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Black N, Noghrehchi F, Yuen WS, Aiken A, Clare PJ, Chan G, Kypri K, McBride N, Bruno R, Slade T, Boland V, Mattick R, Peacock A. Transitions to polysubstance use: Prospective cohort study of adolescents in Australia. Addiction 2024; 119:1100-1110. [PMID: 38499496 DOI: 10.1111/add.16468] [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: 11/06/2022] [Accepted: 01/23/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND AND AIMS Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use. DESIGN Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states. SETTING AND PARTICIPANTS Adolescent-parent dyads (n = 1927; adolescents in grade 7, age ≈13 years) were recruited from Australian schools during 2010/11 (Wave 1). Adolescents were surveyed annually until 2016/17 (n = 1503; age ≈19 years; Wave 7) and parents were surveyed annually until 2014/15 (Wave 5). MEASUREMENTS Alcohol, tobacco, cannabis and 3,4-methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3-7. Potential confounders were collected at Waves 1-6 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status. FINDINGS Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5-7: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (<9%) adolescents transitioning out. More externalizing problems (odds ratio [OR] = 1.10; 99.6% confidence interval [CI] = 1.07-1.14), parental heavy episodic drinking (OR = 1.22; 99.6% CI = 1.07-1.40), parental illicit substance use (OR = 3.56; 99.6% CI = 1.43-8.86), peer alcohol use (OR = 5.68; 99.6% CI = 1.59-20.50) and peer smoking (OR = 4.18; 99.6% CI = 1.95-8.81) were associated with transitioning to polysubstance use. CONCLUSIONS Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets.
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Affiliation(s)
- Nicola Black
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Firouzeh Noghrehchi
- Biomedical Informatics and Digital Health, The University of Sydney, Camperdown, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
- Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Shenton Park, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
- School of Psychological Sciences, University of Tasmania, Hobart, 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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Teesson M, Birrell L, Slade T, Mewton LR, Olsen N, Hides L, McBride N, Chatterton ML, Allsop S, Furneaux-Bate A, Bryant Z, Ellem R, Baker MJ, Healy A, Debenham J, Boyle J, Mather M, Mihalopoulos C, Chapman C, Newton NC. Effectiveness of a universal, school-based, online programme for the prevention of anxiety, depression, and substance misuse among adolescents in Australia: 72-month outcomes from a cluster-randomised controlled trial. Lancet Digit Health 2024; 6:e334-e344. [PMID: 38670742 DOI: 10.1016/s2589-7500(24)00046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The CSC study found that the universal delivery of a school-based, online programme for the prevention of mental health and substance use disorders among adolescents resulted in improvements in mental health and substance use outcomes at 30-month follow-up. We aimed to compare the long-term effects of four interventions-Climate Schools Combined (CSC) mental health and substance use, Climate Schools Substance Use (CSSU) alone, Climate Schools Mental Health (CSMH) alone, and standard health education-on mental health and substance use outcomes among adolescents at 72-month follow-up into early adulthood. METHODS This long-term study followed up adolescents from a multicentre, cluster-randomised trial conducted across three states in Australia (New South Wales, Queensland, and Western Australia) enrolled between Sept 1, 2013, and Feb 28, 2014, for up to 72 months after baseline assessment. Adolescents (aged 18-20 years) from the original CSC study who accepted contact at 30-month follow-up and provided informed consent at 60-month follow-up were eligible. The interventions were delivered in school classrooms through an online delivery format and used a mixture of peer cartoon storyboards and classroom activities that were focused on alcohol, cannabis, anxiety, and depression. Participants took part in two web-based assessments at 60-month and 72-month follow-up. Primary outcomes were alcohol use, cannabis use, anxiety, and depression, measured by self-reported surveys and analysed by intention to treat (ie, in all students who were eligible at baseline). This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000723785), including the extended follow-up study. FINDINGS Of 6386 students enrolled from 71 schools, 1556 (24·4%) were randomly assigned to education as usual, 1739 (27·2%) to CSSU, 1594 (25·0%) to CSMH, and 1497 (23·4%) to CSC. 311 (22·2%) of 1401 participants in the control group, 394 (26·4%) of 1495 in the CSSU group, 477 (37·%) of 1289 in the CSMH group, and 400 (32·5%) of 1232 in the CSC group completed follow-up at 72 months. Adolescents in the CSC group reported slower year-by-year increases in weekly alcohol use (odds ratio 0·78 [95% CI 0·66-0·92]; p=0·0028) and heavy episodic drinking (0·69 [0·58-0·81]; p<0·0001) than did the control group. However, significant baseline differences between groups for drinking outcomes, and no difference in the predicted probability of weekly or heavy episodic drinking between groups were observed at 72 months. Sensitivity analyses increased uncertainty around estimates. No significant long-term differences were observed in relation to alcohol use disorder, cannabis use, cannabis use disorder, anxiety, or depression. No adverse events were reported during the trial. INTERPRETATION We found some evidence that a universal online programme for the prevention of anxiety, depression, and substance use delivered in early adolescence is effective in reducing the use and harmful use of alcohol into early adulthood. However, confidence in these findings is reduced due to baseline differences, and we did not see a difference in the predicted probability of drinking between groups at 72-month follow-up. These findings suggest that a universal prevention programme in adolescence is not sufficient to have lasting effects on mental health and substance use disorders in the long term. In addition to baseline differences, substantial attrition warrants caution in interpretation and the latter factor highlights the need for future long-term follow-up studies to invest in strategies to increase engagement. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Louise R Mewton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nick Olsen
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- Lives Lived Well Group, National Centre for Youth Substance Use Research, School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Ainsley Furneaux-Bate
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Zachary Bryant
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Rhiannon Ellem
- Lives Lived Well Group, National Centre for Youth Substance Use Research, School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Megan J Baker
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Annalise Healy
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Julia Boyle
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Marius Mather
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Catherine Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, 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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5
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Gardner LA, Rowe AL, Stockings E, Champion KE, Hides L, McBride N, Allsop S, O'Dean S, Sunderland M, Lee YY, Mihalopoulos C, Freeman B, Leung J, McRobbie H, Stapinski L, Lee N, Thornton L, Debenham J, Teesson M, Newton NC. Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents. BMC Public Health 2023; 23:683. [PMID: 37046211 PMCID: PMC10090743 DOI: 10.1186/s12889-023-15609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia. METHODS A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12-14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term. DISCUSSION If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control. TRIAL REGISTRATION The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023).
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Amy-Leigh Rowe
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug and Research Institute, EnAble Institute, Curtin University, Perth, WA, Australia
| | - Steve Allsop
- National Drug and Research Institute, EnAble Institute, Curtin University, Perth, WA, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Yong Yi Lee
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Cathy Mihalopoulos
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Becky Freeman
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
| | - Hayden McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Lee
- National Drug and Research Institute, Curtin University, Perth, WA, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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6
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Champion KE, Newton NC, Gardner LA, Chapman C, Thornton L, Slade T, Sunderland M, Hides L, McBride N, O'Dean S, Kay-Lambkin F, Allsop S, Lubans DR, Parmenter B, Mills K, Spring B, Osman B, Ellem R, Smout S, Whife J, Stewart C, McCann KM, Catakovic A, Hunter E, Teesson M. Health4Life eHealth intervention to modify multiple lifestyle risk behaviours among adolescent students in Australia: a cluster-randomised controlled trial. Lancet Digit Health 2023; 5:e276-e287. [PMID: 37032200 DOI: 10.1016/s2589-7500(23)00028-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/20/2023] [Accepted: 02/06/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Lifestyle risk behaviours are prevalent among adolescents and commonly co-occur, but current intervention approaches tend to focus on single risk behaviours. This study aimed to evaluate the efficacy of the eHealth intervention Health4Life in modifying six key lifestyle risk behaviours (ie, alcohol use, tobacco smoking, recreational screen time, physical inactivity, poor diet, and poor sleep, known as the Big 6) among adolescents. METHODS We conducted a cluster-randomised controlled trial in secondary schools that had a minimum of 30 year 7 students, in three Australian states. A biostatistician randomly allocated schools (1:1) to Health4Life (a six-module, web-based programme and accompanying smartphone app) or an active control group (usual health education) with the Blockrand function in R, stratified by site and school gender composition. All students aged 11-13 years who were fluent in English and attended participating schools were eligible. Teachers, students, and researchers were not masked to allocation. Primary outcomes were alcohol use, tobacco use, recreational screen time, moderate to vigorous physical activity (MVPA), sugar-sweetened beverage intake, and sleep duration at 24 months, measured by self-report surveys, and analysed in all students who were eligible at baseline. Latent growth models estimated between-group change over time. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123). FINDINGS Between April 1, 2019, and Sept 27, 2019, we recruited 85 schools (9280 students), of which 71 schools with 6640 eligible students (36 schools [3610 students] assigned to the intervention and 35 [3030 students] to the control) completed the baseline survey. 14 schools were excluded from the final analysis or withdrew, mostly due to a lack of time. We found no between-group differences for alcohol use (odds ratio 1·24, 95% CI 0·58-2·64), smoking (1·68, 0·76-3·72), screen time (0·79, 0·59-1·06), MVPA (0·82, 0·62-1·09), sugar-sweetened beverage intake (1·02, 0·82-1·26), or sleep (0·91, 0·72-1·14) at 24 months. No adverse events were reported during this trial. INTERPRETATION Health4Life was not effective in modifying risk behaviours. Our results provide new knowledge about eHealth multiple health behaviour change interventions. However, further research is needed to improve efficacy. FUNDING Paul Ramsay Foundation, the Australian National Health and Medical Research Council, the Australian Government Department of Health and Aged Care, and the US National Institutes of Health.
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Affiliation(s)
- Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia.
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Lauren A Gardner
- 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
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | | | - Steve Allsop
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - David R Lubans
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
| | - Belinda Parmenter
- School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bridie Osman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Rhiannon Ellem
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jesse Whife
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - Courtney Stewart
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - Karrah M McCann
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Amra Catakovic
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Emily Hunter
- 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
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7
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Upton E, Clare PJ, Aiken A, Boland VC, Torres CD, Bruno R, Hutchinson D, Kypri K, Mattick R, McBride N, Peacock A. Changes in mental health and help-seeking among young Australian adults during the COVID-19 pandemic: a prospective cohort study. Psychol Med 2023; 53:687-695. [PMID: 33966686 PMCID: PMC8144825 DOI: 10.1017/s0033291721001963] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/11/2021] [Accepted: 04/27/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Young people may have elevated risk for poorer mental health during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal studies documenting this impact are lacking. This study assessed changes in mental health and help-seeking since COVID-19 restrictions in young Australians, including gender differences. METHODS Data were drawn from a recent subsample (n = 443; 60% female; Mage = 22.0) of a prospective cohort originally recruited in secondary school to complete annual surveys. The subsample completed an additional COVID-19 survey during COVID-19 restrictions (May-June 2020), which was compared to responses from their latest annual survey (August 2019-March 2020). Mixed effect models with time and gender as the primary predictors were conducted for: (i) scores on the Patient Health Questionnaire Depression 9-item (PHQ-9) and Generalised Anxiety Disorder 7-item (GAD-7) modules assessed before and during COVID-19 restrictions, and (ii) self-reported help-seeking from a health professional in February 2020, and the month preceding May-June 2020. RESULTS Mean symptom scores increased from before to during COVID-19 restrictions on the PHQ-9 (coefficient: 1.29; 95% CI 0.72-1.86) and GAD-7 (0.78; 95% CI 0.26-1.31), but there was no increase in help-seeking over time (odds ratio 0.50; 95% CI 0.19-1.32). There was no evidence of differential changes by gender. CONCLUSIONS This study found increases in depression and anxiety symptoms but not greater help-seeking among young Australian adults during the first wave of the pandemic. Increasing availability and awareness of accessible treatment options and psychoeducation is critical, as well as further research into risk and protective factors to help target treatment to this vulnerable age group.
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Affiliation(s)
- Emily Upton
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Philip J. Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Prevention Research Collaboration, The University of Sydney, Sydney, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Veronica C. Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Clara De Torres
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Centre for Social and Early Emotional Development, Deakin University, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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8
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O'Dean SM, Mewton L, Chung T, Clay P, Clare PJ, Bruno R, Yuen WS, McBride N, Swift W, Isik A, Upton E, Tibbetts J, Johnson P, Kypri K, Slade T. Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults. Addiction 2022; 117:2955-2964. [PMID: 35792050 PMCID: PMC9796318 DOI: 10.1111/add.15991] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/12/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS Tolerance to the effects of alcohol is an important element in the diagnosis of alcohol use disorders (AUD); however, there is ongoing debate about its utility in the diagnosis AUD in adolescents and young adults. This study aimed to refine the assessment of tolerance in young adults by testing different definitions of tolerance and their associations with longitudinal AUD outcomes. DESIGN Prospective cohort study. SETTINGS Australia. PARTICIPANTS A contemporary cohort of emerging adults across Australia (n = 565, mean age = 18.9, range = 18-21 at baseline). MEASUREMENTS Clinician-administered Structured Clinical Interview for DSM-IV Research Version (SCID-IV-RV) assessed for AUD criteria across five interviews, at 6-month intervals over 2.5 years. Tolerance definitions were operationalized using survey-type response (yes/no), clinician judgement (SCID-IV-RV), different initial drinking quantity and percentage increase thresholds and average heavy consumption metrics. AUD persistence was operationalized by the number of times AUD was present across the 2.5-year study period (n = 491), and new-onset AUD was operationalized as any new incidence of AUD during the follow-up period (n = 461). FINDINGS The (i) SCID-IV-RV clinician judgement [odds ratio (OR) = 2.50, P = 0.005], (ii) an initial drinking quantity threshold of four to five drinks and 50% minimum increase (OR = 2.48, P = 0.007) and (iii) 50% increase only (OR = 2.40, P = 0.005) were the tolerance definitions more strongly associated with any new onset of AUD throughout the four follow-up time-points than other definitions. However, these definitions were not associated with persistent AUD (Ps > 0.05). Average heavy consumption definitions of tolerance were most strongly associated with persistent AUD (OR = 6.66, P = 0.001; OR = 4.65, P = 0.004) but not associated with new-onset AUD (Ps > 0.05). CONCLUSIONS Initial drink and percentage change thresholds appear to improve the efficacy of change-based tolerance as an indicator for new-onset alcohol use disorder diagnosis in self-report surveys of young adults. When predicting persistent alcohol use disorder, average heavy consumption-based indicators appear to be a better way to measure tolerance than self-reported change-based definitions.
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Affiliation(s)
- Siobhan M. O'Dean
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Louise Mewton
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyNSWAustralia
| | - Tammy Chung
- Department of Psychiatry, RutgersThe State University of New Jersey, Institute for Health, Healthcare Policy and Aging ResearchNew JerseyUSA
| | - Peter Clay
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Philip J. Clare
- Prevention Research CollaborationUniversity of SydneySydneyAustralia,National Drug and Alcohol Research Centre, UNSWSydneyAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia,School of Psychological SciencesUniversity of TasmaniaHobartTASAustralia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia
| | - Nyanda McBride
- National Drug Research Institute and enAble InstituteCurtin UniversityPerthAustralia
| | - Wendy Swift
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred HospitalCamperdownNSWAustralia
| | - Ashling Isik
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Emily Upton
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia
| | - Joel Tibbetts
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Phoebe Johnson
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Kypros Kypri
- School of Medicine and Public HealthUniversity of NewcastleNSWAustralia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
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9
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Aiken A, Chan G, Yuen WS, Clare PJ, Hutchinson D, McBride N, Najman JM, McCambridge J, Upton E, Slade T, Boland VC, De Torres C, Bruno R, Kypri K, Wadolowski M, Mattick RP, Peacock A. Trajectories of parental and peer supply of alcohol in adolescence and associations with later alcohol consumption and harms: A prospective cohort study. Drug Alcohol Depend 2022; 237:109533. [PMID: 35752023 DOI: 10.1016/j.drugalcdep.2022.109533] [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: 02/13/2022] [Revised: 05/17/2022] [Accepted: 06/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Supply of alcohol to adolescents is associated with increased alcohol consumption and harms including alcohol use disorder (AUD). We aimed to identify: (1) trajectories of alcohol supply to adolescents; (2) sociodemographic characteristics associated with supply trajectory; (3) patterns of alcohol consumption by supply trajectory; and (4) supply trajectory associations with adverse alcohol outcomes. METHODS We used Australian longitudinal survey data (N = 1813) to model latent trajectories of parent and peer alcohol supply over five annual follow-ups (Waves 2-6; Mage 13.9-17.8 years). Regression models assessed associations between supply trajectories and Wave 1 (Mage=12.9 years) sociodemographic factors and associations between supply trajectories and Wave 7 (Mage=18.8 years) alcohol outcomes. RESULTS We identified five alcohol supply classes: (1) minimal supply (n = 739, 40.8%); (2) early parent sips, late peer/parent whole drinks (n = 254, 14.0%); (3) late peer/parent whole drinks (n = 419, 23.1%); (4) early parent sips, mid peer/parent whole drinks (n = 293, 16.2%); (5) early peer/parent whole drinks (n = 108, 6.0%). Compared to minimal supply, the other classes were 2.7-12.9 times as likely to binge drink, 1.6-3.0 times as likely to experience alcohol-related harms, and 2.1-8.6 times as likely to report AUD symptoms at age 19. CONCLUSION Earlier supply of whole drinks, particularly from peers, was associated with increased risk of early adulthood adverse alcohol outcomes. While minimal supply represented the lowest risk, supplying sips only in early-mid adolescence and delaying supply of whole drinks until late adolescence is likely to be less risky than earlier supply of whole drinks.
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Affiliation(s)
- Alexandra Aiken
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia.
| | - Gary Chan
- National Centre For Youth Substance Use Research, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Wing See Yuen
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Philip J Clare
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; Prevention Research Collaboration, The Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Delyse Hutchinson
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA 6845, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD 4072, Australia
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Emily Upton
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Tim Slade
- Sydney Medical School / The Matilda Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Veronica C Boland
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Clara De Torres
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Raimondo Bruno
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Monika Wadolowski
- Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Amy Peacock
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
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10
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Newton NC, Chapman C, Slade T, Birrell L, Healy A, Mather M, McBride N, Hides L, Allsop S, Mewton L, Andrews G, Teesson M. A national effectiveness trial of an eHealth program to prevent alcohol and cannabis misuse: responding to the replication crisis. Psychol Med 2022; 52:274-282. [PMID: 32613919 DOI: 10.1017/s0033291720001919] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The burden of disease attributable to alcohol and other drug (AOD) use in young people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents. METHODS Seventy-one secondary schools across three States participated in a cluster-randomised controlled trial. Year 8 students received either the web-based Climate Schools: Alcohol and Cannabis course (Climate, n = 3236), or health education as usual (Control, n = 3150). Outcomes were measured via self-report and reported here for baseline, 6- and 12-months for alcohol and cannabis knowledge, alcohol, cannabis use and alcohol-related harms. RESULTS Compared to Controls, students in the Climate group showed greater increases in alcohol- [standardised mean difference (SMD) 0.51, p < 0.001] and cannabis-related knowledge (SMD 0.49, p < 0.001), less increases in the odds of drinking a full standard drink[(odds ratio (OR) 0.62, p = 0.014], and heavy episodic drinking (OR 0.49, p = 0.022). There was no evidence for differences in change over time in the odds of cannabis use (OR 0.57, p = 0.22) or alcohol harms (OR 0.73, p = 0.17). CONCLUSIONS The current study provides support for the effectiveness of the web-based Climate Schools: Alcohol and Cannabis course in increasing knowledge and reducing the uptake of alcohol. It represents one of the first trials of a web-based AOD prevention program to replicate alcohol effects in a large and diverse sample of students. Future research and/or adaptation of the program may be warranted with respect to prevention of cannabis use and alcohol harms.
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Affiliation(s)
- Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Annalise Healy
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Marius Mather
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, The University of NSW, Sydney, Australia
| | - Gavin Andrews
- The Clinical Research Unit for Anxiety and Depression, The University of NSW, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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11
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Yuen WS, Bruno R, Chan GCK, McCambridge J, Slade T, Clare PJ, Aiken A, Kypri K, Hutchinson D, McBride N, Boland V, Upton E, Farrell M, Mattick RP, Peacock A. The experience of physiological and psychosocial alcohol-related harms across adolescence and its association with alcohol use disorder in early adulthood: A prospective cohort study. Alcohol Clin Exp Res 2021; 45:2518-2527. [PMID: 34921682 DOI: 10.1111/acer.14726] [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: 05/05/2021] [Revised: 08/27/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Different forms of alcohol-related harm (e.g., hangovers, fighting) may confer differential risk of clinically relevant alcohol problems. We examine: (i) patterns of transition in experiencing alcohol-related harms across adolescence; (ii) whether factors in early adolescence predict transition patterns; and (iii) whether transition patterns predict later alcohol use disorder (AUD) symptoms. METHODS We used a longitudinal Australian cohort (n = 1828) to model latent class transition patterns of alcohol-related harms across three timepoints (Mage = 13.9, 16.8, 18.8 years). Regression models assessed whether child, peer, and parent factors in early adolescence (Mage = 12.9) predicted harms transition patterns and whether these patterns predicted AUD symptoms in early adulthood (Mage = 19.8). RESULTS Five transition patterns characterized most of the cohort (n ≈ 1609, 88.0%): (i) minimal harms (n ≈ 381, 20.8%); (ii) late physiological harms (n ≈ 702, 38.4%); (iii) early physiological harms (n ≈ 226, 12.4%); (iv) late all harms (n ≈ 131, 7.2%); and (v) gradual all harms (n ≈ 169, 9.2%). With late physiological harms as the reference, females had increased risk of experiencing early physiological harms (relative risk [RR]: 2.15; 99.5% CI: 1.19, 3.90). Late all harms (RR: 1.71; CI: 1.19, 2.47) and gradual all harms (RR: 1.84; CI: 1.37, 2.47) were each associated with increased odds of meeting criteria for AUD, even when patterns of alcohol consumption are considered. CONCLUSIONS Adolescents display heterogeneous transition patterns across physiological and psychosocial alcohol-related harms. Females are at greater risk of experiencing early physiological harms. Experience of both physiological and psychosocial harms in late adolescence is an important and potentially modifiable precursor to clinically relevant alcohol problems in early adulthood.
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Queensland, Australia
| | | | - Tim Slade
- The Matilda Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,Prevention Research Collaboration, The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia.,Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
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12
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Clare PJ, Aiken A, Yuen WS, Upton E, Kypri K, Degenhardt L, Bruno R, McCambridge J, McBride N, Hutchinson D, Slade T, Mattick R, Peacock A. Alcohol use among young Australian adults in May-June 2020 during the COVID-19 pandemic: a prospective cohort study. Addiction 2021; 116:3398-3407. [PMID: 34105838 PMCID: PMC8212116 DOI: 10.1111/add.15599] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/20/2021] [Accepted: 05/26/2021] [Indexed: 01/07/2023]
Abstract
AIMS To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. DESIGN Prospective longitudinal cohort. SETTING Secondary schools in New South Wales, Tasmania and Western Australia. PARTICIPANTS Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in September 2017-July 2018, September 2018-May 2019 and August 2019-January 2020), and in May-June 2020. MEASUREMENTS The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm and drinking contexts. FINDINGS Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol-related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender. CONCLUSIONS From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.
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Affiliation(s)
- Philip J. Clare
- Prevention Research CollaborationUniversity of SydneyCamperdownNSWAustralia,National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Alexandra Aiken
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Wing See Yuen
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Emily Upton
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Kypros Kypri
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNSWAustralia
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Raimondo Bruno
- School of Psychological SciencesUniversity of TasmaniaHobartTasmaniaAustralia
| | | | - Nyanda McBride
- National Drug Research InstituteCurtin UniversityPerthWAAustralia
| | - Delyse Hutchinson
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia,Centre for Social and Early Emotional DevelopmentDeakin UniversityMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Murdoch Children's Research Institute, Royal Children's HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | - Richard Mattick
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Amy Peacock
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
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13
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Slade T, Mewton L, O'Dean S, Tibbetts J, Clay P, Isik A, Johnson P, McCraw S, Upton E, Kypri K, Butterworth P, McBride N, Swift W. DSM-5 and ICD-11 alcohol use disorder criteria in young adult regular drinkers: Lifetime prevalence and age of onset. Drug Alcohol Depend 2021; 229:109184. [PMID: 34813987 DOI: 10.1016/j.drugalcdep.2021.109184] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Alcohol Use Disorder (AUD) is a significant contributor to global disease burden. AUD has a relatively early onset during young adulthood (Teesson et al., 2010). However, compared to AUD in adults, we have relatively little understanding of AUD in adolescents and emerging adults. METHODS The RADAR study is a prospective cohort study designed to investigate the emergence of AUD in community-dwelling adolescents and emerging adults across Australia (age range = 18-21 at baseline). At 6 monthly intervals over 2.5 years, participants were interviewed regarding alcohol consumption and alcohol use disorder criteria by clinical psychologists using the SCID-IV-RV. This paper reports the baseline findings of the RADAR cohort. RESULTS Proportions of lifetime criteria endorsement among regular drinkers varied considerably. Tolerance was the most endorsed criterion (50.3%), followed by Social Problems (10.4%) and Larger/Longer (9.0%). The median age of onset for most individual AUD criteria was 18 years of age. 18.4% of our cohort met DSM-5 AUD diagnosis in their lifetime to date, and 16.8% met ICD-11 dependence. When removing Tolerance from the AUD criteria, DSM-5 AUD lifetime prevalence reduced to 11.0%, and ICD-11 AUD lifetime prevalence fell to 7.1% in our cohort. CONCLUSIONS Variable rates of criteria endorsement likely reflect both true differences in the experience of AUD criteria and methodological challenges in the assessment of AUD in an emerging adult age group. High rates of tolerance to the effects of alcohol, and relatively low rates of drinking larger/longer than intended are discussed considering methodological challenges in assessing these criteria in young adults.
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Affiliation(s)
- Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Joel Tibbetts
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Peter Clay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Ashling Isik
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Phoebe Johnson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Stacey McCraw
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
| | - Peter Butterworth
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Wendy Swift
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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14
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Champion KE, Chapman C, Gardner LA, Sunderland M, Newton NC, Smout S, Thornton LK, Hides L, McBride N, Allsop SJ, Mills K, Kay-Lambkin F, Teesson M, Slade T. Lifestyle risks for chronic disease among Australian adolescents: a cross-sectional survey. Med J Aust 2021; 216:156-157. [PMID: 34747039 DOI: 10.5694/mja2.51333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Louise K Thornton
- The 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
| | - Steve J Allsop
- National Drug Research Institute, Curtin University, Perth, WA
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
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15
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Ward N, Correia H, McBride N. Maternal psycho-social risk factors associated with maternal alcohol consumption and Fetal Alcohol Spectrum Disorder: a systematic review. Arch Gynecol Obstet 2021; 304:1399-1407. [PMID: 34468822 DOI: 10.1007/s00404-021-06206-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Fetal Alcohol Spectrum Disorder (FASD) is a preventable range of neurocognitive disorders associated with the biological mother's consumption of alcohol during pregnancy. However, on average, 45% of Australian women continue to consume alcohol during pregnancy resulting in a high rate of alcohol-exposed pregnancies and risk of FASD. This level of exposure is higher than the estimated global average of alcohol-exposed pregnancies (9.8%). This systematic literature review aims to identify demographic, health and psycho-social variables associated with alcohol consumption during pregnancy which may lead to FASD. METHODS Using PRISMA principles, this systematic literature review reports on psycho-social factors which increase the risk of alcohol consumption during pregnancy thereby increasing the risk of FASD. RESULTS Fourteen studies were accepted into this review. Studies were conducted across several countries and included a total of 386,067 cases. Seven studies were case-controlled and seven were cross-sectional design. Multiple studies identified the significance of prior mental illness, anxiety, depression, exposure to abuse and/or domestic violence and alcohol consumption behaviours of partners and family members as strong predictors of risky alcohol consumption during pregnancy and therefore associated risk of FASD. CONCLUSION Clinical services may be able to use the evidence-based findings from this review to improve assessment and treatment services for vulnerable women to reduce alcohol-exposed pregnancies.
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Affiliation(s)
- Naomi Ward
- School of Psychology and Exercise Sciences, Murdoch University, Perth, WA, Australia
| | - Helen Correia
- School of Psychology and Exercise Sciences, Murdoch University, Perth, WA, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia.
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16
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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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17
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Yuen WS, Chan G, Clare P, Bruno R, Boland V, Aiken A, Kypri K, Horwood J, McCambridge J, Degenhardt L, Slade T, Wadolowski M, Hutchinson D, Najman J, McBride N, Mattick R, Peacock A. 962Adolescent Alcohol Use Trajectories: A Prospective Study of Risk Factors and Adulthood AUD Outcomes. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.740] [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
Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be an important predictor of later harms. Previous attempts to conceptualise these trajectories lacked adjustment for known confounders of adolescent drinking, which our study has aimed to address by modelling dynamic changes in drinking whilst adjusting for parent, child, and peer factors.
Methods
Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over five annual follow-ups (Mage=13.9 and 17.8 years). Regression models determined whether child, parent, and peer factors at baseline (Mage =12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD in early adulthood (Mage =18.8 years).
Results
We identified a four-class solution: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Alcohol-specific household rules reduced risk of early-onset heavy drinking compared to late-onset moderate drinking (RRR: 0.31; 99.5% CI: 0.11, 0.83), whereas substance-using peers increased this risk (RRR: 3.43; 99.5% CI: 2.10, 5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (OR: 7.68; 99.5% CI: 2.41, 24.47).
Conclusions
Our study provides evidence that early initiation and heavy alcohol use throughout adolescence is associated with increased risk of alcohol-related harm compared to recommended maximum levels of consumption (late-onset, moderate drinking).
Key messages
Parenting factors and peer influences in early adolescence should be considered to reduce risk of early initiation and heavy drinking, which in turn reduces risk of later harm.
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Gary Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, Australia
| | - Philip Clare
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, The University of Newcastle, University Dr, Callaghan, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Tim Slade
- The Matilda Centre, The University of Sydney, Camperdown, Australia
| | | | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
- Centre for Social and Early Emotional Development, Deakin University, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Childrens Research Institute, Melbourne Royal Children's Hospital, Parkville, Australia
| | - Jake Najman
- School of Public Health, The University of Queensland, St Lucia, Australia
| | | | - Richard Mattick
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
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18
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Yuen WS, Chan G, Bruno R, Clare PJ, Aiken A, Mattick R, Farrell M, Kypri K, Slade T, Hutchinson D, McBride N, McCambridge J, Boland V, Peacock A. Trajectories of alcohol-induced blackouts in adolescence: early risk factors and alcohol use disorder outcomes in early adulthood. Addiction 2021; 116:2039-2048. [PMID: 33464664 DOI: 10.1111/add.15415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/10/2020] [Accepted: 01/06/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Experience of alcohol-induced memory blackouts in adolescence may be an important risk factor for later harms. This longitudinal study (i) modelled trajectories of alcohol-related blackouts throughout adolescence, (ii) explored early-adolescent predictors of blackout trajectories and (iii) examined the association between blackout trajectories and alcohol use disorder (AUD) symptoms. DESIGN Longitudinal study in which data from six annual surveys of a longitudinal cohort of Australian adolescents were used to model latent class growth trajectories of blackouts, adjusting for alcohol consumption frequency and typical quantity. Regression models were used to determine whether parent, child and peer factors at baseline (mean age = 12.9) predicted profiles of blackout trajectory membership and whether blackout trajectories predicted meeting criteria for AUD in early adulthood (mean age = 19.8). SETTING AND PARTICIPANTS Australian adolescents (n = 1821; mean age = 13.9-18.8 years). MEASUREMENTS Alcohol-related blackouts, alcohol consumption frequency, typical consumption quantity and DSM-5 AUD in early adulthood were all self-reported. FINDINGS We identified a three-class solution: delayed alcohol initiation, rare blackouts (n = 701; 38.5%); early initiation, rare blackouts (n = 869; 47.7%); and early initiation, increasing blackouts (n = 251; 13.8%). Female sex was associated with increased risk of early initiation, increasing blackouts relative to delayed initiation, rare blackouts [relative risk ratio (RRR) = 3.90; 99.5% confidence interval (CI) = 1.96, 7.76] and relative to early initiation, rare blackouts (RRR = 2.89; 99.5% CI = 1.42, 5.87). Early initiation, rare blackouts [odds ratio (OR) = 1.96; 99.5% CI = 1.17, 3.29] and early initiation, increasing blackouts (OR = 4.93; 99.5% CI = 2.32, 10.48) were each associated with increased odds of meeting criteria for AUD in early adulthood relative to delayed initiation, rare blackouts. Early initiation, increasing blackouts was associated with increased odds of meeting criteria for AUD in early adulthood relative to early initiation, rare blackouts (OR = 2.51; 99.5% CI = 1.18, 5.38). CONCLUSIONS Females in Australia appear to be at higher risk of adolescent alcohol-related blackouts independent of alcohol consumption levels and age of initiation. Alcohol-related blackouts may be associated with later alcohol use disorder.
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Gary Chan
- Centre for Youth Substance Abuse, The University of Queensland, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Australia.,Department of Paediatrics, The University of Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Australia
| | | | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Australia
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19
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Macdonald JA, Graeme LG, Wynter K, Cooke D, Hutchinson D, Kendall G, StGeorge J, Dowse E, Francis LM, McBride N, Fairweather AK, Manno LD, Olsson CA, Allsop S, Leach L, Youssef GJ. How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years. J Affect Disord 2021; 281:727-737. [PMID: 33234285 DOI: 10.1016/j.jad.2020.11.081] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/18/2020] [Accepted: 11/08/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. METHODS Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. RESULTS Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LIMITATIONS This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. CONCLUSIONS A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.
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Affiliation(s)
- Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Liam G Graeme
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Karen Wynter
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia; Deakin University, Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Australia
| | - Dawson Cooke
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia; University of New South Wales, National Drug and Alcohol Research Centre, Sydney, Australia
| | - Garth Kendall
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | | | - Eileen Dowse
- University of Newcastle, School of Nursing and Midwifery, Newcastle, Australia
| | - Lauren M Francis
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Nyanda McBride
- Curtin University, National Drug Research Institute, Perth, Australia
| | - A Kate Fairweather
- Flinders University, Discipline of Behavioural Health, College of Medicine and Public Health, Adelaide, Australia
| | - Laura Di Manno
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Perth, Australia
| | - Liana Leach
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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20
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Boland VC, Clare PJ, Yuen WS, Peacock A, Aiken A, Wadolowski M, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Degenhardt L, Kypri K, Mattick RP. The association between parental supply of alcohol and supply from other sources to young people: a prospective cohort. Addiction 2020; 115:2140-2147. [PMID: 32141130 DOI: 10.1111/add.15033] [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: 03/29/2019] [Revised: 06/21/2019] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
AIMS Despite legal age limits set for alcohol consumption, parents are one of the main suppliers of alcohol to underage minors. Although supply from non-parental sources has been found to be associated with greater risk of harm compared with parental supply, the association between parental supply and supply from other sources is unclear. This study investigated the associations between parental supply of sips and whole serves of alcohol on subsequent other supply, conditional on current supply from non-parental sources. METHODS Data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents was used. A cohort of 1927 Australian children recruited in grade 7 (mean age 12.9 years) was surveyed annually from 2010 to 2016 (94%, n = 1821 included for analyses). The primary outcome was alcohol exposure from other sources ('other supply'), including alcohol supply from other adults, friends, siblings, or self-supply, compared with adolescents reporting no supply from these sources. Analyses were conducted using random intercept logistic regression (to account for within-respondent correlation). RESULTS Parental supply of alcohol alone was associated with increased odds of receiving alcohol from other non-parental sources in subsequent years (OR: 1.99; 95% CI: 1.65-2.39) after adjusting for confounders. Increased odds of subsequent other supply were associated with current parental supply of sips (OR: 1.92; 95% CI: 1.56-2.36) and whole drinks (OR: 2.76; 95% CI: 1.85-4.11). CONCLUSIONS Parental supply of alcohol appears to increase the risk of subsequent supply of alcohol from other sources in certain contexts.
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Affiliation(s)
- Veronica C Boland
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Monika Wadolowski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, NSW, 2109, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University Geelong, Geelong, Victoria, 3220, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, 3052, Australia
| | - Jackob Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, 4072, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, 2006, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, GPO Box U1987, Perth, , WA, 6845, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, , NSW, 2308, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
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21
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Sharmin S, Kypri K, Wadolowski M, Bruno R, Khanam M, Aiken A, Hutchinson D, Najman JM, Slade T, McBride N, Attia J, Palazzi K, Oldmeadow C, Mattick RP. Parent hazardous drinking and their children's alcohol use in early and mid-adolescence: prospective cohort study. Eur J Public Health 2020; 29:736-740. [PMID: 30851106 DOI: 10.1093/eurpub/ckz029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Why adolescents' drinking is associated with their parents' drinking remains unclear. We examined associations in a prospective cohort study, adjusting for socio-demographic characteristics and family factors. METHODS We recruited 1927 children from grade 7 classes (mean age 13 years), and one of their parents, in three Australian states, contacted participants annually from 2010 to 2014, and analysed data from assessments at ages 13, 14, 15 and 16 years. We used the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) subscale to identify hazardous drinking in parents (score ≥5) and children (score ≥3) and constructed mixed-effect logistic regression models, accounting for clustering within school and adjusting for likely confounders. We evaluated the sensitivity of estimates by imputing missing values assuming the data were missing at random vs. missing not at random. RESULTS Parent hazardous drinking predicted mid-adolescent hazardous drinking, e.g. 15 years olds whose parents [adjusted odds ratio (aOR) 2.00; 95% confidence interval 1.51-2.64] or parents' partners (aOR 1.94; 1.48-2.55) were hazardous drinkers had higher odds of being hazardous drinkers at age 16. The magnitude of univariate associations changed little after adjusting for covariates, and sensitivity analyses confirmed the robustness of the association, across a wide range of assumptions about the missing data. CONCLUSIONS The associations between parents' and their adolescent children's hazardous drinking are unlikely to be due to confounding by socio-demographic and family factors. Parents should be encouraged, and supported by public policy, to reduce their own alcohol consumption in order to reduce their children's risk of becoming hazardous drinkers.
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Affiliation(s)
- Sonia Sharmin
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Monika Wadolowski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, NSW, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS, Australia
| | - Masuma Khanam
- School of Health Science, University of Tasmania, Hobart, TAS, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, Australia
| | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute (HMRI), Newcastle, NSW, Australia
| | | | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales (UNSW), Sydney, NSW, Australia
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22
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Gardner LA, Champion KE, Parmenter B, Grummitt L, Chapman C, Sunderland M, Thornton L, McBride N, Newton NC. Clustering of Six Key Risk Behaviors for Chronic Disease among Adolescent Females. Int J Environ Res Public Health 2020; 17:E7211. [PMID: 33023089 PMCID: PMC7579129 DOI: 10.3390/ijerph17197211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/28/2022]
Abstract
Chronic diseases are the leading cause of disability and mortality globally. In Australia, females are at heightened risk. This research explored the prevalence, patterns, and correlates of six key risk behaviors (physical inactivity, poor diet, recreational screen time, inadequate sleep, alcohol use, and smoking) among adolescent females and whether knowledge of health guidelines was associated with adherence. Adolescent females completed an anonymous online questionnaire (N = 687; Mage = 13.82). Logistic regression assessed the association between knowledge and adherence. A Latent Class Analysis (LCA) and three-step procedure identified risk behavior clusters and their correlates. Despite positive health self-ratings (77% good/very good), most participants reported insufficient moderate-to-vigorous physical activity (MVPA; 89%), vegetable intake (89%), and excessive screen time (63%). Knowledge of guidelines was associated with adherence for MVPA, vegetable intake, sleep, and alcohol abstinence. Three classes emerged: "moderate risk" (76%), "relatively active, healthy eaters" (19%), and "excessive screen users" (5%). These risk-behavior clusters were associated with perceived value of academic achievement and physical wellbeing. Adolescent females commonly perceive they are in good health, despite engaging in unhealthy behaviors. Public health interventions should utilize effective behavior change strategies, adopt a multiple health behavior change approach (MHBC), and be tailored to specific risk profiles and values among females.
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Affiliation(s)
- Lauren A. Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Katrina E. Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Belinda Parmenter
- Department of Exercise Physiology, School of Medical Sciences, UNSW Sydney, Sydney 2052, Australia;
| | - Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth 6102, Australia;
| | | | - Nicola C. Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
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23
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Clare PJ, Dobbins T, Bruno R, Peacock A, Boland V, Yuen WS, Aiken A, Degenhardt L, Kypri K, Slade T, Hutchinson D, Najman JM, McBride N, Horwood J, McCambridge J, Mattick RP. The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood-a prospective cohort study. Addiction 2020; 115:1833-1843. [PMID: 32034841 DOI: 10.1111/add.15005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/22/2019] [Revised: 09/18/2019] [Accepted: 02/02/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS Recent research suggests that parental supply of alcohol is associated with more risky drinking and alcohol-related harm among adolescents. However, the overall effect of parental supply throughout adolescence remains unclear, because parental supply of alcohol varies during adolescence. Due to the complexity of longitudinal data, standard analytical methods can be biased. This study examined the effect of parental supply of alcohol on alcohol-related outcomes in early adulthood using robust methods to minimize risk of bias. DESIGN Prospective longitudinal cohort study. SETTING Australia PARTICIPANTS: A cohort of school students (n = 1906) recruited in the first year of secondary school (average age 12.9 years) from Australian schools in 2010-11, interviewed annually for 7 years. MEASUREMENTS The exposure variable was self-reported parental supply of alcohol (including sips/whole drinks) during 5 years of adolescence (waves 1-5). Outcome variables were self-reported binge drinking, alcohol-related harm and symptoms of alcohol use disorder, measured in the two waves after the exposure period (waves 6-7). To reduce risk of bias, we used targeted maximum likelihood estimation to assess the (counterfactual) effect of parental supply of alcohol in all five waves versus no supply on alcohol-related outcomes. FINDINGS Parental supply of alcohol throughout adolescence saw greater risk of binge drinking [risk ratios (RR) = 1.53; 95% confidence interval (CI) = 1.27-1.84] and alcohol-related harms (RR = 1.44; 95% CI = 1.22-1.69) in the year following the exposure period compared with no supply in adolescence. Earlier initiation of parental supply also increased risk of binge drinking (RR = 1.10; 95% CI = 1.05-1.14), and any alcohol-related harm (RR = 1.09; 95% CI = 1.05-1.13) for each year earlier parental supply began compared with later (or no) initiation. CONCLUSIONS Adolescents whose parents supply them with alcohol appear to have an increased risk of alcohol-related harm compared with adolescents whose parents do not supply them with alcohol. The risk appears to increase with earlier initiation of supply.
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Affiliation(s)
- Philip J Clare
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Victoria, Australia.,Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Victoria, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
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24
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Yuen WS, Chan G, Bruno R, Clare P, Mattick R, Aiken A, Boland V, McBride N, McCambridge J, Slade T, Kypri K, Horwood J, Hutchinson D, Najman J, De Torres C, Peacock A. Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes. Pediatrics 2020; 146:peds.2020-0440. [PMID: 32968030 DOI: 10.1542/peds.2020-0440] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent drinking, which we aimed to address by modeling dynamic changes in drinking throughout adolescence while adjusting for covariates. METHODS Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over 5 annual follow-ups (mean age = 13.9 until 17.8 years). Regression models were used to determine whether child, parent, and peer factors at baseline (mean age = 12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD at the final follow-up (mean age = 18.8 years). RESULTS We identified 4 classes: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Having more alcohol-specific household rules reduced risk of early-onset heavy drinking compared with late-onset moderate drinking (relative risk ratio: 0.31; 99.5% confidence interval [CI]: 0.11-0.83), whereas having more substance-using peers increased this risk (relative risk ratio: 3.43; 99.5% CI: 2.10-5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (odds ratio: 7.68; 99.5% CI: 2.41-24.47). CONCLUSIONS Our study provides evidence that parenting factors and peer influences in early adolescence should be considered to reduce risk of later alcohol-related harm. Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm compared with recommended maximum levels of consumption (late-onset, moderate drinking).
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia;
| | - Gary Chan
- National Centre for Youth Substance Use Research and
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Philip Clare
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; and.,Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Victoria, Australia
| | - Jake Najman
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Clara De Torres
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
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25
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Wynter K, Francis LM, Fletcher R, McBride N, Dowse E, Wilson N, Di Manno L, Teague S, Macdonald JA. Sleep, mental health and wellbeing among fathers of infants up to one year postpartum: A scoping review. Midwifery 2020; 88:102738. [DOI: 10.1016/j.midw.2020.102738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022]
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26
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Champion KE, Gardner LA, McGowan C, Chapman C, Thornton L, Parmenter B, McBride N, Lubans DR, McCann K, Spring B, Teesson M, Newton NC. A Web-Based Intervention to Prevent Multiple Chronic Disease Risk Factors Among Adolescents: Co-Design and User Testing of the Health4Life School-Based Program. JMIR Form Res 2020; 4:e19485. [PMID: 32720898 PMCID: PMC7420628 DOI: 10.2196/19485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 04/20/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic diseases are the leading cause of death worldwide. Addressing key lifestyle risk factors during adolescence is critical for improving physical and mental health outcomes and reducing chronic disease risk. Schools are ideal intervention settings, and electronic health (eHealth) interventions afford several advantages, including increased student engagement, scalability, and sustainability. Although lifestyle risk behaviors tend to co-occur, few school-based eHealth interventions have targeted multiple behaviors concurrently. OBJECTIVE This study aims to summarize the co-design and user testing of the Health4Life school-based program, a web-based cartoon intervention developed to concurrently prevent 6 key lifestyle risk factors for chronic disease among secondary school students: alcohol use, smoking, poor diet, physical inactivity, sedentary recreational screen time, and poor sleep (the Big 6). METHODS The development of the Health4Life program was conducted over 18 months in collaboration with students, teachers, and researchers with expertise relevant to the Big 6. The iterative process involved (1) scoping of evidence and systematic literature review; (2) consultation with adolescents (N=815) via a cross-sectional web-based survey to identify knowledge gaps, attitudes, barriers, and facilitators in relation to the Big 6; (3) content and web development; and (4) user testing of the web-based program with students (n=41) and teachers (n=8) to evaluate its acceptability, relevance, and appeal to the target audience. RESULTS The co-design process resulted in a six-module, evidence-informed program that uses interactive cartoon storylines and web-based delivery to engage students. Student and teacher feedback collected during user testing was positive in terms of acceptability and relevance. Commonly identified areas for improvement concerned the length of modules, age appropriateness of language and alcohol storyline, the need for character backstories and links to syllabus information, and feasibility of implementation. Modifications were made to address these issues. CONCLUSIONS The Health4Life school-based program is the first universal, web-based program to concurrently address 6 important chronic disease risk factors among secondary school students. By adopting a multiple health behavior change approach, it has the potential to efficiently modify the Big 6 risk factors within one program and to equip young people with the skills and knowledge needed to achieve and maintain good physical and mental health throughout adolescence and into adulthood.
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Affiliation(s)
- Katrina Elizabeth Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren Anne Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cyanna McGowan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Cath Chapman
- 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
| | - Belinda Parmenter
- Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Nyanda McBride
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, Australia
| | - Karrah McCann
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Clare Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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27
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Teesson M, Champion KE, Newton NC, Kay-Lambkin F, Chapman C, Thornton L, Slade T, Sunderland M, Mills K, Gardner LA, Parmenter B, Lubans DR, Hides L, McBride N, Allsop S, Spring BJ, Smout S, Osman B. Study protocol of the Health4Life initiative: a cluster randomised controlled trial of an eHealth school-based program targeting multiple lifestyle risk behaviours among young Australians. BMJ Open 2020; 10:e035662. [PMID: 32665344 PMCID: PMC7359380 DOI: 10.1136/bmjopen-2019-035662] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/11/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Lifestyle risk behaviours, including alcohol use, smoking, poor diet, physical inactivity, poor sleep (duration and/or quality) and sedentary recreational screen time ('the Big 6'), are strong determinants of chronic disease. These behaviours often emerge during adolescence and co-occur. School-based interventions have the potential to address risk factors prior to the onset of disease, yet few eHealth school-based interventions target multiple behaviours concurrently. This paper describes the protocol of the Health4Life Initiative, an eHealth school-based intervention that concurrently addresses the Big 6 risk behaviours among secondary school students. METHODS AND ANALYSIS A multisite cluster randomised controlled trial will be conducted among year 7 students (11-13 years old) from 72 Australian schools. Stratified block randomisation will be used to assign schools to either the Health4Life intervention or an active control (health education as usual). Health4Life consists of (1) six web-based cartoon modules and accompanying activities delivered during health education (once per week for 6 weeks), and a smartphone application (universal prevention), and (2) additional app content, for students engaging in two or more risk behaviours when they are in years 8 and 9 (selective prevention). Students will complete online self-report questionnaires at baseline, post intervention, and 12, 24 and 36 months after baseline. Primary outcomes are consumption of sugar-sweetened beverages, moderate-to-vigorous physical activity, sleep duration, sedentary recreational screen time and uptake of alcohol and tobacco use. ETHICS AND DISSEMINATION This study has been approved by the University of Sydney (2018/882), NSW Department of Education (SERAP no. 2019006), University of Queensland (2019000037), Curtin University (HRE2019-0083) and relevant Catholic school committees. Results will be presented to schools and findings disseminated via peer-reviewed journals and scientific conferences. This will be the first evaluation of an eHealth intervention, spanning both universal and selective prevention, to simultaneously target six key lifestyle risk factors among adolescents. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000431123), 18 March 2019.
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Affiliation(s)
- Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Belinda Parmenter
- Department of Exercise Physiology, University of NSW, Sydney, New South Wales, Australia
| | - David R Lubans
- School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Bonnie J Spring
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Bridie Osman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
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28
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Parmenter BJ, Gardner LA, Champion KE, Chapman C, Thornton L, McBride N, Sunderland M, Newton NC. Limitations In Knowledge And Practice Of Healthy Lifestyle Guidelines In A Sample Of Australian Adults. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678580.40034.0d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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29
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Amato TDC, Opaleye ES, McBride N, Noto AR. Reducing alcohol-related risks among adolescents: a feasibility study of the SHAHRP program in Brazilian schools. Cien Saude Colet 2020; 26:3005-3018. [PMID: 34378693 DOI: 10.1590/1413-81232021268.13472020] [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: 01/21/2020] [Accepted: 05/28/2020] [Indexed: 11/21/2022] Open
Abstract
The SHAHRP program was effective reducing drinking and alcohol - harms in Australia, but cross-cultural adaptation is required before replication. This study aimed at assessing the feasibility of SHAHRP in Brazil focused on implementation and acceptability. A mixed-methodsdesign was used: quantitative for implementing the program and evaluation and qualitative for acceptability. The quantitative design was a pilot of a randomized controlled trial. Private schools were randomly divided into four intervention (n=160) and four control (n=188) schools. Student's mean age was 12.7 years. The fidelity of implementation and likely outcome measures were assessed. Qualitative data on acceptability were provided by students and teachers. The percentage of implementation varied from 62.5% to 87.5%. Behaviours such as alcohol-harms requires a larger cohort and longer follow-up to be adequately evaluated. The risk reduction approach and activities had good acceptability from students and teachers. Quantitative and qualitative outcomes on knowledge and decision-making indicated possible improvement in SHAHRP schools. The program is feasible and well accepted in a Brazilian setting, opening the way for a more comprehensive evaluation and dissemination.
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Affiliation(s)
- Tatiana de Castro Amato
- Núcleo de Pesquisa em Saúde e Uso de Substâncias, Departamento de Psicobiologia, Universidade Federal de São Paulo. Rua Botucatu 862 1º andar, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Emérita Sátiro Opaleye
- Núcleo de Pesquisa em Saúde e Uso de Substâncias, Departamento de Psicobiologia, Universidade Federal de São Paulo. Rua Botucatu 862 1º andar, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Nyanda McBride
- National Drug Research Institute, Curtin University. Perth WA Austrália
| | - Ana Regina Noto
- Núcleo de Pesquisa em Saúde e Uso de Substâncias, Departamento de Psicobiologia, Universidade Federal de São Paulo. Rua Botucatu 862 1º andar, Vila Clementino. 04023-062 São Paulo SP Brasil.
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30
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Birrell L, Slade T, Teesson M, Prior K, Chapman C, Hides L, McBride N, Mewton L, Allsop S, Andrews G, Newton NC. Bidirectional relationships in the development of internalising symptoms and alcohol use in adolescence. Drug Alcohol Rev 2020; 39:950-959. [PMID: 32314463 DOI: 10.1111/dar.13070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/14/2018] [Revised: 02/20/2020] [Accepted: 03/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Previous literature has demonstrated an inconsistent relationship between alcohol use and internalising symptoms (anxiety, depression) in youth. This study aimed to clarify this link examining the bidirectional relationships between internalising symptoms and alcohol use in a community sample of adolescents, taking into account the effect of gender and externalising symptoms. DESIGN AND METHODS Parallel latent growth models were run to prospectively explore the bidirectional relationships between internalising symptoms and alcohol use when assessed five times over 2 years, among 1557 (67% female) adolescents from age 13.5 years. RESULTS Results showed that higher initial levels of internalising symptoms predicted increasing alcohol use frequency; however, this association was no longer significant once externalising symptoms and gender were accounted for. No bidirectional associations between internalising symptoms and alcohol use were found. DISCUSSION AND CONCLUSIONS This study adds to the literature examining the bidirectional relationships between internalising symptoms and alcohol use in adolescence. Findings highlight the importance of both gender and externalising symptoms in the development of this type of comorbidity and may help explain discrepant findings in the existing literature. Future prevention efforts for internalising problems and alcohol use should consider gender and externalising symptoms.
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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
| | - Tim Slade
- 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
| | - Katrina Prior
- 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
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Gavin Andrews
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, UNSW Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Clare PJ, Aiken A, Yuen WS, Peacock A, Boland V, Wadolowski M, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Degenhardt L, Kypri K, Mattick RP. Parental supply of alcohol as a predictor of adolescent alcohol consumption patterns: A prospective cohort. Drug Alcohol Depend 2019; 204:107529. [PMID: 31494442 DOI: 10.1016/j.drugalcdep.2019.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/03/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent research has not supported the idea that parental supply of alcohol to adolescents prevents later alcohol-related harm. Yet the specific role of parental supply in shaping patterns of drinking over time remains unclear. This study investigated the role of parental supply of alcohol in patterns of drinking across adolescence, and assessed whether that role remained consistent over time. METHOD Using a longitudinal cohort of 1927 adolescents (mean age 12.9 years), recruited in 2010 and 2011 from schools across Australia and followed up annually until 2016, we assessed three outcomes using mixed-effect negative binomial regression: frequency of consumption, typical quantity consumed, and overall alcohol consumption in the year (frequency * quantity). Child, parental, familial, and peer confounders of adolescent alcohol consumption were measured and adjusted for in the analyses. FINDINGS Parental supply was associated with greater overall consumption in earlier adolescence: Grade 7-8 (incidence rate ratio [IRR]: 3.61; 95% CI: 2.55, 5.12; no supply IRR: 1.00), Grade 8-9 (IRR: 4.84; 95% CI: 3.66, 6.39; no supply IRR: 1.44) and Grade 9-10 (IRR: 8.33; 95% CI: 6.28, 11.05; no supply IRR: 4.75). Alcohol consumption continued to increase in later adolescence regardless of whether parental supply occurred. CONCLUSIONS Parental supply of alcohol was associated with increased alcohol consumption by their children during early adolescence. While parental supply appears to have less impact on drinking in later adolescence, there was no evidence to suggest it is protective. Parents should be advised to avoid supplying children with alcohol, particularly in early adolescence.
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Affiliation(s)
- Philip J Clare
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia.
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Monika Wadolowski
- Discipline of Paediatrics, School of Women's & Children's Health, UNSW, Sydney, NSW 2052, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia; Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria 3220, Australia; The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia; Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; Royal Children's Hospital, Centre for Adolescent Health, Parkville, Victoria 3052, Australia
| | - Jackob Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD 4072, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW 2006, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
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Birrell L, Newton NC, Slade T, Chapman C, Mewton L, McBride N, Hides L, Chatterton ML, Allsop S, Healy A, Mather M, Quinn C, Mihalopoulos C, Teesson M. Correction: Evaluating the Long-Term Effectiveness of School-Based Depression, Anxiety, and Substance Use Prevention Into Young Adulthood: Protocol for the Climate School Combined Study. JMIR Res Protoc 2019; 8:e15391. [PMID: 31573950 PMCID: PMC6795478 DOI: 10.2196/15391] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/18/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Louise Birrell
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nicola C Newton
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Tim Slade
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Catherine Chapman
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louise Mewton
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Leanne Hides
- Centre for Substance Abuse Research, School of Psychology, University of Queensland, Brisbane, Australia
| | - Mary Lou Chatterton
- Population Health Strategic Research Centre, Deakin University, Geelong, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Annalise Healy
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Marius Mather
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Catherine Quinn
- Centre for Substance Abuse Research, School of Psychology, University of Queensland, Brisbane, Australia
| | | | - Maree Teesson
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Champion KE, Parmenter B, McGowan C, Spring B, Wafford QE, Gardner LA, Thornton L, McBride N, Barrett EL, Teesson M, Newton NC, Chapman C, Slade T, Sunderland M, Bauer J, Allsop S, Hides L, Stapinksi L, Birrell L, Mewton L. Effectiveness of school-based eHealth interventions to prevent multiple lifestyle risk behaviours among adolescents: a systematic review and meta-analysis. The Lancet Digital Health 2019; 1:e206-e221. [DOI: 10.1016/s2589-7500(19)30088-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/10/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
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Pocuca N, Hides L, Quinn CA, White MJ, Mewton L, Newton NC, Slade T, Chapman C, Teesson M, Andrews G, Allsop S, McBride N. The interactive effects of perceived peer drinking and personality profiles on adolescent drinking: a prospective cohort study. Addiction 2019; 114:450-461. [PMID: 30311281 DOI: 10.1111/add.14469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/25/2018] [Revised: 05/21/2018] [Accepted: 10/05/2018] [Indexed: 12/26/2022]
Abstract
AIMS (1) To classify Australian adolescents according to their alcohol consumption trajectories; and (2) to assess the direct and interactive effects of perceived peer drinking (PPD) and personality on adolescent drinking. DESIGN Prospective cohort study comprising secondary analysis of six waves of prospective data (collected between 2014 and 2016) from the control arm of the Climate Schools Combined Study. SETTING Nineteen schools across three Australian states. PARTICIPANTS A total of 1492 socio-demographically diverse students (mean age at baseline: 13.47; 68% female; 82% born in Australia). MEASUREMENTS Alcohol consumption trajectories were assessed using self-reported sipping of alcohol, full standard drink consumption, binge drinking and quantity and frequency of alcohol consumption. One item assessed PPD and personality was assessed using the Substance Use Risk Profile Scale. FINDINGS Eight hundred and sixty-four (58%) adolescents consumed alcohol across the study period. Four drinking trajectories were identified: abstaining (n = 513; reference group); onset (n = 361; initiated after baseline); persistent (n = 531; initiated prior to baseline); and decreasing (n = 50; consumed alcohol at baseline but ceased or decreased thereafter). A significant PPD × anxiety sensitivity (AS) interaction affected probability of belonging to the onset (P < 0.001) and persistent (P = 0.003) trajectories. The effect of PPD on probability of belonging to the onset trajectory was only significant when adolescents reported low [95% confidence interval (CI) = 1.464-2.646, P < 0.001], but not high AS. The effect of PPD on probability of belonging to the persistent drinking trajectory was stronger at low (95% CI = 2.144-3.283, P < 0.001), compared with high (95% CI = 1.440-2.308, P < 0.001) AS. CONCLUSIONS In Australian adolescents, self-reported drinking onset and persistent drinking appear to be more strongly associated with perceived peer drinking in those with low anxiety sensitivity than those with high anxiety sensitivity.
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Affiliation(s)
- Nina Pocuca
- Centre for Youth Substance Abuse Research, Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, School of Psychology, University of Queensland, Brisbane, Australia
| | - Catherine A Quinn
- Centre for Youth Substance Abuse Research, School of Psychology, University of Queensland, Brisbane, Australia
| | - Melanie J White
- Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Louise Mewton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Nicola Clare Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Tim Slade
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Cath Chapman
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Gavin Andrews
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, University of New South Wales, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
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Birrell L, Newton NC, Slade T, Chapman C, Mewton L, McBride N, Hides L, Chatterton ML, Allsop S, Healy A, Mather M, Quinn C, Mihalopoulos C, Teesson M. Evaluating the Long-Term Effectiveness of School-Based Depression, Anxiety, and Substance Use Prevention Into Young Adulthood: Protocol for the Climate School Combined Study. JMIR Res Protoc 2018; 7:e11372. [PMID: 30401663 PMCID: PMC6246975 DOI: 10.2196/11372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 11/19/2022] Open
Abstract
Background Mental health and substance use disorders are the leading causes of global disability in children and youth. Both tend to first onset or escalate in adolescence and young adulthood, calling for effective prevention during this time. The Climate Schools Combined (CSC) study was the first trial of a Web-based combined universal approach, delivered through school classes, to prevent both mental health and substance use problems in adolescence. There is also limited evidence for the cost-effectiveness of school-based prevention programs. Objective The aim of this protocol paper is to describe the CSC follow-up study, which aims to determine the long-term efficacy and cost-effectiveness of the CSC prevention program for depression, anxiety, and substance use (alcohol and cannabis use) up to 7 years post intervention. Methods A cluster randomized controlled trial (the CSC study) was conducted with 6386 participants aged approximately 13.5 years at baseline from 2014 to 2016. Participating schools were randomized to 1 of 4 conditions: (1) control (health education as usual), (2) Climate Substance Use (universal substance use prevention), (3) Climate Mental Health (universal mental health prevention), or (4) CSC (universal substance use and mental health prevention). It was hypothesized that the CSC program would be more effective than conditions (1) to (3) in reducing alcohol and cannabis use (and related harms), anxiety, and depression symptoms as well as increasing knowledge related to alcohol, cannabis, anxiety, and depression. This long-term study will invite follow-up participants to complete 3 additional Web-based assessments at approximately 5, 6, and 7 years post baseline using multiple sources of locator information already provided to the research team. The primary outcomes include alcohol and cannabis use (and related harms) and mental health symptoms. An economic evaluation of the program will also be conducted using both data linkage as well as self-report resource use and quality of life measures. Secondary outcomes include self-efficacy, social networks, peer substance use, emotion regulation, and perfectionism. Analyses will be conducted using multilevel mixed-effects models within an intention-to-treat framework. Results The CSC long-term follow-up study is funded from 2018 to 2022 by the Australian National Health and Medical Research Council (APP1143555). The first follow-up wave commences in August 2018, and the results are expected to be submitted for publication in 2022. Conclusions This is the first study to provide a long-term evaluation of combined universal substance use and mental health prevention up to 7 years post intervention. Evidence of sustained benefits into early adulthood would provide a scalable, easy-to-implement prevention strategy with the potential for widespread dissemination to reduce the considerable harms, burden of disease, injury, and social costs associated with youth substance use and mental disorders. International Registered Report Identifier (IRRID) PRR1-10.2196/11372
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Affiliation(s)
- Louise Birrell
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nicola C Newton
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Tim Slade
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Catherine Chapman
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louise Mewton
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Leanne Hides
- Centre for Substance Abuse Research, School of Psychology, University of Queensland, Brisbane, Australia
| | - Mary Lou Chatterton
- Population Health Strategic Research Centre, Deakin University, Geelong, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Annalise Healy
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Marius Mather
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Catherine Quinn
- Centre for Substance Abuse Research, School of Psychology, University of Queensland, Brisbane, Australia
| | | | - Maree Teesson
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Sharmin S, Kypri K, Wadolowski M, Bruno R, Khanam M, Aiken A, Hutchinson D, M. Najman J, Slade T, McBride N, Attia J, P. Mattick R. Parent characteristics associated with approval of their children drinking alcohol from ages 13 to 16 years: prospective cohort study. Aust N Z J Public Health 2018; 42:347-353. [DOI: 10.1111/1753-6405.12811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/01/2018] [Accepted: 05/01/2018] [Indexed: 01/21/2023] Open
Affiliation(s)
- Sonia Sharmin
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health; University of Newcastle; New South Wales
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health; University of Newcastle; New South Wales
| | - Monika Wadolowski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation; Macquarie University; New South Wales
| | | | | | - Alexandra Aiken
- National Drug and Alcohol Research Centre; University of New South Wales (UNSW)
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology; Deakin University; Victoria
| | - Jackob M. Najman
- Queensland Alcohol and Drug Research and Education Centre; University of Queensland
| | - Tim Slade
- National Drug and Alcohol Research Centre; University of New South Wales (UNSW)
| | - Nyanda McBride
- National Drug Research Institute; Curtin University; Western Australia
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health; University of Newcastle; New South Wales
| | - Richard P. Mattick
- National Drug and Alcohol Research Centre; University of New South Wales (UNSW)
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Sekar V, Griffin F, McBride N, Caldwell S, Quigley G, Simms N. The case of the whooshing ‘hammer-head’. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shaw T, Johnston RS, Gilligan C, McBride N, Thomas LT. Child-parent agreement on alcohol-related parenting: Opportunities for prevention of alcohol-related harm. Health Promot J Austr 2018; 29:123-132. [PMID: 30159989 DOI: 10.1002/hpja.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 04/13/2017] [Accepted: 01/31/2018] [Indexed: 01/13/2023] Open
Abstract
ISSUE ADDRESSED Excessive alcohol consumption places adolescents at increased risk of preventable, acute alcohol-related injury. Parental attitudes and behaviours influence adolescents' alcohol use. This study examined alignment in parent and child reports of alcohol-related parenting and whether misalignment related to the child ever having drunk alcohol. METHODS A cross-sectional online survey was conducted in five secondary schools in [information removed for blinding in Perth, Western Australia] in 2015. All students in Years 7, 10 and 12 and their parents were eligible, and data were matched for 124 child-parent dyads. Alignment of parent-child reports was assessed using kappa statistics. In dyads where the parent reported protective attitudes and behaviours, the association between misalignment and alcohol use was tested in logistic regressions. RESULTS Overall, child-parent reports were aligned on parents' expectations, knowledge and actions (65% and higher agreed). While alignment on parental expectations seemed to decrease with age, alignment on parental communication and rule-setting increased. Misalignment on reports of parents' expectations was associated with increased odds of the child reporting having ever had alcohol (OR = 5.5; 95% CI = 2.7-47.7), as was parental supply (OR = 20.2; 95% CI = 3.3-121.5), but misalignment on parental communication, rule-setting and knowledge were not. CONCLUSIONS Parent nonsupply of alcohol and disapproval of use were most important in terms of associations with ever drinking. SO WHAT?: These findings call for interventions that support parents to expect no alcohol use and enable parents to communicate their expectation in a manner that resonates with their child. Effective parenting will contribute to reducing alcohol-related harm in adolescents.
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Affiliation(s)
- Thérèse Shaw
- Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia
| | - Robyn S Johnston
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Centre for Action on Alcohol and Youth, Curtin University, Perth, WA, Australia
| | - Conor Gilligan
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Laura T Thomas
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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39
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Mattick RP, Clare PJ, Aiken A, Wadolowski M, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Kypri K, Vogl L, Degenhardt L. Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study. Lancet Public Health 2018; 3:e64-e71. [PMID: 29396259 DOI: 10.1016/s2468-2667(17)30240-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Some parents supply alcohol to their children, reportedly to reduce harm, yet longitudinal research on risks associated with such supply is compromised by short periods of observation and potential confounding. We aimed to investigate associations between parental supply and supply from other (non-parental) sources, with subsequent drinking outcomes over a 6-year period of adolescence, adjusting for child, parent, family, and peer variables. METHODS We did this prospective cohort study using data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents. Children in grade 7 (mean age 12 years), and their parents, were recruited between 2010 and 2011 from secondary schools in Sydney, Perth, and Hobart, Australia, and were surveyed annually between 2010 and 2016. We examined the association of exposure to parental supply and other sources of alcohol in 1 year with five outcomes in the subsequent year: binge drinking (more than four standard drinks on a drinking occasion); alcohol-related harms; and symptoms of alcohol abuse (as defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]), alcohol dependence, and alcohol use disorder (as defined by DSM-5). This trial is registered with ClinicalTrials.gov, number NCT02280551. FINDINGS Between September, 2010, and June, 2011, we recruited 1927 eligible parents and adolescents (mean age 12·9 years [SD 0·52]). Participants were followed up until 2016, during which time binge drinking and experience of alcohol-related harms increased. Adolescents who were supplied alcohol only by parents had higher odds of subsequent binge consumption (odds ratio [OR] 2·58, 95% CI 1·96-3·41; p<0·0001), alcohol-related harm (2·53, 1·99-3·24; p<0·0001), and symptoms of alcohol use disorder (2·51, 1·46-4·29; p=0·0008) than did those reporting no supply. Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source. Supply from other sources was associated with significant risks of all adverse outcomes, compared with no supply, with an even greater increased risk of adverse outcomes. INTERPRETATION Providing alcohol to children is associated with alcohol-related harms. There is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child. Parents should be advised that this practice is associated with risk, both directly and indirectly through increased access to alcohol from other sources. FUNDING Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre.
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Affiliation(s)
- Richard P Mattick
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
| | - Philip J Clare
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Alexandra Aiken
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Monika Wadolowski
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jackob Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, Australia
| | - Tim Slade
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Laura Vogl
- Black Dog Institute, Randwick, NSW, Australia
| | - Louisa Degenhardt
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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40
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Aiken A, Clare PJ, Wadolowski M, Hutchinson D, Najman JM, Slade T, Bruno R, McBride N, Kypri K, Mattick RP. Age of Alcohol Initiation and Progression to Binge Drinking in Adolescence: A Prospective Cohort Study. Alcohol Clin Exp Res 2017; 42:100-110. [PMID: 29160941 DOI: 10.1111/acer.13525] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [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: 04/12/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence. METHODS A total of 1,673 parent-child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming >4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates. RESULTS Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing. CONCLUSIONS Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use.
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Affiliation(s)
- Alexandra Aiken
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Philip J Clare
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Monika Wadolowski
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Delyse Hutchinson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Tim Slade
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, Tasmania, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
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Pocuca N, Hides L, Quinn CA, White MJ, Mewton L, Newton NC, Slade T, Chapman C, Andrews G, Teesson M, Allsop S, McBride N. The interactive effects of personality profiles and perceived peer drinking on early adolescent drinking. Psychol Addict Behav 2017; 32:230-236. [PMID: 29072478 DOI: 10.1037/adb0000322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Early adolescent drinking has been identified as an important risk factor for the development of alcohol dependence. Both perceived peer drinking and personality profiles have been implicated as risk factors for early adolescent drinking. However, research is yet to determine how these 2 factors may interact to increase such risk. This study aimed to determine whether personality profiles moderated the relationship between perceived peer drinking and early adolescent drinking. Baseline data were utilized in the analyses, from 3,287 adolescents (Mage = 13.51 years, SD = .58; 54% female; 78% born in Australia) participating in the Climate Schools Combined Study (a cluster randomized controlled trial with 75 schools located across Queensland, New South Wales, and Western Australia, Australia). Lifetime consumption of alcohol, perceived peer drinking, and personality profiles (Substance Use Risk Profile Scale) were measured. A moderated binary logistic regression found the personality profiles of impulsivity, sensation seeking, and hopelessness were positively related to early adolescent drinking, whereas anxiety sensitivity had a negative association. A significant interaction revealed that adolescents with higher levels of sensation seeking and who perceived their peers to be drinking were significantly more likely to report early adolescent drinking (consumption of a full standard drink; OR = 1.043; 95% CI [1.018-1.069]). These results indicate that perception of peer drinking is more strongly associated with early adolescent drinking, when adolescents are also high on sensation seeking. Prevention and intervention programs could consider targeting both sensation seeking and perceived peer drinking in adolescents. (PsycINFO Database Record
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Affiliation(s)
- Nina Pocuca
- Centre for Youth Substance Abuse Research, Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Faculty of Health, Queensland University of Technology
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Faculty of Health, Queensland University of Technology
| | - Catherine A Quinn
- Centre for Youth Substance Abuse Research, Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Faculty of Health, Queensland University of Technology
| | - Melanie J White
- Centre for Youth Substance Abuse Research, Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Faculty of Health, Queensland University of Technology
| | - Louise Mewton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Nicola Clare Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Tim Slade
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Cath Chapman
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Gavin Andrews
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Steve Allsop
- National Drug Research Institute, Curtin University
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42
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Ward BM, Kippen R, Munro G, Buykx P, McBride N, Wiggers J, Clark M. Liquor licences issued to Australian schools. BMC Public Health 2017; 18:72. [PMID: 28764668 PMCID: PMC5539886 DOI: 10.1186/s12889-017-4613-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background Children’s positive socialisation to alcohol is associated with early initiation of drinking and alcohol-related harm in adult life. Internationally, there have been reports of adults’ alcohol consumption at school events in the presence of children. The aim of this research was to identify the conditions under which Australian schools are required to apply for a liquor licence and the associated prevalence of liquor licences for these events where children were likely to be present. Methods A document review was conducted to examine temporary liquor licensing legislation. Quantitative analysis was used to examine relevant licensing data. Coding criteria was developed to determine school type, student year levels and the likely presence of children. Results Four jurisdictions provided data on 1817 relevant licences. The average annual licences/100 schools was highest amongst Independent schools followed by Catholic and public (government) schools. The rates were highest in Queensland and Victoria where children were present at 61% and 32% of events respectively. Conclusions While there are legislative differences across jurisdictions, the prevalence of adults’ alcohol use at school events in the presence of children may reflect the various education department policies and principals’ and school communities’ beliefs and attitudes. Licences are not required for all events where liquor is consumed so the prevalence of adults’ use of alcohol at school events is likely to be higher than our analyses imply. Such practices may undermine teaching about alcohol use in the school curriculum and health promotion efforts to develop alcohol-free events when children are present.
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Affiliation(s)
- Bernadette M Ward
- School of Rural Health, Monash University, PO Box 666, Bendigo, VIC, 3552, Australia.
| | - Rebecca Kippen
- School of Rural Health, Monash University, PO Box 666, Bendigo, VIC, 3552, Australia
| | | | - Penny Buykx
- School of Rural Health, Monash University, PO Box 666, Bendigo, VIC, 3552, Australia.,School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Madeline Clark
- School of Rural Health, Monash University, PO Box 666, Bendigo, VIC, 3552, Australia
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43
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Mattick RP, Wadolowski M, Aiken A, Clare PJ, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Degenhardt L, Kypri K. Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study. Psychol Med 2017; 47:267-278. [PMID: 27702422 DOI: 10.1017/s0033291716002373] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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 Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables. METHOD A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates. RESULTS After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33-2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77-0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86-3.45) and bingeing (OR 3.51, 95% CI 2.53-4.87). CONCLUSIONS Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase children's drinking.
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Affiliation(s)
- R P Mattick
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - M Wadolowski
- The Kirby Institute,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - A Aiken
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - P J Clare
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - D Hutchinson
- School of Psychology,Deakin University,Melbourne, VIC 3125,Australia
| | - J Najman
- Queensland Alcohol and Drug Research and Education Centre,University of Queensland,Brisbane, QLD 4072,Australia
| | - T Slade
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - R Bruno
- School of Psychology,University of Tasmania,Hobart, TAS 7000,Australia
| | - N McBride
- National Drug Research Institute,Curtin University,GPO Box U1987,Perth, WA 6845,Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - K Kypri
- Centre for Clinical Epidemiology and Biostatistics,School of Medicine and Public Health,University of Newcastle,Newcastle, NSW 2308,Australia
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44
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McBride N, Johnson S. Fathers' Role in Alcohol-Exposed Pregnancies: Systematic Review of Human Studies. Am J Prev Med 2016; 51:240-248. [PMID: 27017419 DOI: 10.1016/j.amepre.2016.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/21/2016] [Accepted: 02/08/2016] [Indexed: 02/01/2023]
Abstract
CONTEXT The role of paternal alcohol consumption on fetal and infant health outcomes, and on social facilitation of maternal alcohol consumption during pregnancy, has not been well established. This review identifies the range of impacts of paternal preconception alcohol consumption and alcohol consumption during partner's pregnancy, on maternal consumption, and fetal and infant health outcomes. EVIDENCE ACQUISITION The review accessed articles from the following databases: Scopus, Science Direct, Wiley Online, MEDLINE, ProQuest Central, PsycINFO, and Web of Science. The review included medium- and large-scale studies that provided separate paternal alcohol results, had a non-respondent rate ≤20%, an attrition rate ≤10% per year of data collection up to 30%, and were published between 1990 and 2014. The review included both randomly and non-randomly selected studies, and both case-control and non-case-control studies with notation on risk of bias. EVIDENCE SYNTHESIS Independent extraction and assessment of articles by two authors was conducted using predefined data fields, including study quality indicators, during 2015. Studies included in the review (11 studies, N=41,062) provide evidence that paternal alcohol consumption during preconception or during pregnancy has an impact on maternal health and alcohol consumption during pregnancy, fetal outcomes, and infant health outcomes. CONCLUSIONS Attention to paternal preconception health care related to alcohol consumption is an important future focus in policies dealing with reproductive, prenatal, fetal, and infant health.
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Affiliation(s)
- Nyanda McBride
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Sophia Johnson
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
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45
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Taussig D, Williams MA, Wiggins C, Feakins RM, McBride N, Newland AC, Kelsey SM. Clinical Regression and Remission of Primary Refractory Angiocentric Lymphoma Following Autologous Tumour Peptide Antigen-charged Dendritic Cells After High-dose Chemotherapy and Autologous Stem Cell Rescue. ACTA ACUST UNITED AC 2016; 3:277-89. [PMID: 27413880 DOI: 10.1080/10245332.1998.11746400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report on the case of a 34-year old man with a previously refractory high-grade non-Hodgkin's Lymphoma which regressed following dendritic cell based immunotherapy after high-dose chemotherapy. Antigen presenting cells known as dendritic cells were cultured from harvested autologous peripheral blood progenitor cells. The dendritic cells were then exposed to unfractionated tumour peptides derived from a skin biopsy section inflitrated with lymphoma. These charged dendritic cells infused into the patient together with autologous T-lymphocytes after high-dose chemotherapy with peripheral blood stem cell rescue. Although the lymphoma relapsed after the high-dose chemotherapy it regressed again following the dendritic cell infusion. The patient's T-lymphocytes demonstrated in vitro reactivity to tumour peptides whereas the lymphocytes of controls did not. We propose that the lymphoma regression occurred because of a T cell mediated response against the tumour induced by the charged dendritic cells.
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Affiliation(s)
- D Taussig
- a Department of Haematology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
| | - M A Williams
- a Department of Haematology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
| | - C Wiggins
- a Department of Haematology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
| | - R M Feakins
- b Histopathology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
| | - N McBride
- a Department of Haematology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
| | - A C Newland
- a Department of Haematology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
| | - S M Kelsey
- a Department of Haematology , St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London , Whitechapel, London E1 2AD
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46
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Wadolowski M, Hutchinson D, Bruno R, Aiken A, Najman JM, Kypri K, Slade T, McBride N, Mattick RP. Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study of Risk Factors. Pediatrics 2016; 137:e20152611. [PMID: 26921283 DOI: 10.1542/peds.2015-2611] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Parents are a major supplier of alcohol to adolescents, often initiating use with sips. Despite harms of adolescent alcohol use, research has not addressed the antecedents of such parental supply. This study investigated the prospective associations between familial, parental, peer, and adolescent characteristics on parental supply of sips. METHODS Participants were 1729 parent-child dyads recruited from Grade 7 classes, as part of the Australian Parental Supply of Alcohol Longitudinal Study. Data are from baseline surveys (Time 1) and 1-year follow-up (Time 2). Unadjusted and adjusted logistic regressions tested prospective associations between Time 1 familial, parental, peer, and adolescent characteristics and Time 2 parental supply. RESULTS In the fully adjusted model, parental supply was associated with increased parent-report of peer substance use (odds ratio [OR] = 1.20, 95% confidence ratio [CI], 1.08-1.34), increased home alcohol access (OR = 1.07, 95% CI, 1.03-1.11), and lenient alcohol-specific rules (OR=0.88, 95% CI, 0.78-0.99). CONCLUSIONS Parents who perceived that their child engaged with substance-using peers were more likely to subsequently supply sips of alcohol. Parents may believe supply of a small quantity of alcohol will protect their child from unsupervised alcohol use with peers. It is also possible that parental perception of peer substance use may result in parents believing that this is a normative behavior for their child's age group, and in turn that supply is also normative. Further research is required to understand the impacts of such supply, even in small quantities, on adolescent alcohol use trajectories.
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Affiliation(s)
- Monika Wadolowski
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia;
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia; School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia; School of Psychology, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales 2308, Australia; and
| | - Tim Slade
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia 6845, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
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47
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Ward BM, Kippen R, Buykx P, Munro G, McBride N, Wiggers J. Principals' reports of adults' alcohol use in Australian secondary schools. BMC Public Health 2016; 16:195. [PMID: 26924314 PMCID: PMC4770692 DOI: 10.1186/s12889-016-2877-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools provide opportunities for parents and the wider community to connect and support the physical and emotional wellbeing of their children. Schools therefore have the potential to play a role in the socialisation of alcohol use through school policies and practices regarding consumption of alcohol by adults at school events in the presence of children. METHODS This survey was undertaken to a) compare the extent to which alcohol is used at secondary school events, when children are present, in the states of New South Wales (NSW) and Victoria (VIC), Australia; b) describe principals' level of agreement with these practices; c) their awareness of state policies on this issue; and d) the predictors of such events. A random sample of secondary schools, stratified to represent metropolitan and non-metropolitan schools were invited to participate. Bivariate and multivariate analysis were conducted with p values < 0.05 considered significant. RESULTS A total of 241 (43%) schools consented to participate in the study. Fifteen percent of participating NSW schools and 57% of VIC schools held at least one event in which alcohol was consumed by adults in the presence of children in the year before the survey. Of the 100 reported events, 78% were Year 12 graduation dinners, and 18% were debutante balls. Compared to NSW principals, VIC principals were significantly more likely to agree with the use of alcohol at these events; significantly less likely to be aware of their state education department policy on this issue; have a policy at their own school or support policy that prohibits alcohol use at such events; and less likely to report having enough information to make decisions about this. CONCLUSIONS There is a growing focus on adults' use of alcohol at school events when children are present. Schools can play an important role in educating and socialising children about alcohol via both the curriculum and policies regarding adults' alcohol use at school events. Findings from this study suggest education department and school-based policies that prohibit or restrict the use of alcohol, are significant predictors of adults' alcohol use at school events when children are present.
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Affiliation(s)
- Bernadette M Ward
- School of Rural Health, Monash University, PO Box 666, Bendigo, Victoria, 3552, Australia.
| | - Rebecca Kippen
- School of Rural Health, Monash University, PO Box 666, Bendigo, Victoria, 3552, Australia. .,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Penny Buykx
- School of Rural Health, Monash University, PO Box 666, Bendigo, Victoria, 3552, Australia. .,School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | | | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia.
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
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48
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Mewton L, Kessler RC, Slade T, Hobbs MJ, Brownhill L, Birrell L, Tonks Z, Teesson M, Newton N, Chapman C, Allsop S, Hides L, McBride N, Andrews G. The psychometric properties of the Kessler Psychological Distress Scale (K6) in a general population sample of adolescents. Psychol Assess 2015; 28:1232-1242. [PMID: 26619095 DOI: 10.1037/pas0000239] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The 6-item Kessler Psychological Distress Scale (K6; Kessler et al., 2002) is a screener for psychological distress that has robust psychometric properties among adults. Given that a significant proportion of adolescents experience mental illness, there is a need for measures that accurately and reliably screen for mental disorders in this age group. This study examined the psychometric properties of the K6 in a large general population sample of adolescents (N = 4,434; mean age = 13.5 years; 44.6% male). Factor analyses were conducted to examine the dimensionality of the K6 in adolescents and to investigate sex-based measurement invariance. This study also evaluated the K6 as a predictor of scores on the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997). The K6 demonstrated high levels of internal consistency, with the 6 items loading primarily on 1 factor. Consistent with previous research, females reported higher mean levels of psychological distress when compared with males. The identification of sex-based measurement noninvariance in the item thresholds indicated that these mean differences most likely represented reporting bias in the K6 items rather than true differences in the underlying psychological distress construct. The K6 was a fair to good predictor of abnormal scores on the SDQ, but predictive utility was relatively low among males. Future research needs to focus on refining and augmenting the K6 scale to maximize its utility in adolescents. (PsycINFO Database Record
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Affiliation(s)
- Louise Mewton
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, University of New South Wales
| | | | - Tim Slade
- National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Megan J Hobbs
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, University of New South Wales
| | - Louise Brownhill
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, University of New South Wales
| | - Louise Birrell
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Zoe Tonks
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Maree Teesson
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Nicola Newton
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Cath Chapman
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales
| | - Steve Allsop
- National Drug Research Institute, Curtin University
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, Queensland University of Technology
| | | | - Gavin Andrews
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, University of New South Wales
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Wadolowski M, Bruno R, Aiken A, Stone C, Najman J, Kypri K, Slade T, Hutchinson D, McBride N, Mattick RP. Sipping, drinking, and early adolescent alcohol consumption: a cautionary note. Alcohol Clin Exp Res 2015; 39:350-4. [PMID: 25684054 DOI: 10.1111/acer.12613] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 07/01/2014] [Accepted: 10/25/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Epidemiological studies report markedly varying rates of adolescent alcohol involvement. Despite being a common adolescent behavior, a potential cause of this variation is that consumption of sips is either not measured or not distinguished from consumption of whole beverages. METHODS Participants were 1,843 grade 7 adolescents recruited across 49 Australian secondary schools (M age = 12.4, SD = 0.5). Quantity and frequency of lifetime and past 6-month consumption were assessed, distinguishing between sipping and drinking. For comparison with international population surveys, quantity was reported as any consumption, sipping only, and drinking only. RESULTS Combining sipping and drinking into a single category, lifetime consumption was reported by 67.3% of the present sample. Distinguishing lifetime consumption by sipping and drinking: only 7.8% of adolescents had consumed a whole beverage; the remaining 59.6% had only sipped. Consumption of whole beverages was mostly limited to 1 to 2 drinks (84.2% of drinkers). Sipping and drinking were also infrequent: 78.2% of sipping and 60.4% of drinking, occurred less than monthly. Heavy episodic consumption was uncommon (1.2% of the sample). When other population studies were inspected, a clear trend for higher drinking rates were found in those studies where sipping was counted as drinking and vice versa. CONCLUSIONS Consumption of whole beverages appears infrequent in early adolescence, as sipping, but not drinking, was common in our sample. Comparing the present data with international population consumption measures highlights the need to more precisely measure and report adolescent consumption, particularly in relation to sipping.
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Affiliation(s)
- Monika Wadolowski
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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50
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Wadolowski M, Hutchinson D, Bruno R, Aiken A, Clare P, Slade T, Najman J, Kypri K, McBride N, Mattick RP. Early Adolescent Alcohol Use: Are Sipping and Drinking Distinct? Alcohol Clin Exp Res 2015; 39:1805-13. [PMID: 26248081 DOI: 10.1111/acer.12826] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 05/22/2015] [Accepted: 06/22/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sipping alcohol is common during early adolescence, but research has ignored the distinction between sipping and drinking whole alcohol beverages, conflating the 2, or else simply classifying "sippers" as abstainers. Research has not addressed whether sippers are different to drinkers, in relation to variables known to be associated with adolescent alcohol consumption, or considered whether sipping and drinking behaviors may have quite different associations. METHODS Parent-child dyads (N = 1,823) were recruited in 3 states from Australian grade 7 classes. Multinomial logistic analyses compared adolescents who had only had a sip/taste of alcohol (sippers) with adolescents who had consumed at least a whole drink (drinkers) in the past 6 months. The multivariate model assessed a broad range of demographics, parenting practices, peer influences, and adolescent externalizing and internalizing behaviors, and controlled for school clustering. RESULTS Compared to drinkers, sippers were less likely to come from 1-parent households (odds ratio [OR] = 0.59, 95% confidence interval [CI]: 0.35 to 0.98); less likely to come from low-socioeconomic status (SES) households (OR = 0.54, 95% CI: 0.31 to 0.94); more likely to come from families where parents provide stricter alcohol-specific rules (OR = 1.21, 95% CI: 1.11 to 1.32), stricter monitoring of the child's activities (OR = 1.10, 95% CI: 1.04 to 1.16), more consistent parenting practices (OR = 1.13, 95% CI: 1.05 to 1.23), and more positive family relationships (OR = 1.56, 95% CI: 1.02 to 2.43); and report having fewer substance-using peers (OR = 0.80, 95% CI: 0.70 to 0.91) and greater peer disapproval of any substance use (OR = 1.30, 95% CI: 1.19 to 1.42). After adjustment for confounders, the associations with household composition and SES were no longer significant, but the familial and peer associations remained significant in the multivariate analysis, χ(2) (40) = 1,493.06, p < 0.001. CONCLUSIONS Sipping alcohol has different associations with known predictors of adolescent alcohol use than drinking whole beverages, and sipping may be a distinct or separable behavior. Future research should better define quantities of early consumption and assess the relationship between early sipping and drinking on long-term outcomes separately.
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Affiliation(s)
- Monika Wadolowski
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,School of Medicine (Psychology), University of Tasmania, Hobart, Tas., Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Philip Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Jake Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, Qld, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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