Socio-ecological influences on adolescent (aged 10-17) alcohol use and linked unhealthy eating behaviours: protocol for a systematic review and synthesis of qualitative studies

Contextual influences of illicit adolescent marijuana cultivation and trading in the Inqguza Hill local municipality of South Africa: implications for public health policy

Background

Although commercial cultivation and trading of marijuana, commonly known as cannabis or dagga in the South African context, remains an illicit practice, adolescents actively engage in it. However, contextual influences that sustain adolescent involvement in illicit marijuana-related activties remain empirically unascertained.

Objective

This study sought to ascertain the various contextual influences of adolescent illicit marijuana cultivation and trading in two communities in the Ingquza Hill Local Municipality (IHLM) of South Africa, using the tenets of the Socio-Ecological Model (SEM).

Methods

The study utilised focus group discussions approach to interview thirty-three purposefully sampled participants who were recruited through the snowball sampling technique. A semi-structured interview guide was used to conduct the interviews, while thematic content analysis was used to analyse the data.

Results

We found that illicit adolescent marijuana cultivation and trading was influenced by eleven contextual factors that are grouped under four levels of socio-ecological influence. These include intrapersonal influences (knowledge and skills in marijuana cultivation and courage), interpersonal influences (peer and family influences), communal level influences (economic reasons, early childhood exposure to marijuana activities, protection of family lands, the topography of the area and soil fertility) and policy-related influences (lack of communal bylaws on marijuana activities and laxity in law enforcement).

Conclusion

It is recommended that substance abuse prevention policies and programmes focus on discouraging children from engaging in illicit marijuana activities in IHLM across the four tenets of SEM and curtailing adolescent involvement in marijuana cultivation and trading. There is also the need to incorporate the law enforcement approach into demand reduction strategies of the National Drug Master Plan (NDMP), which employs only an educative approach in its current form. Working agreements between municipal authorities, law enforcement agents and social service professionals also need to be strengthened to push demand reduction strategies for marijuana in communities to protect the rights of children as enshrined in the Children’s Act, 38 of 2005.

Factors influencing obesogenic behaviours of adolescent girls and women in low- and middle-income countries: A qualitative evidence synthesis

This systematic review synthesized the qualitative evidence on factors influencing obesogenic behaviours in adolescent girls and women of reproductive age in low- and middle-income countries (LMICs). This qualitative evidence synthesis followed the framework synthesis approach to extract, analyse and synthesize data. Electronic searches were conducted in the Web of Science, SCOPUS, CABI Abstracts, MEDLINE, PsycINFO and Google Scholar. Studies were eligible if they were conducted in LMICs, of qualitative nature, and reported obesogenic behaviours of female adolescents (10-19 years of age) or women of reproductive age (15-49 years of age). The review resulted in 71 included studies from 27 different countries. Thirty-two studies focused on dietary behaviours, 17 on physical activity and 22 on both behaviours. Gender norms and failures to recognize the importance of healthy behaviours across the life cycle were important factors. The abundance and promotion of affordable but unhealthy food, food safety concerns, taste preferences and social desirability of foods drive consumption of unhealthy foods. Busy lives and limited exercise spaces keep girls and women from being physically active. Obesogenic behaviours of adolescent girls and women of reproductive age are influenced by factors at individual, social, physical and environmental levels and require diverse solutions to address these factors in LMICs.

Socio-Ecological Influences on Adolescent (Aged 10-17) Alcohol Use and Unhealthy Eating Behaviours: A Systematic Review and Synthesis of Qualitative Studies

Excess body weight and risky alcohol consumption are two of the greatest contributors to global disease. Alcohol use contributes directly and indirectly to weight gain. Health behaviours cluster in adolescence and track to adulthood. This review identified and synthesised qualitative research to provide insight into common underlying factors influencing alcohol use and unhealthy eating behaviours amongst young people aged 10–17. Sixty two studies met inclusion criteria. Twenty eight studies focused on alcohol; 34 focused on eating behaviours. Informed by principles of thematic analysis and meta-ethnography, analysis yielded five themes: (1) use of alcohol and unhealthy food to overcome personal problems; (2) unhealthy eating and alcohol use as fun experiences; (3) food, but not alcohol, choices are based on taste; (4) control and restraint; and (5) demonstrating identity through alcohol and food choices. Young people faced pressure, reinforced by industry, to eat and drink in very specific ways, with clear social consequences if their attitudes or behaviour were deemed unacceptable. No qualitative studies were identified with an explicit and concurrent focus on adolescent eating behaviours and alcohol consumption. Further exploratory work is needed to examine the links between food and alcohol in young people’s emotional, social and cultural lives.

Disclosure of domestic violence and sexual assault within the context of abortion: meta-ethnographic synthesis of qualitative studies protocol

BACKGROUND

One third of women will have an abortion in their lifetime (Kerr, QUT Law Rev 14:15, 2014; Aston and Bewley, Obstetrician & Gynaecologist 11:163-8, 2009). These women are more likely to have experienced domestic violence or sexual assault than women who continue with their pregnancies. Frontline health personnel involved in the care of women seeking abortions are uniquely positioned to support patients who choose to disclose their violence. Yet, the disclosure of domestic violence or sexual assault within the context of abortion is not well understood. To enhance service provision, it is important to understand the disclosure experience, that is, how frontline health personnel manage such disclosures and how victims/survivors perceive this experience. This review aims to provide a systematic synthesis of qualitative literature to increase understanding of the phenomena and identify research gaps.

METHODS

A meta-ethnography of qualitative evidence following PRISMA-P recommendations for reporting systematic reviews will be performed to better understand the experiences of domestic violence and sexual assault disclosure from the perspective of frontline health personnel providing support and women seeking an abortion. A three-stage search strategy including database searching, citation searching and Traditional Pearl Growing will be applied starting with the terms "domestic violence", "sexual assault", "disclosure" and "abortion", their common synonyms and MeSH terms. The database search will include CINAHL, MEDLINE, Embase and PsycINFO. Published studies from 1970, written in English and from all countries will be included. Two reviewers will screen titles and abstracts and if suitable will then perform a full-text review. To attribute weight to each study, two reviewers will perform the critical appraisal using a modified version of the "Guidelines for Extracting Data and Quality Assessing Primary Studies in Educational Research". Data extraction and coding will occur using EPPI-Reviewer 4 and will be carried out by two reviewers.

DISCUSSION

The reviewers will illuminate what transpires at the interface when women seeking an abortion in the context of domestic violence and sexual assault meet frontline health personnel. Increased knowledge in this area will improve the frontline health personnel's practices and responsiveness to women who seek out healthcare in the context of violence.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42016051136.