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Liu J, Knoll SJ, Pascale MP, Gray CA, Bodolay A, Potter KW, Gilman J, Eden Evins A, Schuster RM. Intention to quit or reduce e-cigarettes, cannabis, and their co-use among a school-based sample of adolescents. Addict Behav 2024; 157:108101. [PMID: 38986353 PMCID: PMC11283349 DOI: 10.1016/j.addbeh.2024.108101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Little is known about the prevalence and predictors of adolescents' intention to quit or reduce use of e-cigarettes and/or cannabis. METHODS Frequencies of intention to change (quit, reduce) e-cigarettes and/or cannabis use were examined among 23,915 surveyed middle and high school students with sole and co-use. Predictors of intention to change were identified via LASSO/multilevel logistic regression. RESULTS Among those with sole e-cigarette use (n = 543), 40.9 % intended to quit and 24.1 % intended to reduce; non-daily e-cigarette use predicted intention to quit and reduce e-cigarettes (p's < 0.03). Among those with sole cannabis use (n = 546), 10.6 % intended to quit and 25.1 % intended to reduce; absence of cannabis cravings predicted intention to reduce cannabis use (p < 0.01). Among those with co-use (n = 816), 26.2 % intended to either quit or reduce (quit/reduce) both substances, 27.5 % intended to quit/reduce e-cigarettes only, and 6.9 % intended to quit/reduce cannabis only. No predictors emerged for intention to change e-cigarette use among those with co-use (p's > 0.09), but younger age, lack of poly-tobacco use, and lack of cannabis craving predicted intention to quit/reduce cannabis use (p's < 0.04). CONCLUSIONS More than half of adolescents with past-month e-cigarette use, regardless of concurrent cannabis use, expressed interest in changing their use. However, only heaviness of e-cigarette use emerged as a predictor of intention to change suggesting. While fewer students expressed interest in changing their cannabis use, cannabis cravings and poly-tobacco use predicted intent to change. Overall, findings emphasize the need to tailor interventions towards adolescents engaging in more problematic substance use patterns.
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Affiliation(s)
- Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Sarah J Knoll
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Michael P Pascale
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Caroline A Gray
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Alec Bodolay
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin W Potter
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jodi Gilman
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - A Eden Evins
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Randi M Schuster
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Chen Q, Gopaldas M, Castillo F, Leckman-Westin E, Nunes EV, Levin FR, Finnerty MT. Prevalence of Opioid Use Disorder and Opioid Overdose Rates Among People With Mental Illness. Psychiatr Serv 2024; 75:953-960. [PMID: 38650488 DOI: 10.1176/appi.ps.20230338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE The authors examined the prevalence and correlates of co-occurring opioid use disorder and opioid overdose among individuals receiving psychiatric services. METHODS This was a cross-sectional study of adults with continuous enrollment in New York State Medicaid who received at least one psychiatric service in 2020 (N=523,885). Logistic regression models were used to examine the correlates of both opioid use disorder and overdose. RESULTS In the study sample, the prevalence rate of opioid use disorder was 8.1%; within this group, 7.7% experienced an opioid overdose in the study year. Opioid use disorder rates were lower among younger (18-24 years; 2.0%) and older (≥65 years; 3.1%) adults and higher among men (11.1%) and among those residing in rural areas (9.9%). Compared with Whites (9.4%), opioid use disorder rates were lower for Asian Americans (2.0%, adjusted odds ratio [AOR]=0.22) and Blacks (6.8%, AOR=0.76) and higher for American Indians (13.2%, AOR=1.43) and Hispanics (9.6%, AOR=1.29). Individuals with any substance use (24.9%, AOR=5.20), posttraumatic stress (15.7%, AOR=2.34), bipolar (14.9%, AOR=2.29), or anxiety (11.3%, AOR=2.18) disorders were more likely to have co-occurring opioid use disorder; those with conduct (4.5%, AOR=0.51), adjustment (7.4%, AOR=0.88), or schizophrenia spectrum (7.4%, AOR=0.87) disorders were less likely to have opioid use disorder. Those with suicidality (23.9%, AOR=3.83) or economic instability (23.7%, AOR=3.35) had higher odds of having opioid use disorder. Overdose odds were higher among individuals with suicidality (34.0%, AOR=6.82) and economic instability (16.0%, AOR=2.57). CONCLUSIONS These findings underscore the importance of providing opioid use disorder screening and treatment for patients receiving psychiatric services.
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Affiliation(s)
- Qingxian Chen
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
| | - Manesh Gopaldas
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
| | - Felipe Castillo
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
| | - Emily Leckman-Westin
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
| | - Edward V Nunes
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
| | - Frances R Levin
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
| | - Molly T Finnerty
- New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty)
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Estrada Y, Lozano A, Tapia MI, Fernández A, Harkness A, Scott D, Lee TK, Rahman A, Prado G. Familias con Orgullo: Pilot Study of a Family Intervention for Latinx Sexual Minority Youth to Prevent Drug Use, Sexual Risk Behavior, and Depressive Symptoms. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01724-4. [PMID: 39331334 DOI: 10.1007/s11121-024-01724-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2024] [Indexed: 09/28/2024]
Abstract
Families are key in the healthy development of Latinx sexual minority youth (Latinx SMY), a group that experiences behavioral, mental, and sexual health disparities. Despite this, there are no family-based interventions for Latinx SMY and their families to prevent drug use, sexual risk behaviors, and depressive symptoms. The purpose of this pilot study was to evaluate the preliminary impact (i.e., estimated effect sizes) of Familias con Orgullo (FcO) and examine its feasibility and acceptability among 30 Latinx SMY and their parents. Parents and adolescents were randomized to FcO or a control condition and assessed pre/post-intervention. Feasibility was measured based on session completion and effect sizes. Focus groups were conducted to evaluate intervention acceptability. Findings showed promising effects favoring FcO on parent-adolescent communication (d = 0.46) and parental involvement (d = 0.34). There were also promising effects favoring FcO on suicidal thoughts (OR = 0.75) and depression symptoms (OR = 0.69). Finally, 100% of the adolescents in FcO either continued to remain drug-free or transitioned from current use to no use (from baseline to post-intervention) compared to 74% in the control. Effect sizes for condomless sex, parental monitoring, and positive parenting were small. Session completion (above 80%) and focus group findings indicated strong feasibility and acceptability. FcO holds promise for reducing drug use and depressive symptoms and improving family functioning among Latinx SMY.
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Affiliation(s)
- Yannine Estrada
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, #440F, Coral Gables, FL, 33146, USA.
| | - Alyssa Lozano
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Maria I Tapia
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, #440F, Coral Gables, FL, 33146, USA
| | - Alejandra Fernández
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Center for Pediatric Population Health, Dallas, TX, USA
| | - Audrey Harkness
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, #440F, Coral Gables, FL, 33146, USA
| | - Dalton Scott
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, #440F, Coral Gables, FL, 33146, USA
| | - Tae Kyoung Lee
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, #440F, Coral Gables, FL, 33146, USA
| | - Abir Rahman
- Department of Epidemiology, Cabell-Huntington Health Department, Huntington, WV, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, #440F, Coral Gables, FL, 33146, USA
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Nayak G, Bahl D, Bassi S, Maity H, Mason-Jones AJ, Arora M, Dutta A. Knowledge, attitude, and practices of adolescents and peer educators in relation to the components of the National Adolescent Health Program in India: findings from a cross-sectional survey. Front Public Health 2024; 12:1378934. [PMID: 39324169 PMCID: PMC11422210 DOI: 10.3389/fpubh.2024.1378934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/14/2024] [Indexed: 09/27/2024] Open
Abstract
Background Adolescence is a critical period of growth and development. Many adverse health outcomes in adulthood begin during adolescence, often due to insufficient knowledge and attitudes resulting from a lack of education. Therefore, appropriate knowledge, attitudes, and practices (KAP) regarding various aspects of health are essential for holistic adolescent and lifelong health. In India, the Rashtriya Kishore Swasthya Karyakram (RKSK or National Adolescent Health Strategy) has utilized an innovative peer-education approach to engage with adolescents and improve their KAPs. Amid limited evidence, we aimed to assess the KAP of adolescents regarding the six themes of the RKSK, with a particular focus on the status of peer educators (PEs). Our objective was to evaluate these aspects disaggregated by sex and to examine how engagement with the RKSK peer-education program influenced their KAP. Methods A cross-sectional survey of 238 peer educators and 2885 adolescents enrolled under peer educators was conducted in two localities; Madhya Pradesh and Maharashtra states. KAPs were estimated using descriptive statistics then disaggregated by gender. Practice scores of nutrition and non-communicable disease (NCD) were modelled upon engagement with RKSK (graded as 0, 1, 2, 3). Results Knowledge was highest regarding substance misuse and lowest in the domains of sexual and reproductive health, and violence and injury. PEs possessed greater knowledge in most domains as compared to adolescents enrolled under them. Attitudes toward abstention from substance misuse were positive, whereas attitudes toward injury and violence, and sexual health, were suboptimal. Boys exhibited better practices related to NCDs, while their nutritional practices were comparatively worse than girls. The RKSK engagement was associated with better nutritional practices: adjusted relative risks (RRs) being 1.04 (95% confidence interval [CI]: 0.94-1.15), 1.12 (1.04-1.21), and 1.21 (1.13-1.31), respectively, for engagement scores 1, 2, and 3 with reference to score 0. The relationship between RKSK engagement and NCD-related practices was restricted to the top engagement group. Conclusion The knowledge regarding sexual health, and injury and violence, was grossly deficient in adolescents. These components must be prioritized in the program because they are critical for health not only across the life course of individuals but also across generations. However, the RKSK engagement was associated with better practices in a variety of domains, which should be leveraged in the future.
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Affiliation(s)
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | - Heeya Maity
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | | | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Bhubaneswar, India
- Public Health Foundation of India, New Delhi, India
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Cadet K, Hill AV, Gilreath TD, Johnson RM. Grade-Level Differences in the Profiles of Substance Use and Behavioral Health Problems: A Multi-Group Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1196. [PMID: 39338079 PMCID: PMC11431565 DOI: 10.3390/ijerph21091196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/21/2024] [Accepted: 08/27/2024] [Indexed: 09/30/2024]
Abstract
We investigated associations between polysubstance use and behavioral problems among adolescents. Because substance use becomes more developmentally normative with age, we examined whether polysubstance use was less likely to co-occur with behavioral problems among older (vs. younger) adolescents. Using data from a nationally representative survey of US high school students, we compared the association between polysubstance use (i.e., use of alcohol, cannabis, tobacco/nicotine, and illicit drugs) and behavioral problems (i.e., suicide attempts, depressive symptoms, poor school performance, and sexual risk behaviors) by grade level. We conducted latent class analysis (LCA) to characterize patterns of polysubstance use, and multi-group LCA to estimate invariance by grade. Among the three latent classes that emerged, classes were distinguished by having low, moderate, and high probabilities for behavior problems and use of substances. Class I comprised 52% of the sample, whereas classes II and III comprised 35% and 12% of the sample, respectively. The multi-group LCA showed that younger adolescents had a higher relative probability of co-occurring problem behaviors and polysubstance use. Findings may be helpful in targeting screening and prevention efforts of high school students by grade. Specifically, our results provide evidence that associations between behavioral problems and alcohol/drug use are weaker in later high school grades, suggesting that substance use may not be a weaker marker of behavioral problems for students in higher grades.
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Affiliation(s)
- Kechna Cadet
- Department of Epidemiology, Columbia University Mailman School of Public Health, New Yok, NY 10032, USA;
| | - Ashley V. Hill
- Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL 60612, USA;
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX 77843, USA
| | - Tamika D. Gilreath
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX 77843, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Renee M. Johnson
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX 77843, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Wallace AL, Courtney KE, Wade NE, Doran N, Delfel EL, Baca R, Hatz LE, Thompson C, Andrade G, Jacobus J. A preliminary investigation of physical and mental health features of cannabis & nicotine co-use among adolescents and young adults by sex. Addict Behav 2024; 156:108064. [PMID: 38821010 DOI: 10.1016/j.addbeh.2024.108064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
INTRODUCTION Cannabis and nicotine/tobacco products (NTP) are commonly co-used in adolescence and young adulthood; however, limited research has been done on predictive health behaviors to co-use. The current study is a preliminary investigation into the relationships of modifiable health behaviors on cannabis and NTP co-use in adolescents and young adults. METHOD 221 participants (ages 16-22) were characterized into cannabis use only (N = 55), NTP use only (N = 20), cannabis and NTP co-use (used cannabis and NTP; N = 96) and control (no use; N = 50) groups based on past 30-day use. Self-report measures for physical activity, sleep quality, mental health, and reward responsivity were utilized. Participants were given a comprehensive neurocognitive battery. Logistic regressions of self-report measures and fluid intelligence composite scores on substance use group status were run stratified by sex. RESULTS Higher approach reward sensitivity traits were associated with increased likelihood of cannabis use only (Odds Ratio (OR) = 1.15, p = .036) in female participants. Increased aerobic activity was associated with decreased likelihood of cannabis use only (OR = 0.91, p = .047) and cannabis and NTP co-use (OR = 0.88, p = .007) in female participants. Higher anxiety was associated with increased likelihood of cannabis NTP co-use (OR = 1.51, p = 0.025) in male participants. DISCUSSION Several health behaviors were linked with cannabis use and cannabis and NTP co-use in both females and male adolescents and young adults. Health markers differed by sex suggesting differing mechanisms of substance co-use. This study informs targetable health behaviors for prevention and intervention efforts.
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Affiliation(s)
- Alexander L Wallace
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Kelly E Courtney
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Natasha E Wade
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Neal Doran
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA; Psychology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Everett L Delfel
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA; SDSU / UC San Diego Joint Doctoral Program in Clinical Psychology, USA
| | - Rachel Baca
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Laura E Hatz
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Courtney Thompson
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Gianna Andrade
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Joanna Jacobus
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA.
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Suchert V, Isensee B, Goecke M, Hanewinkel R. [School-based cannabis prevention: Results of a cluster-randomised trial]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024; 92:347-354. [PMID: 39102842 DOI: 10.1055/a-2364-3055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Acluster-randomised trial was conducted in five German federal states to evaluate the results of a school-based cannabis prevention unit. A total of 55 schools were randomly assigned to the intervention group, i.e. participation in a two-hour cannabis prevention workshop conducted by drug prevention specialists in grades 8 and 9, or to a control group with a waiting list. The knowledge, attitudes, intentions and behaviour of the young people in relation to cannabis were measured at the start of the study and six months later. 2,669 pupils(50.8% girls, average age=14.12 years) made up the sample. Effects of the intervention on the students' knowledge (adjusted regression coefficient=0.26 [0.15-0.38], p<0.001) and on the expected negative consequences of cannabis use in adolescents (adjusted regression coefficient=0.15 [0.04-0.25], p=0.006) were found. Both increased significantly more in the intervention group compared to the control group. There were no effects on other attitude-related variables, intentions or behaviour. A very short school-based workshop for grade 8 and 9 students improved their knowledge of and critical attitudes towards cannabis use, but had no effect on their future intentions and cannabis use.
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Affiliation(s)
- Vivien Suchert
- Institut für Therapie- und Gesundheitsforschung, Kiel, Germany
| | - Barbara Isensee
- Institut für Therapie- und Gesundheitsforschung, Kiel, Germany
| | - Michaela Goecke
- Bundeszentrale fur gesundheitliche Aufklärung, Köln, Germany
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Sulaman I, Hartley S, Elvins R. Therapeutic alliance in the treatment of adolescent substance misuse: a systematic review. Child Adolesc Ment Health 2024; 29:226-241. [PMID: 37528449 DOI: 10.1111/camh.12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Therapeutic alliance has been found to play an influential role in predicting outcomes for adults and adolescents in psychotherapy. However, thus far, the information concerning the impact of therapeutic alliance on outcomes for adolescents in treatment for substance misuse has not yet been critically synthesised. METHODS In accordance with PRISMA guidelines, the current review aimed to systematically collate published research investigating the association between alliance and outcomes for adolescents undergoing substance misuse treatment. Database searching produced 1083 records, with 16 studies meeting eligibility criteria. RESULTS Twelve out of the 16 studies (75%) reported significant alliance-outcome relationships, whereby higher alliance ratings predicted better treatment outcomes, as well as improved engagement and retention in treatment. In addition, the review explored the conditions whereby alliances better predict outcomes, with reference to the alliance rater, the timing of the alliance rating and comorbid diagnoses. These results, however, largely remain inconclusive. CONCLUSIONS The evidence as it stands demonstrates the importance of the therapeutic alliance in predicting outcomes for adolescents in substance misuse treatments. The implications of the review's findings and recommendations for future research are discussed.
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Affiliation(s)
- Iniyah Sulaman
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- GMMH NHS Foundation Trust, Manchester, UK
| | - Samantha Hartley
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- CAMHS at Pennine Care NHS Foundation Trust, Manchester, UK
| | - Rachel Elvins
- Royal Manchester Children's Hospital & Salford CAMHS, Manchester, UK
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Lu W, Xu L, Bessaha ML, Liu Y, Matthews J, Muñoz-Laboy M. Youth participation in substance use prevention: A national profile, 2011-2019. Prev Med 2024; 185:108050. [PMID: 38906276 DOI: 10.1016/j.ypmed.2024.108050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024]
Abstract
PURPOSE Prevention efforts are critical to avoid the negative consequences of substance use in adolescents. This study aimed to examine national trends and sociodemographic differences in adolescents' participation in school-based substance use prevention (SUP) education, community-based SUP programs, as well as family conversations about substance use. METHODS Publicly available data for adolescents aged 12-17 from the annual cross-sectional surveys of the National Survey on Drug Use and Health 2011-2019 were analyzed. RESULTS Across the survey years, up to 74.9%, 12.2%, and 58.1% of adolescents reported having participated in school-based SUP education, community-based SUP programs, and family conversations about the danger of substance use in the past-year, respectively. From 2011 to 2019, statistically significant decreases were observed in adolescents' participation in school-based SUP education (OR = 0.97, 95% CI: 0.96, 0.98, p < 0.001) and community-based SUP programs (OR = 0.98, 95% CI: 0.97, 0.99, p < 0.001). Meanwhile, no significant changes were observed in adolescents' participation in family conversations about the dangers of substance use. Overall, lower levels of participation in school-based and community-based SUP programs were found in adolescents aged 16-17. Adolescents living in rural areas showed lower levels of participation in school-based SUP programs and family conversations about SUP. Racial/ethnic minority adolescents overall were less likely to participate in conversations with parents about SUP than Whites. CONCLUSIONS Further development and implementation of developmentally appropriate, gender-specific, culturally sensitive, and contextually informed SUP programs at school, community, and family levels are needed.
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Affiliation(s)
- Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, The City University of New York, NY, USA.
| | - Lei Xu
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, NC, USA
| | | | - Yifan Liu
- School of Public Health, Rutgers University, NJ, USA
| | - Jennifer Matthews
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, NC, USA
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Salgado G, Gaete J, Gana S, Valenzuela D, Araya R. Acceptability, feasibility and fidelity of the culturally adapted version of Unplugged ("Yo Se Lo Que Quiero"), a substance use preventive program among adolescents in Chile: a pilot randomized controlled study. BMC Public Health 2024; 24:2026. [PMID: 39075465 PMCID: PMC11285342 DOI: 10.1186/s12889-024-19499-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
INTRODUCTION The consumption of alcohol, tobacco, and cannabis is a public health problem that impacts the cognitive, social, and emotional development of adolescents. Prevention strategies such as the "Unplugged" program are effective in delaying the progression of daily smoking and episodes of drunkenness among adolescents. "Yo Se Lo Que Quiero" (YSLQQ) corresponds to the adaptation of this program to the Chilean context. This study assesses the acceptability and feasibility of implementing this program to the local reality. MATERIAL AND METHODS This was a cluster-randomized controlled pilot study conducted on six public schools. All consented students attending 6th, 7th, and 8th grades (n = 1,180) participated in the study. The schools were randomly assigned to one of two conditions in a 1:1 ratio: (1) the "YSLQQ" intervention group (n = 526), and (2) the Control group (n = 654). The program consisted of a 12-hour class-based curriculum based on a comprehensive social-influence approach delivered by a trained facilitator. The acceptability and feasibility were assessed in the intervention group at the end of the intervention using questionnaires answered by students and facilitators. The quality and fidelity of the program were evaluated during the implementation using self-ported surveys answered by the facilitators and the assessment of video-recorded sessions rated by external observers. Finally, a pre-test and a post-test survey assessing past and current substance use and risk and protective factors were conducted before and immediately after the program's implementation. RESULTS A high proportion of students (49.6%) liked the sessions. 79.2% reported that the YSLQQ helped them learn about the dangers of substances, while 65.8% reported having more skills to avoid substance use in the future. Regarding students' satisfaction with YSLQQ, 62.9% reported being happy or very happy with the program. Facilitators reported implementing the intervention according to the manual in 73.9% of sessions. Regarding substance use, students who participated in the intervention groups reported a significant reduction in drunkenness in the last year and last 30-day prevalence and also a significant reduction in a lifetime and 30-day prevalence of cannabis use when compared with those students in the control group. CONCLUSIONS Our results suggest that YSLQQ has adequate acceptability and feasibility to be implemented in the Chilean context, and there were promising results in reducing drunkenness and cannabis use. Future research should confirm these results in a larger RCT study. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov, NCT04566627; registration date: 01/03/2019.
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Affiliation(s)
- Gabriel Salgado
- Magíster en Epidemiología, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Jorge Gaete
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.
- Centro de Investigación en Salud Mental Estudiantil (ISME), Escuela de Educación, Facultad de Ciencias Sociales, Universidad de los Andes, Santiago, Chile.
| | - Sofía Gana
- Doctorado en Ciencias del Desarrollo y Psicopatología, Laboratorio de Ciencias Cognitivas, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Daniela Valenzuela
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Ricardo Araya
- Department of Health Service & Population Research, David Goldberg Centre, King´s College London, London, UK
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Wen W, Li H, Lauffer M, Hu D, Zhang Z, Lin H, Wang Y, Leidinger M, Luo J. Sex-specific effects of alcohol on neurobehavioral performance and endoplasmic reticulum stress: an analysis using neuron-specific MANF deficient mice. Front Pharmacol 2024; 15:1407576. [PMID: 39130640 PMCID: PMC11310019 DOI: 10.3389/fphar.2024.1407576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/09/2024] [Indexed: 08/13/2024] Open
Abstract
Excessive alcohol exposure can cause neurobehavioral deficits and structural alterations in the brain. Emerging research evidence suggests that endoplasmic reticulum (ER) stress plays an important role in alcohol-induced neurotoxicity. Mesencephalic astrocyte-derived neurotrophic factor (MANF) is an ER stress inducible protein and is responsible to maintain ER homeostasis. MANF is highly expressed in both the developing and mature brain. We have previously shown that MANF deficiency exacerbated alcohol induced neurodegeneration and ER stress in the developing brain. However, little is known regarding the role of MANF in alcohol induced neuronal damage in the adult brain. In this study, we used a neuron-specific MANF knockout (KO) mouse model to investigate the effect of MANF deficiency on acute binge alcohol exposure-induced neurobehavioral deficits and ER stress. Adult male and female MANF KO mice and littermate controls received daily alcohol gavage (5 g/kg) for 10 days and then subjected to a battery of neurobehavioral tests including rotarods, balance beam, DigiGait, open field, elevated plus maze, Barnes maze, and three-chamber sociability task. Female MANF KO animals were more susceptible to alcohol-induced body weight loss. Alcohol exposure did not affect motor function, however female but not male MANF KO mice exhibited an increased locomotor activity in open field test. Learning and memory was not significantly impaired, but it was altered by MANF deficiency in females while it was affected by alcohol treatment in males. Both alcohol-exposed male and female MANF KO mice displayed increased sociability. Alcohol induced the expression of ER chaperones GRP78 and GRP94 and altered the levels of several unfolded protein response (UPR) and neuroinflammation markers in MANF KO mice in a sex-specific manner. The expression of MANF interacting proteins neuroplastin, PDIA1, and PDIA6 was increased in MANF KO mice, and was further induced by alcohol. In conclusion, alcohol exposure and neuronal MANF deficiency interacted to alter neurobehavioral outcomes, ER homeostasis and neuroinflammation in a sex-specific manner.
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Affiliation(s)
- Wen Wen
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Hui Li
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Marisol Lauffer
- Neural Circuits and Behavior Core, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Di Hu
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Zuohui Zhang
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Hong Lin
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Yongchao Wang
- Vanderbilt Memory and Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mariah Leidinger
- Comparative Pathology Laboratory, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Jia Luo
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
- Iowa City VA Health Care System, Iowa City, IA, United States
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Prasad S, Verma A, Kumar S, Gupta S. An Evaluation of the Changing Trends in Substance Use Behavior Among Patients in the Tertiary Care Setting After the Implementation of Liquor Prohibition in Bihar, India: A Cross-Sectional Study. Cureus 2024; 16:e63692. [PMID: 39092379 PMCID: PMC11293793 DOI: 10.7759/cureus.63692] [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: 05/16/2024] [Accepted: 06/29/2024] [Indexed: 08/04/2024] Open
Abstract
Background and objective Substance use disorders pose significant global public health challenges, with India being no exception. Bihar, one of India's most populous states, implemented alcohol prohibition in April 2016 to address the adverse effects of alcohol abuse. However, the impact of this policy on overall substance use behavior among patients in healthcare settings remains to be explored. This cross-sectional study aimed to evaluate the changing trends in substance use behavior among patients in the tertiary care setting following the prohibition of alcohol use in Bihar. Methods A total of 372 patients diagnosed with substance use disorders were recruited from tertiary care facilities in Bihar. Data on demographic characteristics, types of substances used, frequency and quantity of use, reasons for use, and awareness of prohibition laws were collected through structured interviews and reviews of medical records. Descriptive and inferential statistics were used for data analysis. Results The majority of the participants were male (n = 346, 93.01%), with a mean age of 38.5 years. While tobacco use remains stable, there are significant increases in opioid and cannabis consumption post-prohibition, highlighting unintended consequences (p-values - opioids: 0.008, cannabis: 0.021). Additionally, heightened daily and weekly substance use after prohibition is evident (p-values: daily: 0.008, weekly: 0.021), emphasizing the necessity for nuanced policy considerations. Reasons for substance use, including coping with stress and peer pressure, showed significant differences before and after the prohibition (p<0.05). Moreover, awareness of alcohol prohibition laws increased significantly after the implementation of the prohibition (p = 0.003). Conclusions Our findings suggest that while alcohol prohibition in Bihar did not significantly lead to any changes in terms of the types of substances used among patients in tertiary care settings, it did influence the frequency and quantity of tobacco and cannabis consumption. Increased awareness of prohibition laws underscores the importance of policy enforcement and public education initiatives in addressing substance use behavior.
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Affiliation(s)
- Sambhu Prasad
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Anant Verma
- Department of Psychiatry, Vardhaman Medical College and Hospital, Nalanda, IND
| | - Santosh Kumar
- Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Sweta Gupta
- Orthodontics, Patna Dental College and Hospital, Patna, IND
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Seekles ML, Mwita W, Andongolile A, Kihange A, Owen G, Hudda A, Mmbaga BT, Obasi AIN. "Alcohol will never run out": Socio-ecological drivers of adolescent boys' alcohol use in Kilimanjaro Region, Tanzania. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002443. [PMID: 38857241 PMCID: PMC11164390 DOI: 10.1371/journal.pgph.0002443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/06/2024] [Indexed: 06/12/2024]
Abstract
Heavy alcohol use amongst adolescent boys is a major public health concern in many countries. It is associated with a range of negative physical and mental health outcomes and predicts alcohol-related problems in adulthood. In Kilimanjaro Region, adolescent boys' alcohol use is widespread, and higher than other regions in Tanzania. An understanding of causal and contextual factors that influence the use of alcohol is needed to inform the development and implementation of effective alcohol prevention interventions. This study aimed to explore these socio-ecological factors in-depth amongst adolescent boys, young men and key stakeholders in Kilimanjaro Region, Tanzania. Between August 2022 and June 2023, multi-method, participatory, qualitative methods including: ethnographic observations (8 weeks), 37 in-depth interviews, 14 focus group discussions and participatory adolescent activities were used to elicit perceptions on factors driving adolescent boys' alcohol use in two (rural/urban) settings. Data were triangulated and deductively analysed, guided by Bronfenbrenner's socio-ecological framework. This study found many dynamic and inter-related factors linked to alcohol use within adolescents' social, cultural, economic, regulatory, and physical environments. In a context of widespread availability of alcohol, low enforcement of alcohol regulation and (mis)conceptions around the benefits of alcohol use (e.g. curative and/or nutritional properties), parental and cultural influences largely determined the initiation of use in childhood and younger adolescence; employment status, peers, lack of alternative recreational activity and social norms around independence appeared to drive continued and increased use in older adolescence. Factors and their impact varied between rural and urban settings. In conclusion, a wide range of determinants and drivers of alcohol use among ABYM work at multiple socio-ecological levels especially parental, cultural and socioeconomic factors. This suggests that effective prevention requires a systems approach intervening across these levels. For example, incorporating education/awareness raising, increased law enforcement, parent-child communication and problem-solving, and income generation activities.
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Affiliation(s)
- Maaike L. Seekles
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Winfrida Mwita
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | - Gilbert Owen
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Aliza Hudda
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Angela I. N. Obasi
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Blanzat C, Phan O, Hamonniere T, Bonnaire C. The PEERCARE peer led programme for college students: A qualitative evaluation of a "chill-out" harm reduction space. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:326-345. [PMID: 38903888 PMCID: PMC11186445 DOI: 10.1177/14550725231225597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/22/2023] [Indexed: 06/22/2024] Open
Abstract
Aims: Harmful patterns of alcohol consumption, such as binge drinking, are prevalent among the student population at universities. Despite the risks of this behaviour, few secondary prevention programmes have been created to meet the specific needs of this population. The PEERCARE programme is a peer-based prevention programme that seeks harm reduction for alcohol overuse in party environments, among other goals. To do so, a "chill-out" space is created by peer educators in party environments to limit the risks associated with alcohol overuse. This study sought to examine peer educators' experience with a chill-out space to identify their specific actions, difficulties and needs, and to consider possibilities for improvement. Methods: Nine engineering students from one French grandes écoles campus trained as peer educators (six men and three women; mean age 21 years) participated. Semi-structured interviews were used for data collection. Results: The thematic analysis showed that the peer educators were highly engaged with this programme in response to alcohol overuse on their campus. The chill-out space was lauded for its non-judgemental and non-moralising nature. In addition, the numerous risk reduction activities that were enacted confirmed the benefits of these spaces during parties. The peer educators' experience was positive, and acting as managers of the chill-out space seemed to answer to a sense of competence recognitiontion. Conclusion: This study confirms the relevance of utilising chill-out spaces during parties and provides preliminary data on the deployment and management of peer-led chill-out space approaches. Expanding the implementation of such spaces to more educational institutions is recommended.
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Affiliation(s)
- Coline Blanzat
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, Boulogne-Billancourt, France
| | - Olivier Phan
- Clinique FSEF Sceaux, Sceaux, France; Centre Pierre Nicole, “Consultation Jeunes Consommateurs”, Croix-Rouge Française, Paris, France; Centre de recherche en Épidémiologie et Santé des Populations (CESP), Inserm, UMR 1018, Université Paris-Saclay, hôpital Paul-Brousse, Villejuif cedex, France; UFR Simone Veil-Santé, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Tristan Hamonniere
- Clinique FSEF Sceaux, Sceaux, France; UR Clipsyd, Université Paris Nanterre, Nanterre, France
| | - Céline Bonnaire
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, Boulogne-Billancourt, France; Centre Pierre Nicole, “Consultation Jeunes Consommateurs”, Croix-Rouge Française, Paris, France
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15
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Walsh SD, Getahune S, Kogan SM. Risk, resilience and family relationships among at-risk Ethiopian immigrant youth in Israel: A focus group investigation. FAMILY PROCESS 2024; 63:711-730. [PMID: 37414724 DOI: 10.1111/famp.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 05/13/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
Despite the pivotal role that parents play in their adolescent children's lives, intervention programs aimed at at-risk, immigrant youth have often neglected the role of the parents. Informed by an ecological perspective, the current study explored how the intersecting experiences of parents and adolescents in the Ethiopian immigrant community in Israel inform adolescent risk and resilience. A sample of 55 parents and adolescent children, who were involved in a program serving at-risk families, and eight service providers participated in five focus groups. Grounded theory analyses of transcripts provided insights into family processes in which the experience of disenfranchisement of parents (due to societal and familial processes) transacts with feelings of isolation and withdrawal of their adolescent children. We documented five issues that reinforced this core pattern: Stigma and discrimination, cultural and language differences between parents and youth, disempowerment in interactions with authorities, parental role strain, and negative influence of the neighborhood. We also documented three resilience processes that counter this pattern (community cohesion, cultural socialization and ethnic and cultural pride, and vigilant parental monitoring). Results suggest a need for family-based intervention programs that can counter reinforcing cycles of disenfranchisement and build on families' resilience resources.
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Affiliation(s)
- Sophie D Walsh
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Simcha Getahune
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
- Kibbutzim College, Tel Aviv, Israel
| | - Steven M Kogan
- Human Development and Family Science, University of Georgia, Athens, Georgia, USA
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16
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Hogue A, Porter NP, Ozechowski TJ, Becker SJ, O'Grady MA, Bobek M, Cerniglia M, Ambrose K, MacLean A, Hadland SE, Cunningham H, Bagley SM, Sherritt L, O'Connell M, Shrier LA, Harris SK. Standard Versus Family-Based Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Primary Care: Protocol for a Multisite Randomized Effectiveness Trial. JMIR Res Protoc 2024; 13:e54486. [PMID: 38819923 PMCID: PMC11179044 DOI: 10.2196/54486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/30/2024] [Accepted: 04/25/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning. There is urgent need to investigate the value of systematically incorporating caregivers in SBIRT-A procedures. OBJECTIVE This randomized effectiveness trial will advance research and scope on SBIRT-A in primary care by conducting a head-to-head test of 2 conceptually grounded, evidence-informed approaches: a standard adolescent-only approach (SBIRT-A-Standard) versus a more expansive family-based approach (SBIRT-A-Family). The SBIRT-A-Family approach enhances the procedures of the SBIRT-A-Standard approach by screening for AOD risk with both adolescents and caregivers; leveraging multidomain, multireporter AOD risk and protection data to inform case identification and risk categorization; and directly involving caregivers in brief intervention and referral to treatment activities. METHODS The study will include 2300 adolescents (aged 12-17 y) and their caregivers attending 1 of 3 hospital-affiliated pediatric settings serving diverse patient populations in major urban areas. Study recruitment, screening, randomization, and all SBIRT-A activities will occur during a single pediatric visit. SBIRT-A procedures will be delivered digitally on handheld tablets using patient-facing and provider-facing programming. Primary outcomes (AOD use, co-occurring behavior problems, and parent-adolescent communication about AOD use) and secondary outcomes (adolescent quality of life, adolescent risk factors, and therapy attendance) will be assessed at screening and initial assessment and 3-, 6-, 9-, and 12-month follow-ups. The study is well powered to conduct all planned main and moderator (age, sex, race, ethnicity, and youth AOD risk status) analyses. RESULTS This study will be conducted over a 5-year period. Provider training was initiated in year 1 (December 2023). Participant recruitment and follow-up data collection began in year 2 (March 2024). We expect the results from this study to be published in early 2027. CONCLUSIONS SBIRT-A is widely endorsed but currently underused in pediatric primary care settings, and questions remain about optimal approaches and overall effectiveness. In particular, referral to treatment procedures in primary care remains virtually untested among youth. In addition, whereas research strongly supports involving families in interventions for adolescent AOD, SBIRT-A effectiveness trial testing approaches that actively engage family members in primary care are absent. This trial is designed to help fill these research gaps to inform the critical health decision of whether and how to include caregivers in SBIRT-A activities conducted in pediatric primary care. TRIAL REGISTRATION ClinicalTrials.gov NCT05964010; https://www.clinicaltrials.gov/study/NCT05964010. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54486.
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Affiliation(s)
- Aaron Hogue
- Family and Adolescent Clinical Technology & Science, Partnership to End Addiction, New York, NY, United States
| | - Nicole P Porter
- Family and Adolescent Clinical Technology & Science, Partnership to End Addiction, New York, NY, United States
| | | | - Sara J Becker
- Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Megan A O'Grady
- University of Connecticut Health Center, Farmington, CT, United States
| | - Molly Bobek
- Family and Adolescent Clinical Technology & Science, Partnership to End Addiction, New York, NY, United States
| | - Monica Cerniglia
- Family and Adolescent Clinical Technology & Science, Partnership to End Addiction, New York, NY, United States
| | - Kevin Ambrose
- Family and Adolescent Clinical Technology & Science, Partnership to End Addiction, New York, NY, United States
| | - Alexandra MacLean
- Family and Adolescent Clinical Technology & Science, Partnership to End Addiction, New York, NY, United States
| | - Scott E Hadland
- Division of Adolescent and Young Adult Medicine, Massachusetts General Hospital for Children, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Hetty Cunningham
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, NY, United States
| | - Sarah M Bagley
- Department of Pediatrics, Chobanian & Avedisian School of Medicine, Boston, MA, United States
- Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States
| | - Lon Sherritt
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Cornerstone Systems Northwest, Lynden, WA, United States
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Maddie O'Connell
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Lydia A Shrier
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Sion Kim Harris
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
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Klein RJ, Lekkas D, Nguyen ND, Jacobson NC. Comparing Transdiagnostic Risk Factors: Predicting Emergence of Significant Depressive, Anxiety, and Substance Abuse Symptoms Among Juvenile Delinquents. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01682-6. [PMID: 38782806 DOI: 10.1007/s10578-024-01682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 05/25/2024]
Abstract
In a 7-year 11-wave study of low-SES adolescents (N = 856, age = 15.98), we compared multiple well-established transdiagnostic risk factors as predictors of first incidence of significant depressive, anxiety, and substance abuse symptoms across the transition from adolescence to adulthood. Risk factors included negative emotionality, emotion regulation ability, social support, gender, history of trauma, parental histories of substance abuse, parental mental health, and socioeconomic status. Machine learning models revealed that negative emotionality was the most important predictor of both depression and anxiety, and emotion regulation ability was the most important predictor of future significant substance abuse. These findings highlight the critical role that dysregulated emotion may play in the development of some of the most prevalent forms of mental illness.
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Affiliation(s)
- Robert J Klein
- Center for Technology and Behavioral Health, Dartmouth College, Hanover, USA.
- The Well Living Lab, Rochester, USA.
- Delos Living, LLC, New York, USA.
- The Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Damien Lekkas
- Center for Technology and Behavioral Health, Dartmouth College, Hanover, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, USA
| | - Nhi D Nguyen
- Center for Technology and Behavioral Health, Dartmouth College, Hanover, USA
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Dartmouth College, Hanover, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, USA
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Bhatia G, Gupta S. Drug Use and Road Traffic Injuries- Shots in the Dark. Indian J Psychol Med 2024; 46:264-267. [PMID: 38699768 PMCID: PMC11062304 DOI: 10.1177/02537176231166144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Affiliation(s)
- Gayatri Bhatia
- Dept. of Psychiatry, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Sahil Gupta
- Dept. of Trauma Surgery and Critical Care, All India Institute of Medical Sciences, New Delhi, India
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Adebisi YA, Lucero-Prisno III DE, Ogaya JB, Cañezo Jr. VC, Niez RA, Delos Santos FE, Magramo MM, Yap-Tan AR, Sy FAR, Kasimieh O. Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey. J Prev Med Public Health 2024; 57:288-297. [PMID: 38726577 PMCID: PMC11164607 DOI: 10.3961/jpmph.24.052] [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: 01/28/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS). METHODS We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05. RESULTS The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent's worries. CONCLUSIONS The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.
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Affiliation(s)
| | | | - Jerico B. Ogaya
- Department of Medical Technology, Far Eastern University, Manila, Philippines
| | | | | | | | | | | | | | - Omar Kasimieh
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
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Jao NC, Tan MM, Albanese A, Lee J, Stroud LR. Perceptions of family functioning impact smoking during pregnancy. J Addict Dis 2024:1-10. [PMID: 38619008 DOI: 10.1080/10550887.2024.2327732] [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] [Indexed: 04/16/2024]
Abstract
BACKGROUND Although socio-environmental factors are known to contribute to the maintenance of smoking behavior, few studies have examined the impact of family functioning on smoking during pregnancy. OBJECTIVE The current study examined the relationship between perceptions of family functioning and smoking during pregnancy. METHODS Pregnant women (N = 345, 59% ethnic/racial minority) completed the Family Assessment Device, a gold-standard assessment examining perceptions of family functioning in seven domains. Multinomial logistic regressions analyzed associations between clinically determined suboptimal levels of family functioning by domain and smoking status during pregnancy (smoking, ≥28 continuous days quit, nonsmoking), with stratified analyses exploring ethnic/racial differences (non-Hispanic/White vs. racial/ethnic minority). RESULTS Participants who reported suboptimal levels of family functioning in domains of Affective Involvement, Affective Responsiveness, Behavioral Control, and Roles were significantly more likely to have been smoking than nonsmoking during pregnancy. Stratified analyses revealed differing effects by ethnic/racial identity, with perceptions of Roles remaining the only significant effect on smoking outcomes for both groups. No significant effects were found regarding the impact of family functioning on whether participants were smoking vs. quit during pregnancy. CONCLUSIONS Suboptimal family functioning may contribute to smoking during pregnancy, but effects may differ based on domain of family functioning and by ethnic/racial identity.
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Affiliation(s)
- Nancy C Jao
- Department of Psychology, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Marcia M Tan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Ariana Albanese
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Jacinda Lee
- Department of Psychology, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, RI, USA
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21
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Harte P, Barry MM. A scoping review of the implementation and cultural adaptation of school-based mental health promotion and prevention interventions in low-and middle-income countries. Glob Ment Health (Camb) 2024; 11:e55. [PMID: 38751723 PMCID: PMC11094552 DOI: 10.1017/gmh.2024.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/13/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024] Open
Abstract
Effective school-based mental health promotion and prevention interventions in low-and middle-income countries (LMICs) can positively impact the mental health and well-being of large numbers of young people. This scoping review aimed to investigate the implementation of effective mental health promotion and prevention interventions in LMIC schools. A scoping review of the international literature was conducted and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Medline, PsycInfo, Scopus, Embase, CINAHL and Cochrane were searched for peer-reviewed literature published from 2014 to 2022. PsycExtra, Google Scholar and the websites of key organisations were searched for relevant grey literature. Study selection focussed on mental health promotion interventions, including the development of social and emotional skills and mental health literacy, and prevention interventions, including anti-bullying and skill-based interventions for "at-risk" students. Twenty-seven studies evaluating 25 school-based interventions in 17 LMICs were included in the review. Fifteen interventions were developed in the implementing country and 10 were adapted from high-income countries (HICs) or other settings. Findings from the studies reviewed were generally positive, especially when interventions were implemented to a high quality. Universal life-skills interventions were found to increase social and emotional skills, decrease problem behaviours and positively impact students' mental health and well-being. Mental health literacy interventions increased mental health knowledge and decreased stigma among students and school staff. Outcomes for externally facilitated anti-bullying interventions were less positive. All 19 effective studies reported on some aspects of programme implementation, and 15 monitored implementation fidelity. Eleven studies outlined the programme's underpinning theoretical model. Only four studies reported on the cultural adaptation of programmes in detail. Including young people in the adaptation process was reported to facilitate natural cultural adaptation of programmes, while input from programme developers was considered key to ensuring that the core components of interventions were retained. The review findings indicate increasing evidence of effective mental health interventions in LMIC schools. To facilitate the sustainability, replication and scaling-up of these interventions, greater attention is needed to reporting on intervention core components, and the processes of implementation and cultural adaptation in the local setting.
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Affiliation(s)
- Patricia Harte
- WHO Collaborating Centre for Health Promotion Research, University of Galway, Galway, Ireland
| | - Margaret M. Barry
- WHO Collaborating Centre for Health Promotion Research, University of Galway, Galway, Ireland
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Debenham J, Birrell L, Champion KE, Newton N. An on-line school-based substance use harm reduction programme: The Illicit Project randomized controlled trial results. Addiction 2024; 119:741-752. [PMID: 38105000 DOI: 10.1111/add.16403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023]
Abstract
AIMS The aim of this study was to measure the effectiveness of an on-line, neuroscience-based harm reduction intervention (The Illicit Project) on substance use, harms and knowledge over a 12-month period. DESIGN We used a two-arm cluster-randomized controlled trial. SETTING The study was conducted at eight secondary schools across New South Wales, Australia. PARTICIPANTS A total of 950 (mean age = 15.9; standard deviation = 0.68) in grades 10-12 at participating schools in 2020 took part. INTERVENTION AND COMPARATOR The Illicit Project intervention group (schools = five, n = 681) received an on-line, universal substance use and harm reduction programme over three classes. The active control group (schools = three, n = 269) received school-based health education as usual. MEASUREMENTS Self-report questionnaires assessed primary [alcohol, nicotine, cannabis, 3,4-methylenedioxymethamphetamine (MDMA), cocaine and prescription drug misuse] and secondary outcomes (alcohol-related harms and drug literacy) at baseline and the 6- and 12-month follow-up assessment. FINDINGS Approximately 63% (n = 595) of the sample completed the 12-month follow-up assessment, including 58% of the intervention group (n = 396/679) and 66% of the active control group (n = 179/271). Participants in the intervention group had slower annual increases in binge drinking [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.12-0.89], nicotine use (OR = 0.80, 95% CI = 0.52-1.23), MDMA use (OR = 0.14, 95% CI = 0.02-1.00), cocaine use (OR = 0.06, 95% CI = 0.01-0.64) and prescription drug misuse (OR = 0.07, 95% CI = 0.01-0.54) compared with the active control group. There was limited evidence of an intervention effect on cannabis use and alcohol-related harm (P > 0.5). The secondary outcomes showed that the intervention group maintained higher levels of drug literacy knowledge (β = 3.71, 95% CI = 1.86-5.56) and harm reduction help-seeking skills (β = 1.55, 95% CI = 0.62-2.48) compared with the active control group. CONCLUSION The Illicit Project (an on-line, neuroscience-based substance use harm reduction intervention) was effective in slowing the uptake of risky substance use and improving drug literacy skills among late secondary school students in Australia, compared with school-based health education as usual.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Aslan R, Aydoğdu M, Akgür SA. Toxicological evaluation of alcohol and substance abuse in children and adolescents. J Ethn Subst Abuse 2024; 23:272-286. [PMID: 35904897 DOI: 10.1080/15332640.2022.2089424] [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] [Indexed: 10/16/2022]
Abstract
Unhealthy behaviors such as use of alcohol and drug usually begin during adolescence. Izmir is on transit route for illicit substance due to geographical situation. Children and adolescents are the most important threatened group in terms of alcohol and substance abuse. In this study, it was aimed to investigate alcohol and substance use profile of children and adolescents in Izmir/Turkey with the toxicological analysis results obtained from Addiction Toxicology Laboratory.Urine and blood samples of 4524 cases at and under the age of 18 years coming from various departments to the laboratory in 2015-2016 were analyzed by enzymatic immunoassay. Information and analysis results of the cases were obtained by retrospective analysis of the hospital system.83,3% of the cases were male and the mean age was 16,69 ± 1,63. Alcohol and/or substance use was determined in 13,2% of the cases. Among the cases with positive results of analysis, cannabis (33%) was mostly detected and was followed by amphetamine type stimulants (ATS, 15%), polysubstance use (15%) and alcohol (13%). While cannabis, polysubstance use and ATS were the most common in male, ethyl alcohol, ATS and benzodiazepine were mostly detected in female. There was a significant increase in the substance use rate in 2016 compared to the previous year.A substance use profile was obtained through drug testing in adolescents who are in the risk group for substance use. In this context, our data will be indicative for the development of new and more effective preventive strategies targeting children and adolescents.
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Affiliation(s)
- Rukiye Aslan
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
| | - Melike Aydoğdu
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
| | - Serap Annette Akgür
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
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Touali R, Chappuy M, Berger-Vergiat A, Deletoille M, Ragonnet D, Rochet T, Poulet E, Tazarourte K, Haesebaert J, Michel P, Rolland B. Screening problematic use of substances among young subjects attending an emergency department, and subsequent treatment seeking. L'ENCEPHALE 2024; 50:170-177. [PMID: 37331923 DOI: 10.1016/j.encep.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Young individuals constitute a key population for the screening of problematic use of substances (PUS), but they are not likely to seek support and are hard to reach. Targeted screening programs should thus be developed in the places of care they may attend for other reasons, including emergency departments (EDs). We aimed to explore the factors associated with PUS in young people attending an ED; we measured the subsequent access to addiction care after ED screening. METHODS This was a prospective interventional single-arm study which included any individual aged between 16 and 25 years who attended the main ED of Lyon, France. Baseline data were sociodemographic characteristics, PUS status using self-report questionnaires and biological measures, level of psychological health, and history of physical/sexual abuse. Quick medical feedback was provided to the individuals presenting a PUS; they were advised to consult an addiction unit, and contacted by phone at three months to ask whether they had sought treatment. Baseline data were used to compare PUS and non-PUS groups using multivariable logistic regressions, to provide adjusted odds ratios (aORs) and 95% confidence intervals (95% CI), with age, sex, employment status, and family environment as the adjustment variables. The characteristics of PUS subjects who subsequently sought treatment were also assessed using bivariable analyses. RESULTS In total, 460 participants were included; 320 of whom (69.6%) were presenting current substance use, and 221 (48.0%) with PUS. Compared to non-PUS individuals, PUS ones were more likely to be males (aOR=2.06; 95% CI [1.39-3.07], P<0.001), to be older (per one-year increase: aOR=1.09; 95% CI [1.01-1.17], P<0.05), to have an impaired mental health status (aOR=0.87; 95% CI [0.81-0.94], P<0.001), and to have a history of sexual abuse (aOR=3.33; 95% CI [2.03-5.47], P<0.0001). Only 132 (59.7%) subjects with PUS could be reached by phone at 3 months, among whom only 15 (11.4%) reported having sought treatment. Factors associated with treatment seeking were social isolation (46.7% vs. 19.7%; P=0.019), previous consultation for psychological disorders (93.3% vs. 68.4%; P=0.044), lower mental health score (2.8±1.6 vs. 5.1±2.6; P<0.001), and post-ED hospitalization in a psychiatric unit (73.3% vs. 19.7%; P<0.0001). DISCUSSION/CONCLUSION EDs are relevant places to screen PUS in youth, but the level of seeking further treatment needs to be substantially improved. Offering systematic screening during an emergency room visit could allow for more appropriate identification and management of youth with PUS.
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Affiliation(s)
- Rdah Touali
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, pôle MOPHA, 95, boulevard Pinel, 69500 Bron, France; Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France.
| | - Mathieu Chappuy
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, pôle MOPHA, 95, boulevard Pinel, 69500 Bron, France; Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France; CSAPA, groupement hospitalier Nord, hospices civils de Lyon, Lyon, France; Service pharmaceutique, hospices civils de Lyon, Lyon, France
| | - Aurélie Berger-Vergiat
- Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Marion Deletoille
- Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Delphine Ragonnet
- Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Thierry Rochet
- Service de Pédopsychiatrie, CH Le Vinatier, Bron, France
| | - Emmanuel Poulet
- Service de psychiatrie d'urgences, groupement hospitalier centre, hospices civils de Lyon, Lyon, France; Inserm U1028, CNRS UMR 5292, CRNL, université de Lyon, UCBL1, Bron, France
| | - Karim Tazarourte
- Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France; Service d'accueil des urgences, groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France; Service recherche et épidémiologie cliniques, hospices civils de Lyon, pôle santé publique, 69003 Lyon, France
| | - Philippe Michel
- Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France; Service recherche et épidémiologie cliniques, hospices civils de Lyon, pôle santé publique, 69003 Lyon, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, pôle MOPHA, 95, boulevard Pinel, 69500 Bron, France; Inserm U1028, CNRS UMR 5292, CRNL, université de Lyon, UCBL1, Bron, France
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Angeli M, Hassandra M, Krommidas C, Morres I, Theodorakis Y. Assessing the Impact of a Health Education Anti-Smoking Program for Students: A Follow-Up Investigation. CHILDREN (BASEL, SWITZERLAND) 2024; 11:387. [PMID: 38671604 PMCID: PMC11049245 DOI: 10.3390/children11040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
In this follow-up study, we aimed to assess the effectiveness of the "I do not smoke, I exercise" anti-smoking preventive health education program. The program was based on the theory of planned behavior supplemented with life skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. A separate paired samples t-test revealed a significant improvement in students' knowledge about smoking (t217 = -5.605, p < 0.001, d = 0.38) and perceived behavioral control (t220 = -2.166, p < 0.05, d = 0.15) following the intervention. However, no significant changes were observed in the remaining variables. In addition, students' overall satisfaction with the implementation of the present health education program was high (M = 5.72 ± 1.39). These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the perceived behavioral control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.
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Affiliation(s)
| | | | | | | | - Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (M.A.); (M.H.); (C.K.); (I.M.)
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26
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Radó MK, Kisfalusi D, Laverty AA, van Lenthe FJ, Been JV, Takács K. Socio-economic inequalities in smoking and drinking in adolescence: Assessment of social network dynamics. Addiction 2024; 119:488-498. [PMID: 37994195 DOI: 10.1111/add.16384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/04/2023] [Indexed: 11/24/2023]
Abstract
AIMS We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups. DESIGN This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves. SETTING Eight Hungarian secondary schools with socio-economically diverse classes took part. PARTICIPANTS This study comprised 232 adolescents aged between 14 and 15 years in the first wave. MEASUREMENTS Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit. FINDINGS Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES. CONCLUSIONS Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.
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Affiliation(s)
- Márta K Radó
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Institute for Analytical Sociology, Department of Management and Engineering, Linköping University, Norrköping, Sweden
- Division of Neonatology, Department of Paediatrics, Erasmus MC, Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Dorottya Kisfalusi
- HUN-REN Centre for Social Sciences, Computational Social Science-Research Center for Educational and Network Studies (CSS - RECENS), Budapest, Hungary
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, the Netherlands
| | - Jasper V Been
- Division of Neonatology, Department of Paediatrics, Erasmus MC, Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Károly Takács
- Institute for Analytical Sociology, Department of Management and Engineering, Linköping University, Norrköping, Sweden
- HUN-REN Centre for Social Sciences, Computational Social Science-Research Center for Educational and Network Studies (CSS - RECENS), Budapest, Hungary
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Ekpenyong MS, Jagun H, Stephen HA, Bakre AT, Odejimi O, Miller E, Nyashanu M, Bosun-Arije SF. Investigation of the prevalence and factors influencing tobacco and alcohol use among adolescents in Nigeria: A systematic literature review. Drug Alcohol Depend 2024; 256:111091. [PMID: 38340401 DOI: 10.1016/j.drugalcdep.2024.111091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
The increase in tobacco and alcohol prevalence among Nigerian teenagers necessitates the need to understand the factors influencing use. The aim of this systematic literature review was to synthesis evidence from studies on tobacco and alcohol use among Nigerian adolescents and young adults in order to determine factors influencing tobacco and alcohol use. Six databases MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ScienceDirect, and Google Scholar were used to search for peer-reviewed articles reporting the prevalence and predictors of tobacco and alcohol use among adolescents/youths published between 2010 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided this review. From our search, twelve articles from the 6 geopolitical zones within Nigeria were included. The high prevalence of tobacco and alcohol use among Nigerian adolescents necessitates the need to understand the factors influencing use. A high prevalence rate was recorded among the male gender. Gender, age, and curiosity appear to place adolescents at extra risk for tobacco and alcohol use. Lack of parental monitoring, peer influence, low socio-economic status, low education level, stressful life events, advertisements, availability, and accessibility are factors identified to influence adolescents' alcohol and tobacco use. Alcohol and tobacco use remains a major public health issue as it continues to contribute largely to the growing occurence of diseases globally. Our review showed that adolescents' alcohol and tobacco use behaviour is triggered by various factors on the personal, interpersonal, organisational, community, and policy levels, and these factors are understood to predict or protect against alcohol and tobacco use.
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Affiliation(s)
- Mandu S Ekpenyong
- School of Nursing and Public Health, Manchester Metropolitan University, Brooks Building, Manchester M15 6GX, United Kingdom.
| | - Halimat Jagun
- Department of Internal Medicine, University of Uyo Teaching Hospital, Abak Road, Akwa Ibom State, Nigeria
| | - Hope A Stephen
- Institute of Inner-City Learning, University of Wales Trinity Saint David, United Kingdom
| | - Aishat T Bakre
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Opeyemi Odejimi
- Institute of Health and Allied Profession, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, United Kingdom
| | - Eula Miller
- School of Nursing and Public Health, Manchester Metropolitan University, Brooks Building, Manchester M15 6GX, United Kingdom
| | - Mathew Nyashanu
- Institute of Health and Allied Profession, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, United Kingdom
| | - Stella F Bosun-Arije
- School of Nursing and Public Health, Manchester Metropolitan University, Brooks Building, Manchester M15 6GX, United Kingdom
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Abstract
Little is understood about the unintended consequences of cannabis liberalization on children. Subsequently, this scoping review aimed to map and identify evidence related to acute cannabis intoxication in children. We searched three medical literature databases from inception until October 2019. We identified 4644 information sources and included 158 which were mapped by topic area relating to 1) public health implications and considerations; 2) clinical management; and 3) experiences and information needs of HCPs and families. Public health implications were addressed by 129 (82%) and often reported an increased incidence of acute pediatric cannabis intoxications. Clinical information was reported in 116 (73%) and included information on signs and symptoms (n = 106, 92%), clinical management processes (n = 60, 52%), and treatment recommendations (n = 42, 36%). Few sources addressed the experiences or information needs of either HCPs (n = 5, <1%) treating children for acute cannabis intoxication or families (n = 1, <1%) seeking care. Increasing incidence of acute cannabis intoxications concurrent with liberalization of cannabis legislation is clear, however, evidence around clinical management is limited. Additionally, further research exploring HCPs and families experiences and information needs around cannabis intoxication is warranted.
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Affiliation(s)
- Lindsay A Gaudet
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kaitlin Hogue
- Department of Pediatric Emergency Medicine, Max Rady College of Medicine, Winnipeg, University of Manitoba, MB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sarah A Elliott
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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Bonsu L, Kumra P, Awan A, Sharma M. A systematic review of binge drinking interventions and bias assessment among college students and young adults in high-income countries. Glob Ment Health (Camb) 2024; 11:e33. [PMID: 38572263 PMCID: PMC10988166 DOI: 10.1017/gmh.2024.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/11/2024] [Accepted: 02/11/2024] [Indexed: 04/05/2024] Open
Abstract
Alcohol is the number one substance used by young people and people of college age. Binge drinking (BD) in this age group is considered one of the most important global health issues, as much harm accrues from it and even lives are lost. This study aimed to review the interventions to curb BD or encourage responsible drinking among college students and young adults. MEDLINE (PubMed), ERIC and APA PsycINFO were searched. The selected articles were published in English and had to evaluate a BD reduction program through a randomized control trial (RCT) among college students or young adults between the ages of 17-24 years. The exclusion criteria included research not published in English, systematic review articles, qualitative studies, designs other than RCTs and discussion articles on college students drinking with no findings. The three reviewers independently screened and extracted the data using the PRISMA guidelines. The overall quality of the studies was assessed. Then, 10 of the 12 interventions studied were found to be successful in reducing BD among college students, though the effect sizes were small to medium. A minority of the studies used behavior change theories. Effective interventions for reducing BD among college students and young adults should include robust behavior change theories, longer follow-up time and the operationalization of multiple outcomes. Process evaluation is needed to be conducted in these studies.
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Affiliation(s)
- Laurencia Bonsu
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
| | - Priyambda Kumra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
| | - Asma Awan
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
| | - Manoj Sharma
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
- Department of Internal Medicine, Kirk Kerkorian School of Medicine, UNLV, Las Vegas, NV89106, USA
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Vázquez AL, Navarro Flores CM, Garcia BH, Barrett TS, Domenech Rodríguez MM. An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic. PLoS One 2024; 19:e0287878. [PMID: 38354165 PMCID: PMC10866513 DOI: 10.1371/journal.pone.0287878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (Mage = 12.5, SD = 1.1; 6th and 8th grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC = .926) and dual use (AUC = .944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent's attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use.
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Affiliation(s)
- Alejandro L. Vázquez
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Cynthia M. Navarro Flores
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Byron H. Garcia
- Department of Psychology, Arizona State University, Tempe, Arizona, United States of America
| | - Tyson S. Barrett
- Highmark Health, Pittsburg, Pennsylvania, United States of America
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Ramamurthy D, Manjunath S, Sarvar R, Nair AS, Kundapur R, Rashmi A, Modi B, Kadri AM. Prevention starts here: effectiveness of substance abuse prevention module among adolescent students in Bengaluru - a quasi experimental study. Int J Adolesc Med Health 2024; 36:79-84. [PMID: 38410844 DOI: 10.1515/ijamh-2023-0191] [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: 12/04/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES This study aims to evaluate the effectiveness of a structured educational module on substance abuse prevention program among adolescents in enhancing their knowledge against substance abuse. METHODS A quasi-experimental design was employed involving 120 students (mean age: 14.3±1.03 years, 59.2% boys) from two English medium schools. Participants were exposed to a structured module on substance abuse over a month. The study assessed changes in knowledge through pretest and post-test evaluations. Statistical analyses examined improvements in scores and the relationship between class of study and post-test knowledge scores. RESULTS The intervention significantly improved students' knowledge about substance abuse (p<0.001) across all measured domains, genders, and classes, with the exception of the 7th class. A positive correlation was found between the class of study and post-test scores (Rs=0.288, p<0.001), indicating that higher classes were associated with greater improvements in knowledge. These findings suggest that the training effectively increased awareness and understanding of substance abuse among participants. CONCLUSIONS The substance abuse prevention program successfully enhanced adolescents' knowledge and equipped them with resilience and coping strategies, thus reducing their vulnerability to peer pressure and substance abuse. Despite the lack of significant improvement in the 7th class, the overall positive outcomes underscore the importance of implementing such educational interventions to foster healthy development and well-being among students. Further research is encouraged to explore the specific barriers to effectiveness in younger classes and to refine program content accordingly.
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Affiliation(s)
- Deepthi Ramamurthy
- Department of Community Medicine, ESIC MC & PGIMSR, Bengaluru, Karnataka, India
| | - Smitha Manjunath
- Department of Psychiatry, ESICMC and PGIMSR, Sanath Nagar, Hyderabad, India
| | - Rana Sarvar
- Department of Community Medicine, ESIC MC & PGIMSR, Bengaluru, Karnataka, India
| | - Aparna S Nair
- Department of Community Medicine, ESIC MC & PGIMSR, Bengaluru, Karnataka, India
| | - Rashmi Kundapur
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Anusha Rashmi
- Department of Community Medicine, KS Hegde Medical Academy, Mangalore, Karnataka, India
| | - Bhavesh Modi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rajkot, Gujarat, India
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Ibrahiem AA, Al Dawsari MM, Almeaqli RE, Keshk AA, Ali NA, Habil H. Parents' Knowledge, Attitude, and Practices toward Methamphetamine Abuse among Youth and its Risk Factors in Saudi Arabia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S753-S756. [PMID: 38595546 PMCID: PMC11000875 DOI: 10.4103/jpbs.jpbs_996_23] [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: 10/04/2023] [Revised: 10/15/2023] [Accepted: 10/22/2023] [Indexed: 04/11/2024] Open
Abstract
Objective The present study aimed to conduct an assessment of parents' knowledge, attitudes, and practices toward methamphetamine "shabu" abuse among youth and its risk factors. Materials and Methods The present cross-sectional descriptive study was conducted on a sample of 1179 parents. Parents were assured that questionnaire content would stay classified and was given anonymously. It had 20 demographic, drug use, and addiction treatment questions. Statistical Package for Social Sciences v. 24 and Chi-Square test were used to examine the data after evaluating and coding it. Results Out of a total of 1179 participants, only 11% had not heard about shabu, about 38% did not know the main symptoms of crystal addiction, and 46% did not know the long side effects of crystal addiction. The majority of participants mentioned that shabu is available in powder format (57%) or liquid (13%), while 27% did not know its form. Most of the participants (97%) think that the drug of shabu or crystal or ice is dangerous; about 60% of participants mentioned that there is an addict in the family. Conclusion Parents have good knowledge levels regarding different aspects of methamphetamine or shabu abuse, symptoms, and its risk factors. Further in-depth studies are needed at whole Saudi Arabia.
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Affiliation(s)
- Amaal A. Ibrahiem
- Department of Biochemistry, Faculty of Science, University of Tabuk, Saudi Arabia
| | | | - Reem E. Almeaqli
- Department of Biochemistry, Faculty of Science, University of Tabuk, Saudi Arabia
| | - Ali A. Keshk
- Department of Chemistry, University of Tabuk, Tabuk, Saudi Arabia
| | - Nasir A. Ali
- College of Public Health and Tropical Medicine, Jazan University, Saudi Arabia
| | - Hussain Habil
- Faculty of Medicine, University MAHSA, Kuala Lumpur, Malaysia
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Hogue A, Brykman K, Guilamo-Ramos V, Ilakkuvan V, Kuklinski MR, Matson P, McKnight ER, Powell TW, Richter L, Walker-Harding LR. Family-Focused Universal Substance Use Prevention in Primary Care: Advancing a Pragmatic National Healthcare Agenda. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:307-317. [PMID: 37994994 DOI: 10.1007/s11121-023-01584-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 11/24/2023]
Abstract
This article advances ideas presented at a National Academies of Sciences, Engineering, and Medicine workshop in 2022 that highlighted clinical practice and policy recommendations for delivering universal, family-focused substance use preventive interventions in pediatric primary care. Pediatric primary care is a natural setting in which to offer families universal anticipatory guidance and links to systematic prevention programming; also, several studies have shown that offering effective parenting programs in primary care is feasible. The article describes a blueprint for designing a pragmatic national agenda for universal substance use prevention in primary care that builds on prior work. Blueprint practice schematics leverage efficacious family-focused prevention programs, identify key program implementation challenges and resources, and emphasize adopting a core element approach and utilizing digital interventions. Blueprint policy schematics specify avenues for improving cross-sector policy and resource alignment and collaboration; expanding, diversifying, and strengthening the prevention workforce; and enhancing financing for family-focused prevention approaches. The article then draws from these schematics to assemble a candidate universal prevention toolkit tailored for adolescent patients that contains four interlocking components: education in positive parenting practices, parent and youth education in substance use risks, a parent-youth structured interaction task, and parent and youth linkage to in-person and web-based prevention resources.
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Affiliation(s)
- Aaron Hogue
- Partnership to End Addiction, 711 Third Avenue, 5th floor, NY, NY, 10017, USA.
| | | | | | - Vinu Ilakkuvan
- PoP Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Pamela Matson
- School of Medicine, Johns Hopkins, Baltimore, MD, USA
| | - Erin R McKnight
- College of Medicine and Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | | | - Linda Richter
- Partnership to End Addiction, 711 Third Avenue, 5th floor, NY, NY, 10017, USA
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Latt NNN, Putdivarnichapong W, Phetrasuwan S, Vongsirimas N. Factors predicting the intention of drug abuse avoidance among adolescents in Pinlaung Township, Myanmar: predictive correlational design. BMC Public Health 2024; 24:8. [PMID: 38166869 PMCID: PMC10759472 DOI: 10.1186/s12889-023-17419-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Adolescence is a critical transition period and is at high risk for drug/substance abuse. In Myanmar, drug use is common among adolescents and is a public health concern. There are no studies of drug abuse prevention among Myanmar adolescents. Intentions to avoid drug abuse can be a protective factor for preventing drug abuse among adolescents. This study investigated the effects of sex, parental history of drug/alcohol abuse, self-efficacy, parental marital status, and family functioning on the intention of drug abuse avoidance among Myanmar adolescents. METHODS This is a predictive correlational study. The Biopsychosocial model was used as the theoretical framework of this study. A convenient sampling method was used to collect data from 157 students aged 13-18 years in a government school, middle school level and high school level, Pinlaung Town, Southern Shan State, Myanmar during the COVID-19 pandemic and political protests. G* power software was used to calculate the sample size. Data was collected by four self-administered questionnaires: a socio-demographic questionnaire, Thai Family Functioning Scale (TFFS), General Self-Efficacy Scale (GSE), and Intention of Drug Avoidance Scale (IDAS). Multiple linear regression was employed to analyze the data. RESULTS Five predictors, including biological sex, parental history without drug/alcohol abuse, self-efficacy, parental marital status, and family functioning, explained 24.4% of the variance in the intention of drug abuse avoidance among Myanmar adolescents (R 2 = .244, F (5,151) = 9.738, p = .000). In addition, only three factors, family functioning (β = .31, p < .001), biological sex (β = -.25, p < .01), and self-efficacy (β = .16, p < .05) statistically and significantly predicted the intention of drug abuse avoidance among Myanmar adolescents. CONCLUSIONS Family functioning, female gender, and self-efficacy predicted the intention of drug abuse avoidance among Myanmar adolescents in Pinlaung Township, Southern Shan State, Myanmar. IMPLICATIONS OF THIS STUDY The results of this study have implications for all stakeholders through research, education, practice, and policymaking leading to improve the intentions of drug abuse avoidance among Myanmar adolescents. Furthermore, the results of this study specifically contribute to create psychoeducational intervention programs for increasing intention to avoid substance use by promoting family functioning and self-efficacy of adolescents. This is especially proper for male adolescents who have less intention to avoid substance use.
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Affiliation(s)
- Nang Nwe Nwe Latt
- Student of Master of Nursing Science Program (International Program), Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Wimolnun Putdivarnichapong
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand.
| | - Supapak Phetrasuwan
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand
| | - Nopporn Vongsirimas
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand
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Walmisley U, De Jong M, George A, Okeyo I, Späth C, Siegfried N, Harker N, Tomlinson M, Doherty T. Whole-of-community and intersectoral interventions that address alcohol-related harms: A scoping review. Glob Public Health 2024; 19:2357211. [PMID: 38916343 DOI: 10.1080/17441692.2024.2357211] [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: 12/19/2023] [Accepted: 05/12/2024] [Indexed: 06/26/2024]
Abstract
Alcohol harms threaten global population health, with youth particularly vulnerable. Low - and middle-income countries (LMIC) are increasingly targeted by the alcohol industry. Intersectoral and whole-of-community actions are recommended to combat alcohol harms, but there is insufficient global evidence synthesis and research examining interventions in LMIC. This paper maps existing literature on whole-of - community and intersectoral alcohol harms reduction interventions in high-income countries (HIC) and LMIC. Systematic searching and screening produced 61 articles from an initial set of 1325: HIC (n = 53), LMIC (n = 8). Data were extracted on geographic location, intersectoral action, reported outcomes, barriers, and enablers. HIC interventions most often targeted adolescents and combined community action with other components. LMIC interventions did not target adolescents or use policy, schools, alcohol outlets, or enforcement components. Programme enablers were a clear intervention focus with high political support and local level leadership, locally appropriate plans, high community motivation, community action and specific strategies for parents. Challenges were sustainability, complexity of interventions, managing participant expectations and difficulty engaging multiple sectors. A learning agenda to pilot, scale and sustain whole-of-community approaches to address alcohol harms in settings is crucial, with consideration of local contexts and capacities, more standardised methods, and a focus on community-driven action.
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Affiliation(s)
- Ulla Walmisley
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Michelle De Jong
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Asha George
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Ida Okeyo
- School of Pharmacy, University of the Western Cape, Belville, South Africa
| | - Carmen Späth
- School of Public Health, University of the Western Cape, Bellville, South Africa
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nandi Siegfried
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Mental Health and Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Nadine Harker
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Tanya Doherty
- School of Public Health, University of the Western Cape, Bellville, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
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Periyasamy C, Ezhumalai S, Vranda MN, Narayanan G, Kandasamy A. Lived Experiences of Intimate Partner Violence and Help-seeking among Wives of Persons with Alcohol Dependence: A Thematic Analysis. JOURNAL OF PSYCHIATRY SPECTRUM 2024; 3:20-27. [PMID: 38274495 PMCID: PMC10810417 DOI: 10.4103/jopsys.jopsys_17_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Background Worldwide, intimate partner violence (IPV) is a significant public health problem. Most of the wives of persons with alcohol dependence (PwAD) experience IPV in their lifetime. The study examined lived experiences of IPV among wives of PwAD. Methods Qualitative research study design was used. Twenty participants were recruited using the consecutive sampling method. The researcher used an in-depth interview guide to collect the data. ATLAS.ti.9 software was used to analyse the qualitative data. Thematic analysis was used for coding and emerging themes. The thematic analysis yielded four themes generated from the in-depth interview: (1) reasons for the IPV, (2) help-seeking, (3) barriers in help-seeking and (4) coping with IPV. Conclusion Survivors of IPV do not seek help due to self-stigma, unavailable resources, and lack of awareness about treatment for alcohol dependence. Clinicians should routinely screen for IPV among female spouses of persons with alcohol-dependent syndrome and provide psychosocial interventions for the survivors of IPV.
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Affiliation(s)
- Chinnadurai Periyasamy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Sinu Ezhumalai
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Mysore Narasimha Vranda
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gitanjali Narayanan
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Arun Kandasamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Xu C, Wang S, Su BB, Ozuna K, Mao C, Dai Z, Wang K. Associations of adolescent substance use and depressive symptoms with adult major depressive disorder in the United States: NSDUH 2016-2019. J Affect Disord 2024; 344:397-406. [PMID: 37844780 DOI: 10.1016/j.jad.2023.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 09/16/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Few studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD). METHODS Data from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016-2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations. RESULTS The overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18. CONCLUSIONS These findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.
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Affiliation(s)
- Chun Xu
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA.
| | - Silas Wang
- Department of Statistics & Data Science, Dietrich College of Humanities and Social Sciences, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Brenda Bin Su
- Department of Pediatrics - Allergy and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Kaysie Ozuna
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - ChunXiang Mao
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Zheng Dai
- Health Affairs Institute, Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV, USA.
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Birgel V, Röding D, Reder M, Soellner R, Walter U. Contextual effects of community capacity as a predictor for adolescent alcohol, tobacco, and illicit drug use: A multi-level analysis. SSM Popul Health 2023; 24:101521. [PMID: 37790085 PMCID: PMC10543175 DOI: 10.1016/j.ssmph.2023.101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/05/2023] Open
Abstract
Adolescent substance use is a major public health issue that can result in enduring physical, psychological, and social consequences. This study seeks to examine the relationship between community capacity for prevention and the 4-week prevalence rate of substance use, including tobacco, alcohol, other drugs, and binge-drinking, among students in Germany ranging from grades 5 to 11. This study employed a cross-sectional design and used baseline data from 28 communities participating in the CTC-EFF study. The sample consisted of 7210 students who were surveyed about their substance use behavior. Additionally, 158 local key informants were surveyed on ten capacity domains, which included commitment, knowledge and skills, resources, leadership, inclusiveness, prevention collaboration, sectoral-collaboration, cohesion, problem-solving skills, and needs orientation. Furthermore, a total capacity score was calculated as the mean of the ten capacity domains. To examine the associations between community capacity and substance use behavior, logistic multi-level models were utilized. The analysis shows a negative association between community capacity (total score) and any substance use (OR = 0.28, 95% CI 0.12-0.56). Specifically, higher levels of total community capacity are associated with lower odds of alcohol use (OR = 0.30, 95% CI 0.13-0.80), tobacco use (OR = 0.09, 95% CI 0.01-0.60), and binge-drinking (OR = 0.67, 95% CI (0.46-0.99). Further analyses of distinct community capacity domains indicate that higher levels of sectoral-collaboration (OR = 0.62, 95% CI 0.37-0.97), knowledge and skills (OR = 0.74, 95% CI 0.40-0.79), resources (OR = 0.52, 95% CI 0.36-0.76), and problem-solving skills (OR = 0.71, 95% CI 0.36-0.89) are associated with lower odds of any substance use. The study findings suggest that community capacity is associated with substance use behavior, emphasizing the importance of capacity building in interventions targeting the reduction of substance use among adolescents.
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Affiliation(s)
- Vera Birgel
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Dominik Röding
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Maren Reder
- University of Hildesheim, Institute for Psychology, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Renate Soellner
- University of Hildesheim, Institute for Psychology, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Ulla Walter
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Kardaş Ö, Şimşek M, Ögel K. Why Do Adolescents Relapse? A Multicenter, Cross-sectional Study. PSYCHIAT CLIN PSYCH 2023; 33:246-253. [PMID: 38765852 PMCID: PMC11037467 DOI: 10.5152/pcp.2023.23748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/14/2023] [Indexed: 05/22/2024] Open
Abstract
Background Adolescents use drugs once, then use them regularly, then start and stop many times. In addiction treatment, relapse is a major barrier to recovery. Relapse is more common among adolescents and is a major problem. Thus, this study aimed to identify the factors impacting the duration of relapse in adolescents. Methods This is a multicenter, cross-sectional study. A total of 157 adolescents who applied to 4 different child and adolescent addiction treatment centers between January 2020 and March 2020 were included in the study. The "Addiction Profile Survey Adolescent Form" was administered to the participants face to face. According to the duration of relapse determined with this form, the cases were analyzed separately as before and after 1 month. Results The sample consisted of 112 (71.34%) males and 45 (28.66%) females, with a mean age of 17.1 ± 0.8 years. Cannabis use (P = .010), late treatment initiation (P = .003), less psychosocial (P = .001), outpatient (P = .006), and inpatient (P = .006) treatment history were significantly associated with relapse before 1 month. Cannabis users were approximately 4 times more likely to relapse in less than a month, while ecstasy users were approximately 4 times more likely to relapse over a month (OR = 0.26, CI = 0.1-0.69), (OR = 4.16, CI = 1.26-13.78). In the multiple logistic regression analysis performed to determine the factors predicting the duration of relapse, it was found that not attending school (P = .018) and receiving less inpatient treatment (P = .019) predicted relapse occurred within 1 month. Conclusion This study is considered remarkable in terms of demonstrating the necessity of early interventions and post-treatment care services. Currently, there are very few studies in the literature that investigate the factors that contribute to relapse in addicted adolescents. According to our literature review, no study examined factors affecting relapse duration in adolescents.
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Affiliation(s)
- Ömer Kardaş
- Department of Child and Adolescent Psychiatry, Kocaeli University, School of Medicine, Kocaeli, Turkey
| | - Melike Şimşek
- The Turkish Green Crescent Counseling Center, Istanbul, Turkey
| | - Kültegin Ögel
- Department of Psychology, Istanbul Kent University, Istanbul, Turkey
- Alcohol and Substance Addiction Treatment Center, Moodist Psychiatry Hospital, Istanbul, Turkey
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Park S, Yon H, Ban CY, Shin H, Eum S, Lee SW, Shin YH, Shin JU, Koyanagi A, Jacob L, Smith L, Min C, Yeniova AÖ, Kim SY, Lee J, Hadalin V, Kwon R, Koo MJ, Fond G, Boyer L, Kim S, Hahn JW, Kim N, Lefkir E, Bondeville V, Rhee SY, Shin JI, Yon DK, Woo HG. National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents. World J Pediatr 2023; 19:1071-1081. [PMID: 36977821 PMCID: PMC10049906 DOI: 10.1007/s12519-023-00715-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/05/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents, more adequate studies are needed to predict the trends of alcohol and substance use during recent periods, including the mid-pandemic period. This study investigated the changes in alcohol and substance use, except tobacco use, throughout the pre-, early-, and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea. METHODS Data on 1,109,776 Korean adolescents aged 13-18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency. We evaluated adolescents' alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes. We define the pre-COVID-19 period as consisting of four groups of consecutive years (2005-2008, 2009-2012, 2013-2015, and 2016-2019). The COVID-19 pandemic period is composed of 2020 (early-pandemic era) and 2021 (mid-pandemic era). RESULTS More than a million adolescents successfully met the inclusion criteria. The weighted prevalence of current alcohol use was 26.8% [95% confidence interval (CI) 26.4-27.1] from 2005 to 2008 and 10.5% (95% CI 10.1-11.0) in 2020 and 2021. The weighted prevalence of substance use was 1.1% (95% CI 1.1-1.2) from 2005 to 2008 and 0.7% (95% CI 0.6-0.7) between 2020 and 2021. From 2005 to 2021, the overall trend of use of both alcohol and drugs was found to decrease, but the decline has slowed since COVID-19 epidemic (current alcohol use: βdiff 0.167; 95% CI 0.150-0.184; substance use: βdiff 0.152; 95% CI 0.110-0.194). The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex, grade, residence area, and smoking status from 2005 to 2021. CONCLUSION The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage (2020-2021) of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period (2005-2019).
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Affiliation(s)
- Sangil Park
- Department of Neurology, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Hyunju Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Chae Yeon Ban
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyoin Shin
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seounghyun Eum
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Barcelona, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Abdullah Özgür Yeniova
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jinseok Lee
- Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
| | - Vlasta Hadalin
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Min Ji Koo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Human Biology, University of Toronto, Toronto, ON, Canada
| | - Guillaume Fond
- AP-HM, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
| | - Laurent Boyer
- AP-HM, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jong Woo Hahn
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Namwoo Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Eléa Lefkir
- Faculty of Medicine, University of Rennes 1, Rennes, France
| | - Victoire Bondeville
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Ho Geol Woo
- Department of Neurology, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
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Horváth K, Túri G, Kaposvári C, Cseh B, Dózsa CL. Challenges and opportunities for improvement in the management and financing system of Health Promotion Offices in Hungary. Front Public Health 2023; 11:1219186. [PMID: 37965520 PMCID: PMC10641462 DOI: 10.3389/fpubh.2023.1219186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background One hundred ten Health Promotion Offices (HPOs) have started operating in Hungary in response to public health challenges. Many of them have been active for almost 10 years, yet their operational experience has not been evaluated. The specific objectives of our study were: (1) to describe the current operational and funding system of HPOs, (2) to identify challenges related to the current management and funding practices, and (3) to formulate recommendations for improvement based on gathered experience and international experience. Design In order to gain a deeper insight into the operational experience of HPOs, an online survey was conducted with the professional or economic managers of HPOs. A scoping review was carried out to gather international experiences about best practices to formulate recommendations for improvement in developing the operational and financing scheme for HPOs. Results We found that current HPO network in Hungary faces three main challenges: a deficient management system, inflexible financing scheme, and unequal ability to purchase or provide services for the population. Conclusions Based on the survey complemented by international experiences, we propose the overhaul of the professional management system and switching toa combination of fixed and performance-based financing scheme for the HPOs in Hungary.
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Affiliation(s)
- Krisztián Horváth
- Department of Public Health, Semmelweis University, Budapest, Hungary
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
| | - Gergo Túri
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
| | - Csilla Kaposvári
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
- Faculty of Health Sciences, Doctoral School, University of Pécs, Pécs, Hungary
| | - Borbála Cseh
- Med-Econ Human Services Ltd., Budapest, Hungary
- Doctoral School of Medical Sciences, Semmelweis University, Budapest, Hungary
| | - Csaba László Dózsa
- Med-Econ Human Services Ltd., Budapest, Hungary
- Department of Theoretical Health Sciences, Faculty of Health Sciences, University of Miskolc, Miskolc, Hungary
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Oosten W, Vos E, Los L, Nelwan M, Pieters T. Towards a New Dynamic Interaction Model of Adolescent CUD Manifestation, Prevention, and Treatment: A Narrative Review. PSYCHOACTIVES 2023; 2:294-316. [PMID: 39280928 PMCID: PMC7616443 DOI: 10.3390/psychoactives2040019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
Background Cannabis is one of the most popular drugs of the 21st century, especially among adolescents and young adults. Evidence of a variety of lasting neuropsychological deficits as a result of chronic cannabis use has increased. Furthermore, regular cannabis use is found to be a predictor of mental health problems, less motivation in school, and school dropout. Aim Our goal is to propose a theoretical model of adolescent cannabis use disorder (CUD) based on Zinberg's drug, set, and setting model and explicated by a review of the literature on adolescent cannabis use to improve the prevention and treatment of CUD for adolescents. Methods PubMed and Web of Science were searched for relevant publications as part of a hypothesis-based and model-generating review. Results Individual (set) and environmental (setting) risk factors play important roles in the development of CUD in adolescents. School performance, motivation, and attendance can be negatively influenced by persistent cannabis use patterns and adolescent brain development can consequently be impaired. Thus, cannabis use can be understood as both being the cause of poor school performance but also the consequence of poor school performance. To prevent and reduce adolescent CUD the drug, set, and setting must all be considered. It is important to notice that the multiple feedback loops (indicated in our dynamic interaction model) are not mutually exclusive, but offer important intervention focus points for social workers, addiction professionals, parents, and other care takers. Conclusion We argue that the three dimensions of drug, set, and setting contribute significantly to the eventual manifestation of CUD. Based on our dynamic interaction model, recommendations are made for possible preventive and therapeutic interventions for the treatment of adolescents and young adults with CUD.
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Affiliation(s)
- Wesley Oosten
- Freudenthal Institute, Utrecht University, P.O. Box 85 170, 3508 AD Utrecht, The Netherlands
| | - Elena Vos
- Trimbos Institute, P.O. Box 80 125, 3500 AS Utrecht, The Netherlands
| | - Leontien Los
- Department of Adolescent Psychiatry and Addiction Prevention, Brijder-Jeugd, 2553 NZ The Hague, The Netherlands
| | - Michel Nelwan
- Department of Children and Adolescent Psychiatry, Erasmus Medical Center Sophia, P.O. Box 2060, 3015 CN Rotterdam, The Netherlands
| | - Toine Pieters
- Freudenthal Institute, Utrecht University, P.O. Box 85 170, 3508 AD Utrecht, The Netherlands
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80 082, 3508 TB Utrecht, The Netherlands
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Krisanits BA, Schuster R, Randise J, Nogueira LM, Lane JT, Panguluri GA, Li H, Helke K, Cuitiño MC, Koivisto C, Spruill L, Ostrowski MC, Anderson SM, Turner DP, Findlay VJ. Pubertal exposure to dietary advanced glycation end products disrupts ductal morphogenesis and induces atypical hyperplasia in the mammary gland. Breast Cancer Res 2023; 25:118. [PMID: 37803429 PMCID: PMC10559657 DOI: 10.1186/s13058-023-01714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/18/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Advanced glycation end products (AGEs) are reactive metabolites intrinsically linked with modern dietary patterns. Processed foods, and those high in sugar, protein and fat, often contain high levels of AGEs. Increased AGE levels are associated with increased breast cancer risk, however their significance has been largely overlooked due to a lack of direct cause-and-effect relationship. METHODS To address this knowledge gap, FVB/n mice were fed regular, low AGE, and high AGE diets from 3 weeks of age and mammary glands harvested during puberty (7 weeks) or adulthood (12 weeks and 7 months) to determine the effects upon mammary gland development. At endpoint mammary glands were harvested and assessed histologically (n ≥ 4). Immunohistochemistry and immunofluorescence were used to assess cellular proliferation and stromal fibroblast and macrophage recruitment. The Kruskal-Wallis test were used to compare continuous outcomes among groups. Mammary epithelial cell migration and invasion in response to AGE-mediated fibroblast activation was determined in two-compartment co-culture models. In vitro experiments were performed in triplicate. The nonparametric Wilcoxon rank sum test was used to compare differences between groups. RESULTS Histological analysis revealed the high AGE diet delayed ductal elongation, increased primary branching, as well as increased terminal end bud number and size. The high AGE diet also led to increased recruitment and proliferation of stromal cells to abnormal structures that persisted into adulthood. Atypical hyperplasia was observed in the high AGE fed mice. Ex vivo fibroblasts from mice fed dietary-AGEs retain an activated phenotype and promoted epithelial migration and invasion of non-transformed immortalized and tumor-derived mammary epithelial cells. Mechanistically, we found that the receptor for AGE (RAGE) is required for AGE-mediated increases in epithelial cell migration and invasion. CONCLUSIONS We observed a disruption in mammary gland development when mice were fed a diet high in AGEs. Further, both epithelial and stromal cell populations were impacted by the high AGE diet in the mammary gland. Educational, interventional, and pharmacological strategies to reduce AGEs associated with diet may be viewed as novel disease preventive and/or therapeutic initiatives during puberty.
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Affiliation(s)
- Bradley A Krisanits
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Reid Schuster
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Jaime Randise
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Lourdes M Nogueira
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Jackson T Lane
- Department of Surgery and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Gowtami A Panguluri
- Department of Surgery and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Hong Li
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Kristi Helke
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
- Department of Comparative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Maria C Cuitiño
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
- College of Health Sciences, Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA
| | - Christopher Koivisto
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
| | - Laura Spruill
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michael C Ostrowski
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
| | - Steven M Anderson
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David P Turner
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA.
- Department of Surgery and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - Victoria J Findlay
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA.
- Department of Surgery and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
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Liu J, Butler R, Turncliff A, Gray C, Lynch S, Whittaker J, Iroegbulem V, Howell D, Schuster RM. An Urgent Need for School-Based Diversion Programs for Adolescent Substance Use: A Statewide Survey of School Personnel. J Adolesc Health 2023; 73:428-436. [PMID: 37318411 PMCID: PMC10524742 DOI: 10.1016/j.jadohealth.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE There has been growing interest in reserving punishment as a last resort to address substance use in schools. However, there is significant variability in adoption of alternative approaches. This study reported school personnel's perceptions of diversion programs, identified characteristics of schools/districts that currently have diversion programs, and defined barriers of implementation of diversion programs. METHODS One hundred fifty six school stakeholders from Massachusetts' K-12 schools, including district administrators, principals and vice principals, school resource officers, guidance counselors, and nurses, completed a web-based survey in May-June 2020. Participants were recruited through e-mail distributed via professional listservs, direct school outreach, and community coalitions. The web survey queried beliefs, attitudes, and actions that schools take regarding substance use infractions as well as perceived barriers to implementing diversion programs. RESULTS Participants endorsed strong beliefs that punishment was an appropriate school response for student substance use, particularly for nontobacco-related infractions. Despite these personal beliefs, diversion programs were rated as more effective but less commonly used than punitive approaches (37% of respondents reported having diversion programs in their schools/districts vs. 85% used punitive approaches) (p < .03). Punishment was more likely to be used to respond to cannabis, alcohol, and other substances compared to tobacco (p < .02). Primary barriers of implementing diversion programs included funding, staff training, and parental support. DISCUSSION Based on school personnel perceptions, these findings lend further support for a transition away from punishment and toward more restorative alternatives. However, barriers to sustainability and equity were identified that warrant consideration when implementing diversion programs.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Rebecca Butler
- Massachusetts Department of Public Health, Office of Youth and Young Adult Services, Boston, Massachusetts
| | - Amy Turncliff
- RockFern Scientific Consulting LLC, Ashland, Massachusetts
| | - Caroline Gray
- Department of Psychiatry, Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Stacey Lynch
- Institute for Health and Recovery, Cambridge, Massachusetts
| | | | - Vanessa Iroegbulem
- Department of Psychiatry, Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Dan Howell
- Massachusetts Department of Public Health, Office of Youth and Young Adult Services, Boston, Massachusetts
| | - Randi M Schuster
- Department of Psychiatry, Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Gabrovec B, Crnkovič N, Vrdelja M, Cesar K, Selak Š. Is Trust in Information Sources Associated with Drug Use? A Population-Based Study. Zdr Varst 2023; 62:129-136. [PMID: 37327128 PMCID: PMC10263369 DOI: 10.2478/sjph-2023-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/19/2023] [Indexed: 06/18/2023] Open
Abstract
Aim Communication and information sources can play an important role when addressing drug use. The aim of this study is to assess the association of different levels of trust in information sources regarding drug use within different population groups. Methods Data was gathered using a mixed methods approach, with an online survey and interviews. A structured questionnaire was designed for data collection using the methodology of the European Monitoring Centre for Drugs and Drug Addiction, with additional items measuring trust in the information sources. Results In total 9,161 inhabitants of Slovenia aged 15-64 years and living in the private households completed the survey as part of this non-experimental quantitative study (response rate: 57%). A total of 20.7% of the participants reported having used cannabis or hashish at least once in their lives, 2.5% cocaine/crack cocaine and 0.4% heroin. Mean age of the first cannabis/hashish use was 19.59 years, cocaine/crack cocaine 22.73 years and heroin 20.63 years. The participants most value and trust the information sources regarding tobacco, alcohol and illicit drugs if it comes from healthcare workers or immediate family and other relatives, and put the least trust in the internet and television. Conclusions The data show that drug users have less trust in the given information sources compared to the whole sample. The present research serves as evidence for development and implementation of targeted interventions, including communication activities and tools.
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Affiliation(s)
- Branko Gabrovec
- National Institute of Public Health, Trubarjeva cesta 2, 1000Ljubljana, Slovenia
| | - Nuša Crnkovič
- National Institute of Public Health, Trubarjeva cesta 2, 1000Ljubljana, Slovenia
| | - Mitja Vrdelja
- National Institute of Public Health, Trubarjeva cesta 2, 1000Ljubljana, Slovenia
| | - Katarina Cesar
- National Institute of Public Health, Trubarjeva cesta 2, 1000Ljubljana, Slovenia
| | - Špela Selak
- National Institute of Public Health, Trubarjeva cesta 2, 1000Ljubljana, Slovenia
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Kemp K, Micalizzi L, Becker SJ, Cheaito A, Suazo NC, Fox K, Hernandez L, Spirito A. Intervention for marijuana using, court-involved non-incarcerated youth. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209100. [PMID: 37315797 PMCID: PMC10529931 DOI: 10.1016/j.josat.2023.209100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/22/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Justice-involved youth (JIY) are at elevated risk for substance use and for substance use-related harm compared to non-JIY. Marijuana use is of significant concern in this population, as it is tied to reoffending. Motivational enhancement therapy (MET) and electronic interventions show promise in reducing youth substance use; the degree to which these findings extend to JIY requires additional research attention. Thus, the purpose of this study was to test the preliminary feasibility and effectiveness of a combined brief electronic parenting intervention plus a brief MET-based electronic intervention for JIY adolescents, followed by feedback and development of a change plan with a court worker, on marijuana use. METHODS Participants were 83 parent-youth dyads recruited from a diversionary family court program who screened positive for past-year marijuana use. At baseline and 3- and 6-month follow-ups, youth self-reported on their substance use, parental monitoring, peer substance use, and dyads completed a discussion task querying parental monitoring, limit setting, and substance use. The study randomized dyads to psychoeducation or the experimental intervention condition post-baseline. The MET-based intervention involved the self-administered e-TOKE (an electronic, marijuana-specific assessment and feedback tool) and a brief follow-up meeting with court staff counselors to review feedback and create a marijuana use change plan. Caregivers completed a computer program aimed at improving parenting and communication with their adolescents. The study administered feasibility and acceptability measures for both conditions. RESULTS Feasibility of study procedures was demonstrated through recruitment and retention (∼75 % success). Acceptability ratings from youth, parents, and court staff were high and positive. While levels of parental monitoring, as assessed by an observational task, improved over the course of the study, the intervention did not result in a significant change in any of the outcomes tested. CONCLUSIONS Despite high acceptability and feasibility ratings for the use of an electronic plus in-person MET intervention, reduction of marijuana and other substances was limited for most youth. This suggests that a more intensive intervention, such as stepped care, may be necessary for JIY who are not specifically referred for court proceedings due to marijuana use or those with already well-established use patterns.
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Affiliation(s)
- Kathleen Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; Rhode Island Family Court Mental Health Clinic, 1 Dorrance Street, Providence, RI 02903, United States
| | - Lauren Micalizzi
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02903, United States
| | - Sara J Becker
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02903, United States
| | - Aya Cheaito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Nazaret C Suazo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Kara Fox
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Lynn Hernandez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States.
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Ayers SL, Kulis SS, Marsiglia FF, Campos AP, Medina-Mora ME. Keepin' It REAL-Mantente REAL in Mexico: Longitudinal Examination of Youth Drug Resistance Strategies and Substance Use Among Early Adolescents. J Adolesc Health 2023; 73:412-420. [PMID: 37422739 PMCID: PMC10524980 DOI: 10.1016/j.jadohealth.2023.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/13/2023] [Accepted: 05/07/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE This study examined if culturally and linguistically adapted versions of a US-developed adolescent substance use prevention intervention, keepin' it REAL (kiREAL), for Mexico increases the use of drug resistance strategies and if increased use of resistance strategies subsequently leads to a reduction in the frequency of substance use (i.e., alcohol, cigarette, marijuana, and inhalants). METHODS Students (N = 5,522, 49% female, age range = 11-17) in 36 middle schools across three cities in Mexico were randomized into three conditions: (1) Mantente REAL (MREAL), the culturally adapted version, (2) kiREAL-S, the linguistically adapted version, and (3) Control. Using survey data collected at four time points, random intercept cross-lagged path analyses tested the direct and indirect effects of MREAL and kiREAL-S compared to Control. RESULTS At time 2, the number of drug resistance strategies used by students increased in both MREAL (β = 0.103, p = .001) and kiREAL-S (β = 0.064, p = .002) compared to Control. However, only MREAL lead to less frequent use of alcohol (β = -0.001, p = .038), cigarettes (β = -0.001, p = .019), marijuana (β = -0.002, p = .030), and inhalants (β = -0.001, p = .021) at time 4, mediated through increased use of drug resistance strategies. DISCUSSION This study provides evidence that MREAL and kiREAL-S are successful in spurring use of the drug resistance strategies that are the core component of the intervention. Only MREAL achieved long-term effects on substance use behaviors, the ultimate objective of these interventions. These findings provide support for the value and importance of rigorous cultural adaptation of efficacious prevention programs as a necessary condition for enhancing prevention benefits for participating youth.
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Affiliation(s)
- Stephanie L Ayers
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona; Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, Arizona.
| | - Stephen S Kulis
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona
| | - Flavio F Marsiglia
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona
| | - Ana Paola Campos
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona; Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, Arizona
| | - Maria Elena Medina-Mora
- Universidad Nacional Autónoma de México, Circuito Interior Ciudad Universitaria, Mexico City, Mexico
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Zheng Y, Li J, Vergunst F. Drinking behaviors of Chinese adolescents over the past three decades: A systematic review and meta-analysis. Prev Med 2023; 173:107558. [PMID: 37263503 DOI: 10.1016/j.ypmed.2023.107558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/10/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023]
Abstract
Adolescent drinking is a major worldwide public health challenge. China is home to the world's second largest youth population, but relatively little is known about adolescent drinking behaviors. This study examined (1) prevalence rates and sex and age differences in drinking behaviors among Chinese adolescents over the past three decades and (2) whether underage drinking declined following the enactment of a strict national underage drinking policy in 2006. Literature search was conducted in one Chinese and five English databases following the PRISMA guidelines. A total of 186 studies were included in the meta-analyses using random-effects models on nine measures (Ns range: 13,489-755,796, number of studies range: 12-110): lifetime, past month, past year, and weekly drinking; lifetime, past year, and past month drunkenness; past month binge drinking, and age at first drinking (≤ 13 years). Males reported higher prevalence on all drinking behaviors except for weekly drinking and past month drunkenness. High school students reported higher prevalence in lifetime drinking, past year drunkenness, and lifetime drunkenness, than middle school students. No measured drinking behavior showed a significant or reliable decline after 2006. The findings suggest that prevalence rates of drinking behaviors remain high among Chinese adolescents but are lower than among European or North American adolescents. The 2006 Chinese national policy to reduce underage drinking did not measurably alter patterns of underage drinking. Implications for prevention, research, and policy are discussed.
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Affiliation(s)
- Yao Zheng
- Department of Psychology, University of Alberta, Edmonton, AB, Canada.
| | - Jiayi Li
- Department of Psychology, University of Alberta, Edmonton, AB, Canada; Department of Child and Youth Studies, Brock University, St. Catharines, ON, Canada
| | - Francis Vergunst
- Department of Special Needs Education, University of Oslo, Norway
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Liu XQ, Guo YX, Wang X. Delivering substance use prevention interventions for adolescents in educational settings: A scoping review. World J Psychiatry 2023; 13:409-422. [PMID: 37547731 PMCID: PMC10401500 DOI: 10.5498/wjp.v13.i7.409] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/26/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Currently, a proportion of adolescents use alcohol, tobacco, and illicit drugs, which inevitably harms their health and academic progress. Adolescence is a peak period for substance use initiation and a critical time for preventing substance use problems. Various entities, such as families, schools, and communities, have implemented a variety of interventions to alleviate adolescent substance use problems, and schools play a unique role. To explore the types, characteristics, and effectiveness of substance use interventions in educational settings for adole-scents, we conducted a scoping review and identified 32 studies after screening. We divided the 32 studies according to intervention type, including curriculum interventions focusing on cognitive-behavioral skill enhancement, exercise interventions, peer interventions and family-school cooperation, and electronic interventions. Except for the mixed results on electronic interventions, the results showed that the other interventions were beneficial to different extents in alleviating adolescent substance use problems. In addition, we analyzed and summarized the advantages and challenges of intervening in adolescent substance use in educational settings. Schools can use equipment and human resources to provide adolescents with various types of intervention measures, but they also face challenges such as stigmatization, ineffective coordination among multiple resources, and poor implementation effects. In the future, school-based intervention measures can fully utilize big data and artificial intelligence technology and collaborate with families and communities to intervene appro-priately while paying attention to the comorbidity risks of substance use disorders and psychological health issues.
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Affiliation(s)
- Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yu-Xin Guo
- School of Education, Tianjin University, Tianjin 300350, China
| | - Xin Wang
- School of Education, Tianjin University, Tianjin 300350, China
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50
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Lyew T, Ikhlas A, Sayed F, Vincent A, Lydon-Staley D. Curiosity, Surprise, and the Recall of Tobacco-Related Health Information in Adolescents. JOURNAL OF HEALTH COMMUNICATION 2023; 28:446-457. [PMID: 37318238 PMCID: PMC10330854 DOI: 10.1080/10810730.2023.2224254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A key goal of health communications designed to prevent smoking initiation during adolescence is for the tobacco-related information to be retained in memory beyond immediate message exposure. Here, we test the role for epistemic emotions, specifically curiosity and surprise, in facilitating memory for tobacco-related health information. Participants (n = 294 never-smoking adolescents, ages 14-16 years) performed a trivia guessing task wherein they guessed the answers to general trivia and smoking-related trivia questions. A subset of participants (n = 154) completed a surprise trivia memory task one week later and answered the previously viewed questions. Results indicate that curiosity about the answers to smoking-related trivia is associated with more accurate recall of smoking-related trivia answers one week later. Surprise also facilitated memory for smoking-related trivia, but the association was limited to cases where confidence in prior knowledge was low. Indeed, when participants had high confidence in their prior knowledge, surprise about the answer to trivia questions was associated with worse recall. Findings suggest that engendering states of curiosity for smoking-related information may facilitate retention of that information in never-smoking adolescents and highlight the need to examine both surprise and confidence in health communications to avoid low message recall.
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Affiliation(s)
- T. Lyew
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - A. Ikhlas
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - F. Sayed
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - A. Vincent
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - D.M Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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