Description of a Behavioral Intervention to Reduce Substance Use and Related Risk and Increase Positive Parenting among Urban Mothers with Alcohol and Other Drug Problems

The abuse of alcohol and other substances by mothers raising adolescent children has serious adverse effects on family functioning and youth outcomes, and on mothers’ own health and adaptation. Mothers who are also HIV-infected face additional challenges. In the present report, we describe a multi-session intervention conducted in individual sessions for mothers with alcohol and other substance use problems who are raising adolescent children. We outline the primary components of the intervention and include case studies and examples of exercises and tools. We found that engagement with the intervention and high rates of attendance were facilitated by tapping into mothers’ desires to improve their relationships with their adolescent children, the use of a harm reduction approach toward substance use, and intensive outreach. We also discuss lessons learned in the course of implementing and evaluating the intervention.     

Prediction of drug and alcohol abuse in hospitalized adolescents: comparisons by gender and substance type

The authors examined psychosocial correlates of drug and alcohol abuse in 462 hospitalized adolescents, and the extent to which these associations may be affected by gender or by substance type. Participants completed a battery of psychometrically-sound, self-report measures of psychological functioning, environmental stress, drug abuse, and alcohol abuse. Four multiple regression analyses were conducted to determine the joint and independent predictors of drug abuse and alcohol abuse, for males and for females. Multiple regression analysis revealed that seven variables--age, depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse--jointly predicted both drug and alcohol abuse, for both males and females. However, several differences were found with respect to which variables made independent contributions to the predictive models--with only delinquent predisposition making a significant independent contribution for all four conditions. We found distinct patterns of psychosocial predictor variables for drug and alcohol abuse, as well as distinct patterns for males and females. These results may reflect differing risk factors for drug abuse and alcohol abuse in adolescent psychiatric patients--and differing risk factors for males and females. Such differences have potential implications for prevention and treatment.     

Community violence exposure,coping, and problematic alcohol and drug use among urban,female caregivers: A prospective study

Victimization is associated with substance use in women, but less is known about linkages between witnessing community violence and substance use, even though more women witness versus directly experience violence. Further, factors that contribute to or protect against women’s problematic substance use are less well understood. Urban female caregivers (N = 318; >92% African American/black) living in low-income communities were interviewed annually for three waves regarding exposure to community violence, coping behaviors, substance use, and protective factors. Path analyses revealed that lifetime witnessing of violence, but not victimization, assessed at baseline, was associated with changes in avoidant coping, but not active coping, one year later; avoidant coping, in turn, was related to changes in and higher levels of problematic drug use the following year. Victimization was directly related to problematic drug use, but not to alcohol use. Regression analyses indicated that high levels of religious commitment and social support at baseline were prospectively associated with lower levels of avoidant coping. Because caregivers are important role models for their children, it is important to attend to the factors that contribute to their substance use and abuse.     

The effectiveness of road safety interventions using three different messages: Emotional,factual or a combination of both messages

The present study is an evaluation of a road safety intervention programme dealing with alcohol in traffic. The intervention was based on a programme developed by the Swedish Road Administration using three different messages. The aim of the study was to evaluate which message (emotional, factual or a combination of both messages) had the largest effect on the variables included in the theory of planned behaviour (TPB). Of the 930 Senior High School Students who took part in the study 265 received an emotional message, 251 received a factual message, 254 received a combination of both messages and 160 were assigned to a control group who did not receive any message. Two scenarios were used describing situations where the participants would receive a lift from someone who had drunk two ‘strong’ beers and was either someone they did not know very well or their best friend. The results showed that the intervention combining the emotional and the factual message had the largest effect on the variables included in the theory of planned behaviour (TPB). Attitude was affected the most by the interventions while further activities need to be taken in order to better target perceived behavioural control and especially subjective norm and thereby also intention.     

The Construct Validity of the Strengths and Difficulties Questionnaire for Aboriginal Children Living in Urban New South Wales,Australia

The current study explores the construct validity of the standard Strengths and Difficulties Questionnaire (SDQ) for Aboriginal children living in urban communities in New South Wales, Australia. Parent report SDQ data from the first 717 Aboriginal children aged 4–17 years who participated in the baseline survey of the Study of Environment on Aboriginal Resilience and Child Health were analysed. The overall construct validity of the SDQ in our sample was acceptable but not “good.” The internal consistency reliability was excellent overall and good for all subscales with the exception of peer problems, a concept that may have a different significance for urban Aboriginal parents. Removing the peer relationships subscale, however, did not improve the fit of the model. The convergent validity of the SDQ was good. The prosocial behaviours scale and both the peer and conduct problems scales were highly correlated suggesting Aboriginal parents conceptualise these differently and that prosocial behaviours may be considered a key indicator of well‐being for Aboriginal children. Overall, the SDQ is a promising tool for urban Aboriginal children in New South Wales. Those working with Aboriginal young people should focus on the SDQ total difficulties score and limit their reliance on the peer relationships subscale.     

Is There Life After DEBI? Examining Health Behavior Maintenance in the Diffusion of Effective Behavioral Interventions Initiative

The evidence-based interventions that are identified, packaged, and disseminated by the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention as part of the Diffusion of Effective Behavioral Interventions (DEBI) initiative—commonly referred to the "DEBIs"—currently represent a primary source of HIV prevention interventions for community-based providers. To date, little attention has focused on whether the intended outcomes of the DEBIs, i.e., reductions in HIV-related risk behaviors, are maintained over time. This review summarized evidence for the sustainability of the effects of the DEBIs on HIV sexual risk behavior and intravenous drug use from studies of original and adapted DEBIs. Evidence of intervention decay or a lack of any intervention effect was identified in several original and adapted versions of the DEBIs included in this review. Recommendations include modifications to current criteria for inclusion in the DEBI portfolio, in addition to the development of remediation strategies to address intervention decay. Further, theoretical models that specify the processes that underlie the maintenance of health behaviors over time should be used in developing HIV prevention interventions.     

Aboriginal language knowledge and youth suicide

This brief report details a preliminary investigation into how community-level variability in knowledge of Aboriginal languages relate to “band”-level measures of youth suicide. In Canada, and, more specifically, in the province of British Columbia (BC), Aboriginal youth suicide rates vary substantially from one community to another. The results reported demonstrate that not only did this simple language-use indicator prove to have predictive power over and above that of six other cultural continuity factors identified in previous research, but also that youth suicide rates effectively dropped to zero in those few communities in which at least half the band members reported a conversational knowledge of their own “Native” language.     

Expectations Among Aboriginal Peoples in Canada Regarding the Potential Impacts of a Government Apology

After continued pressure, the Canadian government offered an apology to Aboriginal peoples for its role in the Indian Residential School (IRS) system, where children were removed from their families in an effort to assimilate the Aboriginal population. Although the apology was sought after, it was unclear what Aboriginal peoples expected it to accomplish in relation to their treatment and quality of life within Canada. Quantitative and qualitative analyses revealed that, although Aboriginal adults (N = 164) felt the apology could potentially be a first step towards improved relations with the government and non‐Aboriginal Canadians, expectations that such changes would actually come to fruition were generally pessimistic. In exploring predictors of such expectations, path analysis indicated that those who had been intimately impacted by IRSs reported greater perceived discrimination that, in turn, was associated with lowered intergroup trust and forgiveness. Those who perceived high levels of discrimination were less likely to expect changes following the apology, which was mediated by the low levels of intergroup trust and forgiveness towards the government, but not towards non‐Aboriginal Canadians. Essentially, an apology was not enough to elicit hope for improved intergroup relations, especially when perceptions of continued discrimination impeded the restoration of intergroup trust and forgiveness.     

Assessing cognitive impairment in Indigenous Australians: Re‐evaluation of the Kimberley Indigenous Cognitive Assessment in Western Australia and the Northern Territory

The Kimberley Indigenous Cognitive Assessment (KICA) was initially developed and validated as a culturally appropriate dementia screening tool for older Indigenous people living in the Kimberley. This paper describes the re‐evaluation of the psychometric properties of the cognitive section (KICA‐Cog) of this tool in two different populations, including a Northern Territory sample, and a larger population‐based cohort from the Kimberley. In both populations, participants were evaluated on the KICA‐Cog tool, and independently assessed by expert clinical raters blinded to the KICA scores, to determine validity and reliability of dementia diagnosis for both groups. Community consultation, feedback and education were integral parts of the research. for the Northern Territory sample, 52 participants were selected primarily through health services. Sensitivity was 82.4% and specificity was 87.5% for diagnosis of dementia, with area under the curve (AUC) of .95, based on a cut‐off score of 31/32 of a possible 39. for the Kimberley sample, 363 participants from multiple communities formed part of a prevalence study of dementia. Sensitivity was 93.3% and specificity was 98.4% for a cut‐off score of 33/34, with AUC = .98 (95% confidence interval: 0.97–0.99). There was no education bias found. The KICA‐Cog appears to be most reliable at a cut‐off of 33/39.