1
|
Sidamo NB, Abebe Kerbo A, Gidebo KD, Wado YD. Adolescent utilization of sexual and reproductive health services in Gamo Zone, Southern Ethiopia. Insights from multilevel and latent class analysis. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1356969. [PMID: 39021710 PMCID: PMC11251959 DOI: 10.3389/frph.2024.1356969] [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: 12/16/2023] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Adolescents face unique challenges related to their sexual and reproductive health (SRH), with access to timely services being critical for positive outcomes. However, SRH service utilization among adolescents remains low. This study aimed to identify factors influencing SRH service use among adolescents in Gamo Zone, Ethiopia. Methods A community-based cross-sectional study involved 1172 adolescents selected through stratified sampling. Structured face-to-face interviews were employed for data collection. Multilevel mixed logistic regression was fitted to identify factors and latent class analysis was conducted to understand population heterogeneity. Results The findings of this study reveal that 198 (16.89%) adolescents (95% CI: 14.8%-19.2%) utilized SRH services within the past 12 months. Factors significantly associated with SRH service utilization included good knowledge about SRH rights (AOR = 4.65; 95% CI: 2.68, 8.07), belonging to one-parent families (AOR = 4.13; 95% CI: 2.39, 7.12), engaging in parental discussions regarding SRH issues (AOR = 3.17; 95% CI: 1.89, 5.29), high family support (AOR = 1.96; 95% CI: 1.09, 3.51), and enrolling in school (AOR = 0.19; 95% CI: 0.11, 0.33). Additionally, access to social media was associated with increased SRH service utilization among adolescents (AOR = 1.98; 95% CI: 1.25, 3.15). Latent class analysis identified four groups: rural school-enrolled adolescents living with parents, urban school-enrolled adolescents with both parents, urban disadvantaged female adolescents, and early adolescents with limited social media access. Conclusions In conclusion, our study sheds light on the utilization of SRH services among adolescents, revealing that 16.89% of the participants accessed these services within the past year. Significant factors associated with SRH service utilization included good knowledge about SRH rights, belonging to one-parent families, engaging in parental discussions regarding SRH issues, high family support, and enrollment in school. Interestingly, access to social media was also linked to increased utilization of SRH services among adolescents. Furthermore, our latent class analysis identified four distinct classes of adolescents based on socio-demographic indicators, highlighting the heterogeneity within this population. These findings underscore the importance of tailored interventions and targeted approaches to address the diverse needs of adolescents in accessing and utilizing SRH services.
Collapse
Affiliation(s)
- Negussie Boti Sidamo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Amene Abebe Kerbo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kassa Daka Gidebo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | |
Collapse
|
2
|
Brathwaite R, Mutumba M, Nannono S, Ssewamala FM, Filiatreau LM, Namatovu P. Prevalence and Correlates of Substance Use Among Youth Living with HIV in Fishing Communities in Uganda. AIDS Behav 2024; 28:2414-2426. [PMID: 38605252 DOI: 10.1007/s10461-024-04339-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 04/13/2024]
Abstract
Alcohol and drug use (ADU) poses a significant barrier to optimal HIV treatment outcomes for adolescents and youths living with HIV (AYLHIV). We aimed to investigate the prevalence and correlates of ADU among ALHIV in Ugandan fishing communities, areas characterized by high HIV and poverty rates. AYLHIV aged 18-24, who knew they were HIV-positive, were selected from six HIV clinics. Substance use was determined through self-report in the last 12 months and urine tests for illicit substances. Utilizing a socioecological framework, the study structured variables into a hierarchical logistic regression analysis to understand the multi-layered factors influencing ADU. Self-reported past 12 months substance use was 42%, and 18.5% of participants had a positive urine test for one or more substances, with alcohol, benzodiazepines, and marijuana being the most commonly used. With the addition of individual-level socio-demographics, indicators of mental health functioning, interpersonal relationships, and community factors, the logistic regression analysis revealed greater exposure to adverse childhood experiences increased the odds of substance use (Odds Ratio [OR] = 1.24; 95% Confidence Interval [CI]: 1.03-1.55). Additionally, exposure to alcohol advertisements at community events significantly raised the odds of substance use (OR = 3.55; 95% CI: 1.43-8.83). The results underscore the high prevalence among AYLHIV and emphasize the need for comprehensive interventions targeting individual (e.g., life skills education and mental health supports), interpersonal (e.g., peer support and family-based interventions), community (e.g., community engagement programs, restricted alcohol advertisements and illicit drug access), and policies (e.g., integrated care models and a national drug use strategy), to address ADU.
Collapse
Affiliation(s)
- Rachel Brathwaite
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA.
| | - Massy Mutumba
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, 400 North Ingalls Building Ann Arbor, MI, 48109-5482, USA
| | - Sylvia Nannono
- International Center for Child Health and Development, Masaka, Uganda
| | - Fred M Ssewamala
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Lindsey M Filiatreau
- Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA
| | - Phionah Namatovu
- International Center for Child Health and Development, Masaka, Uganda
| |
Collapse
|
3
|
Das P, Das T, Roy TB. Investigating key latent factors influencing alcohol consumption among the tribal male adolescents in Dooars region, West Bengal. J Ethn Subst Abuse 2024:1-24. [PMID: 38613768 DOI: 10.1080/15332640.2024.2340540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
BACKGROUND Alcohol consumption among tribal male adolescents in India is a significant social concern. Tribal adolescents are particularly vulnerable and tend to lean toward alcohol addiction. Therefore, it is crucial to introduce some necessary footsteps to reduce alcohol consumption. The primary objective of this study is to investigate the association of various latent factors with the alcohol-drinking behavior of tribal adolescents. METHODS The study collected data from 600 tribal adolescents from the Dooars region, with 241 of them reported consuming alcohol. The study aimed to confirm the theoretical development of hypotheses regarding peer pressure, parental discord, stress, attitude toward alcohol, and food insecurity as exogenous latent factors influencing the alcohol-drinking behavior of tribal adolescents. In this context, the study adopted both measurement and structural models using Partial Least Squares-Structural Equation Modeling (PLS-SEM). RESULTS The findings revealed a significant path relationship between alcohol drinking behavior and various exogenous factors like peer pressure (β = 0.214, p = .000), parental discord (β = 0.121, p = .009), stress (β = 0.170, p = .000), attitude toward alcohol (β = 0.110, p = .004), and food insecurity (β = 0.510, p = .000). This study developed a reflective measurement model, and the evaluation of reflective measurement models was conducted, assessing internal consistency, convergent validity, and discriminant validity, yielding satisfactory results. CONCLUSION To tackle alcohol issues among tribal adolescents in the Dooars region, effective strategies should be employed. These include educating in schools, highlighting tribal role models, aiding peers with alcohol dependence, providing life skills training, and addressing parental discord and food insecurity through awareness campaigns, workshops, and better infrastructure.
Collapse
Affiliation(s)
| | - Tanu Das
- Raiganj University, Raiganj, India
| | | |
Collapse
|
4
|
Sidamo NB, Kerbo AA, Gidebo KD, Wado YD. Exploring Barriers to Accessing Adolescents Sexual and Reproductive Health Services in South Ethiopia Regional State: A Phenomenological Study Using Levesque's Framework. Adolesc Health Med Ther 2024; 15:45-61. [PMID: 38562442 PMCID: PMC10984202 DOI: 10.2147/ahmt.s455517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Evidence suggests that adolescents face multiple barriers to accessing Sexual and Reproductive Health (SRH) services. However, there remains a notable gap in the literature regarding the nuanced interplay between supply-side and demand-side barriers. Therefore, this study aimed to examine barriers to accessing SRH services in the Gamo Zone of South Ethiopia Regional State. Methods A descriptive phenomenology study was conducted from September 04 to October 15, 2023. A total of seven Focus Group Discussions (FGDs), four with girls and three with boys, with a total of 75 adolescents, and ten Key informant interviews (KIIs)with healthcare providers participated in the study. A semi-structured interview guide was used to explore their lived experiences. All interviews and discussions were audio-recorded. To analyze and manage data framework analysis approach was applied using ATLAS Ti version 7 software. Results The major barriers preventing adolescents from accessing SRH services are related to the interplay between supply and demand-side barriers across all five domains of the Levesque framework. Despite the high need for access to health care, lack of SRH literacy, lack of outreach activities, and integration of SRH information in health facilities often hampered adolescents' healthcare need. Additionally, fear of stigma from family and community, social norms, and lack of discussion of SRH issues hindered their ability to seek health care. Shortage of supplies and healthcare providers' behaviors further hindering adolescents' ability to access health care services. Furthermore, the limited involvement of adolescents in decision-making and the lack of effective coordination further complicate the appropriateness of services for adolescents. Conclusion The finding of this study reveals that adolescents face multifaceted barriers. Therefore, there is a need for high-impact complex interventions, program and policy that address both supply and demand side barriers needs to give due intention to improve access to SRH services for adolescents.
Collapse
Affiliation(s)
- Negussie Boti Sidamo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Amene Abebe Kerbo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kassa Daka Gidebo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | |
Collapse
|
5
|
Latt NNN, Putdivarnichapong W, Phetrasuwan S, Vongsirimas N. Factors predicting the intention of drug abuse avoidance among adolescents in Pinlaung Township, Myanmar: predictive correlational design. BMC Public Health 2024; 24:8. [PMID: 38166869 PMCID: PMC10759472 DOI: 10.1186/s12889-023-17419-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Adolescence is a critical transition period and is at high risk for drug/substance abuse. In Myanmar, drug use is common among adolescents and is a public health concern. There are no studies of drug abuse prevention among Myanmar adolescents. Intentions to avoid drug abuse can be a protective factor for preventing drug abuse among adolescents. This study investigated the effects of sex, parental history of drug/alcohol abuse, self-efficacy, parental marital status, and family functioning on the intention of drug abuse avoidance among Myanmar adolescents. METHODS This is a predictive correlational study. The Biopsychosocial model was used as the theoretical framework of this study. A convenient sampling method was used to collect data from 157 students aged 13-18 years in a government school, middle school level and high school level, Pinlaung Town, Southern Shan State, Myanmar during the COVID-19 pandemic and political protests. G* power software was used to calculate the sample size. Data was collected by four self-administered questionnaires: a socio-demographic questionnaire, Thai Family Functioning Scale (TFFS), General Self-Efficacy Scale (GSE), and Intention of Drug Avoidance Scale (IDAS). Multiple linear regression was employed to analyze the data. RESULTS Five predictors, including biological sex, parental history without drug/alcohol abuse, self-efficacy, parental marital status, and family functioning, explained 24.4% of the variance in the intention of drug abuse avoidance among Myanmar adolescents (R 2 = .244, F (5,151) = 9.738, p = .000). In addition, only three factors, family functioning (β = .31, p < .001), biological sex (β = -.25, p < .01), and self-efficacy (β = .16, p < .05) statistically and significantly predicted the intention of drug abuse avoidance among Myanmar adolescents. CONCLUSIONS Family functioning, female gender, and self-efficacy predicted the intention of drug abuse avoidance among Myanmar adolescents in Pinlaung Township, Southern Shan State, Myanmar. IMPLICATIONS OF THIS STUDY The results of this study have implications for all stakeholders through research, education, practice, and policymaking leading to improve the intentions of drug abuse avoidance among Myanmar adolescents. Furthermore, the results of this study specifically contribute to create psychoeducational intervention programs for increasing intention to avoid substance use by promoting family functioning and self-efficacy of adolescents. This is especially proper for male adolescents who have less intention to avoid substance use.
Collapse
Affiliation(s)
- Nang Nwe Nwe Latt
- Student of Master of Nursing Science Program (International Program), Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Wimolnun Putdivarnichapong
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand.
| | - Supapak Phetrasuwan
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand
| | - Nopporn Vongsirimas
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand
| |
Collapse
|
6
|
Namuwonge F, Kizito S, Ssentumbwe V, Kabarambi A, Magorokosho NK, Nabunya P, Namuli F, Namirembe R, Ssewamala FM. Peer Pressure and Risk-Taking Behaviors Among Adolescent Girls in a Region Impacted by HIV/AIDS in Southwestern Uganda. J Adolesc Health 2024; 74:130-139. [PMID: 37804302 PMCID: PMC10841615 DOI: 10.1016/j.jadohealth.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/28/2023] [Accepted: 08/02/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE This paper uses data from a 3-arm Cluster Randomized Control Trial, Suubi4Her (N = 1260; 14-17-year-old school-going girls) to (1) assess the relationship between peer pressure and adolescent risk-taking behaviors; and (2) test the mediating effect of peer pressure on an intervention on adolescent risk-taking behaviors. METHODS Students in the southwestern region of Uganda were assigned to three study arms: control (n = 16 schools, n = 408 students) receiving usual care comprising of sexual and reproductive health curriculum; and two active treatment arms: Treatment 1 (n = 16 schools, n = 471 students) received everything the control arm received plus a savings led intervention. Treatment 2 (n = 15 schools, n = 381 students) received everything the control and treatment arms received plus a family strengthening intervention. We used multilevel models to assess the relationship between peer pressure and risk-taking behaviors. We ran structural equation models for mediation analysis. RESULTS Using baseline data, we found that direct peer pressure was significantly associated with substance use risk behaviors, (β = 0.044, 95% CI = 0.008, 0.079). We also found a statistically significant effect of the intervention on acquiring STIs through the mediating effect of sexual risk-taking significant (β = -0.025, 95% CI: -0.049, -0.001, p = .045) and total indirect (β = -0.042, 95% CI: -0.081, -0.002, p = .037) effects. Also, there was a significant mediation effect of the intervention on substance use through peer pressure (β = -0.030, 95% CI: -0.057, -0.002, p = .033). DISCUSSION Overall, the study points to the role of peer pressure on adolescent girls' risk-taking behaviors; and a need to address peer pressure at an early stage.
Collapse
Affiliation(s)
- Flavia Namuwonge
- International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri
| | - Samuel Kizito
- International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri
| | - Vicent Ssentumbwe
- International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri
| | - Anita Kabarambi
- International Center for Child Health and Development, Masaka Field, Masaka, Uganda
| | - Natasja K Magorokosho
- International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri
| | - Proscovia Nabunya
- International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri
| | - Florence Namuli
- International Center for Child Health and Development, Masaka Field, Masaka, Uganda
| | - Rashida Namirembe
- International Center for Child Health and Development, Masaka Field, Masaka, Uganda
| | - Fred M Ssewamala
- International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri.
| |
Collapse
|
7
|
Carels C, Florence M, Adams S, Savahl S. Alcohol Use as a Predictor of Risky Sexual Behaviour among Young Adults in the Western Cape Province of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7053. [PMID: 37998284 PMCID: PMC10671005 DOI: 10.3390/ijerph20227053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
The aim of this study was to investigate the relation between alcohol consumption and risky sexual behaviour (RSB). This study further aimed to examine whether alcohol use, gender, and employment status predicted RSB among young adults in the Cape Flats. A better understanding of these predictors could potentially lead to a more thorough comprehension of the relation between alcohol consumption and RSB among young adults within the South African context. The study employed a cross-sectional correlational survey design, with a sample of 1001 participants aged 18 to 25 (51% women), using the street-intercept method. Participants were selected using purposive sampling, with age and geographical location employed as inclusion criteria. We used the Self-Report Risky Sexual Behaviours Scale (SRSBS) and the Alcohol Use Disorder Identification Test (AUDIT), which were cognitively tested and modified, in English and Afrikaans. The data were analysed via multivariate multiple regression analysis in Stata. The key findings indicate that alcohol consumption is an important predictor of RSB. Alcohol consumption accounted for 23.22% of the variation in RSB. We also found that alcohol consumption and gender were significant (p < 0.1) predictors of RSB, but not employment status (p > 0.01). Being a woman decreased RSB. The model indicates that alcohol use and gender explain 18.41% of the variance in RSB. This study provides support for the growing body of research evidence that has established a significant link between alcohol consumption and RSB, highlighting the need for longitudinal research to determine patterns of risky drinking in the general population.
Collapse
Affiliation(s)
- Cassandra Carels
- Department of Psychology, University of the Western Cape, Cape Town 7535, South Africa
| | - Maria Florence
- Department of Psychology, University of the Western Cape, Cape Town 7535, South Africa
| | - Sabirah Adams
- Language Development Group, Centre for Higher Education Development, University of Cape Town, Cape Town 7701, South Africa
| | - Shazly Savahl
- Department of Psychology, University of the Western Cape, Cape Town 7535, South Africa
| |
Collapse
|
8
|
Brathwaite R, Mutumba M, Nanteza J, Filiatreau LM, Migadde H, Namatovu P, Nabisere B, Mugisha J, Mwebembezi A, Ssewamala FM. Assessing the Feasibility of Economic Approaches to Prevent Substance Abuse Among Adolescents: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e46486. [PMID: 37314844 PMCID: PMC10337321 DOI: 10.2196/46486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Adolescent alcohol and drug use (ADU) is a significant public health challenge. Uganda, one of the poorest countries in Sub-Saharan Africa (SSA), has the second-highest rate of per capita alcohol consumption in SSA, and over one-third of Ugandan adolescents have used alcohol in their lifetime (over 50% of them engage in heavy episodic drinking). These estimates further increase in fishing villages, a key HIV-vulnerable population, where ADU is normative. However, few studies have assessed ADU among adolescents and youths living with HIV despite their increased risk for ADU and its impact on engagement in HIV care. Moreover, data on risk and resilience factors for ADU are scarce as only few studies evaluating ADU interventions in SSA have reported positive outcomes. The majority have been implemented in school settings, potentially excluding adolescents in fishing communities with high school dropout rates, and none have targeted risk factors including poverty and mental health, which are rampant among adolescents and youths living with HIV and their families, undermine their coping skills and resources, and have been associated with increased risk for ADU among them. OBJECTIVE We propose a mixed methods study with a sample of 200 adolescents and youths living with HIV (aged 18-24 years) seen at 6 HIV clinics in southwestern Uganda's fishing communities to (1) examine the prevalence and consequences of ADU and identify the multilevel risk and resilience factors associated with ADU among them and (2) explore the feasibility and short-term effects of an economic empowerment intervention on ADU among them. METHODS This study comprises four components: (1) focus group discussions (FGDs) with adolescents and youths living with HIV (n=20) and in-depth qualitative interviews with health providers (n=10) from 2 randomly selected clinics; (2) a cross-sectional survey with 200 adolescents and youths living with HIV; (3) a randomized controlled trial with a subgroup of adolescents and youths living with HIV (n=100); and (4) 2 postintervention FGD with adolescents and youths living with HIV (n=10 per group). RESULTS Participant recruitment for the first qualitative phase has completed. As of May 4, 2023, ten health providers from 6 clinics have been recruited, provided written consent to participate, and participated in in-depth qualitative interviews. Two FGDs was conducted with 20 adolescents and youths living with HIV from 2 clinics. Data transcription, translation, and analysis of qualitative data has commenced. The cross-sectional survey will commence shortly after and dissemination of the main study findings is targeted for 2024. CONCLUSIONS Our findings will advance our understanding of ADU among adolescents and youths living with HIV and inform the design of future interventions to address ADU among them. TRIAL REGISTRATION ClinicalTrials.gov NCT05597865; https://clinicaltrials.gov/ct2/show/NCT05597865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46486.
Collapse
Affiliation(s)
- Rachel Brathwaite
- Brown School, Washington University in St. Louis, St Louis, MO, United States
| | - Massy Mutumba
- Department of Health Behavior & Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | | | - Lindsey M Filiatreau
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Herbert Migadde
- International Center for Child Health and Development, Masaka, Uganda
| | - Phionah Namatovu
- International Center for Child Health and Development, Masaka, Uganda
| | - Betina Nabisere
- International Center for Child Health and Development, Masaka, Uganda
| | | | | | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, St Louis, MO, United States
| |
Collapse
|
9
|
González-Cano-Caballero M, Torrejón-Guirado MC, Cano-Caballero MD, Mac Fadden I, Barrera-Villalba MDC, Lima-Serrano M. Adolescents and youths' opinions about the factors associated with cannabis use: a qualitative study based on the I-Change model. BMC Nurs 2023; 22:114. [PMID: 37046264 PMCID: PMC10091594 DOI: 10.1186/s12912-023-01283-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/31/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND To learn about the experiences and opinions of adolescent non-consumers and regular cannabis users about cannabis use and the factors that determine its use, using the I-Change explanatory model as a basis. METHODS Qualitative methodology with a content analysis was used. Focus groups were conducted with adolescents who were non-regular cannabis users (those who had not tried cannabis or had only experimented with it before) and semi-structured interviews were conducted with adolescent and young adult in recovery who were in a detoxification program. A deductive analysis of the audio-recorded and transcribed interviews was performed, using the domains of the I-Change Model as a reference. RESULTS Personal problems, social problems or family problems can lead to cannabis use. There was a lack of knowledge and low risk perception about consumption of this drug. There are other factors that influence consumption, the perception of advantages, such as the feeling of freedom and the influence of the peer group. The consumption of this substance in girls is changing, becoming more and more equal to that of boys. The family has an important role to play in preventing drug use. CONCLUSION Knowledge of these factors is of vital importance as a prior step to the development of efficient intervention measures adjusted to the needs identified and the characteristics of the population.
Collapse
Affiliation(s)
| | - María-Carmen Torrejón-Guirado
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, 41009, Spain
- Department of Health Promotion, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - María Dolores Cano-Caballero
- Deputy Directorate of Care. Virgen de las Nieves University Hospital, Granada, 18014, Spain.
- Department of Nursing, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071, Granada, Spain.
| | | | | | - Marta Lima-Serrano
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, 41009, Spain
| |
Collapse
|
10
|
Birhanu A, Bete T, Eyeberu A, Getachew T, Yadeta E, Negash A, Lami M, Balcha T, Sertsu A, Deballa A. Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. Subst Abuse Rehabil 2023; 14:25-34. [PMID: 37131538 PMCID: PMC10149075 DOI: 10.2147/sar.s401843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/22/2023] [Indexed: 05/04/2023] Open
Abstract
Introduction Psychoactive substance use is a growing health problem in both developing and developed countries. Despite adolescents being at high risk of practicing risky behaviors including substance use, there is no adequate information on the problem in the Harari Region, in the Eastern part of Ethiopia. Hence, the present study aimed to identify the burden of current substance use in high school adolescent students of Harari Region, Ethiopia, from 10th April to 10th May 2022. Methods A school-based cross-sectional study was employed on a total of 1498 randomly selected adolescent students. Poisson regression was used for the assessment of substance use over the last three months among adolescent students. The substance use burden was reported by IRR (incidence rate ratio) at a 95% Confidence interval. The final model fitness was checked using Akaike information criterion (AIC) and Bayesian information criterion (BIC) reports. The variables that had less than 0.05 P-value were declared to be statistically significant. Results The overall psychoactive substance use was 373 (24.9%, 95% Confidence Interval (CI); 22.8-27.1%). The substances included khat (21.6%, 95% CI; 18.6-23.6%), alcohol drinking (1.8%; 95% CI; 1.3-2.6%), and smoking (1.2%, 95% CI; 0.75-1.9%). Being male (IRR (Incidence Rate ratio) = 1.21, 95% CI; 1.11-1.38), availability of the substance (IRR (Incidence Rate ratio) = 2.02, 95%; 1.53-2.66), having substance user friends (IRR=1.60: 95% CI: 1.30-2.01), and being at a younger age (IRR = 1.21; 95% CI: 1.02-1.44) increased the psychoactive substance use rate in the adolescents. Conclusion and Recommendation One out of four adolescents was a current psychoactive substance user. Being male, substance availability, having substance-user friends, and being at younger age increased the psychoactive substance use rate in school adolescents in Eastern Ethiopia. The intervention that involves the schools' community, students' families, and executive bodies should be strengthened to overcome the substance use-related burdens among high school adolescent students.
Collapse
Affiliation(s)
- Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Correspondence: Abdi Birhanu, Haramaya University, P.O. Box: 235, Harar, Ethiopia, Email
| | - Tilahun Bete
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Magarsa Lami
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tegenu Balcha
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- Department of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Deballa
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
11
|
Onaolapo OJ, Olofinnade AT, Ojo FO, Adeleye O, Falade J, Onaolapo AY. Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature. World J Psychiatry 2022; 12:1268-1286. [PMID: 36389088 PMCID: PMC9641378 DOI: 10.5498/wjp.v12.i10.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/01/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023] Open
Abstract
The relationship between man and substances that have abuse potentials, and whose use has been associated with the development or progression of substance use disorders has continued to evolve in terms of geography, economic implications, and time. History shows that local plants with psychoactive constituents can get exported worldwide through global travel, commerce, or even conquest. Time and globalization also change people’s relationship with substances of abuse; hence, an area that was initially alien to certain substances might evolve to becoming a trafficking hub, and then a destination. A case in point is Africa where a rapidly increasing prevalence of substance use/abuse and substance use disorder among adolescents and young adults is putting enormous strain on the economy, healthcare system, and society at large. However, there appears to be a paucity of scientific literature and data on the epidemiology, risk assessment, and contributing factors to substance use and the development of substance use disorders across Africa. In this narrative review, we examine extant literature (PubMed, Google scholar, Medline) for information on the prevalence, trends, and influencers of substance use and the development of substance use disorders. This is with a view of understanding the determinants of substance use and factors that influence the development of substance use disorders in the region, and how this information can be channeled towards developing a comprehensive intervention and treatment program.
Collapse
Affiliation(s)
- Olakunle James Onaolapo
- Behavioral Neuroscience Unit, Neuropharmacology Subdivision, Department of Pharmacology, Ladoke Akintola University of Technology, Ogbomoso 210214 Oyo, Nigeria
| | - Anthony Tope Olofinnade
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University, Ikeja 100001, Lagos, Nigeria
| | - Foluso Olamide Ojo
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| | - Olufunto Adeleye
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| | - Joshua Falade
- Department of Mental Health, Afe Babalola University, Ado-Ekiti 360282, Ekiti, Nigeria
| | - Adejoke Yetunde Onaolapo
- Behavioral Neuroscience Unit, Neurobiology Subdivision, Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| |
Collapse
|
12
|
Jayamaha AR, Dharmarathna ND, Herath ND, Ranadeva ND, Fernando MM, Samarasinghe KL, Amarabandu PN, Senanayake B, Darshana T, Renuka N, Rajapakse IH, Gunasekara CP, Meegoda L, Fernando N. The Pattern of Substance Use and Characteristics of the Individuals Enrolled in Residential Treatment at Selected Rehabilitation Centers in Sri Lanka: A Descriptive Cross-Sectional Study. Subst Abuse 2022; 16:11782218221100823. [PMID: 35645565 PMCID: PMC9130826 DOI: 10.1177/11782218221100823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/26/2022] [Indexed: 01/23/2023]
Abstract
Introduction: Substance use becomes censorious when it leads to harmful effects on
individuals, their families, and the community. The nature of substance use
in Sri Lankan context is poorly understood and empirical evidences are
sparse. The study aimed to describe patterns of substance use and
characteristics of the individuals enrolled in residential treatment at
selected rehabilitation centers in Sri Lanka. Material and methods: A descriptive cross-sectional study was conducted among 205 individuals
enrolled in selected rehabilitation centers. Pretested
interviewer-administered questionnaire was used to collect data. Data were
analyzed using descriptive statistics. Results: Most of the individuals who enrolled in residential treatment at selected
rehabilitation centers were unmarried (n = 124, 60.5%), Sinhala (n = 186,
90.7%), Buddhist (n = 166, 81.0%), males (n = 202, 98.5%) and belonged to
the young adult age (18-35 years) category (n = 178, 86.8%). All the
participants were poly-drug users and cannabis was the most commonly used
(n = 183, 89.3%) illicit drug followed by heroin (n = 172, 83.9%),
methamphetamine (n = 150, 73.2%) and cocaine (n = 78, 38%). The most
(n = 152, 74.1%) problematic substance for life was heroin. Most of the
participants (n = 149, 72.7%) had used drugs several times per day. The mean
duration of substance use was 7 ± 5 years. Participants (n = 177, 86.3%)
reported that the substances were available in their residential areas and
their friends (n = 197, 96.1%) were also using the substances. Conclusions: Pattern of substance use and characteristics of the individuals were unique
in Sri Lanka and need to be considered when implementing and strengthening
the programs for drug prevention and rehabilitation.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Nilani Renuka
- National Dangerous Drugs Control Board, Colombo, Sri Lanka
| | | | | | - Lalitha Meegoda
- University of Sri Jayewardenepura, Jayewardenepura, Sri Lanka
| | - Neluka Fernando
- University of Sri Jayewardenepura, Jayewardenepura, Sri Lanka
| |
Collapse
|
13
|
The Contribution of Parental Factors to Adolescents’ Deviant Behaviour in South Africa: Evidence from Three Rural Communities in South Africa. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11040152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Challenges associated with adolescents are prevalent in South African societies. During the adolescence stage, children may become involved in deviant behaviour. Although a significant number of studies have focused on the factors that contribute to adolescents’ deviant behaviour, including parental factors, there is paucity of research specifically in rural communities. This study explores the contribution of parental factors to adolescents’ deviant behaviour in rural communities in South Africa. Guided by the qualitative approach, the present study makes use of semi-structured interviews to collect data and thematic analysis to analyse data. The parental factors identified include less parental supervision, a lack of support, an absence of parental discipline, parent’s lack of concern and the inability of parents to be role models. These factors play a role in adolescent deviant behaviour, such as crime, dropping out of school and substance abuse. Therefore, by focusing on the family, especially parental behaviour, the potential to reduce adolescent deviant behaviour becomes possible. This is important in promoting the well-being of adolescents, their families and society.
Collapse
|
14
|
Nguyen TT, Dinh TTT, Busse A, Kashino W, Suhartono S, Le MG. Family-based intervention for adolescents with substance use disorders in Vietnam. Addict Behav Rep 2021; 14:100382. [PMID: 34938840 PMCID: PMC8664868 DOI: 10.1016/j.abrep.2021.100382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent substance use is a leading risk factor of medical and social problems in adults. However, evidence-based interventions for substance use disorders (SUD) among youth in resource-limited countries are lacking. Treatnet Family (TF), developed by United Nations Office on Drugs and Crime (UNODC), aims to make youth SUD care more affordable and accessible in low- and middle-income countries. This study explores the suitability of TF in Vietnam. METHOD Twenty interviews were conducted with eight adolescents and their family members who participated in TF, and four practitioners who delivered TF. Questions centred on their experiences with the intervention and suggestions for improvement. Thematic analysis was used to evaluate the data. RESULTS All adolescents were male with an average age of 19.3. Seven of them had left school. Most caregivers were female. Both family members and adolescents expressed a great demand for support, and both groups appreciated the immediate improvement in parent-child communication. However, the impact of TF could be compromised due challenges in recruiting families, possibly arising from the novelty of a family-based intervention in Vietnam and drug-related stigma. The perception of drug use as an acute condition instead of a chronic disorder, and the lack of a continuing care system, also made it difficult to retain participants. CONCLUSION Vietnamese adolescents with SUD and their family members were in great need of support and access to evidence-based interventions. Building a comprehensive, health-centred substance use disorder treatment and care system would enhance treatment impact.
Collapse
Affiliation(s)
- Thu Trang Nguyen
- Centre for Training and Research on Substance Use and HIV, Hanoi Medical University, Viet Nam
| | - Thi Thanh Thuy Dinh
- Centre for Training and Research on Substance Use and HIV, Hanoi Medical University, Viet Nam
| | - Anja Busse
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Wataru Kashino
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Sanita Suhartono
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Minh Giang Le
- Centre for Training and Research on Substance Use and HIV, Hanoi Medical University, Viet Nam
| |
Collapse
|
15
|
Nawi AM, Ismail R, Ibrahim F, Hassan MR, Manaf MRA, Amit N, Ibrahim N, Shafurdin NS. Risk and protective factors of drug abuse among adolescents: a systematic review. BMC Public Health 2021; 21:2088. [PMID: 34774013 PMCID: PMC8590764 DOI: 10.1186/s12889-021-11906-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background Drug abuse is detrimental, and excessive drug usage is a worldwide problem. Drug usage typically begins during adolescence. Factors for drug abuse include a variety of protective and risk factors. Hence, this systematic review aimed to determine the risk and protective factors of drug abuse among adolescents worldwide. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted for the review which utilized three main journal databases, namely PubMed, EBSCOhost, and Web of Science. Tobacco addiction and alcohol abuse were excluded in this review. Retrieved citations were screened, and the data were extracted based on strict inclusion and exclusion criteria. Inclusion criteria include the article being full text, published from the year 2016 until 2020 and provided via open access resource or subscribed to by the institution. Quality assessment was done using Mixed Methods Appraisal Tools (MMAT) version 2018 to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken. Results Out of 425 articles identified, 22 quantitative articles and one qualitative article were included in the final review. Both the risk and protective factors obtained were categorized into three main domains: individual, family, and community factors. The individual risk factors identified were traits of high impulsivity; rebelliousness; emotional regulation impairment, low religious, pain catastrophic, homework completeness, total screen time and alexithymia; the experience of maltreatment or a negative upbringing; having psychiatric disorders such as conduct problems and major depressive disorder; previous e-cigarette exposure; behavioral addiction; low-perceived risk; high-perceived drug accessibility; and high-attitude to use synthetic drugs. The familial risk factors were prenatal maternal smoking; poor maternal psychological control; low parental education; negligence; poor supervision; uncontrolled pocket money; and the presence of substance-using family members. One community risk factor reported was having peers who abuse drugs. The protective factors determined were individual traits of optimism; a high level of mindfulness; having social phobia; having strong beliefs against substance abuse; the desire to maintain one’s health; high paternal awareness of drug abuse; school connectedness; structured activity and having strong religious beliefs. Conclusion The outcomes of this review suggest a complex interaction between a multitude of factors influencing adolescent drug abuse. Therefore, successful adolescent drug abuse prevention programs will require extensive work at all levels of domains.
Collapse
Affiliation(s)
- Azmawati Mohammed Nawi
- Department of Community Health, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- Centre for Research in Psychology and Human Well-Being (PSiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia.
| | - Fauziah Ibrahim
- Centre for Research in Psychology and Human Well-Being (PSiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Community Health, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Noh Amit
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Shafini Shafurdin
- Centre for Research in Psychology and Human Well-Being (PSiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
| |
Collapse
|
16
|
Gordon K, Kutywayo A, Frade S, Naidoo N, Mullick S. Socio-demographic and social support factors related to substance use in South African in-school adolescents: Insights from the Girls Achieve Power (GAP Year) trial in three peri-urban settings. Gates Open Res 2021; 5:154. [PMID: 35445170 PMCID: PMC8994034 DOI: 10.12688/gatesopenres.13422.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Substance use is a significant public health problem worldwide, with consequences including violence, risky behaviours, and even death. Substance use amongst adolescents is increasing in South Africa, and limited research on frequency, risk and protective factors means that prevention interventions are difficult to design. This paper aims to describe and discuss factors associated with substance use among school-going adolescents in three peri-urban South African settings. Methods: A cross-sectional analysis was conducted using baseline data from participants in the Girls Achieve Power (GAP Year) trial. Grade 8 learners (N=2383), aged 11-18, were recruited from 26 lowest quintile public high schools in three townships: Soweto and Thembisa in Gauteng Province, and Khayelitsha in Western Cape Province. A baseline survey gathered demographic and behavioural data. Questions relevant to substance use and social support were used for this analysis. Multivariate logistic regression analyses were conducted to identify factors associated with substance use. The final variables were included in an unadjusted and adjusted logistic regression for current substance use, and a multinomial logistic regression for frequency of substance use. Results: A total of 22.5% (534) of participants indicated they had ever used substances. Being male was strongly associated with substance use (P<0.001), and less strongly with frequency of substance use. Age significantly predicted substance use, with older adolescents being more likely to engage in substance use (P<0.001); having a parent/guardian employed was negatively associated with substance use (P=0.021). Family-related social support variables were predictive of substance use. Being able to count on friends when things went wrong was predictive of lower frequency of substance use (P=0.019). Conclusions: These results can inform the targeting of prevention interventions to males and younger learners, as well as ensuring youth interventions build family and peer support to make substance use less likely and less frequent.
Collapse
Affiliation(s)
- Kerry Gordon
- Wits Reproductive Health & HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg, 2193, South Africa
| | - Alison Kutywayo
- Wits Reproductive Health & HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg, 2193, South Africa
| | - Sasha Frade
- Demography and Population Studies Programme, University of the Witwatersrand, Johannesburg, 2000, South Africa
| | - Nicolette Naidoo
- Wits Reproductive Health & HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg, 2193, South Africa
| | - Saiqa Mullick
- Wits Reproductive Health & HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg, 2193, South Africa
| |
Collapse
|
17
|
Mills R, Mann MJ, Smith ML, Kristjansson AL. Parental support and monitoring as associated with adolescent alcohol and tobacco use by gender and age. BMC Public Health 2021; 21:2000. [PMID: 34736436 PMCID: PMC8567647 DOI: 10.1186/s12889-021-12119-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parental support (PS) and parental monitoring (PM) are known protective factors against adolescent substance use (SU). However, little is known about whether PS and PM may affect SU outcomes differently by gender and age. This study examined the relationship between PS and PM and adolescent SU, specifically alcohol and tobacco use, stratified by gender and age group. METHODS Middle and high school students (n = 2351, 48.5% Female) completed surveys of self-reported SU, perceived PS and PM, and socioeconomic background. Age group was defined dichotomously as grade 7-8 Middle school and grade 9-10 High school students. PS and PM were each measured using previously validated tools. SU was measured by lifetime and past 30 days cigarette/alcohol use. One-way ANOVA and binary logistic regression models were completed. Odds ratios and means were reported. RESULTS PS and PM were significantly and negatively related to all outcome variables regardless of gender and age group. Mean differences in PS and PM were insignificant between age groups. Between genders, PM scores were significantly higher for girls (14.05) compared to boys (13.48) (p < 0.01). Odds Ratios of all four SU types (for alcohol and tobacco use) increased with higher age group, with ORs ranging from 1.45-2.61 (p < .05). CONCLUSIONS PS and PM were protective against SU for all participants, consistent with previous literature. Girls reported greater parental monitoring than boys, irrespective of age-group. While girls experienced higher levels of monitoring, they did not report lower SU than boys. This suggests that monitoring girls more closely than boys appears unnecessary in preventing adolescent SU. Finally, PS was a more significant factor in preventing SU for older adolescents (high school aged group) than for younger adolescents, irrespective of gender suggesting that PS may be more impactful and important as adolescents age. As children mature, particularly from middle school to high school, PS may play a larger role in preventing SU for older adolescents compared to younger ones.
Collapse
Affiliation(s)
- Rosalina Mills
- School of Public Health, West Virginia University, Morgantown, USA.
| | | | | | | |
Collapse
|
18
|
Morojele NK, Ramsoomar L, Dumbili EW, Kapiga S. Adolescent health series - Alcohol, tobacco, and other drug use among adolescents in sub-Saharan Africa: A narrative review. Trop Med Int Health 2021; 26:1528-1538. [PMID: 34637175 DOI: 10.1111/tmi.13687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alcohol, tobacco, and other drug (ATOD) use by adolescents are major contributors to death and disability in sub-Saharan Africa (SSA). This paper reviews the extent of adolescents' ATOD use, risk and protective factors, and studies evaluating prevention interventions for adolescents in SSA. It also describes the harms associated with adolescents' ATOD use in SSA, which mainly include interpersonal violence, sexual risk behaviours, and negative academic outcomes. We use the socio-ecological model as our framework for understanding ATOD use risk and protective factors at individual, interpersonal, peer/school, and societal/structural levels. We used two strategies to find literature evaluating ATOD interventions for adolescents in SSA: (a) we sought systematic reviews of adolescent ATOD interventions in SSA covering the period 2000-2020; and (b) we used a comprehensive evidence review strategy and searched for studies that had evaluated ATOD interventions in all SSA countries between 2000 and 2020. Only two community interventions (a brief intervention and an HIV prevention intervention), out of four that were identified, were partially effective in reducing adolescent ATOD. Furthermore, only one school-based intervention (HealthWise), out of six that we uncovered, had any effect on ATOD use among adolescents. Possible reasons why many interventions were not effective include methodological limitations, involvement of non-evidence-based education-only approaches in some studies, and shortcomings in adaptations of evidence-based interventions. The scale of ATOD and related problems is disproportionate to the number of evaluated interventions to address them in SSA. More ATOD interventions need to be developed and evaluated in well-powered and well-designed studies.
Collapse
Affiliation(s)
- Neo K Morojele
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa.,Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Leane Ramsoomar
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,School of Public Health and Health Systems, University of the Pretoria, Gauteng, South Africa
| | - Emeka W Dumbili
- Institute for Therapy and Health Research, Kiel, Germany.,Department of Sociology and Anthropology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania.,Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
19
|
Jumbe S, Kamninga TM, Mwalwimba I, Kalu UG. Determinants of adolescent substance use in Africa: a systematic review and meta-analysis protocol. Syst Rev 2021; 10:125. [PMID: 33906677 PMCID: PMC8080366 DOI: 10.1186/s13643-021-01680-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/20/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Adolescent substance use continues to be a growing major public health concern in Africa. Recent studies infer an overall estimated prevalence of 42% among adolescents in sub-Saharan Africa. Unfortunately, this phenomenon is not adequately documented across many settings in the continent despite known negative health and social consequences on affected individuals and their communities. Little is known about the social context of substance use in Africa among this population. Our aim is to conduct a systematic review, exploring the determinants and associated factors that influence adolescent substance use in Africa. METHODS We will search the following databases (from January 2000 onwards): PubMed, the Cochrane Library, African Journals Online (AJOL), Google Scholar, ScienceDirect and the World Health Organization (WHO) African Index Medicus. We will include population-based observational studies reporting on determinants and/or risk factors of substance use among adolescents (age 10-19 years) across Africa. Two reviewers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion. Study methodological quality (or bias) will be appraised using appropriate tools. If feasible, we will conduct a random-effects meta-analysis of data. We plan to conduct a meta-synthesis of qualitative studies where appropriate DISCUSSION: This review will describe the range of determinants and associated factors found to significantly influence adolescent substance use in Africa over the last two decades. Documenting this evidence is important as it can potentially inform comprehensive interventions and treatment programmes that are targeted at adolescents and their parents in these settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020190158.
Collapse
Affiliation(s)
- Sandra Jumbe
- The Institute of Population Health Sciences (IPHS), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
| | - Tony Mwenda Kamninga
- African Institute for Development Policy (AFIDEP), P.O Box 31024, Lilongwe, Malawi
| | | | | |
Collapse
|
20
|
Belintxon M, Osorio A, de Irala J, Van Riper M, Reparaz C, Vidaurreta M. Connections between Family Assets and Positive Youth Development: The Association between Parental Monitoring and Affection with Leisure-Time Activities and Substance Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8170. [PMID: 33167382 PMCID: PMC7663813 DOI: 10.3390/ijerph17218170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 01/29/2023]
Abstract
This study aimed to determine the associations between parental monitoring and affection and three adolescent lifestyle aspects: constructive leisure, non-constructive leisure and substance use. A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru). Adolescents aged 12-15 self-completed a multi-purpose questionnaire. Multiple logistic regressions were performed to analyse the association between the parental monitoring and affection variables and the outcomes in terms of the children's lifestyles. The results indicate that parental monitoring is conducive to more constructive leisure and less non-constructive leisure and seems to be conducive to the prevention of substance use. Furthermore, parental affection is conducive to constructive leisure and the prevention of substance use. The discussion focuses on the fact that the family can be a protective resource associated with positive adolescent development.
Collapse
Affiliation(s)
- Maider Belintxon
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain; (M.B.); (M.V.)
- IdisNA, Navarra Institute for Health Research, Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
| | - Alfonso Osorio
- IdisNA, Navarra Institute for Health Research, Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Institute for Culture and Society, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain
- School of Education and Psychology, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain;
| | - Jokin de Irala
- IdisNA, Navarra Institute for Health Research, Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Institute for Culture and Society, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain
- Preventive Medicine and Public Health, School of Medicine, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain
| | - Marcia Van Riper
- School of Nursing and Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Charo Reparaz
- School of Education and Psychology, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain;
| | - Marta Vidaurreta
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, Campus Universitario, Universidad de Navarra, 31009 Pamplona, Spain; (M.B.); (M.V.)
- IdisNA, Navarra Institute for Health Research, Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
| |
Collapse
|
21
|
Manu E, Douglas M, Ayanore MA. Socio-ecological influences of adolescence marijuana use initiation: Qualitative evidence from two illicit marijuana-growing communities in South Africa. S Afr J Psychiatr 2020; 26:1477. [PMID: 32934841 PMCID: PMC7479363 DOI: 10.4102/sajpsychiatry.v26i0.1477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 06/15/2020] [Indexed: 01/11/2023] Open
Abstract
Background Adolescence has been identified as a critical risk period for substance use initiation, such as marijuana. Although several factors have been cited for adolescent marijuana use, those that influence initiation, especially in an African setting where illicit marijuana activities are rife, have not been contextually explored. Aim We ascertained the factors that influence adolescent marijuana use initiation in two marijuana-growing communities in the Eastern Cape province of South Africa, based on the constructs of the socio-ecological model. Setting The study was conducted in two selected illicit marijuana growing communities in the Ingquza Hill Local Municipality of the Eastern Cape province of South Africa. Methods Focus group discussions (FGDs) were conducted among 37 participants, grouped into four focus groups. Purposive and snowball sampling techniques were used to select the communities and participants, respectively. An FGD guide was used to collect the data. The data were analysed using thematic content analysis approach and presented under various themes. Results Twelve influences of adolescent marijuana use initiation, grouped under three main levels of socio-ecological influence, personal characteristics (curiosity, shyness and fulfilment of personal need), micro-level influences (peer pressure, negative school climate, presence of marijuana in households and parental or sibling marijuana use) and macro-level influences (child labour, poverty, presence of marijuana in communities, presence of negative adult role models and breakdown in communal restrictions against marijuana use), were found. Conclusion Health promotion programmes, targeting socio-ecological motives of adolescent marijuana use initiation in the two communities, should be intensified to break the cycle of adolescent marijuana use. Also, alternative livelihood schemes should be implemented in the affected communities to break the cycle of illegal marijuana cultivation that promotes adolescent marijuana use.
Collapse
Affiliation(s)
- Emmanuel Manu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Mbuyiselo Douglas
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Martin A Ayanore
- Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| |
Collapse
|
22
|
Promoting Safer Sexual Behaviours by Employing Social Cognitive Theory Among Gay University Students: A Pilot Study of A Peer Modelling Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051804. [PMID: 32164309 PMCID: PMC7084672 DOI: 10.3390/ijerph17051804] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
Unsafe and unprotected sexual behaviours are some of the significant challenges of health promotions and planning for current school environment. Although schools and health specialists constantly host conferences and workshops for adolescents and university students, the results are not significant. Particularly for sexual minorities, the heterosexual-oriented materials may not satisfy their needs due to the differences. As a recommendation, the current pilot study established a Peer Modelling Programme which engaged gay social workers and gay university students who have associated with unsafe and unprotected sexual activities. The outcomes of this Peer Modelling Programme indicated that gay undergraduate students tended to accept the recommendations and peer modelling exchanges from their gay social workers who understood their difficulties and sexual needs as sexual minorities based on the guideline of Social Cognitive Theory. In conclusion, this study may be used to develop additional social work materials, sexual health promotions and health plans for sexual minorities and people with special needs in the society. This research serves as a guideline to social workers who care about the issues of LGBT and sexual minorities.
Collapse
|
23
|
Uliaszek AA, Hamdullahpur K, Mills L. Examining the Effectiveness of Residential Treatment Among Adolescents With Problem Substance Use. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2019.1682736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - Laura Mills
- Pine River Institute, Toronto, ON, Canada
- Pine River Institute Campus, Shelburne, ON, Canada
- University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
24
|
Abstract
PURPOSE OF REVIEW Epidemiological literature suggests that urbanization is potentially linked to a number of stressors that could be associated with harmful substance use and mental disorders. This may vary by country. This review gives attention to emergent literature examining the pathways between urbanization and harmful substance use. RECENT FINDINGS Studies examining the links between urbanization, mental health and substance use suggest complex pathways between urbanization and substance use as well as a range of modifying variables that could contribute to these associations. Such variables include increased supply of illicit and licit substances brought about by economic development, globalization and technology as well as an increased demand for particular substances. Rural areas may also have unique factors associated with harmful substance use but these are beyond the scope of this review. SUMMARY We have presented evidence to suggest potential associations between urbanization and harmful substance use. We acknowledge that data are limited because of a paucity of longitudinal studies elucidating these relationships.
Collapse
|