Prevention Programs Research Articles

Impact Assessment of an Educational Intervention Programme Using a Serious Game on Cyberviolence against Women and Girls

AbstractCyberviolence among teenagers is a persistent problem addressed by several prevention programmes. In this article, we evaluate an educational intervention programme based on a serious game (CyberSafe Tool) that addresses cyberviolence against women and girls. The goal of the intervention and the serious game was to raise young people’s awareness of online violence against women and girls and to promote safe and responsible online behaviour. The intervention, conducted between 2020 and 2021, included 959 teenagers between 13 and 16 years old from Italy, Greece, Estonia and the United Kingdom. We used a survey questionnaire to conduct an impact assessment. It was administered three times – before the intervention, immediately after the intervention and three weeks after the intervention – to identify participants’ attitudinal changes. The results indicate significant positive attitude changes after the intervention that remained unchanged after the third questionnaire, which was administered three weeks after the intervention.

Impact of the COVID‐19 Pandemic on Oral Health Behaviors Among Children in Iran

ABSTRACTObjectivesParents are responsible for their children's oral health. This study evaluated parents' knowledge, attitudes, and performance on their children's oral health before and after an educational intervention and the impact of COVID‐19 on these variables.Material and MethodsThis quasi‐experimental study included 227 children aged 6–8 years who were referred to 11 Shiraz medical centers from July to December 2021. Data were collected from questionnaires and interviews. After completing the questionnaire, oral health education was provided immediately and then monthly thereafter using dental models and pamphlets. After 3 months, a questionnaire assessed the education's effectiveness. Data were analyzed using independent t‐tests, one‐way analysis of variance (ANOVA), paired t‐tests, and Pearson's correlation.ResultsA total of 163 participants (71.80%) completed all phases, including the second questionnaire. Participants showed moderate knowledge (77.30%), attitude (89.00%), and performance (80.40%). Neither knowledge nor attitude before the intervention had a significant association with demographic characteristics. Parents' education, number of children, and maternal employment were significantly associated with performance (p = 0.002, p = 0.040, p < 0.001, respectively). The intervention significantly enhanced these variables (p < 0.001). In terms of COVID‐19, 72.40% of participants expressed good knowledge about transmission, 52.80% showed moderate concern, and 54% had poor performance. Parental knowledge, attitude, and performance changed significantly following the intervention (p = 0.030, p < 0.001, p < 0.001, respectively).ConclusionsEducational intervention significantly improved parents' knowledge, attitudes, and performance toward children's oral health. Because of the poor performance of parents during the COVID‐19 pandemic, we recommend the implementation of continuing education and preventive oral health programs.

Make the Right Call: formative evaluation for a water safety programme for adults in Western Australia

Background: Preventing drowning in adults is a complex, multifaceted injury prevention issue. The adult drowning rate in Australia is continuing to rise. In 2023, more than half of those who drowned were aged over 45 years. While there has been a call for robust, evidence-informed drowning prevention interventions across the life course, evidence of evaluated, drowning prevention programmes for adults is lacking. For more than a decade, drowning prevention researchers and practitioners in Western Australia (WA) have worked in partnership to design and evaluate evidence-informed programmes. This paper describes formative research to develop ‘Make the Right Call’ (MTRC), an adult water safety programme in WA. Methods: A staged, mixed-methods, formative evaluation was undertaken to inform the design of MTRC. Stages: The approach involved cluster analysis of coronial data 2008–2018 ( n = 93), interviews with adults aged 45–64 years ( n = 10) and 65 years and older ( n = 15), theory mapping, survey design, content and face validity testing of a baseline questionnaire with content experts ( n = 11) and a refined instrument to collect knowledge, and data on norms and water-based activity. The subsequent MTRC programme comprised a media campaign, community swimming and safety classes, lifejacket trade-in, subsidised first-aid training and community education. Discussion: The results of each stage informed the design and evaluation of a new evidence-informed and theory-driven drowning prevention programme for adults aged 45 years and older, delivered by the peak drowning prevention agency in WA, Royal Life Saving Western Australia. An investment in mixed-methods research by the partnership added rigour and credibility to the programme and evaluation design. Conclusion: To the best of our knowledge, this is the first adult water safety programme to apply a theory-driven, evidence-informed approach to its development, implementation and evaluation. The partnership was vital in maximising and accelerating the acceptable transfer of results to enhance knowledge creation and, ultimately, the design of the MTRC drowning prevention programme.

El Cuestionario de Salud General de Goldberg (GHQ-28): Una revisión sistemática

In order to facilitate the understanding of tools that monitor general health, we developed a systematic review of the Goldberg General Health Questionnaire (GHQ-28) to determine the risk factors that explain the psychological problems that were identified in the general population. Previously, a bibliometric approach was carried out to identify research trends on the scientific literature of the GHQ-28. We use Web of Science and Scopus as information sources to retrieve scientific production on GHQ-28, from 2016 and 2021 in English and Spanish. We retrieved 45 studies obtained by search equations, including only 33 systematic review studies after applying the inclusion and exclusion criteria. A massive increase in post-covid-19 pandemic mental health problems was identified, being reported using the GHQ-28 instrument. Common risk factors are identified that inform mental health deterioration. The instrument is useful for the early identification of symptoms and the formulation of prevention and intervention programs in favor of the mental health of the human population.

Evaluating the impact of rock climbing on mental health and emotional well-being in adolescents

BackgroundRock climbing (RC) has gained attention as a therapeutic tool in psychiatric settings that merges physical exertion with mental engagement. It has potential to enhance mental health, through improved self-efficacy and social interaction, making it a novel intervention for addressing anxiety, depression, and behavioral issues in adolescents. This study aimed to investigate the effects of RC as a physical activity on anxiety, depression, and emotional and behavioral problems in adolescents.MethodsThe current study included 57 athletes aged 14.5 ± 1.7 years and 91 adolescents aged 13.6 ± 1.2 years, matched for age and gender, who were not professionally involved in sport. In addition to the socio-demographic form, a detailed psychiatric assessment was carried out by the child psychiatrist; using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version (K-SADS-PL) to detect psychiatric conditions. The Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and the Strengths and Difficulties Questionnaire (SDQ) were also administered to the adolescents in the study.ResultsIn the comparative analysis of the RCADS-CV outcomes between the athlete and control groups, the athletes demonstrated notably lower scores for both Separation Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD), yielding p-values of < 0.001 and 0.031, respectively. Although the mean scores for social phobia, OCD, panic disorder, and MDD were lower in the athlete group, the differences were not statistically significant (p > 0.05). In the correlation analysis, a moderately significant correlation was found between the duration of doing sport and the scale scores for SAD (p:0.010), OCD (p:0.014), and panic disorder (p:0.016). There was no significant difference between groups in terms of SDQ scores.ConclusionThese results suggest that RC, through its unique combination of physical exertion and mental focus, may offer protective benefits against certain anxiety disorders among adolescents. Further studies should be conducted to explore the potential use of RC as a preventive program for both healthy adolescents, as well as those with psychiatric disorder.

Influence of Health Literacy on Physical Activity and Sedentary Behaviors in Older Patients with Coronary Artery Disease

Background: Coronary artery disease is a chronic condition that requires continuous adherence to healthy behaviors. Adhering to physical activity and reducing prolonged sedentary behavior are important for the physical health of older patients with coronary artery disease (CAD). Health literacy is increasingly recognized as a key factor in secondary prevention for these patients. However, evidence regarding the associations among health literacy, physical activity, and sedentary behaviors for secondary prevention in older patients with coronary artery disease remains limited. Objectives: This study aimed to identify the prevalence of limited health literacy and the influence of health literacy on physical activity and sedentary behaviors in older patients with CAD. Methods: This study was a descriptive cross-sectional study conducted from May to December 2022 in South Korea. A total of 186 patients aged 65 and older diagnosed with coronary artery disease participated. Data on health literacy, physical activity, and sedentary behaviors were collected through self-reported questionnaires and electronic medical records. Results: The prevalence of limited health literacy in older patients was 66.7%. Hierarchical linear regression revealed that health literacy was a significant determinant of physical activity (β = −0.50, P < .001) and sedentary behaviors (β = 0.58, P < .001) after adjusting for confounding variables. Conclusions: Our main findings showed that health literacy can facilitate improvements in physical activity and sedentary behaviors. Health literacy can facilitate health decisions for secondary prevention in older patients with CAD. Thus, healthcare professionals should assess patient health literacy and illness severity when designing secondary prevention programs.

Prevalence of mental health problems in people living with HIV: a systematic review and meta-analysis

ABSTRACT HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28–34) for depression, 29% (24–34) for anxiety, 20% (17–24) for suicidal ideation, 20% (13–28) for post-traumatic stress disorder, 47% (40–55) for stigma, 44% (31–56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV.

Integrating an industrial hygienist into the infection prevention and control program.

Integrating an industrial hygienist into the infection prevention and control program.

Overview of CHIC symposia series: Summary of Africa and South Asia symposia

This article presents an overview of the main challenges and lessons learned that were presented during the symposia organized by the Coalition to Strengthen the HPV Immunization Community (CHIC) in Africa and South Asia in 2022. Discussions at these meetings revolved around introduction, planning, implementation, and sustainability of HPV prevention and control programmes, with a particular focus in HPV immunisation, as well as cervical cancer screening in South Asian countries. This article also discusses the recently endorsed off-label single-dose HPV vaccination schedule and its potential impact on programme delivery and access. Furthermore, it highlights the importance of intersectional collaboration, effective communication and advocacy strategies, and the need for robust health information systems. Some of the critical factors identified for reducing the burden of cervical cancer in low- and middle-income countries (LMICs) included strategies for increasing access and coverage, addressing vaccine hesitancy, and building capacity among health care providers. The symposia emphasized the importance of face-to-face interactions for collaboration and decision making, with live translation services enabling full participation by stakeholders from diverse backgrounds. The paper concludes with a call for continued collaboration to make progress in reducing the burden of cervical cancer in LMICs.

Spatial-Temporal Distribution of 12-Year Periodontal Disease Prevalence in a Large Population Using Geographical Information Systems: A Longitudinal Study.

Periodontal diseases, commonly linked to dental biofilm and affecting adults, were studied using Geographic Information Systems (GIS) and Kernel Analyses with epidemiological data. This paper presents a hybrid method for use in epidemiological studies by evaluating the spatiotemporal distribution of disease prevalence. This study analy ed 47,757 patients from the Department of Periodontology out of 662,351 visitors to University Faculty of Dentistry (2012 to July 2023). The central districts of Kayseri in Turkey were selected as the study areas. Periodontitis prevalence was assessed through radiographic evidence and clinical examination. Point-based location data, including gender, age, and disease type, matched household data, creating building-based spatial data. Kernel Density (KD) and Average Nearest Neighbor (ANN) analyses examined patient concentration and disease types in specific regions. Accordingly, standard deviation ellipses were prepared by year to assess the spatial changes in the regions where patients resided. The study found higher periodontitis prevalence in males, increasing with age, while gingivitis decreased. After 2017, periodontitis prevalence notably declined. Location-based data exhibited clustering in patient distribution. KD maps showed similar patient distributions over the years, with more applications from areas closer to the Faculty of Dentistry. The spatial distribution of the patients applying has remained consistent over the last 5 years. Through GIS, KD maps reveal the spatial-temporal distribution of periodontitis patients. This aids in identifying high-prevalence regions and guiding strategic healthcare facility placement. Implementing preventive programs in high-demand areas, particularly in family health centers (local health facilities), can reduce community-wide periodontal disease prevalence.

Diabetes knowledge and behaviour: a cross-sectional study of Jordanian adults.

Diabetes mellitus is a significant global health concern that is projected to affect 7.7% of the global population by 2030. Understanding factors that influence diabetes knowledge and management adherence is crucial for effective diabetes mellitus management and prevention. This study investigates the relationships between demographic and clinical factors and their impact on diabetes knowledge and behaviour, as well as the potential influence of diabetes knowledge on management behaviours. The study comprised a cross-sectional survey of 1050 adults, collecting data on age, sex, marital status, education, employment, hypertension, dyslipidaemia (any lipid imbalance, such as high cholesterol, high LDL-cholesterol or low HDL-cholesterol), smoking and diabetes status. Two multiple linear regression models were used to identify factors associated with diabetes knowledge and behaviour, and a simple linear regression model was used to assess the relationship between knowledge and behaviour. Significant associations were found between diabetes knowledge and the following factors: age (44.32 ± 9.53 for ≥50 years vs 39.73 ± 9.95 for 18 to <25 years; p<0.0001), sex (49.00 ± 12.35 for women vs 45.09 ± 13.27 for men; p<0.0001), marital status (50.92 ± 11.69 for married vs 45.39 ± 13.10 for single; p<0.0001), smoking status (45.78 ± 13.22 for smokers vs 48.22 ± 12.15 for non-smokers; p=0.003), hypertension (46.46 ± 13.11 for present vs 47.31 ± 12.87 for absent; p=0.007) and diabetes status (69.49 ± 17.35 for present vs 62.76 ± 16.88 for absent; p<0.001). Behaviour scores correlated similarly with these factors except for diabetes and smoking status. The adjusted simple linear regression model revealed that diabetes knowledge was significantly associated with better management behaviours (coefficient=0.0794, p<0.001) after adjusting for demographic and clinical factors. This study highlights the importance of demographic and clinical factors in the context of diabetes knowledge and behaviours, underscoring the need for targeted educational and preventive programmes to improve diabetes management, especially in vulnerable populations. Additionally, the strong association between diabetes knowledge and management behaviours supports a knowledge-attitude-behaviour (KAB) model of diabetes management.

Hepatosplenic schistosomiasis, treatment outcomes and associated factors among adult patients treated at public hospitals in the Harari Region of Ethiopia: retrospective cross-sectional study.

Schistosomiasis is one of the neglected tropical diseases that pose a significant burden in developing countries, particularly in sub-Saharan Africa. Hepatosplenic schistosomiasis (HSS) is a substantial cause of morbidity and mortality. This study aimed to determine clinical patterns, outcomes and factors associated with HSS in the Harari Region of Ethiopia. An institutional-based retrospective cross-sectional study was conducted among 93 adult patients diagnosed with HSS at public hospitals in the Harari Region from December 2018 to November 2022. Data were extracted from medical records using a standardized data extraction tool. EpiData version 4.2 and SPSS version 26.0 were used for data entry and analysis. Fisher's exact test was used to identify the association between dependent and independent variables, and statistical significance was declared at p<0.05. In the current study, HSS-related mortality was recorded in 7.5% of patients. Recurrent episodes of upper gastrointestinal (GI) bleeding (p=0.04), hypotension (p=0.02), altered mental status at admission (p=0.009) and antibiotic use for the treatment of spontaneous bacterial peritonitis (p=0.04) were significant factors associated with HSS-related mortality. The study found that treatment outcomes of HSS patients were strongly associated with recurrent upper GI bleeding, hypotension, altered mental status and antibiotic use for spontaneous bacterial peritonitis treatment. The use of antibiotics for spontaneous bacterial peritonitis treatment was strongly associated with the treatment outcome of patients with HSS and was unique to our study. Adequate recording of patient data, improving chart keeping, integration of preventive and curative programs, improvement of the diagnostic tools, comprehensive treatment guidelines, early diagnosis and treatment are strongly recommended. Rigorous prospective studies that can fully reflect cause-and-effect relationships are crucial to fill fundamental evidence gaps.

Racial Disparities in a Teen Pregnancy Prevention Program: Abstinence-Only Versus a Comprehensive Sexuality Education Program.

Despite overall declines in risky teen sexual activity, racial and ethnic disparities persist. This study compared abstinence-only and comprehensive teen pregnancy prevention (TPP) programs to explore the effects of the programs on teen sexual activity-related outcomes that may differ by race/ethnicity. Program evaluation data were collected from 7th-grade students in comprehensive (N = 3244) and abstinence-only (N = 3172) TPP programs. Differences between outcomes by TPP program were analyzed using chi-square tests and logistic regression for each racial/ethnic group. Black and Hispanic students were significantly less likely to indicate positive attitudes, intentions, and behaviors at baseline. Only white students significantly improved in both programs from pre- to post-assessment. Native American students in the abstinence-only program were significantly less likely than Native American students in the comprehensive sexuality programming to improve from pre- to post-assessment regarding male sexuality, refusal skills, sex and teen norms, and sexual abstinence. The findings suggest that youth of diverse racial/ethnic backgrounds do not enter TPP programs with similar attitudes, intentions, or behavior regarding appropriate sexual behavior and that the impact of such programs also may vary by race and ethnicity.

Lifestyle Coach Perceptions of Barriers and Facilitators to Participation and Lifestyle Change Among Black and Latinx National Diabetes Prevention Program Participants

ABSTRACT Background Despite the disproportionate impact of type 2 diabetes on racial/ethnic marginalized groups, interventions have not effectively engaged and retained these populations. To effectively meet the needs of these groups, a better understanding of barriers and facilitators to lifestyle change and participation in interventions is needed. Purpose The social determinants of health (SDOH) framework was utilized to examine barriers and facilitators in the National Diabetes Prevention Program (DPP) from the perspective of Lifestyle Coaches delivering the intervention to Black or Latinx participants. Method Using an online survey, coaches reported on barriers observed among participants and strategies to facilitate engagement and retention in the National DPP. We qualitatively coded and summarized responses. Results Black and Latinx participant-serving coaches shared five of the seven most endorsed barriers. Both groups of coaches shared the same four most endorsed facilitators. Discussion Results illustrate the impact SDOH have on one’s ability to participate in diabetes prevention and enact lifestyle change, suggesting that an adapted approach may help to reach Black and Latinx participants. Translation to Health Education Practice This project informs future National DPP implementation. Competencies in the following areas are addressed: Assessment of Needs and Capacity (I), Evaluation and Research (IV), and Advocacy (V).

School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review.

Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation. This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health. We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023. Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies. After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853). Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes. Among these programmes, seven (41%) employed dissonance-based approaches. Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping. Ten (59%) of the programmes were effective in improving adolescent mental health. Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality. The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students. Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.

Prevalence, Predictors and Reasons for Discharge Against Medical Advice Among Patients With Chronic Disease During COVID-19.

Discharge against medical advice (DAMA) is used in healthcare facilities in a situation where patients refuse care or decide to leave the hospital before the treating physician recommends discharge. Previous studies have found DAMA to be prevalent among patients with various chronic conditions. The study had four objectives. The study aimed to investigate: (1) the prevalence of DAMA during COVID-19 (2020-2021) among Jordanian patients with chronic diseases, (2) the association between DAMA and sociodemographic and clinical characteristics of patients with chronic diseases, (3) the predictors of DAMA and (4) the reasons behind DAMA at the patient, hospital and environmental levels. A descriptive cross-sectional correlational design was used in the study. A convenience sampling approach was used to collect data from 1576 patients with chronic diseases from 3 private hospitals. The study found that the prevalence rate of DAMA was 33.3%. There was a significant association between the sociodemographic and clinical characteristics of patients with chronic diseases and DAMA. Health insurance found to be the strongest predictor of DAMA. Finally, the study found that patient, hospital and environmental-related factors had a low impact on DAMA. DAMA is prevalent among patients with chronic diseases in Jordan during COVID-19 pandemic. The current study's findings can serve as an empirical basis for planning and implementing DAMA prevention programs and/or establishing or revising policies for the target population.

Impact of Personal Protective Equipment Use on Stress and Psychological Well-Being Among Firefighters: Systematic Review and Meta-Analysis

This study evaluated the individual and psychosocial impacts of personal protective equipment on firefighters by conducting a systematic review and meta-analysis. While PPE is necessary for the protection of firefighters, it can also lead to a number of challenges, which may be both physical and psychological. This assessment incorporates insights from several studies that discuss the factors of stress related to the use of PPE by firefighters. The key aspects of the assessment include the adverse effects of overheating, the restriction of free movements, the inability to speak normally, and various other factors that increase stress. Studies have revealed that the use of PPE increases physical and mental stress levels by 10–25%, which increases overall anxiety by 35% and stress levels by 20–30%. The results suggest that the use of PPE is correlated with heightened levels of both physical and mental stress, leading to a 35% increase in anxiety and a 20–30% increase in stress. This study highlights the need to adopt a multidisciplinary approach to address and reduce the effects of PPE use on stress. Policy directions are aimed at improving PPE design, applying stress prevention programs, and controlling organizational strategies to protect firefighters’ safety and well-being.

Public Perceptions of Individuals Attracted to Children: The Impact of the Person's Gender, Child Gender, and Preferentiality on Stigma and Perceived Risk to Offend.

Stigma-related stress may contribute to increased risk in individuals who are sexually attracted to children. Further, certain subgroups of people attracted to children may be more stigmatized than others; this has important implications for prevention programs. We conducted a vignette study to examine whether public stigma toward people attracted to children differed based on the person's gender (man/woman), the gender of the child to whom the person is attracted (boy/girl), and preferentiality (non-preferentially/preferentially attracted to children). A sample of 385 participants (Mage = 41; 66% White; 52% male; 57% US residents) were recruited through Prolific. Participants were randomly assigned to one of eight vignettes presenting a non-offending individual attracted to children. Vignettes varied on the person's gender, the gender of the child to whom they were attracted, and whether they were preferentially or non-preferentially attracted to children. Participants were asked to rate their perception of risk for the person to commit a child sexual offense (and give their reasoning) as well as fill out a measure of stigma regarding the person in the vignette. The only characteristic associated with perception of risk and stigma was preferentiality; participants rated preferentially attracted persons as being a higher risk to offend and endorsed higher stigma regarding that individual. Open-ended responses indicated that in rating risk to offend, participants were concerned with the role of attraction to children, characteristics of the attraction, loss of control and opportunism, lack of offense history, and lifestyle factors.

Parental education, Family Health Climate and accelerometer-based measured physical activity and sedentary behavior of primary school-aged children

IntroductionSociodemographic factors such as parental education level (ED) influence the physical activity (PA) and sedentary behavior (SED) of primary school-aged children. In this context, family factors, such as the physical activity-related Family Health Climate (FHCPA), are relevant. However, the effect of FHCPA on the interaction between ED and children’s activity behavior has not yet been investigated. Therefore, this study aimed to analyze the mediating effect of FHCPA on the relation between parental ED and children’s device-based measured PA and SED.MethodsA total of 94 children and their parents participated in the study. Questionnaires were used to assess parental ED and FHCPA. Children’s moderate to vigorous physical activity (MVPA) and SED were measured using accelerometers. Bivariate correlations were conducted to investigate associations between parental ED and MVPA/SED/FHCPA. Mediation analyses were used to investigate the role of FHCPA in the association between maternal and paternal ED and children’s MVPA/SED. Results indicate a small correlation between maternal ED and FHCPA for the total sample (ρ = 0.318, p &amp;lt; 0.001) and a medium correlation for girls only (ρ = 0.570, p &amp;lt; 0.001). Mediation analyses showed no significant mediation effect. However, there was a significant direct association when considering FHCPA in the relation between higher maternal ED and SED in girls compared to lower ED.DiscussionFuture research should examine more complex models to further develop and refine to facilitate the derivation of more effective recommendations for health prevention programs, particularly for mothers and girls.

Effectiveness, efficacy, acceptability, and feasibility of trauma-informed depression, anxiety, and substance use prevention programs for young people aged 12-25 years: A mixed-methods systematic review.

Mental ill-health and substance use bear significant public health burden on young people. Prevention is key. Trauma-informed approaches to prevention of mental ill-health and substance use demonstrate significant promise, yet it is unclear how well existing approaches work for young people targeting mental ill-health and substance use. This review aimed to assess the effectiveness, feasibility, and acceptability of trauma-informed mental ill-health and/or substance use prevention programs for young people. We searched the PsycINFO, CINAHL, Embase, MEDLINE, and Cochrane Library reference databases for peer-reviewed studies of trauma-informed mental ill-health and/or substance use prevention programs for young people published between 2013 and 2022. Studies in any language were included and reference lists of included articles were scanned for additional studies of relevance. In total, 30 studies were included in this review, comprising five randomized controlled trials (RCTs), seven non-RCTs, 10 quasi-experimental designs, and eight qualitative studies. Among the 30 studies, 27 unique trauma-informed prevention interventions were detailed. Eighteen studies reported statistically significant decreases in mental ill-health, and two studies reported significant decreases in substance use outcomes among participants, up to 6 months following the interventions. Most preventative interventions with statistically significant effects were selective (rather than universal or indicated) in their approach (n = 10, 55%). Broad acceptability and feasibility of trauma-informed prevention programs was observed among studies reporting this information though most quantitative studies were at high risk of bias and/or did not include a control group, whilst qualitative studies tended to report research conducted without a priori research aims. This review synthesizes for the first-time evidence on the effectiveness (or efficacy), feasibility, and acceptability of trauma-informed mental ill-health and/or substance use programs for young people, especially for those exposed to traumatic or adverse experiences. While there are promising efficacy outcomes, further research conducting rigorous, well-powered RCTs is required for large-scale evaluation and scaling of the potential preventative benefits of such programs.