|
|
...on Prevention
|
|
www.ProjectCork.org
|
Winter 2009
|
Hazardous good intentions? Unintended consequences of the project of prevention
Broom D. Health Sociology Review 17(2): 129-140, 2008. (75 refs.)
Preventing disease is by definition a valuable objective, and most debates have revolved around improving the effectiveness of prevention. In this discussion, I explore the latent functions - the unintended consequences - of what I call the 'project of prevention'. Although many latent functions are welcome, some have undesirable effects, and it is therefore important to instigate a rich exchange between innovative theory and rigorous research to minimise such effects. I argue that the hazards are particularly acute in the absence of a reflexive and critical awareness of the political environment and the cultural economy within which prevention occurs. In the paper, I sketch the challenges to mobilising that awareness, show some of the limitations of the conventional theoretical approaches to prevention, and point to directions for developing more fruitful perspectives. Copyright 2008, Econtent Management
Drugs, money, and graphic ads: A critical review of the Montana Meth Project. (review).
Erceg-Hurn D. Prevention Science 9(4): 256-263, 2008. (35 refs.)
The Montana Meth Project (MMP) is an organization that launched a large-scale methamphetamine prevention program in Montana in 2005. The central component of the program is a graphic advertising campaign that portrays methamphetamine users as unhygienic, dangerous, untrustworthy, and exploitive. Montana teenagers are exposed to the advertisements three to five times a week. The MMP, media and politicians have portrayed the advertising campaign as a resounding success that has dramatically increased anti-methamphetamine attitudes and reduced drug use in Montana. The program is currently being rolled out across the nation, and is receiving considerable public funding. This article critically reviews the evidence used by the MMP to claim that its advertising campaign is effective. The main finding is that empirical support for the campaign is weak. Claims that the campaign is effective are not supported by data. The campaign has been associated with increases in the acceptability of using methamphetamine and decreases in the perceived danger of using drugs. These and other negative findings have been ignored and misrepresented by the MMP. There is no evidence that reductions in methamphetamine use in Montana are caused by the advertising campaign. On the basis of current evidence, continued public funding and rollout of Montana-style methamphetamine programs is inadvisable. Copyright 2008, Springer
Longitudinal study of parental movie restriction on teen smoking and drinking in Germany.
Hanewinkel R; Morgenstern M; Tanski SE; Sargent JD. Addiction 103(10): 1722-1730, 2008. (40 refs.)
Aims To determine if adolescents who report that their parents restrict viewing movies based on rating have a lower risk of trying smoking and drinking alcohol in the future. Design: Prospective observational study. A cohort of 2110 German adolescents younger than 15 years who had never smoked or drunk alcohol at baseline were surveyed 12-13 months later to determine smoking and binge drinking initiation. Risk of substance use was assessed as a function of parental restriction on viewing FSK-16 movies (movies that only those aged 16 years and over would be allowed to see in theaters). Findings The percentage of students who tried smoking was 16.3%, 10.9% initiated binge drinking and 5.0% used both substances during the follow-up period. There was a significant effect of parental movie restriction on each substance use outcome measure after controlling for covariates. Compared with adolescents whose parents never allowed them to view FSK-16 movies, the adjusted relative risk [(RR) (95% confidence interval (CI)] for use of both substances were 1.64 (1.05-2.58) for adolescents allowed to view them once in a while, 2.30 (1.53-3.45) for sometimes and 2.92 (1.83-4.67) for all the time. FSK-16 restrictions were associated with lower viewership of all classes of movies, but especially FSK-16/18 movies; in addition, FSK-16 restrictions were associated with substantially lower exposure to movie depiction of tobacco and alcohol use, suggesting a mediational mechanism for the association. Conclusions: Among young adolescents, parental restriction from viewing movies rated for older adolescents/adults decreases the risk of substance use in the future. Copyright 2008, Society for the Study of Addiction to Alcohol and Other Drugs
A formative examination of messages that discourage tobacco use among junior enlisted members of the United States military.
Hoffman KM; Haddock CK; Poston WSC; Taylor JE; Lando HA; Shelton S. Nicotine & Tobacco Research 10(4): 653-661, 2008. (14 refs.)
Smoking prevalence among junior enlisted members of the United States armed forces significantly exceeds that of civilians. Furthermore, nearly 40% of junior enlisted who smoke reported they initiated smoking after joining the military. Although the tobacco industry has attempted to develop messages that encourage military members to use tobacco, no research has examined messages that would counteract industry messages and effectively discourage military members from using tobacco. This study conducted 24 focus groups on four Air Force and two Army installations (N= 189 personnel) to discover effective messages that discourage tobacco use among junior enlisted personnel. Four message themes were identified that hold promise for tobacco control efforts in the military: (a) smoking harms one's ability to positively influence others, (b) smoking increases the chance a military member will be discharged from the military prematurely, (c) smoking lowers readiness to fight and win wars, and (d) smokers are not as productive as other military personnel. In contrast, messages focusing on manipulation by the tobacco industry and the health effects of tobacco use were not strongly supported by military personnel. Copyright 2008, Taylor & Francis
Fear appeals and binge drinking: A terror management theory perspective
Jessop DC; Wade J. British Journal of Health Psychology 13(Part 4): 773-788, 2008. (28 refs.)
Objectives. The aim of the current research was to test the terror management theory-derived hypotheses that exposure to information about the mortality-related risks of binge drinking would make mortality salient (Study 1) and, hence, exacerbate willingness to binge drink amongst those who perceive this behaviour to benefit self-esteem (Study 2). Study 1. Participants (N = 97) were allocated to one of five experimental conditions. Results: confirmed that exposure to information about the mortality-related risks of binge drinking made mortality salient. Study 2. Participants (N = 296) were allocated to one of three experimental conditions. Exposure to mortality-related information about the risks of binge drinking was found to result in greater willingness to binge drink among (i) binge drinkers and (ii) non-binge drinkers who perceived this behaviour to benefit self-esteem. There was no evidence, however, that exposure to such information influenced binge drinking over the following week. Conclusions. Research findings suggest that mortality-related health promotion campaigns might inadvertently make mortality salient, and hence precipitate the very behaviours which they aim to deter among some recipients. Copyright 2008, British Psychological Society
Parents' perceptions of the Drug Abuse Resistance Education program (DARE)
Lucas WL. Journal of Child & Adolescent Substance Abuse 17(4): 99-114, 2008. (29 refs.)
Responses from 420 parents of fifth- and sixth-grade DARE students in a Midwestern county were examined to determine the parents' perceptions of the impact of DARE on their children's and their own attitudes and behavior. Major findings indicated that most parents did not see an impact on their child's school performance or overall attendance. Most perceived program impact with respect to the child's improved understanding and ability to resist drug use and improved perception of police officers. Most parents themselves reported increased awareness of substance abuse problems and increased conversation with their children about drug use as a result of DARE. Relevance of the findings to describing the perceived value and utility of DARE for parents as a stakeholder group is discussed. Copyright 2008, Haworth Press
Perceived effectiveness of tobacco counter-marketing advertisements among young adults.
Murphy-Hoefer R; Hyland A; Higbee C. American Journal of Health Behavior 32(6): 725-734, 2008. (44 refs.)
Objectives: To measure relative effectiveness of tobacco counter-marketing advertisements by category and emotive execution style among young adults. Methods: Participants (n=1011) from 2 US 4-year colleges, one southern and one northern were surveyed before and after viewing advertisements in one of 3 categories: social norms, health consequences, or tobacco industry manipulation and with 4 emotive execution styles: drama, testimonial (negative emotive) and humor, sarcasm (positive). Results: Health consequences and negative emotive advertise-ments were rated significantly most persuasive. Conclusions: This is the first study to support the effectiveness of tobacco countermarketing advertisements emphasizing the negative emotive health consequences of smoking among young adults. Copyright 2008, PNG Publications
Using the Internet to assist smoking prevention and cessation in schools: A randomized, controlled trial
Norman CD; Maley O; Li XQ; Skinner HA. Health Psychology 27(6): 799-810, 2008. (64 refs.)
Objective: TO evaluate the impact of a classroom-based. Web-assisted tobacco intervention addressing smoking prevention and cessation with adolescents. Design: A two-group randomized control trial with 1.402 male and female students in grades 9 through 11 from 14 secondary schools in Toronto, Canada. Participants were randomly assigned to a tailored Web-assisted tobacco intervention or an interactive control condition task conducted during a single classroom session with e-mail follow-up. The cornerstone of the intervention was a five-stage interactive Web site called the Smoking Zine (http: www.smokingzine.org) integrated into a program that included a paper-based journal, a small group form of motivational interviewing, and tailored e-mails. Main Outcome Measure: Resistance to smoking, behavioral intentions to smoke, and cigarette use were assessed at baseline, post-intervention, and three- and six-month follow-up. Multilevel logistic growth modeling was used to assess the effect of the intervention on Change over time. Results: The integrated Smoking Zine program helped smokers significantly reduce the likelihood of having high intentions to smoke and increased their likelihood of high resistance to continued cigarette use at 6 months. The intervention also significantly reduced die likelihood of heavy cigarette use adoption by nonsmokers during the study period. Conclusion: The Smoking Zine intervention provided cessation motivation for smokers most resistant to quitting at baseline and prevented nonsmoking adolescents from becoming heavy smokers at 6 months. By providing an accessible and attractive method of engaging Young People in smoking, prevention and cessation, this interactive and integrated program provides a novel vehicle for school- and population-level health promotion. Copyright 2008, American Psychological Association
Drug use/abuse prevalence, etiology, prevention, and treatment in Hispanic adolescents: A cultural perspective. (review)
Prado G; Szapocznik J; Maldonado-Molina MM; Schwartz SJ; Pantin H. Journal of Drug Issues 38(1): 5-36, 2008. (117 refs.)
The purpose of this article is to provide an overview of the state of drug abuse research among Hispanic adolescents in the areas of prevalence, etiology, prevention, and treatment from a cultural perspective. Cultural and acculturation-related processes are central to the understanding of the epidemiology, etiology, prevention, and treatment of drug use among Hispanic adolescents. Culture is also embedded within each of the efficacious interventions for Hispanic adolescents, suggesting that integrating Hispanic cultural symbols and values is an important element in preventing and treating drug use and related problem behaviors in this population. The recommendations presented in this article, along with existing work in the fields of epidemiology, risk protection, prevention, and treatment, will help to reduce the health disparities in drug use and related problem behaviors in this vulnerable and rapidly growing segment of the U.S. population. Copyright 2008, Journal of Drug Issues, Inc
School-based drug prevention programs: A review of what works.
Soole DW; Mazerolle L; Rombouts S. Australian and New Zealand Journal of Criminology 41(2): 259-286, 2008. (86 refs.)
This article examines the effectiveness of school-based drug prevention programs in preventing illicit drug use. Our article reports the results of a systematic review of the evaluation literature to answer three fundamental questions: (1) do school-based drug prevention programs reduce rates of illicit drug use? (2) what features are characteristic of effective programs? and (3) do these effective program characteristics differ from those identified as effective in reviews of school-based drug prevention of licit substance use (such as alcohol and tobacco)? Using systematic review and meta-analytic techniques, we identify the characteristics of school-based drug prevention programs that have a significant and beneficial impact on ameliorating illicit substance use (i.e., narcotics) among young people. Successful intervention programs typically involve high levels of interactivity time-intensity, and universal approaches that are delivered in the middle school years. These program characteristics aligned with many of the effective program elements found in previous reviews exploring the impact of school-based drug prevention on licit drug use. Contrary to these past reviews, however, our analysis suggests that the inclusion of booster sessions and multifaceted drug prevention programs have little impact on preventing illicit drug use among school-aged children. Limitations of the current review and policy implications are discussed. Copyright 2008, Australian Academy Press
Embedded alcohol messages in television series: The interactive effect of warnings and audience connectedness on viewers' alcohol beliefs
Russell DW; Russell CA. Journal of Studies on Alcohol and Drugs 69(3): 459-467, 2008. (43 refs.)
Objective: This research investigates whether warning viewers about the presence of embedded messages in the content of a television episode affects viewers' drinking beliefs and whether audience connectedness moderates the warning's impact. Method: Two hundred fifty college students participated in a laboratory experiment approximating a real-life television viewing experience. They viewed an actual television series episode containing embedded alcohol messages, and their subsequent beliefs about alcohol consequences were measured. Experimental conditions differed based on a 2 (Connectedness Level: low vs high) x 2 (Timing of the Warning: before or after the episode) x 2 (Emphasis of Warning: advertising vs health message) design. Connectedness was measured, and the timing and emphasis of the warnings were manipulated. The design also included a control condition where there was no warning. Results: The findings indicate that warning viewers about embedded messages in the content of a program can yield significant differences in viewers' beliefs about alcohol. However, the warning's impact differs depending on the viewers' level of connectedness to the program. In particular, in comparison with the no-warning control condition, the advertising prewarning produced lower positive beliefs about alcohol and its consequences but only for the low-connected viewers. Highly connected viewers were not affected by a warning emphasizing advertising messages embedded in the program, but a warning emphasizing health produced significantly higher negative beliefs about drinking than in the control condition. Conclusions: The presence of many positive portrayals of drinking and alcohol product placements in television series has led many to suggest ways to counter their influence. However, advocates of warnings should be conscious of their differential impact on high- and low-connected viewers. Copyright 2008, Alcohol Research Documentation
One-year follow-up evaluation of Project Towards No Drug Abuse (TND-4).
Sun P; Sussman S; Dent CW; Rohrbach LA. Preventive Medicine 47(4): 438-442, 2008. (25 refs.)
Objectives. This paper describes the one-year outcomes of the fourth experimental trial of Project Towards No Drug Abuse. Two theoretical content components of the program were examined to increase our understanding of the relative contribution of each to the effectiveness of the program. Methods. High schools in Southern California (n = 18) were randomly assigned to one of three conditions: cognitive perception information curriculum, cognitive perception information+ behavioral skills curriculum, or standard care (control). The curricula were delivered to high school students (n = 2734) by project health educators and regular classroom teachers. Program effectiveness was assessed with both dichotomous and continuous measures of 30-day substance use at baseline and one-year follow-up. Results. Across all program schools, the two different curricula failed to significantly reduce dichotomous measures of substance use (cigarette, alcohol, marijuana, and hard drugs) at one-year follow-up. Both curricula exerted an effect only on the continuous measure of hard drug use, indicating a 42% (p=0.02) reduction in the number of times hard drugs were used in the last 30 days in the program groups relative to the control. Conclusions. The lack of main effects of the program on dichotomous outcomes was contrary to previous studies. An effect on an ordinal count measure of hard drug use among both intervention conditions replicates previous work and suggests that this program effect may have been due to changes in cognitive misperception of drug use rather than behavioral skill. Copyright 2008, Elsevier Science
Substitute addiction: A concern for researchers.
Sussman S; Black DS. Journal of Drug Education 38(2): 167-180, 2008. (76 refs.)
An understanding of the role of substitute addictions remains unclear. This article examines the range and possible reward functions of substitute addictions. We suggest that prevention education and treatment need to take into account substitute addictions as an influential aspect of recovery. Research is needed to better understand the prevalence and functions of, and solutions to substitute addictions. Copyright 2008, Baywood Publishing.
Quit and Win contests for smoking cessation. (review)
Cahill K; Perera R. Cochrane Database of Systematic Reviews 4(article CD004986), 2008. (59 refs.)
Background: Quit and Win contests were developed in the 1980s by the Minnesota Heart Health Program, and have been widely used since then as a population-based smoking cessation intervention at local, national and international level. Since 1994 an international contest has been held every two years in as many as 80 countries (2002). Objectives: To determine whether quit and win contests can deliver higher long-term quit rates than baseline community quit rates. To assess the impact of such programmes, we considered both the quit rates achieved by participants, and the population impact, which takes into account the proportion of the target population entering the contest. Search strategy: We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, PsycINFO and Google Scholar. Search terms included competition*, quit and win, quit to win, contest*, prize*. Most recent search date was November 2007. Selection criteria: We considered randomized controlled trials, allocating individuals or communities to experimental or control conditions. We also considered controlled studies with baseline and post-intervention measures. Data collection and analysis: Data were extracted by one author and checked by the second. We contacted study authors for additional data where necessary. The main outcome measure was abstinence from smoking for at least six months from the start of the intervention. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. We decided against performing a meta-analysis, because of the heterogeneity of the included studies, and the small number of scientifically valid studies. Main results: Five studies met our inclusion criteria. Three demonstrated significantly higher quit rates (8% to 20%) for the quit and win group than for the control group at the 12-month assessment. However, the population impact measure, where available, suggests that the effect of contests on community prevalence of smoking is small, with fewer than one in 500 smokers quitting because of the contest. Levels of deception, where they could be quantified, were high. Although surveys suggest that international quit and win contests may be effective, especially in developing countries, the lack of controlled studies precludes any firm conclusions from this review. Authors' conclusions: Quit and win contests at local and regional level appear to deliver quit rates above baseline community rates, although the population impact of the contests seems to be relatively low. Contests may be subject to levels of deception which could compromise the validity of the intervention. International contests may prove to be an effective mechanism, particularly in developing countries, but a lack of well-designed comparative studies precludes any firm conclusions. Copyright 2008, John Wiley & Sons
|
