The Journal of Primary Prevention最新文献

Sexual interest in minors (i.e., pedophilia and hebephilia) is considered a risk factor for Child Sexual Abuse (CSA) and the use of Child Sexual Abuse Material (CSAM). This study examined the long-term development of CSA, CSAM use, associated cognitions, and quality of life among self-referred, help-seeking individuals diagnosed with pedophilic or hebephilic disorder (PHD) outside the judicial system. Of the 110 eligible men who had undergone therapy for PHD due to psychological distress or risk of offending, 56 were available for follow-up assessment 1–11 years after treatment. Behavioral manifestations, offense-supportive cognitions, and quality of life were evaluated using interviews and psychometric measures. At follow-up, 7.7% of participants with a history of CSA had re-offended, whereas 89.1% of previous CSAM users reported recidivism, although with less severe material. No new CSA offenses occurred among those without prior CSA. Treatment led to increased cognitive victim empathy and reductions in CSA-supportive and CSAM-supportive attitudes, but only the latter improvement persisted through follow-up. Participants exhibited elevated CSA-supportive attitudes relative to community norms at all time points and diminished quality of life at follow-up. Pedophilic and hebephilic disorder carry a persistent risk of sexual offending, particularly regarding CSAM use. Therapeutic gains in offense-supportive cognitions may erode over time without ongoing care. A comprehensive public health approach encompassing early detection, prevention, and expanded treatment access that addresses both the risk of reoffending and overall well-being is crucial for reducing sexual victimization and improving mental health outcomes for individuals from this target group.

Most alcohol intervention research focuses on program efficacy, yet few studies have investigated the acceptability of a program’s design and implementation to the target population or adapting existing alcohol interventions to different populations. To address these gaps in the literature, we (1) examined participant responsiveness to and implementation quality of FITSTART+, a web-app delivered parent-based alcohol intervention designed for incoming first-year college students in the United States, and (2) gathered feedback on how this intervention could be adapted to other populations of parents. A sample of U.S. parents of 17–20-year-old first-year college students (N = 109) participated in FITSTART+ during their child’s first year of college and completed a survey about parents’ responsiveness to the app and its quality. Next, a sample of non-U.S. parents of adolescents aged 13 to 19 (N = 44) participated in one of 11 focus groups in which they briefly explored the app and then discussed how it could be adapted to be applicable and culturally relevant for them and their context. Results revealed that U.S. parents rated the intervention’s quality as high and parents were responsive to the web-app’s content, but some did not visit one of the most critical aspects of the intervention (i.e., alcohol-related parenting resources). Non-U.S. participants provided a range of suggestions for adapting the intervention to their context, which varied by culture. Results identify areas for improvement, particularly regarding the use of alcohol-related parenting resources, in this intervention and for web-delivered PBIs more broadly.

Introduction

Low birth weight (LBW) is a global issue prevalent in low-income countries. Economic assessments of interventions to reduce this burden are crucial to guide health policies. However, there is a relative scarcity of research that illustrates the magnitude of LBW by country and region to support the design of public policies.

Objective

This study aimed to analyze the temporal trend of fetal growth in newborns in Brazil between 2010 and 2020.

Methods

A time series study was conducted using data from the Live Births Information System (SINASC), which is managed by the Department of Information and Informatics of the Unified Health System (DATASUS) of the Brazilian Ministry of Health. The Prais-Winsten linear model was applied to analyze the annual proportions of LBW. The annual percentage changes (APC) and their respective 95% confidence intervals (95%CI) were calculated. Prevalence rate averages of LBW were calculated and displayed on thematic maps to visualize the evolution dynamics in each Federation Unit (FU).

Results

A total of 31,887,329 women from all Federative Units of Brazil were included in the study from 2010 to 2020. The Southeast region had the largest proportion of participants, with records from 2015 accounting for 9.5% of the total. Among the women in the study, 49.6% were between the ages of 20 and 29, and the majority (75.5%) had between 8 and 12 years of schooling. The newborns of these women were predominantly male (58.8%) and non-white (59.5%). The study found that there was a trend towards stabilization of increasing proportions of LBW in the North, Northeast, and Centre-West regions between 2010 and 2020. In Brazil and other regions, these tendencies remained stable.

Conclusion

To improve living conditions and reduce social inequalities and health inequities, public policies and actions are necessary. Strengthening the Unified Health System (SUS), income transfer programs, quota policies for vulnerable groups, and gender equality measures such as improving access to education for women and the labor sector are among the suggested approaches.

Sexual harassment is an intractable problem that harms the students, community, culture, and success of institutes of higher education (IHEs). The alarming prevalence of sexual harassment at IHEs highlights the urgent need for effective prevention programs. However, there are few empirically supported preventive interventions that effectively target the factors that most impact the determinants, trajectory, and short- and intermediate-term effects of sexual harassment. In this paper, we overview the problem of sexual harassment and propose an organizing framework to help IHEs develop effective interventions to prevent sexual harassment. Guided by prevention science, we propose a framework—modified from SAMHSA’s (2019) guidelines for prevention practitioners—that underscores the criticality of trauma- and equity-informed characteristics in prevention programs. We offer a discussion on how IHEs must consider and evaluate the empirical evidence of effectiveness, flexibility, cultural competency, and sustainability when developing and adapting prevention programs to reduce and—ultimately—ameliorate sexual harassment. We conclude with recommendations that can provide a roadmap for higher education stakeholders and researchers to prevent this urgent public health concern.

The purpose of this research is to develop preventive measures against smoking among youths living in Baan Eua Athon, underprivileged housing projects in Thailand. Utilizing a mixed-methods approach, this research encompassed quantitative and qualitative data collection in nine provinces of Thailand. Stratified multi-stage sampling was conducted, and data was gathered using questionnaires, in-depth interviews, and focus group discussions. Adapting Green and Kreuter’s Precede–Proceed Planning Model, the researchers identified key factors influencing youth smoking initiation through extensive fieldwork from January to December 2021. The results show that the primary drivers for new smokers, in order of significance, are limited knowledge about the effects of smoking, values, perception of associated disease risk, stress and anxiety, influence by family and friends, smoking control policies and activities of educational institutions influencing risk behaviors for new smokers. Research respondents from multiple sectors formulated seven measures to prevent new smokers, namely (1) building the capacity of stakeholders to increase knowledge among the target group; (2) creating a body of knowledge and control with retail shop operators; (3) building a smoke-free network team in the area; (4) creating smoke-free families; (5) creating an application to assess risk behaviors and offer an online consulting system; (6) developing a search process; and (7) analyzing interests to promote the needs of youth. Recommendations from this study can be used to monitor risk behaviors for new smokers and guide policy decisions for substance abuse prevention practitioners in the area.

Abstract

The Communities That Care Youth Survey (CTCYS) assesses risk and protective factors, predicting a range of behavioural health problems, including substance use, violence, and delinquency. Although the survey has been adapted to other contexts and languages, further studies on cross‐cultural adaptations, particularly in non‐English speaking countries, are needed. In 2022, CTCYS was adapted for Estonia, incorporating 38 risk and protective factors, along with measures of substance use, antisocial behaviour, mental health problems, and self-harm. This study investigated the psychometric properties and applicability of the CTCYS in Estonia. The adaptation process involved translating and refining the US CTCYS, followed by focus group discussions with students and specialists and a pilot study in two municipalities, with data obtained from 265 students. A focus group with municipality members explored the measure’s feasibility. Results indicate that the original CTC framework largely captures key issues within the Estonian context. Overall, the survey showed good validity, as evidenced by its ability to predict problem outcomes through both risk and protective factors. Regarding reliability, with the removal of one item, internal consistency reached acceptable levels for all but eight risk and protective factor subscales. The most problematic scales in the Estonian context were Prosocial Involvement, Social Skills, and Belief in the Moral Order. Municipality members perceived the measure as useful but highlighted some challenges regarding its practicality and comprehensibility. It became clear that other elements are needed to effectively support communities in using the CTCYS results for preventive efforts.

Budget analysis entities often cannot capture the full downstream impacts of investments in prevention services, programs, and interventions. This study describes and applies an approach to synthesizing existing literature to more fully account for these effects. This study reviewed meta-analyses in PubMed published between Jan 1, 2010 and Dec 31, 2019. The initial search included meta-analyses on the association between health risk factors, including maternal behavioral health, intimate partner violence, child maltreatment, depression, and obesity, with a later health condition. Through a snowball sampling-type approach, the endpoints of the meta-analyses identified became search terms for a subsequent search, until each health risk was connected to one of the ten costliest health conditions. These results were synthesized to create a path model connecting the health risks to the high-cost health conditions in a cascade. Thirty-seven meta-analyses were included. They connected early-life health risk factors with six high-cost health conditions: hypertension, diabetes, asthma and chronic obstructive pulmonary disorder, mental disorders, heart conditions, and trauma-related disorders. If confounders could be controlled for and causality inferred, the cascading associations could be used to more fully account for downstream impacts of preventive interventions. This would support budget analysis entities to better include potential savings from investments in chronic disease prevention and promote greater implementation at scale.

Predictors of hypertension (HTN) control status have not been well understood in India. This information is crucial for policymakers and program managers to devise newer HTN control strategies and implement relevant policies and programs. Therefore, we undertook this meta-analysis to estimate the effect of various factors on the control status of HTN in India. We systematically searched PubMed and Embase for observational studies and community-based trials published between April 2013 and March 2021 conducted among people (≥ 15 years) with hypertension in India. Quality of studies was assessed using Newcastle Ottawa (NO) scale. Meta-analysis was performed using random effects model. We reported the effect of various factors on the prevalence of controlled HTN using pooled odds ratio (OR) with 95% confidence interval (CI). Of the 842 studies screened, we analyzed nine studies that included 2,441 individuals. Based on the NO scale, majority (90%) of studies had a low risk of bias. The odds of having controlled HTN were significantly higher among women (OR 1.78, 95% CI 1.62–1.95), those aged > 45 years (OR 1.69, 95% CI 1.44–1.97), and those residing in urban parts of India (OR 1.74; 95% CI 1.48–2.03). These measures varied considerably across different regions of the country. Very few studies reported data on the relationship between behavioural risk factors of non-communicable diseases (NCDs) and HTN control status. We did not find any statistically significant differences between behavioural risk factors of NCDs and HTN control status. To improve HTN control in India, the ongoing/newer HTN control programs need to target men, those aged 15–45, and rural residents. Future studies on HTN control determinants should report disaggregated data and use standardized definitions for behavioral risk factors to enhance reliability and comprehensiveness of findings on the determinants of HTN control in future reviews.