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Biomedical subjects

B R Flay

Publications and source records attributed to B R Flay.

At least 55 records · Page 3Linked to original sources
PubMed1993

Naturalistic observation of adolescent tobacco use.

A naturalistic observation study of adolescent tobacco use was conducted to corroborate previous studies which used self-report questionnaire or structured interview methods to study this problem behavior. Several findings converged with previous accounts of adolescent tobacco use. For example, most use occurred in small groups. However, other findings diverged somewhat from previous research in that an unexpectedly low number of offers of tobacco was observed, nonusers were present in smoking groups, and solitary smoking was common. These data suggest that direct, normative social pressure to use tobacco may not be as frequent as more subtle informational social influence, at least in high school adolescent tobacco use groups.

Adolescent↗
PubMed1993

Health behavior changes through television: the roles of de facto and motivated selection processes.

We assess the role played by two types of self-selection in accounting for the influence of a television series on smoking cessation. De facto selection is based on respondents' regular channel viewing habits that can expose them to the series. Motivated self-selection takes place when viewers deliberately select to watch television programming because it meets their desire to quit smoking. Self-selection also can be viewed as a methodological artifact, spuriously accounting for the association between the airing of the series and smoking cessation among the target audience. Subjects were a probability sample of Chicago smokers who regularly watch the evening news on one of the network channels. The intervention was a televised self-help smoking cessation program broadcast on one of the network channels over 20 days. Using nested covariance structure models for the analysis, we conclude that 1) de facto selection had no influence on exposure to the program; 2) motivated selection had no influence on exposure to the program; 3) the program reduced smoking; and 4) this effect cannot be attributed solely to the methodological artifact of self-selection, although motivation to quit smoking did have the strongest influence on attempts to quit.

Adolescent↗
PubMed1993

Young adolescent attitudes toward sex and substance use: implications for AIDS prevention.

This paper explores differences in adolescents' attitudes, beliefs, and resistance skills regarding sexual behaviors and use of substances in the context of AIDS prevention. A total of 553 7th and 8th grade students completed a self-administered questionnaire as baseline data collection for a human immunodeficiency virus (HIV) prevention project. Students' attitudes about sexual behavior and substance use differed markedly. Teens in this sample reported feeling significantly more comfortable discussing substance use with their parents than discussing sex; they also reported that it is easier to say "no" to alcohol or marijuana than to resist pressures to have sex. Furthermore, these young adolescents believed that their parents would be less upset to discover that they were sexually active than to find out they were using drugs. Among students who had ever had sex and who had ever used alcohol, young adolescents indicated that their parents would be much less upset to find out they were having sex than to discover they were smoking, drinking alcohol, or using drugs. Implications of the findings for HIV/AIDS prevention efforts are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Relationship between after-school care of adolescents and substance use, risk taking, depressed mood, and academic achievement.

OBJECTIVE: To examine the relationship between parental monitoring and six negative behaviors: cigarette, alcohol, and marijuana use; depressed mood; risk taking; and lower academic grades. DESIGN: Survey of 3993 ninth-grade students in six school districts in southern California. SUBJECTS: The sample consisted of 1930 boys and 2063 girls, self-classified as non-Hispanic white (32%), African-American (13%), Hispanic (46%), or Asian (9%). RESULTS: A relationship was found between unsupervised care after school and susceptibility to cigarette, alcohol, and marijuana use; depressed mood; risk taking; and lower academic grades. Adolescents who were unsupervised at home were slightly more likely to engage in problem behavior than those who were supervised at home. Adolescents at a neighbor's house, at school, or at a job and especially those who "hang out" were most likely to engage in problem behavior. Risk was higher if the parent had an unengaged parenting style. Although girls were less likely than boys to engage in problem behavior when supervised, as supervision decreased they were significantly more likely to have each of these problems. Family structure had little impact on risk. CONCLUSIONS: Self-care, especially when it occurs outside of the home, is associated with substance use, risk taking, depressed mood, and lower academic grades.

Adolescent↗
PubMed1992

Why children start smoking cigarettes: predictors of onset.

We review findings from 27 prospective studies of the onset of cigarette smoking conducted since 1980. Almost 300 measures of predictors of smoking onset were examined, and 74% of them provided multivariate support for predictors of onset derived from theory and previous empirical findings. Expected relationships were strongly supported for (a) socioeconomic status, with students with compromised status being more likely to try smoking; (b) social bonding variables, particularly peer and school bonding, with less support for family bonding; (c) social learning variables, especially peer smoking and approval, prevalence estimates, and offers/availability, with less consistent support for parent smoking and approval; (d) refusal skills self efficacy; (e) knowledge, attitudes and intentions, with the expected stronger predictions from intentions than from attitudes than from knowledge; and (f) broad indicators of self-esteem. The few investigators who analyzed their data separately by age, gender, or ethnicity found many differences by these factors, though there were too few of them to detect any pattern with confidence. Though the 27 studies are far from perfect, we believe that they confirm the importance of many well-accepted predictors and raise some questions about others. In particular, family smoking, bonding and approval each received unexpectedly low support. It is not clear whether this lack of support reflects reality as it has always been, is due to a changing reality, reflects developmental changes, either in the age of subjects or the stage of onset, or is due to poor measurement and too few tests. Future prospective studies need to be theory-driven, use measures of known reliability and validity, report analyses of scale properties, and use statistical methods appropriate to the hypotheses or theories under study. Finally, we encourage more investigations of the potentially different predictors of transitions to experimental or regular cigarette smoking. This will require multi-wave studies and careful measurement of changes in smoking behavior.

Adolescent↗
PubMed1992

The second Chicago televised smoking cessation program: a 24-month follow-up.

OBJECTIVES: As smoking decreases in the population, the remaining smoking population will change, and cessation initiatives will have to incorporate strategies designed for these smokers. METHODS: To study patterns of response to a cessation intervention composed of 20 televised segments and the American Lung Association Freedom from Smoking in 20 Days manual, this study compared cessation rates over 24 months in a cohort of smokers who registered for a cessation program with those in a cohort selected from the smoking population at large. RESULTS: At post intervention, multiple point prevalence of cessation among participants, adjusted for baseline smoking, was 14% among registrants and 6% in the population; at 24 months the adjusted rates were 6% and 2%, respectively. Heavy smokers benefited more than light smokers, and there was a consistent dose-response relationship between extent of exposure to the intervention and cessation. CONCLUSION: The effects of the intervention were strongest for those who read the manual and watched the programs daily. Manual use was important, and those who did not read it did not appear to benefit. Compared to the population and given full participation, heavy smokers benefited more than lighter smokers.

Adult↗
PubMed1991

Characteristics of participants in a televised smoking cessation intervention.

Participants in various components of a televised self-help smoking cessation program, based on the American Lung Association's Freedom From Smoking in 20 Days, are compared with a sample of the population of smokers to whom the intervention was addressed. Over 325,000 smokers in the target population were exposed to the program at some level. Most watched televised segments. Approximately 75,000 manuals were distributed and about 55,000 were used. Comparisons between participants and the targeted smoking population indicate that the intervention attracted those in the smoking population who are expected to be the majority of smokers by the Year 2000-blacks, females, and those with incomes under $13,000 per year. Participants with these characteristics were most likely to view the televised segments. Heavy smokers, females, and those with the most education were most likely to refer to the manual at least twice a week during the intervention. Older, nonblack participants and those with incomes of $13,000 or more per year were most likely to attend group support sessions outside the home. Overall, the patterns of association indicate that although a televised smoking cessation program can attract individuals similar to those projected to be smokers in 2000, participation in various components of the intervention will vary by demographic characteristics.

Adolescent↗
PubMed1991

Mediating mechanisms in a school-based drug prevention program: first-year effects of the Midwestern Prevention Project.

Describes (a) the effects of a social-influences-based drug prevention program (the Midwestern Prevention Project) on the mediating variables it was designed to change and (b) the process by which the effects on mediating variables changed use of drugs (tobacco, alcohol, and marijuana). Students in 42 middle schools and junior high schools in Kansas City, Missouri, and Kansas City, Kansas, were measured in the fall of 1984 (N = 5,065) and again 1 year later (N = 5,008) after 24 of the schools had been through the program. Compared to students in control schools, students in program schools became less likely to express belief in the positive consequences of drug use, less likely to indicate that they would use such drugs in the future, more likely to report that their friends were less tolerant of drug use, and more likely to believe that they were better able to communicate with their friends about drug or school problems. Change in perceptions of friends' tolerance of drug use was the most substantial mediator of program effects on drug use. There was evidence that intentions to use and beliefs about the positive consequences of use may also mediate program effects on drug use.

Adolescent↗
PubMed1991

Availability of tobacco products at stores located near public schools.

The nearby store is an obvious major site where adolescents obtain tobacco products. We investigated availability of tobacco products to adolescents at those stores located closest to public junior high and high schools by using 3 novel methods: (1) interviewing store personnel; (2) recording types and location of tobacco products, promotional items, and the legal age warning signs within stores; and (3) observing purchasing behavior. Store personnel were interviewed at randomly selected Southern California stores (n = 36) and Illinois stores (n = 12). Results showed that store personnel used tobacco at twice the rate of the general public, and that they often use tobacco while working at the store. Promotional advertisements were present at many stores, while tobacco use legal age signs were posted at few stores. Approximately 50% of the store personnel admitted that they would sell to minors, and many reported that they had seen teenagers using tobacco near the stores. Several apparently illegal purchases were observed. Tobacco use prevention program and policy implications are discussed.

Adolescent↗
PubMed1990

Drug use prevention programs, gender, and ethnicity: evaluation of three seventh-grade Project SMART cohorts.

One-year follow-up data from three seventh-grade cohorts of Project SMART were examined to assess the effects of two social psychology-based programs within each of six subgroups: males, females, Asians, blacks, Hispanics, and whites. The three cohorts (total N = 5,070) were those receiving curriculum or serving as controls as seventh-graders in 1982-1983, 1983-1984, and 1984-1985 school years. The outcome measures used were composite indices based on lifetime and recent use items for cigarettes, alcohol, and marijuana. The major analysis was ANCOVA on classroom means for the composite indices at post-test, using pretest classroom means for the indices as a covariate. The results showed clear prevention effects for females but not for males. Overall prevention effects were strongest for cigarette smoking, but were also evident for alcohol. Significant sex by program interactions, showing differential program effects for males and females, were found for cigarettes and marijuana, but not for alcohol. There was a nonsignificant trend suggesting that the programs were most effective for Asians and least effective for whites.

Adolescent↗
PubMed1990

A televised, self-help, cigarette smoking cessation intervention.

A televised, self-help cigarette smoking cessation intervention was conducted and evaluated. During the 20-day program, reports were broadcast daily on the evening news programs of the local affiliate station of a national television network. Two samples of smokers who requested self-help manuals were interviewed by telephone immediately following the conclusion of the program and again 3 months later concerning their demographic characteristics, participation in the program, and smoking and quitting experiences. In one sample heavier smokers who expressed a greater desire to quit were more likely to participate in the program and, at the three-month followup, 21% reported being abstinent compared to 10% of those who did not participate. Smokers in the other sample were invited to attend three weekly support meetings during the program. More of those who attended meetings (35%) reported quitting during the program than those who did not attend (23%), but this difference did not persist for 3 months. A greater percentage of the meeting sample (27%) than the other sample (21%) reported abstinence initially, but this difference did not persist for three months either. Intervention outcomes are compared with several standards.

Adult↗
PubMed1990

Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents.

This article reviews major risk factors for cigarette smoking, alcohol, and other drug abuse and promising community-based approaches to primary prevention. In a longitudinal experimental study, 8 representative Kansas City communities were assigned randomly to program (school, parent, mass media, and community organization) and control (mass media and community organization only) conditions. Programs were delivered at either 6th or 7th grade, and panels were followed through Grade 9 or 10. The primary findings were (a) significant reductions at 3 years in tobacco and marijuana use and (b) equivalent reductions for youth at different levels of risk. This study provides evidence that a comprehensive community program-based approach can prevent the onset of substance abuse and that the benefits are experienced equally by youth at high and low risk.

Adolescent↗
PubMed1990

Characteristics of eighth-grade students who initiate self-care in elementary and junior high school.

The purpose of this paper is to examine whether children who care for themselves for longer periods of time are at increased risk of poor grades, truancy, anger, family conflict, stress, risk-taking, and peer influences (in addition to the increased risk of substance use previously reported). Demographic characteristics of eighth-grade students who initiate self-care in junior high school are compared with those initiating self-care in elementary school. Further, increased risks for those initiating self-care in elementary school are examined. Over two thirds of the respondents (67.8%) cared for themselves after school without adult supervision at some time during the week; 23.5% for 1 to 4 hours per week, 15.7% for 5 to 10 hours per week, and 28.6% for 11 or more hours per week. Of those in self-care, 48.5% initiated self-care during elementary school and 51.5% during junior high school. Students who were in the highest category of self-care (greater than or equal to 11 hours per week) vs those in self-care zero hours per week were 1.5 to 2 times as likely to score high on risk-taking, anger, family conflict, and stress, to be more likely to see their friends as their major source of influence, and to attend more parties. The self-reports of academic grades did not differ. The grade of initiation of self-care (elementary vs junior high school) conferred additional risk for drinking alcohol (odds ratio = 1.4), risk-taking tendencies (odds ratio = 1.5), and attending parties (odds ratio = 1.6).

Adolescent↗
PubMed1989

A multicommunity trial for primary prevention of adolescent drug abuse. Effects on drug use prevalence.

The entire early adolescent population of the 15 communities that constitute the Kansas City (Kansas and Missouri) metropolitan area has participated in a community-based program for prevention of drug abuse since September 1984. The Kansas City area is the first of two major metropolitan sites being evaluated in the Midwestern Prevention Project, a longitudinal trial for primary prevention of cigarette, alcohol, and marijuana use in adolescents. The project includes mass media programming, a school-based educational program for youths, parent education and organization, community organization, and health policy components that are introduced sequentially into communities during a 6-year period. Effects of the program are determined through annual assessments of adolescent drug use in schools that are assigned to immediate intervention or delayed intervention control conditions. In the first 2 years of the project, 22,500 sixth- and seventh-grade adolescents received the school-based educational program component, with parental involvement in homework and mass media coverage. Analyses of 42 schools indicate that the prevalence rates of use for all three drugs are significantly lower at 1-year follow-up in the intervention condition relative to the delayed intervention condition, with or without controlling for race, grade, socioeconomic status, and urbanicity (17% vs 24% for cigarette smoking, 11% vs 16% for alcohol use, and 7% vs 10% for marijuana use in the last month), and the net increase in drug use prevalence among intervention schools is half that of delayed intervention schools.

Adolescent↗
PubMed1989

The television, school, and family project. V. The impact of curriculum delivery format on program acceptance.

Social psychological interventions have been successful in preventing drug and tobacco use in adolescents, but target audience involvement has not been well documented. Examination of program acceptance is necessary to avoid ambiguity when interpreting findings within and across studies. This report presents results from a program acceptance study of a seventh-grade smoking/drug-use prevention and cessation field trial. The research design is an assessment of two experimentally manipulated variations in program delivery on the program acceptance of all provider and target groups involved. Experimental manipulations included classroom and mass broadcast television demonstrations of social resistance skills against pressures to smoke and use drugs. Three aspects of target audience program acceptance were assessed: participation, satisfaction, and perceived program efficacy. Respondents included the target audience (seventh-grade students and parents), instructors, classroom observers, and school administrative staff. Strong main effects of television delivery on student and parent participation were observed. The findings suggest the usefulness of student homework assignment to view television segments with parents at home as a strategy to achieve family involvement in school-based programs. Both television and classroom delivery separately demonstrated significant positive effects on overall program acceptance with moderate interactive effects on perceived program efficacy. While classroom teacher/observers and school administrators reported strong preferences for the experimental (social resistance) classroom curriculum, acceptance of experimental and comparison (information-based) curricula by the student/parent target audience was equivalent.

Curriculum↗