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...prevention
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www.ProjectCork.org
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Fall 2006
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Community-based prevention programs in the war on drugs: Findings from the "Fighting back" demonstration.
Saxe L; Kadushin C; Tighe E; Beveridge AA; Livert D; Brodsky A; Rindskopf D. Journal of Drug Issues 36(2): 263-293, 2006. (77 refs.)
Illegal drug use remains one of the United States' most serious health problems, and the "War on Drugs" continues without an end in sight. Antidrug programs, which offer the potential to reduce substance abuse problems, are a component of efforts to deal with the problem, but they operate absent adequate scientific analysis. Although policy has shifted from a focus on supply control to one that includes prevention and treatment, research and theory lag behind program implementation. Thus, for example, community-based programs designed to change norms and systems of substance use have been widely promoted despite the lack of data to support their use. The present paper summarizes findings from an evaluation of a large national demonstration program, "Fighting Back." Results of the evaluation of broad-based community initiatives in a dozen communities show that the programs failed to reduce rates of substance use and associated harms. These findings, along with other evidence, place reliance on community-based programs at odds with public rhetoric. To deal more effectively with substance abuse, there is a need to move from "grading" programs to understanding why and how interventions function. Copyright 2006, Journal of Drug Issues, Inc.
Parents' perceptions of the role of schools in tobacco use prevention and cessation for youth.
Wyman J; Price JH; Jordan TR; Dake JA; Telljohann SK. Journal of Community Health 31(3): 225-248, 2006. (22 refs.)
The purpose of this study was to examine Ohio parents' perceptions of the role of schools in smoking prevention, cessation, and anti-tobacco policy for their children. A 46-item questionnaire was based on the CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. Surveys (n = 800) were sent to a stratified random sample of parents of junior high and high school aged students and 57% responded. Parents were supportive of smoking prevention activities, but almost two-thirds believed their child's school should get parents' input. Furthermore, mothers/step-mothers were more likely than fathers/step-fathers to agree that the school had a role in smoking prevention activities. The majority of parents were also supportive of smoking cessation activities. However, only 8% of parent respondents supported schools providing nicotine gum or patches to students trying to quit smoking. Overall, the majority of parents were supportive of the seven recommendations developed by the CDC as guidelines for school health programs to prevent tobacco use and addiction. Schools have the opportunity to impact student smoking through prevention and cessation activities. Schools need to know that parents are supportive of these activities and want to be included in the process of implementing effective prevention or cessation programs. Copyright 2006, Kluwer Academic.
A field test of a web-based substance abuse prevention training program for health promotion professionals.
McPherson TL; Cook RF; Back AS; Hersch RK; Hendrickson A. American Journal of Health Promotion 20(6): 396-400, 2006. (9 refs.)
Purpose. To evaluate a multimedia substance abuse prevention (SAP) training program for health promotion (HP) practitioners designed to provide opportunities for behavioral modeling and skills building and to motivate and build confidence in ability to integrate SAP into HP offerings. Methods. Using a posttest only design, 192 practitioners were randomly assigned to receive web-based (experimental group) or print-based (control group) training. Feelings about ability to conduct effective SAP programming, reactions to training materials, and knowledge about substance abuse and how to implement SAP were assessed. The experimental group also rated specific aspects of the web training. Results. The experimental group gave high evaluation ratings, scored significantly higher on self-efficacy items, and gave significantly higher ratings on 12 of 15 reaction items. Conclusion. Web-based training was more engaging, understandable, user friendly, useful, comprehensive, and motivating than print-based training: it is believed to be more effective in helping to integrate substance abuse prevention; and it will serve as a continuous resource. Copyright 2006, American Journal of Health Promotion, Inc.
A national study of substance abuse prevention professionals in higher education.
Crozier MK; Gressard CF. Journal of Alcohol and Drug Education 49(2): 43-65, 2005. (15 refs.)
There is an established body of research on the effectiveness of comprehensive substance abuse prevention strategies in higher education. There is relatively little research, however, on the characteristics and job functions of prevention professionals and their effectiveness. This study was designed to examine the characteristics of professionals who offer prevention services. It examined the characteristics, training, and job functions of prevention professionals and the relationship between educational preparation and professional affiliations and the comprehensiveness of prevention services. Using multiple regression, a significant relationship was found between the number of prevention workshops and conferences that the prevention professionals attended, the number of professional certifications they held, and the subsequent comprehensiveness of programming offered by their institution. Continued research on the substance abuse prevention professional is recommended in order to better understand the effectiveness of prevention services thus finding the balance between messenger and message in prevention. Copyright 2005, American Alcohol and Drug Information Foundation.
A randomized study of four cards designed to prevent problems during college students' 21st birthday celebrations.
Smith BH; Bogle KE; Talbott L; Gant R; Castillo H. Journal of Studies on Alcohol 67(4): 607-615, 2006. (16 refs.)
Objective: The purpose of this study was to examine the efficacy of sending cards designed to prevent alcohol-related problems during 21st birthday celebrations. Method: College students were randomly assigned to receive cards with one of the following messages: (1) a neutral birthday greeting; (2) harm reduction information; (3) messages designed by the Be Responsible About Drinking (B.R.A.D.) Foundation, including harm reduction information and a description of the tragic death of Brad McCue during his 21st birthday celebration; (4) social norming messages designed to correct misperceptions of drinking; or (5) the combination of messages from Cards 2 and 4. A total of 994 students completed a post-21st birthday phone survey. Effects were evaluated in two cohorts with 444 and 550 students, respectively. Results: There were no significant effects of the cards on drinking or alcohol-related problems. Conclusions: These null findings, plus some unexpected trends in our data, highlight the importance of carefully evaluating mailed interventions before deploying them on a large scale. Copyright 2006, Alcohol Research Documentation, Inc.
Acceptance of web-based personalized feedback: User ratings of an alcohol misuse prevention program targeting US Marines.
Simon-Arndt CM; Hurtado SL; Patriarca-Troyk LA. Health Communication 20(1): 13-22, 2006. (33 refs.)
The use of Web-based programs for a variety of health education, risk reduction, and health promotion purposes can be a valuable tool in the effort to improve the health of a population. Providing theory-based personalized feedback through such a method can be particularly useful in alcohol misuse prevention efforts. A brief alcohol use feedback program was developed for members of the U.S. Marine Corps, and user-satisfaction ratings were collected from 167 participants. Approximately 44% of the sample found the program to be useful or very useful, and 46% of the sample reported that they were likely or very likely to recommend the Web site to others. The Web-based format with tailored responses was preferred by 85% of respondents over other more traditional methods of alcohol training, and 80% of participants felt that the feedback was appropriate for Marines in their community. Significantly higher usefulness, likelihood of recommending the program to others, and overall ratings of the program were reported among younger and nonheavy-drinking participants (p < .05). Results indicate that this computerized assessment and feedback program is a promising mechanism with which to provide personalized alcohol misuse prevention information. Copyright 2006, Lawrence Erlbaum Associates.
Are "drink responsibly" alcohol campaigns strategically ambiguous?
Smith SW; Atkin CK; Roznowski J. Health Communication 20(1): 1-11, 2006. (41 refs.)
This article applies the concept of strategic ambiguity in examining viewer responses to brewer-sponsored "responsible drinking" television advertising campaigns. Strategically ambiguous messages are designed to engender diverse interpretations between varied audience segments, and these different selective perceptions should translate into relatively uniform positive corporate images. In this study, teenage and young adult respondents were shown a series of television spots from two leading alcohol companies. As predicted, there was a high degree of diversity in meanings of message content and campaign purpose derived by viewers, particularly among less sophisticated teenagers. Moreover, evaluative ratings of messages and sponsors were generally favorable and more uniform than interpretive responses. The research demonstrates how seemingly pro-health messages can serve to subtly advance both industry sales and public relations interests. Copyright 2006, Lawrence Erlbaum Associates.
Differential effects of exposure to social norms campaigns: A cause for concern.
Campo S; Cameron KA. Health Communication 19(3): 209-219, 2006. (88 refs.)
College students' processing of alcohol social norms messages, related effects on normative judgments, attitudes toward their own behaviors, and perception of undergraduate attitudes were examined using expectancy violation theories and social norms marketing. Data were collected from 2 universities (N = 393). Following message exposure, the majority moved their normative judgments toward the statistic provided in the message. Slight attitude change occurred but not always in the desired direction. Those most likely to develop unhealthier attitudes drank more than those who developed healthier attitudes, consistent with psychological reactance to the messages. Therefore, the effects of social norms campaigns on those at greatest risk for primary and secondary alcohol effects due to their increased alcohol consumption could lead to increased risk for those participants, indicating that the widespread use of social norms campaigns needs to be scrutinized. Copyright 2006, Lawrence Erlbaum Associates.
Evaluating the believability and effectiveness of the social norms message - "Most students drink 0 to 4 drinks when they party".
Polonec LD; Major AM; Atwood LE. Health Communication 20(1): 23-34, 2006. (48 refs.)
In an effort to reduce dangerous drinking levels among college students, university health educators have initiated social norms campaigns based on the rationale that students will be more likely to reduce their own drinking behaviors if they think that most students on campus are not heavy or binge drinkers. Within the framework of social comparisons theory, this study reports the findings of a survey of 277 college students and explores the correlates of accuracy and bias in students' estimates of whether or not most other students think that binge drinking on campus is a problem and whether or not most other students believe the campaign message. The overwhelming majority (72.6%) of students did not believe the norms message that most students on campus drink "0 to 4" drinks when they party, and 52.7% reported drinking "5 or more" drinks in a sitting. The social norms campaign was effective in motivating 61% of the respondents to think about binge drinking as a problem. For the most part, group or social network norms were more influential on students' own drinking behavior than were their estimates of the campus drinking norm. The findings also clarify that accuracy in estimating the campus social norm in and of itself does not necessarily lead to an increase or reduction in alcohol consumption. The social comparisons approach underscores the complex and social nature of human interaction and reinforces the need for the development of multiple approaches to alcohol education with messages that are designed to target the specific needs of students based on their orientations toward alcohol consumption. Copyright 2006, Lawrence Erlbaum Associates.
Longitudinal effects of pro-tobacco and anti-tobacco messages on adolescent smoking susceptibility.
Weiss JW; Cen S; Schuster DV; Unger JB; Johnson CA; Mouttapa M et al. Nicotine & Tobacco Research 8(3): 455-465, 2006. (55 refs.)
We examined the longitudinal impact of self-reported exposure to pro- and anti-tobacco media on adolescents' susceptibility to smoking, using in-school surveys from a culturally diverse sample. Ethnicity and acculturation also were examined as potential moderators. Middle-school students (N=2,292) completed self-report questionnaires during the 6th, 7th, and 8th grades. Chi-square analyses were conducted to determine whether reported exposure to pro- and anti-tobacco media varied according to ethnicity, acculturation, and immigration status. Logistic regression models were used to examine whether pro- and anti-tobacco media exposure in 6th grade was associated with susceptibility to smoking by later grades. Recall of people smoking in television programs and pro-tobacco advertisements in stores was associated with adolescent smoking susceptibility. Exposure to anti-tobacco advertisements on television protected against susceptibility. No significant interaction effects between pro- and anti-tobacco media exposure on smoking susceptibility were found. Ethnicity and acculturation did not moderate these associations. Our longitudinal study provides evidence that pro-tobacco media and advertising increases susceptibility to smoking over time. More important, anti-tobacco advertisements are not sufficient to reduce the harmful effects of adolescent exposure to pro-tobacco media. Policy-level interventions such as restrictions in tobacco advertising may be necessary to prevent adolescent smoking. Copyright 2006, Taylor & Francis.
Neighborhood crime victimization, drug use and drug sales: Results from the "Fighting back" evaluation.
Ford JM; Beveridge AA.Journal of Drug Issues 36(2): 393-416, 2006. (66 refs.)
A fundamental premise of the "Fighting Back" program was the existence of a direct causal relationship between drug use and crime. Using data from the evaluation of the program and spatial hierarchical models, we examine whether drug use and the presence of visible drug sales lead to elevated levels of three types of crime: assault, burglary, and theft. Our analysis controls for neighborhood disadvantage, racial and Hispanic concentration, percent renter occupied, and population density. For crime victimization rates by neighborhood, we find that for burglary, neighborhood disadvantage, the presence of visible drug sales, and drug use are related to victimization. None of the control variables demon-strate a significant impact on burglary victimization. For assault, only neighborhood disadvantage and visible drug sales are statistically significant, and for theft, only visible drug sales influence the rate of criminal activity. Considering the Fighting Back intervention, there are no differences in changing crime patterns of reported burglary, assault, and theft from 1983 through 1995 and no differences in the pattern of changing crime victimization rates for 1997 to 1999 between the Fighting Back and comparison sites. Possible reasons for the lack of effects of drug use prevention programs in crime reduction and possible alternative strategies are also discussed. Copyright 2006, Journal of Drug Issues, Inc.
Tomorrow is already here, or is it? Steps in preventing a local methamphetamine outbreak.
Singer M; Mirhej G; Santelices C; Hastings E; Navarro J; Vivian J. Human Organization 65(2): 203-217, 2006. (70 refs.)
This paper reports on a research-driven community-based effort to assess the potential for a local methamphetamine drug epidemic and to build a public campaign to head off or at least minimize the potentially severe health and social costs of the spread of a powerful stimulant drug like methamphetamine to a new area. Drawing on diverse national and local datasets, as well as on several years of monitoring changing drug use patterns and analyzing illicit drug diffusion, community researchers in Hartford, CT identified a reasonable likelihood that methamphet-amine - which is rarely used in the city currently - would spread and cause a significant local drug epidemic. In response, community efforts were initiated to draw attention to this looming public health problem and to build a broad based, citywide primary prevention campaign. Based on a review of the spread of methamphetamine nationally, and the considerable health problems that result from methamphetamine addiction, this paper describes the implementation phase of the Hartford prevention campaign, the challenges faced in this effort, and the implications for applied anthropology. Copyright 2006, Society for Applied Anthropology.
Learning about individual risk and the decision to smoke.
Khwaja A; Sloan F; Chung S. International Journal of Industrial Organization 24(4): 683-699, 2006. (29 refs.)
We provide empirical evidence about the process according to which people learn about the risks of cigarette consumption. We formulate a model of individual learning about the risks of smoking through information revealed in the form of health shocks to self and spouse. Exploiting the longitudinal feature of the Health and Retirement Study, we examine how the difference in the qualitative nature of the information about risk, i.e., from personal or non-personal experiences, affects the learning process. Controlling for unobserved heterogeneity, we find that individuals update their subjective survival expectations in response to information from own health shocks, but not as much in response to spousal health shocks. Individuals quit smoking in response to major health shocks but do not respond to spousal health shocks. Taken together, our results imply that individuals learn about smoking risks from their own experiences but not those of their spouses. Our results suggest that regulations, such as direct limits on cigarette consumption (e.g., smoking bans in public places) and excise taxes, are more likely to be effective than antismoking messages, unless these are designed to be highly personalized. Copyright 2006, North Holland.
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