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Possible role of caffeine in nicotine use onset among early adolescents. Evidence from the Young Mountaineer Health Study Cohort : Evidence from the Young Mountaineer Health Study Cohort
(2023-05-11) Kristjansson, A.L.; Kogan, S.M.; Mann, M.J.; Smith, M.L.; Lilly, C.L.; James, J.E.; Department of Psychology
Background Preventing nicotine use onset among children and youth is an important public health goal. One possible contributor that has received little empirical investigation is caffeine use. The goal of this study was to examine the possible contribution of caffeine to nicotine onset during early adolescence. Methods We used data from the Young Mountaineer Health Study Cohort. Survey data were collected from 1,349 (response rate: 80.7%) 6th grade students (mean age at baseline 11.5 years) in 20 middle schools in West Virginia during the fall of 2020 and spring of 2021. We limited our analyses to students reporting never having used any form of nicotine at baseline. Logistic regression was employed in analyses. Results Approximately 8% of participants reported having used nicotine at least once between baseline and the follow-up, and 4.7% reported solely using electronic nicotine delivery systems (ENDS) and no other forms of nicotine. In multivariable analyses, we controlled for many environmental, social, and behavioral variables known to influence nicotine use such as alcohol use, peer substance use, and perceived access to nicotine. We formulated our main independent variable, caffeine consumption, as continuous deciles. Any nicotine use, as well as ENDS use only at follow-up, were modeled as dependent variables. Caffeine was significantly associated with nicotine use in both models with ORs of 1.15 (1.04-1.27) and 1.13 (1.00-1.28). Conclusions Caffeine consumption among 6th grade non-nicotine users was associated with nicotine use at approximately 6-months follow-up.
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Preliminary Impact of the Adoption of the Icelandic Prevention Model in Tarragona City, 2015-2019: A Repeated Cross-Sectional Study : A repeated cross-sectional study
(2023) Meyers, C.A.; Mann, M.J.; Thorisdottir, I.E.; Garcia, P.R.; Sigfusson, J.; Sigfusdottir, I.D.; Kristjansson, A.L.; Department of Psychology
Background: There is a great need for effective primary prevention intervention strategies to reduce and delay onset of adolescent substance use. The Icelandic Prevention Model (IPM) showed great success in Iceland over the past twenty plus years, however, evidence for the transferability of model is still somewhat limited. Using data collected in Tarragona during regional efforts to begin adoption of the IPM in Catalonia, this study tested the transferability and stability of the core risk and protective factor assumptions of the IPM overtime and examined trends of lifetime smoking, e-cigarette-use, alcohol-use, intoxication, and cannabis-use within the same time period. Methods: This study includes responses from 15- to 16-years-olds from two region-wide samples taken in 2015 and 2019 in Tarragona (N = 2,867). Survey questions assessed frequency of lifetime: smoking, e-cigarette-use, alcohol-use, intoxication, and cannabis-use, and the core model assumptions. Demographic data were also collected. Logistic regression models of main effects with and without time interaction were used to test assumptions and their stability across time. Chi-square tests and Wilcoxon–Mann–Whitney U tests were used to compare prevalence of substance use and mean scores of primary prevention variables respectively. Results: Lifetime: smoking (−7%, p < 0.001) and cannabis-use (−4%, p < 0.001) decreased, and e-cigarette-use increased (+33%, p < 0.001) in Tarragona. Lifetime intoxication (−7%, p < 0.001) decreased in a single zone exclusively. Most core model assumptions held in their hypothesised direction across time. The strongest positive association was observed between time spent with parents during weekends and reduced odds of lifetime smoking (OR: 0.62, 95%CI: 0.57–0.67) and the strongest negative association was observed between being outside after midnight and increased odds of lifetime intoxication (OR: 1.41, 95%CI: 1.32–1.51). Mean scores of primary prevention variables also changed disproportionately in Tarragona. Conclusion: This study confirms that the core IPM assumptions are similar in Tarragona as in Iceland and other contexts previously examined. They also indicate that prevalence of lifetime smoking, intoxication, and cannabis-use decreased disproportionately in Tarragona between 2015 and 2019 during the first phase of regional adoption of the model. Thus, targeting model assumptions represents a viable primary prevention strategy for communities that hope to reduce smoking, alcohol-use, intoxication, and cannabis-use among adolescents.
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Examining the implementation of the Icelandic Model for Primary Prevention of Substance Use in a Rural Canadian Community: A study protocol : A study protocol
(2020-08-14) Halsall, T.; Lachance, L.; Kristjansson, AL.; Department of Psychology
Background: The Icelandic Prevention Model (IPM) is a collaborative upstream model that was designed to influence risk and protective factors related to substance use within the community, school, peer and family contexts. By engaging whole communities, the IPM has been found to be effective in reducing youth substance use behaviours across Iceland. As an extension to the IPM's participatory approach, this research will examine how youth involvement can enhance outcomes. In addition, this research will evaluate whether the IPM approach is beneficial for mental health promotion and general youth wellbeing. Methods: The present research protocol applies the bioecological model within a participatory mixed-method case study design to examine the implementation of the IPM in a rural community in Canada. This study was designed to identify whether the Icelandic substance use prevention model is effective in reducing substance use and promoting mental health and development for Canadian youth. It will also explore how to engage youth within the approach and how this adaptation influences implementation and outcomes. Discussion: The findings from this study will contribute to our understanding of upstream prevention of youth substance use and will be used to support scaling of the IPM across Canada.
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Implementación del Modelo Islandés para la Prevención del Uso del Sustancias en Adolescentes
(2020-02) Kristjansson, AL.; Mann, MJ.; Sigfusson, J.; Thorisdottir, IE.; Allegrante, JP.; Sigfusdottir, ID.; Department of Psychology
Esta es la segunda de una serie de dos partes de artículos sobre el Modelo Islandés de Prevención Primaria del Uso de Sustancias (MIP) en Health Promotion Practice. El MIP es una estrategia comunitaria colaborativa que ha demostrado notable efectividad en reducir el inicio del uso de sustancias entres jóvenes de Islandia en los últimos 20 años. Mientras el primer artículo se enfocó en el contexto de fondo, orientación teórica, evaluación y evidencia de su efectividad, y los cinco principios guías del modelo, este segundo artículo describe los 10 pasos centrales en la implementación práctica. Los pasos 1 a 3 se enfocan en cómo construir y mantener la capacidad comunitaria para la implementación del modelo. Los pasos 4 a 6 se enfocan en cómo implementar un sistema riguroso de recolección de datos, como procesarlos, la diseminación de los datos y la traducción de los hallazgos. Los pasos 7 a 9 están diseñados para enfocar la atención de la comunidad y para maximizar el compromiso comunitario en crear y mantener un medioambiente social en el cual la gente joven progresivamente se hace menos proclive a consumir sustancias, e incluye ejemplos ilustrativos de Islandia. Y el paso 10 se enfoca en la naturaleza iterativa, repetitiva y de largo plazo del MIP y describe un amplio y predecible arco de oportunidades y desafíos relacionados con la implementación. Este artículo concluye con una breve discusión sobre las potenciales variaciones en los factores comunitarios para la implementación.
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Barriers to Using Clean Needles Encountered By Rural Appalachian People Who Inject Drugs: Implications for Needle Exchange : Implications for needle exchange
(2019-04-02) Davis, SM.; Kristjansson, AL.; Davidov, Danielle; Zullig, K.; Baus, A.; Fisher, M.; Department of Psychology
Background: Using a new needle for every injection can reduce the spread of infectious disease among people who inject drugs (PWID). No previous study has examined new needle use barriers among PWIDs residing in the rural Appalachian part of the United States, an area currently in the midst of a heroin epidemic. Objective: Therefore, our primary aim was to explore self-reported barriers to using a new needle by PWID attending a needle exchange program (NEP). Methods: We conducted a cross-sectional survey of PWID attending two NEPs in rural West Virginia located in the heart of Central Appalachia. A convenience sample of PWID (n = 100) completed the Barriers to Using New Needles Questionnaire. Results: The median number of barriers reported was 5 (range 0-19). Fear of arrest by police (72% of PWID "agreed" or "strongly agreed") and difficulty with purchasing needles from a pharmacy (64% "agreed" or "strongly agreed") were the most frequently cited barriers. Conclusions/Importance: Congruent with previous findings from urban locations, in rural West Virginia, the ability of PWID to use a new needle obtained from a needle exchange for every injection may be compromised by fear of arrest. In addition, pharmacy sales of new needles to PWID may be blunted by an absence of explicit laws mandating nonprescription sales. Future studies should explore interventions that align the public health goals of NEPs with the occupational safety of law enforcement and health outreach goals of pharmacists.

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