Different self-damaging behaviours, similar motives? Testing measurement invariance of motives for nonsuicidal self-injury, disordered eating and substance misuse.

OBJECTIVES: Theory and research suggest that distinct self-damaging behaviours (SDBs; e.g., nonsuicidal self-injury [NSSI], restrictive eating, binge eating, drug misuse, alcohol misuse) share similar motives. However, few studies have used a common self-report inventory to investigate the shared relevance and relative salience of motives for SDBs. Accordingly, the present study: (1) examined whether self-report scales assessing intrapersonal motives (i.e., relieving negative emotions, enhancing positive emotions, punishing oneself) and interpersonal motives (i.e., bonding with others, conforming with others, communicating distress, communicating strength, reducing demands) have invariant factor structures across SDBs; and (2) compared the salience of these motives across SDBs. METHODS: 1018 adults (54.6% men, Mage = 35.41 years) with a history of SDBs were allocated to the following groups: NSSI (n = 213), restrictive eating (n = 200), binge eating (n = 200), drug misuse (n = 200) or alcohol misuse (n = 205). Participants reported on their motives for engaging in their allocated SDB. Measurement invariance analyses compared the factor structures and latent means of the motive scales across SDBs. RESULTS: The motive scales had comparable factor structures across SDBs. Intrapersonal motives were most strongly endorsed for NSSI and drug misuse. Interpersonal motives were most strongly endorsed for drug and alcohol misuse. All motives were least salient to restrictive eating. CONCLUSIONS: Results suggest that common motives underlie distinct SDBs and that they can be adequately assessed using a single self-report inventory. However, certain motives are more relevant to some SDBs than others, with restrictive eating being the most motivationally distinct SDB. This knowledge can inform transdiagnostic models and interventions for SDBs.

Health-risk behaviours co-occur among adults with tooth loss.

INTRODUCTION: Health-risk behaviours tend to co-occur among the same sectors of the population. The aim of this study is to examine the association between an aggregate of multiple health-risk behaviours and tooth loss among American Adults. METHODS: We used data from the Behavioural Risk Factor Surveillance System (BRFSS) 2022, a nationally representative survey of non-institutionalized American. We included participants aged 18 years and older. An aggregate variable of health-risk behaviours which included smoking, heavy alcohol consumption, lack of physical activities, overweight/obesity, infrequent dental visits and infrequent medical check-up was created. Tooth loss was indicated by losing one tooth or more. Logistic Regression analysis was conducted to test the association between the aggregate of behaviours and tooth loss adjusting for income, education, ethnicity and health insurance. RESULTS: The analysis included 326,561 participants. The mean number of health-risk behaviours was 2.13 and 1.72 among participants with tooth loss and without tooth loss, respectively. The aggregate of health-risk behaviours was significantly associated with tooth loss with odds ratios 1.23 (95% CI, 1.21, 1.26) in a model adjusting for age, gender, education, income ethnicity and health insurance. CONCLUSION: This study demonstrated that an aggregate of health-risk behaviours, with some not directly linked to oral health, is associated with tooth loss among American adults. The study highlights the importance of considering different risk factors when planning health promotion policies to tackle oral health.

Chronic conditions, subjective wellbeing and risky sexual behaviour among adolescents and young adults.

The purpose of this study is to clarify the relationship between having a chronic condition (CC) and several types of risky sexual behaviour (RSB) among adolescents and young adults. We used data from a multicentre cross-sectional study carried out on 14,431 adolescents from 137 French schools. Logistic regression was used to assess the association between several types of RSB and CCs among the 2680 participants aged 17 years or over who reported sexual intercourse. Survival analysis was conducted to assess the association between CCs and age at first sexual intercourse across the whole sample. Analyses were conducted separately by gender with and without adjustment for the parents' education level, early menarche and subjective wellbeing (relationship with mother and father, depression, perceived health status and liking school). Among boys, having a CC was associated with a higher risk of RSB in both univariate (OR: 1.58 [95% CI: 1.10-2.27]) and multivariate analyses (aOR: 1.62 [95% CI: 1.11-2.38]). Among girls, the association between chronic condition and RSB in univariate analysis was non-significant (OR: 1.30 [95% CI: 0.97-1.76]) and disappeared after adjustment on subjective wellbeing (aOR: 1.08 [95% CI: 0.78-1.49]). There was no association between CC and age at first sexual intercourse.    Conclusion: There were major gender differences. Boys with a CC were more prone to engage in RSB independent of their subjective wellbeing, whereas in girls, subjective wellbeing seemed to mediate the relationship between CC and RSB. Clinicians should be aware of those gender differences in order to deliver preventive strategies regarding sexuality that target both genders. What is Known: • Young people with chronic conditions have a higher likelihood of engaging in risky sexual behaviour. • Engaging in such behaviours can be much more costly, as it can weaken their underlying state of health. What is New: • We found major gender differences. Boys were more prone to engage in risky behaviour independent of their subjective wellbeing, whereas in girls, it seemed to play an important role. • By understanding how risky sexual behaviour differs according to gender, clinicians can deliver prevention messages that target both genders.

Risk and protective factors associated with health risk behaviours among school learners in Western Cape, South Africa.

BACKGROUND: Health risk behaviour is rife among school learners in the Western Cape province. This paper assesses risk and protective factors related to health risk behaviours among high school learners. METHOD: Longitudinal data were sourced from 2950, 2675 and 2230 at Time 0, Time 1 and Time 2 among grade 8 learners aged 13-18 years between 2012 and 2013. Health risk behaviours were assessed on alcohol consumption, smoking cannabis in the past six months, and ever having sexual intercourse. The sociodemographic variables examined were age, sex, residence, socioeconomic status (SES), family structure and population group. Contextual variables studied were the feeling of learners about the intervention program, participation in religious activities, paid casual work and school sports. Descriptive statistics, bivariate associations and binary logistic analyses predicting health risk behaviours were carried out using generalized linear mixed models after restructuring the data collected at different time points. RESULT: Health risk behaviours increased consistently for alcohol consumption (25.7-42.7%), smoking cannabis (10.4-22.1%) and (22.3-36.0%) engaging in sexual intercourse. Increasing age emerged as a risk factor for all the health risk behaviours: alcohol consumption [OR:1.3 (1.2-1.4), p < 0.001]; smoking cannabis [OR:1.3 (1.2-1.4), p < 0.001] and had sex [OR:1.5 (1.4-1.7), p < 0.001]. Participation in paid casual work also predicted health risk behaviour: alcohol use [OR:1.5 (1.2-1.8), p < 0.001]; smoking cannabis [OR:1.3 (1.0-1.7), p < 0.05] and sex [OR:1.4 (1.1-1.7), p < 0.01]. High SES and feelings about the EPEP programme enhanced alcohol consumption and smoking cannabis. Smoking cannabis was augmented by residing in an urban area. Participation in school sports was associated with increased alcohol consumption and engaging in sexual intercourse. Participation in religious activities was protected against alcohol consumption [OR:0.7 (0.53-0.83), p < 0.001]; and sex [OR: 0.5 (0.4-0.7), p < 0.001]. Being a female and belonging to a coloured population group diminished engaging in sexual intercourse, and the family structure of both parents attenuated involvement in smoking cannabis. CONCLUSION: The findings of the study on risks and protective factors on health risk behaviours mirror those of school-based programmes in developing countries. Learners who participated in paid work and school sports are at risk of adverse health outcomes. Furthermore, participation in religious practices and family structure roles in attenuating health risk behaviours should be integrated and considered in the school-based intervention programme.

Smoking cessation programme in hospitalised patients due to acute respiratory disease.

BACKGROUND: Hospital environment is generally propitious to smoking cessation for several reasons, such as a legal ban on smoking in hospital facilities, greater vulnerability facing acute illness and the continuous contact with healthcare professionals. AIMS: To evaluate the effectiveness of intensive smoking cessation intervention during hospital admission due to acute respiratory disease and a 6-month follow up after hospital discharge. METHODS: This prospective study included patients admitted at our Pulmonology Department due to acute respiratory disease - active smokers who consented to participate in smoking cessation counselling programme - between January and December 2019. After hospital discharge, the patients completed a 6-month follow up. Statistical analysis was performed with spss system version 24.0, using univariate analysis with Chi-squared and t-test. RESULTS: We included 30 patients, 86.7% male, with a mean age of 58.6 ± 13.6 years. The mean length of stay was 10 ± 11 days. The mean smoking time was 40.3 ± 14.4 years and the mean smoking load 40 ± 26 pack-year units. The mean level of nicotine dependence, measured by the Fagerström test, was 4.3 ± 2.8. None of the patients accepted smoking cessation pharmacological therapy. After hospital discharge, 19 patients were seen in consultation, 11 of whom maintained smoking cessation at 6 months, determining an overall smoking cessation rate of 36.7%. There was a statistically significant difference in the smoking cessation successful group regarding the motivation to quit smoking and the Richmond test compared to the unsuccessful group. CONCLUSION: Smoking cessation counselling behaviour programmes during hospitalisation, with regular follow up after hospital discharge, contribute to an increase in smoking cessation rate.

Health Risk Behaviour Inventory Validation and its Association with Self-regulatory Dispositions.

We put forward a validation of the first instrument to measure the big four health risk behaviours (World Health Organization, Global status report on non-communicable diseases 2014, WHO, 2014) in a single assessment, the Health Risk Behaviour Inventory (HRBI) that assesses physical inactivity, unhealthy diet, smoking and alcohol in Italian- and English-speaking samples. Further, we investigate the instrument's association with self-regulatory dispositions, exploring culture and gender differences in Italian and US subgroup samples. Overall, 304 English- and 939 Italian-speaking participants completed the HRBI and the self-regulatory questionnaire. We explored the factorial structure, convergent validity, invariance and association with self-regulatory dispositions using structural equation modelling.The HRBI has a robust factorial structure; it usefully converges with widely used healthy lifestyle measures, and it is invariant across the categories of age, gender and languages. Regarding self-regulatory dispositions, the promotion focus emerges as the most protective factor over physical inactivity, unhealthy diet, smoking and alcohol, whereas the prevention focus is associated mainly with smoking and alcohol reduction. Results are consistent across genders and US subgroup-Italian samples. The HRBI is a valid instrument for assessing the big four health risk behaviours in clinic and research contexts, and among self-regulatory measures, the promotion and prevention foci have the greatest efficacy in eliciting positive health behaviours.

Associations of loneliness with poor physical health, poor mental health and health risk behaviours among a nationally representative community-dwelling sample of middle-aged and older adults in India.

OBJECTIVES: Loneliness may negatively impact on health outcomes. The study aimed to estimate the associations between loneliness and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India. METHODS: The sample included 72,262 middle-aged and older adults from a cross-sectional national community-dwelling survey in India in 2017-2018. RESULTS: Results indicate that the prevalence of moderate loneliness was 20.5%, and severe loneliness was 13.3%. In the adjusted logistic regression analysis, moderate and/or severe loneliness was significantly positively associated with fair or poor self-rated health status, and significantly negatively associated with life satisfaction and cognitive functioning. Furthermore, loneliness was associated with stroke, angina, physical injury, difficulty of Activities of Daily Living, difficulties of Instrumental Activities of Daily Living and multi-morbidity. Loneliness increased the odds of major depressive disorder and insomnia symptoms. The associations between loneliness and current tobacco use and body mass index were negative and between loneliness and physical inactivity and underweight were positive. CONCLUSIONS: Loneliness is associated with poor physical health, poor mental health and health risk behaviour (physical inactivity), emphasising the need to consider loneliness in various physical and mental health contexts.

Perceived discrimination and health outcomes among middle-aged and older adults in India: results of a national survey in 2017-2018.

BACKGROUND: The study aimed to estimate the associations between perceived discrimination and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India. METHODS: The sample included 72,262 middle-aged and older adults from a cross-sectional national community dwelling survey in India in 2017-2018. RESULTS: The prevalence of moderate (1-2 types) perceived discrimination was 10.7%, and high (3-6 types) perceived discrimination was 6.6%. In the final adjusted logistic, linear or Poisson regression analyses, moderate and/or high perceived discrimination was significantly positively associated with poor mental health (low life satisfaction, poor cognitive functioning, insomnia symptoms, and depressive symptoms), poor physical health (pain conditions count, and functional limitations), and health risk behaviours (heavy episodic drinking and physical inactivity). CONCLUSION: Perceived discrimination is associated with poor mental health, poor physical health, and health risk behaviour, emphasising the need to consider perceived discrimination in various physical and mental health contexts.

Association between self-control and health risk behaviors: a cross-sectional study with 9th grade adolescents in São Paulo.

BACKGROUND: Self-control (SC) has been consistently found associated with diverse health risk behaviors (HRBs), but little research refers to low- and middle-income countries. Furthermore, there is evidence that some HRBs tend to aggregate, however studies with the specific purpose of addressing the relation between SC and multiple health risk behaviors (MHRBs) are rare. The objective of this study is to analyze these associations and provide evidence to help filling these gaps. METHODS: A sample of 2106 9th grade students from the city of São Paulo responded a self-administered questionnaire in 2017. We tested the association of SC measured as an ordinal variable with four levels (higher, high, medium and low) with six HRBs (binge drinking, marijuana use, smoking, high consumption of ultra-processed food, sedentary behavior and bullying perpetration), in both separated and aggregated forms (MHRBs), controlling for potential confounders. Binary logistic regression was used to test the association between exposure (SC) and single outcomes. In order to analyze the association of SC with MHRBs, multinomial logistic regression was employed. RESULTS: SC was associated with five of six HRBs investigated and with MHRBs. The effect size of the association of SC and MHRBs increased in a steep pattern with accumulation of more HRBs. CONCLUSION: Low self-control is associated with most HRBs investigated and the magnitude of the association increases when more than two or three HRBs are accumulated. There seems to be a group of adolescents in a position of pronounced vulnerability for MHRBs. This should be considered when designing public policy and prevention programs. In contexts of limited or scarce resources and public funds, interventions focusing the most vulnerable groups, instead of universal interventions, should be considered.

Self-reported suboptimal sleep and receipt of sleep assessment and treatment among persons with and without a mental health condition in Australia: a cross sectional study.

BACKGROUND: Poor sleep and poor mental health go hand in hand and, together, can have an adverse impact on physical health. Given the already disproportionate physical health inequities experienced by people with a mental health condition worldwide, the need to consider and optimise sleep has been highlighted as a means of improving both physical and mental health status. Sleep recommendations recently developed by the United States' National Sleep Foundation incorporate a range of sleep parameters and enable the identification of 'suboptimal' sleep. Among community-dwelling persons with and without a 12-month mental health condition in Australia, this study reports: [1] the prevalence of 'suboptimal' sleep and [2] rates of sleep assessment by a health care clinician/service and receipt of and desire for sleep treatment. METHODS: A descriptive study (N = 1265) was undertaken using self-report data derived from a cross-sectional telephone survey of Australian adults, undertaken in 2017. RESULTS: Fifteen per cent (n = 184) of participants identified as having a mental health condition in the past 12 months. Across most (7 of 8) sleep parameters, the prevalence of suboptimal sleep was higher among people with a mental health condition, compared to those without (all p < 0.05). The highest prevalence of suboptimal sleep for both groups was seen on measures of sleep duration (36-39% and 17-20% for people with and without a mental health condition, respectively). In terms of sleep assessment and treatment, people with a mental health condition were significantly more likely to: desire treatment (37% versus 16%), have been assessed (38% versus 12%) and have received treatment (30% versus 7%). CONCLUSIONS: The prevalence of suboptimal sleep among persons with a mental health condition in Australia is significantly higher than those without such a condition, and rates of assessment and treatment are low for both groups, but higher for people with a mental health condition. Population health interventions, including those delivered as part of routine health care, addressing suboptimal sleep are needed.

Socioeconomic status, social support, oral health beliefs, psychosocial factors, health behaviours and health-related quality of life in adolescents.

PURPOSE: This study assessed the relationships between socioecononic status (SES), social support, oral health beliefs, psychosocial factors, health-related behaviours and health-related quality of life (HRQoL) in adolescents. METHODS: A school-based follow-up study involving 376 12-year-old adolescents was conducted in Manaus, Brazil. Baseline data included sociodemographic characteristics (sex, parental schooling, family income, household overcrowding and number of goods), social support (SSA questionnaire), oral health beliefs and psychosocial factors (Sense of Coherence [SOC-13 scale] and self-esteem [Rosenberg Self-Esteem Scale]). Health-related behaviours (toothbrushing frequency, sedentary behaviour, smoking and sugar consumption) and HRQoL [KINDL questionnaire] were assessed at 6-month follow-up. Structural Equation Modelling assessed the relationships between variables. RESULTS: Greater social support (ß = 0.30), higher SOC (ß = 0.23), higher self-esteem (ß = 0.23), higher toothbrushing frequency (ß = 0.14) and less smoking (ß = - 0.14) were directly linked with better HRQoL. SES (ß = 0.05), social support (ß = 0.26), oral health beliefs (ß = - 0.02) were indirectly linked to HRQoL. Higher SES directly predicted higher toothbrushing frequency (ß = 0.14) and less smoking (ß = - 0.22). Greater social support also directly predicted higher SOC (ß = 0.55), positive oral health beliefs (ß = - 0.31) and higher self-esteem (ß = 0.58). Greater social support indirectly predicted less smoking via oral health beliefs (ß = - 0.05) and less sugar consumption via SOC (ß = - 0.07). CONCLUSION: Socioeconomic status, social support, oral health beliefs and psychosocial factors were important predictors of adolescent's health behaviours and HRQoL over 6-month period through direct and indirect mechanisms. Health behaviours also directly influenced HRQoL.

Tobacco use and associated mental symptoms and health risk behaviours amongst individuals 15 years or older in South Africa.

BACKGROUND: Tobacco use may deteriorate mental health and increase health risk behaviours. AIM: The aim of this investigation was to identify associations between tobacco use and mental illness symptoms and health risk behaviours in individuals 15 years or older in South Africa. SETTING: Community-based national population sample in South Africa. METHODS: Cross-sectional data were analysed from the 'South African National Health and Nutrition Examination Survey (SANHANES-1) 2012', using a sample of 15 310 individuals 15 years or older (median age 33 years). Measures included information on tobacco use, sociodemographic factors, mental symptoms and health risk behaviour. RESULTS: Compared to non-tobacco users, daily tobacco users were associated with psychological distress and post-traumatic stress disorder (PTSD) in adjusted logistic regression analysis, and with sleeping problems in unadjusted analysis. Past tobacco use, less than daily, and daily tobacco use were highly associated with a drinking problem. In terms of dietary variables, less than daily and daily tobacco use increased the odds of inadequate fruit intake and salty food intake, and daily tobacco use decreased the odds of fast food consumption. Past tobacco use, less than daily, and daily tobacco use were inversely associated with physical inactivity, and daily tobacco use was associated with not always washing hands before eating. CONCLUSIONS: The study showed that compared to non-tobacco users, daily tobacco users had significantly poorer mental health (psychological distress and PTSD) and increased odds for several health risk behaviours (drinking problem, inadequate fruit intake, salty food consumption and not always washing hands before eating) as compared to non-tobacco users.

Risk and protective factors for mental health at a youth mass gathering.

BACKGROUND: Mass gatherings are well-documented for their public health risks; however, little research has examined their impact on mental health or focused on young people specifically. This study explores risk and protective factors for mental health at mass gatherings, with a particular focus on characterising attendees with high levels of psychological distress and risk taking. METHOD: Data collection was conducted in situ at "Schoolies", an annual informal week-long mass gathering of approximately 30,000 Australian school leavers. Participants were 812 attendees of Schoolies on the Gold Coast in 2015 or 2016 (74% aged 17 years old). RESULTS: In both years, attendee mental health was found to be significantly better than population norms for their age peers. Identification with the mass gathering predicted better mental health, and this relationship became stronger across the course of the mass gathering. Attendees with high levels of psychological distress were more likely to be male, socially isolated, impulsive, and in a friendship group where risk taking was normative. CONCLUSIONS: Mass gatherings may have a net benefit for attendee mental health, especially for those attendees who are subjectively committed to the event. However, a vulnerable subgroup of attendees requires targeted mental health support.

Alexithymia, suicidal ideation and health-risk behaviours: a survey of Canadian men.

OBJECTIVE: Restricted emotional abilities may present significant implications for men's health. The purpose of this study was to examine the relationship between alexithymia and several health-risk behaviours: substance misuse, aggressive and risky behaviours and suicidal ideation. METHODS: A nationally representative sample of 1000 Canadian men responded to a survey containing measures of alexithymia, maladaptive coping behaviours, suicidal ideation and depressive symptoms. A series of hierarchical regressions were conducted using alexithymia as the predictor variable and each health-risk behaviour as the criterion variable, controlling for depressive symptom severity. RESULTS: Alexithymia was found to be significantly associated with drug use, alcohol use, angry/aggressive behaviour and risk-taking behaviour - as well as suicidal ideation - beyond the effects of depressive symptoms. CONCLUSIONS: The findings provide evidence for the link between alexithymia and several problematic behaviours that pose risks to men's health.

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.

Sleep duration and health correlates among university students in 26 countries.

The aim of this study was to investigate sleep duration and its health correlates in university students from 26 low-, middle- and high-income countries. Using anonymous questionnaires and anthropometric measurements, data were collected from 19417 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities from 26 countries across Asia, Africa and the Americas. Results indicate that the average number of self-reported hours of sleep was 7.07 (CI = 7.04-7.09), with the prevalence of reporting ≤ 6, 7-8, and ≥ 9 h sleep duration of 39.2, 46.9, and 13.9%, respectively. Multinomial logistic regression found that sociodemographic variables, health risk behaviour and health status variables were found to be associated with short and long sleep duration.

Religiosity and Health Risk Behaviour Among University Students in 26 Low, Middle and High Income Countries.

The aim of this study was to assess religiosity and health risk behaviours among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected from 20,222 undergraduate university students (mean age 20.8, SD = 2. 8) from 27 universities in 26 countries across Asia, Africa and the Americas. Among all students, 41.1 % engaged at least once a week in organized religious activity, 35.8 % practised a non-organized religious activity daily or more than once daily, and more or less two-thirds of the students agreed to the three different statements on intrinsic of subjective religiosity. In multivariate logistic regression analysis, higher reported involvement in organized religious activity was associated with addictive, injury, sexual and oral health risk behaviour, while lower reported involvement in organized religious activity was associated with physical inactivity and oral health risk behaviour. Lower reported involvement in non-organized religious activity was associated with addictive, nutrition risk, injury, sexual and oral health risk behaviour, while higher reported involvement in non-organized religious activity was associated with physical inactivity. Finally, lower reported intrinsic religiosity was associated with addictive and sexual risk behaviour, while higher reported intrinsic religiosity was associated with nutrition risk behaviour, physical inactivity and oral health risk behaviour.

Chronic disease health risk behaviours amongst people with a mental illness.

OBJECTIVE: Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. METHOD: A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. RESULTS: Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. CONCLUSIONS: Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/.

Using reflective poems to describe the lived experiences of street children and adolescents in Ghana.

These two poems emerged from my qualitative research with homeless youth in Accra Central, Ghana. I was overwhelmed at how this method of research rarely used in Ghana offers a researcher the opportunity to capture participants' subjective feelings, and the complexities of their perceptions and experiences of a phenomenon. The aim of the study was to examine the lived experiences of street youth and to explore factors that enhance their survival on the street. These reflective poems shed light on the experiences of both the street youth and researcher, as captured in my reflective journal during the research. It was difficult winning the trust of the street youth, but when the trust was won, it became a worthy journey to understanding the complexities of their daily lives.

Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers.

BACKGROUND: Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship. METHODS: A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology. RESULTS: Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes. DISCUSSION: Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups.