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Brathwaite R, Mutumba M, Nanteza J, Filiatreau LM, Migadde H, Namatovu P, Nabisere B, Mugisha J, Mwebembezi A, Ssewamala FM. Assessing the Feasibility of Economic Approaches to Prevent Substance Abuse Among Adolescents: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e46486. [PMID: 37314844 PMCID: PMC10337321 DOI: 10.2196/46486] [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] [Received: 02/13/2023] [Accepted: 05/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Adolescent alcohol and drug use (ADU) is a significant public health challenge. Uganda, one of the poorest countries in Sub-Saharan Africa (SSA), has the second-highest rate of per capita alcohol consumption in SSA, and over one-third of Ugandan adolescents have used alcohol in their lifetime (over 50% of them engage in heavy episodic drinking). These estimates further increase in fishing villages, a key HIV-vulnerable population, where ADU is normative. However, few studies have assessed ADU among adolescents and youths living with HIV despite their increased risk for ADU and its impact on engagement in HIV care. Moreover, data on risk and resilience factors for ADU are scarce as only few studies evaluating ADU interventions in SSA have reported positive outcomes. The majority have been implemented in school settings, potentially excluding adolescents in fishing communities with high school dropout rates, and none have targeted risk factors including poverty and mental health, which are rampant among adolescents and youths living with HIV and their families, undermine their coping skills and resources, and have been associated with increased risk for ADU among them. OBJECTIVE We propose a mixed methods study with a sample of 200 adolescents and youths living with HIV (aged 18-24 years) seen at 6 HIV clinics in southwestern Uganda's fishing communities to (1) examine the prevalence and consequences of ADU and identify the multilevel risk and resilience factors associated with ADU among them and (2) explore the feasibility and short-term effects of an economic empowerment intervention on ADU among them. METHODS This study comprises four components: (1) focus group discussions (FGDs) with adolescents and youths living with HIV (n=20) and in-depth qualitative interviews with health providers (n=10) from 2 randomly selected clinics; (2) a cross-sectional survey with 200 adolescents and youths living with HIV; (3) a randomized controlled trial with a subgroup of adolescents and youths living with HIV (n=100); and (4) 2 postintervention FGD with adolescents and youths living with HIV (n=10 per group). RESULTS Participant recruitment for the first qualitative phase has completed. As of May 4, 2023, ten health providers from 6 clinics have been recruited, provided written consent to participate, and participated in in-depth qualitative interviews. Two FGDs was conducted with 20 adolescents and youths living with HIV from 2 clinics. Data transcription, translation, and analysis of qualitative data has commenced. The cross-sectional survey will commence shortly after and dissemination of the main study findings is targeted for 2024. CONCLUSIONS Our findings will advance our understanding of ADU among adolescents and youths living with HIV and inform the design of future interventions to address ADU among them. TRIAL REGISTRATION ClinicalTrials.gov NCT05597865; https://clinicaltrials.gov/ct2/show/NCT05597865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46486.
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Affiliation(s)
- Rachel Brathwaite
- Brown School, Washington University in St. Louis, St Louis, MO, United States
| | - Massy Mutumba
- Department of Health Behavior & Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | | | - Lindsey M Filiatreau
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Herbert Migadde
- International Center for Child Health and Development, Masaka, Uganda
| | - Phionah Namatovu
- International Center for Child Health and Development, Masaka, Uganda
| | - Betina Nabisere
- International Center for Child Health and Development, Masaka, Uganda
| | | | | | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, St Louis, MO, United States
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Ba-Break M, Bewick B, Huss R, Ensor T, Abahussin A, Alhakimi H, Elsey H. Systematic review of intervention functions, theoretical constructs and cultural adaptations of school-based smoking prevention interventions in low-income and middle-income countries. BMJ Open 2023; 13:e066613. [PMID: 36787979 PMCID: PMC9930567 DOI: 10.1136/bmjopen-2022-066613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To identify the approaches and strategies used for ensuring cultural appropriateness, intervention functions and theoretical constructs of the effective and ineffective school-based smoking prevention interventions that were implemented in low-income and middle-income countries (LMICs). DATA SOURCES Included MEDLINE, EMBASE, Global Health, PsycINFO, Web of Science and grey literature which were searched through August 2022 with no date limitations. ELIGIBILITY CRITERIA We included randomised controlled trials (RCTs) with ≥6 months follow-up assessing the effect of school-based interventions on keeping pupils never-smokers in LMICs; published in English or Arabic. DATA EXTRACTION AND SYNTHESIS Intervention data were coded according to the Theoretical Domains Framework, intervention functions of Behaviour Change Wheel and cultural appropriateness features. Using narrative synthesis we identified which cultural-adaptation features, theoretical constructs and intervention functions were associated with effectiveness. Findings were mapped against the capability-motivation and opportunity model to formulate the conclusion. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS We identified 11 RCTs (n=7712 never-smokers aged 11-15); of which five arms were effective and eight (four of the effective) arms had a low risk of bias in all criteria. Methodological heterogeneity in defining, measuring, assessing and presenting outcomes prohibited quantitative data synthesis. We identified nine components that characterised interventions that were effective in preventing pupils from smoking uptake. These include deep cultural adaptation; raising awareness of various smoking consequences; improving refusal skills of smoking offers and using never-smokers as role models and peer educators. CONCLUSION Interventions that had used deep cultural adaptation which incorporated cultural, environmental, psychological and social factors, were more likely to be effective. Effective interventions considered improving pupils' psychological capability to remain never-smokers and reducing their social and physical opportunities and reflective and automatic motivations to smoke. Future trials should use standardised measurements of smoking to allow meta-analysis in future reviews.
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Affiliation(s)
- Maryam Ba-Break
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Bridgette Bewick
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Tim Ensor
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Asma Abahussin
- Department of Biomedical Technology, King Saud University, Riyadh, Saudi Arabia
| | - Hamdi Alhakimi
- Head of MedGebra Centre for Research Consultations, Epidemiologist and Community Medicine Specialist, MedGebra Centre for Research Consultations, Utrecht, The Netherlands
| | - Helen Elsey
- Health Sciences, University of York, York, UK
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Adolescent Substance Use Behavior Change Through School Intervention Is Improved by Teacher and School Implementation Support Together, Especially for Girls. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1251-1263. [PMID: 35713739 PMCID: PMC9949964 DOI: 10.1007/s11121-022-01394-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 01/25/2023]
Abstract
An earlier trial of a school-based, preventative intervention, HealthWise South Africa, demonstrated some efficacy in preventing adolescent drinking and smoking in the Western Cape, South Africa. This was followed by the current implementation trial, which examined how implementation support conditions influenced adolescent drinking and smoking behavior change in the HealthWise intervention. The hybridized implementation-effectiveness trial included 34 schools (n = 2175 students) that provided student data at four waves through Grades 8 to 10. Implementation support conditions included a combination of two components (enhanced school environment and teacher consultation), resulting in four conditions: enhanced school environment, teacher consultation, both components, and standard delivery. Using configural frequency analysis, we examined how drinking and smoking behavior change differed across four configurations of intervention support longitudinally and by gender. For baseline non-smokers, results indicated sustained differences in abstention from smoking and smoking initiation between schools that received both support components and schools in the standard delivery condition. These results were primarily driven by girls. For baseline drinkers and smokers in the both components condition, changes in drinking were delayed until Grade 9 and smoking decayed by Grade 10. Results suggest that providing both school and teacher implementation support synergistically facilitates improved intervention outcomes both immediately following intervention and 2 years later across schools with diverse resource levels. Future iterations of HealthWise, and other interventions, may benefit from a multilevel implementation support strategy to improve student outcomes. More research is needed to understand how to improve HealthWise effectiveness among boys.
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Morojele NK, Ramsoomar L, Dumbili EW, Kapiga S. Adolescent health series - Alcohol, tobacco, and other drug use among adolescents in sub-Saharan Africa: A narrative review. Trop Med Int Health 2021; 26:1528-1538. [PMID: 34637175 DOI: 10.1111/tmi.13687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alcohol, tobacco, and other drug (ATOD) use by adolescents are major contributors to death and disability in sub-Saharan Africa (SSA). This paper reviews the extent of adolescents' ATOD use, risk and protective factors, and studies evaluating prevention interventions for adolescents in SSA. It also describes the harms associated with adolescents' ATOD use in SSA, which mainly include interpersonal violence, sexual risk behaviours, and negative academic outcomes. We use the socio-ecological model as our framework for understanding ATOD use risk and protective factors at individual, interpersonal, peer/school, and societal/structural levels. We used two strategies to find literature evaluating ATOD interventions for adolescents in SSA: (a) we sought systematic reviews of adolescent ATOD interventions in SSA covering the period 2000-2020; and (b) we used a comprehensive evidence review strategy and searched for studies that had evaluated ATOD interventions in all SSA countries between 2000 and 2020. Only two community interventions (a brief intervention and an HIV prevention intervention), out of four that were identified, were partially effective in reducing adolescent ATOD. Furthermore, only one school-based intervention (HealthWise), out of six that we uncovered, had any effect on ATOD use among adolescents. Possible reasons why many interventions were not effective include methodological limitations, involvement of non-evidence-based education-only approaches in some studies, and shortcomings in adaptations of evidence-based interventions. The scale of ATOD and related problems is disproportionate to the number of evaluated interventions to address them in SSA. More ATOD interventions need to be developed and evaluated in well-powered and well-designed studies.
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Affiliation(s)
- Neo K Morojele
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa.,Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Leane Ramsoomar
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,School of Public Health and Health Systems, University of the Pretoria, Gauteng, South Africa
| | - Emeka W Dumbili
- Institute for Therapy and Health Research, Kiel, Germany.,Department of Sociology and Anthropology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania.,Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Motamedi M, Caldwell LL, Smith EA, Wegner L, Jacobs J. Supporting South African High School Teachers' Implementation of a Prevention Program via Abridged Consultation: Outcomes and Moderators. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 68:61-72. [PMID: 33325541 DOI: 10.1002/ajcp.12494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Research is lacking on consultation support for school-based evidence-based programs (EBP) intended to prevent youths' risky behaviors in schools in low-resourced settings like high schools surrounding Cape Town, South Africa. Thus, this study's objective was to examine implementation outcomes and moderators of an abridged consultation condition for supporting teachers in better implementing HealthWise, an EBP for preventing youth risky sexual and substance use behaviors. Twenty-one schools with 33 teachers receiving abridged consultation (i.e., three consultation meetings, text message reminders, lesson plans, and support kits) were compared to 26 schools with 41 teachers that did not receive any consultation. Teachers with abridged consultation self-reported delivering more HealthWise content. Moderation analyses found teachers with lower educational degrees, who received abridged consultation reported more student interest in HealthWise. When there was higher school-level risk, teachers who received abridged consultation marginally self-reported adapting HealthWise more. Findings suggest consultation support that is abridged or a lower dose than is typical can be feasible in such a low-resourced, overburdened setting while still being associated with EBP coverage, student interest, and adaptation. However, moderation findings suggest contextual factors should be considered to match teachers/schools to the implementation support that best suits them.
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Affiliation(s)
| | - Linda L Caldwell
- The Pennsylvania State University, University Park, PA, USA
- University of the Western Cape, Bellville, South Africa
| | - Edward A Smith
- The Pennsylvania State University, University Park, PA, USA
- University of the Western Cape, Bellville, South Africa
| | - Lisa Wegner
- University of the Western Cape, Bellville, South Africa
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Layland EK, Ram N, Caldwell LL, Smith EA, Wegner L. Leisure Boredom, Timing of Sexual Debut, and Co-Occurring Behaviors among South African Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2383-2394. [PMID: 34401994 PMCID: PMC8911384 DOI: 10.1007/s10508-021-02014-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/01/2020] [Accepted: 04/16/2021] [Indexed: 06/13/2023]
Abstract
Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an underexplored correlate of sexual behavior that is associated with many adolescent health outcomes. We investigated if and how individual differences in leisure boredom may be associated with timing of sexual debut, and whether individuals engage in safe or risky behaviors at debut. Survival analysis, logistic regression, and Poisson regression were applied to eight-wave longitudinal data obtained from 3,088 South African adolescents (baseline Mage = 13.9 years) to examine associations between leisure boredom and cumulative hazard of sexual debut across adolescence, odds of co-occurring sexual behaviors, and incidence rate of co-occurring sexual risk behaviors at debut. Higher levels of leisure boredom were associated with elevated hazard cumulatively across adolescence. Higher levels of leisure boredom were also associated with lower odds of safe sex and higher odds of substance use during sex and transactional sex at sexual debut, but not casual sex or condom non-use at sexual debut. Although odds of singular risk behaviors were lower for girls than for boys, the association between leisure boredom and the number of risk behaviors at sexual debut was stronger for girls than boys. Higher trait leisure boredom was associated with elevated hazard of sexual debut, greater likelihood that risky behaviors accompanied sexual debut, and greater number of co-occurring risky behaviors at sexual debut. Results support leisure boredom as a potential target for preventing sexual risk behavior among South African adolescents.
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Affiliation(s)
- Eric K Layland
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Nilam Ram
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA
| | - Linda L Caldwell
- Department of Recreation, Park and Tourism Management, The Pennsylvania State University, University Park, PA, USA
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Edward A Smith
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
- Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Lisa Wegner
- Department of Occupational Therapy, University of Western Cape, Cape Town, South Africa
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Saba OA, Weir C, Aceves-Martins M. Substance use prevention interventions for children and young people in Sub-Saharan Africa: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103251. [PMID: 33892280 DOI: 10.1016/j.drugpo.2021.103251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Different techniques and approaches have been used for substance use prevention worldwide. No reviews of prevention interventions in Africa exist; hence this study aimed to systematically review interventions undertaken in Sub-Saharan Africa to prevent substance use in children and young people. METHODS MEDLINE, EMBASE, Cochrane Central, CAB, PsycINFO, CINAHL, SCOPUS, ERIC, and Web of Science databases were searched. Studies were included if they evaluated a substance use prevention intervention for children and young people in a Sub-Saharan African Country between 2000 and 2020. A narrative synthesis was used to explore and describe the data. RESULTS Eighteen studies, mostly from South Africa, were included. Most (10/18) of the interventions were school-based. Only two of the included studies were considered having a strong quality concerning the risk of bias, and some studies poorly reported the interventions. School-based interventions, although successful in improving knowledge, had little or no effects on substance use. Overall, most studies that reported a statistically significant reduction in substance use-related outcomes were brief interventions, individual-focused, and involved participants who were already exposed to substance use. These were mostly delivered by trained professionals using motivational interviewing or cognitive behavioural therapy or both. CONCLUSION School-based programs present an opportunity for substance use prevention efforts in the Sub-Saharan region in Africa. Such programs may benefit from an improved focus on individual students. There is a need for improving the quality of design, implementation, and reporting of substance use interventions within the region.
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Affiliation(s)
| | - Corina Weir
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Magaly Aceves-Martins
- Health Services Research Unit. Health Sciences Building, University of Aberdeen Foresterhill, Aberdeen AB25 2ZD, UK.
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Using Mixed Methods to Identify the Primary Mental Health Problems and Needs of Children, Adolescents, and Their Caregivers during the Coronavirus (COVID-19) Pandemic. Child Psychiatry Hum Dev 2021; 52:1082-1093. [PMID: 33108612 PMCID: PMC7590914 DOI: 10.1007/s10578-020-01089-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2020] [Indexed: 12/26/2022]
Abstract
Our understanding of child, adolescent, and caregiver mental health (MH) problems during the coronavirus pandemic, and which interventions are needed, may be advanced by consumer input. 133 general population caregivers reported top MH problems and needs for themselves and their children (Mage = 8.21; SD = 4.94), using standardized and idiographic measures. We applied linear regression models to quantitative data and thematic analysis to qualitative data. Caregivers' COVID-era depression and anxiety symptom means fell within the clinical range, as did their children's MH symptoms. Caregiver-reported child and adolescent symptoms were positively associated with number of children in the home. Caregiver and caregiver-reported child and adolescent symptoms were more pronounced in regions with more lenient COVID-19 restrictions. Among the kinds of help most urgently needed, MH services were ranked #1 for caregivers and adolescents, #2 for 6-12 year-olds, and #3 for 1-5 year-olds. Top problems identified for each age group highlight pressing pandemic-related intervention targets.
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Tomokawa S, Miyake K, Akiyama T, Makino Y, Nishio A, Kobayashi J, Jimba M, Ayi I, Njenga SM, Asakura T. Effective school-based preventive interventions for alcohol use in Africa: a systematic review. Afr Health Sci 2020; 20:1397-1406. [PMID: 33402988 PMCID: PMC7751548 DOI: 10.4314/ahs.v20i3.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Despite recognition of the risks of alcohol use and importance of prevention from an early age, the effectiveness of school-based interventions in Africa has not been clarified. Objective We aimed to identify effective school-based alcohol use prevention interventions in Africa. Methods We searched eight databases for peer-reviewed articles published until February 3, 2019 that reported on randomized controlled trials, cluster randomized controlled trials, controlled clinical trials, pre-post quasi-experimental studies, cohort studies, and case-control studies. The full-texts of relevant studies were searched. Results Four of 2797 papers met our eligibility criteria. All reported interventions targeted secondary school students in South Africa and were incorporated in the school curriculum. The interventions comprised multi-component activities with participatory and peer educational methods, and applied modified programs originally developed in the US. However, intervention effects were inconsistent among studies, although the interventions tended to have a positive effect on non-drinkers at baseline, with stronger effects in girls. Conclusion interventions had positive effects on students that were non-drinkers at baseline, especially girls. Although we could not find robust evidence that school-based interventions changed attitudes, frequency/quantity of drinking, and intentions to use alcohol, one intervention showed an increase in students' alcohol refusal self-efficacy.
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Affiliation(s)
- Sachi Tomokawa
- Department of sports and sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
| | - Kimihiro Miyake
- Department of sports and sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
| | - Takeshi Akiyama
- Department of Health Science, Nagano College of Nursing, 1694 Akaho, Komagane city, Nagano, 399-4117, Japan
| | - Yuka Makino
- Japanese Consortium for Global school Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Akihiro Nishio
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu City 501-1193, Japan
| | - Jun Kobayashi
- Department of Global Health, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Irene Ayi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P. O. Box LG 581, Legon, Accra, Ghana
| | - Sammy M Njenga
- Kenya Medical Research Institute, P.O. Box 54840 00200 Off Mbagathi Road, Nairobi, Kenya
| | - Takashi Asakura
- Faculty of Education, Tokyo Gakugei University, 4-1-1, Nukuikita, Koganei-city, Tokyo, 184-8501, Japan
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Xie H, Weybright EH, Caldwell LL, Wegner L, Smith EA. Parenting Practice, Leisure Experience, and Substance Use Among South African Adolescents. JOURNAL OF LEISURE RESEARCH 2019; 51:36-55. [PMID: 32981966 PMCID: PMC7518372 DOI: 10.1080/00222216.2019.1620144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is limited understanding of parents' role in positive youth/adolescent development through leisure in developing countries. Using a sample of 6626 8th grade students in South Africa, this study examined the interrelationships among parenting practice, adolescents' leisure experience, and substance use. Results of structural equation modeling showed that parental leisure involvement was associated with less substance use, while parental leisure over-control was associated with greater substance use. The relationship of parental leisure involvement to substance use was mediated by healthy leisure engagement. The relationship of parental leisure over-control to substance use, on the other hand, was mediated by leisure boredom and healthy leisure engagement. The model path coefficients had little variation between genders and socioeconomic groups except that parental leisure over-control had a stronger positive relationship with leisure boredom for males than females. Theoretical and practical implications were discussed.
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Affiliation(s)
- Hui Xie
- Corresponding Author , Phone: (818) 677-5896; Fax: (818) 677-2695
| | | | - Linda L. Caldwell
- The Pennsylvania State University, University of the Western Cape, South Africa
| | - Lisa Wegner
- Department of Occupational Therapy, University of the Western Cape, South Africa
| | - Edward A. Smith
- The Pennsylvania State University, University of the Western Cape, South Africa
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Motamedi M, Caldwell L, Weybright EH, Jones D, Wegner L, Smith E. Doing a Leisure Activity because there is Nothing Else to Do: Related Outcomes and Intervention Effects for Adolescents. JOURNAL OF LEISURE RESEARCH 2019; 51:1-15. [PMID: 38124882 PMCID: PMC10732582 DOI: 10.1080/00222216.2019.1590748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
This study examined whethera leisure focused intervention, HealthWise, was related to reduced youth polysubstance use and delayed sexual debut via reducing how often youth did leisure activitiesbecause there was nothing else to do. HealthWise was compared to a no-interventioncontrol for 5,610 high school students from 8thto 10thgrade in townships near Cape Town, South Africa. Three specific leisure activities were examined: time spent with friends, playing sports, and going to parks. Among girls, time spent with friends because there was nothing else to do significantly mediated the effect of HealthWise on reducing frequent polysubstance use in the past month. For boys, time spent in parks because there was nothing else to do mediatedthe effect of HealthWise on delayed sexual debut. Results partially supported the HealthWise logic model of impacting risky behaviors via leisure and the value of prevention programs addressing the reasons behind leisure choices.
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Affiliation(s)
| | - Linda Caldwell
- The Pennsylvania State University
- University of the Western Cape
| | | | | | | | - Edward Smith
- The Pennsylvania State University
- University of the Western Cape
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Cutuli D, de Guevara-Miranda DL, Castilla-Ortega E, Santín L, Sampedro-Piquero P. Highlighting the Role of Cognitive and Brain Reserve in the Substance use Disorder Field. Curr Neuropharmacol 2019; 17:1056-1070. [PMID: 31204624 PMCID: PMC7052825 DOI: 10.2174/1570159x17666190617100707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/17/2019] [Accepted: 05/31/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cognitive reserve (CR) refers to the ability of an individual to cope with brain pathology remaining free of cognitive symptoms. This protective factor has been related to compensatory and more efficient brain mechanisms involved in resisting brain damage. For its part, Brain reserve (BR) refers to individual differences in the structural properties of the brain which could also make us more resilient to suffer from neurodegenerative and mental diseases. OBJECTIVE This review summarizes how this construct, mainly mediated by educational level, occupational attainment, physical and mental activity, as well as successful social relationships, has gained scientific attention in the last years with regard to diseases, such as neurodegenerative diseases, stroke or traumatic brain injury. Nevertheless, although CR has been studied in a large number of disorders, few researches have addressed the role of this concept in drug addiction. METHODS We provide a selective overview of recent literature about the role of CR and BR in preventing substance use onset. Likewise, we will also discuss how variables involved in CR (healthy leisure, social support or job-related activities, among others) could be trained and included as complementary activities of substance use disorder treatments. RESULTS Evidence about this topic suggests a preventive role of CR and BR on drug use onset and when drug addiction is established, these factors led to less severe addiction-related problems, as well as better treatment outcomes. CONCLUSION CR and BR are variables not taken yet into account in drug addiction. However, they could give us a valuable information about people at risk, as well as patient's prognosis.
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Affiliation(s)
| | | | | | - L.J. Santín
- Address correspondence to these authors at the Instituto de Investigación Biomédica de Málaga (IBIMA), Doctor Miguel Díaz Recio, 28 Málaga 29010, Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos S/N, 29071 Málaga, Spain; E-mails: (P. Sampedro-Piquero) and (L.J. Santín)
| | - P. Sampedro-Piquero
- Address correspondence to these authors at the Instituto de Investigación Biomédica de Málaga (IBIMA), Doctor Miguel Díaz Recio, 28 Málaga 29010, Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos S/N, 29071 Málaga, Spain; E-mails: (P. Sampedro-Piquero) and (L.J. Santín)
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Can organized leisure-time activities buffer the negative outcomes of unstructured activities for adolescents' health? Int J Public Health 2018; 63:743-751. [PMID: 29860658 PMCID: PMC6015610 DOI: 10.1007/s00038-018-1125-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 11/15/2022] Open
Abstract
Objectives We aimed to assess the associations of involvement in selected unstructured activities (UA) with health-risk behaviours and academic achievement and the degree to which the participation in organized leisure-time activities (OLTA) changes these associations.
Methods Using a sample of 6935 Czech adolescents aged 13 and 15 years, we investigated adolescents’ weekly involvement in hanging out, visiting shopping malls for fun and meeting friends after 8 p.m., OLTA and engagement in three health-risk behaviours and academic achievement.
Results Weekly involvement in the selected UA was associated with higher odds for regular smoking, being drunk, having early sexual intercourse and low academic achievement. Concurrent participation in OLTA did not buffer these negative outcomes, except for sexual experience. However, those highly engaged only in UA were more likely to participate in the health-risk behaviours and report worse academic achievement than those participating in any OLTA concurrently. Conclusions The selected UA are strongly associated with an increased occurrence of adolescents’ health-risk behaviours and low academic achievement. Concurrent participation in OLTA does not buffer these negative outcomes significantly, but adolescents engaged only in UA consistently report the least favourable outcomes.
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Probst C, Parry CDH, Rehm J. HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status. BMJ Open 2018; 8:e017955. [PMID: 29467131 PMCID: PMC5855363 DOI: 10.1136/bmjopen-2017-017955] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To quantify HIV/AIDS mortality attributable to alcohol use in the adult general population of South Africa in 2012 by socioeconomic status (SES). DESIGN Comparative risk assessment based on secondary individual data, aggregate data and risk relations reported in the literature. SETTING South African adult general population. PARTICIPANTS For metrics of alcohol use by SES, sex and age: 27 070 adults that participated in a nationally representative survey in 2012. For HRs of dying from HIV/AIDS by SES: 87 029 adults that participated in a cohort study (years 2000 to 2014) based out of the Umkhanyakude district, KwaZulu-Natal. MAIN OUTCOME MEASURES Alcohol-attributable fractions for HIV/AIDS mortality by SES, age and sex were calculated based on the risk of engaging in condom-unprotected sex under the influence of alcohol and interactions between SES and alcohol use. Age-standardised HIV/AIDS mortality rates attributable to alcohol by SES and sex were estimated using alcohol-attributable fractions and SES-specific and sex-specific death counts. Rate ratios were calculated comparing age-standardised rates in low versus high SES by sex. RESULTS The age-standardised HIV/AIDS mortality rate attributable to alcohol was 31.0 (95% uncertainty interval (UI) 21.6 to 41.3) and 229.6 (95% UI 108.8 to 351.6) deaths per 100 000 adults for men of high and low SES, respectively. For women the respective rates were 10.8 (95% UI 5.5 to 16.1) and 75.5 (95% UI 31.2 to 144.9). The rate ratio was 7.4 (95% UI 3.4 to 13.2) for men and 7.0 (95% UI 2.8 to 18.2) for women. Sensitivity analyses corroborated marked differences in alcohol-attributable HIV/AIDS mortality, with rate ratios between 2.7 (95% UI 0.8 to 7.6; women) and 15.1 (95% UI 6.8 to 27.7; men). CONCLUSIONS The present study showed that alcohol use contributed considerably to the socioeconomic differences in HIV/AIDS mortality. Targeting HIV infection under the influence of alcohol is a promising strategy for interventions to reduce the HIV/AIDS burden and related socioeconomic differences in South Africa.
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Affiliation(s)
- Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Nishio A, Saito J, Tomokawa S, Kobayashi J, Makino Y, Akiyama T, Miyake K, Yamamoto M. Systematic review of school tobacco prevention programs in African countries from 2000 to 2016. PLoS One 2018; 13:e0192489. [PMID: 29408895 PMCID: PMC5800696 DOI: 10.1371/journal.pone.0192489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/24/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The World Bank has reported that global smoking rates declined from 2000 to 2012, with the only exception found in males in Sub-Saharan Africa. Sub-Saharan Africa is considered to be in stage one of the tobacco epidemic continuum. To address this problem, school-based programs for smoking prevention are considered cost-effective and promising. Since tobacco prevention programs are influenced by social competence or customs of each country, tobacco prevention programs that have success in Western countries are not always effective in African countries. Therefore, the current study systematically reviewed relevant literature to examine the effects of these types of programs in African countries. METHOD Online bibliographic databases and a hand search were used. We included the studies that examined the impact of school-based programs on preventing tobacco use in Africa from 2000 to 2016. RESULTS Six articles were selected. Four were conducted in South Africa and two were performed in Nigeria. Four programs were systematically incorporated into annual curriculums, targeting 8th to 9th graders, while the other two were temporary programs. All programs were based on the hypothesis that providing knowledge and/or social skills against smoking would be helpful. All studies utilized smoking or polydrug use rates to compare outcomes before/after intervention. There were no significant differences between intervention and control groups in three studies, with the other three demonstrating only partial effectiveness. Additionally, three studies also examined change of knowledge/attitudes towards smoking as an outcome. Two of these showed significant differences between groups. CONCLUSION All RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking. However, they reported no significant change of smoking-rate by the intervention.
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Affiliation(s)
- Akihiro Nishio
- Health Administration Center, Gifu University, Gifu, Japan
- Japanese Consortium for Global School Health Research, Nishihara, Japan
| | - Junko Saito
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Sachi Tomokawa
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- Faculty of Education, Shinshu University, Nagano, Japan
| | - Jun Kobayashi
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- Faculty of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Yuka Makino
- Japanese Consortium for Global School Health Research, Nishihara, Japan
| | - Takeshi Akiyama
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- Nagano College of Nursing, Komagane, Japan
| | - Kimihiro Miyake
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- Faculty of Education, Shinshu University, Nagano, Japan
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Abstract
The present study investigated the associations among alcohol use, socioeconomic status (SES), and human immunodeficiency virus (HIV) status, in the South African context. It was hypothesized that SES (predictor; measured as median split asset score) and alcohol use in the past 12 months (predictor) would interact such that current drinkers of low SES would be at an increased risk of testing HIV-positive (outcome). Nationally representative, cross-sectional survey data from 2005 (N = 16,110), 2008 (N = 13,055), and 2012 (N = 25,979) were analyzed using multinomial regression models. Current drinkers of low SES had an elevated risk of HIV infection in all survey years, ranging from a relative risk ratio (RRR) of 1.94 (95% confidence interval (CI) 1.29-3.00, t = 2.93, p = 0.002) in 2012 to RRR of 3.51 (95% CI 2.02-6.08, t = 4.47, p < 0.001) in 2008. Targeting preventive strategies to alcohol users of low SES could help reduce HIV burden and associated socioeconomic differences.
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The state of methamphetamine ('tik') use among youth in the Western Cape, South Africa. S Afr Med J 2016; 106:1125-1128. [PMID: 27842636 PMCID: PMC5800420 DOI: 10.7196/samj.2016.v106i11.10814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Indexed: 11/18/2022] Open
Abstract
Background Methamphetamine use among youth in the Western Cape Province of South Africa has increased at alarming rates over the past decade. Although current estimates of youth use exist, they range from 2% to 12%. Objectives To identify (i) the prevalence of methamphetamine use in Western Cape youth and (ii) the association between use and known risk factors for methamphetamine use. Methods Data were obtained from 10 000 Western Cape Province Grade 8 learners in 54 secondary schools (mean age 14.0 years). Prevalence was descriptively reported while risk factors for past-month use were modelled in a hierarchical logistic regression with demographic, socioeconomic status, substance use, sexual activity and relationship predictors. Results Approximately 5% (n=496) of learners had used methamphetamine within their lifetime. Of these users, 65% (n=322) had used in the past month or week. Compared to never users, past-month users were more likely to be male, less likely to have a present or partially present mother, less likely to live in an apartment/flat/brick house, more likely to have used alcohol and tobacco and more likely to report having a same-sex partner. Conclusion Results replicate previously known methamphetamine risk factors and highlight the need to address methamphetamine use in comprehensive prevention initiatives.
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