Normalization of Prevention Principles and Practices to Reduce Substance Use Disorders Through an Integrated Dissemination and Implementation Framework

Major research breakthroughs over the past 30 years in the field of substance use prevention have served to: (1) enhance understanding of pharmacological effects on the central and peripheral nervous systems and the health and social consequences of use of psychoactive substances, particularly for children and adolescents; (2) delineate the processes that increase vulnerability to or protect from initiation of substance use and progression to substance use disorders (SUDs) and, based on this understanding, (3) develop effective strategies and practices to prevent the initiation and escalation of substance use. The challenge we now face as a field is to "normalize" what we have learned from this research so that it is incorporated into the work of those involved in supporting, planning, and delivering prevention programming to populations around the world, is integrated into health and social service systems, and helps to shape public policies. But we wish to go further, to incorporate these effective prevention practices into everyday life and the mind-sets of the public, particularly parents and educators. This paper reviews the advances that have been made in the field of prevention and presents a framework and recommendations to achieve these objectives generated during several meetings of prevention and implementation science researchers sponsored by the International Consortium of Universities for Drug Demand Reduction (ICUDDR) that guides a roadmap to achieve "normalization."

Indigenous adolescent health in Aotearoa New Zealand: Trends, policy and advancing equity for rangatahi Maori, 2001-2019

BACKGROUND

Rangatahi Māori, the Indigenous adolescents of Aotearoa New Zealand (NZ), have poorer health outcomes than Pākehā (NZ European /other European/"White") adolescents. We explored the influence of policies for Indigenous youth by presenting health trends, inequities and contrasting policy case examples: tobacco control and healthcare access.

METHODS

Cross-sectional representative surveys of NZ secondary school students were undertaken in 2001, 2007, 2012 and 2019. Health indicators are presented for Māori and Pākehā adolescents (relative risks with 95% CI, calculated using modified Poisson regression) between 2001-2019 and 2012-2019. Policy examples were examined utilising Critical Te Tiriti Analysis (CTA).

FINDINGS

Rangatahi Māori reported significant health gains between 2001 and 2019, but an increase in depressive symptoms (13.8% in 2012 to 27.9% in 2019, RR 2.01 [1.65-2.46]). Compared to Pākehā youth there was a pattern of persistent Māori disadvantage, particularly for racism (RR 2.27 [2.08-2.47]), depressive symptoms (RR 1.42 [1.27-1.59]) and forgone healthcare (RR 1.63 [1.45-1.84]). Tobacco use inequities narrowed (RR 2.53 [2.12-3.02] in 2007 to RR 1.55 [1.25-1.93] in 2019). CTA reveals rangatahi Māori-specific policies, Māori leadership, and political support aligned with improved outcomes and narrowing inequities.

INTERPRETATION

Age-appropriate Indigenous strategies are required to improve health outcomes and reduce inequities for rangatahi Māori. Characteristics of effective strategies include: (1) evidence-based, sustained, and comprehensive approaches including both universal levers and Indigenous youth-specific policies; (2) Indigenous and rangatahi leadership; (3) the political will to address Indigenous youth rights, preferences, priorities; and (4) a commitment to an anti-racist praxis and healthcare Indigenisation.

FUNDING

Two Health Research Council of New Zealand Project Grants: (a) Fleming T, Peiris-John R, Crengle S, Parry D. (2018). Integrating survey and intervention research for youth health gains. (HRC ref: 18/473); and (b) Clark TC, Le Grice J, Groot S, Shepherd M, Lewycka S. (2017) Harnessing the spark of life: Maximising whānau contributors to rangatahi wellbeing (HRC ref: 17/315).

Covid-19 and Domestic Violence: an Indirect Path to Social and Economic Crisis

PURPOSE

We intend to identify the links between Covid-19 and domestic violence, expose the potential reasons behind an increase in domestic violence cases due to Covid-19, and argue that rising incidence of domestic violence may lead to economic and social crisis.

METHOD

This is a brief note in which authors rely on various statistics and insights regarding domestic violence since the detection of Covid-19. Based on the available statistics regarding domestic violence prevalence during previous times of uncertainty, the number and nature of domestic violence incidents around the globe, and existing literature, the authors argue that clear links exist between Covid-19 and domestic violence, which also impacts on the economic and social crisis.

RESULTS

Countries across the world are battling Covid-19 by enacting measures to reduce the speed of transmission. Multiple reports, however, suggest that such measures are increasing the incidence of domestic violence and not only in number but also in severity. We find that layoffs, loss of income, extended domestic stays, and exposure to habits due to stay-at-home orders are driving up the incidence of domestic violence. Moreover, these domestic violence increases are driving economic and social crises due to the form and severity of the violence, the burden placed on government, a crisis of resources, and decreases in the productivity of workforces.

CONCLUSION

Domestic violence increase resulting from Covid-19 is an indirect driver of economic and social crisis. This brief note proposes certain policy changes and strategies required to reduce domestic violence incidence during this turbulent time.

Advocacy to provide good quality oncology services during the COVID-19 pandemic - Actions at 3-levels

The COVID-19 pandemic is a devastating catastrophe to the whole world, China is the first country seriously affected. This review shows that it is possible to stop wide-spread infection in the country and to provide good quality oncology services even during this challenging period, through concerted efforts with well-organized actions at all levels (National/Municipal, Hospital and Department). The key strategies leading to successful impacts are summarized for sharing. In addition to making practice changes to cope with the adverse realities, oncologists should also work together to raise pragmatic suggestions to policy makers and be strong advocates to protect our patients from the detrimental effect of delay or compromised treatment.

Knowledge transfer in the field of parental mental illness: objectives, effective strategies, indicators of success, and sustainability

BACKGROUND

Mental health problems are often transmitted from one generation to the next. However, transferring knowledge about interventions that reduce intergenerational transmission of disease to the field of parental mental illness has been very difficult. One of the most critical issues in mental health services research is the gap between what is generally known about effective treatment and what is provided to consumers in routine care.

DISCUSSION

In this article we discuss several aspects of knowledge transfer in the field of parental mental illness. Effective strategies and implementation prerequisites are explored, and we also discuss indicators of success and sustainability.

SUMMARY

Altogether, this article presents a rationale for the importance of preventive strategies for children of mentally ill parents. Furthermore, the discussion shows how complex it is to change clinical practice.