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.
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:
- International collaboration (or at least dissemination or knowledge exchange?) has a key role to play in enhancing our understanding of what works, where, and how it works.
- We need to embrace the complexity of prevention interventions. They can have a range of intended (and sometimes unintended) outcomes, and these may differ between different groups.
- We sometimes need to move beyond trying to change one behaviour or a narrow aspect of health/wellbeing and embrace connections and systems. At the very least we need to understand how something like parenting, school attachment, or physical activity, sits within a broader network of causal pathways.
- What works in one place doesn't necessarily work in another place, but sometimes it can do.
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.