VIOLENCE, ALCOHOL AND SUBSTANCE USE, AND RELIGIOUS AND PARENTAL PROTECTIVE FACTORS IN A GROUP OF ADOLESCENT FEMALES. Wilma Calvert1, Kathleen Bucholz1, Andrew Heath1, 1Washington University in St. Louis, St. Louis, MO United States
Violence, and the use of alcohol and other illicit drugs (OID) continue to be public health problems among the U.S. adolescent population. The negative consequences associated with alcohol use (e.g., drinking and driving and participation in other risky behaviors) are well-documented. Through a protective factors framework, this research examines the role of parents and religiosity on adolescent violence and use of OID in a sample of 2,552 adolescent females (12–20 years of age at the time of the initial interview; mean age=15.7) obtained from the general population and assessed via telephone diagnostic interviews. Predictors examined included measures of religiosity and variables measuring parental characteristics such as consistent discipline and punishment, support and warmth, and parent(s) fostering independence. Outcomes included prevalence of violence, binge drinking (consuming five or more drinks on the same occasion), and experiencing negative consequences related to alcohol use and alcohol dependency problems as identified in the DSM-IV.Analyses thus far indicate approximately 31% of the participants had used marijuana at least once, and 49% reported having had one drink of alcohol. Nineteen percent reported binge drinking within the previous 30 days, while 31% reported negative consequences (i.e., problems in relationships) related to alcohol use. Fourteen percent had committed at least one act of violence, with initiating a fight being the most frequently reported act of violence. Using logistic regression, models for each outcome were first run with only the parental variables and then rerun with the religion variables to determine the amount of additional variance explained. Parental consistency in ensuring adherence to family rules consistently emerged as a significant protective for the majority of the outcomes, both with and without the religion variables. Religious participation was another significant protective factor in the models.This research supports the importance of the role of parental involvement and religious participation in the lives of adolescent females in order to prevent their participation in negative behaviors. Public health officials are in a prime position to educate parents on the importance of their role in the deterrence of negative behaviors. Program planners might consider incorporating religious institutions as a component of a public health approach in preventing adolescents´ participation in negative behaviors. Because of the potential long-term consequences of adolescent females´ involvement in violence and other negative behaviors (i.e., suicide ideation, alcoholism, drug addiction, enmeshed in violent relationships, unable to care for their children), research with this population is essential.
QUALITATIVE AND QUANTITATIVE ASSESSMENT OF THE RELATIONSHIP BETWEEN TOBACCO USE AND PHYSICAL ACTIVITY AMONG WV ADOLESCENTS. Candice Weller1, Kimberly Horn1, 1West Virginia University, Morgantown, WV, United States
This practicum project was created to explore the relationship between tobacco use and physical activity among West Virginia adolescents. Tobacco use and physical inactivity are two major factors affecting the health of the nation´s adolescent population, especially WV youth. Risky health behaviors tend to co-occur, elevating risks for chronic diseases. Logically, physical inactivity and tobacco use may be related. There is limited knowledge about the relationship between physical activity and tobacco use among youth. Moreover, little is known about the effects of physical activity on tobacco cessation intervention among adolescents. Interestingly, new research suggests that increased physical activity among adult smokers may aid the smoking cessation process. To address the knowledge gap, focus groups with WV adolescent tobacco users and non-users were conducted to gather comparative qualitative and quantitative data regarding their knowledge, attitudes, and behaviors towards physical activity. A discussion guide and a survey tool, using standardized questions, were implemented in 8 1-hour focus groups at 2 WV high schools. The sample consisted of 49 students (17 tobacco users and 32 non-tobacco users) in grades 9-12. Following data collection, the surveys were coded and analyzed using SPSS to examine and compare potential relations between physical activity and tobacco use among both groups. The qualitative focus group data were obtained by audio tapes and field notes. The audio transcriptions were coded by hand. The qualitative data were used to support the findings from the survey. Three major findings emerged from this study. First, males participated in more regular physical activity than females. Second, male tobacco users participated in more physical activity than female tobacco users. Third, although not statistically significant, female tobacco users viewed more television than any other group in the study. In summary, among all youth in this sample, female tobacco users were the least active and most sedentary.
THE CONTEXTUAL EFFECT OF CLASSROOM INDEGREE OF SMARTNESS ON THE RELATIONSHIP BETWEEN CHILDREN´S ACHIEVEMENT AND THEIR PREFERENCE BY PEERS AND TEACHERS. Duan Zhang1, Jan Hughes1, Shuk Wa Wong1, 1Texas A&M University, College Station, TX United States
Children with below-average academic performance at school entrance are at heightened risk for negative school trajectories. Early low achievement is associated with concurrent and future social and academic difficulties and lower academic motivation and engagement. For low achieving students, school is often a stressful environment that contributes to feelings of helplessness and alienation. Children who are both low achieving and peer-rejected are at greatly increased risk for premature withdrawal from school. We expect that characteristics of classrooms may contribute to children´s levels of peer acceptance. To investigate this hypothesis, we borrow from Freeman´s (1979) work on assessing the centrality of social networks. Freeman´s measure of “indegree” is a measure of consensus among members of a social group regarding perceptions of group members. We test the hypothesis that classroom indegree for smartness (i.e., the degree to which classmatesa agree in identifying a relatively small number of children as “smart”) will moderate the association between first and second grade children´s academic achievement and their peer acceptance, such that the positive association between academic achievement and peer acceptance will be stronger in classrooms with higher indegree. We also test the moderating role of classroom indegree on the associations between academic achievement and several indices of school engagement.
The data for this study come from a larger longitudinal study on the impact of grade retention. Participants are 291 first and second grade children (56% male) attending one of three Texas school districts who 1) scored below the median for their school district on a measure of literacy administered in first grade; 2) were not receiving special education assistance; and 3) were enrolled in classrooms in which at least 40% of the class completed sociometric interviews. These 291 participants were nested in 84 classrooms. The ethnic composition of the sample was 39.5% Hispanic, 36.1% Caucasian, 21% African-American, and 3.5% other.
Achievement was assessed with the Broad Reading Scale of the Woodcock Johnson Psychoeducational Battery (WJ-III). Teachers reported on children´s academic engagement, conscientiousness, and learning, and children reported on their sense of school belongingness. Separate two-level hierarchical linear modeling analyses were run with classroom indegree for smartness as second level predictors and child achievement and gender as level 1 predictors. As expected, the cross-level interaction between WJ-III and classroom indegree for smart was significant for children´s peer acceptance (p < .05) and for teacher-rated conscientiousness (p < .05), engagement in learning (p < .01), and learning (p < .05).
MONITORING INCOMING KINDERGARTNERS: THE DEVELOPMENT OF A PARENT-REPORT MEASURE TO ASSESS THE MEDICAL, EDUCATIONAL AND SOCIAL/EMOTIONAL HEALTH OF CHILDREN ENTERING SCHOOL. Emma Forbes-Jones1, Dirk Hightower1, Bohdan Lotyczewski1, Susan Greenberg1, 1Children's Institute/University of Rochester, Rochester, NY United States
Monitoring the well being of children is critical in the prevention of psychological, behavioral, educational and health problems, and in the promotion of children´s successful adaptation. Developing systems to collect, organize and maintain data to guide communities in making program and policy decisions is an important goal for prevention scientists. The objective of this study was to develop a valid and reliable parent-report measure (Parent Appraisal of Children´s Experiences – PACE) that assesses health, school readiness, and social-emotional functioning in a population of entering kindergartners.
Participants included parents (N=1488) of incoming kindergartners (2003-2004), who completed the PACE during kindergarten registration in a large urban school district (78% response rate). 86% of respondents were mothers. 51% of the children were girls and 58% were African American, 18% Caucasian, and 23% Latino. The mean child age was 5.3 (SD=.82). 65% were covered by Medicaid or Child Health Plus.
Items for the Parent Appraisal of Children´s Experiences (PACE) were selected to ensure high content validity. Selection was based on: 1) reviews of the literature; 2) clinical and observational assessments; and 3) input from experts in early childhood. The resultant PACE contains 130 questions, including 1) fill-in–the-blank (i.e., “Name of child´s doctor”); 2) forced-choice (i.e., “Mother´s age”); 3) Likert-scale responses (i.e., “How well does your child run?”). Additionally, kindergarten teachers completed a Child Observation Record (COR; High Scope, 2003) for each child early in the school year. The academic skills, coordinated movement and social engagement subscales of the COR were used as indices of the PACE´s concurrent validity. The COR has high internal consistency, interrater reliability and criterion validity.
Exploratory factor analysis identified ten PACE subscales (Fine motor, Gross motor, Expressive Language, Speech, Learning, Pre-Literacy, Negative Peer Social, Task Oriented, Positive Peer Social and Shy-Anxious), each with adequate internal consistency. Significant correlations among PACE subscales, with PACE demographic and health information, and with the COR support the PACE´s concurrent validity.
Results indicate that the PACE has strong psychometrics in an urban school system and may provide communities with accurate and reliable data on the health and well being of young children.
INTRUSIVE THOUGHTS AS A MEDIATOR BETWEEN EXPOSURE TO COMMUNITY VIOLENCE AND INTERNALIZING PROBLEMS. Patrick Fowler1, Paul Toro1, 1Wayne State University, Detroit, MI United States
This study tested the mediating role of recurrent intrusive thoughts, symptomatic of Posttraumatic Stress Disorder (PTSD), on the relationship between exposure to community violence and internalizing and externalizing problems.
Participants were 200 at risk adolescents (M=15 years) from a large midwestern metropolitan area. Analyses were based on data from a larger study of homeless and housed adolescents. A probability sampling design was used to obtain a representative sample of homeless 13 to 17 year olds using shelters, in-patient and outpatient substance abuse treatment centers, psychiatric facilities, and street settings. A housed sample was obtained through peer nominations provided by the homeless adolescents. The two samples were matched on gender, age, ethnicity, and neighborhood socioeconomic characteristics.
Hierarchal regression analyses were used to test mediation, while controlling for differences in age, ethnicity, gender, homelessness, and parent income. Outcomes included symptoms of anxiety, depression, substance abuse/dependence, and criminal behavior, collected using the 2nd Edition of the Diagnostic Interview Schedule for Children (DISC). In addition, risky sexual behavior was assessed using a checklist of 50-items pertaining to HIV-risk behavior, sexual behaviors, pregnancy, and sexually transmitted diseases.
Results suggested that recurrent intrusive thoughts fully mediated the relationship between victimization by community violence and depressive and anxiety symptoms, as well as the association between witnessing community violence and anxiety symptoms. Specifically, victimization by community violence predicted recurrent intrusive thoughts, which in turn, predicted anxiety and depressive symptoms. In addition, witnessing community violence predicted recurrent intrusive thoughts, which predicted anxiety symptoms.
Yet, intrusive thinking failed to mediate the relationship between exposure to community violence and externalizing problems. Although exposure to community violence predicted recurrent intrusive thoughts, recurrent intrusive thoughts failed to predict substance abuse symptoms, risky sexual behavior, or criminal behavior when exposure to community was included in the model.
These findings suggest that efficient interventions for children exposed to community violence should address recurrent intrusive thoughts. A reduction of intrusive thoughts may decrease internalizing problems. However, this may be less effective on externalizing problems. Further research is needed to determine the mechanism between exposure to community violence and externalizing problems.
DISCREPANT EFFECTS OF PARENT AND ADOLESCENT RELIGION ON ADOLESCENT DEPRESSION: CROSS-SECTIONAL AND GROWTH MODELS. James Paulson1, Natalie Jacobowski1, 1Eastern Virginia Medical School, Norfolk, VA United States
Family functioning and parent-adolescent relationships can have a significant impact on adolescents´ development and mental health. Previous research suggests that religiousness and spirituality positively impact family relationships and parenting style (Mahoney 2001). However, most research in this area has been limited by challenges in assessing religion/spirituality, including the assessment of only parent or adolescent religiosity. Understanding both these influences in an integrated model may allow for the better identification of risk and resiliency factors for adolescent depression. This study explores the unique contributions of parent and adolescent religiosity in an integrated model that predicts change in depression across a one year follow-up period. Parent-adolescent relationships and overall family harmony are examined as mediating factors in this model. Analysis was performed using 2,337 complete cases from the first two waves (initial and one year follow-up) of the National Longitudinal Study of Adolescent Health, which utilized a clustered sampling design of adolescents enrolled in U.S. high schools. Both in-school questionnaires and in-home interviews of adolescents and parents provided multiple indicators of adolescent depression, parent-adolescent communication, and religiosity. These indicators were used to develop latent variables in a growth model targeting adolescent depression as the primary outcome. Mplus software was used to specify and fit this model, which included adjustments for post-stratification weights and sampling design.Results indicate a model with an acceptable fit (RMSEA = .051). Although adolescent religiosity was not associated with starting levels of depression, parent religiosity had a small association with higher adolescent depression. In terms of change in depression, parent religiosity was associated with decreases across the follow-up period, whereas adolescent religiosity had a small association with increases in depression. Parent-adolescent communication and family warmth predicted lower starting levels of depression, but did not predict change. There was insufficient evidence in this model to support a hypothesis of mediation.These findings suggest that, when considering unique contributions, parent and adolescent religiousness may contribute to risk in a contrasting manner. Although parent religiosity predicts higher starting values of adolescent depression, it predicts decreases in depression over time. Adolescent religiosity has the opposite effect. The discrepancy in effects may be related to discordance in parent-adolescent values and beliefs, which is an area of future study strongly suggested by these findings.
ASKING 18 YEAR OLDS ABOUT SEX AND DRUGS: A COMPARISON OF WEB AND IN-PERSON SURVEY MODES. Renee Petrie1, Charles Fleming1, Eric Brown1, Kevin Haggerty1, Tracy Harachi1, Richard Catalano1, 1University of Washington, Seattle, WA United States
Conducting surveys over the internet offers a potentially inexpensive and efficient alternative for collecting high quality data compared to more traditional methods such as mail, telephone or in-person surveys. The self-administered web-based mode also offers the possibility of less social desirability bias in responses to questions about sensitive behaviors such as drug use and sex. However, there is concern that web surveys will result in lower response rates, higher rates of missing data, and higher rates of error due to participants´ lack of motivation or tendency to rush through the interview. This study compares a web mode of survey administration with a computer-assisted in-person interview (CAPI) mode which included computer-assisted self-interview (CASI) modules. The study is based on surveys in the fall of 2004 of 459 participants in the Raising Healthy Children project, a longitudinal study of two-cohorts of students drawn from 10 suburban Pacific Northwest elementary schools. The study participants were randomly assigned to either web or in-person interview mode. Steps were taken to keep the administration of the modes similar in order to make valid comparisons. At the time of survey administration, the study participants were in their first year post-high school and were an average age of 18. The survey was 200 to 300 items long and includes questions on sexual behavior, drug use, drug use expectancies, depression, and the participant´s social environment, including items on employment, educational and living situation and questions concerning the participant´s relationship with family, peers, and intimate partners. Pre-test of the survey indicated that it took from 20 to 50 minutes to complete and pre-field locating efforts showed study participants had nearly universal access to the Internet. This poster compares modes with respect to cost, response pattern (response rates and response speed) and data quality as indicated by the amount of missing data due to skipped or refused items and breakoffs. It also compares rates of reported drug use and sexual activity and levels of association among survey items in an attempt to assess biases that might be introduced by different survey modes. In addition, issues in programming and administration of the two survey modes are discussed as well as the longer term design of tests of substantive mode difference using multiple waves of data collection.
INTERNET BASED SUICIDE PREVENTION EDUCATION AND TRAINING FOR PRIMARY CARE PROVIDERS. Mary Metcalf1, Brandi Woods1, 1Clinical Tools, Inc., Chapel Hill, NC United States
Suicide remains the 11th leading cause of death for all ages. Half of those who commit suicide have seen a primary care physician in the month preceding their attempt; for some groups as many as 66% have seen a physician. Primary care providers represent a missed opportunity for suicide prevention. By utilizing the reach of the Internet we are able to provide additional education on suicide prevention to a wide audience of providers, and address this gap in current training. Thus, with SBIR funding from the National Institute of Mental Health, we are creating a series on online continuing medical education courses for primary care providers available at www.EndingSuicide.com. Course topics include recognition of risk and protective factors, assessment of suicidality, and therapeutic interventions. In addition we have modules specifically focusing on high risk groups such as adolescents and those with mental illness. Continuing education credit is available for physicians, social workers, and certified counselors as of October 2004. Initial results indicate that satisfaction with the online learning experience is high (4.3 out of 5), and knowledge increases. We are currently conducting a study of the impact of the courses on knowledge, self-efficacy and intended behavior; results to May 2005 will be presented. Our educational courses address the objectives of the Surgeon General´s Call to Action by increasing awareness and understanding to decrease stigma, as well as increasing training in suicide prevention.
PILOT STUDY OF PROJECT CATCH-IT: A PRIMARY CARE/WEB-BASED DEPRESSION PREVENTION INTERVENTION FOR ADOLESCENTS. Benjamin Van Voorhees1, Justin Ellis2, 1University of Chicago, Chicago, IL United States; 2University of Chicago, Chiicago, IL United States
BACKGROUND: One in four adolescents will experience an episode of depression before age 24. While depressed mood, dysfunctional thinking (excessively pessimistic) and low social support are modifiable risk factors for depressive disorders, there is no primary care based approach for depression prevention. In this study, we conduct an initial evaluation of a combined primary care/Web-based depression prevention intervention that targets these risk factors in a group of late adolescents. METHODS-INTERVENTION: The intervention includes an initial motivational interview (MI) in primary care to engage the adolescent (GUARDS - Goals Understanding Adolescent Risk Depression Self-efficacy), eleven Web-based modules based on Cognitive-Behavioral and Interpersonal Psychotherapy, and a follow-up MI in primary care to enhance behavior change. In order to increase cultural accessibility, we used a 7-8th grade reading level with common examples and no technical terminology. METHODS-PILOT STUDY: We recruited 14 late adolescents from two urban primary care clinic settings. We evaluated three outcomes: 1) acceptability (performance, reasons for non-completion and satisfaction ratings), 2) adverse effects (negative emotions) and, 3) evidence for benefit (pre/post comparison measures of mood (CES-D), dysfunctional thinking (Automatic Thoughts Questionnaire, ATQ), and social support (SSQ-6). RESULTS: This was a diverse study sample (7/14 male, 7/14 nonwhite) with a mean age of 20 and CES-D score of 13 (mild-moderate depressed mood). All participants completed the first motivational interview, 13/14 engaged the website, and 8/14 completed the entire intervention. Reasons for non-completion included medical illness (1), recommendation by counselor or family member (2), technical problems with site (1), lack of motivation (1) and preferred face-to-face approach for current problem (1). The mean number of modules completed was 7.2/11 (65%) and the mean time on site was 1.8 hours. On a 1-5 scale, completers reported high levels of readability (4.7), and ease of understanding (4.7) and low levels of negative emotions (2.0). Global satisfaction (1-10 scale) was highest for the motivational interview (8.5) and lower for the Web-based components (5.9). For completers, favorable trends were noted for the targeted risk factors between the pre/post measures: mood, CES-D -3, P-value < 0.16; dysfunctional thinking, ATQ, -5.4, p-value < 0.31; and social support, SSQ-6 + 1.8, p-value < 0.13 CONCLUSIONS: A primary care/Web-based depression prevention intervention may be acceptable to late adolescents in community settings with minimal adverse effects. Most reasons for non-completion are potentially modifiable. Completers may experience favorable changes in known risk factors.