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Background: Lifetime trajectories of mental ill-health are often established during adolescence. Effective interventions to prevent the emergence of mental health problems are needed. In the current study we assessed the efficacy of the cognitive behavioural therapy (CBT)-informed Climate Schools universal eHealth preventive mental health programme, relative to a control. We also explored whether the intervention had differential effects on students with varying degrees of social connectedness. Method: We evaluated the efficacy of the Climate Schools mental health programme (19 participating schools; average age at baseline was 13.6) v. a control group (18 participating schools; average age at baseline was 13.5) which formed part of a large cluster randomised controlled trial in Australian schools. Measures of internalising problems, depression and anxiety were collected at baseline, immediately following the intervention and at 6-, 12- and 18-months post intervention. Immediately following the intervention, 2539 students provided data on at least one outcome of interest (2065 students at 18 months post intervention). Results: Compared to controls, we found evidence that the standalone mental health intervention improved knowledge of mental health, however there was no evidence that the intervention improved other mental health outcomes, relative to a control. Student's social connectedness did not influence intervention outcomes. Conclusion: These results are consistent with recent findings that universal school-based, CBT-informed, preventive interventions for mental health have limited efficacy in improving symptoms of anxiety and depression when delivered alone. We highlight the potential for combined intervention approaches, and more targeted interventions, to better improve mental health outcomes. [ABSTRACT FROM AUTHOR]

Background: The burden of disease attributable to alcohol and other drug (AOD) use in young people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents. Methods: Seventy-one secondary schools across three States participated in a cluster-randomised controlled trial. Year 8 students received either the web-based Climate Schools: Alcohol and Cannabis course (Climate, n = 3236), or health education as usual (Control, n = 3150). Outcomes were measured via self-report and reported here for baseline, 6- and 12-months for alcohol and cannabis knowledge, alcohol, cannabis use and alcohol-related harms. Results: Compared to Controls, students in the Climate group showed greater increases in alcohol- [standardised mean difference (SMD) 0.51, p < 0.001] and cannabis-related knowledge (SMD 0.49, p < 0.001), less increases in the odds of drinking a full standard drink[(odds ratio (OR) 0.62, p = 0.014], and heavy episodic drinking (OR 0.49, p = 0.022). There was no evidence for differences in change over time in the odds of cannabis use (OR 0.57, p = 0.22) or alcohol harms (OR 0.73, p = 0.17). Conclusions: The current study provides support for the effectiveness of the web-based Climate Schools: Alcohol and Cannabis course in increasing knowledge and reducing the uptake of alcohol. It represents one of the first trials of a web-based AOD prevention program to replicate alcohol effects in a large and diverse sample of students. Future research and/or adaptation of the program may be warranted with respect to prevention of cannabis use and alcohol harms. [ABSTRACT FROM AUTHOR]

Background Early adolescence is a challenging transition period where mental ill-health and experimentation with alcohol and tobacco often increases. Some foods and eating behaviours can be addictive in a way that is comparable to addictive substances. Few studies have examined the prevalence of food addiction in young people, and none have measured it with mental ill-health and substance-use. Methods 6,700 Year 7 students across NSW, WA and QLD completed the baseline questionnaire for "Health4Life" (Mage=12.7±0.5, 49%F). The prevalence of, and associations between, food addiction (YFAS-C), anxiety (PROMIS-A), depression (PHQ-A), psychological distress (K6), discretionary food/drink intake (SPANS) and alcohol and tobacco use were examined. Results Respondents who met diagnostic criteria for food addiction (5.2%, n = 272) were significantly more likely to screen positively for anxiety (X23=315.4, P < 0.001), probable major depression (X21=299.9, P < 0.001) and psychological distress at levels of serious mental illness (X21=238.885, P < 0.001). They were also significantly more likely to have consumed a full standard drink and smoked tobacco in the past 6-months (X21=53.8, P < 0.001 and X21=29.7, P < 0.001, respectively) and to consume high amounts of sugar-sweetened beverages (X21=15.2, P < 0.001), discretionary foods (X22=26.4, P < 0.001) and energy drinks (X25=28.4, P < 0.001). Relative risks ranged 1.29-4.35. Conclusions Findings suggest a strong link between food addiction, substance use, discretionary food and drink consumption and mental ill-health in early adolescence. Further analysis will model multivariable relationships whilst controlling for affluence, BMI and gender. Key messages Links between food addiction, substance use and mental ill-health are found in the largest sample of adolescents screened for these variables worldwide. [ABSTRACT FROM AUTHOR]

Background Physical inactivity, poor diet, sedentary recreational screen time, poor sleep, alcohol use and smoking (the "Big 6") are key lifestyle risk factors for chronic disease. The Big 6 typically emerge during adolescence, co-occur and continue into adulthood. To improve short- and long-term health, early and effective prevention is critical. Methods A cluster randomised controlled trial (ACTRN12619000431123) is being conducted in 71 schools across NSW, QLD and WA. Schools are randomised to the Health4life intervention or health education as usual. The intervention has three components: 1) An online, school-based program delivered to all Year 7 students; 2) An accompanying smartphone application (all students); 3) Booster content, delivered to at-risk students in Years 8 and 9. Students complete questionnaires on five occasions over three years. Results Preliminary analyses including 6716 students (49% female) indicated that 22% of participants met national guidelines for physical activity, 27% reported drinking 2+ cups of sugar-sweetened beverages/week, 3% had consumed a standard alcoholic drink in the prior 6 months, 2% had tried smoking, 86% engaged in excessive recreational screen time, and 32% had inadequate sleep. The final dataset will be analysed for the conference. Conclusions Many Australian adolescents are engaging in lifestyle behaviours that put them at risk of chronic disease. Effective and scalable preventive interventions that simultaneously target these behaviours are needed. Key messages This is the first trial of an eHealth intervention to concurrently target the Big 6 among adolescents. Health4Life has the potential to improve physical and mental health in adolescence and beyond. [ABSTRACT FROM AUTHOR]

School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures , a six-lesson, curriculum-aligned wellbeing and substance use prevention program that was designed for, and with, the Aboriginal youth. Formative reviews and consultation recommended that the program (i) combine effective components of mainstream prevention with cultural elements, highlighting Aboriginal cultural strengths; (ii) avoid stigma and celebrates the cultural diversity by catering to both Aboriginal and non-Aboriginal students; and (iii) use digital technology to enhance engagement, implementation and scalability. Guided by an Appreciative Inquiry approach, the program was developed in partnership with an Indigenous Creative Design Agency, and four schools in New South Wales and Queensland, Australia. Aboriginal ( n = 41) and non-Aboriginal students ( n = 36) described their role models, positive aspects of their community and reasons to avoid substance use; these formed the basis of an illustrated story which conveyed the key learning outcomes. Feedback from teachers, students and content experts supported the acceptability of the program, which will be evaluated in a subsequent randomised controlled trial.