Community-based programs to promote care seat restraints in children 0-16 years - A systematic review

Study Objective: Community-based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in reducing injury due to inadequate car seat restraint use in children 0-16 years of age. Methods: A comprehensive search of the literature was performed using the following study selection criteria: community-based intervention study: target population was children aged 0-16 years of age; outcome measure was either injury rates due to motor vehicle crashes or observed changes in child restraint use; and use of community control or historical control in the study design. Quality assessment and data abstraction was guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies. Results: This review found eight studies, that met all the inclusion criteria. In the studies that measured injury outcomes, significant reductions in risk of motor vehicle occupant injury (33-55%) were reported in the study communities. For those studies reporting observed car seat restraint use the community-based programs were successful in increasing toddler restraint use in 1-5 year aged children by up to 11%; child booster seat use in 4-8 year aged children by up to 13%; rear restraint use in children aged 0-15 years by 8%; a 50% increase in restraint use in pre-school aged children in a high-risk community; and a 44% increase in children aged 5-11 years. Conclusion: While this review highlights that there is some evidence to support the effectiveness of community-based programs to promote car restraint use and/or motor vehicle occupant injury, limitations in the evaluation methodologies of the studies requires the results to be interpreted with caution. There is clearly a need for further high quality program evaluation research to develop an evidence base. (C) 2004 Elsevier Ltd. All rights reserved.

Training school personnel to implement a universal school-based prevention of depression program under real-world conditions

The present study evaluated the impact of a universal prevention of depression program [the Resourceful Adolescent Program (RAP)] when implemented under real-world conditions in a school setting. Prior research has found the RAP program to be beneficial for high-school students when the program was implemented by university staff selected, trained, and supervised by a research team. The present study evaluated the RAP program when implemented by existing school personnel. Separately, we measured the impact of a training program for facilitators, the quality of subsequent program implementation, and the student's response to the RAP Program. Results showed that, in response to the training program, facilitators believed they had acquired the knowledge and confidence to implement the program and that the quality of program implementation was acceptable. The study did not demonstrate a beneficial impact of the RAP program for the students. The results raise important questions regarding the extent of training and ongoing supervision facilitators require if the beneficial outcomes for students are to be maintained when interventions are implemented under real-world conditions in school settings. (C) 2004 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Long-term outcome of a school-based, universal approach to prevention of depression in adolescents

In this study. the authors examined the 2-, 3-, and 4-year outcomes of a school-based, universal approach to the prevention of adolescent depression. Despite initial short-term positive effects, these benefits were not maintained over time. Adolescents who completed the teacher-administered cognitive-behavioral intervention did not differ significantly from adolescents in the monitoring-control condition in terms of changes in depressive symptoms, problem solving, attributional style, or other indicators of psychopathology from preintervention to 4-year follow-up. Results were equivalent irrespective of initial level of depressive symptoms.

Adolescents' reactions to universal and indicated prevention programs for depression: Perceived stigma and consumer satisfaction

There is a common view that one of the major considerations in selecting between universal and indicated interventions is the marked stigma produced by the latter. However, to date there has been no empirical examination of this assumption. The current study examined reported stigma and program satisfaction following two school-based interventions aimed at preventing depression in 532 middle adolescents. The interventions were conducted either across entire classes by classroom teachers (universal delivery) or in small high risk groups by mental health professionals (indicated delivery). The indicated delivery was associated with significantly greater levels of perceived stigma, but effect sizes were small and neither program was associated with marked stigma in absolute terms. Perceived stigma was more strongly associated with aspects of the individual including being male and showing greater externalizing symptomatology. In contrast, the indicated program was evaluated more positively by both participants and program leaders and effect sizes for these measures of satisfaction were moderate to large. The results point to the need for further empirical evaluation of both perceived stigma and program satisfaction in providing balanced considerations of the value of indicated and universal programs.

The prevalence of childhood obesity in primary school children in urban Khon Kaen, Northeast Thailand

Childhood obesity is a serious public health problem because of its strong association with adulthood obesity and the related adverse health consequences. The published literature indicates a rising prevalence of childhood obesity in both developed and developing countries. However no data exists on the prevalence in Northeast Thailand, one of the poorest regions of the country and one that has experienced a recent economic transition. The objective of this study was to estimate the prevalence of obesity in seven to nine year old children in urban Khon Kaen, Northeast Thailand. A cross-sectional school based survey was conducted to determine the prevalence of obesity in children of urban Khon Kaen, Thailand. Multi-staged cluster sampling was used to select 12 school clusters of 72 children each between the ages of 7 and 9 years, in primary school grades 1, 2 and 3 from government, private and demonstration schools. A total of 864 seven to nine year old school children were studied. Anthropometric measurements of standing height and weight were taken for all subjects to the nearest tenth of a centimetre and tenth of a kilogram respectively. Childhood obesity was defined as a weight-for-height Z-score above 2.0 standard deviations of the National Center for Health Statistics/World Health Organisation reference population median. The prevalence of childhood obesity was 10.8% (95% CI: 7.6, 13.9). Obesity was significantly more prevalent in boys than girls. The biggest difference was observed between the three school types, with the highest prevalence of obesity found at teacher training demonstration schools and the lowest at the government schools. This study provides the first data on childhood obesity prevalence in Northeast Thailand. The prevalence of 10.8 per cent is lower than that found in two other urban areas of Thailand but slightly higher than expected for this relatively poor region. If this prevalence rate increases, as observed in other countries in economic transition, the incidence of non-communicable diseases associated with obesity is also likely to increase, thus raising cause for concern and reason for intervention to both control and prevent obesity during childhood.

Issues in boys' education: A question of teacher threshold knowledges?

This paper explores the effects of specific teacher threshold knowledges about boys and gender on the implementation of a so-called 'boy friendly' curriculum at one junior secondary high school in Australia. Through semi-structured inter-views with selected staff at the school, it examines the normalizing assumptions and 'truth claims' about boys, as gendered subjects, which drive the pedagogical impetus for such a curriculum initiative. This research raises crucial questions about the need for the formulation of both school and governmental policy grounded in sound research-based knowledge about the social construction of gender and its impact on the lives of both boys and girls and their experiences of schooling. This is crucial, we argue, in light of the recent parliamentary report on boys' education in Australia which rejects gender theorizing and given the failure of key staff in the research school to interrogate the binary ways in which masculinity and femininity are socially constructed and institutionalized in schools through a particular 'gender regime'. While some good things are happening in the research school, the failure to acknowledge the social construction of gender means that ultimately the school's programs cannot be successful.

Adapting the 'family wellbeing' empowerment program to the needs of remote indigenous school children

Objective: To adapt the Family Wellbeing empowerment program, which was initially designed to support adults to take greater control and responsibility for their decisions and lives, to the needs of Indigenous school children living in remote communities. Method. At the request of two schools in remote Indigenous communities in far north Queensland, a pilot personal development and empowerment program based on the adult Family Wellbeing principles was developed, conducted and evaluated in the schools. The main aims of the program were to build personal identity and to encourage students to recognise their future potential and be more aware of their place in the community and wider society. Results: Participation in the program resulted in significant social and emotional growth for the students. Outcomes described by participating students and teachers included increased analytical and reflective skills, greater ability to think for oneself and set goals, less teasing and bullying in the school environment, and an enhanced sense of identity, friendship and,social relatedness'. Conclusion: This pilot implementation of the Family Wellbeing Program adapted for schools demonstrated the program's potential to enhance Indigenous young people's personal growth and development. Challenges remain in increasing parental/ family involvement and ensuring the program's sustainability and transferability. The team has been working with relevant stakeholders to further develop and package the School-based Family Wellbeing program for Education Queensland's New Basics curriculum framework.

Evidence-based approaches to dissemination and diffusion of physical activity interventions

With the increasing availability of effective, evidence-based physical activity interventions, widespread diffusion is needed. We examine conceptual foundations for research on dissemination and diffusion of physical activity interventions; describe two school-based program examples; review examples of dissemination and diffusion research on other health behaviors; and examine policies that may accelerate the diffusion process. Lack of dissemination and diffusion evaluation research and policy advocacy is one of the factors limiting the impact of evidence-based physical activity interventions on public health. There is the need to collaborate with policy experts from other fields to improve the interdisciplinary science base for dissemination and diffusion. The promise of widespread adoption of evidence-based physical activity interventions to improve public health is sufficient to justify devotion of substantial resources to the relevant research on dissemination and diffusion.

Queensland's music outcomes: building pedagogical bridges

This paper discusses the challenges surrounding the implementation of the Music strand of the new syllabus for secondary teachers within the context of emerging trends in pedagogical reform in Queensland, and identifies several areas where research is needed to inform classroom music teaching practice and to guide teacher training programs. Secondary music teachers (Years 8-10) have not had the same systemic, school-based curriculum guidance that was given to teachers in years 1-7. This has resulted in a plethora of teaching and learning practices in lower secondary classrooms, many of which may be more experiential than developmental in approach and which may have little reference to the types of music programs common in primary classrooms.

Out of the generosity of your heart: Are we creating active citizens through compulsory volunteer programmes for young people in Australia?

Using governmentality as a theoretical framework, we examine two Australian policy areas where young people are disciplined into becoming good, active citizens. These policies-mutual obligation through the work for the dole programme, and school-based active citizenship programmes similar to American service learning programmes-both mirror volunteer-ope activities, in a social context where volunteers are viewed as good citizens. In this study, we present findings from a qualitative study that addresses the question of whether young people will develop active citizenship through compulsory volunteer-type programmes. The findings show that first, young people are very conscious of the lack of choice involved in these programmes and that this weakened their sense of agency. Second, the programmes failed to develop positive community attitudes and active social behaviours. These results suggest that policies that compel individuals to contribute to society may actually weaken their citizenship identities.

Escalation and deceleration of offending behaviours from adolescence to early adulthood

Relatively little longitudinal research is available in Australia to describe I the age/crime relationship in much detail, particularly patterns of offending occurring during the transition from adolescence to early adulthood. This paper addresses this issue using self-reported criminal involvement from a school-based sample, a group of socially disadvantaged individuals, and a group of officially identified offenders. The findings support the widespread research that rates of offending peak during adolescence, at which time offending is widespread, and that the criminal career is of relatively short duration. However, the results also demonstrate that the age/crime curve is not a unitary phenomenon. The type of offending behaviour being considered, the gender of the population, and the perpetrator's exposure to the criminal justice system contribute to the variability in the curve. In this study, the prevalence and mean level of overall offending for the total sample was higher during early adulthood than adolescence for vehicle offences and drug-use, rates of theft were similar in both periods, and vandalism and serious offending were lower. In addition, socially disadvantaged young people reported involvement in crime that peaked and desisted earlier in the life course compared to the school-based sample, and gender differences within these groups were also found. For the school-based sample, offending for females began and desisted earlier than for males, but within the at-risk group, the opposite was true. Implications for crime-prevention programming are discussed.

Posttraumatic stress disorder and general psychopathology in children and adolescents following a wildfire disaster

Objective: To report on the use of the Post Traumatic Stress Disorder Reaction Index (PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) in identifying children and adolescents who may require psychological interventions following exposure to a wildfire disaster. Method: Six months after a wildfire disaster, we conducted a school-based program to screen for wildfire-related events, such as exposure to and perception of threat, posttraumatic stress disorder (PTSD), and general psychopathology. Results: The screening battery was completed by 222 children (mean age 12.5 years, SD 2.48; range 8 to 18 years). Severe or very severe PTSD was reported by 9.0% of students, while 22.6% scored in the abnormal range on the Emotional Symptoms subscale of the SDQ. Younger children and individuals with greater exposure to and perception of threat experienced higher levels of PTSD and general psychopathology. Female students reported a greater perception of threat but did not report higher levels of PTSD or other symptoms. Conclusions: Screening was well received by students, parents, and staff and proved feasible in the postdisaster environment. The PTSD-RI and SDQ demonstrated different individual risk associations and functioned as complementary measures within the screening battery. The identification of children at greatest risk of mental health morbidity enabled service providers to selectively target limited mental health resources.