Research priorities for child and adolescent physical activity and sedentary behaviours: an international perspective using a twin-panel Delphi procedure

Background
The quantity and quality of studies in child and adolescent physical activity and sedentary behaviour have rapidly increased, but research directions are often pursued in a reactive and uncoordinated manner.

Aim
To arrive at an international consensus on research priorities in the area of child and adolescent physical activity and sedentary behaviour.

Methods
Two independent panels, each consisting of 12 experts, undertook three rounds of a Delphi methodology. The Delphi methodology required experts to anonymously answer questions put forward by the researchers with feedback provided between each round.

Results
The primary outcome of the study was a ranked set of 29 research priorities that aimed to be applicable for the next 10 years. The top three ranked priorities were: developing effective and sustainable interventions to increase children’s physical activity long-term; policy and/or environmental change and their influence on children’s physical activity and sedentary behaviour; and prospective, longitudinal studies of the independent effects of physical activity and sedentary behaviour on health.

Conclusions
These research priorities can help to guide decisions on future research directions.

Reliability and vailidity of self-reported questionnaires related to adolescent violence and consequences, Thailand

In Thailand physical violence among male adolescents is considered a significant public health issue, although there has been little published research into the aetiology and functions of violence in Thai youth. Research in this area has been hampered by a lack of psychometrically sound tools that have been validated to assess problem behaviours in Asian youth. The purpose of this paper is to provide validity and reliability data on an instrument to measure violence in Thai youth. In this study, reliability and validity data for a sample of adolescent Thai youth are reported for the Communities That Care Youth Survey (CTC-YS), a measure of risk and protective factors for violent behaviour, and the STAXI-II, a measure of angry experience and expression. The findings showed overall high internal consistency for both questionnaires, and there was evidence of construct validity. It is concluded that these measures are appropriate for use in research that seeks to investigate youth violence among adolescents in Thailand.

Accounting for the association of family conflict and heavy alcohol use among adolescent girls: the role of depressed mood

Heavy alcohol use increases dramatically at age 14, and there is emerging cross-sectional evidence that when girls experience family conflict at younger ages (11–13 years) the risk of alcohol use and misuse is high. This study evaluated the role of family conflict and subsequent depressed mood in predicting heavy alcohol use among adolescent girls. Method: This was a three-wave longitudinal study with annual assessments (modal ages 12, 13, and 14 years). The participants (N = 886, 57% female) were from 12 metropolitan schools in Victoria, Australia, and participants completed questionnaires during school class time. The key measures were based on the Communities That Care Youth Survey and included family conflict (Wave 1), depressed mood (Wave 2), and heavy alcohol use (Wave 3). Control variables included school commitment, number of peers who consumed alcohol, whether parents were living together, and ethnic background. Results: With all controls in the model, depressed mood at Wave 2 was predicted by family conflict at Wave 1. The interaction of family conflict with gender was significant, with girls showing a stronger association of family conflict and depressed mood. Depressed mood at Wave 2 predicted heavy alcohol use at Wave 3. Conclusions: Girls may be especially vulnerable to family conflict, and subsequent depressed mood increases the risk of heavy alcohol use. The results support the need for gender-sensitive family-oriented prevention programs delivered in late childhood and early adolescence.

Reduction of adolescent alcohol use through family-school intervention: a randomized trial

Purpose
Two-year longitudinal follow-up data evaluated the behavioral impact of Resilient Families, a universal intervention that aimed to prevent early initiation and frequent and heavy adolescent alcohol use in secondary schools in Melbourne, Australia.

Methods
Of 24 secondary schools (62% of those approached), 12 were randomly assigned to intervention and 12 as controls. Intervention students received a social relationship curriculum; their parents received parent education handbooks and invitations to parent education events outlining strategies to encourage healthy adolescent development and reduce adolescent alcohol misuse. At Wave 1 (2004), students were in Year 7 secondary school (mean age, 12.3 years). Data were imputed for students completing at least two of three annual surveys (N = 2,354). Wave 3 (2006; mean, 14.5 years) main outcome measures for alcohol use were “any,” “frequent” (at least monthly), and “heavy” (five or more drinks in a session at least once in the prior fortnight). Multivariate logistic regression assessed intervention exposure effects, adjusting for school classroom clustering and baseline measures.

Results
Relative to controls, intervention students showed significant reductions in any lifetime use (adjusted odds ratio [AOR], .78; 95% confidence interval [CI], .62–.97), and reduced progression to frequent (AOR, .69; CI, .56–.86) and heavy use (AOR, .75; CI, .60–.94).

Conclusions
Randomized assignment to Resilient Families was associated with a significant reduction in adolescent alcohol use among families volunteering for the evaluation. Family–school-based interventions appear promising as a strategy to contribute to population reductions in currently high rates of adolescent alcohol misuse.

Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

Background
There is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services.

Methods/Design
The Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent development, non-compliance of adolescents with requirements of assessment, questionnaire completion and treatment attendance, breaking randomization, and measuring the complexity of change in the context of a family-based intervention.

From diminished men to conditionally masculine: sexuality and Australian men and adolescent boys with intellectual disability

Men and boys with intellectual disability represent a unique group who have hitherto been overlooked by researchers and theorists exploring men and masculinities. Qualitative data from an Australian ethnographic study focused on the sexual health needs of men and adolescent boys with moderate to profound intellectual disability. Findings suggest that masculinity for this group of men is more a biopsychosocial phenomenon than a social construct organised around heteronormative ideals. The conditional masculinity of the men participating in the study was based instead on a number of intrinsic and external factors, which are described in detail.

Contributions of school design to adolescent identity formation : case studies of four Australian secondary schools

The paper presents a summary of the study that examined the relationship between school design and adolescent identity formation. Reviewing theories and empirical studies of identity development, three major processes involved in adolescent identity formation were identified: (1) separation or individuation process, (2) social integration or relational connectedness, and (3) developmental exploration. Two key characteristics of schools that support these identity formation processes were proposed: (1) having a supportive environment addressing needs for individuation and social integration, and (2) providing opportunities for developmental exploration. Implications of these characteristics for school design were studied through a review of research and practices of learning space design. Four secondary schools in Australia which represented an innovative approach to learning space design were then examined to provide insights into these design-related implications and better understand issues and challenges associated with them. The paper concludes with proposing five design principles which supports adolescent identity development through contributing to processes involved in identity formation.

Beyond the primary influences of parents and peers on very young adolescent alcohol use: Evidence of independent community associations

This study examined the extent to which young adolescent alcohol use was related to alcohol-related norms and law enforcement of underage alcohol use, after accounting for known strong parent and peer correlates. Our sample consisted of 7,674 students (X̅ age = 12 years) from 30 Australian communities. Two-level (individuals nested within communities) binary logistic regression was used to examine relationships between recent alcohol use (last 30 days) and perceived community norms about alcohol use, perceived law enforcement of underage alcohol use, parent alcohol use, parent permissiveness of adolescent alcohol use, peer alcohol use, and demographic factors. Results indicated that community norms and perceived law enforcement of alcohol use were associated with alcohol use and this association was independent of parent and peer factors. After accounting for proximal social correlates, community factors were significantly associated with alcohol use among very young adolescents.

Adolescent television viewing and unhealthy snack food consumption: the mediating role of home availability of unhealthy snack foods

Objective
To examine whether home availability of energy-dense snack foods mediates the association between television (TV) viewing and energy-dense snack consumption among adolescents.
Design
Cross-sectional.
Setting
Secondary schools in Victoria, Australia.
Subjects
Adolescents (n 2984) from Years 7 and 9 of secondary school completed a web-based survey, between September 2004 and July 2005, assessing their energy-dense snack food consumption, school-day and weekend-day TV viewing and home availability of energy-dense snack foods.
Results
School-day and weekend-day TV viewing were positively associated with energy-dense snack consumption among adolescent boys (β = 0·003, P < 0·001) and girls (β = 0·03, P < 0·001). Furthermore, TV viewing (school day and weekend day) were positively associated with home availability of energy-dense snack foods among adolescent boys and girls and home availability of energy-dense snack foods was positively associated with energy-dense snack food consumption among boys (β = 0·26, P < 0·001) and girls (β = 0·28, P < 0·001). Home availability partly mediated the association between TV viewing and energy-dense snack consumption.
Conclusions
The results of the present study suggest that TV viewing has a significant role to play in adolescent unhealthy eating behaviours. Future research should assess the efficacy of methods to reduce adolescent energy-dense snack food consumption by targeting parents to reduce home availability of energy-dense foods and by reducing TV viewing behaviours of adolescents.

Identification of factors that can modify peer group influence on adolescent alcohol use

My PhD thesis examined the effect of peer influence on the development of adolescent alcohol use and identified appropriate target points for preventive intervention. The project findings hold unique relevance to efforts in understanding how peer processes are similar or distinct in different cultural contexts at different periods in adolescent development.