Journal of Primary Prevention最新文献

We tested a proposed conceptual framework in which we hypothesized that witnessing parental intimate partner violence (witnessing parental IPV) is linked to children's bullying and peer victimization. We also hypothesized that the relationship between witnessing parental IPV and bullying and peer victimization in childhood would be mediated by increased psychological problem behavior, school absences, and problematic peer interactions. We utilized data from the National Survey of Children's Health. We found that witnessing parental IPV was positively related to children's bullying and peer victimization not only directly, but also indirectly through the mediating role of psychological problem behavior, school absences, and problematic peer interactions. Our findings highlight the importance of exploring the mechanisms by which bullying and peer victimization increase in those who have witnessed parental IPV.

Cancer screening is an important approach to reducing disease burden. The rate of colorectal cancer (CRC) screening among immigrants in the U.S. is very low. Our study's aim was to examine correlates of experience with, and intention to, receive CRC screening among East African men who were up-to-date (UTD) with CRC screening (n = 64, mean age 65) and those who had never been screened or were overdue for one (NOD; n = 47, mean age 60), compared on demographic characteristics, attitudes toward cancer, psychosocial stress, and health behaviors. UTD men had significantly less emotional concerns about cancer screening and experienced significantly greater distress and lower resiliency than NOD men. However, these results were attenuated after controlling for demographic confounders. Perceived risk, trust in the medical system, and PTSD symptoms were significantly associated with an intention to undertake CRC screening in the next 12 months. These results should be used to guide efforts toward increasing CRC screening rates among immigrant communities.

Transgender and gender diverse (TGD) women (i.e., individuals who were assigned male at birth and identify as women or trans women) experience trauma at disproportionate rates compared to cisgender populations. While trauma is associated with increased alcohol use among TGD women, research regarding factors that are protective of this association is scant. The stress-buffering hypothesis of social support suggests that perceived social support, defined as the judgment that social network members will be helpful when individuals experience stress, may buffer and reduce the association between trauma symptoms and alcohol use. However, this relationship has not been examined among TGD women. We examined whether perceived social support moderates the association between trauma and alcohol use among 89 TGD women. Exploratory multiple regression analyses provided support for this hypothesis, insofar as trauma symptoms were related to alcohol use by individuals with low, relative to high levels of perceived social support. Exploratory analyses demonstrated that this finding was driven by perceived social support from friends and family. Our results are the first to suggest that social support reduces alcohol use among TGD women and add to the literature on their trauma and alcohol use.

School connectedness is consistently associated with adolescent mental health and well-being. We investigated whether student perceptions of school connectedness were associated with anxiety and depressive symptoms, even during remote learning due to COVID-19. In June of 2020, after 13 weeks of remote learning, 320 middle and high school students in one Massachusetts school district completed an online survey that included questions about their perceptions of school connectedness, social connectedness, and symptoms of anxiety and depression. Students were approximately evenly distributed across grades, with 37% in middle school (grades 6-8) and 63% in high school (grades 9-12). School connectedness had a significant negative association with symptoms of anxiety and depression. This association persisted in models controlling for demographic factors and social connectedness. Findings indicate that school connectedness is associated with student mental health, even in the context of remote learning due to COVID-19. Schools engaged in remote learning should consider how to foster school connectedness as a means of supporting youth mental health, particularly given expected increases in the mental health needs of adolescents.

Although vaccination is one of the most cost-effective ways of preventing disease, vaccine hesitancy has been included among the ten threats of global health. Addressing low adult vaccination rates requires an adequate understanding of people's views. We explored perceived barriers to immunization among under-vaccinated adults to identify potential differences among vaccine supporters, refuters, and those who are undecided. We conducted a multi-center, mixed-methods study at 23 primary care practices in Greece. Each day, we asked three new randomly-selected adult healthcare users who attended the practice over the course of 30 consecutive working days. We used thematic content analysis to analyze their written answers to open-ended questions that addressed reasons for not getting vaccinated. Out of 1571 participants, two-thirds reported they were under-vaccinated as adults, thus accounting for three out of five of the supporters and the vast majority of the undecided and refuters. "Concerns/fears," a "perception of low susceptibility to disease due to good health status," the "absence of healthcare professional's recommendation," and "previous negative experiences" were four themes common to all three groups. Additional barriers reported by supporters and the undecided included "knowledge gaps about the necessity of adult vaccination," "negligence," and lack of "accessibility." Among refuters, additional themes identified were "mistrust in pharmaceutical companies" and "disbelief in vaccine effectiveness." In conclusion, under-vaccination is common, not only among refuters or the undecided, but also among supporters of adult vaccination. We found similarities and differences in under-vaccinated adults' perceived barriers, depending on their individual perspectives. Physicians and public health services should take into consideration the impact of the wide range of attitudes and beliefs in their effort to address the underlying barriers to vaccination compliance as they attempt to increase vaccination coverage in adults.

Youth Mental Health First Aid (YMHFA) is a gatekeeper training designed to assist professionals in their identification and response to youth mental illness. Despite widespread implementation, few studies have examined how individual-level trainee characteristics may impact the effectiveness of this training. In this study, we examined how pre-existing knowledge and attitudes about youth mental illness (measured prior to participation in the program) influenced training outcomes. We used a sample of 987 child-serving professionals who completed the YMHFA training program to identify demographic and work-related factors that predicted pre-existing attitudes and knowledge. The sample was then divided into two groups based on pre-existing attitudes and knowledge. We examined training effectiveness across four constructs: knowledge, confidence, intentions to intervene, and stigma. Findings indicate that gender and work-related characteristics were associated with pre-existing knowledge and attitudes about youth mental illness. The magnitude of training effectiveness varied across pre-existing attitudes and knowledge. Those participants with above average attitudes and knowledge benefited little from the program, suggesting that universal implementation of YMHFA may not be an efficient use of resources. Suggestions for a tiered implementation plan that prioritizes professionals most in need of the training are discussed.

Social and Emotional Learning (SEL) programs seek to enhance social and emotional competencies in children, including self-awareness, self-management, social awareness, relationship skills, and responsible decision-making. By means of direct instruction regarding social and emotional competencies, SEL programs have the potential to strengthen resilience in children and thus their capacity to effectively cope with life's challenges. Strengthening resilience in children who are repeatedly exposed to adverse experiences, particularly those from economically disadvantaged minority backgrounds, is of particular importance and has implications for the prevention of a multitude of problems later in life. Our study reports the result of an investigation of the SPARK Child Mentoring program, a resilience-focused SEL program designed to reduce risk factors, uncover innate resilience, promote natural emotional well-being, and facilitate school success. We employed a randomized controlled trial comprising 94 elementary school students that included pre- and post-intervention measurements. After controlling for pre-intervention levels, we found a significant difference between students' understanding of underlying program principles; communication, decision making, and problem-solving skills; emotional regulation; and resilience for students who received the intervention compared to students who did not receive the intervention. These results provide initial evidence for the efficacy of the SPARK Child Mentoring program with a diverse sample of elementary school students and adds to the existing literature base concerning positive outcomes associated with SEL programs. We discuss implications for future research focused on long-term preventive effects of the program and the characteristics of students most likely to benefit from it.

Reducing youth alcohol use is a public health priority that can be addressed by implementing evidence-based preventive interventions (EBPIs) with high fidelity. However, when EBPIs are delivered in a new geographical setting, lack of contextual fit might interfere with expected effects. The purpose of our study was to understand the contextual fit of the family preventive program, Guiding Good Choices (GGC), to inform its future adaptation in Zacatecas, Mexico. Four focus groups were conducted with parents of children aged 9-14 years (N = 43) from four private companies. After transcribing audiotaped sessions, we used a general inductive approach to obtain codes and derive themes. Parents expressed a high level of interest in program content, highlighting its potential to decrease underage drinking in Mexico. Surface-structure modifications of program audiovisual materials (e.g., new videos with Mexican actors and locations) and delivery methods were recommended by parents to maximize participant acceptability and engagement. Participant definitions of family and perception of family dynamics both support the cultural relevance of the program modules and activities related to this content. Underage drinking was acknowledged by parents as a major problem in Zacatecas. Our findings suggest a need for incorporating an extra session that focuses on addressing low alcohol literacy levels and parents' positive alcohol expectancies. Machismo was not considered a cultural factor that could affect attendance and program activities. In fact, we observed an opportunity to use local masculinity to ensure practice of parental skills at home. Due to the needs expressed by participants and the apparent compatibility and fit of the curriculum contents with the new context, we conclude that GGC could be an adequate EBPI for preventing underage drinking in Mexico.

Past research on the social determinants of colorectal cancer (CRC) has shown that lower socioeconomic status (SES) is associated with a higher risk of CRC. Similar to SES at the individual level, the neighbourhood social environment may partly affect the development of CRC. Although one important aspect of the neighbourhood social environment is social capital, no large-scale follow-up study has examined its potential effect on CRC. We examined whether neighbourhood "linking social capital," which is established through social relationships and may enable individuals to gain health-promotional resources, is associated with the incidence of and mortality related to CRC, after adjusting for individual- and familial-level factors. This longitudinal study, conducted in Sweden, comprised over 2 million men and over 2 million women aged 25 years or older. The follow-up period started on January 1, 2002 and continued until first incidence of CRC, death due to CRC, death from any other cause, emigration, or the end of the study period on December 31, 2015. We identified over 20,000 CRC cases during the follow-up period. We used multilevel logistic regression models to calculate odds ratios (ORs) with 95% confidence intervals. After adjustment for potential confounding factors, higher ORs of CRC were observed in individuals who lived in neighbourhoods with low, relative to high social capital. Our results suggest that neighbourhood linking social capital has independent effects on CRC. Future studies could explore how simple interventions that can build linking social capital can enhance people's health.

Achieving sustained engagement in family-based preventive intervention programs is a serious challenge faced by program implementers. Despite the evidence supporting the effectiveness and potential population-level impacts for these programs, their actual impact is limited by challenges around retention of participants. In order to inform efforts to better retain families, it is critical to understand the different patterns of attendance that emerge across the duration of program implementation and the factors that are associated with each attendance pattern. In this study, we identified latent classes of attendance patterns across the seven program sessions of the Strengthening Families Program: For Parents and Youth Ages 10-14 (SFP 10-14). Youth and their parents who attended at least one SFP 10-14 program session together were included in the analysis. Four distinct classes emerged: First-Session Attenders (7%), Early Attenders (9%), Declining-High Attenders (18%), and Consistent-High Attenders (66%). An examination of individual, family, and sociodemographic predictors of class membership revealed that adolescent school bonding predicted families having relatively high attendance, adolescent involvement with deviant peers predicted early dropout, and family low-income status predicted early dropout. Findings point to the need for potential targeted strategies for retaining these groups, such as involving school personnel, employing brief interventions to identify and address barriers at the outset, and leveraging the positive influence of Consistent-High Attenders. Findings also shed light on ways to reach those who may continue to drop out early, such as restructuring program content to address critical material early in the program. This study adds to the growing body of literature that seeks to understand for whom, when, and in which ways program dropout occurs.