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Biomedical subjects

M J Telch

Publications and source records attributed to M J Telch.

At least 37 records · Page 2Linked to original sources
PubMed1989

The Stanford Adolescent Heart Health Program.

This study was designed to create, implement, and test a school-based multiple risk factor reduction program for high school students. All tenth graders in four senior high schools (N = 1447) from two school districts participated in the study. Within each district, one school was assigned at random to receive a special 20-session CVD risk reduction intervention and one school served as a control. The schools were matched for size and distribution of racial groups before randomization. At a two-month follow-up, knowledge gains were significantly greater for students in the treatment group on each of the risk factor domains tested: nutrition/diet (p less than 0.0001), physical activity (p less than 0.0001), and cigarette smoking (p less than 0.0001). Compared to controls, a higher proportion of those in the treatment group who were not exercising regularly at baseline, reported regular exercise at follow-up (p less than 0.0003). Almost twice as many baseline experimental smokers in the treatment group reported quitting at follow-up while only 5.6% of baseline experimental smokers in the treatment group graduated to regular smoking compared to 10.3% in the control group (p = 0.009). Students in the treatment group were more likely to report that they would choose heart healthy snack items (p less than 0.0001). Beneficial treatment effects were observed for resting heart rate (p less than 0.0001), BMI (p = 0.05), triceps skinfold thickness (p = 0.003), and subscapular skinfold thickness (p = 0.01). The results suggest that it is feasible to provide CVD risk reduction training to a large segment of the population through school-based primary prevention approaches.

Adolescent↗
PubMed1988

Minimal contact treatment for smoking cessation. A placebo controlled trial of nicotine polacrilex and self-directed relapse prevention: initial results of the Stanford Stop Smoking Project.

To determine the effectiveness of nicotine polacrilex combined with self-administered relapse prevention materials in maintaining smoking cessation, we conducted a randomized, double-blind, placebo controlled trial. Volunteers aged 18 to 65 years responding to media announcements were required to quit smoking for 48 hours without assistance. Of 1844 potential participants, 136 were medically excluded, 535 declined to make a quit attempt, and 573 were unable to quit, leaving 600 participants (35%) who were randomized. Eight self-help relapse prevention modules were mailed weekly. Gum was used either ad lib for smoking urges or on a fixed, hourly schedule (12 pieces per day). Only 15% of the subjects in each gum group stopped using the gum altogether because of side effects, but only 20% of the ad lib groups and 40% of the fixed-dosage group used at least eight pieces of gum per day during the first week. The abstinence rates (for at least seven days) at the six-month follow-up were 31% in both active gum groups and 22% in the placebo and no gum groups. Relapse rates in the two active gum groups were about half those in the placebo and no gum groups. Nicotine polacrilex may be a useful adjunct to minimal contact smoking cessation formats, which have broad appeal. Also, minimal contact relapse prevention programs may assist physicians in helping patients to maintain smoking cessation using nicotine polacrilex.

Adolescent↗
PubMed1988

Are heavy smokers different from light smokers? A comparison after 48 hours without cigarettes.

Correlates of heavy smoking (greater than or equal to 25 cigarettes per day) were examined in a group of 380 smokers participating in a minimal-contact smoking relapse prevention trial. The results indicate that heavy smokers are more dependent on cigarettes. Compared with smokers consuming 15 or fewer cigarettes per day, heavy smokers reported greater difficulty quitting, were more troubled by withdrawal symptoms, experienced stronger urges and cravings, and had higher scores on a modified version of the Fagerstrom tolerance questionnaire. Heavy smokers weighed more and were more obese as measured by body mass index. Eighty percent of heavy smokers were classified correctly using discriminant function analysis with two dependence-related measures entering as the most important discriminator variables. Logistic regression analyses yielded similar results. The findings underscore the importance of addressing potential physical dependence factors when developing smoking-cessation treatments for heavy smokers.

Adult↗
PubMed1988

Autonomic changes after treatment of agoraphobia with panic attacks.

Twenty-three patients meeting DSM-III criteria for agoraphobia with panic attacks and 14 age-, race-, and sex-matched nonanxious controls were tested in the laboratory and on a test walk in a shopping mall. The patients were tested before and after about 15 weeks of treatment with placebo and exposure therapy, imipramine and exposure therapy, or imipramine and initial antiexposure instructions. Controls were tested twice at a similar interval, but without any treatment. On test day 1, patients compared to controls showed higher average heart rate and skin conductance levels and greater numbers of skin conductance fluctuations in the laboratory, and higher heart rates before and during the test walk. Between pretreatment and posttreatment tests, clinical ratings improved and skin conductance levels decreased in all treatment groups. Heart rate levels in the laboratory, on the other hand, decreased in patients on placebo and rose in patients on imipramine. Thus, imipramine compromises the usefulness of heart rate as a measure of emotional arousal. Higher pretreatment heart rates predicted greater clinical improvement.

Adult↗
PubMed1987

Perspectives on adolescent substance use. A defined population study.

We asked 1447 tenth graders to complete a survey on physical activity, nutrition, stress, and substance use and to undergo basic physical assessments. In a multiple regression analysis, increased level of substance use by both boys and girls was most strongly predicted by friends' marijuana use. For boys, this was followed by perceived safety of cigarette smoking; poor school performance; parents' education; and use of diet pills, laxatives, or diuretics for weight control, accounting for 44% of the overall variation in substance use. For girls, friends' marijuana use was followed by poor school performance; self-induced vomiting for weight control; perceived safety of cigarette smoking; use of diet pills, laxatives, or diuretics for weight control; parents' education; perceived adult attitudes about cigarettes; and nonuse of seat belts, accounting for 53% of the overall variance. Separate multiple regression analyses for each substance produced similar results. The homogeneity of the study population precluded ethnic comparisons. These findings suggest that for many purposes substance use may be considered a single behavior regardless of the specific substance(s) used and that substance use may exist as part of a syndrome of adolescent problem behaviors. In addition, the potent influence of perceived social environment suggests that a social influence resistance model may represent the most successful preventive strategy.

Adolescent↗
PubMed1987

Depressive symptoms and substance use among adolescent binge eaters and purgers: a defined population study.

We surveyed 646 tenth grade females in Northern California to assess the prevalence of binge eating and purging behaviors. Of these, 10.3 per cent met study criteria for bulimia and an additional 10.4 per cent reported purging behaviors for weight control. Bulimics and purgers were heavier, had greater triceps and subscapular skinfold thicknesses, and reported higher rates of drunkenness, marijuana use, cigarette use, and greater levels of depressive symptomatology.

Adolescent↗
PubMed1986

Self-induced vomiting and laxative and diuretic use among teenagers. Precursors of the binge-purge syndrome?

Bulimia (binge-purge syndrome) is a recently described but apparently common eating disorder. Purging behaviors associated with bulimia can cause serious medical complications. Prevalence data on purging behaviors are lacking for younger adolescents. A survey was conducted with 1,728 tenth-grade students to assess their attitudes about eating, dieting, weight control, and frequency of purging. Height, weight, and skin-fold thicknesses were also measured. Thirteen percent reported purging behavior. Female purgers outnumbered male purgers 2 to 1. Male purgers were significantly heavier than male nonpurgers and had significantly greater skin-fold thicknesses and weight/height2 ratios. Both male and female purgers felt guiltier after eating large amounts of food, counted calories more often, dieted more frequently, and exercised less than nonpurgers. Our findings suggest that an alarming number of young adolescents may employ unhealthy weight regulation strategies. Physicians who see adolescents should look for the presence of the attitudes and behaviors that characterize bulimia; this will enhance the likelihood of detection of the disorder and prevention of its complications.

Adolescent↗
PubMed1986

Autonomic characteristics of agoraphobia with panic attacks.

We compared electrodermal and heart rate measures of autonomic activation between patients meeting DSM-III criteria for agoraphobia with panic attacks and controls in terms of tonic level, reactivity to various types of stimuli, recovery, habituation, and spontaneous variability. The most striking differences between groups in the laboratory were higher tonic levels of skin conductance and heart rate among patients. Patients' heart rates were also tonically elevated in a test situation outside the laboratory. Certain measures of habituation and spontaneous variability also differed between groups, but there were only weak and inconsistent differences in reactivity to, or recovery from, stimuli with diverse qualities of novelty, startlingness, intensity, or phobicity. The elevated activation levels may be signs of a chronic state or may be phobic responses to the testing situations. A minority of patients failed to show these elevated levels.

Adult↗
PubMed1986

Correlates of seat-belt use by adolescents: implications for health promotion.

This study examined the psychosocial and behavioral correlates of seat-belt use among 1,728 10th-graders in four Northern California high schools. Parent and friend seat-belt use patterns were most highly correlated with student seat-belt use (r = 0.66 and r = 0.61, respectively) and together accounted for 46% of the variation in use. These relationships held across differences in sex, ethnicity, and socioeconomic status. Failure to wear seat belts was associated with a higher use of alcohol, cigarettes, marijuana, and cocaine; more tolerance toward speeding and drinking while driving; less exercise; and more preference for fat in the diet. Our findings attest to the power of parent and peer influences in shaping seat-belt use by adolescents and suggest that not wearing seat belts can be conceptualized as one facet of a pattern of general risk-taking behavior. These findings suggest several possible educational interventions to increase seat-belt use by adolescents.

Adolescent↗
PubMed1984

A comparison of cessation strategies for the outpatient alcoholic.

The present study compared the relative effectiveness of group-administered covert sensitization, supportive group therapy, and a non-specific control in disrupting the drinking response of 28 outpatient alcoholics. Multiple measures of treatment outcome were examined to insure a more comprehensive assessment of treatment effects. These included (a) randomly sampled blood/alcohol levels, (b) reported mean daily drinking frequencies and (c) reported urges to drink. Results indicated that supportive group therapy was significantly more effective than the other two treatments in reducing subjects' reported daily drinking. No significant differences were found on measures of blood/alcohol concentration or subjects' ratings of frequency of urges to drink. All three groups reported significant improvement over time on urge ratings. Results seriously question the efficacy of covert sensitization in helping outpatient alcoholics reduce their intake of alcohol.

Adult↗
PubMed1982

Long-term follow-up of a pilot project on smoking prevention with adolescents.

Seventh graders (N = 353) in one junior high school received an experimental smoking prevention program aimed at teaching students to resist the social pressures to smoke cigarettes. Seventh graders (N = 217) in another school served as controls. Teams of high-school students trained in basic behavior change skills led seven classroom sessions of instruction in counter-arguing during the school year. Significant differences were found between groups in reported smoking at a 9-month posttest. Results were maintained at 21- and 33-month follow-ups.

Adolescent↗
PubMed1982

Smoking cessation with adolescents: a comparison of recruitment strategies.

This study compared two methods for recruiting high school students into a voluntary smoking cessation program. A person-to-person approach was compared to an approach that resembled normal school publicity procedure. Active personal recruitment produced 31 volunteers, while the normal procedures produced only one. Subsequent application of the active approach at sites where only static procedures had been used produced an additional 21 volunteers. Results suggest that active person-to-person recruitment may be an important component of a smoking cessation effort with high school students.

Adolescent↗