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Mehta D, Kelly AB, Laurens KR, Haslam D, Williams KE, Walsh K, Baker PRA, Carter HE, Khawaja NG, Zelenko O, Mathews B. Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention. Child Psychiatry Hum Dev 2023; 54:421-435. [PMID: 34586552 PMCID: PMC8480117 DOI: 10.1007/s10578-021-01258-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 02/08/2023]
Abstract
Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.
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Affiliation(s)
- Divya Mehta
- grid.1024.70000000089150953Centre for Genomics and Personalised Health, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Adrian B. Kelly
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Kristin R. Laurens
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Divna Haslam
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1003.20000 0000 9320 7537Parenting and Family Support Centre, The University of Queensland, Brisbane, Australia
| | - Kate E. Williams
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Early Childhood and Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Child & Family Studies, Queensland University of Technology (QUT), Brisbane, Australia
| | - Kerryann Walsh
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Early Childhood and Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Child & Family Studies, Queensland University of Technology (QUT), Brisbane, Australia
| | - Philip R. A. Baker
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Hannah E. Carter
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Nigar G. Khawaja
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Oksana Zelenko
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia
| | - Ben Mathews
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Law, Queensland University of Technology (QUT), Brisbane, Australia ,grid.21107.350000 0001 2171 9311Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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Röding D, Walter U, Dreier M. Long-Term Effects of Integrated Strategies of Community Health Promotion on Diabetes Mellitus Mortality: a Natural Policy Experiment Based on Aggregated Longitudinal Secondary Data. J Urban Health 2021; 98:791-800. [PMID: 34799821 PMCID: PMC8688653 DOI: 10.1007/s11524-021-00590-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 10/28/2022]
Abstract
Integrated strategies of community health promotion (ISCHP) are based on intersectoral collaborations using the Health in All Policies approach to address determinants of health. While effects on health determinants have been shown, evidence on the effectiveness of ISCHP on health outcomes is scarce. The aim of this study is to assess the long-term effects of ISCHP on diabetes mellitus mortality (DMM) in German communities. A nonrandomized evaluation based on secondary county-level official data (1998-2016) was performed. In April 2019, 149 communities in Germany with ISCHP out of 401 were identified. Communities with < 5 measurements of DMM, starting before 1999 or after 2015, were excluded. Analyses included 65 communities with ISCHP (IG) and 124 without ISCHP (CG). ISCHP ran for a mean of 5.6 years. Fixed effects (FE) models were used to estimate effects of ISCHP and duration on DMM taking into account the time-varying average age. The FE estimator for DMM is b = - 2.48 (95% CI - 3.45 to - 1.51) for IG vs. CG and b = - 0.30 (95% CI - 0.46 to - 0.14) for ISCHP duration (0-16 years). In the first year of an ISCHP, a reduction of the annual DMM of 0.3 per 100,000 population (1%), and in the 16th year of 4.8 (14%) was achieved. This study provides preliminary evidence of the effectiveness of ISCHP in Germany. Limitations include inaccuracies to classify IG and CG and possible selection bias. Longitudinal county-level data may be an efficient data source to evaluate complex interventions, thereby contributing to further strengthen evidence-based integrated health promotion.
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Affiliation(s)
- Dominik Röding
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
| | - Ulla Walter
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Maren Dreier
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Carl-Neuberg Str. 1, 30625, Hannover, Germany
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Scaglione NM, Buben A, Williams J, Cance JD, Elek E, Clarke T, Graham PW. A Latent Class Analysis of Prevention Approaches Used to Reduce Community-Level Prescription Drug Misuse in Adolescents and Young Adults. J Prim Prev 2021; 42:279-296. [PMID: 33811569 DOI: 10.1007/s10935-021-00631-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
The Substance Abuse and Mental Health Services Administration's Strategic Prevention Framework Partnerships for Success (PFS) program supports community-based organizations (CBOs) across the United States in implementing evidence-based prevention interventions to reduce substance use in adolescents and young adults. Little attention has been paid to how CBOs combine interventions to create comprehensive community-specific prevention approaches, or whether different approaches achieve similar community-level effects on prescription drug misuse (PDM). We used PFS evaluation data to address these gaps. Over 200 CBOs reported their prevention intervention characteristics, including strategy type (e.g., prevention education, environmental strategies) and number of unique interventions. Evaluation staff coded whether each intervention was an evidence-based program, practice, or policy (EBPPP). Latent Class Analysis of seven characteristics (use of each of five strategy types, use of one or more EBPPP, and number of interventions implemented) identified six prevention approach profiles: High Implementation EBPPP, Media Campaigns, Environmental EBPPP, High Implementation Non-EBPPP, Prevention Education, and Other Information Dissemination. All approaches except Media Campaigns and Other Information Dissemination were associated with significant reductions in community-level PDM. These approaches may need to be paired with other, more direct, prevention activities to effectively reduce PDM at the community level. However, similar rates of change in PDM across all 6 prevention approaches suggests only weak evidence favoring use of the other four approaches. Community-based evaluations that account for variability in implemented prevention approaches may provide a more nuanced understanding of community-level effects. Additional work is needed to help CBOs identify the most appropriate approach to use based on their target communities' characteristics and resources.
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Affiliation(s)
- Nichole M Scaglione
- RTI International, Division of Behavioral Health Research, 701 13th Street, NW, Suite 750, Washington, DC, 20005, USA. .,Department of Health Education & Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA.
| | - Alex Buben
- RTI International, Division of Behavioral Health Research, 701 13th Street, NW, Suite 750, Washington, DC, 20005, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jason Williams
- RTI International, Division of Behavioral Health Research, 701 13th Street, NW, Suite 750, Washington, DC, 20005, USA
| | - Jessica Duncan Cance
- RTI International, Division of Behavioral Health Research, 701 13th Street, NW, Suite 750, Washington, DC, 20005, USA
| | - Elvira Elek
- RTI International, Division of Behavioral Health Research, 701 13th Street, NW, Suite 750, Washington, DC, 20005, USA
| | - Thomas Clarke
- Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20856, USA
| | - Phillip W Graham
- RTI International, Division of Behavioral Health Research, 701 13th Street, NW, Suite 750, Washington, DC, 20005, USA
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Estefan LF, Armstead TL, Rivera MS, Kearns MC, Carter D, Crowell J, El-Beshti R, Daniels B. Enhancing the National Dialogue on the Prevention of Intimate Partner Violence. Am J Community Psychol 2019; 63:153-167. [PMID: 30801758 PMCID: PMC6449037 DOI: 10.1002/ajcp.12318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Little systematic information exists about how community-based prevention efforts at the state and local levels contribute to our knowledge of intimate partner violence (IPV) prevention. The Centers for Disease Control and Prevention's (CDC) DELTA FOCUS program funds ten state domestic violence coalitions to engage in IPV primary prevention through approaches addressing the outer layers of the social ecology. This paper explored the ways in which DELTA FOCUS recipients have contributed to a national-level dialogue on IPV prevention. Previously undefined, the authors define national-level dialogue and retrospectively apply the CDC Science Impact Framework (SIF) to describe contributions DELTA FOCUS recipients made to it. Authors conducted document review and qualitative content analysis of recipient semi-annual progress reports from 2014 to 2016 (N = 40) using NVivo. A semi-structured coding scheme was applied across the five SIF domains: Creating Awareness, Catalyzing Action, Effecting Change, Disseminating Science, and Shaping the Future. All recipients sought to promote IPV prevention by communicating and sharing with non-CDC-funded state coalitions, national partners, and other IPV stakeholders information and resources accumulated through practice-based prevention efforts. Through implementing and disseminating their prevention work in myriad ways, DELTA FOCUS recipients are building practice-based evidence on community-based IPV prevention.
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Affiliation(s)
- Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Theresa L. Armstead
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Megan C. Kearns
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Denise Carter
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica Crowell
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Weihrauch-Blüher S, Kromeyer-Hauschild K, Graf C, Widhalm K, Korsten-Reck U, Jödicke B, Markert J, Müller MJ, Moss A, Wabitsch M, Wiegand S. Current Guidelines for Obesity Prevention in Childhood and Adolescence. Obes Facts 2018; 11:263-276. [PMID: 29969778 PMCID: PMC6103347 DOI: 10.1159/000486512] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/21/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Current guidelines for prevention of obesity in childhood and adolescence are discussed. METHODS A literature search was performed in Medline via PubMed, and appropriate studies were analyzed. RESULTS Programs to prevent childhood obesity have so far remained mainly school-based and effects have been limited. Analyses by age group show that prevention programs have the best results in younger children (<12 years). Evidence-based recommendations for pre-school- and early school-aged children indicate the need for interventions that address parents and teachers alike. During adolescence, school-based interventions proved most effective when adolescents were addressed directly. To date, obesity prevention programs have mainly focused on behavior-oriented prevention. Recommendations for community- or environment-based prevention have been suggested by the German Alliance of Noncommunicable Diseases and include a minimum of 1 h of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals at kindergartens and schools as well as a ban on unhealthy food advertisement aimed at children. CONCLUSION Behavior-oriented prevention programs showed only limited long-term effects. Certain groups at risk for the development of obesity are not reached effectively by current programs. Although universally valid conclusions cannot be drawn given the heterogeneity of available studies, clearly combining behavior-based programs with community-based prevention to counteract an 'obesogenic environment' is crucial for sustainable success of future obesity prevention programs.
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Affiliation(s)
- Susann Weihrauch-Blüher
- IFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig, Germany
- Department of Pediatrics I / Pediatric Endocrinology and Diabetology, University Hospital of Halle/Saale, Halle/Saale, Germany
| | - Kartin Kromeyer-Hauschild
- Institute of Human Genetics, Jena University Medical Center, Friedrich-Schiller-University of Jena, Jena, Germany
| | - Christine Graf
- Institute of Movement and Neuroscience, German Sport University of Cologne, Cologne, Germany
| | - Kurt Widhalm
- Department Of Clinical Nutrition and Prevention, Children's Hospital, University Hospital of Vienna, Vienna, Austria
| | - Ulrike Korsten-Reck
- Department of Rehabilitative and Preventive Sports Medicine, University Medical Center Freiburg, Freiburg i.Br., Germany
| | - Birgit Jödicke
- Department of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jana Markert
- IFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig, Germany
- Institute of Special and Inclusive Education, University of Leipzig, Leipzig, Germany
| | - Manfred James Müller
- Institute for Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Anja Moss
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Martin Wabitsch
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Susanna Wiegand
- Department of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany
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Cook PA, Hargreaves SC, Burns EJ, de Vocht F, Parrott S, Coffey M, Audrey S, Ure C, Duffy P, Ottiwell D, Kenth K, Hare S, Ardern K. Communities in charge of alcohol (CICA): a protocol for a stepped-wedge randomised control trial of an alcohol health champions programme. BMC Public Health 2018; 18:522. [PMID: 29673337 PMCID: PMC5909208 DOI: 10.1186/s12889-018-5410-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/05/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Communities In Charge of Alcohol (CICA) takes an Asset Based Community Development (ABCD) approach to reducing alcohol harm. Through a cascade training model, supported by a designated local co-ordinator, local volunteers are trained to become accredited 'Alcohol Health Champions' to provide brief opportunistic advice at an individual level and mobilise action on alcohol availability at a community level. The CICA programme is the first time that a devolved UK region has attempted to coordinate an approach to building health champion capacity, presenting an opportunity to investigate its implementation and impact at scale. This paper describes the protocol for a stepped wedge randomised controlled trial of an Alcohol Health Champions programme in Greater Manchester which aims to strengthen the evidence base of ABCD approaches for health improvement and reducing alcohol-related harm. METHODS A natural experiment that will examine the effect of CICA on area level alcohol-related hospital admissions, Accident and Emergency attendances, ambulance call outs, street-level crime and anti-social behaviour data. Using a stepped wedged randomised design (whereby the intervention is rolled out sequentially in a randomly assigned order), potential changes in health and criminal justice primary outcomes are analysed using mixed-effects log-rate models, differences-in-differences models and Bayesian structured time series models. An economic evaluation identifies the set-up and running costs of CICA using HM Treasury approved standardised methods and resolves cost-consequences by sector. A process evaluation explores the context, implementation and response to the intervention. Qualitative analyses utilise the Framework method to identify underlying themes. DISCUSSION We will investigate: whether training lay people to offer brief advice and take action on licensing decisions has an impact on alcohol-related harm in local areas; the cost-consequences for health and criminal justice sectors, and; mechanisms that influence intervention outcomes. As well as providing evidence for the effectiveness of this intervention to reduce the harm from alcohol, this evaluation will contribute to broader understanding of asset based approaches to improve public health. TRIAL REGISTRATION ISRCTN 81942890 , date of registration 12/09/2017.
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Affiliation(s)
- Penny A. Cook
- School of Health Sciences, University of Salford, Manchester, UK
| | | | | | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Steve Parrott
- School of Health Sciences, University of York, York, UK
| | - Margaret Coffey
- School of Health Sciences, University of Salford, Manchester, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Cathy Ure
- School of Health Sciences, University of Salford, Manchester, UK
| | - Paul Duffy
- Public Health England North West, Manchester, UK
| | | | | | - Susan Hare
- Fallowfield Community Guardians c/o School of Health Sciences, University of Salford, Manchester, UK
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Abstract
Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed.
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Affiliation(s)
- Max Crowley
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
- Prevention Economics Planning & Research Network, State College, PA, USA
| | - Damon Jones
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
- Prevention Economics Planning & Research Network, State College, PA, USA
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Molero Y, Gripenberg J, Bakshi AS. Effectiveness and implementation of a community-based prevention programme targeting anabolic androgenic steroid use in gyms: study protocol of a quasi-experimental control group study. BMC Sports Sci Med Rehabil 2016; 8:36. [PMID: 27891233 PMCID: PMC5114785 DOI: 10.1186/s13102-016-0062-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022]
Abstract
Background During the past decades, concerns about increased anabolic androgenic steroid (AAS) use among recreational sportspeople have been raised, yet there is a paucity of AAS prevention efforts targeting this group. Accordingly, doping prevention efforts aimed at gyms have been recommended. The overall objective of the present project is to examine a prevention programme named 100% Pure Hard Training (100% PHT), which targets AAS use among recreational sportspeople training in gyms. Specifically, the project aims to: 1) assess the prevalence of AAS, and its associations with alcohol, illicit drugs, and nutritional supplements use; 2) examine whether 100% PHT can decrease AAS use in gyms, and 3) provide insights into which factors facilitate and/or impede implementation of the programme. Methods/design The intervention group consists of 27 gyms, and 27 gyms serve as controls. Intervention gyms take part in 100% PHT, a community-based programme involving several components: (a) training of key stakeholders (i.e., gym staff, gym owners, local police, and municipal prevention coordinators) regarding AAS use; (b) developing an action plan for AAS prevention for each gym; (c) certification of gyms that follow 100% PHT; (d) cooperative relationship between stakeholders; (e) annual follow-up of gyms. The project consists of two studies: Study A will examine the prevalence of AAS use and the effectiveness of 100% PHT (aims 1 and 2), and data for Study A will be collected using questionnaires distributed to gym attendees at two assessment points: baseline (pre-intervention) and follow-up (post-intervention). Study B will evaluate the implementation of 100% PHT (aim 3), and semi-structured interviews with participating stakeholders will be carried out post-intervention. Discussion Knowledge gained from the present project can be used to develop community-based doping prevention efforts aimed at recreational sportspeople training in gyms. Furthermore, it can provide insights into which factors are important for successful implementation of AAS prevention programmes that target gyms. Results are also expected to yield information on the prevalence of AAS use as well as associations between the use of AAS and other licit and illicit substances, including nutritional supplements, among recreational sportspeople. Trial registration The study was registered retrospectively at isrctn.com (Identifier: ISRCTN11655041; Registration date: 3 November 2016;). Electronic supplementary material The online version of this article (doi:10.1186/s13102-016-0062-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yasmina Molero
- Department of Clinical Neuroscience, STAD, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden ; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Johanna Gripenberg
- Department of Clinical Neuroscience, STAD, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Ann-Sofie Bakshi
- Department of Clinical Neuroscience, STAD, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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Abstract
Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.
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Affiliation(s)
- Greta M Massetti
- Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA.
| | - Kristin M Holland
- Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
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Madridejos Mora R, Majem Fabres L, Puig Acebal H, Sanz Latorre I, Llobet Traveset E, Arce Casas M, Ruiz Morilla D, Mercadal Dalmau A, Pañart Sánchez D. [Healthy heart: Results of a community education program on cardiovascular health]. Aten Primaria 2014; 46:457-63. [PMID: 24768658 PMCID: PMC6983649 DOI: 10.1016/j.aprim.2013.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 12/04/2013] [Accepted: 12/23/2013] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. DESIGN A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. PARTICIPANTS PATIENTS both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). INTERVENTION The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. MAIN MEASUREMENTS The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. RESULTS Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), p<.001, as well as an improvement in physical activity is (IG: 71.2% to 83.1% versus CG: 72.6% to 78.2%), p=.05. The total number of Primary Care visits (medical and nursing) decreased in the IG more than in the CG. The satisfaction rate of the course was very high. CONCLUSIONS This experience is effective in improving cardiovascular health knowledge and promoting some healthy habits.
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Affiliation(s)
| | - Lourdes Majem Fabres
- Atención Primaria, CAP Sant Cugat-Valldoreix de Mútua Terrassa, Barcelona, España
| | - Helena Puig Acebal
- Atención Primaria, CAP Sant Cugat-Valldoreix de Mútua Terrassa, Barcelona, España
| | - Inma Sanz Latorre
- Atención Primaria, CAP Sant Cugat-Can Matas de Mútua Terrassa, Barcelona, España
| | - Eva Llobet Traveset
- Atención Primaria, CAP Rambla de Terrassa de Mútua Terrassa, Barcelona, España
| | - Mar Arce Casas
- Atención Primaria, CAP Sant Cugat-Can Matas de Mútua Terrassa, Barcelona, España
| | - Dolors Ruiz Morilla
- Medicina de familia, CAP Sant Cugat-Can Matas de Mútua Terrassa, Barcelona, España
| | | | - Dani Pañart Sánchez
- Medicina de familia, CAP Rambla de Terrassa de Mútua Terrassa, Barcelona, España
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