Biomedical subjects

C L Perry

Publications and source records attributed to C L Perry.

At least 19 recordsLinked to original sources

PubMed2002

Weight-related attitudes and behaviors of adolescent boys and girls who are encouraged to diet by their mothers.

OBJECTIVE: To assess the relationships between mothers' reports of dieting and encouraging adolescents to diet and adolescents' reports of their own dieting practices and weight-related concerns. DESIGN: Cross-sectional study of parent interviews and adolescent surveys in an ethnically-diverse sample. SUBJECTS: A total of 810 adolescents (n=381 boys and n=429 girls) and their mothers. RESULTS: Mothers' dieting was associated with their adolescent girls' weight-related concerns and behaviors, but these associations were not significant after adjusting for girls' body mass index (BMI). In contrast, mothers' encouragement for sons to diet was associated with sons' binge eating, dieting and other weight-control behaviors, even after controlling for sons' BMI. Compared with mothers who did not encourage their child to diet, mothers who encouraged their child to diet were significantly heavier women and were more likely to view their child as overweight. Forty-three percent of boys and 46% of girls who were encouraged by their mothers to diet were classified as nonoverweight by federal guidelines. CONCLUSIONS: Boys who are encouraged by their mothers to diet may be at risk for health-compromising eating and dieting behaviors, particularly binge-eating, fasting, eating a little bit of food and skipping meals. Parents who are concerned about their children's weight should be educated to encourage healthy eating habits and physical activity to promote their children's health, including healthy weight control.

Adolescent↗

PubMed2001

Characteristics of vegetarian adolescents in a multiethnic urban population.

PURPOSE: To examine the prevalence of adolescents' vegetarianism in a multiethnic, urban population, and its correlates with demographic, personal, weight-related, and behavioral factors. METHODS: Self-report and anthropometric data were collected from a representative sample of 4746 adolescents from 31 public middle schools and high schools in the Twin Cities area of Minnesota. Students answered questions concerning vegetarianism, food and weight, and health behaviors. Height and weight were directly measured. Comparisons were made between self-reported vegetarians and nonvegetarians; these analyses also assessed gender and race/ethnicity interactions. In the second set of analyses, demographic and behavioral characteristics of more restricted and semi-vegetarians were examined. Analyses were done by logistic regression. RESULTS: Teenage vegetarians comprise about 6% of the sample. The vegetarians were more likely than nonvegetarians to be female, not black, weight- and body-conscious, dissatisfied with their bodies, and involved in a variety of healthy and unhealthy weight control behaviors. Vegetarians more often reported having been told by a physician that they had an eating disorder and were more likely to have contemplated and attempted suicide. Vegetarian males were found to be an especially high risk group for unhealthy weight control practices. Few ethnic group differences among vegetarians were noted. Adolescents who did not eat chicken and fish were at lower risk than those who also ate chicken and fish. CONCLUSIONS: Adolescent vegetarians are at greater risk than others for involvement in unhealthy and extreme weight control behaviors. Vegetarian males are at particularly high risk. Vegetarianism among adolescents may therefore be a signal for preventive intervention. Adolescents who choose to become vegetarians may also need to learn how to healthfully do so.

Adolescent↗

PubMed2001

Russian-American partners for prevention. Adaptation of a school-based parent-child programme for alcohol use prevention.

BACKGROUND: The Russian-American Partners for Prevention was an adaptation and evaluation of the Slick Tracy Home Team Program which was developed in Minnesota in order to delay the onset of drinking. The Slick Tracy Home Team Program was the first intervention of Project Northland, a large 3 year community trial of the efficacy of a public health intervention for under age drinking. METHODS: The programme was administered through schools, but involved parents using engaging and fun homework activities. The Russian version was implemented in fifth-grade classrooms in 20 Moscow schools with 1,212 students surveyed at baseline. Students were surveyed again after programme implementation (n = 1,182), of whom 980 were present at baseline. Parents of 1,078 students were surveyed by telephone after programme implementation. RESULTS: The results demonstrated the successful recruitment and retention of 20 Moscow schools in a research project, acceptability of programme materials in Russia, high participation rates, changes in students' knowledge about problems associated with under age drinking and some evidence about increases in parent-child communication about alcohol use. As in the USA, no changes in students' alcohol use rates were observed at the end of the first year of the 3 year programme. CONCLUSION: Russian youth, as compared to Americans, began drinking at earlier ages, received fewer prevention messages from their parents, and had fewer prevention programmes in school. The results suggested that carefully implemented and evaluated replications of the US Project Northland interventions might provide effective and appropriate school-based programmes for Russia.

Adolescent↗

PubMed2001

How did Project Northland reduce alcohol use among young adolescents? Analysis of mediating variables.

Project Northland is a randomized trial designed to create, implement and evaluate multilevel, community-wide strategies to prevent alcohol use among adolescents. This paper will focus on the mediating outcomes of the early adolescent phase of Project Northland when the students in the study cohort were in Grades 6-8. The project was conducted in 24 school districts and adjacent communities in northeastern Minnesota. The intervention consisted of social-behavioral curricula in schools, peer leadership activities, parental involvement and education, and community-wide activities. At the end of 3 years of intervention, significantly fewer students in the intervention school districts reported alcohol use than students in the reference districts. Mediation analyses were conducted to investigate if the intervention's effects on mediating variables could explain the reduction in alcohol use. Important mediators of Project Northland's effect on alcohol use were: (1) peer influence to use, including normative estimates, (2) functional meanings of alcohol use, (3) attitudes and behaviors associated with alcohol and drug problems like stimulus seeking, rule violations and bad judgement, and (4) parent-child alcohol-related communication around alcohol use. In addition, among those who did not use alcohol at baseline, self-efficacy to refuse offers of alcohol was a significant mediator.

Adolescent↗

PubMed2001

Project ARM: alcohol risk management to prevent sales to underage and intoxicated patrons.

Clear policies and expectations are key to increasing responsible service of alcohol in licensed establishments. Few training programs focus exclusively on owners and managers of alcohol establishments to reduce the risk of alcohol service. Project ARM: Alcohol Risk Management is a one-on-one consultation program for owners and managers. Participants received information on risk level, policies to prevent illegal sales, legal issues, and staff communication. This nonrandomized demonstration project was implemented in five diverse bars. Two waves of underage and pseudo-intoxicated purchase attempts were conducted pre- and postintervention in the five intervention bars and nine matched control bars. Underage sales decreased by 11.5%, and sales to pseudo-intoxicated buyers decreased by 46%. Results were in the hypothesized direction but not statistically significant. A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals.

Administrative Personnel↗

PubMed2000

Effectiveness of monetary incentives for recruiting adolescents to an intervention trial to reduce smoking.

BACKGROUND: The study objective is to evaluate the effect of monetary incentives on response rates of adolescents to a smoking-related survey as the first step toward participation in an intervention trial. METHODS: A sample of 4,200 adolescent members of a managed care organization were randomized to one of four incentive groups: a $2 cash group, a $15 cash group, a $200 prize drawing group, or a no-incentive group. We compared group-specific response rates and willingness to be contacted about future study activities, as well as costs. RESULTS: Incentives increased survey response rates (55% response without incentive vs. a 69% response with incentive), with response of 74% in the $15 cash group, 69% in the token group, and 63% with a prize incentive. Incentives did not adversely affect willingness of adolescents to be contacted about a smoking intervention, (65% willing with incentives vs. 60% without, P = 0.03). In terms of cost per additional survey completed, token and prize groups were marginally more expensive than the no-incentive group ($0.40 and $1.42, respectively) while the large cash incentive was substantially more costly ($11.37). CONCLUSIONS: Monetary incentives improve response rates to a mailed survey, without adverse impact on willingness to further participate in intervention activities. However, a variety of issues must be considered when using incentives for recruitment to intervention studies.

Adolescent↗

PubMed2000

Prevalence of marked overweight and obesity in a multiethnic pediatric population: findings from the Child and Adolescent Trial for Cardiovascular Health (CATCH) study.

OBJECTIVE: Determine the prevalence of marked overweight and obesity among children in the Child and Adolescent Trial for Cardiovascular Health (CATCH), identify high risk groups, and compare findings to other recent studies. DESIGN: Cohort study. SUBJECTS/SETTING: Five thousand one hundred-six school children who were participants in CATCH at baseline (age approximately 9 years) during 1991 and 4,019 of those children who had follow-up data from 1994 (age approximately 1 years) available. METHODS: Body mass index (BMI), triceps and subscapular skinfolds, subscapular to triceps skinfold (S/T) ratio, and an estimate of body fat distribution from skinfolds was calculated. Findings were compared to population-based reference data from the First National Health and Nutrition Examination Survey, 1971 to 1973 (NHANES I), to data from the Bogalusa Heart Study, and to data from the Third National Health and Nutrition Examination Survey, 1988 to 1994 (NHANES III). RESULTS: Children in CATCH were markedly heavier and fatter than the NHANES I population and more comparable to the NHANES III population, especially those in the upper percentiles. The prevalence of obesity based on BMI and triceps skinfolds >95th percentile among CATCH children was higher in boys than in girls at both baseline (boys 9.1%, girls 8.6%) and follow-up (boys 11.7%, girls 7.2%). It was higher among African-Americans and Hispanics than whites for both sexes. S/T ratios did not differ appreciably from those observed in the NHANES I reference population, suggesting that body fat distribution was more stable over time than BMI and skinfolds. APPLICATIONS: Our findings support other recent reports that American children, especially African-American and Hispanic children, are becoming heavier and fatter. Preventive measures are warranted, especially for high-risk youth.

Black or African American↗

PubMed2000

Do friendships change behaviors, or do behaviors change friendships? Examining paths of influence in young adolescents' alcohol use.

PURPOSE: This study examined support for models of peer influence, which postulates that young adolescents whose friends use alcohol will also engage in that behavior, and of peer selection, whereby young adolescents seek out friends whose drinking behavior is similar to their own. METHODS: Data for this study are from 1804 adolescents participating in Project Northland, a school- and community-based alcohol use prevention trial. Using latent variable structural equation modeling, a series of models examined directions of influence between participant alcohol use and friend drug use over three points in Grades 7, 8, and 9. RESULTS: Findings indicated that higher levels of friends' drug use led to increased participant alcohol use. The reverse-order relationship (i.e., greater participant involvement in alcohol leading to more drug use among friends) was not supported by these data. Finally, best-fitting models supported the notion that both participants' alcohol use and the alcohol and other drug use of friends were highly stable over time. CONCLUSIONS: Similarity in drinking behavior among adolescent friends may be more related to processes of peer influence than to processes of peer selection. Findings support the utility of alcohol use prevention programs that equip younger teens with skills to resist peer influences to use alcohol.

Adolescent↗

PubMed2000

The Minnesota DARE PLUS Project: creating community partnerships to prevent drug use and violence.

The research community has criticized Drug Abuse Resistance Education (D.A.R.E.) because the extant literature indicates a lack of evidence that the elementary school program prevents drug use. Yet D.A.R.E. continues to be the most widely implemented drug use prevention program in the United States and has considerable community support. To date, the junior high D.A.R.E. program has not been evaluated. The Minnesota DARE PLUS Project is a randomized trial of 24 schools and communities. During 1999-2001, students in eight schools will receive the junior high D.A.R.E. curriculum in 7th grade; eight schools also will receive the curriculum as well as additional parent involvement, peer leadership, and community components in the 7th and 8th grades; and eight schools will serve as controls. This article describes the background and conceptualization, the curriculum and additional intervention components, and the evaluation methods of the DARE PLUS Project.

Adolescent↗

PubMed2000

Project Northland high school interventions: community action to reduce adolescent alcohol use.

Project Northland is a randomized community trial initially implemented in 24 school districts and communities in northeastern Minnesota, with goals of delaying onset and reducing adolescent alcohol use using community-wide, multiyear, multiple interventions. The study targets the Class of 1998 from the 6th to 12th grades (1991-1998). The early adolescent phase of Project Northland has been completed, and reductions in the prevalence of alcohol use at the end of 8th grade were achieved. Phase II of Project Northland, targeting 11th- and 12th-grade students, uses five major strategies: (1) direct action community organizing methods to encourage citizens to reduce underage access to alcohol, (2) youth development involving high school students in youth action teams, (3) print media to support community organizing and youth action initiatives and communicate healthy norms about underage drinking (e.g., providing alcohol to minors is unacceptable), (4) parent education and involvement, and (5) a classroom-based curriculum for 11th-grade students. This article describes the background, design, implementation, and process measures of the intervention strategies for Phase II of Project Northland.

Adolescent↗

PubMed2000

5-a-day Power Plus: process evaluation of a multicomponent elementary school program to increase fruit and vegetable consumption.

The 5-a-Day Power Plus program targeted multiethnic fourth- and fifth-grade students in 10 intervention and 10 control urban elementary schools in St. Paul, Minnesota, to increase fruit and vegetable consumption. The intervention included behavioral curricula in classrooms, parental involvement, school food service changes, and food industry support. Process evaluation was conducted by using surveys and classroom and lunchroom observations to assess the characteristics of teachers and food service staff, the degree the intervention was implemented as intended, and exteral factors that may have affected the program results. Results showed high levels of participation, dose, and fidelity for all of the intervention components, with the exception of parental involvement. The process evaluation findings help explain why the increase in fruit and vegetable consumption occurred mostly at school lunch and not at home. Future intervention research should focus on creating new and potent strategies for parental involvement and for increasing the appeal and availability of vegetables.

Child↗

PubMed2000

Communities mobilizing for change on alcohol: outcomes from a randomized community trial.

OBJECTIVE: Communities Mobilizing for Change on Alcohol (CMCA) was a randomized 15-community trial of a community organizing intervention designed to reduce the accessibility of alcoholic beverages to youths under the legal drinking age. METHOD: Data were collected at baseline before random assignment of communities to intervention or control condition, and again at follow-up after a 2.5-year intervention. Data collection included in-school surveys of twelfth graders, telephone surveys of 18- to 20-year-olds and alcohol merchants, and direct testing of the propensity of alcohol outlets to sell to young buyers. Analyses were based on mixed-model regression, used the community as the unit of assignment, took into account the nesting of individual respondents or alcohol outlets within each community, and controlled for relevant covariates. RESULTS: Results show that the CMCA intervention significantly and favorably affected both the behavior of 18- to 20-year-olds (effect size = 0.76, p<.01) and the practices of on-sale alcohol establishments (effect size = 1.18, p<.05), may have favorably affected the practices of off-sale alcohol establishments (effect size = 0.32, p = .08), but had little effect on younger adolescents. Alcohol merchants appear to have increased age-identification checking and reduced propensity to sell to minors. Eighteen- to 20-year-olds reduced their propensity to provide alcohol to other teens and were less likely to try to buy alcohol, drink in a bar or consume alcohol. CONCLUSIONS: Community organizing is a useful intervention approach for mobilizing communities for institutional and policy change to improve the health of the population.

Adolescent↗

PubMed1999

Three-year maintenance of improved diet and physical activity: the CATCH cohort. Child and Adolescent Trial for Cardiovascular Health.

OBJECTIVE: To assess differences through grade 8 in diet, physical activity, and related health indicators of students who participated in the Child and Adolescent Trial for Cardiovascular Health (CATCH) school and family intervention from grades 3 through 5. DESIGN: Follow-up of the 4-center, randomized, controlled field trial with 56 intervention and 40 control elementary schools. PARTICIPANTS: We studied 3714 (73%) of the initial CATCH cohort of 5106 students from ethnically diverse backgrounds in California, Louisiana, Minnesota, and Texas at grades 6, 7, and 8. RESULTS: Self-reported daily energy intake from fat at baseline was virtually identical in the control (32.7%) and intervention (32.6%) groups. At grade 5, the intake for controls remained at 32.2%, while the intake for the intervention group declined to 30.3% (P<.001). At grade 8, the between-group differential was maintained (31.6% vs 30.6%, P = .01). Intervention students maintained significantly higher self-reported daily vigorous activity than control students (P = .001), although the difference declined from 13.6 minutes in grade 5 to 11.2, 10.8, and 8.8 minutes in grades 6, 7, and 8, respectively. Significant differences in favor of the intervention students also persisted at grade 8 for dietary knowledge and dietary intentions, but not for social support for physical activity. No impact on smoking behavior or stages of contemplating smoking was detected at grade 8. No significant differences were noted among physiologic indicators of body mass index, blood pressure, or serum lipid and cholesterol levels. CONCLUSION: The original CATCH results demonstrated that school-level interventions could modify school lunch and school physical education programs as well as influence student behaviors. This 3-year follow-up without further intervention suggests that the behavioral changes initiated during the elementary school years persisted to early adolescence for self-reported dietary and physical activity behaviors.

Adolescent↗

PubMed1999

The tobacco industry and underage youth smoking: tobacco industry documents from the Minnesota litigation.

OBJECTIVE: To learn how underage youth have been regarded by the major tobacco companies, as revealed in industry documents during the Minnesota litigation. DATA SOURCES: Documents from Brown & Williamson Tobacco Corp, Lorillard Tobacco Co, Philip Morris Inc, and R. J. Reynolds Tobacco Co. STUDY SELECTION: Documents available from the State of Minnesota and Blue Cross and Blue Shield of Minnesota v Philip Morris Inc et al during the discovery process of the trial. Hundreds of industry documents related to youth, teenagers, and young adults were examined. A sample of documents are referenced as illustrations of key points. CONCLUSIONS: Underage youths are viewed by the tobacco industry as critical to its future. Underage youth smoking patterns were examined for decades. Reductions in youth smoking rates were seen by tobacco companies as a negative trend for the companies. Specific marketing campaigns were directed at underage youth and were successful with this age group. Tobacco industry practices should continue to be carefully scrutinized.

Adolescent↗

PubMed1999

Cardiovascular disease prevention among youth: visioning the future.

Health behaviors among youth are interrelated and appear likely to extend into adult years. Thus cardiovascular disease prevention among youth will continue to be needed and may be critical to the prevention of high risk in the first place. These prevention efforts should be guided by behavioral models and etiological research. Healthy environments are important for the maintenance of healthy behaviors among young people and we need to know better how to change them. Moreover, successful prevention strategies among youth need to be disseminated globally as rapidly as they are found.

Adolescent↗

PubMed1999

Pathways family intervention for third-grade American Indian children.

The goal of the feasibility phase of the Pathways family intervention was to work with families of third-grade American Indian children to reinforce health behaviors being promoted by the curriculum, food service, and physical activity components of this school-based obesity prevention intervention. Family behaviors regarding food choices and physical activity were identified and ranked according to priority by using formative assessment and a literature review of school-based programs that included a family component. The family intervention involved 3 primary strategies designed to create an informed home environment supportive of behavioral change: 1) giving the children "family packs" containing worksheets, interactive assignments, healthful snacks, and low-fat tips and recipes to take home to share with their families; 2) implementing family events at the school to provide a fun atmosphere in which health education concepts could be introduced and reinforced; and 3) forming school-based family advisory councils composed of family members and community volunteers who provided feedback on Pathways strategies, helped negotiate barriers, and explored ideas for continued family participation. For strategy 2, a kick-off Family Fun Night provided a series of learning booths that presented the healthful behaviors taught by Pathways. At an end-of-year Family Celebration, a healthy meal was served, students demonstrated newly learned Pathways activities, and certificates were presented in recognition of completion of the Pathways curriculum. Based on evaluation forms and attendance rosters, strategies 1 and 2 were more easily implemented and better received than strategy 3. Implications for developing family involvement strategies for intervention programs are discussed.

Adult↗

PubMed1999

An evaluation of a theatre production to encourage non-smoking among elementary age children: 2 Smart 2 Smoke.

OBJECTIVE: To evaluate the impact of a theatre production on smoking-related attitudes, norms, and intentions of children in grades 1-6 (aged 6-12 years). DESIGN: Seventeen schools were randomly selected among 160 that were participating in the implementation of the theatre production 2 Smart 2 Smoke. Schools that participated in the theatre production after 3 December 1997 were assigned as control schools. Assignment of schools to a given date for the theatre production was a random process. Students in grades 1-6 were surveyed before and after the theatre production and associated activities. The data were examined for pretest-posttest differences and intervention-control differences. The school was the unit of analysis. SETTING: Elementary schools in the Twin Cities metropolitan area. PARTICIPANTS: Students in grades 1-6 in 17 elementary schools. INTERVENTION: Two plays 2 Smart 2 Smoke for grades 1-3 (6-8 year olds) and grades 4-6 (9-12 year olds), respectively, with follow-up activities for the classroom and home. A national theatre company performed the plays at the schools. MAIN OUTCOME MEASURES: Intention to smoke in the future, normative expectations about how many people smoke, functional meanings of smoking, expected outcomes of smoking. RESULTS: 10% more students reported that they would never smoke a cigarette after the theatre production. Students in grades 4-6 showed changes in the functional meanings and expected outcomes of smoking. Students in grades 1-3 showed changes in normative expectations. CONCLUSIONS: Further research on the impact of live theatre productions as a smoking prevention strategy is recommended.

Art↗

PubMed1999

Project Northland: comprehensive alcohol use prevention for young adolescents, their parents, schools, peers and communities.

OBJECTIVE: Project Northland is an ongoing prevention trial with the objective of reducing underage drinking and related problems. Phase I focused on early adolescence and this study describes the multiple interventions, highlighting its parent components. METHOD: A cohort design was used with sixth graders from 24 school districts (N = 2,35 1: 97% of the eligible population: 51.3% boys), randomly assigned to intervention or reference condition. Phase I ended in eighth grade (N = 1,901: 81% retention rate). Both demand and supply reduction guided the interventions. This study examined Project Northland's impact using MMPI-A scales assessing clinical problems related to adolescents' alcohol and other drug use (Alcohol/Drug Problems Proneness scale; Alcohol/Drug Problems Acknowledgement scale), as well as MMPI-A scales related to school functioning (Adolescent-School Problems Content scale: Adolescent-Low Aspirations Content scale) and family functioning (Adolescent-Family Problems Content scale). RESULTS: Results showed significant reductions on the MMPI-A Proneness scale for those exposed to the interventions. The greatest program effects were among baseline nonusers of alcohol. CONCLUSIONS: Results suggest that the impact of Project Northland is not only on specifically targeted alcohol and drug use behaviors and their predictive factors, but also on intra-individual and familial factors generally considered precursors of more extensive problem behaviors and more resistant to change. Furthermore, the engaging home-based sixth-grade intervention, the Slick Tracy Home Team Program, is a promising population-based prevention approach that may generalize to other serious problems within a young person's family.

Adolescent↗