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Biomedical subjects

B R Flay

Publications and source records attributed to B R Flay.

At least 91 records · Page 5Linked to original sources
PubMed1987

The consistency of peer and parent influences on tobacco, alcohol, and marijuana use among young adolescents.

The purpose of this study was to determine the degree to which the use of tobacco, alcohol, and marijuana by young adolescents can be described using a common theoretical model. Structural models were created in which psychosocial variables hierarchically predicted the use of each substance. The fit of a model in which paths from predictor variables were constrained to be equal was not inferior in any meaningful way to that of a model in which all path coefficients were freely estimated, thus suggesting that use of tobacco, alcohol, and marijuana by young adolescents may be considered to be a unitary phenomenon. A simplified model, in which these substances were combined into a single latent variable, showed a good fit. The results of these analyses suggest that it may be beneficial to consider adolescent substance use to be a unitary phenomenon.

Adolescent↗
PubMed1987

Work site group meetings and the effectiveness of a televised smoking cessation intervention.

At the work site, smoking accounts for increased health care expenses and worker absenteeism due to smoking-related illness and reduced productivity and lost wages. Developing comprehensive and accessible smoking cessation programs at the work site is an important objective for health care professionals. In this study, employees of 43 corporations participated in a televised smoking cessation program accompanied by self-help manuals. The media component involved presenting a smoking cessation program on a network television affiliate station during the 4:30 p.m. and 10:00 p.m. news for 20 days. Employees at half the corporations also had access to semiweekly self-help group meetings. Adding self-help support groups to a program involving self-help manuals and the media reports was found to significantly increase abstinence and its maintenance over time. The implications of using the media, self-help groups, and work site locations in large-scale community-based interventions are discussed.

Adult↗
PubMed1987

Adolescent smokeless tobacco incidence: relations with other drugs and psychosocial variables.

This article presents data regarding the prevalence of trying smokeless tobacco in a longitudinal sample of 2,714 urban, ethnically diverse adolescent males and females. A predominance of trial use was found in white males in 8th and 9th grades. Also presented is the relation of smokeless tobacco onset to experimentation with other drugs (cigarettes, alcohol, marijuana), cigarette smoking in significant others, self-image as a smoker, risk taking, and smoking refusal self-efficacy. Smokeless tobacco onset was related to higher levels of cigarette smoking and lower quit rates, and was positively associated with use of cigarettes by significant others, one's self-image as a smoker, and with a disinclination to refuse cigarette offers. Finally, onset was more probable in individuals who had previously tried alcoholic beverages and marijuana, and who reported enjoying taking risks. A multivariate logistic regression analysis retained sex, smoking level, beer and wine use, and risk taking as predictors of smokeless tobacco onset. Apparently, smokeless tobacco is an additional activity in which drug-experimenting male adolescents are likely to participate.

Adolescent↗
PubMed1987

Mass media and smoking cessation: a critical review.

Evaluations of 40 mass media programs/campaigns designed to influence cigarette smoking were reviewed. Information/motivation programs/campaigns generally produced changes in awareness, knowledge, and attitudes. Extensive national campaigns also produced meaningful behavioral change. Programs/campaigns designed to promote some specific smoking-related action produced mixed results, depending in large part on the type of promotion involved. Mass media cessation clinics were found to be effective, with media plus social support being more effective than viewing plus printed material, and either combination being more effective than viewing alone. It was concluded that mass media health promotion programs can be more effective than many academics may have thought, but that the knowledge necessary to ensure such success is seriously lacking. Research studies, rather than simple evaluations, are needed to improve our knowledge base and build a science of mass media health promotion.

Adult↗
PubMed1986

Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs.

The concepts of efficacy and effectiveness are examined from the viewpoints of the traditions and philosophies of health-care research and social program evaluation. Consideration of the status of the program being assessed, its availability to, and its acceptance by the target audience leads to the derivation of four levels of health promotion program testing: efficacy trials, under optimum conditions of program implementation and recipient participation; treatment effectiveness trials, with expected variation in target audience acceptance; implementation effectiveness trials, under varying conditions of implementation; and program evaluation of previously untested programs. These four levels of testing, together with experience in one area of health promotion research (smoking prevention), suggest eight phases of research for the development of health promotion programs: basic research, hypothesis development, pilot applied research, prototype evaluation studies, efficacy trials, treatment effectiveness trials, implementation effectiveness trials, and demonstration evaluations. Issues of design, the use of random assignment, the use of blinding procedures, and of the role of process evaluation in these different research levels, particularly efficacy and effectiveness trials, are considered in light of the terminologies and methods of health-care and social program evaluation research. Suggestions are made for improved health promotion research.

Clinical Trials as Topic↗
PubMed1986

Mass media linkages with school-based programs for drug abuse prevention.

The most appropriate role the media can play in preventing drug abuse is the dissemination of school-based approaches of proven efficacy. In this paper, that statement is justified from theoretical and empirical perspectives. Suggestions for putting it into practice are offered. Review of the theoretical perspectives of Cartwright, Lazarsfeld and Merton, and Katz suggests that effective uses of mass media for drug abuse prevention must ensure adequate dissemination, maximize positive attention by the target audience (selectivity), encourage positive interpersonal communication, and maximize the principles of monopolization, canalization, and supplementation. Several major ways in which mass media programming can be linked with school-based or community-based programming to achieve these objectives are suggested. Mass media programs are seen as means to improve acceptance of school-based prevention programs by parents. Conversely, schools are seen as playing a crucial role in increasing exposure to media prevention programming, especially if it is an inherent component of a classroom curriculum, and increasing and improving interpersonal discussion about the issues, between students, between students and teachers, and particularly between students and parents.

Humans↗
PubMed1985

Are social-psychological smoking prevention programs effective? The Waterloo study.

Recent evaluations of smoking prevention programs have suggested considerable promise for curricula emphasizing resistance of social influences. The present study extends these evaluations by addressing key methodological limitations in previous work. Twenty-two matched schools were randomized to experimental and control conditions. Grade 6 students received a 6-week core curriculum, plus additional sessions through Grades 7 and 8. Questionnaires, and saliva samples to validate self-reported smoking behavior, were collected at five times over the 2-year study period. Cross-sectional and longitudinal analyses examined program impact for five levels of initial smoking experience, ranging from "never smoker" through regular, weekly smoker. Significant program effects were documented, most clearly for those having some experience with smoking before the program began and for those with smoking peer and family models. This study provides the methodologically most rigorous test to date of social influence programs for smoking prevention and documents for the first time significant effects for those at high risk for smoking.

Adolescent↗
PubMed1985

Psychosocial approaches to smoking prevention: a review of findings.

Twenty-seven school-based studies of psychosocial approaches to smoking prevention are reviewed. Two major approaches are represented: the "social influences" approach and the broader "life/social skills" approaches. The research studies are considered in four "generations": the seminal work by Richard Evans and colleagues at the University of Houston; seven "pilot" studies of improved programs at Stanford, Minnesota, New York, and Washington, with one school or classroom per experimental condition; twelve improved "prototype" studies by these four groups and others, with two or three units randomly assigned to conditions; and six studies in which maximizing internal validity was of prime concern. Reported results were fairly consistent, with each tested program seeming to reduce smoking onset by about 50%. However, none of the pilot or prototype studies considered alone provided easily interpreted results. The major contributions were improved programs and methods. The findings from the fourth generation of studies were more easily interpreted, though only two of them were interpreted with high confidence. It seems that psychosocial approaches to smoking prevention, particularly the social influences approach--fourth generation tests of the broader life/social skills approaches have yet to be reported--are effective, but at this time we know very little about why, for whom, or under what conditions. Suggestions are provided for improved future research.

Adolescent↗
PubMed1982

Overcoming design problems in evaluating health behavior programs.

The increasing importance of high-quality evaluative research on health lifestyle change programs is established. Failure to ask the right evaluative research questions and problems of research design are identified as two major reasons for the dearth of well-controlled, interpretable evaluations in this area. Thirteen issues of research design that need to be considered if interpretable answers to evaluative research questions are to be obtained are identified and discussed. Solutions to these problems and design recommendations are offered.

Attitude to Health↗
PubMed1980

Mass media in health promotion: an analysis using an extended information-processing model.

The information-processing model of the attitude and behavior change process was critically examined and extended from six to 12 levels for a better analysis of change due to mass media campaigns. Findings from social psychology and communications research, and from evaluations of mass media health promotion programs, were reviewed to determine how source, message, channel, receiver, and destination variables affect each of the levels of change of major interest (knowledge, beliefs, attitudes, intentions and behavior). Factors found to most likely induce permanent attitude and behavior change (most important in health promotion) were: presentation and repetition over long time periods, via multiple sources, at different times (including "prime" or high-exposure times), by multiple sources, in novel and involving ways, with appeals to multiple motives, development of social support, and provisions of appropriate behavioral skills, alternatives, and reinforcement (preferably in ways that get the active participation of the audience). Suggestions for evaluation of mass media programs that take account of this complexity were advanced.

Attitude to Health↗
PubMedDate not supplied

Factors affecting attrition in a longitudinal smoking prevention study.

BACKGROUND: In longitudinal smoking prevention studies, a difficulty in evaluating treatment effects is understanding whether bias is associated with those who do not complete the study. This study presents the significant predictors of attrition and suggests how to reduce attrition bias in evaluating program effects. METHODS: Survival analysis methods were used to assess factors associated with attrition at different time points of the study. RESULTS: Results of the analysis indicate that those who drop out tend to be of lower academic achievement, have lower tobacco and health knowledge, and have lower social influence/resistance skills knowledge, and are more likely to be smokers and to be marijuana users. Blacks are more likely to drop out than the other ethnic groups. Gender is not a significant predictor for dropout. The dropout rates among the treatment conditions are significantly different. CONCLUSIONS: The findings of this study demonstrate that attritions in longitudinal smoking prevention studies are not at random. By considering the characteristics of dropouts, one can reduce attrition bias using available procedures and can take appropriate strategies for reducing dropout rates in future smoking prevention studies.

Adolescent↗
PubMedDate not supplied

Self-initiated quitting among adolescent smokers.

OBJECTIVES: This paper reviews the literature regarding predictors of adolescent self-initiated smoking cessation and investigates self-initiated smoking cessation among a large sample of alternative high school youth in southern California. Youth transfer to alternative schools because of academic or behavioral problems, and they are at relatively high risk for cigarette smoking. METHODS: Several demographic (e.g., gender), behavioral (e.g., level of smoking), and psychosocial (e.g., risk-taking) predictors of adolescent smoking cessation were investigated. The alternative high school cohort provided a sufficient sample size of quitters (defined as no use in the past 30 days, measured after a 1-year period) to permit a prospective examination of adolescent smoking cessation. RESULTS: Although nine demographic, behavioral, or psychosocial variables discriminated among quitters and nonquitters in univariate analyses, only level of baseline smoking, smoking intention, and perceived stress were predictors in a final multivariable model. CONCLUSIONS: Based on the literature review and findings among the cohort, smoking cessation programs for adolescents should include counteraction of problem-prone attitudes, support of wellness attitudes, provision of motivation to quit strategies, and assistance with overcoming withdrawal symptoms.

Adolescent↗
PubMedDate not supplied

Psychosocial predictors of different stages of cigarette smoking among high school students.

BACKGROUND: Current research on the etiology of cigarette smoking has largely focused on the identification of psychosocial predictors of tobacco onset. Few data are available on the predictors of different stages of smoking among adolescents. The present study examines the psychosocial predictors of different stages of smoking, including trial, experimental, and regular use, among high school students. METHOD: The predictor variables were measured when the students were in the 7th grade. Logistic regression was used to predict different smoking stages at grade 12. RESULTS: The results show that four domains of psychosocial variables, including social and interpersonal factors, attitudinal and belief factors, intrapersonal factors, and use of other substances, predicted one or more stages of smoking. The important correlates of transition from trial to experimental use (all P value <0.001) included friends' smoking and approval, cigarette offers by friends, smoking intentions, school grade, and alcohol and marijuana use. The significant predictors of the transition from experimental to regular use included only parental smoking (P < 0.01) and family conflicts (P < 0.05). We found some gender differences in these predictors. CONCLUSIONS: Psychosocial predictors may differ by different stages of smoking.

Adolescent↗