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Katz-Wise SL, Gordon AR, Sharp KJ, Johnson NP, Hart LM. Developing Parenting Guidelines to Support Transgender and Gender Diverse Children's Well-being. Pediatrics 2022; 150:189276. [PMID: 36045300 DOI: 10.1542/peds.2021-055347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Parents and caregivers' responses to their child's gender identity or expression play a pivotal role in their mental health. Despite increasing visibility of transgender and gender diverse (TGD) children, few scientific resources exist to advise their parents and caregivers. METHODS We used an online Delphi study to generate expert consensus. Expert adult participants (N = 93; 55% cisgender women, 12% cisgender men, 33% gender minority; 83% White race or ethnicity) rated statements describing parenting strategies compiled from a systematic search of community-generated online literature. Participants represented 3 distinct "panels" of expertise: parents and caregivers of a TGD child, TGD persons, and/or professionals working with TGD populations. Statements rated as essential or important by 80% to 100% of each panel were endorsed as a guideline. Three rounds of surveys were used with iterative feedback to develop consensus. RESULTS Of 813 total statements, only 125 were endorsed by all 3 panels. Key domains of consensus included: supportive strategies for parents (eg, open communication, listening), behaviors to avoid (eg, pressuring a child into a gender transition), strategies for navigating healthcare and school systems, and common responses for parents (eg, confusion). Areas of disagreement, in which professional and TGD panels concurred but the parent panel did not, included whether to allow gender identity experimentation during childhood, the value of providing access to gender diverse media, and how to avoid misgendering a child. CONCLUSIONS These consensus-based guidelines offer a unique and needed resource for parents and caregivers and clinicians and can be used to promote the mental health and well-being of TGD children.
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Affiliation(s)
- Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Allegra R Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Kendall J Sharp
- Department of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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2
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Stapinski LA, Nepal S, Guckel T, Grummitt LR, Chapman C, Lynch SJ, Lawler SM, Teesson M, Newton NC. Evaluation of Positive Choices, a National Initiative to Disseminate Evidence-Based Alcohol and Other Drug Prevention Strategies: Web-Based Survey Study. JMIR Pediatr Parent 2022; 5:e34721. [PMID: 36018617 PMCID: PMC9463616 DOI: 10.2196/34721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 06/26/2022] [Accepted: 07/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To prevent adolescents from initiating alcohol and other drug use and reduce the associated harms, effective strategies need to be implemented. Despite their availability, effective school-based programs and evidence-informed parental guidelines are not consistently implemented. The Positive Choices alcohol and other drug prevention initiative and website was launched to address this research and practice gap. The intended end users were school staff, parents, and school students. An 8-month postlaunch evaluation of the website showed that end users generally had positive feedback on the website's usability, and following its use, most of them would consider the evidence base and effectiveness of drug education resources. This study extends this initial evaluation by examining the effectiveness and impact of the Positive Choices initiative over a 3-year period. OBJECTIVE Guided by the five dimensions of the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, the study assessed the impact of the Positive Choices initiative in increasing awareness and implementation of evidence-based drug prevention. METHODS Data were collected between 2017 and 2019, using web-based evaluation and community awareness surveys. Data from the surveys were merged to examine reach, effectiveness, adoption, implementation, and maintenance using descriptive statistics. Google Analytics was used to further understand the reach of the website. The System Usability Scale was used to measure website usability. In addition, inductive analysis was used to assess the participants' feedback about Positive Choices. RESULTS A total of 5 years after launching, the Positive Choices website has reached 1.7 million users. A national Australian campaign increased awareness from 8% to 14% among school staff and from 15% to 22% among parents after the campaign. Following a brief interaction with the website, most participants, who were not already following the recommended strategies, reported an intention to shift toward evidence-based practices. The System Usability Scale score for the website was good for both user groups. The participants intended to maintain their use of the Positive Choices website in the future. Both user groups reported high level of confidence in communicating about topics related to alcohol and other drugs. Participants' suggestions for improvement informed a recent website update. CONCLUSIONS The Positive Choices website has the capacity to be an effective strategy for disseminating evidence-based drug prevention information and resources widely. The findings highlight the importance of investing in ongoing maintenance and promotion to enhance awareness of health websites. With the increased use and acceptability of health education websites, teams should ensure that websites are easy to navigate, are engaging, use simple language, contain evidence-informed resources, and are supported by ongoing promotional activities.
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Affiliation(s)
- Lexine Ann Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Smriti Nepal
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia.,SAX Institute, Glebe, Australia
| | - Tara Guckel
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Lucinda Rachel Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Samantha Jane Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Siobhan Maree Lawler
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Nicola Clare Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
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3
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Cook M, Pennay A, MacLean S, Dwyer R, Mugavin J, Callinan S. Parents' management of alcohol in the context of discourses of 'competent' parenting: A qualitative analysis. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1009-1026. [PMID: 35488431 PMCID: PMC9544359 DOI: 10.1111/1467-9566.13475] [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] [Received: 03/07/2021] [Accepted: 04/06/2022] [Indexed: 05/25/2023]
Abstract
How parents manage potential tensions between normative discourses of 'competent parenting' and their desires to consume alcohol has received little attention. In this article, we explore the elements that encourage or constrain parents' drinking and investigate how parents consider and manage their alcohol use in the context of multiple social roles with sometimes conflicting demands and expectations around 'competent parenting'. Our analysis draws on 30 semi-structured interviews with Australian parents, conducted as part of a broader project which aimed to explore how home drinking is integrated into everyday life. While parents' accounts of drinking alcohol highlighted effects such as embodied experiences of relaxation and facilitating shared adult moments, many participants described drinking less than they otherwise would if their children were not present. Participants discussed various social roles and routines which constrained consumption, with drinking bounded by responsibility. As such, drinking emerged as something needing to be actively negotiated, particularly in light of discourses that frame expectations of what constitutes 'competent parenting'. When considering parents' alcohol consumption in the future, we argue that it is important to destigmatise their consumption by acknowledging the importance of adults' pleasure and wellbeing, alongside children's needs for safety and modelling of safer alcohol consumption.
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Affiliation(s)
- Megan Cook
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
| | - Amy Pennay
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
| | - Sarah MacLean
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
- School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
| | - Robyn Dwyer
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
| | - Janette Mugavin
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
| | - Sarah Callinan
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
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4
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Bowden JA, Delfabbro P, Room R, Miller CL, Wilson C. Levels of Parental Drinking in the Presence of Children: An Exploration of Attitudinal Correlates. Alcohol Alcohol 2021; 57:460-469. [PMID: 34734231 PMCID: PMC9270987 DOI: 10.1093/alcalc/agab071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/06/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022] Open
Abstract
Aims This study aimed to examine perceived social norms, the effect of parental drinking on these norms, alcohol use in front of children, and how norms and consumption vary based on child age and gender of the parent. Methods A cross-sectional online panel survey was undertaken with n = 1000 Australian adults (including 670 parents) aged 18–59 years. The survey assessed: alcohol consumption in front of children; normative attitudes towards drinking in the presence of children; and perceived social norms. Results Overall, 33.9% of parents reported drinking a glass of alcohol each day or a couple of times a week, 18.2% reported getting slightly drunk and 7.8% indicated getting visibly drunk each day or a couple of times a week with their children present. In total, 37.5% reported drinking in front of their children at least weekly. Fathers were more likely to drink in front of children than mothers. Most parents deemed drinking small amounts of alcohol in front of children as acceptable but did not accept drunkenness. Respondents were less concerned about a father drinking one or two drinks in front of their children than a mother. Social expectations were not related to child age, but norms related to others’ perceived behaviour were. Conclusions Many parents, particularly fathers consume alcohol in front of their children. There is a need to target health promotion strategies to adults and parents consuming in excess of health guidelines, and to the many parents who are consuming alcohol at higher levels in front of their children.
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Affiliation(s)
- Jacqueline A Bowden
- University of Adelaide, School of Psychology, Adelaide, South Australia 5000, Australia.,South Australian Health and Medical Research Institute, Health Policy Centre, Adelaide, South Australia 5000, Australia.,University of Adelaide, School of Public Health, Adelaide, South Australia 5000, Australia
| | - Paul Delfabbro
- University of Adelaide, School of Psychology, Adelaide, South Australia 5000, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Melbourne, Victoria 3086, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm SE-106 91, Sweden
| | - Caroline L Miller
- South Australian Health and Medical Research Institute, Health Policy Centre, Adelaide, South Australia 5000, Australia.,University of Adelaide, School of Public Health, Adelaide, South Australia 5000, Australia
| | - Carlene Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia 5042, Australia.,Olivia Newton John Cancer Wellness and Research Centre and School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne 3083, Victoria
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5
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Boyd DT, Opara I, Quinn CR, Waller B, Ramos SR, Duncan DT. Associations between Parent-Child Communication on Sexual Health and Drug Use and Use of Drugs during Sex among Urban Black Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5170. [PMID: 34068128 PMCID: PMC8152761 DOI: 10.3390/ijerph18105170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 12/28/2022]
Abstract
Black youth and their families living in urban settings may experience unique stressors that contribute to underlying issues due to the environmental context. Such factors may exacerbate and promote drug use and engagement in risky sexual behaviors, unknowingly. Little is known about how family factors, peer pressure, condom use, and other related factors are associated with substance use and engaging in sexual behaviors while on drugs among urban African American youth aged 12-22 (N = 638). We used regression models to examine associations between parental bonding, parent-adolescent sexual health communication, condom use, peer pressure on substance use, and having sex while on drugs. Multivariate results indicated that parental bonding was statistically significant and associated with drug use (OR: 1.36, 95%CI: 1.36). Our study highlights that parental bonding plays a critical role in youth using drugs while living in urban environments.
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Affiliation(s)
- Donte T. Boyd
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
- Center for Interdisciplinary Research on AIDS (CIRA) at Yale University, New Haven, CT 06510, USA;
| | - Ijeoma Opara
- Center for Interdisciplinary Research on AIDS (CIRA) at Yale University, New Haven, CT 06510, USA;
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT 06510, USA
| | - Camille R. Quinn
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - Bernadine Waller
- School of Social Work, Adelphi University, Garden City, NY 11530, USA;
| | - S. Raquel Ramos
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
| | - Dustin T. Duncan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
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6
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Desai R, Ruiter RAC, Magan A, Reddy PS, Mercken LAG. Social network determinants of alcohol and tobacco use: A qualitative study among out of school youth in South Africa. PLoS One 2020; 15:e0240690. [PMID: 33079946 PMCID: PMC7575104 DOI: 10.1371/journal.pone.0240690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/30/2020] [Indexed: 11/18/2022] Open
Abstract
An important determinant of alcohol and tobacco use is the adolescent's social network, which has not been explored among out of school youth (OSY). OSY are adolescents not currently enrolled in school and have not completed their schooling. This study aims to qualitatively understand how OSY's social networks support or constrain alcohol and tobacco use. Respondent-driven sampling was used to select 41 OSY (aged 13-20 years) for individual in-depth interviews in a South African urban area. The data were analysed using content analysis. Smoking and drinking friends, family close in age to OSY that drank and smoked, and lack of parental support were associated with alcohol and tobacco use among OSY. Household norms, romantic partners and non-smoking or non-drinking friends were suggested to mitigate alcohol and tobacco use. Understanding how the social network of OSY plays a role in alcohol and tobacco use is useful for gaining an insight into the profile of OSY at risk for alcohol and tobacco use. Registration of OSY youth and community-based peer led programmes that include influential OSY family and friends could be beneficial.
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Affiliation(s)
- Rachana Desai
- Human & Social Capabilities Division, Human Sciences Research Council, South Africa
- Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert A. C. Ruiter
- Department of Work & Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Ansuyah Magan
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Priscilla S. Reddy
- Human & Social Capabilities Division, Human Sciences Research Council, South Africa
| | - Liesbeth A. G. Mercken
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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7
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Tjora T, Skogen JC, Sivertsen B. Increasing similarities between young adults' smoking and snus use in Norway: a study of the trends and stages of smoking and snus epidemic from 2010 to 2018. BMC Public Health 2020; 20:1511. [PMID: 33023560 PMCID: PMC7539463 DOI: 10.1186/s12889-020-09604-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background The prevalence of smoking has been decreasing in Norway for decades. In contrast, the prevalence of snus use has recently increased substantially, especially among females. While there is a clear social gradient in smoking, with a higher smoking prevalence among individuals with low socioeconomic status (SES), a possible social gradient in snus use has been less studied. The aim of the current study was to investigate the trends of smoking and snus use and to examine whether ongoing changes in snus use are similar to prior smoking epidemic development. Methods The study was based on the 2010 (n = 5836), 2014 (n = 13,319) and 2018 (n = 24,515) waves from a nation-wide, cross-sectional, health survey of higher education in Norway (the SHoT study). Variables on smoking, snus use, gender, age and SES were used. Chi-square tests and logistic regression analyses were used to test significance, and Mantel–Haenszel weights were used to test the trends in stratified cross-tabulations. Results Daily smoking decreased from 5.9 to 1.5% between 2010 and 2018, while daily snus use increased from 13.4 to 19.9%. Female snus use almost doubled, from 10.9 to 19.2%. Low SES was associated with both daily smoking and snus use across all three waves. Occasional smoking was also associated with low SES at all waves, but occasional snus use was only associated with low SES in 2010. There were no significant changes over time in either the association between occasional or daily smoking and SES or the association between occasional or daily snus use and SES. Conclusions The overall smoking decrease indicated that the Norwegian smoking epidemic is in its latest stage. Steady male snus use, doubled female snus use and a clear social gradient in snus use all indicate that the snus epidemic in Norway has progressed. If this trend continues, a main implication is that snus prevalence will soon peak, first in males and then in females.
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Affiliation(s)
- Tore Tjora
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research & Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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8
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Brittner MR, Pugh B, Soren K, Richter L, Stockwell MS. Frequency of Parent-Adolescent Alcohol-Specific Communication and Adolescent Perceptions of Alcohol. Clin Pediatr (Phila) 2018; 57:1332-1339. [PMID: 29871501 DOI: 10.1177/0009922818779220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To better understand the optimal frequency of parent-adolescent alcohol-specific communication, we conducted a secondary analysis of the National Center on Addiction and Substance Abuse Culture of High School Survey, a 2010 nationally representative online survey of 1000 high school students. Logistic regression models assessed the relationship between alcohol-specific communication and adolescent perceptions ( binge drinking is very dangerous, drinking is cool, and getting drunk is very dangerous), adjusting for grade, sex, race, personal and peer alcohol use, and parental monitoring. Among adolescents reporting personal and peer alcohol use, a dose-response relationship existed between frequency of alcohol-specific communication and thinking binge drinking is very dangerous (often [adjusted odds ratio [AOR] = 7.98; 95% confidence interval [CI] = 2.98-21.36], sometimes (AOR = 6.08; 95% CI = 2.36-15.69), rarely (AOR = 5.27; 95% CI = 1.95-14.26) vs never), and was also associated with decreased perceptions that drinking is cool (often [AOR = 0.22; 95% CI = 0.08-0.66), rarely vs never [AOR = 0.17; 95% CI = 0.06-0.51]); the inverse was true for never-drinkers without peer use.
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Affiliation(s)
- Mindy R Brittner
- 1 NewYork-Presbyterian Hospital, New York, NY, USA.,2 College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Brandie Pugh
- 3 The National Center on Addiction and Substance Abuse, New York, NY, USA
| | - Karen Soren
- 1 NewYork-Presbyterian Hospital, New York, NY, USA.,2 College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Linda Richter
- 3 The National Center on Addiction and Substance Abuse, New York, NY, USA
| | - Melissa S Stockwell
- 1 NewYork-Presbyterian Hospital, New York, NY, USA.,2 College of Physicians and Surgeons, Columbia University, New York, NY, USA.,4 Mailman School of Public Health, Columbia University, New York, NY, USA
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9
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Amit R, Jacobson SK. Participatory development of incentives to coexist with jaguars and pumas. CONSERVATION BIOLOGY : THE JOURNAL OF THE SOCIETY FOR CONSERVATION BIOLOGY 2018; 32:938-948. [PMID: 29356132 DOI: 10.1111/cobi.13082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/22/2017] [Accepted: 01/12/2018] [Indexed: 06/07/2023]
Abstract
Reducing costs and increasing benefits for rural communities coexisting with large carnivores is necessary for conservation of jaguar (Panthera onca) and puma (Puma concolor). To design acceptable incentives, stakeholders must be involved in the process. We conducted an innovative, structured, group communication process based on a Delphi technique as a template for identifying potential incentives. Community workshops with 133 members of 7 communities and surveys with 25 multidisciplinary experts from government, nongovernmental organizations, and academia provided iterative data to design a plan of incentives through 4 rounds of discussion. The final product integrated 862 ideas into 6 types of incentives: organization of communities, mechanisms for improved dialogue, citizen technical assistance, green labeling for community products, payment for the ecosystem service of biodiversity, and an assessment of financial alternatives. We used quantitative and qualitative techniques to indicate support for decisions about the design of incentives, which reduced researcher subjectivity. The diverse incentives developed and the cooperation from multiple stakeholders resulted in an incentive plan that integrated issues of governance, equity, and social norms.
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Affiliation(s)
- Ronit Amit
- Department of Wildlife Ecology and Conservation, University of Florida, Gainesville, FL 32611-0430, U.S.A
- Programa Gente y Fauna, Asociación Confraternidad Guanacasteca, Guanacaste 50101, Costa Rica
| | - Susan K Jacobson
- Department of Wildlife Ecology and Conservation, University of Florida, Gainesville, FL 32611-0430, U.S.A
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Gibney S, Sexton E, Shannon S. Measuring What Matters: Achieving Consensus on a Positive Aging Indicator Set For Ireland. J Aging Soc Policy 2018; 31:234-249. [PMID: 29883271 DOI: 10.1080/08959420.2018.1485393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The objective of this study was to measure consensus among expert stakeholders on a set of positive aging outcome indicators in Ireland. Stakeholders from academic, public, and voluntary sectors and older people participated in a 3-round, online Delphi study to evaluate indicators for participation, security, healthy aging, attitudes to aging, and information access. Evaluation criteria included: acceptability, utility, accessibility, ranking, and balance and coherence. Consensus was achieved on 56 key indicators that are aligned with action areas in the National Positive Ageing Strategy. These indicators will be reported on a biannual basis to monitor progress in positive aging in Ireland.
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Affiliation(s)
- Sarah Gibney
- a Department of Health , The Healthy and Positive Ageing Initiative , Dublin , Ireland.,b Geary Institute for Public Policy , University College Dublin , Dublin , Ireland
| | - Eithne Sexton
- a Department of Health , The Healthy and Positive Ageing Initiative , Dublin , Ireland.,c The Irish Longitudinal Study on Ageing, Trinity College Dublin , Dublin , Ireland
| | - Sinead Shannon
- a Department of Health , The Healthy and Positive Ageing Initiative , Dublin , Ireland
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11
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Thornton LK, Chapman C, Leidl D, Conroy C, Teesson M, Slade T, Koning I, Champion K, Stapinski L, Newton N. Climate schools plus: An online, combined student and parent, universal drug prevention program. Internet Interv 2018; 12:36-45. [PMID: 30135767 PMCID: PMC6096315 DOI: 10.1016/j.invent.2018.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/09/2018] [Accepted: 03/20/2018] [Indexed: 12/21/2022] Open
Abstract
Early initiation of substance use significantly increases one's risk of developing substance use dependence and mental disorders later in life. To interrupt this trajectory, effective prevention during the adolescent period is critical. Parents play a key role in preventing substance use and related harms among adolescents and parenting interventions have been identified as critical components of effective prevention programs. Despite this, there is currently no substance use prevention program targeting both students and parents that adopts online delivery to overcome barriers to implementation and sustainability. The Climate Schools Plus (CSP) program was developed to meet this need. CSP is an online substance use prevention program for students and parents, based on the effective Climate Schools prevention program for students. This paper describes the development of the parent component of CSP including a literature review and results of a large scoping survey of parents of Australian high school students (n = 242). This paper also includes results of beta-testing of the developed program with relevant experts (n = 10), and parents of Australian high school students (n = 15). The CSP parent component consists of 1) a webinar which introduces shared rule ranking, 2) online modules and 3) summaries of student lessons. The parent program targets evidence-based modifiable factors associated with a delay in the onset of adolescent substance use and/or lower levels of adolescent substance use in the future; namely, rule-setting, monitoring, and modelling. To date, this is the first combined parent-student substance use prevention program to adopt an online delivery method.
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Affiliation(s)
- Louise K. Thornton
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia,Corresponding author at: NDARC, UNSW Australia, NSW 2052, Australia.
| | - Cath Chapman
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Dana Leidl
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia,School of Psychology, UNSW, Sydney, Australia
| | - Chloe Conroy
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Tim Slade
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Ina Koning
- Faculty of Social and Behavioural Sciences, Universiteit Utrecht, The Netherlands
| | - Katrina Champion
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60614, United States
| | - Lexine Stapinski
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Nicola Newton
- NHMRC Centre of Research Excellence in Substance Use and Mental Health, National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
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12
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Shaw T, Johnston RS, Gilligan C, McBride N, Thomas LT. Child-parent agreement on alcohol-related parenting: Opportunities for prevention of alcohol-related harm. Health Promot J Austr 2018; 29:123-132. [PMID: 30159989 DOI: 10.1002/hpja.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 01/31/2018] [Indexed: 01/13/2023] Open
Abstract
ISSUE ADDRESSED Excessive alcohol consumption places adolescents at increased risk of preventable, acute alcohol-related injury. Parental attitudes and behaviours influence adolescents' alcohol use. This study examined alignment in parent and child reports of alcohol-related parenting and whether misalignment related to the child ever having drunk alcohol. METHODS A cross-sectional online survey was conducted in five secondary schools in [information removed for blinding in Perth, Western Australia] in 2015. All students in Years 7, 10 and 12 and their parents were eligible, and data were matched for 124 child-parent dyads. Alignment of parent-child reports was assessed using kappa statistics. In dyads where the parent reported protective attitudes and behaviours, the association between misalignment and alcohol use was tested in logistic regressions. RESULTS Overall, child-parent reports were aligned on parents' expectations, knowledge and actions (65% and higher agreed). While alignment on parental expectations seemed to decrease with age, alignment on parental communication and rule-setting increased. Misalignment on reports of parents' expectations was associated with increased odds of the child reporting having ever had alcohol (OR = 5.5; 95% CI = 2.7-47.7), as was parental supply (OR = 20.2; 95% CI = 3.3-121.5), but misalignment on parental communication, rule-setting and knowledge were not. CONCLUSIONS Parent nonsupply of alcohol and disapproval of use were most important in terms of associations with ever drinking. SO WHAT?: These findings call for interventions that support parents to expect no alcohol use and enable parents to communicate their expectation in a manner that resonates with their child. Effective parenting will contribute to reducing alcohol-related harm in adolescents.
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Affiliation(s)
- Thérèse Shaw
- Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia
| | - Robyn S Johnston
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Centre for Action on Alcohol and Youth, Curtin University, Perth, WA, Australia
| | - Conor Gilligan
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Laura T Thomas
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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Yap MBH, Cheong TWK, Zaravinos-Tsakos F, Lubman DI, Jorm AF. Modifiable parenting factors associated with adolescent alcohol misuse: a systematic review and meta-analysis of longitudinal studies. Addiction 2017; 112:1142-1162. [PMID: 28178373 DOI: 10.1111/add.13785] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/08/2016] [Accepted: 02/01/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Adolescent alcohol misuse is a growing global health concern. Substantial research suggests that parents have an important role in reducing young people's risk for early initiation of alcohol and alcohol-related harms. To facilitate research translation, we conducted a systematic review and meta-analyses of longitudinal studies examining the range of modifiable parenting factors that are associated with adolescent alcohol initiation and levels of later use/misuse. METHODS A systematic literature search was conducted in PubMed, PsycINFO and Embase. Studies were included if they (i) used a longitudinal design; (ii) were published in English; (iii) measured any modifiable parenting factors in adolescence as predictors; (iv) assessed any alcohol-related outcome variables in adolescence and/or alcohol-related problems in adulthood; and (v) had a follow-up interval of at least 1 year. Parental behaviours were categorized into 12 parenting factors. Stouffer's P analyses were used to determine whether the associations between variables were reliable; when there were sufficient studies available, meta-analyses were also conducted to estimate mean effect sizes. RESULTS Based on 131 studies, three risk factors (parental provision of alcohol, favourable parental attitudes towards alcohol use and parental drinking) and four protective factors (parental monitoring, parent-child relationship quality, parental support and parental involvement) were identified as longitudinal predictors of both alcohol initiation and levels of later alcohol use/misuse, based on their significant results in both Stouffer's P analyses and meta-analyses. The mean effect sizes were mainly small (rs = -0.224 to 0.263). CONCLUSIONS Risk of adolescent alcohol misuse is positively associated with parental provision of alcohol, favourable parental attitudes towards alcohol use and parental drinking. It is negatively associated with parental monitoring, parent-child relationship quality, parental support and parental involvement.
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Affiliation(s)
- Marie B H Yap
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria,, Australia.,School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Tony W K Cheong
- Section of Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Foivos Zaravinos-Tsakos
- Section of Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Fitzroy, Victoria, Australia
| | - Anthony F Jorm
- School of Population and Global Health, University of Melbourne, Carlton, Australia
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Carver H, Elliott L, Kennedy C, Hanley J. Parent–child connectedness and communication in relation to alcohol, tobacco and drug use in adolescence: An integrative review of the literature. DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.1080/09687637.2016.1221060] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hannah Carver
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, Scotland,
| | - Lawrie Elliott
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, and
| | - Catriona Kennedy
- Faculty of Health and Social Care, School of Nursing and Midwifery, Robert Gordon University, Aberdeen, Scotland
| | - Janet Hanley
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, Scotland,
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Cablova L, Csemy L, Belacek J, Miovsky M. Parenting styles and typology of drinking among children and adolescents. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2015.1040087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Cheng TC, Lo CC. Change in Adolescents’ Alcohol-Use Patterns, From Non-Drinking to Non-Heavy Drinking or Heavy Drinking. JOURNAL OF DRUG ISSUES 2015. [DOI: 10.1177/0022042615604013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study examined risk and protective factors at work when adolescents change from a non-drinking alcohol-use pattern to either non-heavy drinking or heavy drinking. Using a sample of 1,725 non-drinkers extracted from the National Longitudinal Study of Adolescent to Adult Health, we conducted multinomial logistic regression and found that likelihood of change from non-drinking to non-heavy drinking was associated positively with safe neighborhood, female, peers’ drinking, emotional maltreatment, and delinquent behaviors. We found a negative association between such likelihood and being African American. We found that likelihood of change from non-drinking to heavy drinking was associated positively with peers’ drinking, depressive feelings, drug use, and repeating a grade(s) at school. We found a negative association between such likelihood and having a married mother, being African American or some other non-Hispanic minority ethnicity, and maternal supervision. Implications for intervention and future research are discussed.
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Yap MBH, Fowler M, Reavley N, Jorm AF. Parenting strategies for reducing the risk of childhood depression and anxiety disorders: A Delphi consensus study. J Affect Disord 2015; 183:330-8. [PMID: 26047961 DOI: 10.1016/j.jad.2015.05.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 05/04/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Substantial evidence that some modifiable parental factors are associated with childhood depression and anxiety indicates that parents can play a crucial role in the prevention of these disorders in their children. However, more effective translation of research evidence is required. METHODS This study employed the Delphi methodology to establish expert consensus on parenting strategies that are important for preventing depression or anxiety disorders in children aged 5-11 years. A literature search identified 289 recommendations for parents. These were presented to a panel of 44 international experts over three survey rounds, who rated their preventive importance. RESULTS 171 strategies were endorsed as important or essential for preventing childhood depression or anxiety disorders by ≥90% of the panel. These were written into a parenting guidelines document, with 11 subheadings: Establish and maintain a good relationship with your child, Be involved and support increasing autonomy, Encourage supportive relationships, Establish family rules and consequences, Encourage good health habits, Minimise conflict in the home, Help your child to manage emotions, Help your child to set goals and solve problems, Support your child when something is bothering them, Help your child to manage anxiety, and Encourage professional help seeking when needed. LIMITATIONS This study relied on experts from Western countries; hence the strategies identified may not be relevant for all ethnic groups. CONCLUSIONS This study produced new parenting guidelines that are supported by research evidence and/or international experts, which can now be promoted in Western English-speaking communities to help parents protect their children from depression and anxiety disorders.
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Affiliation(s)
- Marie Bee Hui Yap
- School of Psychological Sciences, Monash University, Bld 17, 18 Innovation Walk, Clayton, Victoria 3800, Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia.
| | - Michelle Fowler
- Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Nicola Reavley
- Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Anthony Francis Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Australia
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Young people in drug treatment in Ireland: their views on substance use aetiology, trajectory, parents' role in substance use and coping skills. Ir J Psychol Med 2015; 32:247-258. [PMID: 30185264 DOI: 10.1017/ipm.2014.77] [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] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of the current study was to gain insight into the process of initiation and progression to problematic use among young people who reach clinically significant levels of substance use requiring treatment. METHOD Twenty young people, aged between 15 and 19 years from two different drug treatment centres in Ireland were interviewed regarding their views on their pathway into substance use, their progress to more problematic use, their perception of their parents' role, if any, in their trajectory and their typical coping style before treatment. Content analysis was conducted on the resulting narratives. RESULTS The use of substances to cope with life stressors emerged as a prominent theme at initial and problematic stages of use. Multiple maladaptive coping approaches were reported. Both direct and indirect influences from parents in their substance use problem were cited. However, some participants reported that parents had no causal role in their substance use trajectory, in particular regarding mothers. CONCLUSIONS The current findings suggest that substance misuse is a multi-determined problem and a number of intervention strategies are suggested to delay onset and related harms associated with adolescent substance use.
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Crutzen R, Giabbanelli PJ, Jander A, Mercken L, de Vries H. Identifying binge drinkers based on parenting dimensions and alcohol-specific parenting practices: building classifiers on adolescent-parent paired data. BMC Public Health 2015; 15:747. [PMID: 26243154 PMCID: PMC4526422 DOI: 10.1186/s12889-015-2092-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/24/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Most Dutch adolescents aged 16 to 18 engage in binge drinking. Previous studies have investigated how parenting dimensions and alcohol-specific parenting practices are related to adolescent alcohol consumption. Mixed results have been obtained on both dimensions and practices, highlighting the complexity of untangling alcohol-related factors. The aim of this study was to investigate (1) whether parents' reports of parenting dimensions and alcohol-specific parenting practices, adolescents' perceptions of these dimensions and practices, or a combination are most informative to identify binge drinkers, and (2) which of these parenting dimensions and alcohol-specific parenting practices are most informative to identify binge drinkers. METHODS Survey data of 499 adolescent-parent dyads were collected. The computational technique of data mining was used to allow for a data driven exploration of nonlinear relationships. Specifically, a binary classification task, using an alternating decision tree, was conducted and measures regarding the performance of the classifiers are reported after a 10-fold cross-validation. RESULTS Depending on the parenting dimension or practice, parents' reports correctly identified the drinking behaviour of 55.8% (using psychological control) up to 70.2% (using rules) of adolescents. Adolescents' perceptions were best at identifying binge drinkers whereas parents' perceptions were best at identifying non-binge drinkers. CONCLUSIONS Of the parenting dimensions and practices, rules are particularly informative in understanding drinking behaviour. Adolescents' perceptions and parents' reports are complementary as they can help identifying binge drinkers and non-binge drinkers respectively, indicating that surveying specific aspects of adolescent-parent dynamics can improve our understanding of complex addictive behaviours.
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Affiliation(s)
- Rik Crutzen
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Philippe J Giabbanelli
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, CB2 0QQ, Cambridge, UK. .,Interdisciplinary Research in the Mathematical and Computational Sciences (IRMACS) Centre, Simon Fraser University, Burnaby, Canada.
| | - Astrid Jander
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Hein de Vries
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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20
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Johnston R, Hearn L, Cross D, Thomas LT, Bell S. Parent voices guide smoking intervention development. HEALTH EDUCATION 2015. [DOI: 10.1108/he-03-2014-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose– While parents’ influence on their children’s smoking behaviour is widely recognised, little is known about parents of four to eight year olds’ attitudes and beliefs around smoking cessation and how they communicate with their children about smoking. The purpose of this paper is to explore parents’ perceptions of quitting smoking and their beliefs and actions related to the use of parenting practices to discourage smoking by their children.Design/methodology/approach– Four focus groups and 17 interviews were conducted with parents (n=46) of four to eight year old children in Perth, Western Australia.Findings– Many parents indicated their children strongly influenced their quitting behaviours, however, some resented being made to feel guilty about their smoking because of their children. Parents were divided in their beliefs about the amount of influence they had on their children’s future smoking. Feelings of hypocrisy appear to influence the extent to which parents who smoked talked with their child about smoking. Parents recommended a variety of resource options to support quitting and talking with their child about smoking.Practical implications– Interventions aimed at parents who smoke and have young children should: reinforce parents’ importance as role models; highlight the importance of talking to children about smoking when they are young and provide strategies for maintaining ongoing communication; be supportive and avoid making parents feel guilty; and emphasise that quitting smoking is the best option for their child’s health (and their own), while also providing effective harm minimisation options for parents who have not yet quit.Originality/value– Parents of children of lower primary school age can be highly influential on their children’s later smoking behaviours, thus, effective interventions that address the current beliefs and practices of these parents may be particularly advantageous.
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21
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Yap MBH, Jorm AF, Lubman DI. What are parents doing to reduce adolescent alcohol misuse? Evaluating concordance with parenting guidelines for adolescent alcohol use. BMC Public Health 2015; 15:114. [PMID: 25880926 PMCID: PMC4331448 DOI: 10.1186/s12889-015-1452-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 01/20/2015] [Indexed: 11/12/2022] Open
Abstract
Background The Parenting Guidelines for Adolescent Alcohol Use were developed to support parents in reducing adolescent alcohol misuse. The aims of this paper were to: (1) validate an online parent self-assessment survey as a criterion-referenced measure of parental factors that are important for predicting adolescent alcohol misuse; (2) examine parent web-users’ concordance with the Parenting Guidelines (extent to which their knowledge and behaviours align with Guidelines recommendations), and (3) examine the associations of parent and child characteristics with parental Guidelines concordance. Methods Participants were 489 parents who completed the online survey. The survey assessed parent and child characteristics and parental concordance with the Guidelines in nine parenting areas. Reliability of the survey measure was assessed via an estimate of the agreement coefficient for each of the nine areas. Concurrent validity was examined by exploring the correlates of parental Guidelines concordance. Results Reliability of the measure was acceptable to high in eight of the nine parenting areas. Greater parental Guidelines concordance was associated with being female, beliefs about healthy levels of drinking that align with the Australian national alcohol use guidelines, drinking within guidelines-recommended levels, the reduced likelihood of another adult in the household with a drinking problem, an older age of adolescent alcohol initiation, and greater confidence in the reported age of adolescent initiation. Conclusions This validated self-assessment parenting measure can be useful for identifying targets for parenting interventions designed to prevent or reduce adolescent alcohol misuse, and as a pre- and post-intervention assessment to assess the effects of such interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1452-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie B H Yap
- School of Psychological Sciences, Monash University, Melbourne, Australia. .,School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Anthony F Jorm
- School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Melbourne, Australia.
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Hart LM, Damiano SR, Chittleborough P, Paxton SJ, Jorm AF. Parenting to prevent body dissatisfaction and unhealthy eating patterns in preschool children: a Delphi consensus study. Body Image 2014; 11:418-25. [PMID: 25084034 DOI: 10.1016/j.bodyim.2014.06.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/17/2014] [Accepted: 06/28/2014] [Indexed: 10/24/2022]
Abstract
Interventions to prevent body dissatisfaction and unhealthy eating patterns are needed in early childhood. Identifying effective parenting strategies would be useful for parents and prevention researchers. To develop expert consensus, an online Delphi study was conducted with experts (N=28, Mage=44.34) who rated statements describing potential parenting strategies gleaned from a systematic literature search. If 90-100% rated a statement as either Essential or Important, it was endorsed as a guideline. From a total of 335 statements 153 were endorsed. Despite some areas of disagreement, including whether parents should weigh their child or discourage weighing, experts were able to reach consensus on a wide range of issues, such as how to discuss healthy eating with children. The developed guidelines provide a novel and required resource for parents, and a framework for researchers developing interventions to prevent the onset of body dissatisfaction and unhealthy eating patterns in early childhood.
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Affiliation(s)
- Laura M Hart
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Stephanie R Damiano
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Philip Chittleborough
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Susan J Paxton
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Hadlaczky G, Hökby S, Mkrtchian A, Carli V, Wasserman D. Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis. Int Rev Psychiatry 2014; 26:467-75. [PMID: 25137113 DOI: 10.3109/09540261.2014.924910] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants' knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass's Δ = 0.56 (95% CI = 0.38 - 0.74; p < 0.001), 0.28 (95% CI = 0.22 - 0.35; p < 0.001) and 0.25 (95% CI = 0.12 - 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or 'publication quality' (journal impact factor). The results demonstrate that MHFA increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.
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Affiliation(s)
- Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet , Stockholm , Sweden
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Yap MBH, Pilkington PD, Ryan SM, Kelly CM, Jorm AF. Parenting strategies for reducing the risk of adolescent depression and anxiety disorders: a Delphi consensus study. J Affect Disord 2014; 156:67-75. [PMID: 24359862 DOI: 10.1016/j.jad.2013.11.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 11/20/2013] [Accepted: 11/21/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND The family setting, particularly parents, is a strategic target for preventive interventions for youth depression and anxiety disorders. However, more effective translation of relevant research evidence is required. METHOD This study employed the Delphi methodology to establish expert consensus on parenting strategies that are important for preventing adolescent depression or anxiety disorders. A literature search identified 402 recommendations for parents. These were presented to a panel of 27 international experts over three survey rounds, who rated their preventive importance. RESULTS One-hundred and ninety parenting strategies were endorsed as important or essential in reducing adolescents' risk of developing depression or anxiety disorders by ≥90% of the panel. These strategies were written into a document suitable for parents, categorised under 11 sub-headings: You can reduce your child's risk of depression and anxiety problems, Establish and maintain a good relationship with your teenager, Be involved and support increasing autonomy, Establish family rules and consequences, Minimise conflict in the home, Encourage supportive relationships, Help your teenager deal with problems, Encourage good health habits, Help your teenager to deal with anxiety, Encourage professional help seeking when needed, and Don׳t blame yourself. LIMITATIONS This study utilised an international panel of experts from Western countries, hence the strategies identified may not be relevant for families from other cultural groups. CONCLUSIONS This study produced a set of parenting strategies that are supported by research evidence and/or international experts, which can now be promoted in Western English-speaking communities to help parents protect their adolescents from depression and anxiety disorders.
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Affiliation(s)
- Marie B H Yap
- Melbourne School of Population and Global Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia.
| | - Pamela D Pilkington
- Melbourne School of Population and Global Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
| | - Siobhan M Ryan
- Melbourne School of Population and Global Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Australia; School of Psychology, Deakin University, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
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Brown PC, Dunn ME, Budney AJ. Development and Initial Evaluation of a Web-Based Program to Increase Parental Awareness and Monitoring of Underage Alcohol Use: A Brief Report. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2014; 23:109-115. [PMID: 25774082 DOI: 10.1080/1067828x.2012.750553] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The development of a web-based parent-focused intervention to improve parental awareness and monitoring of adolescent alcohol use was preliminarily evaluated. Upon completion of baseline assessment, sixty-seven parents were randomly assigned to the experimental web-based parent-focused intervention or an assessment only control condition. Participants who completed the experimental program, relative to control participants, significantly improved knowledge of problems related to underage drinking (p < .01) while improvements in overall monitoring of their children approached significance (p = .08). Improvements in monitoring by experimental participants, relative to controls, were pronounced in phone monitoring (p < .01) and indirect monitoring (p = .05). Participants in this study improved their communication about alcohol from pre- to post-intervention regardless of intervention. There were no statistical between group differences found regarding underage drinking attitudes. This pilot evaluation demonstrates that this program warrants further examination in controlled trials with greater power. Study implications are discussed in light of results.
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Affiliation(s)
- Pamela C Brown
- University of Arkansas for Medical Sciences, 4301 West Markham Street #825-A, Little Rock, Arkansas 72205-1799, United States
| | - Michael E Dunn
- University of Central Florida, P.O. Box 161390, Orlando, Florida 32816-1390, United States
| | - Alan J Budney
- University of Arkansas for Medical Sciences, 4301 West Markham Street #825-A, Little Rock, Arkansas 72205-1799, United States
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Experiences of pediatric emergency physicians in providing alcohol-related care to adolescents in the emergency department. Pediatr Emerg Care 2013; 29:1260-5. [PMID: 24257589 DOI: 10.1097/pec.0000000000000024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The emergency department (ED) is a key clinical care setting for identifying and managing patients with alcohol-related presentations. We explored the experiences of emergency physicians in providing alcohol-related care to adolescents. METHODS Purposeful sampling was used to identify pediatric emergency physicians with at least 1 year of experience (n = 12) from pediatric EDs across Canada. Data were collected via telephone using a semistructured interview guide. Hermeneutic phenomenology was used to identify common and unique experiences among respondents, using Moustakas' immersion/crystallization procedures. RESULTS Physicians expressed frustration with patient behaviors accompanying intoxication and described providing care as a struggle; developing an effective therapeutic alliance was challenging. Physicians believed intoxicated adolescent patients required more clinical time and resources than they could offer. Although physicians described the ED as unsuitable for ensuring continuity of care and addressing the broader social issues that accompany alcohol use, they did view the ED as a place to medically stabilize the patient and initiate a discussion on alcohol use and its harmful effects. CONCLUSIONS Pediatric ED physicians struggled during the caring experience and were skeptical that broader, more chronic social issues that are often associated with adolescent alcohol misuse can be effectively managed in a clinical setting where they feel primarily responsible for providing medical stabilization. Physicians did believe the ED was an appropriate place to ensure medical stability of a patient and then initiate a conversation regarding alcohol use and its harmful effects.
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Yap MBH, Reavley N, Jorm AF. Where would young people seek help for mental disorders and what stops them? Findings from an Australian national survey. J Affect Disord 2013; 147:255-61. [PMID: 23228570 DOI: 10.1016/j.jad.2012.11.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND In order to improve help seeking by young people for mental illness, a better understanding is required of their help-seeking intentions and barriers to their help seeking from various different sources and for different disorders. METHODS Young people's help-seeking intentions and perceived barriers to help seeking were assessed by a national telephone survey of 3021 youths aged 15-25 years. Respondents were presented with a vignette of a young person portraying depression, depression with suicidal thoughts, depression with alcohol abuse, post-traumatic stress disorder, social phobia, or psychosis. RESULTS Embarrassment or shyness was the most frequently mentioned barrier to seeking help from most sources. However, different barriers featured prominently depending on the disorder and the helper. Age, sex, and knowing a family member or friend who had received professional help for mental illness predicted some barriers. LIMITATIONS Help-seeking intentions and barriers were assessed with reference to a vignette character and may not reflect actual experience or behaviors. CONCLUSIONS Findings can facilitate the targeting of future efforts to improve young people's help seeking for mental disorders by highlighting the barriers that are more relevant for specific disorders, sources of help and personal characteristics.
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Affiliation(s)
- Marie Bee Hui Yap
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia.
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Gilligan C, Kypri K. Parent attitudes, family dynamics and adolescent drinking: qualitative study of the Australian Parenting Guidelines for Adolescent Alcohol Use. BMC Public Health 2012; 12:491. [PMID: 22747699 PMCID: PMC3461436 DOI: 10.1186/1471-2458-12-491] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 06/21/2012] [Indexed: 11/30/2022] Open
Abstract
Background Parents play a critical role in their children’s introduction to alcohol. A range of parenting factors have been associated with the progression to risky drinking among adolescents, and have recently formed the basis of the Australian ‘Parenting Guidelines for Adolescent Alcohol Use’ designed to help parents delay or reduce their adolescents’ alcohol use. Methods This study aimed to explore the experiences and attitudes of parents of adolescents to gain insight into: (1) the extent to which the behaviours of parents follow the recommendations made in the guidelines; and (2) approaches to reduce hazardous drinking among adolescents. Thirty-two telephone and face-to-face interviews were conducted with parents, and the content of discussions was examined using thematic analysis. Results Parents used approaches they thought would minimise harm and promote healthy development in their children. The guidelines address key areas of concern for parents but their adherence to these approaches is low in certain areas. Many parents provided some alcohol to their adolescents and often cited the social norm of drinking among their adolescents’ peers as a source of pressure to supply. Conclusions Further dissemination of the guidelines may be the first step in a public health strategy, but it is likely that parents will require support to effectively adopt the recommendations. Understanding the influences on parents’ beliefs about their children’s drinking and the functions of social networks in the creation of behavioural norms relating to alcohol consumption and supply may be necessary to address adolescent risky drinking.
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Affiliation(s)
- Conor Gilligan
- Discipline of Health Behaviour Science and Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, University Drive Callaghan, Newcastle, 2308 NSW, Australia.
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Kelly A, Chan GCK, O'Flaherty M. How important is the context of an adolescent's first alcoholic drink? Evidence that parental provision may reduce later heavy episodic drinking. Eur Addict Res 2012; 18:140-8. [PMID: 22398663 DOI: 10.1159/000335059] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 10/28/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study examined the extent to which a retrospective measure of parental provision of the first alcoholic beverage was related to current heavy episodic drinking and current responsible drinking practices. SAMPLE 608 14- to 17-year-olds from the 2007 Australian National Drug Strategy Household Survey. MEASURES Source of first alcoholic beverage (friends/parents/others), source of current alcohol, age of onset of alcohol use, current responsible drinking practices, and proportion of current friends who drink. RESULTS Binary logistic and multiple regression procedures revealed that parental provision of an adolescent's first alcoholic beverage predicted lower current heavy episodic drinking, and responsible drinking mediated this association. DISCUSSION The results suggested that for adolescents who become alcohol users, parental provision of the first drink may reduce subsequent alcohol-related risks compared to introduction to alcohol by friends and other sources. Alcohol-related risks remain significant for adolescents who consume alcohol, independent of who is the provider.
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Affiliation(s)
- Adrian Kelly
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia. a.kelly @ uq.edu.au
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Drugs as instruments from a developmental child and adolescent psychiatric perspective. Behav Brain Sci 2011; 34:312-3. [PMID: 22074965 DOI: 10.1017/s0140525x11000690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Developmental, epidemiological, and neurobiological studies indicate that the adaptive and maladaptive functions, as well as immediate and long-term consequences of drug use, may vary by age. Early initiation seems to be associated with a reduced ability to use drugs purposely in a temporally stable, non-addictive manner. Prevention strategies should consider social environmental factors and aim to delay age at initiation.
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