The Dunedin Study - DMHDRU

Publications

All peer reviewed publications are listed below.

Displaying page 13 of 23.

Chlamydia pneumoniae serological status is not associated with asthma in children or young adults | 2000
Mills, G.D., Lindeman, J.A., Fawcett, ... Show all » J.P., Herbison, G.P., Sears, M.R. « Hide
International Journal of Epidemiology, 2000, 29(29), 280-284.
Our ref: RO350
Show abstract » BACKGROUND: The factors that cause the allergic sensitization and inflammation in asthma still remain to be clarified. A role for Chlamydia pneumoniae has been suggested although serological studies have produced conflicting findings. This study aims to clarify the relationship between asthmatic variables and C. pneumoniae serological status. METHODS: A case-control study was undertaken on an asthma-enriched subset from a longitudinal birth cohort. In all, 198 subjects (96 with self-reported asthma) had C. pneumoniae serology (microimmunofluorescence [MIF] IgG, IgA) undertaken at age 11 and age 21 and assessment made in relation to a number of asthma variables. RESULTS: The only statistically significant finding was in subjects self-reporting asthma at age 21 who had evidence of lower IgG titres (P = 0.046), a finding in the opposite direction to that expected from the hypothesis. Subjects with high IgG titres (> or =128) were less likely to have reported ever having asthma; odds ratio (OR) = 0.29, (95% CI: 0.10-0.87). No association existed between symptoms suggestive of asthma in the previous 12 months and either IgG (P = 0.127) or IgA (P = 0.189) antibody titres at age 21. Likewise, no association was found between symptoms suggestive of asthma in the previous two years and C. pneumoniae IgG antibody titre (P = 0.81) at age 11. There was no evidence of an association with any of the other variables examined at either age 11 or age 21. These included use of inhaled steroids, serum IgE levels, airway responsiveness, skin test evidence of atopy, or smoking status. CONCLUSION: The results of this study suggest that C. pneumoniae infection when diagnosed by MIF serology is not a major risk factor for the development of asthma in children and young adults. The study has not, however, addressed the role this organism may play in specific asthmatic subsets or asthma exacerbations.
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A longitudinal study of cannabis use and mental health from adolescence to early adulthood | 2000
McGee, R., Williams, S.M., Poulton, ... Show all » R., Moffitt, T.E. « Hide
Addiction, 2000, 95(95), 491-503.
download pdf Our ref: RO349
Show abstract » AIMS: To examine the longitudinal association between cannabis use and mental health. DESIGN: Information concerning cannabis use and mental health from 15 to 21 years was available for a large sample of individuals as part of a longitudinal study from childhood to adulthood. PARTICIPANTS: Participants were enrolled in the Dunedin Multidisciplinary Health and Development Study, a research programme on the health, development and behaviour of a large group of New Zealanders born between 1 April 1972 and 31 March 1973. MEASUREMENTS: Cannabis use and identification of mental disorder was based upon self- report as part of a general assessment of mental health using a standard diagnostic interview. Daily smoking and alcohol use at age 15 were assessed by self-report. Indices of family socio-economic status, family climate and parent-child interaction were formed using information gathered from parent report and behavioural observations over early childhood. Childhood behaviour problems were assessed by parent and teacher report. Attachment to parents was assessed in adolescence. FINDINGS: Cross-sectional associations between cannabis use and mental disorder were significant at all three ages. Both outcome variables shared similar pathways of low socio-economic status and history of behaviour problems in childhood, and low parental attachment in adolescence. Mental disorder at age 15 led to a small but significantly elevated risk of cannabis use at age 18; by contrast, cannabis use at age 18 elevated the risk of mental disorder at age 21. The latter association reflected the extent to which cannabis dependence and other externalizing disorders at age 21 were predicted by earlier level of involvement with cannabis. CONCLUSIONS: The findings suggest that the primary causal direction leads from mental disorder to cannabis use among adolescents and the reverse in early adulthood. Both alcohol use and cigarette smoking had independent associations with later mental health disorder.
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The child is the father of the man: Personality continuities from childhood to adulthood | 2000
Caspi, A.
Journal of Personality and Social Psychology, 2000, 78(78), 158-172.
Our ref: RO348
Show abstract » This article presents findings about continuities in personality development that have been uncovered in the Dunedin Study. At age 3, children were classified into temperament groups on the basis of observations of their behaviour. In young adulthood, data were collected from Study members themselves, from people who knew them well, and from official records. Undercontrolled 3-year-olds grew up to be impulsive, unreliable and antisocial, and had more conflict with members of their social networks and in their work. Inhibited 3-year-olds were more likely to be unassertive and depressed and had few sources of social support. Early appearing temperamental differences have a pervasive influence on life-course development and offer clues about personality structure, interpersonal relations, psychopathology, and crime in adulthood.
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The inter-relationship of indices of body composition and zinc status in 11 year old New Zealand children | 2000
Gibson, R.S., Skeaff, M., Williams, ... Show all » S.M. « Hide
Biological Trace Element Research, 2000, 73(73), 65-77.
Our ref: RO338
Show abstract » Serum zinc and hair zinc concentrations of some New Zealand children aged 11 years, were examined in relation to selected anthropometric indices. Serum zinc concentrations (n=453) in boys and girls were similar, and unrelated to anthropometric indices and hair zinc concentrations. Mean hair zinc concentration (n=620) of the girls was higher than that for the boys (2.95 ± 0.49 vs. 2.46 ± 0.47 mmol/g; p<0.001). Correlation analysis demonstrated that, for the boys, all the studied anthropometric indices with the exception of height, were significantly related to hair zinc composition and that the confounding effects of mid-parent height and the timing of the adolescent growth spurt are small. Results for the girls were similar but less significant. Dichotomizing the hair zinc results divided both the boys and girls into two groups: those with hair zinc < 2.44 mmol/g were heavier (girls 39.0 v 35.2 kg, boys 36.6 v 34.7 kg) and fatter (mid-upper-arm fat area: girls 15.2 v 12.0 cm2, boys 11.1 v 9.5 cm2) compared to their counterparts with hair zinc >2.44mmol/g. The results demonstrate that in these healthy New Zealand children, those with lower hair zinc concentrations are fatter and heavier than their high hair zinc counterparts.
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Road traffic practices among a cohort of young adults in New Zealand | 1999
Begg, D.J., Langley, J.D.
New Zealand Medical Journal, 1999, 112(112), 9-12.
Our ref: NZ76
Show abstract » Aim: To describe the road safety practices of young adults in New Zealand. Method: Face to face structured interviews, seeking information on a range of road safety practices, were conducted with 948 members of the DMHDS cohort when they were 21 years old. Results: In the 30 days before the interview, 49% of the males and 32% of the females reported driving within two hours of drinking alcohol; 19% males and 8% females reported driving after drinking too much to perhaps be able to drive safely; and 25% males and 9% females reported driving after using marijuana. Also, 25% males and 6% females reported that they often drove fast just for the thrill of it, and 38% males and 11% females reported often driving faster than 120 kph on the open road. Seatbelt use as a driver was reported as always or nearly always by 87% of the males and 95% of the females, but as a rear seat passenger it was 34% for males and 47% for females. Conclusions: Unsafe road traffic practices, especially among males, were unacceptably high. Continued efforts are required to find new ways of addressing these issues.
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Low self-control, social bonds, and crime: social causation, social selection, or both? | 1999
Wright, B.R., Caspi, A., Moffitt, ... Show all » T.E., Silva, P.A. « Hide
Criminology, 1999, 37(37), 479-514.
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Our ref: RO347
Show abstract » This article examines the social-selection and social-causation processes that generate criminal behavior. We describe these processes with three theoretical models: a social-causation model that links crime to contemporaneous social relationships; a social-selection model that links crime to personal characteristics formed in childhood; and a mixed selection-causation model that links crime to social relationships and childhood characteristics. We tested these models with a longitudinal study in Dunedin, New Zealand, of individuals followed from birth through age 21. We analyzed measures of childhood and adolescent low self-control as well as adolescent and adult social bonds and criminal behavior. In support of social selection, we found that low self-control in childhood predicted disrupted social bonds and criminal offending later in life. In support of social causation, we found that social bonds and adolescent delinquency predicted later adult crime and, further, that the effect of self-control on crime was largely mediated by social bonds. In support of both selection and causation, we found that the social-causation effects remained significant even when controlling for preexisting levels of self-control, but that their effects diminished. Taken together, these findings support theoretical models that incorporate social-selection and social-causation processes.
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Validity of self-reported crashes and injuries in a longitudinal study of young adults | 1999
Begg, D.J., Langley, J.D., Williams, ... Show all » S.M. « Hide
Injury Prevention, 1999, 5(5), 142-144.
Our ref: RO346
Show abstract » OBJECTIVES: The aim of this study was to determine the validity of self report as a source of information on crashes and injuries. SETTING: This study was part of the Dunedin Multidisciplinary Health and Development Study (DMHDS), which is a longitudinal study of the health, development, and behaviour of a cohort of young New Zealanders. METHOD: At the age 21 assessment DMHDS study members were asked to report serious injury and motor vehicle traffic crashes experienced over the previous three years. The self reported injuries were compared with the New Zealand Health Information Service (NZHIS) public hospital discharge file to determine the completeness of the self reported data. The traffic crashes were compared with the police traffic crash reports to determine the accuracy of self reported crash details. RESULTS: Twenty five (86%) of the 29 unintentional injuries, six (67%) of the nine assaults, and one (14%) of the six self inflicted injuries on the NZHIS file were self reported. The level of agreement between the self reported crash details and those recorded on the traffic crash report was high. CONCLUSIONS: The results show that self reports can be a useful and valid source of injury and crash data.
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Relationship between fetal growth and the development of asthma and atopy in childhood | 1999
Leadbitter, P., Pearce, N., Cheng, ... Show all » S., Sears, M.R., Holdaway, M.D., Flannery, E.M., Herbison, G.P., Beasley, R. « Hide
Thorax, 1999, 54(54), 905-910.
Our ref: RO345
Show abstract » BACKGROUND: A study was undertaken to investigate the relationship between birth anthropometric measures and the subsequent development of asthma, airway hyperresponsiveness, and atopy in later childhood. METHODS: A longitudinal study was performed on 734 subjects (71%) from a cohort of children born in Dunedin, New Zealand in 1972-73. The birth anthropometric measures were available from hospital records and the main outcome measures of reported asthma, skin prick tests, and methacholine hyperresponsiveness were measured at the age of 13 years, while the serum total IgE was measured at 11 years. RESULTS: After adjustment for other factors, infants with a larger head circumference at birth tended to have higher serum total IgE at 11 years of age (p = 0.02) but IgE was not associated significantly with birth length or birth weight. The adjusted odds ratio for raised serum IgE (>150 IU/ml) in infants with a head circumference of 37 cm or more was 3.4 (95% CI 1.4 to 7.9). In contrast, recent asthma symptoms were positively associated with birth length (p = 0. 04) but not with head circumference. The adjusted odds ratio for asthma in the previous two years in infants with a birth length of 56 cm or more was 6.4 (95% CI 2.0 to 19.8). Infants with a birth weight of less than 3.0 kg had an odds ratio for reported asthma of 0.2 (95% CI 0.0-0.6). There were no significant associations of any of the birth parameters with skin prick positivity, reported hay fever, or eczema. CONCLUSIONS: These results suggest that increased fetal growth is related to an increased risk of asthma and atopy in childhood. The precision of the findings is limited by the small numbers in the extreme categories of each birth parameter, but the results are consistent with intrauterine programming of the developing respiratory and immune systems.
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Predicting BMI in young adults from childhood data using two approaches to modelling adiposity rebound | 1999
Williams, S.M., Davie, G., Lam, ... Show all » F.C. « Hide
International Journal of Obesity, 1999, 23(23), 348-354.
Our ref: RO344
Show abstract » OBJECTIVE: To identify the age of adiposity rebound and the value of its associated BMI and examine their association with BMI at ages 18 and 21 y for males and females. DESIGN: A longitudinal study of a large cohort of people born in Dunedin, New Zealand between 1972-1973. SUBJECTS: Four hundred and seventy-four males and 448 females aged between birth and 21 y. MEASUREMENTS: BMI was derived from measurements of weight and height made when the participants were born and at intervals from age 3-21 y. RESULTS: When a random coefficients model was fitted to the data for those who had five or more measures of BMI between age 3 and age 18y, adiposity rebound occurred at 6.0 y of age for boys and 5.6y for girls. The values of BMI associated with these were 15.7 kg/m2 for boys and 15.5 kg/m2 for girls. The correlations between age at adiposity rebound and BMI at ages 18 and 21 y were between -0.72 and -0.65 for boys and -0.59 and -0.47 for girls. These were higher than those derived from fitting individual curves or from deriving the adiposity rebound from data collected up to age 11 y. The correlation between BMI at age 7 y and BMI at ages 18 and 21 y were 0.70 and 0.61 for boys and 0.56 and 0.52 for girls. The correlations between measures of skeletal maturity at age 7 y and adiposity rebound were statistically significant for boys but not for girls. CONCLUSIONS: BMI in early adulthood was associated with both age of adiposity rebound and BMI at that age. As the correlations between BMI at age 7 y and BMI at ages 18 and 21 y were similar in magnitude, BMI at age 7 y may be a more practical way of predicting BMI in early adulthood.
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Twins and maternal smoking, ordeals for the fetal origins hypothesis. A cohort study | 1999
Williams, S.M., Poulton, R.
BMJ, 1999, 3(3), 897-900.
Our ref: RO341
Show abstract » OBJECTIVE: To assess the direct and indirect effects of being a twin, maternal smoking, birth weight, and mother's height on blood pressure at ages 9 and 18 years. DESIGN: Longitudinal study. Subjects: Cohort born in 1972-3. Setting: Dunedin, New Zealand. Main outcome measure: Blood pressure at ages 9 and 18 years. RESULTS: Compared with singletons, twins had a systolic blood pressure 4.55 (95% confidence interval 1.57 to 7.52) mm Hg lower at age 9 after adjustment for direct and indirect effects of sex, maternal smoking, mother's height, socioeconomic status, and birth weight, as well as concurrent height and body mass index. Blood pressure in children whose mothers had smoked during pregnancy was 1.54 (0.46 to 2.62) mm Hg higher than in those whose mothers did not. The total effect of birth weight on systolic blood pressure at age 9 was -0.78 (-1.76 to 0.20) mm Hg and that for mother's height was 0.10 (0.06 to 0.14) mm Hg. Similar results were obtained for systolic blood pressure at age 18. The total effect of twins, maternal smoking, and birth weight on diastolic blood pressure was not significant at either age. CONCLUSIONS: Twins had lower birth weight and lower systolic blood pressure at ages 9 and 18 than singletons. This finding challenges the fetal origins hypothesis. The effect of maternal smoking was consistent with the fetal origin hypothesis in that the infants of smokers were smaller and had higher blood pressure at both ages. This may be explained by pharmacological rather than nutritional effects. The total effect of birth weight on systolic blood pressure, after its indirect effect working through concurrent measures of height and body mass index was taken into account, was small.
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Reconsidering the relationship between SES and delinquency: causation but not correlation | 1999
Wright, B.R., Caspi, A., Moffitt, ... Show all » T.E., Miech, R.A., Silva, P.A. « Hide
Criminology, 1999, 37(37), 175-194.
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Our ref: RO336
Show abstract » Many theories of crime have linked low levels of socioeconomic status (SES) to high levels of delinquency. However, empirical studies have consistently found weak or nonexistent correlations between individuals' SES and their self-reported delinquent behavior. Drawing upon recent theoretical innovations (Hagan et al., 1985; Jensen, 1993; Tittle, 1995), we propose that this apparent contradiction between theory and data may be reconciled by recognizing that SES has both a negative and a positive indirect effect upon delinquency that, in tandem, results in little overall correlation between the two. We tested this proposal with longitudinal data from the Dunedin Multidisciplinary Health and Development Study. We used measures of parental SES recorded at Study members' birth through age 15, social-psychological characteristics at age 18, and self-reported delinquency at ages 18 and 21. We found that low SES promoted delinquency by increasing individuals' alienation, financial strain and aggression, and by decreasing educational and occupational aspirations, whereas high SES promoted individuals' delinquency by increasing risk taking and social power, and by decreasing conventional values. These findings suggest a reconciliation between theory and data, and they underscore the conceptual importance of elucidating the full range of causal linkages between SES and delinquency.
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Low socioeconomic status and mental disorders: A longitudinal study of selection and causation during young adulthood | 1999
Miech, R.A., Caspi, A., Moffitt, ... Show all » T.E., Wright, B.R., Silva, P.A. « Hide
American Journal of Sociology, 1999, 104(104), 1096-1131.
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Our ref: RO335
Show abstract » This article examines low socioeconomic status (SES) as both a cause and a consequence of mental illnesses by investigating the mutual influence of mental disorders and educational attainment, a core element of SES. The analyses are based on a longitudinal panel design and focus on four disorders: anxiety, depression, antisocial disorder, and attention deficit disorder. The article shows that each disorder has a unique relationship with SES, highlighting the need for greater consideration of antisocial disorders in the status attainment process and for further theoretical development in the sociology of mental disorders to account for disorder-specific relations with SES.
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Staying in school protects boys with poor self-regulation in childhood from later crime: A longitudinal study | 1999
Henry, B., Caspi, A., Moffitt, ... Show all » T.E., Harrington, H. L., Silva, P.A. « Hide
International Journal of Behavioural Development, 1999, 23(23), 1049-1073.
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Our ref: RO334
Show abstract » Based on a theoretical model that emphasises the distinction between individual and contextual determinants of antisocial behaviour, the current study examined whether school attendance throughout adolescence acted as a protective factor for individuals at risk for criminal behaviour in early adulthood. Specifically, Lack of Control, an index of self-regulation which has previously been shown to predict later criminal behaviour, was expected to interact with early school leaving to predict self-reports and official records of criminal behaviour collected at age 21. Multivariate regression analyses revealed a significant three-way interaction between school attendance, self-regulation, and sex. Among males, after controlling for the effects of socioeconomic status and IQ, the main effects for Lack of Control and school attendance were found to be significant; additionally, the interaction between Lack of Control and school attendance was significant, indicating that the strength of the relation between Lack of Control and criminal outcomes was moderated by school attendance. The main effects for Lack of Control and school attendance were significant for females, but the interaction between Lack of Control and school attendance was not significant. The protective effect of school attendance among males could not be accounted for by differences in familial disruption or adolescent delinquency.
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A longitudinal study of lifestyle factors as predictors of injuries and crashes among young adults | 1999
Begg, D.J., Langley, J.D., Williams, ... Show all » S.M. « Hide
Accident Analysis and Prevention, 1999, 31(31), 1-11.
Our ref: RO328
Show abstract » This study was part of the Dunedin Multidisciplinary Health and Development Study. This is a longitudinal study of the health, development and behaviour of a cohort of 1037 young people born in Dunedin, New Zealand between 1 April 1972 and 31 March 1973. Explanatory measures covering background, behavioural and personality factors were obtained at ages 15 and 18 and were used as potential predictors of outcomes reported at age 21. Four outcomes were considered: any crash, injury crash, non-injury crash, and serious injury (not motor vehicle related). Overall, very few lifestyle factors were important predictors of any of these outcomes. Factors that were shown to predict injury crashes differed from those that predicted non- injury crashes. Also, those that predicted a traffic crash differed from those that predicted a serious non-traffic injury. These results suggest that focusing injury prevention efforts on changing the lifestyles of young adults is unlikely to reduce overall crash risk, and would have little impact on the risk of serious injury.
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Water trauma and swimming experiences up to age 9 and fear of water at age 18: A longitudinal study | 1999
Poulton, R., Menzies, R.G., Craske, ... Show all » M.G., Langley, J.D., Silva, P.A. « Hide
Behaviour Research and Therapy, 1999, 37(37), 39-48.
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Our ref: RO322
Show abstract » A small number of retrospective studies on the etiology of specific fears have obtained findings consistent with a biological (non- associative) explanation of fear acquisition. Unfortunately, reliance on imperfect memory to recall conditioning events which occurred many years earlier limits the conclusions that can be drawn from such data. The present investigation attempts to overcome this methodological shortcoming by examining the relationship between water trauma (i.e. conditioning) and water skills (e.g. swimming) before the age of 9 and the presence of water fear and phobia at age 18 in a longitudinal birth cohort. We found no evidence of a relationship between water confidence and water trauma up to the age of 9 and fear of water at age 18. Similar findings were obtained for water phobia at age 18 with the exception that study members who were less able to immerse themselves in water with confidence at age 9 were more likely to report water phobia at age 18. Associative and non-associative explanations of these findings were discussed.
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Personality traits in late adolescence predict mental disorders in early adulthood: A prospective-epidemiological study | 1999
Krueger, R.F.
Journal of Personality, 1999, 67(67), 39-65.
https://doi.org/10.1111/1467-6494.00047
download pdf Our ref: RO318
Show abstract » Prospective relations between personality traits and mental disorders were assessed in a longitudinal study of a representative birth cohort of young men and women from Dunedin, New Zealand. Personality traits were assessed via self-report questionnaire at age 18, and mental disorders were assessed via diagnostic interview at both ages 18 and 21. High negative emotionality (a propensity to experience aversive affective states) at age 18 was linked with affective, anxiety, substance dependence, and antisocial personality disorders at age 21 when corresponding mental disorders at age 18 were controlled. Low constraint (difficulty inhibiting the expression of affect and impulse) at age 18 was linked with substance dependence and antisocial personality disorders at age 21 when corresponding mental disorders at age 18 were controlled. The findings are discussed in terms of their implications for the development and treatment of mental disorders in young adulthood.
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Iron deficiency and anaemia in a longitudinal study of New Zealanders at ages 11 and 21 years | 1998
Fawcett, J.P., Brooke, M., Beresford, ... Show all » C.H. « Hide
New Zealand Medical Journal, 1998, 111(111), 400-402.
Our ref: NZ75
Show abstract » AIMS: To determine iron status in a longitudinal study of New Zealanders, the Dunedin Multidisciplinary Health and Development Study (DMHDS), at ages 11 (1983-4) and 21 (1993-4). METHODS: Red cell variables were measured in 553 (298 males, 255 females) and 784 (413 males, 371 females) members of the DMHDS at ages 11 and 21, respectively. A total of 456 (259 males, 197 females) members were tested at both ages. Serum ferritin was measured at age 21 only. RESULTS: The prevalence of anaemia in females (haemoglobin < 120 g/L) increased from 3.1% at age 11 to 5.8% at age 21 (pregnant women excluded). There was a significant association between low haemoglobin at age 11 and low haemoglobin at age 21. In males, prevalence of anaemia decreased from 2.3% at age 11 to 0.97% (haemoglobin < 130 g/L) at age 21. The prevalence of iron deficiency (ferritin < 12 ng/mL) at age 21 was 0.24% in men and 6.7% in women. The prevalence of iron deficiency with anaemia at age 21 was zero in men and 2.2% in women. CONCLUSIONS: The prevalences of anaemia and iron deficiency in the DMHDS appear to be low by comparison with similar populations in other countries. Anaemia appears to be a stable trait in young women and screening may be useful for its early detection.
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Physical assault in New Zealand: the experience of 21 year old men and women in a community sample | 1998
Martin, J., Nada-Raja, S., Langley, ... Show all » J.D., Feehan, M., McGee, R., Clarke, J.A., Begg, D.J., Hutchinson-Cervantes, M.E., Moffitt, T.E., Rivara, F.P. « Hide
New Zealand Medical Journal, 1998, 111(111), 158-160.
Our ref: NZ74
Show abstract » AIM: To obtain epidemiological information on physical assault in a high risk group of New Zealanders. METHOD: Rates of physical assault in the preceding twelve months were ascertained by interview in a cohort of 21 year old, Dunedin-born men (n = 482) and women (n = 462). RESULTS: Forty-five percent of the men and one quarter of the women reported at least one physical assault, either completed, attempted or threatened. A small proportion of these received medical treatment. Most serious assaults were by a perpetrator who was thought to have been drinking alcohol. Most assaults on men were by strangers but partners carried out more assaults against women, especially those receiving medical treatment. One quarter of all assaults on women were by other women, compared to 15% of the assaults on men. Differences between patterns of assaults on women and on men are discussed. CONCLUSION: It is important for doctors to be aware of the widespread occurrence of interpersonal violence in New Zealand and its underreporting.
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Caregiving and well-being in a sample of women in midlife | 1998
Knight, R.G., Williams, S.M., McGee, ... Show all » R., Olaman, S. « Hide
Australian and New Zealand Journal of Public Health, 1998, 22(22), 616-620.
Our ref: RO361
Show abstract » A survey of 742 women in midlife found that 12% were involved in the care of another person with a chronic health disorder. Of note was the diversity of circumstances that led to the women becoming caregivers. Further, about a third of the carers were supporting more than one person. Carers did not differ on measures of depression or subjective health ratings from persons not involved in care. Burden scores were predicted by co-residence, low satisfaction with social support, and poorer health ratings on the part of the carers but not by the relationship between the person cared for and the carer.
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Impact of liking for advertising and brand allegiance on drinking and alcohol-related aggression: A longitudinal study | 1998
Casswell, S., Zhang, J.F.
Addiction, 1998, 93(93), 1209-1217.
Our ref: RO343
Show abstract » Aim: To test a hypothesized model of the effect of televised alcohol advertising and allegiance to specific brands of beer on subsequent beer consumption and self-reports of aggressive behaviour linked with drinking. Findings: The hypothesized model assumed a positive impact of liking of alcohol advertising and brand allegiance at age 18 on the volume of beer consumed at age 21 and self-reports of alcohol-related aggressive behaviour. This was found to be a good fit to the data from the longitudinal study. Conclusion: This measurable impact of alcohol advertising occurred during a time of decline in aggregate alcohol in New Zealand. While this effect was not large enough to halt the decline in aggregate alcohol consumption it does indicate a measurable, specific impact of broadcast alcohol advertising on alcohol consumption and related behaviour which is of relevance for public health policy.
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Is mental health in childhood a major predictor of smoking in adolescence | 1998
McGee, R., Williams, S.M., Stanton, ... Show all » W.R. « Hide
Addiction, 1998, 93(93), 1869-1874.
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Our ref: RO342
Show abstract » Aim: To test an extended version of Pomerleau's (1997) hypothesis that children with mental health problems are at higher risk of smoking in preadolescence and adolescence. Findings: None of the potential risk factors of gender, childhood disadvantage or childhood mental health problems predicted onset of smoking in pre-adolescence. Daily smoking at age 15 was best predicted by smoking in preadolescence, being female and experiencing childhood disadvantage. Pre-adolescent mental health was only weakly predictive of later smoking and this association appeared to be confounded with background disadvantage. Conclusions: Little support was found for the extension of Pomerleau's (1997) hypothesis to childhood mental health. The findings also run counter to recent suggestions for targeting smoking prevention at groups of children with mental health disorders.
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Dental caries and changes in dental anxiety in late adolescence | 1998
Kruger, E., Thomson, W.M., Poulton, ... Show all » R., Davies, S., Brown, R.H., Silva, P.A. « Hide
Community Dentistry and Oral Epidemiology, 1998, 26(26), 355-359.
download pdf Our ref: RO340
Show abstract » Little is known about changes in dental anxiety with ageing and their association with changes in oral health. This study examined the relationship between changes in dental caries experience and dental anxiety from 15 to 18 years of age among adolescent participants in the Dunedin Multidisciplinary Health and Development Study. Dental anxiety was estimated using the Corah Dental Anxiety Scale (DAS), and individuals with a DAS score of 13+ were identified as being dentally anxious. Dental examinations were performed on 649 individuals at ages 15 and 18, and a DMFS score was computed for each. Caries prevalence among those who were dentally anxious at both 15 and 18 years was significantly higher than for those who were not at either age. Regression analysis revealed that dental anxiety predicted caries incidence between ages 15 and 18 years. Dental anxiety is likely to be a significant predictor of dental caries experience, and may be a risk factor for dental caries incidence.
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Where young people with multiple sexual partners seek medical care: implications for screening for chlamydial infection | 1998
Dickson, N., Paul, C., Herbison, ... Show all » G.P. « Hide
Sexually Transmitted Infections, 1998, 74(74), 445-447.
Our ref: RO339
Show abstract » Objective: To investigate among young people the relation between the number of sexual partners and use of medical services in order to guide planning of sexually transmitted disease screening. Design: Cross sectional study within a birth cohort using a questionnaire presented by computer. Setting: Dunedin, New Zealand in 1993-4. Subjects: 477 men and 458 women aged 21 enrolled in the Dunedin Multidisciplinary Health and Development Study, comprising 91.7% of survivors of the cohort. Results: Men with multiple sexual partners in the previous year were less likely to have a general practitioner than men with one or no partners (76.2% v 88.5%, p<0.01). Among the women the respective proportions (83.1% and 88.4%) were not significantly different. Significantly more women than men (75.8% v 50.7%, p=0.03) with five or more partners in the previous year had visited their own general practitioner over that period. Among the sexually experienced, more women than men attended any setting appropriate for sexually transmitted disease screening (93.6% v 71.6%, p<0.001). Conclusions: In New Zealand a screening programme for sexually transmitted diseases among young adults reliant on invitation by their own general practitioner would be biased towards those at less risk. Opportunistic screening in general practice would potentially include only about half the most sexually active men and three quarters of such women over a 12 month period. The extension of opportunistic screening to other settings considered appropriate for discussion of sexual health issues could potentially engage the vast majority of women, but not men, at most risk. Any screening programme should incorporate an effective method of finding and treating the sexual partners of infected women.
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A longitudinal investigation of psychological and social predictors of traffic convictions among young New Zealand drivers | 1998
Reeder, A.I., Alsop, J., Begg, ... Show all » D.J., Nada-Raja, S., McLaren, R.L. « Hide
Transportation Research Part F: Traffic Psychology and Behaviour, 1998, 1(1), 25-45.
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Our ref: RO337
Show abstract » The study aimed to determine, irrespective of driver licence status, whether young drivers with traffic conviction records at age 21 years differed from those without, with respect to prior personal characteristics measured around the minimum age of licensure (presently 15 years in New Zealand). From a broad range of psychological and social factors, the strongest and most stable predictors were male gender, part time work, rural residence, marijuana use, estimated driving exposure during the follow up period, and early motorcycle riding. Experiences of riding as a passenger with young drivers or with an alcohol intoxicated adult driver were also significant predictors. Some road safety implications are considered.
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Seroprevalence of Helicobacter pylori in a longitudinal study of New Zealanders at ages 11 and 21 | 1998
Fawcett, J.P., Shaw, J.P., Brooke, ... Show all » M., Walker, A., Barbezat, G.O. « Hide
Australian and New Zealand Journal of Medicine, 1998, 28(28), 585-589.
Our ref: RO333
Show abstract » Background: Helicobacter pylori seroprevalence increases with age in adult life but spontaneous reversion may occur in childhood and adolescence. Aims: To determine the seroprevalence of H. pylori in a longitudinal study of New Zealanders at ages 11 and 21. Methods: Serum from members of the DMHDS at age 11 (n=561; 303 males, 258 females) and 21 (n=785; 413 males, 372 females) was tested for H. pylori antibodies. A large proportion of those tested at age 11 was retested at age 21 (n=465; 262 males, 203 females). Serological status was examined in terms of gender, socioeconomic status (SES) and self-reported use of antibiotics. Results: The seroprevalence of H. pylori decreased by 38% from 6.6% (37/561) at age 11 to 4.1% (32/785) at age 21. Seroprevalence at age 11 was not associated with gender or SES. For those tested at both ages, the drop in seroprevalence from 6.7% to 4.1% was statistically significant (t-2.57, p<0.01, paired t-test) and was much greater in females (71%) than males (12%). Of the 31 seropositive individuals at age 11, 17 (six males, 11 females) seroreverted and self-reported antibiotic use in the year preceeding age 21 was more common in females (8/11) than males (0/6). Of the 434 seronegative individuals at age 11, only five (four males, one female) had seroconverted at age 21. Conclusions: Seroprevalence in the DMHDS declined from age 11 to 21 predominantly in females. The decline involved a greater rate of seroreversion and lower rate of seroconversion in females than males.
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Are young adults checking their skin for Melanoma? | 1998
Douglass, H.M., McGee, R., Williams, ... Show all » S.M. « Hide
Australian and New Zealand Journal of Public Health, 1998, 22(22), 562-567.
Our ref: RO331
Show abstract » This study examined the prevalence and predictors of self screening for melanoma in a large sample of young New Zealanders. A self-report questionnaire was administered to a sample of 909 21-year-olds to investigate if young adults check their skin for changes in lesions which could be melanoma, and to identify the factors which influence this behaviour and any subsequent help seeking. Fifty-three per cent reported checking their skin in the past year, with 20% noticing a change in a mole or freckle. Forty-five per cent of those who noticed a change sought medical advice. The most common reason for not seeking advice was cost. Women were more likely than men to have checked their skin, to have noticed a change and to have sought medical advice. In addition to gender, tendency to self check was also associated with knowledge of melanoma and perceived risk of melanoma. These results are discussed in light of the current debate regarding skin cancer screening. This study fills a gap in the literature regarding self screening for melanoma in young adults and identifies ways in which future prevention campaigns might be modified to address the concerns of this age group.
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Persistence, remission and relapse of childhood asthma: a longitudinal study from age 9 to age 21. | 1998
Sears, M.R., Wiecek, E., Willan, ... Show all » A., Flannery, E.M., Taylor, D.R., Herbison, G.P., Holdaway, M.D. « Hide
European Respiratory Journal, 1998, 12(12), 401s.
Our ref: RO330
Show abstract » Many children with wheezing symptoms in childhood become asymptomatic in adolescence, others have persistent wheezing, while others remit then relapse. We have followed an unselected birth cohort of New Zealand children from age 9 to age 21, with questionnaires, pulmonary function measurements including airway responsiveness, and skin tests, with reviews every 2 or 3 years. Of 815 subjects seen at age 9, 601 (74%) provided data on all subsequent surveys. persistent wheezing (3 or more episodes per year) was defined as wheezing reported at every survey from the age at which it was first documented, remission as permanent loss of previously reported wheezing, relapse as recurrence of wheezing symptoms after negative reports at one or more surveys, and normal as never reporting 3 or more wheezing episodes in a year. At age 21, 21.3% of the 601 subjects had persistent wheezing, 6.8% had had wheezing followed by full remission, 13.4% had had wheezing then remission followed by relapse, 21.8% had wheezing reported at only one survey, 4.8% intermittently reported wheezing with no classifiable pattern, and 31.9% had never reported symptoms. Hence by age 21, 68.1% of the birth cohort had reported recurrent wheezing at one or more surveys, 46.3% had reported wheezing at two or more surveys, and 30% had wheezing persisting into early adult life. The strongest risk factors for persistence to age 21 were atopy to house dust mite and cat, and increased airway responsiveness at age 9, odds ratio >2.0 for each of these factors.
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Herpes simplex type 2 infection in a cohort aged 21 years. | 1998
Eberhart-Phillips, J., Dickson, N., Paul, ... Show all » C., Fawcett, J.P., Holland, D., Taylor, J., Cunningham, A.L. « Hide
Sexually Transmitted Infections, 1998, 74(74), 216-218.
Our ref: RO327
Show abstract » OBJECTIVES: To measure the prevalence of HSV-2 antibodies in a birth cohort of 21 year old New Zealanders from whom detailed sexual histories had been obtained, and to assess the potential for HSV-2 serology in characterising a young adult population's risk for sexually transmitted diseases (STD). METHODS: Sera from 784 cohort members were tested using an indirect IgG enzyme linked immunoassay specific to the HSV-2 glycoprotein G. Positive results were confirmed by western blot. RESULTS: In all, 27 subjects were seropositive for HSV-2 (3.4%), only seven of whom gave a history of genital herpes (26%). Risk among females increased with lifetime number of partners, while risk for males increased with having a first partner who was aged 16 years or under. CONCLUSIONS: The seroprevalence of HSV-2 infection in this cohort was low, but similar to that seen in several other populations in this age group. HSV-2 seropositivity did not appear to be a sensitive marker for high risk sexual activity in this young population. This may be because a critical mass of HSV-2 carriers has not accumulated among potential partners by age 21 years.
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Adult physical health outcomes of adolescent girls with conduct disorder, depression and anxiety | 1998
Bardone, A.M., Moffitt, T.E., Caspi, ... Show all » A., Dickson, N., Stanton, W.R., Silva, P.A. « Hide
Journal of the American Academy of Child and Adolescent Psychiatry, 1998, 37(37), 594-601.
download pdf Our ref: RO325
Show abstract » Objective: To examine the young adult physical health outcomes of adolescent girls with behavior problems. Method: Girls with conduct disorder, girls with depression, girls with anxiety, and healthy girls (N=459) who had been evaluated at age 15 years were followed up at age 21 when general physical health, substance dependence and reproductive health were assessed. Results: After control for potentially confounding variables including prior health, adolescent conduct disorder predicted more medical problems, poorer self-reported overall health, lower body mass index, alcohol and/or marijuana dependence, tobacco dependence, daily smoking, more lifetime sexual partners, sexually transmitted disease, and early pregnancy. Adolescent depression predicted only adult tobacco dependence and more medical problems; adolescent anxiety predicted more medical problems. Conclusions: The robust link between female adolescent conduct disorder and poor physical health in adulthood suggests that intervention with girls who have conduct disorder may be a strategy for preventing subsequent health problems.
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The structure and stability of common mental disorders (DSM-III-R): A longitudinal/epidemiological study | 1998
Krueger, R.F., Caspi, A., Moffitt, ... Show all » T.E., Silva, P.A. « Hide
Journal of Abnormal Psychology, 1998, 107(107), 216-227.
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Our ref: RO324
Show abstract » The latent structure and stability of 10 common mental disorders were examined in a birth cohort at ages 18 and 21. A 2-factor model, in which some disorders were presumed to reflect internalizing problems and others were presumed to reflect externalizing problems, provided a more optimal fit to the data than either a 1- or a 4-factor model. To a significant extent, persons in the sample retained their relative positions on the latent factors across the 3-year period from age 18 to age 21. Results offer potential clarification of the meaning of comorbidity in psychopathology research by suggesting that comorbidity may results from common mental disorders being reliable, covariant indicators of stable, underlying core psychopathological processes.
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Assortative mating for antisocial behavior: Developmental and methodological implications | 1998
Krueger, R.F., Moffitt, T.E., Caspi, ... Show all » A., Bleske, A., Silva, P.A. « Hide
Behavior Genetics, 1998, 28(28), 173-186.
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Our ref: RO323
Show abstract » Do people mate assortatively for antisocial behavior? If so, what are the implications for the development and persistence of antisocial behavior? We investigated assortative mating for antisocial behavior and its correlates in a sample of 360 couples from Dunedin, New Zealand. We found substantial assortative mating for self-reports of antisocial behavior per se and for self-reports of couple members' tendencies to associate with antisocial peers (0.54 on average). Perceptions about the likelihood of social sanctions for antisocial behavior (e.g., being caught by the authorities or losing the respect of one's family) showed moderate assortative mating (0.32 on average). However, assortative mating for personality traits related to antisocial behavior was low (0.15 on average). These findings suggest that, whereas assortative mating for many individual-difference variables (such as personality traits) is low, assortative mating for actual antisocial behaviors is substantial. We conclude that future family studies of antisocial behavior should endeavor to measure and understand the influence of assortative mating. In addition, we outline a testable behavior-genetic model for the development of antisocial behavior, in which genes and environments promoting or discouraging antisocial behavior become concentrated within families (due to assortative mating), giving rise to widely varying individual developmental trajectories that are, nevertheless, similar within families.
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Dental fear with and without blood-injection fear: implications for dental health and clinical practice | 1998
Poulton, R., Thomson, W.M., Brown, ... Show all » R.H., Silva, P.A. « Hide
Behaviour Research and Therapy, 1998, 36(36), 591-597.
download pdf Our ref: RO321
Show abstract » The relation between dental, blood and injection fear and oral health was examined in 936 New Zealand 18-year-olds. Of the approximately ten percent (n = 96) of the sample who reported a dental fear, 1 in 10 also reported a fear of blood and 53% a co-morbid fear of injections. Study members with dental fear alone or co-morbid dental and blood or injection fear had significantly worse oral health (i.e. greater caries experience) than a no-fear comparison group or individuals with blood- injection fear only. Further, individuals with dental and blood or injection fear had a significantly higher level of recent tooth decay than individuals with dental fear alone. Time since last dental treatment also tended to be highest in this group. Implications for dental health and practice were discussed.
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Evidence for a non-associative model of the acquisition of a fear of heights | 1998
Poulton, R., Davies, S., Menzies, ... Show all » R.G., Langley, J.D., Silva, P.A. « Hide
Behaviour Research and Therapy, 1998, 36(36), 537-544.
download pdf Our ref: RO320
Show abstract » Theories that fear results from previous traumatic experience (i.e. conditioning theories) have enjoyed widespread support for over half a century. Recent research, however, has cast doubt on the validity of these models in some specific phobias. Two studies on the etiology of height phobia have obtained findings consistent with a non-associative, evolutionary explanation of fear acquisition (Menzies and Clarke, 1993a, Behaviour Research and Therapy, 31, 355-365; Menzies and Clarke, 1995a, Behaviour Research and Therapy, 33, 795-805). Unfortunately, the retrospective nature of these studies limits the conclusions that can be drawn from these data. Like all retrospective research, these studies depend on adult subjects imperfect ability to recall conditioning events that may have occurred many years earlier. The present investigation overcomes these methodological shortcomings by examining the relationship between putative conditioning events before the age of 9 yr and the presence of height fear at ages 11 and 18 yr in a large birth cohort studied longitudinally. To our knowledge this is the first study that has prospectively examined the relationship between relevant traumatic events early in life and the onset of height fear in late adolescence. No positive relationship was found between a history of falls resulting in injury (i.e. fracture, dislocation, intracranial injury or laceration) before the age of 9 and fear of heights at age 11 or 18. Interestingly, falls resulting in injury between the ages of 5 and 9 occurred more frequently in those without a fear of heights at 18 (P < 0.01)--a finding in the opposite direction to that predicted by conditioning theory but consistent with non- associative theories of fear acquisition. In general, the results provide strong support for non-associative models of fear and are difficult to reconcile with conditioning theories.
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Developmental antecedents of partner abuse: A prospective-longitudinal study | 1998
Magdol, L., Moffitt, T.E., Caspi, ... Show all » A., Silva, P.A. « Hide
Journal of Abnormal Psychology, 1998, 107(107), 375-389.
download pdf Our ref: RO319
Show abstract » Prospective measures of risk factors for partner abuse were obtained from a large birth cohort in 4 domains: socioeconomic resources, family relations, educational achievements, and problem behaviors. Partner abuse outcomes were measured at age 21. Results showed that antecedents of abuse included risk factors from all 4 domains. Risk factors were similar for men and women. Some age 3 antecedents were significant, but the strongest correlations were from age 15. In multivariate analyses, the most consistent predictor was the presence of early problem behaviors. In a cross-validation test, abuse was moderately predictable by the same antecedents, whether the outcome measure was self-report or reports from partners of sample members. Findings suggest that theories of partner abuse should account for developmental influences from multiple life domains and that primary prevention of partner abuse should begin in adolescence.
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Factors associated with doubled-up housing - a common precursor to homelessness | 1998
Wright, B.R., Caspi, A., Moffitt, ... Show all » T.E., Silva, P.A. « Hide
Social Service Review, 1998, 72(72), 92-111.
download pdf Our ref: RO317
Show abstract » Previous research on housing problems has concentrated on the more visible homelessness rather than more intermediate forms of housing problems such as doubled-up housing. This article expands this research by analyzing entrance into doubled-up housing among a sample of adolescents. This common type of vulnerable housing has been linked to various social and psychological problems. It commonly precedes homelessness, and it potentially increases the risk of homelessness. We find that doubled-up housing frequently occurs during young adulthood and is predicted by insufficient human capital, broken social ties, and personal disabilities.
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Early failure in the labor market: Childhood and adolescent predictors of unemployment in the transition to adulthood | 1998
Caspi, A., Wright, B.R., Moffitt, ... Show all » T.E., Silva, P.A. « Hide
American Sociological Review, 1998, 63(63), 424-451.
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Our ref: RO316
Show abstract » We investigate the childhood and adolescent predictors of youth unemployment in a longitudinal study of young adults who have been studied for the 21 years since their births in 1972-1973. We test hypotheses about the predictors of youth unemployment using information about each individual's human capital, social capital, and personal capital. In the human capital domain, lack of high-school qualifications, poor reading skills, low IQ scores, and limited parental resources significantly increased the risk of unemployment. In the social capital domain, growing up in a single-parent family, family conflict, and lack of attachment to school also increased the risk of unemployment. In the personal capital domain, children involved in antisocial behavior had an increased risk of unemployment. These predictors of unemployment reached back to early childhood suggesting that they began to shape labor-marker outcomes years before these youths entered the work force. In addition, these effects remained significant after controlling for the duration of education and educational attainment, suggesting that many early personal and family characteristics affect labor-market outcomes, not only because they restrict the accumulation of human capital (e.g., education), but also because they directly affect labor-market behaviors. Failure to account for prior social, psychological, and economic risk factors may lead to inflated estimates of the effects of unemployment on future outcomes.
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Comorbidity between abuse of an adult and DSM-III-R mental disorders: Evidence from an epidemiological Study | 1998
Danielson, K.K., Moffitt, T.E., Caspi, ... Show all » A., Silva, P.A. « Hide
American Journal of Psychiatry, 1998, 155(155), 131-133.
download pdf Our ref: RO315
Show abstract » OBJECTIVE: The purpose of this study was to report the prevalence, risk, and implications of comorbidity between partner violence and psychiatric disorders. METHOD: Data were obtained from a representative birth cohort of 941 young adults through use of the Conflict Tactics Scales and Diagnostic Interview Schedule. RESULTS: Half of those involved in partner violence had a psychiatric disorder; one-third of those with a psychiatric disorder were involved in partner violence. Individuals involved in severe partner violence had elevated rates of a wide spectrum of disorders. CONCLUSIONS: The findings support the importance of mental health clinicians screening for partner violence and treating victims and perpetrators before injury occurs.
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Comorbid mental disorders: Implications for clinical treatment and sample selection | 1998
Newman, D.L., Moffitt, T.E., Caspi, ... Show all » A., Silva, P.A. « Hide
Journal of Abnormal Psychology, 1998, 107(107), 305-311.
download pdf Our ref: RO314
Show abstract » Disorders from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) were assessed in a birth cohort of 961 young adults. Comorbid cases exceeded single-disordered cases in chronic history of mental illness, use of treatments, physical health problems, functional interference in daily life, and impaired adaptation across domains such as work, education, health, and social-support networks. Single-disorder cases were also more impaired than nondisordered cases, but comorbid cases were the most severely impaired. Our findings suggest that (a) samples that underrepresent comorbidity (pure single-disorder cases or student samples) will underestimate effect sizes for relations between a disorder and its correlates, whereas samples that overrepresent comorbidity (clinical or adjudicated samples) will overestimate effect sizes, (b) comorbidity is accompanied by complications that challenge treatment planning, compliance, and coordination of service delivery, and (c) comorbidity is associated with physical, educational, and economic problems that make it a broad societal concern.
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Hitting without a license: testing explanations for differences in partner abuse between young adult daters and cohabiters | 1998
Magdol, L., Moffitt, T.E., Caspi, ... Show all » A., Silva, P.A. « Hide
Journal of Marriage and the Family, 1998, 60(60), 41-55.
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Our ref: RO313
Show abstract » We compared partner abuse by cohabiters and daters among 21-year-olds. Cohabiters were significantly more likely than daters to perform abusive behaviors. We identified factors that differentiate cohabitors from daters and tested whether these factors explained the difference in partner abuse. As controls in regression models predicting abuse, none of these factors individually explained the difference in partner abuse between cohabiters and daters. With all factors added to the model simultaneously, the effect of cohabitation remained significant, but was substantially reduced. These findings have intervention implications because premarital cohabitation is a risk factor for abuse after marriage.
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Continuity and change in sporting and leisure time physical activities during adolescence | 1998
Dovey, S.M., Reeder, A.I., Chalmers, ... Show all » D.J. « Hide
British Journal of Sports Medicine, 1998, 32(32), 53-57.
Our ref: RO312
Show abstract » OBJECTIVES: To map the pattern of involvement in physical activities by adolescents at ages 15 and 18 years. METHODS: Data from a longitudinal cohort study were used. Participants in the Dunedin Multidisciplinary Health and Development Study provided information about their sporting and similar physical activities during the 12 months before study assessments at ages 15 and 18 years. RESULTS: Total participation time at age 18 was 63% of that reported at age 15. Mean participation time for girls decreased from 7.5 hours a week to 4.3 hours a week (p<0.001) whereas for boys it decreased from 11.7 hours a week to 7.8 hours a week (p<0.001). At both ages, boys spent significantly more time in physical activity than girls. More time in physical activity at age 18 was reported by participants who judged their fitness higher than their peers (odds ratio (OR) 1.7: 1.2, 2.5), those who played sport for their school (OR 1.8: 1.3, 2.4), and those reporting very good self assessed health (OR 1.4: 1.0, 1.8) at age 15. The overall median number of activities decreased from seven at age 15 to three at 18. Boys were involved in more activities at age 15 but there was no sex difference at age 18 in the number of different activities reported. CONCLUSION: Although involvement in school sporting activities and high levels of fitness in mid-adolescence may protect against marked reductions in physical activity in late adolescence, social and organisational factors are also likely to be important. There is a need for innovative approaches to health promotion which will encourage adolescents to maintain higher levels of physical activity after they leave school.
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