These findings suggest that exposure to tobacco outlets near home environments may be important for understanding adolescents' past-month smoking. Restricting access to tobacco outlets and controlling the number of outlets in residential areas may be an effective preventive strategy to help reduce adolescents' smoking.
This article examines prevalence of non-medical use of prescription drugs (NMUPD) in a sample of elementary and high school students in an Appalachian Tennessee county. We found that lifetime prevalence of NMUPD (35%) was higher than prevalence of cigarette use (28%) and marijuana use (17%), but lower than lifetime prevalence of alcohol use (46%). We examined characteristics, as well as risk and protective factors in several domains, as predictors of NMUPD. For comparison, we also examined these characteristics and factors as predictors of alcohol, cigarette, and marijuana use. Using survey data from a sample of late elementary school and high school students (grades 5, 7, 9, and 11), logistic regression analyses showed that the risk factors of friends’ non-medical use and perceived availability, and the protective factors of perceived risk, parents’ disapproval, school commitment, and community norms against youth NMUPD were significant predictors of lifetime prevalence of NMUPD. Implications for prevention are discussed.
This article presents an oral health (OH) strategy and pilot study focusing on individuals with intellectual and/or developmental disabilities (IDD) living in group homes. The strategy consists of four components: (1) planned action in the form of the behavioral contract and caregiver OH action planning; (2) capacity building through didactic and observation learning training; (3) environmental adaptations consisting of additional oral heath devices and strategies to create a calm atmosphere; and (4) reinforcement by post-training coaching. A pilot study was conducted consisting of pre- and post-assessment data collected one week before and one week after implementing a one-month OH strategy. The study sample comprised 11 group homes with 21 caregivers and 25 residents with IDD from one service organization in a Midwestern city. A process evaluation found high-quality implementation of the OH strategy as measured by dosage, fidelity, and caregiver reactions to implementing the strategy. Using repeated cross-sectional and repeated measures analyses, we found statistically significant positive changes in OH status and oral hygiene practices of residents. Caregiver self-efficacy as a mechanism of change was not adequately evaluated; however, positive change was found in some but not all types of caregiver OH support that were assessed. Lessons learned from implementing the pilot study intervention and evaluation are discussed, as are the next steps in conducting an efficacy study of the OH strategy.
Data were collected from samples of youth (ages 11-18; N = 38,268) and young 10 adults (ages 18-24; N = 602) across 30 Tennessee counties using surveys and telephone interviews conducted in 2006-2008. Data were analyzed using hierarchical nonlinear modeling to determine: (1) which risk and protective factors predicted alcohol and marijuana use, and (2) whether predictors differed as a function of developmental period. Findings provide preliminary evidence that prevention efforts need to take into consideration the changing environment and related influences as youth age, especially as they move from a more protected community environment to one where they live somewhat independently. Implications and limitations are discussed.
Objective An emerging literature suggests patients with chronic illnesses can benefit from integrated, person-centric approaches to health care, including group-based programs. However, much of the research in this area is disease specific. The objective of this study was to collect preliminary evidence on the efficacy of Taking Charge of My Life and Health (TCMLH), a Whole Health group-based program that emphasizes self-care and empowerment on the overall health and well-being of veterans, a population burdened with high rates of multiple chronic conditions. Method Self-reported outcomes, including standardized survey measures, were collected at pretest, posttest, and 2-month follow-up from 77 participants across 15 groups at four VA sites. Random intercept mixed-model regressions were used to analyze data. Results Results from this initial study showed high satisfaction with the program and facilitators, and high attendance. There were significant pre–post gains in self-care attitudes and behaviors, patient motivation, meaning and purpose, mental health, perceived stress, goal progress, and goal-specific hope. Outcomes were maintained at 2-month follow-up for patient motivation, perceived stress, goal-specific hope, and goal progress. Significant gains were observed in health care empowerment and physical health from pretest to follow-up. Conclusions Preliminary findings support the efficacy of TCMLH, a Whole Health group-based program that emphasizes patient empowerment, self-care practices, and peer support. Future research priorities include a rigorous evaluation with a larger sample size and control group to assess effectiveness.
Objectives: Veterans often suffer from multiple chronic illnesses, including mental health disorders, diabetes, obesity, and cardiovascular disease. The improvement of engagement in their own health care is critical for enhanced well-being and overall health. Peer-led group programs may be an important tool to provide support and skill development. We conducted a pilot study to explore the impact of a peer-led group-based program that teaches Veterans to become empowered to engage in their own health and well-being through mindful awareness practices, self-care strategies, and setting life goals.Design: Surveys were collected before and immediately after participation in the Taking Charge of My Life and Health (TCMLH) peer-led group program.Settings/location: Sessions were held in non-clinical settings within a VA medical center in the Midwest. Subjects: Our sample comprised 48 Veteran participants who were enrolled in TCMLH and completed a pretest and post-test survey.Intervention: TCMLH is a 9-week peer-led group program with an established curriculum that leverages the power of peer support to improve patient engagement, empowerment, health, and well-being among Veterans through Whole Health concepts, tools, and strategies. Programs were led by 1 of 12 trained Veteran peer facilitators.Outcome measures: Program impact on Veteran well-being was assessed by pre-post measures, including the Patient Activation Measure (PAM), the Perceived Stress Scale (PSS), the Patient-Reported Outcomes Measurement Information System Scale (PROMIS-10), the Perceived Health Competency Scale (PHCS), and the Life Engagement Test (LET).Results: There was a significant decrease in perceived stress (PSS score). Significant improvements were also seen in mental health and quality of life (PROMIS-10), participant accordance with the statement ''I have a lot of reasons for living'' (LET), and patient engagement (PAM score).Conclusions: As the Whole Health movement expands-both in VA and elsewhere-our findings suggest that guiding patients in an exploration of their personal values and life goals can help in key areas of patient engagement and mental and physical health outcomes. Further study is warranted, and expansion of the TCMLH program will allow for a more rigorous evaluation with a larger sample size.
A laboratory experiment, funded by the U.S. National Institutes of Health, involved 243 U.S. undergraduate students and employed a 2 (gain-framed vs. loss-framed) × 2 (high vs. low threat) plus control group pretest-posttest experimental design to assess the combined effects of frame (gain vs. loss) and level of threat of public service announcements (PSAs) about marijuana on attitudes, beliefs, and intentions related to marijuana, as well as the relationship of message condition to ratings of PSAs. Results suggest that loss-framed messages may lead to greater perceived threat, as well as reactance, and gain-framed messages may lead to a greater reduction in positive attitudes toward marijuana than loss-framed messages. Finally, frame and threat may interact in a complex way. Further research is suggested to replicate these findings. A substantial body of carefully crafted and systematic research studies examining both content and features of messages increasingly informs mass media prevention efforts, including the development of public service announcements (PSAs). Although the significance of messages on commercial broadcast stations may be diminishing with the increasing role and impact of new media, many of the basic questions addressed by this research are likely to apply across media channels. Nonetheless, important questions about what makes a message effective in changing an individual's attitudes or behavior remain to be answered. In this paper, the authors focus on two theoretically derived strategies that offer possibilities for developing persuasive messages: framing and threat.
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