Developing Empirically Based, Culturally Grounded Drug Prevention Interventions for Indigenous Youth Populations

This article describes the relevance of a culturally grounded approach toward drug prevention development for indigenous youth populations. This approach builds drug prevention from the “ground up” (i.e., from the values, beliefs, and worldviews of the youth that are the intended consumers of the program) and is contrasted with efforts that focus on adapting existing drug prevention interventions to fit the norms of different youth ethnocultural groups. The development of an empirically based drug prevention program focused on rural Native Hawaiian youth is described as a case example of culturally grounded drug prevention development for indigenous youth; the impact of this effort on the validity of the intervention and on community engagement and investment in the development of the program are discussed. Finally, implications of this approach for behavioral health services and the development of an indigenous prevention science are discussed.     

Culturally Relevant Smoking Prevention for Minority Youth

A rap contest methodology for smoking prevention was tested with sixth and seventh grade students in a predominantly minority public school district. Contests were held after initial assemblies in which students heard anti-smoking rap messages from same-age and older peers on audio and video tape. Pretesting and posttesting (N = 268) indicated high preference ratings for most aspects of the intervention. Analyses of variance revealed no differences across races on any of the dependent measures. However, smaller assemblies were more effective than larger ones in enhancing attitudes against smoking and obtaining more positive contest evaluations and predictions about smoking behavior. A rap contest method therefore may be effective against the initiation of smoking by disadvantaged children in sixth and seventh grades because it is highly acceptable and perceived as culturally relevant. This effectiveness may be more demonstrable in single classrooms rather than larger assemblies.     

Suicide Prevention Media Campaigns: A Systematic Literature Review

Suicide prevention media campaigns are gaining traction as a means of combatting suicide. The current review set out to synthesize information about the effectiveness of these campaigns. We searched four electronic databases for studies that provided evidence on the effectiveness of media campaigns. We focused on studies that described an evaluation of the effectiveness of an entire campaign or a public service announcement explicitly aimed at suicide prevention. We identified 20 studies of varying quality. Studies that looked at whether campaign exposure leads to improved knowledge and awareness of suicide found support for this. Most studies that considered whether campaign materials can achieve improvements in attitudes toward suicide also found this to be the case, although there were some exceptions. Some studies found that media campaigns could boost help-seeking, whereas others suggested that they made no difference or only had an impact when particular sources of help or particular types of help-seeking were considered. Relatively few studies had sufficient statistical power to examine whether media campaigns had an impact on the ultimate behavioral outcome of suicides, but those that did demonstrated significant reductions. Our review indicates that media campaigns should be considered in the suite of interventions that might be used to prevent suicide. Evidence for their effectiveness is still amassing, but there are strong suggestions that they can achieve positive results in terms of certain suicide-related outcomes. Care should be taken to ensure that campaign developers get the messaging of campaigns right, and further work is needed to determine which messages work and which ones do not, and how effective messages should be disseminated. There is an onus on those developing and delivering campaigns to evaluate them carefully and to share the findings with others. There is a need for evaluations that employ rigorous designs assessing the most pertinent outcomes. These evaluations should explore the nature of given campaigns in detail – in particular the messaging contained within them – in order to tease out which messages work well and which do not. They should also take into account the reach of the campaign, in order to determine whether it would be reasonable to expect that they might have their desired effect.     

A Systematic Review of Family Victimization Experiences Among Sexual Minority Youth

Sexual minority youth experience substantially higher rates of family victimization than their heterosexual peers. No systematic review has yet identified the predictors and consequences in this vulnerable population of childhood abuse, exposure to sibling abuse and domestic violence, and sibling aggression. This systematic review aims to (a) describe differences in these family victimization rates by sexual orientation, gender, and race/ethnicity; (b) identify potential sexual minority and non-sexual minority-specific risk factors; and (c) identify physical, mental, and behavioral health and extrafamilial victimization correlates. The systematic review, which followed PRISMA guidelines, yielded 32 articles that met study inclusion criteria. Rates of childhood physical, sexual, and emotional abuse were consistently higher for sexual minority youth than for their heterosexual peers. Bisexual youth appear to be at greater risk for physical abuse than their gay and lesbian peers. Younger age at sexual minority milestones (first awareness, disclosure, and same-sex sexual contact) and higher levels of sexual minority-specific (sexuality disclosure, gender non-conformity) and non-sexual minority-specific (delinquent behaviors, parental drinking) risk factors were associated with higher rates of family victimization. Sexual minorities who experienced some form of childhood abuse reported more frequent physical (higher rates of HIV, higher BMIs, lower levels of perceived health), mental (higher rates of depression, PTSD symptoms, experiential avoidance, internalized homophobia), and behavioral (higher rates of suicidality, substance misuse, earlier sexual debut, unprotected anal sex) health problems relative to heterosexual or non-abused sexual minority peers. Sexual minority females who experienced childhood physical or sexual abuse were at greater risk than abused sexual minority males for sexual assault later in life. We conclude this systematic review with recommendations for future research, including the necessity for longitudinal research that utilizes a poly-victimization conceptual framework to identify the developmental pathways connecting risk factors, different types of family victimization, and health and extrafamilial victimization consequences.     

Community-Based Prevention Programs for Anxiety and Depression in Youth: A Systematic Review

Little is known about the effectiveness of prevention and early intervention programs for young people and adolescents once they leave or dropout from school. The effectiveness of 18 anxiety and 26 depression studies addressing prevention in community programs were identified using systematic review methodology. Anxiety and depression symptoms were reduced in ~60% of the programs. Cognitive behavioral therapy programs were more common than other interventions and were consistently found to lower symptoms or prevent depression or anxiety. Automated or computerized interventions showed promise, with 60% of anxiety programs and 83% of depression programs yielding successful outcomes on at least one measure. Further research is needed to determine the active components of successful programs, to explore cost-effectiveness and scalability factors, to investigate individual predictors of successful outcome, and to design best practice prevention programs.     

Oral Health Literacy in Migrant and Ethnic Minority Populations: A Systematic Review

Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs.

     

A Systematic Literature Review of Sport and Physical Activity Participation in Culturally and Linguistically Diverse (CALD) Migrant Populations

Culturally and linguistically diverse (CALD) migrants face significant health risks as they adapt to new cultures. These risks are exacerbated by their limited participation in preventative behaviours such as sports and physical activity. The review aimed to identify studies that examined the correlates of sport and physical activity participation in migrants. The systematic review identified 72 papers, including 6 interventions, 18 qualitative and 48 quantitative studies. The 44 identified correlates highlight the complexities involved in working with migrants. The correlates were grouped in four themes using the social ecological model; acculturation, demographic, psychosocial and environmental/organisational. The social ecological model identified general correlates such as social support and safety. However, there were unique correlates relating to individuals who are facing cultural changes such as acculturation and language. Overall, there is a lack of contextualisation of CALD migrants’ sport and physical activity experiences because many studies fail to consider acculturation comprehensively.     

A Systematic Review of the Literature on Weight in Sexual Minority Women

BackgroundOver the past 20 years, a growing literature has demonstrated that sexual minority women have greater weight than heterosexual women, prompting concern that they may be at high risk for disparities in physical disorders. In 2008, Bowen et al. published a review of the existing research on sexual minority women and obesity, finding no methodologically strong studies with representative sampling procedures.MethodWe conducted a systematic review of the literature covering the period of July 2006 to February 2014 on the relationship between sexual orientation and weight. The review includes 20 population-based and 17 nonprobability sample studies.ConclusionsThe majority of these studies found that lesbian and bisexual women had significantly greater body mass index (BMI) or a higher percentage with a BMI over 30 than heterosexual women. The difference in BMI was fairly consistent across the lifespan, with the weight differences beginning in adolescence. The studies, however, did not show a higher prevalence of physical disorders thought to be associated with weight. This potentially paradoxical finding warrants further research to compare prevalence of chronic disease by BMI category and sexual orientation.     

Intersection of Health, Immigration, and Youth: A Systematic Literature Review

The goal of this literature review is to provide a critical overview of existing research on the health of immigrant youth within the last decade. Although the review focuses primarily on Canada, the findings have implications for public health planning, policy, and settlement/immigration services in other immigrant-receiving countries. The main objectives are: (i) to locate relevant literature written in the past 10 years (January 1998–January 2008); (ii) to undertake a critical review of retrieved studies; (iii) to highlight gaps in the current state of our knowledge and make recommendations for future research directions. The review focuses on the influence of migration experience on health of youth.     

A Systematic Review on Micronutrient Intake Adequacy in Adult Minority Populations Residing in Europe: The Need for Action

This systematic review evaluated micronutrient intake inadequacy of ten micronutrients for adult ethnic minority populations residing in Europe. Pubmed was searched for studies, related references were checked and experts consulted. Ten studies were identified and six were included in the final analysis representing Albanian, Roma, Sub-Saharan African, South Asian and African-Caribbean minority groups. The Estimated Average Requirement cut point was applied to estimate inadequate intake. With the exception of a sub-Saharan African study, of seven micronutrients analysed, inadequate intakes were markedly elevated (>50 % of the population in most cases) in both genders for folate, vitamin B₁₂, calcium and iron (the latter in females only). A pressing need exists for intake adequacy studies with sound methodologies addressing ethnic minority groups in Europe. These populations constitute a vulnerable population for inadequate intakes and results substantiate the need for further investigation, interventions and policy measures to reduce their nutritional risk.     

Strategies to Recruit Minority persons: A Systematic Review

To identify and describe strategies used to recruit persons of ethnically and culturally diverse backgrounds and to examine their reported effectiveness. Studies (n = 26) reporting on recruitment of persons of different cultural and ethnic backgrounds, published in English between 1995 and 2012, were included in this systematic review. Data on the type of recruitment strategies and overall reported effectiveness of the strategy in recruiting participants were extracted. The vote counting method was used to synthesize the findings on effectiveness. Both proactive (face-to-face) and reactive recruitment strategies (collaboration with key leaders, snowball and word of mouth, printed material, and broadcast media) and providing compensation, being flexible, building rapport and trust, and employing ethnically and culturally diverse research staff were effective in recruiting participants. A list of strategies that are effective in recruiting persons of diverse ethnic and cultural backgrounds were generated. Researchers can select the evidence-based strategies that are most applicable in the context of their study.     

Examining the Cultural Context of Youth Mentoring: A Systematic Review

While research in youth mentoring is extensive in the U.S., little research has explored its effectiveness in New Zealand, despite its growth in the past 20?years. While arguments have been raised that overseas models may not fit all cultural contexts within New Zealand, there appears to be limited evidence supporting this contention. Further, little is known about associations between effectiveness and the cultural appropriateness of programs and research. This systematic review of youth mentoring programs in New Zealand is based on 26 studies that met inclusion criteria. Of those, 14 had a significant proportion (15% or more) of indigenous Māori youth and six had a significant proportion of Pasifika (Pacific Islander) youth. While almost all programs and associated research were culturally appropriate to the overall New Zealand context, they tended to be less culturally appropriate for programs working with Māori and Pasifika youth. Further, there was a negative association between cultural appropriateness and program effectiveness.     

Data Quality: A Systematic Review of the Biosurveillance Literature

Objective

To highlight how data quality has been discussed in the biosurveillance literature in order to identify current gaps in knowledge and areas for future research.

Introduction

Data quality monitoring is necessary for accurate disease surveillance. However it can be challenging, especially when “real-time” data are required. Data quality has been broadly defined as the degree to which data are suitable for use by data consumers [1]. When compromised at any point in a health information system, data of low quality can impair the detection of data anomalies, delay the response to emerging health threats [2], and result in inefficient use of staff and financial resources. While the impacts of poor data quality on biosurveillance are largely unknown, and vary depending on field and business processes, the information management literature includes estimates for increased costs amounting to 8–12% of organizational revenue and, in general, poorer decisions that take longer to make [3].

Methods

To fill an unmet need, a literature review was conducted using a structured matrix based on the following predetermined questions:

• -How has data quality been defined and/or discussed?
• -What measurements of data quality have been utilized?
• -What methods for monitoring data quality have been utilized?
• -What methods have been used to mitigate data quality issues?
• -What steps have been taken to improve data quality?

The search included PubMed, ISDS and AMIA Conference Proceedings, and reference lists. PubMed was searched using the terms “data quality,” “biosurveillance,” “information visualization,” “quality control,” “health data,” and “missing data.” The titles and abstracts of all search results were assessed for relevance and relevant articles were reviewed using the structured matrix.

Results

The completeness of data capture is the most commonly measured dimension of data quality discussed in the literature (other variables include timeliness and accuracy). The methods for detecting data quality issues fall into two broad categories: (1) methods for regular monitoring to identify data quality issues and (2) methods that are utilized for ad hoc assessments of data quality. Methods for regular monitoring of data quality are more likely to be automated and focused on visualization, compared with the methods described as part of special evaluations or studies, which tend to include more manual validation.Improving data quality involves the identification and correction of data errors that already exist in the system using either manual or automated data cleansing techniques [4]. Several methods of improving data quality were discussed in the public health surveillance literature, including development of an address verification algorithm that identifies an alternative, valid address [5], and manual correction of the contents of databases [6].Communication with the data entry personnel or data providers, either on a regular basis (e.g., annual report) or when systematic data entry errors are identified, was mentioned in the literature as the most common step to prevent data quality issues.

Conclusions

In reviewing the biosurveillance literature in the context of the data quality field, the largest gap appears to be that the data quality methods discussed in literature are often ad hoc and not consistently implemented. Developing a data quality program to identify the causes of lower quality health data, address data quality problems, and prevent issues would allow public health departments to more efficiently and effectively conduct biosurveillance and to apply results to improving public health practice.     

Culturally Sensitive Interventions and Health and Behavioral Health Youth Outcomes: A Meta-Analytic Review

Despite Census Bureau projections that youth from minority cultures will comprise the majority of the nation's youth in approximately a decade, little research has been conducted on culturally sensitive interventions (CSIs). Accordingly, this study sought to determine: (1) the effectiveness of CSIs designed to address health and behavioral health outcomes, (2) whether effectiveness varies depending on the class or type of outcome, and (3) whether race/ethnicity moderates effectiveness. The results suggest that CSIs (n = 21) are modestly effective (Hedges' g = .239, 95% C.I. = .139 to .339, p < .001). Effectiveness did not vary significantly by outcome class or by race/ethnicity. Especially in the latter case, however, the pattern of point estimates raises the possibility of moderation with an increase in power. Suggestions for future research conclude the article.     

Workplace-Based Return-to-Work Interventions: A Systematic Review of the Quantitative Literature

Introduction: A systematic review was conducted to review the effectiveness of workplace-based return-to-work (RTW) interventions. Method: Seven databases were searched, in English and French, between January 1990 and December 2003 for peer-reviewed studies of RTW interventions provided at the workplace to workers with work disability associated with musculoskeletal or other pain-related conditions. Methodological quality appraisal and data extraction were conducted by pairs of reviewers. Results: Of a total of 4124 papers identified by the search, 10 studies were of sufficient quality to be included in the review. There was strong evidence that work disability duration is significantly reduced by work accommodation offers and contact between healthcare provider and workplace; and moderate evidence that it is reduced by interventions which include early contact with worker by workplace, ergonomic work site visits, and presence of a RTW coordinator. For these five intervention components, there was moderate evidence that they reduce costs associated with work disability duration. Evidence for sustainability of these effects was insufficient or limited. Evidence regarding the impact of supernumerary replacements was insufficient. Evidence levels regarding the impact of the intervention components on quality-of-life was insufficient or mixed. Conclusions: Our systematic review provides the evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs, however the evidence regarding their impact on quality-of-life outcomes was much weaker. Donald Cole, Jeremy Dacombe, Jaime Guzman, Sheilah Hogg-Johnson, Ellen MacEachen, Victoria Pennick, Anusha Raj, Rhoda Reardon, Dwayne Van Eerd.