Prevention of alcohol and other drug problems in culturally and linguistically diverse communities

Australia has long been known as a multicultural society. In 2009 around one-quarter of Australia’s population was born overseas and immigrants come from more than 200 countries. While most of Australia’s migrants come from New Zealand, the United Kingdom, India or China, the fastest growing immigrant populations are from sub-Saharan and northern Africa, and the Middle East. Immigrants from a non-English speaking country, as well as their children and grandchildren, are commonly referred to as culturally and linguistically diverse (CLD) as a way of acknowledging differences in ethnic identity and affiliation, as well as cultural and language practices and preferences. Culturally and linguistically diverse groups in Australia face many health challenges, one of which is a potential vulnerability to alcohol and other drug (AOD) use.

The primary aim of this paper is to identify and evaluate primary prevention programs and initiatives aimed at preventing AOD harms in CLD communities.

Diversity, tradition and family : Australian same-sex attracted parents and their families

This paper describes the diversity of family forms within a sample of 455 families parented by same-sex couples and same-sex attracted sole parents from Australia and New Zealand. Around one-third of this sample had conceived at least one of their children while in a previous heterosexual relationship. The remaining two-thirds had conceived at least one child within a same-sex relationship or while they were single. Among this group, the largest proportion was women who conceived using home-based self-insemination with a known donor. A smaller proportion of women had conceived through clinic-based insemination or assisted reproduction with a known or unknown donor. There were 60 male participants in the sample. Around 20% of these men were raising children they had conceived through a surrogacy arrangement; the rest had conceived their children within previous heterosexual relationships or through donor arrangements with single women or lesbians. Around 50% of participants described their family form in terms of a two-parent model, where they and their partner were their children's only parents. Around 34% were sharing care of their children with ex-partners, either a previous heterosexual (opposite sex) partner or a previous same-sex partner. Around 10% described themself as their child's sole parent. In large part, participants in this study were not creating radically new family formations, with around half of all participants describing their family in terms of a two-parent ‘nuclear’ model, albeit a model involving parents of the same gender. However, pathways to conception and/or parenthood did reflect nontraditional patterns.

Family dynamics and the risks for child maltreatment of stepchildren

The thesis examined systemic factors that placed children in stepfamilies at greater risk of physical abuse and neglect by comparing differences between biological- and step-families on a number of known risk factors. A model describing the pathway of child abuse and neglect for children living in stepfamilies was developed to aid in prevention.The portfolio presents four case studies which demonstrate the impact of disruptions to attachment experiences and the sequelae on psychological functioning and how the associated affect dysregulation may be linked to attachment disruptions.

Family violence : key findings from the evaluation of the 2006 family law reforms

The different types, prevalence and consequences of family violence, as demonstrated by the Australian Institute of Family Studies' Evaluation of the 2006 Family Law Reforms, are discussed. Family violence is shown to be an extremely complex phenomenon, which affects the mental and social well-being of the children. Hence, different measures that can be adopted to deal with pre- and post-separation periods and child care problems are also analyzed.

Parenting, family functioning and lifestyle in a new culture : the case of African migrants in Melbourne, Victoria, Australia

This study documented the parenting styles among African migrants now living in Melbourne, Victoria, Australia, and assessed how intergenerational issues related to parenting in a new culture impact on family functioning and the modification of lifestyles. A total of 10 focus group discussions (five with parents and five with 13–17-year-old children; N = 85 participants) of 1.5–2 hours duration were conducted with Sudanese, Somali and Ethiopian migrant families. The analysis identified three discrete themes: (i) parenting-related issues; (ii) family functioning and family relations; and (iii) lifestyle changes and health. African migrant parents were restrictive in their parenting; controlled children's behaviours and social development through strict boundary-setting and close monitoring of interests, activities, and friends; and adopted a hierarchical approach to decision-making while discouraging autonomy among their offspring. Programmes seeking to improve the health and welfare of African migrants in their host countries need to accommodate the cultural and social dimensions that shape their lives. Such programmes may need to be so broad as to apply an acculturation lens to planning, and to assist young people, parents and families in addressing intergenerational issues related to raising children and growing up in a different social and cultural milieu.

Shared parenting : adding children's voices and their measures of adjustment to the evaluation

Shared parenting has been advocated to be a better arrangement for children than sole residence and access arrangements after parental separation. Although there is some research on this issue, studies have been restricted in their reliance on the reports of others. In this paper, we report on a study in Australia, in which children in each of these arrangements were compared with children in intact families on a range of adjustment measures and with each other in relation to their responses to their parents' separation, using both self- and parent-reporting. We found that there was little difference between children in the three family configurations, suggesting that shared parenting is not necessarily associated with better outcomes for the child. On other aspects of adjustment, the children in shared parenting and sole residence/access families did not differ. We also found that parents in all groups underestimated the emotional problems reported by children. In separated families, they also overestimated the children's desire for parents to re-unite. Finally, we found that parents in shared parenting families are more satisfied with their situation than are their children, and fathers are particularly so. The findings suggest that the promotion of shared parenting as the best post-separation family structure is contestable.

The longitudinal influence of home and neighbourhood environments on children's body mass index and physical activity over 5 years : the CLAN study

Objective: To determine the independent contributions of family and neighbourhood environments to changes in youth physical activity and body mass index (BMI) z-score over 5 years.

Methods: In 2001, 2004 and 2006, 301 children (10–12 years at baseline) had their height and weight measured (BMI was converted to z-scores using Centers for Disease Control and Prevention reference charts; see http://www.cdc.gov/growthcharts) and moderate-to-vigorous physical activity (MVPA) assessed using accelerometers. In 2001, parents reported on the home environment (social support, role modelling, rules and restrictions, physical environment) and perceived neighbourhood environment (local traffic, road safety, sporting venues, public transport), and Geographic Information Systems were used to map features of the neighbourhood environment (destinations, road connectivity, traffic exposure). Generalized estimating equations were used to predict average BMI z-score and MVPA over time from baseline home and perceived and objective neighbourhood environment factors.

Results: Among boys, maternal education and heavy traffic were inversely associated, and sibling physical activity, maternal role modelling of MVPA and the presence of dead-end roads were positively associated with MVPA. Having unmarried parents, maternal MVPA role modelling and number of home sedentary items were positively associated with BMI z-score among boys. Among girls, having siblings, paternal MVPA role modelling, physical activity rules and parental physical activity co-participation were positively associated with MVPA. Having unmarried parents and maternal sedentary behaviour role modelling were positively associated, and number of sedentary behaviour rules and physical activity items were inversely associated with BMI z-score among girls.

Conclusion: The home environment seems more important than the neighbourhood environment in influencing children's physical activity and BMI z-score over 5 years. Physical activity and weight gain programmes among youth should focus on parental role modelling, rules around sedentary and active pursuits, and parental support for physical activity. Intervention studies to investigate these strategies are warranted.

Individual, social and physical environmental correlates of children's active free-play : a cross-sectional study

Background
Children's unstructured outdoor free-play (or active free-play) has the potential to make an important contribution to children's overall physical activity levels. Limited research has, however, examined physical activity in this domain. This study examined associations between individual, social and physical environmental factors and the frequency with which children play in particular outdoor locations outside school hours. This study also investigated whether the frequency of playing in outdoor locations was associated with children's overall physical activity levels.

Methods
Participants including 8-9 year old children and their parents (n = 187) were recruited from a selection of primary schools of varying socioeconomic status across metropolitan Melbourne, Australia. Parents completed a survey and children's overall physical activity levels were measured by accelerometry. Regression models examined the odds of children playing in various outdoor settings according to particular correlates.

Results
Inverse associations were found between preference for activities not involving physical activity, and the likelihood of children playing in the yard at home on the weekend (OR = 0.65; CI = 0.45,0.95). Positive correlates of children playing in their own street included: parental perceptions that it was safe for their child to play in their street (weekdays [OR = 6.46; CI = 2.84,14.71], weekend days [OR = 6.01; CI = 2.68,13.47]); children having many friends in their neighbourhood (OR = 2.63; CI = 1.21,5.76); and living in a cul-de-sac (weekdays [OR = 3.99; CI = 1.65,9.66], weekend days [OR = 3.49; CI = 1.49,8.16]). Positive correlates of more frequent play in the park/playground on weekdays included family going to the park together on a weekly basis on weekdays (OR = 6.8; CI = 3.4,13.6); and on weekend days (OR = 7.36; CI = 3.6,15.0). No differences in mean mins/day of moderate-vigorous physical activity were found between children in the highest and lowest tertiles for frequency of playing in particular outdoor locations.

Conclusion
The presence of friends, safety issues and aspects of the built environment were reported by parents to be associated with children's active free-play in outdoor locations. Future research needs to further examine associations with time spent in active free-play and objectively-measured overall physical activity levels. It is also important to investigate strategies for developing a supportive social and physical environment that provides opportunities for children to engage in active free-play.

Dog ownership, dog walking and children's and parents' physical activity

This study aimed to determine cross-sectional associations of dog ownership, dog walking, and physical activity (PA) among children and their parents. Objective measures of PA were obtained for children ages 5-6 and 10-12 years from 19 primary schools across Melbourne, Australia. Parents self-reported their PA, dog ownership, and frequency of dog walking: 53% of families owned a dog, 41% of children who owned a dog did not walk their dog at all, and 32% reported never or rarely walking their dog as a family. Dog ownership was associated with an additional 29 min/day in PA among younger girls, and 70 and 59 min/week more in PA among mothers of younger boys and older girls, respectively. Among mothers of older girls, dog owners were 1.6 times as likely to meet PA guidelines. Mothers with older boys and girls, and fathers with younger boys, who reported walking the dog regularly as a family, spent more time in PA (105, 90, and 158 more min/week, respectively). Promoting dog ownership and dog walking among children and as a family are potential strategies for increasing PA participation in some families.

Evidence-based development of school-based and family-involved prevention of overweight across Europe : the ENERGY-project's design and conceptual framework

Background
There is an urgent need for more carefully developed public health measures in order to curb the obesity epidemic among youth. The overall aim of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY)-project is the development and formative evaluation of a theory-informed and evidence-based multi-component school-based and family-involved intervention program ready to be implemented and evaluated for effectiveness across Europe. This program aims at promoting the adoption or continuation of health behaviors that contribute to a healthy energy balance among school-aged children. Earlier studies have indicated that school and family environments are key determinants of energy-balance behaviors in schoolchildren. Schools are an important setting for health promotion in this age group, but school-based interventions mostly fail to target and involve the family environment.

Methods
Led by a multidisciplinary team of researchers from eleven European countries and supported by a team of Australian experts, the ENERGY-project is informed by the Environmental Research Framework for Weight gain Prevention, and comprises a comprehensive epidemiological analysis including 1) systematic reviews of the literature, 2) secondary analyses of existing data, 3) focus group research, and 4) a cross European school-based survey.

Results and discussion
The theoretical framework and the epidemiological analysis will subsequently inform stepwise intervention development targeting the most relevant energy balance-related behaviors and their personal, family-environmental and school-environmental determinants applying the Intervention Mapping protocol. The intervention scheme will undergo formative and pilot evaluation in five countries. The results of ENERGY will be disseminated among key stakeholders including researchers, policy makers and the general population.

Conclusions
The ENERGY-project is an international, multidisciplinary effort to develop and test an evidence-based and theory-informed intervention program for obesity prevention among school-aged children.

A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3-to 5-year-old children : study protocol

Background: Inadequate fruit and vegetable consumption in childhood increases the risk of developing chronic disease. Despite this, a substantial proportion of children in developed nations, including Australia, do not consume sufficient quantities of fruits and vegetables. Parents are influential in the development of dietary habits of young children but often lack the necessary knowledge and skills to promote healthy eating in their children. The aim of this study is to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption of their 3- to 5-year-old children.
Methods/Design: The study, conducted in the Hunter region of New South Wales, Australia, employs a cluster randomised controlled trial design. Two hundred parents from 15 randomly selected preschools will be randomised to receive the intervention, which consists of print resources and four weekly 30-minute telephone support calls delivered by trained telephone interviewers. The calls will assist parents to increase the availability and accessibility of fruit and vegetables in the home, create supportive family eating routines and role-model fruit and vegetable consumption. A further two hundred parents will be randomly allocated to the control group and will receive printed nutrition information only. The primary outcome of the trial will be the change in the child's consumption of fruit and vegetables as measured by the fruit and vegetable subscale of the Children's Dietary Questionnaire. Pre-intervention and post-intervention parent surveys will be administered over the telephone. Baseline surveys will occur one to two
weeks prior to intervention delivery, with follow-up data collection calls occurring two, six, 12 and 18 months following baseline data collection.
Discussion: If effective, this telephone-based intervention may represent a promising public health strategy to increase fruit and vegetable consumption in childhood and reduce the risk of subsequent chronic disease.
Trial registration: Australian Clinical Trials Registry ACTRN12609000820202

Parenting, family functioning and lifestyle in a new culture : the case of African migrants in Melbourne, Victoria, Australia

This study documented the parenting styles among African migrants now living in Melbourne, Victoria, Australia, and assessed how intergenerational issues related to parenting in a new culture impact on family functioning and the modification of lifestyles. A total of 10 focus group discussions (five with parents and five with 13–17-year-old children; N = 85 participants) of 1.5–2 hours duration were conducted with Sudanese, Somali and Ethiopian migrant families. The analysis identified three discrete themes: (i) parenting-related issues; (ii) family functioning and family relations; and (iii) lifestyle changes and health. African migrant parents were restrictive in their parenting; controlled children's behaviours and social development through strict boundary-setting and close monitoring of interests, activities, and friends; and adopted a hierarchical approach to decision-making while discouraging autonomy among their offspring. Programmes seeking to improve the health and welfare of African migrants in their host countries need to accommodate the cultural and social dimensions that shape their lives. Such programmes may need to be so broad as to apply an acculturation lens to planning, and to assist young people, parents and families in addressing intergenerational issues related to raising children and growing up in a different social and cultural milieu.

How information technology can support family law and mediation

In Australia, before a divorcing couple can have their case heard by the Family Court, they must undertake mediation. Thus it is useful to develop information technology tools to support negotiation and mediation in family law. Most negotiation support systems focus upon integrative bargaining. In doing so, they tend to ignore issues of fairness. In Australian Family Law, the interests of the children, as opposed to those of their parents/guardians, are paramount. We investigate the use of providing BATNAs and integrative bargaining in providing family mediation decision support. The discussion is highlighted with examples taken from the domain of Australian Family Law

Mothers in family literacy : a critical feminist analysis

This research addresses the invisibility of mothers in the Family Literacy movement and explores the work of the mother in maintaining and extending family literacy practices. Despite the centrality of mothers in their children's education, mothers are largely invisable in the research literature theorising and decribing family and intergenerational literacy practices and programs, or they are viewed as somehow deficient in their literacy practices. In this study I aim to address this absence and offer a feminist analysis of the Family Literacy movement throught an exploration of the mother's literacy practices within families. I make visible the complexity of the literacy work performed by mothers within families, and extend further feminist discussion on the body through an analysis of the embodiment of language and literacy practices within the mother/child reading dyad. I reconceptualise family literacy programs within a post structuralist feminist framework, and suggest pedagogies which acknowledge the multiple subjectivities of womenas mothers. learners and teachers of their children.