Brief report on a systematic review of youth violence prevention through media campaigns: Does the limited yield of strong evidence imply methodological challenges or absence of effect?

Psychological profiles, including emotion regulation characteristics, defence strategies and mentalisation capacity, of male adolescents involved in fights among peers

BACKGROUND

Youth violence has become a worrying public health issue worldwide. In Europe and the USA, research has shown a prevalence of this phenomenon ranging from 30 to 70% in boys.

AIMS

This descriptive study aimed to evaluate psychological profiles of male adolescents involved in fights with their peers.

METHOD

Identity consolidation was evaluated with the Self-Concept and Identity Measure; defence strategies were assessed by the Response Evaluation Measure for Youth; emotion regulation was assessed with the Difficulties in Emotion Regulation Scale and mentalisation capacity was evaluated by the Reflective Functioning Questionnaire.

RESULTS

Through a series of multivariate analyses of variance, our results showed that adolescents reporting four or more fights in the past year, when compared with peers reporting none or fewer than four fights, displayed lower identity consolidation, greater use of immature defence strategies, poorer emotion regulation processes and poorer mentalisation capacity.

CONCLUSIONS

The results of this study could be useful for the promotion of prevention and intervention programmes to stem fights among adolescents.

What Works in Violence Prevention Among Young People?: A Systematic Review of Reviews

Violence prevention programs aim to raise awareness, change attitudes, normative beliefs, motivation, and behavioral responses. Many programs have been developed and evaluated, and optimistic claims about effectiveness made. Yet comprehensive guidance on program design, implementation, and evaluation is limited. The aim of this study was to provide an up-to-date review of evidence on what works for whom. A systematic search of PsycINFO, MEDLINE, ERIC, and Sociology Collection ProQuest identified 40 reviews and meta-analyses reporting on the effectiveness of violence prevention programs among young people (age 15-30) in educational institutions, published before October 2018. These included reviews of programs designed to reduce (i) bullying, (ii) dating and relationship violence, (iii) sexual assault, and (iv) antisocial behavior. Only evaluations that reported on behavioral outcomes such as perpetration, victimization, and bystander behavior were included. The reviewed evaluations reported on programs that were mainly implemented in high-income countries in Europe and North America. The majority found small effects on violence reduction and victimization and increases in self-reported bystander behavior. Our findings expose critical gaps in evaluation research in this area and provide recommendations on how to optimize the effectiveness of future programs.

What Works to Address Violence Against Children (VAC) in and Around Schools

Violence against children (VAC) is a pervasive, global issue with both short- and long-term health, social, and economic consequences. This systematic review sought to identify best practices for designing and implementing social and behavior change communication (SBCC) programs targeting VAC in and around schools. Combinations of key search terms within five domains were entered into four databases: PubMed Central, Google Scholar, Sociological Abstracts, and EBSCOhost. Results were screened according to the inclusion and exclusion criteria. Namely, articles had to be published in English, be published after March 2014, focus on VAC in and around schools, focus on children, and use SBCC approaches. The searches produced 892,271 results. Of these, 63,183 were screened and 54 articles were selected. These articles were combined with 16 articles, gathered from a previous systematic review using the same databases and search domains conducted by the same research team, for a total of 70 articles. Articles were quantitatively analyzed using a coding guide in STATA and qualitatively analyzed using Nvivo. Results showed that most programs addressed bullying, were implemented in high-income countries, and included children aged 10 and older. Best practices in program design were using theory, conducting formative research, and involving program beneficiaries. Best practices in implementation were combining whole-school and targeted approaches, including special and hidden populations, involving secondary and tertiary audiences, using nonclassroom settings, using peer leader/mentor and cascade training models, and conducting process monitoring. Implications and avenues for future planning and implementation of SBCC interventions to address VAC in and around schools are discussed.

How can adolescent aggression be reduced? A multi-level meta-analysis

Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.

Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence

Background

Mass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours.

Objectives

To (1) review evidence on the effective use of mass media in six health topic areas (alcohol, diet, illicit drugs, physical activity, sexual and reproductive health and tobacco), (2) examine whether or not effectiveness varies with different target populations, (3) identify characteristics of mass media campaigns associated with effectiveness and (4) identify key research gaps.

Design

The study comprised (1) a systematic review of reviews, (2) a review of primary studies examining alcohol mass media campaigns, (3) a review of cost-effectiveness evidence and (4) a review of recent primary studies of mass media campaigns conducted in the UK. A logic model was developed to inform the reviews. Public engagement activities were conducted with policy, practitioner and academic stakeholders and with young people.

Results

The amount and strength of evidence varies across the six topics, and there was little evidence regarding diet campaigns. There was moderate evidence that mass media campaigns can reduce sedentary behaviour and influence sexual health-related behaviours and treatment-seeking behaviours (e.g. use of smoking quitlines and sexual health services). The impact on tobacco use and physical activity was mixed, there was limited evidence of impact on alcohol use and there was no impact on illicit drug behaviours. Mass media campaigns were found to increase knowledge and awareness across several topics, and to influence intentions regarding physical activity and smoking. Tobacco and illicit drug campaigns appeared to be more effective for young people and children but there was no or inconsistent evidence regarding effectiveness by sex, ethnicity or socioeconomic status. There was moderate evidence that tobacco mass media campaigns are cost-effective, but there was weak or limited evidence in other topic areas. Although there was limited evidence on characteristics associated with effectiveness, longer or greater intensity campaigns were found to be more effective, and messages were important, with positive and negative messages and social norms messages affecting smoking behaviour. The evidence suggested that targeting messages to target audiences can be effective. There was little evidence regarding the role that theory or media channels may play in campaign effectiveness, and also limited evidence on new media.

Limitations

Statistical synthesis was not possible owing to considerable heterogeneity across reviews and studies. The focus on review-level evidence limited our ability to examine intervention characteristics in detail.

Conclusions

Overall, the evidence is mixed but suggests that (1) campaigns can reduce sedentary behaviour, improve sexual health and contribute to smoking cessation, (2) tobacco control campaigns can be cost-effective, (3) longer and more intensive campaigns are likely to be more effective and (4) message design and targeting campaigns to particular population groups can be effective.

Future work

Future work could fill evidence gaps regarding diet mass media campaigns and new-media campaigns, examine cost-effectiveness in areas other than tobacco and explore the specific contribution of mass media campaigns to multicomponent interventions and how local, regional and national campaigns can work together.

Study registration

This study is registered as PROSPERO CRD42015029205 and PROSPERO CRD42017054999.

Funding

The National Institute for Health Research Public Health Research programme.

Systematic comparison of recommendations for safe messaging about suicide in public communications

BACKGROUND

The diversity of guidelines for safe public messaging about suicide and the heterogeneous scientific research on the topic warrants comparisons of guidelines and analysis of the relevance of research findings to determine best practices.

METHODS

We searched databases and websites for organizations' guidelines concerning safe public messaging on suicide, and relevant research articles.

RESULTS

We identified 24 public messaging guidelines, 11 terminology guidelines and 44 research papers. No recommendations were in all guidelines, with more agreement on what not to do than on what to do. Recommendations in over half of guidelines are: avoid glorifying suicide, do not describe suicide methods, don't say suicide in inexplicable or explain simplistically, do not state that suicide is frequent in specific circumstances, encourage help seeking. There were disagreements on including personal details about people who died by suicide, and agreement to avoid: "committed suicide," "completed suicide," "successful suicide," "failed suicide/attempt" "unsuccessful suicide/attempt". Only "died by suicide" was recommended by a majority. Some recommended and some said to avoid: "Suicide attempt," "attempt to end his life," "attempted suicide," "non-fatal attempt at suicide," "unintentional (death)," "intentional self-harm," "suicidal ideation," "completed suicide," "survivor," "suicide loss survivor." Research papers had a wide range of objectives, methodologies, media studied and target populations. None provided empirical data that could help support or refute any recommendations.

LIMITATIONS

Lack of justifications for guidelines and scarce relevant research makes validation of recommendations challenging.

CONCLUSIONS

Research is needed to validate recommendations and terminology and develop consensus on guidelines for public messages, and determine if media guidelines for reporting on suicide are relevant for public messaging who's goal is to inform and educate rather than report news.