Journal of prevention (2022)最新文献

This article examines the implementation of the European Prevention Curriculum (EUPC) in Germany since 2019. Since its introduction, EUPC has been delivered in Germany to 307 participants through 22 courses (17 basic, 5 advanced), offering both online and in-person training. Key partnerships with the State Prevention Council of Lower Saxony, the German Forum for Crime Prevention, and the Hannover Medical School have strengthened implementation. An evaluation with 51 prevention professionals showed significant improvements across 14 of 25 competency domains, with strongest effects in evidence-based program registry usage and prevention advocacy. Germany's federal structure presented challenges for nationwide implementation, reflected in varying regional engagement. The curriculum's alignment with the Prevention Act of 2015, which promotes quality-assured prevention measures, created a supportive policy framework for EUPC graduates. Despite its voluntary nature limiting mainstream adoption, EUPC has fostered evidence-based practices and cultivated a professional community united by a common understanding of prevention quality. Recommendations include building strategic partnerships, leveraging existing policies, and systematically fostering the community of practice that emerges from the training.

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.

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.

Childhood exposures to adversity are common and increase risk for negative health and social outcomes throughout the life course. There is limited evidence regarding interventions to prevent or reduce the impact of adverse childhood experiences (ACEs), particularly for families with multiple adversities. Here we present the findings of mixed methods research to co-design a complex intervention to prevent adverse childhood experiences, and their impacts. Using established research methods, and the framework of the Medical Research Council (MRC) complex interventions development guidance, the work was conducted in four stages, shaped by stakeholder engagement and input at every stage. The first stage, Discover, was exploratory and employed evidence synthesis and quantitative (n = 11,564) and qualitative (n = 31) research methods to understand needs, experiences, and evidence gaps. The Define stage developed three intervention principles and identified intervention options, through a series of six co-design workshops with 41 participants and an academic research team workshop. The Develop and Deliver stages were undertaken through a Policy Lab (22 participants), and developed options for intervention design, before converging on a defined intervention that could be delivered and tested. Through this process, we developed a 'village-style' intervention, which functions at three levels: individual service users, operational, and system/strategy. Central to this are link or community health workers who would build relationships with family members, and act as a single point of contact. They should develop an understanding of family needs and the interaction of multiple complex adversities, and advocate for families, facilitating access to services. Crucially, they should use this understanding to work at and feed into operational and strategic levels to reshape services and enhance access for all families at risk of or experiencing adversity. Entry into the intervention through assessments at existing universal touch points, for example at routine perinatal or newborn appointments, should provide a prevention focus and follow the principles of proportionate universalism. Sensitive enquiry regarding financial stress may be a component of the assessment, in response to the findings of this work regarding the contexts created through the interaction of poverty and other adversities. The proposed intervention is designed to improve individual and family outcomes, and generate positive system-level changes. A feasibility study and evaluation will be required in future work, to assess the effects, costs and benefits. The processes and frameworks we developed and used may provide an adaptable template for future intervention co-design work.

Schools play a crucial role in shaping the health and well-being of children and adolescents. With the global impact of COVID-19, the need for robust disease prevention and control programs within educational settings has become more apparent than ever. This study examined the association between school-based disease prevention and control programs and students' physical health and academic performance in Ghana, a developing country, with a focus on the mediating roles of mental health and health literacy. Conducted with 386 students using a descriptive cross-sectional design and a quantitative research approach, the study employed questionnaires for data collection and structural equation modeling (PLS-SEM) for analysis. The findings indicated that school-based disease prevention and control programs are associated with higher health literacy among students and linked to better physical health and academic performance. However, the impact on mental health was not significant. The results indicated that these programs are positively associated with physical health outcomes and academic achievement, with mental health serving as a partial mediator. This research highlights the importance of integrating comprehensive disease prevention and control programs, including mental health workshops, to address gaps in mental health outcomes in schools. It also emphasizes the need for governments and development partners to develop robust health policies focused on school-based health programs. Adapting these initiatives to local contexts while implementing evidence-based strategies aligns with the Sustainable Development Goals of good health and well-being (SDG 3) and quality education (SDG 4).

Emotional eating (EE; eating in response to negative emotions) is a considerable problem in adults with obesity. Recent meta-analyses of behavioral treatments for those with elevated body mass index (BMI) have demonstrated inconsistent, but generally minimal, effects for dealing with EE. This might largely be due to inappropriate sampling, cross-sectional research designs, and a lack of understanding of theory-driven psychosocial mechanisms of EE change. This study aimed to inform mental health, medical, and health behavior-change professionals on methods to address EE within obesity treatments. Within the present field-based research, women with high EE participated in 6-month community-based obesity treatments emphasizing either weight-management education + attention on EE (n = 34), self-regulatory skills-no attention on EE (n = 43), or self-regulatory skills + attention on EE (n = 42). Each condition incorporated physical activity for its mood-change potentials. Significant improvements in physical activity, mood, eating-related self-regulation and self-efficacy, EE, and weight were found in all groups, with greater advances occurring in the self-regulation vs. educationally focused conditions. Incorporating aggregated data, significant theory- and previous research-derived paths from changes in physical activity → mood → self-regulation → self-efficacy → EE change over 6 months, and over 12 months, were identified. Reductions in EE over 6 and 12 months predicted weight loss over 6, 12, and 24 months. Findings supported tenets of social cognitive theory, self-regulation theory, the mood-behavior model, and self-efficacy theory, and informed future behavioral obesity treatments on evidence-driven methods to better-address EE within scalable settings.

This bibliometric study aims to contribute to the literature on adolescent pregnancy by exploring gaps, research trends, contributing countries and journals, collaboration networks, and subject themes, offering a macro perspective on the field's development and future directions. This study employed a bibliometric research methodology. Publications containing the keywords adolescent, adolescence, youth, teenager, puberty, juvenile, pregnancy, and pregnant were retrieved from the Web of Science (WoS) database (1980-April 24, 2024) and analyzed using VOSviewer and the open-source R bibliometric package, adhering to predefined inclusion/exclusion criteria. The concept of adolescent pregnancy has been studied annually from 1980 to the present, peaking in 2022. Key research topics include sexual and reproductive health, contraception, and depression. According to Lotka's Law, 84.7% of authors in this field have published only once. Recent studies have focused on birth weight and pregnancy risks. The most cited publication globally and locally is by Ganchimeg et al., while the Journal of Adolescent Health is the most productive platform. The United States, Brazil, the United Kingdom, South Africa, Canada, and Turkey are the most productive countries in this field. The results of this study highlight that adolescent pregnancy remains a global public health issue, as evidenced by its consistent presence in annual research. Key research gaps and trends include social and emotional challenges faced by pregnant adolescents, physical development and health during adolescent pregnancy, causes and prevalence trends, preventive education services, and psychosocial interventions. Further research is essential to develop effective interventions for preventing adolescent pregnancy and safeguarding the best interests of children.

School suspension in adolescence has been shown to predict homelessness in young adulthood, suggesting that it may be a point of intervention to reduce young adult homelessness. Under zero tolerance policies, school suspension is more common in the United States relative to Australia. Multilevel modeling of cross-national longitudinal data from the International Youth Development Study tested prospective associations between adolescent problem behaviors, student-perceived likelihood of suspension/expulsion, school-level behavior management policy, and young adult homelessness. Population-based samples of participants from Washington State (United States) and Victoria (Australia) were surveyed at ages 13, 14, 15 (2002-2004), and 25 years (2014-15; n = 1945; 51% female). Over half of the young adults who reported homelessness within the previous year at age 25 had experienced school suspension. Individual-level school suspension in middle school predicted young adult homelessness. Higher levels of adolescent rebelliousness, non-violent and violent antisocial behavior, and substance use predicted a higher likelihood of school suspension at the person-level and were indirectly related to increased risk for homelessness at age 25. School behavior management policy was not related to a history of school suspension at either the person- or school-level once individual factors were controlled. Findings demonstrate the importance of school suspension as a risk factor for future homelessness and suggest that prevention programming that aims to mitigate substance use, antisocial behaviors, and school suspension may help to reduce young adult homelessness.