Coproduction of Research Questions and Research Evidence in Public Health: The Study to Prevent Teen Drinking Parties

Translating evidence-based behavioral weight loss into a multi-level, community intervention within a community-based participatory research framework: the Wellness Engagement (WE) Project

Black Americans and individuals from economically disadvantaged backgrounds are at disproportionate risk for obesity, yet are underrepresented in behavioral weight loss (BWL) trials and experience less benefit from traditional programs. The Wellness Engagement (WE) Project sought to translate evidence-based BWL within a CBPR framework to promote change across multiple domains of influence in an under-resourced, predominantly Black community. The purpose of this paper is to describe the efforts we undertook to translate data from our extensive formative phase into programming well suited to meet the needs of the Petersburg community. In addition, we present data from our pilot work on feasibility and acceptability. Formative data were collected using a variety of methods including a community-wide survey, asset mapping, house chats, focus groups, and key informant interviews. In collaboration with key stakeholders and community members, evidence-based approaches to weight loss were adapted to meet the needs of the community with respect to both content and delivery modality. Materials were adapted to focus on small, realistic changes appropriate for the specific context. Behavioral groups, experiential nutrition and exercise sessions, and walking groups leveraged existing assets and were open to all community members. Feasibility and acceptability ratings were promising. Furthermore, the WE Project appeared to contribute to a culture of wellness. CBPR might be a viable approach for engaging under-resourced Black communities in behavioral weight management; larger scale implementation and evaluation efforts are needed.

Advancing complexity-informed health promotion: a scoping review to link health promotion and co-creation

A complexity-informed approach has recently been proposed as a hopeful revolution for health promotion (HP), requesting appropriate ways of tackling the complexities of health, equity and well-being. In addition, co-creation has gained traction as an approach to tackle complexity. HP and co-creation are established concepts that have long been enacted in practice. Although each concept is premised on similar approaches to value-creation such as participation and collaboration, little has been done to link the two approaches. To advance complexity-informed HP, this scoping review presents findings from peer-reviewed articles, published in English, between 2009 and March 2020. Articles were identified through searches of academic databases. Twenty-seven articles met the inclusion criteria, explicitly linking HP and co-creation. Included articles were charted by descriptive information and main focus, and advanced by a thematic analysis. Four themes suggest a potential avenue for advancing complexity-informed HP: (i) dealing with complexity, (ii) value creation, (iii) the value of the values and (iv) benefits and challenges. While current links between HP and co-creation are scarce they are increasing and promising. Based on the findings from the review, propositions to advance complexity-informed HP is outlined and discussed. Overall it is argued that co-creation and HP are mutually beneficial concepts, providing a framework for participative, collaborative, context-sensitive and knowledge-based practice that reflects the complex nature of health. More research is needed to highlight potential and challenges of integrating co-creation in HP, especially related to health equity and sustainable development.

Methods for Population Research on Substance Use and Consequences

This chapter reviews the array of methods used in contemporary research on population-level research on substance use and its consequences. We argue that there are critical questions that can best - or in some cases, only - be addressed at the level of a population. We then describe the major categories of data collection methods used in population research, including surveys, ecological momentary assessment, administrative data, audit methods, and unobtrusive assessment of substance use. Two categories of measures are then discussed: measures of an individual's use of substances and related problems and measures of harm to others caused by one's use. We then review factors that may be considered causes or correlates of substance use and consequences, including both individual and environmental factors. We close with a few thoughts on the accumulation of knowledge and its translation to policy and practice.

More drugs, more problems? Simultaneous use of alcohol and marijuana at parties among youth and young adults

BACKGROUND

Simultaneous alcohol and marijuana (SAM) use by youth and young adults often occurs at parties and may result in an increased risk of experiencing adverse consequences compared to use of either substance alone. This study sought to examine the relationship between SAM use by youth and young adults and consequences experienced at, or immediately following, parties.

METHODS

We conducted a repeated cross-sectional survey of 15 to 20-year-olds residing in 24 communities across seven states within the United States in 2015 and 2016 (n = 2681). Logistic regression analyses were used to examine associations between SAM use and six consequences (e.g. hangover, sex without a condom, involved in a fight) among 834 youth and young adults (53.7% female, 78.3% White, mean age: 18.4 years) who reported using either alcohol or marijuana at the last party they attended.

RESULTS

72.3% consumed alcohol exclusively, 5.2% used marijuana exclusively, and 22.5% engaged in SAM use. In multivariable analyses, those who reported SAM use had significantly greater odds of experiencing any (AOR = 1.9; 95% CI: 1.3, 2.8) and 2 or more (AOR = 4.0; 95% CI: 2.0, 8.0) consequences compared to those who used only alcohol.

CONCLUSIONS

Our findings suggest that SAM use in a party context is associated with an increased risk of experiencing consequences among youth and young adults after controlling for the quantity of alcohol consumed. Policy and educational prevention strategies should target SAM at parties to reduce harms among youth and young adults.

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

More than just Alcohol: Marijuana and Illicit Drug Use at Parties Attended by 15-20 Year Olds

BACKGROUND

Parties are a common setting for marijuana and illicit drug use among adolescents.

OBJECTIVES

This study examined the context of parties with alcohol, marijuana and illicit drug use attended by adolescents and young adults.

METHODS

In 2016, an address-based sample of 1,764 15-20-year-olds in 24 U.S. communities participated in an online survey. Parties were categorized as alcohol-only (Alc-only), marijuana + alcohol (Mj + Alc), and illicit + marijuana + alcohol (ID + Mj + Alc) based on survey participants' observations and self-reported drug use at the last party attended. Multivariable logistic regression was used to identify correlates of substance use at parties.

RESULTS

1,089 participants (61.7%) reported ever attending a party where alcohol was consumed. Of those, 60.1% reported that the last party they attended had Alc-only, 24.9% had Mj + Alc, and 10.0% had ID + Mj + Alc. Older participants were more likely to attend a party with Mj + Alc or ID + Mj + Alc. Participants whose mother had a college degree (compared to less than a college degree) were less likely to attend a party with ID + Mj + Alc. Parties with Mj + Alc and ID + Mj + Alc were larger and the majority of attendees were under 21. Parties with ID + Mj + Alc were more likely to be majority female compared to mixed gender. Parties with Mj + Alc were more likely to occur at someone else's home and be in states where medical and recreational marijuana use was legal.

CONCLUSION

One-third of parties attended by 15-20-year-olds had marijuana and/or illicit drug use in addition to alcohol consumption. The identified risk factors of parties with marijuana and illicit drug use can be used to develop targeted prevention strategies.

Promoting Community and Population Health in Public Health and Medicine: A Stepwise Guide to Initiating and Conducting Community-engaged Research

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed to guide the community-engaged research process. The process includes steps such as: networking and partnership establishment and expansion; building and maintaining trust; identifying health priorities; conducting background research, prioritizing "what to take on"; building consensus, identifying research goals, and developing research questions; developing a conceptual model; formulating a study design; developing an analysis plan; implementing the study; collecting and analyzing data; reviewing and interpreting results; and disseminating and translating findings broadly through multiple channels. Here, we outline and describe each of these steps.

Rethinking the Way We Do Research: The Benefits of Community-Engaged, Citizen Science Approaches and Nontraditional Collaborators

There is tremendous opportunity for basic scientists to enhance the impact of our research by engaging more deeply with nontraditional partners and expanding the way we think about interdisciplinary research teams. These efforts can include more deeply engaging our participants, and the broader public, in our research; working with individuals from other fields to take a more active role in the dissemination and translation of our research; and working with collaborators from the arts and communication sciences to make our research more engaging and understandable. In this review, I provide an overview of our efforts along these lines in a project called Spit for Science (https://spit4science.vcu.edu/). This project draws from concepts central to community-engaged participatory research and citizen science. Although conducting research in this way involves a considerable time commitment, it has many potential benefits, including raising awareness about our research areas and findings; creating a public that is more connected to and aware of the importance of research, which can have potential implications for funding for science; creating new job opportunities for students; and increasing participation rates in our studies. By thinking creatively about how we conduct our research, and more broadly engaging diverse groups of individuals in the research process, we have the potential to significantly increase the reach and impact of our science.