Worldwide, schools implement social-emotional learning programs to enhance students' social-emotional skills. Although parents play an essential role in teaching these skills, knowledge about their perspectives on social-emotional learning is limited. In providing insight into the perspectives of parents from adolescent students this paper adds to this knowledge. An explorative qualitative study was conducted to gain insight into parents' perspectives on adolescent social-emotional learning. A broadly used professional framework for social emotional learning was used as a frame of reference in interviews with parents from diverse backgrounds. Within and across case analyses were applied to analyze the interviews. A conceptual model of four social-emotional skills constructs considered crucial learning by parents emerged from the data: respectful behavior, cooperation, self-knowledge and self-reliance. Parents' language, interpretations and orderings of skills indicate that the model underlying these constructs differs from skills embedded in the professional framework.
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Abstract: The primary aim of the dissertation was to develop and evaluate a smartphone app, the WhiteTeeth app, designed to promote good oral health behaviour and oral hygiene among adolescent orthodontic patients between the ages of 12 and 16. The app's development and evaluation was guided methodically by intervention mapping (IM). Development thus starts with an analysis of the health problem and the identification of the psychosocial factors and health behaviour related to it. To identify the psychosocial factors underlying oral health behaviour in our target group, a systematic literature review with meta-analysis was conducted,a cross-sectional clinical study and semi-structured interviews. Then, to target these psychosocial factors and facilitate continuous behavioural support, various behaviour-changing techniques were incorporated into the app. The app provides feedback on users' oral health behaviour and allows users to evaluate and monitor their behaviour. Finally, a randomised controlled trial was conducted. This showed that the app had improved oral hygiene in adolescent orthodontic patients after 12 weeks.
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The worldwide obesity epidemic is a major and complex problem, resulting from the interaction of individual metabolic, genetic, and psychological factors with meso- and macro environmental factors. Adolescents, with their rapid changes in body composition, together with their shift in orientation from the direct family to the peer-related environment, are particularly vulnerable to unhealthy changes in life style. Habits with respect to food and physical activity tend to change substantially in this period as compared to earlier childhood, and peers seem to play an important role in shaping the behavior of adolescents. Adolescents tend to mimic their peers' behavior related to both healthy and unhealthy food choices as well as to physical activity and sports participation. This influence of peers depends on environmental circumstances such as availability of snacks, and is affected by individual psychological and demographic factors, and by macro-environmental factors such as cultural and social norms, legislation, food distribution, and media and advertising. A rapidly expanding source of influence on health behavior are media such as television, the internet (e.g., Facebook, twitter), and smartphones. These media may enhance overweight and reduce physical strength by reinforcing a sedentary life. However, potentially these media could be used to monitor and influence snacking behavior and physical activity for the better. An example of the use of new technology to enhance health behavior is the 'Wii' home video game. Using insights from social psychology, thoughtful choice architecture can be established to nudge adolescents to choose what is best for them without restricting freedom of choice and to help them with really implementing healthy intentions. A challenge for the coming decade is to develop 'Apps' aimed to decrease adolescent obesity while making use of social networks.
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Background: More knowledge about characteristics of children and adolescents who need intensive levels of psychiatric treatment is important to improve treatment approaches. These characteristics were investigated in those who need youth Assertive Community Treatment (youth-ACT). Method: A cross-sectional study among children/adolescents and their parents treated in either a regular outpatient clinic or a youth-ACT setting in a specialized mental health treatment center in the Netherlands. Results: Child, parent and family/social context factors were associated with treatment intensification from regular outpatient care to youth-ACT. The combination of the child, parent, and family/social context factors adds substantially to the predictive power of the model (Nagelkerke R2 increasing from 36 to 45% for the three domains separately, to 61% when all domains are combined). The strongest predictors are the severity of psychiatric disorders of the child, parental stress, and domestic violence. Conclusions: Using a wide variety of variables that are potentially associated with treatment intensification from regular outpatient clinic to youth-ACT, we constructed a regression model illustrating a relatively strong relation between the predictor variables and the outcome (Nagelkerke R2 = 0.61), with three strong predictors, i.e. severity of psychiatric disorders of the child, parental stress, and domestic violence. This emphasizes the importance of a system-oriented approach with primary attention for problem solving and stress reduction within the system, in addition to the psychiatric treatment of the child, and possibly also the parents. Auteurs: Vijverberg, R., Ferdinand, R., Beekman, A., & van Meijel B.
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Aims: To investigate the influence of parenting styles (overprotection, emotional warmth, and rejection) in early adolescence on regular alcohol use in late adolescence. Methods: We analyzed data from the first three waves (mean ages: 11.09, 13.56, and 16.27 years, respectively) of a population-based prospective cohort study of 2,230 adolescents, conducted between 2001 and 2007. Adolescents reported on parental overprotection, emotional warmth, and rejection (T1). Regular alcohol use was defined as six and seven glasses or more a week for girls and boys, respectively. We further assessed family socioeconomic status, parental divorce, parental alcohol use, educational level of the adolescent, and alcohol use at baseline. Results: Parental overprotection had the strongest relationship to regular alcohol use: adolescents who perceived more parental overprotection were at increased risk of developing regular alcohol use, even after adjustment for several confounders. Rejection was not related to adolescents' alcohol use and, after adjustment for the other variables, neither was emotional warmth. Conclusion: Overprotective parenting is a determinant of future regular adolescent alcohol use and therefore health professionals should pay particular attention to those adolescents who have overprotective parents. The role of adolescent characteristics in the relationship between overprotection and alcohol use deserves further study
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Background: Increasing health literacy (HL) in children could be an opportunity for a more health literate future generation. The aim of this scoping review is to provide an overview of how HL is conceptualized and described in the context of health promotion in 9–12-year-old children. Methods: A systematic and comprehensive search for ‘health literacy’ and ‘children’ and ‘measure’ was performed in accordance with PRISMA ScR in PubMed, Embase.com and via Ebsco in CINAHL, APA PsycInfo and ERIC. Two reviewers independently screened titles and abstracts and evaluated full-text publications regarding eligibility. Data was extracted systematically, and the extracted descriptions of HL were analyzed qualitatively using deductive analysis based on previously published HL definitions. Results: The search provided 5,401 original titles, of which 26 eligible publications were included. We found a wide variation of descriptions of learning outcomes as well as competencies for HL. Most HL descriptions could be linked to commonly used definitions of HL in the literature, and some combined several HL dimensions. The descriptions varied between HL dimensions and were not always relevant to health promotion. The educational setting plays a prominent role in HL regarding health promotion. Conclusion: The description of HL is truly diverse and complex encompassing a wide range of topics. We recommend adopting a comprehensive and integrated approach to describe HL dimensions, particularly in the context of health promotion for children. By considering the diverse dimensions of HL and its integration within educational programs, children can learn HL skills and competencies from an early age.
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Alcohol use among adolescents has become a major public health concern over the past decade. This alcohol use is associated with various other problems, therefore it is important to detect at-risk adolescents as a starting point for interventions. The main aim of this thesis is to identify determinants of adolescent alcohol use. Furthermore, determinants of multiple health risk behaviors were studied. The studies described in this thesis were embedded within the TRAILS (TRacking Adolescents’ Individual Lives Survey) study. TRAILS is a large prospective cohort study of the psychological, social and psychical development of children into adulthood. The TRAILS study started in 2001 when the children were aged 10-12 years. The results of this thesis show that parenting is a determinant for adolescent alcohol use. Furthermore, Self-control, aggressive behavior, alcohol use of friends and various socio-demographic characteristics were predictive for alcohol use. Low self-control does not increase the risk of alcohol use, but does increase the risk of alcohol abuse and multiple health risk behaviors. Although some aspects of parenting were found to be predictive for adolescent alcohol use, the effects were small. The results show that in future research on determinants for alcohol use by adolescents a distinction should be made between specific patterns of alcohol use and that the association with other health risk behaviors should be studied. The same holds true for the development of preventive intervention programs. Further increase of the cooperation between schools and Preventive Child Healthcare may increase the efficiency of these programs.
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The Kennedy Axis V is a routine outcome measurement instrument which can assist the assessment of the short-term risk for violence and other adverse patient outcomes. The purpose of this study was to evaluate the interrater reliability and clinical utility of the instrument when used by mental health nurses in daily care of patients with mental illness. This cross-sectional study was conducted in inpatient and outpatient adult psychiatric care units and in one adolescent inpatient unit at a university hospital in the Netherlands. Interrater reliability was measured based on the independent scores of two different nurses for the same patients. The clinical utility of the instrument was evaluated by means of a clinical utility questionnaire. To gain a deeper understanding of rating difficulties at the adolescent unit, additional data were collected in two focus group interviews. The overall results revealed a substantial level of agreement between nurses (intraclass correlation coefficient and Pearson 0.79). Some rating challenges were identified, including difficulties with scoring the instrument and using tailor-made interventions related to the scores. These challenges can be resolved using refined training and implementation strategies. When the Kennedy Axis V is accompanied by a solid implementation strategy in adult mental health care, the instrument can be used for short-term risk assessment and thereby contribute in efforts to reduce violence, suicide, self-harm, severe selfneglect, and enhanced objectivity in clinical decision-making.
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There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision‐making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short‐Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non‐field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real‐world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.
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De verdediging hiervan was op 26 september. Background: The insertion of fixed orthodontic appliances increases the risk of dental caries, particularly in adolescents. Caries can be prevented through good oral health behavior. To support adolescents with fixed orthodontic appliances and for promoting oral health behavior, we developed a theory- and evidence-based mHealth program, the WhiteTeeth app. Objective: The objective of our paper was to describe the systematic development and content of the WhiteTeeth app. Methods: For systematic development of the program, we used the intervention mapping (IM) approach. In this paper, we present the results of applying the first 5 steps of IM to the design of an mHealth program: (1) identifying target behaviors and determinants through problem analysis, including a literature search, a survey study, and semistructured interviews, to explore adolescent oral health behavior during orthodontic therapy; (2) defining program outcomes and objectives; (3) selecting theoretical methods and translating them into practical strategies for the program design; (4) producing the program, including a pilot test with 28 adolescents testing the acceptability and usability of the WhiteTeeth app; and (5) planning implementation and adoption. Auteurs: Scheerman, J.F.M., van Empelen, P., van Loveren, C., & van Meijel, B. (2018)
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