Paediatrics (RCH) - Research Publications
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ItemA clustered randomised trial examining the effect of social marketing and community mobilisation on the age of uptake and levels of alcohol consumption by Australian adolescents(BMJ PUBLISHING GROUP, 2013)INTRODUCTION: Throughout the world, alcohol consumption is common among adolescents. Adolescent alcohol use and misuse have prognostic significance for several adverse long-term outcomes, including alcohol problems, alcohol dependence, school disengagement and illicit drug use. The aim of this study was to evaluate whether randomisation to a community mobilisation and social marketing intervention reduces the proportion of adolescents who initiate alcohol use before the Australian legal age of 18, and the frequency and amount of underage adolescent alcohol consumption. METHOD AND ANALYSIS: The study comprises 14 communities matched with 14 non-contiguous communities on socioeconomic status (SES), location and size. One of each pair was randomly allocated to the intervention. Baseline levels of adolescent alcohol use were estimated through school surveys initiated in 2006 (N=8500). Community mobilisation and social marketing interventions were initiated in 2011 to reduce underage alcohol supply and demand. The setting is communities in three Australian states (Victoria, Queensland and Western Australia). Students (N=2576) will complete school surveys in year 8 in 2013 (average age 12). PRIMARY OUTCOMES: (1) lifetime initiation and (2) monthly frequency of alcohol use. Reports of social marketing and family and community alcohol supply sources will also be assessed. Point estimates with 95% CIs will be compared for student alcohol use in intervention and control communities. Changes from 2006 to 2013 will be examined; multilevel modelling will assess whether random assignment of communities to the intervention reduced 2013 alcohol use, after accounting for community level differences. Analyses will also assess whether exposure to social marketing activities increased the intervention target of reducing alcohol supply by parents and community members. TRIAL REGISTRATION: ACTRN12612000384853.
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ItemAdverse adult consequences of different alcohol use patterns in adolescence: an integrative analysis of data to age 30 years from four Australasian cohorts(WILEY, 2018-10)BACKGROUND AND AIMS: Studies have linked adolescent alcohol use with adverse consequences in adulthood, yet it is unclear how strong the associations are and to what extent they may be due to confounding. Our aim was to estimate the strength of association between different patterns of adolescent drinking and longer-term psychosocial harms taking into account individual, family and peer factors. DESIGN: Participant-level data were integrated from four long-running longitudinal studies: Australian Temperament Project, Christchurch Health and Development Study, Mater Hospital and University of Queensland Study of Pregnancy and Victorian Adolescent Health Cohort Study. SETTING: Australia and New Zealand. PARTICIPANTS: Participants were assessed on multiple occasions between ages 13 and 30 years (from 1991 to 2012). Number of participants varied (up to n = 9453) by analysis. MEASUREMENTS: Three patterns of alcohol use (frequent, heavy episodic and problem drinking) were assessed prior to age 17. Thirty outcomes were assessed to age 30 spanning substance use and related problems, antisocial behaviour, sexual risk-taking, accidents, socio-economic functioning, mental health and partner relationships. FINDINGS: After covariate adjustment, weekly drinking prior to age 17 was associated with a two- to threefold increase in the odds of binge drinking [odds ratio (OR) = 2.14; 95% confidence interval (CI) = 1.57-2.90], drink driving (OR = 2.78; 95% CI = 1.84-4.19), alcohol-related problems (OR = 3.04; 95% CI = 1.90-4.84) and alcohol dependence (OR = 3.30; 95% CI = 1.69-6.47) in adulthood. Frequency of drinking accounted for a greater proportion of the rate of most adverse outcomes than the other measures of alcohol use. Associations between frequent, heavy episodic and problem drinking in adolescence and most non-alcohol outcomes were largely explained by shared risk factors for adolescent alcohol use and poor psychosocial functioning. CONCLUSIONS: Frequency of adolescent drinking predicts substance use problems in adulthood as much as, and possibly more than, heavy episodic and problem drinking independent of individual, family and peer predictors of those outcomes.
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ItemLongitudinal Prediction of Mid-Adolescent Psychosocial Outcomes From Early Adolescent Family Help Seeking and Family Support(WILEY, 2015-06)This study examined whether family help seeking and family support represented the same or distinct constructs and prospective associations between emergent constructs and psychosocial outcomes. Data were from 1,713 school‐based adolescents participating in a randomized controlled trial, in Victoria, Australia. Family help seeking emerged as a single factor, distinct from family support, and was prospectively associated with improved psychosocial outcomes. Father closeness predicted lower depressive symptoms. Family help seeking predicted higher help seeking for peers. Interactions between family help seeking and family support on psychosocial outcomes were not apparent. Findings highlight the importance of examining family help seeking and family support separately in future studies of adolescents' help‐seeking behavior.
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ItemFamily risk factors for cannabis use: a population-based survey of Australian secondary school students(CARFAX PUBLISHING, 2003-06)The objective of this study was to investigate relationships between adolescent cannabis use and indices of parent - child attachment, family functioning and parent attitudes to drugs and delinquency. A total of 2848 year 9 and 2363 year 11 students participated in the Victorian Adolescent Health and Well-Being Survey (1999). The study was a school-based random sample of 535 metropolitan and rural, government and non-government secondary schools throughout Victoria, Australia. Cannabis use was defined as 'any' and 'weekly' use in the last 30 days. Multivariate logistic regression was used to identify independent associations between cannabis use and parent - child attachment, family functioning and parent attitudes to drugs and delinquency. Cannabis use in year 9 was associated with permissive parent attitudes to drugs and delinquency (any use: adjusted odds ratio (OR) = 8.1; weekly use: adjusted OR = 7.6), and was particularly sensitive to small changes in the quality of the parent - child relationship with risk increasing threefold for those describing their attachment as 'good' compared with 'very good' (any use: adjusted OR = 2.8, weekly use adjusted OR = 2.9). A similar, but more moderate pattern association was evident in year 11. After adjusting for other family and background factors, poor family functioning showed minimal association with level of cannabis use at both year levels. Results suggest that intervention efforts might sensibly target strengthening parent - children relationships and promoting less permissive parent attitudes to drug use.