mHealth Interventions to Reduce Alcohol Use in Young People: A Systematic Review of the Literature.

Harmful use of alcohol has serious effects on public health and is considered a significant risk factor for poor health. mHealth technology promotes health behavior change and enhances health through increased social opportunities for encouragement and support. It remains unknown whether these types of applications directly influence the health status of young people in reducing harmful levels of alcohol consumption. The purpose of this systematic review is to examine current evidence on the effectiveness of mHealth technology use in positively influencing alcohol-related behaviors of young people without known alcohol addiction. Relevant articles published from 2005 to January 2017 were identified through electronic searches of eight databases. Studies with interventions delivered by mHealth (social networking sites, SMS and mobile phone applications) to young people aged 12-26 years were included. Outcome measures were alcohol use, reduction in alcohol consumption or behavior change. Eighteen studies met the inclusion criteria. Interventions varied in design, participant characteristics, settings, length and outcome measures. Ten studies reported some effectiveness related to interventions with nine reporting a reduction in alcohol consumption. Use of mHealth, particularly text messaging (documented as SMS), was found to be an acceptable, affordable and effective way to deliver messages about reducing alcohol consumption to young people. Further research using adequately powered sample sizes in varied settings, with adequate periods of intervention and follow-up, underpinned by theoretical perspectives incorporating behavior change in young people's use of alcohol, is needed.

Before and after the trauma bay: the prevention of violent injury among youth.

Despite a decline in the incidence of homicide in recent years, the United States retains the highest youth homicide rate among the 26 wealthiest nations. Homicide is the second leading cause of death overall and the leading cause of death for male blacks aged 15 to 24 years. High rates of health care recidivism for violent injury, along with increasing research that demonstrates the effectiveness of violence prevention strategies in other arenas, dictate that physicians recognize violence as a complex preventable health problem and implement violence prevention activities into current practice rather than relegating violence prevention to the criminal justice arena. The emergency department (ED) and trauma center settings in many ways are uniquely positioned for this role. Exposure to firearm violence doubles the probability that a youth will commit violence within 2 years, and research shows that retaliatory injury risk among violent youth victims is 88 times higher than among those who were never exposed to violence. This article reviews the potential role of the ED in the prevention of youth violence, as well as the growing number of ED- and hospital-based violence prevention programs already in place.

Graduated driver licensing policy in the Great Lakes states: current benefits and future potential.

BACKGROUND: Motor vehicle crashes are the leading cause of teenage deaths in the United States. Graduated Driver Licensing (GDL) policies effectively decrease teenage crash deaths. Emerging research is identifying the most effective components of GDL. This study examines GDL policies across 6 Great Lakes states, describing the beneficial impact, and investigating how evidence-based policy modifications could further reduce teenage driving deaths and injuries. METHODS: GDL policies were reviewed in 6 Great Lakes states (Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin). Incidence rate ratios for fatal and injury crashes for 16-year-old drivers were obtained from the Nationwide Review of GDL Study. Ratios were applied to the fatal and injury crashes reported from each state between 2002 and 2006 for 16-year-old drivers. The potential impact (crashes avoided) for each state was determined based on the state using a 3-phase GDL policy (a learner and intermediate stage prior to full licensure). In addition, the impact on crash reductions for each state if they had employed 5 of the recommended GDL components was determined. RESULTS: All 6 states had a 3-phase GDL policy, resulting in potential avoidance of 124 fatal and more than 21,000 injury crashes. The 6 states had 1 to 3 of the qualifying GDL components. If these states had adopted 5 of the qualifying components, an additional 309 fatal and more than 27,000 injury crashes could have been avoided. CONCLUSION: Three-phase GDL policy is effective at saving the lives of teenage drivers and vehicle occupants; evidence-based modification of GDL has the potential to further reduce teenage motor vehicle crash deaths and injuries.