The little intervention that could: creative aging implies healthy aging among Canadian seniors.

OBJECTIVES: Through a process of 'creative ageing', there is increased interest in how active participation in the arts can help promote health and well-being among seniors. However, few studies have quantitatively examined the benefits of a foray into artistic expression, and even fewer employ rigorous identification strategies. Addressing this knowledge gap, we use a series of quantitative techniques (ordinary least squares and quantile regression) to analyze the impact of an arts-based intervention targeting the elderly. METHODS: Recruited from Saint John, New Brunswick (a city of about 125,000 people in Eastern Canada), 130 seniors were randomly assigned to the programme, with the remaining 122 serving as the control. This intervention consisted of weekly 2-h art sessions (i.e. drawing, painting, collage, clay-work, performance, sculpting, and mixed media), taking place from January 2020 until April 2021. RESULTS: Relative to the control group, the intervention tended to reduce participant loneliness and depression, and improve their mental health. Outcomes were more evident toward the latter part of the programme, were increasing in attendance, and most efficacious among those with initially low levels of well-being. CONCLUSION: These findings imply that creative ageing promotes healthy ageing, which is especially noteworthy given COVID-19 likely attenuated our results.

A breath of fresh air: The effect of public smoking bans on Indigenous youth.

In general, past studies have estimated the average effect of public smoking bans on youth, ignoring differences across sub-populations. We extend the literature by considering Indigenous youth, who are a vulnerable and previously unexamined group (however, our analysis excludes First Nations youth who live on reserve). We also consider previously unexamined outcomes among youth: self-assessed health and subjective well-being. Our difference-in-differences estimates from Canada indicate that public bans reduced youth smoking and second-hand exposure in public places, on average. There was no displacement on the extensive margin, but the bans increased the number of people who smoke in the homes of youth, conditional on the presence of smokers in the household. Beyond average effects, however, we find that public bans reduced second-hand exposure in the homes of Indigenous youth (particularly Métis youth), on the extensive and intensive margins. The same youth experienced concurrent improvements in self-assessed health and life satisfaction. We conclude that public bans mitigate disparities in health and well-being between Indigenous and non-Indigenous youth, but the extent varies across Indigenous sub-populations, even within a particular country.

Steering Clear of Driving After Drinking: a Tailored e-Health Intervention for Reducing Repeat Offending and Modifying Alcohol Use in a High-Risk Cohort.

PURPOSE: Digital interventions to reduce risk behaviours are emerging as effective public health measures; however, few have been applied to drink driving and associated alcohol use based on a harm reduction perspective. This paper reports on the design, development, and pilot of a novel intervention which aims to reduce repeat offending by first-time convicted drink driving offenders. It explores whether an online program is acceptable and user friendly and contains useful and relevant content, with a sample of first-time drink driving offenders recruited at the time of conviction. METHOD: Building upon existing research into interventions to reduce drink driving recidivism and problem alcohol use, a tailored program was designed to provide content specifically concerned with drink driving and with an additional component related to alcohol use. Following stakeholder and internal review, the 'Steering Clear First Offender Drink Driving Program' was subsequently piloted with 15 first-time drink driving offenders. Evaluative data was analysed both quantitatively and qualitatively. RESULTS: The pilot results indicate that the participants found the program to be user friendly, as demonstrated by high scores in relation to navigation, online delivery, engagement, avatar usage and straightforwardness. They reported that they found the content to be useful and relevant and that the key learning area was in relation to the consequences of drink driving. CONCLUSION: Online interventions for reducing risky behaviour such as drink driving may be useful and cost effective from a public health perspective. Potentially, they can directly address risky behaviours associated with alcohol use in high-risk cohorts that may not ordinarily receive intervention.

NARRATIVE AND META-ANALYTIC REVIEW OF INTERVENTIONS AIMING TO IMPROVE MATERNAL-CHILD ATTACHMENT SECURITY.

Early secure maternal-child attachment relationships lay the foundation for children's healthy social and mental development. Interventions targeting maternal sensitivity and maternal reflective function during the first year of infant life may be the key to promoting secure attachment. We conducted a narrative systematic review and meta-analysis to examine the effectiveness of interventions aimed at promoting maternal sensitivity and reflective function on maternal-child attachment security, as measured by the gold standard Strange Situation (M. Ainsworth, M. Blehar, B. Waters, & S. Wall, 1978) and Q-set (E. Waters & K. Deane, 1985). Studies were identified from electronic database searches and included randomized or quasi-randomized controlled parallel-group designs. Participants were mothers and their infants who were followed up to 36 months' postpartum. Ten trials, involving 1,628 mother-infant pairs, were included. Examination of the trials that provided sufficient data for combination in meta-analysis revealed that interventions of both types increased the odds of secure maternal-child attachment, as compared with no intervention or standard intervention (n = 7 trials; odds ratio: 2.77; 95% confidence interval: 1.69, 4.53, n = 965). Of the three trials not included in the meta-analyses, two improved the likelihood of secure attachment. We conclude that interventions aimed at improving maternal sensitivity alone or in combination with maternal reflection, implemented in the first year of infants' lives, are effective in promoting secure maternal-child attachments. Intervention aimed at the highest risk families produced the most beneficial effects.

An examination of health care efficiency in Canada: a two-stage semi-parametric approach.

Using data envelopment analysis, we examine the efficiency of Canada's universal health care system by considering a set of labour (physicians) and capital (beds) inputs, which produce a level of care (measured in terms of health quality and quantity) in a given region. Data from 2013-2015 were collected from the Canadian Institute for Health Information regarding inputs and from the Canadian Community Health Survey and Statistics Canada regarding our output variables, health utility (quality) and life expectancy (quantity). We posit that variation in efficiency scores across Canada is the result of regional heterogeneity regarding socioeconomic and demographic disparities. Regressing efficiency scores on such covariates suggests that regional unemployment and an older population are quite impactful and associated with less efficient health care production. Moreover, regional variation indicates the Atlantic provinces (Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick) are quite inefficient, have poorer economic prospects, and tend to have an older population than the rest of Canada. Oaxaca-Blinder decompositions suggest that the latter two factors explain about one-third of this efficiency gap. Based on our two-stage semi-parametric analysis, we recommend Canada adjust their transfer payments to reflect these disparities, thereby potentially reducing inequality in regional efficiency.

Beyond the billboard: A review of other external sources of driver distraction.

Road corridors contain countless sources of distraction, each carrying the potential to draw drivers' eyes and minds off roads, thus increasing the risk of a crash. While the impact of billboards on driver distraction has received considerable attention, empirical data for other types of roadside advertising signs is very limited. Furthermore, the existing research examining other potential external sources of distraction is fragmentary, which makes it difficult to develop evidence-based road safety policies to mitigate risk. Therefore, the aim of this study was to conduct an exploratory review to ascertain and synthesise the available distraction-related literature for various types of roadside advertising signs (excluding billboards) and other potential external sources of distraction in the road corridor. Based on distraction-related theory and existing literature, 58 predefined categories of potential distraction sources were developed to guide an exploratory literature search using the Scopus database. Fourteen documents relating to external distraction sources were identified in the database search with a further five studies found using a backwards citation chaining search (N=19). However, no studies for non-billboard types of roadside advertising signs were found. Studies included those that investigated driver distraction in relation to construction zones, commercial logos contained within official traffic management Dynamic Message Signs (DMS) and service (logo) signs, drones, murals, roadside memorials and wind turbines. While one study investigated whether an external source of distraction can have a positive effect on driver behaviour, the remainder focused on the potential negative impacts on road safety of these sources of distraction. A key finding of the review is that crash risk increases when drivers continue to visually and cognitively engage with a source of distraction. Overall, the studies provide insights into the types of distractions that can be encountered in road corridors and the impact they can have on driver behaviour. However, more research is required before the mechanisms and pathways involved in these types of distractions can be effectively conceptualised, and thereby mitigated to reduce the burden of distraction risk and road trauma.

Predicting risky driving behaviours using the theory of planned behaviour: A meta-analysis.

The current meta-analysis explored the efficacy of the theory of planned behaviour (TPB) in predicting high-risk driving behaviours. Specifically, we examined speeding (in relation to exceeding the limit as well as speed compliance), driving under the influence, distracted driving, and seat belt use. We searched four electronic databases (i.e., PubMed, Web of Science, Scopus, and ProQuest) and included original studies that quantitatively measured the relationships between the TPB variables (attitude, subjective norm, perceived behavioural control [PBC], intention, and prospective/objective behaviour). The study identified 80 records with 94 independent samples. Studies were assessed for risk of bias using the JBI checklist for cross-sectional studies and compliance with the TPB guidelines. Together, attitude, subjective norm and PBC explained between 30 % and 51 % of variance found in intention, with attitude showing as the strongest predictor for intention across the different driving behaviours. The findings also showed that the model explained 36 %-48 % variance found in predicting the observed and/or prospective behaviours for distracted driving, speed compliance and speeding. Understanding the varying strengths and thus relative importance of TPB constructs in predicting different risky driving behaviours is crucial for developing targeted road safety interventions.

How do perceptions of procedural justice, police legitimacy, and legitimacy of laws influence intentions to drug drive?

INTRODUCTION: There is a need for improved drug driving enforcement to promote greater driver compliance with drug driving laws. In Australia, Roadside Drug Testing (RDT) suffers from operational challenges that undermine its effectiveness in reducing drug driving. OBJECTIVE: To identify potential improvements to RDT, this study investigated the extent to which drivers perceive RDT to be procedurally just and that the policing of drug driving and the associated laws are legitimate. These perceptions were then compared with those applying to Random Breath Testing (RBT) and examined in relation to their respective influence on intentions to drug and drink drive in the future. METHOD: A sample of 1,483 licensed drivers from three Australian states completed an online survey. RESULTS: Those participants who reported engaging in drug driving perceived RDT to be less procedurally just than non-drug drivers. Similarly, drug drivers perceived the police and associated drug driving laws to be less legitimate than non-drug drivers. Furthermore, drug drivers who had been tested at an RDT operation in the past perceived RDT to be less procedurally just and considered drug driving policing and laws to be less legitimate, compared with the corresponding perceptions of drink drivers who had been tested at an RBT operation. A regression analysis indicated that stronger intentions to drug drive in the future were associated with lower perceptions of police legitimacy and the legitimacy of drug driving laws, but not with the elements of procedural justice. However, follow-up analyses indicated that the influence of procedural justice on intentions was mediated by the two legitimacy variables, thus weakening its direct impact on intentions. PRACTICAL APPLICATIONS: The results highlight the need for road safety authorities to enhance the perceived legitimacy of drug driving enforcement and associated laws. Changes to current police practices and/or drug-driving laws may also be needed to enhance the effectiveness of RDT.

Extending the explanatory utility of the EPPM beyond fear-based persuasion.

In the 20 years since its inception, the Extended Parallel Process Model (EPPM) has attracted much empirical support. Currently, and unsurprisingly, given that is a model of fear-based persuasion, the EPPM's explanatory utility has been based only upon fear-based messages. However, an argument is put forth herein that draws upon existing evidence that the EPPM may be an efficacious framework for explaining the persuasive process and outcomes of emotion-based messages more broadly when such messages are addressing serious health topics. For the current study, four different types of emotional appeals were purposefully devised and included a fear-, an annoyance/agitation-, a pride-, and a humor-based message. All messages addressed the serious health issue of road safety, and in particular the risky behavior of speeding. Participants (n = 551) were exposed to only one of the four messages and subsequently provided responses within a survey. A series of 2 (threat: low, high) × 2 (efficacy: low, high) analysis of variance was conducted for each of the appeals based on the EPPM's message outcomes of acceptance and rejection. Support was found for the EPPM with a number of main effects of threat and efficacy emerging, reflecting that, irrespective of emotional appeal type, high levels of threat and efficacy enhanced message outcomes via maximizing acceptance and minimizing rejection. Theoretically, the findings provide support for the explanatory utility of the EPPM for emotion-based health messages more broadly. In an applied sense, the findings highlight the value of adopting the EPPM as a framework when devising and evaluating emotion-based health messages for serious health topics.

What contributes to drug driving? An exploratory investigation into the influence of problematic substance use, roadside testing and alternative transport options.

Despite a strong reliance on enforcement approaches to prevent drug driving in Australia, this behaviour is still prevalent. The objective of this study was to investigate the influence of problematic drug use (i.e., showing indications of addiction), exposure to roadside drug testing, the use of detection avoidance strategies, and perceptions relating to alternative transport options on drug driving among illicit drug users. A total of 1,541 licensed drivers from the states of Queensland, New South Wales, and Victoria completed an online survey. The survey collected demographic and problematic substance use information, as well as items assessing drug driving behaviour. Cannabis was reported to be the most commonly used drug (36.0%); the most common drug of problematic use (27.9%), and the drug most often taken prior to driving (43.5%). Observing police operating Roadside Drug Tests (RDT) was more common among the participants than being tested by RDT (35.7% vs 23%). The results indicated a significant association between being a drug driver and observing or being tested by RDT. The drug drivers were significantly more likely to report using a range of strategies to avoid police detection than the non-drug drivers. Similarly, the drug drivers reported that it was more difficult for them to use various alternative transport options than the non-drug drivers. Decision tree analyses found that significant predictors of self-reported drug driving were problematic drug use, holding a provisional or probationary licence, earning a low- or middle-income, and using detection avoidance strategies like remaining watchful for police vehicles and taking back streets. The findings of this study suggest that ongoing improvements to drug driving enforcement will need to be complemented by health-based approaches designed to reduce drug abuse and dependence, and improvements to public transport, in order to achieve a sustainable reduction in drug driving.

The prototype willingness model: An application to adolescent driver speeding.

INTRODUCTION: Many young drivers are involved in crashes due to speeding. Some studies have used the Prototype Willingness Model (PWM) to explain the risky driving behavior of young people. However, many have measured PWM constructs in a manner inconsistent with its formulation. The PWM asserts that the social reaction pathway is underpinned by a heuristic comparison of oneself with a cognitive prototype of someone who engages in a risky behavior. This proposition has not been comprehensively examined and few PWM studies specifically examine social comparison. The current study investigates intentions, expectations, and willingness to speed by teen drivers using operationalizations of PWM constructs more aligned with their original conceptualizations. Additionally, the influence of dispositional social comparison tendency on the social reaction pathway is examined to further test the original propositions underpinning the PWM. METHOD: Two hundred and eleven independently driving adolescents completed an online survey including items measuring PWM constructs and social comparison tendency. Hierarchical multiple regression was used to investigate the influence of perceived vulnerability, descriptive and injunctive norms, and prototypes on speeding intentions, expectations, and willingness. A moderation analysis examined the effect of social comparison tendency on the association between prototype perceptions and willingness. RESULTS: The regression models explained substantial amounts of variance in intentions (39%), expectations (49%), and willingness (30%) to speed. There was no evidence that social comparison tendency influences the relationship between prototypes and willingness. CONCLUSIONS: The PWM is useful for predicting teenage risky driving. More studies should confirm that social comparison tendency does not moderate the social reaction pathway. However, there may be need for further theoretical development of the PWM. PRACTICAL APPLICATIONS: The study suggests that it may be possible to develop interventions to reduce adolescent driver speeding based on manipulation of PWM constructs such as speeding driver prototypes.

Are Populists Insecure About Themselves or About Their Country? Political Attitudes and Economic Perceptions.

We investigate whether greater economic insecurity increases distrust in government and fosters authoritarian politics. Using the 2016 American National Election Studies dataset, we build on the literature regarding "egotropic" and "sociotropic" economic concerns to distinguish between "micro" insecurity (perceived insecurity regarding the individual's own personal economic well-being), and "macro" insecurity (negative expectations concerning the macro economy). Our results suggest micro insecurity is not significantly correlated with attitudinal differences, but macro-level insecurity is associated with increased levels of political distrust, accompanied by greater authoritarianism. Greater macro-level insecurity is also associated with more negative feelings toward "out-groups" (e.g. Muslims, the LGBTQ+ community, feminists, immigrants) and was a key predictor in reduced affinity for Hillary Clinton and the rise in support for Donald Trump. Results are robust to controls for political affiliation and aggregate macroeconomic indicators, suggesting that rising levels of income inequality and weakening social safety nets increase political polarization and encourage xenophobia, racism, and homophobia.

A systematic review of factors associated with illegal drug driving.

Drug driving is a serious problem worldwide that can increase the risk of road crashes. This systematic review seeks to identify factors associated with drug driving (i.e., driving after consuming drugs other than alcohol) to highlight gaps in existing knowledge and inform the design of more effective countermeasures. A search of the literature was conducted for the period January 1, 2005 to July 31, 2021 using six different databases. The search protocol followed PRISMA guidelines and was registered in PROSPERO (#CRD42021234616). Studies that met inclusion criteria compared drug drivers with either non-drug drivers, alcohol-only drivers or drug drivers from an earlier time period, to identify factors specifically associated with drug driving, rather than common to all drivers. Two hundred and nineteen publications met the inclusion criteria and were included within the review. Based on the findings, a logic model was developed that presents the factors associated with drug driving. Various sociodemographic, psychosocial and legal factors emerged as the main factors associated with illegal drug driving. At the sociodemographic and psychological levels, drug drivers were more likely to be single, young males who often drive after using cannabis and who score high on sensation-seeking and impulsivity scales. The key social factor found to be associated with drug driving was peer acceptance/disapproval of the behaviour. At the legal level, the review suggested that the effectiveness of current enforcement approaches to drug driving vary among jurisdictions around the world due to differences in the level of perceived certainty of apprehension and the chances of punishment avoidance. Future research into the anticipated and actual rewards for drug driving is needed to inform the development of more effective countermeasures.

The psychological distress of the young driver: a brief report.

The objective of the research was to explore the role of psychological distress in the self-reported risky driving of young novice drivers. A cross-sectional online survey incorporating Kessler's Psychological Distress Scale and the Behaviour of Young Novice Drivers Scale was completed by 761 tertiary students aged 17-25 years with an intermediate (Provisional) driving licence in Queensland, Australia, between August and October 2009. Regression analyses revealed that psychological distress uniquely explained 8.5% of the variance in young novices' risky driving, with adolescents experiencing psychological distress also reporting higher levels of risky driving. Psychological distress uniquely explained a significant 6.7% and 9.5% of variance in risky driving for males and females respectively. Medical practitioners treating adolescents who have been injured through risky behaviour need to be aware of the potential contribution of psychological distress, while mental health professionals working with adolescents experiencing psychological distress need to be aware of this additional source of potential harm. The nature of the causal relationships linking psychological distress and risky driving behaviour are not yet fully understood, indicating a need for further research so that strategies such as screening can be investigated.

Parental economic insecurity and child health.

We explore the effects of parental economic insecurity on their children's hyperactivity and anxiety. Our central argument is that even after controlling for current family income and employment status, parents may have legitimate feelings of economic insecurity, and these may be detrimental for their children. Data from the National Longitudinal Survey of Children and Youth indicate that the health of 2- to 5-year-old children is worse when parents report themselves to be "worried about having enough money to support the family." In particular, boys are more hyperactive and girls are more anxious when parents feel less economically secure. Changes in parenting styles appear to be channels through which parental economic insecurity affects their children.

Racial/Ethnic Differences in Light of 100% Smoke-free State Laws: Evidence from Adults in the United States.

This study estimates racial/ethnic differences in the association between 100% smoke-free state laws and smoking, as well as self-reported health, to facilitate policy aimed at reducing disparities. Data pertain to adults aged 18 years and older, obtained from the public-use Behavioral Risk Factor Surveillance System (2002-2014). The authors exploit variation in the timing of 100% smoke-free state laws using a difference-in-differences model. Examining heterogeneity across racial/ethnic minority groups, the authors consider the association between smoke-free laws and the probability of being: a daily smoker (versus occasional); an occasional smoker (versus former); and at the top of the self-reported health scale (versus the bottom). The authors find that 100% smoke-free state laws were not correlated with smoking among women. Moreover, racial/ethnic minority men who smoked occasionally were less likely to quit than white men, and results suggest that smoke-free laws did not reduce these disparities. However, there is evidence that smoke-free laws reduced the probability of being a daily smoker for Asian and Hispanic/Latinx men, but not the probability of quitting or being at the top of the self-reported health scale. More generally, smoke-free laws were not associated with self-reported health, except that there may have been an improvement among nonsmoking American Indian/Alaska Native women. These findings underscore the importance of looking beyond average effects to consider how 100% smoke-free state laws impact racial/ethnic minorities. There is evidence that they reduced smoking and improved self-reported health for some groups, but a suite of tobacco control policies is necessary to reduce racial/ethnic disparities more broadly.

A unified deterrence-based model of legal and non-legal factors that influence young driver speeding behaviour.

Young driver speeding behaviour remains a large contributor to road trauma worldwide. In order to provide a more-in depth understanding of how to deter young drivers from this behaviour, this study developed and tested a model of the legal and non-legal factors that influence young driver's intentional speeding behaviour (exceeding the speed limit by more than 10 km/hr). A prospective survey design was conducted to measure the impact of perceptions of legal factors (including classical deterrence and reconceptualised deterrence variables) and non-legal factors (including the variables of fear of physical loss, material loss and perceived social sanctions, as well as the perception that it is safe to engage in the behaviour without being involved in a crash) at time 1, on engagement in speeding behaviour at time 2, which occurred 3 months later. A total of 200 participants aged 17-25 years completed both surveys (Mean age = 20.44 years). Using structural equation modelling, a unique model combining classical and extended deterrence theory, as well as prominent non-legal factors was created, and the variables were able to explain 41% of the variance in speeding behaviour. A high perceived severity of the punishment, experiencing direct punishment avoidance and perceiving that it is safe to speed were significant direct predictors. Meanwhile, there were also numerous significant partially mediated relationships found for both legal and non-legal variables. These findings provide important implications for both the application of deterrence-based theories in road safety and for improving countermeasures to deter young drivers more effectively from engagement in speeding.

Are perceptions of penalties stable across time? The problem of causal ordering in deterrence applied to road safety.

This study addressed the causal ordering problem in deterrence research by examining the perceptual stability of deterrence variables over time and comparing the results via cross-sectional and longitudinal surveys. This research extends upon scant previous research by including three key classical deterrence variables (i.e., the perceived certainty of apprehension and the perceived severity and swiftness of punishment), as well as Homel's (1988) extra-legal deterrence-related variables of the fear of physical loss, material loss and social sanctions. A longitudinal survey design was utilised over a three month-time period (N = 200, Mage = 20.38 years, 71 males) that examined the stability of the deterrence-related variables for three road rule violations, consisting of 1) exceeding the speed limit by more than 10 km/hr, 2) reading a message on a phone while driving and 3) using the social media platform of Snapchat while driving. Overall, fluctuations were found in all the deterrence-related variables (both legal and extra-legal sanctions), with the largest difference being for the perceptions of the certainty of apprehension. Consequently, it can be suggested that: (a) longitudinal surveys are more reliable when measuring the impact of deterrence perceptions on engagement in offending behaviour and (b) the problem of causal ordering regarding utilising cross-sectional surveys is further illuminated. The results suggest that deterrence is a dynamic process, constantly changing based upon individual experiences, which reinforces the need for continued enforcement efforts (both legal and non-legal), within the road safety arena to maximise rule compliance.

Gender differences in the effectiveness of public education messages aimed at smartphone use among young drivers.

Objective: The main aim of this survey study was to evaluate the relative persuasiveness of three newly developed and piloted public education messages aimed at monitoring/reading social interactive technology on a smartphone among young male and female drivers. In accordance with the Step Approach to Message Design and Testing, the messages were evaluated on a number of outcome measures and also explored the influence of self-reported involvement in the target behavior.Methods: Participants (N = 152; 105 F) were aged 17 to 25 years (Mage = 20.14 years, SD = 2.35) and were randomly allocated to either an intervention (one of the three messages) or control (no message) condition. The messages in the intervention group were assessed on acceptance (i.e., behavioral intention and message effectiveness), rejection, and the third person effect (TPE) differential score (i.e., the message is perceived to be more effective for others than for themselves).Results: Hierarchical regression analyses found that, compared to males, females reported: a) lower intention to monitor/read social interactive technology on a smartphone while driving, b) lower rejection; and, c) lower TPE likelihood, irrespective of message.Conclusions: These findings suggest that young male drivers and young female drivers require different message content to be effective and support the importance of including multiple outcome measures to explain the messages' persuasive effects.