Janina Hildebrand

Psychoactive Medications and Crash Involvement Requiring Hospitalization for Older Drivers: A Population-Based Study

OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.

HIV risk among Australian men travelling overseas: networks and context matter

Increasing international mobility presents a risk for communicable disease transmission. Overseas-acquired HIV infections have been increasingly observed across Australian jurisdictions. This includes a mix of men emigrating from countries with high HIV prevalence and men travelling abroad. There is currently little research exploring international mobility and HIV risk, and as a consequence the increase of men acquiring HIV while travelling overseas is poorly understood. This paper draws on data from a qualitative study exploring the risk perspectives and experiences of 14 Australian men who acquired HIV while travelling overseas in the years between 2000 and 2009. Participants articulated a strong desire to distance themselves from the identity of a tourist. Social networks were highlighted as important entry points to engage with other foreign travellers and expatriates. These networks were highly influential and were understood by the participants to provide guidance on how they should negotiate the local scene, including where to meet sex partners. Limited discussion of safe sex and HIV was mentioned in these contexts. The findings suggest that prevalent social norms and social networks play an influential role in how participants negotiate sex and social relations in overseas settings. These networks could potentially provide sites for effective HIV-prevention programmes.

Psychotropic medications and crash risk in older drivers: a review of the literature

Objective. An extensive review of Australian and international literature was undertaken, examining the association between psychotropic medications and crash risk involving older drivers. Methods. The review summarizes the findings in experimental and epidemiological studies related to (a) prevalence of psychotropic medication use among older drivers; (b) side effects of driving under the influence of psychotropic medications; and (c) association between psychotropic medications and crash risk for older drivers. Results. Current evidence indicates that several types of psychotropic medications have the potential to impair driving ability and increase the risk of crash involvement. A major limitation is that few studies have specifically examined the effects on older drivers, despite the fact that the majority of the population using psychotropic medications are older. Discussion. More knowledge about the safety of therapeutic use of psychotropic medications is needed. Large-scale, whole-population, epidemiological studies, such as data linkage studies, may be the optimal study design.

Investigation of alcohol-related social norms among youth aged 14–17 years in Perth, Western Australia: protocol for a respondent-driven sampling study

Introduction Alcohol use among young people is a major public health concern in Australia and internationally. Research elucidating social norms influencing alcohol use supports the desire to conform to peers. However, there is a lack of evidence on how social norms are transmitted from the community to young people and between family members and peers, as previous studies are limited to mainly school and university environments. This article describes the proposed process to investigate common alcohol-related norms held by 14-year-olds to 17-year-olds in Perth, Western Australia, and to clarify the process and pathways through which proalcohol norms are transmitted to adolescents. Methods and analysis This cross-sectional quantitative study will use respondent-driven sampling (RDS) to recruit a sample of 672 adolescents from sporting groups, youth programmes and the community in Perth. Data will be collected with a previously developed and validated multidimensional online survey instrument. A variety of strategies will be explored to aid participation including face-to-face recruitment and survey administration, web-based RDS and a ‘mature minor’ consent assessment protocol. Data analysis will include descriptive statistics of demographic characteristics, as well as social network and dyadic analyses, to explore the connections between shared understanding of norms and behaviours among individuals and how these translate into reported practices. Ethics and dissemination This research is expected to extend our understanding of normative development pathways to inform future interventions, and will be widely disseminated through conference presentations, peer-reviewed papers, media channels and community seminars. A study reference group of key health industry stakeholders will be established to encourage integration of study findings into policy and practice, and results will guide the development of community interventions. The Curtin University Human Research Ethics Committee has granted approval for this research.

Ethical considerations in investigating youth alcohol norms and behaviours: a case for mature minor consent

Mature minor consent only became available in Australia in 2007. There is neither an explicitly defined protocol, nor a clear definition evident in the literature relating to use of the mature minor concept in health research. Due to difficulties in defining fixed age ranges to varying levels of maturity and vulnerability, there is a lack of clarity surrounding when it might be reasonable and ethical to apply for or grant a waiver for parental consent. This paper describes the challenges faced and solutions created when gaining approval for use of mature minor consent in a respondent-driven sampling (RDS) study to explore the social norms and alcohol consumption among 14-17-year-old adolescents (n = 1012) in the community. The Universitys Human Research Ethics Committee granted mature minor consent for this study, and the techniques applied enabled recruitment of adolescents from community-based settings through use of RDS to achieve the required sample. This paper has relevance for research that requires a waiver for parental consent; it presents a case study for assessing mature minors and makes recommendations on how ethical guidelines can be improved to assist human research ethics application processes.

Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents

Introduction Harmful drinking among young people is common in Australia and many other countries. Social norms and their influence on adolescents’ alcohol consumption behaviours have received much research attention in recent years. However, there is limited understanding of how social norms related to alcohol are developed and transmitted across social networks and a specific tool that measures these constructs has yet to be developed. This paper outlines the rationale and protocol for the design and validation of a multidimensional survey instrument which measures the development and transmission pathways of alcohol-related norms among adolescents. A longer term aim is to apply the instrument in a respondent-driven sampling study with a large adolescent cohort. Methods and analysis Social Cognitive Theory (SCT) and relevant literature will guide the design of the online survey instrument. Feedback from a practitioner-based stakeholder committee, academic expert panel reviews, focus groups and interviews with adolescents aged 13–17 years in Perth, Western Australia (WA) will serve to ascertain content and face validity. A test–retest will be conducted using a purposive sample of students (n=400) at secondary schools in Perth. The instruments psychometric properties will be analysed, including exploratory factor analyses, discriminant validity, internal consistency and test–retest reliability. Ethics and dissemination The results of this research will provide public health researchers and practitioners with a comprehensive standardised instrument to explore the characteristics of individual-level and community-level social influences and norms associated with use of alcohol by adolescents and the routes through which these norms are transmitted. The data collected by the instrument is anticipated to inform the design of youth specific interventions with the potential to reduce alcohol-related harms. The Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The study has received approval from the Curtin University Human Research Ethics Committee.

How they got it and how they wanted it: marginalised young people's perspective on their experiences of sexual health education

Young people in Australia are at greatest risk of contracting sexually transmitted infections, and priority actions are necessary for this population group. This study of marginalised and at-risk young people in out-of-school environments was conducted in Western Australia with the aim of obtaining young peoples perceptions about their experience of sexual health education and preferred means of gaining sexual health knowledge and skills. A participatory research methodology was implemented through a series of workshops with 88 young people recruited through community youth agencies. The results of the study support what is already known about sexual health promotion for young people and the importance of a holistic approach to promoting positive relationships and sexual health. However, the findings emphasise that this should include the need for demonstrated trust, confidence and safe environments, and the complementary role of community youth agencies and peer-based programmes which may play an important role in reaching young people who may disengage with, or not be reached by school-based sexual health education.

Potential and challenges in collecting social and behavioral data on adolescent alcohol norms: comparing respondent-driven sampling and web-based respondent-driven sampling

Background Respondent-driven sampling (RDS) is a method successfully used to research hard-to-access populations. Few studies have explored the use of the Internet and social media with RDS, known as Web-based RDS (WebRDS). This study explored the use of combining both “traditional” RDS and WebRDS to examine the influences on adolescent alcohol use. Objective This paper reports on the recruitment processes and the challenges and enablers of both RDS and WebRDS. It details comparative recruitment data and provides a summary of the utility of both methods for recruiting adolescents to participate in an online survey investigating youth alcohol norms. Methods Process evaluation data collected from research staff throughout the study were used to assess the challenges and solutions of RDS and WebRDS. Pearson chi-square test (Fisher’s exact test if applicable) was used to compare the differences in sociodemographics and drinking behavior between data collected by RDS and WebRDS. Results Of the total sample (N=1012), 232 adolescents were recruited by RDS and 780 by WebRDS. A significantly larger proportion of Aboriginal or Torres Strait Islander (P<.001) participants who spoke English as their main language at home (P=.03), and of middle and lower socioeconomic status (P<.001) was found in the RDS sample. The RDS sample was also found to have a higher occurrence of past 7-day drinking (P<.001) and past 7-day risky drinking (P=.004). No significant differences in gender, age, past month alcohol use, and lifetime alcohol use were observed between the RDS and WebRDS samples. This study revealed RDS and WebRDS used similar lengths of chains for recruiting participants; however, WebRDS conducted a faster rate of recruitment at a lower average cost per participant compared to RDS. Conclusions Using WebRDS resulted in significant improvements in the recruitment rate and was a more effective and efficient use of resources than the traditional RDS method. However, WebRDS resulted in partially different sample characteristics to traditional RDS. This potential effect should be considered when selecting the most appropriate data collection method.

Development and testing of the Youth Alcohol Norms Survey (YANS) instrument to measure youth alcohol norms and psychosocial influences

Objectives This study aimed to develop and validate an online instrument to: (1) identify common alcohol-related social influences, norms and beliefs among adolescents; (2) clarify the process and pathways through which proalcohol norms are transmitted to adolescents; (3) describe the characteristics of social connections that contribute to the transmission of alcohol norms; and (4) identify the influence of alcohol marketing on adolescent norm development. Setting The online Youth Alcohol Norms Survey (YANS) was administered in secondary schools in Western Australia Participants Using a 2-week test–retest format, the YANS was administered to secondary school students (n=481, age=13–17 years, female 309, 64.2%). Primary and secondary outcome measures The development of the YANS was guided by social cognitive theory and comprised a systematic multistage process including evaluation of content and face validity. A 2-week test–retest format was employed. Exploratory factor analysis was conducted to determine the underlying factor structure of the instrument. Test–retest reliability was examined using intraclass correlation coefficient (ICC) and Cohen’s kappa. Results A five-factor structure with meaningful components and robust factorial loads was identified, and the five factors were labelled as ‘individual attitudes and beliefs’, ‘peer and community identity’, ‘sibling influences’, ‘school and community connectedness’ and ‘injunctive norms’, respectively. The instrument demonstrated stability across the test–retest procedure (ICC=0.68–0.88, Cohen’s kappa coefficient=0.69) for most variables. Conclusions The results support the reliability and factorial validity of this instrument. The YANS presents a promising tool, which enables comprehensive assessment of reciprocal individual, behavioural and environmental factors that influence alcohol-related norms among adolescents.