Monika Wadolowski

What Australian women want and when they want it: cervical screening testing preferences, decision-making styles and information needs

Background  New testing technologies and human papillomavirus (HPV) vaccines have recently brought changes to cervical cancer screening. In 2006, the Australian government also changed the protocol for managing abnormal Pap smears. Australian women’s attitudes and preferences to these changes are largely unknown. Quantitative data on information needs and community attitudes to informed decision making in screening in Australia are also limited.

Cohort Profile: The Australian Parental Supply of Alcohol Longitudinal Study (APSALS)

The Australian Parental Supply of Alcohol Longitudinal Study (APSALS) was established in 2010 to investigate the short- and long-term associations between exposure to early parental alcohol provision, early adolescent alcohol initiation, subsequent alcohol use and alcohol-related harms, controlling for a wide range of parental, child, familial, peer and contextual covariates. The cohort commenced with 1927 parent-child dyads comprising Australian Grade 7 school students (mean age = 12.9 years, range = 10.8-15.7 years), and a parent/guardian. Baseline, 1- and 2-year follow-up data have been collected, with > 90% retention, and a 3-year follow-up is under way. The data collected include child, familial, parental and peer factors addressing demographics, alcohol use and supply, parenting practices, other substance use, adolescent behaviours and peer influences. The cohort is ideal for prospectively examining predictors of initiation and progression of alcohol use, which increases markedly through adolescence.

Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study

BACKGROUND Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables. METHOD A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates. RESULTS After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33-2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77-0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86-3.45) and bingeing (OR 3.51, 95% CI 2.53-4.87). CONCLUSIONS Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase childrens drinking.

Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study of Risk Factors.

BACKGROUND: Parents are a major supplier of alcohol to adolescents, often initiating use with sips. Despite harms of adolescent alcohol use, research has not addressed the antecedents of such parental supply. This study investigated the prospective associations between familial, parental, peer, and adolescent characteristics on parental supply of sips. METHODS: Participants were 1729 parent–child dyads recruited from Grade 7 classes, as part of the Australian Parental Supply of Alcohol Longitudinal Study. Data are from baseline surveys (Time 1) and 1-year follow-up (Time 2). Unadjusted and adjusted logistic regressions tested prospective associations between Time 1 familial, parental, peer, and adolescent characteristics and Time 2 parental supply. RESULTS: In the fully adjusted model, parental supply was associated with increased parent-report of peer substance use (odds ratio [OR] = 1.20, 95% confidence ratio [CI], 1.08–1.34), increased home alcohol access (OR = 1.07, 95% CI, 1.03–1.11), and lenient alcohol-specific rules (OR=0.88, 95% CI, 0.78–0.99). CONCLUSIONS: Parents who perceived that their child engaged with substance-using peers were more likely to subsequently supply sips of alcohol. Parents may believe supply of a small quantity of alcohol will protect their child from unsupervised alcohol use with peers. It is also possible that parental perception of peer substance use may result in parents believing that this is a normative behavior for their child’s age group, and in turn that supply is also normative. Further research is required to understand the impacts of such supply, even in small quantities, on adolescent alcohol use trajectories.

Parental Supply of Alcohol in Childhood and Risky Drinking in Adolescence: Systematic Review and Meta-Analysis

Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant terms and included only original English language peer-reviewed journal articles with a prospective design. Two reviewers independently screened articles, extracted data and assessed risk of bias. Seven articles met inclusion criteria, six of which used analytic methods allowing for meta-analysis. In all seven studies, the follow-up period was ≥12 months and attrition ranged from 3% to 15%. Parental supply of alcohol was associated with subsequent risky drinking (odds ratio = 2.00, 95% confidence interval = 1.72, 2.32); however, there was substantial risk of confounding bias and publication bias. In all studies, measurement of exposure was problematic given the lack of distinction between parental supply of sips of alcohol versus whole drinks. In conclusion, parental supply of alcohol in childhood is associated with an increased likelihood of risky drinking later in adolescence. However, methodological limitations preclude a causal inference. More robust longitudinal studies are needed, with particular attention to distinguishing sips from whole drinks, measurement of likely confounders, and multivariable adjustment.

Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study

BACKGROUND Some parents supply alcohol to their children, reportedly to reduce harm, yet longitudinal research on risks associated with such supply is compromised by short periods of observation and potential confounding. We aimed to investigate associations between parental supply and supply from other (non-parental) sources, with subsequent drinking outcomes over a 6-year period of adolescence, adjusting for child, parent, family, and peer variables. METHODS We did this prospective cohort study using data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents. Children in grade 7 (mean age 12 years), and their parents, were recruited between 2010 and 2011 from secondary schools in Sydney, Perth, and Hobart, Australia, and were surveyed annually between 2010 and 2016. We examined the association of exposure to parental supply and other sources of alcohol in 1 year with five outcomes in the subsequent year: binge drinking (more than four standard drinks on a drinking occasion); alcohol-related harms; and symptoms of alcohol abuse (as defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]), alcohol dependence, and alcohol use disorder (as defined by DSM-5). This trial is registered with ClinicalTrials.gov, number NCT02280551. FINDINGS Between September, 2010, and June, 2011, we recruited 1927 eligible parents and adolescents (mean age 12·9 years [SD 0·52]). Participants were followed up until 2016, during which time binge drinking and experience of alcohol-related harms increased. Adolescents who were supplied alcohol only by parents had higher odds of subsequent binge consumption (odds ratio [OR] 2·58, 95% CI 1·96-3·41; p<0·0001), alcohol-related harm (2·53, 1·99-3·24; p<0·0001), and symptoms of alcohol use disorder (2·51, 1·46-4·29; p=0·0008) than did those reporting no supply. Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source. Supply from other sources was associated with significant risks of all adverse outcomes, compared with no supply, with an even greater increased risk of adverse outcomes. INTERPRETATION Providing alcohol to children is associated with alcohol-related harms. There is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child. Parents should be advised that this practice is associated with risk, both directly and indirectly through increased access to alcohol from other sources. FUNDING Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre.

Parent characteristics associated with approval of their children drinking alcohol from ages 13 to 16 years: prospective cohort study

Objective: We investigated parent sociodemographic and drinking characteristics in relation to whether they approved of their children drinking at ages 13, 14, 15 and 16 years.

Parental Supply of Alcohol: How Does It Prospectively Relate to Sipping and Drinking?

Introduction and Aims: The aim of this study was to investigate patterns of supplement use among male university students, who have been identified as high consumers of these substances. Design and Methods: An online survey investigating supplement use was conducted over four weeks. Participants were sent a link to the survey via email and through posts on the online homepages of units from the School of Exercise and Nutrition Sciences at Deakin University. Results: Sixty-one males completed the survey (median age 21 years). All participants had used at least one supplement in their lifetime, with most having used legal supplements; the most commonly used supplement was sports drinks (80%), followed by protein (80%), and vitamins and minerals (80%). Although no participants reported use of anabolic-androgenic steroids, 18% would consider using them in the future. Motivations for use differed according to substance; for instance, vitamins and minerals were used for general health purposes while creatine was used to gain muscle. Friends were a common source of information about supplements (57%), followed by online (36%) and a supplement store staff member (22%). Participants reported few negative side effects from supplement use. Discussion and Conclusions: Supplement use is common among this group, and some indicate intentions to use more serious substances such as steroids. This study presents valuable findings about supplement use habits and patterns among male university students. However, more research is needed among this population to determine whether body image and exercise habits can influence supplement use.Abstract presented at the Australasian Professional Society on Alcohol and other Drugs Conference 2014, 9-12 November 2014, Adelaide, AustraliaAbstract presented at the Australasian Professional Society on Alcohol and other Drugs Conference 2014, 9-12 November 2014, Adelaide, AustraliaIntroduction and aims: contemporary research examining drinking behaviour highlights the importance of implicit processes in the initiation and maintenance of alcohol consumption. By definition, implicit attitudes are formed through experience with a target object. It is argued that implicit attitudes toward alcohol may be ambivalent because consuming alcohol can produce various negative (e.g. feeling nauseous) and positive consequences (e.g. feeling relaxed). Therefore the aim of the current study was to examine the ambivalent nature of implicit alcohol-related attitudes. Design and methods: participants (N= 343, M= 25.72 years) completed a Single-Category Implicit Association Test (SC-IAT) in which they were required to classify alcohol-related words with positively- and negatively-valenced words. The reaction times (RTs) for each pairing were then calculated and compared. Implicit ambivalence was operationalised as having similar RTs for classifying alcohol-related words with positive words and classifying alcohol-related words with negative words. Results: RTs for pairing alcohol with positive words (M= 752ms) were similar to those pairing alcohol with negative words (M= 716ms), suggesting implicit ambivalence toward alcohol consumption. ANOVAs revealed a pattern of results suggesting that drinking more standard drinks in a single drinking episode produced greater feelings of implicit ambivalence. Discussion and conclusions: these findings suggest that individuals hold both positive and negative implicit evaluations toward alcohol consumption. Furthermore, implicit attitudes toward alcohol may become more ambivalent as individuals consume more alcohol. This suggests that greater alcohol consumption may produce more experiences with both positive and negative consequences and lead to the development of implicitly ambivalent attitudes.

Young and not so drunk: Sipping, drinking and Australian adolescents

Issue: Harmful use of alcohol is a leading cause of disease burden for young Australians. Little is known about the context of adolescent alcohol initiation and the development of harmful patterns of consumption. This research reports descriptive baseline data from a national Australian longitudinal cohort. Approach: Parent-child dyads were recruited nationally via NSW, Tasmanian and WA secondary schools. During 2010/11, 1929 parent–child dyads completed baseline surveys. Measures include: alcohol use and harms; rules; parental style and monitoring; family relationships, confl ict and relations; peer substance use and approval; and delinquency. Key Findings: Sixty-eight percent of adolescents (M = 12.5 yrs) had tried alcohol. Parent factors including frequency and quantity of alcohol consumption (÷2 (3, N=1880) = 79.27, P < 0.00005; ÷2 (3, N=1879) = 63.75, P < 0.00005), drinking alcohol in the presence of their child (÷2 (3, N=1879) = 81.63, P < 0.00005) and younger age of alcohol initiation (÷2 (1, N=1785) = 20.13, P < 0.00005) were associated with adolescent alcohol initiation. Children with higher levels of rule breaking and aggressive behaviour (÷2 (1, N=1903) = 44.43, P < 0.0005; ÷2 (1, N=1893) = 13.40, P = 0.0003), who were male (÷2 (1, N=1904) = 6.72, P = 0.0095) and who had at least some friends who had tried alcohol (÷2 (3, N=1896) = 506.94, P < 0.00005) and who approved of drinking alcohol (÷2 (2, N=1903) = 91.21, P < 0.00005) were more likely to have tried alcohol themselves. Implications: To address current levels of binge drinking and long term harms from alcohol, it is essential to understand the context of early-adolescent alcohol use and how harmful trajectories may develop. Conclusion: Future analyses of this cohort will provide insight into the impact of contextual factors on adolescent alcohol use and inform public health policy and prevention.

Context of early adolescent alcohol use: First results from a longitudinal Australian cohort

Issue: Harmful use of alcohol is a leading cause of disease burden for young Australians. Little is known about the context of adolescent alcohol initiation and the development of harmful patterns of consumption. This research reports descriptive baseline data from a national Australian longitudinal cohort. Approach: Parent-child dyads were recruited nationally via NSW, Tasmanian and WA secondary schools. During 2010/11, 1929 parent–child dyads completed baseline surveys. Measures include: alcohol use and harms; rules; parental style and monitoring; family relationships, confl ict and relations; peer substance use and approval; and delinquency. Key Findings: Sixty-eight percent of adolescents (M = 12.5 yrs) had tried alcohol. Parent factors including frequency and quantity of alcohol consumption (÷2 (3, N=1880) = 79.27, P < 0.00005; ÷2 (3, N=1879) = 63.75, P < 0.00005), drinking alcohol in the presence of their child (÷2 (3, N=1879) = 81.63, P < 0.00005) and younger age of alcohol initiation (÷2 (1, N=1785) = 20.13, P < 0.00005) were associated with adolescent alcohol initiation. Children with higher levels of rule breaking and aggressive behaviour (÷2 (1, N=1903) = 44.43, P < 0.0005; ÷2 (1, N=1893) = 13.40, P = 0.0003), who were male (÷2 (1, N=1904) = 6.72, P = 0.0095) and who had at least some friends who had tried alcohol (÷2 (3, N=1896) = 506.94, P < 0.00005) and who approved of drinking alcohol (÷2 (2, N=1903) = 91.21, P < 0.00005) were more likely to have tried alcohol themselves. Implications: To address current levels of binge drinking and long term harms from alcohol, it is essential to understand the context of early-adolescent alcohol use and how harmful trajectories may develop. Conclusion: Future analyses of this cohort will provide insight into the impact of contextual factors on adolescent alcohol use and inform public health policy and prevention.