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Halsall T, Lachance L, Kristjansson AL. Examining the implementation of the Icelandic model for primary prevention of substance use in a rural Canadian community: a study protocol. BMC Public Health 2020; 20:1235. [PMID: 32795290 PMCID: PMC7426669 DOI: 10.1186/s12889-020-09288-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/23/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Icelandic Prevention Model (IPM) is a collaborative upstream model that was designed to influence risk and protective factors related to substance use within the community, school, peer and family contexts. By engaging whole communities, the IPM has been found to be effective in reducing youth substance use behaviours across Iceland. As an extension to the IPM's participatory approach, this research will examine how youth involvement can enhance outcomes. In addition, this research will evaluate whether the IPM approach is beneficial for mental health promotion and general youth wellbeing. METHODS The present research protocol applies the bioecological model within a participatory mixed-method case study design to examine the implementation of the IPM in a rural community in Canada. This study was designed to identify whether the Icelandic substance use prevention model is effective in reducing substance use and promoting mental health and development for Canadian youth. It will also explore how to engage youth within the approach and how this adaptation influences implementation and outcomes. DISCUSSION The findings from this study will contribute to our understanding of upstream prevention of youth substance use and will be used to support scaling of the IPM across Canada.
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Alangari AS, Knox SS, Kristjansson AL, Wen S, Innes KE, Bilal L, Alhabeeb A, Al-Subaie AS, Altwaijri YA. Barriers to Mental Health Treatment in the Saudi National Mental Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3877. [PMID: 32486182 PMCID: PMC7311952 DOI: 10.3390/ijerph17113877] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Objectives: To examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the Saudi National Mental Health Survey (SNMHS). Methods: The SNMHS is a community-based epidemiological survey in a nationally representative household sample of respondents aged 15-65 in the Kingdom of Saudi Arabia. The World Health Organization Composite International Diagnostic Interview (CIDI) 3.0 was used. Predictors of barriers to treatment were analyzed with multivariable logistic regression. Results: Among participants with a 12-month DSM-IV/CIDI disorder (n = 711), 86.1% reported no service use. Of those (n = 597), 50.7% did not think they needed any help (categorized as "low perceived need") and 49.3% did perceive need. Of those who perceived need (n = 309), the majority (98.9%) reported attitudinal barriers to initiation. In contrast, 10.3% of those with a perceived need reported structural barriers. Respondents who were previously married or indicated below-average income were more likely to believe they needed help. Conclusions: Among people with a diagnosed mental disorder, low perceived need and attitudinal barriers are the primary barriers to mental health treatment in the KSA. The results suggest that addressing poor mental health literacy may be essential factor in reducing the unmet need for mental health treatment in the KSA.
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Daily SM, Mann MJ, Lilly CL, Bias TK, Smith ML, Kristjansson AL. School Climate as a Universal Intervention to Prevent Substance Use Initiation in Early Adolescence: A Longitudinal Study. HEALTH EDUCATION & BEHAVIOR 2020; 47:402-411. [PMID: 32281413 DOI: 10.1177/1090198120914250] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Initiation of substance use often starts during adolescence, with tobacco and alcohol use frequently preceding the use of marijuana and other illicit drugs. Studies suggest that a positive school climate may prevent substance use while promoting healthy student behaviors. The purpose of this study was to determine the longitudinal associations between school climate and substance use initiation in a group of middle school students. Parallel latent growth curve modeling was used to examine changes among study variables longitudinally using a sample of 2,097 sixth-, seventh-, and eighth-grade students across 16 regional schools located in three counties in West Virginia. Results suggest that a positive school climate may prevent substance use initiation (β = -0.07 to -0.25, p < .01). However, perceptions of school climate decreased on their own over time (β = -0.28 to -0.66, p < .01). Furthermore, substance use initiation also increased as students grew older (β = 0.96 to 0.99, p < .01) and reduced the effects of school climate longitudinally (β = -0.07 to -0.24, p < .01). Early substance use initiation may be a warning sign of other underlying student issues and requires additional school support to foster student success. Findings suggest that a positive school climate may delay substance use initiation and promote school success. School climate may, therefore, be useful as an intervention to support school-based health promotion.
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Daily SM, Mann MJ, Lilly CL, Dyer AM, Smith ML, Kristjansson AL. School Climate as an Intervention to Reduce Academic Failure and Educate the Whole Child: A Longitudinal Study. THE JOURNAL OF SCHOOL HEALTH 2020; 90:182-193. [PMID: 31903632 PMCID: PMC7427837 DOI: 10.1111/josh.12863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/10/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Preventing student academic failure is crucial to student health and life success. Previous studies suggest a positive school climate may reduce students' risk for academic failure and contribute to academic success. The purpose of this study was to determine the longitudinal associations between school climate and academic grades in a group of middle school students who transition into high school. METHODS Parallel latent growth curve modeling was used to examine changes among study variables longitudinally using a sample of 2604 in 6th, 7th, and 8th-grade students across 16 regional schools located in 3 counties in West Virginia. RESULTS Students with higher perceptions of a positive school climate exhibited sustained or improved academic achievement over time (β = 0.22 to 0.30, p < .01). Higher positive perceptions of school climate appear to sustain students who earn As/Bs (β = 0.20 to 0.27, p < .01) and strengthen students who earn Cs/Ds/Fs (β = -0.16 to -0.46, p < .05). CONCLUSIONS Positive student perceptions of school climate may sustain high academic performance while strengthening students who earn Cs/Ds/Fs. School climate may be useful as an intervention to support school-based health promotion to reduce the achievement gap in the United States.
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Kristjansson AL, Mann MJ, Sigfusson J, Thorisdottir IE, Allegrante JP, Sigfusdottir ID. Implementación del Modelo Islandés para la Prevención del Uso del Sustancias en Adolescentes. Health Promot Pract 2020. [DOI: 10.1177/1524839919899086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Resumen Esta es la segunda de una serie de dos partes de artículos sobre el Modelo Islandés de Prevención Primaria del Uso de Sustancias (MIP) en Health Promotion Practice. El MIP es una estrategia comunitaria colaborativa que ha demostrado notable efectividad en reducir el inicio del uso de sustancias entres jóvenes de Islandia en los últimos 20 años. Mientras el primer artículo se enfocó en el contexto de fondo, orientación teórica, evaluación y evidencia de su efectividad, y los cinco principios guías del modelo, este segundo artículo describe los 10 pasos centrales en la implementación práctica. Los pasos 1 a 3 se enfocan en cómo construir y mantener la capacidad comunitaria para la implementación del modelo. Los pasos 4 a 6 se enfocan en cómo implementar un sistema riguroso de recolección de datos, como procesarlos, la diseminación de los datos y la traducción de los hallazgos. Los pasos 7 a 9 están diseñados para enfocar la atención de la comunidad y para maximizar el compromiso comunitario en crear y mantener un medioambiente social en el cual la gente joven progresivamente se hace menos proclive a consumir sustancias, e incluye ejemplos ilustrativos de Islandia. Y el paso 10 se enfoca en la naturaleza iterativa, repetitiva y de largo plazo del MIP y describe un amplio y predecible arco de oportunidades y desafíos relacionados con la implementación. Este artículo concluye con una breve discusión sobre las potenciales variaciones en los factores comunitarios para la implementación.
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Kristjansson AL, Mann MJ, Sigfusson J, Thorisdottir IE, Allegrante JP, Sigfusdottir ID. Principios Directrices y Desarrollo del Modelo Islandés para la Prevención del Uso de Sustancias en Adolescentes. Health Promot Pract 2020. [DOI: 10.1177/1524839919899078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Resumen El uso de sustancias por los adolescentes (i.e. el consumo de alcohol, tabaco, y otras drogas), persiste como un problema global, y se mantiene como un desafío para nuestras sociedades y autoridades de salud pública. Como respuesta a las altas tasas de uso de sustancias en adolescentes en los años ‘90, en Islandia han sido pioneros en el desarrollo del Modelo Islandés Para la Prevención Primaria del Uso de Substancias – un método basado en la teoría y evidencia científica que ha demostrado su efectividad en bajar los niveles de consumo en Islandia en los últimos 20 años. Para documentar este método e informar sobre los procesos basados-en-la-práctica que puedan ayudar en establecer este modelo en otros países, describimos esquemáticamente en esta serie de dos partes la teoría, antecedentes, principios directrices del método, y los pasos centrales en la implementación exitosa del modelo. En este artículo describimos los antecedentes y contexto necesarios, la orientación teórica, el desarrollo del método, y brevemente revisamos los hallazgos y datos publicados. Adicionalmente, presentamos los cinco principios guía en los que se basa el método del Modelo de Prevención Islandés para la prevención del uso de sustancias en adolescentes, y discutimos la evidencia acumulada que apoya la efectividad del modelo. En el siguiente artículo, parte 2, identificamos y describimos procesos clave en el modelo y los diez pasos centrales de la implementación efectiva y basada en la práctica de este modelo.
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Alamir YA, Zullig KJ, Wen S, Montgomery-Downs H, Kristjansson AL, Misra R, Zhang J. Association Between Nonmedical Use of Prescription Drugs and Sleep Quality in a Large College Student Sample. Behav Sleep Med 2019; 17:470-480. [PMID: 29131654 PMCID: PMC5949251 DOI: 10.1080/15402002.2017.1403325] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective/Background: Poor sleep and nonmedical use (NMU) of prescription drugs (NMUPD) are both common among college students. Since lack of sleep adversely influences academic performance, this study examined the association between NMUPD and subjective sleep quality among college students. Participants: Students who completed the American College Health Association-National College Health Assessment data (Fall 2010, Spring 2011; N = 135,874). Methods: Associations were examined between NMUPD in four classes over the past 12 months (antidepressant, painkillers, sedatives, and stimulants), and five aspects of sleep quality (Enough Sleep, Early Awakening, Daytime Sleepiness, Difficulty Falling Asleep, and Problem With Daytime Sleepiness) in the past seven days. Results: Any NMUPD (at least one class), NMU of stimulants specifically, and NMU of painkillers specifically were associated with getting fewer days of Enough Sleep (OR: 0.86, 0.93, and 0.84 respectively), more days of Early Awakening (OR: 1.28, 1.10, and 1.28 respectively), Daytime Sleepiness (OR: 1.23, 1.13, and 1.16 respectively), and Difficulty Falling Asleep (OR:1.32, 1.10, and 1.27 respectively; p < .0001, each). NMU of sedatives was significantly associated with having Problem With Daytime Sleepiness (OR: 1.10), more days of Early Awakening (OR: 1.12), and Difficulty Falling Asleep (OR: 1.17; p < .0001). Conclusions: NMUPD is associated with poor sleep among college students. Therefore, behavioral medicine screening and treatment of this vulnerable population should consider sleep health, NMUPD, and the potential that these problems may be comorbid.
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Kristjansson AL, Allegrante JP, Sigfusson J, Sigfusdottir ID. Do population trends in adolescent electronic cigarette use coincide with changes in prevalence of cigarette smoking? Prev Med Rep 2019; 15:100913. [PMID: 31211028 PMCID: PMC6562370 DOI: 10.1016/j.pmedr.2019.100913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 11/18/2022] Open
Abstract
Adolescents who initiate electronic cigarette (EC) use without having ever used tobacco are more likely than those that have not initiated EC use to try cigarette smoking over time. However, whether rates of EC use coincide with cigarette smoking rates at the population level remains unknown. This study aimed to compare trends in ever, current, and daily use of EC and cigarette smoking among adolescents in Iceland from 2015 to 2018. We analyzed four waves of pooled cross-sectional population-based school survey data with students enrolled in the 8th, 9th and 10th grades in the national Icelandic school system (n = 42,440, boys = 50.1%). Response rates ranged between 83.3% and 86.0%. Findings for 8th, 9th, and 10th grade students, and the combined sample, revealed a consistent pattern: prevalence of cigarette smoking either remained unchanged or decreased minimally over the study period. In the combined sample rates of ever smoking remained between 9 and 10% during the entire study period, whereas the prevalence of daily cigarette smoking was around 1%. The use of EC increased 2- to 3-fold in all age groups. Ever use increased from 12% to roughly 30% in the combined group and daily use increased from about 2% to 6% during the same period. We conclude that the prevalence of adolescent cigarette smoking in Iceland remained mostly unchanged between the years 2015 and 2018, whereas EC use increased exponentially during the same period. The prevalence of EC use now far outweighs cigarette smoking in 8th–10th grade youth in Iceland. Trends in adolescent e-cigarette use and cigarette smoking, 2015–2018, is reported. Cigarette smoking remained mostly unchanged during the study period. E-cigarette use increased exponentially in all age groups during the study period. E-cigarette use now far outweighs cigarette smoking among youth in Iceland. Over 40% of 10th grade students have tried e-cigarettes and 10% are daily users.
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Kristjansson AL, Mann MJ, Sigfusson J, Thorisdottir IE, Allegrante JP, Sigfusdottir ID. Development and Guiding Principles of the Icelandic Model for Preventing Adolescent Substance Use. Health Promot Pract 2019; 21:62-69. [PMID: 31162978 PMCID: PMC6918020 DOI: 10.1177/1524839919849032] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Adolescent substance use—the consumption of alcohol, tobacco, and other harmful
drugs—remains a persistent global problem and has presented ongoing challenges
for public health authorities and society. In response to the high rates of
adolescent substance use during the 1990s, Iceland has pioneered in the
development of the Icelandic Model for Primary Prevention of Substance Use—a
theory-based approach that has demonstrated effectiveness in reducing substance
use in Iceland over the past 20 years. In an effort to document our approach and
inform potentially replicable practice-based processes for implementation in
other country settings, we outline in a two-part series of articles the
background and theory, guiding principles of the approach, and the core steps
used in the successful implementation of the model. In this article, we describe
the background context, theoretical orientation, and development of the approach
and briefly review published evaluation findings. In addition, we present the
five guiding principles that underlie the Icelandic Prevention Model’s approach
to adolescent substance use prevention and discuss the accumulated evidence that
supports effectiveness of the model. In a subsequent Part 2 article, we will
identify and describe key processes and the 10 core steps of effective
practice-based implementation of the model.
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Kristjansson AL, Mann MJ, Sigfusson J, Thorisdottir IE, Allegrante JP, Sigfusdottir ID. Implementing the Icelandic Model for Preventing Adolescent Substance Use. Health Promot Pract 2019; 21:70-79. [PMID: 31162979 PMCID: PMC6918021 DOI: 10.1177/1524839919849033] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This is the second in a two-part series of articles about the Icelandic Model for
Primary Prevention of Substance Use (IPM) in this volume of Health
Promotion Practice. IPM is a community collaborative approach that
has demonstrated remarkable effectiveness in reducing substance use initiation
among youth in Iceland over the past 20 years. While the first article focused
attention on the background context, theoretical orientation, evaluation and
evidence of effectiveness, and the five guiding principles of the model, this
second article describes the 10 core steps to practical implementation. Steps 1
to 3 focus on building and maintaining community capacity for model
implementation. Steps 4 to 6 focus on implementing a rigorous system of data
collection, processing, dissemination, and translation of findings. Steps 7 to 9
are designed to focus community attention and to maximize community engagement
in creating and sustaining a social environment in which young people become
progressively less likely to engage in substance use, including demonstrative
examples from Iceland. And Step 10 focuses on the iterative, repetitive, and
long-term nature of the IPM and describes a predictable arc of
implementation-related opportunities and challenges. The article is concluded
with a brief discussion about potential variation in community factors for
implementation.
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Davis SM, Kristjansson AL, Davidov D, Zullig K, Baus A, Fisher M. Barriers to using new needles encountered by rural Appalachian people who inject drugs: implications for needle exchange. Harm Reduct J 2019; 16:23. [PMID: 30940136 PMCID: PMC6444507 DOI: 10.1186/s12954-019-0295-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 03/20/2019] [Indexed: 01/28/2023] Open
Abstract
Background Using a new needle for every injection can reduce the spread of infectious disease among people who inject drugs (PWID). No previous study has examined new needle use barriers among PWIDs residing in the rural Appalachian part of the United States, an area currently in the midst of a heroin epidemic. Objective Therefore, our primary aim was to explore self-reported barriers to using a new needle by PWID attending a needle exchange program (NEP). Methods We conducted a cross-sectional survey of PWID attending two NEPs in rural West Virginia located in the heart of Central Appalachia. A convenience sample of PWID (n = 100) completed the Barriers to Using New Needles Questionnaire. Results The median number of barriers reported was 5 (range 0–19). Fear of arrest by police (72% of PWID “agreed” or “strongly agreed”) and difficulty with purchasing needles from a pharmacy (64% “agreed” or “strongly agreed”) were the most frequently cited barriers. Conclusions/Importance Congruent with previous findings from urban locations, in rural West Virginia, the ability of PWID to use a new needle obtained from a needle exchange for every injection may be compromised by fear of arrest. In addition, pharmacy sales of new needles to PWID may be blunted by an absence of explicit laws mandating nonprescription sales. Future studies should explore interventions that align the public health goals of NEPs with the occupational safety of law enforcement and health outreach goals of pharmacists. Electronic supplementary material The online version of this article (10.1186/s12954-019-0295-5) contains supplementary material, which is available to authorized users.
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Daily SM, Mann MJ, Kristjansson AL, Smith ML, Zullig KJ. School Climate and Academic Achievement in Middle and High School Students. THE JOURNAL OF SCHOOL HEALTH 2019; 89:173-180. [PMID: 30680750 DOI: 10.1111/josh.12726] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 02/15/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Emergent evidence suggests a positive school climate may be a promising population-level intervention to promote academic achievement and student well-being. However, researchers have called for expanding the school climate evidence-base to better describe how the construct is associated with student outcomes. The purpose of this study was to determine the associations between 10 school climate domains and academic achievement among middle and high school students. METHODS ANOVAs were used to analyze survey data from 6-12 grade students in a Mid-Atlantic US state (n = 2405, response rate: middle school = 82.4%, 50.5% female; high school = 62.5%, 56.1% female). RESULTS Significant main effects were found for all school climate domains and varied between middle and high school students apart from academic support. Effect sizes ranged from small to medium, with academic support demonstrating the strongest effects among both middle and high school students. CONCLUSIONS Findings suggest school climate is associated with academic achievement for both middle and high school students. Correctly identifying the role of key aspects of school climate by grade-level may provide improved and developmentally appropriate recommendations for the delivery of instruction and school-based interventions that promote positive school well-being and student performance.
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Davis SM, Davidov D, Kristjansson AL, Zullig K, Baus A, Fisher M. Qualitative case study of needle exchange programs in the Central Appalachian region of the United States. PLoS One 2018; 13:e0205466. [PMID: 30312333 PMCID: PMC6185728 DOI: 10.1371/journal.pone.0205466] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/25/2018] [Indexed: 02/04/2023] Open
Abstract
Background The Central Appalachian region of the United States is in the midst of a hepatitis C virus epidemic driven by injection of opioids, particularly heroin, with contaminated syringes. In response to this epidemic, several needle exchange programs (NEP) have opened to provide clean needles and other supplies and services to people who inject drugs (PWID). However, no studies have investigated the barriers and facilitators to implementing, operating, and expanding NEPs in less populous areas of the United States. Methods This qualitative case study consisted of interviews with program directors, police chiefs, law enforcement members, and PWID affiliated with two NEPs in the rural state of West Virginia. Interview transcripts were coded inductively and analyzed using qualitative data analysis software. Final common themes related to barriers and facilitators of past program openings, current program operations, and future program plans, were derived through a consensus of two data coders. Results Both NEPs struggled to find existing model programs, but benefited from broad community support that facilitated implementation. The largest operational barrier was the legal conundrum created by paraphernalia laws that criminalize syringe possession. However, both PWID and law enforcement appreciated the comprehensive services provided by these programs. Program location and transportation difficulties were additional noted barriers. Future program operations are threatened by funding shortages and bans, but necessitated by unexpected program demand. Conclusion Despite broad community support, program operations are threatened by growing participant volumes, funding shortages, and the federal government’s prohibition on the use of funds to purchase needles. Paraphernalia laws create a legal conundrum in the form of criminal sanctions for the possession of needles, which may inadvertently promote needle sharing and disease transmission. Future studies should examine additional barriers to using clean needles provided by rural NEPs that may blunt the effectiveness of NEPs in preventing disease transmission.
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Kristjansson AL, Allegrante JP, Sigfusdottir ID. Perceived parental reactions to substance use among adolescent vapers compared with tobacco smokers and non-users in Iceland. Public Health 2018; 164:115-117. [PMID: 30268032 DOI: 10.1016/j.puhe.2018.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/23/2018] [Accepted: 08/09/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective is to assess perceived parental reactions to cigarette smoking, vaping, drunkenness, and marijuana use among cigarette smokers, vapers, and those who neither smoke nor vape (non-users). STUDY DESIGN It is a population-based, cross-sectional, school survey with all accessible 13- to 16-year-old students in Iceland (response rate: 84.1%). METHODS Data were analyzed in Mplus using multinomial logistic regression for categorical data with maximum likelihood and robust standard errors, adjusting for potential school clustering. RESULTS Across all four outcome categories and controlling for background factors, non-users were more likely than vapers and smokers to perceive their parental reactions to substance use as negative (P < 0.01). Vapers were significantly more likely than smokers to perceive their parental reactions as negative toward all types of substance use (P < 0.01). CONCLUSIONS Adolescent smokers, vapers, and non-users appear to form a sequential risk gradient toward perceived parental reactions to substance use, with smokers being least likely to perceive their parental reactions as negative and vapers thereafter; non-users are most likely to perceive their parental reactions toward substance use as negative.
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Kristjansson AL, Thomas S, Lilly CL, Thorisdottir IE, Allegrante JP, Sigfusdottir ID. Maternal smoking during pregnancy and academic achievement of offspring over time: A registry data-based cohort study. Prev Med 2018; 113:74-79. [PMID: 29758305 PMCID: PMC6002605 DOI: 10.1016/j.ypmed.2018.05.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/13/2018] [Accepted: 05/11/2018] [Indexed: 12/21/2022]
Abstract
Few studies have assessed the cumulative impact of maternal smoking during pregnancy (MSDP) on scholastic outcomes over time. We examined the relations between MSDP and academic achievement in the 4th, 7th and 10th grades using registry data collected at birth, during the neonatal period, and at each grade level from the 2000, LIFECOURSE study birth cohort in Reykjavik, Iceland (N = 1151, girls = 49.3%). Latent growth modeling showed that MSDP influenced Icelandic achievement scores, standardized to a range from 0 to 60, at baseline (β = -0.04), and over time (β = -0.05). Likewise, MSDP was negatively associated with standardized mathematics scores at baseline (ß = -0.09) and continued to exert a negative impact on mathematics scores over time (ß = -0.08) after controlling for gender, income, cohabitation, and baseline mathematics and Icelandic achievement scores. Results provide evidence of the persistent negative impact of MSDP on academic achievement in offspring. Findings support the proposition that children whose mothers smoke during the first trimester of pregnancy are, on average, at greater risk for poor scholastic outcomes over time than children whose mothers do not smoke during their first trimester. To our knowledge, this is the first study using a longitudinal cohort design to assess whether the impacts of maternal smoking during pregnancy may persist over time. This study contributes to the current state of knowledge by providing an assessment that focuses on the impact of smoking during pregnancy on academic achievement from childhood into early adolescence.
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Kristjansson AL, Thorisdottir IE, Steingrimsdottir T, Allegrante JP, Lilly CL, Sigfusdottir ID. Maternal smoking during pregnancy and scholastic achievement in childhood: evidence from the LIFECOURSE cohort study. Eur J Public Health 2018; 27:850-855. [PMID: 28957474 PMCID: PMC5881721 DOI: 10.1093/eurpub/ckx074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Research on the impact of maternal smoking during pregnancy (MSDP) on scholastic achievement in the offspring has shown conflicting findings. The objective of this study was to assess the impact of MSDP on scholastic achievement in a birth cohort of children in 4th, 7th and 10th grades. Methods We analysed data from the LIFECOURSE study, a cohort study of risk and protective factors in all children born in Reykjavik, Iceland, in the year 2000 (N = 1151, girls = 49.3%). Retrospective registry data for 2014–2015 were merged with prospective survey data that were collected in April 2016. Data on MSDP were assessed during regular antenatal visits at the end of the first trimester. Standardized academic achievement scores were obtained from official school transcripts. Data were analysed using OLS regressions that were entered in three hierarchical blocks. Results Children of mothers who smoked tobacco during the first trimester consistently revealed between 5% and 7% lower scores on standardized academic achievement in 4th, 7th and 10th grade (∼6–8 points on a normally distributed 120 point scale) than those of mothers who had not smoked tobacco during this period (P < 0.05). These findings held after controlling for several factors associated with the time of birth (e.g. birth weight, maternal age at birth, birth order, parental cohabitation and household income), as well as the year of scholastic assessment (parental cohabitation, household income and parental education). Conclusions Maternal smoking during pregnancy was negatively related to scholastic achievement in the offspring during 4th, 7th and 10th grade.
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Mann MJ, Kristjansson AL, Smith ML, Daily SM, Thomas S, Murray S. From Tactics to Strategy: Creating and Sustaining Social Conditions That Demand and Deliver Effective School Health Programs. THE JOURNAL OF SCHOOL HEALTH 2018; 88:333-336. [PMID: 29609212 DOI: 10.1111/josh.12614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/27/2017] [Accepted: 09/14/2017] [Indexed: 06/08/2023]
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Kristjansson AL, Kogan SM, Mann MJ, Smith ML, Juliano LM, Lilly CL, James JE. Does early exposure to caffeine promote smoking and alcohol use behavior? A prospective analysis of middle school students. Addiction 2018; 113:10.1111/add.14261. [PMID: 29707859 PMCID: PMC6207478 DOI: 10.1111/add.14261] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/19/2017] [Accepted: 04/20/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Despite the negative consequences associated with caffeine use among children and youth, its use is increasingly widespread among middle school students. Cross-sectional studies reveal links between caffeine and other substance use. The potential for caffeine use to confer increased vulnerability to substance use, however, has not been investigated using prospective designs. We hypothesized that caffeine use at baseline would be associated positively with increased alcohol use, drunkenness, smoking and e-cigarette use. DESIGN Prospective cohort study with 12 months separating baseline from follow-up. SETTING West Virginia, USA. PARTICIPANTS Middle school students (6th and 7th grades; n = 3932) in three West Virginia (WV) counties provided data at baseline and follow-up 12 months later. MEASUREMENTS Youth self-reported their use of caffeine from multiple sources (e.g. soda, energy drinks, coffee and tea), cigarette smoking, electronic cigarette use, alcohol use and drunkenness. FINDINGS Cross-lagged path models for individual substance use categories provided a good fit to the data. Controlling for demographic variables and other substance use at baseline, caffeine at time 1 (T1) was associated positively with T2 cigarette smoking (β = 0.27, P = 0.001), e-cigarette use (β = 0.21, P = 0.001), alcohol use (β = 0.17, P = 0.001) and drunkenness (β = 0.15, P = 0.001). Conversely, non-significant relations emerged between three of four substances at T1 and caffeine at T2. Positive relations were found between e-cigarette use at T1 and caffeine use at T2 (β = 0.07, P = 0.006). These findings were supported by an omnibus model with all substances included. Specifically, significant relations were observed between caffeine at T1 and all substance use outcomes at T2, whereas no significant relations were observed between substance use and caffeine over time. CONCLUSIONS Caffeine may promote early use of other types of substances among middle school-aged adolescents.
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Sigfusdottir ID, Kristjansson AL, Gudmunsdottir ML, Allegrante JP. A collaborative community approach to adolescent substance misuse in Iceland. Int Psychiatry 2018. [DOI: 10.1192/s1749367600006007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Substance use has become a major threat to health and human development in many European countries. In 23 out of 28 countries participating in the European School Survey Project on Alcohol and Other Drugs (ESPAD), there was a constant and substantial increase in substance use among secondary-school students between the years 1995 and 2003 (Hibell et al, 2003). Iceland experienced a similar upward trend in substance use (Sigfusdottir et al, 2008). Throughout the 1990s, the use of alcohol, tobacco and other drugs increased steadily among 15- and 16-year-olds. In 1998, approximately 17% of 16-year-olds had tried hashish, which was the highest frequency to be measured in Iceland, and over 80% reported that they had used alcohol once or more in their lives (Thorlindsson et al, 1998).
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Abildso CG, Dyer A, Kristjansson AL, Mann MJ, Bias T, Coffman J, Vasile E, Davidov D. Evaluation of an Intimate Partner Violence Training for Home Visitors Using the Theory of Planned Behavior. Health Promot Pract 2017; 19:194-202. [PMID: 28893112 DOI: 10.1177/1524839917728050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Intimate partner violence (IPV) is a public health issue with recent intervention focus by home visiting programs with at-risk families in the United States. Home visitors are typically required to assess IPV but feel unprepared to do so and desire training. Our aim was to evaluate the impact of a daylong IPV training on the intention to enact three key IPV behaviors (screening, making referrals, and safety planning) using the theory of planned behavior. METHOD Survey of 125 home visitors in West Virginia was conducted before and after a daylong IPV training. RESULTS The IPV training had a positive impact on intention to perform the three behaviors of interest, with the greatest impact on the intention to conduct IPV screenings. DISCUSSION Results provide important preliminary evidence supporting the effectiveness of professional development as a means of increasing intentions to conduct activities related to IPV. The impact on IPV screening intention is promising because screening is the first step in addressing IPV. CONCLUSION The IPV training proved beneficial in increasing intentions and such trainings should be expanded, but further study is needed to link intentions to subsequent behaviors to address IPV with at-risk families.
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Kristjansson AL, Mann MJ, Smith ML. Prevalence of substance use among middle school-aged e-cigarette users compared with cigarette smokers, nonusers, and dual users: Implications for primary prevention. Subst Abus 2017. [PMID: 28622100 DOI: 10.1080/08897077.2017.1343218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The objective of this study was to compare the prevalence of substance use in e-cigarette (EC)-only users with combustible cigarette (CC)-only users, dual users, and nonusers in a large sample of middle school-aged adolescents. METHODS Population-based cross-sectional school survey conducted in 15 middle schools in 3 counties in West Virginia in the United States between October and December of 2015 (N = 6547, girls = 49.6%; response rate 84.7%). RESULTS Approximately 4.3% of participants had used EC only, 4.5% had used CC only, and around 5.5% were dual users. Nonusers had the lowest prevalence of all 9 forms of substance use assessed in the study (i.e., chewing tobacco, any alcohol, drunkenness, marijuana, sniffing, prescription drugs, hallucinogens, synthetic marijuana, and bath salts), followed by EC and CC users. Dual users had the highest prevalence of 8 of 9 forms of substance use. Multinomial logistic regression models showed that EC-only users had significantly greater odds over nonusers of using 8 of 9 types of substances included in the study. Conversely, EC-only users had significantly lower odds of using 7 of 9 types of substances when compared with dual users. However, EC-only users did not differ from CC-only users in odds of use in any of the 9 substances included in this analysis. CONCLUSIONS Among middle school-aged adolescents, EC-only users do not differ from CC-only users in odds for other forms of substance use. Primary prevention programs should consider EC use initiation as a pathway to greater risk of other licit and illicit substances among young adolescents.
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Davis SM, Daily S, Kristjansson AL, Kelley GA, Zullig K, Baus A, Davidov D, Fisher M. Needle exchange programs for the prevention of hepatitis C virus infection in people who inject drugs: a systematic review with meta-analysis. Harm Reduct J 2017; 14:25. [PMID: 28514954 PMCID: PMC5436422 DOI: 10.1186/s12954-017-0156-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 05/08/2017] [Indexed: 12/16/2022] Open
Abstract
Background Previous research on the effectiveness of needle exchange programs (NEP) in preventing hepatitis C virus (HCV) in people who inject drugs (PWID) has shown mixed findings. The purpose of this study was to use the meta-analytic approach to examine the association between NEP use and HCV prevention in PWIDs. Methods Study inclusion criteria were (1) observational studies, (2) PWIDs, (3) NEP use, (4) HCV status ascertained by serological testing, (5) studies published in any language since January 1, 1989, and (6) data available for measures of association. Studies were located by searching four electronic databases and cross-referencing. Study quality was assessed using the Newcastle Ottawa (NOS) scale. A ratio measure of association was calculated for each result from cohort or case–control studies and pooled using a random effects model. Odds ratio (OR) and hazard ratio (HR) models were analyzed separately. Results were considered statistically significant if the 95% confidence interval (CI) did not cross 1. Heterogeneity was estimated using Q and I2 with alpha values for Q ≤ 0.10 considered statistically significant. Results Of the 555 citations reviewed, 6 studies containing 2437 participants were included. Studies had an average NOS score of 7 out of 9 (77.8%) stars. Concerns over participant representativeness, unclear adjustments for confounders, and bias from participant nonresponse and loss to follow-up were noted. Results were mixed with the odds ratio model indicating no consistent association (OR, 0.51, 95% CI, 0.05–5.15), and the hazard ratio model indicating a harmful effect (HR, 2.05, 95% CI, 1.39–3.03). Substantial heterogeneity (p ≤ 0.10) and moderate to large inconsistency (I2 ≥ 66%) were observed for both models. Conclusions The impact of NEPs on HCV prevention in PWIDs remains unclear. There is a need for well-designed research studies employing standardized criteria and measurements to clarify this issue. Trial registration PROSPERO CRD42016035315 Electronic supplementary material The online version of this article (doi:10.1186/s12954-017-0156-z) contains supplementary material, which is available to authorized users.
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Kristjansson AL, Mann MJ, Sigfusson J, Sarbu EA, Grubliauskiene J, Daily SM, Sigfusdottir ID. Prevalence of e-cigarette use among adolescents in 13 Eastern European towns and cities. Public Health 2017; 147:66-68. [PMID: 28404498 DOI: 10.1016/j.puhe.2017.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 01/02/2017] [Accepted: 02/03/2017] [Indexed: 11/18/2022]
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Ragnarsdottir LD, Kristjansson AL, Thorisdottir IE, Allegrante JP, Valdimarsdottir H, Gestsdottir S, Sigfusdottir ID. Cumulative risk over the early life course and its relation to academic achievement in childhood and early adolescence. Prev Med 2017; 96:36-41. [PMID: 28011137 PMCID: PMC5340470 DOI: 10.1016/j.ypmed.2016.12.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 12/06/2016] [Accepted: 12/15/2016] [Indexed: 11/30/2022]
Abstract
Early-life risk factors, such as family disruption, maltreatment, and poverty, can negatively impact children's scholastic abilities; however, most previous studies have relied on cross-sectional designs and retrospective measurement. This study investigated the relation between cumulative risk factors during the early life course and subsequent academic achievement in a cohort of children and adolescents. Data for this study were based on registry-data material from the LIFECOURSE study of 1151 children from the 2000 birth cohort in Reykjavik, Iceland, assembled in 2014-2016. Multiple lifetime risk factors, including maternal smoking during pregnancy, parent's disability status, being born to a young mother, number of children in the household, family income, number of visits to school nurses, and reports of maltreatment, were assessed. Latent class analysis and Analysis of Covariance (ANCOVA) were used to predict academic achievement in the 4th and 7th grades. Individuals with no risk factors reported the highest average academic achievement in the 4th (M=66 points, SD=17) and 7th grades (M=67 points, SD=15). There was a significant main effect for 4th-grade risk factors and academic achievement (F [7, 1146]=12.06, p<0.001) and a similar relationship between the risk factor profile and achievement scores in 7th grade (F [7, 1146]=15.08, p<0.001). Each additional risk factor was associated with a drop in academic achievement at both grade levels. We conclude that academic achievement declines in proportion to the number of risk factors in early life.
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Mann MJ, Smith ML, Kristjansson AL. Energy drink consumption and substance use risk in middle school students. Prev Med Rep 2016; 3:279-82. [PMID: 27419027 PMCID: PMC4929213 DOI: 10.1016/j.pmedr.2016.03.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 03/15/2016] [Accepted: 03/19/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Energy drink (ED) sales have increased greatly in recent years and ED is now a common topic in health behavior research. Most studies work with samples of college students and/or young adults and to a lesser degree with high school students. Research is lacking on ED consumption in younger users. The purpose of this study was to fill this gap and assess the prevalence of ED consumption in a sample of middle school students as well to analyze the relationships between ED use and illicit and licit drug use in girls and boys of this age. METHOD We use cross-sectional school-survey data from 6-8th grade students in three US mid-Atlantic schools conducted in September to November 2014 (N = 1152, response rate: 82.4%). RESULTS Approximately 20% of participants had consumed ED and 10% had smoked cigarettes. Almost 14% had used alcohol at least once in their lifetime and 5.5% marijuana. Boys were more likely than girls to have used ED but no gender difference was observed in the prevalence of illicit substances. However, ED use was positively related to smoking and alcohol use among both genders, but also to several forms of illicit drug use among girls. CONCLUSION ED consuming girls are particularly prone to also use illicit substances. This is the first survey-type study which reports a positive relationship between ED consumption with both licit and illicit drug use in middle school-aged girls and boys.
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