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Director's Report to the National Advisory Council on Drug Abuse - May, 2006

Research Findings - Prevention Ressearch

Effect of Combined School and Community Communication Campaign on Youth Alcohol, Tobacco and Marijuana Use

This study tested the impact of an in-school mediated communication campaign based on social marketing principles, in combination with a participatory, community-based media effort, on marijuana, alcohol and tobacco uptake among middle-school students. Eight media treatment and eight control communities throughout the US were randomly assigned to condition. Within both media treatment and media control communities, one school received a research-based prevention curriculum and one school did not, resulting in a crossed, split-plot design. Four waves of longitudinal data were collected over 2 years in each school and were analyzed using generalized linear mixed models to account for clustering effects. Youth in intervention communities (N = 4216) showed fewer users at final post-test for marijuana [odds ratio (OR) = 0.50, P = 0.019], alcohol (OR = 0.40, P = 0.009) and cigarettes (OR = 0.49, P = 0.039). Growth trajectory results were significant for marijuana (P = 0.040), marginal for alcohol (P = 0.051) and non-significant for cigarettes (P = 0.114). Results suggest that an appropriately designed in-school and community-based media effort can reduce youth substance uptake. Effectiveness does not depend on the presence of an in-school prevention curriculum. Slater, M.D., Kelly, K.J., Edwards, R.W., Thurman, P.J., Plested, B.A., Keefe, T.J., Lawrence, F.R., and Henry, K.L. Combining In-School and Community-Based Media Efforts: Reducing Marijuana and Alcohol Uptake Among Younger Adolescents. Health Education Research, 21(1), pp. 157-167, 2006.

Definition and Outcome of the ATHENA Program to Prevent Disordered Eating and Body-Shaping Drug Use in Female Athletes

This study examined the outcomes of the Athlete Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) intervention in female high school athletes. The ATHENA program is based on the Athletes Training and Learning to Avoid Steroids (ATLAS) curriculum, a sport team-centered drug-use prevention program for male high school athletes, which has been shown to reduce alcohol and illicit drug use. Just as anabolic steroid use is associated with male athletes, female sport participants may be at a greater risk for disordered eating and body-shaping drug use. Extending sport team-centered programs to young women athletes required defining and ranking factors related to developing those harmful behaviors. Survey results from a cross-sectional cohort of female middle and high school student athletes were used to identify and prioritize potential curriculum components, including mood and self-esteem, norms of behavior, perceptions of healthy body weight, effects of media depictions of women, and societal pressures to be thin. The derived sport team-centered program was prospectively assessed among a second group of female student athletes from 18 high schools, randomized to receive the intervention or the usual care control condition. The ATHENA intervention is a scripted, coach-facilitated, peer-led 8-session program, which was incorporated into a team's usual training activities. The ATHENA program significantly altered the targeted risk factors and reduced ongoing and new use of diet pills and body-shaping substances (amphetamines, anabolic steroids, and sport supplements). These findings illustrate the utility of a structured process to define curriculum content, and the program's positive results also confirm the sport team's potential as a vehicle to effectively deter health-harming behaviors. Elliot, D., Moe, E., Goldberg, L., Defrancesco, C., Durham, M., and Hix-Small, H. Definition and Outcome of a Curriculum to Prevent Disordered Eating and Body-Shaping Drug Use. J Sch Health, 76(2), pp. 67-73, 2006.

Prevention Study Confirms Positive Impact on Rate of Substance Use

This study reports findings on a combined family and school-based competency-training intervention involving two intervention programs, the Life Skills Training school-based program and the Strengthening Families Program 10-14. Thirty-six rural schools were randomly assigned to (a) a combined family and school intervention condition, (b) a school-only condition, or (c) a control condition. A previous study showed a significant reduction of substance initiation for both the combined intervention and the school-only intervention at the 1-year follow-up as measured by a combined index of lifetime alcohol, cigarette, and marijuana use. The current study extends this work by examining effects from 2.5 years past baseline using multilevel growth curve analysis in a addition to point-in-time analysis. In addition, the authors introduce analysis of problematic alcohol use (i.e., regular alcohol use and weekly drunkenness). The earlier significant outcome was replicated, such that growth in substance initiation for both the combined and school-only conditions was slower than for the control group. Furthermore, positive point-in-time results for weekly drunkenness were observed for the combined intervention as compared to the control intervention. However, there were no statistically significant outcomes for tests of intervention impact on regular alcohol use. Spoth, R., Randall, G., Shin, C., and Redmond, C. Randomized Study of Combined Universal Family and School Preventive Interventions: Patterns of Long-term Effects on Initiation, Regular use, and Weekly Drunkenness. Psychol Addict Behav, 19(4), pp. 372-381, 2005.

Effects of Age and Sensation Seeking on Processing PSAs

This article investigates how sensation seeking and age influence television viewers' online information processing of substance-abuse public service announcements (PSAs). College students and adolescents viewed 30 PSAs that varied in terms of arousing content and production pacing. The experiment used a mixed Arousing Content (2) x Production Pacing (3) x Message (5) x Order of Presentation (3) x Sensation Seeking (2) x Age (2) factorial design. Fifty-nine undergraduate college students (aged 18-27) and eighty-six adolescent high school students (aged 12 to 17) participated in the study. Dependent variables included substance use, self-reported emotional responses (valence and arousal), physiological responses (heart rate and skin conductance response), and recognition. Results show that high-sensation seekers prefer all messages, remember more, and exhibit lower arousal compared to low-sensation seekers. Adolescents remember more information from the PSAs than college students. However, all participants exhibited cognitive overload at the same point in time. Specifically, the combination of arousing content and fast pace overloaded the cognitive system and resulted in decreases in recognition memory for both adolescents and college students and sensation seeking had no effect on this interaction. Lang, A., Chang, Y., Lee, S., Schwartz, N., and Shin, M. It's an Arousing, Fast-Paced Kind of World: The Effects of Age and Sensation Seeking on The Information Processing of Substance-Abuse PSAs. Media Psychology, 7(4), pp. 421-454, 2005.

Written Personal Feedback Profile as Effective as Brief Motivational Interview

This study evaluated two brief personal feedback substance-use interventions for students mandated to the Rutgers University Alcohol and Drug Assistance Program for Students (ADAPS). One intervention was a brief motivational interview (BMI) and the other intervention involved written feedback-only (WF). A key question addressed was whether there is a need for face-to-face feedback in the context of motivational interviewing to affect changes in substance-use behaviors or whether a written personal feedback profile is enough to motivate students to change their substance use. The participants included 222 students who were mandated to ADAPS. Eligible students completed a baseline assessment from which a personal feedback profile was created. They were then randomly assigned to the BMI or WF condition. Students were reassessed 3 months later. Students in both interventions reduced their alcohol consumption, prevalence of cigarette and marijuana use, and problems related to alcohol and drug use between baseline and follow-up. There were no differences between the two intervention conditions in terms of substance-use outcomes. These results suggest that assessment and WF students changed similarly to those who had an assessment and WF within the context of a BMI. Given the fact that the former is less costly in terms of time and personnel, written profiles may be found to be a cost-effective means of reducing alcohol and drug use and related problems among low- to moderate-risk mandated college students. White, H.R., Morgan, T.J., Pugh, L.A., Celinska, K., Labouvie, E.W., and Pandina, R.J. Evaluating Two Brief Substance-Use Interventions for Mandated College Students. Journal of Studies on Alcohol, 67(2), pp. 309-317, 2006.

Intensity of Contact with Preventive Intervention is Associated with Improved Intervention Outcomes

The ATP intervention is a school-based, family-focused intervention to reduce risk of substance use and other problem behaviors. A family resource center (FRC), staffed by a professionally-trained parent consultant, is created within the participating school. A menu of family-centered intervention services, ranging from brief supportive contacts such as email reports of behavior, attendance, and homework completion to family therapy, are available to families. The goal of this study was to test whether dosage of FRC contacts would predict teacher perception of risk behavior. Four middle schools were involved in the three-year study where contacts with family teachers and youth were tracked and recorded. Five hundred eighty-four youth enrolled in the study and data from all three measurement periods were available for 394 students. Overall 59% of the total contacts were in person, 27% were phone contacts, and 14% were letter or email contacts. Greater student reported substance use, antisocial behavior, deviant peer affiliations, and low academic achievement in 6th grade lead to more family contact with the FRC during 8th grade. Furthermore, larger numbers of FRC contacts predicted a stronger rate of decline in teacher-rated student risk. Stormshak, E., Dishion, T., Light, J., and Yasui, M. Implementing Family-Centered Interventions Within the Public Middle School: Linking Service Delivery to Change in Student Problem Behavior. J Abnorm Child Psychol, 33(6), pp. 723-733, 2005.

Intervention Outcomes for Girls Referred From Juvenile Justice: Effects on Delinquency

An increasing number of girls are entering the juvenile justice system. However, intervention programs for delinquent girls have not been examined empirically. The authors examined the 12-month outcomes of a randomized intervention trial for girls with chronic delinquency (N = 81). Girls were randomly assigned into an experimental condition (Multidimensional Treatment Foster Care; MTFC) or a control condition (group care; GC). Analysis of covariance indicated that MTFC youth had a significantly greater reduction in the number of days spent in locked settings and in caregiver-reported delinquency and had 42% fewer criminal referrals than GC youth (a trend) at the 12-month follow-up. Implications for reducing girls' chronic delinquency are discussed. Leve, L., Chamberlain, P., and Reid, J. Intervention Outcomes for Girls Referred From Juvenile Justice: Effects on Delinquency. J Consult Clin Psychol, 73(6), pp. 1181-1185, 2005.

Effects of Culturally Adapted Parent Management Training

A randomized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors. Intervention feasibility was evaluated through weekly parent satisfaction ratings, intervention participation and attendance, and overall program satisfaction. Intervention effects were evaluated by examining changes in parenting and youth adjustment for the intervention and control groups between baseline and intervention termination approximately 5 months later. Findings provided strong evidence for the feasibility of delivering the intervention in a larger community context. The intervention produced benefits in both parenting outcomes (i.e., general parenting, skill encouragement, overall effective parenting) and youth outcomes (i.e., aggression, externalizing, likelihood of smoking and use of alcohol, marijuana, and other drugs). Differential effects of the intervention were found related to youth nativity status such that parents of U.S.-born youth benefited more from participation in the intervention than parents of foreign-born youth. Martinez, C., and Eddy, J. Effects of Culturally Adapted Parent Management Training on Latino Youth Behavioral Health Outcomes. J Consult Clin Psychol, 73(5), pp. 841-851, 2005.

Skills That Are Foci of Drug Prevention Predict Academic Achievement

This study assessed whether characteristics of individuals that are predictors of youth problem behavior such as substance use, delinquency, and violence also predict academic achievement. Longitudinal data from 576 suburban students participating in the Raising Healthy Children (RHC) project were analyzed. Tenth-grade academic achievement was measured by scores on a standardized test administered to students in Washington State and by student self-report of grades. Measures of social and behavioral characteristics at seventh grade were based on data from student, parent, and teacher surveys. Researchers assessed overall correlations between 7th-grade predictors and 10th-grade academic achievement as well as partial correlations adjusted for demographic characteristics and scores on an earlier achievement test, the Comprehensive Test of Basic Skills, in 4th grade. Results indicated that higher levels of school bonding and better social, emotional, and decision-making skills were related to higher test scores and higher grades. Lower test scores and lower grades were predicted by elevated levels of attention problems, negative behavior of peers, and disruptive and aggressive behavior. Lower test scores also were predicted by early use of alcohol and cigarettes. These findings support the premise that school-based social development interventions that address specific risk factors, curb early manifestations of antisocial behavior, and promote school bonding and social and emotional skills are likely to improve student academic achievement. Fleming, C., Haggerty, K., Catalano, R., Harachi, T., Mazza, J., and Gruman, D. Do Social and Behavioral Characteristics Targeted by Preventive Interventions Predict Standardized Test Scores and Grades? J Sch Health, 75(9), pp. 342-349, 2005.

The Building Resiliency and Vocational Excellence (BRAVE) Program: A Violence-Prevention and Role Model Program for Young, African American Males

There are sharp disparities between non-Hispanic Whites and African Americans in mortality and years of potential life lost for numerous health-related conditions, including HIV/AIDS. The Building Resiliency and Vocational Excellence (BRAVE) Program is an intervention using Resiliency Networking designed for use with African American young men to help offset these disparities. Resiliency Networking incorporates coaching, career planning, and re-definition of gender roles to help young men develop a sense of purpose and future and to manage their lifestyles effectively. In addition to fostering a strong link with an older mentor, the program fosters healthy peer-to-peer relationships. This paper reports on preliminary use of the intervention and recommends future applications. Griffin, J. The Building Resiliency and Vocational Excellence (BRAVE) Program: A Violence-Prevention and Role Model Program for Young, African American Males. J Health Care Poor Underserved, 16(4 Suppl B), pp. 78-88, 2005.

Inattention Associated With Early-Onset Smoking

This research examines the covariation of attention processes in childhood and adolescence with tobacco use in middle adolescence, controlling for both comorbid antisocial behavior and psychosocial risk. Study participants originated from a sample of 672 6th grade children enrolled in an prevention study. Attention and behavior problems were assessed during T1 via parent report on the Child Behavior Checklist (CBCL). In 11th grade, 501 of these youth completed the Attention Network Test (ANT), a test of the efficiency of alerting, orienting, and executive function systems. Parent ratings of childhood inattention increased the risk of early-onset smoking (odds ratio= 4.12). During adolescence, high performance on an attention task was associated with increased risk (odds ratio=2.07) for patterned tobacco use after controlling for antisocial behavior and known psychosocial risk factors. These analyses suggest a possible regulatory dynamic linking patterned tobacco use and inattention. Gardner, T., Dishion, T., Posner, M., and Posner, M. Attention and Adolescent Tobacco Use: A Potential Self-Regulatory Dynamic Underlying Nicotine Addiction. Addict Behav, 31(3), pp. 531-536, 2006.

Cost-Effectiveness of a Behavioral Intervention for Seropositive Youth

An intervention for young people living with HIV (YPLH) was effective in reducing the number of partners of unknown serostatus and the number of unprotected sexual risk acts. New methods are outlined to assess the cost-effectiveness of this intervention. Over a period of 3 months, the intervention would avert an estimated 2.02 new infections per 1,000 YPLH. The cost of mounting the intervention was estimated at US 522 dollars/YPLH, with the cost-effectiveness over a 1-year period being US 103,366 dollars/infection averted. Based on standardized estimates of the cost of treating HIV-positive persons and the adjusted quality of life years lost (10.23 for partners of a mean age of 29 years), the cost utility estimate shows that the treatment costs averted exceed the cost of the intervention. Both the methodology of calculating cost-effectiveness and the cost utility of interventions are important for focusing policy makers, clinicians, community providers, and researchers on prevention for persons living with HIV. Lee, M., Leibowitz, A., and Rotheram-Borus, M. Cost-effectiveness of a Behavioral Intervention for Seropositive Youth. AIDS Educ Prev, 17(2), pp. 105-118, 2005.

Screening High School Students for Suicide: Challenges and Opportunities

This study evaluated the feasibility of a population-based approach to preventing adolescent suicide, through screening for suicide risk. A total of 930 high risk students in 10 high schools that were participating in a randomized controlled trial testing the effectiveness of the Reconnecting Youth intervention for improving school performance, decreasing substance use and improving mood management, and 393 low-risk, "typical," students completed the Suicide Risk Screen (SRS). Screening results, student follow-up, staff feedback, and school responses were assessed. Overall, 29% of the participants were rated as at risk of suicide. As a result of this overwhelming percentage, school staffs chose to discontinue the screening after 2 semesters. In further analysis, about half of the students identified through the SRS were deemed at high risk for suicide on the basis of high levels of depression, suicidal ideation, or suicidal behavior. And students with high risk for suicide also were more likely to have other related problems, including more drug use, less family support, more feelings of hopelessness, and less connection to school. A simpler, more specific screening instrument than the SRS would identify approximately 11% of urban high school youths for assessment, offering high school officials an important opportunity to identify young people at the greatest levels of need and to target scarce health resources. This study shows that a lack of feasibility testing greatly contributes to the gap between science and practice. Hallfors, D., Brodish, P., Khatapoush, S., Sanchez, V., Cho, H., and Steckler, A. Feasibility of Screening Adolescents For Suicide Risk in. Am J Public Health, 96(2), pp. 282-287, 2006.

Religiosity and Drug Use Among Mexican and Mexican American Youth

Among a predominately Mexican and Mexican American sample of pre-adolescents, religiosity protected against lifetime alcohol, cigarette, and marijuana use and recent alcohol and cigarette use when religious affiliation was controlled. When religiosity was controlled, however, adolescents with no religious affiliation and adolescents who were religiously affiliated reported similar substance use outcomes. Interaction effects demonstrated that the protective effect of greater religiosity operated more strongly in some religions than in others for selected outcomes. Overall, the impact of religiosity on reported drug use did not differ significantly for more and less acculturated Latino youth. Marsiglia, F., Kulis, S., Nieri, T., and Parsai, M. God Forbid! Substance Use Among Religious and Nonreligious Youth. Am J Orthopsychiatry, 75(4), pp. 585-598, 2005.

Ethnic and Gender-specific Substance Use Patterns in Adolescence

This article documents the prevalence of self-reported substance use among White and American Indian adolescents enrolled in seventh grade (ages 12 through 13) in 1997 in a Northern Plains state. Data were collected by self-administered questionnaire preceding adolescents' participation in a randomized field trial of Project Alert, a seventh and eighth grade substance use prevention curriculum. Rates of lifetime and past-month use of cigarettes and marijuana were higher among American Indians than among Whites of the same gender. American Indian girls exceeded American Indian boys as well as White girls and White boys on lifetime and past-month use of cigarettes and marijuana as well as alcohol and inhalants; differences on cigarette and inhalant use reached statistical significance. These findings add to the sparse literature on substance use among adolescents as young as 12 through 13 years old and underscore the importance of examining gender-specific substance use patterns early in adolescence. Spear, S., Longshore, D., McCaffrey, D., and Ellickson, P. Prevalence of Substance Use Among White and American Indian Young Adolescents in a Northern Plains State. J Psychoactive Drugs, 37(1), pp. 1-6, 2005.

Externalizing Behavior & Gender Predict Drug Initiation Trajectories

The purpose of the current study was to investigate the influence of externalizing behaviors on substance initiation trajectories among rural adolescents over a 42-month period. Data were obtained from 198 rural adolescents who were participating in a longitudinal study. At the baseline assessment, subjects were on average 12.3 years old. Controlling for gender, higher baseline levels of externalizing were associated with a greater number of substances initiated over time. The initiation trajectory was curvilinear. Girls, compared with boys, reported a lower number of substances initiated at baseline, a greater linear growth trajectory, and a deceleration of growth over time. Lillehoj, C., Trudeau, L., Spoth, R., and Madon, S. Externalizing Behaviors as Predictors of Substance Initiation Trajectories Among Rural Adolescents. J Adolesc Health, 37(6), pp. 493-501, 2005.

Identifying High School Students At Risk for Substance Use and Related Problems

Attendance and grade point average (GPA) data are universally maintained in school records and can potentially aid in identifying students with concealed behavioral problems, such as substance use. Researchers evaluated attendance (truancy) and GPA as a means to identify high school students at risk for substance use, suicide behaviors, and delinquency in 10 high schools in San Antonio, Texas, and San Francisco, California, during the spring and fall of 2002. These schools were involved in a randomized controlled trial testing the effectiveness of the Reconnecting Youth Program, an indicated prevention program designed to improve school performance, decrease substance use, and improve mood management in high risk students. A screening protocol identified students as "high risk" if (1) in the top quartile for absences and below the median GPA or (2) teacher referred. Survey responses of 930 high-risk students were compared with those from a random sample of 393 "typical" students not meeting the protocol. Bivariate and multivariate analyses assessed associations between the screening protocol variables and demographics, risk and protective factors, and problem outcomes. The individual contribution of each of the variables was also assessed. Students identified as high risk were significantly more likely than typical students to use cigarettes, alcohol, and marijuana, evidence suicide risk factors, and engage in delinquent behavior. Norms varied between the two districts; nevertheless, high-risk students showed consistent differences in risk and protective factors, as well as problem behaviors, compared with typical students. Because of site differences in data collection and teacher participation, the comprehensive protocol is recommended, rather than individual indicators alone (e.g., truancy). Strengths of the screening protocol are the ready availability of school record data, the ease of use of the adapted protocol, and the option of including teacher referral. More research is recommended to test the generalizability of the protocol and to ensure that there are no unintended negative effects associated with identification of students as high risk. Hallfors, D., Cho, H., Brodish, P., Flewelling, R., and Khatapoush, S. Identifying High School Students "At Risk" for Substance Use and Other Behavioral Problems: Implications for Prevention. Subst Use Misuse, 41(1), pp. 1-15, 2006.

Association with Delinquent Peers: Intervention Effects for Youth in the Juvenile Justice System

Although association with delinquent peers is a recognized precursor to ongoing delinquency problems, youth in the juvenile justice system are commonly prescribed intervention services that aggregate delinquent youth. However, little is known about the process variables that mediate the relationship between aggregating youth in intervention settings and poor subsequent outcomes. The researchers examined data from two randomized intervention trials (one male sample and one female sample) with delinquent adolescents placed either in Multidimensional Treatment Foster Care (MTFC) or in group care. Path analysis suggested that the MTFC youth had fewer associations with delinquent peers at 12 months than did the group care youth. Further, associating with delinquent peers during the course of the intervention mediated the relationship between group condition and 12-month delinquent peer association. Implications for the development of interventions with delinquent youth are discussed. Leve, L., and Chamberlain, P. Association with Delinquent Peers: Intervention Effects for Youth in the Juvenile Justice System. J Abnorm Child Psychol, 33(3), pp. 339-347, 2005.

Female Caregivers' Experiences With Intimate Partner Violence Are Related to Child Functioning

This study examined the relationship between women's experiences with intimate partner violence and their reports of child behavior problems. Data were from the National Survey of Child and Adolescent Well-Being, a national probability study of children who were the subjects of child abuse and neglect investigations. The sample consisted of 2020 female caregivers of children between the ages of 4 and 14 years who were interviewed about demographic characteristics, child behavior problems, female caregiver mental health, parenting behaviors, experiences with intimate partner violence, and community characteristics. Information on child abuse and neglect was obtained in interviews with child protective services workers. Multiple-regression analyses were used to investigate the association between caregiver victimization and child behavior problems while controlling for the effects of child, family, and environmental characteristics. The potential moderating effects of caregiver depression and parenting practices on the relation between intimate partner violence and child behavior problems were examined also. Severe intimate partner violence was associated with both externalizing and internalizing behavior problems when other risk factors were controlled. Use of corporal punishment and psychological aggression were significant moderators, but maternal depression did not moderate the relation between intimate partner violence and behavior problems. This study adds to the evidence that maternal caregivers' experiences with intimate partner violence are related to child functioning. The findings suggest that systematic efforts are needed to ensure that mental health needs are identified and addressed appropriately in children exposed to this violence. Hazen, A., Connelly, C., Kelleher, K., Barth, R., and Landsverk, J. Female Caregivers' Experiences With Intimate Partner Violence and Behavior Problems in Children Investigated as Victims of Maltreatment. Pediatrics, 117(1), pp. 99-109, 2006.

Differences Among Sexually Abused and Nonabused Youth Living with HIV

Risk behaviors were compared between sexually abused and non-abused youth living with HIV (YLH). Abused YLH were significantly more likely to have attempted suicide, to have been admitted into an alcohol and/or drug treatment program, and to have engaged in crack cocaine use than were non-abused YLH and had a greater number of sexual partners. A significantly higher proportion of abused YLH had been incarcerated in contrast to non-abused youth. There were also significantly greater conduct problems among abused YLH. Finally, abused YLH had significantly higher scores on positive action and social-support coping styles than non-abused youth. Consistent with previous research, abused youth are at higher risk for a variety of negative outcomes and are also similar in many respects to sexually abused youth who are not HIV-positive. The high frequencies of two positive styles of coping among abused YLH were also observed. Anaya, H.D., Swendeman, D., and Rotheram-Borus, M.J. Differences Among Sexually Abused and Nonabused Youth Living with HIV. J Interpers Violence, 20(12), pp. 1547-1559, 2005.

Predictors of Serostatus Disclosures to Partners Among Young People Living with HIV in the Pre- and Post-HAART Eras

Predictors of serostatus disclosure were identified among youth living with HIV pre- and post-introduction of highly active antiretroviral therapy (HAART). Two cohorts of HIV-positive youth, aged 13-24, in 1994-1996 (n = 351) and 1999-2000 (n = 253) in Los Angeles, New York, San Francisco, and Miami were sampled through medical providers and a variety of social service agencies. Data were collected on demographic, social, medical, and behavioral topics. Men who had sex with men were more likely to disclose serostatus to their partners. Moreover, a positive association with length of time since diagnosis and the likelihood of disclosure exists; across time, youth were less likely to disclose serostatus to casual partners or HIV-negative partners. Post-HAART, number of sex acts with a partner was associated with increased likelihood of disclosure. Interventions for HIV-positive youth must improve disclosure to casual and serodiscordant sexual partners. Batterham, P., Rice, E., and Rotheram-Borus, M. Predictors of Serostatus Disclosure to Partners Among Young People Living with HIV in the Pre- and Post-HAART Era. AIDS Behav, 9(3), pp. 281-287, 2005.

Correlates of HIV Status among Injection Drug Users in a Border Region of Southern China and Northern Vietnam

This article presents an analysis of the correlates of HIV status among samples of injection drug users (IDUs) in Lang Son Province, Vietnam (n=348), and Ning Ming County, Guangxi Province, China (n=294), who were interviewed and tested for HIV antibody just before the start of a peer-based HIV prevention intervention in this border region. Participants were largely male, in their 20s, and single. Logistic regression analysis suggests that among Chinese IDUs, border-related factors (eg, living closer to the border, buying drugs across the border more frequently) and younger age are the best predictors of HIV positivity. In Vietnam, HIV status seems to drive behavior (eg, some risk reduction practices are predictive of HIV positivity). These differing patterns may reflect the fact that the intertwined epidemics of heroin injection and HIV began earlier and HIV prevalence has reached significantly higher levels in Lang Son than across the border in Ning Ming. Although border-related factors emerge as predictors in Ning Ming, more IDUs in Lang Son are HIV-positive and may be reacting behaviorally to that status. Their greater likelihood of engaging in risk reduction measures may reflect some combination of a belief that risk reduction can slow disease progression and an altruistic desire to avoid infecting others. Hammett, T., Johnston, P., Kling, R., Liu, W., Ngu, D., Tung, N., Binh, K., Dong, H., Hoang, T., Van, L., Donghua, M., Chen, Y., and Des Jarlais, D. Correlates of HIV Status Among Injection Drug Users in a Border Region of Southern China and Northern Vietnam. J Acquir Immune Defic Syndr, 38(2), pp. 228-235, 2005.

Self-Perceived Social Acceptance and Peer Social Standing in Children with Aggressive-Disruptive Behaviors

Examining children's perceptions of their social acceptance in conjunction with others' ratings of their peer social standing can enhance our understanding of the heterogeneity in children exhibiting disruptive behavior problems. Using a sample of 213 youth rated in the top 31 percent of their class on aggressive-disruptive behaviors, the current study examined the interaction between children's perceptions of their social acceptance and their peer-rated social standing in predicting emotional and behavioral problems. Overall, lower peer-rated social standing was associated with higher levels of antisocial behavior, academic problems, and hyperactivity/inattention. On the other hand, higher self-perceived social acceptance was associated with increased levels of peer-rated fighting at school. For children who were rated as having high social standing among their peers, poorer self-perceived social acceptance was associated with increased oppositional behaviors and conduct problems at home. In addition, children who reported lower self-perceived social acceptance exhibited increased levels of depressive symptoms, even when they were relatively well liked by their peers. The potential implications for working with subgroups of children with aggressive-disruptive behaviors are discussed. Pardini, D.A., Barry, T.D., Barth, J.M., Lochman, J.E., and Wells, K.C. Self-Perceived Social Acceptance and Peer Social Standing in Children with Aggressive-Disruptive Behaviors. Social Development, 15(1), pp. 46-64, 2006.

Adverse School Context Moderates the Outcomes of Selective Interventions for Aggressive Children

Drawing on social ecological theory and empirical studies on the role of school context in aggression, the authors argue that school adversity is an important consideration in choosing selective interventions for aggressive children. The moderating role of school adversity on intervention effectiveness is illustrated with data from a randomized clinical trial study investigating 2 selective interventions administered to 86 aggressive 2nd and 3rd graders. The authors expected that PrimeTime, an intervention targeting child competencies, would be more effective in low-adversity schools, whereas Lunch Buddy, an intervention targeting peer ecology, would be more effective in high-adversity schools. Hierarchical linear regression analysis showed significant post-treatment effects on composite measures of aggression and achievement for the interaction between the level of school adversity and treatment condition. Hughes, J., Cavell, T., Meehan, B., Zhang, D., and Collie, C. Adverse School Context Moderates the Outcomes of Selective Interventions for Aggressive Children. J Consult Clin Psychol, 73(4), pp. 731-736, 2005.

Measuring Adolescents' Smoking Expectancies

Outcome expectancies have been related to smoking behavior among adults, but less attention has been given to expectancies about smoking among adolescents at differing levels of smoking experience. The present study reports the psychometric properties and predictive validity of a brief expectancy scale across two samples of adolescents. Sample 1 (N = 349) consisted of high school students (54% female) who were regular smokers enrolled in a cessation program. Sample 2 (N = 273) consisted of 8th- and 10th-grade early experimenters (54% female) involved in a natural history study of smoking trajectories. In both samples, a principal component analysis of a 13-item expectancy scale yielded four factors (taste, weight control, boredom relief, and negative affect management), each with high internal consistency (coefficient alphas >.77) and accounting for 73% and 80% of the total variance for each sample, respectively. Expectancies were significantly higher among current smokers than among early initiators. In Sample 1, boredom relief and weight management expectancies predicted smoking status 6 months later. In Sample 2, students whose smoking increased over 18 months had higher overall expectancies at baseline compared with those who tried smoking and did not escalate. These findings support the predictive validity of expectancies in predicting escalation and cessation. Wahl, S., Turner, L., Mermelstein, R., and Flay, B. Adolescents ' Smoking Expectancies: Psychometric Properties and Prediction of Behavior Change. Nicotine Tob Res, 7(4), pp. 613-623, 2005.

Psychometric Examination of English and Spanish Versions of Scales

The psychometric properties of the Revised Conflict Tactics Scales (CTS2) are examined for English-speaking (n = 211) and Spanish-speaking (n = 194) Latino women. Internal consistency of total scale scores is satisfactory (Cronbach's alpha of .70 to .84). However, subscale alphas range from .46 to .80. Confirmatory factor analysis supported five factors of negotiation, minor and severe psychological aggression, and minor and severe physical assault. In unconstrained two-group models, loadings are of similar magnitude across language of administration, with the exception of the Physical Assault scales. Unconstrained and constrained model comparisons show scale structure varied by language group for physical assault. Although results of this study show some comparability for English-speaking and Spanish-speaking Latinas, simply combining results across language groups may obscure important differences in rates of endorsement and patterns of responses reflecting cultural, educational, and economic differences. Connelly, C., Newton, R., and Aarons, G. A Psychometric Examination of English and Spanish Versions of the Revised Conflict Tactics Scales. J Interpers Violence, 20(12), pp. 1560-1579, 2005.

Measurement Properties of the Communities That Care Youth Survey Across Demographic Groups

Prevention science has produced information about risk and protective factors that predict adolescent use and related problem behaviors. This paper investigates the Communities That Care Youth survey that measures multiple risk and protective factors. Using a sample of 172,628 students who participated in surveys administered in seven states in 1998, analyses were conducted to test the factor structure of these risk and protective factors and to test the equivalence of the factor models across five racial/ethnic groups (African Americans, Asians or Pacific Islanders, Caucasians, Hispanic Americans, and Native Americans), four grade levels (6th, 8th, 10th and 12th), and both gender groups. Results support the construct validity of the survey's risk and protective factor scales and indicate that the measures are equally reliable across males and females and five racial/ethnic groups. Implications of these findings for science-based prevention planning are discussed. Glaser, R.R., Van Horn, M.L., Arthur, M.W., Hawkins, J.D., and Catalano, R.F. Measurement Properties of the Communities That Care Youth Survey Across Demographic Groups. J Quantitative Crim, 21(1), pp. 73-101, 2005.

Tobacco Industry Successfully Prevented Tobacco Control Legislation in Argentina

This study evaluates how transnational tobacco companies, working through their local affiliates, influenced tobacco control policymaking in Argentina between 1966 and 2005. Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self-regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organized tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope. Sebrié, E., Barnoya, J., Pérez-Stable, E., and Glantz, S. Tobacco Industry Successfully Prevented Tobacco Control Legislation in Argentina. Tob Control, 14(5), pp. e2-e22, 2005.


Federal HIV prevention strategy seeks to increase efforts by health care providers to identify and reduce their HIV-positive patients transmission-related behaviors. Implementation of these recommendations will be hindered if providers perceive these efforts have the potential to harm their relationships with patients. Because transmission-related behaviors (unsafe sex and sharing needles) and the related issues of drug and alcohol use also jeopardize the health of HIV-positive patients, providers can use patient-centered counseling when addressing those behaviors. The researchers suggest efforts to increase provider-delivered transmission-prevention counseling be reframed so that "prevention with positives" includes the goal of protecting HIV-positive patients health. The researchers review the specific consequences of these risky behaviors on HIV-positive patient's health and review brief counseling strategies appropriate for HIV care providers. Gerbert, B., Danley, D., Herzig, K., Clanon, K., Ciccarone, D., Gilbert, P., Allerton, M., and Allerton, M. Reframing "Prevention with Positives": Incorporating Counseling Techniques that Improve the Health of HIV-Postitive Patients. AIDS Patient Care STDS, 20(1), pp. 19-29, 2006.


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