Journal of prevention (2022)最新文献

Substance use is a well-known public health problem among adolescents and emerging adults. Digital prevention components, oftentimes included in interventions to target substance use, offer unique possibilities and might be particularly suited for these age groups. However, thus far, a comprehensive overview of substance use prevention interventions utilising digital components is lacking. Hence, the overall aim of this study is to fill this research gap by identifying the type of digital components, their theoretical approaches and their combinations employed in substance use interventions for adolescents and emerging adults, and how the evidence base for their (individual) effectiveness was assessed. The literature was searched in four databases: MEDLINE, PsychInfo, CINAHL and Web of Science in May 2023. Inclusion criteria based on the PCC concept were: Population (adolescents and emerging adults aged 12-21 years), Concept ((a) digital components of interventions AND (b) prevention or reduction AND (c) substance use), Context (all contexts). Studies were selected after title/abstract screening by two independent researchers. Data extraction included: substances and substance use behaviour, underlying theory/approach, characteristics of digital intervention components, methods used for evidence assessment, and study characteristics. These data were narratively summarised. 4,905 publications were screened and 176 were included, of which 114 reported on interventions with emerging adults and 62 with adolescents. These interventions were predominantly delivered in educational settings (86%), namely universities/(vocational)schools. Alcohol was the most commonly investigated single target substance (74%). The majority of all interventions were based on more than one theory/approach and it was not always clear which theories were combined. The most commonly reported approach in interventions for adolescents was the provision of information/education, for emerging adults, interventions were based on Social Norms Theory most frequently. The majority of interventions were delivered web-based. Randomized controlled study designs dominated, and evaluation was rarely performed separately for the intervention components. A variety of digital intervention components exist to reduce or prevent substance use among adolescents and emerging adults. However, different intervention components based on diverse theoretical approaches are often combined in one intervention and the individual effects of single components remain largely unmeasured. Future studies should consider innovative methods to analyse the effectiveness of individual components, and their possible interactions, within complex interventions. Combining effective digital components or adding these components to non-digital interventions could optimize the effectiveness of interventions for young people.

Bystander intervention (BI) is among the most extensively studied phenomena in social psychology, with theoretical models underscoring a range of situational factors that influence helping behavior. Yet, despite considerable attention and emphasis placed on understanding these processes, we know very little about momentary and dynamic factors that effect actual BI in real-time. This is especially problematic because BI prevention programs are designed to promote in-the-moment behavioral responses to emergent risk, yet the evidence base supporting their use relies predominantly on cross-sectional retrospective self-reports, intervention-likelihood paradigms, and other proxy outcomes with limited external and ecological validity. Due to longstanding methodological constraints, our collective knowledge of how proximal and situational factors directly influence real-world BI behavior remains limited, yet understanding how event-level influences such as acute alcohol intoxication impact BI is essential for creating effective sexual violence prevention programming. In this debate paper, we synthesize the current literature on proximal influences of BI and propose a framework to guide future research using ecologically valid, real-time momentary assessment methods.

The aim of this study was to assess the impact of organized screening programs on incidence and mortality rates of cervical cancer in women. A systematic review of the relevant literature was performed in accordance with the PRISMA 2020 protocol by searching PubMed, Scopus and Web of Science. Endnote20 and Rayyan Systematic Review Screening Software were used for duplicate removal and then, independent evaluation was done by two reviewers. The quality of studies was assessed using the Newcastle Ottawa scale. A random-effects meta-analysis was performed in order to compute the pooled effect size, with Hartung-Knapp adjustment for random effects model. DerSimonian-Laird estimator for Tau², Mantel-Haenszel estimator used in calculation of Q and Tau², and calculation of I² based on Q were used to assess and quantify heterogeneity between studies. Inverse variance method was also used. The results of the meta-analysis show that women who were regularly screened in an organized cervical cancer screening program were statistically significantly less likely to develop (OR = 0.40, 95% CI 0.29-0.55) or die (OR = 0.31, 95% CI 0.16 to 0.58) from cervical cancer. Significant heterogeneity among the case-control studies evaluating the incidence of cervical cancer has been detected (Tau² = 0.1034; χ² = 245.42; df = 12, p < 0.0001; I² = 95.1%). Moderate to high heterogeneity among the case-control studies evaluating the mortality has been detected (Tau² = 0.1161; χ² = 20.12; df = 3, p < 0.0002; I² = 85.1%). The results of tests for assessing asymmetry (Egger's and Begg's test, p < 0.05), indicates the absence of publication biases. The results of our meta-analysis show that women who participate in organized screening programs are significantly less likely to develop and die from cervical cancer, especially if they are screened regularly. Women who irregularly participated in an organized cervical cancer screening program have almost equal risk for cervical cancer compared to women who did not participate in an organized cervical cancer screening program. Women with irregular participation in an organized cervical cancer screening program have a cervical cancer risk that is nearly comparable to the risk among non-participants.

Analyze the effects of substituting time spent in sleep, sedentary behavior, and moderate-to-vigorous physical activity on the physical performance of older adults. The sample consisted of 457 participants from the Alcobaça Elderly Health Longitudinal Study. Physical performance was measured using the Short Physical Performance Battery, while physical activity and sedentary behavior were assessed with the International Physical Activity Questionnaire, and sleep with the Pittsburgh Sleep Quality Index. For statistical analysis, the isotemporal substitution approach was applied to examine the hypothetical effects of reallocating time between sleep, sedentary behavior, and moderate-to-vigorous physical activity on physical performance. The results showed that substituting small periods of sleep or sedentary behavior with moderate-to-vigorous physical activity was associated with a significant reduction in the risk of poor physical performance. The reallocation of just 5 min/day already showed a protective effect (a reduction of 13% to 14%), with an increasing impact proportional to the amount of time replaced, reaching an 82% reduction for 60 min/day. Model-based analyses suggest that replacing short periods of sedentary behavior or sleep with moderate-to-vigorous physical activity is associated with a lower risk of poor physical performance in older adults.

To develop effective health policies and prevention strategies for reducing lung cancer mortality, it is essential to understand its associations with contextual factors, yet prior studies have produced inconsistent results suggesting the associations might vary over space. Very few studies have explicitly examined gender-specific spatial variations in the associations and investigated how the spatial patterns are shaped by community socioeconomic characteristics. This study aimed to examine spatial variations and gender differences in associations of lung cancer mortality rate with contextual environmental, socioeconomic, and health factors in response to the varying socioeconomic characteristics across 159 counties in Georgia, USA for 2019-2023. Following a cross-sectional ecological study design based on county-level aggregated data, this study linked three environmental, fifteen socioeconomic, and fourteen health factors to lung cancer mortality rates for males and females, and conducted various statistical and spatial analyses including Geographically Weighted Regression (GWR) to explore the spatially varying associations of lung cancer mortality rate with those contextual factors. As an explanatory local spatial statistical technique, GWR revealed that the associations varied across space and gender, with significant links observed in fewer counties than nonsignificant ones. No significant spatial autocorrelation was detected in the residuals from the GWR models of lung cancer mortality rate for either males or females (I=-0.121, p = 0.064 for males; I=-0.110, p = 0.098 for females). Key findings include: (1) radon was a more consistent factor associated with elevated lung cancer mortality rates than PM_2.5 and ozone, particularly for males in urban and suburban areas, while air pollutants were significant only in some rural counties; (2) higher socioeconomic and household vulnerabilities increased risks for both genders in rural counties, whereas higher minority populations and greater housing density were linked to lower risks, especially for males in northern urban/suburban counties; (3) prevalences of chronic diseases and smoking were significant factors associated with elevated lung cancer mortality rate for both genders, with chronic diseases showing more spatially consistent effects among females, while annual checkup was a stronger factor associated with reduced lung cancer mortality rate for females, especially in less socioeconomically vulnerable urban/suburban counties; and (4) health factors had the strongest and most spatially consistent effects on mortality rate, followed by socioeconomic and then environmental factors. These findings suggest that effective lung cancer control requires public health policies and preventive measures to be locally tailored, gender-sensitive, emphasizing chronic disease management, smoking cessation, regular preventive care, and socioeconomic development.

This study presents the results of evaluating the pilot implementation of the Lions Quest programme "Skills for Action" (LQSFAc) in the Croatian education system. "Skills for Action" is a prevention programme for social-emotional learning based on the Collaborative for Academic, Social and Emotional Learning framework. This model encompasses intrapersonal, interpersonal, and cognitive aspects of social-emotional well-being that are important at all stages of development. This is the first attempt to evaluate the LQSFAc programme in Croatia, focusing on its outcomes. The aim of the study is to analyse the extent to which the two-year pilot implementation of the programme contributes to the development of students' intrapersonal and interpersonal social-emotional skills. A questionnaire for self-assessment of students' social-emotional skills was used. The programme was introduced on a trial basis in 13 Croatian secondary schools during the 2023/2024 and 2024/2025 school years. This quasi-experimental study includes quantitative data from 326 students who participated in the pre- and post-test (163 students participated in the programme and 163 did not). The data were analysed using descriptive statistics and a multilevel model (mixed linear model with a random effect for the school where the programme was implemented). Students in the LQSFAc classes achieved higher scores in all analysed social-emotional skills in the post-test than students in the comparison classes. The results suggest that the contribution of the LQSFAc programme is most evident in students' social awareness. Implementing the LQSFAc programme in full, which requires a whole-school approach, is essential for achieving better results.

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.

Young children face elevated risks of unintentional fire injuries, yet few early childhood programs incorporate explicitly theory-informed prevention approaches. Grounded in the Health Action Model (HAM), which emphasizes beliefs, motivation, intentions, and action realization, this study evaluated a developmentally adapted curriculum designed to strengthen preschoolers' fire safety literacy in a preschool located in northern Taiwan. A quasi-experimental design was conducted with 60 senior kindergarten children (aged 5-6 years) assigned to an experimental or waitlist control group. The five-week curriculum integrated scenario simulations, multimedia learning, and hands-on drills targeting five HAM-aligned domains: knowledge, attitudes, skills, intentions, and behaviors. Assessments included picture recognition tasks, teacher-facilitated structured responses, and video-rated skill demonstrations by trained external firefighters. Generalized Estimating Equations (GEE) examined group, time, and interaction effects, controlling for prior fire-related experiences. The intervention produced significant improvements across all five domains of fire safety literacy. While both groups demonstrated short-term gains at post-test, the experimental group showed significantly greater and more sustained improvements at follow-up. These sustained effects were particularly evident in practical fire safety skills (group × follow-up: B = 3.33, p < .001; d = 3.08) and fire safety intentions (group × follow-up: B = 2.00, p < .001; d = 1.43). Significant group × follow-up interactions supported the maintenance of intervention effects over time rather than indicating delayed onset. Prior fire-related experience did not significantly influence outcomes. The HAM-based curriculum was associated with meaningful improvements across multiple domains of preschoolers' fire safety literacy and produced sustained improvements in key domains. These findings highlight the applicability of theory-driven, mechanism-oriented curricula in early childhood injury prevention and support the integration of structured fire safety programs into preschool education.