Showing papers by "James White published in 2012"

Individual‐, family‐, and school‐level interventions targeting multiple risk behaviours in young people

Abstract: Background Engagement in multiple risk behaviours can have adverse consequences for health during childhood, during adolescence, and later in life, yet little is known about the impact of different types of interventions that target multiple risk behaviours in children and young people, or the differential impact of universal versus targeted approaches. Findings from systematic reviews have been mixed, and effects of these interventions have not been quantitatively estimated. Objectives To examine the effects of interventions implemented up to 18 years of age for the primary or secondary prevention of multiple risk behaviours among young people. Search methods We searched 11 databases (Australian Education Index; British Education Index; Campbell Library; Cumulative Index to Nursing and Allied Health Literature (CINAHL); Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; Embase; Education Resource Information Center (ERIC); International Bibliography of the Social Sciences; MEDLINE; PsycINFO; and Sociological Abstracts) on three occasions (2012, 2015, and 14 November 2016)). We conducted handsearches of reference lists, contacted experts in the field, conducted citation searches, and searched websites of relevant organisations. Selection criteria We included randomised controlled trials (RCTs), including cluster RCTs, which aimed to address at least two risk behaviours. Participants were children and young people up to 18 years of age and/or parents, guardians, or carers, as long as the intervention aimed to address involvement in multiple risk behaviours among children and young people up to 18 years of age. However, studies could include outcome data on children > 18 years of age at the time of follow-up. Specifically,we included studies with outcomes collected from those eight to 25 years of age. Further, we included only studies with a combined intervention and follow-up period of six months or longer. We excluded interventions aimed at individuals with clinically diagnosed disorders along with clinical interventions. We categorised interventions according to whether they were conducted at the individual level; the family level; or the school level. Data collection and analysis We identified a total of 34,680 titles, screened 27,691 articles and assessed 424 full-text articles for eligibility. Two or more review authors independently assessed studies for inclusion in the review, extracted data, and assessed risk of bias.We pooled data in meta-analyses using a random-effects (DerSimonian and Laird) model in RevMan 5.3. For each outcome, we included subgroups related to study type (individual, family, or school level, and universal or targeted approach) and examined effectiveness at up to 12 months' follow-up and over the longer term (> 12 months). We assessed the quality and certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Main results We included in the review a total of 70 eligible studies, of which a substantial proportion were universal school-based studies (n = 28; 40%). Most studies were conducted in the USA (n = 55; 79%). On average, studies aimed to prevent four of the primary behaviours. Behaviours that were most frequently addressed included alcohol use (n = 55), drug use (n = 53), and/or antisocial behaviour (n = 53), followed by tobacco use (n = 42). No studies aimed to prevent self-harm or gambling alongside other behaviours.Evidence suggests that for multiple risk behaviours, universal school-based interventions were beneficial in relation to tobacco use (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.60 to 0.97; n = 9 studies; 15,354 participants) and alcohol use (OR 0.72, 95% CI 0.56 to 0.92; n = 8 studies; 8751 participants; both moderate-quality evidence) compared to a comparator, and that such interventions may be effective in preventing illicit drug use (OR 0.74, 95% CI 0.55 to 1.00; n = 5 studies; 11,058 participants; low-quality evidence) and engagement in any antisocial behaviour (OR 0.81, 95% CI 0.66 to 0.98; n = 13 studies; 20,756 participants; very low-quality evidence) at up to 12 months' follow-up, although there was evidence of moderate to substantial heterogeneity (I² = 49% to 69%). Moderate-quality evidence also showed that multiple risk behaviour universal school-based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50; I² = 0%; n = 4 studies; 6441 participants). We considered observed effects to be of public health importance when applied at the population level. Evidence was less certain for the effects of such multiple risk behaviour interventions for cannabis use (OR 0.79, 95% CI 0.62 to 1.01; P = 0.06; n = 5 studies; 4140 participants; I² = 0%; moderate-quality evidence), sexual risk behaviours (OR 0.83, 95% CI 0.61 to 1.12; P = 0.22; n = 6 studies; 12,633 participants; I² = 77%; low-quality evidence), and unhealthy diet (OR 0.82, 95% CI 0.64 to 1.06; P = 0.13; n = 3 studies; 6441 participants; I² = 49%; moderate-quality evidence). It is important to note that some evidence supported the positive effects of universal school-level interventions on three or more risk behaviours.For most outcomes of individual- and family-level targeted and universal interventions, moderate- or low-quality evidence suggests little or no effect, although caution is warranted in interpretation because few of these studies were available for comparison (n ≤ 4 studies for each outcome).Seven studies reported adverse effects, which involved evidence suggestive of increased involvement in a risk behaviour among participants receiving the intervention compared to participants given control interventions.We judged the quality of evidence to be moderate or low for most outcomes, primarily owing to concerns around selection, performance, and detection bias and heterogeneity between studies. Authors' conclusions Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours, demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in improving physical activity among young people, but not in preventing other risk behaviours. Results of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of evidence highlight the need for high-quality multiple- risk behaviour intervention studies to further strengthen the evidence base in this field.

Change in alcohol outlet density and alcohol-related harm to population health (CHALICE).

Abstract: Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community.

Prospective Associations Between Physical Activity and Obesity Among Adolescent Girls Racial Differences and Implications for Prevention

Abstract: OBJECTIVE: To test for differences in prospective associations between physical activity and obesity among black and white adolescent girls. DESIGN: Prospective cohort study using data from the National Heart, Lung, and Blood Institute Growth and Health Study. SETTING Multicenter study at the University of California (Berkeley), Children's Medical Center at the University of Cincinnati (Cincinnati, Ohio), and Westat, Inc, and Group Health Association (Rockville, Maryland). PARTICIPANTS: A total of 1148 adolescent girls (538 black and 610 white) who provided valid data on levels of physical activity and obesity at ages 12 and 14 years. INTERVENTION: Physical activity, assessed as accelerometer counts per day. MAIN OUTCOME MEASURES: Three measurements of obesity were obtained using the Centers for Disease Control and Prevention definition of obesity (at or above the age-specific 95th percentile of body mass index), the International Obesity Task Force reference body mass index cut points for obesity in children, and the sums of skinfold thickness (with the cohort ≥90th percentile as indicative of obesity). RESULTS: We found a strong negative dose-response association between quartiles of accelerometer counts per day at age 12 years and obesity at age 14 years (using all 3 measurements of obesity) in white but not black girls (P < .001 for body mass index interaction and P = .06 for sums of skinfold thickness interaction). The odds ratios for obesity (using the cohort ≥90th percentile for sums of skinfold thickness) in adjusted models between the top and the bottom quartiles of accelerometer counts per day were 0.15 (95% CI, 0.04-0.63; P = .03 for trend) in white girls and 0.85 (95% CI, 0.32-2.26; P = .93 for trend) in black girls. CONCLUSIONS: Higher levels of physical activity are prospectively associated with lower levels of obesity in white adolescent girls but not in black adolescent girls. Obesity prevention interventions may need to be adapted to account for the finding that black girls are less sensitive to the effects of physical activity.

Intelligence across childhood in relation to illegal drug use in adulthood: 1970 British Cohort Study

Abstract: Background Recent reports have linked high childhood IQ scores with excess alcohol intake and alcohol dependency in adult life, but the relationship with illegal drug use in later life is relatively unknown. Methods The authors used data from a large population-based birth cohort (1970 British Cohort Study) with measures of lifetime cannabis and cocaine use, parental social class and psychological distress at 16 years; cannabis, cocaine, amphetamine, ecstasy and polydrug use (more than three drugs) in the past 12 months; and social class, educational attainment and gross monthly income at 30 years. All members of the cohort with IQ scores at 5 or 10 years were eligible to be included in the analyses. Results Of the 11 603 (at 5 years) and 11 397 (at 10 years) cohort members eligible, 7904 (68.1%) and 7946 (69.7%) were included in the analyses. IQ scores at 5 years were positively associated with cannabis (OR (bottom vs top tertile) =2.25, 95% CI 1.71 to 2.97) and cocaine use (OR 2.35, 95% CI 1.41 to 3.92) in women and with amphetamines (OR 1.46, 95% CI 1.03 to 2.06), ecstasy (OR 1.65, 95% CI 1.15 to 2.36) and polydrug use (OR 1.57, 95% CI 1.09 to 2.26) in men at 30 years. IQ scores at 10 years were positively associated with cannabis, cocaine (only at 30 years), ecstasy, amphetamine and polydrug use. Associations were stronger in women than in men and were independent from psychological distress in adolescence and life-course socioeconomic position. Conclusion High childhood IQ may increase the risk of illegal drug use in adolescence and adulthood.

The contribution of parent–child interactions to smoking experimentation in adolescence: implications for prevention

Abstract: Because few prospective studies have examined the independent influence of mothers and fathers on smoking experimentation, we tested the association between a set of parent-specific, familial and peer interactions with smoking experimentation in early adolescence. Data come from two cohorts in the British Youth Panel Survey (N = 1736; mean age at baseline, 11.26; SD = 0.65), a study of children resident with members of the British Household Panel Survey. Baseline data showed 8.2% of participants had smoked which increased to 40.3% after a 3-year follow-up. Multivariate logistic regression models showed risk factors for the onset of experimentation included frequent time spent with peers (P < 0.001), maternal smoking (P = 0.001), female gender and older participant age (P < 0.001). Parent–child quarrels, mother–child conversations, family meal frequency and household income were not significantly associated with experimentation. Frequent father–child conversations, about things which mattered to children, were the only type of parent–child contact associated with a reduced risk of experimentation (P < 0.001), and a significant interaction suggested that maternal smoking increased the likelihood of girls but not boys experimentation (P = 0.01). This study suggests that familial risk and protective factors operate independently and that more attention should be paid to the role of fathers in smoking prevention.

Individual-, family-, and school-level interventions for preventing multiple risk behaviours in individuals aged 8 to 25 years (Protocol)

Abstract: MacArthur G, Kipping R, White J, Chittleborough C, Lingam R, Pasch K, Gunnell D, Hickman M, Campbell R