Moderators of two Indicated Cognitive-Behavioral Depression Prevention Approaches for Adolescents in a School-Based Effectiveness Trial

Objective: Our aim was to identify moderators of the effects of a cognitive behavioral group-based prevention program (CB group) and CB bibliotherapy, relative to an educational brochure control condition and to one another, in a school-based effectiveness randomized controlled prevention trial. Method: 378 adolescents (M age ¼ 15.5, 68% female) with elevated depressive symptoms were randomized in one of three conditions and were assessed at pretest, posttest, and 6-month follow-up. We tested the moderating effect of three individual (baseline depressive symptoms, negative attributional style, substance use), three environmental (negative life events, parental support, peer support), and two sociodemographic (sex, age) characteristics. Results: Baseline depressive symptoms interacted with condition and time. Decomposition indicated that elevated baseline depressive symptoms amplified the effect of CB bibliotherapy at posttest (but not 6-month follow-up) relative to the control condition, but did not modify the effect of CB group relative to the control condition or relative to bibliotherapy. Specifically, CB bibliotherapy resulted in lower posttest depressive symptoms than the control condition in individuals with elevated, but not average or low baseline symptoms. We found no interaction effect for other putative moderators. Conclusions: Our findings suggest that bibliotherapy is effective only in participants who have elevated depressive symptoms at baseline. The fact that no study variable moderated the effects of CB group, which had a significant main effect in reducing depressive symptoms relative to the control condition, suggests that this indicated prevention intervention is effective for a wide range of adolescents.

Moderators of two Indicated Cognitive-Behavioral Depression Prevention Approaches for Adolescents in a School-Based Effectiveness Trial

Objective: Our aim was to identify moderators of the effects of a cognitive behavioral group-based prevention program (CB group) and CB bibliotherapy, relative to an educational brochure control condition and to one another, in a school-based effectiveness randomized controlled prevention trial. Method: 378 adolescents (M age ¼ 15.5, 68% female) with elevated depressive symptoms were randomized in one of three conditions and were assessed at pretest, posttest, and 6-month follow-up. We tested the moderating effect of three individual (baseline depressive symptoms, negative attributional style, substance use), three environmental (negative life events, parental support, peer support), and two sociodemographic (sex, age) characteristics. Results: Baseline depressive symptoms interacted with condition and time. Decomposition indicated that elevated baseline depressive symptoms amplified the effect of CB bibliotherapy at posttest (but not 6-month follow-up) relative to the control condition, but did not modify the effect of CB group relative to the control condition or relative to bibliotherapy. Specifically, CB bibliotherapy resulted in lower posttest depressive symptoms than the control condition in individuals with elevated, but not average or low baseline symptoms. We found no interaction effect for other putative moderators. Conclusions: Our findings suggest that bibliotherapy is effective only in participants who have elevated depressive symptoms at baseline. The fact that no study variable moderated the effects of CB group, which had a significant main effect in reducing depressive symptoms relative to the control condition, suggests that this indicated prevention intervention is effective for a wide range of adolescents.

Cost-benefit, cost-effectiveness research of drug abuse prevention : implications for programming and policy /

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Internet-based indicated prevention for panic disorder: An effectiveness trial in primary care

Previous studies have shown that an internet delivered indicated prevention program for panic disorder can be effective. However, those studies were done with select populations. Most individuals who are at risk for panic disorder present to hospital emergency rooms and primary care settings. This paper reports on a study currently being undertaken in Scotland where the program is being trialed in primary care. The intervention and experimental design will be described. However the key research question is whether General Practitioners will make use of the internet-based intervention system. Preliminary results will be reported. The results of the study will have implications for the way that primary care is recruited into the prevention of mental health problems.

Ideological Closure : Drug Prevention in a Post-political Society

The aim of this thesis is to critically examine drug prevention as a field of problematizations  – how drug prevention becomes established as a political technology within this field, how it connects to certain modes of governance, how and under which conditions it constitutes it’s problematic, the questions it asks,  it´s implications in terms of political participation and representation, the various bodies of knowledge through which it constitutes the reality upon which it acts, the limits it places on ways of being, questioning, and talking  in the world. The main analyses have been conducted in four separate but interrelated articles. Each article addresses a specific dimension of drug prevention in order to get a grasp of how this field is organized. Article 1 examines the shift that has occurred in the Swedish context during the period 1981–2011 in how drugs have been problematized, what knowledge has grounded the specific modes of problematization and which modes of governance this has enabled. In article 2, the currently dominant scientific discipline in the field of drug prevention – prevention science – is critically examined in terms of how it constructs the “drug problem” and the underlying assumptions it carries in regard to reality and political governance. Article 3 addresses the issue of communities’ democratic participation in drug prevention efforts by analyzing the theoretical foundations of the Communities That Care prevention program. The article seeks to uncover how notions of community empowerment and democratic participation are constructed, and how the “community” is established as a political entity in the program. The fourth and final article critically examines the Swedish Social and Emotional Training (SET) program and the political implications of the relationship the program establishes between the subject and emotions. The argument is made that, within the field of drug prevention, questions of political values and priorities in a problematic way are decoupled from the political field and pose a significant problem in terms of the possibilities to engage in democratic deliberation. Within this field of problematizations it becomes impossible to mobilize a politics against social injustice, poverty and inequality. At the same time, the scientific grounding of this mode of governing the drug “problem” acts to naturalize a specific – highly political – way of engaging with drugs.

Fall prevention among older adults: a quantitative and qualitative study

The purpose of this study was to investigate the effect of a fall prevention program on older adults as well as to explore the perceptions of older adults have on fall risk and the fall prevention program. This research was completed in Newfoundland and Labrador, Canada with participants above the age of 65. The 10-week fall prevention program focused on balance, strength, and flexibility and was followed by focus groups with the control and intervention groups. Pre and post-test measures (postural sway, TUG test, foam and dome test, ABC Scale, ESE Scale, FES Scale, SAFFE) were completed to determine if the fall prevention program decreased fall risk. The results of the quantitative portion of the study did not produce significant results however the qualitative portion was very informative. Five themes emerged from the focus group data: risk factor awareness, confidence, connectedness, quality of life, and program promotion. This research highlights the importance of fall prevention programs for older adults, not only to keep them healthy, but also for the personal and social benefits they facilitate.

Child anxiety, resiliency, and the FRIENDS for Life program

Anxiety disorders are the most commonly diagnosed group of mental disorders in children (Kessler et al., 2012). Resiliency, defined as a child’s ability to successfully overcome an adverse event (Newland, 2014) is believed to be comprised of protective factors such as self-esteem and positive coping strategies (Rutter, 1987). These protective factors are related to child anxiety in that their presence or absence may augment or hinder a child’s resiliency towards anxiety-provoking events and situations (Lo Casico, Guzzo, & Pace, 2013; Thorne, Andrews, & Nordstokke, 2013). The FRIENDS for Life (FFL) program is a school-based anxiety prevention program which aims to decrease anxiety and increase resiliency in 8- to 11-year-old children (Barrett & Sonderegger, 2003). Previous studies have shown FFL to be an effective tool in decreasing anxiety and increasing resiliency; however, not all previous studies have utilized control or comparison groups (Brownlee et al., 2013; Neil & Christensen 2007; Stopa, Barrett, & Golingi, 2011). Moreover, existing FRIENDS literature has not previously considered the potential role of parent anxiety in child outcomes. The present study aimed to evaluate child anxiety, resiliency, and parent anxiety in relation to the FFL program while including a no-treatment control group. It was hypothesized that child anxiety would decrease and child resiliency would increase following FFL. Results obtained from a non-identified school-based sample were not entirely consistent with predictions, such that decreases in anxiety and increases in resiliency were observed in both the experimental and control groups.

Backflow prevention certification workshop information and materials

The information enclosed in this booklet consists of memos, policy statements and other pertinent information to guide you in the establishment of a backflow prevention program.

Factors Influencing the Implementation of Substance Use Prevention Programs in Elementary Schools

Prevention scientists have called for more research on the factors affecting the implementation of substance use prevention programs. Given the lack of literature in this area, coupled with evidence that children as early as elementary school engage in substance use, the purpose of this study was to identify the factors that influence the implementation of substance use prevention programs in elementary schools. This study involved a mixed methods approach comprised of a survey and in-person interviews. Sixty-five guidance counselors and teachers completed the survey, and 9 guidance counselors who completed the survey were interviewed individually. Correlation analyses and hierarchical multiple regression were conducted. Quantitative findings revealed ease of implementation most frequently influenced program implementation, followed by beliefs about the program’s effectiveness. Qualitative findings showed curriculum modification as an important theme, as well as difficulty of program implementation. The in-person interviews also shed light on three interrelated themes influencing program implementation – The Wheel, time, and scheduling. Results indicate the majority of program providers modified the curriculum in some way. Implications for research, policy, and practice are discussed, and areas for future research are suggested.

Competencies Required in Education Research and Teaching Systematization according to Students from the Preschool, Primary and Secondary Education Programs of the University of Costa Rica

The purpose of this paper is to present the results of two online forums carried out with the participation of 42 students of the Licenciaturas  in Preschool Education, Primary Education and Secondary Education of the University of Costa Rica. The main purpose of the forums was to determine the insights of the participant students about the competencies they have achieved in the field of education research, and which have been the essential tools for them to systematize their own teaching practices. The discussion forums were part of the course FD5091 Métodos de Investigación Educativa [Education Research Methods] of the School of Teacher Education, delivered from March-April 2010.  Of the sample, 60 percent were students of the Preschool teaching program, 35 percent were from the Primary Education teaching program and 5 percent were from the Secondary Education teaching program in the fields of Science, Mathematics and Social Studies. According to the insights and beliefs showed by the participants –both, the future teachers and the profession practitioners–, there are no opportunities for research or systematization of their own teaching mediation, in the current work situation.(1) Translator’s Note: In Costa Rica, the “Licenciatura” is a one-year post-Bachelor study program, usually including thesis. “Primary Education” refers to students from the 1st to 6th grades, and “Secondary Education” refers to students from the 7th to 11th grades.

Teaching young people first aid skills to reduce injury

Background First aid given immediately after a motor vehicle crash can have considerable benefits. Less understood however is first aid training as a prevention strategy for reducing risk-taking. A first step is to understand whether first aid skills are associated with risk-taking and injury experiences. Further, students and teachers who undergo or deliver such training offer important perspectives about implementation. Aims The research has two aims: (i) to identify whether first aid knowledge is associated with road risk-taking and injury and (ii) to examine teachers’ and students’ experiences of first aid activities within a school-based injury prevention and control program. Method Participants were 173 Year 9s (47% male) who completed a survey which included demographic information, first aid knowledge and risk-taking behaviour and injury experiences. Focus groups were held with 8 teachers who delivered, and 70 students who participated in, a school-based injury prevention and control program. Results Results showed a relationship between greater first aid knowledge and reduced engagement in risk-taking and injury experiences. Both students and teachers reported favourably on first aid however teachers also acknowledged challenges in delivering practical activities. Discussion & Conclusion It appears that first aid can be implemented within the school setting, particularly at the Year 9 level, and that both students and teachers involved in such training identify multiple benefits and positive experiences with first aid training. In addition, the findings suggest that first aid knowledge could be an important part of a prevention program.

The research pathway to developing a health promotion intervention for the high school curriculum

Introduction: Schools provide the opportunity to reach a large number of adolescents in a systematic way however there are increasing demands on curriculum providing challenges for health promotion activities. This paper will describe the research processes and strategies used to design an injury prevention program.----- Methods: A multi-stage process of data collection included: (1) Surveys on injury-risk behaviours to identify targets of change (examining behaviour and risk/ protective factors among more than 4000 adolescents); (2) Focus groups (n= 30 high-risk adolescents) to understand and determine risk situations; (3) Hospital emergency outpatients survey to understand injury types/ situations; (4) Workshop (n= 50 teachers/ administrators) to understand the target curriculum and experiences with injury-risk behaviours; (5) Additional focus groups (students and teachers) regarding draft material and processes.----- Results: Summaries of findings from each stage are presented particularly demonstrating the design process. The baseline data identified target risk and protective factors. The following qualitative study provided detail about content and context and with the hospital findings assisted in developing ways to ensure relevance and meaning (e.g. identifying high risk situations and providing insights into language, culture and development). School staff identified links to school processes with final data providing feedback on curriculum fit, feasibility and appropriateness of resources. The data were integrated into a program which demonstrated reduced injury.----- Conclusions: A comprehensive research process is required to develop an informed and effective intervention. The next stage of a cluster randomised control trial is a major task and justifies the intensive and comprehensive development.

Bicycle helmet wearing among adolescents

Adolescents experience many benefits from bicycling; however, there are also potentially significant injury consequences. One effective counter-measure for the prevention of adolescent bicycling injuries is to promote bicycle helmet wearing. An overview is provided of injury risks of bicycle riding with particular attention to the role of helmet wearing and associated countermeasures such as legislation and school and community approaches. The findings are presented of a study conducted in Australia that examined the effectiveness of a theory-based injury prevention program, Skills for Preventing Injury in Youth (SPIY) for ninth-grade students (age 13 to 14 years). The findings showed a significant, 20.2% decrease in cycling without a helmet among the intervention students (n = 360) and no change for the students in the comparison group (n = 363) after 6 months. In addition, it was found that failing to wear a helmet was significantly associated with engaging in other transport-related risks, being male, having friends who do not wear a helmet and are specific targets of change in the SPIY program, showing a negative attitude toward risk, failing to intervene in friends' risk-taking, and having low knowledge of first aid. Overall, the SPIY program appeared to be an effective theory-based intervention to increase helmet wearing among early adolescents, a group not often targeted in school and community helmet-wearing programs.

A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare')

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC). Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

Malnutrition and falls risk in community-dwelling older adults

Background and Aims: Falls and fall-related injuries result in reduced functioning, loss of independence, premature nursing home admissions and mortality. Malnutrition is associated with falls in the acute setting, but little is known about malnutrition and falls risk in the community. The aim of this study was to assess the association between malnutrition risk, falls risk and falls over a one-year period in community-dwelling older adults. Methods: Two hundred and fifty four subjects >65 years of age were recruited to participate in a study in order to identify risk factors for falls. Malnutrition risk was determined using the Mini Nutritional Assessment–Short Form. Results: 28.6% had experienced a fall and according to the Mini Nutritional Assessment-Short Form 3.9% (n=10) of subjects were at risk of malnutrition. There were no associations between malnutrition risk, the risk of falls, nor actual falls in healthy older adults in the community setting. Conclusions: There was a low prevalence of malnutrition risk in this sample of community-dwelling older adults and no association between nutritional risk and falls. Screening as part of a falls prevention program should focus on the risk of developing malnutrition as this is associated with falls.