from a realist approach. We use a theory-driven evidence synthesis to assess how and why community mobilisation interventions work/do not work to prevent adolescent MRB and in what contexts. METHODS This realist review used a six-stage iterative process, guided by the RAMESES framework. We systematically searched PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological Abstracts, from their inception to 2021. Studies were screened for relevance to the programme theory, assessed for rigour and included based on a priori criteria. Two independent reviewers selected, screened and extracted data from included studies. A realist logic of analysis was used to develop context-mechanism-outcome configurations that contributed to our programme theory. FINDINGS We reviewed 35 documents describing 22 separate community mobilisation intervention studies. Most studies (n = 17) had a quality assessment score of three or four (out of four). We analysed the studies in relation to three middle range theories. To uphold our theory that these interventions work by creating a social environment where adolescents are less likely to engage in MRB, interventions should: (1) embed a framework of guiding principles throughout the community, (2) establish community readiness with population data and (3) ensure a diverse coalition with the support of intervention champions. Mechanisms such as empowerment through coalition ownership over the delivery of the intervention, cohesion across the community and motivation to work collaboratively to improve adolescent health are triggered to achieve social environment shifts. However, certain contexts (e.g. limited funding) restrict intervention success as these mechanisms are not fired. CONCLUSIONS For community mobilisation interventions to reduce adolescent MRB, the coalitions within them must seek to alter the social environment in which these behaviours occur. Mechanisms including empowerment, cohesion and motivation lead to this shift, but only under certain contexts. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020205342.
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Affiliation(s)
- Laura Tinner
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK.
| | - Claire Kelly
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK
| | - Deborah Caldwell
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK
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Sodipo OY, Afolaranmi TO, Agbo HA, Envuladu EA, Lar LA, Udofia EA, Zoakah AI. Co-occurrence of non-communicable disease risk factors among adolescents in Jos, Nigeria. Afr J Prim Health Care Fam Med 2024; 16:e1-e8. [PMID: 38426771 PMCID: PMC10913136 DOI: 10.4102/phcfm.v16i1.4342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The co-occurrence and clustering of risk factors for non-communicable disease (NCD) is a global public health concern. AIM This study aimed to assess the co-occurrence and clustering of risk factors for NCDs among in-school and out-of-school adolescents in Jos North Local Government Area, Plateau State, Nigeria. SETTING Secondary schools and markets in Jos North Local Government Area. METHODS A comparative cross-sectional study was conducted among 377 in-school and 377 out-of-school adolescents, aged 10-19 years of age. An interviewer-administered questionnaire was used to collect information on behavioural and physical risk factors for NCDs. Chi-square and Mann-Whitney U tests were used for comparisons at a 5% level of significance. Statistical analysis was carried out using Statistical Product and Service Solutions (SPSS) version 23.0. RESULTS Of the 754 sampled adolescents, 386 (51.2%) were females and 368 (48.8%) were males. Adolescents aged 10-14 years made up 37.8% of the participants, 15 to 17 years of age accounted for 46.9% and 18-19 years 15.3%. Risk factors with the highest prevalence were a sedentary lifestyle (94.2%) and an unhealthy diet (92.4%). Majority (97.2%) had two or more risk factors while 1.9% of adolescents had no risk factor. More in-school adolescents (24.1%) had two risk factors compared to 14.1% of out-of-school adolescents (p 0.001); 14.1% of out-of-school adolescents had five or more risk factors compared to 2.9% of those in school (p 0.001). CONCLUSION Co-occurrence and clustering of behavioural and physical risk factors was found among both in-school and out-of-school adolescents.Contribution: This study highlighted the burden of risk factors for NCDs among both in-school and out-of-school adolescents in the North-Central part of Nigeria. This is especially useful in developing targeted interventions to tackle these risk factors.
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Affiliation(s)
- Olutomi Y Sodipo
- Department of Community Medicine, Jos University Teaching Hospital, Jos.
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10
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Kirchhoff E, Keller R, Blanc B. Empowering young people-the impact of camp experiences on personal resources, well-being, and community building. Front Psychol 2024; 15:1348050. [PMID: 38420173 PMCID: PMC10899333 DOI: 10.3389/fpsyg.2024.1348050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Personal resources and resources of the sociocultural environment help children and adolescents to successfully cope with challenges in everyday life, which is associated with better individual well-being. SCOUT, the 'Study on Competence development in OUT-of-school settings', investigated whether participation in a summer camp enhanced adolescents' personal resources, well-being, and readiness to contribute to the community. Methods The research took place during the Swiss National Jamboree of the Swiss Guide and Scout Movement, a two-week event in the summer of 2022, with a paper-pencil pretest (beginning of the camp - T1) and posttest (end of the camp - T2) survey (N = 607, aged 14-17). Confirmatory factor analyses were used to examine whether personal resources, well-being, and readiness to contribute to the community changed over time, and structural equation models were applied to test the direct and indirect effects of caring support from group leaders on the development of these variables. Results In less than two weeks, camp participants demonstrated increased empathy, emotional self-control, optimism, and assertiveness. Furthermore, the adolescents reported more positive emotions, higher self-esteem, and stronger readiness to contribute to the community. Group leaders played a crucial role by influencing the positive development of well-being and readiness to contribute to the community both directly and indirectly through the promotion of personal resources. Discussion The findings indicate that young people benefit not only from participating in collaborative activities in a stimulating environment, but also from caring support provided by their group leaders.
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Affiliation(s)
| | - Roger Keller
- Zurich University of Teacher Education, Zürich, Switzerland
| | - Barbara Blanc
- Zurich University of Teacher Education, Zürich, Switzerland
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Mahadevan J, Gautam M, Benegal V. Mental health and well-being for the prevention of substance use disorders. Indian J Psychiatry 2024; 66:S272-S282. [PMID: 38445279 PMCID: PMC10911324 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_716_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 03/07/2024] Open
Affiliation(s)
- Jayant Mahadevan
- Department of Psychiatry, Centre for Addiction Medicine, NIMHANS, Bangalore, Karnataka, India E-mail:
| | - Manaswi Gautam
- Consultant Psychiatrist, Gautam Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Vivek Benegal
- Department of Psychiatry, Centre for Addiction Medicine, NIMHANS, Bangalore, Karnataka, India E-mail:
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12
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Salam RA, Khan MH, Meerza SSA, Das JK, Lewis-Watts L, Bhutta ZA. An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents. Nat Med 2024; 30:290-301. [PMID: 38195753 DOI: 10.1038/s41591-023-02737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Substance misuse, obesity, mental health conditions, type 1 diabetes, cancers, and cardiovascular and chronic respiratory diseases together account for 41% of disability-adjusted life years linked to noncommunicable diseases (NCDs) among children and adolescents worldwide. However, the evidence on risk factors and interventions for this age group is scarce. Here we searched four databases to generate an evidence gap map of existing interventions and research gaps for these risk factors and NCDs. We mapped 159 reviews with 2,611 primary studies; most (96.2%) were conducted in high-income countries, and only 100 studies (3.8%) were from low- and middle-income countries (LMICs). The efficacy of therapeutic interventions on biomarkers and adverse events for NCDs appears to be well evidenced. Interventions for mental health conditions appear to be moderately evidenced, while interventions for obesity and substance misuse appear to be moderate to very low evidenced. Priority areas for future research include evaluating digital health platforms to support primary NCD prevention and management, and evaluating the impact of policy changes on the prevalence of obesity and substance misuse. Our findings highlight the wide disparity of evidence between high-income countries and LMICs. There is an urgent need for increased, targeted financing to address the research gaps in LMICs.
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Affiliation(s)
- Rehana A Salam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Maryam Hameed Khan
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Saqlain Ali Meerza
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
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13
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Pinho-Gomes AC, Santos JA, Jones A, Thout SR, Pettigrew S. E-cigarette attitudes and behaviours amongst 15-30-year-olds in the UK. J Public Health (Oxf) 2023; 45:e763-e775. [PMID: 37525566 PMCID: PMC10687603 DOI: 10.1093/pubmed/fdad138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/08/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The use of e-cigarettes has been rising in the UK, particularly by young people. This study investigated behaviours, attitudes and beliefs about e-cigarettes amongst 15-30-year-olds in the UK. METHODS An online survey was administered to a sample of 1009 15-30-year-olds in the UK. RESULTS About one in five participants currently used e-cigarettes at least monthly, with 1 in 10 using them daily. Amongst those using e-cigarettes at least monthly, 90% had used e-cigarettes containing nicotine. E-cigarettes were mainly obtained from vape shops and used at home. Having friends who used e-cigarettes and using them to help quit/reduce smoking were the most common reasons for vaping. About half of participants had been exposed to e-cigarette advertising, especially online, and warning labels on e-cigarettes. Most participants agreed that e-cigarettes are addictive (75%), help people quitting smoking (64%) and are bad for health (63%). Previous or current tobacco smokers were 9 and 22 times more likely to use e-cigarettes than never smokers, respectively. Perceiving e-cigarettes as harmful was associated with a 40% lower likelihood of use. CONCLUSION Raising awareness on the uncertain long-term consequences of vaping and regulation of marketing and sales are crucial to protect young people in the UK.
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Affiliation(s)
- Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, School of Public Health, Imperial College London, 58 Wood Lane London, W12 7RZ, UK
- Institute of Health Informatics, University College London, 222 Euston Road London, NW1 2DA, UK
| | - Joseph A Santos
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street Newtown 2042, Sydney, NSW, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street Newtown 2042, Sydney, NSW, Australia
| | - Sudhir Raj Thout
- The George Institute for Global Health, 308, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre New Delhi 110025, India
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street Newtown 2042, Sydney, NSW, Australia
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14
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Purba AK, Thomson RM, Henery PM, Pearce A, Henderson M, Katikireddi SV. Social media use and health risk behaviours in young people: systematic review and meta-analysis. BMJ 2023; 383:e073552. [PMID: 38030217 PMCID: PMC10685288 DOI: 10.1136/bmj-2022-073552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years). DESIGN Systematic review and meta-analysis. DATA SOURCES EMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXic, PsyArXiv, medRxiv, and Google Scholar (1 January 1997 to 6 June 2022). METHODS Health risk behaviours were defined as use of alcohol, drugs, tobacco, electronic nicotine delivery systems, unhealthy dietary behaviour, inadequate physical activity, gambling, and anti-social, sexual risk, and multiple risk behaviours. Included studies reported a social media variable (ie, time spent, frequency of use, exposure to health risk behaviour content, or other social media activities) and one or more relevant outcomes. Screening and risk of bias assessments were completed independently by two reviewers. Synthesis without meta-analysis based on effect direction and random-effects meta-analyses was used. Effect modification was explored using meta-regression and stratification. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS Of 17 077 studies screened, 126 were included (73 included in meta-analyses). The final sample included 1 431 534 adolescents (mean age 15.0 years). Synthesis without meta-analysis indicated harmful associations between social media and all health risk behaviours in most included studies, except inadequate physical activity where beneficial associations were reported in 63.6% of studies. Frequent (v infrequent) social media use was associated with increased alcohol consumption (odds ratio 1.48 (95% confidence interval 1.35 to 1.62); n=383 068), drug use (1.28 (1.05 to 1.56); n=117 646), tobacco use (1.85, 1.49 to 2.30; n=424 326), sexual risk behaviours (1.77 (1.48 to 2.12); n=47 280), anti-social behaviour (1.73 (1.44 to 2.06); n=54 993), multiple risk behaviours (1.75 (1.30 to 2.35); n=43 571), and gambling (2.84 (2.04 to 3.97); n=26 537). Exposure to content showcasing health risk behaviours on social media (v no exposure) was associated with increased odds of use of electronic nicotine delivery systems (1.73 (1.34 to 2.23); n=721 322), unhealthy dietary behaviours (2.48 (2.08 to 2.97); n=9892), and alcohol consumption (2.43 (1.25 to 4.71); n=14 731). For alcohol consumption, stronger associations were identified for exposure to user generated content (3.21 (2.37 to 4.33)) versus marketer generated content (2.12 (1.06 to 4.24)). For time spent on social media, use for at least 2 h per day (v <2 h) increased odds of alcohol consumption (2.12 (1.53 to 2.95); n=12 390). GRADE certainty was moderate for unhealthy dietary behaviour, low for alcohol use, and very low for other investigated outcomes. CONCLUSIONS Social media use is associated with adverse health risk behaviours in young people, but further high quality research is needed to establish causality, understand effects on health inequalities, and determine which aspects of social media are most harmful. STUDY REGISTRATION PROSPERO, CRD42020179766.
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Affiliation(s)
- Amrit Kaur Purba
- 1 Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- 2Public Health Scotland, Edinburgh, UK
- 3School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | - Rachel M Thomson
- 1 Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- 2Public Health Scotland, Edinburgh, UK
- 3School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | - Paul M Henery
- 1 Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- 2Public Health Scotland, Edinburgh, UK
- 3School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | - Anna Pearce
- 1 Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- 2Public Health Scotland, Edinburgh, UK
- 3School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | - Marion Henderson
- 1 Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- 2Public Health Scotland, Edinburgh, UK
- 3School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | - S Vittal Katikireddi
- 1 Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- 2Public Health Scotland, Edinburgh, UK
- 3School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
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15
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Younossi ZM, Zelber-Sagi S, Henry L, Gerber LH. Lifestyle interventions in nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2023; 20:708-722. [PMID: 37402873 DOI: 10.1038/s41575-023-00800-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 07/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a dynamic chronic liver disease that develops in close association with metabolic irregularities. Between 2016 and 2019, the global prevalence among adults was reported as 38% and among children and adolescents it was about 10%. NAFLD can be progressive and is associated with increased mortality from cardiovascular disease, extrahepatic cancers and liver complications. Despite these numerous adverse outcomes, no pharmacological treatments currently exist to treat nonalcoholic steatohepatitis, the progressive form of NAFLD. Therefore, the main treatment is the pursuit of a healthy lifestyle for both children and adults, which includes a diet rich in fruits, nuts, seeds, whole grains, fish and chicken and avoiding overconsumption of ultra-processed food, red meat, sugar-sweetened beverages and foods cooked at high heat. Physical activity at a level where one can talk but not sing is also recommended, including leisure-time activities and structured exercise. Avoidance of smoking and alcohol is also recommended. Policy-makers, community and school leaders need to work together to make their environments healthy by developing walkable and safe spaces with food stores stocked with culturally appropriate and healthy food items at affordable prices as well as providing age-appropriate and safe play areas in both schools and neighbourhoods.
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Affiliation(s)
- Zobair M Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
- Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA.
- Inova Medicine, Inova Health System, Falls Church, VA, USA.
| | | | - Linda Henry
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
- Inova Medicine, Inova Health System, Falls Church, VA, USA
| | - Lynn H Gerber
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
- Inova Medicine, Inova Health System, Falls Church, VA, USA
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16
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Sánchez-Franco S, Montgomery SC, Torres-Narvaez ES, Ramírez AM, Murray JM, Tate C, Llorente B, Bauld L, Hunter RF, Kee F, Sarmiento OL. How Do Adolescent Smoking Prevention Interventions Work in Different Contextual Settings? A Qualitative Comparative Study Between the UK and Colombia. Int J Behav Med 2023:10.1007/s12529-023-10211-z. [PMID: 37697141 DOI: 10.1007/s12529-023-10211-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings. METHOD A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15 years). The Theoretical Domains Framework guided a content analysis of the data. RESULTS We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape. CONCLUSION These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.
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Affiliation(s)
- Sharon Sánchez-Franco
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia
| | | | - Erika S Torres-Narvaez
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia
| | - Ana M Ramírez
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia
| | - Jennifer M Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Christopher Tate
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | | | - Linda Bauld
- College of Medicine and Veterinary Medicine, Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Olga L Sarmiento
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia.
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17
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Sloboda Z, Johnson KA, Fishbein DH, Brown CH, Coatsworth JD, Fixsen DL, Kandel D, Paschall MJ, Silva FS, Sumnall H, Vanyukov M. Normalization of Prevention Principles and Practices to Reduce Substance Use Disorders Through an Integrated Dissemination and Implementation Framework. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1078-1090. [PMID: 37052866 PMCID: PMC10476513 DOI: 10.1007/s11121-023-01532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
Major research breakthroughs over the past 30 years in the field of substance use prevention have served to: (1) enhance understanding of pharmacological effects on the central and peripheral nervous systems and the health and social consequences of use of psychoactive substances, particularly for children and adolescents; (2) delineate the processes that increase vulnerability to or protect from initiation of substance use and progression to substance use disorders (SUDs) and, based on this understanding, (3) develop effective strategies and practices to prevent the initiation and escalation of substance use. The challenge we now face as a field is to "normalize" what we have learned from this research so that it is incorporated into the work of those involved in supporting, planning, and delivering prevention programming to populations around the world, is integrated into health and social service systems, and helps to shape public policies. But we wish to go further, to incorporate these effective prevention practices into everyday life and the mind-sets of the public, particularly parents and educators. This paper reviews the advances that have been made in the field of prevention and presents a framework and recommendations to achieve these objectives generated during several meetings of prevention and implementation science researchers sponsored by the International Consortium of Universities for Drug Demand Reduction (ICUDDR) that guides a roadmap to achieve "normalization."
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Affiliation(s)
- Zili Sloboda
- Applied Prevention Science International, Ontario, OH, USA.
| | - Kimberly A Johnson
- Department of Mental Health Law and Policy, College of Community and Behavioral Sciences, University of South Florida, Tampa, FL, USA
- International Consortium of Universities of Drug Demand Reduction, Tampa, FL, USA
| | - Diana H Fishbein
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
- National Prevention Science, The Pennsylvania State University, State College, Harrisburg, PA, USA
| | | | | | - Dean L Fixsen
- Active Implementation Research Network, Inc, Chapel Hill, NC, USA
| | - Denise Kandel
- Department of Psychiatry and School of Public Health, Columbia University, New York, NY, USA
| | - Mallie J Paschall
- Prevention Research Center (PRC), Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - Harry Sumnall
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Michael Vanyukov
- Departments of Pharmaceutical Sciences, Psychiatry, and Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Guthold R, Kann L, Bhatti L, Abduvahobov P, Ansong J, Atkinson U, Baltag V, Caffe S, Caixeta R, Diallo CB, Fouad H, Haddad S, Hachri H, Jaggi JA, Joshi P, Karna P, Louazani SA, Mbola Mbassi S, Mehta R, Mudgal Y, Nigg CR, Okely AD, Ondarsuhu D, Ouaourir T, Trhari FZ, Riley LM. Effectiveness of a participatory approach to develop school health interventions in four low resource cities: study protocol of the 'empowering adolescents to lead change using health data' cluster randomised controlled trial. BMJ Open 2023; 13:e071353. [PMID: 37407059 PMCID: PMC10335517 DOI: 10.1136/bmjopen-2022-071353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION Comprehensive local data on adolescent health are often lacking, particularly in lower resource settings. Furthermore, there are knowledge gaps around which interventions are effective to support healthy behaviours. This study generates health information for students from cities in four middle-income countries to plan, implement and subsequently evaluate a package of interventions to improve health outcomes. METHODS AND ANALYSIS We will conduct a cluster randomised controlled trial in schools in Fez, Morocco; Jaipur, India; Saint Catherine Parish, Jamaica; and Sekondi-Takoradi, Ghana. In each city, approximately 30 schools will be randomly selected and assigned to the control or intervention arm. Baseline data collection includes three components. First, a Global School Health Policies and Practices Survey (G-SHPPS) to be completed by principals of all selected schools. Second, a Global School-based Student Health Survey (GSHS) to be administered to a target sample of n=3153 13-17 years old students of randomly selected classes of these schools, including questions on alcohol, tobacco and drug use, diet, hygiene, mental health, physical activity, protective factors, sexual behaviours, violence and injury. Third, a study validating the GSHS physical activity questions against wrist-worn accelerometry in one randomly selected class in each control school (n approximately 300 students per city). Intervention schools will develop a suite of interventions using a participatory approach driven by students and involving parents/guardians, teachers and community stakeholders. Interventions will aim to change existing structures and policies at schools to positively influence students' behaviour, using the collected data and guided by the framework for Making Every School a Health Promoting School. Outcomes will be assessed for differential change after a 2-year follow-up. ETHICS AND DISSEMINATION The study was approved by WHO's Research Ethics Review Committee; by the Jodhpur School of Public Health's Institutional Review Board for Jaipur, India; by the Noguchi Memorial Institute for Medical Research Institutional Review Board for Sekondi-Takoradi, Ghana; by the Ministry of Health and Wellness' Advisory Panel on Ethics and Medico-Legal Affairs for St Catherine Parish, Jamaica, and by the Comité d'éthique pour la recherche biomédicale of the Université Mohammed V of Rabat for Fez, Morocco. Findings will be shared through open access publications and conferences. TRIAL REGISTRATION NUMBER NCT04963426.
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Affiliation(s)
- Regina Guthold
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
| | - Laura Kann
- Noncommunicable Diseases Department, WHO, Geneva, Switzerland
| | - Lubna Bhatti
- Noncommunicable Diseases Department, WHO, Geneva, Switzerland
| | - Parviz Abduvahobov
- Health and Education Section, Division for Peace and Sustainable Development, Education Sector, UNESCO, Paris, France
| | | | - Uki Atkinson
- National Council on Drug Abuse, Kingston, Jamaica
| | - Valentina Baltag
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
| | - Sonja Caffe
- Family, Health Promotion and Life Course, PAHO, Washington, Columbia, USA
| | - Roberta Caixeta
- Noncommunicable Diseases and Mental Health Department, PAHO, Washington, Columbia, USA
| | - Cheick Bady Diallo
- Universal Health Coverage/Communicable and Noncommunicable Diseases, WHO Regional Office for Africa, Brazzaville, Congo
| | - Heba Fouad
- Noncommunicable Diseases and Mental Health Department, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Sally Haddad
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | | | - Jeannine A Jaggi
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | | | - Priya Karna
- WHO Country Office for India, New Delhi, India
| | | | - Symplice Mbola Mbassi
- Universal Health Coverage/Life Course, WHO Regional Office for Africa, Brazzaville, Congo
| | - Rajesh Mehta
- WHO Regional Office for South-East Asia, New Delhi, India
| | | | - Claudio R Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Anthony D Okely
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Dolores Ondarsuhu
- Noncommunicable Diseases and Mental Health Department, PAHO, Washington, Columbia, USA
| | - Tahar Ouaourir
- Population Department, Ministry of Health, Rabat, Morocco
| | | | - Leanne M Riley
- Noncommunicable Diseases Department, WHO, Geneva, Switzerland
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19
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Lloyd EC, Reed ZE, Wootton RE. The absence of association between anorexia nervosa and smoking: converging evidence across two studies. Eur Child Adolesc Psychiatry 2023; 32:1229-1240. [PMID: 34939143 PMCID: PMC10276073 DOI: 10.1007/s00787-021-01918-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Previous studies have found increased smoking prevalence amongst adults with anorexia nervosa (AN) compared to the general population. The current investigation explored bidirectional associations between AN and smoking behaviour (initiation and heaviness), to address questions surrounding causation. In Study One, logistic regression models with variance robust standard errors assessed longitudinal associations between AN and smoking, using data from adolescent participants of the Avon Longitudinal Study of Parents and Children (N = 5100). In Study Two, two-sample Mendelian randomisation (MR) tested possible causal effects using summary statistics from publicly available genome-wide association studies (GWAS). Study One provided no clear evidence for a predictive effect of AN on subsequent smoking behaviour, or for smoking heaviness/initiation predicting later AN. MR findings did not support causal effects between AN and smoking behaviour, in either direction. Findings do not support predictive or causal effects between AN and smoking behaviour. Previously reported associations may have been vulnerable to confounding, highlighting the possibility of smoking and AN sharing causal risk factors.
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Affiliation(s)
- E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Zoe E Reed
- School of Psychological Science, University of Bristol, Priory Road, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
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20
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Kuschick D, Kuck J, Pachanov A, Geene R. Health promotion for families with parental alcohol addiction: a systematic review. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01845-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Abstract
Aim
Alcohol-related illnesses represent a major burden and challenge to families and pose health risks for all involved. Therefore, health promotion attempts need to focus on these vulnerable families and identify effective interventions. A systematic review was conducted of approaches to health promotion and prevention and their effectiveness for families with addiction concerns. The review focused on parental alcohol dependency.
Subject and methods
A systematic search of relevant databases was conducted, followed by a multistep screening process and a narrative synthesis of results.
Results
A total of 20 studies were included that evaluated 14 intervention programmes. The main target group was children with any form of fetal alcohol spectrum disorders and their caregivers. The study sample was dominated by behavioural approaches. The evidence base was heterogeneous. There was limited evidence of the effectiveness of combined counselling and coaching interventions that aimed to strengthen psychosocial resources.
Conclusion
The robustness of the results is limited by the moderate methodological quality of the studies. Because of the search strategy, which focused on studies with outcomes for parents with alcohol dependence, and the systematic review methodology, almost all studies reviewed featured behavioural prevention interventions. Very few studies provided specific information on the effectiveness of interventions for alcohol-dependent parents with a focus on environmental changes. The selected approach provided a limited mapping of the field of interest. However, these review findings provide the foundation for an evidence-based approach to health promotion for families with parental alcohol dependence.
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21
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Homeyer D, Memaran N, Kück M, Grams L, von der Born J, Bauer E, Schwalba M, Kerling A, von Maltzahn N, Albrecht A, Haverich A, Stiesch M, Melk A, Tegtbur U. Participating in a School-Integrated Daily Exercise Program Improves Motor Performance Significantly in School-Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4764. [PMID: 36981673 PMCID: PMC10048861 DOI: 10.3390/ijerph20064764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Children's sedentary time has increased, while daily physical activity and motor performance have decreased. We evaluated an integrated school-based exercise program by assessing changes in motor skills after one year and comparing these changes to children who did not participate. We included 303 children from five schools in this longitudinal study and assigned them either to the exercise group (EG; n = 183 with daily exercise program) or the waiting group (WG; n = 120). Motor skills were assessed at baseline and after one year. Mixed modeling was used to analyze inter-group differences of change in motor skills and to determine the effect of sex, age group, and weight status. EG improved more strongly than WG for sprint, side jumps (both p = 0.017), stand and reach (p = 0.012), and ergometry (p ≤ 0.001) when compared to WG. Girls improved more strongly in the sit-ups than boys, second graders more than fifth graders in the backwards balance and the ergometry, and non-overweight children more in the standing long jump than overweight children. The exercise program is effective in increasing motor skills and physical fitness. Girls were not disadvantaged, and overweight children profited as much as their non-overweight peers in all categories but one.
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Affiliation(s)
- Denise Homeyer
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Nima Memaran
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Momme Kück
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Lena Grams
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Jeannine von der Born
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Elena Bauer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Martina Schwalba
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Arno Kerling
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Nadine von Maltzahn
- Department for Dental Prosthodontics and Biomedical Materials Science, Center for Dentistry and Oral Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Alexander Albrecht
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Axel Haverich
- Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany
| | - Meike Stiesch
- Department for Dental Prosthodontics and Biomedical Materials Science, Center for Dentistry and Oral Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Uwe Tegtbur
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
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22
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Fishbein DH, Sloboda Z. A National Strategy for Preventing Substance and Opioid Use Disorders Through Evidence-Based Prevention Programming that Fosters Healthy Outcomes in Our Youth. Clin Child Fam Psychol Rev 2023; 26:1-16. [PMID: 36542196 PMCID: PMC9768412 DOI: 10.1007/s10567-022-00420-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
The recently released National Drug Control Strategy (2022) from the White House Office of National Drug Control Policy (ONDCP) lays out a comprehensive plan to, not only enhance access to treatment and increase harm reduction strategies, but also increase implementation of evidence-based prevention programming at the community level. Furthermore, the Strategy provides a framework for enhancing our national data systems to inform policy and to evaluate all components of the plan. However, not only are there several missing components to the Strategy that would assure its success, but there is a lack of structure to support a national comprehensive service delivery system that is informed by epidemiological data, and trains and credentials those delivering evidence-based prevention, treatment, and harm reduction/public health interventions within community settings. This paper provides recommendations for the establishment of such a structure with an emphasis on prevention. Systematically addressing conditions known to increase liability for behavioral problems among vulnerable populations and building supportive environments are strategies consistently found to avert trajectories away from substance use in general and substance use disorders (SUD) in particular. Investments in this approach are expected to result in significantly lower rates of SUD in current and subsequent generations of youth and, therefore, will reduce the burden on our communities in terms of lowered social and health systems involvement, treatment needs, and productivity. A national strategy, based on strong scientific evidence, is presented to implement public health policies and prevention services. These strategies work by improving child development, supporting families, enhancing school experiences, and cultivating positive environmental conditions.
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Affiliation(s)
- Diana H Fishbein
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, 105 Smith Level Road, Chapel Hill, NC, 27599, USA.
- The Pennsylvania State University, State College, PA, USA.
- National Prevention Science Coalition to Improve Lives, Oakland, CA, USA.
| | - Zili Sloboda
- National Prevention Science Coalition to Improve Lives, Oakland, CA, USA
- Applied Prevention Science International, Ontario, OH, USA
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23
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Jang H, Kim J. Peers' parental education and cardiovascular disease risk in adulthood: The mediating role of health-related behaviors. Soc Sci Med 2023; 320:115673. [PMID: 36652756 DOI: 10.1016/j.socscimed.2023.115673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 11/19/2022] [Accepted: 01/11/2023] [Indexed: 01/14/2023]
Abstract
RATIONALE Although there is a growing body of empirical evidence on the relationship between peers' parental education and adolescents' educational outcomes, little is known about whether exposure to highly educated peers' parents is associated with improved physical health in adulthood. OBJECTIVE This study investigated the relationship between the education level of peers' parents (Wave I) and the risk of developing cardiovascular disease (CVD) in adulthood (Wave IV). Moreover, we considered a set of health-related behaviors (Wave II) as the underlying mechanisms linking peers' parental education to later-life physical health such as substance use (smoking, binge drinking, and marijuana use) and other lifestyle behaviors (physical activity, sedentary behavior, and unhealthy dietary habits). METHODS Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), spanning respondents' adolescence to adulthood, were used. To address the endogenous school selection problem and account for the unobserved school-level confounders, this study exploited quasi-experimental within-school/across-cohort variation in peer composition. To formally test for mediation, Sobel tests were conducted. RESULTS The results of this study revealed that independent of own parents' education levels, exposure to higher levels of peers' parental education is associated with a lower CVD risk score in adulthood. For a one-standard-deviation increase in peers' parental education-that is, about a 0.98-year increase in grademates' parental educational attainment, a CVD risk in adulthood increased by about 6.2%. Our mediation analyses showed that part of this association is explained by a decrease in substance use (27% for smoking, 10% for binge drinking, and 11% for marijuana use). In contrast, none of the other lifestyle behaviors evaluated significantly mediated the association. CONCLUSION The study's findings suggest that the role of peers' parents should not be overlooked when developing health-promoting interventions for adolescents. Policymakers and practitioners may wish to increase opportunities for students to benefit from health-related social learning from their peers' highly educated parents.
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Affiliation(s)
- Hayun Jang
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
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24
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Botwright S, Sutawong J, Kingkaew P, Anothaisintawee T, Dabak SV, Suwanpanich C, Promchit N, Kampang R, Isaranuwatchai W. Which interventions for alcohol use should be included in a universal healthcare benefit package? An umbrella review of targeted interventions to address harmful drinking and dependence. BMC Public Health 2023; 23:382. [PMID: 36823618 PMCID: PMC9948368 DOI: 10.1186/s12889-023-15152-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND This study aimed to identify targeted interventions for the prevention and treatment of harmful alcohol use. Umbrella review methodology was used to summarise the effectiveness across a broad range of interventions, in order to identify which interventions should be considered for inclusion within universal health coverage schemes in low- and middle-income countries. METHODS AND FINDINGS We included systematic reviews with meta-analysis of randomised controlled trials (RCTs) on targeted interventions addressing alcohol use in harmful drinkers or individuals with alcohol use disorder. We only included outcomes related to alcohol consumption, heavy drinking, binge drinking, abstinence, or alcohol-attributable accident, injury, morbidity or mortality. PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and the International HTA Database were searched from inception to 3 September 2021. Risk of bias of reviews was assessed using the AMSTAR2 tool. After reviewing the abstracts of 9,167 articles, results were summarised narratively and certainty in the body of evidence for each intervention was assessed using GRADE. In total, 86 studies met the inclusion criteria, of which the majority reported outcomes for brief intervention (30 studies) or pharmacological interventions (29 studies). Overall, methodological quality of included studies was low. CONCLUSIONS For harmful drinking, brief interventions, cognitive behavioural therapy, and motivational interviewing showed a small effect, whereas mentoring in adolescents and children may have a significant long-term effect. For alcohol use disorder, social network approaches and acamprosate showed evidence of a significant and durable effect. More evidence is required on the effectiveness of gamma-hydroxybutyric acid (GHB), nalmefene, and quetiapine, as well as optimal combinations of pharmacological and psychosocial interventions. As an umbrella review, we were unable to identify the extent to which variation between studies stemmed from differences in intervention delivery or variation between country contexts. Further research is required on applicability of findings across settings and best practice for implementation. Funded by the Thai Health Promotion Foundation, grant number 61-00-1812.
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Affiliation(s)
- Siobhan Botwright
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand.
| | - Jiratorn Sutawong
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand.
| | - Pritaporn Kingkaew
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
| | - Thunyarat Anothaisintawee
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
| | - Saudamini Vishwanath Dabak
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
| | - Chotika Suwanpanich
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
| | - Nattiwat Promchit
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
| | - Roongnapa Kampang
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Tiwanon Rd, 6Th Floor, 6Th Building, Muang, 11000, Nonthaburi, Thailand
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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25
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Kabiri S, Sharepour M, Howell CJ, Wellen H, Smith HP, Cochran JK, Shadmanfaat SM(S, Andersen TS. Violations of Emergent Norms Regarding COVID-19 Mitigation and Social Hygiene: An Application of Agnew’s General Theory of Crime. CRIME AND DELINQUENCY 2022:00111287221130961. [PMCID: PMC9742734 DOI: 10.1177/00111287221130961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
This study examines self-reported violations of emergent norms and regulations regarding COVID-19 mitigation and social hygiene practices among a sample of high school students randomly selected from public schools in Rasht, Iran. The study seeks to explain these COVID-19 ordinance violations through the application of Agnew’s general integrated theory of crime. Findings demonstrate that life domains, motivations, and constraints have a direct effect on COVID-19 misbehavior. Moreover, life domains have an indirect effect on COVID-19 misbehavior through both constraints and motivations. Finally, the relationship between motivations and COVID-19 misbehavior is moderated by the peers domain, whereas the relationship between constraints and COVID-19 misbehavior is moderated by the family domain and school domain.
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Affiliation(s)
- Saeed Kabiri
- University of Mazandaran, Babolsar, Islamic Republic of Iran
| | | | | | - Hadley Wellen
- University of South Carolina System, Columbia, SC, USA
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26
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Patil SJ, Tallon E, Wang Y, Nayyar M, Hodges K, Phad A, Rodriguez E, Gefter L. Effect of Stanford Youth Diabetes Coaches' Program on Youth and Adults in Diverse Communities. FAMILY & COMMUNITY HEALTH 2022; 45:178-186. [PMID: 35385435 PMCID: PMC9156535 DOI: 10.1097/fch.0000000000000323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Stanford Youth Diabetes Coaches' Program (SYDCP) trains high school students to become diabetes coaches for friends and adult family members. The objective of this study was to assess effects of SYDCP participation on youth and adults from a rural and urban underserved high school community. We used a mixed-methods approach. Patient-Reported Outcomes Measurement Information System (PROMIS) measures for Pediatric Sense of Meaning and Purpose were measured in high school students. PROMIS Adult Global Health and Self-Efficacy was measured in coached adults. Paired t tests compared pre- and postintervention and 6-month follow-up scores. Thematic analysis was used to analyze focus group discussion of adults. Twenty-five students participated, 15 students coached adults with diabetes or prediabetes. Students' sense of meaning and purpose significantly improved postintervention compared to preintervention. Diet and physical activity behaviors improved. Adolescent-adult relationships mediated participation benefits. Our study showed SYDCP improved adolescents' sense of meaning and purpose. In addition, youth and adult relatedness led to improved health behaviors. These findings have important implications, as a sense of purpose and youth-adult connectedness are associated with health behaviors and psychological well-being. Further larger studies of health education programs that engage related youth-adult dyads and assess long-term behaviors and health outcomes are needed.
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Affiliation(s)
- Sonal J Patil
- Departments of Family and Community Medicine (Drs Patil, Wang, and Hodges) and Endocrinology (Dr Nayyar), University of Missouri, Columbia; University of Missouri Sinclair School of Nursing, Columbia (Ms Tallon); University of Missouri Institute for Data Science & Informatics, Columbia (Ms Tallon); Center for Diabetes Translation Research, Washington University in St Louis, St Louis, Missouri (Ms Phad); Department of Pediatrics, Li Ka Shing Learning and Knowledge Center (Dr Rodriguez), and Division of Primary Care and Population Health (Dr Gefter), Stanford University School of Medicine, Stanford, California. Dr Patil is now at the Department of Wellness & Preventive Medicine, Cleveland Clinic Community Care, Cleveland, Ohio
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27
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Rodríguez Sierra N, Sánchez Rodríguez E, Castiblanco Montañez RA, Carrillo Algarra AJ, Hernandez-Zambrano SM. Intervenciones de prevención sobre el consumo de alcohol en jóvenes universitarios. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La ingesta de alcohol está condicionada por aspectos individuales y culturales. Objetivo: Identificar el efecto de intervenciones realizadas en el contexto latinoamericano sobre pautas de consumo o factores de riesgo asociados al consumo de alcohol en jóvenes universitarios. Materiales y Métodos: Revisión sistemática a partir de la pregunta PICO, Se realizó búsqueda desde abril a agosto del 2020 en las bases de PubMed, CUIDEN, BVS, Scielo, Google Scholar y Repositorios Gubernamentales. Se utilizaron descriptores DeCS y MeSH, en español, inglés y portugués con los operadores AND y OR. Criterios de elegibilidad: estudios experimentales y cuasi experimentales publicados entre 2014 y 2020. Se obtuvieron 49 artículos, la lectura crítica permitió seleccionar 8 a los cuales se les aplicaron las escalas AMSTAR2, TREND y CONSORT quedando 6 artículos para análisis. Según la Resolución 008430/93, Artículo10, se consideró como investigación sin riesgo. Resultados: Intervenciones unicomponente reportaron efectos sobre creencias conductuales, actitudes, conocimiento de la sustancia, rendimiento académico, menor frecuencia de consumo y no conducir bajo efectos del alcohol. Las intervenciones multicomponente disminuyen en 3.03% el riesgo de consumo y reportan percepción positiva respecto a la utilidad de las actividades desarrolladas, satisfacción de expectativas, satisfacción general, calidad de materiales empleados, asistencia y puntualidad. Discusión: Los estudios sugieren implementar nuevas intervenciones, estrategias y políticas en salud primaria para promover una transformación social, educativa y sanitaria que generen un impacto favorable para mitigar la problemática actual de consumo de alcohol en jóvenes universitarios. Conclusiones: Esta revisión sistemática permitió sintetizar y valorar la evidencia disponible frente a intervenciones unicomponente y multicomponente realizadas en el contexto latinoamericano y del caribe que modifican positivamente factores de riesgo y pautas de consumo en jóvenes universitarios.
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28
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Tinner L, Palmer JC, Lloyd EC, Caldwell DM, MacArthur GJ, Dias K, Langford R, Redmore J, Wittkop L, Watkins SH, Hickman M, Campbell R. Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis. BMC Public Health 2022; 22:1111. [PMID: 35658920 PMCID: PMC9165543 DOI: 10.1186/s12889-022-13072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engagement in multiple substance use risk behaviours such as tobacco smoking, alcohol and drug use during adolescence can result in adverse health and social outcomes. The impact of interventions that address multiple substance use risk behaviours, and the differential impact of universal versus targeted approaches, is unclear given findings from systematic reviews have been mixed. Our objective was to assess effects of interventions targeting multiple substance use behaviours in adolescents. METHODS Eight databases were searched to October 2019. Individual and cluster randomised controlled trials were included if they addressed two or more substance use behaviours in individuals aged 8-25 years. Data were pooled in random-effects meta-analyses, reported by intervention and setting. Quality of evidence was assessed using GRADE. Heterogeneity was assessed using between-study variance, τ2 and Ι2, and the p-value of between-study heterogeneity statistic Q. Sensitivity analyses were undertaken using the highest and lowest intra-cluster correlation coefficient (ICC). RESULTS Of 66 included studies, most were universal (n=52) and school-based (n=41). We found moderate quality evidence that universal school-based interventions are likely to have little or no short-term benefit (up to 12 months) in relation to alcohol use (OR 0.94, 95% CI: 0.84, 1.04), tobacco use (OR 0.98, 95% CI: 0.83, 1.15), cannabis use (OR 1.06, 95% CI: 0.86, 1.31) and other illicit drug use (OR 1.09, 95% CI: 0.85, 1.39). For targeted school-level interventions, there was low quality evidence of no or a small short-term benefit: alcohol use (OR 0.90, 95% CI: 0.74-1.09), tobacco use (OR 0.86, 95% CI: 0.66, 1.11), cannabis use (OR 0.84, 95% CI: 0.66-1.07) and other illicit drug use (OR 0.79, 95% CI 0.62-1.02). There were too few family-level (n=4), individual-level (n=2) and combination level (n=5) studies to draw confident conclusions. Sensitivity analyses of ICC did not change results. CONCLUSIONS There is low to moderate quality evidence that universal and targeted school-level interventions have no or a small beneficial effect for preventing substance use multiple risk behaviours in adolescents. Higher quality trials and study reporting would allow better evidence syntheses, which is needed given small benefit of universal interventions can have high public health benefit. TRIAL REGISTRATION Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD011374. DOI: 10.1002/14651858.CD011374.
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Affiliation(s)
- Laura Tinner
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jennifer C Palmer
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Deborah M Caldwell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Georgie J MacArthur
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Kaiseree Dias
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rebecca Langford
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - James Redmore
- York Teaching Hospitals NHS Foundation Trust, Wiggington Road, York, UK
| | - Linda Wittkop
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Matthew Hickman
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rona Campbell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
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29
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A School-Based Multilevel Intervention to Increase Physical Activity of Adolescents in Pakistan: From a Social-Ecological Perspective. SUSTAINABILITY 2022. [DOI: 10.3390/su14106024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study aimed to develop an intervention strategy based on the social-ecological model’s individual, interpersonal, and organizational levels for increasing adolescents’ physical activity in Pakistan. Based on the social-ecological model, an 8-week intervention was conducted for 618 school students in Rawalpindi, Pakistan. A quantitative method with a quasi-experimental design was adopted, administering self-report measures before and after the intervention. Intervention materials were delivered by leaflet once a week to the intervention group. Repeated measure analysis of variance was applied to verify the intervention effects at pre- and post-test conditions. The results show that a significant intervention effect was identified from the repeated measure analysis of variance for the intervention group’s physical activity participation compared to the control group from baseline (M = 12.01, SD = 0.136) to the 8-week post-test (M = 16.30, SD = 0.125). The intervention based on the social-ecological model has sufficiently and effectively improved physical activity among school adolescents in Pakistan.
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30
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Machado do Vale TC, da Silva Chagas L, de Souza Pereira H, Giestal-de-Araujo E, Arévalo A, Oliveira-Silva Bomfim P. Neuroscience Outside the Box: From the Laboratory to Discussing Drug Abuse at Schools. Front Hum Neurosci 2022; 16:782205. [PMID: 35634202 PMCID: PMC9133440 DOI: 10.3389/fnhum.2022.782205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
One of the effects of the current COVID-19 pandemic is that low-income countries were pushed further into extreme poverty, exacerbating social inequalities and increasing susceptibility to drug use/abuse in people of all ages. The risks of drug abuse may not be fully understood by all members of society, partly because of the taboo nature of the subject, and partly because of the considerable gap between scientific production/understanding and communication of such knowledge to the public at large. Drug use is a major challenge to social development and a leading cause of school dropout rates worldwide. Some public policies adopted in several countries in recent decades failed to prevent drug use, especially because they focused on imposing combative or coercive measures, investing little or nothing in education and prevention. Here we highlight the role of neuroscience education as a valid approach in drug use education and prevention. We propose building a bridge between schools and scientists by promoting information, student engagement and honest dialogue, and show evidence that public policy regulators should be persuaded to support such science-based education programs in their efforts to effect important positive changes in society.
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Affiliation(s)
- Thereza Cristina Machado do Vale
- NuPEDEN, Nucleus for Research, Education, Dissemination and Neurosciences Popularization, Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Luana da Silva Chagas
- NuPEDEN, Nucleus for Research, Education, Dissemination and Neurosciences Popularization, Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Helena de Souza Pereira
- Department of Molecular and Cell Biology, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Elizabeth Giestal-de-Araujo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Analía Arévalo
- Department of Experimental Surgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Priscilla Oliveira-Silva Bomfim
- NuPEDEN, Nucleus for Research, Education, Dissemination and Neurosciences Popularization, Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- *Correspondence: Priscilla Oliveira-Silva Bomfim,
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31
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Nagy-Pénzes G, Vincze F, Bíró É. A School Intervention's Impact on Adolescents' Health-Related Knowledge and Behavior. Front Public Health 2022; 10:822155. [PMID: 35359760 PMCID: PMC8963932 DOI: 10.3389/fpubh.2022.822155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMany factors can influence health behavior during adolescence, and the lifestyle of adolescents is associated with health behavior during adulthood. Therefore, their behavior can determine not only present, but also later health status.ObjectiveWe aimed to develop an intervention program to improve high school students' health behavior and to evaluate its effectiveness.MethodsWe performed our study at a secondary school in a rural town in East Hungary between 2016 and 2020. Sessions about healthy lifestyles were organized regularly for the intervention group to improve students' knowledge, to help them acquire the right skills and attitudes, and to shape their behavior accordingly. Data collection was carried out via self-administered, anonymous questionnaires (n = 192; boys = 49.5%; girls = 50.5%; age range: 14–16). To determine the intervention-specific effect, we took into account the differences between baseline and post-intervention status, and between the intervention and control groups using individual follow-up data. We used generalized estimating equations to assess the effectiveness of our health promotion program.ResultsOur health promotion program had a positive effect on the students' health-related knowledge and health behavior in the case of unhealthy eating, moderate to vigorous physical activity, and alcohol consumption.ConclusionOur findings suggest that school health promotion can be effective in knowledge transfer and lifestyle modification. To achieve a more positive impact on health behavior, preventive actions must use a complex approach during implementation.
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Affiliation(s)
- Gabriella Nagy-Pénzes
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- *Correspondence: Gabriella Nagy-Pénzes
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Andueza N, Navas-Carretero S, Cuervo M. Effectiveness of Nutritional Strategies on Improving the Quality of Diet of Children from 6 to 12 Years Old: A Systematic Review. Nutrients 2022; 14:nu14020372. [PMID: 35057552 PMCID: PMC8781853 DOI: 10.3390/nu14020372] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
Dietary habits, that are formed during childhood and consolidated in adulthood, are known to influence the development of future chronic diseases such as metabolic syndrome or type 2 diabetes. The aim of this review was to evaluate the effectiveness of nutritional interventions carried out in recent years focused on improving the quality of the diet of the child population. A systematic search of the PubMed and Scopus databases was performed from January 2011 until September 2021. A total of 910 articles were identified and screened based on their title, abstract and full text. Finally, 12 articles were included in the current systematic review. Of those, in six studies the intervention was based on the provision of healthy meals and in the other six studies the intervention focused on modifying the school environment. Six of the studies selected included other components in their intervention such as nutritional education sessions, physical activity and/or families. A wide variety of methods were used for diet assessments, from direct method to questionnaires. The results suggest that interventions that modify the school environment or provide different meals or snacks may be effective in improving children’s dietary patterns, both in the short and long term. Further research is necessary to evaluate the real effectiveness of strategies with multidisciplinary approach (nutritional sessions, physical activity and family’s involvement).
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Affiliation(s)
- Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948425600
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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Cegolon L, Bortolotto M, Bellizzi S, Cegolon A, Bubbico L, Pichierri G, Mastrangelo G, Xodo C. A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020897. [PMID: 35055720 PMCID: PMC8776027 DOI: 10.3390/ijerph19020897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 02/06/2023]
Abstract
Background. The peak of sexually transmitted infections (STI) among adolescents/young adults suggests a low level of prevention. In order to assess whether the level of sexual health education (SHE), received by several channels, was effective at improving sexual behaviors, we conducted a survey among freshmen from four Italian universities. Methods. This observational cross-sectional study was carried out with an anonymous self-reported paper questionnaire, administered during teaching lectures to university freshmen of the northern (Padua, Bergamo, and Milan campuses) and southern (Palermo campus) parts of the country. Knowledge of STI (a linear numerical score), knowledge of STI prevention (dichotomous variable: yes vs. no) and previous STI occurrence (polytomous variable: "no"; "don't know"; "yes") were the outcomes in the statistical analysis. Results. The final number of freshmen surveyed was 4552 (97.9% response rate). The mean age of respondents was 21.4 ± 2.2 years and most of them (70.3%) were females. A total of 60% of students were in a stable romantic relationship. Only 28% respondents knew the most effective methods to prevent STI (i.e., condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs were 5.1%; they reported referring mostly to their general practitioner (GP) (38.1%) rather than discussing the problem with their partner (13.1%). At multivariable analysis, a significantly higher level of STI knowledge was observed in older students (25+ years of age), biomedical students, and those from a non-nuclear family; lower levels were found among students of the University of Palermo, and those who completed a vocational secondary school education. Those who had less knowledge about the most effective tools to prevent STIs included males, students from the University of Palermo, students registered with educational sciences, economics/political sciences, those of foreign nationality, and those whose fathers had lower educational levels. The risk of contracting a STI was significantly lower only in students not in a stable relationship (relative risk ratio, RRR = 0.67; 95% confidence interval, 95%CI = 0.48; 0.94), whereas such risk was significantly higher in students with higher STI knowledge (RRR = 1.15; 95%CI = 1.08; 1.22). Discussion and Conclusions. University freshmen investigated in this study had poor knowledge of STIs and their prevention. Unexpectedly, those with higher levels of knowledge had an increased risk of STIs. There have been no educational interventions-with good quality and long-term follow-ups-that increased the confidence that such SHE programs could have population level effects. A new high-quality study is therefore recommended to assess the effectiveness of an intervention generating behavioral changes; increasing only STI knowledge may not be sufficient.
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Affiliation(s)
- Luca Cegolon
- Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
- Correspondence: or
| | | | | | - Andrea Cegolon
- Department of Political, Social & International Relationships Sciences, University of Macerata, 62100 Macerata, Italy;
| | - Luciano Bubbico
- Department of Sensorineural Disabilities, INAPP/Italian Institute of Social Medicine, 00198 Rome, Italy;
| | - Giuseppe Pichierri
- Microbiology Department, Kingston Hospital NHS Foundation Trust, Kingston upon Thames KT2 7QB, UK;
| | - Giuseppe Mastrangelo
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, Padua University, 35128 Padua, Italy;
| | - Carla Xodo
- FISPPA Department, Padua University, 35137 Padua, Italy; (M.B.); (C.X.)
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O’Brien KM, Barnes C, Yoong S, Campbell E, Wyse R, Delaney T, Brown A, Stacey F, Davies L, Lorien S, Hodder RK. School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews. Nutrients 2021; 13:4113. [PMID: 34836368 PMCID: PMC8618558 DOI: 10.3390/nu13114113] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Schools are identified as a key setting to influence children's and adolescents' healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.
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Affiliation(s)
- Kate M. O’Brien
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Serene Yoong
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
- Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, VIC 3122, Australia
| | - Elizabeth Campbell
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Tessa Delaney
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Alison Brown
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Fiona Stacey
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Lynda Davies
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
| | - Sasha Lorien
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Rebecca K. Hodder
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
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Reyes BD, Hargreaves DS, Creese H. Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study. BMC Public Health 2021; 21:2039. [PMID: 34749702 PMCID: PMC8577004 DOI: 10.1186/s12889-021-12141-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Early uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study. Methods Total maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years. Results Children of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%). Conclusions Lower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12141-5.
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Affiliation(s)
- Beatrice D Reyes
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK.
| | - Dougal S Hargreaves
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK
| | - Hanna Creese
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK
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Tinner L, Wright C, Heron J, Caldwell D, Campbell R, Hickman M. Is adolescent multiple risk behaviour associated with reduced socioeconomic status in young adulthood and do those with low socioeconomic backgrounds experience greater negative impact? Findings from two UK birth cohort studies. BMC Public Health 2021; 21:1614. [PMID: 34479524 PMCID: PMC8414729 DOI: 10.1186/s12889-021-11638-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/18/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescent multiple risk behaviour (MRB) is associated with negative outcomes such as police arrests, unemployment and premature mortality and morbidity. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. We test whether adolescent MRB is associated with socioeconomic status (SES) in young adulthood and whether it is moderated by early life SES variables. METHODS Prospective cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991-1992, were used and two comparable MRB variables were derived. Logistic regression was used to determine the association between MRB and young adult SES. The moderating effect of three early life SES variables was assessed using logistic regression models with and without interaction parameters. Evidence to support the presence of moderation was determined by likelihood ratio tests ≤p = 0.05. Multiple imputation was used to account for missing data. RESULTS Adolescents had a median of two risk behaviours in BCS70 and three in ALSPAC. Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response relationship, with each additional risk behaviour resulting in reduced odds of university degree attainment. MRB was associated occupational status at age 34 in BCS70 (OR 0.86 95% CI: 0.82, 0.90). In BCS70, there was evidence that maternal education (p = 0.03), parental occupational status (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES in that the negative effect of MRB is stronger for those with low socioeconomic backgrounds. No evidence of moderation was found in the ALSPAC cohort. CONCLUSIONS Adolescence appears to be a critical time in the life course to address risk behaviours, due to the likelihood that behaviours established here may have effects in adulthood. Intervening on adolescent MRB could improve later SES outcomes and thus affect health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that more detailed measures should be investigated to capture the nuance of contemporary young adult SES.
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Affiliation(s)
- Laura Tinner
- Population Health Sciences, Bristol Medical School, University of Bristol, BG3 Oakfield House, Bristol, BS8 2BN UK
| | - Caroline Wright
- Population Health Sciences, Bristol Medical School, University of Bristol, BG3 Oakfield House, Bristol, BS8 2BN UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, BG3 Oakfield House, Bristol, BS8 2BN UK
| | - Deborah Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, BG3 Oakfield House, Bristol, BS8 2BN UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, BG3 Oakfield House, Bristol, BS8 2BN UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, BG3 Oakfield House, Bristol, BS8 2BN UK
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Richter A, Schienkiewitz A, Starker A, Krug S, Domanska O, Kuhnert R, Loss J, Mensink GBM. Health-promoting behaviour among adults in Germany - Results from GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2021; 6:26-44. [PMID: 35146315 PMCID: PMC8734172 DOI: 10.25646/8553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/16/2021] [Indexed: 11/20/2022]
Abstract
Health-promoting behaviours are important at any age to prevent diseases and to promote well-being. Using data from GEDA 2019/2020-EHIS, a Germany-wide, representative survey, this article describes how often the adult population in Germany reports certain types of health-promoting behaviour in their everyday lives. The behaviours considered are nonsmoking, low-risk alcohol consumption, achievement of the World Health Organization's (WHO) recommendations on aerobic physical activity, at least daily fruit and vegetable consumption, and maintaining a body weight within the normal range. This article describes the proportion of people who report these behaviours in their everyday lives by gender, age and education level, the number of health-promoting behaviours each person reports and the most common combinations in which they occur. Young adults between 18 and 29 years are most likely to achieve a health-promoting lifestyle. The proportion of people who report at least 150 minutes of physical activity per week and a normal body weight is lower in later adulthood than among 18- to 29-year-olds. The recommendation to eat fruit and vegetables daily is implemented least often of all five aspects of health behaviour under study. Finally, women are more likely to lead a health-promoting lifestyle than men.
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Affiliation(s)
- Almut Richter
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Klingberg S, van Sluijs EMF, Draper CE. Parent perspectives on preschoolers' movement and dietary behaviours: a qualitative study in Soweto, South Africa. Public Health Nutr 2021; 24:3637-3647. [PMID: 33077021 PMCID: PMC8369460 DOI: 10.1017/s1368980020003730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/24/2020] [Accepted: 09/18/2020] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Childhood obesity is of increasing concern in South Africa, and interventions to promote healthy behaviours related to obesity in children are needed. Young children in urban low-income settings are particularly at risk of excess adiposity. The current study aimed to describe how parents of preschool children in an urban South African township view children's movement and dietary behaviours, and associated barriers and facilitators. DESIGN A contextualist qualitative design was utilised with in-depth interviews conducted in the home setting and analysed using reflexive thematic analysis. Field notes were used to contextualise findings. SETTING Four neighbourhoods in a predominantly low-income urban township. PARTICIPANTS Sixteen parents (fourteen mothers, two fathers) of preschool-age children were recruited via preschools. RESULTS Four themes were developed: children's autonomy and the limits of parental control; balancing trust and fears; the appeal of screens; and aspirations and pressures of parenthood. Barriers to healthy behaviours included children's food preferences, aspirations and pressures to consume unhealthy foods, other adults giving children snacks, lack of safe places to play, unhealthy food environments and underlying structural factors. Facilitators included set routines, the preschool environment, safe places to play and availability of healthy foods. CONCLUSIONS Low-income families in Soweto face many structural challenges that cannot easily be addressed through public health interventions, but there may be opportunities for behavioural interventions targeting interpersonal and organisational aspects, such as bedtime routines and preschool snacks, to achieve positive changes. More research on preschoolers' movement and dietary behaviours, and related interventions, is needed in South Africa.
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Affiliation(s)
- Sonja Klingberg
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, CambridgeCB2 0QQ, UK
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg1862, South Africa
| | - Esther MF van Sluijs
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, CambridgeCB2 0QQ, UK
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg1862, South Africa
| | - Catherine E Draper
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg1862, South Africa
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Caldwell DM, Davies SR, Thorn JC, Palmer JC, Caro P, Hetrick SE, Gunnell D, Anwer S, López-López JA, French C, Kidger J, Dawson S, Churchill R, Thomas J, Campbell R, Welton NJ. School-based interventions to prevent anxiety, depression and conduct disorder in children and young people: a systematic review and network meta-analysis. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background
Schools in the UK increasingly have to respond to anxiety, depression and conduct disorder as key causes of morbidity in children and young people.
Objective
The objective was to assess the comparative effectiveness of educational setting-based interventions for the prevention of anxiety, depression and conduct disorder in children and young people.
Design
This study comprised a systematic review, a network meta-analysis and an economic evaluation.
Data sources
The databases MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to 4 April 2018, and the NHS Economic Evaluation Database (NHS EED) was searched on 22 May 2019 for economic evaluations. No language or date filters were applied.
Main outcomes
The main outcomes were post-intervention self-reported anxiety, depression or conduct disorder symptoms.
Review methods
Randomised/quasi-randomised trials of universal or targeted interventions for the prevention of anxiety, depression or conduct disorder in children and young people aged 4–18 years were included. Screening was conducted independently by two reviewers. Data extraction was conducted by one reviewer and checked by a second. Intervention- and component-level network meta-analyses were conducted in OpenBUGS. A review of the economic literature and a cost–consequence analysis were conducted.
Results
A total of 142 studies were included in the review, and 109 contributed to the network meta-analysis. Of the 109 studies, 57 were rated as having an unclear risk of bias for random sequence generation and allocation concealment. Heterogeneity was moderate. In universal secondary school settings, mindfulness/relaxation interventions [standardised mean difference (SMD) –0.65, 95% credible interval (CrI) –1.14 to –0.19] and cognitive–behavioural interventions (SMD –0.15, 95% CrI –0.34 to 0.04) may be effective for anxiety. Cognitive–behavioural interventions incorporating a psychoeducation component may be effective (SMD –0.30, 95% CrI –0.59 to –0.01) at preventing anxiety immediately post intervention. There was evidence that exercise was effective in preventing anxiety in targeted secondary school settings (SMD –0.47, 95% CrI –0.86 to –0.09). There was weak evidence that cognitive–behavioural interventions may prevent anxiety in universal (SMD –0.07, 95% CrI –0.23 to 0.05) and targeted (SMD –0.38, 95% CrI –0.84 to 0.07) primary school settings. There was weak evidence that cognitive–behavioural (SMD –0.04, 95% CrI –0.16 to 0.07) and cognitive–behavioural + interpersonal therapy (SMD –0.18, 95% CrI –0.46 to 0.08) may be effective in preventing depression in universal secondary school settings. Third-wave (SMD –0.35, 95% CrI –0.70 to 0.00) and cognitive–behavioural interventions (SMD –0.11, 95% CrI –0.28 to 0.05) incorporating a psychoeducation component may be effective at preventing depression immediately post intervention. There was no evidence of intervention effectiveness in targeted secondary, targeted primary or universal primary school settings post intervention. The results for university settings were unreliable because of inconsistency in the network meta-analysis. A narrative summary was reported for five conduct disorder prevention studies, all in primary school settings. None reported the primary outcome at the primary post-intervention time point. The economic evidence review reported heterogeneous findings from six studies. Taking the perspective of a single school budget and based on cognitive–behavioural therapy intervention costs in universal secondary school settings, the cost–consequence analysis estimated an intervention cost of £43 per student.
Limitations
The emphasis on disorder-specific prevention excluded broader mental health interventions and restricted the number of eligible conduct disorder prevention studies. Restricting the study to interventions delivered in the educational setting may have limited the number of eligible university-level interventions.
Conclusions
There was weak evidence of the effectiveness of school-based, disorder-specific prevention interventions, although effects were modest and the evidence not robust. Cognitive–behavioural therapy-based interventions may be more effective if they include a psychoeducation component.
Future work
Future trials for prevention of anxiety and depression should evaluate cognitive–behavioural interventions with and without a psychoeducation component, and include mindfulness/relaxation or exercise comparators, with sufficient follow-up. Cost implications must be adequately measured.
Study registration
This study is registered as PROSPERO CRD42016048184.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Deborah M Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah R Davies
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Joanna C Thorn
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jennifer C Palmer
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Sarah E Hetrick
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
| | - Sumayya Anwer
- Centre for Reviews and Dissemination, University of York, York, UK
| | - José A López-López
- Department of Basic Psychology and Methodology, Faculty of Psychology, University of Murcia, Murcia, Spain
| | - Clare French
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - James Thomas
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), University College London, London, UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
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Robinson M, Aventin Á, Hanratty J, Ruane-McAteer E, Tomlinson M, Clarke M, Okonofua F, Lohan M. Nothing so practical as theory: a rapid review of the use of behaviour change theory in family planning interventions involving men and boys. Reprod Health 2021; 18:126. [PMID: 34120630 PMCID: PMC8201745 DOI: 10.1186/s12978-021-01173-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/06/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND There is growing recognition of the need for interventions that effectively involve men and boys to promote family planning behaviours. Evidence suggests that the most effective behavioural interventions in this field are founded on theoretical principles of behaviour change and gender equality. However, there are few evidence syntheses on how theoretical approaches are applied in this context that might guide best practice in intervention development. This review addresses this gap by examining the application and reporting of theories of behaviour change used by family planning interventions involving men and boys. METHODS We adopted a systematic rapid review approach, scoping findings of a previously reported evidence and gap map of intervention reviews (covering 2007-2018) and supplementing this with searches of academic databases and grey literature for reviews and additional studies published between 2007 and 2020. Studies were eligible for inclusion if their title, abstract or keywords referred to a psychosocial or behavioural intervention targeting family planning behaviours, involved males in delivery, and detailed their use of an intervention theory of change. RESULTS From 941 non-duplicate records identified, 63 were eligible for inclusion. Most records referenced interventions taking place in low- and middle-income countries (65%). There was a range of intervention theories of change reported, typically targeting individual-level behaviours and sometimes comprising several behaviour change theories and strategies. The most commonly identified theories were Social Cognitive Theory, Social Learning Theory, the Theory of Planned Behaviour, and the Information-Motivation-Behaviour Skills (IMB) Model. A minority of records explicitly detailed gender-informed elements within their theory of change. CONCLUSION Our findings highlight the range of prevailing theories of change used for family planning interventions involving men and boys, and the considerable variability in their reporting. Programmers and policy makers would be best served by unified reporting and testing of intervention theories of change. There remains a need for consistent reporting of these to better understand how complex interventions that seek to involve men and boys in family planning may lead to behaviour change.
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Affiliation(s)
- Martin Robinson
- School of Nursing and Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Áine Aventin
- School of Nursing and Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Jennifer Hanratty
- School of Nursing and Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | | | - Mark Tomlinson
- School of Nursing and Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Mike Clarke
- School of Nursing and Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Friday Okonofua
- Women's Health Action Research Centre, Benin City, Edo State, Nigeria
| | - Maria Lohan
- School of Nursing and Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
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Cimino S, Marzilli E, Erriu M, Carbone P, Casini E, Cerniglia L. Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies. Behav Sci (Basel) 2021; 11:bs11060079. [PMID: 34063788 PMCID: PMC8223781 DOI: 10.3390/bs11060079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/01/2021] [Accepted: 05/18/2021] [Indexed: 12/18/2022] Open
Abstract
International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic and Clinical Psychology, University of Rome, Sapienza, 00186 Rome, Italy; (S.C.); (E.M.); (M.E.); (P.C.); (E.C.)
| | - Eleonora Marzilli
- Department of Dynamic and Clinical Psychology, University of Rome, Sapienza, 00186 Rome, Italy; (S.C.); (E.M.); (M.E.); (P.C.); (E.C.)
| | - Michela Erriu
- Department of Dynamic and Clinical Psychology, University of Rome, Sapienza, 00186 Rome, Italy; (S.C.); (E.M.); (M.E.); (P.C.); (E.C.)
| | - Paola Carbone
- Department of Dynamic and Clinical Psychology, University of Rome, Sapienza, 00186 Rome, Italy; (S.C.); (E.M.); (M.E.); (P.C.); (E.C.)
| | - Elisa Casini
- Department of Dynamic and Clinical Psychology, University of Rome, Sapienza, 00186 Rome, Italy; (S.C.); (E.M.); (M.E.); (P.C.); (E.C.)
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy
- Correspondence: ; Tel.: +39-066-920-761
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Laura T, Deborah C, Rona C. Community mobilisation approaches to preventing and reducing adolescent multiple risk behaviour: a realist review protocol. Syst Rev 2021; 10:147. [PMID: 33980307 PMCID: PMC8117311 DOI: 10.1186/s13643-021-01696-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/30/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Adolescent multiple risk behaviour (MRB) continues to be a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, rather than targeting the wider environmental or structural context. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. Despite this, there are gaps in the current literature, theory and implementation that would benefit from a realist approach due to the suitability of this methodology to analysing complex interventions. The objective of this study is to understand 'how, why, for whom and in what circumstances and time periods' do community mobilisation interventions work to prevent and/or reduce adolescent multiple risk behaviour. METHODS This is a protocol for a realist review. The review will use a six-stage iterative process, guided by the RAMESES framework. We will systematically search PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological Abstracts, from their inception to 2021. Studies will be screened for relevance to the programme theory and included based on a priori eligibility criteria including (1) reporting a community mobilisation intervention (2) targeting two health risk behaviors (3) for adolescent populations. Two independent reviewers will select, screen and extract data related to the program theory from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome configurations that contribute to our programme theory. The findings will be synthesised to produce a refined programme theory model. DISCUSSION The goal of this realist review is to identify and refine a programme theory for community mobilisation approaches to the prevention and/or reduction of adolescent multiple risk behaviour. Our aim is that the findings surrounding the programme theory refinement can be used to develop and implement adolescent multiple risk behaviour interventions and maintain collaboration between local policy makers, researchers and community members. SYSTEMATIC REVIEW REGISTRATION This realist review is registered on the PROSPERO database (registration number: CRD42020205342).
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Affiliation(s)
- Tinner Laura
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL UK
| | - Caldwell Deborah
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL UK
| | - Campbell Rona
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL UK
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43
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Wright C, Heron J, Kipping R, Hickman M, Campbell R, Martin RM. Young adult cancer risk behaviours originate in adolescence: a longitudinal analysis using ALSPAC, a UK birth cohort study. BMC Cancer 2021; 21:365. [PMID: 33827470 PMCID: PMC8028717 DOI: 10.1186/s12885-021-08098-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/24/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND An estimated 40% of cancer cases in the UK in 2015 were attributable to cancer risk behaviours. Tobacco smoking, alcohol consumption, obesity, and unprotected sexual intercourse are known causes of cancer and there is strong evidence that physical inactivity is associated with cancer. These cancer risk behaviours co-occur however little is known about how they pattern longitudinally across adolescence and early adulthood. Using data from ALSPAC, a prospective population-based UK birth cohort study, we explored patterns of adolescent cancer risk behaviours and their associations with cancer risk behaviours in early adulthood. METHODS Six thousand three hundred fifty-one people (46.0% of ALSPAC participants) provided data on all cancer risk behaviours at one time during adolescence, 1951 provided data on all cancer risk behaviours at all time points. Our exposure measure was quartiles of a continuous score summarising cumulative exposure to cancer risk behaviours and longitudinal latent classes summarising distinct categories of adolescents exhibiting similar patterns of behaviours, between age 11 and 18 years. Using both exposure measures, odds of harmful drinking (Alcohol Use Disorders Identification Test-C ≥ 8),daily tobacco smoking, nicotine dependence (Fagerström test ≥4), obesity (BMI ≥30), high waist circumference (females: ≥80 cm and males: ≥94 cm, and high waist-hip ratio (females: ≥0.85 and males: ≥1.00) at age 24 were estimated using logistic regression analysis. RESULTS We found distinct groups of adolescents characterised by consistently high and consistently low engagement in cancer risk behaviours. After adjustment, adolescents in the top quartile had greater odds of all outcomes in early adulthood: nicotine dependency (odds ratio, OR = 5.37, 95% confidence interval, CI = 3.64-7.93); daily smoking (OR = 5.10, 95% CI =3.19-8.17); obesity (OR = 4.84, 95% CI = 3.33-7.03); high waist circumference (OR = 2.48, 95% CI = 1.94-3.16); harmful drinking (OR = 2.04, 95% CI = 1.57-2.65); and high waist-hip ratio (OR = 1.88, 95% CI = 1.30-2.71), compared to the bottom quartile. In latent class analysis, adolescents characterised by consistently high-risk behaviours throughout adolescence were at higher risk of all cancer risk behaviours at age 24, except harmful drinking. CONCLUSIONS Exposure to adolescent cancer risk behaviours greatly increased the odds of cancer risk behaviours in early adulthood. Interventions to reduce these behaviours should target multiple rather than single risk behaviours and should focus on adolescence.
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Affiliation(s)
- Caroline Wright
- Department of Population Health Sciences, Population Health Sciences, Bristol Medical School, University of Bristol, BF4, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - Jon Heron
- Department of Population Health Sciences, Population Health Sciences, Bristol Medical School, University of Bristol, BF4, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Department of Population Health Sciences, Population Health Sciences, Bristol Medical School, University of Bristol, BF4, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Matthew Hickman
- Department of Population Health Sciences, Population Health Sciences, Bristol Medical School, University of Bristol, BF4, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Rona Campbell
- Department of Population Health Sciences, Population Health Sciences, Bristol Medical School, University of Bristol, BF4, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Richard M Martin
- Department of Population Health Sciences, Population Health Sciences, Bristol Medical School, University of Bristol, BF4, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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Zhu X, Haegele JA, Sun H. Health-related fitness knowledge growth in middle school years: Individual- and school-level correlates. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:664-669. [PMID: 33308818 PMCID: PMC7749269 DOI: 10.1016/j.jshs.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/13/2018] [Accepted: 01/24/2019] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health-related fitness knowledge (HRFK) has been an essential concept for many health and physical education programs. There has been limited understanding and longitudinal investigation on HRFK growth. This longitudinal study examined HRFK growth and its individual- and school-level correlates in middle school years under 1 curriculum condition: Five for Life. METHODS Participants were 12,044 students from 47 middle schools. Data were collected at both individual/participant and school/institution levels. Individual-level variables included gender, grade, and HRFK test scores. School-level variables included percentage of students receiving free and reduced meals (FARM), student-to-faculty ratio for physical education, and school academic performance (SAP). We used hierarchical linear modeling to examine HRFK 3-year growth in relation to individual- and school-level correlates. RESULTS The average HRFK score at 6th grade for females was 42.81% ± 1.32%. The predicted HRFK growth was 17.06% ± 1.02% per year, holding other factors constant. A 1-standard deviation increase in FARM correlated with a 14.68%-point decrease in predicted test score (p = 0.02). A 1-standard deviation increase in SAP was associated with an 11.90%-point increase in HRFK score. Males had a significantly lower growth rate than females during the middle school years (0.78%/year, p = 0.02). CONCLUSION The result showed that both individual- and school-level variables such as gender, FARM, and SAP influenced HRFK growth. Educators should heed gender differences in growth curves and recognize the correlates of school-level variables.
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Affiliation(s)
- Xihe Zhu
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA.
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | - Haichun Sun
- Department of Teaching and Learning, University of South Florida, Tampa, FL 33620, USA
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Maepa MP, Ntshalintshali T. Family Structure and History of Childhood Trauma: Associations With Risk-Taking Behavior Among Adolescents in Swaziland. Front Public Health 2020; 8:563325. [PMID: 33154959 PMCID: PMC7591591 DOI: 10.3389/fpubh.2020.563325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Risk-taking and self-harm behavior among adolescent are a global challenge. This study explored family structure and history of childhood trauma and their association with risk-taking and self-harm behaviors among adolescents in Swaziland. Methods: Using a cross-sectional design, a sample of 470 male and female adolescents were sampled through simple random sampling from selected high schools in Swaziland. They completed a questionnaire assessing family structure, history of childhood trauma, and risk-taking and self-harm behaviors. Analysis of variance and t-test were used to analyze the results. Results: The findings revealed that family structure significantly influence risk-taking and self-harm behavior among adolescents [F(2, 247) = 5.481; P < 0.004] those from child-headed and single-parent households reported higher risk-taking and self-harm behaviors. The results also revealed adolescents history of childhood trauma to be more risk-takers than those without history of childhood trauma t(468) = 3.409, p < 0.001. Discussion: Study results suggest that family structure and history of childhood trauma have significant association with adolescents' risk-taking and self-harm behaviors.
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Affiliation(s)
- Mokoena Patronella Maepa
- Department of Clinical Psychology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Thobile Ntshalintshali
- Psychosocial and Behavioural Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Trends of Alcohol Use, Dietary Behaviour, Interpersonal Violence, Mental Health, Oral and Hand Hygiene Behaviour among Adolescents in Lebanon: Cross-Sectional National School Surveys from 2005, 2011 and 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197096. [PMID: 32998227 PMCID: PMC7579130 DOI: 10.3390/ijerph17197096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 12/30/2022]
Abstract
Health risk behaviours during adolescence can have long-term negative consequences. Little is known, however, about the recent health risk behaviour trends in adolescents in Lebanon. This investigation aimed to report the trends in the prevalence of various health risk behaviours, such as alcohol use, dietary behaviour, interpersonal violence, mental health, oral and hand hygiene, among adolescents in Lebanon. Cross-sectional nationally representative data were analysed from 13,109 adolescents (14 years median age) that participated in three waves (2005, 2011 and 2017) of the “Lebanon Global School-Based Student Health Survey (GSHS)”. Results indicate that significant improvements were found among both boys and girls in the decline in interpersonal violence (bulling victimization, being physically attack and involvement in physical fighting), poor washing of hands after using the toilet, and suicide planning, and among girls only loneliness, worry-induced sleep disturbance and suicidal ideation. Significant increases were found among both boys and girls in the prevalence of inadequate fruit consumption, and among boys only unintentional injury and not always washing hands before eating. In conclusion, several decreases but also increases in health risk behaviours were found over three assessment points during a period of 12 years calling for continued health enhancing activities in this adolescent population.
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Hammerton G, Edwards AC, Mahedy L, Murray J, Maughan B, Kendler KS, Hickman M, Heron J. Externalising pathways to alcohol-related problems in emerging adulthood. J Child Psychol Psychiatry 2020; 61:721-731. [PMID: 31769047 PMCID: PMC7242151 DOI: 10.1111/jcpp.13167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Both 'early-onset persistent' and 'adolescent-onset' conduct problems (CPs) are associated with alcohol-related problems in emerging adulthood. The escalation of early CPs into criminal behaviour and heavy alcohol consumption prior to emerging adulthood are both likely to be important pathways. METHODS Data were analysed from 3,038 young people in a UK birth cohort, the Avon Longitudinal Study of Parents and Children. The exposure was developmental trajectories of CPs ('low', 'childhood-limited', 'adolescent-onset' and 'early-onset persistent') between ages 4 and 13 years. The mediator was latent classes representing heavy alcohol consumption and/ or criminal behaviour at age 15 years. For the outcome, a quadratic latent growth curve was estimated to capture nonlinear change in alcohol-related problems between ages 18 and 23 years. RESULTS Those with 'early-onset persistent' [b(95% CI) = 1.16 (0.17, 2.14)] and 'adolescent-onset' CPs [b(95% CI) = 1.31 (0.17, 2.45)] had higher levels of alcohol-related problems at age 18 years compared to those with 'low' CPs', but there was little evidence of an association with alcohol-related problems after age 19 years. There was evidence for an indirect effect of 'early-onset persistent' CPs [b(95% CI) = 1.12 (0.52, 1.72)] on alcohol-related problems at age 18 years via the latent classes of alcohol and criminal behaviour in adolescence. This was not found for 'adolescent-onset' CPs [b(95% CI) = 0.35 (-0.36, 1.07)]. CONCLUSIONS Strong associations exist between early CPs, adolescent alcohol consumption and criminal behaviour and alcohol-related problems at age 18 years. Associations between early CPs and alcohol-related problems weakened considerably across emerging adulthood.
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Affiliation(s)
- Gemma Hammerton
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth UniversityRichmondVAUSA
| | - Liam Mahedy
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Joseph Murray
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasRio Grande do SulBrazil
| | - Barbara Maughan
- MRC Social, Genetic & Developmental Psychiatry CentreKing's College LondonLondonUK
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth UniversityRichmondVAUSA
| | - Matthew Hickman
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Jon Heron
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
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Terson de Paleville D, Harman K, Richards E, Jaggers JR, King K. Physiology Understanding Week in a public middle school in Southern Indiana: exercise and health. ADVANCES IN PHYSIOLOGY EDUCATION 2020; 44:254-261. [PMID: 32412382 DOI: 10.1152/advan.00198.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Physiology Understanding (PhUn) Week is a national outreach event sponsored by the American Physiological Society. Our PhUn team conducted an event for 551 students (12.5 ± 0.9 yr old) in a middle school in Indiana. The aims of this program were to: 1) teach about the negative consequences of inactivity on cardiovascular (CV) health and overall well-being; 2) help students to determine their own CV fitness level and design their fitness plan; and 3) test the hypothesis that students who are offered daily physical education (PE) classes are able to meet the Physical Activity Guidelines for Americans. The University of Louisville PhUn team visited the school during school hours to execute the outreach program to students enrolled in Health and PE as their course elective. During the event, students were educated about CV physiology and the effects of exercise on CV fitness and metabolism. Additionally, students were asked to completed a questionnaire about their physical activity behaviors outside the school. Students were also educated about ways to increase energy expenditure by 150 METy (units of metabolism for youth) per day during 7 days. CV fitness levels were estimated by using the PACER (Progressive Aerobic Cardiovascular Endurance Run) test, and students were asked to create a plan to increase energy expenditure daily. The results showed that 53% of the students did not perform enough physical activity outside school to meet the guidelines. In conclusion, the incorporation of PE in schools is critical to cultivate healthy lifestyles and decrease the sedentarism epidemic in the U.S.
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Affiliation(s)
| | - Kathryn Harman
- Department of Health and Sport Sciences, University of Louisville, Louisville, Kentucky
| | | | - Jason R Jaggers
- Department of Health and Sport Sciences, University of Louisville, Louisville, Kentucky
| | - Kristi King
- Department of Health and Sport Sciences, University of Louisville, Louisville, Kentucky
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Wright C, Heron J, Campbell R, Hickman M, Kipping RR. Adolescent multiple risk behaviours cluster by number of risks rather than distinct risk profiles in the ALSPAC cohort. BMC Public Health 2020; 20:290. [PMID: 32131789 PMCID: PMC7057689 DOI: 10.1186/s12889-020-8369-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/18/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Experimentation with new behaviours during adolescence is normal. However, engagement in two or more risk behaviours, termed multiple risk behaviours is associated with socioeconomic disadvantage and poor health and social outcomes. Evidence of how adolescents cluster based on their risk behaviours is mixed. METHODS Latent Class Analysis was used to study patterns of engagement in 10 self-reported risk behaviours (including substance use, self-harm and sexual health) from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort at ages 15-16 years. Data was available for 6556 adolescents. Associations between risk profile and sex were explored. RESULTS A 3-class model for both females and males was deemed to have acceptable fit. Whilst we found evidence of a sex difference in the risk behaviours reported within each class, the sex-specific results were very similar in many respects. For instance, the prevalence of membership of the high-risk class was 8.5% for males and 8.7% for females and both groups had an average of 5.9 behaviours. However, the classes were both statistically dubious, with class separation (entropy) being poor as well as conceptually problematic, because the resulting classes did not provide distinct profiles and varied only by quantity of risk-behaviours. CONCLUSION Clusters of adolescents were not characterised by distinct risk behaviour profiles, and provide no additional insight for intervention strategies. Given this is a more complicated, software-specific method, we conclude that an equally effective, but more readily replicable approach is to use a count of the number of risk behaviours.
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Affiliation(s)
- Caroline Wright
- Population Health Sciences, Bristol Medical School, Barley House, University of Bristol, Oakfield Grove, Clifton, Bristol, BS8 2BN UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, Barley House, University of Bristol, Oakfield Grove, Clifton, Bristol, BS8 2BN UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, Barley House, University of Bristol, Oakfield Grove, Clifton, Bristol, BS8 2BN UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, Barley House, University of Bristol, Oakfield Grove, Clifton, Bristol, BS8 2BN UK
| | - Ruth R. Kipping
- Population Health Sciences, Bristol Medical School, Barley House, University of Bristol, Oakfield Grove, Clifton, Bristol, BS8 2BN UK
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Gilligan C, Wolfenden L, Foxcroft DR, Williams AJ, Kingsland M, Hodder RK, Stockings E, McFadyen T, Tindall J, Sherker S, Rae J, Wiggers J. Family-based prevention programmes for alcohol use in young people. Cochrane Database Syst Rev 2019; 3:CD012287. [PMID: 30888061 PMCID: PMC6423557 DOI: 10.1002/14651858.cd012287.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alcohol use in young people is a risk factor for a range of short- and long-term harms and is a cause of concern for health services, policy-makers, youth workers, teachers, and parents. OBJECTIVES To assess the effectiveness of universal, selective, and indicated family-based prevention programmes in preventing alcohol use or problem drinking in school-aged children (up to 18 years of age).Specifically, on these outcomes, the review aimed:• to assess the effectiveness of universal family-based prevention programmes for all children up to 18 years ('universal interventions');• to assess the effectiveness of selective family-based prevention programmes for children up to 18 years at elevated risk of alcohol use or problem drinking ('selective interventions'); and• to assess the effectiveness of indicated family-based prevention programmes for children up to 18 years who are currently consuming alcohol, or who have initiated use or regular use ('indicated interventions'). SEARCH METHODS We identified relevant evidence from the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, MEDLINE (Ovid 1966 to June 2018), Embase (1988 to June 2018), Education Resource Information Center (ERIC; EBSCOhost; 1966 to June 2018), PsycINFO (Ovid 1806 to June 2018), and Google Scholar. We also searched clinical trial registers and handsearched references of topic-related systematic reviews and the included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster RCTs (C-RCTs) involving the parents of school-aged children who were part of the general population with no known risk factors (universal interventions), were at elevated risk of alcohol use or problem drinking (selective interventions), or were already consuming alcohol (indicated interventions). Psychosocial or educational interventions involving parents with or without involvement of children were compared with no intervention, or with alternate (e.g. child only) interventions, allowing experimental isolation of parent components. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 46 studies (39,822 participants), with 27 classified as universal, 12 as selective, and seven as indicated. We performed meta-analyses according to outcome, including studies reporting on the prevalence, frequency, or volume of alcohol use. The overall quality of evidence was low or very low, and there was high, unexplained heterogeneity.Upon comparing any family intervention to no intervention/standard care, we found no intervention effect on the prevalence (standardised mean difference (SMD) 0.00, 95% confidence interval (CI) -0.08 to 0.08; studies = 12; participants = 7490; I² = 57%; low-quality evidence) or frequency (SMD -0.31, 95% CI -0.83 to 0.21; studies = 8; participants = 1835; I² = 96%; very low-quality evidence) of alcohol use in comparison with no intervention/standard care. The effect of any parent/family interventions on alcohol consumption volume compared with no intervention/standard care was very small (SMD -0.14, 95% CI -0.27 to 0.00; studies = 5; participants = 1825; I² = 42%; low-quality evidence).When comparing parent/family and adolescent interventions versus interventions with young people alone, we found no difference in alcohol use prevalence (SMD -0.39, 95% CI -0.91 to 0.14; studies = 4; participants = 5640; I² = 99%; very low-quality evidence) or frequency (SMD -0.16, 95% CI -0.42 to 0.09; studies = 4; participants = 915; I² = 73%; very low-quality evidence). For this comparison, no trials reporting on the volume of alcohol use could be pooled in meta-analysis.In general, the results remained consistent in separate subgroup analyses of universal, selective, and indicated interventions. No adverse effects were reported. AUTHORS' CONCLUSIONS The results of this review indicate that there are no clear benefits of family-based programmes for alcohol use among young people. Patterns differ slightly across outcomes, but overall, the variation, heterogeneity, and number of analyses performed preclude any conclusions about intervention effects. Additional independent studies are required to strengthen the evidence and clarify the marginal effects observed.
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Affiliation(s)
- Conor Gilligan
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - David R Foxcroft
- Oxford Brookes UniversityDepartment of Psychology, Social Work and Public HealthMarston Road, Jack Straws LaneMarstonOxfordEnglandUKOX3 0FL
| | - Amanda J Williams
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Emily Stockings
- University of New South WalesNational Drug and Alcohol Research Centre (NDARC)SydneyAustralia
| | - Tameka‐Rae McFadyen
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Jenny Tindall
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Shauna Sherker
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Alcohol and Drug FoundationProgram Development and EvaluationLevel 12, 607 Bourke StreetMelbourneVictoriaAustralia3000
| | - Julie Rae
- Alcohol and Drug FoundationProgram Development and EvaluationLevel 12, 607 Bourke StreetMelbourneVictoriaAustralia3000
| | - John Wiggers
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
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