Risk and protective factors for adolescent substance use in Washington State, the United States and Victoria, Australia : a longitudinal study

Purpose
To compare the levels of risk and protective factors and the predictive influence of these factors on alcohol, tobacco, and cannabis use over a 12-month follow-up period in Washington State in the United States and in Victoria, Australia.

Method
The study involved a longitudinal school-based survey of students drawn as a two-stage cluster sample recruited through schools, and administered in the years 2002 and 2003 in both states. The study used statewide representative samples of students in the seventh and ninth grades (n = 3,876) in Washington State and Victoria.

Results
Washington State students, relative to Victorian students, had higher rates of cannabis use but lower rates of alcohol and tobacco use at time 1. Levels of risk and protective factors showed few but important differences that contribute to the explanation of differences in substance use; Washington State students, relative to Victorian students, reported higher religiosity (odds ratio, .96 vs. .79) and availability of handguns (odds ratio, 1.23 vs. 1.18), but less favorable peer, community, and parental attitudes to substance use. The associations with substance use at follow-up are generally comparable, but in many instances were weaker in Washington State.

Conclusions
Levels of risk and protective factors and their associations with substance use at follow-up were mostly similar in the two states. Further high-quality longitudinal studies to establish invariance in the relations between risk and protective factors and substance use in adolescence across diverse countries are warranted.

Implementation of diabetes prevention programs in rural areas : Montana and south-eastern Australia compared

Objective: To identify the key elements that enabled the Greater Green Triangle Diabetes Prevention Project (GGT DPP) and the Montana Cardiovascular Disease and Diabetes Prevention (CDDP) programs successful establishment and implementation in rural areas, as well as identifying specific challenges or barriers for implementation in rural communities.
Methods: Focus groups were held with the facilitators who delivered the GGT DPP in Australia and the Montana CDDP programs in the USA. Interview questions covered the facilitators’ experiences with recruitment, establishing the program, the components and influence of rurality on the program, barriers and challenges to delivering the program, attributes of successful participants, and the influence of community resources and partnerships on the programs.
Results: Four main themes emerged from the focus groups: establishing and implementing the diabetes prevention program in the community; strategies for recruitment and retention of participants; what works in lifestyle intervention programs; and rural-centred issues.
Conclusions: The results from this study have assisted in determining the factors that contribute to developing, establishing and implementing successful diabetes prevention programs in two rural areas. Recommendations to increase the likelihood of success of programs in rural communities include: securing funding early for the program; establishing support from community leaders and developing positive relationships with health care providers; creating a professional team with passion for the program; encouraging participants to celebrate their small and big successes; and developing procedures for providing post-intervention support to help participants maintain their success.

Early age alcohol use and later alcohol problems in adolescents : individual and peer mediators in a bi-national study

This paper examines whether there is cross-national similarity in the longitudinal relationship between early age alcohol use and adolescent alcohol problems. Potential mechanisms underlying this relationship also are examined, testing adolescent alcohol use, low self-regulation, and peer deviance as possible mediators. Students (N = 1,945) participating in the International Youth Development Study, a longitudinal panel survey study, responded to questions on alcohol use and influencing factors, and were followed annually over a 3-year period from 2002 to 2004 (98% retention rate). State-representative, community student samples were recruited in grade 7 in Washington State, United States (US, n = 961, 78% of those eligible; Mage = 13.09, SD = .44) and Victoria, Australia (n = 984, 76% of those eligible; Mage = 12.93, SD = .41). Analyses were conducted using multiple-group structural equation modeling. In both states, early age alcohol use (age 13) had a small but statistically significant association with subsequent alcohol problems (age 15). Overall, there was little evidence for mediation of early alcohol effects. Low self-regulation prospectively predicted peer deviance, alcohol use, and alcohol problems in both states. Peer deviance was more positively related to alcohol use and low self-regulation among students in Victoria compared to students in Washington State. The small but persistent association of early age alcohol use with alcohol problems across both samples is consistent with efforts to delay alcohol initiation to help prevent problematic alcohol use. Self-regulation was an important influence, supporting the need to further investigate the developmental contribution of neurobehavioral disinhibition.

The impact of school suspension on student tobacco use : a longitudinal study in Victoria, Australia, and Washington State, United States

Context: School suspension may have unintended consequences in contributing to problem behaviors, including dropping out from school, substance use, and antisocial behavior. Tobacco use is an early-onset problem behavior, but prospective studies of the effects of suspension on tobacco use are lacking.

Method: Longitudinal school-based survey of students drawn as a two-stage cluster sample, administered in 2002 and 2003, in Washington State, United States, and Victoria, Australia. The study uses statewide representative samples of students in Grades 7 and 9 (N = 3,599). Results: Rates of tobacco use were higher for Victorian than Washington State students. School suspension remained a predictor of current tobacco use at 12-month follow-up, after controlling for established risk factors including prior tobacco and other drug use for Grade 7 but not Grade 9 students.

Conclusions: School suspension is associated with early adolescent tobacco use, itself an established predictor of adverse outcomes in young people. Findings suggest the need to explore process mechanisms and alternatives to school suspensions as a response to challenging student behavior in early adolescence.

Predictors and responses to the growth in physical violence during adolescence : a comparison of students in Washington State and Victoria, Australia

This study investigates patterns in violence over 3 time points in early to midadolescence in 2 statewide representative samples of youth, one in Washington State, USA, and the other in Victoria, Australia. Comparable data collection methods in both states were used to cross-nationally compare patterns of violence, risk factors, and responses to violence (school suspensions and arrests) in 2 policy contexts. Risk factors include early use of alcohol, binge drinking, involvement with antisocial peers, family conflict, poor family management, sensation seeking, and bully victimization. These are modeled as correlates of initial violence and predictors of change in violence over a 3-year period, from ages 12–15, for participating youth. Results suggest that patterns and predictors of violence are mostly similar in the 2 states. Initial levels of violence (age 13) and change over time in violence were associated in both states with more youth school suspensions and more police arrests in Grade 9. Some cross-national differences were also shown. For example, correlations of violence with gender and violence with binge drinking were stronger in Victoria, whereas correlations of violence with early use of alcohol and with antisocial peer involvement were stronger in Washington State. Antisocial peer involvement and family conflict were significant predictors of a gradual increase in violence from Grades 7–9 for youth in Victoria only. Implications are discussed with attention to prevention and intervention efforts.

Dietary salt loading impairs arterial vascular reactivity 1-3

BACKGROUND: Studies of sodium have shown improvements in vascular function and blood pressure (BP). The effect of chronic sodium loading from a low-sodium diet to a Western diet on vascular function and BP has been less well studied.

OBJECTIVE: The objective was to examine the effects of dietary salt intake on vascular function and BP.

DESIGN: Thirty-five hypertensive volunteers met the inclusion criteria. After a 2-wk run-in with a low-sodium diet (60 mmol/d), the participants maintained their diets and were randomly assigned to receive sequentially 1 of 3 interventions for 4 wk, with a 2-wk washout between interventions: sodium-free tomato juice (A), tomato juice containing 90 mmol Na (B), and tomato juice containing 140 mmol Na (C). The outcomes were changes in pulse wave velocity (PWV), systolic BP (SBP), and diastolic BP (DBP).

RESULTS: The difference in PWV between interventions B and A was 0.39 m/s (95% CI: 0.18, 0.60 m/s; P = 0.001) and between C and A was 0.35 m/s (95% CI: 0.13, 0.57 m/s; P = 0.01). Differences in SBP and DBP between interventions B and A were 4.4 mm Hg (95% CI: 1.2, 7.8 mm Hg; P = 0.01) and 2.4 mm Hg (95% CI: 0.8, 4.1 mm Hg; P = 0.001), respectively, and between interventions C and A were 5.6 mm Hg (95% CI: 2.7, 8.4 mm Hg; P = 0.01) and 3.3 mm Hg (95% CI: 1.5, 5.0 mm Hg; P = 0.001), respectively. Changes in PWV correlated with changes in SBP (r = 0.52) and DBP (r = 0.58).

CONCLUSIONS: Dietary salt loading produced significant increases in PWV and BP in hypertensive volunteers. Correlations between BP and PWV suggest that salt loading may have a BP-independent effect on vascular wall function. This further supports the importance of dietary sodium restriction in the management of hypertension. This trial was registered with the Australian and New Zealand Clinical Trials Registry as ACTRN12609000161224.

A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3-5 year old children

Objective : To examine the potential efficacy of a brief telephone-based parental intervention in increasing fruit and vegetable consumption in children aged 3–5 years and to examine the feasibility of intervention delivery and acceptability to parents.

Design : A pre–post study design with no comparison group. Telephone surveys were conducted approximately 1 week before and following intervention delivery.
Setting Participants were recruited through pre-schools in the Hunter region, New South Wales, Australia.

Subjects : Thirty-four parents of 3–5-year-olds received four 30-min interventional telephone calls over 4 weeks administered by trained telephone interviewers. The scripted support calls focused on fruit and vegetable availability and accessibility within the home, parental role modelling of fruit and vegetable consumption and on implementing supportive family eating routines.

Results : Following the intervention, the frequency and variety of fruit and vegetable consumption increased (P = 0·027), as measured by a subscale of the children's dietary questionnaire. The intervention was feasible to be delivered to parents, as all participants who started the intervention completed all four calls, and all aspects of the interventional calls, including the number, length, content, format and relevance, were considered acceptable by more than 90 % of parents.

Conclusions : A brief telephone-based parental intervention to encourage fruit and vegetable consumption in pre-school-aged children may be effective, feasible and acceptable. Further investigation is warranted in a randomised controlled trial.

A cluster randomized controlled trial of a telephone-based parent intervention to increase preschoolers’ fruit and vegetable consumption

Background: Inadequate fruit and vegetable consumption is associated with increased chronic disease risk and represents a considerable global health burden. Despite evidence that dietary habits track from early childhood, there are few published trials of interventions attempting to increase preschoolers’ fruit and vegetable consumption.

Objective: The Healthy Habits trial aimed to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption in their 3–5-y-old children.

Design: A cluster randomized controlled trial was conducted involving 394 parents of children aged 3–5 y recruited through local preschools. Parents allocated to the intervention received printed resources plus four 30-min telephone calls targeting aspects of the home food environment associated with children's fruit and vegetable consumption. Parents allocated to the control group received generic printed nutrition information. Children's fruit and vegetable consumption was assessed by using the Fruit and Vegetable Subscale of the Children's Dietary Questionnaire, which was administered via telephone interview at baseline and 2 and 6 mo later.

Results: Analysis of all available data showed that children's fruit and vegetable scores were significantly higher in the intervention group than in the control group at 2 mo (P < 0.001) and at 6 mo (P = 0.021). Sensitivity analysis using baseline observation carried forward showed an intervention effect at 2 mo (P = 0.008) but not at 6 mo (P = 0.069).

Conclusions: Telephone-delivered parent interventions may be an effective way of increasing children's fruit and vegetable consumption in the short term. Further investigation to determine whether the intervention effect is maintained in the longer term is recommended.

Multiple identification and risks : examination of peer factors across multiracial and single-race youth

Multiracial youth are thought to be more vulnerable to peer-related risk factors than are single-race youth. However, there have been surprisingly few well-designed studies on this topic. This study empirically investigated the extent to which multiracial youth are at higher risk for peer influenced problem behavior. Data are from a representative and longitudinal sample of youth from Washington State (N = 1,760, mean age = 14.13, 50.9% girls). Of those in the sample, 225 youth self-identified as multiracial (12.8%), 1,259 as White (71.5%), 152 as Latino (8.6%), and 124 as Asian American (7.1%). Results show that multiracial youth have higher rates of violence and alcohol use than Whites and more marijuana use than Asian Americans. Higher levels of socioeconomic disadvantage and single-parent family status partly explained the higher rates of problem behaviors among multiracial youth. Peer risk factors of substance-using or antisocial friends were higher for multiracial youth than Whites, even after socioeconomic variables were accounted for, demonstrating a higher rate of peer risks among multiracial youth. The number of substance-using friends was the most consistently significant correlate and predictor of problems and was highest among multiracial youth. However, interaction tests did not provide consistent evidence of a stronger influence of peer risks among multiracial youth. Findings underscore the importance of a differentiated understanding of vulnerability in order to better target prevention and intervention efforts as well as the need for further research that can help identify and explain the unique experiences and vulnerabilities of multiracial youth.

Pathways from school suspension to adolescent nonviolent antisocial behavior in students in Victoria, Australia and Washington State, United States

School suspension is associated with school dropout, crime, delinquency, and alcohol and other drug use for the suspended student. Important research questions are how academic and related factors are relevant to the school suspension process and the generality of the process in different sites. State-representative samples of Grade 7 students (N = 1,945) in Washington State, United States and Victoria, Australia were followed from 2002 to 2004. In both states, Grade 7 school suspension was associated with higher rates of nonviolent antisocial behavior and suspension 24 months later, before Grade 8 factors were entered into the model. Relevant factors were Grade 8 low school grades and association with antisocial peers, as well as Grade 8 antisocial behavior in Washington State only. The implications of these findings for the ways in which suspension is used in schools are outlined.

Incredibly close encounters : magical realism and the intimate elegies of Jonathan Safran Foer’s everything is illuminated and extremely loud and incredibly close

This paper will investigate the relationship between prose elegy and magical realism in Jonathan Safran Foer’s novels, Everything is Illuminated and Extremely Loud and Incredibly Close. It will propose that absence is generative, and that the state of melancholia—or unsuccessful, unresolved grief—is conducive to creativity.