Dawning Dependence: Processes underlying smoking cessation in adolescence

During adolescence young people are known to try out a range of risk behaviours, including smoking. Even though the detrimental health consequences of smoking are well known, the prevalence of smoking among Dutch adolescents remains high. Until today, efforts to control adolescent smoking are mainly focused on the prevention of smoking, whereas fewer efforts are made towards facilitating smoking cessation. Since the chance of a successful attempt to cease smoking diminishes the longer that people smoke, it is important that cessation interventions also focus on adolescents. However, compared to the many reports on predictors of smoking initiation, the literature addressing adolescent smoking cessation is rather limited, and the field is still considered to be underdeveloped. To facilitate the planning and development of programs to promote cessation among adolescents who smoke, the current thesis presents a number of studies that focus on identifying and studying potential determinants of smoking cessation, as well as determinants of important parameters of successful cessation such as readiness to quit smoking and undertaking quit attempts. Multiple levels of influence on the process of adolescent smoking cessation are considered and tested, including addiction, psychological and environmental factors. In addition, predictions and assumptions of several theories that are frequently used in explaining health behaviour, such as the Transtheoretical Model and Social Cognitive Theory, were tested in their applications to adolescent smoking cessation

The Need for a Data Ecosystem for Youth Mental Health in The Netherlands

The Netherlands is missing nationally representative data on child and adolescent mental health, e.g., on prevalence, course, and consequences of psychological disorders and mental health care utilization. Researchers and policy makers also lack a basic data infrastructure that is necessary to provide timely and reliable data crucial for benchmarking and informed decision making. In this article, we describe the necessity for a clear and well-organized overview of data on youth mental health and mental health care. We look back on three key moments in time to illustrate the breadth of the desire for data. Barriers in collecting structured, national data on a frequent basis are discussed, and several recommendations are provided of what is needed to move towards a data ecosystem that can help us to track the development and mental well-being of all children and youth and the impact of the care they receive.</p

The Need for a Data Ecosystem for Youth Mental Health in The Netherlands

The Netherlands is missing nationally representative data on child and adolescent mental health, e.g., on prevalence, course, and consequences of psychological disorders and mental health care utilization. Researchers and policy makers also lack a basic data infrastructure that is necessary to provide timely and reliable data crucial for benchmarking and informed decision making. In this article, we describe the necessity for a clear and well-organized overview of data on youth mental health and mental health care. We look back on three key moments in time to illustrate the breadth of the desire for data. Barriers in collecting structured, national data on a frequent basis are discussed, and several recommendations are provided of what is needed to move towards a data ecosystem that can help us to track the development and mental well-being of all children and youth and the impact of the care they receive

Psychometric properties of the Dutch version of the Evidence-Based Practice Attitude Scale (EBPAS).

BackgroundThe Evidence-Based Practice Attitude Scale (EBPAS) was developed in the United States to assess attitudes of mental health and welfare professionals toward evidence-based interventions. Although the EBPAS has been translated in different languages and is being used in several countries, all research on the psychometric properties of the EBPAS within youth care has been carried out in the United States. The purpose of this study was to investigate the psychometric properties of the Dutch version of the EBPAS.MethodsAfter translation into Dutch, the Dutch version of the EBPAS was examined in a diverse sample of 270 youth care professionals working in five institutions in the Netherlands. We examined the factor structure with both exploratory and confirmatory factor analyses and the internal consistency reliability. We also conducted multiple linear regression analyses to examine the association of EBPAS scores with professionals' characteristics. It was hypothesized that responses to the EBPAS items could be explained by one general factor plus four specific factors, good to excellent internal consistency reliability would be found, and EBPAS scores would vary by age, sex, and educational level.ResultsThe exploratory factor analysis suggested a four-factor solution according to the hypothesized dimensions: Requirements, Appeal, Openness, and Divergence. Cronbach's alphas ranged from 0.67 to 0.89, and the overall scale alpha was 0.72. The confirmatory factor analyses confirmed the factor structure and suggested that the lower order EBPAS factors are indicators of a higher order construct. However, Divergence was not significantly correlated with any of the subscales or the total score. The confirmatory bifactor analysis endorsed that variance was explained both by a general attitude towards evidence-based interventions and by four specific factors. The regression analyses showed an association between EBPAS scores and youth care professionals' age, sex, and educational level.ConclusionsThe present study provides strong support for a structure with a general factor plus four specific factors and internal consistency reliability of the Dutch version of the EBPAS in a diverse sample of youth care professionals. Hence, the factor structure and reliability of the original version of the EBPAS seem generalizable to the Dutch version of the EBPAS

A school-based program to prevent depressive symptoms and strengthen well-being among pre-vocational students (Happy Lessons):protocol for a cluster randomized controlled trial and implementation study

BACKGROUND: Depression is one of the leading causes of illness and disability among young people. In the Netherlands, one in twelve Dutch adolescents has experienced depression in the last 12 months. Pre-vocational students are at higher risk for elevated depressive symptoms. Effective interventions, especially for this risk group, are therefore needed to prevent the onset of depression or mitigate the adverse long-term effects of depression. The aim of this study is to examine the effectiveness and implementation of a school-based program Happy Lessons (HL), that aims to prevent depression and promote well-being among pre-vocational students. METHODS: A cluster randomized controlled trial (RCT) with students randomized to HL or to care as usual will be conducted. Pre-vocational students in their first or second year (aged 12 to 14) will participate in the study. Subjects in both conditions will complete assessments at baseline and at 3- and 6-months follow-up. The primary outcome will be depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) at 6-months follow-up. Secondary outcomes are well-being using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and life satisfaction (Cantril Ladder) measured at 6-months follow-up. Alongside the trial, an implementation study will be conducted to evaluate the implementation of HL, using both quantitative and qualitative methods (interviews, survey, and classroom observations). DISCUSSION: The results from both the RCT and implementation study will contribute to the limited evidence base on effective school-based interventions for the prevention of depression and promotion of well-being among pre-vocational adolescents. In addition, insights from the implementation study will aid identifying factors relevant for optimizing the future implementation and scale-up of HL to other schools and contexts. TRIAL REGISTRATION: This study was registered on 20 September 2021 in the Dutch Trial Register (NL9732). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12321-3

Mindfulness-based stress reduction for elementary school teachers:a randomized controlled trial

Educators frequently grapple with elevated levels of job-related stress, heightening the risk of mental health issues. Although Mindfulness-Based Stress Reduction (MBSR) has demonstrated effectiveness in reducing stress among the general populace, its implementation among educators, especially in non-United States settings, has received limited exploration. This pre-registered randomized-controlled trial investigates the effectiveness of the standard MBSR in reducing perceived stress among Dutch elementary school teachers. Additionally, it examines the impact of MBSR on mindfulness skills, emotion regulation, and self-compassion as secondary proximal outcomes, along with exploring its influence on teacher self-efficacy, perceived pupil-teacher relationships, and classroom climate quality as secondary distal outcomes. Involving 146 teachers randomly assigned to either the intervention (n = 72) or waitlist-control condition (n = 74), assessments were conducted pre- and post-intervention or control period, with a 3-month follow-up. Participants in the intervention reported significantly lower perceived stress compared to the control group, demonstrating a substantial effect size at post-treatment (d = −0.84) and a moderate effect at follow-up (d = −0.69). MBSR not only yielded improvements in personal well-being but also positively impacted teacher self-efficacy and classroom climate quality at both post-treatment and follow-up. These positive outcomes aligned with enhancements in mindfulness skills, emotion regulation, and self-compassion. However, no significant effects were observed on the pupil-teacher relationship. Exploratory analyses revealed no moderation effects based on past or present psychological problems, school weight/pupil population, years of experience, or age on perceived stress at post-measurement. Furthermore, the study examined the potential influence of COVID-19 on the results, concluding that the pandemic had no discernible impact. These findings advocate for the widespread adoption of the standard MBSR program as a means of enhancing the well-being of elementary school teachers.</p

Mindfulness-based stress reduction for elementary school teachers: a randomized controlled trial

Educators frequently grapple with elevated levels of job-related stress, heightening the risk of mental health issues. Although Mindfulness-Based Stress Reduction (MBSR) has demonstrated effectiveness in reducing stress among the general populace, its implementation among educators, especially in non-United States settings, has received limited exploration. This pre-registered randomized-controlled trial investigates the effectiveness of the standard MBSR in reducing perceived stress among Dutch elementary school teachers. Additionally, it examines the impact of MBSR on mindfulness skills, emotion regulation, and self-compassion as secondary proximal outcomes, along with exploring its influence on teacher self-efficacy, perceived pupil-teacher relationships, and classroom climate quality as secondary distal outcomes. Involving 146 teachers randomly assigned to either the intervention (n = 72) or waitlist-control condition (n = 74), assessments were conducted pre- and post-intervention or control period, with a 3-month follow-up. Participants in the intervention reported significantly lower perceived stress compared to the control group, demonstrating a substantial effect size at post-treatment (d = −0.84) and a moderate effect at follow-up (d = −0.69). MBSR not only yielded improvements in personal well-being but also positively impacted teacher self-efficacy and classroom climate quality at both post-treatment and follow-up. These positive outcomes aligned with enhancements in mindfulness skills, emotion regulation, and self-compassion. However, no significant effects were observed on the pupil-teacher relationship. Exploratory analyses revealed no moderation effects based on past or present psychological problems, school weight/pupil population, years of experience, or age on perceived stress at post-measurement. Furthermore, the study examined the potential influence of COVID-19 on the results, concluding that the pandemic had no discernible impact. These findings advocate for the widespread adoption of the standard MBSR program as a means of enhancing the well-being of elementary school teachers

A Game-Based School Program for Mental Health Literacy and Stigma on Depression (Moving Stories): Cluster Randomized Controlled Trial

Background: Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world. Objective: The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial. Methods: A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables. Results: Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=−0.53, 95% CI −1.02 to −0.03; t179.16=−2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=−0.57, 95% CI −1.11 to −0.03; t174.39=−2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%). Conclusions: The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms

Cue-Reminders to Prevent Health-Risk Behaviors: A Systematic Review

Introduction: It has been proposed that the use of cue-reminders may increase the effectiveness of interventions that aim to prevent health-risk behaviors (i.e., having unsafe sex, unhealthy dietary intake, lack of physical activity, and substance use). The aim of this systematic review was to explore whether there is evidence supporting this proposition, and to explore how cue-reminders are applied in health-risk behavior interventions to date.Method: We systemically reviewed (non-) randomized trials that examine differences in health-risk behaviors between an experimental group receiving an intervention with exposure to a cue-reminder and a control group receiving the intervention without such cue.Results: Six studies were eligible for inclusion. The studies differed in sample and research design, and how the cue-reminder was applied. One study demonstrated a positive and small effect, and one study found a negative medium effect of the cue-reminder. In the remaining studies, the effect sizes were positive but non-significant.Discussion: It is unclear whether complementing health-risk behavior interventions with cue-reminders increases the effectiveness of these interventions. Further investigation and experimentation into the efficiency and effectiveness of cue-reminders is needed before health-risk behavior interventions are complemented with cue-reminders

Latent Classes of Substance Use in Young Adults–A Systematic Review

Background: This systematic review provides an overview of studies on latent classes related to the substance use among young adults (18–25 years). Identifying these classes helps to detect high-risk groups, setting a base for selective prevention. Methods: This systematic literature review included peer-reviewed studies (published up to February, 2021) that identified latent classes and investigated predictors of latent classes relating to the use of marijuana, alcohol and/or other substances within samples of young adults. Results: Twenty studies (sample sizes N = 171 to N = 21945) met the inclusion criteria. 14 studies identified ‘low-level engagers’, ‘light alcohol and tobacco use’, ‘heavy alcohol and tobacco use’ and ‘heavy use/polysubstance use’ classes. Four studies differentiated within the ‘heavy/polysubstance’ class and found ‘traditional clubdrugs’, ‘hallucinogens’ and ‘wide-range illicit drugs’ classes. Male gender and white race predicted membership of the ‘heavy use/polysubstance use’ class consistently across studies. Other predictors of polysubstance use that were consistent across studies were peer substance use, depressive symptoms, parental drinking and participating in an honor society. Conclusions: The investigated predictors of class membership provide insight into social settings and characteristics that predict heavy use or polysubstance use. They can contribute to the development of effective prevention interventions by allowing for a more targeted approach