This study examined the effectiveness of two transtheoretical model-tailored, computer-delivered interventions designed to impact multiple substance use or energy balance behaviors in a middle school population recruited in schools. Twenty middle schools in Rhode Island including sixth grade students (N=4,158) were stratified and randomly assigned by school to either a substance use prevention (decreasing smoking and alcohol) or an energy balance (increasing physical activity, fruit and vegetable consumption, and limiting TV time) intervention group in 2007. Each intervention involved five in-class contacts over a 3-year period with assessments at 12, 24, and 36 months. Main outcomes were analyzed using random effects modeling. In the full energy balance group and in subsamples at risk and not at risk at baseline, strong effects were found for physical activity, healthy diet, and reducing TV time, for both categorical and continuous outcomes. Despite no direct treatment, the energy balance group also showed significantly lower smoking and alcohol use over time than the substance use prevention group. The energy balance intervention demonstrated strong effects across all behaviors over 3 years among middle school students. The substance use prevention intervention was less effective than the energy balance intervention in preventing both smoking and alcohol use over 3 years in middle school students. The lack of a true control group and unrepresented secular trends suggest the need for further study.

Despite a specific need for transfused blood among African Americans due to higher rates of sickle cell disease, African Americans donate blood significantly less frequently than their White counterparts. This study describes the development and validation of culturally adapted measures of the transtheoretical model (TTM) constructs of Stage of Change, Decisional Balance, and Self-efficacy applied to blood donation in an African American sample. Exploratory and confirmatory analyses produced one pros and two cons scales for the Decisional Balance Inventory, and one scale for the Situational Self-efficacy Measure. Expected patterns for the Decisional Balance and Self-efficacy Scales by Stage of Change were found, but only the pros and one cons scale varied significantly. Results provide support for use of the TTM applied to blood donation and have important implications for development of effective assessment and intervention tools to increase blood donation among the African American population.

BACKGROUND Blacks have significantly lower blood donation (BD) rates than Whites. Many views, experiences, and behaviors associated with BD are unique to Black culture. Evidence suggests that culturally tailored health promotion programs help with increasing Black BD. To be effective, tailored interventions should be based on valid and reliable measures. The Transtheoretical Model's (TTM) Processes of Change (POC) construct provides an assessment of participants’ covert and overt activities and experiences in BD. This study describes development and validation of POC for increasing BD tailored to Blacks. STUDY DESIGN AND METHODS Cross-sectional measure development with online survey dissemination was used in 566 Blacks in Northeastern US. Factor analytic structural modeling procedures were used to examine validity of the POC measure. BD POC were examined in participants representing a range of BD history and intentions (non-donors, sometimes donors, regular donors) based on an established algorithm. RESULTS Confirmatory analyses replicated the theoretically expected structure of POC scales which is a ten-factor, fully correlated best fit model. Expected POC patterns by SOC based on theoretical and empirical predictions were confirmed. The range of effect sizes for 10 POC were η2= .04-.25; indicating that TTM POC are strong strategies in BD decision making for Blacks and can be applied to interventions to increase BD for a minority population. CONCLUSION POC measure was internally and externally valid in a sample of Blacks. Interventions can utilize the POC measure to guide stage matched interventions to encourage use of relevant experiential and behavioral strategies to increase blood donation.

The structures of these measures replicated with good internal and external validity, except for the cons scale, which requires additional development. Results support the use of these measures in tailored interventions to increase exercise among African-Americans.

A measurement model should be equivalent across the different subgroups of a target population. The Decisional Balance Inventory for the Prevention of Alcohol Use is a 2- factor correlated model with 3 items for Pros of alcohol use and 3 items for Cons. The measure is part of a tailored intervention for middle school students. This study evaluated the important psychometric assumptions of factorial invariance and scale reliability with a large sample of sixth grade students (N = 3565) from 20 schools. A measure is factorially invariant when the model is the same across subgroups. Three levels of invariance were assessed, from least restrictive to most restrictive: 1) Configural Invariance (unconstrained nonzero factor loadings); 2) Pattern Identity Invariance (equal factor loadings); and 3) Strong Factorial Invariance (equal factor loadings and measurement errors). Structural equation modeling was used to assess invariance over two levels of gender (male and female), race (white and black), ethnicity (Hispanic and non-Hispanic), and school size (large, indicating >200 students per grade, or small). The strongest level of invariance, Strong Factorial Invariance, was a good fit for the model across all of the subgroups: gender (CFI: 0.94), race (CFI: 0.96), ethnicity (CFI: 0.93), and school size (CFI: 0.97). Coefficient alpha was 0.61 for the Pros and 0.67 for Cons. Together, invariance and reliability provide strong empirical support for the validity of the measure.

With acceptability and feasibility confirmed, the next steps are to test efficacy and cost-effectiveness for use to increase blood donation, particularly in priority populations.

Effective interventions require an understanding of the behaviors and cognitions that facilitate positive change as well as the development of psychometrically sound measures. This paper reports on the psychometric properties of the Temptations to Try Alcohol Scale (TTAS), including factorial invariance across different subgroups. Data were collected from 3565 6th grade RI middle school students. Structural equation modeling was used to determine the appropriate factorial invariance model for the 9-item TTAS. The measure consists of three correlated subscales: Social Pressure, Social Anxiety, and Opportunity. Three levels of invariance, ranging from the least to the most restrictive, were examined: Configural Invariance, which constrains only the factor structure and zero loadings; Pattern Identity Invariance, which requires factor loadings to be equal across the groups; and Strong Factorial Invariance, which requires factor loadings and error variances to be constrained. Separate analyses evaluated the invariance across two levels of gender (males vs. females), race (white vs. black) ethnicity (Hispanic vs. NonHispanic) and school size (small, meaning <200 6 th graders, or large). The highest level of invariance, strong factorial invariance, provided a good fit to the model for gender (CFI: .95), race (CFI: .94), ethnicity (CFI: .94), and school size (CFI: .97). Coefficient Alpha was .90 for Social Pressure, .81 for Social Anxiety, and .82 for Opportunity. These results provide strong empirical support for the psychometric structure and construct validity of the TTAS in middle school students. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. KeywordsAn early version of this paper was presented at the Society for Prevention Research Meeting, Denver, CO, June, 2010. , 1997;Velicer et al., 2000) is an integrative framework made up of multiple dimensions. The TTM has been validated in many studies and has been used to develop many effective, population-based interventions (Velicer et al., 2000). The core constructs of TTM include stages of change, processes of change, decisional balance, and self-efficacy (or situational temptations). The Situational Temptations Scale assesses an individual's desire to perform a behavior in difficult situations (Velicer, DiClemente, Rossi, & Prochaska, 1990) and is based on the self-efficacy construct of Bandura (1977;1982) and the relapse prevention literature. This paper describes a variation of the measure, designed for the prevention of alcohol acquisition with middle school students. Based on preliminary results (Burditt, Harrin...

The IPCBS demonstrated good psychometric properties and external validation, advancing research, education, and training for IPC practice. (PsycINFO Database Record