Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 190
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
MMWR Morb Mortal Wkly Rep ; 69(10): 265-270, 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32163383

RESUMO

Binge drinking* is a leading preventable public health problem. From 2006 to 2010, binge drinking contributed to approximately 49,000 annual deaths resulting from acute conditions (e.g., injuries and violence) (1). Binge drinking also increases the risk for adverse health conditions, including some chronic diseases (e.g., breast cancer) and fetal alcohol spectrum disorders (2). In 2004, 2013, and again in 2018, for all U.S. adults aged ≥18 years in primary care, the U.S. Preventive Services Task Force (USPSTF) recommended alcohol screening and brief intervention (alcohol SBI) or counseling for persons whose screening indicated drinking in excess of recommended limits or in ways that increase risk for poor health outcomes (3-5). However, previous CDC surveillance data indicate that patients report rarely talking to their provider about alcohol use,† and alcohol SBI is traditionally delivered through conversation. CDC recently analyzed 2017 data from the Behavioral Risk Factor Surveillance System (BRFSS) survey's five-question module, which asked adults in 13 states§ and the District of Columbia (DC) about the delivery of alcohol SBI during their most recent checkup in the past 2 years. Overall, 81.4% of adults (age-standardized estimate) reported being asked about alcohol use by a health professional in person or on a form during a checkup in the past 2 years, but only 37.8% reported being asked a question about binge-level alcohol consumption, which is included on USPSTF recommended instruments (3). Among module respondents who were asked about alcohol use at a checkup in the past 2 years and reported current binge drinking (past 30 days) at time of survey, only 41.7% were advised about the harms of drinking too much at a checkup in the past 2 years, and only 20.1% were advised to reduce or quit drinking at a checkup in the past 2 years. These findings suggest that missed opportunities remain for health care providers to intervene with patients who report binge drinking. Working to implement alcohol SBI at a systems level, including the provision of the new Healthcare Effectiveness Data Information Set (HEDIS) measure, Unhealthy Alcohol Use Screening and Follow-Up, can improve alcohol SBI's use and benefit in primary care.


Assuntos
Bebedeira/diagnóstico , Bebedeira/prevenção & controle , Aconselhamento/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Aconselhamento/métodos , District of Columbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
2.
Cyberpsychol Behav Soc Netw ; 22(11): 677-683, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31697597

RESUMO

Reducing the rate of college binge drinking is a major public health goal. Social media sites such as Facebook serve as platforms for young adults' online communication, so they could potentially extend the reach of health campaign messages via retransmission. Thus, it is important to identify the factors that predict intentions to share health-related messages on social media. Drawing on the Spiral of Silence framework, the current research examined the effects of opinion climate, message efficacy, and publicness of social media on message retransmission intentions for anti-binge drinking "how-to" messages-messages that include advice and recommendations that target beliefs about efficacy. A 2 × 2 × 2 (efficacy: high vs. low × opinion climate: support vs. oppose × channel: public vs. private) between-subjects experiment was conducted. Data from 245 participants on Amazon Mechanical Turk demonstrated that people were more willing to share when they had an anti- rather than a pro-binge drinking opinion climate, when the messages were more useful, and when they were asked to share via private messaging rather than via public status updates. Theoretical and practical implications for the psychological mechanisms underlying message retransmission on social media are discussed.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/prevenção & controle , Intenção , Mídias Sociais , Adolescente , Adulto , Bebedeira/psicologia , Feminino , Promoção da Saúde , Humanos , Masculino , Universidades , Adulto Jovem
3.
Alcohol Alcohol ; 54(3): 295-301, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30869118

RESUMO

AIMS: The current study examined college students' perceptions of loss framed and gain framed messages aimed at reducing binge drinking. METHODS: Using focus groups (n = 3) consisting of undergraduates (n = 131), an iterative process was undertaken to ensure the acceptability and construct validity of loss framed and gain framed video messages. Both quantitative and qualitative data were collected. RESULTS: Results across all focus groups demonstrated that each message condition possessed strong construct validity. Participants in focus Group 3 rated messages as moderately to highly acceptable and acceptability ratings across loss framed messages and gain framed messages were comparable. CONCLUSIONS: These findings demonstrate the importance of focus group testing in the development of brief alcohol interventions among college students. Messages used in the currents study will be included in a video intervention aimed at reducing binge drinking among college students.


Assuntos
Bebedeira/prevenção & controle , Grupos Focais , Estudantes/psicologia , Gravação em Vídeo , Adolescente , Comportamento do Consumidor , Feminino , Humanos , Masculino , Universidades , Adulto Jovem
4.
J Addict Nurs ; 30(1): 14-23, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30829996

RESUMO

Binge drinking, an extreme drinking pattern and the most common form of hazardous alcohol consumption among university students, has remained a public health concern with physical, psychological, academic, and social problems. Tracking multiple factors is needed to find ways to deal with such hazardous drinking patterns and their adverse consequences. In Thailand, the particular factors leading to binge drinking patterns among university students are still not recognized. Four hundred thirteen university students in Northern Thailand self-administered a Web-based survey about the causal factors. The survey was based on a hypothesized model from the Social Ecological Model and from empirical studies. There were four factors that were hypothesized to directly increase binge drinking behavior: attitudes toward drinking, peer influence, physical environments of drinking, and alcohol advertisements. However, there were another four factors that were hypothesized to directly decrease binge drinking behavior: drinking refusal self-efficacy, university alcohol regulations, alcohol public policies, and knowledge. Through testing of the hypothesized model by Structural Equation Modeling, the causal model of binge drinking among Thai university students revealed "binge drinking refusal self-efficacy" (ß = -.22, p < .001) and "peer influence" (ß = -.14, p < .05) as significant negative factors and "physical environments" (ß = .18, p < .001) as a positive predictor regarding binge drinking. The study shows how healthcare providers may be able to lessen binge drinking by designing effective prevention programs centering on an intrapersonal factor (binge drinking refusal self-efficacy), an interpersonal factor (peer influence), and a community factor (physical environments).


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/epidemiologia , Bebedeira/prevenção & controle , Adolescente , Adulto , Atitude , Bebedeira/enfermagem , Estudos Transversais , Feminino , Humanos , Masculino , Infuência dos Pares , Fatores de Risco , Inquéritos e Questionários , Tailândia/epidemiologia , Universidades , Adulto Jovem
5.
BMC Womens Health ; 19(1): 29, 2019 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-30728002

RESUMO

BACKGROUND: There is a large disparity between alcohol treatment access and prevalence of hazardous drinking among same-sex attracted women (SSAW). Yet, this population typically report low satisfaction with care and a reluctance to attend mainstream health services. Currently, there are few culturally tailored services for SSAW available despite evidence indicating that many feel uncomfortable in mainstream services. This paper describes the protocol of a randomised controlled trial aimed at examining the impact of a culturally sensitive four-week short message service (SMS) alcohol intervention on SSAW's alcohol intake, wellbeing, and engagement with alcohol treatment. METHODS: A randomised controlled trial comparing a culturally tailored SMS intervention (The Step One Program) with a generic 'thank you' message, and a nested qualitative study to further explore the intervention's feasibility and acceptability. The Step One Program was co-designed using an Intervention Mapping framework and engaging potential consumers in the developmental process. Participants are block randomised (1:1 ratio) and followed up at the completion of the intervention and at 12 weeks post-intervention. The primary outcomes are alcohol reduction (as measured by the Alcohol Use Disorders Identification Test and self-reported alcohol intake), wellbeing (as measured by the Personal Wellbeing Index - Adult), and help-seeking (as measured by the number of alcohol services accessed and frequency of access). Upon completion of the 12-week post-intervention survey, participants in the intervention group were contacted via email regarding a phone interview on intervention acceptability. DISCUSSION: This study may have important implications for clinical practice, improve healthcare access and equity for SSAW, and provide direction for future research in this field. The outcomes of the current study may stimulate the development of other culturally tailored health programs for SSAW. The results will inform whether individually tailoring the messages according to content and delivery frequency may be warranted to increase its acceptability. TRIAL REGISTRATION: This trial was registered with the Australian New Zealand Clinical Trials Registry (trial ID: ACTRN12617000768392 ).


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Promoção da Saúde/métodos , Homossexualidade Feminina/psicologia , Mensagem de Texto , Adulto , Austrália , Bebedeira/prevenção & controle , Feminino , Humanos , Sistemas de Alerta , Inquéritos e Questionários
6.
Psychol Addict Behav ; 33(1): 1-14, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30640504

RESUMO

This study examines effects of a randomized controlled trial for an online, family-based prevention program for older teens, Smart Choices 4 Teens, on alcohol use and related outcomes. Families (N = 411; teen age M = 16.4, SD = 0.5) were randomly assigned to the intervention or control condition in 2014-2015. Both intent to treat (ITT) and dosage models were conducted. ITT models: At the 6-month follow-up, teens in the experimental condition reported fewer friends who had been drunk, and parents in the experimental group reported more communication about social host laws. At the 12-month follow-up, parents in the experimental condition reported consuming fewer drinks than parents in the control group. Dosage models: At the 6-month follow-up, dosage was inversely related to teen drinking in the past 6 months or 30 days, frequency of teen drinking during the past 6 months and 30 days, drinks consumed by teens over the past 6 months, teen drunkenness and binge-drinking during the past 30 days, teen reported communication about safe drinking and positively related to parent and teen reported communication about social host laws. At 12 months, dosage was inversely related to teen alcohol use, frequency of teen drinking over the past 30 days, drinks consumed by teens over the past 6 months and 30 days, and teen drunkenness over the past 6 months. Results suggest that Smart Choices 4 Teens is beneficial for families. Dissemination and implementation strategies that motivate completion of program content will improve outcomes related to older teens' alcohol use. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Bebedeira/prevenção & controle , Comunicação , Internet , Pais , Consumo de Álcool por Menores/prevenção & controle , Adolescente , Consumo de Bebidas Alcoólicas , Intoxicação Alcoólica/prevenção & controle , Atitude , Feminino , Humanos , Masculino , Relações Pais-Filho , Grupo Associado
7.
Psychol Health ; 34(4): 478-496, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30636436

RESUMO

OBJECTIVE: Excessive alcohol consumption, including binge drinking, increases when students enter university. This study tests whether combining messages targeting theory of planned behaviour (TPB) constructs with if-then plans (i.e. implementation intentions) to avoid binge drinking reduces binge drinking in new university students. DESIGN: One month after starting university, students (N = 407) were randomly assigned to condition in a 2 (TPB messages) × 2 (implementation intentions) factorial design. MAIN OUTCOME MEASURES: Cognitions about binge drinking were assessed immediately post-intervention. Frequency of binge drinking was assessed at one-month follow-up (n = 205). RESULTS: Participants who viewed the messages had significantly weaker intentions to engage in binge drinking and less favourable cognitions about binge drinking (affective attitude, descriptive norms, and self-efficacy) than those who did not view the messages. In addition, participants who formed an implementation intention to avoid binge drinking reported significantly fewer instances of binge drinking at follow-up. CONCLUSION: The findings provide some support for the use of interventions based on the TPB to reduce intentions to engage in binge drinking and for forming implementation intentions to reduce the frequency of binge drinking in new university students. No evidence was found for the synergistic effect of combining the two interventions.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/prevenção & controle , Bebedeira/psicologia , Intenção , Teoria Psicológica , Estudantes/psicologia , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
8.
Neuropsychopharmacology ; 44(6): 1132-1140, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30647448

RESUMO

Neuropeptide Y (NPY) signaling via limbic NPY1 and 2 receptors (NPY1R and NPY2R, respectively) is known to modulate binge-like ethanol consumption in rodents. However, the role of NPY signaling in the medial prefrontal cortex (mPFC), which provides top-down modulation of the limbic system, is unknown. Here, we used "drinking-in-the-dark" (DID) procedures in C57BL/6J mice to address this gap in the literature. First, the impact of DID on NPY immunoreactivity (IR) was assessed in the mPFC. Next, the role of NPY1R and NPY2R signaling in the mPFC on ethanol consumption was evaluated through site-directed pharmacology. Chemogenetic inhibition of NPY1R+ neurons in the mPFC was performed to further evaluate the role of this population. To determine the potential role of NPY1R+ neurons projecting from the mPFC to the basolateral amygdala (BLA) this efferent population was selectively silenced. Three, 4-day cycles of DID reduced NPY IR in the mPFC. Intra-mPFC activation of NPY1R and antagonism of NPY2R resulted in decreased binge-like ethanol intake. Silencing of mPFC NPY1R+ neurons overall, and specifically NPY1R+ neurons projecting to the BLA, significantly reduced binge-like ethanol intake. We provide novel evidence that (1) binge-like ethanol intake reduces NPY levels in the mPFC; (2) activation of NPY1R or blockade of NPY2R reduces binge-like ethanol intake; and (3) chemogenetic inhibition of NPY1R+ neurons in the mPFC and NPY1R+ mPFC neurons projecting to the BLA blunts binge-like drinking. These observations provide the first direct evidence that NPY signaling in the mPFC modulates binge-like ethanol consumption.


Assuntos
Complexo Nuclear Basolateral da Amígdala/metabolismo , Bebedeira/metabolismo , Neuropeptídeo Y/metabolismo , Córtex Pré-Frontal/metabolismo , Receptores de Neuropeptídeo Y/metabolismo , Animais , Complexo Nuclear Basolateral da Amígdala/efeitos dos fármacos , Bebedeira/prevenção & controle , Modelos Animais de Doenças , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Vias Neurais/efeitos dos fármacos , Vias Neurais/metabolismo , Neuropeptídeo Y/efeitos dos fármacos , Córtex Pré-Frontal/efeitos dos fármacos , Receptores de Neuropeptídeo Y/efeitos dos fármacos
9.
Nurse Educ ; 44(2): 106-111, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29994998

RESUMO

BACKGROUND: The college years are a time of transition in which students experiment with behaviors including use of alcohol. Nursing students can be instrumental in supporting positive health behaviors and influencing the drinking culture. PURPOSE: This article describes the findings of a collaborative nursing student-faculty research project about alcohol use with a focus on binge drinking. METHODS: Using a nursing student-faculty collaborative model, a longitudinal design was used to evaluate a mass media campaign with social norming messages and education to influence the drinking culture on a college campus. RESULTS: Students in Greek life and athletics engaged in binge drinking significantly more than other students. Students observed the mass media messages, with 81.9% viewing posters. A significant decrease in binge drinking was reported. CONCLUSIONS: The nursing student-faculty team implemented a mass media campaign, which was effective at influencing the drinking culture on a college campus.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/prevenção & controle , Promoção da Saúde , Meios de Comunicação de Massa , Cultura Organizacional , Estudantes de Enfermagem/psicologia , Universidades/organização & administração , Adolescente , Adulto , Bebedeira/psicologia , Comportamento Cooperativo , Docentes/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Pesquisa em Enfermagem/educação , Aprendizagem Baseada em Problemas , Adulto Jovem
10.
Subst Use Misuse ; 54(5): 737-746, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30572765

RESUMO

OBJECTIVES: The aim of this study was as follows: (a) to study the relation between alcohol advertisement exposure and the initiation of (binge) alcohol drinking among secondary school students, and (b) to identify subgroups of students that may be more vulnerable for the influence of alcohol marketing than others. METHODS: A longitudinal survey was conducted with three waves (12- and 24-month interval). Eight secondary schools of various school levels in the Netherlands participated. Participants included 942 second grade students, average age 13.2 years, 46.0% boys. Exposure to alcohol and non-alcohol advertisements was measured at baseline with images of 16 commercial advertisements with all brand information removed. Students were asked to indicate contact frequency and recall brand names. Outcome measure was initiation of (binge) alcohol drinking between baseline and 12- and 24-month follow-up. RESULTS: The results showed small but statistically significant associations between alcohol advertisement exposure and both drinking and binge drinking initiation over a 12-month interval. Over a 24-month interval, a statistically significant association was only found for initiation of binge drinking. The association was stronger for students from the lowest school level. CONCLUSION: The study confirms previous longitudinal studies demonstrating an association between exposure to alcohol marketing and initiation of (binge) drinking among adolescents. This association is moderated by school level. Students from the lower school levels may therefore be the most appropriate target group for selective prevention efforts and should be taken particularly into account when formulating policies to reduce and prevent underage drinking.


Assuntos
Bebedeira/psicologia , Rememoração Mental , Consumo de Álcool por Menores/psicologia , Adolescente , Bebedeira/prevenção & controle , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Países Baixos , Estudantes , Consumo de Álcool por Menores/prevenção & controle
11.
J Stud Alcohol Drugs ; 79(6): 868-875, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30573017

RESUMO

OBJECTIVE: College students' reliance on social media is both a risk factor for alcohol-related problems and a possible avenue for intervention. Greater understanding of students' social media habits in relation to drinking may lead to more effective prevention efforts. This study examined the use of alcohol and social media in Hispanic and non-Hispanic college students with and without a history of binge drinking. METHOD: Participants (N = 424; age 18-25; 84% female) completed online surveys of alcohol use, intensity of use for Snapchat, Instagram, Facebook, and Twitter, social media addiction, and retrospective frequency of social media use while drinking and after intoxication. RESULTS: Historical binge drinkers had greater intensity scores for Snapchat, Instagram, and Twitter, and were more likely to report using social media and alcohol concurrently, even while intoxicated (ps < .05). Compared with Hispanics, non-Hispanics exhibited greater intensity of use for Instagram (ps = .001). Quantity and frequency of alcohol use was positively correlated with intensity scores for Snapchat, Instagram and Twitter (ps < .001), as well as social media addiction (p < .001), and use of social media while drinking and after intoxication (ps < .001). Age at first alcohol use and first intoxication were negatively correlated with use of social media while drinking and after intoxication (ps < .001). CONCLUSIONS: The results of this study may inform intervention efforts aimed at curbing hazardous college drinking by highlighting a context in which students could be exposed to harm-reduction messages presented through social media.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/psicologia , Hispano-Americanos/psicologia , Mídias Sociais/tendências , Estudantes/psicologia , Universidades/tendências , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Bebedeira/etnologia , Bebedeira/prevenção & controle , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
12.
J Health Commun ; 23(12): 1072-1076, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30522412

RESUMO

The large amount of vocational community college students that continue showing binge-drinking behavior might be an indication that interventions targeting this behavior have not been hugely successful. It might be that these interventions targeted beliefs that are less or not related with vocational community college binge-drinking behavior. The aim of this study was to identify vocational community college students` salient beliefs about binge drinking. In the context of the integrative model of behavioral prediction, we applied deductive qualitative content analysis of conversations about binge drinking. The analysis of vocational community college students` conversations about binge drinking revealed a significant amount of salient beliefs, such as cognitive and affective outcome beliefs and efficacy beliefs. These beliefs may be important indicators of vocational community college students` binge drinking. Moreover, to our knowledge, this study was the first to reveal a new set of beliefs, namely social judgment beliefs (i.e., vocational community college students` judgments about their peers` binge-drinking behavior). We believe that our study yielded salient beliefs that may serve as input for future interventions targeting binge drinking among vocational community college students.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/psicologia , Estudantes/psicologia , Adolescente , Atitude Frente a Saúde , Bebedeira/prevenção & controle , Feminino , Humanos , Masculino , Países Baixos , Mídias Sociais , Universidades
13.
Prev Chronic Dis ; 15: E151, 2018 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-30522582

RESUMO

Limited information exists about the effectiveness of interventions to enforce laws prohibiting alcohol sales to intoxicated patrons in licensed establishments. New Mexico Behavioral Risk Factor Surveillance System data were used to evaluate an intervention on binge drinking intensity in licensed (eg, bars) versus unlicensed (eg, homes) locations. The proportion of binge drinkers in licensed locations who consumed 8 or more drinks on a binge drinking occasion decreased from 42.1% in 2004-2005 to 22.6% in 2007-2008 (adjusted odds ratio, 0.4; 95% confidence interval, 0.2-0.9), while the proportion in unlicensed locations was essentially unchanged. Enhanced enforcement of overservice laws may reduce excessive drinking in licensed establishments.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebedeira/epidemiologia , Comércio , Adolescente , Adulto , Distribuição por Idade , Bebidas Alcoólicas/economia , Sistema de Vigilância de Fator de Risco Comportamental , Bebedeira/prevenção & controle , Estudos Transversais , Feminino , Humanos , Licenciamento , Masculino , Pessoa de Meia-Idade , New Mexico/epidemiologia , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
14.
J Addict Nurs ; 29(4): E9-E15, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30507826

RESUMO

BACKGROUND: Over the past decade, the changes to the pattern of alcohol consumption in Portugal, in particular among young people with heavy episodic drinking (binge drinking), are well documented. However, there are limited studies in individuals aged between 20 and 30 years, which is an important period of transition into adulthood where binge drinking can negatively influence the resolution of developmental tasks. Therefore, this study aims at analyzing the pattern of alcohol consumption and binge drinking among young adults aged between 20 and 30 years living in the municipality of Lisbon. METHODOLOGY: This is a quantitative, descriptive correlational study using a convenience sample composed of 259 individuals. We used the Alcohol Use Disorders Identification Test for data collection. RESULTS: Among the sampled subjects, 19.3% of them reported being nondrinkers. Among the alcohol-drinking subjects (N = 209), 61.3% reported binge drinking behaviors. We found a higher percentage of binge drinkers among vocational training students than among university students, as well as a relatively higher percentage of women. In both cases, we found no statistically significant differences. Within the total sample, 10.8% reported hazardous or harmful consumption, with men showing greater hazardous consumption. CONCLUSIONS: Although approximately one fifth of the sampled subjects reported being nondrinkers, the percentage of binge drinkers in this study was significantly higher than that reported in other studies. We also found that binge drinking is more common among vocational training students, although this difference was not statistically significant. Further studies are needed on this age group and in nonacademic settings.


Assuntos
Comportamento Aditivo , Bebedeira/epidemiologia , Adulto , Bebedeira/enfermagem , Bebedeira/prevenção & controle , Feminino , Humanos , Masculino , Portugal/epidemiologia , Inquéritos e Questionários , Adulto Jovem
15.
PLoS One ; 13(10): e0204500, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30296276

RESUMO

Basal forebrain cholinergic neurons mature in adolescence coinciding with development of adult cognitive function. Preclinical studies using the rodent model of adolescent intermittent ethanol (AIE; 5.0 g/kg, i.g., 2-days on/2-days off from postnatal day [P]25 to P55) reveal persistent increases of brain neuroimmune genes that are associated with cognitive dysfunction. Adolescent intermittent ethanol exposure also reduces basal forebrain expression of choline acetyltransferase (ChAT), an enzyme critical for acetylcholine synthesis in cholinergic neurons similar to findings in the post-mortem human alcoholic basal forebrain. We report here that AIE decreases basal forebrain ChAT+IR neurons in both adult female and male Wistar rats following early or late adolescent ethanol exposure. In addition, we find reductions in ChAT+IR somal size as well as the expression of the high-affinity nerve growth factor (NGF) receptor tropomyosin receptor kinase A (TrkA) and the low-affinity NGF receptor p75NTR, both of which are expressed on cholinergic neurons. The decrease in cholinergic neuron marker expression was accompanied by increased phosphorylation of NF-κB p65 (pNF-κB p65) consistent with increased neuroimmune signaling. Voluntary wheel running from P24 to P80 prevented AIE-induced cholinergic neuron shrinkage and loss of cholinergic neuron markers (i.e., ChAT, TrkA, and p75NTR) as well as the increase of pNF-κB p65 in the adult basal forebrain. Administration of the anti-inflammatory drug indomethacin (4.0 mg/kg, i.p prior to each ethanol exposure) during AIE also prevented the loss of basal forebrain cholinergic markers and the concomitant increase of pNF-κB p65. In contrast, treatment with the proinflammatory immune activator lipopolysaccharide (1.0 mg/kg, i.p. on P70) caused a loss of cholinergic neuron markers that was paralleled by increased pNF-κB p65 in the basal forebrain. These novel findings are consistent with AIE causing lasting activation of the neuroimmune system that contributes to the persistent loss of basal forebrain cholinergic neurons in adulthood.


Assuntos
Prosencéfalo Basal/efeitos dos fármacos , Bebedeira/prevenção & controle , Terapia por Exercício , Indometacina/farmacologia , Fármacos Neuroprotetores/farmacologia , Consumo de Álcool por Menores , Animais , Prosencéfalo Basal/crescimento & desenvolvimento , Prosencéfalo Basal/imunologia , Prosencéfalo Basal/patologia , Bebedeira/imunologia , Bebedeira/patologia , Depressores do Sistema Nervoso Central/efeitos adversos , Neurônios Colinérgicos/efeitos dos fármacos , Neurônios Colinérgicos/imunologia , Neurônios Colinérgicos/patologia , Modelos Animais de Doenças , Etanol/efeitos adversos , Feminino , Masculino , Neuroimunomodulação/efeitos dos fármacos , Neuroimunomodulação/fisiologia , Distribuição Aleatória , Ratos Wistar , Corrida/fisiologia , Maturidade Sexual , Volição
16.
Eval Program Plann ; 71: 28-35, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30092491

RESUMO

American Indian youth substance use is a major public health concern. To date, there has been limited evaluation of American Indian youth substance use prevention programs. Evaluation of prevention programs is necessary to understand the aspects of programming that are effective or not effective. This mixed-methods evaluation focuses on select outcomes of a 3-year culturally-based prevention program located in six American Indian communities in the Rocky Mountain Region. The goals of the prevention program are to reduce binge drinking by 30% and increase community readiness by 1-point over a 5- year period. In the first year of the program, community members worked with program staff to develop an evaluation plan that would measure the following outcomes: lowering substance use, increasing community readiness, and increasing the reach of prevention messaging through culturally based prevention. The primary research questions this outcome evaluation sought to answer were as follows: 1) Are there differences in American Indian youth who participate in culturally-based prevention activities compared with American Indian youth who do not participate in these activities? 2) Was the prevention program effective in increasing community readiness over a 3-year period? 3) Did community involvement in prevention activities increase overtime? Results from this evaluation indicate that substance use was similar among intervention (n = 200) and non-intervention youth (n = 369). This was somewhat surprising because Intervention youth reported higher levels of social support and community connections than non-intervention group youth. Community readiness decreased -.81 point from 2015 to 2017. The reach of prevention activities increased 365% from 2015 to 2017. We provide lessons learned that may help other communities as they document outcomes related to prevention efforts. Substance use is a multi-faceted problem facing our communities, families, schools, and nation. Innovative, effective, culturally-based prevention programs like the one highlighted in this paper underscore the need for primary prevention strategies.


Assuntos
Bebedeira/prevenção & controle , Participação da Comunidade/métodos , Competência Cultural , Promoção da Saúde/organização & administração , Índios Norte-Americanos , Adolescente , Bebedeira/etnologia , Criança , Relações Familiares , Feminino , Humanos , Masculino , Noroeste dos Estados Unidos/epidemiologia , Avaliação de Programas e Projetos de Saúde/métodos , Autoimagem , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adulto Jovem
17.
Drug Alcohol Depend ; 191: 98-109, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30096640

RESUMO

BACKGROUND: The effects of parent-based interventions on adolescent alcohol use are unclear, including what factors moderate intervention effects. This study examines the effects of parent-based interventions on adolescent alcohol use and whether the treatment effects vary by participants' characteristics and intervention characteristics. METHODS: Eleven electronic databases and relevant studies' references were searched for eligible studies published before March 2017. Randomized controlled trials investigating the efficacy of any parent-based intervention for alcohol use outcomes among adolescents up to 18 years old were eligible for review. Two reviewers independently conducted screening, data extraction, and risk of bias assessment. Robust variance estimation in meta-regression was used to analyze treatment effect size estimates and to conduct moderator analysis. RESULTS: Twenty studies were included in the meta-analysis. The average treatment effect size across all drinking outcomes, with 44 effect sizes from 20 studies, was g = -0.23 with a 95% confidence interval [-0.35, -0.10] which is statistically significant. Parent-based interventions appreared to have larger mean effect sizes on adolescent drinking intention than binge drinking. Interventions targeting both general and alcohol-specific parenting strategies had larger average effect sizes than interventions targeting alcohol-specific parenting only. CONCLUSIONS: This meta-analysis found evidence of parent-based interventions' efficacy in preventing or reducing adolescent alcohol use.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Bebedeira/prevenção & controle , Poder Familiar/psicologia , Consumo de Álcool por Menores/prevenção & controle , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Bebedeira/psicologia , Humanos , Intenção , Relações Pais-Filho , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Consumo de Álcool por Menores/psicologia
18.
Qual Life Res ; 27(10): 2629-2637, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29934797

RESUMO

INTRODUCTION: The objective for this study was to combine drinking characteristics and two subjective measures, drinker identity and alcohol-related quality of life, i.e., negative impact of alcohol on quality of life, to determine relevant profiles for indicated prevention programs. In particular, we hypothesized that different profiles of students with high level of alcohol consumption exist when exploring subjectivity. METHODS: We performed an online survey among 16,930 students. We collected sociodemographics and environmental data, including alcohol-related quality of life, drinker identity, and drinking characteristics. We performed a hierarchical clustering on principal components. We described all variables in each cluster and explored between clusters differences by Kruskal-Wallis tests. RESULTS: We identified five clusters as regarding drinker identity, drinking characteristics, and alcohol-related quality of life. Among these five clusters, three clusters presented high drinking characteristics. A very vulnerable cluster showed high level of alcohol consumption, impact on quality of life and on academic results, and strong drinker identity. An egodystonic cluster showed high level of consumption, mild impact on quality of life and on academic results, but low drinker identity. A cluster seemed short-term super-adapted in heavy drinking environment, showing high level of alcohol consumption and drinker identity, but low impact on quality of life and on academic results (all between clusters p values < 0.001 with Kruskal-Wallis tests). CONCLUSION: The subjective experience of students from these clusters was significantly different (p value < 0.001), and could explain some inadequacy of certain prevention strategies, considering binge drinker student as a homogeneous group. Prospective studies are needed to explore changes over time of these clusters.


Assuntos
Alcoolismo/prevenção & controle , Alcoolismo/psicologia , Bebedeira/prevenção & controle , Bebedeira/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Adulto Jovem
19.
Addiction ; 113(11): 1984-2018, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29806876

RESUMO

BACKGROUND AND AIMS: Whole-of-community interventions aim to reduce alcohol and other drug (AOD) use and harms by mobilizing community leaders, organizations and policy-makers to respond effectively to AOD use. The aim of this review is to estimate the effectiveness of whole-of-community interventions in reducing population-level harms arising from AOD use. DESIGN: A systematic review of electronic databases CENTRAL, Embase, Medline, Medline in Process and PsycINFO was conducted from database inception to August 2017. Eligible trials had a parallel comparison group, implemented interventions in two or more community settings, and reported data on AOD use or harms. SETTING: Intervention settings included schools, sporting clubs, police and law enforcement agencies, community centres, local media and retail premises. PARTICIPANTS: Twenty-four trials from 63 publications were included (n = 249 125 participants). MEASUREMENTS: Outcomes from AOD consumption (quantity and frequency), AOD-related crime and AOD-related accidents, injuries and hospital admissions. Data were pooled using random-effects inverse variance meta-analysis in Review Manager version 5.3. FINDINGS: Risk of bias was mostly high, due to lack of random allocation, selective reporting and significant attrition. Meta-analyses indicated significant reductions in risky drinking [Alcohol Use Disorders Identification Scale (AUDIT) > 8; three trials (7 data points), relative risk (RR) = 0.78, 95% confidence interval (CI) = 0.62-0.99)], but found no impact on past-month alcohol use (five trials, RR = 0.95, 95% CI = 0.89-1.02), binge drinking (five trials, RR = 0.97, 95% CI = 0.89-1.06) or 12-month marijuana use (two trials, RR = 0.98, 95% CI = 0.86-1.11). Narrative synthesis indicated some reductions in AOD-related assault rates and arrests, but were equivocal for quantity of alcohol consumed, 12-month illicit drug use, assault or abuse, motor vehicle accidents and hospital admissions. CONCLUSIONS: Interventions to reduce alcohol and other drug use and harms applied to whole communities have resulted so far in small reductions in risky alcohol consumption, but have had little impact upon past month alcohol use, binge drinking or 12-month marijuana use and the studies have been subject to high risk of bias.


Assuntos
Bebedeira/prevenção & controle , Crime , Redução do Dano , Promoção da Saúde/métodos , Saúde Pública , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Ferimentos e Lesões , Acidentes , Consumo de Bebidas Alcoólicas , Hospitalização , Humanos
20.
BMC Public Health ; 18(1): 449, 2018 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-29618331

RESUMO

BACKGROUND: Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. This paper describes the design, implementation and evaluation of the first web-based computer tailored intervention aimed at the prevention of binge drinking in Spanish adolescents. METHODS: The Alerta Alcohol program is based on the I-Change Model. First, feedback from focus and Delphi groups are used for cultural adaptation and to obtain further information on the items to be included on the program. A pilot study is then conducted to assess feasibility and to identify strengths and weaknesses. Second, a Cluster Randomized Controlled Trial is conducted to test the effectiveness of Alerta Alcohol in students aged 16 to 18 years. The study is performed in 16 high schools from Andalusia (southern Spain), which are randomized either to the experimental or the control condition (EC and CC). The EC receives the Alerta Alcohol intervention, which consists of four sessions at school (baseline questionnaire, two sessions in three scenarios: at home, celebrations, and public places, and a final evaluation). The adolescents are provided with answers related to their views of each scenario; this information is used to provide highly specific feedback regarding their knowledge, risk perception, self-esteem, attitude, social influence, and self-efficacy. In addition, two booster sessions are given at home to reinforce the previous messages. The CC just completes the baseline and the final evaluation questionnaires and then they are allowed to receive the intervention as well (as a waiting list). Evaluation takes place after four months. The primary endpoint is binge drinking within 30 days prior to the evaluation and alcohol use in the previous week. It is expected that Alerta Alcohol reduce the prevalence of binge drinking by 10%. Follow up analyses are carried out to determine the differences in effectiveness according to the compliance of the program (quality of the implementation). DISCUSSION: The results are expected to be applicable and may incorporate improvements in the practice of the Healthcare and Education Systems. If the program proves to be effective, regional and eventual national implementation should be considered. TRIAL REGISTRATION: Trial registration number (ClinicalTrials.gov): NCT03288896 . This study was retrospectively registered on 19/09/2017.


Assuntos
Bebedeira/prevenção & controle , Promoção da Saúde/métodos , Internet , Consumo de Álcool por Menores/prevenção & controle , Adolescente , Feminino , Humanos , Masculino , Projetos Piloto , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Espanha
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA