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Paternal Incarceration and Adolescent Delinquency: Role of Father Engagement and Early Child Behavior Problems. 父亲入狱与青少年犯罪:父亲参与和儿童早期行为问题的作用。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-02 DOI: 10.1007/s11121-024-01734-2
Abigail J Anderson, Christopher C Henrich, Sylvie Mrug

Paternal incarceration is an important predictor of teen delinquency, but the factors that may explain this relationship-such as early child problem behaviors and level of father engagement-have not been adequately explored. The current longitudinal study examined paternal history of incarceration as a predictor of teen self-reported delinquency over a 15-year gap, considering early child problem behaviors and father engagement as mediators. Sex differences in these relationships were also evaluated. This four-wave longitudinal study included an analytic sample of 4897 teens who participated in the birth-cohort Future of Families and Child Well-Being Study. Mothers and fathers were interviewed shortly after the focal child's birth and were then reassessed in follow-up interviews at child ages 1, 3, 5, 9, and 15. The focal children were interviewed at ages 9 and 15. Results showed that paternal prior incarceration at year 1 was associated with greater child behavior problems and father engagement at year 5; however, those relationships disappeared by age 9. Paternal history of incarceration was not related to teen delinquency, but child behavior problems at age 9 were directly related to subsequent engagement in delinquent behaviors. Paternal current incarceration was related to subsequent father engagement but was not associated with later child behaviors. No significant indirect pathways emerged, indicating a lack of support for mediation. No sex differences in these relationships were observed. Overall, the findings underscore the complexity of the relationships between paternal incarceration, child behavior, and father engagement in the emergence of delinquent behaviors.

父亲入狱是青少年犯罪的一个重要预测因素,但可能解释这种关系的因素--如儿童早期问题行为和父亲参与程度--尚未得到充分探讨。本纵向研究考察了父亲的监禁史对青少年自我报告的 15 年间犯罪的预测作用,并将儿童早期问题行为和父亲参与程度作为中介因素加以考虑。研究还评估了这些关系中的性别差异。这项四波纵向研究的分析样本包括参加出生队列 "家庭未来和儿童福祉研究 "的 4897 名青少年。母亲和父亲在重点儿童出生后不久接受了访谈,然后在儿童 1、3、5、9 和 15 岁时接受了后续访谈。重点儿童在 9 岁和 15 岁时接受了访谈。结果显示,父亲在孩子 1 岁时的监禁史与孩子 5 岁时更多的行为问题和父亲的参与度有关;然而,这些关系在孩子 9 岁时消失了。父亲的监禁史与青少年犯罪无关,但 9 岁时的儿童行为问题与随后的犯罪行为直接相关。父亲目前的监禁史与父亲后来的参与有关,但与孩子后来的行为无关。没有出现明显的间接途径,表明缺乏中介支持。在这些关系中没有观察到性别差异。总体而言,研究结果强调了父亲入狱、儿童行为和父亲参与犯罪行为之间关系的复杂性。
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引用次数: 0
Investigating Longitudinal Trajectories of COVID-19 Disruption: Methodological Challenges and Recommendations. 调查 COVID-19 干扰的纵向轨迹:方法论挑战与建议
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-02 DOI: 10.1007/s11121-024-01726-2
W Andrew Rothenberg, Jennifer E Lansford, Ann T Skinner, Lei Chang, Kirby Deater-Deckard, Laura Di Giunta, Kenneth A Dodge, Sevtap Gurdal, Daranee Junla, Qin Liu, Qian Long, Paul Oburu, Concetta Pastorelli, Emma Sorbring, Laurence Steinberg, Liliana Maria Uribe Tirado, Saengduean Yotanyamaneewong, Liane Peña Alampay, Suha M Al-Hassan, Dario Bacchini, Marc H Bornstein

Relatively few studies have longitudinally investigated how COVID-19 has disrupted the lives and health of youth beyond the first year of the pandemic. This may be because longitudinal researchers face complex challenges in figuring out how to code time, account for changes in COVID-19 spread, and model longitudinal COVID-19-related trajectories across environmental contexts. This manuscript considers each of these three methodological issues by modeling trajectories of COVID-19 disruption in 1080 youth from 12 cultural groups in nine nations between March 2020-July 2022 using multilevel modeling. Our findings suggest that for studies that attempt to examine cross-cultural longitudinal trajectories during COVID-19, starting such trajectories on March 11, 2020, measuring disruption along 6-month time intervals, capturing COVID-19 spread using death rates and the COVID-19 Health and Containment Index scores, and using modeling methods that combine etic and emic approaches are each especially useful. In offering these suggestions, we hope to start methodological dialogues among longitudinal researchers that ultimately result in the proliferation of research on the longitudinal impacts of COVID-19 that the world so badly needs.

相对而言,很少有研究纵向调查 COVID-19 在大流行的第一年之后是如何扰乱青少年的生活和健康的。这可能是因为纵向研究人员面临着复杂的挑战,他们需要弄清楚如何对时间进行编码、如何考虑 COVID-19 传播的变化以及如何建立跨环境的 COVID-19 相关纵向轨迹模型。本手稿采用多层次建模方法,对 2020 年 3 月至 2022 年 7 月期间来自 9 个国家 12 个文化群体的 1080 名青少年的 COVID-19 干扰轨迹进行建模,对上述三个方法学问题进行了探讨。我们的研究结果表明,对于试图研究 COVID-19 期间跨文化纵向轨迹的研究而言,从 2020 年 3 月 11 日开始研究此类轨迹、以 6 个月为时间间隔测量干扰情况、使用死亡率和 COVID-19 健康与遏制指数得分来捕捉 COVID-19 的扩散情况,以及使用将等式方法和动式方法相结合的建模方法都特别有用。通过提出这些建议,我们希望在纵向研究人员之间开展方法论对话,最终促成世界急需的 COVID-19 纵向影响研究的普及。
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引用次数: 0
A Qualitative Inquiry into Nurse-Family Partnership Black Client Perspectives. 对护士-家庭合作关系的定性调查 黑人客户的观点。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI: 10.1007/s11121-024-01709-3
Brooke Dorsey Holliman, Nathalie Dieujuste, Elly Yost, Mandy A Allison

Nurse-Family Partnership (NFP) is a home visiting program designed to improve pregnancy outcomes, child health and development, and life course outcomes for families facing socioeconomic inequalities through support and education provided by nurses to first-time mothers during pregnancy and up to 2 years postpartum. Studies show that home visiting programs like NFP have positive outcomes, but attrition remains a concern which may impact the desired health equity goals. Black mothers are more likely to withdraw from the NFP program, and research is lacking regarding their experiences in home visiting programs despite facing maternal health inequities rooted in racism. The present study aimed to understand factors that influenced program continuation and provide insights for program improvement. Semi-structured qualitative interviews were conducted with 21 Black NFP clients from multiple sites. Key findings include the importance of the nurse-client relationship, access to reliable health information, and racial concordance in the nurse-client pairing. Clients valued supportive, nonjudgmental nurses who provided dependable support and education. Racially concordant partnerships were perceived as more comfortable and understanding, fostering trust and open communication. Clients also suggested that invasion of privacy during home visits and a lack of connection with their nurse could contribute to program discontinuation. Efforts to increase program retention of Black clients should focus on fostering a strong nurse-client alliance. Recommendations include increasing racial diversity in the nurse workforce, implementing a nurse-client matching system, and allowing clients to request a new nurse if needed.

护士-家庭伙伴计划(NFP)是一项家访计划,旨在通过护士为孕期和产后两年内的初为人母者提供支持和教育,改善面临社会经济不平等问题的家庭的妊娠结果、儿童健康和发展以及生命历程结果。研究表明,NFP 等家访计划具有积极的成果,但自然减员仍是一个令人担忧的问题,这可能会影响预期的健康公平目标。黑人母亲更有可能退出 NFP 计划,尽管她们面临着植根于种族主义的孕产妇健康不平等问题,但有关她们在家访计划中的经历的研究仍然缺乏。本研究旨在了解影响项目继续的因素,并为项目改进提供启示。研究人员对来自多个地点的 21 名黑人 NFP 客户进行了半结构化定性访谈。主要发现包括护士-客户关系的重要性、获得可靠健康信息的途径以及护士-客户配对中的种族一致性。客户重视提供可靠支持和教育的支持性、不做评判的护士。种族和谐的合作关系被认为更舒适、更容易理解,能促进信任和坦诚交流。客户还提出,家访期间侵犯隐私以及与护士缺乏联系可能会导致计划中断。为提高黑人客户的项目保留率所做的努力应侧重于促进护士与客户之间强有力的联盟。建议包括增加护士队伍的种族多样性、实施护士-客户匹配系统以及允许客户在需要时要求更换护士。
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引用次数: 0
Advancing Science to Prevent Firearm Violence in Communities: A Process for Harmonizing Studies to Develop Research Infrastructure. 推动科学预防社区枪支暴力:协调研究以发展研究基础设施的程序》。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1007/s11121-024-01723-5
Rebeccah Sokol, Maureen Walton, Daniel Lee, Laura Seewald, Victor Medina Del Toro, Mahum Farooqui, Gregory Sallabank, Marc Zimmerman, Mark Edberg, Yan Wang, Tanya Zakrison, Elizabeth L Tung, William B Hillegass, Laura Vearrier, Lei Zhang, Matthew E Kutcher, Dara Blachman-Demner, Patrick M Carter

The Community Firearm Violence Prevention Network (CFVP Network), funded by the National Institutes of Health (NIH), supports a network of research projects that develop and test interventions through collaborations with community partners to prevent firearm violence, injury, and mortality. The CFVP Network presents a unique opportunity to accelerate the science of preventing firearm injuries. The data harmonization workgroup of the CFVP Network led the process of aligning studies across the three unique inaugural network projects, with particular attention to how the CFVP Network could address current gaps in the science. The goal of the data harmonization workgroup was to align study measures, assessment timelines, and data management and archival processes across projects to enable robust cross-project analyses that accelerate the science of preventing firearm injuries. To accomplish this goal, the workgroup established the infrastructure to facilitate cross-project data collection, data sharing and archiving, and analyses. Among the three inaugural network projects, the workgroup's process resulted in harmonizing two assessment timepoints (baseline and one year post-implementation) and 60 constructs (with 31 identical standardized constructs). These harmonized products provide opportunities for novel analyses across the network projects. We expect that the harmonized study infrastructure developed through this process will catalyze future research focused on preventing firearm injury, including and extending beyond CFVP Network projects. The CFVP data harmonization workgroup's process can serve as a model for future networks that seek to build the science in a particular area.

社区枪支暴力预防网络(CFVP Network)由美国国立卫生研究院(NIH)资助,支持一个研究项目网络,通过与社区合作伙伴合作开发和测试干预措施,以预防枪支暴力、枪支伤害和枪支致死。CFVP 网络为加速科学预防枪支伤害提供了一个独特的机会。CFVP 网络的数据协调工作组领导了对三个独特的首批网络项目的研究进行协调的过程,并特别关注 CFVP 网络如何解决当前的科学空白。数据协调工作组的目标是协调各项目之间的研究措施、评估时间表以及数据管理和存档流程,以便能够进行强有力的跨项目分析,加快预防枪支伤害科学的发展。为实现这一目标,工作组建立了促进跨项目数据收集、数据共享和存档以及分析的基础设施。在三个首批网络项目中,工作组的工作流程统一了两个评估时间点(基线和实施后一年)和 60 个结构(31 个相同的标准化结构)。这些统一的产品为整个网络项目的新型分析提供了机会。我们预计,通过这一过程开发的统一研究基础设施将促进未来以预防枪支伤害为重点的研究,包括并超越 CFVP 网络项目。CFVP 数据协调工作组的工作流程可作为未来网络在某一特定领域建立科学的典范。
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引用次数: 0
Effectiveness of Psychosocial Interventions in Preventing Postpartum Depression Among Teenage Mothers-Systematic Review and Meta-analysis of Randomized Controlled Trials. 社会心理干预对预防未成年母亲产后抑郁症的效果--随机对照试验的系统回顾和元分析》(Psychosocial Interventions in Preventing Postpartum Depression Among Teenage Mothers-Systematic Review and Meta-analysis of Randomized Controlled Trials)。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-10-03 DOI: 10.1007/s11121-024-01728-0
Lebeza Alemu Tenaw, Fei Wan Ngai, Chan Bessie

Postpartum depression is a significant public health issue that occurs within the first 12 weeks after childbirth. It is more prevalent among teenage mothers compared to adults. However, the findings of the existing interventional studies cannot be readily applied to teenage mothers due to their unique psychosocial concerns. Furthermore, these findings have shown inconsistencies regarding the benefit of psychological and psychosocial interventions in reducing the incidence of postpartum depression. The current review is aimed at investigating the effectiveness of psychosocial interventions in preventing postpartum depression, specifically among teenage mothers. The preferred reporting items for systematic reviews and meta-analysis manuals were utilized to identify and select relevant articles for this review. The articles were retrieved using population, intervention, control, and outcome models. The quality of each article was assessed using the Cochrane risk of bias tool. Statistical analysis was conducted using STATA version 17. The effect size of the intervention was estimated using the standard mean difference in depression scores between the intervention and control groups. Heterogeneity among the studies was assessed using the I2 statistic and Q statistic, while publication bias was evaluated through funnel plot asymmetry and Egger's test. A total of nine eligible articles were included. While psychosocial interventions have been demonstrated to decrease the incidence of postpartum depression compared to usual maternal health care, it is worth noting that the mean difference in depression scores was significant in only three of the included studies. The meta-analysis revealed that psychosocial interventions were effective at preventing postpartum depression, with a pooled effect size of - 0.5 (95% CI: - 0.95, - 0.06) during the final postpartum depression assessment. The heterogeneity was substantial, with an I2 value of 82.3%. Although publication bias was not observed, small studies had a significant effect on the pooled effect size. The findings of this review suggest that psychosocial interventions can effectively prevent PPD, particularly within the first 3 months of the postpartum period. This review highlights the scarcity of interventional studies in low-income countries, indicating the need for further research in diverse communities.

产后抑郁症是一个重要的公共卫生问题,发生在分娩后的头 12 周内。与成年人相比,产后抑郁症在未成年母亲中更为普遍。然而,由于未成年母亲独特的社会心理问题,现有的干预性研究结果不能轻易应用于她们。此外,这些研究结果表明,心理和社会心理干预对降低产后抑郁症发病率的益处并不一致。本综述旨在研究社会心理干预对预防产后抑郁症的有效性,特别是对未成年母亲的有效性。本综述采用系统综述和荟萃分析手册的首选报告项目来识别和选择相关文章。文章采用人群、干预、对照和结果模型进行检索。采用 Cochrane 偏倚风险工具对每篇文章的质量进行了评估。统计分析使用 STATA 17 版本进行。采用干预组和对照组抑郁评分的标准平均差估算干预效果大小。研究之间的异质性通过 I2 统计量和 Q 统计量进行评估,发表偏倚则通过漏斗图不对称和 Egger 检验进行评估。共纳入了 9 篇符合条件的文章。虽然与普通的产妇保健相比,心理干预已被证明能降低产后抑郁症的发病率,但值得注意的是,在纳入的研究中,只有三项研究的抑郁评分平均差异显著。荟萃分析表明,社会心理干预能有效预防产后抑郁,在最终的产后抑郁评估中,荟萃效应大小为-0.5(95% CI:- 0.95,- 0.06)。异质性很大,I2 值为 82.3%。虽然没有观察到发表偏倚,但小型研究对汇总效应大小有显著影响。本综述的研究结果表明,心理干预可以有效预防 PPD,尤其是在产后的前 3 个月。本综述强调了低收入国家干预研究的稀缺性,表明有必要在不同社区开展进一步研究。
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引用次数: 0
Telehealth in Home Visiting for New Mothers: Are Outcomes Different if the First Visits Are in Person? 远程医疗在新妈妈家访中的应用:如果首次探访是面对面的,结果会有不同吗?
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 DOI: 10.1007/s11121-024-01731-5
Margaret L Holland, Dorothy J Fitch, Drishtant Regmi, Lois S Sadler

Home visiting programs for new parents have a broad range of goals, including improvements in maternal and child health, reductions in child maltreatment, and improvements in child development. Before 2020, few home visits were conducted through phone or video encounters, i.e., telehealth home visiting (teleHV). However, rapid adoption of teleHV was required by the coronavirus disease 2019 (COVID-19) pandemic. To understand how conducting initial visits via teleHV was associated with outcomes, we performed a secondary data analysis to make use of the natural experiment created by COVID-19. Utilizing data from the Nurse-Family Partnership, a US national evidence-based model, we compared outcomes for families whose initial home visits were in person (enrolled 10/2019 to 1/2020; n = 7066) to those whose first visits were through teleHV (enrolled 4/2020 to 12/2020; n = 14,587). TeleHV at intake was associated with a higher likelihood of elevated depressive symptoms at 12 months (OR = 1.37; 95% CI 1.07, 1.76), a lower likelihood of retention to child's age 12 months (OR = 0.67; 95% CI 0.58, 0.78), a higher likelihood of early drop from the program (OR = 1.77; 95% CI 1.48, 2.12), and fewer screening assessments completed (b =  - 0.06; 95% CI - 0.07, - 0.04). No differences were detected between groups for the likelihood of breastfeeding at child's age 6 months, elevated intimate partner violence (IPV) risk, 90% of attempted visits completed, or time to attrition. COVID-19 may have led families in different groups to have different experiences during key points of child development; however, as both groups' involvement in the program occurred primarily during the pandemic, they were both subject to comparable influences. These findings suggest that in-person visits have some advantages in the first months of program involvement.

针对新生儿父母的家访计划具有广泛的目标,包括改善母婴健康、减少虐待儿童现象以及改善儿童发展。在 2020 年之前,很少有家访是通过电话或视频会面进行的,即远程健康家访(teleHV)。然而,2019 年冠状病毒病(COVID-19)大流行要求迅速采用远程家访。为了了解通过远程医疗进行初次家访与结果之间的关系,我们利用 COVID-19 创造的自然实验进行了二次数据分析。利用美国国家循证模式 "护士-家庭伙伴关系"(Nurse-Family Partnership)的数据,我们比较了首次家访为亲自到访的家庭(注册时间为 2019 年 10 月 10 日至 2020 年 1 月 1 日;n = 7066)与首次家访为远程医疗的家庭(注册时间为 2020 年 4 月 4 日至 2020 年 12 月 12 日;n = 14587)的结果。入院时进行远程会诊与以下因素相关:12 个月时抑郁症状升高的可能性较高(OR = 1.37;95% CI 1.07,1.76),保留至儿童 12 个月大的可能性较低(OR = 0.67;95% CI 0.58,0.78),提前退出计划的可能性较高(OR = 1.77;95% CI 1.48,2.12),以及完成的筛查评估较少(b = - 0.06;95% CI - 0.07,- 0.04)。在儿童 6 个月大时母乳喂养的可能性、亲密伴侣暴力 (IPV) 风险升高、完成 90% 的尝试性访视或流失时间方面,未发现组间存在差异。COVID-19 可能导致不同组别的家庭在儿童成长的关键时期有不同的经历;但是,由于两组家庭参与该计划的时间主要是在大流行期间,因此他们受到的影响不相上下。这些研究结果表明,在参与计划的最初几个月,面对面访问具有一定的优势。
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引用次数: 0
A Systematic Review and Meta-analysis of School-Based Preventive Interventions Targeting E-Cigarette Use Among Adolescents. 针对青少年使用电子烟的校本预防干预措施的系统回顾和元分析。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI: 10.1007/s11121-024-01730-6
Lauren A Gardner, Amy-Leigh Rowe, Nicola C Newton, Lyra Egan, Emily Hunter, Emma K Devine, Tess Aitken, Louise Thornton, Maree Teesson, Emily Stockings, Katrina E Champion

This study aimed to examine the efficacy of school-based e-cigarette preventive interventions via a systematic review and meta-analysis. We searched Medline, Embase, PsycINFO, Scopus, CINAHL, Cochrane, and clinical trial registries for studies published between January 2000 and June 2023 using keywords for e-cigarettes, adolescents, and school. Of 1566 double-screened records, 11 met the criteria of targeting adolescents, evaluating an e-cigarette preventive intervention, being conducted in a secondary school, using a randomized controlled trial (RCT), cluster RCT, or quasi-experimental design, and comparing an intervention to a control. Pre-specified data pertaining to the study design, outcomes, and quality were extracted by one reviewer and confirmed by a second, and where necessary, a third reviewer. Meta-analyses found no evidence that school-based interventions prevented e-cigarette use at the longest follow-up, which ranged between 6 and 36 months post-intervention (OR = 0.43, 95% CI = 0.16, 1.12; p = 0.09). However, subgroup analyses identified significant effects at post-test and when studies with < 12-month follow-up were omitted. No effect was found for tobacco use at the longest follow-up (OR = 1.01, 95% CI = 0.65, 1.59, p = 0.95); however, reductions in past 30-day tobacco use (OR = 0.59, 95% CI = 0.39, 0.89, p = 0.01) which encompassed e-cigarettes in some studies were identified. Narrative synthesis supported these mixed results and found some school-based interventions prevented or reduced e-cigarette and/or tobacco use; however, some increased use. School-based interventions were also associated with improved knowledge (SMD =  - 0.38, 95% CI =  - 0.68, - 0.08, p = 0.01), intentions (SMD =  - 0.15, 95% CI =  - 0.22, - 0.07, p = 0.0001), and attitudes (SMD =  - 0.14, 95% CI =  - 0.22, - 0.06; p = 0.0007) in the short term. Overall, the quality of evidence was low-to-moderate. School-based interventions hold the potential for addressing e-cigarette use, however, can have null or iatrogenic effects. More high-quality research is needed to develop efficacious interventions, and schools must be supported to adopt evidence-based programs. This is the first systematic review and meta-analysis to examine the efficacy of school-based preventive interventions for e-cigarette use. It provides crucial new knowledge about the efficacy of such interventions in preventing e-cigarette use and improving other outcomes (e.g., tobacco use, knowledge, intentions, attitudes, and mental health) among adolescents and the key characteristics associated with efficacious interventions. Our findings have important practical implications, highlighting future research directions for the development and evaluation of e-cigarette preventive interventions, along with the need to provide support to schools to help them identify and adopt evidence-based programs.

本研究旨在通过系统综述和荟萃分析来研究校内电子烟预防干预措施的有效性。我们在 Medline、Embase、PsycINFO、Scopus、CINAHL、Cochrane 和临床试验登记处检索了 2000 年 1 月至 2023 年 6 月间发表的研究,检索时使用了电子烟、青少年和学校等关键词。在经过双重筛选的 1566 条记录中,有 11 条符合以下标准:针对青少年、评估电子烟预防干预措施、在中学进行、采用随机对照试验 (RCT)、群组 RCT 或准实验设计、将干预措施与对照进行比较。有关研究设计、结果和质量的预设数据由一名评审员提取,并由第二名评审员和必要时由第三名评审员确认。Meta 分析发现,没有证据表明校本干预能在最长的随访期(干预后 6 至 36 个月)预防电子烟的使用(OR = 0.43,95% CI = 0.16,1.12;P = 0.09)。然而,亚组分析发现,在测试后以及在有以下情况的研究中,效果显著
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引用次数: 0
Familias con Orgullo: Pilot Study of a Family Intervention for Latinx Sexual Minority Youth to Prevent Drug Use, Sexual Risk Behavior, and Depressive Symptoms. Familias con Orgullo:针对拉丁裔性少数群体青少年的家庭干预试点研究,以预防吸毒、性风险行为和抑郁症状。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-09-27 DOI: 10.1007/s11121-024-01724-4
Yannine Estrada, Alyssa Lozano, Maria I Tapia, Alejandra Fernández, Audrey Harkness, Dalton Scott, Tae Kyoung Lee, Abir Rahman, Guillermo Prado

Families are key in the healthy development of Latinx sexual minority youth (Latinx SMY), a group that experiences behavioral, mental, and sexual health disparities. Despite this, there are no family-based interventions for Latinx SMY and their families to prevent drug use, sexual risk behaviors, and depressive symptoms. The purpose of this pilot study was to evaluate the preliminary impact (i.e., estimated effect sizes) of Familias con Orgullo (FcO) and examine its feasibility and acceptability among 30 Latinx SMY and their parents. Parents and adolescents were randomized to FcO or a control condition and assessed pre/post-intervention. Feasibility was measured based on session completion and effect sizes. Focus groups were conducted to evaluate intervention acceptability. Findings showed promising effects favoring FcO on parent-adolescent communication (d = 0.46) and parental involvement (d = 0.34). There were also promising effects favoring FcO on suicidal thoughts (OR = 0.75) and depression symptoms (OR = 0.69). Finally, 100% of the adolescents in FcO either continued to remain drug-free or transitioned from current use to no use (from baseline to post-intervention) compared to 74% in the control. Effect sizes for condomless sex, parental monitoring, and positive parenting were small. Session completion (above 80%) and focus group findings indicated strong feasibility and acceptability. FcO holds promise for reducing drug use and depressive symptoms and improving family functioning among Latinx SMY.

拉美裔性少数群体青年(Latinx SMY)在行为、心理和性健康方面存在差异,家庭是他们健康成长的关键。尽管如此,目前还没有针对拉丁裔性少数群体青少年及其家庭的基于家庭的干预措施来预防吸毒、性风险行为和抑郁症状。本试点研究旨在评估 Familias con Orgullo (FcO) 的初步影响(即估计效应大小),并考察其在 30 名拉美裔 SMY 及其父母中的可行性和可接受性。家长和青少年被随机分配到 FcO 或对照组,并在干预前后接受评估。根据课程完成情况和效果大小来衡量可行性。为评估干预的可接受性,还进行了焦点小组讨论。研究结果显示,FcO 在家长与青少年沟通(d = 0.46)和家长参与(d = 0.34)方面的效果良好。此外,FcO 对自杀念头(OR = 0.75)和抑郁症状(OR = 0.69)也有良好效果。最后,与对照组的 74% 相比,参与 FcO 的青少年中,100% 要么继续不吸毒,要么从目前吸毒过渡到不吸毒(从基线到干预后)。无安全套性行为、父母监督和积极养育的效果大小较小。课程完成率(80% 以上)和焦点小组的研究结果表明,该方法具有很强的可行性和可接受性。FcO有望减少拉美裔青少年的吸毒和抑郁症状,并改善家庭功能。
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引用次数: 0
Healthy Communities for Youth: A Cost Analysis of a Community-Level Program to Prevent Youth Violence. 青少年健康社区:预防青少年暴力社区计划成本分析》。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-09-30 DOI: 10.1007/s11121-024-01729-z
Zhongzhe Pan, Derek A Chapman, Terri N Sullivan, Diane L Bishop, April D Kimmel

Youth violence is a national public health concern in USA, especially in resource-constrained urban communities. Between 2018 and 2021, the Healthy Communities for Youth (HCFY) program addressed youth violence prevention in select economically marginalized urban communities, with the HCFY program reducing the likelihood of youth-involved violent crime. Leveraging costs from program expense reports, this study analyzes the costs of the HCFY program in order to inform policymaking and the program's future ongoing implementation. Total HCFY program costs were $821,000 ($290,100 annually including program start-up costs) over the 34-month project period. Operationalization costs contributed the largest share (64.8%), with 45% attributable to intervention coordinators. In the intervention community, the program costs $100 per capita, $1100 per youth-involved crime case, and $8100 per youth-involved violent crime case. Findings were sensitive to the number of youth-involved crime or violent crime cases and costs of high-level program leadership and self-evaluation analysts, with the per youth-involved violent crime case cost ranging between $700 and $1600 over the program period. Analysis of HCFY program costs is an important step in determining the affordability of a community-level program to prevent youth violence in resource-limited urban communities.

青少年暴力是美国全国性的公共卫生问题,尤其是在资源有限的城市社区。2018 年至 2021 年期间,"青年健康社区"(HCFY)计划在部分经济边缘化的城市社区开展了预防青少年暴力活动,该计划降低了青少年参与暴力犯罪的可能性。本研究利用项目支出报告中的成本,分析了 HCFY 项目的成本,以便为政策制定和项目未来的持续实施提供参考。在为期 34 个月的项目期间,"高瞻远瞩 "计划的总成本为 82.1 万美元(每年 29.01 万美元,包括计划启动成本)。其中运作成本所占比例最大(64.8%),干预协调员的成本占 45%。在干预社区,该计划的人均成本为 100 美元,每起青少年犯罪案件的成本为 1100 美元,每起青少年暴力犯罪案件的成本为 8100 美元。调查结果对涉及青少年犯罪或暴力犯罪案件的数量以及高层项目领导和自我评估分析师的成本很敏感,在项目期间,每起涉及青少年暴力犯罪案件的成本在 700 美元到 1600 美元之间。分析 HCFY 计划的成本是确定在资源有限的城市社区预防青少年暴力的社区级计划的可负担性的重要一步。
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引用次数: 0
Acceptability of Four Intervention Components Supporting Medication Adherence in Women with Breast Cancer: a Process Evaluation of a Fractional Factorial Pilot Optimization Trial. 支持乳腺癌妇女坚持用药的四项干预措施的可接受性:分数因子试点优化试验的过程评估。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-01 Epub Date: 2024-07-26 DOI: 10.1007/s11121-024-01711-9
Sophie M C Green, Nikki Rousseau, Louise H Hall, David P French, Christopher D Graham, Kelly E Lloyd, Michelle Collinson, Pei Loo Ow, Christopher Taylor, Daniel Howdon, Robbie Foy, Rebecca Walwyn, Jane Clark, Catherine Parbutt, Jo Waller, Jacqueline Buxton, Sally J L Moore, Galina Velikova, Amanda Farrin, Samuel G Smith

Adjuvant endocrine therapy (AET) reduces mortality in early-stage breast cancer, but adherence is low. We developed a multicomponent intervention to support AET adherence comprising: text messages, information leaflet, acceptance and commitment therapy (ACT), and side-effect website. Guided by the multiphase optimization strategy, the intervention components were tested in the ROSETA pilot optimization trial. Our mixed-methods process evaluation investigated component acceptability. The pilot optimization trial used a 24-1 fractional factorial design. Fifty-two women prescribed AET were randomized to one of eight experimental conditions, containing unique component combinations. An acceptability questionnaire was administered 4 months post-randomization, and semi-structured interviews with 20 participants further explored acceptability. Assessments were guided by four constructs of the theoretical framework of acceptability: affective attitude, burden, perceived effectiveness, and coherence. Quantitative and qualitative findings were triangulated to identify agreements/disagreements. There were high overall acceptability scores (median = 14-15/20, range = 11-20). There was agreement between the qualitative and quantitative findings when triangulated. Most participants "liked" or "strongly liked" all components and reported they required low effort to engage in. Between 50% (leaflet) and 65% (SMS) "agreed" or "strongly agreed," it was clear how each component would help adherence. Perceived effectiveness was mixed, with 35.0% (text messages) to 55.6% (ACT) of participants "agreeing" or "strongly agreeing" that each component would improve their adherence. Interview data provided suggestions for improvements. The four components were acceptable to women with breast cancer and will be refined. Mixed-methods and triangulation were useful methodological approaches and could be applied in other optimization trial process evaluations.

辅助内分泌疗法(AET)可降低早期乳腺癌患者的死亡率,但其依从性却很低。我们开发了一种支持坚持内分泌治疗的多成分干预措施,包括:短信、信息传单、接受与承诺疗法(ACT)和副作用网站。在多阶段优化策略的指导下,这些干预措施在 ROSETA 试点优化试验中进行了测试。我们的混合方法过程评估调查了各组成部分的可接受性。试点优化试验采用了 24-1 分因子设计。52名开具AET处方的妇女被随机分配到八个实验条件之一,其中包含独特的成分组合。随机化后 4 个月进行了可接受性问卷调查,并对 20 名参与者进行了半结构化访谈,进一步探讨了可接受性问题。评估以可接受性理论框架的四个结构为指导:情感态度、负担、感知有效性和连贯性。对定量和定性结果进行了三角测量,以确定一致/不一致之处。总体可接受性得分较高(中位数 = 14-15/20,范围 = 11-20)。对定性和定量结果进行三角分析后,发现两者之间存在一致性。大多数参与者 "喜欢 "或 "非常喜欢 "所有内容,并表示参与这些内容所需的努力较少。50%(传单)和 65%(短信)的参与者 "同意 "或 "非常同意 "每项内容对坚持治疗的帮助。对有效性的看法不一,35.0%(短信)到 55.6%(ACT)的参与者 "同意 "或 "非常同意 "每项内容都能提高他们的依从性。访谈数据提供了改进建议。患有乳腺癌的妇女可以接受这四个组成部分,并将对其进行改进。混合方法和三角测量是有用的方法论,可用于其他优化试验过程评估。
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引用次数: 0
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Prevention Science
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