Artykuły w czasopismach na temat „Controlling Alcohol and Relationship Enhancement program”

AbstractWe assessed the effects of the Controlling Alcohol and Relationship Enhancement (CARE) program, an early intervention combining reduction of hazardous alcohol consumption and enhancement of couple relationships. Thirty-seven hazardous drinking couples were randomly allocated to either the CARE program or to a control condition. CARE couples improved their communication more than controls, but couples in both conditions reduced hazardous drinking to a similar extent. CARE is a potentially useful means of promoting positive relationship communication in hazardous drinking couples.

Abstract Introduction Emerging empirical evidence suggests green space exposure is protective against insufficient sleep. Limited studies exist, however, exploring the relationship between greenspace exposure and sleep among low income populations in the United States. Methods Using a sample of Supplemental Nutrition Assistance Program (SNAP) participants (n=104) recruited from Champaign County, Illinois, we examined the relationship between self-reported sleep duration and exposure to green space. Sleep duration was determined using the question, “On average, how many hours did you sleep each night during the past 4 weeks?” Green space exposure was determined using satellite imagery from the National Aeronautic Space Administration (NASA) normalized difference vegetation index (NDVI). An NDVI score was assigned to each participant based on residential geo-referenced data. Multiple linear regression was performed in SPSS to explore the relationship between self-reported sleep duration and green space. Results Higher number of hours of sleep within a 24-hour period was positively associated with higher scores for greenspace exposure (β=0.091, P=0.02), controlling for age, gender, smoking status, education, alcohol consumption, and sleep quality. Sleep duration was negatively associated with age (β=-0.03, P=0.007), but positively associated with sleep quality (β=0.856, P=0.008). Conclusion In a sample of SNAP participants, exposure to green space was associated with more hours of sleep per night. Additional studies with larger, and more geographically diverse samples of low income adults are needed to determine whether this relationship is robust. Support USDA UNC/DUKE BECR Center

Abstract Objectives To characterize the relationship between dietary fiber intake and the prevalence of allergic diseases, seasonal allergies and asthma, in a college student population. Methods Data were collected from 2012–2021 through the College Health and Nutrition Assessment Survey, an ongoing cross-sectional study at a midsized, public New England university. Students (18–24 years; n = 4135; 67% female) completed a comprehensive, online demographic and health information survey, a 3-day food record, and an analysis of their average nutrient intake via an online program (Diet and Wellness Plus). After stratifying by sex, students’ fiber intake (g/day) were grouped into quartiles; differences in allergy and asthma prevalence across quartiles were evaluated via chi-square tests. Logistic regression was used to examine differences in allergy and asthma prevalence between low fiber intake and those with higher intakes after controlling for covariates BMI, smoking status, and alcohol consumption. Results Of the final sample, 37.6% and 19.2% reported a seasonal allergy and asthma, respectively, after exclusion of participants with missing data (4135 of 5093). Food records indicate only 18.2% of females and 12.2% of males are meeting recommended intakes of dietary fiber. Quartile fiber consumption was associated with seasonal allergy prevalence in males (X2 = 10.657, df = 3, P = 0.014) and females (X2 = 15.526, df = 3, P = 0.001). Females consuming the lowest quartile of fiber intake (<13.62 g/day) experience 1.39 times the odds of seasonal allergies (P < 0.001, 95% CI 1.164–1.651) when controlling for the covariates of BMI, smoking status, and alcohol use. No significant differences in asthma prevalence were identified between fiber intake quartiles. Conclusions Consistent with previously identified associations, our findings suggest fiber intake is related to seasonal allergies but not asthma, with a stronger relationship among females. This study further emphasizes the need to investigate potential dietary risk factors for allergic diseases and to inform institutions on key dietary priorities for college student health. Funding Sources New Hampshire Agriculture Experiment Station and USDA National Institute of Food and Agriculture Hatch Project 1,010,738.

The research was focused on the relationship of management functions of the administrators to the attainment of the school’s vision and mission because the researcher believed that it is possible for the College to accomplish and to attain the school’s vision and mission if only there will be direct participation, cooperation and coordination among administrators and staff. Specifically, it sought to find out the following: the effectiveness level of the said management functions of the school administrators and the different assessments on these matters by the two sets of respondents; the attainment level of the school’s vision and mission; the relationship, if there is any, between the two cited variables of the study; the frequency occurrence of the problems related to management functions; and the proposed framework for skills enhancement program. The respondents of the study were all 56 teaching staff and 17 non-teaching staff of the City College of Calamba. No sampling technique was used. Statistical treatments applied to the data of the study include the frequency and percent distributions in presenting the category of the respondents; the simple mean in determining the effectiveness level of the management practices, attainment level of the school’s vision and mission and the occurrence frequency of related problems; and the Goodman and Kruskal’s Gamma Correlation in establishing relationship between the two variables of the study. The research focused on three integrated elements comprised of the heart of every organization and its culture: its primary purpose; its desired future; and its core beliefs about itself and others. These serve as the “what to do and how to do” of every organization. Its achievement is the success and end-all, but this could only be attained if it is organized, operated and administered. According to the research result, the management functions of the CCC Administrators specifically, planning, organizing, leading and controlling were generally effective as assessed by the two sets of respondents. In the management functions of the School’s Administrators in relation to the attainment of CCC’s vision and mission the conducted correlation analysis generated a computed gamma coefficients of 0.577 and 0.729 which means that there are “high positive correlations” between the effectiveness of the management practices of the school administrators and the attainment both of the CCC’s vision and mission. Some related problems to the management functions of the school’s administrators were identified by both teaching and non-teaching staff such as: (1) poor learning environment – no air conditioning, insufficient space & lighting, and primitive toilet facilities (2) the work is not appropriately divided among faculty members and staff (3) they believe that the school administrators are the role policy maker in the school and (4) the teaching staff observe the existence of gap between the administrators and subordinates with a mean of 3.30 (sometimes), while the non-teaching staff was observed to withhold information (lie or tell half-truths) with a mean of 3.53 (sometimes). A proposed framework for skills enhancement program was formulated. It has the following: aspects of management for development, objective, activity, implementing strength, KRA indicator, performance indicator, budget and time. In the aspects of management for development, there are the four management practices – planning, organizing, leading and controlling. This was believed to be a great help for the administrators of City College of Calamba to improve the level of their effectiveness towards the attainment of the school’s vision and mission. Key words: public administration, management, effectiveness, efficiency, skills enhancement, development, descriptive method, city college

The co-morbidity of personality disorders (PDs) and other dysregulatory personality patterns with addiction have been well-established, although few studies have examined this interplay on long-term sobriety outcome. In addition, health care professionals suffering from addiction have both a significant public health impact and a unique set of treatment and recovery challenges. The aim of this study was to investigate if personality variables differentiated sobriety outcome in this population over a two year interval. A clinical sample of health care professionals participated in a substance abuse hospital treatment program individually tailored with respect to personality. Participants took the Temperament and Character Inventory and the Millon Clinical Multiaxial Inventory at intake, and were tracked two years post-discharge to determine sobriety status. Univariate analyses showed antisocial personality, female gender, and alcohol dependence were independent predictors of relapse, however a significant relationship between personality and substance use did not exist in multivariate analysis when controlling for demographic variables The lack of multivariate relationships demonstrates the heterogeneity in self-report measures of personality, which suggests the interplay of personality and addiction is complex and individualized.

Physical and sexual violence are commonly researched as risk factors for human immunodeficiency virus (HIV). However, psychological violence and its relationship with HIV risk behaviors have received limited attention among African American/Black (Black) women. This study examined (a) the frequency of recent (past 3 months) psychological violence, physical violence, and sexual violence and (b) the association of HIV risk behaviors, including unprotected sex, sex under the influence of alcohol/drugs, and sex exchange for money/drugs/shelter, with psychological violence. Participants included 191 women (89.2% Black), who were recruited through information sessions held at community centers, Parent Teacher Association meetings, substance use and HIV counseling centers, radio public service announcements, and word of mouth. Interested women participated in a multisession HIV and substance use prevention program and completed a self-reported assessment at program baseline. The current study utilized baseline data collected for a longitudinal study. Results from descriptive analysis indicated that the rate of psychological violence was higher than physical violence or sexual violence, and it was strongly associated with physical and sexual violence. Furthermore, hierarchical logistic regression analysis showed that unprotected sex was significantly associated with recent psychological violence after controlling for covariates. Findings suggest that recent psychological violence is more common than physical or sexual violence and it relates to sexual risk behaviors among Black women. Recent psychological violence may indicate psychosocial and sexual vulnerability for HIV and warrants particular attention among Black women.

Introduction Antiretroviral therapy (ART) has reduced HIV viral replication and transmission of disease. However, continuing incidence of new HIV infections has been attributed to undiagnosed HIV infections among injection drug users. This purpose of this retrospective cross-sectional study was to determine whether depression moderates the relationship between injection drug use and HIV screening among people with substance use in the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program. Methods Electronic health record data were obtained from three consenting medical facilities (n = 103). Multivariable logistic regression analysis was conducted to determine the moderating effect of depression on the relationship between injection drug use and HIV screening. Results Bivariate analyses revealed that HIV screening was more common among individuals not engaged in injection drug use, 75% and 57% respectively. Participants who had never been screened had worse depressive symptoms on the PHQ-2 (M = 3.00, SE = 0.42) than individuals who had been screened for HIV (M = 1.45, SE = 0.17). After controlling for demographic variables, tobacco use, alcohol consumption, and drug abuse, results indicated a moderating effect of depression on the relationship between injection drug use and receipt of HIV screening (aOR = 0.85 [95% CI = 0.84, 0.86). Discussion Findings suggest that high risk subgroups such as injection drug users with severe depression may not be using HIV prevention services, leading to possible delays in HIV diagnosis. Integration of behavioral interventions and HIV prevention services may reduce risk factors among depressed injection drug users. Such interventions may improve retention for injection drug users who experience worse depressive symptoms post HIV diagnosis.

AbstractThe aim of this study is to characterize the relationship between major depression and the metabolic syndrome in a large community based sample of Australian men and women aged 26–90 years. A lifetime history of major depression was assessed by telephone interview following the DSM–III-R. A current history of metabolic syndrome was assessed following the United States National Cholesterol Education Program Adult Treatment Panel III (NCEP AP-III) guidelines 1 to 3 years later. Logistic regression was used to estimate the association between depression and the metabolic syndrome, and its component criteria, controlling for age, sex and alcohol dependence. There was no association between a lifetime history of major depression and the presence of the metabolic syndrome. There was a weak association between depression and low high-density lipoprotein cholesterol but not with other component criteria of the metabolic syndrome. Despite calls for interventions directed at depression to reduce the onset of the metabolic syndrome there are important failures to replicate in large samples such as this, no consensus regarding the threshold at which depression may pose a significant risk even allowing for heterogeneity across populations, and no consensus regarding confounders that may explain inter-study differences. The absence of any dosage effect of depression on the associated risk for the metabolic syndrome in other unselected samples does not support a direct causal relationship. The call for intervention studies on the basis of the currently published evidence base is unwarranted.

The association between descriptive norms regarding peer drinking and college students’ binge drinking has been established; however, the mediating and moderating mechanisms underlying this relationship among first-and second-year college students remain minimally explored. Drawing on social norms theory, motivational model of alcohol use, and the theory of normative social behavior, the current study investigated whether enhancement drinking motives mediated the relationship between descriptive norms regarding peer drinking and college students’ binge drinking, and whether this relationship was moderated by alcohol resistance self-efficacy. Five hundred and nineteen first-and second-year college students (Mage = 19.19 years, SD = 0.98) who were from four universities and had at least one time of heavy episodic drinking during the last year completed self-report questionnaires. After controlling for sex, age, and university variable, stronger descriptive norms regarding peer drinking were positively associated with a greater frequency of binge drinking. Enhancement drinking motives partially mediated the effects of descriptive peer drinking norms on binge drinking. Furthermore, alcohol resistance self-efficacy moderated the direct effects of descriptive peer drinking norms on binge drinking. Compared with college students who reported high alcohol resistance self-efficacy, the direct effects of descriptive peer drinking norms on binge drinking were stronger among students with low alcohol resistance self-efficacy. These findings point to the potential value of alcohol intervention approaches including efforts to help first-and second-year college students change enhancement drinking motives and increase their ability of resisting drinks in the context of pervasive peer drinking.

Background and Aims: It is assumed that a relevant subgroup of individuals experiences an addiction-like eating behaviour (Food Addiction), characterized by an impaired control over eating behaviour, emotional eating and food craving. Individuals experiencing Food Addiction partially share common symptomatology with Binge-Eating-Disorder and Bulimia Nervosa. The aim of this study was to investigate the prevalence of Food Addiction, general psychopathology, and associations with weight- and addiction-related constructs in individuals with overweight and obesity, who did not suffer from Binge-Eating-Disorder or Bulimia Nervosa.Methods:N=213 (67.1% female; MBMI=33.35kg/m2, SDBMI=3.79kg/m2) participants who were included in a weight loss program (I-GENDO project) reported BMI and completed questionnaires before the start of the treatment. Food Addiction severity, depressive symptoms, alcohol use disorder, internet use disorder, psychological distress, impulsivity personality trait, impulsive and emotional eating behaviour, food related inhibitory control, weight bias internalization, and self-efficacy were assessed.Results: The prevalence of Food Addiction was 15% with higher, although not statistically significant, prevalence in female (18.2%) compared to male (8.6%) participants. Food Addiction was associated with higher BMI at baseline assessment, low self-esteem, impulsive and emotional eating behaviour, weight bias internalization, and deficits in food-related inhibitory control. In addition, correlations were found between Food Addiction and severity of depressive symptoms, internet use disorder, and psychological distress.Conclusion: A relevant subgroup of participants experiences Food Addiction even when controlling for Binge-Eating-Disorder and Bulimia Nervosa. Future studies are warranted that investigate whether Food Addiction affects treatment success.

Background: Individuals with opioid dependence experience stigma and discrimination. Stigma can potentially reduce treatment-seeking and negatively affect treatment outcomes. We aimed to study the course of stigma and its correlates among patients receiving opioid agonist treatment (OAT). Methods: We recruited 51 subjects (aged between 18 and 45 years) registered in the OAT clinic from February to September 2019. We excluded subjects dependent on alcohol and other drugs (except for cannabis and tobacco), with severe mental illness, intellectual disability, and organic brain disease. We assessed the internalized and enacted stigma and quality of life at the treatment entry and after 3 months. Relationship of stigma with quality of life, socio-demographic, and other clinical variables were examined at the treatment entry. Results: Mean age of the subjects was 26.7 (± 5) years. At the end of three months, 33 (64.7%) patients were retained in the treatment. Internalized stigma correlated negatively with the social and environmental domains of quality of life. The strength of the correlations was modest. No significant correlation was found between demographic and clinical variables and internalized stigma and enacted stigma scores. Both internalized and enacted stigma scores reduced significantly at 3 months follow-up. The significance levels were retained even after controlling for the baseline quality of life scores. Stigma at the treatment entry did not predict early dropout. Conclusion: Despite higher severity at the treatment entry, the level of internalized and enacted stigma reduced significantly within three months of an outpatient-based OAT program.

Recovery capital refers to internal and external resources that facilitate recovery from alcohol and drug disorders. Examples include support from friends and family, access to health and other services, stable housing and finances, and internal assets, such as self-esteem and motivation. Recovery capital is receiving increased emphasis as an integral component of addiction services. However, there are a limited number of studies assessing recovery capital in different settings. The current study assessed recovery capital among 363 individuals entering sober living (recovery) houses (SLHs) and showed how recovery capital was associated with individual and social environment characteristics of the houses. Individual characteristics were assessed shortly after residents entered the house ( M = 17 days, SD = 9 days). Approximately 1 month later, individuals were interviewed about their perceptions of the social environment within the household. We hypothesized residents’ perceptions of social model characteristics within the household would be associated with higher recovery capital. Study findings showed individual characteristics associated with recovery capital included motivation, support from friends and family, and 12-step involvement. Perceptions of the social environment assessed by four subscales on the Community Oriented Program Evaluation Scale and a measure of social model characteristics were correlated with recovery capital. Regression analyses controlling for individual characteristics showed modest but consistent associations with recovery capital. Even after relatively short periods of time in SLHs, resident perceptions of the social environment show associations with recovery capital. Additional research is needed to understand causal dynamics of this relationship and associations with outcome.

Abstract Background Stigma against mental illness cuts across all age, religion, ethnic origin or socio-economic status. Similarly, self-stigma among psychiatric patients is also prevalent worldwide. The consequences of self-stigma are low self-esteem, increased severity of symptoms, low treatment adherence, increased rate of suicidality and decreased quality of life. Thus, this study aims to find the prevalence of self-stigma and its association with self-esteem of patients with mental illness in Nepal. Methods This was a cross-sectional study conducted among 180 patients with mental illness attending a psychiatric Outpatient Department (OPD). Non-probability purposive sampling technique was used for the study. The data was collected by face to face interview technique. Structured interview schedule questionnaire (brief version of internalized stigma scale and Rosenberg self-esteem scale) was used to collect the data. Descriptive statistics, inferential statistics and correlation analysis were used for data analysis. P value was set at 0.05. Results Overall prevalence of self-stigma was 54.44%. Among those who had self-stigma 48% had mild self-stigma, 34.7% had moderate self-stigma and 17.3% had severe self-stigma. Among the five components of self-stigma scale, the highest mean score was on stereotype endorsement, followed by discrimination experience, social withdrawal, stigma resistance, and the lowest for the component of alienation. Furthermore, strong negative correlation (r = − 0.74) was found between self-stigma and self-esteem. The correlation was still significant (r = − 0.69) after controlling for socio-demographic and clinical variables. Hospital admission and diagnostic category of respondents were significantly associated with self-stigma. However, no significant association was found between socio-demographic variables and self-stigma. Conclusion Based on the findings of this study, it can be concluded that self-stigma is prevalent among psychiatric patients in Nepal. Most of the respondents experienced stereotype endorsement. Also, higher self-stigma is significantly associated with poor self-esteem suggesting self-stigma reduction programs. Furthermore, strong negative relationship between self-stigma and self-esteem suggests some causal relationship studies to confirm if self-esteem enhancement program can be beneficial to reduce self-stigma among psychiatric patients.

BackgroundMental illness is not uncommon among males. It is estimated that males are more likely to die by suicide, become dependent on alcohol, report frequent drug use, and be dissatisfied with their life, compared to women. In this study, we assessed the potential to offer support to this population using Text4Hope, a texting mental health service.MethodsThe study was a naturalistic randomized controlled trial comparing two populations of Text4Hope male subscribers; an intervention group (IG, Text4Hope subscribers who received once-daily supportive text messages for 6 weeks) and a control group (CG, Text4Hope subscribers who joined the program in the same time frame but were yet to receive text messages). Inferential statistics were used to compare the severity and the prevalence of the likely stress, anxiety, and depression, between the two groups, using the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorder 7-item (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9), and defined the Composite Mental Health (CMH) score as the sum of these three. T-test, Chi-squared association, and binary logistic regression analyses were applied.ResultsThere were 286 male subscribers to Text4Hope. The majority were above 40 years, white, employed, had postsecondary education, were in a relationship, and owned a home. Mean scores of PSS-10, GAD-7, and PHQ-9 scales and the CMH were significantly higher for the CG compared to the IG, 11.4, 28.8, 25.8, and 18.7%, respectively. Similarly, a statistically significantly lower prevalence in IG, compared to the CG, on likely MDD (58.15 vs. 37.4%) and likely GAD (50 vs. 30.8%), with a small effect size. The IG was a significant predictor for lower odds of both likely MDD and likely GAD while controlling for sociodemographic characteristics.ConclusionsThe Text4Hope service is an effective tool for mental health support for male subscribers during the COVID-19 pandemic. Compared to the males who didn't receive the service, those who received it were in better mental health conditions. Further effort is still needed to encourage males to participate in such online services that can help them receive adequate support, particularly during crisis times.

This article uses a case study of a Melbourne-based youth media project called Youthworx to explore the processes at stake in cultural engagement for marginalised young people. Drawing on ethnographic research conducted between 2008 and 2010, I identify some ways in which the city is implicated in promoting or preventing access to socially valued spaces of creativity and intended social mobility. The ethnographic material presented here has both empirical and theoretical value. It reveals the important relationships between the experience of place, creativity, and social life, demonstrating potentialities and limits of creativity-focused development interventions for marginalised youth. The articulation of these relationships and processes taking place within a particular city setting has theoretical implications. It opens up an opportunity to consider "suburbs" as enacted by specific forms of access, contingencies, and opportunities for a particular demographic, rather than treating "suburbs" as abstract, analytical constructs. Finally, my empirically grounded discussion draws attention to cultural and social consequences that inhabiting certain social worlds and acts of travelling "to and beyond" them have for young people. Youthworx is a community-based youth media initiative employing pathway-based semi-formal creative practices to re-engage young people who have a history of drug or alcohol abuse or juvenile justice, who have been long disconnected from mainstream education, or who are homeless. The focus on media production allows it to tap into, and in fact leverage, popular creativity, tacit knowledge, and familiar media-based activities that young people bring to bear on their media training and work in this context. Underpinned by social and creative industry policy, Youthworx brings together social service agency The Salvation Army (TSA), educational provider Northern Melbourne Institute of TAFE (NMIT), youth community media organisation SYN Media, and researchers at Institute for Social Research, Swinburne University. Its day-to-day operation is run by contractual, part-time media facilitators, social workers (as part of TSA’s in-kind support), as well as media industry experts who provide casual media training. Youthworx is characterised by the diversity of its young demographic. One can differentiate between at least two groups of participants: those who join Youthworx because of the social opportunities, and those who put more value on its skill-development, or vocational creative industries orientation. This social organisation is, however, far from static. Over the two years of research (2008-2010) we observed evolving ideas about the identity of the program, its key social functions, and how they can be best served. This had proceeded with the construction of what the Youthworx staff term "a community of safe belonging" to a more "serious" media work environment, exemplified by the establishment of a social enterprise (Youthworx Productions) in 2010 that offers paid traineeships to the most capable and determined young creators. To accommodate the diversity of literacy levels, needs, and aspirations of its young participants, the project offers a tailored media education program with a mix of diversionary, educational, and commercial objectives. One-on-one media training sessions, accredited courses in Creative Industries (Media), and industry training within Youthworx Productions are provided to help young people develop a range of skills transferable into a variety of personal, social and professional contexts. Its creative studio, where learning occurs, is located in a former jeans factory warehouse in the heart of an industrial area of Melbourne’s northern inner-city suburb of Brunswick. Young people are referred to Youthworx by a range of social agencies, and they travel to Brunswick from across Melbourne. Some participants are known to spend over three hours commuting from outer suburbs such as Frankston or even regional towns such as King Lake. Unlike community-based creative programs reliant on established community structures within local suburbs (for example, ICE in Western Sydney), Youthworx moved into Tinning Street in Brunswick because its industry partner—The Salvation Army—had existing youth service infrastructure there. The program, however, was not tapping into an existing media “community of practice” (Lane and Wenger); it had to forge its own culture of media participation. In the early days of the program, there were necessary material resources and professional expertise (teachers/social workers/a creative venue), but it took a long while, and a high level of dedication, passion, and practical optimism on the part of the project managers and teaching staff, for young people to genuinely engage in media training and production. Now, Youthworx’s creative space is a “practised place” in de Certeau’s sense. As “the street geometrically defined by urban planning is transformed into a space by walkers” (De Certeau 117), so is the Youthworx space produced by practices of media learning and making by professional creative practitioners and young amateur creators (Raffo; for ideas on institutionalised co-creative practice see Spurgeon et al.). The Brunswick location is where our extensive ethnographic research has taken place, including regular participant observation and qualitative interviews with staff and young participants. The ethnographers frequently travelled with young people to other locations within Melbourne, accompanying them on their trips to youth community radio station SYN Media in the CBD, where they produce a weekly radio show, as well as to film shoots and public social events around the city. As an access learning program for marginalised youth from around Melbourne, Youthworx provides an interesting example to explore how the concerns of material and cultural capital, geographic and cultural distance intersect and shape processes of creative participation and social inclusion. I draw on our ethnographic material to illustrate how these metonymic relationships play out in the ways young participants “travel distance” (Dewson et. al.) on the project and across the city, both figuratively and literally. The idea of “distance travelled” is adapted here from evaluation literature (for other relevant references see Dowmunt et al.; Hayes and Edwards; Holdsworth et al.), and builds on the argument made previously (Podkalicka and Staley 5), to encompass both the geographical mobility and cultural transformation that young people are supported to undergo as an intended outcome of their involvement in Youthworx. This paper also takes inspiration from ethnographic approaches that study a productive and transformative relationship between material culture, spatial geography and processes of identity formation (see Miller). What happens to Youthworx young participants as they travel in a trivial, and at first sight perhaps inconsequential, way between the suburbs they live in, the Youthworx Brunswick location and the city is both experientially real and meaningful. “Suburban space” is then a cultural site that simultaneously refers to concrete, literal places as well as “a state of mind”—that is, identification and connections that are generative of a sense of identity and belonging (Ferber et al.). Youthworx is an intermediary point on these young people’s travels, rather than the final destination (Podkalicka and Staley 5). It provides access to various forms of new spatial, social, and creative experiences and modes of expression. Creating opportunities for highly disenfranchised young people to access and develop new social and creative experiences is an important aspect of Youthworx’s developmental agenda, and is played out at both philosophical and practical levels. On the one hand, a strength-based approach to youth work assumes respect for young people’s potential and knowledges—unlike public discourses that deny them agency due to an assumed lack of life experience (e.g., Poletti). In addition to the material provision of "food and shelter" typical of traditional social work, attention is paid the higher levels of the Maslow hierarchy of human needs, with creativity, self-esteem, and social connectedness at the top of the scale (see also Podkalicka and Campbell; Podkalicka and Thomas). Former Manager of The Salvation Army’s Brunswick Youth Services (BYS)—one of Youthworx’s partners—Craig Campbell argues: Things like truth and beauty are a higher order of dreams for these kids. And by truth I don’t mean the simple lies that can be told to get them out of trouble [but] is there a greater truth to life than a grinding existence in the impoverished neighbourhood, is there something like beauty and aesthetics that wakes us up in the morning and calls a larger life out of us? Most of those kids only faintly dream of such a thing, and this dream is rapidly being extinguished under the weight of drugs and alcohol, abusive family systems, savage interaction with law and justice system, and education as a toxic environment and experience. (Campbell) Campbell's articulate reflection captures the way the Youthworx project has been conceived. It is also a pertinent example of the many reflections on experience and practice at Youthworx that were recorded in my fieldwork, which illustrate the way these kinds of social projects can be understood, interpreted and evaluated. The following personal narrative and contextual description introduce some of the important issues at stake. (The names and other personal details of young people have been changed.) Nineteen-year-old Dave is temporarily staying in an inner-city refuge. Normally, however, like most Youthworx participants, he lives in Broadmeadows, a far northern suburb of Melbourne. To get to Brunswick, where he does his accredited media course three days a week, he either catches a train or waits for a mini-bus to drive him there. The early-morning pick-up for about ten young people is organised by the program’s partner—The Salvation Army. At the Youthworx creative studio, located in the heart of Brunswick, right next to railway tracks, young people produce an array of media products: live and pre-recorded radio programs, digital storytelling, mini-documentaries, and original music. Once at Youthworx, they share the local neighbourhood with other artists who have adapted warehouses into art workshops, studios and galleries. The suburb of Brunswick is well-known for its multicultural profile, a combination of industrial and residential estates, high rates of tertiary students due to its proximity to universities, and its place in the recent history of urban gentrification. However, Youthworx participants don’t seek out or engage with the existing, physically proximate creative base, even within the same street. On a couple of occasions, the opposite has been the case: Youthworx students have been involved in acts of vandalism of local residents’ property, including nearby parked cars. Their connections to the Brunswick neighbourhood remain poor, often reflecting their low social capital as a result of unstable residential situations, isolation, and fraught relationships with family. From Brunswick, they often travel to the city on their own, wander around, sit on the steps of Flinders Street train station—an inner-city hub and popular meeting place for locals and tourists alike. Youthworx plays an important role in these young people’s lives, as an important access point to not only creative digital media-based experiences and skill development, but also to greater and basic geographical mobility and experiences within the city. As one of the students commented: They are giving us chances that we wouldn’t usually get. Every day you’re getting to a place, where it’s pretty damn easy to get into; that’s what’s good about it. There are so many places where you have to do so much to get there and half the time, some people don’t even have the bloody bus ticket to get a [job] interview. But [at Youthworx/BYS], they will pick you up and drive you around if you need it. They are friends. It is reportedly a common practice for many young people at Youthworx and BYS to catch a train or a tram (rather than bus) without paying for a ticket. However, to be caught dodging a fare a few times has legal consequences and young people often face court as a result. The program responds by offering its young participants tickets for public transport, ready for pick-up after afternoon activities, or, if possible, "driving them around"—as some young people told me. The program’s social workers revealed that girls are particularly afraid to travel on their own, especially when catching trains to the outer northern suburbs, for fear of being harassed or attacked. These supported travels are as practical and necessary as they are meaningful for young people’s identity formation, and as such are recognised and built into the project’s design, co-ordination and delivery. At the most basic level, The Salvation Army’s social workers pick young people up from the Broadmeadows area in the mornings. Youthworx creative practitioners assist young people to make trips to SYN Media in the city. For most participants, this is either the first or sporadic experience of travelling to the city, something they enjoy very much but are also somewhat daunted by. Additionally, as part of the curriculum, Youthworx staff make a point of taking young people to inner-city movie theatres or public media events. The following vignette from the fieldwork highlights another important connection between physical journey and creative expression. There is an excitement in Dave’s voice when he talks about his favourite pastime: hanging out around the city. “Why would you walk around the streets?” a curious female friend interjects. Dave replies: “No, it’s not the streets, man. It’s just Federation Square, everywhere … There is just all these young wannabe criminals and shit. People don’t know what goes on; and I want to do a doco on the city, a little doco of the people there, because I know a lot of it.” Dave’s interest in exploring the city may be interpreted as a rather common, mundane routine shared by mildly adventurous adolescents of all walks. And yet, there is much more at stake in his account, and for Youthworx young participants more generally. As mentioned before, for many of these young people, it is the first opportunity to travel to the city. This experience then is crucial in a sense of self-exploration and self-discovery. As they overcome their fear of venturing out into the city on their own, they also learn that they have knowledge which others might lack. This moment of realisation is significant and empowering, and they want to communicate this knowledge to others. Youthworx assists them in learning how to translate this knowledge in a creative and constructive way, through an expression that weaves between the free individual and the social voice constructed to enable a dialogue or understanding (Podkalicka; Podkalicka and Campbell; Podkalicka and Thomas; also Soep and Chavez). For an effective communication to occur, a crafted social voice requires skills and a critical awareness of oneself and an audience, which is very different from the modes of expression that these young people might have accessed previously. Youthworx's young participants draw heavily on their life experiences, geographical locations, the suburbs they come from, and places they visit in the city: their cultural productions often reference their homes, music clubs and hang-out venues, inner city streets, Federation Square, and Youthworx’s immediate physical surroundings, with graffiti-covered narrow alleys and railway tracks. The frequent depiction of Youthworx in young people’s creative outputs is often a token of appreciation of the creative, educational and social opportunities it has offered them. Social and professional connections they make there are found to be very valuable. The existing creative industries literature emphasises the importance of social networks to existing communities of interest and practice for human capacity building. Value is argued to lie not only in specific content produced, but in participatory processes that establish a link between personal growth, individual skills and social and professional networks (Hearn and Bridgestock). In a similar vein, Carlo Raffo uses Granovetter’s concept of “weak ties” to suggest that access to “social relations that go beyond the immediate locality and hence their immediate experiences” can provide marginalised young people with “pathways for authentic and informal learning that go beyond the structuring influences of class, gender and ethnicity and into new and emerging economic experiences” (Raffo 11). But higher levels of confidence or social skills are required to make the most of vocational or professional opportunities beyond the supportive context of Youthworx. Connections between Youthworx participants and other creative practitioners within the creative locality of Brunswick have been absent thus far. Transitions into mainstream education and employment have also proven challenging for this group of heavily marginalised youth. As we found during our ongoing fieldwork, even the most talented students find it hard to get into mainstream education courses, or to get or keep jobs. The project serves as a social basis for young people to develop self-agency and determination so they can start engaging with new opportunities and social networks outside the program (Raffo 15). Indeed, the creative practitioners at Youthworx are key facilitators of connections between young people and the external world. They act as positive role models socially, and illustrate what is possible professionally in terms of media excellence and employment (see also Raffo). There are indications that this very supportive, gradual process of social learning is starting to bear fruit for individual students and the Youthworx community as a whole as they grow more confident with themselves, in interactions with others, and the media work they do. Media projects such as Youthworx are examples of what Leadbeater and Wong call “disruptive innovation,” as they provide new ways of learning for those alienated by formal education. The use of digital hands-on media production makes educational processes relevant and engaging for young people. However, as I demonstrate in this paper, there are tangible, material barriers to releasing creativity, or enhancing self-discovery and sociality. There are, as Leadbeater and Wong observe, persistent links between cultural environment, socio-economic status, corresponding attitudes to learning and educational success in the developed world. In the UK, for example, only small percent of those from the lowest socio-economic background go to university (Leadbeater and Wong 10). Youthworx provides an opportunity and motivation for young people to break a cycle of individual self-destructive behaviour (e.g. getting locked up every 6 months), intergenerational reliance on welfare, or entrenched negative attitudes to learning. At the basic level, it encourages and often insists that young people get up in the morning, with social workers often reporting to have to “knock at people’s houses and get them ready.” The involvement in Youthworx is often an important reason to start delineating between day and night, week and weekend. A couple of students commented: I slept a lot. Yeah, I was always sleeping during the day and out at night; I could have still been doing nothing with my life [were it not for Youthworx]. Now people ask if I want to go out during the week, and I just can’t be bothered. I just want to sleep and then go to [Youthworx] and then weekends are when you go out. It also offers a concrete means to begin exploring the city beyond the constraints of their local suburbs. This literal, geographical mobility is interlocked with potential for a changed perception of opportunities, individual transformation and, consequently, social mobility. Dave, as we have seen, is attracted to the idea of exploring the city but also has creative aspirations, and contemplates professional prospects in the creative industries. It is important to note that the participants are resilient in their negotiation between the suburban, Youthworx and inner city worlds they can inhabit. Accessing learning, despite previous negative schooling experiences, is for many of them very important, and reaffirming of life they aspire to. An opportunity to pursue dreams, creative forms of expression, social networks and education is a vital part of human existence. These aspects of social inclusion are recognised in the current articulation of social policy reconceptualised beyond material, economic equality. Creative industry policy, on the other hand, is concerned with fostering creative outputs and skills to generate engagement and employment opportunities in the knowledge-based economies for wide sections of the population. The value is located in human capacity building, involving basic social as well as vocational skills, and links to social networks. The Youthworx project merges these two policy frameworks of the social and creative to test in practice new collaborative approaches to youth development. The spatial and cultural practices of young people described here serve a basis for proposing a theoretical framework that can help understand the term "suburb" in an intrinsically relational, grounded way. The relationships at stake in cultural and social participation for marginalised young people lead me to suggest that the concept of ‘suburb’ takes on two tightly interwoven meanings. The first refers symbolically to a particular locale for popular creativity (Burgess) or even marginal creativity by a group of young people living at the periphery of the social system. The second meaning refers to the interlocked forms of material and cultural capital (and distance), as theorised in Bourdieu’s work (e.g., Bourdieu). It includes physical, spatial conditions and relations, as well as cultural resources and possibilities made available to young participants by the project (e.g., the instituted, supported travel across the city, or the employment of creative practitioners), and interlinked with everyday dispositions, practices, and status of young people (e.g., taste). This empirically-grounded discussion allows to theorise ‘suburbs’ as perceived and socially enacted by concrete, relational forms of access, contingencies, and opportunities for a particular demographic, rather than analytically pre-conceived, designated spaces within an urban system. The ethnographic material reveals that cultural participation for marginalised youth requires an integrated approach, with a parallel focus on material and creative opportunities made available within creative sites such as Youthworx or even the Brunswick creative area. The important material constraints exemplified in this paper concern socio-economic background, cultural disadvantage and geographical isolation and point to the limits of the creative industries-based interventions to address social inclusion if carried out in isolation. They tap into the very basis of risks for this specific demographic of marginalised youth or "youth at risk." The paper suggests that the productive emphasis on the role of media and communication for (youth) development needs to be contextualised and considered along with the actual realities of everyday existence that often limit young people’s educational and vocational prospects (see Bentley et al.; Leadbeater and Wong). On the other hand, an exclusive focus on material support risks cancelling out the possibilities for positive life transitions, such as those triggered by constructive, non-reductionist engagement with “beauty, aesthetics” (Campbell) and creativity. By exploring how participation in Youthworx engenders both the physical mobility between suburbs and the city, and identity transformation, we are able to gain insights into the nature of social exclusion, its meanings for the youth involved and the project managers and staff. Thinking about Youthworx not just as a hub of creative production but as a cultural site—“a space within a practiced place of identity” (De Certeau 117) in the suburb of Brunswick—opens up a discussion that combines the policy language of opportunity and necessity with concrete creative and material possibilities. Social inclusion objectives aimed at positive youth transitions need to be considered in the light of the connection—or disconnection—between the Youthworx Brunswick site itself, young participants’ suburbs, and, by extension, the trajectory between the inner city and other spaces that young people travel through and inhabit. Acknowledgment I would like to thank all the young participants, staff and industry partners involved in the Youthworx project. I also acknowledge the comments of anonymous peer reviewer which helped to strengthen the argument by foregrounding the value of the empirical material. The paper draws on the larger project funded by the Centre of Excellence in Creative Industries and Innovation. Youthworx research team includes: Prof Denise Meredyth (CI); Prof Julian Thomas (CI); Ass/Prof David MacKenzie (CI); Ass/Prof Ellie Rennie; Chris Wilson (PhD candidate), and Jon Staley (Youthworx Manager and PhD candidate). References Bentley, Tom, and Kate Oakley. “The Real Deal: What Young People Think about Government, Politics and Social Exclusion.” Demos. 12 Jan. 2011 ‹http://www.demos.co.uk/files/theRealdeal.pdf›. Bourdieu, Pierre. Distinction: A Social Critique of the Judgement of Taste. Cambridge: Harvard U P, 1987. Burgess, Jean. “Hearing Ordinary Voices: Cultural Studies, Vernacular Creativity and Digital Storytelling.” Continuum 20.2 (2006): 201–14. Campbell, Craig. Personal Interview. Melbourne, 2009. De Certeau, Michel. The Practice of Everyday Life. Los Angeles: University of California Press, 1984. 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