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This paper describes how knowledge from life-course research and community intervention studies can be integrated within community coalition models to inform a feasible national plan to measurably prevent and reduce mental and behavioral disorders. In many nations, including Australia, mental and behavioral disorders are increasing in child and youth populations, forewarning of increased future disorders. There is limited evidence that treatment interventions can turn the tide. However, we argue here that universal (whole population) and selective (group targeted) preventative interventions are feasible, effective, and cost-effective for reducing child and adolescent mental and behavioral disorders. Modifiable risk factors (causal or associational predictors) and protective factors (risk modifiers) have been identified across diverse settings (e.g., family, school, and community). As no single factor is solely responsible for the development of child and adolescent mental and behavioral disorders, a multi-factor intervention approach is required. Given communities vary in their profile of child and adolescent mental and behavioral disorders, and local risk and protective influences, tailoring prevention strategies to community conditions is essential. We present here the ‘Communities That Care’ model as a feasible community coalition training approach, scalable to cost-effectively prevent and reduce child and adolescent mental and behavioral disorders across large populations. The Communities That Care model comprises five phases that sequentially prepare and formalize a community coalition, assist a needs assessment, strategically planned implementation, and evaluation. Australian evaluations demonstrate that municipal completion of the model achieves youth-reported improvements in substance use, behavior problems and risk and protective factors. Archival data analyses associate municipal completion with annual reductions of above 8 % per annum in child and adolesc

Enhancing social inclusion in young people could increase engagement in education, yet few longitudinal studies have examined this relationship. This study aimed to identify whether social inclusion in an Australian adolescent sample predicted high school completion three years later. Using state-representative data from the International Youth Development Study, two waves of the youngest cohort (51.6% female and 94.6% Australian born) during mid-adolescence (n = 825, Mage = 15.99, SD = 0.39) and post-secondary school (n = 809, Mage = 19.03, SD = 0.44) were analyzed. Factor analysis identified a 4-factor structure that represented an overarching social inclusion construct: (1) Citizenship, (2) Connectedness to Community, (3) Connectedness to Family, and (4) Connectedness to and Participation in School. Multivariate regression analyses indicated higher social inclusion levels in mid-adolescence predicted an increased likelihood of high school completion three years later. The implementation of strategies that incorporate the enhancement of social inclusion may improve educational outcomes for young people.

Adolescent and young adult health, development, and behavior lay a foundation for future population health. Increasing rates of young adult homelessness mean there is a need for research which generates evidence to support a stronger focus on population-level prevention. Using longitudinal data from a population-based sample of young adults participating in the cross-nationally matched International Youth Development Study, we examined adolescent antecedents of young adult homelessness in Washington State in the USA and in Victoria, Australia. Participants were surveyed using a modified version of the Communities That Care youth survey. Analyses of prospective, longitudinal data from 1945 participants, recruited as state-representative secondary school samples at grade 7 (average age 13, 2002) and longitudinally compared at young adulthood (average age 25, 2014), showed that young adults in Washington State reported higher rates of past year homelessness (5.24%) compared to those in Victoria (3.25%). Path modeling showed less positive family management strategies at age 13 uniquely increased risk for age 25 homelessness. This effect remained after accounting for age 15 antecedents in peer-group, school, and community environments. Friends' drug use, school suspension, academic failure, and low neighborhood attachment at age 15 mediated the association between less positive family management strategies at age 13 and age 25 homelessness. Despite observing some cross-national differences in levels of family, peer-group, school, and community antecedents, we found that these factors equally increased risk for age 25 homelessness in both states, suggesting similar cross-national influences for young adult homelessness. The findings indicate cross-nationally common adolescent antecedents for young adult homelessness that could be targeted by prevention strategies across international settings.

Changes in the working, study and social lives of emerging adults due to the COVID-19 pandemic have led to greater need for external supports. Many who lived independently may have sought that support by returning to live with parents. This study identifies factors associated with returns made between 2019 and 2020. It describes supports needed and obtained, relationships between parents and their resident emerging adults and identifies correlates of poor coping and high psychological distress. Data from the Longitudinal Surveys of Australian Youth and the Longitudinal Study of Australian Children were used and showed half of the emerging adults who moved did so due to COVID-19 restrictions. Loss of work and increased need for emotional and financial support were key drivers of moves. Nineteen per cent who returned found spending more time with family difficult and over half did not have their support needs fully met, increasing their odds of poor coping at that time (OR = 2.9, 4.3, respectively) and subsequent psychological distress (OR = 6.0). Families were an important source of support but could not necessarily mitigate all challenges; for some emerging adults, returning to live with parents gave rise to additional difficulties which negatively affected mental health.

Worldwide, Indigenous youth face ongoing challenges and inequalities. Increasing our understanding of life course patterns in Indigenous youth will assist the design of strategies and interventions that encourage positive development. This study aimed to increase understanding of resilience and positive development in Indigenous and non-Indigenous youth across Australia and the United States of America. The Australian sample comprised 9680 non-Indigenous and 176 Pacific Islander and Aboriginal and Torres Strait Islander peoples. The USA sample comprised 2258 non-Indigenous and 220 Pacific Islander, Native Hawaiian and Native American/American Indian peoples. Data were used to examine how Indigenous background, volunteering, and community involvement at average age 15 years (Grade 9) predicted five young adult positive development indicators: Year 12 (Grade 12) school completion, tertiary education participation, independent income, paid employment, and intimate relationship formation from age 18 to 28 years. Multilevel regression analyses revealed that while Indigenous youth showed slower increases in positive young adult development over time, when adjusting for socioeconomic disadvantage, there was a reduction in this difference. Moreover, we found that Grade 9 community involvement and volunteering were positively associated with young adult development for Indigenous and non-Indigenous youth. Findings indicate the importance of addressing structural inequalities and increasing adolescent opportunities as feasible strategies to improve positive outcomes for young Indigenous adults.

OBJECTIVE: To test the premise that youth alcohol harm minimization policies (compared with abstinence policies) reduce later drinking and harmful consequences of alcohol use in young adulthood, we compared associations among adolescent alcohol use, young adult alcohol consumption, and alcohol-related harms in Victoria, Australia and Washington State, United States. METHOD: Data came from the International Youth Development Study, a longitudinal, cross-national study of the development of substance use. State-representative samples of seventh-grade (age 13) students in Victoria (n = 984, 53% female, 90% White) and Washington (n = 961, 54% female, 73% White) were surveyed in 2002, 2003, 2004, and 2014 (age 25). Participants self-reported alcohol initiation by age 15 and age 25 alcohol consumption (per the Alcohol Use Disorders Identification Test). Path modeling tested associations among age 15 alcohol use, age 25 consumption, and alcohol-related harms at age 25; multiple group modeling tested the equivalence of parameter estimates across states. RESULTS: Age 25 alcohol consumption was lower in Washington versus Victoria and was associated with poor physical and mental health, partner conflict, substance use, criminal behavior, and violence exposure in both states equally. Living in Washington predicted lower levels of multiple alcohol-related harms at age 25 indirectly via lower age 25 alcohol consumption. CONCLUSIONS: Young adults growing up in Victoria reported greater alcohol consumption in young adulthood, which was associated to the same degree with the harms measured regardless of alcohol policy context. Findings support state-level policies that promote alcohol abstinence in adolescence and reduced consumption in young adulthood.

Homelessness is associated with various co-occurring health and social problems yet; few contemporary international studies have examined these problems in young adulthood. This descriptive study presents cross-state comparison of the prevalence of young adult homelessness in Washington State, USA and Victoria, Australia using state representative samples from the International Youth Development Study (IYDS; n = 1,945, 53% female). Associations between young adult homelessness and a range of co-occurring problems were examined using a modified version of the Communities That Care youth survey. Results showed significantly higher rates of past year homelessness were reported by young adults in Washington State (5.24% vs. 3.25% in Victoria). Cross-state differences were evident in levels of friends' drug use, antisocial behavior, weekly income and support from peers. Unemployment (Adjusted Odds Ratio [AOR] = 2.67), antisocial behavior (AOR = 3.54) and victimization (AOR = 3.37) were more likely among young adults reporting homelessness in both states. Young adults with higher weekly income were less likely to report homelessness (AOR = .69) in both states. No significant association between mental health problem symptoms, substance use, family conflict or interaction with antisocial peers and homelessness were found in either state. Rates of violent behavior were more strongly related to young adult homelessness in Washington State than Victoria. The current findings suggest that programs that enable young adults to pursue income and employment, reduce antisocial behavior and include services for those who have been victimized, may help to mitigate harm among young adults experiencing homelessness.

Homelessness is associated with a range of negative health and behavioral outcomes, yet life-course pathways to homelessness from adolescence to early adulthood are not well-documented. This study asks to what extent do early-mid adolescent risk and protective factors predict young adult homelessness, and whether the predictive nature of these factors is similar in Victoria, Australia, and Washington State in the USA. As part of the International Youth Development Study, adolescents were recruited as state representative secondary school samples at grade 7 (age 13, 2002) and longitudinally compared at average age 25. Higher rates of past year homelessness were reported by Washington State (5.24%), compared to Victorian young adults (3.25%). Although some cross-state differences in levels of adolescent demographic, individual, family, peer group, school, and community predictors were found, cross-state comparisons showed these factors were equally predictive of young adult homelessness in both states. In univariate analyses, most adolescent risk and protective factors were significant predictors. Unique multivariate adolescent predictors associated with young adult homelessness included school suspension (adjusted odds ratio [AOR] = 2.76) and academic failure (AOR = 1.94). No significant unique protective effects were found. Prevention and intervention efforts that support adolescents' academic engagement may help in addressing young adult homelessness. The similar cross-state profile of adolescent predictors suggests that programs seeking to support academic engagement may influence risk for homelessness into young adulthood in both states. The similarity in life-course pathways to homelessness suggests that the USA and Australia can profitably translate prevention and intervention efforts to reduce homelessness while continuing to identify modifiable predictors.

BACKGROUND: Injuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors. METHOD: Using a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups. RESULTS: Statistically significant relative reductions in all hospital injury admissions in 0-4 year olds were associated with communities completing the CTC process and in 0-19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries. CONCLUSION: The findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.

Background This study sought to identify depression trajectories across childhood and to model a range of child and family predictors of whether a child may be on an increasing trajectory towards depressive disorder in adolescence. Methods Multi-group growth mixture modelling (MGMM) was used on a sample of 4983 children from the Longitudinal Study of Australia Children (LSAC). Depressive symptoms of these children were assessed over 10-years with six time-points, administered every second year commencing at 4 years via the parent report version of the Strength and Difficulties Questionnaire. Predictors of class membership were also examined. Results Four trajectories were found to be the best fitting model characterising low-stable (75%); decreasing (11%); increasing (9%); high and rising (6%) groups. Females were more likely to be in a trajectory of increasing depressive symptoms between 4 and 14 years of age than males. Reactive temperament and maternal depression at four and six years of age were consistent predictors of increasing and high trajectories while persistent temperament acts as a protective factor for females. Limitations The findings should be interpreted in the light of limitations due to common-method variance and the absence of diagnostic indicators of depressive disorder. Conclusions We conclude that there are gender differences in patterns of depressive symptoms from childhood to adolescence and meaningful predictors of these early developmental trajectories. Preventative interventions in childhood targeting parents with depression and children with temperamental difficulties may be indicated.

BACKGROUND: This cluster randomised control trial is designed to evaluate whether the Communities That Care intervention (CTC) is effective in reducing the proportion of secondary school age adolescents who use alcohol before the Australian legal purchasing age of 18 years. Secondary outcomes are other substance use and antisocial behaviours. Long term economic benefits of reduced alcohol use by adolescents for the community will also be assessed. METHODS: Fourteen communities and 14 other non-contiguous communities will be matched on socioeconomic status (SES), location, and size. One of each pair will be randomly allocated to the intervention in three Australian states (Victoria, Queensland and Western Australia). A longitudinal survey will recruit grade 8 and 10 students (M = 15 years old, N = 3500) in 2017 and conduct follow-up surveys in 2019 and 2021 (M = 19 years old). Municipal youth populations will also be monitored for trends in alcohol-harms using hospital and police administrative data. DISCUSSION: Community-led interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-level behaviour change, including reduced alcohol and drug use. We expect that the study will be associated with significant effects on alcohol use amongst adolescents because interventions adopted within communities will be based on evidence-based practices and target specific problems identified from surveys conducted within each community. TRIAL REGISTRATION: The trial was retrospectively registered in September, 2017 ( ACTRN12616001276448 ), as communities were selected prior to trial registration; however, participants were recruited after registration. Findings will be disseminated in peer-review journals and community fora.

INTRODUCTION AND AIMS: There is a need to explain reported trends of reduced alcohol and drug (substance) use in school-aged children in Australia. This study used student survey data collected in the states of Victoria, Western Australia and Queensland to examine trends in substance use and associated influencing factors. DESIGN AND METHODS: Youth self-reports were examined from 11 cross-sectional surveys completed by 41 328 adolescents (average age 13.5 years, 52.5% female) across 109 Australian communities between 1999 and 2015. Multi-level modelling was used to identify trends in adolescent reports of lifetime alcohol, tobacco and cannabis use, adjusted for age, gender, social disadvantage and minority status. Trends in influencing factors were also examined that included: individual attitudes, and family, school and community environments. Multivariate analyses estimated the main contributors to alcohol use trends. RESULTS: Alcohol, tobacco and cannabis use all fell significantly from 1999 to 2015. Higher levels of use were observed in Victoria compared to Western Australia or Queensland. Multivariate analyses identified reductions in favourable parent attitudes and lower availability of substances as direct contributors to reducing alcohol use trends. Indicators of school and family adjustment did not show similar trend reductions. DISCUSSION AND CONCLUSIONS: Reductions in adolescent alcohol, tobacco and cannabis use from 1999 to 2015 were associated with similar reductions in parent favourable attitudes and availability of substances. It is plausible that a reduced tendency for parents and other adults to supply adolescent alcohol are implicated in the reductions in adolescent alcohol use observed across Australia.