Donna Cross

The prevention of anxiety and depression in children from disadvantaged schools

A randomised controlled trial evaluated the Aussie Optimism Program in preventing anxiety and depression. Grade 7 students (n = 496) from disadvantaged government schools in Perth Western Australia, participated. Six schools were randomly assigned to Aussie Optimism and six schools received their usual health education lessons. Students completed questionnaires on depression, anxiety, attribution style, and social skills. Parents completed the Child Behavior Checklist. No significant group effects were found for student-reported data. Parents of intervention group only students reported reductions in internalizing problems at post-test. No follow-up group effects were significant. Students and teachers found the program acceptable.

Improved sun protection behaviour in children after two years of the Kidskin intervention.

Objective:To evaluate a school‐based intervention in terms of reducing childrens sun exposure and improving their use of sun protection measures.

The PRECEDE-PROCEED model: application to planning a child pedestrian injury prevention program.

OBJECTIVES: The objectives were first, to modify the PRECEDE-PROCEED model and to use it is as a basis for planning a three year intervention trial that aims to reduce injury to child pedestrians. A second objective was to assess the suitability of this process for planning such a relatively complex program. SETTING: The project was carried out in 47 primary schools in three local government areas, in the Perth metropolitan area. METHODS: The program was developed, based on extensive needs assessment incorporating formative evaluations. Epidemiological, psychosocial, environmental, educational, and demographic information was gathered, organised, and prioritised. The PRECEDE-PROCEED model was used to identify the relevant behavioural and environmental risk factors associated with child pedestrian injuries in the target areas. Modifiable causes of those behavioural and environmental factors were delineated. A description of how the model facilitated the development of program objectives and subobjectives which were linked to strategy objectives, and strategies is provided. RESULTS: The process used to plan the child pedestrian injury prevention program ensured that a critical assessment was undertaken of all the relevant epidemiological, behavioural, and environmental information. The gathering, organising, and prioritising of the information was facilitated by the process. CONCLUSIONS: The use of a model such as PRECEDE-PROCEED can enhance the development of a child injury prevention program. In particular, the process can facilitate the identification of appropriate objectives which in turn facilitates the development of suitable interventions and evaluation methods.

Incidence of injury in elite junior Rugby Union: a prospective descriptive study

The high incidence of injury in Rugby Union is well documented, particularly at elite levels of competition. This article describes the incidence and nature of all injuries sustained by elite Western Australian junior Rugby Union players during the 26 weeks up to and including the 1997 National Championship campaign. Informed consent was gained for each participant (n = 44) prior to completion of an extensive baseline questionnaire. Exposure and injury data were collected at each training session and game. The injury incidence rate over the 26 week period was 13.26/1000 player hours. Injury data were analysed by phase of play, position, severity and if occurred at games or training. The incidence of injury was significantly associated with the position played (chi2 = 67.49, p value = 0.008) and the phase of play in which the injury occurred (chi2 = 8.07, p value = 0.042). Tackling was the most dangerous phase of play (52% of injuries) and the most common site of injury was the lower limb (37%). Most injuries occurred during games (56%) and the flanker was the position most at risk of injury (12%). Further research is needed to identify the aetiology of injury at all levels of competition and to use these findings to develop effective injury prevention strategies in this sport. Position-specific risk factors should also be investigated, as should the mechanism of injury associated with tackling which is the phase of play in which significantly more injuries occur in rugby.

Reduced sun exposure and tanning in children after 2 years of a school-based intervention (Australia)

AbstractObjective: This paper presents the results of the evaluation of measured suntan and parent-reported sun exposure in participating children after 2 years of the Kidskin study, a 5-year school-based sun protection intervention undertaken in Perth, Western Australia (1995–1999). Methods: The study involves three groups: a control, a “moderate”, and a “high” intervention group. Participants were 5 or 6 years of age at the beginning of the study. Control schools received the standard Health Education curriculum, while intervention schools received a multicomponent intervention including a specially designed curriculum. Children in the high intervention group also received program materials over the summer vacation and were offered sun-protective swimwear at low cost. At the end of the second summer, suntan was measured and parents completed a questionnaire about their childs sun-related behavior. Results: Children in the intervention groups – especially the high group – were less tanned at the end of the summer; this effect was greater for the back than for the forearms. These children were also reported to have received less sun exposure and made greater use of sun protection measures. Conclusion: Intensive school-based interventions can reduce tanning and reported sun exposure in children.

Measuring community/environmental interventions: the Child Pedestrian Injury Prevention Project

Objectives—To assess the effectiveness of community/environmental interventions undertaken as part of the Child Pedestrian Injury Prevention Project (CPIPP). Setting—Three communities (local government areas) in the Perth metropolitan area, Western Australia. Methods—A quasiexperimental community intervention trial was undertaken over three years (1995–97). Three communities were assigned to either: a community/environmental road safety intervention and a school based road/pedestrian safety education program (intervention group 1); a school based road/pedestrian safety education program only (intervention group 2); or to no road safety intervention (comparison group). Quantification of the various road safety community/environmental activities undertaken in each community during the trial was measured, and a cumulative community activity index developed. Estimates of the volume and speed of vehicular traffic were monitored over a two year period. Results—Greater road safety activity was observed in intervention group 1 compared with the other groups. A significant reduction in the volume of traffic on local access roads was also observed over the period of the trial in intervention group 1, but not in the remaining groups. Conclusions—The findings indicate that the various community/environmental interventions initiated in collaboration with CPIPP in intervention group 1 contributed, in part, to the observed reduction in the volume of traffic. A combination of community/environmental interventions and education are likely to reduce the rate of childhood pedestrian injury.

The impact of a parent-directed intervention on parent–child communication about tobacco and alcohol

INTRODUCTION AND AIM Given the likelihood of engaging in the hazardous use of tobacco and alcohol increases during teenage years, pre-adolescence is a critical time to implement prevention programmes. While social factors other than those associated with parenting play a role in determining a childs risk for initiation of tobacco and alcohol use, parents can have a significant influence on their childrens decisions about these issues. The aim of this study was to assess the impact of an in-home parent-directed drug education intervention on parent-child communication about tobacco and alcohol. DESIGN AND METHODS A group randomised intervention trial was conducted in Perth, Western Australia. Schools were selected using stratified random sampling and randomised to three study conditions. A total of 1201 parents of 10- 11-year-old children were recruited from 20 schools. The impact of a self-help intervention, comprised of five communication sheets containing information and activities designed to encourage parents to talk with their 10- 11-year-old child about issues related to smoking cigarettes and drinking alcohol, was assessed. RESULTS Intervention-group parents were more likely to have spoken with their children, to have spoken more recently, to have engaged the child during the discussion and to have addressed the topics identified as being protective of childrens involvement in tobacco and alcohol. In addition, the duration of talks about alcohol was longer than for parents in the comparison group. DISCUSSION AND CONCLUSIONS Parents of 10- 11-year-old children appear to be receptive to participating in a home-based drug-related educational intervention and the parent-directed intervention seems to have enhanced parent-child tobacco- and alcohol-related communication.

Occasional Cigarette Smokers: Cue for Harm Reduction Smoking Education

Since abstinence-based smoking prevention education strategies have not impeded increases in teenage smoking in the 1990s, strategies including harm reduction merit consideration. This study explored determinants of regular and occasional smoking and the feasibility and acceptability of smoking harm reduction messages among Western Australian 12-15 year old students. Sixteen hundred and sixty-two students completed a quantitative survey. A random sub-sample of 256 regular, occasional, experimental, ex- and non-smokers also completed a qualitative questionnaire. Regular smokers reported less intention and less self efficacy to quit, perceived greater benefits from smoking and perceived lower risk from smoking and other drug use than did occasional smokers. Occasional smokers were not significantly different from non-, ex- or experimental smokers except they identified more benefits from smoking and perceived lower risks from drug use. All students were more receptive to harm reduction messages which include abstinence messages and less amenable to abstinence-only smoking prevention messages. A harm reduction approach may be more positively received by occasional and regular smokers than abstinence only education approaches.

Using Theory to Guide Practice in Children's Pedestrian Safety Education.

Abstract Few pedestrian injury prevention programs appear to articulate the theory upon which their design and evaluation are based. This article describes how theory was used to plan, develop, implement, and evaluate the educational component of a comprehensive child pedestrian intervention. Organizational and planning theories were used to guide the conceptual development, implementation, and evaluation of the program, while behavioral and child development theories were used to identify the content and strategies to address the pedestrian behavior of seven to nine year old children. The resultant program demonstrated improved road crossing and playing behaviors in the intervention group children compared to those in the comparison group. The systematic use of relevant theory in this program is likely to be associated with its positive impact on childrens pedestrian safety.

Sun safety education intervention for school and home

Few developers of school‐based health education programs actively involve the primary and secondary target audience in their program’s development. Kidskin was a sun protection intervention study involving a cohort of 1,776 children recruited from 33 primary schools in Perth, Western Australia. A formative evaluation to develop the Kidskin sun safety classroom and home education program for grades 1 to 4 children and their families was conducted. Process data collected from teachers revealed high levels of satisfaction with the program with the majority agreeing that the activities were developmentally appropriate, effective and enjoyable for students. Mailouts to students’ homes, reinforcing sun safety messages, were used to successfully reach most students and their families during the summer school holidays.