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Klamert L, Craike M, Bedi G, Kidd S, Pascoe MC, Parker AG. Underreporting of implementation strategies and barriers in physical activity interventions for young people at risk of problematic substance use: a brief report. Implement Sci Commun 2024; 5:45. [PMID: 38649968 PMCID: PMC11036629 DOI: 10.1186/s43058-024-00578-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Several studies have assessed whether physical activity interventions can reduce substance use in young people at risk of problematic substance use. This report identifies and describes the reporting of implementation characteristics within published studies of physical activity interventions for young people at risk of problematic substance use and provides recommendations for future reporting. METHODS Reported implementation strategies (including intervention manualization), barriers, implementation fidelity, and personnel acceptance were extracted from studies of physical activity interventions for young people aged 12-25 years at risk of problematic substance use that were included in a previous systematic review of intervention efficacy. RESULTS Implementation strategies were reported in less than half of the included studies (42.9%), implementation barriers in only 10.7% of studies, intervention fidelity in 21.4%, and personnel acceptance in a single study (3.6%). CONCLUSIONS Results indicate insufficient reporting of implementation strategies, barriers, fidelity, and personnel acceptance. Consideration of implementation characteristics is essential for implementing physical activity interventions in practice. Inadequate or limited reporting of these characteristics may contribute to delayed uptake and adoption of evidence-based interventions in clinical practice. Recommendations to improve the reporting of implementation information include integrating standards for reporting implementation characteristics into existing reporting guidelines, developing an international taxonomy of implementation strategies, and upskilling intervention researchers in the fundamentals of implementation science.
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Affiliation(s)
- Lisa Klamert
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia.
- , Orygen, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia.
| | - Melinda Craike
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray, VIC, 3011, Australia
| | - Gillinder Bedi
- , Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Susan Kidd
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
- Acute Care Service, Tweed Byron Mental Health, Northern NSW Health District, Lismore, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
- , Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia
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Klamert L, Craike M, Bedi G, Kidd S, Pascoe MC, Parker AG. Behaviour change techniques in physical activity-focused interventions for young people at risk of problematic substance use: A systematic review and meta-analysis. Early Interv Psychiatry 2023; 17:1139-1153. [PMID: 37749782 DOI: 10.1111/eip.13467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/06/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
AIM This systematic review investigates behaviour change techniques in interventions promoting physical activity for young people aged 12-25 years at heightened risk of problematic substance use, and the effect of these techniques on physical activity participation and substance use outcomes. METHODS Four databases (PsycINFO, CINAHL, SPORTDiscus and Medline) were searched between November 2020 and November 2022 for randomized and non-randomized controlled studies according to inclusion criteria. Meta-analyses were calculated using weighted, standardized averages of effect sizes (Hedges' g). RESULTS Twenty-eight studies were included, 14 studies in the meta-analysis (intervention n = 1328; control n = 845). Reported BCTs included behavioural instructions, social comparison and goal setting. There was a significant effect of behaviour change techniques on combined substance use outcomes, such as cravings and consumption, for interventions reporting multiple behaviour change techniques (g = -0.33, p < .001, 95% CI [-0.50,-0.16]) or one single behaviour change technique (g = -1.84, p < .001, 95% CI [-2.89,-0.8]). Limitations include unexplained variance and limited reporting of relevant behaviour change technique data in the included studies. CONCLUSION The results indicate that using behaviour change techniques in interventions that promote physical activity for young people has an effect on substance use. Further research needs to be completed comparing the impact of the number and type of behaviour change technique, and improved reporting of intervention content is required.
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Affiliation(s)
- Lisa Klamert
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melinda Craike
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray, Victoria, Australia
| | - Gillinder Bedi
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Susan Kidd
- Acute Care Service, Tweed Byron Mental Health, Northern NSW Health District, Tweed Heads, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
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Zeinomar N, Grant-Alfieri A, Burke KR, de Hoz M, Tehranifar P, Walker DAH, Morton T, Shepard P, Herbstman JB, Miller RL, Perera F, Terry MB. Cancer Risk Reduction Through Education of Adolescents: Development of a Tailored Cancer Risk-Reduction Educational Tool. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1220-1227. [PMID: 33523407 DOI: 10.1007/s13187-020-01943-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
Growing evidence links adolescent exposures to cancer risk later in life, particularly for common cancers like breast. The adolescent time period is also important for cancer risk reduction as many individual lifestyle behaviors are initiated including smoking and alcohol use. We developed a cancer risk-reduction educational tool tailored for adolescents that focused on five modifiable cancer risk factors. To contextualize risk factors in adolescents' social and physical environments, the intervention also focused on structural barriers to individual- and community-level change, with an emphasis on environmental justice or the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. The educational tool consisted of a 50-min module that included an introduction to cancer biology including genetic susceptibility and environmental interactions, cancer burden in the local community, and risk reduction strategies. The module also included an interactive activity in which adolescent students identify cancer risk factors and brainstorm strategies for risk reduction at both the individual and community level. We administered the module to 12 classes of over 280 high school and college students in New York City. Cancer risk reduction strategies identified by the students included family- or peer-level strategies such as team physical activity and community-level action including improving parks and taxing sugary foods. We developed a novel and interactive cancer risk-reduction education tool focused on multiple cancers that can be adopted by other communities and educational institutions.
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Affiliation(s)
- Nur Zeinomar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Room 1611, New York, NY, 10032, USA
| | - Amelia Grant-Alfieri
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Kimberly R Burke
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Room 1611, New York, NY, 10032, USA
| | | | | | | | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rachel L Miller
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Frederica Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Room 1611, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
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Grant-Alfieri A, Burke K, Zeinomar N, Delgado ML, Terry MB. Cancer Education Interventions in Adolescents: A Systematic Review of Scope and Content. HEALTH EDUCATION & BEHAVIOR 2022; 49:993-1003. [PMID: 35898117 DOI: 10.1177/10901981221109142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Given the long induction time of many cancers and the fact that modifiable risk factors (e.g., cigarette smoking) including preventive factors (e.g., human papillomavirus [HPV] vaccination, healthy dietary and physical activity patterns) are influenced in adolescence, educating adolescents about cancer causation and risk reduction may have a large impact on reducing the cancer burden. We conducted a systematic review of literature evaluating the impact of cancer education interventions on adolescent knowledge of cancer risk reduction. We searched for articles published from 2000 to 2019 and identified 33 studies meeting our criteria. Given the methodological heterogeneity across studies, we briefly assessed effectiveness but focused on examining the design of the intervention and study. The majority of studies took place outside of the United States (67%). Most studies solely addressed skin or cervical cancer (67%) with only 18% (n = 6) discussing multiple cancers. The majority of interventions were a single-session (55%), did not involve a control or comparison group (67%), and were evaluated using a pre-test and a single post-test (61%); some studies administered multiple post-tests. Few studies (12%) investigated adolescents' knowledge of lifestyle and environmental risk factors at both the individual and community level. Most studies (94%) reported improvement in knowledge following an intervention. Our review revealed wide methodological variation and a deficit in research evaluating interventions that address multiple cancer types and risk factors. Future research should robustly test whether comprehensive cancer education for adolescents can reduce the cancer burden, particularly in communities with major cancer health disparities.
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Affiliation(s)
| | - Kimberly Burke
- Columbia University Mailman School of Public Health, New York, NY, USA.,Columbia University Irving Medical Center, New York, NY, USA
| | - Nur Zeinomar
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Mary Beth Terry
- Columbia University Mailman School of Public Health, New York, NY, USA.,Columbia University Irving Medical Center, New York, NY, USA
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Luo M, Allman-Farinelli M. Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020. Nutrients 2021; 13:nu13114161. [PMID: 34836417 PMCID: PMC8623843 DOI: 10.3390/nu13114161] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.
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Affiliation(s)
- Man Luo
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310020, China
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Correspondence: ; Tel.: +61-2-90367045
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Smith C, Goss HR, Issartel J, Belton S. Health Literacy in Schools? A Systematic Review of Health-Related Interventions Aimed at Disadvantaged Adolescents. CHILDREN-BASEL 2021; 8:children8030176. [PMID: 33668861 PMCID: PMC7996245 DOI: 10.3390/children8030176] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 02/08/2023]
Abstract
Socioeconomically disadvantaged populations are at greater risk of adopting unhealthy behaviours and developing chronic diseases. Adolescence has been identified as a crucial life stage to develop lifelong healthy behaviours, with schools often suggested as the ideal environment to foster healthy habits. Health literacy (HL) provides a possible solution to promote such healthy behaviours. The aim of this study was to review school-based HL-related interventions targeting socioeconomically disadvantaged adolescents and to identify effective intervention strategies for this population. Searches were performed in six databases. Inclusion criteria included age: 12–16; the implementation of a school-based intervention related to HL aimed at socioeconomically disadvantaged populations; an intervention focused on: physical activity (PA), diet, mental health, substance abuse or sleep. Forty-one articles were included, with the majority focusing on PA and diet (n = 13), PA (n = 9) or mental health (n = 7). Few interventions focused solely on substance abuse (n = 2) or sleep (n = 1), and none targeted or assessed HL as an outcome measure. There was huge heterogeneity in study design, outcomes measures and effectiveness reported. Effective intervention strategies were identified that can be used to guide future interventions, including practical learning activities, peer support and approaches targeting the school environment, the parents or that link the intervention to the community.
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O'Connor E, Thomas R, Senger CA, Perdue L, Robalino S, Patnode C. Interventions to Prevent Illicit and Nonmedical Drug Use in Children, Adolescents, and Young Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2020; 323:2067-2079. [PMID: 32453373 DOI: 10.1001/jama.2020.1432] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
IMPORTANCE Illicit and nonmedical (use in ways other than instructed) drug use is common in adolescents and young adults and increases the risk of harmful outcomes such as injuries, violence, and poorer academic performance. OBJECTIVE To review the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMED, PsycINFO, and the Cochrane Central Register of Controlled Trials (January 1, 2013, to January 31, 2019 [children and adolescents]; January 1, 1992, to January 31, 2019 [young adults <25 years]); surveillance through March 20, 2020. STUDY SELECTION Clinical trials of behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among young people. DATA EXTRACTION AND SYNTHESIS Critical appraisal was completed independently by 2 investigators. Data were extracted by 1 reviewer and checked by a second. Random-effects meta-analysis was used to estimate the effect sizes associated with the interventions. MAIN OUTCOMES AND MEASURES Number of times illicit drugs were used; any illicit drug or any cannabis use. RESULTS Twenty-nine trials (N = 18 353) met inclusion criteria. Health, social, or legal outcomes such as mental health symptoms, family functioning, consequences of drug use, and arrests were reported in 19 trials and most showed no group differences. The effects on illicit drug use in 26 trials among nonpregnant youth (n = 17 811) were highly variable; the pooled result did not show a clinically important or statistically significant association with illicit drug use (standardized mean difference, -0.08 [95% CI, -0.16 to 0.001]; 24 effects [from 23 studies]; n = 12 801; I2 = 57.0%). The percentage of participants using illicit drugs ranged from 2.3% to 38.6% in the control groups and 2.4% to 33.7% in the intervention groups at 3 to 32 months' follow-up. The median absolute risk difference between groups was -2.8%, favoring the intervention group (range, -11.5% to 14.8%). The remaining 3 trials provided a perinatal home-visiting intervention to pregnant Native American youth. One trial (n=322) found a reduction in illicit drug use at 38 months (eg, cannabis use in the previous month, 10.7% in the intervention group and 15.6% in the control group) but not at earlier follow-up assessments. Across all 29 trials, only 1 trial reported on harms and found no statistically significant group differences. CONCLUSIONS AND RELEVANCE The evidence for behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Health, social, and legal outcomes were sparsely reported, and few showed improvements.
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Affiliation(s)
- Elizabeth O'Connor
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Rachel Thomas
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Caitlyn A Senger
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Leslie Perdue
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Shannon Robalino
- Center for Evidence-based Policy, Oregon Health & Science University, Portland
| | - Carrie Patnode
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, Donahue K, Doubeni CA, Epling JW, Kubik M, Ogedegbe G, Pbert L, Silverstein M, Simon MA, Tseng CW, Wong JB. Primary Care-Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults: US Preventive Services Task Force Recommendation Statement. JAMA 2020; 323:2060-2066. [PMID: 32453374 DOI: 10.1001/jama.2020.6774] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE In 2017, an estimated 7.9% of persons aged 12 to 17 years reported illicit drug use in the past month, and an estimated 50% of adolescents in the US had used an illicit drug by the time they graduated from high school. Young adults aged 18 to 25 years have a higher rate of current illicit drug use, with an estimated 23.2% currently using illicit drugs. Illicit drug use is associated with many negative health, social, and economic consequences and is a significant contributor to 3 of the leading causes of death among young persons (aged 10-24 years): unintentional injuries including motor vehicle crashes, suicide, and homicide. OBJECTIVE To update its 2014 recommendation, the USPSTF commissioned a review of the evidence on the potential benefits and harms of interventions to prevent illicit drug use in children, adolescents, and young adults. POPULATION This recommendation applies to children (11 years and younger), adolescents (aged 12-17 years), and young adults (aged 18-25 years), including pregnant persons. EVIDENCE ASSESSMENT Because of limited and inadequate evidence, the USPSTF concludes that the benefits and harms of primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults are uncertain and that the evidence is insufficient to assess the balance of benefits and harms. More research is needed. RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care-based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs, in children, adolescents, and young adults. (I statement).
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Affiliation(s)
| | - Alex H Krist
- Fairfax Family Practice Residency, Fairfax, Virginia
- Virginia Commonwealth University, Richmond
| | - Karina W Davidson
- Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York
| | | | | | | | | | | | | | | | | | | | - Lori Pbert
- University of Massachusetts Medical School, Worcester
| | | | | | - Chien-Wen Tseng
- University of Hawaii, Honolulu
- Pacific Health Research and Education Institute, Honolulu, Hawaii
| | - John B Wong
- Tufts University School of Medicine, Boston, Massachusetts
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Zullig KJ, Valois RF, Hobbs GR, Kerr JC, Romer D, Carey MP, Brown LK, DiClemente RJ, Vanable PA. Can a Multilevel STI/HIV Prevention Strategy for High Risk African American Adolescents Improve Life Satisfaction? JOURNAL OF HAPPINESS STUDIES 2020; 21:417-436. [PMID: 33828410 PMCID: PMC8023228 DOI: 10.1007/s10902-019-00084-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, impacts from interventions on life satisfaction are relatively unexplored. This study examined data (n = 1658) from a randomized, multi-site, multi-level STI/HIV prevention intervention trial (Project iMPAACS) to determine whether increased protective and reduced sexual risk-taking behaviors associated with STI/HIV would also improve self-reported life satisfaction. Taking into account the nested study design and controlling for confounders, a mixed model ANOVA was performed where Total mean life satisfaction scores were analyzed at baseline and 3, 6, 12, and 18 months post-recruitment. Significance levels of 0.05 were used to determine significance and η 2 was used to assess effect size. We hypothesized that as intervention participants engaged in the intentional activity associated with increasing protective behaviors and reducing sexual risk-taking behaviors associated with STI/HIV, life satisfaction reports would also improve over the course of the intervention. A significant main effect for sex was detected (F = 5.19, p = .02, η 2 = .03), along with three interactions: between experimental condition and media intervention (F = 7.96, p = .005, η 2= .04); experimental condition, sex, and media intervention (F = 6.51, p = .01, η 2 = .04); and experimental condition, sex, assessment point, and media intervention (F = 3.23, p = .01, η 2 = .02). With the exception of the control condition, female life satisfaction reports improved from baseline assessments to 18-months post-recruitment, whereas male reports decreased. Project iMPPACS was not designed with the intent on improving participants' life satisfaction. However, study results suggest incorporating strategies to address subjective well-being into future adolescent STI/HIV risk-reduction interventions is beneficial for females and additional research is necessary for males.
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Affiliation(s)
- Keith J. Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 9190-26506, USA
| | - Robert F. Valois
- Department of Health Promotion, Education and Behavior, Department of Family and Preventive Medicine, Schools of Public Health and Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - Gerald R. Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV 26506, USA
| | - Jelani C. Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40202, USA
| | - Daniel Romer
- Public Policy Center, Annenberg School for Communication, Adolescent Communication Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael P. Carey
- The Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University, Providence, RI, USA
| | - Larry K. Brown
- The Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University, Providence, RI, USA
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY 10012, USA
| | - Peter A. Vanable
- Department of Psychology, Center for Health and Behavior, Syracuse University, Syracuse, NY, USA
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Kerr JC, Valois RF, DiClemente RJ, Carey MP, Stanton B, Romer D, Fletcher F, Farber N, Brown LK, Vanable PA, Salazar LF, Juzang I, Fortune T. The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents. AIDS Patient Care STDS 2015; 29:150-6. [PMID: 25738952 DOI: 10.1089/apc.2014.0207] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma.
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Affiliation(s)
- Jelani C. Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky
| | - Robert F. Valois
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina
| | - Ralph J. DiClemente
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michael P. Carey
- Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Bonita Stanton
- Wayne State University, Department of Pediatrics, Detroit, Michigan
| | - Daniel Romer
- Annenberg Public Policy Center, College of Arts and Sciences, Pennsylvania, Pennsylvania
| | - Faith Fletcher
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, Illinois
| | - Naomi Farber
- College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Larry K. Brown
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island
| | - Peter A. Vanable
- Department of Psychology, Center for Health & Behavior, Syracuse University, Syracuse, New York
| | - Laura F. Salazar
- Division of Health Promotion and Behavior, Institute of Public Health, Georgia State University, Atlanta, Georgia
| | - Ivan Juzang
- Motivational Educational Entertainment, Philadelphia, Pennsylvania
| | - Thierry Fortune
- Motivational Educational Entertainment, Philadelphia, Pennsylvania
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Pearson GS, Hines-Martin VP, Evans LK, York JA, Kane CF, Yearwood EL. Addressing gaps in mental health needs of diverse, at-risk, underserved, and disenfranchised populations: a call for nursing action. Arch Psychiatr Nurs 2015; 29:14-8. [PMID: 25634869 DOI: 10.1016/j.apnu.2014.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022]
Abstract
Psychiatric nurses have an essential role in meeting the mental health needs of diverse, at-risk, underserved, and disenfranchised populations across the lifespan. This paper summarizes the needs of individuals especially at-risk for mental health disorders, acknowledging that such vulnerability is contextual, age-specific, and influenced by biological, behavioral, socio-demographic and cultural factors. With its longstanding commitment to cultural sensitivity and social justice, its pivotal role in healthcare, and its broad educational base, psychiatric nursing is well-positioned for leadership in addressing the gaps in mental health prevention and treatment services for vulnerable and underserved populations. This paper describes these issues, presents psychiatric nursing exemplars that address the problems, and makes strong recommendations to psychiatric nurse leaders, policy makers and mental health advocates to help achieve change.
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Malseed C, Nelson A, Ware R. Evaluation of a School-Based Health Education Program for Urban Indigenous Young People in Australia. Health (London) 2014. [DOI: 10.4236/health.2014.67077] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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