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Bailey S, Newton N, Perry Y, Grummitt L, Goldbach J, Barrett E. It's time for change: inequities and determinants of health-related quality of life among gender and sexually diverse young people in Australia. Qual Life Res 2024; 33:1647-1662. [PMID: 38605187 DOI: 10.1007/s11136-024-03633-z] [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] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE This study was guided by three research aims: firstly, to examine the longitudinal trends of health-related quality of life (HR-QoL) among gender and sexuality diverse (LGBTQA2S+) young people through adolescence (ages 14-19); secondly, to assess longitudinal associations between poor mental health and HR-QoL among LGBTQA2S+ young people through adolescence; and thirdly, to examine differences in HR-QoL among LGBTQA2S+ young people during early adolescence (ages 14 and 15) depending on select school-, peer-, and parent-level factors. METHODS This study used three of nine available waves of data from a large population-level, probability sample-based, longitudinal cohort study, namely the K' cohort: children aged 4-5 years old at time of study enrolment followed-up biennially (~ 61% retention rate). HR-QoL weighted means and standard deviations were calculated using Child Health Utility 9D (CHU-9D) scores for LGBTQA2S+ participants at ages 14 and 15 (Wave 6), ages 16 and 17 (Wave 7), and ages 18 and 19 (Wave 8). To strategically identify policy-relevant modifiable behavioural factors suitable for prevention and early intervention, non-parametric Wilcoxon signed-rank tests tested differences in mean CHU-9D ranks at ages 14 and 15 (Wave 6) between groups (gender identity: trans vs. cis; identity-level sexuality: gay, lesbian, bisexual, or other diverse sexuality vs. heterosexual; group-level sexuality: sexually diverse vs. not sexually diverse) and selected school factors (school acceptance, belonging, freedom of expression), peer factors (peer relationship quality, trust, respect), and family factors (parental acceptance, understanding, trust), with Hedge's g correction statistics computed for effect sizes. Longitudinal associations between gender, sexuality, and poor mental health (depressive symptoms, anxiety, symptoms, self-harm thoughts/behaviour, and suicidal thoughts/behaviour) and HR-QoL were tested using mixed-effects models with random intercepts and random slopes for nested clustering (participants within postcodes). RESULTS HR-QoL disparities disproportionately affecting LGBTQA2S+ groups relative to their cisgender, heterosexual peers, were well-established by age 14 to 15 relatively steeper reductions in HR-QoL were observed throughout adolescence among all LGBTQA2S+ groups, with HR-QoL widening the most for trans participants. Poor mental health was significantly associated with HR-QoL declines. LGBTQA2S+ participants with positive school- and parent factors related to feelings of acceptance, belonging, and freedom of self-expression, reported significantly higher HR-QoL during early adolescence. CONCLUSION Evidence-based public health policy responses are required to address the dire HR-QoL inequities among LGBTQA2S+ young people, particularly trans young people. Prioritising the promotion of school- and family-based interventions which foster LGBTQA2S+ inclusivity, acceptance, and a sense of belonging from early adolescence through young adulthood, represents a feasible, evidence-based, and cost-effective response to address these HR-QoL disparities.
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Affiliation(s)
- Sasha Bailey
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jeremy Goldbach
- The Brown School, Washington University in St. Louis, St. Louis, USA
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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O'Dean S, Sunderland M, Newton N, Gardner L, Teesson M, Chapman C, Thornton L, Slade T, Hides L, McBride N, Kay-Lambkin FJ, Allsop SJ, Lubans D, Parmenter B, Mills K, Spring B, Osman B, Ellem R, Smout S, McCann K, Hunter E, Catakovic A, Champion K. The Health4Life e-health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled trial. Med J Aust 2024; 220:417-424. [PMID: 38613175 DOI: 10.5694/mja2.52279] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 10/17/2023] [Indexed: 04/14/2024]
Abstract
OBJECTIVES To investigate the effectiveness of a school-based multiple health behaviour change e-health intervention for modifying risk factors for chronic disease (secondary outcomes). STUDY DESIGN Cluster randomised controlled trial. SETTING, PARTICIPANTS Students (at baseline [2019]: year 7, 11-14 years old) at 71 Australian public, independent, and Catholic schools. INTERVENTION Health4Life: an e-health school-based multiple health behaviour change intervention for reducing increases in the six major behavioural risk factors for chronic disease: physical inactivity, poor diet, excessive recreational screen time, poor sleep, and use of alcohol and tobacco. It comprises six online video modules during health education class and a smartphone app. MAIN OUTCOME MEASURES Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol-related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous). RESULTS A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow-up survey, 5698 (85.8%) two or more follow-up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57-2.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64-1.47); increased light physical activity: OR, 1.00 (95% CI, 0.72-1.38); tobacco use frequency: relative difference, 0.03 (95% CI, -0.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, -0.34 (95% CI, -1.16 to 0.49) days per 30 days; device use time: relative difference, -0.07 (95% CI, -0.29 to 0.16) hours per day. CONCLUSIONS Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e-health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective).
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Affiliation(s)
- Siobhan O'Dean
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Nicola Newton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Lauren Gardner
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Cath Chapman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Louise Thornton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Leanne Hides
- Centre of Youth Substance Abuse, University of Queensland, Brisbane, QLD
- University of Queensland, Brisbane, QLD
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA
| | - Frances J Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW
| | - Steve J Allsop
- National Drug Research Institute, Curtin University of Technology, Perth, WA
| | | | | | - Katherine Mills
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Bonnie Spring
- Northwestern University, Evanston, United States of America
| | - Bridie Osman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | | | - Scarlett Smout
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Karrah McCann
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Emily Hunter
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | | | - Katrina Champion
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
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Bauducco SV, Gardner LA, Champion K, Newton N, Gradisar M. It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep. J Sleep Res 2024; 33:e13940. [PMID: 37192612 DOI: 10.1111/jsr.13940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
This study investigated how changing or maintaining parent-set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage = 12.6 [0.5] years; 47% m) self-reported their sleep patterns, and whether they had parent-set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent-set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent-set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re-introducing a parent-set bedtime may be possible and beneficial for adolescents' sleep.
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Affiliation(s)
- S V Bauducco
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden
- College of Education, Psychology & Social Work, Flinders University, Adelaide, South Australia, Australia
| | - L A Gardner
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - K Champion
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - N Newton
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - M Gradisar
- Sleep Cycle, Gothenburg, Sweden
- WINK Sleep, Adelaide, South Australia, Australia
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Rezapour T, Rafei P, Baldacchino A, Conrod PJ, Dom G, Fishbein DH, Kazemi A, Hendriks V, Newton N, Riggs NR, Squeglia LM, Teesson M, Vassileva J, Verdejo-Garcia A, Ekhtiari H. Neuroscience-informed classification of prevention interventions in substance use disorders: An RDoC-based approach. Neurosci Biobehav Rev 2024; 159:105578. [PMID: 38360332 PMCID: PMC11081014 DOI: 10.1016/j.neubiorev.2024.105578] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 01/15/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024]
Abstract
Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.
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Affiliation(s)
- Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Parnian Rafei
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Alex Baldacchino
- Division of Population and Behavioral Science, University of St Andrews School of Medicine, St Andrews, United Kingdom
| | - Patricia J Conrod
- CHU Sainte-Justine Research Center, Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Belgium
| | - Diana H Fishbein
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, NC, USA; College of Health and Human Development, Pennsylvania State University, PA, USA
| | - Atefeh Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC, Brijder Addiction Treatment), Zoutkeetsingel 40, The Hague 2512 HN, the Netherlands; Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Center, Leiden, Netherlands
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Nathaniel R Riggs
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Lindsay M Squeglia
- Medical University of South Carolina, Psychiatry and Behavioral Sciences, Charleston, SC, USA
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jasmin Vassileva
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, VIC, Australia
| | - Hamed Ekhtiari
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
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Debenham J, Birrell L, Champion KE, Newton N. An on-line school-based substance use harm reduction programme: The Illicit Project randomized controlled trial results. Addiction 2024; 119:741-752. [PMID: 38105000 DOI: 10.1111/add.16403] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023]
Abstract
AIMS The aim of this study was to measure the effectiveness of an on-line, neuroscience-based harm reduction intervention (The Illicit Project) on substance use, harms and knowledge over a 12-month period. DESIGN We used a two-arm cluster-randomized controlled trial. SETTING The study was conducted at eight secondary schools across New South Wales, Australia. PARTICIPANTS A total of 950 (mean age = 15.9; standard deviation = 0.68) in grades 10-12 at participating schools in 2020 took part. INTERVENTION AND COMPARATOR The Illicit Project intervention group (schools = five, n = 681) received an on-line, universal substance use and harm reduction programme over three classes. The active control group (schools = three, n = 269) received school-based health education as usual. MEASUREMENTS Self-report questionnaires assessed primary [alcohol, nicotine, cannabis, 3,4-methylenedioxymethamphetamine (MDMA), cocaine and prescription drug misuse] and secondary outcomes (alcohol-related harms and drug literacy) at baseline and the 6- and 12-month follow-up assessment. FINDINGS Approximately 63% (n = 595) of the sample completed the 12-month follow-up assessment, including 58% of the intervention group (n = 396/679) and 66% of the active control group (n = 179/271). Participants in the intervention group had slower annual increases in binge drinking [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.12-0.89], nicotine use (OR = 0.80, 95% CI = 0.52-1.23), MDMA use (OR = 0.14, 95% CI = 0.02-1.00), cocaine use (OR = 0.06, 95% CI = 0.01-0.64) and prescription drug misuse (OR = 0.07, 95% CI = 0.01-0.54) compared with the active control group. There was limited evidence of an intervention effect on cannabis use and alcohol-related harm (P > 0.5). The secondary outcomes showed that the intervention group maintained higher levels of drug literacy knowledge (β = 3.71, 95% CI = 1.86-5.56) and harm reduction help-seeking skills (β = 1.55, 95% CI = 0.62-2.48) compared with the active control group. CONCLUSION The Illicit Project (an on-line, neuroscience-based substance use harm reduction intervention) was effective in slowing the uptake of risky substance use and improving drug literacy skills among late secondary school students in Australia, compared with school-based health education as usual.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Laugharne R, Wilcock M, Rees J, Wainwright D, Newton N, Sterritt J, Badger S, Bishop R, Bassett P, Shankar R. Clinical characteristics of people with intellectual disability admitted to hospital with constipation: identifying possible specific high-risk factors. J Intellect Disabil Res 2024; 68:277-284. [PMID: 38031737 DOI: 10.1111/jir.13108] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) die on an average 20 years earlier to the general population. They have higher rates of multimorbidity and polypharmacy. Around 25% of people with ID report chronic constipation. The England Learning Disabilities Mortality Review found that nearly 25% of deaths identified constipation as a long-term health problem. However, the likely risk factors for constipation related harm are poorly enumerated. We sought to identify possible specific high-risk factors by examining the clinical characteristics of people with ID admitted to hospital with constipation. METHODS Data of people with ID admitted with constipation in two general hospitals covering a population of 1.3 million from 2017 to 2022 were reported using the STROBE guideline for cohort studies. Collected data included age, gender, intellectual disability severity, recorded medication, presenting complaint and co-morbidities. The medication anticholinergic burden was calculated using the anticholinergic burden scale. Continuous variables were summarised by mean and standard deviation if normally distributed, with categorical variables summarised by the number and percentage in each category. RESULTS Of 46 admissions (males 52%), 57% had moderate to profound ID, 37% had epilepsy, 41% prescribed antiseizure medication (ASM) and 45% were on laxatives. Average age was 46 years. The anticholinergic burden score mean was 2.3 and median, one. CONCLUSIONS We can hypothesise that people with more severe ID, suffering from epilepsy and on ASM may be more at risk of developing severe constipation. Some admissions may be avoided with earlier use of laxatives in the community.
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Affiliation(s)
- R Laugharne
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
- Cornwall Intellectual Disability Equitable Research (CIDER) University of Plymouth Peninsula School of Medicine, Truro, UK
| | - M Wilcock
- Pharmacy department Learning Disability Liasion service, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - J Rees
- Pharmacy department Learning Disability Liasion service, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - D Wainwright
- Adult Learning Disability Services, Devon Partnership NHS Trust, Exeter, UK
| | - N Newton
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
| | - J Sterritt
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
| | - S Badger
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
| | - R Bishop
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
- Cornwall Intellectual Disability Equitable Research (CIDER) University of Plymouth Peninsula School of Medicine, Truro, UK
| | - P Bassett
- Statsconsultancy Ltd. Bucks, London, UK
| | - R Shankar
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
- Cornwall Intellectual Disability Equitable Research (CIDER) University of Plymouth Peninsula School of Medicine, Truro, UK
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Bailey S, Newton N, Perry Y, Davies C, Lin A, Marino JL, Skinner RS, Grummitt L, Barrett E. Minority stressors, traumatic events, and associations with mental health and school climate among gender and sexuality diverse young people in Australia: Findings from a nationally representative cohort study. J Adolesc 2024; 96:275-290. [PMID: 38018791 DOI: 10.1002/jad.12274] [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] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/19/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION Population-level, nationally representative data on the prevalence of minority stressors and traumatic events, mental ill-health effects, and the preventative utility of school climate, among gender and sexuality diverse young people in Australia, is significantly lacking. In this study, we estimated the prevalence and distribution of minority stressors and traumatic events among young people by sexuality identity (gay/lesbian, bisexual, other sexuality, heterosexual), sexuality diversity (sexuality diverse, not sexuality diverse), and gender identity (transgender, cisgender) and assessed associations with mental ill-health and the moderating role of school climate factors. METHODS Using Wave 8 (2018) follow-up data from a population-level, nationally representative longitudinal cohort study, the sample comprised 3037 young people aged 17-19 years in Australia. Prevalence ratios for minority stressors and traumatic events were calculated for gender and sexuality diverse categories using logistic regression models. Linear regression models were used to test associations between traumatic events and minority stressors, and mental ill-health. Multivariate linear regression tested school climate factors as effect modifier between minority stressors and mental ill-health among sexuality diverse young people. RESULTS Rates of traumatic events and minority stressors were highest among bisexual and gay/lesbian young people and were significantly associated with mental ill-health among all gender and sexuality diverse young people. Highest mental ill-health effects were observed among trans young people. Among sexuality diverse young people, positive and negative feelings toward school climate were associated with decreased and increased mental ill-health, respectively. After accounting for sexuality diversity, positive overall school climate appeared protective of mental ill-health effects of sexuality-based discrimination. DISCUSSION Minority stressors, traumatic events, and associated mental ill-health are prevalent among gender and sexuality diverse young people in Australia, especially trans, bisexual, and gay/lesbian young people. Promotion of affirmative, safe, and inclusive school climate demonstrates significant promise for the prevention and early intervention of mental ill-health among gender and sexuality diverse young people.
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Affiliation(s)
- Sasha Bailey
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Cristyn Davies
- School of Medicine, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ashleigh Lin
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Parkville, Australia
- School of Population Health, University of Western Australia, Perth, Australia
| | - Jennifer L Marino
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Rachel S Skinner
- School of Medicine, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Mewton L, Davies S, Sunderland M, Champion K, Hoy N, Newton N, Teesson M, Squeglia LM. Longitudinal relationships between lifestyle risk factors and neurodevelopment in early adolescence. Health Psychol 2023; 42:904-912. [PMID: 37616102 PMCID: PMC10840638 DOI: 10.1037/hea0001248] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
OBJECTIVE The goal of this study is to investigate the cross-sectional and longitudinal relationships between clustered lifestyle risk factors (sleep, physical activity, body mass index [BMI], and screen time) and neurodevelopment over the early adolescent period. METHOD Data from the ABCD Study Data Release 3.0 consisted of 11,878 participants (aged 9-10 years) at baseline and 6,571 participants (aged 11-12 years) at 2-year follow-up. The interrelationships between lifestyle risk factors and brain structure were analyzed using bivariate multiple indicator latent change score models. Using confirmatory factor analysis, a single lifestyle risk factor domain (measured by sleep, physical activity, BMI, and screen time) was shown to fit the data well. Using exploratory and confirmatory factor analysis, seven brain structure domains were extracted and labeled as temporal-parietal, frontotemporal, occipital, orbitofrontal, temporal, cingulate, parietal, and cuneus domains. All bivariate latent change score models accounted for age, sex at birth, race/ethnicity, parental education, and marital status. RESULTS Higher lifestyle risk was associated with smaller brain volume at baseline. Higher baseline lifestyle risk was also associated with a greater rate of change (i.e., greater decreases) in brain volume for the temporal-parietal, frontotemporal, orbitofrontal, parietal, and cuneus domains. Effects were not reciprocal; baseline brain volume did not predict changes in lifestyle behaviors over time. CONCLUSION These findings are important for understanding the biological mechanisms underpinning health risk factors and can be used to target interventions and improve brain health during this critical developmental phase. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Louise Mewton
- Centre for Healthy Brain Ageing, School of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Sarah Davies
- Centre for Healthy Brain Ageing, School of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Nicholas Hoy
- Centre for Healthy Brain Ageing, School of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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Bailey S, Newton N, Perry Y, Grummitt L, Baams L, Barrett E. Trauma-informed prevention programmes for depression, anxiety, and substance use among young people: protocol for a mixed-methods systematic review. Syst Rev 2023; 12:203. [PMID: 37907971 PMCID: PMC10617188 DOI: 10.1186/s13643-023-02365-4] [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: 09/16/2022] [Accepted: 10/07/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Mental ill-health and substance use bear a substantial burden and harm on young people and often arise from co-occurring and compounding risk factors, such as traumatic stress. Trauma-informed prevention of mental ill-health and substance use demonstrates significant promise in reducing this burden. A systematic literature review is required to identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental ill-health and/or substance use prevention programmes for young people aged 12-24 years. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Cochrane Library will be searched from 2012 through September 2022. Reference lists of included articles will be citation-chained. Title and abstracts will be screened and two reviewers will review articles full-text. One reviewer will extract data from eligible articles using a piloted data extraction form, and 20% of the data will be verified by a second reviewer. Risk of bias will be assessed using the Cochrane risk-of-bias tool for randomised trials (RoB 2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), and The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (CASP), depending on the study type. Characteristics of existing trauma-informed mental ill-health and/or substance use prevention programmes for young people will be summarised narratively. Effectiveness, feasibility, and acceptability will be qualitatively described and summarised, with proportions and effect sizes quantitatively synthesised, where possible. DISCUSSION Trauma-informed approaches to prevention demonstrate significant promise, yet to date, no study has systematically summarised and synthesised the available literature. To fill this gap, the present review will systematically identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental health and/or substance use prevention programmes for young people aged 12-24. This review will inform the development, adaptation, evaluation, and implementation of future trauma-informed mental ill-health and substance use prevention programmes for young people. Findings will inform critical efforts to interrupt and prevent already elevated trajectories of mental ill-health, substance use, and related harms among those young people exposed to adversity. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022353883.
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Affiliation(s)
- S Bailey
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - N Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Y Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - L Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - L Baams
- University of Groningen, Groningen, Netherlands
| | - E Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Birrell L, Debenham J, Furneaux-Bate A, Prior K, Spallek S, Thornton L, Chapman C, Newton N. Evaluating a Peer-Support Mobile App for Mental Health and Substance Use Among Adolescents Over 12 Months During the COVID-19 Pandemic: Randomized Controlled Trial. J Med Internet Res 2023; 25:e45216. [PMID: 37756116 PMCID: PMC10538359 DOI: 10.2196/45216] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/12/2023] [Accepted: 07/20/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Although it is well known that adolescents frequently turn to their friends for support around mental health and substance use problems, there are currently no evidence-based digital programs to support them to do this. OBJECTIVE The aim of this study was to evaluate the efficacy of the Mind your Mate program, a digital peer-support program, in improving mental health symptoms, reducing the uptake of substance use, and increasing help seeking. The Mind your Mate program consists of a 40-minute web-based classroom lesson and a companion smartphone mobile app. The active control group received school-based health education as usual. METHODS A cluster randomized controlled trial was conducted with 12 secondary schools and 166 students (mean age 15.3, SD 0.41 years; 72/166, 43.4% female; and 133/166, 80.1% born in Australia). Participants completed self-reported questionnaires assessing symptoms of mental health (depression, anxiety, and psychological distress), substance use (alcohol and other drug use), and help-seeking measures at baseline and at 6-month and 12-month follow-ups. RESULTS Students who received the Mind your Mate program had greater reductions in depressive symptoms over a 12-month period than controls (b=-1.86, 95% CI -3.73 to 0.02; Cohen d=-0.31). Anxiety symptoms decreased among students in the intervention group; however, these reductions did not meet statistical significance thresholds. No differences were observed in relation to psychological distress or help-seeking. CONCLUSIONS Small to moderate reductions in depression symptoms were observed among students allocated to receive the Mind your Mate intervention. Although the current results are encouraging, there is a need to continue to refine, develop, and evaluate innovative applied approaches for the prevention of mental disorders in real-world settings. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000753954; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000753954. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/26796.
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Affiliation(s)
- Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ainsley Furneaux-Bate
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Sophia Spallek
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Catherine Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Faller J, Le LKD, Chatterton ML, Perez JK, Chiotelis O, Tran HNQ, Sultana M, Hall N, Lee YY, Chapman C, Newton N, Slade T, Sunderland M, Teesson M, Mihalopoulos C. A systematic review of economic evaluations for opioid misuse, cannabis and illicit drug use prevention. BJPsych Open 2023; 9:e149. [PMID: 37551098 PMCID: PMC10594094 DOI: 10.1192/bjo.2023.515] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/15/2023] [Accepted: 06/08/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear. AIMS This review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use. METHOD Literature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist. RESULTS Eleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost-benefit studies reported cost-savings. One cost-effectiveness and two cost-utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds. CONCLUSIONS There are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics ('the Network System to Prevent Doctor-Shopping for Narcotics') show promising cost-effectiveness and warrant consideration.
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Affiliation(s)
- Jan Faller
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Mary Lou Chatterton
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Joahna Kevin Perez
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Oxana Chiotelis
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Huong Ngoc Quynh Tran
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Marufa Sultana
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Natasha Hall
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Yong Yi Lee
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; School of Public Health, The University of Queensland, Australia; and Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Matt Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; and Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
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Andrews JL, Birrell L, Chapman C, Teesson M, Newton N, Allsop S, McBride N, Hides L, Andrews G, Olsen N, Mewton L, Slade T. Evaluating the effectiveness of a universal eHealth school-based prevention programme for depression and anxiety, and the moderating role of friendship network characteristics. Psychol Med 2023; 53:5042-5051. [PMID: 35838377 DOI: 10.1017/s0033291722002033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND Lifetime trajectories of mental ill-health are often established during adolescence. Effective interventions to prevent the emergence of mental health problems are needed. In the current study we assessed the efficacy of the cognitive behavioural therapy (CBT)-informed Climate Schools universal eHealth preventive mental health programme, relative to a control. We also explored whether the intervention had differential effects on students with varying degrees of social connectedness. METHOD We evaluated the efficacy of the Climate Schools mental health programme (19 participating schools; average age at baseline was 13.6) v. a control group (18 participating schools; average age at baseline was 13.5) which formed part of a large cluster randomised controlled trial in Australian schools. Measures of internalising problems, depression and anxiety were collected at baseline, immediately following the intervention and at 6-, 12- and 18-months post intervention. Immediately following the intervention, 2539 students provided data on at least one outcome of interest (2065 students at 18 months post intervention). RESULTS Compared to controls, we found evidence that the standalone mental health intervention improved knowledge of mental health, however there was no evidence that the intervention improved other mental health outcomes, relative to a control. Student's social connectedness did not influence intervention outcomes. CONCLUSION These results are consistent with recent findings that universal school-based, CBT-informed, preventive interventions for mental health have limited efficacy in improving symptoms of anxiety and depression when delivered alone. We highlight the potential for combined intervention approaches, and more targeted interventions, to better improve mental health outcomes.
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Affiliation(s)
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Leanne Hides
- University of Queensland, Brisbane, QLD, Australia
| | - Gavin Andrews
- University of New South Wales, Sydney, NSW, Australia
| | - Nick Olsen
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Louise Mewton
- University of New South Wales, Sydney, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
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Le LKD, Faller J, Chatterton ML, Perez JK, Chiotelis O, Tran HNQ, Sultana M, Hall N, Lee YY, Chapman C, Newton N, Slade T, Sunderland M, Teesson M, Mihalopoulos C. Interventions to prevent alcohol use: systematic review of economic evaluations. BJPsych Open 2023; 9:e117. [PMID: 37365798 DOI: 10.1192/bjo.2023.81] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Alcohol use is a leading risk factor for death and disability worldwide. AIMS We conducted a systematic review on the cost-effectiveness evidence for interventions to prevent alcohol use across the lifespan. METHOD Electronic databases (EMBASE, Medline, PsycINFO, CINAHL and EconLit) were searched for full economic evaluations and return-on-investment studies of alcohol prevention interventions published up to May 2021. The methods and results of included studies were evaluated with narrative synthesis, and study quality was assessed by the Drummond ten-point checklist. RESULTS A total of 69 studies met the inclusion criteria for a full economic evaluation or return-on-investment study. Most studies targeted adults or a combination of age groups, seven studies comprised children/adolescents and one involved older adults. Half of the studies found that alcohol prevention interventions are cost-saving (i.e. more effective and less costly than the comparator). This was especially true for universal prevention interventions designed to restrict exposure to alcohol through taxation or advertising bans; and selective/indicated prevention interventions, which involve screening with or without brief intervention for at-risk adults. School-based interventions combined with parent/carer interventions were cost-effective in preventing alcohol use among those aged under 18 years. No interventions were cost-effective for preventing alcohol use in older adults. CONCLUSIONS Alcohol prevention interventions show promising evidence of cost-effectiveness. Further economic analyses are needed to facilitate policy-making in low- and middle-income countries, and among child, adolescent and older adult populations.
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Affiliation(s)
- Long Khanh-Dao Le
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Jan Faller
- MHE, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Mary Lou Chatterton
- PharmD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Joahna Kevin Perez
- MHE, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Oxana Chiotelis
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Huong Ngoc Quynh Tran
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Marufa Sultana
- PhD, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Natasha Hall
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Yong Yi Lee
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; School of Public Health, The University of Queensland, Australia; and Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Cath Chapman
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Nicola Newton
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Tim Slade
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Matt Sunderland
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Cathrine Mihalopoulos
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
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Smout S, Gardner LA, Newton N, Champion KE. Dose-response associations between modifiable lifestyle behaviours and anxiety, depression and psychological distress symptoms in early adolescence. Aust N Z J Public Health 2023; 47:100010. [PMID: 36645951 DOI: 10.1016/j.anzjph.2022.100010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To investigate associations between key modifiable lifestyle behaviours (sleep; physical activity; fruit, vegetable and sugar-sweetened beverage consumption; screen time; alcohol use and tobacco use) and mental health among early adolescents in Australia. METHODS Cross-sectional self-report data from 6,640 Year 7 students (Mage:12.7[0.5]; 50.6% male, 48.9% female, 0.5% non-binary) from 71 schools in New South Wales, Queensland and Western Australia were analysed using multivariate linear regression adjusting for sociodemographic factors and school-level clustering. RESULTS All examined behaviours were associated with anxiety, depression and psychological distress (p≤0.001), with the lowest mental health symptom scores observed in participants who slept 9.5-10.5 hours per night; consumed three serves of fruit daily; consumed two serves of vegetables daily; never or rarely drank sugar-sweetened beverages; engaged in six days of moderate-to-vigorous physical activity per week; kept daily recreational screen time to 31-60 minutes; had not consumed a full standard alcoholic drink (past six months); or smoked a cigarette (past six months). CONCLUSIONS Targeting modifiable risk behaviours offers promising prevention potential to improve adolescent mental health; however, further longitudinal research to determine directionality and behavioural interactions is needed. IMPLICATIONS FOR PUBLIC HEALTH While Australian Dietary, Movement and Alcohol Guidelines target physical health, findings indicate similar behaviour thresholds may offer mental health benefits.
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Affiliation(s)
- Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Sampson D, Heinsch M, Geddes J, Velleman R, Velleman G, Teesson M, Newton N, Kay-Lambkin F. 'I no longer know that person': Experiences of families living with someone using crystal methamphetamine. PLoS One 2023; 18:e0284156. [PMID: 37043501 PMCID: PMC10096493 DOI: 10.1371/journal.pone.0284156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/24/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Crystal methamphetamine ('ice') use is a large and growing worldwide problem, yet few research studies have explored the impact of crystal methamphetamine use on affected friends and family members. We explored the experiences and narratives of family members and friends of people who use methamphetamine to inform the development of a Family and Friend Support Program. METHODS This paper reports on a subset of findings from a mixed method study, which sought to better understand the experiences of family members and friends of people who use methamphetamine. Participants were recruited via Facebook advertising and asked to complete a survey outlining their experiences. At the end of the survey, participants were invited to be interviewed by a clinical psychologist on the research team, to discuss their experiences in greater depth; seventeen people agreed to be interviewed. This paper is based on a qualitative thematic analysis of these interviews using Braun and Clarke's 6-stage approach to identify key areas of concern for friends and family members of people who use methamphetamine. RESULTS Through thematic analysis, five key themes were developed, namely: (1) loss, (2) stigma, (3) support (or lack thereof), (4) ways of coping, and (5) the value in sharing personal experiences. The results of this study revealed the profound sadness, frustration and loss friends and family members experienced when caring for a loved one who uses methamphetamine. This loss was further complicated by societal stigma surrounding the use of methamphetamine, which often extended to friends and family members themselves. Since experiences of grief and loss were interwoven across the three themes, concepts of ambiguous loss, disenfranchised grief, and narrative constructivist approaches to understanding loss, were applied to the discussion of results. CONCLUSION This study provides a more complete picture of family and caregiver experiences when caring for a loved one using methamphetamine, which may further help inform the design of intervention programs. Implications for future research and practice with this population are considered.
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Affiliation(s)
- Dara Sampson
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- National Health and Medical Research Centre for Mental Health and Substance Use, University of New South Wales, Sydney, Australia
| | - Milena Heinsch
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- National Health and Medical Research Centre for Mental Health and Substance Use, University of New South Wales, Sydney, Australia
| | - Jenny Geddes
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- National Health and Medical Research Centre for Mental Health and Substance Use, University of New South Wales, Sydney, Australia
| | - Richard Velleman
- Department of Psychology, University of Bath, Bath, United Kingdom
- Velleman Consultancy Ltd, Bath, United Kingdom
- Addictions Research Group, Sangath Foundation, Goa, India
| | | | - Maree Teesson
- National Health and Medical Research Centre for Mental Health and Substance Use, University of New South Wales, Sydney, Australia
| | - Nicola Newton
- National Health and Medical Research Centre for Mental Health and Substance Use, University of New South Wales, Sydney, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- National Health and Medical Research Centre for Mental Health and Substance Use, University of New South Wales, Sydney, Australia
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Grummitt L, Barrett E, Kelly E, Newton N. An Umbrella Review of the Links Between Adverse Childhood Experiences and Substance Misuse: What, Why, and Where Do We Go from Here? Subst Abuse Rehabil 2022; 13:83-100. [PMID: 36411791 PMCID: PMC9675346 DOI: 10.2147/sar.s341818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/24/2022] [Accepted: 11/09/2022] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A wealth of research has identified adverse childhood experiences (ACEs; abuse, neglect, violence or disorder in the home) as a strong risk factor for substance misuse. Synthesis of the existing evidence is critical to shape policy and inform directions for future research. Existing reviews have focused on specific substances or substance use outcomes (eg, disorder), and do not include discussion of the mechanisms that operate between ACEs and substance misuse. The current umbrella review aims to synthesize reviews on the relationship between ACEs and substance misuse, review the evidence on the mechanisms linking these, identify existing gaps in our knowledge, and discuss critical directions for future research, practice, and public policy. METHODS Two electronic databases (PsycINFO and Medline) were searched for reviews published between 1998 and 2022 on the link between ACEs and substance misuse. Twenty articles met eligibility criteria and were qualitatively synthesized. RESULTS Results overwhelmingly demonstrated an elevated risk of substance misuse or disorder, among adolescents and adults exposed to ACEs. Research on the mechanisms that explain this link highlights a multitude of potential intervention targets, with childhood stress propelling a cascade of effects across neurobiological, endocrine, immune, metabolic, and nervous systems, impacting psychosocial and cognitive functioning. Nonetheless, the literature is subject to limitations surrounding potential unmeasured cofounders and causality, as well as decontextualizing childhood adversity from broader structural issues that influence the link between ACEs and substance misuse. Research, policy, and practice that seek to holistically understand and address the relationship between ACEs and substance misuse within the broader social determinants of health is crucial.
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Affiliation(s)
- Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
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Lawler S, Stapinski L, Teesson M, Prior K, Basto-Pereira M, Newton N, Barrett EL. Unpacking Violent Behavior in Young Adulthood: The Relative Importance of Hazardous Alcohol Use. J Interpers Violence 2022; 37:NP18935-NP18959. [PMID: 34715761 DOI: 10.1177/08862605211044103] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Young adulthood is an important developmental period for investigating the nature of violent behavior. This study examines the unique contribution of alcohol use to violence perpetration among young adults in the Australian community, after accounting for the influence of sociodemographic, early life, trait, and well-being influences. Cross-sectional, self-report data was collected from 507 young adults aged 18-20 years in the Australian general community via an online survey. Sequential logistic regressions examined the relative and independent contribution of adverse childhood experiences (ACEs), impulsivity, psychological distress, and hazardous alcohol use to past-year violent behavior. Results show one in eight young adults aged 18-20 (13%) reported at least one act of violent behavior in the past year, primarily assault perpetrated against another person. Sequential logistic regression identified that after controlling for other risk factors, the number of ACEs reported and hazardous alcohol use were independently and positively associated with increased odds of reporting violent behavior in young adulthood. These findings demonstrate that ACEs and hazardous alcohol use are important, independent correlates of violent behavior in young adults. While preventing early adversity is key for reducing violence in the community, this evidence suggests that it is also important to target proximal causes such as hazardous alcohol use. Increasing early and widespread access to evidence-based, trauma-informed violence-prevention programs targeting risk factors across multiple settings is critical for reducing harm and supporting young people into healthy adulthood.
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McCallum SM, Batterham PJ, Christensen H, Werner-Seidler A, Nicolopoulos A, Newton N, Teesson M, Calear AL. Personality factors associated with suicidal ideation, plans and attempts in adolescents. J Affect Disord 2022; 310:135-141. [PMID: 35537543 DOI: 10.1016/j.jad.2022.05.010] [Citation(s) in RCA: 2] [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] [Received: 07/23/2021] [Revised: 04/07/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide is the leading cause of death among young Australians, therefore identifying factors that increase risk is important. The aims of this study was to investigate the association between personality domains and suicidal ideation, plans and attempts in a community-based sample of adolescents. METHODS 1428 students from thirteen secondary schools in Australia completed a survey consisting of demographic information (gender and age), personality risk across four domains (Hopelessness, Impulsivity, Sensation Seeking and Anxiety Sensitivity) as measured by the Substance Use Risk Profile Scale, and psychological distress measured by the Distress Questionnaire 5 scale. Outcome measures included suicidal ideation, plans and attempts measured by the Youth Risk Behavior Survey. RESULTS Students were aged between 11 and 17 years old (mean: 13.3, SD = 1.2) with 59% identifying as female. Proportions of participants reporting suicidal ideation, plans and at least one attempt were 14%, 9% and 7% respectively. Hopelessness was associated with twice the odds (OR = 3.1 and 2.9) of suicidal thoughts and plans respectively. Hopelessness also had 45% increased odds for suicide attempt (OR = 2.1), however this was not significant in the suicidal ideation sub-group. Impulsivity and sensation seeking were associated with suicidal ideation (OR = 1.3), while only impulsivity was associated with attempt (OR = 1.5). LIMITATIONS The study was cross-sectional, considered suicidal thoughts and behaviors in past 12 months only and used one measure of personality. CONCLUSIONS Personality traits may be important for determining suicide risk in adolescents. Developing screening and interventions targeting personality may have implications for the detection and prevention of suicide.
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Affiliation(s)
- Sonia M McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | | | - Ally Nicolopoulos
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre, University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre, University of Sydney, Sydney, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia.
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19
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Grummitt LR, Debenham J, Kelly E, Barrett EL, Champion K, Conrod P, Teesson M, Newton N. Selective personality‐targeted prevention of suicidal ideation in young adolescents:
post hoc
analysis of data collected in a cluster randomised controlled trial. Med J Aust 2022; 216:525-529. [PMID: 35568380 PMCID: PMC9542662 DOI: 10.5694/mja2.51536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/06/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022]
Abstract
Objective Design Setting, participants Intervention Main outcome measure Results Conclusion Trial registration (CAP study only)
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Affiliation(s)
- Lucinda R Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
| | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
| | - Patricia Conrod
- University of Montreal Montreal Canada
- Sainte Justine Hospital Research Centre University of Montreal Montreal Canada
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use University of Sydney Sydney NSW
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20
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Parmenter B, Burley C, Stewart C, Whife J, Champion K, Osman B, Newton N, Green O, Wescott AB, Gardner LA, Visontay R, Birrell L, Bryant Z, Chapman C, Lubans DR, Sunderland M, Slade T, Thornton L. Measurement properties of smartphone approaches to assess physical activity in healthy young people: A systematic review (Preprint). JMIR Mhealth Uhealth 2022; 10:e39085. [PMID: 36269659 PMCID: PMC9636527 DOI: 10.2196/39085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background Physical inactivity is a preventable risk factor for several chronic diseases and one of the driving forces behind the growing global burden of disease. Recent evidence has shown that interventions using mobile smartphone apps can promote a significant increase in physical activity (PA) levels. However, the accuracy and reliability of using apps is unknown. Objective The aim of our review was to determine the accuracy and reliability of using mobile apps to measure PA levels in young people. We conducted a systematic review guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Methods Studies published from 2007 to 2020 were sourced from 8 databases—Ovid MEDLINE, Embase (Elsevier), Cochrane Library (Wiley), PsychINFO (EBSCOhost), CINAHL (EBSCOhost), Web of Science (Clarivate), SPORTDiscus (EBSCOhost), and IEEE Xplore Digital Library database. Studies were conducted in young people aged 10-24 years and without chronic illnesses, who evaluated a mobile app’s ability to measure PA. Primary outcomes included validity, reliability, and responsiveness of the measurement approach. Duplicate screening was conducted for eligibility, data extraction, and assessing the risk of bias. Results were reported as a systematic review. The main physical activity measures evaluated for each study were the following: total PA time (min/day or min/week), total moderate to vigorous PA per week, daily step count, intensity measure (heart rate), and frequency measure (days per week). Results Of the 149 identified studies, 5 met the inclusion criteria (322 participants, 176 female; mean age 14, SD 3 years). A total of 3 studies measured criterion validity and compared PA measured via apps against PA measured via an Actigraph accelerometer. The 2 studies that reported on construct validity identified a significant difference between self-reported PA and the objective measure. Only 1 of the 5 apps examined was available to the public, and although this app was highly accepted by young people, the app recorded PA to be significantly different to participants’ self-reported PA. Conclusions Overall, few studies assess the reliability, validity, and responsiveness of mobile apps to measure PA in healthy young people, with studies typically only reporting on one measurement property. Of the 3 studies that measured validity, all concluded that mobile phones were acceptable and valid tools. More research is needed into the validity and reliability of smartphone apps to measure PA levels in this population as well as in populations with other characteristics, including other age groups and those with chronic diseases. Trial Registration PROSPERO CRD42019122242; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=122242
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Affiliation(s)
- Belinda Parmenter
- School of Health Sciences, University of New South Wales, Kensington, Australia
| | - Claire Burley
- School of Health Sciences, University of New South Wales, Kensington, Australia
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Courtney Stewart
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Jesse Whife
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Katrina Champion
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Bridie Osman
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Nicola Newton
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Olivia Green
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Annie B Wescott
- Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren A Gardner
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Rachel Visontay
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Louise Birrell
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Zachary Bryant
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Cath Chapman
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - David R Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Tim Slade
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
| | - Louise Thornton
- The Matilda Centre, The University of Sydney, Sydney, NSW, Australia
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21
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Debenham J, Champion K, Birrell L, Newton N. Effectiveness of a neuroscience-based, harm reduction program for older adolescents: A cluster randomised controlled trial of the Illicit Project. Prev Med Rep 2022; 26:101706. [PMID: 35111569 PMCID: PMC8789601 DOI: 10.1016/j.pmedr.2022.101706] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/16/2021] [Accepted: 01/15/2022] [Indexed: 11/16/2022] Open
Abstract
The prevention of risky adolescent substance use is critical. Limited age-appropriate, school-based programs target adolescents aged 16-19 years, despite this representing the age of initiation and escalation of substance use. The Illicit Project is a neuroscience-based, harm reduction program targeting late adolescents, designed to address this gap. The current study aims to evaluate the program's effectiveness in reducing risky substance use and related harms among late adolescents. A cluster randomised controlled trial was conducted involving 950 students (Mage = 15.9 years SD = 0.68; 60% Female) from eight secondary schools in Australia. Five schools received The Illicit Project program, and three schools were randomised into the active control group (health education as usual). All students completed a self-report survey at baseline and 6-months post-baseline and intervention students completed a program evaluation survey. Outcomes include alcohol and substance use, alcohol related harms and drug literacy levels (knowledge and skills). At 6-months post baseline, individuals in the intervention group were less likely to engage in weekly binge drinking (OR = 0.56), high monthly alcohol consumption (OR = 0.56), early onset cannabis use (OR = 0.35), risky single occasion cannabis use (OR = 0.48), MDMA use (OR = 0.16) or nicotine product use (OR = 0.59) compared to the control group. Students in the intervention group were less likely to have experience alcohol related harms (OR = 0.57) and more likely to have higher drug literacy scores (β = 2.44) at follow-up. These preliminary results support the effectiveness of The Illicit Project. Further follow-up is required to determine the durability of the results over time.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
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22
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Hoy N, Newton N, Kochan NA, Sunderland M, Baillie A, Chapman C, Winter V, Sachdev P, Teesson M, Mewton L. Rethink My Drink: study protocol for a 12-month randomised controlled trial comparing a brief internet-delivered intervention to an online patient information booklet in reducing risky alcohol consumption among older adults in Australia. Addiction 2022; 117:815-825. [PMID: 34426994 DOI: 10.1111/add.15672] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Alcohol consumption is increasing among older adults. Rethink My Drink is a brief internet-delivered intervention to reduce alcohol consumption and related harms, adapted specifically for older adults. This protocol for a large-scale randomised controlled trial will evaluate whether Rethink My Drink is effective in reducing alcohol consumption and cognitive decline in a sample of older risky drinkers, compared with an active control. DESIGN 1:1 parallel group, randomised controlled trial. SETTING Online trial in Australia. PARTICIPANTS Hazardous or harmful drinkers (defined as those scoring ≥5 on the Alcohol Use Disorders Identification Test [AUDIT]) age 60 to 75 years old (n = 842). Participants will be recruited from August 2021 to August 2022 through online social media advertisements and community networks. INTERVENTION AND COMPARATOR Participants will be randomly allocated to receive access to Rethink My Drink (intervention) or Alcohol: The Facts (comparator), an online patient information booklet provided by New South Wales (NSW) Health. MEASUREMENTS Primary outcomes include (i) average weekly standard drinks and (ii) rate of cognitive decline. Secondary outcomes include (i) typical quantity of drinks per drinking day; (ii) heavy episodic drinking; (iii) age-specific risky drinking; (iv) alcohol-related harms; (v) subjective cognitive complaints; and (vi) quality of life. All primary and secondary outcomes will be assessed at baseline, post-intervention (4 weeks) and 12 months. Effectiveness will be evaluated using multilevel linear regression, adjusting for baseline demographic differences. Bonferroni adjustments will be used to control for multiple comparisons. Multiple imputation, regression weighting and sensitivity analyses will assess the effect of attrition. COMMENTS This will be the first large-scale trial, internationally, to examine whether a brief internet-delivered intervention is effective in reducing alcohol consumption and cognitive decline among older adults. If successful, the intervention will provide an accessible and highly scalable treatment to reduce risky alcohol consumption in older adulthood.
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Affiliation(s)
- Nicholas Hoy
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Andrew Baillie
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Virginia Winter
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
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23
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Basto-Pereira M, Gouveia-Pereira M, Pereira CR, Barrett EL, Lawler S, Newton N, Stapinski L, Prior K, Costa MSA, Ximenes JM, Rocha AS, Michel G, Garcia M, Rouchy E, Al Shawi A, Sarhan Y, Fulano C, Magaia AJ, El-Astal S, Alattar K, Sabbah K, Holtzhausen L, Campbell E, Villanueva L, Gomis-Pomares A, Adrián JE, Cuervo K, Sakulku J. The global impact of adverse childhood experiences on criminal behavior: A cross-continental study. Child Abuse Negl 2022; 124:105459. [PMID: 35007971 DOI: 10.1016/j.chiabu.2021.105459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/23/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have been associated with a greater risk of later criminal offending. However, existing research in this area has been primarily conducted in Western developed countries and cross-cultural studies are rare. OBJECTIVES This study examined the relationship between ACEs and criminal behaviors in young adults living in 10 countries located across five continents, after accounting for sex, age, and cross-national differences. PARTICIPANTS AND SETTING In total, 3797 young adults aged between 18 and 20 years (M = 18.97; DP = 0.81) were assessed locally in community settings within the 10 countries. METHOD The ACE Questionnaire was used to assess maltreatment and household dysfunction during childhood and a subset of questions derived from the Deviant Behavior Variety Scale (DBVS) was used to determine past-year criminal variety pertaining to 10 acts considered crime across participating countries. RESULTS Physical and sexual abuse, physical neglect, and household substance abuse were related to criminal variety, globally, and independently across sexes and countries ranked differently in the United Nations Human Development Index (HDI). In addition, three out of five experiences of household dysfunction were related to criminal variety, but subsequent analyses indicate that some forms of household dysfunction only hold statistical significance among males or females, or in countries ranking lower in the HDI. CONCLUSIONS This research strengthens the finding that there are cross-cultural mechanisms perpetuating the cycle of violence. It also indicates that forms of household dysfunction have an impact on criminal behavior that is shaped by gender and the country's levels of social well-being.
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Affiliation(s)
- Miguel Basto-Pereira
- William James Center for Research, ISPA-Instituto Universitário, R. Jardim do Tabaco 34, 1100-304 Lisboa, Portugal..
| | - Maria Gouveia-Pereira
- APPsyCI, ISPA - Intituto Universitário, R. Jardim do Tabaco 34, 1100-304 Lisboa, Portugal
| | - Cicero Roberto Pereira
- Institute of Social Sciences, University of Lisbon (ICS-ULisboa), Av. Prof. Aníbal Bettencourt 9, 1600-189, Lisbon, Portugal; Federal University of Paraíba, Campus I - Lot. Cidade Universitaria, PB 58051-900, Brazil
| | - Emma Louise Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Siobhan Lawler
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Maria Suely Alves Costa
- Universidade Federal do Ceará, UFC, Campus Sobral, R. Cel. Estanislau Frota, 563 - Centro, Sobral, CE 62010-560, Brazil
| | - Jocélia Medeiros Ximenes
- Universidade Federal do Ceará, UFC, Campus Sobral, R. Cel. Estanislau Frota, 563 - Centro, Sobral, CE 62010-560, Brazil
| | - André Sousa Rocha
- Universidade Federal do Ceará, UFC, Campus Sobral, R. Cel. Estanislau Frota, 563 - Centro, Sobral, CE 62010-560, Brazil
| | - Grégory Michel
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, 4 rue du Maréchal Joffre, 1er étage, 33000 Bordeaux, France; Department of Psychology, University of Bordeaux, ISCJ, 4 rue du Maréchal Joffre, 33075 Bordeaux, France
| | - Mathieu Garcia
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, 4 rue du Maréchal Joffre, 1er étage, 33000 Bordeaux, France; Department of Psychology, University of Bordeaux, ISCJ, 4 rue du Maréchal Joffre, 33075 Bordeaux, France
| | - Emma Rouchy
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, 4 rue du Maréchal Joffre, 1er étage, 33000 Bordeaux, France; Department of Psychology, University of Bordeaux, ISCJ, 4 rue du Maréchal Joffre, 33075 Bordeaux, France
| | - Ameel Al Shawi
- Department of Community & Family Medicine, College of Medicine, University of Fallujah, Fallujah City, Anbar Governorate, Iraq
| | - Yassen Sarhan
- Department of Community & Family Medicine, College of Medicine, University of Anbar, Ramadi city, Anbar Governorate, Iraq
| | - Celso Fulano
- Universidade Pedagógica, Rua João Carlos Raposo Beirão n° 135, Maputo, Mozambique; Maputo Municipal Council, Bairro Chali, n°142, estrada 403, Maputo, Mozambique
| | - Angélica José Magaia
- Ministry of Gender, Children and Social Action, National Director of Children, Av Ahmed S Touré 908, Maputo, Mozambique
| | - Sofián El-Astal
- Al Azhar University-Gaza, Jamal Abdl Naser St., Gaza, Palestine
| | - Kefaya Alattar
- Al Azhar University-Gaza, Jamal Abdl Naser St., Gaza, Palestine
| | - Khetam Sabbah
- Al Azhar University-Gaza, Jamal Abdl Naser St., Gaza, Palestine
| | - Leon Holtzhausen
- Department of Social Development, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
| | - Emma Campbell
- Department of Social Development, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
| | - Lidón Villanueva
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Aitana Gomis-Pomares
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Juan E Adrián
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Keren Cuervo
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Jaruwan Sakulku
- School of Psychology, Faculty of Liberal Arts, Thammasat University, 99 Moo 18 Paholyothin Rd. Khlong Nueng, Khlong Luang, Pathumthani 12121, Thailand
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Lees B, Riches J, Mewton L, Elliott EJ, Allsop S, Newton N, Thomas S, Rice LJ, Nepal S, Teesson M, Stapinski LA. Fetal alcohol spectrum disorder resources for educators: A scoping review. Health Promot J Austr 2022; 33:797-809. [PMID: 35028999 PMCID: PMC9544813 DOI: 10.1002/hpja.574] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/08/2021] [Accepted: 01/04/2022] [Indexed: 12/02/2022] Open
Abstract
Children with foetal alcohol spectrum disorder (FASD) can experience neurodevelopmental, physical, psychological and behavioural impairments that can result in a disrupted school experience. However, educators often have limited knowledge or experience in the identification and support of students with FASD, and there is a critical need for effective tools and resources to ensure students with FASD are supported in their ongoing learning and development. This scoping review aimed to identify and evaluate publicly available educator resources that aid in the identification, and support of students with FASD in primary/elementary school. In addition, educators and FASD experts were consulted to obtain feedback on currently available resources, and key issues and priorities for FASD resources. In total, 124 resources were identified by searching peer‐reviewed and grey literature databases, app stores, podcast services and contacting FASD experts. Information was found on identification (23 resources) and support of students with FASD (119 resources). No resources provided information on the referral. Most resources were average (40%) to good (33%) quality, as measured by a composite tool based on adaptions of the NHMRC FORM Framework and iCAHE Guideline Quality Checklist. A minority of resources had been formally evaluated (7%). Review findings and consultations with experts and educators indicate a critical need for referral guides, evidence‐based short‐format resources and centralised access for school communities to high‐quality resources. Taken together, this study has identified key areas for future resource development and research to better support primary school students with FASD.
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Affiliation(s)
- Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Julia Riches
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Australia
| | - Elizabeth J Elliott
- The University of Sydney, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, Sydney, Australia.,The Sydney Children's Hospitals Network, Westmead, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia
| | - Lauren J Rice
- The Sydney Children's Hospitals Network, Westmead, Sydney, Australia.,The Brain and Mind Centre, The University of Sydney, Australia
| | - Smriti Nepal
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
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25
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Birrell L, Furneaux-Bate A, Debenham J, Spallek S, Newton N, Chapman C. Development of the Mind your Mate program: A peer-support mobile application and web-based lesson for adolescent mental health (Preprint). JMIR Form Res 2022; 6:e36068. [PMID: 35622401 PMCID: PMC9187963 DOI: 10.2196/36068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ainsley Furneaux-Bate
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Sophia Spallek
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Catherine Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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26
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Stapinski L, Routledge K, Snijder M, Doyle M, Champion K, Chapman C, Ward J, Baumgart A, Lee KSK, Teesson M, Newton N. A Web-Based Alcohol and Other Drug Prevention Program (Strong & Deadly Futures) for Aboriginal and Torres Strait Islander School Students: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34530. [PMID: 34994696 PMCID: PMC8783274 DOI: 10.2196/34530] [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: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background There are no available school-based alcohol and drug prevention programs with evidence of effectiveness among Aboriginal and Torres Strait Islander youth. To address this, we codeveloped the Strong & Deadly Futures well-being and alcohol and drug prevention program in partnership with an Indigenous creative design agency and 4 Australian schools. Objective This paper presents the protocol to evaluate the effectiveness of Strong & Deadly Futures in reducing alcohol and other drug use and improving well-being among Aboriginal and Torres Strait Islander youth. Methods The target sample will be 960 year 7 and 8 students from 24 secondary schools in Australia, of which approximately 40% (384/960) will identify as Aboriginal or Torres Strait Islander. The study design is a 2-group, parallel cluster randomized controlled trial with allocation concealment. Recruited schools will be block randomized (ratio 1:1), stratified by geographical remoteness, by an independent statistician. Schools will be randomized to receive Strong & Deadly Futures, a web-based alcohol and drug prevention and social and emotional well-being program that delivers curriculum-aligned content over 6 lessons via an illustrated story, or health education as usual (control). Control schools will be supported to implement Strong & Deadly Futures following trial completion. Surveys will be administered at baseline, 6 weeks, 12 months, and 24 months (primary end point) post baseline. Primary outcomes are alcohol use (adapted from the National Drug Strategy Household Survey), tobacco use (Standard High School Youth Risk Behavior Survey), and psychological distress (Kessler-5 Psychological Distress Scale). Secondary outcomes are alcohol and drug knowledge and intentions, alcohol-related harms, binge drinking, cannabis use, well-being, empowerment, appreciation of cultural diversity, and truancy. Results The trial was funded by the National Health and Medical Research Council in January 2019, approved by the Human Research Ethics Committee of the University of Sydney (2020/039, April 2020), the Aboriginal Health and Medical Research Council of New South Wales (1620/19, February 2020), the Western Australian Aboriginal Health Ethics Committee (998, October 2021), and the ethics committees of each participating school, including the New South Wales Department of Education (2020170, June 2020), Catholic Education Western Australia (RP2020/39, November 2020), and the Queensland Department of Education (550/27/2390, August 2021). Projected dates of data collection are 2022-2024, and we expect to publish the results in 2025. A total of 24 schools have been recruited as of submission of the manuscript. Conclusions This will be the first cluster randomized controlled trial of a culturally inclusive, school-based alcohol and drug prevention program for Aboriginal and Torres Strait Islander youth; therefore, it has significant potential to address alcohol and other drug harms among Aboriginal and Torres Strait Islander youth. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620001038987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380038&isReview=true International Registered Report Identifier (IRRID) PRR1-10.2196/34530
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Affiliation(s)
- Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Kylie Routledge
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Mieke Snijder
- Institute of Development Studies, The University of Sussex, Brighton, United Kingdom
| | - Michael Doyle
- National Health and Medical Research Council Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - James Ward
- University of Queensland Poche Centre for Indigenous Health, University of Queensland, St Lucia, Australia
| | - Amanda Baumgart
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - K S Kylie Lee
- National Health and Medical Research Council Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, Australia.,National Drug Research Institute, Curtin University, Bentley, Australia.,Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
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Egan L, Gardner LA, Newton N, Champion K. eHealth interventions targeting poor diet, alcohol use, tobacco smoking and vaping among disadvantaged youth: A systematic review protocol (Preprint). JMIR Res Protoc 2021; 11:e35408. [PMID: 35560002 PMCID: PMC9143768 DOI: 10.2196/35408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/23/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Background Chronic disease burden is higher among disadvantaged populations. Preventing lifestyle risk behaviors such as poor diet, alcohol use, tobacco smoking, and vaping in adolescence is critical for reducing the risk of chronic disease and related harms in adolescence and adulthood. Although eHealth interventions are a promising prevention approach among the general population, it is unclear whether they adequately serve adolescents from disadvantaged backgrounds such as those living in geographically remote or lower socioeconomic areas. Objective This is the first systematic review to identify, evaluate, and synthesize evidence for the effectiveness of eHealth interventions targeting adolescents living in geographically remote or lower socioeconomic areas in preventing poor diet, alcohol use, tobacco smoking, and vaping. Methods A systematic search will be conducted in 7 electronic databases: the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PROSPERO, MEDLINE (Ovid), Embase (Ovid), Scopus, and PsycInfo (Ovid). The search will be limited to eHealth-based experimental studies (ie, randomized controlled trials and quasi-experimental studies) targeting diet, alcohol use, tobacco smoking, and vaping among adolescents (aged 10-19 years). Eligible studies will be those reporting on at least one marker of socioeconomic status (eg, social class, household income, parental occupation status, parental education, and family affluence) or geographical remoteness (eg, living in rural, regional, and remote areas, or living outside major metropolitan centers). One reviewer will screen all studies for eligibility, of which 25% will be double-screened. Data will be extracted and summarized in a narrative synthesis. Risk of bias will be assessed using the Cochrane Revised Risk of Bias Tool. Results As of December 2021, the title and abstract screening of 3216 articles was completed, and the full-text review was underway. The systematic review is expected to be completed in 2022. Conclusions This systematic review will provide an in-depth understanding of effective eHealth interventions targeting poor diet, alcohol use, tobacco smoking, and vaping among adolescents living in geographically remote or lower socioeconomic areas and the factors that contribute to their effectiveness. This in turn will provide critical knowledge to improve future interventions delivered to these populations. Trial Registration PROSPERO CRD42021294119; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=294119 International Registered Report Identifier (IRRID) PRR1-10.2196/35408
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Affiliation(s)
- Lyra Egan
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Lauren Anne Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Kershaw S, Birrell L, Champion K, Duong F, Grager A, Stapinski L, Newton N, Kay-Lambkin F, Teesson M, Chapman C. Cracks in the ice: a digital health initiative disseminating evidence-based information about ‘ice’. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Crystal methamphetamine (‘ice') causes significant societal harm and attracts a high level of concern in Australia. Cracks in the Ice (CITI: cracksintheice.org.au) is a digital public health initiative that was developed as part of a national response to concerns about ice. CITI is the first centralised national online portal for evidence-based information and resources about ice in Australia. It provides targeted information and resources for health workers, people who use ice, their family and friends, community groups and schools. CITI was developed collaboratively with input from drug and alcohol experts and over 500 Australian community members, including people with lived experience. A national online survey was conducted to evaluate whether CITI is meeting the needs of the Australian community.
Methods
Eligible participants were Australian residents aged 18 years and over, and were recruited via the CITI website, email direct marketing, and social media. The survey assessed participants' perceptions of CITI (e.g., usability, navigation, utility) and their knowledge and attitudes about ice.
Results
2110 participants completed the survey, including people who use ice, affected family members, health workers, and general community members. Participants' response to CITI was overall positive and their knowledge of ice was generally good, but many held negative or stigmatising attitudes towards ice and people who use it.
Conclusions
Digital public health initiatives stand to overcome structural, geographical, and attitudinal barriers to alcohol and other drug (AOD) prevention efforts. CITI ensures evidence-based information about the drug ice is readily available across all of Australia. Community evaluations have shown that CITI is meeting the needs of the Australian community.
Key messages
Crystal methamphetamine (‘ice’) attracts a high level of concern in Australia. CITI is the first centralised national online portal for evidence-based information and resources about ice. Digital health initiatives stand to overcome structural, geographical, and attitudinal barriers to AOD prevention. Community evaluations ensure these initiatives meet the needs of their end-users.
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Affiliation(s)
- S Kershaw
- Matilda Centre, University of Sydney, Sydney, Australia
| | - L Birrell
- Matilda Centre, University of Sydney, Sydney, Australia
| | - K Champion
- Matilda Centre, University of Sydney, Sydney, Australia
| | - F Duong
- Matilda Centre, University of Sydney, Sydney, Australia
| | - A Grager
- Matilda Centre, University of Sydney, Sydney, Australia
| | - L Stapinski
- Matilda Centre, University of Sydney, Sydney, Australia
| | - N Newton
- Matilda Centre, University of Sydney, Sydney, Australia
| | - F Kay-Lambkin
- Matilda Centre, University of Sydney, Sydney, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, Australia
| | - M Teesson
- Matilda Centre, University of Sydney, Sydney, Australia
| | - C Chapman
- Matilda Centre, University of Sydney, Sydney, Australia
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Smout S, Gardner L, Newton N, Champion K, Chapman C, Slade T, Sunderland M, Thornton L, Kay-Lambkin F, Teesson M. 436Food addiction, mental health and substance-use during a transition period: Data from 6,700 Australian 12/13-year-olds. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early adolescence is a challenging transition period where mental ill-health and experimentation with alcohol and tobacco often increases. Some foods and eating behaviours can be addictive in a way that is comparable to addictive substances. Few studies have examined the prevalence of food addiction in young people, and none have measured it with mental ill-health and substance-use.
Methods
6,700 Year 7 students across NSW, WA and QLD completed the baseline questionnaire for “Health4Life” (Mage=12.7±0.5, 49%F). The prevalence of, and associations between, food addiction (YFAS-C), anxiety (PROMIS-A), depression (PHQ-A), psychological distress (K6), discretionary food/drink intake (SPANS) and alcohol and tobacco use were examined.
Results
Respondents who met diagnostic criteria for food addiction (5.2%, n = 272) were significantly more likely to screen positively for anxiety (X23=315.4, P < 0.001), probable major depression (X21=299.9, P < 0.001) and psychological distress at levels of serious mental illness (X21=238.885, P < 0.001). They were also significantly more likely to have consumed a full standard drink and smoked tobacco in the past 6-months (X21=53.8, P < 0.001 and X21=29.7, P < 0.001, respectively) and to consume high amounts of sugar-sweetened beverages (X21=15.2, P < 0.001), discretionary foods (X22=26.4, P < 0.001) and energy drinks (X25=28.4, P < 0.001). Relative risks ranged 1.29-4.35.
Conclusions
Findings suggest a strong link between food addiction, substance use, discretionary food and drink consumption and mental ill-health in early adolescence. Further analysis will model multivariable relationships whilst controlling for affluence, BMI and gender.
Key messages
Links between food addiction, substance use and mental ill-health are found in the largest sample of adolescents screened for these variables worldwide.
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Affiliation(s)
- Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Lauren Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
| | | | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Darlington, Australia
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Gardner L, Champion K, Teesson M, Newton N, Kay-Lambkin F, Chapman C, Thornton L, Slade T, Mills K, Sunderland M, Allsop S, Hides L, McBride N, Bauer J, Parmenter B, Spring B, Lubans D. 195The Health4Life Initiative: An eHealth intervention targeting multiple lifestyle risk behaviours among Australian adolescents. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Physical inactivity, poor diet, sedentary recreational screen time, poor sleep, alcohol use and smoking (the “Big 6”) are key lifestyle risk factors for chronic disease. The Big 6 typically emerge during adolescence, co-occur and continue into adulthood. To improve short- and long-term health, early and effective prevention is critical.
Methods
A cluster randomised controlled trial (ACTRN12619000431123) is being conducted in 71 schools across NSW, QLD and WA. Schools are randomised to the Health4life intervention or health education as usual. The intervention has three components: 1) An online, school-based program delivered to all Year 7 students; 2) An accompanying smartphone application (all students); 3) Booster content, delivered to at-risk students in Years 8 and 9. Students complete questionnaires on five occasions over three years.
Results
Preliminary analyses including 6716 students (49% female) indicated that 22% of participants met national guidelines for physical activity, 27% reported drinking 2+ cups of sugar-sweetened beverages/week, 3% had consumed a standard alcoholic drink in the prior 6 months, 2% had tried smoking, 86% engaged in excessive recreational screen time, and 32% had inadequate sleep. The final dataset will be analysed for the conference.
Conclusions
Many Australian adolescents are engaging in lifestyle behaviours that put them at risk of chronic disease. Effective and scalable preventive interventions that simultaneously target these behaviours are needed.
Key messages
This is the first trial of an eHealth intervention to concurrently target the Big 6 among adolescents. Health4Life has the potential to improve physical and mental health in adolescence and beyond.
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Affiliation(s)
- Lauren Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University Of Sydney, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Belinda Parmenter
- Department of Exercise Physiology, School of Medical Sciences, UNSW Sydney, Sydney, Australia
| | - Bonnie Spring
- Feinberg School of Medicine, Northwestern University, Chicago, United States
| | - David Lubans
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, Australia
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Kershaw S, Chapman C, Birrell L, Champion K, Deen H, Stapinski L, Kay-Lambkin HF, Teesson M, Newton N. 1220Barriers to care for people who use crystal methamphetamine. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Crystal methamphetamine (‘ice’) causes significant societal harm in Australia and is perceived by the public to be the drug of most concern nationally. Although effective treatments exist, it is estimated that only a third of people dependent on amphetamine-type stimulants receive treatment each year. Barriers to care may for people who use ice can include psychosocial (e.g., knowledge, attitudinal) and structural barriers. This study aimed to look at the perceived and actual barriers to care for Australians, as well as help-seeking behaviours among people who use ice.
Methods
An online survey was conducted among 2,110 Australians including people with lived experience, health workers, affected family members/friends and community members. All participants were asked about perceived barriers to care. People with lived experience were asked additional questions about help seeking.
Results
Attitudinal reasons were the highest perceived barrier to care among 63.1% of participants, followed by knowledge (21.9%). People with lived experience were more likely to endorse attitudinal barriers (OR 1.35), whereas health workers were more likely to endorse knowledge related barriers (OR 0.69). Among people with lived experience who had sought help, 74.5% had visited a counsellor/psychologist and 60.6% had asked help from a family member/friend.
Conclusions
Understanding and reducing barriers to care is essential to reduce the harms associated with the drug. It is important to support families and friends as they are often asked to help or support a loved one using ice.
Key messages
It is important to understand and reduce the perceived and actual barriers to care for people who use ice. This is essential to reduce the harms associated with the drug.
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Affiliation(s)
- Steph Kershaw
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Hannah Deen
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Honorary Frances Kay-Lambkin
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
- The Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
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Debenham J, Birrell L, Champion K, Lees B, Yücel M, Newton N. Neuropsychological and neurophysiological predictors and consequences of cannabis and illicit substance use during neurodevelopment: a systematic review of longitudinal studies. Lancet Child Adolesc Health 2021; 5:589-604. [PMID: 33991473 DOI: 10.1016/s2352-4642(21)00051-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022]
Abstract
Adolescence and early adulthood are crucial periods of neurodevelopment characterised by functional, structural, and cognitive maturation, which helps prepare young people for adulthood. This systematic review of longitudinal studies aims to delineate neural predictors from neural consequences of cannabis and illicit substance use, as well as investigate the potential for the developing brain (at ages 10-25 years) to recover after damage. Five databases were searched to yield a total of 38 eligible studies, with some assessing multiple outcome techniques, including 22 neuroimaging, two neurophysiological, and 22 neuropsychological findings. High-quality evidence suggested that delayed or irregular neurodevelopment in executive functioning, particularly emotional perception, might predispose young people to higher frequency substance use. There was evidence of functional, structural, and cognitive deficits proceeding substance use, with harm potentially dependent on the frequency of use and recovery potentially dependent on the duration of use. Identifying aberrant neurodevelopment in young people is crucial for preventing substance use-related harm.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia.
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
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Smout A, Chapman C, Mather M, Slade T, Teesson M, Newton N. It's the Content That Counts: Longitudinal Associations between Social Media Use, Parental Monitoring, and Alcohol Use in an Australian Sample of Adolescents Aged 13 to 16 Years. Int J Environ Res Public Health 2021; 18:ijerph18147599. [PMID: 34300049 PMCID: PMC8307079 DOI: 10.3390/ijerph18147599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 01/13/2023]
Abstract
(1) Background: More time spent on social media has been linked to increased alcohol use, with exposure to peer alcohol-related content on social media (content exposure) named as a critical factor in this relationship. Little is currently known about whether early content exposure may have lasting effects across adolescent development, or about the capacity of parental monitoring of social media use to interrupt these links. (2) Methods: These gaps were addressed in both cross-sectional and longitudinal contexts among a longitudinal sample of Australian secondary school students (n = 432) across the ages of 13–16. (3) Results: Evidence was found for links between social media use and alcohol use frequency in early development. Social media time at age 13 was significantly associated with concurrent alcohol use frequency. At age 13, alcohol use frequency was significantly higher among those who reported content exposure compared to those who reported no exposure. Longitudinally, the frequency of alcohol use over time increased at a faster rate among participants who reported content exposure at age 13. In terms of parental monitoring, no longitudinal effects were observed. However, parental monitoring at age 13 did significantly reduce the concurrent relationship between alcohol use frequency and content exposure. (4) Conclusion: The impact of social media content exposure on alcohol use in adolescence may be more important than the time spent on social media, and any protective effect of parental monitoring on content exposure may be limited to the time it is being concurrently enacted.
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Affiliation(s)
- Anna Smout
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia; (C.C.); (T.S.); (M.T.); (N.N.)
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC 3800, Australia
- Correspondence:
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia; (C.C.); (T.S.); (M.T.); (N.N.)
| | - Marius Mather
- Sydney Informatics Hub, The University of Sydney, Sydney, NSW 2008, Australia;
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia; (C.C.); (T.S.); (M.T.); (N.N.)
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia; (C.C.); (T.S.); (M.T.); (N.N.)
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia; (C.C.); (T.S.); (M.T.); (N.N.)
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Debenham J, Newton N, Champion K, Lawler S, Lees B, Stapinski L, Teesson M, Birrell L. Neuroscience literacy and substance use prevention: How well do young people understand their brain? Health Promot J Austr 2021; 33:395-402. [PMID: 34173994 DOI: 10.1002/hpja.516] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 11/08/2022] Open
Abstract
ISSUE Reducing substance use harm in young people is a major public health priority, however, health promotion messages often struggle to achieve meaningful engagement. Neuroscience-based teachings may provide an innovative new way to engage young people in credible harm minimisation health promotion. This study aims to evaluate the acceptability and credibility of a series of neuroscience-based drug education animations and investigate neuroscience literacy in young people. METHODS Three animations were developed around the impact of alcohol, MDMA and cannabis use on the growing brain, labelled the 'Respect Your Brain' video series. Sixty young people (mean age 21.9 years; 48% female) viewed the animations and completed a 20-minute web-based, self-report survey to provide feedback on the animations and a 19-item neuroscience literacy survey, assessing knowledge and attitudes towards the brain. RESULTS The Alcohol, Cannabis and MDMA videos were rated as good or very good by the majority of participants (82%, 89% and 85%, respectively) and all participants wanted to see more 'Respect your Brain' videos. On average the Alcohol, Cannabis and MDMA videos were rated as containing the right level of detail and being interesting, relevant and engaging by the majority of participants (80%, 81% and 83%, respectively). Participants scored an average of 74% in the neuroscience literacy questionnaire, demonstrating some knowledge of brain functioning and positive attitudes towards the brain. CONCLUSION This study provides evidence that age-appropriate, neuroscience-based resources on alcohol, Cannabis and MDMA are engaging and relevant to young people and offer a potential new avenue to reduce alcohol and other drug related harm and promote healthy lifestyle choices in young people.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Siobhan Lawler
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Grummitt L, Kelly E, Barrett E, Keyes K, Newton N. Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review. PLoS One 2021; 16:e0252815. [PMID: 34097711 PMCID: PMC8183991 DOI: 10.1371/journal.pone.0252815] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background and aims Childhood adversity is a strong, and concerningly prevalent, risk factor for the later development of substance misuse. Yet despite substantial accumulating evidence for causal mechanisms, there has been little attempt to synthesize the strength of the evidence. Importantly, these mechanisms may be amenable to intervention, providing targets for substance use prevention among those exposed to childhood adversity. The present review aimed to systematically identify mediating and moderating mechanisms operating between childhood adversity and substance use. Methods A systematic review was conducted. Electronic databases (PubMed, MEDLINE, PsycINFO, Web of Science and CINAHL) were searched from 1998 to 2020 for modifiable mediators and moderators of the relationship between childhood adversity and substance use in people aged 10–24. Data was qualitatively synthesised, using a socio-ecological perspective to group mediators/moderators into individual, interpersonal, community, and public policy/cultural levels of behaviour. Results After screening against eligibility criteria, 50 studies were included in the current review. The mediators at the individual level of behaviour showing the largest and most consistent effect sizes included externalising behaviour, anger, coping motives for substance use, and post-traumatic stress symptoms. Among individual-level moderators, religiosity, future orientation and depressive symptoms all attenuated the relationship between childhood adversity and substance use. At the interpersonal level, peer relationships and mother-child relationships mediated the effect of adversity on substance use. Moderators included family cohesion and relationship quality. Community factors were less commonly studied, though school mobility and educational achievement mediated 14% and 28% of the total effect of childhood adversity on substance use respectively. No mediators or moderators were identified for public policy/culture. Conclusions A substantial proportion of the relationship between childhood adversity and substance use in youth is mediated through individual, interpersonal and community factors. Coupled with the knowledge that existing, evidence-based programs effectively address many of the identified mediators and moderators, this review advances knowledge on optimal targets to prevent substance misuse among those exposed to childhood adversity.
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Affiliation(s)
- Lucinda Grummitt
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Sydney, Australia
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Erin Kelly
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Emma Barrett
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Nicola Newton
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Sydney, Australia
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Debenham J, Birrell L, Champion K, Newton N. Study protocol for a cluster randomised controlled trial of The Illicit Project, a digital, neuroscience-based substance use intervention for secondary school students. Contemp Clin Trials 2021; 107:106467. [PMID: 34098037 DOI: 10.1016/j.cct.2021.106467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/07/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
Older adolescence (16-19 years) is characterised by an increase in alcohol and illicit substance use, however limited age-appropriate prevention programs exist to target this critical group. Schools are increasingly opting for web-based programs to deliver health education due to their effectiveness, accessibility and scalability. This study outlines the web-based adaptation of a neuroscience-based harm reduction program targeting older adolescents known as, The Illicit Project, and the study protocol to evaluate its effectiveness. A cluster randomised controlled trial will be conducted with Year 10, 11 and/or 12 students (aged 16-19 years) from 8 secondary schools across New South Wales, Australia. Participating schools will be randomised into the control group (health education as usual) or the intervention group (The Illicit Project program; a three-lesson, web-based program delivered fortnightly over 6 weeks) and will complete four web-based assessments at baseline, 6-, 12- and 24-months post baseline. Primary outcomes are the quantity and frequency of substance use, alcohol-related harms and drug literacy levels, with the 12-month follow-up, the primary end point. Secondary outcomes include intentions to use alcohol and other drugs in the future and risk perceptions. This trial has been registered with Australia and New Zealand Clinical Trials Registry (ACTRN12620000805976). Intervention effects will be estimated using multilevel mixed effects models with an intention-to-treat sample. This is the first evaluation of a web-based, age-appropriate neuroscience-based prevention program for substance use targeting older adolescents.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia.
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
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Lees B, Elliott EJ, Allsop S, Thomas S, Riches J, Nepal S, Rice LJ, Newton N, Mewton L, Teesson M, Stapinski LA. Fetal Alcohol Spectrum Disorder resources for educators working within primary school settings: a scoping review protocol. BMJ Open 2021; 11:e045497. [PMID: 33820791 PMCID: PMC8030464 DOI: 10.1136/bmjopen-2020-045497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Many children affected by Fetal Alcohol Spectrum Disorder (FASD) exhibit neurocognitive delays that contribute to secondary consequences, including a disrupted school experience. Educators often have limited knowledge or experience in the identification, referral, management and accommodation of students with FASD. Effective resources and tools for educators are crucial to ensure these students are supported in their ongoing learning, development and school participation. This scoping review aims to identify and evaluate resources for educators that aid in the identification, management, or accommodation of students with FASD. METHODS AND ANALYSIS A search will be conducted in 9 peer-reviewed and 11 grey literature databases, Google search engine, two app stores and two podcast streaming services (planned search dates: November 2020 to February 2021). Relevant experts, including researchers, health professionals and individuals with lived experience of FASD, will be contacted in February and March 2021 to identify additional (including unpublished) resources. Resources will be selected based on registered, prespecified inclusion-exclusion criteria, and the quality of included resources will be critically appraised using a composite tool based on adaptions of the National Health and Medical Research Council FORM Framework and the iCAHE Guideline Quality Checklist. Relevant experts will also be requested to provide feedback on included resources. ETHICS AND DISSEMINATION Ethical approval for this scoping review was obtained from the University of Sydney Human Research Ethics Committee (2020/825). Results of the review will be disseminated through a peer-reviewed publication, conference presentations, and seminars targeting audiences involved in the education sector. TRIAL REGISTRATION Open Science Framework: osf.io/73pjh.
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Affiliation(s)
- Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, New South Wales, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Julia Riches
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, New South Wales, Australia
| | - Smriti Nepal
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lauren J Rice
- The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
- The Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, New South Wales, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Randwick, New South Wales, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, New South Wales, Australia
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Snijder M, Lees B, Stearne A, Ward J, Garlick Bock S, Newton N, Stapinski L. An ecological model of drug and alcohol use and related harms among Aboriginal and Torres Strait Islander Australians: A systematic review of the literature. Prev Med Rep 2021; 21:101277. [PMID: 33391981 PMCID: PMC7773534 DOI: 10.1016/j.pmedr.2020.101277] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 07/26/2020] [Revised: 10/23/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022] Open
Abstract
Globally, Indigenous populations experience a disproportionately higher burden of disease related to substance use. Effective prevention of harm related to substance use is a key strategy for improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples in Australia. To inform preventative approaches, this review synthesised the evidence of risk and protective factors of substance use and related harms among Aboriginal and Torres Strait Islander peoples. Eight peer-reviewed and two grey literature databases were systematically searched for quantitative or qualitative studies assessing factors associated with substance use and related harms among Aboriginal and Torres Strait Islander peoples, published between 1 January 1990 and 30 April 2018. Study quality was assessed using validated instruments. Risk or odds ratios were extracted or calculated and factors were summarised in an ecological model into individual, relationship, community, societal or culturally-distinct levels. Thirty-eight relevant studies were identified and reviewed. Individual-level risk factors for substance use were identified including low socio-economic status, high psychological distress, poly drug use and being male. Relationship-level factors were peer pressure and partner/family substance use; protective factors were supportive environments and positive role models. Community-level risk factors included availability of substances. Culturally-distinct factors included cultural connection as a protective factor, but cultural obligations around sharing was a risk factor. Societal risk factors included intergenerational trauma caused by government policies. These findings highlight the importance of tailored preventative approaches for Aboriginal and Torres Strait Islander communities that address identified risk factors and promote protective factors across all ecological levels.
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Affiliation(s)
- Mieke Snijder
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | | | - James Ward
- The Poche Centre for Indigenous Health, University of Queensland, St Lucia, 4067 Queensland, Australia
| | - Sophia Garlick Bock
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
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Deen H, Kershaw S, Newton N, Stapinski L, Birrell L, Debenham J, Champion KE, Kay-Lambkin F, Teesson M, Chapman C. Stigma, discrimination and crystal methamphetamine (‘ice’): Current attitudes in Australia. International Journal of Drug Policy 2021; 87:102982. [DOI: 10.1016/j.drugpo.2020.102982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
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Snijder M, Stapinski L, Lees B, Ward J, Conrod P, Mushquash C, Belone L, Champion K, Chapman C, Teesson M, Newton N. Preventing Substance Use Among Indigenous Adolescents in the USA, Canada, Australia and New Zealand: a Systematic Review of the Literature. Prev Sci 2020; 21:65-85. [PMID: 31641922 PMCID: PMC6957574 DOI: 10.1007/s11121-019-01038-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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] [Indexed: 11/30/2022]
Abstract
This systematic review assessed the current evidence base of substance use prevention programs for Indigenous adolescents in the USA, Canada, Australia and New Zealand. The authors investigated (a) the outcomes, type, setting and context of prevention programs; (b) the common components of beneficial prevention programs; and (c) the methodological quality of evaluations of included prevention programs. The authors searched eight peer-reviewed and 20 grey literature databases for studies published between 1 January 1990 and 31 August 2017. Data extracted included type of program (culturally adapted, culture-based or unadapted), the setting (school, community, family or multi-setting), delivery (computerised or traditional), context (Indigenous-specific or multi-cultural environment) and common components of the programs. Program evaluation methodologies were critically appraised against standardised criteria. This review identified 26 eligible studies. Substance use prevention programs for Indigenous youth led to reductions in substance use frequency and intention to use; improvements in substance-related knowledge, attitudes and resistance strategies; and delay in substance use initiation. Key elements of beneficial programs included substance use education, skills development, cultural knowledge enhancement and community involvement in program development. Five programs were rated as methodologically strong, seven were moderate and fourteen were weak. Prevention programs have the potential to reduce substance use among Indigenous adolescents, especially when they are developed in partnership with Indigenous people. However, more rigorously conducted evaluation trials are required to strengthen the evidence base.
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Affiliation(s)
- Mieke Snijder
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia.
| | - Lexine Stapinski
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Briana Lees
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Patricia Conrod
- Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Christopher Mushquash
- Centre for Rural and Northern Health Research, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Canada
| | - Lorenda Belone
- Department of Health, Exercise & Sports Sciences, College of Education, University of New Mexico, Albuquerque, NM, USA
| | - Katrina Champion
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Cath Chapman
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Maree Teesson
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Nicola Newton
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
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Nepal S, Stapinski L, Newton N, Grummitt L, Lawler S, Guckel T, Lynch S, Chapman C, Teesson M. Positive Choices: Addressing the evidence-practice gap in alcohol and other drug prevention. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
Alcohol and other drug (AOD) use during adolescence puts young people at risk of juvenile offending, poor educational outcomes, school dropout, and mental health issues. Since parents and school teachers are the primary source of contact for adolescents, it is important that they are equipped with accurate and up-to-date response strategies. There are a number of effective drug prevention strategies, however, they are not widely implemented.
Description of the practice
To address this evidence-practice gap, the Positive Choices initiative was launched in 2015. Positive Choices supports implementation of evidence-based and prevention strategies through provision of training and a centralised information and resources portal for young people, their parents and teachers. The portal contains information factsheets and webinars and was developed in consultation with AOD experts and target users. Drug education resources and curriculum programs meeting pre-specified criteria for relevance, quality and evidence-base are listed in the resources database.
Results
Positive Choices has been accessed by one-million Australian and international users. The most popular resources are videos, factsheets, webinars. In 2019, 71% parents and 65% teachers said that they would continue using the website. Half (54%) of school staff were not currently implementing evidence-based prevention strategies, of these 89% intended to shift to evidence-based practice after using Positive Choices. The majority of the users have said they would recommend the website to their colleagues and friends.
Lessons
Positive Choices is effective in changing users' intentions to implement evidence-based strategies. Drug education programs need to engage parents and teachers if they are to be effective.
Key messages
Positive Choices has increased users’ awareness of evidence-based prevention strategies. Positive Choices has increased users’ intentions to implement evidence-based prevention strategies.
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Affiliation(s)
- S Nepal
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - L Stapinski
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - N Newton
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - L Grummitt
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - S Lawler
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - T Guckel
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - S Lynch
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - C Chapman
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - M Teesson
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
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Kamarajah SK, Newton N, Navidi M, Wahed S, Immanuel A, Hayes N, Griffin SM, Phillips AW. Long-term outcomes of clinical and pathological-staged T3 N3 esophageal cancer. Dis Esophagus 2020; 33:5707333. [PMID: 31950184 DOI: 10.1093/dote/doz109] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 12/12/2019] [Indexed: 12/11/2022]
Abstract
Locally advanced esophageal cancer is associated with poor long-term survival. Pre- and post-treatment stages may differ because of neoadjuvant therapy and inaccuracies in staging. The aim of this study was to determine the outcomes of patients staged with clinical T3 N3 and pathological T3 N3 carcinoma of the esophagus and determine differences between the groups. Consecutive patients from a single unit between 2010 and 2018 were included with either clinical (cT3 N3) or pathological (pT3 N3) esophageal cancer. Outcomes were compared between patients that underwent esophagectomy with or without neoadjuvant treatment and those patients staged cT3 N3 treated non-surgically (NSR). Patients were staged using the TNM 8. This study included 156 patients, 63 patients were staged cT3 N3 initially and had NSR treatment, only three of these had radical treatment. Of the remaining 93 patients who underwent esophagectomy, 34 were initially staged as cT3 N3, 54 were found to be pT3 N3 having been staged earlier initially, and five were unchanged before and after treatment. Median overall survival (OS) for surgical cT3 N3 patients was significantly longer than pT3 N3 and NSR (median: NR vs 19 vs 8 months, P < 0.001). Twenty-seven patients with cT3 N3 had lower staging following treatment, while three had a higher stage. T3 N3 disease carries a poor prognosis. Within this cohort, cT3 N3 disease treated surgically has a high 5-year OS suggesting possible over-staging and stage migration due to neoadjuvant therapy. Those not having surgery, have a dismal prognosis. The impact of neoadjuvant treatment cannot be predicted and, current staging modalities may be inaccurate. Clinical stage should be used with caution when counseling patients regarding management and prognosis.
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Affiliation(s)
- S K Kamarajah
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Newton
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK
| | - M Navidi
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK
| | - S Wahed
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK
| | - A Immanuel
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK
| | - N Hayes
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK
| | - S M Griffin
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK
| | - A W Phillips
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University Trust Hospitals, Newcastle-Upon-Tyne, UK.,School of Medical Education, Newcastle University, Newcastle-Upon-Tyne, UK
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Debenham J, Newton N, Birrell L, Yücel M, Lees B, Champion K. Cannabis and Illicit Drug Use During Neurodevelopment and the Associated Structural, Functional and Cognitive Outcomes: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e18349. [PMID: 32716005 PMCID: PMC7418018 DOI: 10.2196/18349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/20/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 01/16/2023] Open
Abstract
Background High rates of cannabis and illicit drug use are experienced by young people during the final stages of neurodevelopment (aged 15-24 years), a period characterized by high neuroplasticity. Frequent drug use during this time may interfere with neurophysiological and neuropsychological development pathways, potentially leading to ongoing unfavorable neuroadaptations. The dose-response relationship between illicit drug use, exposure, and individual neurodevelopmental variation is unknown but salient with global shifts in the legal landscape and increasingly liberal attitudes and perceptions of the harm caused by cannabis and illicit drugs. Objective This systematic review aims to synthesize longitudinal studies that investigate the effects of illicit drug use on structural, functional, and cognitive brain domains in individuals under the neural age of adulthood (25 years). This protocol outlines prospective methods that will facilitate an exhaustive review of the literature exploring pre- and post-drug use brain abnormalities arising during neurodevelopment. Methods Five electronic databases (Medline, Embase, PsycINFO, ProQuest Central, and Web of Science) will be systematically searched between 1990 and 2019. The search terms will be a combination of MeSH (Medical Subject Headings), with keywords adapted to each database. Study reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and if relevant, study quality will be assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Eligible studies are those that sampled youth exposed to cannabis or illicit drugs and employed neurophysiological or neuropsychological assessment techniques. Studies will be excluded if participants had been clinically diagnosed with any psychiatric, neurological, or pharmacological condition. Results This is an ongoing review. As of February 2020, papers are in full-text screening, with results predicted to be complete by July 2020. Conclusions Integrating data collected on the three brain domains will enable an assessment of the links between structural, functional, and cognitive brain health across individuals and may support the early detection and prevention of neurodevelopmental harm. Trial Registration PROSPERO CRD42020151442; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=151442 International Registered Report Identifier (IRRID) PRR1-10.2196/18349
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Briana Lees
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Lees B, Stapinski LA, Prior K, Sunderland M, Newton N, Baillie A, Teesson M, Mewton L. Exploring the complex inter-relations between internalising symptoms, executive functioning and alcohol use in young adults. Addict Behav 2020; 106:106351. [PMID: 32145497 DOI: 10.1016/j.addbeh.2020.106351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/05/2020] [Accepted: 02/09/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Globally, the prevalence of hazardous drinking peaks in young adulthood, and there is mixed evidence on whether internalising symptoms and executive functioning deficits are associated with this increased risk. This study tested whether internalising symptoms in interaction with executive functioning deficits are associated with high alcohol use disorder symptoms in emerging adulthood, via drinking motives to cope with negative affect and alcohol consumption. METHOD An Australian sample of 155 young adults aged 17 to 24 years (M = 20.97, SD = 2.40) provided self-report data on internalising symptom severity and alcohol-related outcomes (n = 155), and neuropsychological data measuring executive functioning (n = 104). Confirmatory factor analyses were conducted to identify two latent variables representing internalising symptoms and executive functions. A series of latent moderated structural equation models and a latent mediated moderation structural equation model examined the inter-relations between internalising symptoms, executive functions and alcohol measures. RESULTS High levels of internalising symptoms in interaction with executive functioning deficits were associated with strong drinking motives to cope with negative affect, high past month alcohol consumption and greater alcohol use disorder symptoms. Drinking motives to cope with negative affect and alcohol consumption mediated the relationship between the internalising symptoms and executive functioning latent interaction term with alcohol use disorder symptoms. CONCLUSIONS This research highlights greater executive functioning resources are associated with low desires to drink hazardous amounts of alcohol as a maladaptive way to cope with negative feelings among young people. It therefore may be useful to target executive functioning ability alongside internalising symptomology in alcohol prevention and intervention initiatives.
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Abstract
OBJECTIVES The primary aim is to evaluate the feasibility of a newly developed, neuroscience-based, alcohol and other drug (AOD) use prevention programme, 'The Illicit Project', in Australian older adolescents. The secondary aim is to investigate the impact of the programme on students' drug literacy levels (a combination of knowledge, attitudes and skills). DESIGN A pilot study examining the feasibility of The Illicit Project in Australian schools was conducted. PARTICIPANTS Students aged 15-19 years from two secondary schools and a youth centre and 11 teachers and health professionals from various organisations in Sydney were recruited. INTERVENTION The intervention consisted of three 90 min workshops delivered by trained facilitators within a month. PRIMARY AND SECONDARY MEASURES Students completed a drug literacy questionnaire before and after intervention. All participants (students, teachers and health professionals) completed an evaluation questionnaire postprogramme delivery. A paired-sample t-test and descriptive analytics were performed. RESULTS Students (n=169) demonstrated a significant increase in drug literacy levels from preintervention to postintervention (t(169) = -13.22, p<0.0001). Of students evaluating the programme (n=252), over threequarters agreed that The Illicit Project was good or very good (76%), that the neuroscience content was interesting (76%) and relevant (81%), and that they plan to apply the concepts learnt to their own lives (80%). In addition, all teachers and health professionals (n=11) agreed that the programme was feasible and valid for schools and perceived the programme to be effective in reducing the harms and use of AOD. CONCLUSIONS There is evidence to suggest that The Illicit Project is credible and feasible in the school environment and there are preliminary data to suggest it may help to improve drug literacy levels in young people. A large-scale evaluation trial of the intervention will be conducted to determine the programme's effectiveness in minimising the harms of AOD in older adolescents.
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Affiliation(s)
- Jennifer Debenham
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Birrell
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Katrina Champion
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mina Askovic
- Business Faculty, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola Newton
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Chmelo J, Dent B, Newton N, Coyne P. An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein - case report. ACTA ACUST UNITED AC 2019; 98:326-327. [PMID: 31462055 DOI: 10.33699/pis.2019.98.8.326-327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. CASE REPORT We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patients abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. CONCLUSION Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.
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Abstract
IMPORTANCE Increases in screen time have been found to be associated with increases in depressive symptoms. However, longitudinal studies are lacking. OBJECTIVE To repeatedly measure the association between screen time and depression to test 3 explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals. DESIGN, SETTING, AND PARTICIPANTS This secondary analysis used data from a randomized clinical trial assessing the 4-year efficacy of a personality-targeted drug and alcohol prevention intervention. This study assessed screen time and depression throughout 4 years, using an annual survey in a sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. Data were collected from September 2012 to September 2018. Analysis began and ended in December 2018. MAIN OUTCOMES AND MEASURES Independent variables were social media, television, video gaming, and computer use. Symptoms of depression was the outcome, measured using the Brief Symptoms Inventory. Exercise and self-esteem were assessed to test displacement and upward social comparison hypothesis. RESULTS A total of 3826 adolescents (1798 girls [47%]; mean [SD] age, 12.7 [0.5] years) were included. In general, depression symptoms increased yearly (year 1 mean [SD], 4.29 [5.10] points; year 4 mean [SD], 5.45 [5.93] points). Multilevel models, which included random intercepts at the school and individual level estimated between-person and within-person associations between screen time and depression. Significant between-person associations showed that for every increased hour spent using social media, adolescents showed a 0.64-unit increase in depressive symptoms (95% CI, 0.32-0.51). Similar between-level associations were reported for computer use (0.69; 95% CI, 0.47-0.91). Significant within-person associations revealed that a further 1-hour increase in social media use in a given year was associated with a further 0.41-unit increase in depressive symptoms in that same year. A similar within-person association was found for television (0.18; 95% CI, 0.09-0.27). Significant between-person and within-person associations between screen time and exercise and self-esteem supported upward social comparison and not displacement hypothesis. Furthermore, a significant interaction between the between-person and within-person associations concerning social media and self-esteem supported reinforcing spirals hypothesis. CONCLUSIONS AND RELEVANCE Time-varying associations between social media, television, and depression were found, which appeared to be more explained by upward social comparison and reinforcing spirals hypotheses than by the displacement hypothesis. Both screen time modes should be taken into account when developing preventive measures and when advising parents.
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Affiliation(s)
- Elroy Boers
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Mohammad H. Afzali
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Nicola Newton
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Patricia Conrod
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
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Afzali MH, Sunderland M, Stewart S, Masse B, Seguin J, Newton N, Teesson M, Conrod P. Machine-learning prediction of adolescent alcohol use: a cross-study, cross-cultural validation. Addiction 2019; 114:662-671. [PMID: 30461117 DOI: 10.1111/add.14504] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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] [Received: 06/15/2018] [Revised: 08/21/2018] [Accepted: 11/02/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS The experience of alcohol use among adolescents is complex, with international differences in age of purchase and individual differences in consumption and consequences. This latter underlines the importance of prediction modeling of adolescent alcohol use. The current study (a) compared the performance of seven machine-learning algorithms to predict different levels of alcohol use in mid-adolescence and (b) used a cross-cultural cross-study scheme in the training-validation-test process to display the predictive power of the best performing machine-learning algorithm. DESIGN A comparison of seven machine-learning algorithms: logistic regression, support vector machines, random forest, neural network, lasso regression, ridge regression and elastic-net. SETTING Canada and Australia. PARTICIPANTS The Canadian sample is part of a 4-year follow-up (2012-16) of the Co-Venture cohort (n = 3826, baseline age 12.8 ± 0.4, 49.2% girls). The Australian sample is part of a 3-year follow-up (2012-15) of the Climate Schools and Preventure (CAP) cohort (n = 2190, baseline age 13.3 ± 0.3, 43.7% girls). MEASUREMENTS The algorithms used several prediction indices, such as F1 prediction score, accuracy, precision, recall, negative predictive value and area under the curve (AUC). FINDINGS Based on prediction indices, the elastic-net machine-learning algorithm showed the best predictive performance in both Canadian (AUC = 0.869 ± 0.066) and Australian (AUC = 0.855 ± 0.072) samples. Domain contribution analysis showed that the highest prediction accuracy indices yielded from models with only psychopathology (AUC = 0.816 ± 0.044/0.790 ± 0.071 in Canada/Australia) and only personality clusters (AUC = 0.776 ± 0.063/0.796 ± 0.066 in Canada/Australia). Similarly, regardless of the level of alcohol use, in both samples, externalizing psychopathologies, alcohol use at baseline and the sensation-seeking personality profile contributed to the prediction. CONCLUSIONS Computerized screening software shows promise in predicting the risk of alcohol use among adolescents.
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Affiliation(s)
- Mohammad H Afzali
- Department of Psychiatry, University of Montreal, Montréal, QC, Canada
| | - Matthew Sunderland
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Sherry Stewart
- Department of Psychiatry, Dalhousie University, Life Sciences Centre-Psychology, Halifax, NS, Canada
| | - Benoit Masse
- Department of Psychiatry, University of Montreal, Montréal, QC, Canada
| | - Jean Seguin
- Department of Psychiatry, University of Montreal, Montréal, QC, Canada
| | - Nicola Newton
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Maree Teesson
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Patricia Conrod
- Department of Psychiatry, University of Montreal, Montréal, QC, Canada
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Debenham J, Newton N, Birrell L, Askovic M. Alcohol and other drug prevention for older adolescents: It's a no brainer. Drug Alcohol Rev 2019; 38:327-330. [DOI: 10.1111/dar.12914] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/09/2019] [Accepted: 02/04/2019] [Indexed: 01/04/2023]
Affiliation(s)
| | - Nicola Newton
- The Matilda CentreThe University of Sydney Sydney Australia
| | - Louise Birrell
- The Matilda CentreThe University of Sydney Sydney Australia
| | - Mina Askovic
- The University of Sydney Business SchoolThe University of Sydney Sydney Australia
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Mewton L, Visontay R, Chapman C, Newton N, Slade T, Kay-Lambkin F, Teesson M. Universal prevention of alcohol and drug use: An overview of reviews in an Australian context. Drug Alcohol Rev 2018; 37 Suppl 1:S435-S469. [DOI: 10.1111/dar.12694] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/17/2018] [Accepted: 02/14/2018] [Indexed: 02/04/2023]
Affiliation(s)
- Louise Mewton
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
| | - Rachel Visontay
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
| | - Cath Chapman
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
| | - Nicola Newton
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
| | - Tim Slade
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
| | - Frances Kay-Lambkin
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
| | - Maree Teesson
- Centre of Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre, University of New South Wales; Sydney Australia
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