Co-design of digital public health substance use resources: A collaboration between young people and experts.

ISSUE ADDRESSED: Substance use and mental illness remain critical issues for young Australians, however, engagement with evidence-based health resources is challenging among this age group. This study aimed to develop engaging, useful digital health resources, underpinned by neuroscience principles, to build awareness of the harms of electronic cigarettes (e-cigarettes) and concurrent alcohol and antidepressant use. METHODS: A mixed-methods approach was adopted to co-design two evidence-based videos resources. The resources were co-designed with the Matilda Centre's Youth Advisory Board Centre's Youth Advisory Board through a series focus groups and individual feedback reviews. Young people residing in New South Wales were then invited to complete a survey to evaluate the usefulness, relatability and impact on perceived harms associated with each substance pre- and post-viewing resources. RESULTS: A total of 100 participants completed the survey (mean age = 21.5 years, SD = 2.77, 42% Female, 2% Non-binary). The animated videos were well received, with the large majority (91% and 87% respectively) of participants rating them 'excellent' or 'very good'. After viewing the videos, there was a significant increase in the perception of harm associated with e-cigarette use, monthly (t(99) = 2.76, p = .003), weekly (t(99) = 4.82, p < .001) and daily (t(99) = 4.92, p < .001), and consuming alcohol whilst taking antidepressants both weekly (t(100) = 2.93, p = .004) and daily (t(100) = 3.13, p = .002). CONCLUSIONS: This study describes a successful co-design process demonstrating how meaningful involvement of young people, alongside traditional research methods, can produce substance use prevention resources that are useful, engaging and increase knowledge of harms among young people. SO WHAT?: To achieve meaningful public health impact researchers, experts and digital creators can work together to co-create substance use educational materials that are engaging, well-liked, while imparting important health knowledge.

Discrimination as a frame-of-reference effect in overlapping friendship communities of ethnically diverse youth.

OBJECTIVES: To what extent is the frame of reference of overlapping friendship communities important for young people's feelings of discrimination and subjective well-being? That is, do youth feel better or worse to the extent that they feel less or more discrimination than their friends? METHOD: Participants (N = 898; Mage = 14.13; SDage = 3.37; 46% females; 46% Whites; 20% Indigenous; 34% other minorities) were high school students of three ethnically diverse, low socioeconomic status public schools in New South Wales, Australia. Cross-sectional data were collected to measure felt discrimination, mental health, subjective well-being, social support, and nominations of close friends. A state-of-the-art method of clustering links was used to identify overlapping friendship communities, and multiple membership multilevel models were run to examine whether community-level discrimination moderated the link between individual-level discrimination and well-being. RESULTS: When the community level discrimination was low, there was no well-being related cost or benefit of individual-level discrimination. But when the community-level discrimination was high, individuals in those communities who themselves felt low discrimination had better well-being than individuals who themselves felt high discrimination. CONCLUSIONS: We provide evidence for a frame-of-reference effect involving discrimination. Individuals' relative standing in their friendship communities with high group-level discrimination reliably predicted the individuals' well-being levels, regardless of ethnicity. The results highlight the importance of identifying overlapping friendship communities for understanding the dynamics of discrimination and well-being of ethnically diverse youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Unintended consequences: Alcohol screening at urban Aboriginal Community Controlled Health Services was suppressed during COVID-19 lockdowns.

INTRODUCTION: Regular screening for risky drinking is important to improve the health of Aboriginal and Torres Strait Islander Australians. We explored whether the rate of screening for risky drinking using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questions was disrupted at Aboriginal Community Controlled Health Services (ACCHS) during state-wide and territory-wide COVID-19 lockdowns in 2020. METHODS: Retrospective analysis of screening data from 22 ACCHSs located in New South Wales, the Northern Territory, Queensland, South Australia, Victoria and Western Australia. These services provide holistic and culturally appropriate primary care. A multi-level Poisson regression, including AR(1) autocorrelation, was used to predict counts of AUDIT-C screening at ACCHSs. RESULTS: AUDIT-C screening was suppressed during state-wide and territory-wide lockdowns in 2020 (incident rate ratio [IRR] 0.42 [0.29, 0.61]). The effect of lockdowns differed by service remoteness. While there was a substantial reduction in AUDIT-C screening for urban and inner regional services (IRR 0.25 [95% confidence interval (CI) 0.15, 0.42]), there was not a statistically significant change in screening at outer regional and remote (IRR 0.60 [95% CI 0.33, 1.09]) or very remote services (IRR 0.67 [95% CI 0.40, 1.11]). DISCUSSION AND CONCLUSIONS: The COVID-19 lockdowns in Australia likely suppressed rates of screening for risky drinking in urban and inner regional regions. As harm from alcohol consumption may have increased during lockdowns, policymakers should consider implementing measures to enable screening for risky drinking to continue during future lockdowns.

Overcoming Limitations in Peer-Victimization Research That Impede Successful Intervention: Challenges and New Directions.

Peer victimization at school is a worldwide problem with profound implications for victims, bullies, and whole-school communities. Yet the 50-year quest to solve the problem has produced mostly disappointing results. A critical examination of current research reveals both pivotal limitations and potential solutions. Solutions include introducing psychometrically sound measures to assess the parallel components of bullying and victimization, analyzing cross-national data sets, and embracing a social-ecological perspective emphasizing the motivation of bullies, importance of bystanders, pro-defending and antibullying attitudes, classroom climate, and a multilevel perspective. These solutions have been integrated into a series of recent interventions. Teachers can be professionally trained to create a highly supportive climate that allows student-bystanders to overcome their otherwise normative tendency to reinforce bullies. Once established, this intervention-enabled classroom climate impedes bully-victim episodes. The take-home message is to work with teachers on how to develop an interpersonally supportive classroom climate at the beginning of the school year to catalyze student-bystanders' volitional internalization of pro-defending and antibullying attitudes and social norms. Recommendations for future research include studying bullying and victimization simultaneously, testing multilevel models, targeting classroom climate and bystander roles as critical intervention outcomes, and integrating school-wide and individual student interventions only after improving social norms and the school climate.

The Upsides and Downsides of the Dark Side: A Longitudinal Study Into the Role of Prosocial and Antisocial Strategies in Close Friendship Formation.

Resource control theory (RCT) posits that both antisocial and prosocial behaviors combine in unique ways to control resources such as friendships. We assessed students (N = 2,803; 49.7% male) yearly from junior (grades 8-10) to senior high school (11-12) on antisocial (A) and prosocial (P) behavior, peer nominated friendship, and well-being. Non-parametric cluster analyses of the joint trajectories of A and P identified four stable profiles: non-strategic (moderately low A and P), bi-strategic (moderately high on A and P), prosocial (moderately low A and moderately high on P), and antisocial (moderately low on P, and very high on A). There were clear benefits to youth using bi-strategic strategies in junior high: they attracted relatively high levels of opposite sex friendship nominations. However, this benefit disappeared in senior high. There were also clear costs: bi-strategic youth experienced relatively low well-being, and this effect was significantly more pronounced for females than males. Prosocial youth were the only ones who maintained both high friendship numbers and high well-being throughout high school. We discuss the cost/benefit trade-offs of different resource control strategies.