Picie alkoholu przez piętnastoletnią młodzież a praktyki wychowawcze rodziców

Aim: To assess, in the context of other socialization factors, importance of alcohol specific parenting practices for adolescents drinking behaviors.Method: Questionnaire data collected from the random sample of Warsaw 15-year old students (N = 984) on: alcohol use and getting drunk, perception of parental rules and attitudes toward alcohol use by a child, child’s monitoring and support by parents, school climate and support by peers.Results: Logistic regression analysis confirmed that parental disapproval of alcohol use by teenagers and setting clear rules forbidding alcohol use are significant protective factors. Among adolescents who already drink, the risk of getting drunk is lower if they communicate openly with parents about their alcohol related behaviors. Parental factors seem to be more significant for girls than for boys and for those who have not initiate alcohol use yet.Conclusions: More research and preventive activities is needed to strengthen parents in their alcohol specific parenting behaviors

School Culture and Climate vs. Students’ Problem Behaviours

The aim of the project was to assess the relationship between school culture/climate and students’ problem behaviours. An anonymous questionnaire survey was conducted among second grade students from 4 junior high schools in Warsaw (n = 282). The cross-school comparisons showed significant differences in school culture (indicated by students’ socio-demographic characteristics), school climate (indicated by rates of students who like their school and behavioural norms), students’ functioning (indicated by the school load), leading to a varying prevalence of problem behaviours. A logistic regression analysis indicated the most significant risk factors related to school culture (focus on students’ achievements), climate (negative student-teacher relationships and positive relationships among students) and students school functioning (low school load and frequent truancy). The study results suggest the adoption of prevention guidelines, strengthening in particular teachers’ skills and involvement

Effectiveness of the Strengthening Families Programme 10–14 in Poland: cluster randomized controlled trial

Background: The Strengthening Families Programme for youth aged 10-14 and parents/carers (SFP10-14) is a family-based prevention intervention with positive results in trials in the United States. We assessed the effectiveness of SFP10-14 for preventing substance misuse in Poland. Methods: Cluster randomized controlled trial with 20 communities (511 families; 614 young people) were allocated to SFP10-14 or a control arms. Primary outcomes were alcohol, smoking and other drug use. Secondary outcomes included parenting practices, parent–child relations, and child problem behaviour. Interview-based questionnaires were administered at baseline and at 12- and 24-months post-baseline, with respective 70.4% and 54.4% follow-up rates. Results: In Bayesian regression models with complete case data we found no effects of SFP10-14 for any of the primary or secondary outcomes at either follow-up. For example at 24-months, posterior odds ratios and 95% credible intervals for past year alcohol use, past month binge drinking, past year smoking, and past year other drug use, were 0.83 (0.44-1.56), 0.83 (0.27-2.65), 1.94 (0.76-5.38), and 0.74 (0.15-3.58), respectively. Although moderate to high attrition rates, together with some evidence of systematic attrition bias according to parent education and family disposable income, could have biased the results, the results were supported in further analyses with propensity score matched data and 40 multiple imputed datasets. Conclusion: We found no evidence for the effectiveness of SFP10-14 on the prevention of alcohol or tobacco use, parenting behaviour, parent-child relations or 4 child problem behaviour at 12- or 24-month follow-up in a large cluster randomised controlled trial in Poland

Attitudes and delivering brief interventions for heavy drinking in primary health care: analyses from the ODHIN five country cluster randomized factorial trial

Contains fulltext : 170028.pdf (publisher's version ) (Open Access)In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers' screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity

Impact of practice, provider and patient characteristics on delivering screening and brief advice for heavy drinking in primary health care secondary analyses of data from the ODHIN five country cluster randomized factorial trial

BACKGROUND: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. OBJECTIVES: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline. METHODS: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised. RESULTS: Nurses tended to screen more patients than doctors (OR = 3.1; 95%CI: 1.9, 4.9). Screen-positive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95%CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95%CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status. CONCLUSIONS: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552

Effectiveness of the Strengthening Families Programme 10–14 in Poland for the prevention of alcohol and drug misuse: protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Alcohol and other drug use and misuse is a significant problem amongst Polish youth. The SFP10-14 is a family-based prevention intervention that has positive results in US trials, but questions remain about the generalizability of these results to other countries and settings.</p> <p>Methods/Design</p> <p>A cluster randomized controlled trial in community settings across Poland. Communities will be randomized to a SFP10-14 trial arm or to a control arm. Recruitment and consent of families, and delivery of the SFP10-14, will be undertaken by community workers. The primary outcomes are alcohol and other drug use and misuse. Secondary (or intermediate) outcomes include parenting practices, parent–child relations, and child problem behaviour. Interview-based questionnaires will be administered at baseline, 12 and 24 months.</p> <p>Discussion</p> <p>The trial will provide information about the effectiveness of the SFP10-14 in Poland.</p> <p>Trial registration</p> <p>International Standard Randomised Controlled Trial Number: ISRCTN89673828</p

Impact of primary health care providers’ initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

Background: Brief interventions in primary healthcare to detect and intervene in risky alcohol consumption are cost-effective in reducing drinking problems, but poorly implemented in routine care. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.Methods: In a cluster randomised factorial trial 120 Primary Healthcare Units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. Results: Data from 746 providers of 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore there were no significant interactions between these characteristics and allocated groups. Conclusions: The extent to which providers’ managed to change their brief intervention proportions when submitted to different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research more attention is needed for the causal relation between these parameters, as it can inform us whether to focus on these or not in implementation trajectories

Diagnosis of Fetal Alcohol Spectrum Disorders (FASDs): Guidelines of Interdisciplinary Group of Polish Professionals

(1) Background: Considerable prevalence in Poland and serious health consequences of prenatal alcohol exposure indicated the need to develop national guidelines for the diagnosis of fetal alcohol spectrum disorders (FASDs). It was assumed that the guidelines must be in line with international standards but adjusted to the Polish context. (2) Methods: Work on recommendations was carried out by an interdisciplinary team of Polish specialists. Its first stage was to assess the usefulness in our country of the U.S. and Canadian guidelines. In the second stage, after several rounds of discussions, a consensus was achieved. (3) Results: The Polish guidelines for diagnosing FASD cover the following issues: 1. distinguished diagnostic categories; 2. diagnostic procedure; 3. assessment of prenatal exposure to alcohol; 4. assessment of sentinel facial dysmorphias; 5. assessment of body weight, height, and head circumference; 6. neurodevelopmental assessment. An important element of the recommendation is appendices containing practical tools that are useful in the diagnostic procedure. (4) Conclusions: National guidelines may improve the quality and standardization of FASD diagnosis in Poland, but their practical utility has to be monitored

Is Public Health Response to the Phenomenon of Alcohol Use during Pregnancy Adequate to the Polish Women&rsquo;s Needs?

Due to the risks it poses to a child&rsquo;s health, drinking alcohol during pregnancy is a serious problem that the public health sector is struggling to deal with. The reasons why women who do not have alcohol problems do not give up drinking alcohol completely during pregnancy are still poorly understood. And the knowledge available about them does not translate into communication strategies in Poland. The analysis of standards and examples of good practice allows to formulate proposals for improving the quality and effectiveness of social campaigns addressed to the general population and women of childbearing age in order to reduce the risk associated with the prenatal exposure to alcohol

Picie alkoholu przez piętnastoletnią młodzież a praktyki wychowawcze rodziców

Aim: To assess, in the context of other socialization factors, importance of alcohol specific parenting practices for adolescents drinking behaviors.Method: Questionnaire data collected from the random sample of Warsaw 15-year old students (N = 984) on: alcohol use and getting drunk, perception of parental rules and attitudes toward alcohol use by a child, child’s monitoring and support by parents, school climate and support by peers.Results: Logistic regression analysis confirmed that parental disapproval of alcohol use by teenagers and setting clear rules forbidding alcohol use are significant protective factors. Among adolescents who already drink, the risk of getting drunk is lower if they communicate openly with parents about their alcohol related behaviors. Parental factors seem to be more significant for girls than for boys and for those who have not initiate alcohol use yet.Conclusions: More research and preventive activities is needed to strengthen parents in their alcohol specific parenting behaviors