BackgroundAlcohol intoxicated adolescents (AIA) in emergency department are an important target group for prevention and valid information on their familial risk and protective factors (RPF) is crucial for implementing customized family-based counseling in hospitals. We therefore, examined the psychometric characteristics of scales which assess familial RPF.MethodsWe used seven family scales from the Communities That Care Youth Survey Instrument (CTC-F7); four assess risk factors: family conflicts, poor family management, parental attitudes favorable towards drug use/antisocial behavior; three assess protective factors: family attachment, opportunities and rewards for prosocial involvement. To assess physical and emotional abuse and emotional neglect, we created a new scale composed of six items from the Childhood Trauma Questionnaire (CTQ-6). We tested these eight scales on 342 AIA aged 13-17. Based on the classical test theory we calculated descriptive item and scale statistics and internal consistency. We assessed construct validity by confirmatory factor analysis with Maximum Likelihood (ML) estimation in a sample with imputed missing values (EM-Algorithm). To check robustness, we repeated the analyses with complete cases, with multiple imputed data, and with methods suitable for categorical data. We used SPSS 21, AMOS 21 and R (randomForrest and lavaan package).ResultsThree of seven CTC-F scales showed poor psychometric properties in the descriptive analysis. A ML-confirmatory model with five latent factors fitted the remaining CTC-F scales best (CTC-F5). The latent structure of the CTQ-6 is characterized by three first-order factors (physical abuse, emotional abuse, emotional neglect) and one second-order factor. The global goodness-of-fit indices for the CTC-F5 and the CTQ-6 demonstrated acceptable fit (for both models: TLI and CFI>0.97, RMSEA<0.05). The confirmatory evaluation based on complete cases (n=266), on multiple imputed data, and with alternative estimation methods produces global and local model-fit indices that are comparable to those from the main analysis. The final subscales CTC-F5 and CTQ-6 show acceptable to good internal consistency (α>0.7).ConclusionsThe final CTC-F5 and the newly developed CTQ-6 demonstrate acceptable to good psychometric properties for the AIA sample. The CTC-F5 and the CTQ-6 facilitate a psychometrically sound assessment of familial RPF for this vulnerable and important target group for prevention.

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BackgroundThere are multiple negative consequences associated with heavy episodic drinking and close associations between substance abuse and depression, alcohol-intoxicated adolescents (AIA) represent a vulnerable group. We aim to add to the current literature by investigating the cross-sectional relationship of perceived familial protective factors with depressive symptoms in AIA in hospitals, with respect to sex. Depression is among the 10 leading causes of disabilities during childhood and adolescence, with girls being more vulnerable than boys. Considerable evidence reveals a strong association between depression and alcohol abuse. The family provides the possibility to positively influence depressive symptoms.MethodsWe present cross-sectional data of a German multisite, epidemiological cohort study on AIA. By using youth’s self-reports, we assessed sociodemographic data, as well as data on perceived familial protective factors and depressive symptoms using items of the Communities that Care Youth Survey instrument. We performed descriptive and multigroup analyses to evaluate the measurement invariance of the used instruments. Moreover, to investigate the relationships between the constructs, we used structural equation modelling.ResultsThe study sample comprised 342 AIA, with a mean age of 15.5 years (SD = 1.2; 48.1% girls). The final structural equation model achieved an acceptable model fit of χ2 (69, 342) = 110.056; p = .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.046; SRMR = 0.042, and the rewards for prosocial involvement in the family context correlated significantly negatively with present depressive symptoms, (ß = − 0.540, p <  0.001). The effects were stronger in boys (ß = − 0.576, p <  0.001) than in girls (ß = − 0.519, p <  0.001).ConclusionIn vulnerable youth in Germany, depressive symptoms are correlated to good experiences within the family. Future research should assess whether interventions that enhance parental support reduce the risk of depressive symptoms in AIA. Our findings highlight the need for family-based prevention programmes, particularly for AIA with an increased risk of depression.

Purpose The purpose of this paper is twofold: first, to introduce MEDIA PROTECT, a multi-modal intervention for parents and teachers with six components preventing problematic, and in the long run addictive, use of screen media by children; second, to present results of a formative evaluation of the teacher training, an important component of the intervention. Design/methodology/approach In presenting the intervention, the authors used a common framework to describe complex interventions systematically. For the evaluation, participants were recruited from German schools and kindergarten for a cluster-controlled trial. As part of a formative evaluation, the participants completed written questionnaires to determine the importance of different components of the intervention in addition to their overall satisfaction. Additional qualitative interviews with teachers were conducted. Findings The authors recruited n=50 kindergartens and n=9 schools; n=30 received the intervention. N=222 teachers participated in the training and n=192 completed the questionnaire (86 per cent). Seven qualitative interviews were conducted. Participants exhibited high levels of overall satisfaction with the training, considered it moderately to highly relevant to their work, and exhibited varying satisfaction levels with different components and multipliers. The qualitative data support these findings. Originality/value Few interventions to date have pursued a universal approach to the prevention of problematic screen media use. This evaluation of MEDIA PROTECT is the most recent study in Germany, which involves a complex programme through which teachers are taught ways to promote the age-adequate use of screen media in the family, parents are provided with guidance and healthy leisure time activities for children are fostered.

Zusammenfassung. Hintergrund: Geschätzt ist etwa ein Drittel der Jugendlichen, das aufgrund einer akuten Alkoholintoxikation im Krankenhaus ist, in seiner Entwicklung gefährdet. Es ist jedoch wenig bekannt über Art und Umfang von Entwicklungsgefährdungen (EG) und familialen Schutzfaktoren zum Zeitpunkt der Intoxikation und deren prognostischer Relevanz. Methode: Prospektive, multizentrische Kohortenstudie mit zwei Erhebungszeitpunkten bei alkoholintoxikierten Jugendlichen (12 – 18 Jahren). Erhoben werden im Krankenhaus (T0) Angaben zu Risiko-, Schutzfaktoren und EG (CTC-Survey). Sechs Monate später (T1) werden ausschließlich zwischenzeitlich eingetretene EG erfragt. Mittels multipler logistischer Regression prädizieren wir in den 6 Monaten nach der Entlassung aus dem Krankenhaus eingetretene EG. Ergebnis: Von den n = 228 zu beiden Zeitpunkten erreichten Jugendlichen, weisen 45,2 % zum Zeitpunkt des Krankenhausaufenthaltes zwei und mehr EG (aktuell/ lebenszeitlich) auf. In den 6 Monaten später sind es 22,4 % (nur aktuell). Bei Jugendlichen mit zwei zu T0 bestehenden EG erhöht sich das Risiko für eine mittelfristige starke Gefährdung um das Fünffache (RR: 5,0 95 %-Konfidenzintervall 2,6 – 9,5). Unter Ausschluss von EG aus dem Modell zeigt sich die Wirkung familialer Schutzfaktoren. Schlussfolgerung/Diskussion: EG sind zum Zeitpunkt des Krankenhausaufenthaltes verbreitet und erhöhen die Wahrscheinlichkeit für mittelfristig eintretende Gefährdungen.