Abstract Purpose To evaluate whether anti-bullying policies that are inclusive of sexual orientation are associated with a reduced prevalence of suicide attempts among lesbian, gay, and bisexual ...youths. Methods A total of 31,852 11th-grade public school students (1,413 lesbian, gay, and bisexual individuals; 4.4%) in Oregon completed the Oregon Healthy Teens survey in 2006–2008. The independent variable was the proportion of school districts in the 34 counties participating in the Oregon Healthy Teens survey that adopted anti-bullying policies inclusive of sexual orientation. The outcome measure was any self-reported suicide attempt in the past 12 months. We stratified results by sexual orientation. Results Lesbian and gay youths living in counties with fewer school districts with inclusive anti-bullying policies were 2.25 times (95% confidence interval CI, 1.13–4.49) more likely to have attempted suicide in the past year compared with those living in counties where more districts had these policies. Inclusive anti-bullying policies were significantly associated with a reduced risk for suicide attempts among lesbian and gay youths, even after controlling for sociodemographic characteristics (sex, race/ethnicity) and exposure to peer victimization (odds ratio, .18; 95% CI, .03–.92). In contrast, anti-bullying policies that did not include sexual orientation were not associated with lower suicide attempts among lesbian and gay youths (odds ratio, .38; 95% CI, .02–7.33). Conclusions Inclusive anti-bullying policies may exert protective effects for the mental health of lesbian and gay youths, including reducing their risk for suicide attempts.
School‐based programmes for preventing smoking Thomas, Roger E; McLellan, Julie; Perera, Rafael ...
Cochrane database of systematic reviews,
04/2013, Letnik:
2013, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Background
Helping young people to avoid starting smoking is a widely endorsed public health goal, and schools provide a route to communicate with nearly all young people. School‐based interventions ...have been delivered for close to 40 years.
Objectives
The primary aim of this review was to determine whether school smoking interventions prevent youth from starting smoking. Our secondary objective was to determine which interventions were most effective. This included evaluating the effects of theoretical approaches; additional booster sessions; programme deliverers; gender effects; and multifocal interventions versus those focused solely on smoking.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Tobacco Addiction Group's Specialised Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, Health Star, and Dissertation s for terms relating to school‐based smoking cessation programmes. In addition, we screened the bibliographies of articles and ran individual MEDLINE searches for 133 authors who had undertaken randomised controlled trials in this area. The most recent searches were conducted in October 2012.
Selection criteria
We selected randomised controlled trials (RCTs) where students, classes, schools, or school districts were randomised to intervention arm(s) versus a control group, and followed for at least six months. Participants had to be youth (aged 5 to 18). Interventions could be any curricula used in a school setting to deter tobacco use, and outcome measures could be never smoking, frequency of smoking, number of cigarettes smoked, or smoking indices.
Data collection and analysis
Two reviewers independently assessed studies for inclusion, extracted data and assessed risk of bias. Based on the type of outcome, we placed studies into three groups for analysis: Pure Prevention cohorts (Group 1), Change in Smoking Behaviour over time (Group 2) and Point Prevalence of Smoking (Group 3).
Main results
One hundred and thirty‐four studies involving 428,293 participants met the inclusion criteria. Some studies provided data for more than one group.
Pure Prevention cohorts (Group 1) included 49 studies (N = 142,447). Pooled results at follow‐up at one year or less found no overall effect of intervention curricula versus control (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.85 to 1.05). In a subgroup analysis, the combined social competence and social influences curricula (six RCTs) showed a statistically significant effect in preventing the onset of smoking (OR 0.49, 95% CI 0.28 to 0.87; seven arms); whereas significant effects were not detected in programmes involving information only (OR 0.12, 95% CI 0.00 to 14.87; one study), social influences only (OR 1.00, 95% CI 0.88 to 1.13; 25 studies), or multimodal interventions (OR 0.89, 95% CI 0.73 to 1.08; five studies). In contrast, pooled results at longest follow‐up showed an overall significant effect favouring the intervention (OR 0.88, 95% CI 0.82 to 0.96). Subgroup analyses detected significant effects in programmes with social competence curricula (OR 0.52, 95% CI 0.30 to 0.88), and the combined social competence and social influences curricula (OR 0.50, 95% CI 0.28 to 0.87), but not in those programmes with information only, social influence only, and multimodal programmes.
Change in Smoking Behaviour over time (Group 2) included 15 studies (N = 45,555). At one year or less there was a small but statistically significant effect favouring controls (standardised mean difference (SMD) 0.04, 95% CI 0.02 to 0.06). For follow‐up longer than one year there was a statistically nonsignificant effect (SMD 0.02, 95% CI ‐0.00 to 0.02).
Twenty‐five studies reported data on the Point Prevalence of Smoking (Group 3), though heterogeneity in this group was too high for data to be pooled.
We were unable to analyse data for 49 studies (N = 152,544).
Subgroup analyses (Pure Prevention cohorts only) demonstrated that at longest follow‐up for all curricula combined, there was a significant effect favouring adult presenters (OR 0.88, 95% CI 0.81 to 0.96). There were no differences between tobacco‐only and multifocal interventions. For curricula with booster sessions there was a significant effect only for combined social competence and social influences interventions with follow‐up of one year or less (OR 0.50, 95% CI 0.26 to 0.96) and at longest follow‐up (OR 0.51, 95% CI 0.27 to 0.96). Limited data on gender differences suggested no overall effect, although one study found an effect of multimodal intervention at one year for male students. Sensitivity analyses for Pure Prevention cohorts and Change in Smoking Behaviour over time outcomes suggested that neither selection nor attrition bias affected the results.
Authors' conclusions
Pure Prevention cohorts showed a significant effect at longest follow‐up, with an average 12% reduction in starting smoking compared to the control groups. However, no overall effect was detected at one year or less. The combined social competence and social influences interventions showed a significant effect at one year and at longest follow‐up. Studies that deployed a social influences programme showed no overall effect at any time point; multimodal interventions and those with an information‐only approach were similarly ineffective.
Studies reporting Change in Smoking Behaviour over time did not show an overall effect, but at an intervention level there were positive findings for social competence and combined social competence and social influences interventions.
Intervention acceptability has become an increasingly key consideration in the development, evaluation and implementation of health and social interventions. However, to date this area of ...investigation has been constrained by the absence of a consistent definition of acceptability, comprehensive conceptual frameworks disaggregating its components, and few reliable assessment measures. This paper aims to contribute to this gap, by proposing a conceptual framework and exploratory model for acceptability with a specific priority population for health and developmental interventions: adolescents and youth in Africa. We document our multi-staged approach to model development, comprising both inductive and deductive components, and both systematic and interpretative review methods. This included thematic analyses of respective acceptability definitions and findings, from 55 studies assessing acceptability of 60 interventions conducted with young people aged 10–24 in (mainly Southern and Eastern) Africa over a decade; a consideration of these findings in relation to Sekhon et al.‘s Theoretical Framework of Acceptability (TFA); a cross-disciplinary review of acceptability definitions and models; a review of key health behavioural change models; and expert consultation with interdisciplinary researchers. Our proposed framework incorporates nine component constructs: affective attitude, intervention understanding, perceived positive effects, relevance, perceived social acceptability, burden, ethicality, perceived negative effects and self-efficacy. We discuss the rationale for the inclusion and definition of each component, highlighting key behavioural models that adopt similar constructs. We then extend this framework to develop an exploratory model for acceptability with young people, that links the framework components to each other and to intervention engagement. Acceptability is represented as an emergent property of a complex, adaptive system of interacting components, which can influence user engagement directly and indirectly, and in turn be influenced by user engagement. We discuss opportunities for applying and further refining or developing these models, and their value as a point of reference for the development of acceptability assessment tools.
•Our model development includes systematic and interpretative review methods.•We propose a conceptual framework for adolescent and youth acceptability.•Our conceptual framework comprises nine component constructs of acceptability.•Acceptability is an emergent property of a complex system of interacting components.•Acceptability can both influence and be influenced by intervention engagement.
Children and young people's mental health services have been under increasing pressure following COVID-19. Understanding, for which channels help is sought from, will highlight services needing ...support. This study aims to explore the professional services that parents of children, and young people get help from when they have a concern for the child's/their mental health. Secondary analysis of data is taken from Mental Health of Children and Young People in England Survey, 2017. 7608 reports of mental health-related contact with professional services from parents of 5-16 year-olds and self-reports from young people aged 17-19 were available. Service contact was reported by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis, age, gender and ethnicity. Less than two-thirds of children and young people with a DSM-V diagnosis (63.5% (95% CI 58.6-68.1) aged 5-10, and 64.0% (95% CI 59.4-68.4) aged 11-16) reported contact with any professional services. The figure was lower for those aged 17-19; 50.1% (95% CI 42.8-58.2), p = 0.005. Children and young people aged 5-16 from Black (11.7%; 95% CI 2.4-41.4), Asian (55.1%; 95% CI 34.7-73.9) and Mixed (46.0%; 95% CI 32.4-60.3) ethnic groups reported less contact with professional services compared to those from the White group (66.9%; 95% CI 63.5-70.2). Patterns of service access during the three main educational stages aid with understanding service need during childhood. These lower levels of reported service access for young people aged 17-19 with a DSM-V diagnosis and those in ethnic minority groups demand further investigation.
What do young people consider “news”? Now that news is dislocated from dedicated outlets of news organizations, it has become increasingly difficult to distinguish from other cultural forms, ...including entertainment, advertising and misinformation. Especially on visual social media, where many different forms, topics and tones circulate, so-called “news feeds” offer blends of content that only partially match traditional journalistic conceptualizations. This paper advances current conceptual debates around news(-ness), by going beyond what is culturally accepted and cognitively recognized as news. We make an argument for the importance of capturing young people’s affective and tacit understandings of news, by analyzing what feels like news to them on Instagram. These judgments matter because what users understand as news or non-news also affects their assessments of trustworthiness and reliability. Drawing upon a three-wave study (2020-2022) employing in-depth interviews with and walk-throughs of the Instagram feeds of N = 111 Dutch smartphone users (aged 16-25), we find that while young people are strongly aware of societal norms around what news is or should be, these cognitive understandings do not necessarily align with what they experience as news(-like) within their everyday practices. Although some users do employ traditional journalistic conceptualizations of news, others negotiate or challenge such definitions through processes of compartmentalization, homogenization or reconceptualization, to mitigate tensions between what they cognitively recognize versus what they affectively perceive as news. Consequently, we argue that more inclusive epistemological approaches are needed to comprehend young people’s shifting experiences of news and conceptualize news from an audience perspective.
Uncertainty triggers negative psychological responses, while positive institutional evaluations elevate the sense of control in individuals and satisfy their need for structure and order. Data from ...the 2015 Chinese Social Survey (CSS) (
N
= 4,605) demonstrated that objective uncertainty negatively predicted the happiness of young people (aged 18–45 years). However, this negative relationship was attenuated among those who evaluated the institutional system (e.g., social security, local government effectiveness, and trust in government) positively; in other words, positive institutional evaluation may have protected people's happiness from the threat of uncertainty. In addition, participants from different age groups evaluated the institutional system differently. The first generation born after the Chinese economic reform, which includes young people born in the 1980s (aged 26–35 years), had unique experiences compared to the preceding (aged 36–45 years, born in the 1970s) and succeeding (aged 18–25 years, born in the 1990s) generations. Among the three age groups, young people born in the 1980s held the least positive evaluation of the institutional system. The institutional evaluation also showed the weakest moderating effect on this group's happiness.
Summary
Characterising sleep in young people (aged 15–25 years) with borderline personality disorder (BPD) features is crucial given the association between BPD features and sleep disturbance, ...negative consequences of poor sleep, and normative developmental sleep changes that occur in this age group. The present study aimed to characterise the sleep profile of young people with BPD to determine whether this profile is non‐normative and specific to BPD. Participants were 96 young people (40 with BPD features, 38 healthy individuals, and 18 young people seeking help for mental health difficulties without BPD). Sleep was measured subjectively (self‐report questionnaires) and objectively (10 days of actigraphy). Young people with BPD features reported poorer subjective sleep quality, greater insomnia symptoms and later chronotype than same‐age healthy and clinical comparison groups. Young people with BPD features also displayed irregular sleep timing, later rise times, greater time in bed and longer sleep durations than healthy young people. Those with BPD features had superior sleep quality (greater sleep efficiency, less wake after sleep onset) and longer sleep durations than the clinical comparison group. Sleep profiles were similar across young people with BPD features with and without co‐occurring depression. Overall, the findings revealed a subjective–objective sleep discrepancy and suggest that sleep‐improvement interventions might be beneficial to improve subjective sleep in young people with BPD features.
Background and Objectives
Although various surveys have tracked the prevalence of anabolic‐androgenic steroid (AAS) use in American teenagers and young adults, no recent surveys have assessed the ...lifetime prevalence of AAS use in Americans overall. We therefore analyzed serial youth‐survey data to derive estimates of the lifetime prevalence of AAS use in the current American general population.
Methods
We first determined the distribution of age of onset of AAS use, based on pooled data from nine studies. Using this distribution, we then developed equations to project the eventual lifetime prevalence of AAS use among young survey respondents, once they aged and completed the period of risk for initiating AAS. We similarly calculated the denominator of lifetimes of risk for AAS use in the total American population. We next applied these equations to four independent national youth datasets to derive current American general‐population estimates for lifetime AAS use. Finally, using data from 10 pooled studies, we estimated the lifetime prevalence of AAS dependence among AAS users.
Results
Age‐of‐onset studies consistently showed that AAS use begins later than most drugs, with only 22% of users (95% confidence interval: 19–25%) starting before age 20. Applying the age‐of‐onset findings to national youth datasets, we estimated that among Americans currently age 13–50 years, 2.9–4.0 million have used AAS. Within this group, roughly 1 million may have experienced AAS dependence.
Conclusions and Scientific Significance
Although subject to various limitations, our estimation techniques suggest a surprisinigly high prevalence of AAS use and dependence among Americans. (Am J Addict 2014;23:371–377)
The burden of tuberculosis (TB) in migrant children and young people (CYP) is commonly overlooked, despite the increasing incidence of TB in migrant populations in the European region. This study ...aimed to examine the distribution and disease characteristics of TB among migrant and native-born CYP through analysis of data from the European Centre for Disease Prevention and Control (ECDC) surveillance system (TESSy).
Retrospective database analysis.
A retrospective database analysis was conducted on all CYP TB cases (0–17 years) reported to TESSy (1995–2017), exploring distribution, site of TB, and presence of MDR-TB using multivariate analysis in R statistical software.
Of the 73,176 CYP TB cases reported in the EU/EFTA (1995–2017), 24.4% (n = 17,879) occurred in migrant CYP and 75.6% (n = 55,297) occurred in native-born CYP. Migrant CYP were more likely (P < 0.001) to have pulmonary TB (OR: 1.90; 95% CI: 1.74–2.09) and unsuccessful treatment outcomes (OR: 2.05; 95% CI: 1.74–2.40) compared to native-born CYP. The proportion of extrapulmonary TB, compared to pulmonary TB across total CYP cases was higher than the existing evidence base.
Overall, there were significant differences in the site of TB and treatment outcomes between migrant and native-born CYP. To improve outcomes, TB screening and detection practices should focus on facilitating care in migrant CYP. However, to better understand the implications of these findings on broader TB control, TB among CYP should be addressed more frequently in reports and research.
The paper explores the importance of the type of settlement for marital and reproductive behaviour of young people. More specifically, it examines the differences in the evaluation and practice of ...certain forms of marital and reproductive behaviour between young people living in different types of settlements. The data were collected with the aid of quantitative techniques like surveys and scaling. The research was conducted in the region of Southern and Eastern Serbia. The quota sample consisted of the total of 500 respondents, aged from 15 to 35 years. The results of the research show that the type of settlement is an important determinant, but more for the purpose of evaluation than for practising certain models of marital and reproductive behaviour of young people. Young people living in villages are more loyal to the traditional values in terms of marriage and parenthood, while young people living in the city tend to embrace modern values. However, practice shows that rural youth, besides maintaining traditional patterns of behaviour, also manifests certain deviations from them (like postponement of marriage and parenthood, reduced reproductive norms, cohabitation and out-of-wedlock parenting).
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