Biomedical subjects

J L Forster

Publications and source records attributed to J L Forster.

At least 37 records · Page 2Linked to original sources

PubMed1996

Project Northland: outcomes of a communitywide alcohol use prevention program during early adolescence.

OBJECTIVES: Project Northland is an efficacy trial with the goal of preventing or reducing alcohol use among young adolescents by using a multilevel, communitywide approach. METHODS: Conducted in 24 school districts and adjacent communities in northeastern Minnesota since 1991, the intervention targets the class of 1998 (sixth-grade students in 1991) and has been implemented for 3 school years (1991 to 1994). The intervention consists of social-behavioral curricula in schools, peer leadership, parental involvement/education, and communitywide task force activities. Annual surveys of the class of 1998 measure alcohol use, tobacco use, and psychosocial factors. RESULTS: At the end of 3 years, students in the intervention school districts report less onset and prevalence of alcohol use than students in the reference districts. The differences were particularly notable among those who were nonusers at baseline. CONCLUSIONS: The results of Project Northland suggest that multilevel, targeted prevention programs for young adolescents are effective in reducing alcohol use.

Adolescent↗

PubMed1995

Commercial availability of alcohol to young people: results of alcohol purchase attempts.

OBJECTIVES: Commercial availability is an important contributor to alcohol use by young people. The purpose of this study was to test the purchasability of alcohol by youth who appeared to be under the legal age of sale in all types of businesses licensed to sell alcohol in upper Midwest communities. METHODS: Female buyers who were age 21 but whose apparent age as rated by a panel averaged 19 years attempted to purchase beer without age identification at all off-sale outlets (n = 395) and a random sample of on-sale outlets (n = 492) in 24 communities in Minnesota and Wisconsin. Two purchase attempts were made at each outlet, with the buyer randomly assigned to outlet and community. Characteristics of the outlets, clientele, signs, interaction with the sellers or servers, and purchase success were recorded. RESULTS: The buyers were successful in purchasing beer without age identification in 50% of attempts in on-sale outlets and 52% of off-sale attempts. Almost 75% of the outlets sold beer to the buyers at least once in two attempts. In off-sale businesses buyers were more successful if the salespersons were male and if the businesses were located in residential areas or malls. On-sale purchase attempts were more likely to be successful if the server appeared to be younger than 30 years, if the business was a restaurant as opposed to a bar alone, and if signs warning against sales to minors were located at the checkouts. CONCLUSIONS: The results of this study confirm and extend previous reports of the ability of youth to purchase alcohol and support the conclusion that commercial availability of alcohol to youth is widespread.

Adolescent↗

PubMed1995

Weight concerns and change in smoking behavior over two years in a working population.

The hypothesis that weight concerns are related to less successful smoking cessation and greater relapse among ex-smokers was prospectively evaluated. A population-based sample of 4981 working women and men 17 to 71 years of age was surveyed at 32 work sites. Current and previous weight loss efforts and smoking behavior were self-reported at baseline and 2 years later. Dieting and weight concerns were unrelated to smoking cessation or relapse. However, female smokers who had previously participated in a formal weight control program were three times more likely to quit smoking than those without a history of participation (25% vs 11%; odds ratio = 3.25, 95% confidence interval = 1.86, 5.67). Weight concerns and dieting efforts do not appear to inhibit smoking cessation or increase relapse in adults.

Adolescent↗

PubMed1994

Dieting status and its relationship to weight, dietary intake, and physical activity changes over two years in a working population.

The present study prospectively examined changes in dietary intake, physical activity and weight associated with self-reported efforts to lose weight in a cohort of 3671 men and women sampled from the general population. Dieting efforts, dietary intake, physical activity and weight were measured at two points in time, 24 months apart. At baseline, current dieters reported consuming fewer dairy products, sweets, meat, soft drinks and fried potatoes (all p's < .0001), and engaging more frequently in high-intensity physical activity (p < .0001) than those not currently dieting. At follow-up, current dieters reported consuming fewer sweets (p < .0001) and fried potatoes (p < .0008), and engaging more frequently in moderate-intensity physical activity (p < .02) than those not currently dieting. Prospectively, those who initiated weight-loss diets showed the largest decrease in consumption of sweets (p < .0001), soft drinks (p < .0001), and fried potatoes (p < .01), and increase in frequency of high-intensity physical activity (p < .0001) and moderate-intensity physical activity (p < .007). Those initiating weight-loss diets were the only group to lose weight (1 lb.). Those dieting at baseline but not at follow-up gained the most weight (4 lbs.). Self-reports of current dieting correspond to reported changes in dietary intake and physical activity, and to measured changes in weight over the same time period. Individuals who report dieting to lose weight have healthier eating and exercise patterns than those who do not report dieting.

Adult↗

PubMed1994

Restrictive smoking policies in the workplace: effects on smoking prevalence and cigarette consumption.

BACKGROUND: Thirty-two worksites participating in a randomized trial of worksite health promotion aimed at reducing smoking and obesity were categorized at baseline and 2 years later as having either restrictive or unrestrictive smoking policies. Between the two assessment points, 16 sites received health promotion interventions. RESULTS: At baseline 15 sites had restrictive policies and 17 unrestrictive policies. Smoking restrictions were associated with significantly lower smoking prevalence and higher lifetime quit rates among ever smokers. They also were associated with more recent quit attempts and lower daily cigarette consumption, although these effects were not significant. Between baseline and follow-up, 9 of the 17 worksites that had few smoking restrictions at baseline became restrictive. Although neither baseline smoking policies nor changes in smoking policy predicted change in smoking prevalence or in the frequency of quit attempts, smokers in sites changing from unrestrictive to restrictive policies reported a significant reduction in daily cigarette consumption. CONCLUSIONS: The worksite health promotion program was successful in reducing smoking prevalence in intervention sites compared to controls. However, the existence of restrictive smoking policies neither helped nor hindered these intervention efforts. The present data are believed to support the idea that restrictive smoking policies have beneficial effects on the smoking habits of employees, but that the magnitude of this effect is modest.

Analysis of Variance↗

PubMed1994

The ability of young people to purchase alcohol without age identification in northeastern Minnesota, USA.

The purpose of this study was to determine the rate at which young people can purchase alcohol without age identification in off-premises businesses, and the factors which influence the rate of purchase. All retail outlets licensed to sell distilled spirits and/or full strength beer and wine in 28 northern Minnesota communities were visited on different occasions by three 21-year-old female buyers who appeared to be aged 19 or younger. These youthful buyers were able to purchase beer without age identification in 47% of the 336 purchase attempts. Almost four-fifths of the businesses sold beer to these buyers at least once in three attempts. These results provide clear evidence that many commercial off-sale businesses in the US supply alcohol to youthful buyers, and that practices vary significantly by community and by business. These results support the need for greater attention to availability as a factor in teenage drinking patterns.

Age Factors↗

PubMed1994

The use of commercial tanning facilities by suburban Minnesota adolescents.

In 1991, 1008 suburban St. Paul, Minn, high school students were surveyed via self-administered questionnaire regarding use of commercial tanning facilities, injuries experienced from tanning, use of protective measures while tanning indoors, and knowledge of the risks of tanning. Overall, 34% of the respondents had used commercial tanning facilities. Fifty percent said they had not been warned by tanning facility operators about the risks of tanning indoors, 28% reported not being told to wear goggles, and 17% reported never wearing goggles. The results indicate that these adolescents use commercial tanning services at high rates, and often in ways that increase their risk for a variety of health problems.

Adolescent↗

PubMed1994

Predictors of weight change over two years among a population of working adults: the Healthy Worker Project.

The present study examined behavioural predictors of body weight cross-sectionally and longitudinally in a cohort of 1639 male and 1913 female employees in 32 companies participating in a worksite intervention study for smoking cessation and weight control. Dietary intake, current and previous dieting behaviours, and physical activity were examined for their association with body weight over the two-year period. Cross-sectionally in both men and women, history of previous dieting, previous participation in a formal weight loss programme, current dieting and meat consumption were positively related to body weight while high intensity activity was negatively related to body weight. Prospectively, history of participation in a formal weight loss programme and dieting to lose weight at baseline, and increased consumption over time of french fries, dairy products, sweets and meat, independently predicted increases in body weight in women. Women who were dieting to lose weight or who had previously participated in a formal weight loss programme at baseline gained 1.99 lb and 1.74 lb more, respectively, than those who were not dieting to lose weight or who had not previously participated in a formal weight loss programme. Increased exercise, either walking or high intensity activity, predicted decreases in body weight in women (1.76 lb and 1.39 lb, respectively, for each session increase per week). In men, previous participation in a formal weight loss programme predicted increases in body weight over the two-year period. Men who had previously participated in a formal weight loss programme at baseline gained 4.83 lb more than those who had never previously participated in a formal weight loss programme. Increases in consumption of sweets and egg were prospectively related to increases in body weight, while increased walking and high intensity activity were related to decreases in body weight (0.86 lb and 3.54 lb, respectively, for each session increase per week). These results suggest the role that specific diet and exercise behaviours may play in body weight changes over time.

Adult↗

PubMed1993

Background, conceptualization and design of a community-wide research program on adolescent alcohol use: Project Northland.

Project Northland is a community-wide research program funded by the National Institute on Alcoholism and Alcohol Abuse, for a 5-year period (1990-95). The aim of the study is to prevent or delay onset of alcohol use among young adolescents, as well as to reduce use among those who are already drinkers. Twenty communities were recruited in northeastern Minnesota, an area referred to as the Northland, Arrowhead or Iron Range region, and then were randomly assigned to either Education or Delayed Program conditions. The 10 Education school districts have agreed to participate in 3 years of intervention programs in schools, with parents and in the community-at-large. One group of young adolescents, the Class of 1998 (sixth grade students in the 1991-92 school year), form the study cohort. Surveys (1991-94) of the Class of 1998, their parents, community leaders and alcohol merchants are the primary components of the program's evaluation. Many conceptual and methodological questions emerged during the development of the research protocols for Project Northland over the past 2 years. These questions are the impetus for this article. Specifically, the focus on young adolescents and alcohol use was selected, as contrasted with older adolescents or with multiple problem behaviors. The project was designed using a community-wide model that addresses both supply and demand issues, rather than limited to a school-based model. Intervention strategies and evaluation methods were chosen that could address community-level as well as individual-level behavior change, which required the development and application of new technologies. The rationale for these decisions may be useful to others considering community-wide health promotion efforts.

Adolescent↗

PubMed1993

The evolution, operation and future of Minnesota SAFPLAN: a coalition for family planning.

Health coalitions are a key means by which health educators can pursue policy objectives. However, little research to date has focused on the formation, operation and maintenance of health coalitions. This paper examines the development and operation of Minnesota SAFPLAN (Statewide Association for Family Planning), a coalition of organizations and individuals that came together in 1990 to address the problem of inadequate state-subsidized family planning funds. Data were collected through 31 structured interviews with coalition member representatives and lobbyists, review of documentary data, and participant observation in coalition activities and meetings. The paper focuses on SAFPLAN's recruitment of members and division of labor. Recruitment of member organizations of SAFPLAN relied heavily on existing interpersonal and interorganizational networks. While this allowed rapid mobilization of a coalition that was an effective force in the state legislature, it left important gaps in SAFPLAN's membership and lingering questions about whom the coalition was designed to represent. A division of labor that reflected variation in members' commitment, skill, knowledge and discretionary time was developed. The SAFPLAN model merits careful consideration by health educators and others interested in affecting public policy through health coalitions.

Family Planning Services↗

PubMed1993

The worksite component of variance: design effects and the Healthy Worker Project.

Variance estimates in worksite health promotion studies depend partly on the intraclass correlation coefficient (ICC). ICC quantifies homogeneity of a variable within worksites. ICC would be zero for randomly formed worksites, but is generally positive because employees tend to share personal characteristics. The ratio comparing the variance estimated from worksite means with that estimated from individuals under simple random sampling is the design effect (DEFF). A DEFF of 1.0 indicates no excess variance due to worksite. The Healthy Worker Project (HWP) was a 32 worksite cross-sectional and longitudinal study of a weight and smoking intervention program. ICCs in cross-sectional surveys for health-related outcome variables ranged from 0.006 to 0.009, DEFFs from 2.0 to 2.6 ICCs/DEFF's in longitudinal analysis were smaller; ICCs ranged from -0.002 to 0.003, DEFFs from 0.7 to 1.5. Positive ICCs substantially increased variance estimates at a single measurement, yet variance of longitudinal analysis was less subject to worksite dependence. It is concluded the worksite component of variance is real and should not be ignored, although the worksite component of variance is small in these longitudinal analyses. This observation should be replicated before it is used in other worksite health promotion research.

Analysis of Variance↗

PubMed1993

Effects of work-site health promotion on illness-related absenteeism.

This study examined the effects of work-site health promotion on employee absenteeism. Thirty-two work sites were randomized to programs for weight control and smoking cessation or to no treatment for 2 years. The prevalence of self-reported absences from work was assessed at baseline and follow-up. Results using work site as the unit of analysis showed a net reduction in the percent of workers reporting a sick day in the last month in treatment versus control work sites of 3.7% (P = .04) and 3.4% (P = .06) in cross-sectional and cohort analysis, respectively. Further analyses found that the rate of participation in smoking (P = .09) but not weight programs (P = .72) was positively associated with change in sick day prevalence and that this effect was strongest in baseline smokers (P = .002). It is concluded that work-site smoking cessation programs may yield important short-term economic benefits by reducing employee absenteeism.

Absenteeism↗

PubMed1993

The Healthy Worker Project: a work-site intervention for weight control and smoking cessation.

OBJECTIVES: A randomized trial was conducted to evaluate the effectiveness of a work-site health promotion program in reducing obesity and the prevalence of cigarette smoking. METHODS: Thirty-two work sites were randomized to treatment or no treatment for 2 years. Treatment consisted of health education classes combined with a payroll-based incentive system. Evaluation was based on cohort and cross-sectional surveys. RESULTS: Of 10,000 total employees in treatment work sites, 2041 and 270 participated in weight control and smoking cessation programs, respectively. Weight losses averaged 4.8 lbs, and 43% of smoking participants quit. Net 2-year reductions in smoking prevalence in treatment vs control work sites were 4.0% and 2.1% in cross-sectional and cohort surveys, respectively. No treatment effect was found for weight. Treatment effects for smoking prevalence and weight were both positively correlated with participation rates in the intervention programs (r = .45 for smoking and r = .55 for weight). CONCLUSIONS: This work-site health promotion program was effective in reducing smoking prevalence at a cost that is believed to make the investment worthwhile.

Adult↗

PubMed1992

Availability of cigarettes to underage youth in three communities.

BACKGROUND: Underage youth report that they primarily obtain cigarettes from commercial sources. Thus policies that effectively prevent purchase by minors could have an effect on the prevalence of young people's cigarette use. METHODS: In this study, 12- to 15-year-old male and female confederates attempted to purchase cigarettes from all cigarette outlets in three communities. RESULTS: A success rate of 53% over the counter and 79% from vending machines was achieved. These results show that minors can purchase cigarettes in all types of businesses, even those characterized as "adult" locations. Boys in this study had more difficulty than girls in purchasing cigarettes over the counter, and younger individuals had more difficulty than 15-year-olds. However, these differences were not found in vending machine sales. Similarly, over-the-counter sales of cigarettes were significantly reduced following a state-wide increase in the penalty for tobacco sales to minors, but vending machine sales were not affected. CONCLUSIONS: These results support stringent and universal controls over the sale of cigarettes as an essential part of any tobacco use prevention strategy.

Adolescent↗

PubMed1992

Locking devices on cigarette vending machines: evaluation of a city ordinance.

OBJECTIVES: Policymakers, researchers, and citizens are beginning to recognize the need to limit minors' access to tobacco by restricting the sale of cigarettes through vending machines. One policy alternative that has been proposed by the tobacco industry is a requirement that vending machines be fitted with electronic locking devices. This study evaluates such a policy as enacted in St. Paul, Minn. METHODS: A random sample of vending machine locations was selected for cigarette purchase attempts conducted before implementation and at 3 and 12 months postimplementation. RESULTS: The rate of noncompliance by merchants was 34% after 3 months and 30% after 1 year. The effect of the law was to reduce the ability of a minor to purchase cigarettes from locations originally selling cigarettes through vending machines from 86% at baseline to 36% at 3 months. The purchase rate at these locations rose to 48% at 1 year. CONCLUSIONS: Our results suggest that cigarette vending machine locking devices may not be as effective as vending machine bans and require additional enforcement to ensure compliance with the law.

Adolescent↗

PubMed1991

Prevalence of dieting among working men and women: the healthy worker project.

Examined dieting to lose weight in a population of 2,107 men and 2,540 women employed in 32 worksites in the upper Midwest. Lifetime prevalence of this behavior was estimated to be 47% in men and 75% in women, and point prevalence was reported as 13% and 25% in men and women, respectively. Lifetime prevalence of participation in organized weight-loss programs was 6% in men and 31% in women; current prevalence was 1% in men and 6% in women. The strongest correlate of dieting behavior was relative body weight. In logistic regression analyses, dieting tended to be associated positively with education and occupational status and, in men only, was more prevalent among those with a history of hypertension. Dieters reported lower food intakes than nondieters, but the two groups did not differ consistently in reported physical activity. Overall, dieting appears to be a pervasive behavioral U.S. phenomenon that may contribute in part to population differences in the prevalence of obesity.

Adult↗

PubMed1991

Use of carbon monoxide breath validation in assessing exposure to cigarette smoke in a worksite population.

Assessed the usefulness of carbon monoxide (CO) breath validation of self-reported smoking status in a large worksite population (N = 4,647). CO assessment was performed as part of a baseline survey procedure. CO levels differed substantially in relation to self-reported smoking status and amount smoked. Correcting for ambient exposure (estimated by mean CO levels among never smokers) produced more satisfactory results than uncorrected CO levels. Striking company differences were observed in mean CO exposures among self-reported never smokers. An unexpected finding was that 17.1% of current smokers reported smoking less than daily. Although the CO measure was excellent in detecting moderate and heavy smokers, it was inadequate in detecting occasional and light smokers. If detection of occasional or lighter smoking is critical to the purposes of the study, the more expensive (but more accurate) cotinine measure is preferred.

Adult↗

PubMed1991

Socioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project.

Obesity and health behaviors that influence energy balance (diet, exercise, and dieting to lose weight) were examined in a population of 2108 and 2539 working men and women in relation to socioeconomic status (SES). The hypothesis investigated was that the inverse relationship between SES and obesity observed in a number of studies is due to the fact that the distribution of obesity relevant health behaviors differs by social class. Body mass index (BMI), as expected, was found to be inversely related to SES. Higher SES was also associated with several behaviors that contribute importantly to energy balance. High SES respondents reported a lower fat diet, more exercise, and a higher prevalence of dieting to control weight. However, lower smoking rates were observed in upper SES men and women and higher alcohol consumption was reported in upper SES women. Both of these associations appear to be inconsistent with the hypothesis that the inverse association between SES and obesity is caused by differences in health behaviors. In multiple regression analyses, SES remained a significant predictor of BMI after controlling for all measured health behaviors. Weaknesses in the methodologies for measuring health behaviors and possible effects of obesity itself on social mobility are suggested as possible explanations for the residual association between obesity and SES.

Adult↗