Projects
One aim of the CRE for Driving Global Investment in Adolescent Health is to deliver research that drives investment in neglected areas of adolescent health including groups experiencing significant discrimination or disadvantage specifically, Indigenous young people and young people in contact with the justice system.
Neglected areas of adolescent health include mental health, non-communicable disease risk, injury and violence and substance use.
The CREs research streams are designed to drive a cycle of accountability across neglected areas of adolescent health globally; in priority adolescent groups in Australia; and in two partner countries, China and Indonesia, both of which have large adolescent populations.
CRE work streams | health topics
This work stream is led by Professor Rebecca Ivers AM, who is Head of the School of Population Health, UNSW Sydney, and Honorary Professorial Fellow at the George Institute for Global Health.
Funding from the CRE has supported work by Dr Amy Peden and Dr Patricia Cullen to conduct two systematic reviews of injury interventions to prevent injury in adolescents, and lead two papers using GBD data on estimates of injury in adolescence. Members of the team have also published papers on young driver safety and mental health.
Publications
Cullen, P., Peden, A. E., Francis, K. L., Cini, K. I., Azzopardi, P., … & Ivers, R. Q. (2024). Interpersonal Violence and Gender Inequality in Adolescents: A Systematic Analysis of Global Burden of Disease Data From 1990 to 2019. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 74(2), 232–245. https://doi.org/10.1016/j.jadohealth.2023.08.044
Peden, A. E., Cullen, P., Bhandari, B., Testa, L., Wang, A., … & Ivers, R. (2023). A systematic review of the evidence for effectiveness of interventions to address transport and other unintentional injuries among adolescents. Journal of safety research, 85, 321–338. https://doi.org/10.1016/j.jsr.2023.03.005
GBD 2019 Adolescent Transport and Unintentional Injuries Collaborators (2022). Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019. The Lancet. Public health, 7(8), e657–e669. https://doi.org/10.1016/S2468-2667(22)00134-7
Cullen, P., Mőller, H., Baffsky, R., Martiniuk, A., Senserrick, T., … & Ivers, R. Q. (2023). Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 29(4), 302–308. https://doi.org/10.1136/ip-2022-044807
Cullen, P., Möller, H., Woodward, M., Senserrick, T., Boufous, S., … & Ivers, R. (2021). Are there sex differences in crash and crash-related injury between men and women? A 13-year cohort study of young drivers in Australia. SSM – Population Health, 14, 100816. https://doi.org/10.1016/j.ssmph.2021.100816
Peden, AE, Franklin, RC, Clemens, T. Can child drowning be eradicated? A compelling case for continued investment in prevention. Acta Paediatr. 2021; 110: 2126– 2133. https://doi.org/10.1111/apa.15618
Blog post for Centre for Adolescent Health – https://blogs.rch.org.au/cah/2021/09/17/3978/
This work stream is led by Professor Nicola Reavley, a Principal Research Fellow and Deputy Director of the Centre for Mental Health, Melbourne School of Population and Global Health at the University of Melbourne.
Funding from the CRE has supported work by Dr Monika Raniti.
Publications
Aston, R., Raniti, M., & Shinde, S. (2023). Editorial: The role of schools in adolescent mental health in low- and middle-income countries: considerations and future directions. Frontiers in psychiatry, 14, 1307350. https://doi.org/10.3389/fpsyt.2023.1307350
Raniti, M., Rakesh, D., Patton, G. C., & Sawyer, S. M. (2022). The role of school connectedness in the prevention of youth depression and anxiety: a systematic review with youth consultation. BMC public health, 22(1), 2152. https://doi.org/10.1186/s12889-022-14364-6
Patton, G. C., Raniti, M., & Reavley, N. (2021). Rediscovering the mental health of populations. World psychiatry : official journal of the World Psychiatric Association (WPA), 20(2), 151–152. https://doi.org/10.1002/wps.20842
Patton, G. C., Raniti, M., & Reavley, N. (2021). A job for life: How the transition from education to employment predicts early mortality. The Lancet regional health. Europe, 3, 100057. https://doi.org/10.1016/j.lanepe.2021.100057
Sawyer, S. M., Raniti, M., & Aston, R. (2021). Making every school a health-promoting school. The Lancet. Child & adolescent health, 5(8), 539–540. https://doi.org/10.1016/S2352-4642(21)00190-5
Promoting health in schools: Old idea, new opportunities. Article published in Pursuit, Monika Raniti, Ruth Aston, Susan Sawyer
Linked work
Health Promoting Schools
Our current suite of projects largely sit within a WHO and UNESCO new initiative of “Making every School a Health Promoting School”, a United Nations collaboration that includes UNICEF, UNFPA, UNAIDS and UNRWA. We have been engaged to review current policies and evidence, and to develop new global standards and an implementation guidance for HPS. Read more about this work.
Wellcome ‘active ingredients’ for mental health interventions
Since 2020, Wellcome has commissioned research teams from around the world to review “active ingredients” of effective interventions for youth anxiety and depression. In 2021, the Centre for Adolescent Health was proud to have had two recipient teams.
- Dr Monika Raniti, Prof Susan Sawyer and Prof George Patton were commissioned to synthesise the evidence for the role of school connectedness in the prevention of youth (14-24 years) anxiety and depression, in partnership with a youth advisory committee with lived experience of mental health promotions and the schooling system. Read more about the project.
- Dr Shilpa Aggarwal, Prof George Patton and Prof Nicola Reavley were commissioned to review and synthesise evidence on the role of religious and spiritual beliefs in prevention, treatment and coping with difficulties in anxiety and depression in young people. The review focused on the evidence from low- and middle-income countries and was guided by lived experience consultants participating as co-researchers in the project. Read more about the project.
This work stream is led by Professor Tim Olds, Emeritus Professor, UniSA Allied Health & Human Performance, University of South Australia.
Funding from the CRE has supported work by Dr Dot Dumuid, Karly Cini (PhD candidate) and Aaron Miatke (PhD candidate).
Publications
Kerr, J. A., Dumuid, D., Downes, M., Lange, K., O’Connor, M., … & Wake, M. (2023). Socioeconomic disadvantage and polygenic risk for high BMI magnify obesity risk across childhood: a longitudinal, population, cohort study. The Lancet. Global health, 11 Suppl 1, S9–S10. https://doi.org/10.1016/S2214-109X(23)00094-3
Dumuid, D., Singh, B., Brinsley, J., Virgara, R., Curtis, R. G., … & Maher, C. A. (2023). Trends in Well-Being Among Youth in Australia, 2017-2022. JAMA network open, 6(8), e2330098. https://doi.org/10.1001/jamanetworkopen.2023.30098
Cini, K. I., Wulan, N. R., Dumuid, D., Nurjannah Triputri, A., Abbsar, I., … & Azzopardi, P. S. (2023). Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders. The Lancet regional health. Southeast Asia, 18, 100260. https://doi.org/10.1016/j.lansea.2023.100260
Miatke, A., Olds, T., Maher, C., Fraysse, F., Mellow, M. L., … & Dumuid, D. (2023). The association between reallocations of time and health using compositional data analysis: a systematic scoping review with an interactive data exploration interface. The international journal of behavioral nutrition and physical activity, 20(1), 127. https://doi.org/10.1186/s12966-023-01526-x
Olds, T., Singh, B., Miatke, A., Eglitis, E., Maher, C., & Dumuid, D. (2023). The Association Between Socioeconomic Status and Use of Time in Australian Children and Adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 73(6), 1068–1076. https://doi.org/10.1016/j.jadohealth.2023.07.007
Dumuid, D., Olds, T., Lange, K., Edwards, B., Lycett, K., … & Wake, M. (2022). Goldilocks Days: optimising children’s time use for health and well-being. Journal of epidemiology and community health, 76(3), 301–308. https://doi.org/10.1136/jech-2021-216686
Dumuid, D., Olds, T., & Sawyer, S. M. (2021). Moving beyond more: towards a healthy balance of daily behaviours. Lancet (London, England), 398(10298), 373–374. https://doi.org/10.1016/S0140-6736(21)01600-7
National Adolescent Mental Health Surveys (NAMHS)
Lead: Associate Professor Holly Erskine (Principal Investigator)
Mental disorders are the leading cause of burden in adolescents across the globe. While the majority of adolescents live in low- and middle-income countries (LMICs), relatively little to no data exists on the prevalence of mental disorders among adolescents living in these regions. The existence of these ‘data deserts’ severely limits evidence-based service planning and prioritisation for adolescent mental health in LMICs, with implications for both in-country health departments and global health organisations.
To address the lack of data in these regions, this project has conducted nationally-representative household surveys of adolescent mental disorders in three LMICs: Kenya (K-NAMHS), Indonesia (I-NAMHS), and Vietnam (V-NAMHS). Data collection was conducted throughout 2021, with over 5000 interviews with adolescents and their primary caregivers completed in each country. The data generated by these surveys is representative of the general population and provides vital information for service planning and advocacy by stakeholders. Additionally, data on country-specific risk factors that can be targeted for prevention and early intervention strategies has been collected.
Results dissemination is currently underway for these results. National reports presenting the key findings on mental health, service use and COVID-19 in each country has been disseminated to key stakeholders and are available through the below links.
This project is funded by The University of Queensland in America (TUQIA) through support from Pivotal Ventures, a Melinda French Gates company. It is not a project of the CRE, the CRE is co-funding a postdoc to support additional results analysis and dissemination.
Website
https://qcmhr.org/uncategorised/national-adolescent-mental-health-surveys-namhs
Reports
- Kenya – National Adolescent Mental Health Survey (K-NAMHS) Report (2.15 MB)
- Indonesia – National Adolescent Mental Health Survey (I-NAMHS) Report (English) (8.89 MB)
- Indonesia – National Adolescent Mental Health Survey (I-NAMHS) Report (Bahasa Indonesia) (10.91 MB)
- Viet Nam – Adolescent Mental Health Survey (V-NAMHS) Report (English) (1.69 MB)
- Viet Nam – Adolescent Mental Health Survey (V-NAMHS) Report (Vietnamese) (2.07 MB)
Publications
Erskine, H.E., Enright, M.E., Blondell, S.J., Shadid, J., … Whiteford, H.A. Core Principles of International Research: Lessons From the National Adolescent Mental Health Surveys. Journal of Adolescent Health. 2023; 72(1): S15-S17. DOI: 10.1016/j.jadohealth.2021.05.006
Erskine, H.E., Blondell, S.J., Enright, M.E., Shadid, J., … Scott, J.G. Measuring the Prevalence of Mental Disorders in Adolescents in Kenya, Indonesia, and Vietnam: Study Protocol for the National Adolescent Mental Health Surveys. Journal of Adolescent Health. 2023; 72(1): S71-S78. DOI: 10.1016/j.jadohealth.2021.05.012
Content to come
CRE work streams | priority population groups
Young people and adults who come into contact with the criminal justice system are among society’s most vulnerable. They are distinguished by a high prevalence of complex, co-occurring health problems, typically set against a backdrop of entrenched disadvantage.
This work stream is led by Professor Stuart Kinner, who is Head of the Justice Health Group, Curtin University and holds honorary appointments at the Murdoch Children’s Research Institute, University of Melbourne, Monash University, University of Queensland, and Griffith University.
Funding from the CRE has supported work by Dr Melissa Willoughby and Dr Lucas Calais-Ferreira.
Publications
Calais-Ferreira, L., Young, J. T., Francis, K., Willoughby, M., Pearce, L., … & Kinner, S. A. (2023). Non-communicable disease mortality in young people with a history of contact with the youth justice system in Queensland, Australia: a retrospective, population-based cohort study. The Lancet. Public health, 8(8), e600–e609. https://doi.org/10.1016/S2468-2667(23)00144-5
Kerr, J. A., Gillespie, A. N., O’Connor, M., Deane, C., Borschmann, R., … & Patton, G. C. (2023). Intervention targets for reducing mortality between mid-adolescence and mid-adulthood: a protocol for a machine-learning facilitated systematic umbrella review. BMJ open, 13(10), e068733. https://doi.org/10.1136/bmjopen-2022-068733
Willoughby, M., Janca, E., Kwon, S., Johnston, B., Collins, T., … & Borschmann, R. (2023). Interventions to Prevent and Respond to Violence Against Justice-Involved Young Women: A Scoping Review. Trauma, violence & abuse, 15248380231171183. Advance online publication. https://doi.org/10.1177/15248380231171183
Willoughby, M., Young, J. T., Borschmann, R., Spittal, M. J., Keen, C., … & Kinner, S. A. (2023). Violence-Related Death in Young Australians After Contact With the Youth Justice System: A Data Linkage Study. Journal of interpersonal violence, 38(17-18), 9923–9942. https://doi.org/10.1177/08862605231169490
Willoughby, M., Young, J. T., Hail-Jares, K., Spittal, M. J., Borschmann, R., … & Kinner, S. A. (2021). Circumstances and toxicology of violence-related deaths among young people who have had contact with the youth justice system: a data linkage study. BMC public health, 21(1), 2207. https://doi.org/10.1186/s12889-021-12244-z
- Identify the priorities and needs of Indigenous adolescents across nations
- Define policy relevant indicators to ensure these can be monitored
- Assemble the best evidence for actions to enable responses
Read more here – https://adolescentsourfuture.com/the-global-collective-for-indigenous-adolescent-health-evidence-based-action
CRE work stream | health economic modelling
In the context of the Centre of Research Excellence for Driving Global Investment in Adolescent Health, health economic modelling involves building a mathematical representation or model of how people move between health states (i.e. from being health to becoming infected with a virus, or experiencing a mental health condition) based on risks they face.
Once we have built this model and we are confident in its ability represents the real world we can run scenarios on this model to see what would happen to important health outcome if we introduced an intervention, scaled up an existing intervention or policy change in the model. The economic side of things comes in once we apply costs to the scenarios we run, where we can then calculate how much the intervention costs each year or how much it would cost if we scaled it up to effect more people. We can then calculate how much money was saved by either treating someone with a health outcome or preventing them from experiencing it initially. Further, once we have a set of interventions, services, policy changes and other actions that influence the model we can run a process of optimisation to arrive at which set of actions will have the largest effect on the burden of the disease given a pre-specified amount of money available to be spent. Read more about this work stream – Health economic modelling
CRE work streams | country partners
Project name
Informing an effective response to non-communicable disease amongst adolescents in Indonesia
Brief summary
Analysis of the burden of disease, inter-related risk factors, and qualitative insights from key stakeholders.
Objectives
- Undertake a qualitative inquiry with relevant stakeholders to understand what is required to address NCD risks for adolescents in Indonesia, perceptions of the current situation, and how young people can be meaningfully involved.
- Describe the causes of NCDs and NCD risk amongst adolescents in Indonesia and compare these patterns regionally and globally.
- Describe subnational variations in NCDs amongst adolescents across Indonesia with further stratification by sex and socioeconomic gradient.
- Investigate in greater depth cardiometabolic changes in Indonesian adolescents, clustering of key risks, correlates, and inter-relationship with poor mental health.
Thesis title
Adiposity as a risk factor in Adolescence: Towards global coverage for an adequate measure of risk
Principal Investigator
Karly Cini (Phd Candidate)
Primary Supervisors
George Patton / Peter Azzopardi
Partners
Universitas Hasanuddin, Qualitative study: UNICEF/ Burnet partnership
Publications
Cini, K. I., Wulan, N. R., Dumuid, D., Nurjannah Triputri, A., Abbsar, I., Li, L., Priambodo, D. A., Sameve, G. E., Camellia, A., Francis, K. L., Sawyer, S. M., Patton, G. C., Ansariadi, A., & Azzopardi, P. S. (2023). Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders. The Lancet regional health. Southeast Asia, 18, 100260. https://doi.org/10.1016/j.lansea.2023.100260
Thesis title
The Construction of Mental Health Index of School-Age Children in Indonesia
Principal Investigator
Margaretha (PhD Candidate)
Primary Supervisor
Peter Azzopardi / Susan Sawyer
Publication
Margaretha, M., Azzopardi, P. S., Fisher, J., & Sawyer, S. M. (2023). School-based mental health promotion: A global policy review. Frontiers in psychiatry, 14, 1126767. https://doi.org/10.3389/fpsyt.2023.1126767
Content to come
Additional global adolescent health initiatives
In 2017 the Lancet proposed a Lancet Standing Commission on Adolescent Health and Wellbeing with the following objectives:
- Continuing momentum globally and at the country level for comprehensive and integrated approaches to adolescent health and take forward the recommendations from the 2016 report, Our future: a Lancet Commission on adolescent health and wellbeing
- Maintaining the visibility of adolescent health including neglected areas (e.g., nutrition, mental health and injury) and neglected groups (Indigenous young people, adolescents in contact with the justice system).
- Map progress in adolescent health and wellbeing including investments globally and nationally.
- Provide mechanisms for addressing the barriers to progress
- Extend the evidence base for cost-effective and scalable action in adolescent health at both global and national levels.
Current initiatives include a Lancet series on adolescent nutrition (2021), analyses of future NCD risks (2022), analyses of injury disease burden and investment cases (2022) and a Lancet series on adolescent indigenous health (2023). For further information, please visit the Standing Commission webpage.