Melissa C. Davis

Rationale, design and methods for a staggered-entry, waitlist controlled clinical trial of the impact of a community-based, family-centred, multidisciplinary program focussed on activity, food and attitude habits (Curtin University’s Activity, Food and Attitudes Program—CAFAP) among overweight adolescents

BackgroundCurrent estimates place just under one quarter of adolescents in Australia as overweight or obese. Adolescence has been identified as a critical period for the development of obesity, yet despite this recognition, there is limited systematic research into or evaluation of interventions for overweight adolescents. Reviews have concluded that there is a substantive evidence gap for effective intervention, but physical activity, lifestyle change and family involvement have been identified as promising foci for treatment.MethodsThis paper reports on the development of a staggered-entry, waitlist controlled clinical trial to assess the impact of a multidisciplinary intervention aiming to change the poor health trajectory of overweight adolescents and help them avoid morbid obesity in adulthood—Curtin University’s Activity, Food and Attitudes Program (CAFAP). 96 adolescents, aged 11–16 years, and parents, will attend twice weekly during an 8 week intensive multidisciplinary program with maintenance follow-up focussed on improving activity, food and attitude habits. Follow-up assessments will be conducted immediately after completing the intensive program, and at 3, 6 and 12 months post intensive program. Main outcomes will be objectively-measured physical activity, sedentary behaviour and activity behaviours; food intake (measured by 3 day diary) and food behaviours; body composition, fitness and physical function; mental and social well-being (quality of life, mood and attitudes), and family functioning.DiscussionThis trial will provide important information to understand whether a community based multidisciplinary intervention can have short and medium term effects on activity and food habits, attitudes, and physical and mental health status of overweight adolescents.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12611001187932.

Adolescent drug use, psychosocial functioning and spinal pain

This study tested whether there is an independent relationship between adolescent drug use and neck and shoulder pain (NSP) and back pain (BP) when psychosocial functioning is controlled in a community sample of 1608 14-year-old Australian adolescents. Multivariable logistic regression was used to calculate the odds ratios of alcohol and cigarette use for NSP and BP before and after adjusting for a range of psychosocial variables. Results showed that the use of alcohol, but not cigarettes or marijuana, has a significant independent association with adolescent spinal pain. Future research needs to investigate these variables longitudinally to inform interventions for adolescent spinal pain.

Bidirectional relationships between cigarette use and spinal pain in adolescents accounting for psychosocial functioning

OBJECTIVES The objective of this study was to determine the presence of possible bidirectional causal pathways between cigarette use and spinal pain in adolescents controlling for psychosocial functioning, using a prospective longitudinal research design. DESIGN The data for this study was collected from a cohort of Australian adolescents at 14 (n = 1596) and 17 (n = 1291) years of age. METHODS Multivariable logistic regression was used to assess i) if cigarette use at 14 predicted low back pain (LBP), mid back pain (MBP) or neck shoulder pain (NSP) at 17 in those adolescents without each condition at 14, and ii) if back pain only (BP), neck shoulder pain only (NSP) or comorbid BP and NSP at 14 predicted cigarette use at 17 in those adolescents who did not smoke at 14. RESULTS After controlling for psychosocial factors, cigarette use at 14 predicted MBP at 17 (OR = 3.05, p = 0.049, 95% CI [1.01-9.24]). BP only at 14 was a significant risk factor for smoking at 17 (OR = 1.84, p = 0.006, 95% CI [1.19-2.84]) after controlling for psychosocial factors. CONCLUSION The findings indicate that there are bi-directional relationships between cigarette use and spinal pain and that these relationships vary with pain location.

Development and preliminary validation of the Parent Efficacy for Child Healthy Weight Behaviour Scale

This study developed a new measure of parent self-efficacy for promoting healthy weight behaviours in their children, the Parent Efficacy for Child Healthy Weight Behaviour Scale (PECHWB). In total 601 primary caregivers of children aged 4–17 completed an online survey consisting of the PECHWB, a measure of general parenting self-efficacy, measures of parental depression, anxiety and stress and demographic questions. Factor analysis identified four PECHWB subscales with high levels of internal consistency. The PECHWB showed significant small positive correlations with a measure of global parenting self-efficacy and small negative correlations with measures of parental negative affect. This study provides initial evidence for the reliability and validity of the PECHWB. Future research is required to establish further evidence of the psychometric properties of the PECHWB scale in independent samples before the scale can be used in evaluating intervention outcomes.

Preventing Internalizing Problems in 6–8 Year Old Children: A Universal School-Based Program

The Aussie Optimism Program: Feelings and Friends (AOP-FF) is a 10 week, universal mental health promotion program based on social/emotional and cognitive and behavioral strategies. The aim of the current study was to evaluate the efficacy of a universal Cognitive Behavioral Therapy based program in preventing and reducing internalizing problems in 6–8 year olds (Years 1–3 in Australia). Year 1–3 students from a low SES primary school (N = 206) were randomly assigned in classes to either an intervention or a control group and assessed at baseline and post-test. Results showed a significant (p = 0.009) and small to moderate (partial eta-squared = 0.034) pre-post decrease in parent-reported anxiety symptoms for the intervention group, in conjunction with a non-significant (p = 0.708) and negligible (partial eta-squared = 0.001) pre-post increase for the control group. A larger randomized controlled trial assessing longer term effects is needed. In addition the program needs to be simplified for year 1–2 students with a separate more developmentally appropriate program for year 3 students.

Assessment of a model for achieving competency in administration and scoring of the WAIS-IV in post-graduate psychology students

There is a need for an evidence-based approach to training professional psychologists in the administration and scoring of standardized tests such as the Wechsler Adult Intelligence Scale (WAIS) due to substantial evidence that these tasks are associated with numerous errors that have the potential to significantly impact clients’ lives. Twenty three post-graduate psychology students underwent training in using the WAIS-IV according to a best-practice teaching model that involved didactic teaching, independent study of the test manual, and in-class practice with teacher supervision and feedback. Video recordings and test protocols from a role-played test administration were analyzed for errors according to a comprehensive checklist with self, peer, and faculty member reviews. 91.3% of students were rated as having demonstrated competency in administration and scoring. All students were found to make errors, with substantially more errors being detected by the faculty member than by self or peers. Across all subtests, the most frequent errors related to failure to deliver standardized instructions verbatim from the manual. The failure of peer and self-reviews to detect the majority of the errors suggests that novice feedback (self or peers) may be ineffective to eliminate errors and the use of more senior peers may be preferable. It is suggested that involving senior trainees, recent graduates and/or experienced practitioners in the training of post-graduate students may have benefits for both parties, promoting a peer-learning and continuous professional development approach to the development and maintenance of skills in psychological assessment.

Reliability and validity of the Parent Efficacy for Child Healthy Weight Behaviour (PECHWB) scale

BACKGROUND Interventions for childhood overweight and obesity that target parents as the agents of change by increasing parent self-efficacy for facilitating their childs healthy weight behaviours require a reliable and valid tool to measure parent self-efficacy before and after interventions. Nelson and Davis developed the Parent Efficacy for Child Healthy Weight Behaviour (PECHWB) scale with good preliminary evidence of reliability and validity. The aim of this research was to provide further psychometric evidence from an independent Australian sample. METHODS Data were provided by a convenience sample of 261 primary caregivers of children aged 4-17 years via an online survey. PECHWB scores were correlated with scores on other self-report measures of parenting efficacy and 2- to 4-week test-retest reliability of the PECHWB was assessed. RESULTS The results of the study confirmed the four-factor structure of the PECHWB (Fat and Sugar, Sedentary Behaviours, Physical Activity, and Fruit and Vegetables) and provided strong evidence of internal consistency and test-retest reliability, as well as good evidence of convergent validity. CONCLUSION Future research should investigate the properties of the PECHWB in a sample of parents of overweight or obese children, including measures of child weight and actual child healthy weight behaviours to provide evidence of the concurrent and predictive validity of PECHWB scores.