搜索结果：Journal of prevention (2022)

This article reports on the effectiveness of the drug use prevention program Mantente REAL (MREAL) with elementary school students in Uruguay. MREAL is the Spanish language version of Original Program, an internationally validated program recognized as an efficacious universal intervention for youth drug use prevention. In partnership with selected elementary schools, a binational team of investigators implemented and evaluated a linguistically and culturally adapted version of MREAL in Montevideo, Uruguay. The sample included 223 sixth-grade students from six public schools located in low-income neighborhoods. The students' regular classroom teachers implemented the intervention after receiving a two-day training. Schools were randomly assigned into experimental and control conditions and all consented students, regardless of condition, completed a pre- and post-test survey. Compared to control school students, those receiving MREAL reported significant desired effects for cigarette use, marijuana/hard drug use, drug use personal norms, and drug offers from peers. Findings indicated that MREAL is a promising program for preventing drug use in Uruguay elementary schools with similar socioeconomic characteristics. The article concludes with a set of policy, practice and future research implications and recommendations for the further advancement of evidence-based universal prevention in Uruguay.

The European Prevention Curriculum (EUPC) was introduced in Georgia to ensure the quality of the National Drug Prevention Strategy implementation. This paper provides a practitioner's narrative of the experiences and lessons learned during the implementation of EUPC in Georgia, as part of a Special Issue on EUPC implementation experiences. The narrative is grounded in the authors' direct involvement in the implementation of the EUPC, including the translation and cultural adaptation of the curriculum, the capacity building of national trainers, and the delivery and evaluation of EUPC training to 146 local stakeholders. Drawing on implementation experiences, training participant feedback, and implementers' observations, the account highlights key lessons learned. The translation and cultural adaptations of the EUPC manual along with the development of national training capacity laid a strong foundation for piloting the first EUPC training for decision-makers, opinion leaders and policymakers (DOPs) in Georgia. As a result of the training, participants demonstrated an increased understanding of evidence-based prevention principles. However, challenges emerged, including the culture-specific pace of content comprehension and the participants' limited prior exposure to evidence-based prevention. Key lessons include the necessity to tailor training complexity to the needs of different target groups while putting in place the mechanisms assuring fidelity, quality and the necessity of creating a sustainable infrastructure for EUPC implementation.

Adolescent substance use remains a significant public health concern in Spain. This study evaluates the effectiveness of "Tú Decides 2.0," an updated school-based drug prevention program, in reducing substance use among Spanish adolescents. A nine-month, two-arm, quasi-experimental controlled trial was conducted involving 2251 adolescents (aged 12-17) from 13 secondary schools in three Spanish regions. The intervention group (n = 1209) received the "Tú Decides 2.0" program, while the control group (n = 1042) underwent only assessment sessions. Primary outcomes were past 30-day use of alcohol, tobacco, e-cigarettes, and cannabis at three-month follow-up. Overall, prevalence of use was lower than the national mean data. GEE analyses following an ITT approach showed significant effects of the program in reducing the prevalence of self-reported e-cigarette use in the intervention group compared to the control group in 2nd (OR = 0.54; CI = 0.32; 0.90) and 4th (OR = 0.33; CI = 0.27; 1.14) CSE years. Significant effects were also found in reducing the prevalence of alcohol (OR = 0.57; CI = 0.32; 1.00) and tobacco (OR = 0.57; CI = 0.37; 0.88) use at three-months follow-up among students in 2nd CSE year. No significant effects were observed for cannabis nor for the 1st and 3rd CSE years. Models conducted using Multiple Imputation yielded similar results. The "Tú Decides 2.0" program demonstrated effectiveness in reducing both the incidence and prevalence of e-cigarette, alcohol and tobacco use among Spanish adolescents. These findings support the implementation of updated, digitalized school-based interventions for substance use prevention.Trial Registration ClinicalTrials.gov Registry (#NCT05950074).

This practitioner narrative aims to describe the implementation of the European Prevention Curriculum (EUPC) in Latvia, highlighting the structure, key achievements, challenges, and lessons learnt to inform future implementation efforts. Until 2025, Latvia has translated the EUPC handbook into the national language, ensured EUPC basic trainings since 2021 and the academic course since 2023, and, with the support of the European Drugs Agency (EUDA, formerly known as the European Monitoring Centre for Drugs and Drug Addiction, EMCDDA), trained five national EUPC trainers. Currently, the EUPC training is offered at most twice a year-once for national decision-makers, opinion leaders, and policymakers (DOPs) and once for university students. Key barriers to the large-scale implementation of the EUPC include limited funding, the additional workload associated with delivering EUPC trainings for national trainers, the absence of a national implementation framework, and the lack of official recognition of EUPC certification. Nevertheless, an analysis of participants' pre-test and post-test responses demonstrates an increase in self-reported knowledge related to EUPC content. Furthermore, elements of the EUPC have been integrated into various methodological and educational materials on substance use prevention in Latvia.

Schools play an important role in preventing mental health problems among children and young people. While existing frameworks describe the components of school-based prevention, less is known about how schools themselves conceptualise prevention and what they see as priorities for development. We conducted four workshops with 18 school staff members from 13 educational institutions. Participants identified current and desired prevention activities and prioritised those they considered most important to develop. The listed activities were analysed using qualitative content analysis to create a data-driven categorisation of prevention activities. 12 categories of activities emerged under two overarching themes: prevention delivery (activities aimed at students or parents) and prevention organisation (conditions necessary for effective delivery, such as planning, cooperation, staff support, and training). While schools reported widespread implementation of universal prevention-related activities, their highest priorities for improvement were organisational, particularly systematic planning, coordination, and ensuring sufficient and supported personnel. The findings suggest that school staff view organisational capacity-building as an integral part of prevention, underlining the need for prevention policies and systems that recognise and support the organisational work schools do to sustain mental health problem prevention.

Substance use is a well-known public health problem among adolescents and emerging adults. Digital prevention components, oftentimes included in interventions to target substance use, offer unique possibilities and might be particularly suited for these age groups. However, thus far, a comprehensive overview of substance use prevention interventions utilising digital components is lacking. Hence, the overall aim of this study is to fill this research gap by identifying the type of digital components, their theoretical approaches and their combinations employed in substance use interventions for adolescents and emerging adults, and how the evidence base for their (individual) effectiveness was assessed. The literature was searched in four databases: MEDLINE, PsychInfo, CINAHL and Web of Science in May 2023. Inclusion criteria based on the PCC concept were: Population (adolescents and emerging adults aged 12-21 years), Concept ((a) digital components of interventions AND (b) prevention or reduction AND (c) substance use), Context (all contexts). Studies were selected after title/abstract screening by two independent researchers. Data extraction included: substances and substance use behaviour, underlying theory/approach, characteristics of digital intervention components, methods used for evidence assessment, and study characteristics. These data were narratively summarised. 4,905 publications were screened and 176 were included, of which 114 reported on interventions with emerging adults and 62 with adolescents. These interventions were predominantly delivered in educational settings (86%), namely universities/(vocational)schools. Alcohol was the most commonly investigated single target substance (74%). The majority of all interventions were based on more than one theory/approach and it was not always clear which theories were combined. The most commonly reported approach in interventions for adolescents was the provision of information/education, for emerging adults, interventions were based on Social Norms Theory most frequently. The majority of interventions were delivered web-based. Randomized controlled study designs dominated, and evaluation was rarely performed separately for the intervention components. A variety of digital intervention components exist to reduce or prevent substance use among adolescents and emerging adults. However, different intervention components based on diverse theoretical approaches are often combined in one intervention and the individual effects of single components remain largely unmeasured. Future studies should consider innovative methods to analyse the effectiveness of individual components, and their possible interactions, within complex interventions. Combining effective digital components or adding these components to non-digital interventions could optimize the effectiveness of interventions for young people.

There is growing interest in assisting individuals who return to homelessness after obtaining permanent housing. However, little evidence exists on those who make multiple exits to permanent housing and subsequently return to homelessness over time. This study estimated the rates of multiple returns to homelessness among Veterans who accessed permanent housing and identified Veteran characteristics associated with these returns. The study used several Department of Veterans Affairs (VA) administrative data sources to calculate rates of multiple returns to homelessness within 12- and 24-months among Veterans who exited a VA homeless assistance program to a permanent housing destination between January 2018 and April 2021. Binary logistic regression models assessed the association between Veteran characteristics and multiple returns. Roughly 0.4% and 2.2% of Veterans experienced multiple returns to homelessness within 12- and 24-months, respectively. Diagnoses of alcohol use disorder, drug use disorder and psychoses were the most prominent predictors of higher odds of multiple returns. Although rare, multiple returns to homelessness highlight the need for targeted supports to help prevent recurrent homelessness and promote long-term housing stability.

The goal of this study was to evaluate a mediation model of two approaches to deterring the onset of alcohol, cigarette, and marijuana among middle school adolescents. Students completed surveys that included yes/no self-reports about their past 30-day and lifetime alcohol, cigarettes, and marijuana use. Surveys assessed dispositions: perceptions that drug use would interfere with desired lifestyles, perceptions about drug use prevalence and acceptability, and drug use intentions. Surveys also assessed skills: students' ability to achieve goals, make decisions, and refuse drug use offers. Classrooms were assigned by convenience to one of three conditions. In the control condition, students (N = 394) received no prescribed intervention. Core condition students (N = 101) received instruction in All Stars Core, which targeted changing students' dispositions. Students in the combined Core and Plus condition (N = 135) received instruction in both All Stars Core and in All Stars Plus, which also targeted improving students' skills. Analysis revealed that the programs achieved reductions in the onset of drug use through maintaining these students' dispositions. In contrast, control students' dispositions eroded over time, increasing their risk for drug use. The Plus intervention that targeted skills, failed to have a sufficiently large impact to allow analysis to validate skills as a statistically significant mediator of drug use outcomes. These results speak to the conclusion that, for prevention programs to succeed at deterring the onset of alcohol and drug use, interventions need to maintain or improve students' dispositions. This includes improving lifestyle incongruence, reducing perceptions that drug use is common and acceptable, and by increasing commitments to avoid drugs. Interventions that focus on building skills are less likely to achieve preventive effects.

Childhood exposures to adversity are common and increase risk for negative health and social outcomes throughout the life course. There is limited evidence regarding interventions to prevent or reduce the impact of adverse childhood experiences (ACEs), particularly for families with multiple adversities. Here we present the findings of mixed methods research to co-design a complex intervention to prevent adverse childhood experiences, and their impacts. Using established research methods, and the framework of the Medical Research Council (MRC) complex interventions development guidance, the work was conducted in four stages, shaped by stakeholder engagement and input at every stage. The first stage, Discover, was exploratory and employed evidence synthesis and quantitative (n = 11,564) and qualitative (n = 31) research methods to understand needs, experiences, and evidence gaps. The Define stage developed three intervention principles and identified intervention options, through a series of six co-design workshops with 41 participants and an academic research team workshop. The Develop and Deliver stages were undertaken through a Policy Lab (22 participants), and developed options for intervention design, before converging on a defined intervention that could be delivered and tested. Through this process, we developed a 'village-style' intervention, which functions at three levels: individual service users, operational, and system/strategy. Central to this are link or community health workers who would build relationships with family members, and act as a single point of contact. They should develop an understanding of family needs and the interaction of multiple complex adversities, and advocate for families, facilitating access to services. Crucially, they should use this understanding to work at and feed into operational and strategic levels to reshape services and enhance access for all families at risk of or experiencing adversity. Entry into the intervention through assessments at existing universal touch points, for example at routine perinatal or newborn appointments, should provide a prevention focus and follow the principles of proportionate universalism. Sensitive enquiry regarding financial stress may be a component of the assessment, in response to the findings of this work regarding the contexts created through the interaction of poverty and other adversities. The proposed intervention is designed to improve individual and family outcomes, and generate positive system-level changes. A feasibility study and evaluation will be required in future work, to assess the effects, costs and benefits. The processes and frameworks we developed and used may provide an adaptable template for future intervention co-design work.

The aim of this study was to assess the impact of organized screening programs on incidence and mortality rates of cervical cancer in women. A systematic review of the relevant literature was performed in accordance with the PRISMA 2020 protocol by searching PubMed, Scopus and Web of Science. Endnote20 and Rayyan Systematic Review Screening Software were used for duplicate removal and then, independent evaluation was done by two reviewers. The quality of studies was assessed using the Newcastle Ottawa scale. A random-effects meta-analysis was performed in order to compute the pooled effect size, with Hartung-Knapp adjustment for random effects model. DerSimonian-Laird estimator for Tau2, Mantel-Haenszel estimator used in calculation of Q and Tau2, and calculation of I2 based on Q were used to assess and quantify heterogeneity between studies. Inverse variance method was also used. The results of the meta-analysis show that women who were regularly screened in an organized cervical cancer screening program were statistically significantly less likely to develop (OR&#x2009;=&#x2009;0.40, 95% CI 0.29-0.55) or die (OR&#x2009;=&#x2009;0.31, 95% CI 0.16 to 0.58) from cervical cancer. Significant heterogeneity among the case-control studies evaluating the incidence of cervical cancer has been detected (Tau2&#x2009;=&#x2009;0.1034; &#x3c7;2&#x2009;=&#x2009;245.42; df&#x2009;=&#x2009;12, p&#x2009;<&#x2009;0.0001; I2&#x2009;=&#x2009;95.1%). Moderate to high heterogeneity among the case-control studies evaluating the mortality has been detected (Tau2&#x2009;=&#x2009;0.1161; &#x3c7;2&#x2009;=&#x2009;20.12; df&#x2009;=&#x2009;3, p&#x2009;<&#x2009;0.0002; I2&#x2009;=&#x2009;85.1%). The results of tests for assessing asymmetry (Egger's and Begg's test, p&#x2009;<&#x2009;0.05), indicates the absence of publication biases. The results of our meta-analysis show that women who participate in organized screening programs are significantly less likely to develop and die from cervical cancer, especially if they are screened regularly. Women who irregularly participated in an organized cervical cancer screening program have almost equal risk for cervical cancer compared to women who did not participate in an organized cervical cancer screening program. Women with irregular participation in an organized cervical cancer screening program have a cervical cancer risk that is nearly comparable to the risk among non-participants.

Analyze the effects of substituting time spent in sleep, sedentary behavior, and moderate-to-vigorous physical activity on the physical performance of older adults. The sample consisted of 457 participants from the Alcoba&#xe7;a Elderly Health Longitudinal Study. Physical performance was measured using the Short Physical Performance Battery, while physical activity and sedentary behavior were assessed with the International Physical Activity Questionnaire, and sleep with the Pittsburgh Sleep Quality Index. For statistical analysis, the isotemporal substitution approach was applied to examine the hypothetical effects of reallocating time between sleep, sedentary behavior, and moderate-to-vigorous physical activity on physical performance. The results showed that substituting small periods of sleep or sedentary behavior with moderate-to-vigorous physical activity was associated with a significant reduction in the risk of poor physical performance. The reallocation of just 5&#xa0;min/day already showed a protective effect (a reduction of 13% to 14%), with an increasing impact proportional to the amount of time replaced, reaching an 82% reduction for 60&#xa0;min/day. Model-based analyses suggest that replacing short periods of sedentary behavior or sleep with moderate-to-vigorous physical activity is associated with a lower risk of poor physical performance in older adults.

The rising prevalence of illicit drug use among Romanian youth underscores the need for effective prevention service delivery systems, particularly in European contexts characterized by high social transition, severe resource constraints, and limited prevention service infrastructure. This study explored international expert and local Romanian stakeholder perspectives regarding factors contributing to the contextual adaptation and potential implementation of the Communities That Care (CTC) prevention system in Romania. Through qualitative interviews with experts in CTC (n&#x2009;=&#x2009;15) and validation of findings with Romanian community stakeholders (n&#x2009;=&#x2009;9), this study examined potential challenges in implementing CTC in Romania, such as lack of evidence-based interventions, resource scarcity, cultural differences, and resistance to change. Key factors identified by CTC experts as needed for successful implementation include community improved readiness, continuous adaptation, favorable facilitator and champion characteristics, and community engagement. Romanian stakeholder perspectives further suggested that rural communities may offer particularly favorable conditions for CTC implementation. Stakeholders emphasized the need for partnerships that reflect the needs of local groups and for attention to Romanian values (e.g., including strong family ties, religious traditions, and respect for authority), which should be considered alongside broader societal experiences (e.g., migration, funding limitations, and long-standing institutional distrust). By situating Romania within a broader European context, these findings provide valuable insights for stakeholders seeking to adapt and implement CTC in countries new to the prevention science movement and highlight the relevance of the Romanian case for the Balkan region and similar European settings.

The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children's centres. Parents were involved using two approaches: open events with 'silent conversations', and individual conversations. Parents were invited to comment on four issues: which families should receive FWbS; how to make FWbS accessible; the process of delivering FWbS; and the nature or content of FWbS. The article describes how we approached parents via existing services, how conversations were facilitated and how parents' views informed the immediate service redesign and new research on FWbS to improve parent and child outcomes. It also identifies learning, for instance on engaging people not involved in services, involving people throughout a project and offering training and support for researchers and service providers around how to involve people with lived experience of poverty in respectful and meaningful ways.

Self-harm is the most significant risk factor for death by suicide. The aim of this study is to present trends and characteristics of hospital-presenting intentional self-harm and events of undetermined intent in Croatia from 2017 to 2023, with a focus on sex and age differences, in order to identify the at-risk groups towards whom prevention activities should be directed. Data were collected from the National Public Health Information System, and hospitalization rates were analyzed by sex, age, and year of hospitalization. The average hospitalization rate for intentional self-harm was 27.46 per 100,000, while the overall rate (including events of undetermined intent) was 44.47 per 100,000. Trends over the years indicate a general increase in hospitalization rates from 2017 to 2023, with the exception of 2020, when a temporary (statistically non-significant) decline was recorded. The highest rate in the observed period was reached in 2022. Furthermore, significant sex differences were observed. The hospitalization rate for intentional self-harm was statistically significantly higher among females (24% lower in males). However, when events of undetermined intent were included, the hospitalization rate became statistically significantly higher among males (7% higher compared to females). The highest hospitalization rates were recorded among females aged 15-19 years, peaking in 2022 (195.76 per 100,000). It is necessary to strengthen the system of monitoring and diagnostics and to develop targeted, gender-sensitive preventive interventions in order to reduce the risk of self-harm and the associated risk of suicide mortality.

Cochrane reviews provide high-quality evidence syntheses. To guide the production and dissemination of new Cochrane reviews, an evidence map based on the characteristics of existing reviews is necessary. This study is a scoping review that aimed to create an evidence map of Cochrane reviews on nutrition and physical activity (PA) in healthy and at-risk populations, describe stakeholder involvement in review production and assess the dissemination of these reviews. This scoping review follows a registered protocol and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA ScR) guideline. Eligible studies were Cochrane reviews on nutrition and PA for healthy and at-risk populations that were identified in the Cochrane Database of Systematic Reviews through to 22 January 2026 and selected independently by two researchers from 2043 search hits. Extracted data included bibliographic, population, and intervention or concept characteristics, information on stakeholder involvement in review production and open-access Altmetric data on the online and scientific attention towards Cochrane reviews. Data were processed into meaningful categories and synthesised using descriptive statistics. The included Cochrane reviews (n&#x2009;=&#x2009;260) were published between 1999 and 2026. Review focus was on nutrition (n&#x2009;=&#x2009;193, 74%), PA (n&#x2009;=&#x2009;39, 15%), and nutrition&#x2009;+&#x2009;PA (n&#x2009;=&#x2009;28, 11%). Most reviews included any populations by age and sex (n&#x2009;=&#x2009;52, 20%) or specific populations by age (adults: n&#x2009;=&#x2009;62, 24%; children: n&#x2009;=&#x2009;54, 21%; and child-caregiver dyads: n&#x2009;=&#x2009;50, 19%). The interventions or concepts were predominantly non-digital (n&#x2009;=&#x2009;230, 88%), included mainly nutrition components (e.g. supplementation: n&#x2009;=&#x2009;104, 40%; diet: n&#x2009;=&#x2009;68, 26%), and were conducted in any unspecified settings (e.g. community, population; n&#x2009;=&#x2009;226, 87%). The outcomes were mainly disease-related (e.g. disease prevention and risk factor reduction; n&#x2009;=&#x2009;129, 50%) and reproductive (e.g. maternal and child health promotion; n&#x2009;=&#x2009;56, 22%). There were less or no reviews with the following characteristics: (1) populations of older adults and males, (2) interventions or concepts with digital modality and with components targeting PA promotion, behaviour change, and other factors (e.g. policy), (3) specific settings (e.g. vulnerable, organisational), (4) outcomes targeting general health promotion and psychosocial (e.g. behavioural, cognitive, and mental) functioning. Involvement of various stakeholders (e.g. consumers, clinicians, and advisory boards) was reported in the production of 32% of Cochrane reviews. Online attention was highest for reviews with nutrition components (i.e. supplementation and diet) while scientific attention was highest for reviews with mixed components (i.e. PA and supplementation). New Cochrane reviews on nutrition and PA need to target specific populations (especially older adults and males) and settings, assess digital interventions or concepts, and focus on components and outcomes targeting physical and mental health promotion. Stakeholder involvement in review production and online and scientific attention could be further promoted to potentially improve review uptake in practice.

Health literacy is critical for reducing inequality and promoting effective implementation of health services and better health outcomes. The health literacy agenda is gaining momentum worldwide, including in Latin America and the Caribbean. However, a comprehensive overview of research developments in the region is lacking. This study aimed to explore the state of the art of health literacy research in Latin America and the Caribbean. A scoping review was conducted in January 2024 drawing upon data from the databases: La Referencia, BVS, PubMed, Web of Science, CINAHL, PsycINFO, and ERIC. The search results were reviewed in Rayyan by all co-authors. The title and abstracts were screened, based on inclusion and exclusion criteria followed by extraction, analysis and synthesis of data according to the research objectives. The search yielded 375 publications including 289 peer-reviewed articles and 86 dissertations and theses. The sample included quantitative (73.9%), qualitative (13.9%), mixed-methods (5.9%), and bibliographic (1.9%) studies and other types of scientific publications (4.5%). Two thirds of the countries published health literacy research. Most originated from Brazil, followed by Mexico, Chile, Peru, and Colombia. There was a marked increase in publications from 2017 onward, reaching a peak in 2022. The most frequently cited definitions were by S&#xf8;rensen et al. (S&#xf8;rensen et al in BMC Pub Health 12:80, 2012 and the WHO Health Promotion Glossary (World Health Organization (WHO). (1998). Health promotion glossary.). The prominent research topics included oral health literacy and non-communicable diseases. Other topics include e.g., general health literacy, communicable diseases, functional health literacy, and healthcare literacy. Health literacy was measured 312 times with a variety of established and newly developed instruments. This scoping review highlights progress and challenges concerning health literacy research in Latin America and the Caribbean. The active health literacy research community adopts multiple research strategies, themes and multidisciplinary approaches for adapting health literacy interventions to diverse populations. Brazil and its vibrant health literacy community can inspire the development of health literacy in the region. Ongoing research, policy innovation, and community-based action are needed to maximize health literacy's potential for improving health services, public health, and wellbeing in the region.

Depression is one of the risk factors for chronic digestive system diseases. As a chronic mental disorder, its occurrence and development process is usually slow and gradual, while there are significant individual differences. Depression varies among different individuals in terms of the speed of onset, the stages of the disease course and its manifestations. Therefore, we speculate that this disease will exhibit different disease development trajectories in the population. This study aims to understand the characteristics of the development trajectory of depression among middle-aged and elderly people in China, explore its association with chronic digestive system diseases, and further propose individualized measures to prevent the occurrence of chronic digestive system diseases in people with different development trajectories of depression. This research can provide scientific value for the precise prevention and management of chronic diseases among middle-aged and elderly people. Data for this analysis were sourced from the China Health and Retirement Longitudinal Study (CHARLS), which included 4565 participants aged 45 years and older. Group-based trajectory modelling was used to identify trajectories of depressive symptoms, and multivariable logistic regression was used to assess the association between these trajectories and chronic digestive diseases. Five distinct depressive symptom trajectories were identified: low-stable, moderate-stable, moderate-increase, high-decrease, and high-stable. Compared to the low-stable group, the risks of chronic digestive diseases in the moderate-stable, moderate-increase, high-decrease, and high-stable groups were 1.62(Odds Ratio[OR]&#x2009;=&#x2009;1.62, 95% CI: 1.31-2.00), 2.59(OR&#x2009;=&#x2009;2.59, 95% CI: 1.96-3.41), 3.11(OR&#x2009;=&#x2009;3.11, 95% CI: 2.35-4.10), and 3.41(OR&#x2009;=&#x2009;3.41, 95% CI: 2.40-4.81) times higher, respectively. Subgroup analyses confirmed the robustness of these associations across most groups. In China, five distinct depressive symptom trajectories were identified among middle- aged and elderly people. The more severe and persistent the depressive symptoms were, the higher the risk of developing chronic gastrointestinal diseases. For those experiencing more severe or gradually worsening depressive symptoms, timely mental health intervention is of vital importance. These findings indicate that depression, as a key modifiable risk factor, can alleviate the burden of digestive diseases in the elderly population through early intervention.

This study presents the results of evaluating the pilot implementation of the Lions Quest programme "Skills for Action" (LQSFAc) in the Croatian education system. "Skills for Action" is a prevention programme for social-emotional learning based on the Collaborative for Academic, Social and Emotional Learning framework. This model encompasses intrapersonal, interpersonal, and cognitive aspects of social-emotional well-being that are important at all stages of development. This is the first attempt to evaluate the LQSFAc programme in Croatia, focusing on its outcomes. The aim of the study is to analyse the extent to which the two-year pilot implementation of the programme contributes to the development of students' intrapersonal and interpersonal social-emotional skills. A questionnaire for self-assessment of students' social-emotional skills was used. The programme was introduced on a trial basis in 13 Croatian secondary schools during the 2023/2024 and 2024/2025 school years. This quasi-experimental study includes quantitative data from 326 students who participated in the pre- and post-test (163 students participated in the programme and 163 did not). The data were analysed using descriptive statistics and a multilevel model (mixed linear model with a random effect for the school where the programme was implemented). Students in the LQSFAc classes achieved higher scores in all analysed social-emotional skills in the post-test than students in the comparison classes. The results suggest that the contribution of the LQSFAc programme is most evident in students' social awareness. Implementing the LQSFAc programme in full, which requires a whole-school approach, is essential for achieving better results.

This study evaluated the efficacy of the Claudia Carraro universal prevention program in reducing eating disorder (ED) specific and non-specific risk factors in adolescents. A cluster randomized controlled trial was conducted in Italian secondary schools (N&#x2009;=&#x2009;1205; mean age&#x2009;=&#x2009;15.2&#x2009;&#xb1;&#x2009;0.8&#xa0;years; 65% girls). Schools were randomized to the intervention (three 2.5&#xa0;h sessions delivered over three weeks) or no-intervention control group. Assessments were conducted at baseline and 24-week follow-up; the intervention group was also assessed post-intervention. Primary outcomes were ED psychopathology (Eating Disorder Examination Questionnaire, EDE-Q), self-referred physical activity, and adherence to the Mediterranean diet. Of 938 participants with complete data, no significant overall differences emerged between intervention and control groups. However, subgroup analyses revealed that girls in the intervention group showed significant reductions in EDE-Q global score and shape concern at follow-up compared with controls EDE-Q global scores decreased in the intervention group (2.1-1.9) but not in controls (1.9-1.9; p&#x2009;=&#x2009;0.028), with similar effects for shape concern (2.9-2.6 vs. 2.6-2.6; p&#x2009;=&#x2009;0.017). In secondary analyses, girls maintained reductions in ED concerns from post-intervention to follow-up, whereas boys showed short-term improvements that were not sustained. The Claudia Carraro program did not demonstrate significant overall effects on eating disorder risk factors. Exploratory findings suggest small gender-specific effects among girls, but these should be interpreted cautiously given the limited effect sizes and underpowered subgroup analyses. Further research should evaluate targeted or gender-adapted approaches and longer-term outcomes.