Prevention Science最新文献

Parental emotion socialization is crucial to children's development, yet emotion-focused parenting programs are scarce in non-Western contexts. In this study, we developed a four-week emotion-focused parenting program based on the principles of emotion coaching for Chinese families with preschool-aged children. This program integrated parent group sessions with home-based parent-child shared reading. A total of 73 parents of preschoolers were recruited and randomly assigned to experimental and waitlist control groups. Three waves of data on parents' emotion-related parenting beliefs and practices and parenting stress were collected at pre-intervention, post-intervention, and three-month follow-up. Significant reductions in parents' punitive reactions, minimization reactions, and parent-child dysfunctional interactions were found in both the experimental and the waitlist control groups immediately after completion of the program. When combining data from both groups, a significant improvement in parents' expressive encouragement was observed at post-intervention and follow-up. Additionally, delayed effects of the program were found on parents' emotion-dismissing beliefs, problem-focused reactions, and overall parenting stress. This study was one of the first in China to develop an emotion-focused parenting program and rigorously examine its feasibility and effects, offering insights into the development of similar parenting programs in China.

Little is known about how race and ethnicity influence the association between college enrollment and past-year suicide attempts. In this brief report, the relationship between college enrollment and past-year suicide attempts varied across racial groups in a nationally representative sample of 12,474 full-time college enrolled and unenrolled young adults. Only White students displayed a protective association between enrollment and past-year suicide attempts (aOR, 0.32; 95% CI, 0.17, 0.62). Race and ethnicity significantly moderated the relationship between enrollment and past-year suicide attempts for Black/African American (P = 0.003) and multiracial (P = 0.03) compared to White young adults.

Marijuana use in adolescence is associated with significant adverse outcomes. Romantic relationships are an important context for marijuana use. Prior research suggests a bi-directional relationship between marijuana use and relationship functioning; however, the complex interplay between adolescent relationship dynamics and marijuana use remains unclear. We engaged youth to participate in group model building, a system science approach, to understand from their perspective how social complexities influence the uptake, continuation, and escalation of marijuana use. Two independent groups of clinic and community-recruited youth aged 15-20 participated in a series of four 2-h workshops. Through structured activities, participants generated a causal loop diagram (CLD) representing critical features of the complex and dynamic social system impacting marijuana use for youth in their community. The CLD that emerged represents the mental models of youth and features fourteen feedback loops, including balancing and reinforcing loops, across three domains. These interrelated domains span within-relationship behaviors, factors proximal to marijuana use, and influences on the partner pool, which impact the quality of adolescent romantic relationships and contribute to a high prevalence of marijuana use among youth. Applying a system perspective offers new insights on how stress, and behaviors within relationships in response to stress, feed back to magnify relationship dysfunction and fuel marijuana use. This model provides a new foundation for future research and data collection to better understand and test the identified relationships and feedback loops. Our findings further underscore the importance of educational programs that teach youth about healthy relationship dynamics and stress-coping approaches that do not involve substance use. Understanding how factors function as a system provides important information toward illuminating relationship dynamics and designing more impactful and synergistic interventions.

The COVID-19 pandemic disrupted the ability to receive health care services. Field-based health services became a logistically feasible alternative to medical center-based care. We compared two different field-based approaches to the delivery of SARS-CoV-2 testing and health education services for Latine communities using a quasi-experimental design that included propensity score matching to accommodate the challenges posed to research by the pandemic. From September 2021 through October 2022, we held 434 testing events, of which 234 used a geolocation approach and 200 used a partner-located approach to determine the location of the health services (n = 68 field sites in Oregon). We hypothesized that partner-located sites would obtain higher numbers of tests collected relative to geolocated sites, and that longer drive times to testing sites would be associated with lower testing rates. There were no differences in the number of tests collected by geolocated versus partner-located sites, controlling for population size and time-varying pandemic vulnerabilities measured as COVID-19 cases and deaths. Prior to propensity score weighting, a longer drive time to the testing site (both site types) was associated with a lower likelihood of total tests (IRR = .87, p < .01, CI [0.54, 0.92]), of Latine tests (IRR = .69, p < .001, CI [0.56, 0.84]), and of male tests collected (IRR = .67, p < .05, CI [0.47, 0.94]). The site's number of prior tests was associated with a significant 2% increase in tests collected and the prior week's number of county deaths was associated with a roughly 30% decrease in the likelihood of tests collected. However, the reduced testing rate when the death rate was higher was less likely in geolocated sites (IRR = 1.55, p < .001, CI [1.20, 2.01]). Implications for the utility of propensity score matching and time-varying covariates to accommodate pandemic challenges posed to research are discussed. Clinicaltrials.gov registration number: NCT05082935. Date of registration: 10/15/2021.

Evidence reveals that minoritized groups face disparities, underscoring the need for interventions to address behavioral health inequities. This review examined which minoritized populations are represented in evidence-based preventive interventions (EBPIs) and whether they equitably benefit from these programs. Using the Blueprints for Healthy Youth Development online clearinghouse, we synthesized findings from 240 high-quality experimental evaluations of EBPIs conducted in the U.S. between 2010 and 2023 and performed a descriptive analysis based on consensus coding to assess (1) the prevalence of culturally tailored EBPIs; (2) how frequently tests for subgroup effects were conducted; and (3) whether subgroup tests indicated differential benefits for minoritized groups. We found few culturally tailored interventions (31%), with 4% evaluating EBPIs developed for African American or Black populations and 1% for Hispanic or Latino youth. Additionally, only 25% and 15% tested for subgroup effects by race and ethnicity, respectively. For other subgroups, few (28%) evaluations included effects by economic disadvantage while 47% examined outcomes by binary gender categories. Essentially no reports tested for subgroup effects by sexual identity, location, or nativity status. Encouraging findings were that EBPIs more often benefited racial and ethnic minoritized groups, and there was an upward trend in reporting subgroup tests across time. EBPIs should test for subgroup effects to answer the questions of "what works for whom?" and "in which settings?" and to better understand the generalizability of findings. Investments are needed in culturally grounded programs developed for historically marginalized populations and trials of EBPIs that investigate mitigating health disparities.

In task-shared, mental health, and psychosocial support interventions, monitoring the quality of delivery (fidelity and competence) of nonspecialist providers is critical. Quality of delivery is frequently reported in brief, summary statistics, and while both fidelity and competence scores tend to be high, rarely have factors associated with quality of delivery in low-resource, mental health, and psychosocial support interventions been examined using inferential statistics. Understanding both modifiable and non-modifiable predictors of quality of delivery is important for adapting training and supervision approaches throughout intervention delivery. In this study, we use a parallel process latent growth model to examine the association of non-modifiable, demographic characteristics of nonspecialists and changes in both fidelity and competence over time. We find that nonspecialist age is significantly associated with higher initial fidelity and competence scores and smaller improvements in fidelity and competence over time, although this finding is interpreted in the presence of ceiling effects. In addition, nonspecialists in a certain district were more likely to have higher initial fidelity and competence scores but also see smaller changes over time. Fidelity and competence were found to significantly co-vary. This study provides conceptual and measurement guidance regarding quality of delivery, suggesting that fidelity and competence are theoretically distinct and must be measured separately, but linked together under the umbrella of quality of delivery. This study also has implications for recruiting, training, and supporting nonspecialists delivering behavioral interventions, suggesting that future implementation teams can further contribute to research on how to better support high-quality training, supervision, and personal and professional growth among the growing nonspecialist workforce globally.

Coping Power (CP) is an empirically supported school-based intervention for children at risk for aggression. A child's social status with peers and the extent to which they accurately perceive it are important aspects of preadolescent social development that may influence how intervention format affects disruptive behavior outcomes. Further, reactive (RA) and proactive (PA) functional subtypes of aggression have differential relations with peer acceptance. This study is the first to test whether the effects of group (GCP) and individual (ICP) format of CP on RA and PA differed based on children's actual social status (aim 1) and whether they over- or underestimated their acceptance relative to their actual social status (perceptual accuracy; aim 2). This study involved secondary data analyses using a large-scale randomized controlled trial that assigned 360 children ages 9 to 11 (M = 9.74, SD = .62), predominantly male (n = 234, 65%), and Black (n = 273, 75.8%), with elevated levels of aggression to either ICP or GCP condition. Polynomial regression analyses and three-dimensional response surface plots tested and probed significant (p < .05) interactions between either actual acceptance or perceptual accuracy and intervention format on postintervention reactive and proactive aggression. Actual acceptance moderated the effects of GCP on RA, such that those with higher acceptance showed smaller reductions in RA from either preintervention or postintervention to follow-up. Perceptual accuracy also moderated the effects of ICP on PA, with those underestimating their acceptance showing smaller decreases in PA from postintervention to follow-up. These findings provide valuable insights into how children's actual peer acceptance and perceptual accuracy influence CP outcomes for different functional subtypes of aggression based on intervention format, raising important questions about potential mechanisms.

Suicide prevention programs delivered in school settings have been shown to reduce suicide attempts and ideation among adolescents. School-based digital interventions targeting at-risk youth are a promising avenue for suicide prevention, and some evidence has shown that blending digital and face-to-face components may improve the effectiveness. However, further evidence on its acceptability, feasibility, and effectiveness is needed, especially in Latin America, where mental health support is limited. Reframe-IT is an internet-based Cognitive Behavioral Therapy (CBT) program to reduce youth suicidal ideation in school settings. We created four complementary face-to-face CBT sessions and, through a pilot study, tested the acceptability, feasibility, and effectiveness of a blended intervention (Reframe-IT +) in adolescents (N = 52) from 6 public schools in Chile, randomized into two groups: Reframe-IT + (N = 33) and Control (N = 19). We found that the intervention was acceptable and feasible, with high degrees of satisfaction and adherence. We also observed a significant reduction in suicidal ideation and depressive symptoms in the intervention group compared to the control group at post-intervention. Our results suggest that the Reframe-IT + could be delivered as a suitable, acceptable, and effective intervention to reduce suicide ideation in adolescents in school settings. Further research is needed to confirm these preliminary results.

This paper reviews evidence about the impact of marketing on ill health. We summarize evidence that marketing practices in six industries (tobacco, alcohol, pharmaceutical, processed food, firearm, and fossil fuel) are causal influences on the occurrence of injury, disease, and premature death. For each industry, we provide a brief overview on the extent of harmful marketing, efforts from each industry to obscure or otherwise conceal the impact of their marketing strategies, and efforts to counter the impact of harmful marketing in these industries. However, considering the ubiquitous belief that regulation is harmful to society, little headway has been made in reducing harmful marketing. We propose the substitution of a public health framework for the currently dominant free market ideology. Doing so would situate harmful marketing as a social determinant of health and consolidate the disparate efforts to regulate marketing of harmful products. Implications for future policy and research efforts are discussed.

Developing accurate and equitable screening protocols can lead to more targeted, efficient, and effective, teen dating violence (TDV) prevention programming. Current TDV screening protocols perform poorly and are rarely implemented, but recent research and policy emphasizes the importance of leveraging more trauma-focused screening measures for improved prevention outcomes. In response, the present study examined which adversities (i.e., indices of family violence), trauma-focused risk factors (i.e., threat and reward biases) and strengths (i.e., social support and racial/ethnic identity) best classified concurrent and prospective risk for physical and psychological forms of TDV-perpetration. Participants included 584 adolescents aged 12-18 years (M_Age = 14.43; SD = 1.22), evenly distributed across gender (48.9% female), race (35% African American; 38.5% White) and ethnicity (40% Hispanic). Surveys completed at baseline and 1-year follow-up were analyzed using an evidence-based medicine (EBM) analytic protocol (i.e., logistic regression, area-under-the-curve; (AUC), diagnostic likelihood ratios (DLR), calibration curves) and compared to machine learning models. Results revealed hostility best classified risk for concurrent and prospective physical TDV-perpetration (AUCs > 0.70; DLRs > 2.0). Additionally, domestic violence (DV) exposure best forecasted prospective psychological TDV-perpetration (AUC > 0.70; DLR > 3.0). Both indices were well-calibrated (i.e., non-significant Spiegelhalter's Z statistics) and statistically fair. Machine learning models added minimal incremental validity. Results demonstrate the importance of prioritizing hostility and DV-exposure for accurate, equitable, and feasible screening for physical and psychological forms of TDV-perpetration, respectively. Integrating these findings into existing prevention protocols can lead to a more targeted approach to reducing TDV-perpetration.