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Övervikt och fetma är ett globalt folkhälsoproblem som på sikt kommer innebära stora hälsoproblem på såväl individ- som samhällsnivå. Både förebyggande insatser och behandling mot fetma har positiv effekt, men det är svårt och det krävs mångamedvetna förändringar och en hög motivation av såväl barnen och ungdomarna själva som hos familjen för att lyckas. Forskning visar att insatser ger bättre effekt ju tidigare i livet man startar. Gruppen funktionshindrade barn och ungdomar är en utsatt grupp som visat sig ha lägre grad av fysisk aktivitetsnivå, högre prevalens av övervikt och fetma och en större sjuklighetav en etablerad fetma. Främjande av hälsosamma levnadsvanor är en högtprioriterad fråga, men gruppen funktionshindrade har inte i tillräcklig grad uppmärksammats.Syftet med studien är att utforska genomförda forskningsinterventioner för att förebygga och/eller behandla fetma riktade till barn och ungdomar med funktionshinder samt att kartlägga vilken effekt dessa metoder har haft. Resultaten förväntas bidra tillökad förståelse för hur fortsatt forskning till denna målgrupp kan planeras samt tillföra fördjupad kunskap vid implementering av hälsofrämjande program. Strukturerade litteratursökningar genomfördes och analyserades genom kvalitativ innehållsanalys. Resultatet visar att forskning på interventioner riktade mot gruppen funktionshindrade börjar komma, men att behovet att undersöka anpassade, verksamma metoder fortsatt är stort.Resultaten pekar mot att funktionshindrade och deras familjer möter större hinder att välja hälsosamma levnadsvanor än andra men att anpassade insatser och kunskap gör valen möjligt. Familjebaserade metoder för att förändra kost och motionsvanor samt anpassad fysisk träning verkar ge bra resultat på livsstilsrelaterad ohälsa. Kunskap för att kunna analysera individens förutsättningar är viktig för att kunna bibehålla ett salutogent förhållningssätt i arbetet med livsstilsrelaterad ohälsa för individer med funktionshinder. / Overweight and obesity is a global public health problem which could lead to serious health problems for the individual as well as for the society. Both prevention and treatment of obesity has positive effect, but it is difficult and takes great effort and high motivation from the family to succeed. Research has shown that intervention early in life produces better results. Disabled children and adolescents are overlooked groups, having a higher prevalence of overweight and obesity, a lower level of physical activity and a higher risk of negative health outcomes if obese. Promoting a healthy lifestyle is therefore of great importance, but interventions targeting disabled persons so far haven´t got enough attention. The aim of this thesis was to investigate research interventions made to prevent and/or treat obesity targeting children and adolescents with disabilities and to investigate what effect these methods have had. The results are expected to contribute to increased knowledge about how further research targeting this group can be formed and to contribute to a deeper understanding when implementing heath promoting programs.  A structured literature search was undertaken and was analyzed with qualitative content analysis. The result shows that research on the problem has started, but further investigation on effective intervention needs to be undertaken. The analysis shows that this group will probably face greater obstacles trying to choose a healthy life style than others but interventions and knowledge adjusted to this group seem to help. Family based interventions, changing eating habits, physical activity levels and adapted exercise to promote strength and fitness seems to have good results on lifestyle-related health problems. Knowledge to be able to analyze the individual’s conditions is important to be able to preserve a salutogenetic approach in the work with lifestyle related health problems in individuals with disabilities.

The transition to secondary school can represent a significant life event for many adolescents and can adversely affect their psychological adjustment and wellbeing. Little is known about how adjustment to this transition can be facilitated for young people. The review paper critically evaluated the evidence-base for school transition programmes that target pupil's mental wellbeing. A keyword search of abstract databases was conducted and 20 studies were evaluated. The majority of studies could not conclude that their intervention improved mental wellbeing to a statistically significant level, and numerous methodological limitations weaken the existing evidence-base. However, the most promising areas of research pertain to intervening with the parents and teachers of adolescents experiencing school transition. Further research should investigate this further. The empirical paper employed a qualitative methodology to examine how adolescents make sense of and create meaning from their experience of going to boarding school, and to explore what can be done to facilitate this adjustment. Ten female and male adolescents were interviewed in their second year of attending boarding school. The interviews, analysed using lnterpretative Phenomenological Analysis, yielded three superordinate themes: 1) 'Home is where the heart is', which captures adolescents experiences of homesickness, the stronger relationships formed with their family, and the development of new attachment figures with their house matron and peers, 2) 'Living in a bubble', which reflects a feeling of being constrained at boarding school and an awareness of it being a hierarchical environment, and 3) 'Gaining familiarity with the place and just being me' as adolescents appeared to positively adjust over time. Results are discussed in terms of attachment, coping and adjustment theories and models of psychosocial development. Clinical and organisational implications for professionals working in boarding schools, as well as suggestions for future research arc discussed.

Background: Parent behaviours have a long-lasting impact on the health, education, and behaviour of the young people in their care. Group-based parenting interventions are a promising approach to improve parenting, as well as to prevent and reduce physical and emotional maltreatment of children. While a billion of adolescents live in low- and middle- income countries, few evaluations have examined parenting approaches for families with adolescents in these countries. Objectives: This study was nested within a randomised controlled trial of Sinovuyo Teen, a parenting programme for families with adolescents. The trial took place in rural South Africa in 2015-2016 with 552 families in 40 study clusters. Primary intervention outcomes included parenting and child maltreatment. This dissertation aims to: (1) describe the implementation (attendance, engagement, and fidelity) of the intervention delivered within the evaluation, (2) examine if participant characteristics affected attendance and engagement in the intervention, (3) examine if implementation characteristics affected programme results, and (4) examine if participant characteristics affected programme results. Methods: Programme implementation was assessed through observations of all programme group sessions and the records of the implementing organisation. The analyses also draw on participant self-report data from three time-points (baseline, immediate post-test, and follow-up). The data were analysed using a series of correlation and multilevel regression analyses, presented in three papers. Findings: Attendance levels in the intervention were somewhat lower than in previous similar studies, perhaps due to the role of home visits. Generally, more disadvantaged families participated at similar rates as families with more material and social resources. However, a number of factors affected attendance on individual and family levels, e.g. an overcrowded household, and at the community level, e.g. funeral and grant receipt days. Intervention fidelity was similar to the levels reported in high-income countries, thus suggesting that high implementation quality is feasible in a low-resource setting. There was no consistent impact of the variation in participation and implementation on participant outcomes. Baseline risks did not consistently affect variation in treatment effects, confirming recent findings that families at-risk can benefit from parenting support as much or more than less at-risk families.

Gender-based violence (GBV) and violence against children are pervasive and destructive globally, but the exacerbation of violence in emergency contexts makes addressing them an urgent priority in humanitarian action. However, despite recognition of overlapping risks and intervention opportunities, child protection programming and GBV programming have hitherto followed discrete trajectories, resulting in adolescent (aged between 10 and 19 years) girls falling between the domains, despite their heightened vulnerability to GBV. This research explores how humanitarian protection interventions address GBV against displaced adolescent girls in Jordan. Data is collected using detailed, semi-structured interviews with four specialist humanitarian practitioners from leading organisations in child protection and GBV programming within the refugee response in Jordan. Qualitative, grounded coding and analysis is conducted on the transcribed data to identify key themes and patterns. The findings report child marriage, domestic violence and sexual violence as the most prevalent forms of GBV against adolescents. The social ecology of the girls is explored and salient risk factors at each level are identified, including lack of awareness, cultural norms and stigma, and absence of data information to direct programming. Corresponding protection interventions, including case-management, capacity-building of service providers and awareness-raising are identified, and the limited extent to which they empower adolescent girls is debated. Finally, the nexus between child protection and GBV programming is discussed, and key challenges, including coordination between child protection and GBV policies, campaigns, services and actors, decreasing funding and nationalisation of services, an absence of meaningful participation of adolescent girls in programming, and the organisations’ issue-focused approach, are identified and explored in the context of empowerment of adolescent girls. The research concludes that addressing GBV by meaningful participation of adolescents, adopting rights-based approaches, and proactive coordination of protection actors, is essential for the empowerment of adolescent girls to be agents of their own protection.

Suicide rates have been relatively constant in Australia for over a hundred years, albeit peaking in 1997 and since returning towards historically average levels. Suicide now represents the commonest cause of violent deaths and exceeds deaths from motor vehicle accidents and armed conflict. There have been a number of national programs following the lead of Finland in the 1980s. Modern research has clearly demonstrated many of the risk factors, but they lack specificity in terms of prediction, and therefore the numbers needed to demonstrate the effectiveness of any intervention are particularly daunting. This makes research problematic and it is probably impossible to ever get Level 1 evidence because of the large numbers and expense required. Therefore many research studies are either epidemiologically oriented or directed to crisis care and treatment algorithms. Rural suicide presents particular challenges because of the increasing numbers of young and elderly men who take their lives, the lack of services available locally and the paucity of research in rural societies, with it usually being confined to examining risk factors and comparing them with urban populations. This thesis describes an approach to rural suicide which, whilst cognisant of the broad range of risk factors, was more directed to tackling poor mental health on a community basis, utilising local resources. It used four main approaches: educating the community to enhance mental health literacy by appreciating the causes of poor mental health; building the social capital or community capacity of existing resources; emphasising early identification and intervention of problems; and the establishment of a community child and adolescent program based in the local school, but with close liaison with the local medical practitioners. The educative approach to mental health literacy was to engage the whole community as widely as possible with special programs for general practitioners, nurses, and teachers; community capacity and social capital were increased by teaching the community warning signs, techniques to engage and refer to known entry points into the system; early identification was undertaken by screening for poor mental health within the doctors’ office, the hospital and the school; and a child and adolescent program was devised to detect dysfunctional students, formulate an assessment and management plan, and then evaluate the outcome. The most important results were a statistically significant reduction of suicides from twelve in ten years to one in the following decade, as well as a statistically significant reduction in the number of suicide attempts. In addition there was the establishment of a primary mental health service within the community which was independent of specific government finance and resources. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1292809 / Thesis(M.D.)-- School of Medicine, 2007.

This study developed and validated the Youth Empowerment Scale (YES) for young people with psychosis. This PhD thesis consisted of four phases. Phase 1 conceptualised empowerment from the perspective of young people with psychosis. Phase 1 qualitative findings informed the development of the measurement of empowerment; the Youth empowerment Scale (YES). Phase 2 developed and validated the YES in a non-clinical population. Phase 3 explored the relationship between psychological processes (self-efficacy, control, coping, thinking style, and social support), empowerment, mental health wellbeing and recovery. The YES was then validated again in phase 4 on a clinical population, young people within Child and Adolescents Mental Health Services (CAMHS). This study confirmed that the YES is a valid and reliable measure of empowerment which can be used in future work identifying and supporting empowerment for young people with psychosis.