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Park MH, Song HY. Transtheoretical model to predict the stages of changes in smoking cessation behavior among adolescents. Front Public Health 2024; 12:1399478. [PMID: 39081357 PMCID: PMC11286591 DOI: 10.3389/fpubh.2024.1399478] [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: 03/15/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Previous studies on adolescent smoking cessation behavior based on the transtheoretical model have primarily focused on the development of cessation programs. Attempting to quit smoking is a prerequisite for executing smoking cessation. Appropriate methods must be selected based on the characteristics and intentions of individuals to increase smokers' satisfaction and success rates in quitting. Therefore, this study aimed to identify changing processes influencing the stages of change associated with successful smoking cessation among adolescents and examined the related factors. This descriptive study explored a transtheoretical model of different stages of changes in smoking cessation behavior among adolescent smokers. Methods The participants included 237 middle and high school students in South Korea. We examined the differences in stages of changes in smoking cessation behaviors based on general characteristics, smoking-related characteristics, smoking cessation change processes (cognitive and behavioral), smoking decisional balance (pros and cons of smoking), and self-efficacy. Results The probability of reaching the preparation stage of smoking cessation was significantly lower among participants who did not know their father's educational level than among those who knew their father's educational level. Conversely, this probability was significantly higher among participants whose mothers had a college or higher education level and those who did not know their mother's educational level than in those whose mothers had a high school or lower education level. Conclusion These findings indicated that parental education is a significant predictor of the preparation stage of smoking cessation, highlighting the importance of the family environment in facilitating smoking cessation among adolescents. Accordingly, communication and support at home could help reinforce adolescents' determination to quit smoking and make relevant plans. Thus, smoking cessation support should stress the need to enhance communication at home.
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Affiliation(s)
- Min Hee Park
- Department of Nursing, Wonkwang University, Iksan, Republic of Korea
| | - Hye-Young Song
- College of Nursing, Woosuk University, Jeonju, Republic of Korea
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Park JH, Kim MJ, Lee HJ. A Study on the Factors Influencing Smoking in Multicultural Youths in Korea. Healthcare (Basel) 2023; 11:healthcare11101437. [PMID: 37239723 DOI: 10.3390/healthcare11101437] [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: 04/07/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Based on the ecological integration model, this study examined the factors affecting smoking in adolescents from multicultural families by dividing them into two levels: microsystem and social network factors. The data were from the Korea Youth Risk Behavior Web-Based Survey (KYRBS) from 2016 to 2020. It included 4577 respondents whose fathers, mothers, or both, were not born in Korea. The factors affecting smoking among multicultural teenagers were determined by a composite-sample multiple logistic regression analysis. Male smoking rates among multicultural adolescents were 2.49 times higher than female rates in the microsystem. When the father was "Korean" rather than a "Foreigner", smoking was 0.55 times lower in family factors in terms of social network. In social factors of social networks, multicultural adolescents' smoking was 12.02 times greater when they were drinking than when they were not, and 3.62 times higher when the answer to the question of whether they had experienced violence was "yes" than "no." Based on the ecological model in this study, social factors such as drinking, and violence were highly related to smoking. Since multicultural adolescents were closely influenced by the surrounding environment, such as family, school, and social relationship, it was necessary to let parents and schoolteachers be involved in the intervention of smoking of multicultural adolescents so that they can help multicultural adolescents adjust better to school and perform better academically while decreasing risky behaviors for their health, such as drinking and, ultimately, smoking.
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Affiliation(s)
- Jin-Hee Park
- Department of Nursing, Changshin University, 262 Palyongro, MasanHoewon-gu, Changwon 51352, Gyeongsangnam-do, Republic of Korea
| | - Mi-Jin Kim
- Department of Nursing, Daegu Haany University, Hanuidae-ro, Gyeongsan-si 38610, Gyeongsangbuk-do, Republic of Korea
| | - Hee-Joo Lee
- Department of Nursing, Sangmyung University, 31 Sangmyungdae-gil, Dongnam-gu, Cheonan 31066, Chungnam, Republic of Korea
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Song HY, Yang SJ. Factors Associated with Smoking Behaviors in Out-of-School Youth: Based on an Ecological Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6380. [PMID: 34204696 PMCID: PMC8296201 DOI: 10.3390/ijerph18126380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate the association between smoking behavior in out-of-school youths (OSY) and individual, interpersonal, and organizational factors through an ecological model. METHODS Participants were 297 OSY aged 13-18 years, who visited J area's counseling center. The independent variables were self-control (intrapersonal factor), parental attachment and social network (interpersonal factors), and exposure to no-smoking policy (community factor). The dependent variable was smoking. Descriptive statistics, χ2-tests, correlation analyses, and logistic regression analysis were performed. RESULTS The predictors of smoking in OSY were analyzed using demographic, intrapersonal, interpersonal, and community factors. Period after discontinuation of school, self-control, parental attachment, and friends' smoking behavior were significant predictors. Smoking behavior was found to decrease when the period after discontinuation of school was over than one year, when the parents attachment increased and when self-control increased. Conversely, smoking increased when friends' smoking increased. CONCLUSIONS When administering smoking prevention programs for OSY, parental attachment and psychological traits, such as self-control, should be taken into consideration. Therefore, for effective results, such programs need to strengthen self-control, stress the importance of parental attachment through parent education, and enroll adolescents along with their friends who smoke. Implications and Contribution: Based on an ecological model, this descriptive survey, conducted to investigate the association between smoking behavior among out-of-school youths and individual, interpersonal, and organizational factors, proposes that smoking prevention programs should consider parental attachment and psychological traits, including self-control, for optimal effectiveness.
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Affiliation(s)
- Hye-Young Song
- Department of Nursing, Woosuk University, Jeonbuk 55338, Korea;
- College of Nursing, Ewha Womans University, Seoul 03760, Korea
| | - Sook-Ja Yang
- College of Nursing, Ewha Womans University, Seoul 03760, Korea
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Guo Y, Sims OT, Qin W, Yang F. Factors Associated with Symptoms of Depression and Psychological Distress during the COVID-19 Pandemic. Behav Sci (Basel) 2021; 11:bs11020013. [PMID: 33494234 PMCID: PMC7909766 DOI: 10.3390/bs11020013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 12/18/2022] Open
Abstract
The objective of this study was to examine factors associated with symptoms of depression and psychological distress during the COVID-19 pandemic in China. Convenience sampling and snowball sampling were used to recruit a sample of adults in China (n = 2130) from 14 February 2020 to 3 March 2020 to complete an online survey. Linear regression was used to examine the predictors of symptoms of depression and psychological distress. Living in a non-urban area and the number of confirmed cases in their city of residence were positively associated with symptoms of depression. Female gender, not being married, practicing social distancing, the amount of time spent daily on social media searching for and reading information on COVID-19, the number of confirmed cases of COVID-19 in their city of residence, and having confirmed or suspected cases of COVID-19 in personal networks were positively associated with psychological distress. Social distancing is a widely used public health approach for population-wide virus-containment of COVID-19. However, reductions in population-wide psychological well-being are inadvertent consequences of social distancing. There is an emerging need to negate factors that increase adverse mental health vulnerabilities during the COVID-19 pandemic.
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Affiliation(s)
- Yuqi Guo
- School of Social Work, College of Health and Human Services, University of North Carolina Charlotte, Charlotte, NC 28223, USA;
| | - Omar T. Sims
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Integrative Center for Aging Research, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Correspondence: (O.T.S.); (F.Y.)
| | - Weidi Qin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Fan Yang
- Social Welfare Program, School of Public Administration, Dongbei University of Finance and Economics, Dalian 102488, China
- Institute of Quantitative & Technological Economies, Chinese Academy of Social Sciences, Beijing 102488, China
- Correspondence: (O.T.S.); (F.Y.)
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Brown R, Van Godwin J, Copeland L, Hallingberg B, Angel L, MacDonald S, Segrott J, Moore G. Ecological Exploration of Knowledge and Attitudes Towards Tobacco and E-Cigarettes Among Primary School Children, Teachers, and Parents in Wales: A Qualitative Study. Tob Use Insights 2020; 13:1179173X20938770. [PMID: 32848489 PMCID: PMC7425248 DOI: 10.1177/1179173x20938770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/28/2020] [Indexed: 12/27/2022] Open
Abstract
Experimentation with e-cigarettes has grown rapidly among UK adolescents. To date, this topic has been primarily researched in secondary schools, with less understanding of development of attitudes and behaviours at an earlier age. This research reports qualitative data from interviews with pupils, parents, and teachers at 4 case study schools in Wales (N = 42). It draws on Bronfenbrenner's Ecological Systems Theory to consider how the intersection of systems surrounding primary school-age children and their interaction with these systems, shape knowledge, and attitudes towards e-cigarettes and tobacco. Findings indicate that consistent messaging on smoking from school and family was reflected in strong disapproval among pupils and clear understanding of harms. This was less evident for e-cigarettes, where messages were mixed and inconsistent between home and school, with concerns over what to tell children about e-cigarettes in light of mixed messages and absence of official guidance. Implications of findings for policy and teaching are discussed.
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Affiliation(s)
- Rachel Brown
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jordan Van Godwin
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Britt Hallingberg
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Lianna Angel
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Sarah MacDonald
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Spectrum Consortium, London, UK
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Fredriksson I, Geidne S, Eriksson C. Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden. Scand J Public Health 2018; 46:72-79. [PMID: 29552968 DOI: 10.1177/1403494817743900] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. METHODS In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. RESULTS As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. CONCLUSIONS There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.
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Affiliation(s)
- Ingela Fredriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
| | - Susanna Geidne
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
| | - Charli Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
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Elmore KC, Scull TM, Kupersmidt JB. Media as a "Super Peer": How Adolescents Interpret Media Messages Predicts Their Perception of Alcohol and Tobacco Use Norms. J Youth Adolesc 2017; 46:376-387. [PMID: 27837371 PMCID: PMC5243166 DOI: 10.1007/s10964-016-0609-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
Abstract
Adolescents' media environment offers information about who uses substances and what happens as a result-how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents' (n = 817, 48 % female, 64 % white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents' media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents' media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents' interest in alcohol and tobacco use.
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Affiliation(s)
- Kristen C Elmore
- Bronfenbrenner Center for Translational Research, Cornell University, Beebe Hall, 110 Plantations Rd., Ithaca, NY, 14853, USA.
| | - Tracy M Scull
- Innovation Research & Training, Durham, NC, 27713, USA
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So ES, Yeo JY. Factors Associated with Early Smoking Initiation among Korean Adolescents. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:115-9. [PMID: 26160239 DOI: 10.1016/j.anr.2015.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 12/29/2014] [Accepted: 01/02/2015] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to identify factors associated with early initiation of cigarette smoking among Korean adolescents. METHODS A secondary analysis was conducted on the 2012 Korea Youth Risk Behavior Web-based Survey data using Cox proportional hazards regression. RESULTS Early smoking initiation was associated with being male, having a positive subjective health status, perceiving oneself as thin or average weight (body image), having an average happiness level, being stressed, consuming alcohol, having suicidal ideation, experiencing sexual intercourse, having low or average academic grades, having a parental education level of high school or below, not taking a family trip in the previous 12 months, and having a family that approves of smoking in the home. CONCLUSIONS Interventions targeting the prevention of smoking initiation among adolescents should include individual factors such as health status, body weight, perceived mental health status, health-risk behaviors, and academic characteristics as well as family factors that reinforce family cohesion and home smoking bans. Moreover, male adolescents aged 12-13 years and their parents should be the main target of these interventions.
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Affiliation(s)
- Eun Sun So
- College of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Ji Young Yeo
- Department of Nursing, Seoul Women's College of Nursing, Seoul, South Korea.
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Geidne S, Fredriksson I, Dalal K, Eriksson C. Two NGO-Run Youth-Centers in Multicultural, Socially Deprived Suburbs in Sweden—Who Are the Participants? Health (London) 2015. [DOI: 10.4236/health.2015.79131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Atilola O. Child mental-health policy development in sub-Saharan Africa: broadening the perspectives using Bronfenbrenner's ecological model. Health Promot Int 2014; 32:380-391. [DOI: 10.1093/heapro/dau065] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Corliss HL, Rosario M, Birkett MA, Newcomb ME, Buchting FO, Matthews AK. Sexual orientation disparities in adolescent cigarette smoking: intersections with race/ethnicity, gender, and age. Am J Public Health 2014; 104:1137-47. [PMID: 24825218 DOI: 10.2105/ajph.2013.301819] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined sexual orientation differences in adolescent smoking and intersections with race/ethnicity, gender, and age. METHODS We pooled Youth Risk Behavior Survey data collected in 2005 and 2007 from 14 jurisdictions; the analytic sample comprised observations from 13 of those jurisdictions (n = 64,397). We compared smoking behaviors of sexual minorities and heterosexuals on 2 dimensions of sexual orientation: identity (heterosexual, gay-lesbian, bisexual, unsure) and gender of lifetime sexual partners (only opposite sex, only same sex, or both sexes). Multivariable regressions examined whether race/ethnicity, gender, and age modified sexual orientation differences in smoking. RESULTS Sexual minorities smoked more than heterosexuals. Disparities varied by sexual orientation dimension: they were larger when we compared adolescents by identity rather than gender of sexual partners. In some instances race/ethnicity, gender, and age modified smoking disparities: Black lesbians-gays, Asian American and Pacific Islander lesbians-gays and bisexuals, younger bisexuals, and bisexual girls had greater risk. CONCLUSIONS Sexual orientation, race/ethnicity, gender, and age should be considered in research and practice to better understand and reduce disparities in adolescent smoking.
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Affiliation(s)
- Heather L Corliss
- At the time of the study, Heather L. Corliss was with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital/Harvard Medical School, Boston, MA. Margaret Rosario is with the Department of Psychology in Clinical Psychology, Health Psychology, and Clinical Science, and Basic and Applied Social Psychology, City University of New York-City College and Graduate Center, New York, NY. Michelle A. Birkett and Michael E. Newcomb are with the Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL. Francisco O. Buchting is with Horizons Foundation, San Francisco, CA. Alicia K. Matthews is with the Department of Health Systems Sciences, University of Illinois at Chicago
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Bonell CP, Fletcher A, Jamal F, Wells H, Harden A, Murphy S, Thomas J. Theories of how the school environment impacts on student health: systematic review and synthesis. Health Place 2013; 24:242-9. [PMID: 24177419 DOI: 10.1016/j.healthplace.2013.09.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 10/26/2022]
Abstract
Public-health interventions informed by theory can be more effective but complex interventions often use insufficiently complex theories. We systematically reviewed theories of how school environments influence health. We included 37 reports drawing on 24 theories. Narrative synthesis summarised and categorised theories. We then produced an integrated theory of school environment influences on student health. This integrated theory could inform complex interventions such as health promoting schools programmes. Using systematic reviews to develop theories of change might be useful for other types of 'complex' public-health interventions addressing risks at the individual and community levels.
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Affiliation(s)
- C P Bonell
- Department of Childhood, Families and Health, Institute of Education, University of London, 20 Bedford Way, London WC1H 0AL, UK.
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Bonell C, Jamal F, Harden A, Wells H, Parry W, Fletcher A, Petticrew M, Thomas J, Whitehead M, Campbell R, Murphy S, Moore L. Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis. PUBLIC HEALTH RESEARCH 2013. [DOI: 10.3310/phr01010] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BackgroundIn contrast to curriculum-based health education interventions in schools, the school environment approach promotes health by modifying schools' physical/social environment. This systematic review reports on the health effects of the school environment and processes by which these might occur. It includes theories, intervention outcome and process evaluations, quantitative studies and qualitative studies.Research questionsResearch question (RQ)1: What theories are used to inform school environment interventions or explain school-level health influences? What testable hypotheses are suggested? RQ2: What are the effects on student health/inequalities of school environment interventions addressing organisation/management; teaching/pastoral care/discipline; and the physical environment? What are the costs? RQ3: How feasible/acceptable and context dependent are such interventions? RQ4: What are the effects on student health/inequalities of school-level measures of organisation/management; teaching/pastoral care/discipline; and the physical environment? RQ5: Through what processes might such influences occur?Data sourcesA total of 16 databases were searched between 30 July 2010 and 23 September 2010 to identify relevant studies, including the British Educational Index, the Cumulative Index to Nursing and Allied Health Literature, the Health Management Information Consortium, EMBASE, MEDLINE and PsycINFO. In addition, references of included studies were checked and authors contacted.Review methodsIn stage 1, we mapped references concerning how the school environment affects health and consulted stakeholders to identify stage 2 priorities. In stage 2, we undertook five reviews corresponding to our RQs.ResultsStage 1: A total of 82,775 references were retrieved and 1144 were descriptively mapped. Stage 2: A total of 24 theories were identified (RQ1). The human functioning and school organisation, social capital and social development theories were judged most useful. Ten outcome evaluations were included (RQ2). Four US randomised controlled trials (RCTs) and one UK quasi-experimental study examined interventions building school community/relationships. Studies reported benefits for some, but not all outcomes (e.g. aggression, conflict resolution, emotional health). Two US RCTs assessed interventions empowering students to contribute to modifying food/physical activity environments, reporting benefits for physical activity but not for diet. Three UK quasi-experimental evaluations examined playground improvements, reporting mixed findings, with benefits being greater for younger children and longer break times. Six process evaluations (RQ3) reported positively. One study suggested that implementation was facilitated when this built on existing ethos and when senior staff were supportive. We reviewed 42 multilevel studies, confining narrative synthesis to 10 that appropriately adjusted for confounders. Four UK/US reports suggested that schools with higher value-added attainment/attendance had lower rates of substance use and fighting. Three reports from different countries examined school policies on smoking/alcohol, with mixed results. One US study found that schools with more unobservable/unsupervised places reported increased substance use. Another US study reported that school size, age structure and staffing ratio did not correlate with student drinking. Twenty-one qualitative reports from different countries (RQ5) suggested that disengagement, lack of safety and lack of participation in decisions may predispose students to engage in health risks.LimitationsWe found no evidence regarding health inequalities or cost, and could not undertake meta-analysis.ConclusionsThere is non-definitive evidence for the feasibility and effectiveness of school environment interventions involving community/relationship building, empowering student participation in modifying schools' food/physical activity environments, and playground improvements. Multilevel studies suggest that schools that add value educationally may promote student health. Qualitative studies suggest pathways underlying these effects. This evidence lends broad support to theories of social development, social capital and human functioning and school organisation. Further trials to examine the effects of school environment modifications on student health are recommended.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- C Bonell
- Centre for Evidence Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - F Jamal
- Institute for Health and Human Development, University of East London, London, UK
| | - A Harden
- Institute for Health and Human Development, University of East London, London, UK
| | - H Wells
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - W Parry
- Department of Quantitative Social Science, Institute of Education, University of London, London, UK
| | - A Fletcher
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - M Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - J Thomas
- Department of Childhood, Families and Health, Institute of Education, University of London, London, UK
| | - M Whitehead
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - R Campbell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - S Murphy
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - L Moore
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
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Brouwer AM, Mosack KE, Wendorf AR, Sokolova L. Patterns of Missing Data in Ethnic Minority Health Research: A Survey Project With Russian-Speaking Immigrant Women With Hypertension. Res Theory Nurs Pract 2013; 27:276-95. [DOI: 10.1891/1541-6577.27.4.276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We explored cultural-level variables and their associations with missing data in a group of immigrants from the Former Soviet Union (FSU). Elderly hypertensive women (N = 105) completed a health survey. Prevalence of missing data and z scores were calculated to determine which survey items and measures were more likely to have missing data. Hierarchical linear regressions were performed to test whether cultural variables predicted the rate of missing data beyond individual variables. Culture variables associated with survey nonresponse and missing data were related to depression, anxiety, medication beliefs and practices, attitudes toward physicians, and cultural and behavioral identity. An interpretation of the patterns of missing data and strategies to reduce the likelihood of missing data in this population are discussed. Cultural norms likely influence patients’ orientations toward their health care providers. Providers would do well to normalize difficulties with medical adherence and encourage patients to ask questions about such directives. We recommend that researchers consider the cultural appropriateness of survey items and consider alternative methods (i.e., qualitative designs) for culturally sensitive topics such as mental health and sexuality.
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Bonell C, Parry W, Wells H, Jamal F, Fletcher A, Harden A, Thomas J, Campbell R, Petticrew M, Murphy S, Whitehead M, Moore L. The effects of the school environment on student health: a systematic review of multi-level studies. Health Place 2012; 21:180-91. [PMID: 23501377 DOI: 10.1016/j.healthplace.2012.12.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 12/07/2012] [Accepted: 12/10/2012] [Indexed: 12/23/2022]
Abstract
Health outcomes vary between schools and it is theorised that this may be partly attributable to variation in the school environment. Existing systematic reviews have not drawn authoritative conclusions because of methodological limitations in the review or studies available. We identified 42 multi-level studies, ten of which were judged of sufficient quality to narratively synthesize. There was consistent evidence that schools with higher attainment and attendance than would be expected from student intake had lower rates of substance use. Findings on the influence of smoking/alcohol policies were mixed. Three studies examined the health effects variously associated with school campus area and observability, year structure, school size and pupil-to-teacher ratio with mixed findings. The studies reviewed support the potential influence of the school environment on student health.
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Affiliation(s)
- Chris Bonell
- Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, Oxford OX1 2ER, United Kingdom.
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Ludden AB. What if you caught them using? Prospective teachers' beliefs about responding to student substance use. JOURNAL OF DRUG EDUCATION 2012; 42:59-85. [PMID: 22873014 DOI: 10.2190/de.42.1.d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This survey research examined how prospective teachers' (N=384) beliefs about the nature of adolescence, their substance use, and their preparedness for dealing with substance use situations are linked to perceptions of how they would respond to students' possession or use of cigarettes, alcohol, and marijuana at school. Results suggested that prospective teachers are not prepared for these situations. Feeling prepared, perceiving that few adolescents engage in problem behavior, and low personal substance use were associated with more responses to substance use situations. Women were more likely than men to think they would respond to adolescent substance use yet they felt less prepared. Males who used alcohol, cigarettes, or marijuana recently were the least likely to perceive that they would respond to adolescents using substances at school.
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Affiliation(s)
- Alison Bryant Ludden
- Psychology Department, College of the Holy Cross, Worcester, Massachusetts 01610, USA.
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WIIUM NORA, WOLD BENTE. Actions taken by schools when tobacco policies are violated: Associations with adolescent smoking prevalence. Scand J Psychol 2011; 52:494-501. [DOI: 10.1111/j.1467-9450.2011.00897.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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