Journal of prevention (2022)最新文献

Depression is one of the risk factors for chronic digestive system diseases. As a chronic mental disorder, its occurrence and development process is usually slow and gradual, while there are significant individual differences. Depression varies among different individuals in terms of the speed of onset, the stages of the disease course and its manifestations. Therefore, we speculate that this disease will exhibit different disease development trajectories in the population. This study aims to understand the characteristics of the development trajectory of depression among middle-aged and elderly people in China, explore its association with chronic digestive system diseases, and further propose individualized measures to prevent the occurrence of chronic digestive system diseases in people with different development trajectories of depression. This research can provide scientific value for the precise prevention and management of chronic diseases among middle-aged and elderly people. Data for this analysis were sourced from the China Health and Retirement Longitudinal Study (CHARLS), which included 4565 participants aged 45 years and older. Group-based trajectory modelling was used to identify trajectories of depressive symptoms, and multivariable logistic regression was used to assess the association between these trajectories and chronic digestive diseases. Five distinct depressive symptom trajectories were identified: low-stable, moderate-stable, moderate-increase, high-decrease, and high-stable. Compared to the low-stable group, the risks of chronic digestive diseases in the moderate-stable, moderate-increase, high-decrease, and high-stable groups were 1.62(Odds Ratio[OR] = 1.62, 95% CI: 1.31-2.00), 2.59(OR = 2.59, 95% CI: 1.96-3.41), 3.11(OR = 3.11, 95% CI: 2.35-4.10), and 3.41(OR = 3.41, 95% CI: 2.40-4.81) times higher, respectively. Subgroup analyses confirmed the robustness of these associations across most groups. In China, five distinct depressive symptom trajectories were identified among middle- aged and elderly people. The more severe and persistent the depressive symptoms were, the higher the risk of developing chronic gastrointestinal diseases. For those experiencing more severe or gradually worsening depressive symptoms, timely mental health intervention is of vital importance. These findings indicate that depression, as a key modifiable risk factor, can alleviate the burden of digestive diseases in the elderly population through early intervention.

Adolescent substance use remains a pressing public health concern, particularly in low- and middle-income countries (LMICs) where prevention infrastructures are limited. This mixed-methods study evaluated the feasibility, acceptability, utility, and preliminary efficacy of a linguistically adapted version of the keepin' it REAL (KiR) substance use prevention curriculum for junior secondary school students in Lagos, Nigeria. Participants included 532 students (age 11-13) from eight public schools randomly assigned to intervention or control conditions and the teachers implementing KiR (N = 9). Quantitative surveys assessed implementation outcomes and proximal behavioral indicators (e.g., personal anti-drug norms, resistance strategies, intentions to use substances), while qualitative interviews and open-ended responses captured implementation experiences. Results showed high feasibility (e.g., strong student participation and consistent curriculum delivery) and acceptability across sites, as reflected in student interest and high satisfaction ratings despite infrastructural challenges. Students reported meaningful learning, especially regarding REAL resistance strategies. Regression analyses indicated that participation in KiR significantly predicted stronger anti-drug norms (p = .01) and greater use of resistance strategies (p < .001) at post-test. Findings suggest that KiR can be feasibly implemented in Nigerian schools with some adaptation to the context, offering promise as a culturally responsive strategy to reduce adolescent substance use in West African settings.

Against a background of a higher prevalence of adolescent substance use compared to use among adults, UNODC searched for a peer-to-peer intervention since peer influence is one of the most persuasive factors at the age range of 14-17 year old. Friends in Focus is an intervention of six two-hour sessions delivered by young trainers to peers aged 14-17, aiming for the latter to have enhanced interaction with their friends. The trainers are equipped with a standardized practical manual and a three-day interactive training. The article narrates the design process, grounded in prevention science and drawing on open-source, evidence-based interventions. The preparatory steps and building blocks established to ensure a solid foundation for a future effectiveness study. From a practitioner's perspective in this development process, we learnt that a large, global review group with scientists, practitioners and youth delivered critical input for the intervention components and that prototyping in the field delivers crucial data to improve the intervention components for a robust effectiveness study in the near future.

Early adolescence is a critical developmental period, and effective evidence-based parenting interventions during this time are crucial. Traditional parenting interventions are rife with barriers including cost, access, and availability of providers. The use of digital parenting interventions, such as the Family Check-Up (FCU) Online, can provide parents with needed supports and reduce barriers to access. The FCU Online is a flexible parenting intervention involving the development of parent training skills via an app and supplemental family coaching sessions. The intervention was adapted to respond to family-related stressors due to the COVID-19 pandemic in the Pacific Northwest of the United States. The current study investigated patterns of parent engagement in the FCU Online and their links to family contextual factors and outcomes, with the following questions: (1) What are the rates of parent intervention engagement in the FCU Online coaching and the app? (2) Did parent intervention engagement differ based on individual or contextual factors (e.g., depression, SES)? and (3) Does engagement level in the FCU Online predict differential outcomes for parents and their families six months after intervention enrollment? Two groups for coaching and two groups for the app were created based on n = 74 parents' engagement (Typical or High Engagement). One-Way ANOVA's and MANCOVA's were used to address the second and third research questions, respectively. All parents engaged in the FCU Online intervention. Parents with higher depression and stress, lower parenting confidence, and who had adolescents with more problem behaviors were in the High Engagement group for coaching. No differences in app engagement were found based on contextual factors. Higher coaching engagement predicted improvements in quality time, and higher app engagement predicted reduced parent anxiety. The FCU Online may be successful in maintaining parent engagement, particularly among parents needing more support with depression, stress, parenting confidence, and adolescent problem behaviors. Higher intervention engagement was beneficial for quality time and parent anxiety. This study (R01MH122213-01S1) was registered September 15th, 2020.

The Push-Up Challenge is an Australian health promotion event combining mental health awareness with an exercise goal. This study aimed to evaluate its impact on participants' resilience, wellbeing and mental health, physical activity, social connectedness, and mental health literacy. Using a pre-post design, we analysed survey data across three timepoints: pre-event (N = 29,069), two weeks post-event (N = 9,970), and three months post-event (N = 4,346). Outcomes included resilience, depression and anxiety symptoms, wellbeing, help-seeking behaviours, self-care activities, and physical activity levels. Survey respondents were mostly male (64.8%) with a mean age of 35.68 years (SD = 12.8). Mixed-effects models were used to assess change over time, adjusting for factors associated with missingness. At three-month follow-up, results showed very small significant reductions in depression (d = -0.09, p < 0.001) and anxiety symptoms (d = -0.09, p < 0.001), and small improvements in positive wellbeing (d = 0.15, p < 0.001). There were no significant changes in resilience, physical activity, social connection, or odds of experiencing a mental health problem. Participants were more likely to seek help for mental health problems (OR = 2.05 [1.31, 3.19]) and adopt self-care strategies (OR = 3.79 [2.64, 5.45]). Physical activity levels increased significantly post-event (d = 0.10, p < 0.001) but were not maintained at follow-up. While improvements in mental health symptoms were small, this is consistent with similar population-level mental health promotion interventions. Findings suggest that The Push-Up Challenge shows promise as a multifaceted intervention combining exercise-based mental health promotion with mental health awareness and literacy components.

There is growing interest in assisting individuals who return to homelessness after obtaining permanent housing. However, little evidence exists on those who make multiple exits to permanent housing and subsequently return to homelessness over time. This study estimated the rates of multiple returns to homelessness among Veterans who accessed permanent housing and identified Veteran characteristics associated with these returns. The study used several Department of Veterans Affairs (VA) administrative data sources to calculate rates of multiple returns to homelessness within 12- and 24-months among Veterans who exited a VA homeless assistance program to a permanent housing destination between January 2018 and April 2021. Binary logistic regression models assessed the association between Veteran characteristics and multiple returns. Roughly 0.4% and 2.2% of Veterans experienced multiple returns to homelessness within 12- and 24-months, respectively. Diagnoses of alcohol use disorder, drug use disorder and psychoses were the most prominent predictors of higher odds of multiple returns. Although rare, multiple returns to homelessness highlight the need for targeted supports to help prevent recurrent homelessness and promote long-term housing stability.

Support for families experiencing domestic violence and abuse (DVA), mental ill-health (MH) and substance misuse (SU) is often delivered in siloes, despite the frequent co-occurrence of these public health issues. Little evidence-based guidance exists on which interventions best support families experiencing a combination of these problems. Identifying intervention components with common impacts across parental DVA, MH and SU could inform policy and practice. We conducted an Intervention Components Analysis (ICA) to identify intervention components that have common impacts across parental DVA, MH and SU. We searched ten databases for randomised controlled trials of family-focused interventions targeting, and measuring an impact on, one or more of these issues. We developed an initial coding framework using open coding to guide the coding of subsequent studies. Descriptive analyses identified common components across target outcomes (DVA/MH/SU) and robust variance meta-regressions explored the relationship between intervention components and treatment effects. A Lived Experience Advisory Group informed our presentation and interpretation of the results. We identified 164 interventions: 40 focused on a combination of DVA, MH and SU and 124 addressed one issue alone. None of the 20 components identified were unique to any specific outcome and no single component was associated with meaningful improvement in outcomes. Interventions aiming to provide integrated support across outcomes were less successful at improving MH and SU outcomes than those targeting single issues. We found no evidence of commonly effective intervention components. Better alignment between components and underlying processes driving DVA/MH/SU, and alternative intervention designs, are needed.

Adolescent substance use remains a significant public health concern in Spain. This study evaluates the effectiveness of "Tú Decides 2.0," an updated school-based drug prevention program, in reducing substance use among Spanish adolescents. A nine-month, two-arm, quasi-experimental controlled trial was conducted involving 2251 adolescents (aged 12-17) from 13 secondary schools in three Spanish regions. The intervention group (n = 1209) received the "Tú Decides 2.0" program, while the control group (n = 1042) underwent only assessment sessions. Primary outcomes were past 30-day use of alcohol, tobacco, e-cigarettes, and cannabis at three-month follow-up. Overall, prevalence of use was lower than the national mean data. GEE analyses following an ITT approach showed significant effects of the program in reducing the prevalence of self-reported e-cigarette use in the intervention group compared to the control group in 2nd (OR = 0.54; CI = 0.32; 0.90) and 4th (OR = 0.33; CI = 0.27; 1.14) CSE years. Significant effects were also found in reducing the prevalence of alcohol (OR = 0.57; CI = 0.32; 1.00) and tobacco (OR = 0.57; CI = 0.37; 0.88) use at three-months follow-up among students in 2nd CSE year. No significant effects were observed for cannabis nor for the 1st and 3rd CSE years. Models conducted using Multiple Imputation yielded similar results. The "Tú Decides 2.0" program demonstrated effectiveness in reducing both the incidence and prevalence of e-cigarette, alcohol and tobacco use among Spanish adolescents. These findings support the implementation of updated, digitalized school-based interventions for substance use prevention.Trial Registration ClinicalTrials.gov Registry (#NCT05950074).

Addiction prevention is a strategic priority in public health, aimed at promoting effective, ethical, and evidence-based interventions. This study examines the training, knowledge, and use of evidence-based tools and quality standards among addiction prevention professionals in Spain. It identifies differences according to professional profile and explores their training needs. A non-experimental, cross-sectional design was employed, with a descriptive and exploratory approach. Data collection combined closed-ended items with a single open-ended question. A total of 623 professionals participated, categorized into Técnicos Municipales de Prevención (MAPT) and Otros Profesionales de Prevención (OPP). Descriptive and comparative statistical analyses (frequencies, percentages, and between-group comparisons) were conducted, along with qualitative content analysis of the open responses. MAPTs reported more structured training and greater familiarity with tools such as the European Prevention Curriculum (EUPC), the European Drug Prevention Quality Standards, and the Spanish Good Practice Portal (BBPP). In contrast, OPPs reported more general training deficiencies and less knowledge of these tools, although they more frequently reported using scientific sources such as the EMCDDA. Both groups showed an underutilization of key portals and a strong demand for training in planning, evaluation, and the use of technical resources. Findings reveal significant inequalities in access to specialized training and evidence-based tools. These results underscore the need to develop differentiated training pathways aligned with international quality standards and tailored to the specific roles and responsibilities of each professional profile.