Life course predictors of child emotional distress during the COVID-19 pandemic: Findings from a prospective intergenerational cohort study.

BACKGROUND: We examine precursors of child emotional distress during the COVID-19 pandemic in a prospective intergenerational Australian cohort study. METHODS: Parents (N = 549, 60% mothers) of 934 1-9-year-old children completed a COVID-19 specific module in 2020 and/or 2021. Decades prior, a broad range of individual, relational and contextual factors were assessed during parents' own childhood, adolescence and young adulthood (7-8 to 27-28 years old; 1990-2010) and again when their children were 1 year old (2012-2019). RESULTS: After controlling for pre-pandemic socio-emotional behaviour problems, COVID-19 child emotional distress was associated with a range of pre-pandemic parental life course factors including internalising difficulties, lower conscientiousness, social skills problems, poorer relational health and lower trust and tolerance. Additionally, in the postpartum period, pre-pandemic parental internalising difficulties, lower parental warmth, lower cooperation and fewer behavioural competencies predicted child COVID-19 emotional distress. CONCLUSIONS: Findings highlight the importance of taking a larger, intergenerational perspective to better equip young populations for future adversities. This involves not only investing in child, adolescent, and young adult emotional and relational health, but also in parents raising young families.

Parental history of positive development and child behavior in next generation offspring: A two-cohort prospective intergenerational study.

This study examined whether positive development (PD) in adolescence and young adulthood predicts offspring behavior in two Australasian intergenerational cohorts. The Australian Temperament Project Generation 3 Study assessed PD at age 19-28 (years 2002-2010) and behavior in 1165 infants (12-18 months; 608 girls) of 694 Australian-born parents (age 29-35; 2012-2019; 399 mothers). The Dunedin Multidisciplinary Health and Development Parenting Study assessed PD at age 15-18 (years 1987-1991) and behavior in 695 preschoolers (3-5 years; 349 girls) and their New Zealand born parents (age 21-46; 1994-2018; 363 mothers; 89% European ethnicity). In both cohorts, PD before parenthood predicted more positive offspring behavior (ßrange  = .11-.16) and fewer behavior problems (ßrange  = -.09 to -.11). Promoting strengths may secure a healthy start to life.

Inequalities in the distribution of COVID-19-related financial difficulties for Australian families with young children.

BACKGROUND: We examine (1) the frequency of financial difficulties in Australian families with young children (0-8 years) in the early and later phases of the pandemic; (2) the extent to which parents' pre-pandemic socio-economic disadvantage (SED) predicted financial difficulties; and (3) whether grandparent intergenerational SED further amplified this risk. METHOD: Data: Australian Temperament Project (ATP; established 1983, N = 2443) and ATP Generation 3 study (ATPG3; established 2012; N = 702), of which 74% (N = 553) completed a COVID-specific module in the early (May-September 2020) and/or later (October-December 2021) phases of the pandemic. OUTCOMES: Parent-reported loss of employment/reduced income, difficulty paying for essentials, and financial strain. EXPOSURES: Pre-pandemic parent and grandparent education and occupation. ANALYSIS: Logistic regressions, estimated via generalized estimating equations, were used to examine associations between the pre-pandemic SED of parents and grandparents and their interaction with financial difficulties, adjusting for potential confounders. RESULTS: At both pandemic time points, a third of parents reported adverse financial impacts (early: 34%, 95% confidence interval [CI] = 30-38; later: 32%, 95% CI = 28-36). Each standard deviation increase in the parents' pre-pandemic SED was associated with a 36% increase in the odds of reporting multiple financial difficulties (odds ratio [OR] = 1.36, 95% CI = 1.04-1.78). There was little evidence of an interaction between the SED of parents and grandparents. CONCLUSIONS: Financial impacts related to the COVID-19 pandemic were common and, irrespective of grandparent SED, disproportionately borne by parents with higher pre-pandemic SED. Given the well-established relationship between disadvantage and child health and development, sustained and well-targeted government supports will be critical to minimizing adverse impacts in years to come.

Supporting children's mental health in primary schools: a qualitative exploration of educator perspectives.

Schools are often seen as a key setting for the provision of mental health support for children. This study aimed to explore the professional perspectives of primary school educators in Victoria, Australia, regarding how schools can support the mental health of their students. Semi-structured interviews and focus groups were conducted with 17 primary school educators, from four schools. Thematic analysis was used to generate themes from the data. This study indicates that educators report significant concerns about the complexities of their role and their capacity to support children's mental health due to a lack of resources, overwhelming demands, and inadequate training. Educators highlighted the importance of partnership and communication with families and of a school culture that prioritises mental health. This study provides insights into external factors that can undermine effective support of children's mental health within primary schools and indicates a need for a more integrated approach to supporting children's mental health across education and healthcare.

Do risk factors for adolescent internalising difficulties differ depending on childhood internalising experiences?

PURPOSE: This study aimed to examine the continuity of internalising difficulties from childhood to adolescence, and determine if the influence of established risk factors on adolescent mental health differed depending on childhood internalising experiences. METHODS: Data were used from the Kindergarten cohort of the Longitudinal Study of Australian Children (LSAC, N = 4983, est. 2004). Internalising difficulties were measured via parent report on the Strengths and Difficulties Questionnaire (SDQ) at each wave from 4-5 to 14-15 years of age, and defined as symptoms in the borderline or abnormal range (≥ 4). Logistic generalised estimating equations were used to characterise associations between childhood internalising problems (4-9 years) and previously identified risk factors with adolescent internalising difficulties at three time points (10-11, 12-13 and 14-15 years). RESULTS: The risk of internalising problems was elevated at each adolescent age for those who previously experienced internalising symptoms in childhood compared to those who did not (10-11 years: OR 3.67, 95% CI 3.01-4.47, 12-13 years: OR 2.84, 95% CI 2.32-3.46, and 14-15 years: OR 2.33, 95% CI 1.90-2.87). Other known risk factors were found to be associated with adolescent internalising problems as expected. We found no statistical evidence that these associations differed for adolescents who previously experienced internalising symptoms in childhood. CONCLUSION: Findings of this study confirm the continuity of childhood mental health problems and the role of individual and family characteristics in the aetiology of adolescent internalising difficulties. The same risk factors appear relevant to target for adolescents who first experienced internalising symptoms in childhood.

Better support for children with additional health and developmental needs in school settings: Perspectives of education experts.

AIM: Many children start school with additional health and developmental needs (AHDN), yet how best to support these children for optimal outcomes in the school setting is a complex challenge. This study aims to determine the views of education experts on what differentiates the most effective primary schools. METHODS: Qualitative interviews were conducted with nine senior leaders across the education system responsible for managing or improving practice across a range of schools or school regions in Victoria. Using a positive deviance approach, which investigates strategies already implemented in organizations achieving desired outcomes, the semi-structured interviews aimed to elicit instances of perceived good practice that already exists within the school system. Interviews were analysed using inductive content analysis. RESULTS: All education experts reported high variability across schools and suggested a number of factors differentiating those that were most effective at supporting children with AHDN. They included the presence of strong teacher support by the school leadership team; explicit and documented processes to guide the practice of teachers and ensure consistency at a whole school level; inclusive relationships and environments; participation and knowledge sharing between medical, allied health and other stakeholders in the care team; and an evidenced-based approach to allocating resources to programmes and strategies. CONCLUSION: This exploration of instances of good practice can generate novel insights into a complex problem. Current findings suggest a number of potential opportunities for enhancing practice that can be tested in future research. Improving outcomes for this vulnerable and significant group of children will require collaboration across health and education.

Learning outcomes of children with teacher-identified emerging health and developmental needs.

OBJECTIVES: Children's additional health and developmental needs are often first identified by teachers when they begin school. This study estimates the Grade 3 literacy and numeracy outcomes of children with teacher-identified additional needs emerging in the first year of school, including the added burden conferred by socioeconomic disadvantage. METHODS: Population linked data (n = 42,619) were analysed from the Australian Early Development Census, which include teacher reports on children's health and development at school entry, and the National Assessment Program-Literacy and Numeracy, a direct assessment of reading and numeracy skills at Grade 3. Linear regression analyses were used to estimate associations between emerging needs and learning outcomes, adjusted for sociodemographic characteristics. The combined effect of emerging needs and low maternal education (an indicator of socioeconomic disadvantage) on academic outcomes was examined by estimating the relative excess risk due to interaction (RERI). RESULTS: Emerging health and developmental needs at school entry were associated with lower reading (b = -26.86, 95% CI = -29.19, -24.52) and numeracy (b = -24.39, 95% CI = -26.43, -22.35) outcomes at Grade 3. The combined effect of emerging needs and socioeconomic disadvantage was greater than expected when their individual effects are summed (RERI = 0.38, 95% CI 0.22, 0.55 for reading and RERI = 0.27, 95% CI 0.10, 0.43 for numeracy). CONCLUSION: In the current study, emerging health and developmental needs identified by teachers at the outset of schooling were associated with poorer literacy and numeracy skills at Grade 3, and family socioeconomic disadvantage appeared to further amplify this effect. Meeting the needs of these children will require timely and coordinated supports across the health and education systems, particularly for those children who are also disadvantaged.

Trends in the prevalence and distribution of teacher-identified special health-care needs across three successive population cohorts.

AIM: Some children's special health-care needs (SHCN) are formalised at the start of schooling (established SHCN), but a larger proportion start with difficulties that are milder or not yet diagnosed (emerging SHCN). This study explores whether: (i) the prevalence of teacher-identified SHCN (both overall and according to type of needs) and (ii) distribution across disadvantaged communities have changed over three successive population cohorts of Australian children. METHODS: We draw on repeated cross-sectional data from the Australian Early Development Census, a teacher-reported checklist completed on full populations of Australian school entrants in 2009, 2012 and 2015. It includes a measure of SHCN, as well as demographic information. RESULTS: The proportion of children with emerging and established needs was mostly stable from 2009 to 2015 (emerging needs: 17.1-18.9%; established needs: 4.4-4.9%). Change over time was observed in the prevalence of some specific types of impairment. Speech impairment rose by 14.7% for children with emerging needs, and emotional problems rose by 13.7% for children with established needs. Children living in the most disadvantaged neighbourhoods had higher odds of SHCN in all years (e.g. emerging needs relative risk ratio 1.65 (99% confidence interval 1.55-1.75) in 2015; established needs relative risk ratio 1.88 (99% confidence interval 1.71-2.06) in 2015). CONCLUSIONS: A large proportion of children starting school each year have SHCN. The types of SHCN that children present with increasingly reflect complex difficulties that require input from both the health and education sectors. Effective responses also need to consider the added impact of disadvantage.

Parent and teacher perceptions of emerging special health care needs.

AIM: A fifth of children enter school with special health care needs (SHCN) impacting on their physical, psychosocial or educational development, including many with emerging SHCN who often do not qualify for additional supports. This study aimed to compare the perceptions of parents and teachers on children's emerging SHCN, and explore correlates of conflicting reports. METHODS: The Longitudinal Study of Australian Children (LSAC) is a nationally representative study of Australian children, which includes the abbreviated Children with Special Health Care Needs Screener. Data were analysed from a subsample of n = 720 children from the LSAC Kindergarten cohort (n = 4983) for whom teachers also completed the Australian Early Development Index checklist, a measure of early childhood development that includes teacher reported SHCN. RESULTS: Teachers (n = 120, 17.34%) identified more emerging SHCN than parents (n = 74, 10.74%), and reports were often discrepant. Children were more likely to have consistent reports of emerging SHCN when their parents had high levels of involvement at school (OR 4.86; 95% CI 1.08-21.80; P < 0.05), whereas children who came from disadvantaged family backgrounds were more likely to have teacher-only identified difficulties (OR 3.66; 95% CI 1.17-11.50; P < 0.05). CONCLUSION: Parents and teachers bring different perspectives to children's development and additional support needs, each of which is valuable. Greater attention should be given to ensuring that common understandings about a child's needs at school are established early in children's educational pathways.

Developmental antecedents of abnormal eating attitudes and behaviors in adolescence.

OBJECTIVE: This study capitalizes on developmental data from an Australian population-based birth cohort to identify developmental markers of abnormal eating attitudes and behaviors in adolescence. The aims were twofold: (1) to develop a comprehensive path model identifying infant and childhood developmental correlates of Abnormal Eating Attitudes and Behaviors in adolescence, and (2) to explore potential gender differences. METHOD: Data were drawn from a 30-year longitudinal study that has followed the health and development of a population based cohort across 15 waves of data collection from infancy since 1983: The Australian Temperament Project. Participants in this analysis were the 1,300 youth who completed the 11th survey at 15-16 years (1998) and who completed the eating disorder inventory at this time point. RESULTS: Developmental correlates of Abnormal Eating Attitudes and Behaviors in mid-adolescence were temperamental persistence, early gestational age, persistent high weight, teen depression, stronger peer relationships, maternal dieting behavior, and pubertal timing. Overall, these factors accounted for 28% of the variance in Abnormal Eating Attitudes and Behaviors at 15-16 years of age. Depressive symptoms, maternal dieting behavior, and early puberty were more important factors for girls. Late puberty was a more important factor for boys. DISCUSSION: Findings address an important gap in our understanding of the etiology of Abnormal Eating Attitudes and Behaviors in adolescence and suggest multiple targets for preventive intervention.

The effects of adverse and positive experiences on cardiovascular health in Australian children.

BACKGROUND: Limited evidence suggests that positive experiences in childhood may promote cardiovascular health, providing additional opportunities for prevention and early intervention. This study aimed to examine the effects of adverse and positive experiences on cardiovascular health in late childhood. METHODS: Data sources: Longitudinal Study of Australian Children (N = 1874). EXPOSURES: Adverse and positive experiences assessed repeatedly (age 0-11 years). OUTCOMES: Cardiovascular health (high versus low or moderate) quantified by four health behaviors (diet, physical activity, cigarette smoking, and sleep) and four health factors (body mass index, non-high-density lipoprotein, blood pressure, and blood glucose) (age 11-12 years) as per the American Heart Association's Life's Essential 8 metrics. ANALYSES: Separate generalized linear models with log-Poisson links were used to estimate the effects of adverse and positive experiences on cardiovascular health, adjusting for confounders. RESULTS: Children exposed to multiple adverse experiences (≥ 2) were less likely to have high cardiovascular health (RR = 0.82, 95% CI = 0.67 to 1.02) than those not exposed. Children exposed to multiple positive experiences (≥ 2) were more likely to have high cardiovascular health (RR = 1.14, 95% CI = 0.94 to 1.38) than those not exposed. Stratified analyses suggested that exposure to multiple positive experiences might buffer the detrimental effects of multiple adverse experiences on cardiovascular health. CONCLUSIONS: Both adverse and positive experiences were found to be modestly associated with cardiovascular health in Australian children. Future research and practice should not only consider addressing childhood adversity but also use a strengths-based approach to promoting positive experiences to improve cardiovascular health.

Household income supplements in early childhood to reduce inequities in children's development.

BACKGROUND: Early childhood interventions have the potential to reduce children's developmental inequities. We aimed to estimate the extent to which household income supplements for lower-income families in early childhood could close the gap in children's developmental outcomes and parental mental health. METHODS: Data were drawn from a nationally representative birth cohort, the Longitudinal Study of Australian Children (N = 5107), which commenced in 2004 and conducted follow-ups every two years. Exposure was annual household income (0-1 year). Outcomes were children's developmental outcomes, specifically social-emotional, physical functioning, and learning (bottom 15% versus top 85%) at 4-5 years, and an intermediate outcome, parental mental health (poor versus good) at 2-3 years. We modelled hypothetical interventions that provided a fixed-income supplement to lower-income families with a child aged 0-1 year. Considering varying eligibility scenarios and amounts motivated by actual policies in the Australian context, we estimated the risk of poor outcomes for eligible families under no intervention and the hypothetical intervention using marginal structural models. The reduction in risk under intervention relative to no intervention was estimated. RESULTS: A single hypothetical supplement of AU$26,000 (equivalent to ∼USD$17,350) provided to lower-income families (below AU$56,137 (∼USD$37,915) per annum) in a child's first year of life demonstrated an absolute reduction of 2.7%, 1.9% and 2.6% in the risk of poor social-emotional, physical functioning and learning outcomes in children, respectively (equivalent to relative reductions of 12%, 10% and 11%, respectively). The absolute reduction in risk of poor mental health in eligible parents was 1.0%, equivalent to a relative reduction of 7%. Benefits were similar across other income thresholds used to assess eligibility (range, AU$73,329-$99,864). CONCLUSIONS: Household income supplements provided to lower-income families may benefit children's development and parental mental health. This intervention should be considered within a social-ecological approach by stacking complementary interventions to eliminate developmental inequities.

Socioeconomic disadvantage and polygenic risk for high BMI magnify obesity risk across childhood: a longitudinal, population, cohort study.

BACKGROUND: Across the life course, socioeconomic disadvantage disproportionately afflicts those with genetic predispositions to inflammatory diseases. We describe how socioeconomic disadvantage and polygenic risk for high BMI magnify the risk of obesity across childhood, and using causal analyses, explore the hypothetical impact of intervening on socioeconomic disadvantage to reduce adolescent obesity. METHODS: Data were drawn from a nationally representative Australian birth cohort, with biennial data collection between 2004 and 2018 (research and ethics committee approved). We generated a polygenic risk score for BMI using published genome-wide association studies. We measured early-childhood disadvantage (age 2-3 years) with a neighbourhood census-based measure and a family-level composite of parent income, occupation, and education. We used generalised linear regression (Poisson-log link) to estimate the risk of overweight or obesity (BMI ≥85th percentile) at age 14-15 years for children with early-childhood disadvantage (quintiles 4-5) versus average (quintile 3) and least disadvantage (quintiles 1-2), for those with high and low polygenic risk separately. FINDINGS: For 1607 children (n=796 female, n=811 male; 31% of the original cohort [N=5107]), polygenic risk and disadvantage were both associated with overweight or obesity; effects of disadvantage were more marked as polygenic risk increased. Of children with polygenic risk higher than the median (n=805), 37% of children living in disadvantage at age 2-3 years had an overweight or obese BMI by adolescence, compared with 26% of those with least disadvantage. For genetically vulnerable children, causal analyses indicated that early neighbourhood intervention to lessen disadvantage (to quintile 1-2) would reduce risk of adolescent overweight or obesity by 23% (risk ratio 0·77; 95% CI 0·57-1·04); estimates for improving family environments were similar (0·59; 0·43-0·80). INTERPRETATION: Actions addressing socioeconomic disadvantage could mitigate polygenic risk for developing obesity. This study benefits from population-representative longitudinal data but is limited by sample size. FUNDING: Australian National Health and Medical Research Council.

The potential of intervening on childhood adversity to reduce socioeconomic inequities in body mass index and inflammation among Australian and UK children: A causal mediation analysis.

BACKGROUND: Lower maternal education is associated with higher body mass index (BMI) and higher chronic inflammation in offspring. Childhood adversity potentially mediates these associations. We examined the extent to which addressing childhood adversity could reduce socioeconomic inequities in these outcomes. METHODS: We analysed data from two early-life longitudinal cohorts: the Longitudinal Study of Australian Children (LSAC; n=1873) and the UK Avon Longitudinal Study of Parents and Children (ALSPAC; n=7085). EXPOSURE: low/medium (below university degree) versus high maternal education, as a key indicator of family socioeconomic position (0-1 year). OUTCOMES: BMI and log-transformed glycoprotein acetyls (GlycA) (LSAC: 11-12 years; ALSPAC: 15.5 years). Mediator: multiple adversities (≥2/<2) indicated by family violence, mental illness, substance abuse and harsh parenting (LSAC: 2-11 years; ALSPAC: 1-12 years). A causal mediation analysis was conducted. RESULTS: Low/medium maternal education was associated with up to 1.03 kg/m2 higher BMI (95% CI: 0.95 to 1.10) and up to 1.69% higher GlycA (95% CI: 1.68 to 1.71) compared with high maternal education, adjusting for confounders. Causal mediation analysis estimated that decreasing the levels of multiple adversities in children with low/medium maternal education to be like their high maternal education peers could reduce BMI inequalities by up to 1.8% and up to 3.3% in GlycA. CONCLUSIONS: Our findings in both cohorts suggest that slight reductions in socioeconomic inequities in children's BMI and inflammation could be achieved by addressing childhood adversities. Public health and social policy efforts should help those affected by childhood adversity, but also consider underlying socioeconomic conditions that drive health inequities.

Life course psychosocial precursors of parent mental health resilience during the COVID-19 pandemic: A three-decade prospective cohort study.

BACKGROUND: There has been widespread interest in the implications of COVID-19 containment measures on the mental health of parents. Most of this research has focused on risk. Much less is known about resilience; yet such studies are key to protecting populations during major crises. Here we map precursors of resilience using life course data spanning three decades. METHODS: The Australian Temperament Project commenced in 1983 and now follows three generations. Parents (N = 574, 59 % mothers) raising young children completed a COVID-19 specific module in the early (May-September 2020) and/or later (October-December, 2021) phases of the pandemic. Decades prior, parents had been assessed across a broad range of individual, relational and contextual risk and promotive factors during childhood (7-8 years to 11-12 years), adolescence (13-14 years to 17-18 years) and young adulthood (19-20 years to 27-28 years). Regressions examined the extent to which these factors predicted mental health resilience, operationalised as lower than expected anxiety and depressive symptoms during the pandemic relative to pre-pandemic symptoms. RESULTS: Parent mental health resilience during the COVID-19 pandemic was consistently predicted by several factors assessed decades before the pandemic. These included lower ratings of internalizing difficulties, less difficult temperament/personality traits and stressful life events, and higher ratings of relational health. LIMITATIONS: The study included 37-39-year-old Australian parents with children age between 1 and 10 years. DISCUSSION: Results identified psychosocial indicators across the early life course that, if replicated, could constitute targets for long-term investment to maximise mental health resilience during future pandemics and crises.

Addressing Child Mental Health Inequities Through Parental Mental Health and Preschool Attendance.

BACKGROUND: Prevention is key to reducing socioeconomic inequities in children's mental health problems, especially given limited availability and accessibility of services. We investigated the potential to reduce inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. METHODS: Data from the nationally representative birth cohort, Longitudinal Study of Australian Children (N = 5107, commenced in 2004), were used to examine the impact of socioeconomic disadvantage (0-1 year) on children's mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities could be reduced by improving disadvantaged children's parental mental health (4-5 years) and their preschool attendance (4-5 years). RESULTS: Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their nondisadvantaged peers (18.7%): confounder-adjusted difference in prevalence is 11.6% (95% confidence interval: 7.7% to 15.4%). Improving disadvantaged children's parental mental health and their preschool attendance to the level of their nondisadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in children's mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% confidence interval: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. CONCLUSIONS: Targeted policy interventions that improve parental mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children's mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.

Intervention targets for reducing mortality between mid-adolescence and mid-adulthood: a protocol for a machine-learning facilitated systematic umbrella review.

INTRODUCTION: A rise in premature mortality-defined here as death during the most productive years of life, between adolescence and middle adulthood (15-60 years)-is contributing to stalling life expectancy in high-income countries. Causes of mortality vary, but often include substance misuse, suicide, unintentional injury and non-communicable disease. The development of evidence-informed policy frameworks to guide new approaches to prevention require knowledge of early targets for intervention, and interactions between higher level drivers. Here, we aim to: (1) identify systematic reviews with or without meta-analyses focused on intervention targets for premature mortality (in which intervention targets are causes of mortality that can, at least hypothetically, be modified to reduce risk); (2) evaluate the review quality and risk of bias; (3) compare and evaluate each review's, and their relevant primary studies, findings to identify existing evidence gaps. METHODS AND ANALYSIS: In May 2023, we searched electronic databases (MEDLINE, PubMed, Embase, Cochrane Library) for peer-reviewed papers published in the English language in the 12 years from 2012 to 2023 that examined intervention targets for mortality. Screening will narrow these papers to focus on systematic reviews with or without meta-analyses, and their primary papers. Our outcome is death between ages 15 and 60 years; with potential intervention targets measured prior to death. A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) will be used to assess quality and risk of bias within included systematic reviews. Results will be synthesised narratively due to anticipated heterogeneity between reviews and between primary studies contained within included reviews. ETHICS AND DISSEMINATION: This review will synthesise findings from published systematic reviews and meta-analyses, and their primary reviewed studies, meaning ethics committee approval is not required. Our findings will inform cross-cohort consortium development, be published in a peer-reviewed journal, and be presented at national and international conferences. PROSPERO REGISTRATION NUMBER: CRD42022355861.

The relationship between positive development and psychopathology during the transition to adulthood: a person-centred approach.

The transition to adulthood is characterised by potential for both positive development and problem outcomes such as psychopathology, yet little is known about relationships between the two. Given the diversity of pathways observed during this transition period, there is likely to be significant heterogeneity in young people's experiences of these outcomes. Drawing on data from 1158 19-20 year olds in the Australian Temperament Project and using latent profile analysis, we identified six subgroups. For most, higher positive development was associated with lower psychopathology and vice versa. One group (33.6%) was high across all positive development measures and low on psychopathology, and another (47.7%) average in both areas. The remaining four groups were low on positive development but differentiated by average psychopathology (4.7%), high internalising (5.5%), and moderate (7.2%) and severe (1.3%) externalising problems. Tailored intervention strategies that address both the promotion of competence and prevention of problem outcomes are needed.

The longitudinal prediction of alcohol consumption-related harms among young adults.

This study explores the longitudinal pathways by which risk and protective factors influence the development of alcohol-related harms in a representative community sample of 941 young adults (19-20 years) from Victoria, Australia, focusing on the role of concurrent risky drinking. Impulsivity at 15-16 years, alcohol-related harms at 15-16 years and 17-18 years, frequency of intoxication at 17-18 years, and antisocial behavior, friends' drinking and living arrangements at 19-20 years were directly related to alcohol-related harms, as well as indirectly related to harms through increased risky drinking. Paternal drinking at 17-18 years was directly related to alcohol-related harms. Friends' drinking at 19-20 years and alcohol-related harms at age 17-18 interacted with risky drinking to increase the likelihood of alcohol-related harms. Implications for intervention efforts are discussed.

Access to and Quality of Neighbourhood Public Open Space and Children's Mental Health Outcomes: Evidence from Population Linked Data across Eight Australian Capital Cities.

Neighbourhood-level interventions offer a promising opportunity to promote child mental health at a population level; however, neighbourhood effects are still regarded as a 'black box' and a better understanding of the specific design elements, such as public open space, is needed to inform actionable policy interventions. METHODS: This study leveraged data from a population linked dataset (Australian Early Development Census-Built Environment) combining information from a national census of children's developmental outcomes with individualised geospatial data. Associations between access to (within 400 m and 800 m from home), and quality of, public open space and child mental health outcomes across eight capital cities were estimated using multilevel logistic regression models, adjusting for demographic and contextual factors. Access was defined based on proximity of public open space to children's home addresses, within distance thresholds (400 m, 800 m) measured along the road network. Effect modification was tested across maternal education groups. RESULTS: Across the eight capital cities, inequities in access to child friendly public open spaces were observed across maternal education groups and neighbourhood disadvantage quintiles. Children with access to any type of public open space within 800 m of home had lower odds of demonstrating difficulties and higher odds of competence. Children with access to child friendly public open spaces within 800 m of home had the highest likelihood of demonstrating competence. CONCLUSION: Improving access to neighbourhood public open space appears to be a promising strategy for preventing mental health difficulties and promoting competence in early childhood. Action is needed to redress socio-spatial inequities in access to child friendly public open space.