Gender, Culture and Intervention: Exploring Differences between Aboriginal and Non-Aboriginal Children’s Responses to an Early Intervention Programme

Evaluation of a group parenting programme in the Northern Territory of Australia showed significant differences in benefits for Aboriginal and non-Aboriginal boys and girls. The analysis considers whether boys and girls from different cultural backgrounds present with different problems; whether parental expectations for boys and girls differ and whether the intervention activates different responses in different settings. Conclusions suggest that there is a need to closely examine the ‘cultural logic’ of interventions, the appropriateness of their assumptions about child development and hypothesised mechanisms of change in different settings

Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage

<p>Abstract</p> <p>Background</p> <p>Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey.</p> <p>Methods</p> <p>Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS), a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls); and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy.</p> <p>Results</p> <p>There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages.</p> <p>Conclusions</p> <p>Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.</p

Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised trial in Western Australia

Background: Infant simulator-based programmes seek to prevent teenage pregnancy. They are utilised in western and developing countries but, despite growing popularity, there is no published evidence of their long-term impact. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) Programme, on the pregnancy outcomes of birth and induced abortion. Methods: Fifty-seven of 66 eligible schools (86%) in Perth, Western Australia enrolled in the pragmatic clustered (by school) randomised trial (ISRCTN24952438) with even randomisation to the intervention and control groups. Between 2003 and 2006, the VIP programme was administered to 1,267 girls in the intervention schools, while 1,567 girls in the control schools received the standard health education curriculum. Participants were aged 13-15 years and were followed until age 20 via data linkage to hospital medical and abortion clinic records. Log binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. Findings: Compared to girls Findings: Compared to girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (7.6%, n=97; 4·3%, n=67) or at least one abortion as the first pregnancy event (8.9%, n=113; 6.4%, n=101). After adjustment for potential confounding, the intervention group had a higher overall pregnancy risk (RR = 1·36, 95% CI 1.10–1·67, p=0.003) compared to the control group. Similar results were obtained using proportional hazard models (HR = 1.35, 95% CI 1.10–1·67, p=0·016). Interpretation: The infant-simulator based VIP Programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before turning 20 years of age. Funding: The Health Promotion Research Foundation of Western Australia (Healthway), Lotteries WA, the Western Australian Department of Education and Training and the Western Australian Department of Health

Adolescent dietary patterns are associated with lifestyle family psycho-social factors

Background/ Objectives: Dietary intake during adolescence contributes to lifelong eating habits and the development of early risk factors for disease in adulthood. Few studies have examined the dietary patterns of adolescents and the social and environmental factors that may affect them during this life stage. The present study describes dietary patterns in a cohort of adolescents and examines their associations with socioeconomic factors, as well as parental and adolescent risk factor behaviours. Design: A semi quantitative FFQ was used to assess study adolescents’ usual dietary intake over the previous year. Information was collected on family functioning and various socio economic and risk factor variables via questionnaire. Adolescents visited the clinic for anthropometric measurements. Setting: The Western Australian Pregnancy Cohort Study (Raine Study), Perth, Western Australia. Subjects: Adolescents (n 1631) aged 14 years from a pregnancy cohort study. Results: Factor analysis identified two distinct dietary patterns that differed predominantly in fat and sugar intakes. The ‘Western’ pattern consisted of high intakes of take away foods, soft drinks, confectionery, French fries, refined grains, full fat dairy products and processed meats. The ‘Healthy’’ pattern included high intakes of whole grains, fruit, vegetables, legumes and fish. ANOVA showed that the ‘Western’ dietary pattern was positively associated with greater television viewing and having a parent that smoked, and was inversely associated with family income. The ‘Healthy’’ pattern was positively associated with female gender, greater maternal education, better family functioning and being in a two parent family, and was inversely associated with television viewing. Conclusions: This study suggests that both lifestyle factors and family psycho social environment are related to eating patterns in Australian adolescents

Efficacy of the Aussie Optimism Program: Promoting pro-social behavior and preventing suicidality in primary school students. A randomised-controlled trial

The efficacy of an enhanced version of the Aussie Optimism Program (AOP) was investigated in a cluster randomized controlled trial. Grade 6 students aged 10–11 years of age (N = 2288) from 63 government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders. Results indicated that Aussie Optimism with teacher training plus coaching was associated with the best outcomes: a significant increase in student-reported pro-social behavior from pre-test to post-test 1 (maintained at post-test 2) and significantly lower incidence rates from suicidal ideation at post-test 2 and follow-up. No significant intervention effects on anxiety and depressive disorders, and total difficulties were reported. These findings suggest that the AOP with teacher training along with coaching may have the potential to positively impact on suicidality and pro-social behavior in the pre-adolescent years

Efficacy of the Aussie Optimism Program: Promoting pro-social behavior and preventing suicidality in primary school students. A randomised-controlled trial

The efficacy of an enhanced version of the Aussie Optimism Program (AOP) was investigated in a cluster randomized controlled trial. Grade 6 students aged 10–11 years of age (N = 2288) from 63 government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders. Results indicated that Aussie Optimism with teacher training plus coaching was associated with the best outcomes: a significant increase in student-reported pro-social behavior from pre-test to post-test 1 (maintained at post-test 2) and significantly lower incidence rates from suicidal ideation at post-test 2 and follow-up. No significant intervention effects on anxiety and depressive disorders, and total difficulties were reported. These findings suggest that the AOP with teacher training along with coaching may have the potential to positively impact on suicidality and pro-social behavior in the pre-adolescent years

A good-quality breakfast is associated with better mental health in adolescence

Objective: Breakfast consumption has been associated with better mental health in adulthood, but the relationship between breakfast and mental health in adolescence is less well known. The aims of the present study were to evaluate breakfast quality in a cohort of adolescents and to investigate associations with mental health. Design: Cross-sectional population-based study. Breakfast quality was assessed by intake of core food groups at breakfast, as determined from 3 d food diaries. Mental health was assessed using the Child Behaviour Checklist (CBCL), with higher scores representing poorer behaviour. Setting: The Western Australian Pregnancy Cohort (Raine) Study, Perth, WesternAustralia. Subjects: Eight hundred and thirty-six males and females aged between 13 and 15 years. Results: Mean mental health score as assessed by the CBCL was 45.24 (SD 11.29). A high-quality breakfast consisting of at least three food groups was consumed by 11% of adolescents, while 7% of adolescents did not consume any items from core food groups on average over the 3 d period. The two most common core food groups consumed at breakfast in this population were dairy products followed by breads and cereals. For every additional food group eaten at breakfast, the associated total mental health score decreased by 1.66 (95% CI-22.74, -0.59) after adjustment for potential confounding factors, representing an improvement in mental health score. Conclusion: These findings support the concept that breakfast quality is an important component in the complex interaction between lifestyle factors and mental health in early adolescence.KeywordsAdolescent/adolescenceBreakfastMental healthChild Behaviour Checklis

Prevention of child behavior problems through universal implementation of a group behavioral family intervention.

The aim of this mental health promotion initiative was to evaluate the effectiveness of a universally delivered group behavioral family intervention (BFI) in preventing behavior problems in children. This study investigates the transferability of an efficacious clinical program to a universal prevention intervention delivered through child and community health services targeting parents of preschoolers within a metropolitan health region. A quasiexperimental two-group (BFI, n=804 vs. Comparison group, n=806) longitudinal design followed preschool aged children and their parents over a 2-year period. BFI was associated with significant reductions in parent-reported levels of dysfunctional parenting and parent-reported levels of child behavior problems. Effect sizes on child behavior problems ranged from large (.83) to moderate (.47). Positive and significant effects were also observed in parent mental health, marital adjustment, and levels of child rearing conflict. Findings are discussed with respect to their implication for significant population reductions in child behavior problems as well as the pragmatic challenges for prevention science in encouraging both the evaluation and uptake of preventive initiatives in real world settings