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Ranker LR, Ross CS, Rudolph AE, Weuve J, Xuan Z. Identifying and describing trajectories of alcohol use frequency and binge drinking frequency among those aged 15-30 years in a national cohort of US adolescents: A group-based trajectory modeling approach. Addiction 2023; 118:1739-1750. [PMID: 37069487 DOI: 10.1111/add.16216] [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: 06/29/2022] [Accepted: 03/29/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND AIMS Analyzing long-term trajectories of alcohol use has the potential to strengthen policy and intervention priorities and timing. We identified and described trajectories of alcohol use and binge drinking frequency from mid-adolescence to early adulthood and measured the association of the role of early drinking initiation with trajectory membership. DESIGN, SETTING, PARTICIPANTS This was a longitudinal cohort study conducted in the United States. The National Longitudinal Survey of Youth 1997 is a nationally representative cohort of youth aged 12-16 years at baseline. The analytic sample included individuals who participated in two or more annual interviews between ages 15 and 30 years (n = 8809). MEASUREMENTS Participants self-reported the number of days in the past 30 days they: (1) drank alcohol and (2) binge drank (five or more drinks on one occasion). We used group-based trajectory modeling to identify distinct trajectories from ages 15-30 years of past 30-day drinking and past 30-day binge drinking. Using multinomial logistic regression, we evaluated associations between early drinking initiation (≤ 14 years) and key demographics with trajectory membership. FINDINGS We identified five past 30-day drinking groups: late-escalating (16.0%), moderate frequency (19.0%), high frequency (11.2%), low frequency (35.4%) and no/infrequent (18.4%). Early drinking initiation (versus later) was associated with higher odds of membership in the moderate [adjusted multinomial odds ratio (aMOR) = 4.88; 95% confidence interval (CI) = 4.00, 5.94] and high-frequency groups (aMOR = 4.68; 95% CI = 3.74, 5.86) than in the no/infrequent comparator trajectory. We identified five groups with distinct binge drinking frequency patterns: later escalating (9.9%), high frequency (3.9%), low frequency (28.7%), earlier onset (9.5%) and no/infrequent (48.0%). Early initiation was associated with increased odds of membership in earlier-onset and high-frequency groups compared with the no/infrequent group. For both outcomes, additional differences in probability of group membership were identified by gender, racial identity, parental factors (religiosity, high school completion) and household characteristics (household size, income, and region of residence). CONCLUSIONS Youth in the United States appear to follow heterogeneous drinking and binge drinking trajectories from adolescence into adulthood. These may include higher-use trajectories as well as trajectories with different escalation timing (e.g. earlier versus later). Early initiation of drinking may increase risk of membership in higher- and earlier-use trajectory groups.
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Affiliation(s)
- Lynsie R Ranker
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Craig S Ross
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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Martín-Turrero I, Sureda X, Escobar F, Bilal U, Berasaluce M, Valiente R. How Can We Measure Alcohol Outlet Density Around Schools? A Comparison Between Two Buffer-Based Methods. J Urban Health 2023:10.1007/s11524-023-00740-z. [PMID: 37351726 DOI: 10.1007/s11524-023-00740-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/24/2023]
Abstract
Measuring the density of alcohol outlets around schools is a critical step towards understanding the drivers of drinking among adolescents. Different methodologies have been used in the literature for this purpose, but the implications of using one methodology or another have not been clearly assessed. Our aim was to compare different methods to measure alcohol outlet density and highlight under which characteristics of the environment might be best using each approach. We used Geographic Information Systems to geolocate schools (n = 576) and alcohol outlets (n = 21,732) in Madrid. We defined the density of alcohol outlets as the number of establishments within an area of 400 m around schools measured using two buffering methods: crow flies' and street network distances. We evaluated the agreement between both methods visually and through regression models, including street connectivity, population density, and density of recreational venues as predictors of disagreement. The density of alcohol outlets around schools was higher using crow flies' distances compared to street network distances. The differences between methodologies were wider in areas of higher density of outlets, especially in the downtown areas, where there are higher population density and street connectivity. Our results suggest that the spatial characteristics and morphology of the study area (e.g., street connectivity and population density) should be considered when deciding the methodology to be used to measure alcohol outlet density. Future studies should explore the implications of different exposure measures in their association with drinking prevalence and consumption patterns among different geographical contexts.
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Affiliation(s)
- Irene Martín-Turrero
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Campus Universitario - Crta. de Madrid-Barcelona, Km. 33,600. Alcalá de Henares, 28871, Madrid, Spain
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Campus Universitario - Crta. de Madrid-Barcelona, Km. 33,600. Alcalá de Henares, 28871, Madrid, Spain.
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA.
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, 19104, USA
| | - Maitane Berasaluce
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Campus Universitario - Crta. de Madrid-Barcelona, Km. 33,600. Alcalá de Henares, 28871, Madrid, Spain
| | - Roberto Valiente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Campus Universitario - Crta. de Madrid-Barcelona, Km. 33,600. Alcalá de Henares, 28871, Madrid, Spain
- Center for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, London, UK
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Ng CS, Au M, Ma R, Leung JY, Quan J. The impact of alcohol pricing policies on public health in Hong Kong, China: A modelling study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 26:100510. [PMID: 35789827 PMCID: PMC9250035 DOI: 10.1016/j.lanwpc.2022.100510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Contrary to most developed economies, Hong Kong has reduced and eliminated taxes on beer and wine over the last 15 years and observed increasing alcohol consumption. METHODS We applied econometric epidemiological modelling to assess the impact of reverting ad valorem taxation to pre-2008 levels (20% on wine and 40% on beer) on consumption and health outcomes. We used 15 years of industry sales and pricing data (2004-2018) to derive 25 own-price and cross-price elasticity estimates. We applied risk functions from the World Health Organization 2018 Global Status Report to assess the impact on 25 alcohol-attributable conditions. FINDINGS An estimated 616 deaths (91.3% in men) were attributable to alcohol in 2018. Raising taxes to pre-2008 levels is estimated to reduce consumption of pure alcohol consumption by 8.0%, 15.9%, and 31.1%; and reduce alcohol-attributable deaths by 11.6%, 21.8%, and 40.2% assuming 25%, 50% and 100% pass through rates of taxes to consumers. The largest projected decreases in alcohol-attributable mortality in absolute numbers are alcohol abuse, alcohol dependence, and alcoholic psychoses (wholly alcohol-attributable disorders). The largest absolute number of new alcohol-attributable cases in 2018 were hypertension, alcohol dependence and alcohol abuse; which are estimated to be reduced by 31.3%, 34.2%, and 34.3% respectively by raising taxes to pre-2008 levels. The alcohol-attributable health burden and absolute reductions in health harms are far greater in men. INTERPRETATION Reversing the 2008 alcohol tax reductions is potentially effective in averting the alcohol-attributable health burden and thus mitigate against the avoidable harms of alcohol-related disease. FUNDING Health and Medical Research Fund, Food and Health Bureau of the Hong Kong SAR, China [03170067].
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Affiliation(s)
- Carmen S. Ng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Minnie Au
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Robyn Ma
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - June Y.Y. Leung
- SHORE & Whariki Research Centre, College of Health, Massey University, New Zealand
| | - Jianchao Quan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Volpicelli JR, Menzies P. Rethinking Unhealthy Alcohol Use in the United States: A Structured Review. Subst Abuse 2022; 16:11782218221111832. [PMID: 35899221 PMCID: PMC9310219 DOI: 10.1177/11782218221111832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/06/2022] [Indexed: 11/21/2022]
Abstract
Greater than moderate alcohol use spans a continuum that includes high levels of
total alcohol consumed per period (heavy drinking) as well as episodes of
intense drinking (binges) and can give rise to alcohol use disorder (AUD) when
associated with an inability to control alcohol use despite negative
consequences. Although moderate drinking and AUD have standard, operable
definitions in the United States (US), a significant “gray area” remains in
which an individual may exceed recommended drinking guidelines but does not meet
the criteria for AUD (hereafter referred to as unhealthy alcohol use). To
address this need, we conducted a structured literature search to evaluate how
this gray area is defined and assess its burden within the US. For purposes of
this review, we will refer to this gray area as “unhealthy alcohol use.”
Although numerous terms are used to describe various unsafe drinking practices,
our review did not find any studies in which the specific prevalence and/or
burden of unhealthy alcohol use was evaluated. That is, we found no studies that
focus exclusively on individuals who exceed moderate drinking guidelines but do
not meet AUD criteria. Furthermore, we did not discover an established framework
for identifying individuals with unhealthy alcohol use. The lack of a consistent
framework for identifying unhealthy alcohol users has significant implications
for patient management and disease burden assessment. Therefore, we propose the
following framework in which unhealthy alcohol use comprises 2 distinct
subpopulations: those at risk of experiencing alcohol-related consequences and
those who have subthreshold problems associated with use. The former, termed
“risky drinkers,” are defined by exceeding recommended guidelines for moderate
drinking (⩽1 or 2 drinks per day for women and men, respectively). People with
subthreshold problems associated with use, defined as exhibiting exactly 1 AUD
symptom, would be classified as “problematic drinkers” within this proposed
framework. These definitions would help bring the core elements of unhealthy
alcohol use into focus, which in turn would help identify and provide management
strategies sooner to those affected and reduce the overall burden of unhealthy
alcohol use.
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Affiliation(s)
| | - Percy Menzies
- Assisted Recovery Centers of America, St Louis, MO, USA
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Bowen MT, George O, Muskiewicz DE, Hall FS. FACTORS CONTRIBUTING TO THE ESCALATION OF ALCOHOL CONSUMPTION. Neurosci Biobehav Rev 2022; 132:730-756. [PMID: 34839930 PMCID: PMC8892842 DOI: 10.1016/j.neubiorev.2021.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/05/2021] [Accepted: 11/12/2021] [Indexed: 01/03/2023]
Abstract
Understanding factors that contribute to the escalation of alcohol consumption is key to understanding how an individual transitions from non/social drinking to AUD and to providing better treatment. In this review, we discuss how the way ethanol is consumed as well as individual and environmental factors contribute to the escalation of ethanol consumption from intermittent low levels to consistently high levels. Moreover, we discuss how these factors are modelled in animals. It is clear a vast array of complex, interacting factors influence changes in alcohol consumption. Some of these factors act early in the acquisition of ethanol consumption and initial escalation, while others contribute to escalation of ethanol consumption at a later stage and are involved in the development of alcohol dependence. There is considerable need for more studies examining escalation associated with the formation of dependence and other hallmark features of AUD, especially studies examining mechanisms, as it is of considerable relevance to understanding and treating AUD.
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Affiliation(s)
- Michael T. Bowen
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, 2050, Australia,The University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, 2006, Australia,Corresponding Author: Michael T. Bowen, Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia,
| | - Olivier George
- Department of Psychology, University of California, San Diego, School of Medicine, La Jolla, CA, 92093, USA
| | - Dawn E. Muskiewicz
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA
| | - F. Scott Hall
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA
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Defoe IN. Towards a hybrid criminological and psychological model of risk behavior: The developmental neuro-ecological risk-taking model (DNERM). DEVELOPMENTAL REVIEW 2021. [DOI: 10.1016/j.dr.2021.100995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Leal-López E, Sánchez-Queija I, Vieno A, Currie D, Torsheim T, Pavlova D, Moreno-Maldonado C, De Clercq B, Kalman M, Inchley J. Cross-national time trends in adolescent alcohol use from 2002 to 2014. Eur J Public Health 2021; 31:859-866. [PMID: 34259859 PMCID: PMC8790077 DOI: 10.1093/eurpub/ckab024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Adolescent alcohol consumption is a major public health concern that should be continuously monitored. This study aims (i) to analyze country-level trends in weekly alcohol consumption, drunkenness and early initiation in alcohol consumption and drunkenness among 15-year-old adolescents from 39 countries and regions across Europe and North America between 2002 and 2014 and (ii) to examine the geographical patterns in adolescent alcohol-related behaviours. Methods The sample was composed of 250 161 adolescents aged 15 from 39 countries and regions from Europe and North America. Survey years were 2002, 2006, 2010 and 2014. The alcohol consumption and drunkenness items of the HBSC questionnaire were employed. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. Results Data show a general decrease in all four alcohol variables between 2002 and 2014 except for some countries. However, there is variability both within a country (depending on the alcohol-related behaviour under study) and across countries (in the beginning and shape of trends). Some countries have not reduced or even increased their levels in some variables. Although some particularities have persisted over time, there are no robust patterns by regions. Conclusions Despite an overall decrease in adolescent alcohol consumption, special attention should be paid to those countries where declines are not present, or despite decreasing, rates are still high. Further research is needed to clarify factors associated with adolescent drinking, to better understand country specificities and to implement effective policies.
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Affiliation(s)
- Eva Leal-López
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Seville, Spain
| | | | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Dorothy Currie
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Torbjorn Torsheim
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Daria Pavlova
- Ukrainian Institute for Social Research After Olexander Yaremenko, Kyiv, Ukraine
| | | | - Bart De Clercq
- Mensura R&D Department, Mensura EDPB, Antwerpen, Belgium
| | - Michal Kalman
- Department of Recreation and Leisure Studies, Palacky University Olomouc, Olomouc, Czech Republic
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Burtch G, Greenwood BN, McCullough JS. Ride-Hailing Services and Alcohol Consumption: Longitudinal Analysis. J Med Internet Res 2021; 23:e15402. [PMID: 33502328 PMCID: PMC7875688 DOI: 10.2196/15402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/21/2020] [Accepted: 10/25/2020] [Indexed: 11/25/2022] Open
Abstract
Background Alcohol consumption is associated with a wide range of adverse health consequences and a leading cause of preventable deaths. Ride-hailing services such as Uber have been found to prevent alcohol-related motor vehicle fatalities. These services may, however, facilitate alcohol consumption generally and binge drinking in particular. Objective The goal of the research is to measure the impact of ride-hailing services on the extent and intensity of alcohol consumption. We allow these associations to depend on population density as the use of ride-hailing services varies across markets. Methods We exploit the phased rollout of the ride-hailing platform Uber using a difference-in-differences approach. We use this variation to measure changes in alcohol consumption among a local population following Uber’s entry. Data are drawn from Uber press releases to capture platform entry and the Behavioral Risk Factor Surveillance Systems (BRFSS) Annual Survey to measure alcohol consumption in 113 metropolitan areas. Models are estimated using fixed-effects Poisson regression. Pre- and postentry trends are used to validate this approach. Results Ride-hailing has no association with the extent of alcohol consumption in high (0.61 [95% CI –0.05% to 1.28%]) or low (0.61 [95% CI –0.05% to 1.28%]) density markets, but is associated with increases in the binge drinking rate in high-density markets (0.71 [95% CI 0.13% to 1.29%]). This corresponds to a 4% increase in binge drinking within a Metropolitan Statistical Area. Conclusions Ride-hailing services are associated with an increase in binge drinking, which has been associated with a wide array of adverse health outcomes. Drunk driving rates have fallen for more than a decade, while binge drinking continues to climb. Both trends may be accelerated by ride-hailing services. This suggests that health information messaging should increase emphasis on the direct dangers of alcohol consumption and binge drinking.
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Affiliation(s)
- Gordon Burtch
- Carlson School, University of Minnesota, Minneapolis, MN, United States
| | - Brad N Greenwood
- Department of Information Systems and Operations Management, George Mason University, Fairfax, VA, United States
| | - Jeffrey S McCullough
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, United States
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Fairman BJ, Goldstein RB, Simons-Morton BG, Haynie DL, Liu D, Hingson RW, Gilman SE. Neighbourhood context and binge drinking from adolescence into early adulthood in a US national cohort. Int J Epidemiol 2020; 49:103-112. [PMID: 31263877 DOI: 10.1093/ije/dyz133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment. However, longitudinal evidence has been limited and few studies have examined time-varying neighbourhood factors and demographic subgroup variation. METHODS We investigated neighbourhood influences and binge drinking in a national cohort of US 10th grade students at four times (2010-2014; n = 2745). We estimated odds ratios (OR) for past 30-day binge drinking associated with neighbourhood disadvantage, personal and property crime (quartiles), and number of liquor, beer and wine stores within 5 km, and then evaluated whether neighbourhood associations differ by age, sex and race/ethnicity. RESULTS Neighbourhood disadvantage was associated with binge drinking before 18 [OR = 1.54; 95% confidence interval (1.14, 2.08)], but not after 18 years of age. Property crime in neighbourhoods was associated with a higher odds of binge drinking [OR = 1.54 (0.96, 2.45)], an association that was stronger in early adulthood [4th vs 1st quartile: OR = 1.77 (1.04, 3.03)] and among Whites [4th vs 1st quartile: OR = 2.46 (1.03, 5.90)]. Higher density of liquor stores predicted binge drinking among Blacks [1-10 stores vs none: OR = 4.31 (1.50, 12.36)] whereas higher density of beer/wine stores predicted binge drinking among Whites [one vs none for beer: OR = 2.21 (1.06, 4.60); for wine: OR = 2.04 (1.04, 4.03)]. CONCLUSIONS Neighbourhood conditions, particularly those related to economic circumstances, crime and alcohol outlet density, were related to binge drinking among young adults, but associations varied across age and individual characteristics.
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Affiliation(s)
- Brian J Fairman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Risë B Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Bruce G Simons-Morton
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Danping Liu
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health
| | - Ralph W Hingson
- Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kabore A, Afriyie-Gyawu E, Awuah J, Hansen A, Walker A, Hester M, Wonadé Sié MA, Johnson J, Meda N. Social ecological factors affecting substance abuse in Ghana (West Africa) using photovoice. Pan Afr Med J 2019; 34:214. [PMID: 32180886 PMCID: PMC7061025 DOI: 10.11604/pamj.2019.34.214.12851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 12/09/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Substance abuse is an important public health issue affecting West Africa; however, there is currently a dearth of literature on the actions needed to address it. The aim of this study was to assess the risks and protective factors of substance abuse in Ghana, West Africa, using the photovoice method. METHODS This study recruited and trained 10 participants in recovery from substance abuse and undergoing treatment in the greater Accra region of Ghana on the photovoice methodology. Each participant received a disposable camera to take pictures that represented the risk and protective factors pertinent to substance abuse in their communities. They were also given the opportunity to provide narratives of the pictures using pre-identified themes and the different levels of the social-ecological model and participatory action research (PAR). RESULTS Participants identified at the individual level: ignorance; interpersonal level: family and peer pressure; organizational level: lack of regulation; community level: media, availability of drugs, cost of drugs, urbanization, slum communities and cultural factors; and policy level: lack of regulations and their enforcement. Education and beliefs were cited at the individual level; family at the interpersonal level; religion at the organizational level; organizing youth, media and narcotics anonymous at the community level; and nothing at the policy level. CONCLUSION This is an exploratory study that will add to the limited body of knowledge in the scientific literature with respect to substance abuse in the country and also help develop interventions to address the respective needs of several communities in Ghana.
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Affiliation(s)
- Ahmed Kabore
- Jiann-Ping Hsu College of Public Health, Statesboro, Georgia Southern University, Georgia, United States
- Centre Muraz, Department of Public Health, Bobo-Dioulasso, Burkina Faso
- Joseph Ki-Zerbo University, Department of Public Health, Ouagadougou, Burkina Faso
| | - Evans Afriyie-Gyawu
- Jiann-Ping Hsu College of Public Health, Statesboro, Georgia Southern University, Georgia, United States
| | - James Awuah
- University of South Dakota, Sanford School of Health Sciences, South Dakota, United States
| | - Andrew Hansen
- Jiann-Ping Hsu College of Public Health, Statesboro, Georgia Southern University, Georgia, United States
| | - Ashley Walker
- Jiann-Ping Hsu College of Public Health, Statesboro, Georgia Southern University, Georgia, United States
| | - Melissa Hester
- Jiann-Ping Hsu College of Public Health, Statesboro, Georgia Southern University, Georgia, United States
| | | | - Jarrett Johnson
- Jiann-Ping Hsu College of Public Health, Statesboro, Georgia Southern University, Georgia, United States
| | - Nicolas Meda
- Centre Muraz, Department of Public Health, Bobo-Dioulasso, Burkina Faso
- Joseph Ki-Zerbo University, Department of Public Health, Ouagadougou, Burkina Faso
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[Trends in alcohol consumption among school-aged adolescents in Spain (2010-2018)]. GACETA SANITARIA 2019; 35:35-41. [PMID: 31785892 DOI: 10.1016/j.gaceta.2019.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze trends in beer, wine, and distilled spirits consumption, as well as drunkenness among school-aged adolescents in Spain from 2010 to 2018 by sex and age. METHOD The sample is composed of 35,310 adolescents aged 15 to 18. The data is representative of the adolescent school population in Spain in 2010, 2014, and 2018. The alcohol consumption questionnaire and the drunkenness questionnaire provided by the international team of the study (removed for blinded review) were employed. Prevalence Ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. RESULTS the data show a general decrease in alcohol consumption (beer, wine, as well as distilled spirits) and in drunkenness, but the decrease mainly occurs between 2010 and 2014. Sex differences (higher consumption and drunkenness among boys) are found among adolescents aged 17-18 but not in the age group of 15-16 years old. Older adolescents show higher levels of consumption and drunkenness than younger adolescents. DISCUSSION the results confirm the relevance of carrying out specific analyses in order to identify risk groups which are not detected through general analyses. This data highlights the need to maintain alcohol prevention and control policies due to the risk of stabilization in alcohol-related behaviours.
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