Public Health Prevention Interventions Research Articles

Ten-year trends in major lifestyle risk factors using an ongoing population surveillance system in Australia.

BackgroundUnderstanding how risk factors (tobacco, alcohol, physical inactivity, unhealthy diet, high blood pressure, and high cholesterol) change over time is a critical aim of public health. The associations across the social gradient over time are important considerations. Risk factor surveillance systems have a part to play in understanding the epidemiological distribution of the risk factors so as to improve preventive measures and design public health interventions for reducing the burden of disease.MethodsRepresentative, cross-sectional data were collected in South Australia using telephone interviews, conducted on a minimum of 600 randomly selected people (of all ages) each month. Data were collected from January 2004 to December 2013. Unadjusted prevalence over time, the relative percentage change over the 10 years, and the absolute change of the risk factors with sex, age group, and socio-economic status (SES) estimates are presented.ResultsIn total 55,548 adults (≥18 years) were interviewed (mean age = 47.8 years, 48.8% male). Decreases were apparent for insufficient physical activity, inadequate fruit and vegetables, smoking, and soft drink consumption of ≥500 ml/day. Increases were found over the 10 years for obesity, high cholesterol, diabetes, and for those with no risk factors. Apparent differences were noticeable by different sex, age, and SES categories. While increases in physical activity and fruit and vegetable consumption and decreases in smoking prevalence and multiple risk factors are to be expected in 2020–2021, the prevalence of obesity, high blood pressure, high cholesterol, and diabetes are expected to increase.ConclusionsPublic health efforts in increasing the proportion of the population undertaking appropriate risk factor behavior are showing signs of success, with data from 2004 to 2013 showing encouraging trends. Deriving comparable trends over time by key demographics and SES variables provides evidence for policymakers and health planners to encourage interventions aimed at preventing chronic disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-014-0031-z) contains supplementary material, which is available to authorized users.

The association of extreme temperatures and the incidence of tuberculosis in Japan.

Seasonal variation in the incidence of tuberculosis (TB) has been widely assumed. However, few studies have investigated the association between extreme temperatures and the incidence of TB. We collected data on cases of TB and mean temperature in Fukuoka, Japan for 2008-2012 and used time-series analyses to assess the possible relationship of extreme temperatures with TB incident cases, adjusting for seasonal and interannual variation. Our analysis revealed that the occurrence of extreme heat temperature events resulted in a significant increase in the number of TB cases (relative risk (RR) 1.20, 95 % confidence interval (CI) 1.01-1.43). We also found that the occurrence of extreme cold temperature events resulted in a significant increase in the number of TB cases (RR 1.23, 95 % CI 1.05-1.45). Sex and age did not modify the effect of either heat or cold extremes. Our study provides quantitative evidence that the number of TB cases increased significantly with extreme heat and cold temperatures. The results may help public health officials predict extreme temperature-related TB incidence and prepare for the implementation of preventive public health interventions.

Sociodemographic and Clinical Factors Associated with Seroprevalence of HSV2 Infection among Antenatal Clinic Attendees in Benin

Background: Knowledge of the Sociodemoraphic factors associated with HSV-2 seroprevalence and identification of the associated patient-recognizable clinical features will enable informed preventive public health interventions. There’s yet no documented data on the clinical and sociodemographic factors associated with HSV 2 Seroprevalence among pregnant women in Nigeria. Objectives: To identify sociodemographic and clinical correlates of HSV-2 seroprevalence among pregnant women attending ante-natal clinics in Benin, Nigeria. Study Location, Design and Duration: All the participants were prospectively recruited from the two major hospitals in Benin: University of Benin Teaching Hospital and Central Hospital, Benin. The cross-sectional study took place between November 2011 and June 2012. Methodology: Participants were recruited on booking. Data on their sociodemographic profiles, clinical history and obstetric characteristics were obtained by the use of structured questionnaires and hospital case records. Their blood samples were also promptly collected on recruition. Each participant’s serum was analyzed for HSV-2 IgG antibodies by gG-based type-specific ELISA. Counselling and testing for HIV were also carried out. Data analysis was done using SPSS version 16. Results: The average age of the 674 enrolled participants was 30.6±5.2 years and most Original Research Article International Journal of TROPICAL DISEASE & Health, 4(4): 402-410, 2014 403 of them were married and had complete secondary education. Seroprevalence of HSV-2 was 46.3%. Factors that was significantly associated with HSV-2 seropositivity included age, level of education, parity, HIV seropositivity and positive history of sexually transmitted infections. The HSV-2-infected were also significantly more likely to recall episodes of genital rashes (occurrence of rashes of any type in the external genitalia), vaginal discharge and urethral discharge. Conclusion: Risk factors for HSV-2 infection among pregnant women could include increasing age, higher parity, education below secondary level, HIV-positive status, and positive history of sexually transmitted infections. History of genital rashes, vaginal discharge and urethral discharge syndromes were associated with HSV-2 infection.

The intake of energy and selected nutrients by thai urban sedentary workers: an evaluation of adherence to dietary recommendations.

Rapid changes in Thailand's nutrition and lifestyles have led to increasing diet-related pathologies among people with sedentary occupations. This study examines the extent to which the dietary intake of nutrients and energy by a sample of Thai sedentary workers conforms to the Thai Dietary Reference Intakes (Thai DRIs). The nutrients and energy intake estimates were based on self-reported information collected with a single 24-hour dietary recall and nonweighed 2-day food record. The study participants were Thai adults aged 20–50 years employed in sedentary occupations. A convenience sample of 215 healthy individuals (75 males and 140 females) was based on four randomly selected worksites in the Bangkok metropolitan area. For male participants, the study found a median energy intake of 1,485 kcal/day, with 54.4% of energy coming from carbohydrate, 15.9% from protein, and 29.6% from fat. Females' median energy intake was 1,428 kcal/day, 56% of which came from carbohydrate, 16.2% from protein, and 28.6% from fat. Both genders showed insufficient intake of fiber and most micronutrients. This study provides the material for preventive public health interventions focusing on nutrition-related diseases affecting Thailand's rapidly growing sedentary workforce.

Public Health Science Agenda for Congenital Heart Defects: Report From a Centers for Disease Control and Prevention Experts Meeting

Congenital heart defects (CHDs) are the most common type of birth defect, affecting ≈1% of births per year.[1][1] Although survival has been improving over time, there remain numerous gaps in the understanding of the public health impact of CHDs across the lifespan. Recognizing that there was “a

Parenting Strategies African American Mothers Employ to Decrease Sexual Risk Behaviors in Their Early Adolescent Daughters

The impact of parenting strategies on adolescent's behavior has been the focus of research in the past three decades; the findings have never been more critical, particularly among African American mothers. According to the World Health Organization, approximately 70% of all new HIV cases are among female African Americans (AA) aged 15-24years. The purpose of this study is to explore the process by which AA mothers intervene with their early adolescent daughters to decrease risky sexual situations, with the long-term goal of HIV prevention. A total of 64 AA mother-daughter dyads were recruited and separate focus groups were conducted for mothers and daughters with 6-8 per group. Focus group methodology with principles of participatory action research was employed to formulate focus group questions, recruit dyads, and to analyze the data. Five codes emerged: scaring, limit setting, monitoring, nurturing/instilling values and identifying with one's ethnicity. The findings also showed an interaction between neighborhood risks, mother-daughter relationships and parenting strategies. Parenting strategies could be targeted for public health prevention interventions with the long-term goal of HIV prevention.

It's Your Game…Keep It Real: can innovative public health prevention research thrive within a comparative effectiveness research framework?

The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It's Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research.

Characteristics and health service utilization in two samples of young injection drug users recruited using direct and referral methods in San Francisco, California.

Background: Targeted sampling (TS) and respondent-driven sampling (RDS) methods are methods used to recruit ‘hard-to-reach’ populations. We examine similarities and differences in population characteristics and health service utilization, in two independent samples of young adult injection drug users (IDU). Methods: Data from two samples of young adult (18-29 years) IDU sampled using RDS (N=31) and TS (N=97) in San Francisco, California were compared: (1) a cross-sectional study of IDU using RDS as part of the National HIV Behavioral Survey (NHBS) IDU-2 Study conducted by the San Francisco Department of Public Health, from May 2009 to December 2009; and (2) the UFO Study, an ongoing prospective study of young IDU that used TS methods to sample young IDU (<30 years) from May 2010 to December 2010. Results: Compared to the TS sample, the RDS sample was more heterogeneous demographically: a higher proportion of women, and racial/ethnic diversity; a significantly larger proportion of the RDS sample (vs. TS) previously received an HIV test (98.6% vs. 88.5%) whereas the TS sample had a significantly higher prevalence of HCV (58.7% vs. 15.1%). Conclusion: TS and RDS reached a similar cross section of the young adult IDU population in San Francisco; however, some notable differences were observed, especially in HCV infection prevalence. The findings highlight the need for continued efforts to improve sampling strategies aimed high risk IDU, so as to inform both public health surveillance, research and prevention interventions.

Epidemiology of Hepatitis B and Associated Liver Diseases in China

Hepatitis B virus (HBV) infection has long been a critical public health challenge in China. National surveys revealed a prevalence of approximate 10% for chronic HBV infection in general population. HBV has been the leading cause of chronic hepatitis, cirrhosis, and liver cancers in Chinese population and a common pathogen of acute viral hepatitis. Meanwhile, the epidemic provided important opportunities to research the natural history, public health impact, and therapeutic and preventive interventions for HBV in China. In this review, we summarized the selected key epidemiological studies since 1970s regarding HBV infection and its associated liver diseases in China, and provided considerations for future research, prevention and treatment of HBV.

What is complexity and what do you do with it? Reflections on use of controlled trials to assess complex public health interventions

BackgroundDebate about the appropriate means to assess the effects of complex public health interventions is very much ongoing, particularly the feasibility and value of randomised controlled trials. There has been little systematic investigation of complexity in studies of public health interventions, but an approach to evaluation that explicitly investigates the signs and sources of complexity in an intervention has the potential to increase understanding of why an intervention works or fails. We review the debate about how randomised controlled trials can accommodate complex interventions, how complexity can be investigated within the controlled trial framework, and what the added benefits of such an approach might be. We use the Well London cluster randomised trial as a case study. Case studyLocal adaptation is a commonly cited feature of complexity, as are complicated intervention delivery logistics and interactions between multiple intervention components. A key unresolved objection to the use of controlled trials for complex intervention evaluation is the reductionist conceptualisation of the intervention. The effectiveness component of the Well London trial necessarily treats this multiple-component, locally adapted, community engagement for health programme as simple, to allow valid causal inference. Although the trial includes quantitative community-level outcomes and examines interaction between the intervention and context, this analysis is in a subgroup model. Only the qualitative study nested within the trial directly addresses signs of complexity (synergies between intervention components, phase changes, unexpected outcomes). We propose that the notion of an intervention as simple or complex is dictated by the research question. From this view, although the effectiveness component of a trial treats the intervention as simple, and as such could be seen as overly reductionist, it is not theoretically inconsistent for an assessment to include some additional components investigating aspects of complexity. Additional methods could be easily accommodated, both quantitative and qualitative, including collection of outcome and exposure data continuously throughout the intervention period from a subcohort of study participants; diaries and other ongoing reflective documentation by community members and practitioners delivering the intervention; and social network analysis. Logic models play a central part in identification of potential unexpected outcomes and sources of complexity for investigation. However, methods for logic model development must accommodate non-linear aspects of community engagement interventions to be useful. InterpretationThe benefit of a focus on complexity in the controlled trial framework is to provide rich data about how the intervention interacts with context to assess transferability and explain the findings of the effectiveness component, whether they are positive, null, or negative. The knowledge produced will expand the comparatively sparse basic science evidence base underpinning upstream, preventive public health interventions, which do not receive developmental funding akin to pharmaceutical interventions, to understand in detail how the intervention takes effect before an effectiveness trial. Complexity is important to consider in the process of development of research questions with relevant stakeholders. Consideration of complexity at that stage provides a less reductionist way of thinking about public health interventions and the social systems within which they exist, motivating selection of different research questions and, importantly, different outcomes for the study. FundingWellcome Trust (grant 083679/Z/07/Z).

Negotiating safety and sexual risk reduction with clients in unsanctioned safer indoor sex work environments: a qualitative study.

We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed. Women's accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms. This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs.

(A232) Volcanic Eruptions: Health Consequences and Preventive Health Measures — An Overview

The 2010 eruptions in Iceland, and on Mount Merapi in Indonesia, caused enormous disruption and opened a new chapter in the history of volcanic eruptions, emerging hazards, and disaster crisis management. A volcanic eruption can be devastating for the local wildlife as well as for the human population. Volcanic eruptions represent a different kind of hazard compared with floods, hurricanes, and earthquakes. Their onset also may be sudden, but they differ in that the danger does not necessarily decline rapidly with time, and actually may increase because of the unpredictability of the eruptive behavior and desire of a willing population to believe that the danger has passed and they can resume normal living. Volcanoes and their eruptions can result in a wide range of health impacts and kill people in a remarkably large number of ways. At least 500 million people worldwide live within potential exposure range of volcanic activity and possible eruption. The range of adverse health effects is quite broad and extensive. This presentation will provide an overview of the main causes of death and injury caused by a volcanic eruptions and the preventive health measures and public health interventions to be adopted during a volcanic eruption. Information on the causes of death and injury in eruptions is sparse, but the available literature is summarized in this report for the benefit of volcanologists and emergency planners. Healthcare workers and physicians responding to the volcanic events might find themselves involved in scenarios as varied as disaster planning, epidemiological surveillance, treating the injured, or advising on the health hazards associated with long range transport of volcanic emissions. Medical treatment only has a small role during severe volcanic eruptions. The preventive measures are paramount if injuries and loss of life are to be reduced.

Personalized Medicine in the Age of Pharmacoproteomics: A Close up on India and Need for Social Science Engagement for Responsible Innovation in Post-Proteomic Biology.

Obesity and associated diseases such as diabetes have become an epidemic that represents a major threat to global public health. In the last two decades, an explosive increase in the number of persons diagnosed with diabetes has been observed worldwide. The global figure of affected individuals is expected to increase from currently 150 million to 300 million in 2025. The obesity spectrum diseases also impact individuals at a young age, posing a tremendous burden on the global public health system. Dietary interventions and pharmacological strategies have so far failed to deliver appreciable success in the fight against obesity. This paper examines the emerging role of metabonomic-based gut microbiome biomarkers for personalized interventions against obesity. We also highlight that chronobiology is a potentially relevant consideration for systems biology research in obesity. Mechanism-oriented molecular diagnostics for obesity offer the promise to substantively influence the long term trajectory of obesity related diseases and create a space whereby preventive public health interventions can be designed effectively. Human gut and microbiome warrant attention in future research efforts for personalized medicine, and rational therapeutics for obesity and the associated continuum of diseases.

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?

The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a “life course approach.” Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses.

Health System and Personal Barriers Resulting in Decreased Utilization of HIV and STD Testing Services among At-Risk Black Men Who Have Sex with Men in Massachusetts

Testing for HIV and other sexually transmitted diseases (STD) remains a cornerstone of public health prevention interventions. This analysis was designed to explore the frequency of testing, as well as health system and personal barriers to testing, among a community-recruited sample of Black men who have sex with men (MSM) at risk for HIV and STDs. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered assessment, with optional voluntary HIV counseling and testing. Logistic regression procedures examined factors associated with not having tested in the 2 years prior to study enrollment for: (1) HIV (among HIV-uninfected participants, n = 145) and (2) STDs (among the entire mixed serostatus sample, n = 197). The odds ratios and their 95% confidence intervals obtained from this analysis were converted to relative risks. (1) HIV: Overall, 33% of HIV-uninfected Black MSM had not been tested for HIV in the 2 years prior to study enrollment. Factors uniquely associated with not having a recent HIV test included: being less educated; engaging in serodiscordant unprotected sex; and never having been HIV tested at a community health clinic, STD clinic, or jail. (2) STDs: Sixty percent had not been tested for STDs in the 2 years prior to study enrollment, and 24% of the sample had never been tested for STDs. Factors uniquely associated with not having a recent STD test included: older age; having had a prior STD; and never having been tested at an emergency department or urgent care clinic. Overlapping factors associated with both not having had a recent HIV or STD test included: substance use during sex; feeling that using a condom during sex is "very difficult"; less frequent contact with other MSM; not visiting a health care provider (HCP) in the past 12 months; having a HCP not recommend HIV or STD testing at their last visit; not having a primary care provider (PCP); current PCP never recommending they get tested for HIV or STDs. In multivariable models adjusting for relevant demographic and behavioral factors, Black MSM who reported that a HCP recommended getting an HIV test (adjusted relative risk [ARR] = 0.26; p = 0.01) or STD test (ARR = 0.11; p = 0.0004) at their last visit in the past 12 months were significantly less likely to have not been tested for HIV or STDs in the past 2 years. Many sexually active Black MSM do not regularly test for HIV or STDs. HCPs play a pivotal role in encouraging testing for Black MSM. Additional provider training is warranted to educate HCPs about the specific health care needs of Black MSM, in order to facilitate access to timely, culturally competent HIV and STD testing and treatment services for this population.

Characterizing and Reaching High‐Risk Drinkers Using Audience Segmentation

Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment, including where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions, and research efforts. We described the results of a segmentation analysis of those individuals who self-reported to consume 5 or more drinks per drinking episode at least twice in the last 30 days. The study used the proprietary PRIZM (Claritas, Inc., San Diego, CA) audience segmentation database merged with the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top 10 of the 66 PRIZM audience segments for this risky drinking pattern are described. For five of these segments we provided additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers resided. The top 10 audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge-drinking behavior is referred to as the "Cyber Millenials." This cluster is characterized as "the nation's tech-savvy singles and couples living in fashionable neighborhoods on the urban fringe." Almost 65% of Cyber Millenials households are found in the Pacific and Middle Atlantic regions of the United States. Additional consumer behaviors of the Cyber Millenials and other segments are also described. Audience segmentation can assist in identifying and describing target audience segments, as well as identifying places where segments congregate on- or offline. This information can be helpful for recruiting subjects for alcohol prevention research as well as planning health promotion campaigns. Through commercial data about high-risk drinkers as "consumers," planners can develop interventions that have heightened salience in terms of opportunities, perceptions, and motivations, and have better media channel identification.

Web 2.0 and beyond: risks for sexually transmitted infections and opportunities for prevention

The continued growth of the Internet as a communication medium has had major implications for the transmission and prevention of sexually transmitted infections (STIs). The purpose of this review is to describe recent developments in this rapidly changing environment. The interface between the Internet and STIs is described from three perspectives: the Internet as a risk environment, that is, a place where prospective, potentially STI-infected, sex partners can be recruited; the Internet as a venue where public health prevention interventions aimed at STIs and HIV prevention can be placed; and the Internet as an increasingly important work environment for all STI prevention disciplines. The review highlights recent developments and identifies potential avenues for future research and program development. The increasing interactivity of the Internet, known as 'Web 2.0', especially the user-driven social networking sites that allow users to share near limitless amounts of personal information with their peers in the network, is compounding the potential of the Internet as an environment for both STI risk and prevention.

Epidemiology and 12-Month Outcomes From Traumatic Brain Injury in Australia and New Zealand

An epidemiologic profile of traumatic brain injury (TBI) in Australia and New Zealand was obtained following the publication of international evidence-based guidelines. Adult patients with TBI admitted to the intensive care units (ICU) of major trauma centers were studied in a 6-month prospective inception cohort study. Data including mechanisms of injury, prehospital interventions, secondary insults, operative and intensive care management, and outcome assessments 12-months postinjury were collected. There were 635 patients recruited from 16 centers. The mean (+/-SD) age was 41.6 years +/- 19.6 years; 74.2% were men; 61.4% were due to vehicular trauma, 24.9% were falls in elderly patients, and 57.2% had severe TBI (Glasgow Coma Scale score </=8). Secondary brain insults were recorded in 28.5% and 34.8% underwent neurosurgical procedures before ICU admission. There was concordance with TBI and ICU practice guidelines, although intracranial pressure monitoring was used in 44.5% patients with severe TBI. Twelve-month mortality was 26.9% in all patients and 35.1% in patients with severe TBI. Favorable outcomes at 12 months were recorded in 58.8% of all patients and in 48.5% of patients with severe TBI. In Australia and New Zealand, mortality and favorable neurologic outcomes after TBI were similar to published data before the advent of evidence-based guidelines. A high incidence of prehospital secondary brain insults and an ageing population may have contributed to these outcomes. Strategies to improve outcomes from TBI should be directed at preventive public health strategies and interventions to minimize secondary brain injuries in the prehospital period.

Supplemental Material for Long-Term Effects From a Randomized Trial of Two Public Health Preventive Interventions for Parental Depression

Supplemental Material for Long-Term Effects From a Randomized Trial of Two Public Health Preventive Interventions for Parental Depression

Long-term effects from a randomized trial of two public health preventive interventions for parental depression.

This article presents long-term effects of a randomized trial evaluating 2 standardized, manual-based prevention strategies for families with parental mood disorder: informational lectures and a brief, clinician-based approach including child assessment and a family meeting. A sample of 105 families, in which at least 1 parent suffered from a mood disorder and at least 1 nondepressed child was within the 8- to 15-year age range, was recruited. Parents and children were assessed separately at baseline and every 9 to 12 months thereafter on behavioral functioning, psychopathology, and response to intervention. Both interventions produced sustained effects through the 6th assessment point, approximately 4.5 years after enrollment, with relatively small sample loss of families (<14%). Clinician-based families had significantly more gains in parental child-related behaviors and attitudes and in child-reported understanding of parental disorder. Child and parent family functioning increased for both groups and internalizing symptoms decreased for both groups, with no significant group differences. These findings demonstrate that brief, family-centered preventive interventions for parental depression may contribute to long-term, sustained improvements in family functioning.