Biomedical subjects

B R Flay

Publications and source records attributed to B R Flay.

At least 73 records · Page 4Linked to original sources

PubMed1989

Factors in smoking cessation among participants in a televised intervention.

This paper analyzes factors associated with smoking cessation during a 1-year period following a televised, self-help intervention among a sample of smokers who registered and participated in the program. Factors examined include readiness to quit smoking, extent of use of self-help materials, degree of exposure to the televised intervention, and environmental support for quitting from within the smoker's household. Behavioral response immediately following the intervention appeared to persist over the year of observation. Of those who reported stopping smoking immediately following the intervention, fewer than half (about 10% of the total sample that was followed) were continuously abstinent at 12 months. The results indicate that environmental support when the individual is attempting to quit smoking is very important in differentiating between those who successfully quit and those who attempt but fail to sustain their abstinence. The results also suggest that an approach combining television and self-help may reach large populations of smokers and induce a substantial number to quit and remain abstinent.

Chicago↗

PubMed1989

Tracking and attrition in longitudinal school-based smoking prevention research.

Research in the development of school-based smoking prevention programs has resulted in a set of approaches of known short-term efficacy. Further evaluation of these approaches now requires long-term follow-up of participants. To minimize the problems caused by attrition in these longitudinal studies, investigators have developed techniques for tracking study participants. Based primarily on the use of the telephone, mail, and public documents, these methods require good background information on both the study participants and their parents. This article summarizes the experience of three teams of researchers engaged in such follow-up studies. These investigators have identified the types of background information most useful in long-term follow-up of participants, have developed a set of strategies to obtain such background information, and have developed methods for successfully tracking participants after a lapse of several years.

Adolescent↗

PubMed1989

Smoking education: comparison of practice and state-of-the-art.

The purpose of this paper is to compare the content of samples of curricula in current use in the nation's schools and curricula recently developed by researchers. We describe briefly the nature of these curricula. We then provide an analysis of their content.

Adaptation, Psychological↗

PubMed1989

Longitudinal effects of the midwestern prevention project on regular and experimental smoking in adolescents.

The purpose of this study was to compare longitudinal smoking prevention program effects estimated on a population-based cohort sample of sixth- and seventh-grade students (average n per year = 4,664) using different schools as units of analysis (middle/junior high school as the school of origin or high school as the endpoint school of intervention). Fifty schools in 15 school districts were demographically matched and assigned to either a school and community-based program for prevention of cigarette, alcohol, and marijuana use, or a health education as usual control group. Smoking was measured by questionnaires administered to the students. An expired air (CO) measure of smoking was also administered to increase accuracy of self-reports. Program effects were estimated with regression analyses, controlling for school-level socioeconomic status, racial/ethnic make-up, urbanicity, and grade. Using school of origin as the unit of analysis, program effects showed 1 year net reductions of -8, -6, and -5% in prevalence rates of smoking in the last month, last week, and last 24 hr; 2-year program effects showed similar net reductions of -6, -5, and -3% (P's less than 0.10-0.001). Analyses with endpoint school as the unit showed slightly weaker effects at the 2-year follow-up, the year during which 64% of students had moved to a junior high or high school. The findings are discussed in terms of the potential contamination of experimental groups in longitudinal studies from school consolidations, family mobility, and feeder patterns to high schools, and the different smoking environments represented by middle, junior high, and high schools.

Adolescent↗

PubMed1989

The television, school and family smoking prevention/cessation project. IV. Controlling for program success expectancies across experimental and control conditions.

A major issue in smoking prevention research is that no study has tried to equate program success expectancies across experimental and placebo control conditions. Equivalent overall program success expectancies should be established to help rule out the effects of extra-theoretical variables which influence program outcomes. The present study tested whether an attention-placebo (information based) smoking prevention program would produce equivalent expectancies about the likelihood of program success in comparison to an experimental social influences program. To try to equate program success expectancies, the design of the two programs differed in content but was similar in procedure. Fourteen middle schools were randomly assigned to the two conditions. As hypothesized, baseline expectancies were found to predict outcome measures, even after controlling for baseline smoking intentions, ethnic group, and gender. Second, the equivalence of program expectancies at posttest was tested. Youths held equivalent overall expectancies for success across conditions. This study suggested the need to control for program expectancies in prevention research, and showed that program expectancies could be controlled for by equating process of program delivery.

Adolescent↗

PubMed1989

Evidence for two paths of alcohol use onset in adolescents.

Research is needed to identify risk factors specifically associated with the development of substance abuse. The current study explored the possibility that adolescents classified as having a problem behavior prone orientation (Type II) are predisposed to more rapid alcohol use onset compared to more normally socialized (Type I) adolescents. It was hypothesized that both types of adolescents would increase their alcohol use over time, but that problem behavior prone adolescents would increase their rates of alcohol consumption more rapidly than would normally socialized adolescents. Using ANCOVA (with baseline alcohol use as a covariate) and t tests (examining only nondrinkers at baseline), the hypotheses were strongly supported. Both Type I and Type II adolescents significantly increased their alcohol use over a one-year period. Type II adolescents, in comparison to Type I adolescents, had significantly higher alcohol use. The greater alcohol use among Type II adolescents was attributed to their problem behavior prone orientation. The findings suggest the existence of two different developmental pathways of alcohol use onset, one initiated by normally socialized adolescents and the other by adolescents with a problem behavior prone orientation. Future alcohol abuse prevention programs may benefit from tailored intervention strategies which take into account population specific risk factors.

Adolescent↗

PubMed1989

Joiners and non-joiners in worksite smoking treatment: pretreatment smoking, smoking by significant others, and expectation to quit as predictors.

Treatment joiners were differentiated from non-joiners when examined across six worksite clinic locations in the Los Angeles area. Predictors examined included preprogram smoking, demographic variables, smoking by significant others, behavioral expectations to quit, and self-efficacy regarding completing treatment and resisting urges to smoke. Non-joiners reported higher preprogram smoking levels and more friends and children who smoked.

Adult↗

PubMed1989

Primary prevention of chronic diseases in adolescence: effects of the Midwestern Prevention Project on tobacco use.

This article reports six-month, one-year, and two-year effects of a longitudinal multicomponent community program directed toward delaying the onset of cigarette smoking in adolescence. Results are based on a longitudinal panel of sixth and seventh grade students from eight schools in the Kansas City Standard Metropolitan Statistical Area (n = 1,122). In the fall of 1984, schools were assigned to either a program group, which received school, booster, parent, and mass media program components, or a control group that received regular health education programming in school and mass media exposure. By six months, there was a significant effect of the program on recent smoking, with the prevalence of smokers in the program group increasing more slowly than in the control group. At two years, 19% of students in the program group reported smoking in the last month versus 29% of students in the control group; and 12% versus 19%, respectively, reported smoking in the last week. The lifetime prevalence rate showed a marginal program effect at two years, with 57% of students in the program group having smoked once or more compared with 65% in the control group. The program was also effective across different levels of cigarette use ranging from no current use to use of one pack or more per day at two years.

Adolescent↗

PubMed1989

Estimating intervention effects in longitudinal studies.

Longitudinal studies aimed at assessing the impact of interventions on disease risk factors often confront several statistical problems. These problems include 1) dependent variables measured by ordered categories, 2) numerous potentially relevant patterns of transition between outcome levels, 3) mixed units of analysis (e.g., assignment by social unit while theorizing in terms of individuals), 4) incomplete randomization, and 5) correlated estimates for successive occasions of longitudinal measurement. Longitudinal data on use of cigarettes, alcohol, and marijuana among adolescents (n = 1,244, complete data) from the Midwestern Prevention Project are used to demonstrate solutions to each of these problems: 1) a proportional odds regression model, 2) conditional logistic models of transitions with interactions between baseline level and intervention effect, 3) a logistic model estimated with linear regression methods on measures aggregated by social unit, 4) conditional and unconditional models of effect magnitude, and 5) a repeated measures logistic regression technique. Panel data fit to the various models yielded the following conclusions concerning intervention effects in the Midwestern Prevention Project: reduction in the prevalence of cigarette users in treatment schools compared with control schools (8% vs. 18% smoked in the last week at one year follow-up), mixed evidence of an effect on marijuana use, and no evidence of an effect on alcohol use.

Adolescent↗

PubMed1989

Six-year follow-up of the first Waterloo school smoking prevention trial.

This paper reports six-year follow-up data from the first large-scale randomized trial of the social influences approach to smoking prevention. In 1979, 22 schools were randomly assigned to program or control conditions. Students in program schools received a social influences curriculum in six core and two maintenance sessions in grade 6, two booster sessions in grade 7, and one booster session in grade 8. All students were assessed at pretest (T1), immediate posttest (T2), end of grade 6 (T3), beginning and end of grade 7 (T4 and T5), end of grade 8 (T6), and grades 11 and 12 (T7 and T8). Ninety percent of study students were relocated and data obtained from over 80 percent of them at T8. Program effects on experimental smoking observed in grades 7 and 8 had completely decayed by T8, six years after the beginning of the program. Grade 6 smoking experience and social risk were each strong predictors of T8 smoking behavior. Subjects who had left school were smoking at more than twice the rate of subjects still in high school (grade 12) at T8. We discuss implications of the results.

Adolescent↗

PubMed1989

One year follow-up of the Chicago televised smoking cessation program.

We compared the relative effectiveness of four different conditions of self-help and social support provided to people attempting to quit smoking in conjunction with a televised cessation program: Smokers ready to quit were able to request written manuals from hardware stores to accompany a televised program. At worksites we provided the written manual to all workers. At a random half of the worksites, we also provided training to discussion leaders who subsequently led discussions among smokers attempting to quit with the program. At health maintenance organization sites we invited smokers who had requested program materials to participate in similar group discussions at health centers. In this paper we report one year follow-up results for the above four groups and compare them with previously reported results of a self-help manual alone. Results for the television plus manual condition were better than those of past studies (25 percent nonsmoking prevalence and 10 percent continuous cessation one year after the program) and considerably better than the manual alone. None of the other conditions designed to supplement the manual plus television produced better long-term outcomes; we explore the reasons for this. The program did encourage and help over 50,000 Chicago smokers to attempt quitting with the American Lung Association manual, 100 times as many as would have done so without the televised program. At least 15 other similar programs implemented since 1984 multiply this effect.

Adult↗

PubMed1989

The power of policy: the relationship of smoking policy to adolescent smoking.

This study examined the effects of smoking policy on 4,807 adolescents in 23 schools over a two-county area in California. Amounts and prevalence rates of adolescent smoking were measured with a self-report survey and a biochemical measure; school smoking policy was measured with two independent surveys of school staff. Policy effects were evaluated with multiple and logistic regression analyses controlling for school-level socioeconomic status and environmental support for teaching and administration. Of the 23 schools, 100 percent had a formal written and regularly enforced policy component restricting student smoking on school grounds, 94 percent restricted students leaving school grounds, 65 percent restricted smoking near school grounds, and 57 percent had a smoking prevention education plan. Schools with policies having all four versus less than four components, high versus low emphasis on prevention, and a low versus high emphasis on cessation reported lower amounts of smoking in the last week and in the last 24 hours. Punitive consequences of policy violation had no effect. Results were compared to school staff observations of adolescent smoking, and school archival records of student smoking violations in the last year. Results suggest that school smoking policy is associated with decreased amounts of smoking in adolescents.

Adolescent↗

PubMed1989

Media manipulation of adolescents' personal level judgements regarding consequences of smokeless tobacco use.

Videotapes were developed to try to impact on personal level judgements of concern and risk in the context of smokeless tobacco use, a growing substance use problem in adolescents. In a within-and-between-subjects design, convincingness (i.e., dramatic portrayal) of the videotaped message (high and low) and perceived probability of consequences portrayed in the message (high and low) were manipulated.

Adolescent↗

PubMed1989

A comprehensive community approach to adolescent drug abuse prevention: effects on cardiovascular disease risk behaviors.

This paper reports the effects of a multi-community drug prevention trial on the use of cigarettes, alcohol, and marijuana in early adolescents and their parents, effects on parent prevention practices, and the relationship of family health behaviors to adolescent cigarette and alcohol use. Annual self-report surveys were administered to a population-based sample of 6/7th grade students from all schools in a 15 community area (n = 5008). Students were also administered an expired air (CO) measure of cigarette smoking to increase the accuracy of self-reported smoking and drug use. A sub-sample of parents were also surveyed at one year follow-up (n = 620). Logistic regression analyses of student data indicated that program groups were increasing in monthly drug use prevalence rates at an average of half the rates of control groups at one year follow-up (3.4 vs 14.5% for cigarette use, 4.2 vs 9.6% for alcohol use (greater than 1 drink), 3.5 vs 7.6% for marijuana use); effects were similar for weekly use rates, and have been maintained at two year follow-up. Analyses of parent data at one year follow-up indicated that the odds of program group parents rating drug prevention practices and personal involvement in prevention programs as extremely important, discussing prevention with their children, and exercising regularly were higher compared to control group parents; and perceived child use of cigarettes and marijuana, and self-use of alcohol in the last week was lower (odds ratios averaged across prevention ratings for each substance = 1.85, 1.72, 1.37, 1.53; for use items .34, .73, .59; P less than .10-- .002).

Adolescent↗

PubMed1989

Project SMART parent program: preliminary results of a chronic disease risk reduction trail.

Project SMART Parent Program is a school-based healthy lifestyle promotion program designed to reduce chronic disease risk in adults and to provide a health-conscious home environment for children through the adoption of healthy lifestyle by their parents. Parents in the high involvement condition received comprehensive health status appraisals, and a program designed to reduce dietary fat intake, and increase aerobic activity levels. Parents in the low involvement condition received only the comprehensive health status appraisals. ANCOVA, using treatment condition as the independent variable and change scores as the dependent variables, were used to assess program outcomes. At the first posttest measure, the intervention group compared to the control group had a significantly greater decrease in blood cholesterol, a greater gain in aerobic fitness, a greater weight loss, and a greater decrease in body fat. At the second posttest measure, the intervention group had significantly greater gain in aerobic fitness, a greater decrease in body fat, a greater decrease in systolic blood pressure, and a marginally significant decrease in weight. Preliminary results provide strong support for the effectiveness of the Parent Program in reducing chronic disease risks.

Adolescent↗

PubMed1989

Activity involvement, risk-taking, demographic variables, and other drug use: prediction of trying smokeless tobacco.

Four activity participation variables (clubs, sports, church, and parties); two indices of "risk-taking" (preference for risk-taking, getting into trouble at school); three demographic variables (sex, ethnic group, socioeconomic status); and two drug use variables (trial of cigarettes and alcohol) were examined as correlates and prospective predictors of trial of smokeless tobacco in two cohorts of seventh graders in urban Los Angeles. The data were analyzed separately for males and females. Cross-sectional logistic regression analyses indicated that correlates of trying smokeless tobacco among the seventh-grade cohorts or among these same cohorts in the eighth grade (considering those persons who had not tried smokeless tobacco in seventh grade) generally included being white, trying cigarettes, risk-taking, and attending parties. Prospective logistic regression analyses with data from subjects who had not tried smokeless tobacco in the seventh grade indicated that predictors of subsequent trial of it generally included only being white and having tried cigarettes. Sports participation predicted onset only in one cohort of female subjects but not in males. Some activities that have been proposed as being predictive of smokeless tobacco use (e.g., sports participation) are generally irrelevant for a large sample of young adolescents in urban Los Angeles. White male cigarette smokers, regardless of the activities they have engaged in, are most likely to try smokeless tobacco.

Adolescent↗

PubMed1988

The television school and family smoking prevention and cessation project. 1. Theoretical basis and program development.

Program development processes for the Television, School, and Family Project, a school-based smoking prevention and cessation project, are presented in this article. We first review applications of social-psychological and communications theory to school-based and mass media program development. These include the three broad areas of (a) mediators of mass media effects on behavior change, (b) the social influences approach to smoking prevention, and (c) a self-management and social support approach to smoking cessation. A program development model for school-based mass media efficacy trials, with a summary of formative research and pilot study processes, is then presented. The importance of reciprocal support among school district administrators, project research staff, and television station personnel is emphasized with recommendations for future research and demonstration efforts.

Adolescent↗

PubMed1988

Affective and social influences approaches to the prevention of multiple substance abuse among seventh grade students: results from project SMART.

Two drug abuse prevention curricula were tested to determine their efficacy in preventing the onset of tobacco, alcohol, and marijuana use among adolescents. The first program focused on prevention through social pressure resistance training. The second featured affective education approaches to prevention. Curricula were tested on seventh grade students. Subjects were pretested just prior to the program and were post-tested at 12 and 24 months. Post-test analyses indicated that the social program delivered to seventh grade subjects was effective in delaying the onset of tobacco, alcohol, and marijuana use. No preventive effect of the affective education program was observed. By the final post-test, classrooms that had received the affective program had significantly more drug use than controls.

Adaptation, Psychological↗