Reducing Children’s Susceptibility to Alcohol Use: Effects of a Home-Based Parenting Program

This 4-year efficacy trial tested whether a home-based, self-administered parenting program could have a long-term effect on children’s cognitive susceptibility to alcohol use, and it tested hypothesized moderators and mediators of any such program effect. Using a two-group randomized controlled design, 1076 children (540 treatment; 536 control; mean age of 9.2 years at baseline) completed telephone interviews prior to randomization and follow-up interviews 12, 24, 36, and 48 months post-baseline. Mothers of children randomized to treatment received a 5-month-long parenting program during year 1, followed by two 1-month-long boosters in years 2 and 3. Exposure to the program was significantly inversely associated with susceptibility to alcohol use 48 months post-baseline (b?=??0.03, p?=?.04), with no variation in program effects by parental alcohol use or mother’s race/ethnicity or education, suggesting broad public health relevance of the parenting program. Path analyses of simple indirect effects through each hypothesized mediator showed that program exposure positively influenced parental communication to counter pro-drinking influences in the family and media domains and parental rule setting 36 months post-baseline; these variables, in turn, predicted reduced susceptibility to alcohol use 48 months post-baseline. Parallel (multiple) mediation analysis showed that the program had a significant indirect effect on susceptibility through parental rule setting. Together, the findings indicate that internalization of protective alcohol-related expectancies and intentions is possible among children whose mothers provide early exposure to alcohol-specific socialization. Additional research is needed to link alcohol-specific socialization during childhood with adolescent drinking outcomes.     

The Outcomes of an Alcohol Prevention Program on Parents’ Rule Setting and Self-efficacy: a Bidirectional Model

Most adolescents have their first encounter with alcohol in early or middle adolescence. Parents’ rule setting about alcohol has been shown to be important to delay the onset and reduce the frequency of adolescents’ alcohol drinking, but less is known about the potential role of parents’ beliefs about their competence in and ability to influence their adolescents’ drinking habits (i.e., parental self-efficacy [PSE], Bandura (Psychological Review, 84, 191–215, 1977). In this study, we examined the direction of influence between parents’ rule setting and PSE as outcomes of the program “Prevention of Alcohol use in Students” (PAS), a prevention program aiming to reduce underage drinking by targeting parents and adolescents both separately and in a combined intervention. We tested two mediation processes in which the program would (a) have a direct effect on PSE, which in turn would increase parents’ rule setting or (b) have a direct effect on parents’ rule setting, which in turn would increase PSE. To examine these processes, we used a sample of 2562 parent-adolescent dyads (age 12 at baseline), followed annually over 3 years. The results showed that the combined intervention increased PSE via an increase in parents’ rule setting. No significant effect of the intervention on rules about alcohol via PSE was found. This is the first study to test the mediation processes involving PSE and parental rule setting in an experimental context where parenting practices are being actively changed. The results suggest that giving parents concrete advice on how to deal with alcohol drinking in their adolescents and at the same time helping adolescents to develop healthy attitudes about alcohol drinking have a positive influence on parents’ self-efficacy.     

Binational Cultural Adaptation of the keepin’ it REAL Substance Use Prevention Program for Adolescents in Mexico

Prevention Science - Sharp increases in substance use rates among youth and the lack of evidence-based prevention interventions in Mexico are a major concern. A team of investigators from Mexico...     

Alcohol, Marijuana, and Tobacco Use Among Canadian Youth: Do We Need More Multi-Substance Prevention Programming?

Data from the Canadian Youth Smoking Survey (n = 27,030 in 2006; n = 16,705 in 2004; n = 11,757 in 2002) were used to examine changes in the prevalence and comorbid use of alcohol, tobacco, and marijuana over time and examine if demographic factors and binge drinking are associated with comorbid substance use among youth. Alcohol was the most prevalent substance used, and it was rare to find youth who had used tobacco or marijuana without also having tried alcohol. Youth who reported binge drinking were substantially more likely to also have tried tobacco and/or marijuana. These data suggest that multi-substance prevention programs are required for youth populations.     

Effects of the “Preparing for the Drug Free Years” Curriculum on Growth in Alcohol Use and Risk for Alcohol Use in Early Adolescence

Preparing for the Drug-Free Years (PDFY) is a curriculum designed to help parents learn skills to consistently communicate clear norms against adolescent substance use, effectively and proactively manage their families, reduce family conflict, and help their children learn skills to resist antisocial peer influences. This study examined the effects of PDFY on the trajectories of these factors, as well as on the trajectory of alcohol use from early to mid adolescence. The sample consisted of 424 rural families of sixth graders from schools randomly assigned to an intervention or a control condition. Data were collected from both parents and students at pretest, posttest, and 1-, 2- and 3 -year follow-ups. Latent growth models were examined. PDFY significantly reduced the growth of alcohol use and improved parent norms regarding adolescent alcohol use over time. Implications for prevention and evaluation are discussed.     

Promoting a Culture of Prevention in Albania: the “Si Je?” Program

Prevention Science - Albania is a small country on the Balkan Peninsula that recently implemented an innovative primary healthcare program called “Si Je?” (How are you?) which allowed...     

Talking “truth”: Predictors and Consequences of Conversations about a Youth Antismoking Campaign for Smokers and Nonsmokers

Using data from the Legacy Media Tracking Survey II, this study investigated relations among youth's evaluations of the “truth” antismoking campaign, campaign-related interpersonal discussion, and campaign-relevant outcomes (n = 8,000). Regression analyses showed that smokers were less likely to have discussed the campaign than nonsmokers, and this effect was mediated by negative campaign evaluation. However, smokers with a negative evaluation of the campaign were more likely to talk about it than were nonsmokers reporting negative evaluation. Nonsmokers who talked about the campaign had beliefs, attitudes, and intentions in greater agreement with campaign messages than those who did not talk about the campaign. For smokers, talking about the campaign was associated with beliefs, attitudes, and intentions in greater agreement with campaign messages, but only if associated with positive campaign evaluation. For smokers with a negative campaign evaluation, talking about the campaign was associated with beliefs and attitudes counter to the campaign messages.     

Design and Evaluation of a Ventilated Garment for Use in Temperatures up to 200°C

The protection of personnel against high air and radiant temperatures is a problem that has been confronting industry for many years now, and for many industrial situations it still has not been solved. The experiments reported here were intended to determine the most suitable form of insulation for a hot entry suit for use primarily in furnace wrecking where mean radiant temperatures of 200°C. are met and where heat-reflecting garments are unsuitable due to the rapid deterioration of the reflecting surface.

From a preliminary consideration of the problem it was concluded that a ventilated garment was required and that conventional ventilated garments in which air is induced to flow parallel to the body surfaces (axial ventilation) are basically unsound in design as the air is not utilized for the transfer of heat in the most efficient manner. A new form of ventilation was therefore developed in which air flows out through a permeable suit (radial ventilation). This form of ventilation produces what is called dynamic insulation, and this method of insulation, when compared with two alternative methods on a physical model, was found to be very effective.

The model experiments were confirmed by comparative trials of three ventilated suits each using one of three different forms of insulation thought to be suitable for use in heat-protective clothing.

Physiological measurements made on the subjects and physical measurement made on the suits confirmed that dynamic insulation is the most suitable insulation for a hot entry suit for furnace wrecking.

With the air flows used in these experiments, dynamic insulation had a thermal conductance one-fifth that of conventional static insulation, and sweat losses and oral temperature rises were reduced by one-third and one-half respectively.

     

Early Initiatives for Children at Risk—Development of a Program for the Prevention and Treatment of Behavior Problems in Primary Services

During the past decade, Norwegian authorities have initiated and funded a project to scale up the use of evidence-based programs for the prevention and treatment of conduct problems in children. The first step in this process was to increase treatment competence by implementing the Parent Management Training-Oregon Model (PMTO) in specialist services for children. The second step was to develop the program Early Initiatives for Children at Risk (Norwegian acronym, TIBIR), designed to identify children with possible conduct problems as early as possible and to offer tailored interventions as part of the ordinary primary services for children in individual municipalities. The theoretical rationale and practical considerations leading to the design of TIBIR are presented, together with the program modules and current research activities. Some of the challenges concerning the program’s ability to reach various risk groups are discussed, as are the challenges encountered regarding quality assurance and fidelity maintenance. Finally, some future research questions are presented and discussed.     

Development and Evaluation of Let’s Do Lunch: A Congregate Meal Program at an Urban Senior Center

A mixed-methods needs assessment was conducted in an urban senior center serving lower-income seniors in Toronto, Ontario, to determine whether they should offer a congregate meal program. Methods included three focus groups with participants (n?=?31), a focus group with staff (n?=?8), a center-wide survey (n?=?36), and a community scan of programs in the area. Interviews with five coordinators at other seniors’ centers who offered meal programs were also used to gauge interest and assist with program development. The results of these activities supported offering a twice weekly lunch program with user fees. Over a 6-month pilot period, process evaluation was conducted, comprising observations, record review, and focus groups with participants (n?=?9) and staff/volunteers (n?=?7) to examine delivery, usage, and costs. Results indicated that the program was well-received and affordable, and that demands on staff were reasonable when a facilitator with culinary training was available. The lessons learned can be used to guide other senior centers in developing and evaluating congregate meal programs.     

Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers’ Health Surveillance Program for Sustainable Employability of Meat Processing Workers

Objective To evaluate the effectiveness of a comprehensive workers’ health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer’s perspective were performed as well. Results Primary outcomes sickness absence (OR?=?1.40), work ability (B?=??0.63) and productivity (OR?=?0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B?=?0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1–3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.     

“Home Practice Is the Program”: Parents’ Practice of Program Skills as Predictors of Outcomes in the New Beginnings Program Effectiveness Trial

An examination of the content and processes of evidence-based programs is critical for empirically evaluating theories about how programs work, the “action theory” of the program (West et al. in American Journal of Community Psychology, 21, 571–605, 1993). The New Beginnings Program (NBP; Wolchik et al., 2007), a parenting-after-divorce preventive intervention, theorizes that program-induced improvements in parenting across three domains: positive relationship quality, effective discipline, and protecting children from interparental conflict, will reduce the negative outcomes that are common among children from divorced families. The process theory is that home practice of program skills related to these parenting domains is the primary mechanism leading to positive change in parenting. This theory was tested using multi-rater data from 477 parents in the intervention condition of an effectiveness trial of the NBP (Sandler et al. 2016a, 2016b). Four research questions were addressed: Does home practice of skills predict change in the associated parenting outcomes targeted by the program? Is the effect above and beyond the influence of attendance at program sessions? What indicators of home practice (i.e., attempts, fidelity, efficacy, and competence) are most predictive of improvements in parenting? Do these indicators predict parenting improvements in underserved subpopulations (i.e., fathers and Latinos)? Structural Equation Modeling analyses indicated that parent-reported efficacy and provider-rated parent competence of home practice predicted improvements in the targeted parenting domains according to both parent and child reports. Moreover, indicators of home practice predicted improvements in parenting for fathers and Latinos, although patterns of effects varied by parenting outcome.     

Examining Intervention Component Dosage Effects on Substance Use Initiation in the Strengthening Families Program: for Parents and Youth Ages 10–14

Prevention Science - Family-based prevention programs increasingly are being disseminated and can be effective for an array of adolescent problem behaviors, including substance use initiation. Yet,...     

The Use of Experiential Learning in an Occupational Therapy Program: Can it Foster Skills for Clinical Practice?

ABSTRACT

This paper examines the effectiveness of the integration of experiential learning opportunities near the end of the occupational therapy students’ didactic education. Using a pretest–post-test questionnaire, journaling, and feedback from a focus group, results suggested that there was a significant improvement in occupational therapy students’ self-perception of their ability to perform a multitude of occupational therapy-related skills. The development of professional skills was also seen in the provision of client-centered care during occupational therapy interventions. Although clinical reasoning skills were enhanced, results indicated that it had a large impact on the students’ professional growth and development.     

Cigar, Cigarillo, and Little Cigar Use among Canadian Youth: Are We Underestimating the Magnitude of This Problem?

Data from 29,296 students in grades 9-12 as part of the 2008-2009 Youth Smoking Survey were used to examine the prevalence of cigar, cigarillo, and little cigar use and factors associated with their use. Among Canadian youth in grades 9-12, 12.9% reported current use of cigarillos or little cigars, and 8.1% reported current use of cigars. The characteristics of youth most likely to use either cigars or cigarillos and little cigars were being male, being in grade 11 or 12, being a daily or occasional cigarette smoker, having more than $20 of weekly spending money, and having ever tried flavored tobacco. Our findings suggest that cigars, cigarillos, and little cigars are used by a substantial number of Canadian youth, many of whom do not smoke cigarettes. As such, current national prevalence estimates of youth smoking may be underestimated, and existing tobacco control prevention programs and policies may be overlooking a large population of at-risk youth.     

Constructing “Packages” of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC’s Youth Violence Prevention Centers

This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.     

Evaluation of the ECOHIS and the CARIES-QC among an Australian “Aboriginal” population

Quality of Life Research - An evaluation of the reliability and validity of two child oral health-related quality of life (COHRQoL) measures among Australian Aboriginal children who participated in...