I don't know why, but I always seem to write better when it rains. How can that be? Maybe it's the rhythm of the sound of the rain falling on the roof windows in my office. I also normally write with music on - it seems to have some background noise against which to work and think - having absolute silence is no good for me, though I know for many others it's essential. I once met an academic who had the radio and TV on in the background when she wrote.
... I was not writing at all. Ironing a shirt, I suddenly found the answer to a problem - how to strengthen the discussion section in a paper. Shirt - poorly ironed; - writing idea - fairly good I think.
Maybe it's the old one of the mind working away at things when you're not asking it too. Now just have to get the ironing right.
James Taylor once said: "I don't read music. I don't write it. So I wander around on the guitar until something starts to present itself.
My Day 2 highlight from the conference was the excellent parallel session on school health. Chris Bonell gave a paper on the results of a systematic review of school effects on pupils’ health. One key finding was that ‘valued added’ schools (which had higher attainment and lower truancy levels than might be expected) had better health outcomes. He suggested that this might be because these ‘authoritative’ schools provide support and control which engage pupils in school-based identities.
In the same session Yoland Anyon discussed the differing levels of school-based service utilisation among different ethnic groups. One conclusion was that students from Asian backgrounds had lower levels of service use, perhaps because staff were less likely to pick up their internalising behaviours, as opposed to more externalising behaviours which were more prevalent among other groups. This seemed to match very closely some of the key findings I identified whilst recently reviewing the literature on school-based mental health services. Jamie Dowdy presented the third paper in the session, which examined differing levels of engagement with extra-curricular activities in school.
At lunchtime I led a ‘brown bag’ discussion group (though there were no brown bags) on developing and evaluating complex interventions. A key issue that we discussed concerned the challenges around selecting which prevention interventions to adopt, when many share overlapping content. Should we be thinking about sharing and replicating programmes, or the principles that form their basis?
As well as the plenary and parallel sessions in the afternoon, there was also another poster session in the evening. These sessions always seem to be well attended, and with authors standing by their poster are a great way to ask questions about people’s work, and more generally promote knowledge exchange.
Finally on Day 2 there was the conference dance, with music provided by the Mothers of Prevention band (all conference delegates). Great music, and all the more impressive given that they only get to practice together a couple of times a year. And as with other aspects of the conference, a very inclusive feeling, with the opportunity to meet new people.
And so to Friday. I started off in a session looking at how prevention interventions aimed at preventing substance misuse in adolescents can have longer term impacts on the health and wellbeing of young adults. The presentations by Richard Spoth, Mark Eddy and Marie-Héléne Verénneau examined three different interventions – Strengthening Families Programme 10-14, LIFT and Family Check-up. Given the challenges of retaining participants in trials, the follow-up data presented – some of which was around 10 years after initial recruitment, was impressive. I also learnt more in Hélène’s presentation of how CACE analysis is undertaken to look at the outcome of participants who engaged (or would have engaged with) the intervention being evaluated.
Friday morning’s plenary had three quite different presentations. Megan Gunnar discussed how early adversity in childhood can affect neurological and physiological development, but that nurturing and attachment can act as a buffer. Irwin Sandler examined the effects of the NBP parenting intervention. Whilst this had positive effects only on parenting and externalising behaviours at 6 months, there were a much larger number of effects at long term follow-up, and better impacts for high risk families. Next came what for me was probably one of the best talks of the whole conference. Carl Castro gave an overview of the US army’s attempts to improve the psychological health of soldiers returning from deployment.
After lunch I headed to a session which comprised four short papers on different aspects of the development and evaluation of Familias Unidas a parenting intervention for Latino families in the US. One of the key take home messages from this session was that interventions which attempt to change/impact one behaviour or outcome have the potential to influence others which they never intended to modify. In this case, there appeared to be some increase in physical activity among youth from families with low parental involvement at baseline. It was also interesting to see not only mediation and moderation being incorporated into analyses, but also moderated mediation.
For the final session of the day, and the conference, I chaired a session of three papers concerned with different aspects of alcohol consumption. The first by Kerry Lippy examined how alcohol policies around alcohol consumption or social norms/social disorganisation have the potential to reduce alcohol-related sexual violence. The second paper by Kate Karriker-Jaffee was concerned with how neighbourhoods socio economic characteristics might affect negative consequences of drinking, and using a moderated mediation analysis looked at the role of economic distress, affluence, and drinking norms. Finally, Eileen Pitpitan reported the findings of a survey of clients of female sex workers in Mexico, which examined whether place of sex moderated the association between alcohol consumption and condom use. The key finding was that sex in bars/clubs was more likely to take place without condom use.
And then it was time to head to the airport. I got a lot out of the four days of the conference. Key highlights and things I learnt were perhaps the following:
So that’s me done. I hope to go back next year – it was worth the journey and the jetlag to come away with new ideas and connections. Now the challenge is to try and harness them in my own work.
So writing a conference diary each day seemed like a good idea. But it didn’t prove to be as easy as I thought, maybe because I was too busy ... well, doing the conference.
My pre-conference day was spent doing all things international. In the morning I attended my first meeting of the Advisory Group for the Society for Prevention Research’s International Task Force. It was good to hear about what the Task Force is doing to help facilitate and promote international collaboration.
The afternoon was taken up with the International Networking Forum (organised by the International Taskforce). It’s a great idea, as it helps connect prevention researchers from different countries, and is an excellent way to make people feel welcome. This meeting included an overview of what the International Task Force would be working on during the coming year, the four priorities being:
Some highlights for me were the discussions we had about the challenges of international collaboration, potential sources of help (such as the International Association of Addiction Journals mentorship scheme), the work of the UN ODC which tries to ensure prevention is based on research and evidence, and the plans for the future development of the EU SPR.
Then it was time for the international poster session, at which I was presenting our work on an exploratory trial of the Kids, Adults Together Programme.
So, then to Wednesday – day 1 of the main conference.
A fantastic start, with some really good plenary papers on the crucial role of the social and environmental determinants of health. Leonard Syme argued that social class is often controlled for in studies, but rarely studied. His key point was that we have to move away from a narrow focus on individual behaviours and risk factors. Sandro Galea described the need to avoid allowing the 'urgent' crowd out the 'important', and suggested that focusing on individual behaviour interventions (rather than looking at social determinants) was a form of 'riveting distraction'. He made the point that unless we address social determinants we will always have social gradients.
Then was a parallel session on engaging high risk youth and their families into preventive interventions. The papers in this session and the interesting summary at the end highlighted the importance of understanding what we mean by engagement, and how best to promote it.
After lunch there was an excellent session on the transportability and adaptation of parenting interventions. Frances Gardner from Oxford University presented the results of a systematic review which examined the effectiveness of interventions in new countries (i.e. countries to which they had been transported from their original place of development). The take home message was that the four interventions included in the studies reviewed indicated that they were at least as effective in the new country - sometimes more so, with stronger effects in non Western countries. Helen Baker Henningham described the adaptation of Incredible Years for Jamaican schools, and highlighted the importance of understanding the environments in which teachers worked, and how to optimise the intervention so that they could implement it fully.
In the last parallel session of the day I attended, Jonathan Pettigrew gave an interesting paper on the relationship between implementation quality and the outcomes in a trial of Keepin It Real - a school-based substance misuse prevention intervention. His results indicated that the quality of intervention delivery mattered as much (if not more so) than levels of adherence (the extent to which all programme activities were delivered).
So what have I learnt so far? It's striking just how much research at the conference has been about parenting and family relationships, and it brings home for me the real impact which processes like parental communication can have on young people's health and wellbeing. Secondly, sometimes our research findings can surprise us and raise questions as well as answers. Why for instance, should programmes which are adapted for new countries be more effective than in their original country of development? Thirdly, studying implementation is crucial - it tells us so much about how our interventions work, the contexts they operate within.
So less of a conference diary, and a more a rather random set of thoughts. I think the best thing about this conference is the willingness of people to talk to others - to share,and to ask questions.
Arrived in San Francisco this evening for the annual conference of the Society for Prevention Research. I'll be blogging my conference diary here. Spent the flight over from the UK doing some writing, and watched a documentary - Dust Bowl, on the depression and drought that hit the Mid West of the USA in the 1930s. A powerful account of how desperate life became for people, and the resilience of both the families who stayed to try and make a living in what had become a desert, and those who left for other parts of the country.
So here's an idea I had last night. How about a #PublicHealth Day on Twitter? A day when everyone who works in, studies, or takes an interest in public health, tweets interesting stuff, and uses a suitable hashtag (#PublicHealth, PublicHealth13)? And the people who are already tweeting interesting stuff just carry on, but include the hashtag every time they tweet.
The aim would be to get #PublicHealth trending on Twitter, to raise awareness (and engagement with) the work that researchers, policy makers and practitioners are doing, and to generate lots of new followers for public health tweeters. We could do it in the summer on a 'slow news' day, and hopefully get some media attention.
Has anyone ever done this? Is it a good idea, and would you be up for it?