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Barnes C, McCrabb S, Bialek C, Turon H, Dray J, Duffy M, Lane C, Lum M, Brown A, Doyle J, Wolfenden L. Factors associated with child and adolescent electronic nicotine and non-nicotine delivery systems use: A scoping review. Prev Med 2024; 181:107895. [PMID: 38354861 DOI: 10.1016/j.ypmed.2024.107895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To identify, characterise and broadly synthesise factors associated with child and adolescent electronic nicotine delivery systems (ENDS) and/or electronic non-nicotine delivery systems (ENNDS) ever-use and/or current use. METHODS Four electronic databases were searched from inception to 3rd June 2022. Non-experimental studies that provided quantitative factors associated with adolescent and/or child ENDS or ENNDS ever-use and/or current use were included. Factors associated with ever-use (any lifetime use) and/or current use (use in past 30 days) were included. All screening and data extraction was conducted independently by paired review authors. Frequencies for country, study design, sample size, measure of ENDS/ENNDS use and factors examined were calculated. Factors were categorised according to the Theory of Triadic Influence domains and sub-domains. RESULTS The search of electronic databases identified 4756 records, 240 of which were included. The majority of studies examined factors categorised within the Biology and Personality domain of the Theory of Triadic Influence (89.2%; 95%CI 84.6, 82.5), followed by the Social Context (50.8%; 95%CI 44.5, 57.2) and Broader Environment domains (30.4%; 95%CI 24.6, 36.3). The proportion of factors significantly associated with ENDS/ENNDS use was >75% for the Behavioural (78.0%; factors included use of tobacco, other drugs and alcohol), Peer Attitudes and Behaviours (80.0%; factors included peer use of ENDS/ENNDS and tobacco), and Legislation/Policy sub-domains (78.6%; factors included accessibility and advertising). CONCLUSIONS The evidence base on factors associated with ENDS/ENNDS use in children and adolescents is rapidly developing, predominately by research concentrated in high income regions and focused on behavioural- and personality-related factors.
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Affiliation(s)
- Courtney Barnes
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia.
| | - Sam McCrabb
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
| | - Caitlin Bialek
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
| | - Heidi Turon
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
| | - Julia Dray
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Acton, ACT, Australia
| | - Megan Duffy
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
| | - Cassandra Lane
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
| | - Melanie Lum
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia; Global Centre for Preventive Nutrition and Health, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC 3125, Australia
| | - Alison Brown
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
| | - Jodie Doyle
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Centre of Implementation Science, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter New-England Population Health, Hunter New England Local Health District Wallsend, NSW, Australia
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Regan C, Dray J, Fehily C, Campbell E, Bartlem K, Orr M, Govindasamy S, Bowman J. Co-development of implementation strategies to assist staff of a mental health community managed organisation provide preventive care for health behaviours. Health Promot J Austr 2023. [PMID: 37821103 DOI: 10.1002/hpja.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
ISSUE ADDRESSED People with a mental health condition are at risk of developing chronic physical disease due to smoking tobacco, inadequate nutrition, high alcohol consumption, low physical activity and poor sleep (SNAPS). Community managed organisations (CMOs) represent an opportune setting to support mental health consumers to improve their health behaviours through providing preventive care. Reporting of methods used to co-develop implementation strategies to assist CMO staff to deliver preventive care for SNAPS are scarce yet warranted. OBJECTIVES This study aims to: (1) describe a co-development workshop involving CMO staff and researchers to identify preferred implementation support strategies to help staff routinely provide preventive care; (2) describe the strategies that emerged from the workshop; and (3) report staff ratings of the workshop on four co-development principles. METHODS A three-hour co-development workshop was conducted on two occasions with staff of one CMO in New South Wales, Australia. Twenty staff participated in the workshops. RESULTS Participants generated and ranked a total of seven discrete implementation strategies within five categories (training, point of care prompts, guidelines, continuous quality improvement and consumer activation). Training for staff to have difficult conversations about behaviour change was ranked highest in both workshops. Participants rated the workshops positively across four co-development principles. CONCLUSIONS The co-development workshop enabled implementation strategies to be developed within the context in which they were to be delivered and tested, potentially increasing their feasibility, acceptability, appropriateness and impact. SO WHAT?: Implementation strategies selected from the workshops will inform a pilot implementation support trial to assist CMO staff to provide preventive care to people with mental health conditions.
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Affiliation(s)
- Casey Regan
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Ultimo, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia Dray
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Caitlin Fehily
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Ultimo, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kate Bartlem
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Ultimo, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mark Orr
- Flourish Australia, Sydney Olympic Park, New South Wales, Australia
| | | | - Jenny Bowman
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Ultimo, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Doherty E, Kingsland M, Wiggers J, Wolfenden L, Hall A, McCrabb S, Tremain D, Hollis J, Licata M, Wynne O, Dilworth S, Daly JB, Tully B, Dray J, Bailey KA, Elliott EJ, Hodder RK. The effectiveness of implementation strategies in improving preconception and antenatal preventive care: a systematic review. Implement Sci Commun 2022; 3:121. [PMID: 36419177 PMCID: PMC9682815 DOI: 10.1186/s43058-022-00368-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Clinical guideline recommendations for addressing modifiable risk factors are not routinely implemented into preconception and antenatal care. This review assessed the effectiveness of implementation strategies in improving health professional provision of preconception and antenatal care addressing tobacco smoking, weight management and alcohol consumption. METHODS A systematic review of randomised and non-randomised studies with a parallel comparison group was conducted. Eligible studies used implementation strategy/ies targeted at health professionals to improve at least one element of preconception and/or antenatal care (smoking: ask, advise, assess, assist, arrange; weight/alcohol: assess, advise, refer) compared to usual practice/control or alternative strategies. Eligible studies were identified via CENTRAL, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL and other sources. Random-effects meta-analyses were conducted where appropriate, with other findings summarised using the direction of effect. The certainty of the pooled evidence was assessed using the GRADE approach. RESULTS Fourteen studies were included in the review. Thirteen were in the antenatal period and 12 tested multiple implementation strategies (median: three). Meta-analyses of RCTs found that implementation strategies compared to usual practice/control probably increase asking (OR: 2.52; 95% CI: 1.13, 5.59; 3 studies; moderate-certainty evidence) and advising (OR: 4.32; 95% CI: 3.06, 6.11; 4 studies; moderate-certainty evidence) about smoking and assessing weight gain (OR: 57.56; 95% CI: 41.78, 79.29; 2 studies; moderate-certainty evidence), and may increase assessing (OR: 2.55; 95% CI: 0.24, 27.06; 2 studies; low-certainty evidence), assisting (OR: 6.34; 95% CI: 1.51, 26.63; 3 studies; low-certainty evidence) and arranging support (OR: 3.55; 95% CI: 0.50, 25.34; 2 studies; low-certainty evidence) for smoking. The true effect of implementation strategies in increasing advice about weight gain (OR: 3.37; 95% CI: 2.34, 4.84; 2 non-randomised studies; very low-certainty evidence) and alcohol consumption (OR: 10.36; 95% CI: 2.37, 41.20; 2 non-randomised studies; very low-certainty evidence) is uncertain due to the quality of evidence to date. CONCLUSIONS Review findings provide some evidence to support the effectiveness of implementation strategies in improving health professional delivery of antenatal care addressing smoking and weight management. Rigorous research is needed to build certainty in the evidence for improving alcohol and weight gain advice, and in preconception care. TRIAL REGISTRATION PROSPERO-CRD42019131691.
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Affiliation(s)
- Emma Doherty
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Melanie Kingsland
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - John Wiggers
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia ,National Centre of Implementation Science, Wallsend, NSW 2287 Australia
| | - Luke Wolfenden
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia ,National Centre of Implementation Science, Wallsend, NSW 2287 Australia
| | - Alix Hall
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Sam McCrabb
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Danika Tremain
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia
| | - Jenna Hollis
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Milly Licata
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Olivia Wynne
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Sophie Dilworth
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Justine B. Daly
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Belinda Tully
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia
| | - Julia Dray
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia
| | - Kylie A. Bailey
- grid.266842.c0000 0000 8831 109XSchool of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW Australia
| | - Elizabeth J. Elliott
- grid.1013.30000 0004 1936 834XFaculty of Medicine and Health and Discipline of Child and Adolescent Health, The University of Sydney, Camperdown, NSW 2006 Australia ,grid.413973.b0000 0000 9690 854XSydney Children’s Hospital Network, Kids’ Research Institute, Westmead, NSW 2145 Australia
| | - Rebecca K. Hodder
- grid.3006.50000 0004 0438 2042Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287 Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.cPopulation Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia ,National Centre of Implementation Science, Wallsend, NSW 2287 Australia
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Bradley T, Campbell E, Dray J, Bartlem K, Wye P, Hanly G, Gibson L, Fehily C, Bailey J, Wynne O, Colyvas K, Bowman J. Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition. Syst Rev 2022; 11:198. [PMID: 36085250 PMCID: PMC9462072 DOI: 10.1186/s13643-022-02067-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. METHODS Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. RESULTS Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant (< 0.05) effect of interventions on mean weight loss (-1.42 kg), achieving 5% weight loss (OR 2.48), weight maintenance (-2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (-0.48 units) and waist circumference (-0.87cm), but not mental health (depression: SMD -0.03; anxiety: SMD -0.49; severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. CONCLUSION Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019137197.
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Affiliation(s)
- Tegan Bradley
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287 Australia
| | - Julia Dray
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Kate Bartlem
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Paula Wye
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Grace Hanly
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Lauren Gibson
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Caitlin Fehily
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Jacqueline Bailey
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Olivia Wynne
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Kim Colyvas
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Jenny Bowman
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
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Dray J, Licata M, Doherty E, Tully B, Williams B, Curtin S, White D, Lecathelinais C, Ward S, Hasson S, Elliott EJ, Wiggers J, Kingsland M. Enhancing clinician participation in quality improvement training: implementation and impact of an evidence-based initiative to maximise antenatal clinician participation in training regarding women’s alcohol consumption during pregnancy. BMC Health Serv Res 2022; 22:402. [PMID: 35351113 PMCID: PMC8962084 DOI: 10.1186/s12913-022-07717-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/23/2022] [Indexed: 11/15/2022] Open
Abstract
Background There are significant challenges in ensuring sufficient clinician participation in quality improvement training. Clinician capability has been identified as a barrier to the delivery of evidence-based care. Clinician training is an effective strategy to address this barrier, however, there are significant challenges in ensuring adequate clinician participation in training. This study aimed to assess the extent of participation by antenatal clinicians in evidence-based training to address alcohol consumption during pregnancy, and to assess differences in participation by profession. Methods A 7-month training initiative based on six evidence-based principles was implemented in a maternity service in New South Wales, Australia. Descriptive statistics described participation in training (% attending: any training; six evidence-based principles of training; all principles). Regression analyses examined differences by profession. Results Almost all antenatal clinicians participated in some training (182/186; 98%); 69% participated in ≥1 h of training (μ = 88.2mins, SD:56.56). The proportion of clinicians participating in training that satisfied each of the six principles ranged from 35% (training from peers and experts) to 82% (training was educational and instructional). Only 7% participated in training that satisfied all principles. A significantly higher proportion of midwifery compared to medical clinicians participated in training satisfying five of the six training principles. Conclusions A training initiative based on evidence-based principles resulted in almost all clinicians receiving some training and 69% participating in at least 1 h of training. Variability between professions suggests training needs to be tailored to such groups. Further research is required to determine possible associations with care delivery outcomes. Trial registration Australian and New Zealand Clinical Trials Registry, No. ACTRN12617000882325 (date registered: 16/06/2017).
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Hanly G, Campbell E, Bartlem K, Dray J, Fehily C, Bradley T, Murray S, Lecathelinais C, Wiggers J, Wolfenden L, Reid K, Reynolds T, Bowman J. Effectiveness of referral to a population-level telephone coaching service for improving health risk behaviours in people with a mental health condition: study protocol for a randomised controlled trial. Trials 2022; 23:49. [PMID: 35039058 PMCID: PMC8762844 DOI: 10.1186/s13063-021-05971-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a mental health condition have a shorter life expectancy than the general population. This is largely attributable to higher rates of chronic disease and a higher prevalence of modifiable health risk behaviours including tobacco smoking, alcohol consumption, poor nutrition, and physical inactivity. Telephone support services offer a viable option to provide support to reduce these health risk behaviours at a population-level; however, whilst there is some research pertaining to Quitlines, there is limited other research investigating whether telephone services may offer effective support for people with a mental health condition. This protocol describes a randomised controlled trial that aims to evaluate the referral of people with a mental health condition to a population-level telephone coaching service to increase physical activity, healthy eating, or weight management, and increase attempts to do so. METHODS A parallel-group randomised controlled trial will be conducted recruiting participants with a mental health condition through community mental health services and advertisement on social media. Participants will be randomly assigned to receive either a health information pack only (control) or a health information pack and a proactive referral to a free, government-funded telephone coaching service, the NSW Get Healthy Coaching and Information Service® (intervention), which offers up to 13 telephone coaching calls with a University Qualified Health Coach to assist with client-identified goals relating to physical activity, healthy eating, weight management, or alcohol reduction. Data will be collected via telephone surveys at baseline and 6 months post-recruitment. Primary outcomes are as follows: (1) minutes of moderate to vigorous physical activity per week, (2) serves of fruit consumed per day, (3) serves of vegetables consumed per day, and (4) a composite measure assessing attempts to change at least one health risk behaviour (any attempts to change physical activity, fruit consumption, vegetable consumption, or other parts of nutrition). Secondary outcomes include weight and body mass index. DISCUSSION This study is the first to evaluate the effectiveness of referral to a population-level telephone support service for reducing health risk behaviours relating to physical activity, healthy eating, and weight in people with a mental health condition. Results will inform future policy and practice regarding the delivery of telephone-based behaviour change coaching services and the management of physical health for this population to reduce health inequity and the burden of chronic disease. TRIAL REGISTRATION The Australian New Zealand Clinical Trials Registry ACTRN12620000351910 . Retrospectively registered on 12 March 2020.
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Affiliation(s)
- Grace Hanly
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Elizabeth Campbell
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
| | - Kate Bartlem
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Julia Dray
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Caitlin Fehily
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Tegan Bradley
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Sonya Murray
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Christophe Lecathelinais
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
| | - Kate Reid
- NSW Office of Preventive Health, Liverpool, NSW Australia
| | | | - Jenny Bowman
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
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7
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Delaney T, Mclaughlin M, Hall A, Yoong SL, Brown A, O’Brien K, Dray J, Barnes C, Hollis J, Wyse R, Wiggers J, Sutherland R, Wolfenden L. Associations between Digital Health Intervention Engagement and Dietary Intake: A Systematic Review. Nutrients 2021; 13:nu13093281. [PMID: 34579158 PMCID: PMC8470016 DOI: 10.3390/nu13093281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. The aim of this review is to describe the association between DHI engagement and dietary intake. A systematic search of four electronic databases and grey literature for records published before December 2019 was conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ≥18 years). From 10,653 citations, seven studies were included. Five studies included usage measures of engagement and two examined subjective experiences. Narrative synthesis, using vote counting, found mixed evidence of an association with usage measures (5 of 12 associations indicated a positive relationship, 7 were inconclusive) and no evidence regarding an association with subjective experience (both studies were inconclusive). The findings provide early evidence supporting an association between measures of usage and dietary intake; however, this was inconsistent. Further research examining the association between DHI engagement and dietary intake is warranted.
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Affiliation(s)
- Tessa Delaney
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
- Correspondence: ; Tel.: +612-49246-499
| | - Matthew Mclaughlin
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alix Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Alison Brown
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Kate O’Brien
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Julia Dray
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jenna Hollis
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; (M.M.); (A.H.); (S.L.Y.); (A.B.); (K.O.); (J.D.); (C.B.); (J.H.); (R.W.); (J.W.); (R.S.); (L.W.)
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia
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8
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Hollis JL, Doherty E, Dray J, Tremain D, Hunter M, Takats K, Williams CM, Murray H, Pennell CE, Tully B, Wiggers J, Daly JB, Kingsland M. Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol. Syst Rev 2020; 9:204. [PMID: 32878647 PMCID: PMC7469269 DOI: 10.1186/s13643-020-01453-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/13/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women. METHODS Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ 2 behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped-wedge RCTs and non-randomised control trials will be eligible. Studies that include a no-intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form. DISCUSSION The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care and will help researchers, policy-makers and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short- and long-term health outcomes for women and their children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018095315.
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Affiliation(s)
- Jenna L Hollis
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia. .,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia. .,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, Australia. .,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Danika Tremain
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mandy Hunter
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Karen Takats
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Christopher M Williams
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Henry Murray
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Craig E Pennell
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Justine B Daly
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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9
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Fehily C, Hodder R, Bartlem K, Wiggers J, Wolfenden L, Dray J, Bailey J, Wilczynska M, Stockings E, Clinton-McHarg T, Regan T, Bowman J. The effectiveness of interventions to increase preventive care provision for chronic disease risk behaviours in mental health settings: A systematic review and meta-analysis. Prev Med Rep 2020; 19:101108. [PMID: 32477852 PMCID: PMC7248238 DOI: 10.1016/j.pmedr.2020.101108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/01/2020] [Accepted: 04/26/2020] [Indexed: 11/25/2022] Open
Abstract
Clinical practice guidelines direct mental health services to provide preventive care to address client chronic disease risk behaviours, however, this care is not routinely provided. The aim of this systematic review was to synthesise evidence regarding the effectiveness of interventions to increase provision of preventive care by mental health services; by care element (ask, assess, advice, assist, arrange) and risk behaviour (tobacco smoking, poor nutrition, harmful alcohol consumption, physical inactivity). Electronic bibliographic databases, Google Scholar, relevant journals, and included study reference lists were searched. Eligible studies were of any design with a comparison group that reported the effectiveness of an intervention to increase the provision of at least one element of preventive care for at least one risk behaviour in a mental health setting. Twenty studies were included, most commonly examining smoking (n = 20) and 'ask' (n = 12). Meta-analysis found interventions involving task shifting were effective in increasing smoking 'advice' (n = 2 RCTs; p = 0.009) and physical activity 'advice' (n = 2 RCTs; p = 0.002). Overall, meta-analysis and narrative synthesis indicated that effective intervention strategies (categorised according to the Effective Practice and Organisation of Care taxonomy) were: task shifting, educational meetings, health information systems, local consensus processes, authority and accountability, and reminders. The most consistent findings across studies were with regard to preventive care for smoking, while conflicting or limited evidence was found regarding other risk behaviours. While further rigorous research examining key risk behaviours is recommended, the findings may inform the selection of strategies for future interventions and service delivery initiatives.
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Affiliation(s)
- Caitlin Fehily
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Rebecca Hodder
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Kate Bartlem
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Julia Dray
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - Jacqueline Bailey
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
| | - Magda Wilczynska
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, Randwick, NSW, Australia
| | - Tara Clinton-McHarg
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Timothy Regan
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Jenny Bowman
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
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10
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Gnanavel S, Orri M, Mohammed M, Dray J, Baroud E, Kato H, Jui GT, Rajalakshmi AK, Hansen AS, Seker A, Ori D, Munjiza A, Martsenkovskyi D. Child and adolescent psychiatry research during the COVID-19 pandemic. Lancet Psychiatry 2020; 7:735. [PMID: 32828155 PMCID: PMC7440875 DOI: 10.1016/s2215-0366(20)30314-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Sundar Gnanavel
- Northumbria NHS Foundation Trust, Newcastle upon Tyne NE29 4HG UK.
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Muftau Mohammed
- Department of Psychiatry, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Julia Dray
- Faculty of Science, School of Psychology, The University of Newcastle, Newcastle, NSW, Australia
| | - Evelyne Baroud
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hidekazu Kato
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Goh Tze Jui
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Aarya K Rajalakshmi
- Department of Child and Adolescent Psychiatry, Massachusetts General Hospital and McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna Sofie Hansen
- Research Unit for Child and Adolescent Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | - Asilay Seker
- Department of Psychiatry, Erciyes University Hospital, Kayseri, Turkey
| | - Dorottya Ori
- Department of Child and Adolescent Psychiatry, Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Ana Munjiza
- Child and Adolescent Clinic, Institute of Mental Health, Belgrade, Serbia
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kiev, Ukraine
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11
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Doherty E, Kingsland M, Wolfenden L, Wiggers J, Dray J, Hollis J, Elliott EJ, Daly JB, Bailey KA, Attia J, Hunter M, Symonds I, Tully B, Tremain D, Hodder RK. Implementation strategies to improve preconception and antenatal care for tobacco smoking, alcohol consumption and weight management: a systematic review protocol. Syst Rev 2019; 8:285. [PMID: 31759397 PMCID: PMC6874816 DOI: 10.1186/s13643-019-1193-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/09/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Despite existing best practice care recommendations for addressing tobacco smoking, alcohol consumption and weight management in preconception and antenatal care, such recommendations are often not implemented into routine practice. Effective strategies that target known barriers to implementation are key to reducing this evidence to practice gap. The aim of this review is to synthesise the evidence on the effectiveness of implementation strategies in improving the provision of preconception and antenatal care for these modifiable risk factors. METHODS Randomised and non-randomised study designs will be eligible for inclusion if they have a parallel control group. We will include studies that either compare an implementation strategy to usual practice or compare two or more strategies. Participants may include any health service providing preconception or antenatal care to women and/or the health professionals working within such a service. The primary outcome will be any measure of the effectiveness of implementation strategies to improve preconception and/or antenatal care for tobacco smoking, alcohol consumption and/or weight management (including care to improve nutrition and/or physical activity). Secondary outcomes will include the effect of the implementation strategy on women's modifiable risk factors, estimates of absolute costs or cost-effectiveness and any reported unintentional consequences. Eligible studies will be identified via searching Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, ProQuest Dissertations and Theses and other sources (e.g. contacting experts in the field). Study selection, data extraction and risk of bias will be assessed independently by two review authors and differences resolved by a third reviewer. If data permits, we will conduct fixed-effects or random-effects meta-analysis where appropriate. If studies do not report the same outcome or there is significant heterogeneity, results will be summarised narratively. DISCUSSION This review will identify which implementation strategies are effective in improving the routine provision of preconception and antenatal care for tobacco smoking, alcohol consumption and weight management. Such a review will be of interest to service providers, policy makers and implementation researchers seeking to improve women's modifiable risk factors in preconception and antenatal care settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019131691.
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Affiliation(s)
- Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia. .,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia. .,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia Dray
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Jenna Hollis
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - Justine B Daly
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kylie A Bailey
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Primary Care, Newcastle, New South Wales, Australia
| | - John Attia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mandy Hunter
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Ian Symonds
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Danika Tremain
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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12
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Doherty E, Wiggers J, Wolfenden L, Anderson AE, Crooks K, Tsang TW, Elliott EJ, Dunlop AJ, Attia J, Dray J, Tully B, Bennett N, Murray H, Azzopardi C, Kingsland M. Antenatal care for alcohol consumption during pregnancy: pregnant women's reported receipt of care and associated characteristics. BMC Pregnancy Childbirth 2019; 19:299. [PMID: 31419964 PMCID: PMC6698023 DOI: 10.1186/s12884-019-2436-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/29/2019] [Indexed: 12/31/2022] Open
Abstract
Background Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women’s reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women’s acceptability of care. Methods From July 2017 – February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. Results At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3–99.4%). Conclusions Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.
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Affiliation(s)
- Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia. .,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia. .,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Amy E Anderson
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kristy Crooks
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Tracey W Tsang
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - Adrian J Dunlop
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - John Attia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia Dray
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | - Nicole Bennett
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Henry Murray
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Carol Azzopardi
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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13
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Doherty E, Kingsland M, Wiggers J, Anderson AE, Elliott EJ, Symonds I, Tully B, Dray J, Wolfenden L. Barriers to the implementation of clinical guidelines for maternal alcohol consumption in antenatal services: A survey using the theoretical domains framework. Health Promot J Austr 2019; 31:133-139. [PMID: 31087792 DOI: 10.1002/hpja.258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/12/2019] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED The aim of this study was to assess potential barriers to the implementation of clinical guideline recommendations regarding maternal alcohol consumption by antenatal clinicians and managers. METHODS Cross-sectional surveys of antenatal clinicians and managers employed in a New South Wales Local Health District were undertaken. Survey items were developed based on 11 domains of the Theoretical Domains Framework. Consistent with previous studies, a cut point of less than 4 was applied to mean values of survey items (range: 1-5) to identify domains representing barriers to the implementation. RESULTS Thirty-three antenatal clinicians and eight managers completed the surveys. For clinicians, the domains with the lowest mean values included "environmental context and resources" (ie, complexity of appointments and availability of supporting systems) (mean: 3.13, SD: 0.93); "social influences" (ie, expectations of others that alcohol will be addressed) (mean: 3.33, SD: 0.68); "beliefs about capabilities" (ie, confidence in providing guideline recommendations) (mean: 3.51, SD: 0.67); and "behavioural regulation" (ie, planning and responding to feedback) (mean: 3.53, SD: 0.64). For managers, "emotion regulation" (ie, stress in managing change) (mean: 2.13, SD: 0.64) and "environmental context and resources" (ie, complexities of managing change) (mean: 3.13, SD: 0.83) were the lowest scoring domains. CONCLUSIONS The antenatal service environment and availability of resources appear to be primary barriers to both clinicians and managers implementing guidelines for maternal alcohol consumption. SO WHAT?: In the development of interventions to support the delivery of clinical guideline recommendations addressing alcohol consumption during pregnancy, a broad range of potential barriers at both the clinician and manager levels need to be considered and targeted by effective implementation strategies.
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Affiliation(s)
- Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Amy E Anderson
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, Australia.,Sydney Children's Hospital Network, Kids' Research Institute, Westmead, NSW, Australia
| | - Ian Symonds
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Julia Dray
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia
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14
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Hodder RK, Freund M, Bowman J, Wolfenden L, Campbell E, Dray J, Lecathelinais C, Oldmeadow C, Attia J, Wiggers J. Differential intervention effectiveness of a universal school-based resilience intervention in reducing adolescent substance use within student subgroups: exploratory assessment within a cluster-randomised controlled trial. BMJ Open 2018; 8:e021047. [PMID: 30158221 PMCID: PMC6119444 DOI: 10.1136/bmjopen-2017-021047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/08/2018] [Accepted: 07/06/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Interventions addressing the individual and environmental protective factors of adolescents are suggested to have potential for reducing adolescent substance use. While universally delivered school-based substance use prevention interventions are common, previous studies have suggested variable effectiveness by subgroups of students. An exploratory study was undertaken to examine the differential effectiveness of a universal school-based resilience intervention on adolescent substance use and protective factors according to their sociodemographic and previous substance use. DESIGN Secondary analysis of data from a cluster-randomised controlled trial. SETTING 32 Australian secondary schools. PARTICIPANTS Cohort of grade 7 students (n=3155) followed up in grade 10 (aged 15-16 years; 2014; n=2105). INTERVENTION Three-year universal school-based intervention implemented by school staff that targeted a range of student resilience protective factors (2012-2014). MEASUREMENTS Primary outcomes included: tobacco (recent, number of cigarettes) and alcohol (recent, 'risk' and number of drinks) use, and secondary outcomes included: marijuana (recent) and other illicit substance (recent) use, and aggregate individual and environmental protective factor scores. Generalised and linear mixed models examined interactions between treatment and student subgroups (gender; socioeconomic disadvantage (low/high); geographic location (major city/inner regional/outer regional-remote); and previous substance use (non-user/user)) at follow-up (36 models). RESULTS Analysis of student follow-up data showed no differential intervention effect for any substance use or protective factor outcome for any subgroup, with the exception of one differential effect found by socioeconomic status for the outcome of mean number of cigarettes smoked by recent smokers (p=0.003). There was no evidence of an intervention effect within the low (mean difference (MD) -12.89, 95% CI -26.00 to 0.23) or high (MD 16.36, 95% CI -1.03 to 33.76) socioeconomic subgroups. CONCLUSIONS No evidence of an intervention effect on substance use and protective factors was found according to student subgroups defined by sociodemographic characteristics or previous substance use. TRIAL REGISTRATION NUMBER ACTRN12611000606987.
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Affiliation(s)
- Rebecca Kate Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Megan Freund
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jenny Bowman
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, IT, and Statistical Support (CReDITSS), Hunter Medical Research Institute, Wallsend, New South Wales, Australia
| | - John Attia
- Clinical Research Design, IT, and Statistical Support (CReDITSS), Hunter Medical Research Institute, Wallsend, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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15
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Fehily C, Bartlem K, Wiggers J, Wolfenden L, Regan T, Dray J, Bailey J, Bowman J. Systematic review of interventions to increase the provision of care for chronic disease risk behaviours in mental health settings: review protocol. Syst Rev 2018; 7:67. [PMID: 29712561 PMCID: PMC5928577 DOI: 10.1186/s13643-018-0735-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/20/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND People with a mental illness experience a higher morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of risk behaviours, including tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity, is a substantial contributor to this health inequity. Clinical practice guidelines recommend that mental health services routinely provide care to their clients to address these risk behaviours. Such care may include the following elements: ask, assess, advise, assist and arrange (the '5As'), which has been demonstrated to be effective in reducing risk behaviours. Despite this potential, the provision of such care is reported to be low internationally and in Australia, and there is a need to identify effective strategies to increase care provision. The proposed review will examine the effectiveness of interventions which aimed to increase care provision (i.e. increase the proportion of clients receiving or clinicians providing the 5As) for the chronic disease risk behaviours of clients within the context of mental health service delivery. METHODS Eligible studies will be any quantitative study designs with a comparison group and which report on the effectiveness of an intervention strategy (including delivery arrangements, financial arrangements, governance arrangements and implementation strategies) to increase care provision specifically for chronic disease risk behaviours (tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity). Screening for studies will be conducted across seven electronic databases: PsycINFO, MEDLINE, Excerpta Medica database (EMBASE), Psychology and Behavioural Sciences Collection, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two authors will independently screen studies for eligibility and extract data from included studies. Where studies are sufficiently homogenous, meta-analysis will be performed. Where considerable heterogeneity exists (I 2 ≥ 75), narrative synthesis will be used. DISCUSSION This review will be the first to synthesise evidence for the effectiveness of intervention approaches to facilitate care provision for chronic disease risk behaviours in the context of mental health service delivery. The results have the potential to inform the development of evidenced-based approaches to address the health inequities experienced by this population group. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017074360 .
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Affiliation(s)
- Caitlin Fehily
- The University of Newcastle, Callaghan, NSW Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Kate Bartlem
- The University of Newcastle, Callaghan, NSW Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - John Wiggers
- The University of Newcastle, Callaghan, NSW Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Luke Wolfenden
- The University of Newcastle, Callaghan, NSW Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Timothy Regan
- The University of Newcastle, Callaghan, NSW Australia
| | - Julia Dray
- The University of Newcastle, Callaghan, NSW Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Jacqueline Bailey
- The University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
| | - Jenny Bowman
- The University of Newcastle, Callaghan, NSW Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, Australia
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16
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Hodder RK, Homer S, Freund M, Bowman JA, Lecathelinais C, Colyvas K, Campbell E, Gillham K, Dray J, Wiggers JH. The association between adolescent condom use and individual and environmental resilience protective factors. Aust N Z J Public Health 2018. [PMID: 29528537 DOI: 10.1111/1753-6405.12744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Individual and environmental resilience protective factors are suggested to be associated with adolescent condom use; however, previous studies have not comprehensively examined such associations. This study aimed to determine the associations between condom use, and numerous individual and environmental resilience protective factors in sexually active Australian adolescents. METHODS Participants were Grade 10 students attending 28 Australian government high schools (n=1,688). An online survey (2011) collected data regarding: sexual intercourse (past year), condom use and 14 individual and environmental resilience protective factors. Multivariable backward stepwise logistic regression models examined associations between student condom use and protective factors (total, subscale). RESULTS Only total environmental protective factors remained in the final total score model; students with higher total environmental protective factors scores were 2.59 times more likely to always use a condom(95%CI:1.80-3.74). Only three of 14 protective factor subscales were associated with a higher likelihood of always using a condom in the final subscale model (individual: goals/aspirations; environmental: community participation, pro-social peers). CONCLUSIONS Total environmental and three protective factor subscales demonstrated prominent associations with consistent use of condoms in sexually active adolescents. Implications for public health: Consideration of particular resilience protective factors in adolescent sexual risk behaviour prevention, such as condom use, is warranted.
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Affiliation(s)
- Rebecca Kate Hodder
- Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Sally Homer
- School of Psychology, The University of Newcastle, New South Wales
| | - Megan Freund
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Jennifer A Bowman
- School of Psychology, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | | | - Kim Colyvas
- School of Psychology, The University of Newcastle, New South Wales
| | - Elizabeth Campbell
- Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Karen Gillham
- Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,School of Psychology, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - John H Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
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17
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Milner S, Sherker S, Clinton-McHarg T, Dray J, Zukowski N, Gonzalez S, Kingsland M, Ooi JY, Murphy A, Brooke D, Wiggers J, Wolfenden L. Cluster randomised controlled trial of a multicomponent intervention to support the implementation of policies and practices that promote healthier environments at junior sports clubs: study protocol. BMJ Open 2018; 8:e018906. [PMID: 29362260 PMCID: PMC5786080 DOI: 10.1136/bmjopen-2017-018906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/06/2017] [Accepted: 11/30/2017] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION A large proportion of children and adolescents participate in organised sport, making community sports clubs a promising setting to support healthy behaviours. To date, however, there have been few interventions conducted in junior sports clubs that have targeted health-promoting practices. The primary aim of this pilot study is to assess the potential effectiveness of an intervention to implement health-promoting policies and practices in junior sporting clubs targeting alcohol and tobacco practices, healthy food and beverage availability, and physical activity via participation in sport. A secondary outcome is to assess the impact of such strategies on child exposure to alcohol and tobacco use at the club, purchasing behaviours by/for children at the club canteen and child sports participation opportunities. METHODS AND ANALYSIS The study will employ a cluster randomised controlled trial design and be conducted in metropolitan and regional areas of two Australian states. Randomisation will occur at the level of the football league. Community football clubs with over 40 junior players (players under 18 years) within each league will be eligible to participate. The intervention will be developed based on frameworks that consider the social, cultural and environmental factors that influence health behaviours. Intervention clubs will be supported to implement 16 practices targeting alcohol management, tobacco use, nutrition practices, new player recruitment activity, equal participation for players and the development of policies to support these practices. Trained research staff will collect outcome data via telephone interviews at baseline and follow-up. Interviews will be conducted with both club representatives and parents of junior players. ETHICS AND DISSEMINATION The study has been approved by the University of Newcastle Human Research Ethics Committee (H-2013-0429). The results of the study will be disseminated via peer-reviewed publications and presentations at conferences. TRIAL REGISTRATION NUMBER ACTRN12617001044314; Pre-results.
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Affiliation(s)
| | | | - Tara Clinton-McHarg
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julia Dray
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Nadya Zukowski
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Sharleen Gonzalez
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Melanie Kingsland
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
| | - Jia Ying Ooi
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Allan Murphy
- Alcohol and Drug Foundation, Melbourne, Australia
| | - Daisy Brooke
- Alcohol and Drug Foundation, Melbourne, Australia
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
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18
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Dray J, Bowman J, Campbell E, Freund M, Wolfenden L, Hodder RK, McElwaine K, Tremain D, Bartlem K, Bailey J, Small T, Palazzi K, Oldmeadow C, Wiggers J. Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting. J Am Acad Child Adolesc Psychiatry 2017; 56:813-824. [PMID: 28942803 DOI: 10.1016/j.jaac.2017.07.780] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/24/2017] [Accepted: 07/26/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To examine the effect of universal, school-based, resilience-focused interventions on mental health problems in children and adolescents. METHOD Eligible studies were randomized controlled trials (RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015. Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child: 5-10 years; adolescent: 11-18 years), length of follow-up (short: post-≤12 months; long: >12 months), and gender (narrative). RESULTS A total of 57 included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up, interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. CONCLUSION The findings may suggest most promise for using universal resilience-focused interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups, the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains an important area for future research. SYSTEMATIC REVIEW PROTOCOL AND REGISTRATION Systematic Review of Universal Resilience Interventions Targeting Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908.
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Affiliation(s)
- Julia Dray
- Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia, Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, New South Wales, and Hunter Medical Research Institute, New Lambton Heights, New South Wales.
| | - Jenny Bowman
- Faculty of Science and IT, School of Psychology, University of Newcastle and Hunter Medical Research Institute
| | - Elizabeth Campbell
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Hunter New England Population Health Research Group, Hunter New England Local Health District, and Hunter Medical Research Institute
| | - Megan Freund
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle and Hunter Medical Research Institute
| | - Luke Wolfenden
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Hunter New England Population Health Research Group, Hunter New England Local Health District, and Hunter Medical Research Institute
| | - Rebecca K Hodder
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Hunter New England Population Health Research Group, Hunter New England Local Health District, and Hunter Medical Research Institute
| | - Kathleen McElwaine
- Hunter New England Population Health Research Group, Hunter New England Local Health District and Hunter Medical Research Institute
| | - Danika Tremain
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Hunter New England Population Health Research Group, Hunter New England Local Health District, and Hunter Medical Research Institute
| | - Kate Bartlem
- Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia, Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, New South Wales, and Hunter Medical Research Institute, New Lambton Heights, New South Wales
| | - Jacqueline Bailey
- Faculty of Science and IT, School of Psychology, University of Newcastle and Hunter Medical Research Institute
| | - Tameka Small
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Hunter New England Population Health Research Group, Hunter New England Local Health District, and Hunter Medical Research Institute
| | | | - Christopher Oldmeadow
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle and Hunter Medical Research Institute
| | - John Wiggers
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Hunter New England Population Health Research Group, Hunter New England Local Health District, and Hunter Medical Research Institute
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Hodder RK, Freund M, Bowman J, Wolfenden L, Campbell E, Dray J, Lecathelinais C, Oldmeadow C, Attia J, Wiggers J. Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial. BMJ Open 2017; 7:e016060. [PMID: 28821523 PMCID: PMC5629645 DOI: 10.1136/bmjopen-2017-016060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/06/2017] [Accepted: 06/16/2017] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Initiation of tobacco, alcohol and illicit substance use typically occurs during adolescence, with the school setting recommended to reduce adolescent substance use. Strengthening individual (eg, problem solving) and environmental (eg, caring relationships at school) resilience protective factors of adolescents has been suggested as a strategy for reducing substance use by adolescents; however, few studies have examined this potential. A study was conducted to investigate the effectiveness of a pragmatic school-based universal 'resilience' intervention in reducing the prevalence of tobacco, alcohol and illicit substance use, and increasing the individual and environmental protective factors of students. DESIGN A cluster-randomised controlled trial. SETTING Thirty-two Australian secondary schools (20 intervention; 12 control). PARTICIPANTS Cohort of grade 7 students followed-up in grade 10 (2014; aged 15-16 years). INTERVENTION A pragmatic intervention involving school staff selection and implementation of available programmes and resources targeting individual and environmental 'resilience' protective factors for all grade 7-10 students was implemented in schools (2012-2014). School staff were provided implementation support. MEASUREMENTS An online survey collected baseline and follow-up data for primary outcomes: tobacco (ever, recent) and alcohol (ever, recent, 'risk') use, and secondary outcomes: marijuana and other illicit substance use, and individual (six-factor subscales, aggregate) and environmental (three-factor subscales, aggregate) protective factor scores. Generalised and linear mixed models examined follow-up differences between groups. RESULTS Follow-up data from 2105 students (intervention=1261; control=844; 69% of baseline cohort) were analysed. No significant differences were found between intervention and control students for any primary (ever tobacco: OR 1.25, 95% CI 0.92 to 1.68, p=0.14; recent tobacco: OR 1.39, 95% CI 0.84 to 2.31, p=0.19; recent ever alcohol: OR 1.11, 95% CI 0.83 to 1.48, p=0.46; alcohol: OR 1.13, 95% CI 0.78 to 1.62, p=0.51; 'risk' alcohol: OR 0.98, 95% CI 0.70 to 1.36, p=0.89) or secondary outcomes (marijuana: OR 1.12, 95% CI 0.74 to 1.68, p=0.57; other illicit substance: OR 1.19, 95% CI 0.67 to 2.10, p=0.54; individual protective factors: MD=0, 95% CI -0.07 to 0.06, p=0.89; environmental protective factors: MD: -0.02, 95% CI -0.09 to 0.06, p=0.65). CONCLUSIONS The universally implemented pragmatic school-based intervention was not effective in reducing the prevalence of tobacco, alcohol or illicit substance use, or in increasing the protective factors of students. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Register reference: ACTRN12611000606987.
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Affiliation(s)
- Rebecca Kate Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Megan Freund
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jenny Bowman
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, IT, and Statistical Support (CReDITSS), Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - John Attia
- Clinical Research Design, IT, and Statistical Support (CReDITSS), Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Dray J, Bowman J, Campbell E, Freund M, Hodder R, Wolfenden L, Richards J, Leane C, Green S, Lecathelinais C, Oldmeadow C, Attia J, Gillham K, Wiggers J. Effectiveness of a pragmatic school-based universal intervention targeting student resilience protective factors in reducing mental health problems in adolescents. J Adolesc 2017; 57:74-89. [PMID: 28384523 DOI: 10.1016/j.adolescence.2017.03.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/29/2022]
Abstract
Worldwide, 10-20% of adolescents experience mental health problems. Strategies aimed at strengthening resilience protective factors provide a potential approach for reducing mental health problems in adolescents. This study evaluated the effectiveness of a universal, school-based intervention targeting resilience protective factors in reducing mental health problems in adolescents. A cluster randomised controlled trial was conducted in 20 intervention and 12 control secondary schools located in socio-economically disadvantaged areas of NSW, Australia. Data were collected from 3115 students at baseline (Grade 7, 2011), of whom 2149 provided data at follow up (Grade 10, 2014; enrolments in Grades 7 to 10 typically aged 12-16 years; 50% male; 69.0% retention). There were no significant differences between groups at follow-up for three mental health outcomes: total SDQ, internalising problems, and prosocial behaviour. A small statistically significant difference in favour of the control group was found for externalising problems. Findings highlight the continued difficulties in developing effective, school-based prevention programs for mental health problems in adolescents. TRIAL REGISTRATION ANZCTR (Ref no: ACTRN12611000606987).
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Affiliation(s)
- Julia Dray
- Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia.
| | - Jenny Bowman
- Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Elizabeth Campbell
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Megan Freund
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Rebecca Hodder
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Luke Wolfenden
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Jody Richards
- Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Catherine Leane
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Sue Green
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Christophe Lecathelinais
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Christopher Oldmeadow
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - John Attia
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - Karen Gillham
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
| | - John Wiggers
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2310, Australia
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Hodder RK, Freund M, Bowman J, Wolfenden L, Gillham K, Dray J, Wiggers J. Association between adolescent tobacco, alcohol and illicit drug use and individual and environmental resilience protective factors. BMJ Open 2016; 6:e012688. [PMID: 27888175 PMCID: PMC5168489 DOI: 10.1136/bmjopen-2016-012688] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Research suggests that individual and environmental resilience protective factors may be associated with adolescent substance use; however, the associations between a broad range of such factors and use of various types of substances have not been examined. The study aimed to determine the association between a comprehensive range of adolescent individual and environmental resilience protective factors and measures of tobacco, alcohol and illicit substance use. DESIGN Cross-sectional study. SETTING 32 Australian secondary schools. PARTICIPANTS Grade 7-10 students (aged 11-17 years). MEASURES Data regarding 14 student individual and environmental resilience protective factors and seven substance use measures (tobacco, alcohol, marijuana, other illicit drug use) were obtained via an online self-report survey. Adjusted multivariate logistic regression analyses examined the association between all student resilience protective factors and seven substance use measures. RESULTS Inverse univariate associations were found for 94 of 98 relationships examined (n=10 092). Multivariate analyses found: consistent inverse associations between 2 of 14 protective factors and all substance use measures ('goals and aspirations', 'prosocial peers'); inverse associations between 4 protective factors with multiple substance use measures ('home support' (5 of 7), 'school support' (3 of 7), 'self-awareness' (2 of 7), 'community meaningful participation' (2 of 7)); positive associations between 2 resilience protective factors with multiple measures of substance use ('community support' (3 of 7), 'peer caring relationships' (5 of 7)) and 6 protective factors not to be associated with any substance use measure. CONCLUSIONS Despite individual relationships between the majority of resilience protective factors and substance use types, the protective benefit of such factors for adolescent substance use was limited to only a small number of such factors when considered collectively. Such results suggest that interventions seeking to reduce adolescent substance use may need to target specific protective factors to address specific types of substance use. TRIAL REGISTRATION NUMBER ACTRN12611000606987, Results.
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Affiliation(s)
- Rebecca Kate Hodder
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Priority Research Centre Health Behaviour, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Megan Freund
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Priority Research Centre Health Behaviour, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Jenny Bowman
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- School of Psychology, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Priority Research Centre Health Behaviour, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Karen Gillham
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Julia Dray
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- School of Psychology, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Priority Research Centre Health Behaviour, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
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Dray J, Bowman J, Freund M, Campbell E, Hodder RK, Lecathelinais C, Wiggers J. Mental health problems in a regional population of Australian adolescents: association with socio-demographic characteristics. Child Adolesc Psychiatry Ment Health 2016; 10:32. [PMID: 27651830 PMCID: PMC5022199 DOI: 10.1186/s13034-016-0120-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Population level data regarding the general mental health status, and the socio-demographic factors associated with the mental health status of adolescents in Australia aged 12-16 years is limited. This study assessed prevalence of mental health problems in a regional population of Australian students in Grades 7-10, and investigated associations between mental health problems and socio-demographic factors. METHODS A web-based survey was conducted in 21 secondary schools located in disadvantaged local government areas in one regional local health district of NSW Australia. Mental health problems were measured using the youth self-report Strengths and Difficulties Questionnaire (SDQ) total SDQ score and three subscale scores (internalising problems, externalising problems and prosocial behaviour). Associations between each SDQ outcome and student socio-demographic characteristics (age, gender, Aboriginal and/or Torres Strait Islander Status, remoteness of residential location and socio-economic disadvantage) were investigated. RESULTS Data are reported for 6793 students aged 12-16 years. Nineteen percent of participants scored in the 'very high' range for the total SDQ, 18.0 % for internalising problems, 11.3 % for externalising problems and 8.9 % for prosocial behaviour problems. Gender and Aboriginal status were associated with all four SDQ outcomes, while age was associated with two, excluding externalising problems and prosocial behaviour. Aboriginal adolescents scored higher for mental health problems than non-Aboriginal adolescents for all four SDQ outcomes. Females scored higher than males for total SDQ and internalising problems, with mean difference greatest at age 15. Males scored higher for externalising problems and lower for prosocial behaviour than females. CONCLUSIONS The finding that mental health problems significantly varied by age, gender and Aboriginality may suggest a need for tailored interventions for groups of adolescents with highest levels of mental health problems. Trial Registration ANZCTR ACTRN12611000606987. Registered 14/06/2011.
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Affiliation(s)
- Julia Dray
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW Australia
- Faculty of Science and IT, School of Psychology, University of Newcastle, University Drive, Callaghan, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Jenny Bowman
- Faculty of Science and IT, School of Psychology, University of Newcastle, University Drive, Callaghan, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Megan Freund
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Elizabeth Campbell
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW Australia
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Rebecca K. Hodder
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW Australia
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW Australia
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW Australia
| | - John Wiggers
- Hunter New England Population Health Research Group, Hunter New England Local Health District, Wallsend, NSW Australia
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
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Dray J, Bowman J, Wolfenden L, Campbell E, Freund M, Hodder R, Wiggers J. Systematic review of universal resilience interventions targeting child and adolescent mental health in the school setting: review protocol. Syst Rev 2015; 4:186. [PMID: 26715359 PMCID: PMC4696155 DOI: 10.1186/s13643-015-0172-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 12/18/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The mental health of children and adolescents is a key area of health concern internationally. Previous empirical studies suggest that resilience may act as a protective mechanism towards the development of mental health problems. Resilience refers to the ability to employ a collection of protective factors to return to or maintain positive mental health following disadvantage or adversity. Schools represent a potential setting within which protective factors of all children and adolescents may be fostered through resilience-focussed interventions. Despite this potential, limited research has investigated the effectiveness of universal school-based resilience-focussed interventions on mental health outcomes in children and adolescents. The objective of the present review is to assess the effects of universal school-based resilience-focussed interventions, relative to a comparison group, on mental health outcomes in children and adolescents. METHODS/DESIGN Eligible studies will be randomised (including cluster-randomised) controlled trials of universal interventions explicitly described as resilience-focussed or comprising strategies to strengthen a minimum of three internal protective factors, targeting children aged 5 to 18 years, implemented within schools, and reporting a mental health outcome. Screening for studies will be conducted across six electronic databases: MEDLINE, PsycINFO, Educational Resources Information Center (ERIC), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials (CENTRAL). Two reviewers will retrieve eligible articles, assess risk of bias, and extract data. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. Narrative description will be used to synthesise trial outcome data where data cannot be combined or heterogeneity exists. DISCUSSION This review will aid in building an evidence base for the effectiveness of universal school-based resilience-focussed interventions and in doing so provide an opportunity to better inform the development of interventions to potentially prevent mental health problems in child and adolescent populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015025908.
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Affiliation(s)
- Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
| | - Jenny Bowman
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
| | - Elizabeth Campbell
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
| | - Megan Freund
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
| | - Rebecca Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW, 2310, Australia.
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Reix P, Bacchetta J, Mazur S, Delaup V, Perceval M, Braillon P, Dray J, Chapurlat R, Boutroy S. WS04.6 Children with cystic fibrosis: How compromised is bone? J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dray J, Gilchrist P, Singh D, Cheesman G, Wade TD. Training mental health nurses to provide motivational interviewing on an inpatient eating disorder unit. J Psychiatr Ment Health Nurs 2014; 21:652-7. [PMID: 24842409 DOI: 10.1111/jpm.12163] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2014] [Indexed: 11/29/2022]
Abstract
This study examined whether: (1) brief training in motivational interviewing (MI) can prepare mental health nurses (MHNs) to provide MI to patients; and (2) this MI impacts on patients with respect to premature discharge. Six MHNs on an inpatient eating disorder unit were trained in MI, and their treatment adherence and competence were evaluated at post-training and 2-month follow-up. Premature discharge was examined by comparing a 3-month period in 2009 before MI administration with 2010 when MI was being administered. MHNs significantly improved their MI adherence and competence. Satisfaction with the training was high as was patient satisfaction with MI. Premature discharge rates significantly decreased. Brief training in MI is sufficient to significantly increase competency and adherence in the practice of MI by MHNs, which may in turn be effective in improving patients' treatment adherence by reducing premature discharge rates. Future research will need to utilize a randomized controlled design in order to further investigate these findings.
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Affiliation(s)
- J Dray
- School of Psychology, Flinders University, Adelaide, SA, Australia
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Dray J, Bowman J, Freund M, Campbell E, Wolfenden L, Hodder RK, Wiggers J. Improving adolescent mental health and resilience through a resilience-based intervention in schools: study protocol for a randomised controlled trial. Trials 2014; 15:289. [PMID: 25037455 PMCID: PMC4223719 DOI: 10.1186/1745-6215-15-289] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/18/2014] [Indexed: 12/03/2022] Open
Abstract
Background Research investigating the effectiveness of universal interventions to reduce the risk of mental health problems remains limited. Schools are a promising setting within which adolescents can receive interventions aimed at promoting their mental health. The aim of this study is to assess the effectiveness of a resilience-based prevention-focused intervention in reducing the risk of mental health problems among adolescents attending secondary school in socio-economically disadvantaged areas. Methods/design A cluster randomised control trial will be conducted, with schools as the unit of randomisation. Initially, 32 secondary schools will be randomly allocated to a control or intervention group (12 control and 20 intervention). An intervention focused on improving student internal and external resilience factors will be implemented in intervention schools. A survey of students in Grade 7 in both intervention and control schools will be conducted (baseline) and repeated three years later when the students are in Grade 10. The Strengths and Difficulties Questionnaire will be used to measure the risk of mental health problems. At follow-up, the risk of mental health problems will be compared between Grade 10 students in intervention and control schools to determine intervention effectiveness. Discussion The study presents an opportunity to determine the effectiveness of a comprehensive resilience-based intervention in reducing the risk of mental health problems in adolescents attending secondary schools. The outcomes of the trial are of importance to youth, schools, mental health clinicians and policymakers. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12611000606987, registered 14 June 2011.
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Affiliation(s)
- Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287, Australia.
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Hodder RK, Freund M, Wolfenden L, Bowman J, Gillham K, Dray J, Wiggers J. Systematic review of universal school-based resilience interventions targeting adolescent tobacco, alcohol or illicit drug use: review protocol. BMJ Open 2014; 4:e004718. [PMID: 24861548 PMCID: PMC4039828 DOI: 10.1136/bmjopen-2013-004718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential. METHODS AND ANALYSIS The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5-18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a consistent measure, or standardised mean difference where trials report a comparable measure. Otherwise, trial outcomes will be described narratively. DISSEMINATION Review findings will be disseminated via peer-reviewed journals and conferences.
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Affiliation(s)
- Rebecca Kate Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Megan Freund
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Luke Wolfenden
- The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Jenny Bowman
- The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Karen Gillham
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Julia Dray
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
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Dray J, Menosky JA. Computers and a new world order. Technol Rev 1983; 86:12-6. [PMID: 10260494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Koerber LG, Dray J. A computerized diet survey for dental patients. J Indiana Dent Assoc 1979; 58:26-9. [PMID: 297086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Davitz LJ, Wassil WJ, Bethea WM, Hassid P, Hochheiser LI, Grant SO, Nelson DW, Frisco T, Clark M, Draper RA, Sweeny VK, Connell ED, Shaw MD, Blackmon NC, Janiga K, Outlaw FH, Robinson LK, Webb M, Lamkin S, Maloney T, Casey J, Dray J, Lane J, Swennen A, Cordle CA, Loija EA, Crisman D, Warnes A, Putney MK. Letters. Am J Nurs 1974. [DOI: 10.2307/3469785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Dray J, Dray TF, Ullmann A. [Hydrolysis of urinary metabolites of different steroid hormones by -glucuronidase from Escherichia coli]. Ann Inst Pasteur (Paris) 1972; 123:853-7. [PMID: 4570336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Abstract
Serum glucose and immunoreactive insulin responses to an oral glucose load were measured before and several weeks after treatment with chlorpropamide in eighteen patients with maturity-onset diabetes mellitus. The fall in serum glucose concentration produced by the sufonylurea compound was not associated with an increase in serum insulin concentration. Instead, there appeared to be a direct relationship between control of hyperglycemia and associated decreases in insulin concentration. These observations raise the possibility that sulfonylurea compounds may lower glucose concentration by means other than simply stimulating pancreatic insulin secretion.
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