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Taylor-Robinson D, Pickett KE, Bennett D. Reverse the benefit cap to tackle poor child health. BMJ 2024; 387:q2131. [PMID: 39353650 DOI: 10.1136/bmj.q2131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Affiliation(s)
- David Taylor-Robinson
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, York, UK
| | - Davara Bennett
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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Jiang W, Peng S, Liu Q, Lu C, Ni Y, Guo L. Associations of childhood household dysfunction and healthy lifestyle with depressive symptoms in adolescents. Soc Sci Med 2024; 360:117336. [PMID: 39299151 DOI: 10.1016/j.socscimed.2024.117336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVE Limited understanding exists regarding the cumulative impact of childhood household dysfunction (CHD) on adolescent depressive symptoms in developing countries, as well as the role of lifestyles in this association. This study aims to explore the associations of individual and cumulative CHD indicators with depressive symptoms among Chinese adolescents. Additionally, we investigate potential interactions and joint associations of CHD and lifestyles on depressive symptoms. METHODS In the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research, data on depressive symptoms, CHD indicators, lifestyle factors, and other covariates were collected from 3106 students (mean [SD] age, 15.16 [1.52] years). Linear and logistic mixed-effects models were employed, with both stratified and joint analyses conducted. RESULTS Except for parental death, each CHD indicator was associated with an increased risk of depressive symptoms. The accumulation of CHD indicators exhibited a positive, graded association with depressive symptoms scores (β = 3.22, 95% CI: 2.48 to 3.97 for one CHD indicator; β = 5.45, 95% CI: 4.41 to 6.49 for two or more CHD indicators, all P < 0.01). A significant interaction was found between the number of CHD indicators and the healthy lifestyle score (interaction β = -0.40, 95% CI: -0.78 to -0.03, P < 0.05), indicating that healthy lifestyles may mitigate the risk of depressive symptoms in individuals experiencing CHD. For example, the OR for having depressive symptoms among adolescents with favourable lifestyles compared with those with unfavourable lifestyles was 0.21 (95% CI: 0.10 to 0.45, P < 0.01) among those experiencing CHD. Moreover, adolescents with two or more CHD indicators and unfavourable lifestyles faced the highest risk of having depressive symptoms (OR = 8.03, 95% CI: 4.83 to 13.34, P < 0.01) compared with those with no CHD indicator and favourable lifestyles. CONCLUSIONS These findings underscore the importance of promoting comprehensive healthy lifestyles and reducing CHD exposure for the prevention of depressive symptoms in adolescents.
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Affiliation(s)
- Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Shuyi Peng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Qianyu Liu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Yanyan Ni
- The University of Hong Kong, LKS Faculty of Medicine, Hong Kong Special Administrative Region, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
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Adjei NK, Jonsson KR, Straatmann VS, Melis G, McGovern R, Kaner E, Wolfe I, Taylor-Robinson DC. Impact of poverty and adversity on perceived family support in adolescence: findings from the UK Millennium Cohort Study. Eur Child Adolesc Psychiatry 2024; 33:3123-3132. [PMID: 38353677 PMCID: PMC11424735 DOI: 10.1007/s00787-024-02389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/25/2024] [Indexed: 03/21/2024]
Abstract
Emotional support from family members may have an important effect on adolescent health outcomes, and has been identified as a target for policy to protect against the impacts of poverty and other early life adversities. However, few studies have assessed the extent to which poverty and adversity themselves influence the nature of emotional support that parents can provide to adolescents. We, therefore, aimed to investigate the impact of trajectories of income poverty and family adversities, including parental mental ill health, alcohol misuse and domestic violence across childhood developmental stages on young people's relationships with their families and perceived emotional support received. We analysed longitudinal data on 10,976 children from the nationally representative UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months-14 years). The outcomes were perceived emotional support and quality of family relationships, measured by the three-item Short Social Provisions Scale (SPS-3) and levels of parent-adolescent closeness and conflict, measured at age 14. ORs and 95% CIs were estimated using multivariable logistic regression models, adjusting for potential confounding factors. At age 14, the overall prevalence of low perceived emotional support was 13% (95% CI: 12, 14). Children of mothers with lower socioeconomic status (SES) were more likely to report low emotional support, with a clear social gradient (education-degree plus: 10.3% vs. no qualifications: 15.4%). Compared with children exposed to low levels of poverty and adversity, children in the persistent adversity trajectory groups experienced higher odds of low emotional support and low-quality parent-adolescent relationship; those exposed to both persistent poverty and poor parental mental health were particularly at increased risk of experiencing poor family relationships and low perceived emotional support (adjusted odds ratio 2·2; 95% CI 1·7-2·9). Low perceived emotional support and poor family relationships in adolescence are more prevalent among socially disadvantaged children and adolescents and those experiencing social adversity. Policies to improve levels of family support for UK adolescents should focus on improving modifiable determinants such as child poverty and family mental health.
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Affiliation(s)
- Nicholas Kofi Adjei
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK.
| | - Kenisha Russell Jonsson
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, Göteborg, Sweden
| | | | - Gabriella Melis
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Ingrid Wolfe
- Department of Women and Children's Health, King's College London, London, UK
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Tang F, Tracy M, Radigan M, Vásquez E. Trajectories of maternal parenting stress and adolescent behavioral symptoms in unmarried families: The role of family immigration status. J Affect Disord 2024; 367:297-306. [PMID: 39218316 DOI: 10.1016/j.jad.2024.08.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 03/27/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Maternal parenting stress during childhood may have important influences on offspring internalizing and externalizing behaviors during adolescence in unmarried households, but it is unclear whether effects differ across different trajectory patterns of maternal parenting stress and for native-born vs. immigrant families. METHODS Using data from the Future of Families and Child Wellbeing Study, we identified trajectory patterns of maternal parenting stress from ages 1-9 years using semi-parametric group-based trajectory modeling. We used negative binomial regression models to estimate associations between maternal parenting stress trajectories and adolescent behavioral symptoms at age fifteen. RESULTS Five maternal parenting stress trajectory groups were identified among the 1982 unmarried families included in this study, representing consistently low (9.2 %), consistently mild (54.2 %), moderate and decreasing (14.4 %), moderate and increasing (16.0 %) and consistently high (6.2 %) levels of maternal parenting stress. For adolescent internalizing symptoms, all maternal parenting stress trajectory groups exhibited higher symptoms compared to the consistently low group: IRR for consistently mild: 1.21 (95 % CI: 0.98-1.56); IRR for moderate/decreasing: 1.34 (95 % CI: 1.04-1.74); IRR for moderate/increasing: 1.62 (95 % CI: 1.28-2.13); and IRR for consistently high: 1.74 (95 % CI = 1.29-2.41). Similar results were observed for adolescent externalizing symptoms. Stronger effects of maternal parenting stress trajectories on adolescent externalizing symptoms were observed among native-born vs. immigrant families. LIMITATIONS Differential attrition and same-source bias may lead to under- or over-estimation of the associations of interest. CONCLUSIONS Interventions targeting unmarried families with elevated maternal parenting stress during childhood may reduce behavioral symptoms in adolescence.
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Affiliation(s)
- Fei Tang
- Department of Epidemiology and Biostatistics, University at Albany - State University of New York, United States of America.
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, University at Albany - State University of New York, United States of America
| | - Marleen Radigan
- Department of Health Policy, Management and Behavior, University at Albany - State University of New York, United States of America
| | - Elizabeth Vásquez
- Department of Epidemiology and Biostatistics, University at Albany - State University of New York, United States of America
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Allen K, Melendez-Torres GJ, Ford T, Bonell C, Berry V. Parental domestic violence and abuse, mental ill-health, and substance misuse and the impact on child mental health: a secondary data analysis using the UK Millennium Cohort Study. BMC Public Health 2024; 24:2310. [PMID: 39187800 PMCID: PMC11346203 DOI: 10.1186/s12889-024-19694-1] [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: 11/20/2023] [Accepted: 08/05/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) can have a negative impact on both parents and children. However, it remains unclear if and how parental DVA, MH, and SU cluster and the impacts this clustering might have. We examined how parental DVA, MH, and SU cluster during early childhood, the demographic/contextual profiles of these clusters, and how these clusters relate to child MH trajectories. METHODS We examined data from 15,377 families in the UK Millennium Cohort Study. We used: (1) latent class analysis to create groups differentially exposed to parental DVA, MH, and SU at age three; (2) latent growth curve modelling to create latent trajectories of child MH from ages 3-17; and (3) a case-weight approach to relate latent classes to child MH trajectories. RESULTS We identified three latent classes: high-frequency alcohol use (11.9%), elevated adversity (3.5%), and low-level adversity (84.6%). Children in the elevated adversity class had higher probabilities of being from low-socioeconomic backgrounds and having White, younger parents. Children exposed to elevated adversity displayed worse MH at age three (intercept = 2.274; p < 0.001) compared the low-level adversity (intercept = 2.228; p < 0.001) and high-frequency alcohol use class (intercept = 2.068; p < 0.001). However, latent growth factors (linear and quadratic terms) of child MH did not differ by latent class. CONCLUSIONS Parental DVA, MH, and SU cluster during early childhood and this has a negative impact on children's MH at age three, leading to similar levels of poor MH across time. Intervening early to prevent the initial deterioration, using a syndemic-approach is essential.
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Affiliation(s)
- Kate Allen
- University of Exeter, South Cloisters, St Luke's Campus, College Road, Exeter, EX1 1TE, UK.
| | - G J Melendez-Torres
- University of Exeter, South Cloisters, St Luke's Campus, College Road, Exeter, EX1 1TE, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Vashti Berry
- University of Exeter, South Cloisters, St Luke's Campus, College Road, Exeter, EX1 1TE, UK
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Tannerah A, Hazel O, Desson S, Farah R, Kamil‐Thomas Z, Iqbal H, Eames C, Saini P, Bifarin O. Consultations With Muslims From Minoritised Ethnic Communities Living in Deprived Areas: Identifying Inequities in Mental Health Care and Support. Health Expect 2024; 27:e14132. [PMID: 38956944 PMCID: PMC11220172 DOI: 10.1111/hex.14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/27/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. METHODS Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. FINDINGS Twenty-seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. CONCLUSIONS The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti-racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence-based mental health care provisions to tackle mental health inequities. PATIENT AND PUBLIC INVOLVEMENT This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region.
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Affiliation(s)
- Ashraf Tannerah
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
- Alder Hey Children's NHS Foundation TrustLiverpoolUK
| | | | - Sheree Desson
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
- Mersey Care NHS Foundation TrustLiverpoolUK
| | - Rahima Farah
- Central Liverpool Primary Care NetworkLiverpoolUK
- Liverpool City CouncilLiverpoolUK
| | - Zalihe Kamil‐Thomas
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Halima Iqbal
- School of Nursing and Healthcare LeadershipUniversity of BradfordBradfordUK
| | - Catrin Eames
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Pooja Saini
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Oladayo Bifarin
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
- Mersey Care NHS Foundation TrustLiverpoolUK
- Senior Research Leader ProgrammeNational Institute for Health and Care Research (NIHR)LondonUK
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Wabe N, Timothy A, Urwin R, Xu Y, Nguyen A, Westbrook JI. Analysis of Longitudinal Patterns and Predictors of Medicine Use in Residential Aged Care Using Group-Based Trajectory Modeling: The "MEDTRAC-Cardiovascular" Longitudinal Cohort Study. Pharmacoepidemiol Drug Saf 2024; 33:e5881. [PMID: 39090793 DOI: 10.1002/pds.5881] [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: 02/14/2024] [Revised: 06/11/2024] [Accepted: 07/12/2024] [Indexed: 08/04/2024]
Abstract
AIM Cardiovascular diseases are the leading cause of death globally. Ensuring ongoing use of medicines-medication persistence-is crucial, yet no prior studies have examined this in residential aged care facilities (RACFs). We aimed to identify long-term trajectories of persistence with cardiovascular medicines and determine predictors of persistence trajectories. METHOD A longitudinal cohort study of 2837 newly admitted permanent residents from 30 RACFs in New South Wales, Australia. We monitored weekly exposure to six cardiovascular medicine classes-lipid modifiers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs), beta-blockers, diuretics, calcium channel blockers (CCB), and cardiac therapy-over 3 years. Group-based trajectory modeling was employed to determine persistence trajectories for each class. RESULTS At baseline, 76.6% (n = 2172) received at least one cardiovascular medicine with 41.2% receiving lipid modifiers, 31.4% ACEI/ARBs, 30.2% beta-blockers, 24.4% diuretics, 18.7% CCBs, and 14.8% cardiac therapy. The model identified two persistence trajectories for CCBs and three trajectories for all other classes. Sustained high persistence rates ranged from 68.4% (ACEI/ARBs) to 79.8% (beta-blockers) while early decline in persistence and subsequent discontinuation rates ranged from 7.6% (cardiac therapy) to 25.3% (CCBs). Logistic regressions identified 11 predictors of a declining persistence across the six medicine classes. CONCLUSION Our study revealed varied patterns of cardiovascular medicine use in RACFs, with 2-3 distinctive medicine use trajectories across different classes, each exhibiting a unique clinical profile, and up to a quarter of residents discontinuing a medicine class. Future studies should explore the underlying reasons and appropriateness of nonpersistence to aid in identifying areas for improvement.
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Affiliation(s)
- Nasir Wabe
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Andrea Timothy
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Rachel Urwin
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Ying Xu
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
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Wabe N, Huang G, Silva SM, Nguyen AD, Seaman K, Raban MZ, Gates P, Day R, Close JCT, Lord SR, Westbrook JI. A Longitudinal Study of the Use and Effects of Fall-Risk-Increasing Drugs in Residential Aged Care. J Am Med Dir Assoc 2024; 25:105074. [PMID: 38857685 DOI: 10.1016/j.jamda.2024.105074] [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: 12/01/2023] [Revised: 03/04/2024] [Accepted: 05/06/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES Fall-risk-increasing drugs (FRIDs)-psychotropics and cardiovascular disease (CVD) drugs-may elevate the risk of falling, with strong evidence observed in psychotropic FRIDs, whereas findings from cardiovascular disease (CVD) FRIDs remain inconclusive. Existing studies on FRIDs and falls are often hampered by methodologic limitations. Leveraging longitudinal observational data, we aimed to determine the long-term patterns of FRID use and their association with falls in residential aged care (RAC) homes. DESIGN A retrospective longitudinal cohort study. SETTING AND PARTICIPANTS A total of 4207 permanent residents newly admitted to 27 RAC homes in Sydney, Australia. METHOD The outcomes were incidence of all and injurious falls. We measured exposure to each FRID over 60 months using the Proportion of Days Covered (PDC) metric. We used group-based multitrajectory modeling to determine concurrent usage patterns of psychotropics and CVD FRIDs and applied negative binomial regression to assess their associations with the outcomes. RESULTS A total of 83.6% (n = 3516) and 77.3% (n = 3254) residents used psychotropic and CVD FRIDs, respectively. The PDC values ranged from 67.3% (opioids) to 86.9% (antidepressants) for specific psychotropics and 79.0% (α-adrenoceptor antagonists) to 89.6% (β blockers) for CVD FRIDs. We identified 4 groups: group 1, low psychotropics-low CVDs use (16.7%, n = 701); group 2, low psychotropics-high CVDs (25.0%, n = 1054); group 3, high psychotropics-high CVDs (41.0%, n = 1723); and group 4, high psychotropics-low CVDs (17.3%, n = 729). Group 4 had a significantly higher rate of falls than the other groups for both outcomes, including relative to group 3, in which exposure to both FRID classes was high. CONCLUSIONS AND IMPLICATIONS Our findings reveal concerningly high FRID use in RAC homes and highlight a critical difference in the impact of the 2 major FRID classes on falls. Psychotropics were strongly associated with falls, whereas the studied CVD FRIDs did not elevate risk of falling.
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Affiliation(s)
- Nasir Wabe
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
| | - Guogui Huang
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Sandun M Silva
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Amy D Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Magdalena Z Raban
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Peter Gates
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Ric Day
- St Vincent's Clinical School, University of New South Wales Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jacqueline C T Close
- Neuroscience Research Australia, UNSW Sydney, Sydney, New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, UNSW Sydney, Sydney, New South Wales, Australia; School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
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Balogun-Katung A, Artis B, Alderson H, Brown E, Kaner E, Rankin J, Lingam R, McGovern R. Practitioner perspectives on the nature, causes and the impact of poor mental health and emotional wellbeing on children and young people in contact with children's social care: A qualitative study. CHILD ABUSE & NEGLECT 2024; 154:106867. [PMID: 38852432 DOI: 10.1016/j.chiabu.2024.106867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/09/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Children and young people (CYP) who are in contact with social care are at higher risk of developing mental health difficulties compared to the general population. This has been attributed to their experience of significant childhood adversity. With an increased likelihood of experiencing poorer health outcomes which can persist into adulthood, it is crucial that key factors for their positive mental health development are identified. OBJECTIVE To identify factors associated with the poor mental health of CYP in contact with social care from the perspective of practitioners working in children's social care and mental health. PARTICIPANTS AND SETTING Social care and mental health practitioners; three Local Authorities across the North-East of England. METHODS Four focus groups were conducted with 23 practitioners between April and May 2022. A semi-structured topic guide exploring the nature and associated factors of mental health was used to focus discussion. Data were thematically analysed and informed by the four levels of the socio-ecological model. RESULTS Individual level risk factors were associated with the CYP's emotional health and included what practitioners described as the 'sense of shame'. Interpersonal level risk factors were most recurrent and included parental factors within the home environment. Community level risk factors consisted of characteristics of settings and institutions that increased the risk of the CYP developing mental health and wellbeing difficulties. Societal level risk factors included broader societal factors such as poverty. Practitioners maintained that certain protective factors possessed or developed by CYP including secure attachments, prevent the development of mental health difficulties. CONCLUSIONS Our current study provides strong evidence for the interlinkage between multiple levels of risk and their interacting impact on the CYP's mental health and emotional wellbeing. It is imperative that this, and the need to strengthen protective factors, whilst reducing risks are carefully considered for the development of effective support interventions for CYP in contact with social care.
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Affiliation(s)
- A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland.
| | - B Artis
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - E Brown
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - R Lingam
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland; Population Child Health Research Group, UNSW, Australia
| | - R McGovern
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
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Muir C, Kedzior SGE, Barrett S, McGovern R, Kaner E, Wolfe I, Forman JR. Co-design workshops with families experiencing multiple and interacting adversities including parental mental health, substance use, domestic violence, and poverty: intervention principles and insights from mothers, fathers, and young people. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:67. [PMID: 38926798 PMCID: PMC11202333 DOI: 10.1186/s40900-024-00584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Clustering and co-occurring of family adversities, including mental health problems, substance use, domestic violence and abuse, as well as poverty can increase health and behavioural risks for children, which persist throughout the life course. Yet, interventions that acknowledge and account for the complex interactive nature of such risks are limited. This study aimed to develop intervention principles based on reflections from mothers, fathers, and young people who experience multiple and interacting adversities. These principles will show how family members perceive an intervention may bring about positive change and highlight key insights into design and delivery. METHODS A series of six co-design workshops with mothers, fathers, and young people who experienced multiple and interacting adversities (n = 41) were iteratively conducted across two regions in England (London and North-East) by four researchers. Workshop content and co-design activities were informed by advisory groups. Data from facilitator notes and activities were analysed thematically, resulting in a set of intervention principles. RESULTS The intervention principles highlighted that: (1) to reduce isolation and loneliness parents and young people wanted to be connected to services, resources, and peer support networks within their local community, particularly by a knowledgeable and friendly community worker; (2) to address feelings of being misunderstood, parents and young people wanted the development of specialised trauma informed training for practitioners and to have the space to build trusting, gradual, and non-stigmatising relationships with practitioners; and (3) to address the needs and strengths of individual family members, mothers, fathers, and young people wanted separate, tailored, and confidential support. CONCLUSIONS The current study has important implications for practice in supporting families that experience multiple and interacting adversities. The intervention principles from this study share common characteristics with other intervention models currently on offer in the United Kingdom, including social prescribing, but go beyond these to holistically consider the whole families' needs, environments, and circumstances. There should be particular focus on the child's as well as the mothers' and fathers' needs, independently of the family unit. Further refinement and piloting of the developing intervention are needed.
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Affiliation(s)
- Cassey Muir
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Sophie G E Kedzior
- Department of Women and Children's Health, King's College London, London, UK
| | - Simon Barrett
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ingrid Wolfe
- Department of Women and Children's Health, King's College London, London, UK
| | - Julia R Forman
- Department of Women and Children's Health, King's College London, London, UK
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11
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Jo Driscoll D, Kiely E, O'Keeffe LM, Khashan AS. Poverty trajectories and child and mother well-being outcomes in Ireland: findings from an Irish prospective cohort. J Epidemiol Community Health 2024; 78:409-416. [PMID: 38688701 PMCID: PMC11187358 DOI: 10.1136/jech-2023-221794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood. OBJECTIVE To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and mother indicators of physical health and psychopathology in Ireland. METHODS We used a nationally representative, prospective cohort (Growing Up in Ireland-Infant Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9 months, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression). RESULTS Of 11 134 participants, 4 trajectories were identified: never in poverty (43.1%), material/subjective>monetary poverty (16.1%), monetary>material poverty (25.6%) and persistent poverty (15.2%). Children in persistent poverty compared with those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (aOR) 1.70, 95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51, 95% CI 1.20, 1.91), and psychopathology (aOR 2.06, 95% CI 1.42, 2.99). The outcomes for primary parents (99.7% were mothers) were as follows: having higher odds of being overweight (aOR 1.49, 95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13, 95% CI 1.63, 2.79), and depression (aOR 3.54, 95% CI 2.54, 4.94). CONCLUSIONS Any poverty trajectory was associated with poorer psychopathology and physical well-being in late childhood for children and their mothers in Ireland.
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Affiliation(s)
- David Jo Driscoll
- School of Public Health, University College Cork, Cork, Ireland
- Specialist Neurodevelopmental ADHD Pathway (SNAP), Cork and Kerry Child and Adolescent Mental Health Services, Cork, Ireland
| | - Elizabeth Kiely
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Linda M O'Keeffe
- School of Public Health, University College Cork, Cork, Ireland
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
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12
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Jiang X, Zhang K. Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01719-w. [PMID: 38782807 DOI: 10.1007/s10578-024-01719-w] [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: 05/16/2024] [Indexed: 05/25/2024]
Abstract
This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.
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Affiliation(s)
- Xiaoliu Jiang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China
| | - Kuo Zhang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China.
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13
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Manitsa I, Gregory AM, Broome MR, Bagshaw AP, Marwaha S, Morales-Muñoz I. Shorter night-time sleep duration and later sleep timing from infancy to adolescence. J Child Psychol Psychiatry 2024. [PMID: 38708717 DOI: 10.1111/jcpp.14004] [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: 03/25/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Here, we (a) examined the trajectories of night-time sleep duration, bedtime and midpoint of night-time sleep (MPS) from infancy to adolescence, and (b) explored perinatal risk factors for persistent poor sleep health. METHODS This study used data from 12,962 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Parent or self-reported night-time sleep duration, bedtime and wake-up time were collected from questionnaires at 6, 18 and 30 months, and at 3.5, 4-5, 5-6, 6-7, 9, 11 and 15-16 years. Child's sex, birth weight, gestational age, health and temperament, together with mother's family adversity index (FAI), age at birth, prenatal socioeconomic status and postnatal anxiety and depression, were included as risk factors for persistent poor sleep health. Latent class growth analyses were applied first to detect trajectories of night-time sleep duration, bedtime and MPS, and we then applied logistic regressions for the longitudinal associations between risk factors and persistent poor sleep health domains. RESULTS We obtained four trajectories for each of the three sleep domains. In particular, we identified a trajectory characterized by persistent shorter sleep, a trajectory of persistent later bedtime and a trajectory of persistent later MPS. Two risk factors were associated with the three poor sleep health domains: higher FAI with increased risk of persistent shorter sleep (OR = 1.20, 95% CI = 1.11-1.30, p < .001), persistent later bedtime (OR = 1.28, 95% CI = 1.19-1.39, p < .001) and persistent later MPS (OR = 1.30, 95% CI = 1.22-1.38, p < .001); and higher maternal socioeconomic status with reduced risk of persistent shorter sleep (OR = 0.99, 95% CI = 0.98-1.00, p = .048), persistent later bedtime (OR = 0.98, 95% CI = 0.97-0.99, p < .001) and persistent later MPS (OR = 0.99, 95% CI = 0.98-0.99, p < .001). CONCLUSIONS We detected trajectories of persistent poor sleep health (i.e. shorter sleep duration, later bedtime and later MPS) from infancy to adolescence, and specific perinatal risk factors linked to persistent poor sleep health domains.
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Affiliation(s)
- Ifigeneia Manitsa
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham, UK
- Early Intervention Service, Birmingham Women's and Children's NHS Trust, Birmingham, UK
| | - Andrew P Bagshaw
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Specialist Mood Disorders Clinic, Birmingham and Solihull Mental Health Trust, Birmingham, UK
| | - Isabel Morales-Muñoz
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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14
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Kedzior SGE, Barrett S, Muir C, Lynch R, Kaner E, Forman JR, Wolfe I, McGovern R. "They had clothes on their back and they had food in their stomach, but they didn't have me": The contribution of parental mental health problems, substance use, and domestic violence and abuse on young people and parents. CHILD ABUSE & NEGLECT 2024; 149:106609. [PMID: 38181566 DOI: 10.1016/j.chiabu.2023.106609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/03/2023] [Accepted: 12/14/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND The parental risk factors of mental health problems, substance use, and domestic violence and abuse each individually negatively impacts children's health and developmental outcomes. Few studies have considered the lived experience and support needs of parents and children in the real-world situation where these common risks cluster. OBJECTIVE This study explores parents' and young people's lived experiences of the clustering of parental mental health problems, parental substance use, and domestic violence and abuse. METHODS Semi-structured interviews were conducted with 18 mothers, 6 fathers, and 7 young people with experiences of these parental risk factors. Transcribed interviews were analysed using reflexive thematic analysis. RESULTS Four themes were developed, 1) cumulative adversity, 2) the impact of syndemic risk, 3) families navigating risk, and 4) family support. Parents and young people described family situations of stress wherein they experienced cumulative impact of multiple parental risk factors. Parents sought to navigate stressors and parent in positive ways under challenging conditions, often impeded by their own childhood trauma and diminished confidence. Parents and young people spoke of the need for, and benefits of having, support; both as a family and as individuals, to successfully address this trio of parental risks and the related impact. CONCLUSIONS This study highlights the high level of stress families experience and the efforts they go to mitigate risk. Services and interventions need to reflect the complexity of multiple needs and consider both the whole family and individuals when providing support.
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Affiliation(s)
- Sophie G E Kedzior
- Department of Women and Children's Health, King's College London, London, United Kingdom.
| | - Simon Barrett
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Cassey Muir
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rebecca Lynch
- Sociology, Philosophy, and Anthropology, University of Exeter, United Kingdom
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Julia R Forman
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | - Ingrid Wolfe
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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15
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Moor I, Herke M, Markert J, Böhm M, Reiß F, Bilz L, Sudeck G, Winter K. Trends in health inequalities in childhood and adolescence in Germany: Results of the HBSC study 2009/10 - 2022. JOURNAL OF HEALTH MONITORING 2024; 9:79-98. [PMID: 38559681 PMCID: PMC10977468 DOI: 10.25646/11876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/27/2023] [Indexed: 04/04/2024]
Abstract
Background Many studies have identified health inequalities in childhood and adolescence. However, it is unclear how these have developed in recent years, particularly since the COVID-19 pandemic. Methods Analyses are based on the German data from the international Health Behaviour in School-aged Children (HBSC) study from 2009/10 (n = 5,005), 2013/14 (n = 5,961), 2017/18 (n = 4,347), and 2022 (n = 6,475). A total of 21,788 students aged approximately between 11 and 15 years were included. Socioeconomic status (SES) was assessed using the Family Affluence Scale (FAS). Several health indicators were analysed stratified by gender using bivariate and multivariate analysis methods. Results In 2022, there are clear socioeconomic inequalities in life satisfaction, self-rated health, fruit and vegetable consumption, and physical activity. These inequalities remained largely constant or increased between 2009/10 and 2022. Between 2017/18 and 2022, no significant changes in inequalities were found. Conclusions Health inequalities are persistent and reduce the chances of growing up healthy. There is no evidence that inequalities in the analysed outcomes have changed during the pandemic period (between 2017/18 and 2022). Rather, the changes in the health indicators seem to affect all adolescents in a similar way.
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Affiliation(s)
- Irene Moor
- Martin Luther University Halle-Wittenberg, Halle (Saale), Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology
| | - Max Herke
- Martin Luther University Halle-Wittenberg, Halle (Saale), Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology
| | - Jenny Markert
- Martin Luther University Halle-Wittenberg, Halle (Saale), Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology
| | - Marie Böhm
- Martin Luther University Halle-Wittenberg, Halle (Saale), Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology
| | - Franziska Reiß
- University Medical Centre Hamburg-Eppendorf, Centre for Psychosocial Medicine, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Child Public Health Research Section
| | - Ludwig Bilz
- Brandenburg University of Technology, Cottbus-Senftenberg, Institute of Health
| | - Gorden Sudeck
- Eberhard Karls University of Tübingen, Institute of Sports Science
- Eberhard Karls University of Tübingen, Interfaculty Research Institute for Sport and Physical Activity
| | - Kristina Winter
- Martin Luther University Halle-Wittenberg, Halle (Saale), Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology
- Nordhausen University of Applied Sciences, Institute for Social Medicine, Rehabilitation, Sciences and Health Services Research
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16
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Hickey L, Harms L, Evans J, Noakes T, Lee H, McSwan A, Bean H, Hope J, Allison L, Price S, Harris N. Review: Improving access to mental health interventions for children from birth to five years: A Scoping Review. Child Adolesc Ment Health 2024; 29:84-95. [PMID: 37137699 DOI: 10.1111/camh.12652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND In spite of infants and children aged 0-5 years experiencing mental health difficulties being estimated to be in the range of 6%-18% globally, the mental health care needs for this age group are often overlooked in the design of specialist mental health services. Although there is increasing recognition of the importance of infant mental health services and treatments for younger children, access remains a barrier. Mental health services specifically designed for children 0-5 years are vital; however, little is known about how these services ensure access for infants at risk of mental health difficulties and their families. This scoping review seeks to address this knowledge gap. METHODS A scoping review methodology framework was used to search for relevant articles published between January 2000 and July 2021, identified using five databases: MEDLINE, CINAHL, PsycINFO, SocIndex and Web of Science. The selection of studies was based on empirical research about access to infant mental health services and models of care. A total of 28 relevant articles met the eligibility criteria for inclusion in this review. RESULTS Findings can be summarised under five broad themes: (1) accessibility for at-risk populations (2) the importance of early detection of infants in need of mental health services and interventions; (3) the promotion of culturally responsive services and interventions; (4) ensuring the sustainability of IMH services and programs and (5) the integration of innovative interventions to improve existing practice models. CONCLUSIONS The findings from this scoping review highlight barriers to access and provision of infant mental health services. Future infant mental health service design, informed by research, is needed to improve access for infants and young children with mental health difficulties and their families.
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Affiliation(s)
- Lyndal Hickey
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - Louise Harms
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - Jackson Evans
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - Tahnee Noakes
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - Henrietta Lee
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - Amity McSwan
- Child and Youth Mental Health Service, Eastern Health, Box Hill, Vic., Australia
| | - Helena Bean
- Child and Youth Mental Health Service, Eastern Health, Box Hill, Vic., Australia
| | - Judith Hope
- Eastern Health Clinical School, Monash University, Box Hill, Vic., Australia
- Mental Health Program, Eastern Health, Box Hill, Vic., Australia
- Centre for Mental Health Education and Research, Delmont Private Hospital, Glen Iris, Vic., Australia
| | - Lynne Allison
- Child and Youth Mental Health Service, Eastern Health, Box Hill, Vic., Australia
- Perinatal Emotional Health Service, Eastern Health, Box Hill, Vic., Australia
| | - Sophie Price
- Child and Youth Mental Health Service, Eastern Health, Box Hill, Vic., Australia
| | - Nicole Harris
- Child and Youth Mental Health Service, Eastern Health, Box Hill, Vic., Australia
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17
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Barrett S, Muir C, Burns S, Adjei N, Forman J, Hackett S, Hirve R, Kaner E, Lynch R, Taylor-Robinson D, Wolfe I, McGovern R. Interventions to Reduce Parental Substance Use, Domestic Violence and Mental Health Problems, and Their Impacts Upon Children's Well-Being: A Systematic Review of Reviews and Evidence Mapping. TRAUMA, VIOLENCE & ABUSE 2024; 25:393-412. [PMID: 36789663 PMCID: PMC10666514 DOI: 10.1177/15248380231153867] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Children exposed to parental intimate partner violence and abuse, mental illness, and substance use experience a range of problems which may persist into adulthood. These risks often co-occur and interact with structural factors such as poverty. Despite increasing evidence, it remains unclear how best to improve outcomes for children and families experiencing these adversities and address the complex issues they face. AIMS AND METHODS Systematic review of systematic reviews. We searched international literature databases for systematic reviews, from inception to 2021, to provide an evidence overview of the range and effectiveness of interventions to support children and families where these parental risk factors had been identified. RESULTS Sixty-two systematic reviews were included. The majority (n = 59) focused on interventions designed to address single risk factors. Reviews mostly focused on parental mental health (n = 38) and included psychological interventions or parenting-training for mothers. Only two reviews assessed interventions to address all three risk factors in combination and assessed structural interventions. Evidence indicates that families affected by parental mental health problems may be best served by integrated interventions combining therapeutic interventions for parents with parent skills training. Upstream interventions such as income supplementation and welfare reform were demonstrated to reduce the impacts of family adversity. CONCLUSION Most intervention approaches focus on mitigating individual psychological harms and seek to address risk factors in isolation, which presents potentially significant gaps in intervention evidence. These interventions may not address the cumulative impacts of co-occurring risks, or social factors that may compound adversities.
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18
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Yildirim J, Alpaslan B, Karakas-Aydinbakar A, Hibiki A. The effect of environmental degradation on self-reported health: the role of renewable energy consumption. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:343-356. [PMID: 38015397 DOI: 10.1007/s11356-023-30981-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
Although there are a number of studies in the literature that have explored the effect of environmental degradation on the subjective well-being and life satisfaction, no previous study has addressed the role of renewable energy consumption in examining the effect of environmental degradation on self-reported health. To this end, we employ a conditional mixed process (CMP) model, using a unique dataset that combines both micro-level data from the 6th (2010-2014) and 7th (2017-2022) Waves of the World Values Survey (WVS) database and macro-level data from the World Bank. Our study has several important empirical findings. First, while environmental degradation deteriorates self-reported health, social capital and health expenditure have a positive impact on self-reported health. Second, the share of renewable energy consumption in total final energy consumption has a statistically significant negative impact on environmental degradation. Third, urbanization has a deteriorating effect on environmental quality and the total number of people increases environmental degradation.
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Affiliation(s)
- Julide Yildirim
- Department of Economics, TED University, Ankara, 06420, Turkey
| | - Barış Alpaslan
- Department of Economics, Social Sciences University of Ankara, Ankara, 06050, Turkey.
- Graduate School of Economics and Management, Tohoku University, Sendai, 980-8576, Japan.
| | - Aysenur Karakas-Aydinbakar
- Department of Economics, Social Sciences University of Ankara, Ankara, 06050, Turkey
- Graduate School of Economics and Management, Tohoku University, Sendai, 980-8576, Japan
| | - Akira Hibiki
- Graduate School of Economics and Management, Tohoku University, Sendai, 980-8576, Japan
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Lu Z, Ahmadiankalati M, Tan Z. Joint clustering multiple longitudinal features: A comparison of methods and software packages with practical guidance. Stat Med 2023; 42:5513-5540. [PMID: 37789706 DOI: 10.1002/sim.9917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 06/07/2023] [Accepted: 09/13/2023] [Indexed: 10/05/2023]
Abstract
Clustering longitudinal features is a common goal in medical studies to identify distinct disease developmental trajectories. Compared to clustering a single longitudinal feature, integrating multiple longitudinal features allows additional information to be incorporated into the clustering process, which may reveal co-existing longitudinal patterns and generate deeper biological insight. Despite its increasing importance and popularity, there is limited practical guidance for implementing cluster analysis approaches for multiple longitudinal features and evaluating their comparative performance in medical datasets. In this paper, we provide an overview of several commonly used approaches to clustering multiple longitudinal features, with an emphasis on application and implementation through R software. These methods can be broadly categorized into two categories, namely model-based (including frequentist and Bayesian) approaches and algorithm-based approaches. To evaluate their performance, we compare these approaches using real-life and simulated datasets. These results provide practical guidance to applied researchers who are interested in applying these approaches for clustering multiple longitudinal features. Recommendations for applied researchers and suggestions for future research in this area are also discussed.
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Affiliation(s)
- Zihang Lu
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Mathematics and Statistics, Queen's University, Kingston, Ontario, Canada
| | | | - Zhiwen Tan
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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20
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Muir C, Adams EA, Evans V, Geijer-Simpson E, Kaner E, Phillips SM, Salonen D, Smart D, Winstone L, McGovern R. A Systematic Review of Qualitative Studies Exploring Lived Experiences, Perceived Impact, and Coping Strategies of Children and Young People Whose Parents Use Substances. TRAUMA, VIOLENCE & ABUSE 2023; 24:3629-3646. [PMID: 36384375 PMCID: PMC10594843 DOI: 10.1177/15248380221134297] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Parental substance use is highly prevalent worldwide, presenting major child safeguarding and public health concerns. Qualitative research enables in-depth understanding of how young people experience parental substance use and helps inform practice and policy through illustrative cases of experiences. This review aimed to synthesize published qualitative evidence exploring the lived experiences, perceived impact, and coping strategies of children and young people whose parents use substances. International literature databases including Medline, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, International Bibliography of the Social Sciences, Social Science Database, Sociology Collection, and Scopus were searched from inception to 2022, alongside grey literature searching and relevant websites. Qualitative accounts were included, provided by participants aged below 25 years. No language, date, or geographical limits were applied. A thematic synthesis of 35 studies, across 49 papers, covering over 700 children and young people's voices, identified five overarching themes. These themes included, (a) living with the unpredictable: insecurity within the family; (b) social and emotional impact of parental substance use; (c) controlling the uncontrollable: creating safety within the family; (d) coping with and resisting the emotional and social impacts; and (e) formal and informal support. The findings emphasize that children and young people who experience parental substance use are trying to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and often stigmatizing experiences, usually without formal support in place. Further research is needed to coproduce child-centered interventions that promote children and young people's social and emotional resilience.
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Affiliation(s)
- Cassey Muir
- Newcastle University, Newcastle upon Tyne, UK
| | | | | | | | | | | | - Domna Salonen
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
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21
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Berge V, Thyen U. [Effects of High Birth Weight on the Development of Preschoolers]. Z Geburtshilfe Neonatol 2023; 227:448-465. [PMID: 37758195 DOI: 10.1055/a-2160-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
BACKGROUND A high birth weight above 4,000 g may lead to risks in the development of affected children. The association is less studied than the effects of very low birth weight and is the subject of this study. METHODS The retrospective study design used data from school entry surveys in Schleswig-Holstein (Germany) collected in 2014-2017 and included 88,858 children aged 5-6 years. End points examined were language, motor skills, cognition, and behavior; use of support measures; and recommendation for special educational needs. Logistic regression models were used to estimate the association between birth weight and the outcome measures, adjusting for sociodemographic factors. RESULTS After accounting for sociodemographic factors, high birth weight is not associated with impaired child development, whereas low birth weight emerges as a significant predictor. Across all birth weights, sociodemographic factors explain most of the variance in multivariate models of the influence of birth weight on child development. CONCLUSIONS Very high birth weight does not justify a general recommendation for support measures. Therefore, individual developmental trajectories should be monitored. Growing up in disadvantaged circumstances may represent a significant risk and should be a reason for early intervention.
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Affiliation(s)
- Valerie Berge
- UKSH Campus Lübeck, Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
- Institut für Humangenetik, Universität zu Lübeck, Lübeck, Germany
| | - Ute Thyen
- UKSH Campus Lübeck, Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
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22
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Liu Y, Patalay P, Stafford J, Schott JM, Richards M. Lifecourse investigation of the cumulative impact of adversity on cognitive function in old age and the mediating role of mental health: longitudinal birth cohort study. BMJ Open 2023; 13:e074105. [PMID: 37940163 PMCID: PMC10632868 DOI: 10.1136/bmjopen-2023-074105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE To investigate the accumulation of adversities (duration of exposure to any, economic, psychosocial) across the lifecourse (birth to 63 years) on cognitive function in older age, and the mediating role of mental health. DESIGN National birth cohort study. SETTING Great Britain. PARTICIPANTS 5362 singleton births within marriage in England, Wales and Scotland born within 1 week of March 1946, of which 2131 completed at least 1 cognitive assessment. MAIN OUTCOME MEASURES Cognitive assessments included the Addenbrooke's Cognitive Examination-III, as a measure of cognitive state, processing speed (timed-letter search task), and verbal memory (word learning task) at 69 years. Scores were standardised to the analytical sample. Mental health at 60-64 years was assessed using the 28-item General Health Questionnaire, with scores standardised to the analytical sample. RESULTS After adjusting for sex, increased duration of exposure to any adversity was associated with decreased performance on cognitive state (β=-0.39; 95% CI -0.59 to -0.20) and verbal memory (β=-0.45; 95% CI -0.63 to -0.27) at 69 years, although these effects were attenuated after adjusting for further covariates (childhood cognition and emotional problems, educational attainment). Analyses by type of adversity revealed stronger associations from economic adversity to verbal memory (β=-0.54; 95% CI -0.70 to -0.39), with a small effect remaining even after adjusting for all covariates (β=-0.18; 95% CI -0.32 to -0.03), and weaker associations from psychosocial adversity. Causal mediation analyses found that mental health mediated all associations between duration of exposure to adversity (any, economic, psychosocial) and cognitive function, with around 15% of the total effect of economic adversity on verbal memory attributable to mental health. CONCLUSIONS Improving mental health among older adults has the potential to reduce cognitive impairments, as well as mitigate against some of the effect of lifecourse accumulation of adversity on cognitive performance in older age.
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Affiliation(s)
- Yiwen Liu
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Jean Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
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Elsenburg LK, Rieckmann A, Bengtsson J, Lange T, Baker JL, Sørensen TIA, Rod NH. Early childhood adversity and body mass index in childhood and adolescence: linking registry data on adversities with school health records of 53,401 children from Copenhagen. Int J Obes (Lond) 2023; 47:1057-1064. [PMID: 37626127 PMCID: PMC10599995 DOI: 10.1038/s41366-023-01355-9] [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: 11/14/2022] [Revised: 06/26/2023] [Accepted: 07/17/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE We examined whether childhood adversity experienced in early childhood (0-5 years) is related to body mass index (BMI) in childhood (6-7 years) and adolescence (12-15 years). METHODS This study combined data from the nationwide register-based DANLIFE study on childhood adversities with data on height and weight of school children in Copenhagen. Data were available for 53,401 children born in Denmark between 1980 and 1996. Children were divided into groups of early childhood adversity by applying group-based multi-trajectory modelling using their yearly count of childhood adversity in three dimensions (i.e., material deprivation, loss or threat of loss, and family dynamics) from 0-5 years. Direct and total associations between the early childhood adversity groups and BMI z-scores in childhood and adolescence were estimated using sex-stratified structural equation models. RESULTS Five exclusive and exhaustive groups of early childhood adversity were identified, which were characterized by low adversity (51%), moderate material deprivation (30%), high material deprivation (14%), loss or threat of loss (3%) and high adversity (2%). Boys and girls exposed to moderate or high material deprivation and loss or threat of loss had a slightly higher BMI z-score, especially in adolescence, compared with those in the low adversity group, with the strongest association found for girls in the loss or threat of loss group (b (95% CI) = 0.18 (0.10, 0.26)). Additionally, boys in the high adversity group had a slightly lower BMI z-score in childhood than boys in the low adversity group (b (95% CI) = -0.12 (-0.22, -0.02)). CONCLUSIONS Whereas associations with BMI were found for children and adolescents exposed to material deprivation, loss or threat of loss, and high adversity, the effect sizes were generally small. Contrary to prevailing hypotheses, weight changes in childhood is probably not a major explanatory mechanism linking early childhood adversity with later-life morbidity.
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Affiliation(s)
- Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Andreas Rieckmann
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Bengtsson
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jennifer L Baker
- Section of Epidemiology, Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Section on Genomic Physiology and Translation, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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24
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Pierce M, Bai Y, Nevriana A, Dalman C, Hope HF, Kosidou K, Ohlis A, Wicks S, Abel KM. Prevention of Childhood Adversities and Children's Common Mental Disorders and School Grades. JAMA Netw Open 2023; 6:e2336408. [PMID: 37796502 PMCID: PMC10556962 DOI: 10.1001/jamanetworkopen.2023.36408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023] Open
Abstract
Importance Adversity during childhood can limit children's chances of achieving their optimal developmental and psychological outcomes. Well-designed observational studies might help identify adversities that are most implicated in this, thereby helping to identify potential targets for developing interventions. Objective To compare the association between preventing childhood poverty, parental mental illness and parental separation, and the population rate of offspring common mental disorders (ages 16-21 years) or average school grades (age 16 years). Design, Setting, and Participants A population-based, longitudinal cohort study using Swedish registries was conducted. A total of 163 529 children born in Sweden between January 1, 1996, and December 31, 1997, were followed up until their 21st birthday. They were linked to registries using Sweden's national personal identification number. Children were linked to birth parents, hospital records, and school data. Parents were linked to registries containing health, income, sociodemographic, and obstetric data. Analyses were conducted between January 10, 2021, and August 26, 2022. Exposures Childhood adversities of relative poverty (household disposable income <50% of the median), parental inpatient admission for a mental illness, or parental separation. Adversities were categorized into developmental periods: ages 0 to 3, 4 to 7, 8 to 11, and 12 to 16 years. Main Outcomes and Measures The main outcomes were children's hospital records with a diagnosis of anxiety or depression between ages 16 and 21 years and school grades at the end of compulsory education (age 16 years). The parametric g-formula modeled population changes in outcomes associated with the counterfactual, hypothetical preventing adversity exposures, accounting for fixed and time-varying confounders. Adjustments were made for parental demographic characteristics, obstetric variables, and socioeconomic data at birth. Results A total of 163 529 children were included in the cohort (51.2% boys, 51.4% born in 1996). Preventing all adversities was associated with an estimated change in the prevalence of offspring common mental disorders from 10.2% to 7.6% and an improvement in school grades with an SD of 0.149 (95% CI, 0.147-0.149). Preventing parental separation provided for the greatest improvement, with an estimated 2.34% (95% CI, 2.23%-2.42%) fewer children with a common mental disorder and an improvement in school grades by 0.127 SDs (0.125-0.129). Greater improvements were shown by hypothetically targeting adolescents (age 12-16 years) and those whose parents had a mental illness when the child was born. Conclusions and Relevance The results of this cohort modeling study suggest that preventing childhood adversity could provide notable improvements in the rates of common mental disorders and school grades. Many children might achieve better life outcomes if resources are properly allocated to the right adversities (parental separation), the right groups (children with parental mental illness), and at the right time (adolescence).
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Affiliation(s)
- Matthias Pierce
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Yushi Bai
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Alicia Nevriana
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Holly F. Hope
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Anna Ohlis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Susanne Wicks
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Kathryn M. Abel
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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25
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Olsavsky AK, Chirico I, Ali D, Christensen H, Boggs B, Svete L, Ketcham K, Hutchison K, Zeanah C, Tottenham N, Riggs P, Epperson CN. Maternal Childhood Maltreatment, Internal Working Models, and Perinatal Substance Use: Is There a Role for Hyperkatifeia? A Systematic Review. Subst Abuse 2023; 17:11782218231186371. [PMID: 37476500 PMCID: PMC10354827 DOI: 10.1177/11782218231186371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023]
Abstract
The parent-infant relationship is critical for socioemotional development and is adversely impacted by perinatal substance use. This systematic review posits that the mechanisms underlying these risks to mother-infant relationships center on 3 primary processes: (1) mothers' childhood maltreatment experiences; (2) attachment styles and consequent internal working models of interpersonal relationships; and (3) perinatal substance use. Further, the review considers the role of hyperkatifeia, or hypersensitivity to negative affect which occurs when people with substance use disorders are not using substances, and which drives the negative reinforcement in addiction. The authors performed a systematic review of articles (published 2000-2022) related to these constructs and their impact on mother-infant relationships and offspring outcomes, including original clinical research articles addressing relationships between these constructs, and excluding case studies, reviews, non-human animal studies, intervention studies, studies with fewer than 30% female-sex participants, clinical guidelines, studies limited to obstetric outcomes, mechanistic/biological studies, and studies with methodological issues precluding interpretation. Overall 1844 articles were screened, 377 were selected for full text review, and data were extracted from 157 articles. Results revealed strong relationships between mothers' childhood maltreatment experiences, less optimal internal working models, and increased risk for perinatal substance use, and importantly, all of these predictors interacted with hyperkatifeia and exerted a marked impact on mother-infant relationships with less data available on offspring outcomes. These data strongly support the need for future studies addressing the additive impact of maternal childhood maltreatment experiences, suboptimal internal working models, and perinatal substance use, with hyperkatifeia as a potential moderator, and their interacting effects on mother-infant socioemotional outcomes.
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Affiliation(s)
- Aviva K. Olsavsky
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
| | - Isabella Chirico
- SUNY Downstate Health Sciences University College of Medicine, Brooklyn, NY, USA
| | - Diab Ali
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Hannah Christensen
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
| | - Brianna Boggs
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
| | - Lillian Svete
- University of Colorado School of Medicine, Aurora, CO, USA
- University of Kentucky College of Medicine, Louisville, KY, USA
| | | | - Kent Hutchison
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Charles Zeanah
- Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Paula Riggs
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
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26
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Mansukoski L, Lockyer B, Creaser A, Sheringham J, Sheard L, Garnett P, Yang T, Cookson R, Albert A, Islam S, Shore R, Khan A, Twite S, Dawson T, Iqbal H, Skarda I, Villadsen A, Asaria M, West J, Sheldon T, Wright J, Bryant M. Meta-evaluation of a whole systems programme, ActEarly: A study protocol. PLoS One 2023; 18:e0280696. [PMID: 37262082 PMCID: PMC10234514 DOI: 10.1371/journal.pone.0280696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/19/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Living in an area with high levels of child poverty predisposes children to poorer mental and physical health. ActEarly is a 5-year research programme that comprises a large number of interventions (>20) with citizen science and co-production embedded. It aims to improve the health and well-being of children and families living in two areas of the UK with high levels of deprivation; Bradford in West Yorkshire, and the London Borough of Tower Hamlets. This protocol outlines the meta-evaluation (an evaluation of evaluations) of the ActEarly programme from a systems perspective, where individual interventions are viewed as events in the wider policy system across the two geographical areas. It includes investigating the programme's impact on early life health and well-being outcomes, interdisciplinary prevention research collaboration and capacity building, and local and national decision making. METHODS The ActEarly meta-evaluation will follow and adapt the five iterative stages of the 'Evaluation of Programmes in Complex Adaptive Systems' (ENCOMPASS) framework for evaluation of public health programmes in complex adaptive systems. Theory-based and mixed-methods approaches will be used to investigate the fidelity of the ActEarly research programme, and whether, why and how ActEarly contributes to changes in the policy system, and whether alternative explanations can be ruled out. Ripple effects and systems mapping will be used to explore the relationships between interventions and their outcomes, and the degree to which the ActEarly programme encouraged interdisciplinary and prevention research collaboration as intended. A computer simulation model ("LifeSim") will also be used to evaluate the scale of the potential long-term benefits of cross-sectoral action to tackle the financial, educational and health disadvantages faced by children in Bradford and Tower Hamlets. Together, these approaches will be used to evaluate ActEarly's dynamic programme outputs at different system levels and measure the programme's system changes on early life health and well-being. DISCUSSION This meta-evaluation protocol presents our plans for using and adapting the ENCOMPASS framework to evaluate the system-wide impact of the early life health and well-being programme, ActEarly. Due to the collaborative and non-linear nature of the work, we reserve the option to change and query some of our evaluation choices based on the feedback we receive from stakeholders to ensure that our evaluation remains relevant and fit for purpose.
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Affiliation(s)
- Liina Mansukoski
- Department of Health Sciences, University of York, York, United Kingdom
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Bridget Lockyer
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Amy Creaser
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Jessica Sheringham
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Laura Sheard
- Department of Health Sciences, University of York, York, United Kingdom
| | - Philip Garnett
- The School for Business and Society, University of York, York, United Kingdom
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Richard Cookson
- Centre for Health Economics, University of York, York, United Kingdom
| | | | - Shahid Islam
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Robert Shore
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Aiysha Khan
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Simon Twite
- Public Health Division, London Borough of Tower Hamlets, London, United Kingdom
| | - Tania Dawson
- The School for Business and Society, University of York, York, United Kingdom
| | - Halima Iqbal
- School of Nursing and Healthcare Leadership, University of Bradford, Bradford, United Kingdom
| | - Ieva Skarda
- Centre for Health Economics, University of York, York, United Kingdom
| | - Aase Villadsen
- Centre for Longitudinal Studies, University College London, London, United Kingdom
| | - Miqdad Asaria
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Jane West
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Trevor Sheldon
- Centre for Public Health & Policy, Queen Mary University of London, London, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Maria Bryant
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
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27
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McGovern R, Bogowicz P, Meader N, Kaner E, Alderson H, Craig D, Geijer-Simpson E, Jackson K, Muir C, Salonen D, Smart D, Newham JJ. The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: a systematic review and meta-analysis. Addiction 2023; 118:804-818. [PMID: 36607011 DOI: 10.1111/add.16127] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/06/2022] [Indexed: 01/07/2023]
Abstract
AIMS There is substantial evidence showing an association between parental substance use and child substance use and/or mental health problems. Most research focuses upon maternal substance use, with the influence of paternal substance use often being overlooked. We aimed to investigate the differential effects of maternal and paternal substance use upon children aged 0-18 years. METHODS We used systematic review methods to identify observational studies examining the association between either maternal or paternal substance use and child substance use and/or mental health problems. The odds ratio (OR) effect measure was used, for ease of computation. We used a random-effects model with the inverse variance method to meta-analyse the findings from eligible studies. RESULTS We included 17 unique studies with a total of 47 374 child participants. Maternal and paternal substance use were both associated with increased odds of child any drug use [OR = 2.09; 95% confidence interval (CI) = 1.53, 2.86; n = 12 349 participants; three studies and OR = 2.86; 95% CI = 1.25, 6.54; n = 5692 participants; three studies, respectively], child alcohol problem use (OR = 2.16; 95% CI = 1.73, 2.71; n = 7339 participants; four studies and OR = 1.70; 95% CI = 1.36, 2.12; n = 14 219 participants; six studies), child externalizing problems (OR = 1.81; 95% CI = 1.01, 3.22; n = 1748 participants; three studies and OR = 1.60; 95% CI = 1.18, 2.17; n = 2508 participants; six studies) and child internalizing problems (OR = 1.60; 95% CI = 1.25, 2.06; n = 1748 participants; three studies and OR = 1.42; 95% CI = 1.12, 1.81; n = 2248 participants; five studies). Child any alcohol use was associated with maternal substance use only (OR = 2.26; 95% CI = 1.08, 4.70; n = 28 691 participants; five studies). CONCLUSIONS Both maternal and paternal substance use are associated with child substance use and mental health problems.
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Affiliation(s)
- Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Paul Bogowicz
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nick Meader
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Emma Geijer-Simpson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine Jackson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Cassey Muir
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Domna Salonen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Deborah Smart
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - James J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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28
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Allen K, Melendez-Torres GJ, Ford T, Bonell C, Finning K, Fredlund M, Gainsbury A, Berry V. Family focused interventions that address parental domestic violence and abuse, mental ill-health, and substance misuse in combination: A systematic review. PLoS One 2022; 17:e0270894. [PMID: 35905105 PMCID: PMC9337671 DOI: 10.1371/journal.pone.0270894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/18/2022] [Indexed: 11/19/2022] Open
Abstract
Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) are three public health issues that tend to cluster within families, risking negative impacts for both parents and children. Despite this, service provision for these issues has been historically siloed, increasing the barriers families face to accessing support. Our review aimed to identify family focused interventions that have combined impacts on parental DVA, MH, and/or SU. We searched 10 databases (MEDLINE, PsycINFO, Embase, CINAHL, Education Research Information Centre, Sociological Abstracts, Applied Social Sciences Index & Abstracts, ProQuest Dissertations and Theses Global, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials) from inception to July 2021 for randomised controlled trials examining the effectiveness of family focused, psychosocial, preventive interventions targeting parents/carers at risk of, or experiencing, DVA, MH, and/or SU. Studies were included if they measured impacts on two or more of these issues. The Cochrane Risk of Bias Tool 2 was used to quality appraise studies, which were synthesised narratively, grouped in relation to the combination of DVA, MH, and/or SU outcomes measured. Harvest plots were used to illustrate the findings. Thirty-seven unique studies were identified for inclusion. Of these, none had a combined positive impact on all three outcomes and only one study demonstrated a combined positive impact on two outcomes. We also found studies that had combined adverse, mixed, or singular impacts. Most studies were based in the U.S., targeted mothers, and were rated as 'some concerns' or 'high risk' of bias. The results highlight the distinct lack of evidence for, and no 'best bet', family focused interventions targeting these often-clustered risks. This may, in part, be due to the ways interventions are currently conceptualised or designed to influence the relationships between DVA, MH, and/or SU. Trial registration: PROSPERO registration: CRD42020210350.
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Affiliation(s)
- Kate Allen
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katie Finning
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Mary Fredlund
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | | | - Vashti Berry
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
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29
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Black M, Taylor-Robinson D, Lee AC, Morling JR. 'Levelling up' in the UK must involve a reduction in inequalities in children's life chances. PUBLIC HEALTH IN PRACTICE 2022; 3:100246. [PMID: 36101766 PMCID: PMC9461528 DOI: 10.1016/j.puhip.2022.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Michelle Black
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | | | - Andrew Ck Lee
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
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