TEST OF A RISK REDUCTION MODEL FOR THE PREVENTION OF PANIC. Kimberly Babson1, Meggan Bucossi1, Matthew Feldner1, Anka Vujanovic1, Michael Zvolensky1, 1University of Vermont, Burlington, VT United States
The present controlled randomized selected prevention program sought to concurrently modify cigarette smoking-related behaviors (i.e., motivation to quit smoking and confidence to refrain from smoking) and anxiety sensitivity in order to (1) reduce the incidence of panic disorder (PD) and associated panic-related problems and (2) increase smoking cessation behaviors. The study employed a 2 (group: panic-specific intervention; general health information control)x— 3 (within subject assessment period: pre-intervention, post-intervention, six-month follow-up) mixed factorial design. Participants included 2 groups of 56 regular smokers (i.e., 10 cigarettes per day) high in anxiety sensitivity, as indexed by the Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986), who were randomly assigned to either a panic-specific intervention or general health information control condition. Data collection currently is 80% complete with an expected completion date of 12/01/04.
In terms of post-intervention hypotheses, we expect that a specialized (brief) cognitive-behavioral group-based intervention targeting anxiety sensitivity and smoking-related behaviors, relative to a general health information control condition, will result in reductions in anxiety sensitivity and increases in motivation to quit smoking and confidence to refrain from smoking. At the six-month follow-up, we expect that the panic-specific intervention, compared to the control condition, will result in greater (1) reductions in panic attacks, diagnoses of PD, agoraphobic avoidance, and panic-related healthcare utilization as well as (2) increases in smoking cessation attempts and longest duration of a quit attempt. Preliminary analyses support our hypotheses. We expect the results of this investigation to uniquely and significantly assist in the development of novel specialized prevention programs for PD and contribute to our understanding of co-occurring risk factors for PD and their application to anxiety-substance use psychiatric comorbidity.
ACTIVITY-BASED INTERVENTIONS FOR YOUTH: A VIABLE APPROACH?. Lori-Ann Palen1, J. Douglas Coatsworth1, Erin Sharp1, Jochebed Gayles1, 1Pennsylvania State University, University Park, PA United States
Activity involvement is an important context for adolescent development; it has been linked to a range of outcomes, including college attendance, volunteerism, delinquency and substance use. One possible explanation for these associations is that some activities promote identity expression, a crucial developmental task of adolescence. If, through intervention, youth become more involved in identity-fostering activities, they may have higher well-being and lower incidence of harmful behaviors.
Parental support and a lack of rejection and psychological control are also important for adolescent development. Therefore, an adolescent´s family may influence her ability to benefit from interventions that improve activity experiences. The current study examined the effects of family risk, activity involvement and activity expressiveness on youth outcomes.
Participants were 113 high school students (63% female; mean age 16.5 yrs) recruited through youth activity organizations in three Pennsylvania communities, plus one parent/guardian of each. Adolescents completed a checklist of activity involvement and a modified version of the Personally Expressive Activities Questionnaire (Waterman, 1990), which measured experiences in activities that demonstrate “who you really are as a person.” Adolescents also completed measures of parental emotional awareness, psychological control, support, and encouragement of identity exploration, used to create a family risk composite. Outcome measures were adolescent-reported well-being, depression/negative emotionality, substance use, and delinquency, and parent reported anti-social and internalizing behaviors.
Results of hierarchical regression analyses controlling for gender, age, community and family income supported family risk as a robust predictor of positive and negative adolescent outcomes. Activity involvement and activity expressiveness both uniquely predicted well-being. Activity involvement also predicted substance-use and parent-reported anti-social and internalizing behavior. Neither activity involvement nor expressiveness predicted adolescent-reported delinquency or depression/negative emotionality. Interactions between risk/involvement and risk/expressiveness were not significant.
These results suggest that while staying busy in activities during non-school hours may be beneficial to adolescents, the associated identity experiences also matter for well-being. Focusing specifically on identity-fostering activities may be useful for positive youth development, but not necessarily for prevention of problem behaviors. However, the ubiquitous relation between family risk and youth outcomes implies that a comprehensive intervention would also need to reduce family risk and/or enhance parent-adolescent relations.
FEASIBILITY OF AN INTERACTIVE CD-ROM TRAINING FOR PREVENTION PROVIDERS. Christopher Williams1, Rodney Thomas1, Araxi Macaulay1, Kenneth Griffin2, Gilbert Botvin2, 1National Health Promotion Associates, White Plains, NY United States; 2Institute for Prevention Research, Weill Medical College, Cornell University, NY, NY United States
Purpose: Despite the advances in drug abuse prevention research and the U.S. Department of Education´s mandate to spend allocated funds on effective programs, relatively few schools appear to have adopted the recommended evidence-based prevention programs. Even fewer schools are implementing evidence based drug prevention programs with fidelity. The purpose of this study was to assess the potential efficacy and usefulness of a high-quality prevention training CD-ROM for providers based on a state-of-the-art drug prevention program called Life Skills Training (LST), using a series of online focus groups.
Background: There is a serious need to increase the availability of training for providers of research-based prevention programs such as LST in order to ensure program fidelity. This can be achieved through the use of CD-ROM technology. There is a clear need for a complement to conventional training that is flexible, inexpensive, and can serve as an ongoing resource. The LST Provider Training CD-ROM offers this possibility, and increases the potential of facilitating large-scale dissemination of research-based prevention programs such as LST in a manner that will maximize implementation fidelity.
Methodology: Approximately six hundred potential LST providers of the middle school LST curriculum were assigned into one of three conditions: (1) LST Provider CD-ROM group only; (2) LST Provider workshop group only; and (3) LST Provider workshop training + LST Provider CD-ROM group. Of these, approximately 20% (n=110) were asked to participate in a series of online focus groups in order to obtain qualitative feedback on the appropriateness, feasibility, and potential effectiveness of the different forms of the LST Provider training.
Results: Among CD-ROM Training Only and CD-ROM/Live Training participants, the LST Provider Training CD-ROM was considered to be an appealing and well-organized product. The majority of participants felt that a CD-ROM training tool would be used more often than the live training citing cost-effectiveness as a contributing factor. CD-ROM Only participants felt the model lessons were effectively taught and were confident about teaching the LifeSkills Training Program after viewing LST Provider Training CD-ROM.
Conclusions: The LST Provider CD-ROM has been shown to be an extremely useful tool in training LST providers to deliver the program effectively and with fidelity. Provider reactions to the product were positive overall and reinforced the impact of having supplemental training material available.
CO-PARENTING WITHIN FOSTER CARE: INFLUENCES ON CHILD DEVELOPMENT.. Daniela Montalto1, L. Oriana Linares1, 1New York University, New York, NY United States
Increasing evidence suggests that `co-parenting´, whether parents function as partners or adversaries in their parenting roles, makes an independent contribution to child adjustment, beyond parenting alone. Virtually all work to date has focused on intact and/or divorced families; very little research has been done to generalize the concept of co-parenting to other less traditional family systems. This study is the first of its kind to extend the investigation of co-parenting to foster care.Given the pivotal role of foster families and the primary goal of foster care (reuniting children with their biological parents), it is important to understand aspects of the foster and biological parent relationship that may exacerbate, as well as prevent, future problems.METHODS: Twenty-four biological and foster parent (non-kinship) pairs and their foster child (M = 6.9 years; SD = 2.6) were videotaped on a structured task (agreeing on a dinner) adopted from the Structural Family Systems Rating Scale (Szapocznik, Hervis et al., 1985). A reliable coding scheme consisting of 13 behavioral anchored items was developed to assess supportive and unsupportive co-parenting (The Foster Care & Co-parenting Rating System; FCCRS). In addition, a 17-item questionnaire was created (Co-parenting Events Scale; CES) to measure the content of the co-parenting process occurring between parents. Both parents reported on child behaviors (CBCL) and FosP reported on social skills in the home (SSRS).RESULTS: Over 90% of the families fell below the midpoint (M = 12) on the FCCRS supportive (M = 9.2, SD = 2.1) and unsupportive subscales (M = 6.6, SD = 1.5). Most (79%) of the interactions were hierarchical and mainly directed by the foster parent (63%). Although a strong relationship was not found for FCCRS and child behavior, medium to large effects were found for the CES. A large inverse effect was found for biological parents on CES and externalizing behaviors, ES= -.89; large negative effects were also found for internalizing and total behaviors, ES = -.59 and -.69, respectively. For foster parents, a large negative effect was found between CES and internalizing behaviors, ES = -.68. Social competence was related to FCCRS supportive, ES = .40, and inversely related to unsupportive co-parenting, ES= -.25.CONCLUSIONS: Findings suggest a relationship between co-parenting and child behavior outcomes in foster care and underscore the need for further research. Results also highlight the need for services that are multimodal, addressing child, family (foster and biological) and social factors.
ONE-YEAR MAINTENANCE EFFECTS OF A COMBINED PARENT AND SCHOOL-BASED DRUG PREVENTION PROGRAM FOR MIDDLE SCHOOL STUDENTS. Araxi Macaulay1, Kenneth Griffin2, Elizabeth Gronewold1, Gilbert Botvin2, 1National Health Promotion Associates Inc., White Plains, NY United States; 2Cornell University, New York, NY United States
Purpose: A growing literature suggests that the use of family-based prevention programs can be an effective way to prevent adolescent substance use, yet few such interventions have been designed to complement effective school-based prevention programs. The purpose of this study was to determine the efficacy of a newly developed home-based substance abuse prevention program based on an effective school-based prevention curriculum called Life Skills Training (LST). The home-based program was designed to be implemented by parents of middle school students. The parent intervention focused on factors which have been found in the research literature to influence adolescent´s risk of drug use such as family communication, parental monitoring, parental disciplining, and how to be a good parental role model.
Background: A family-based drug prevention program that supplements an already effective research-based school program would serve multiple purposes, such as educating caregivers, increasing parenting skills, and reinforcing to young people what they have learned in a school-based program. The parent intervention tested in the present study incorporated a video and guide and included parent-related content focusing on decreasing adolescent risk of drug use and interactive activities which promote use of general social and personal skills by the participating children.
Methodology: In the present study, 335 parents of students from 34 middle schools were randomly assigned to either receive the parent prevention program or serve in a control group. Pretest, posttest and 1-year follow-up home surveys assessed changes in parent role modeling behavior, family drug use norms, disciplining skills and practices, communication skills, parental monitoring and parents conveying an anti-drug message.
Results: A series of GLM ANCOVAs were conducted, examining the posttest and 1 year follow-up means for the parent subscales, controlling for pretest levels on these outcomes. Analyses showed that at the posttest assessment, intervention parents reported significantly higher scores for role modeling behavior, parental disciplinary practices, family communication, and parental monitoring. Data from the one-year follow-up showed that the intervention effects for several outcomes remained statistically significant, including role modeling behavior and family communication, with intervention parents scoring better than controls. Conclusions: This study shows that using a parent component in combination with an already proven school-based substance abuse prevention program for middle school students helped to improve a number of important parenting skills relevant to drug prevention and that these effects were maintained for up to a year after the intervention.
USING HEALTH AND PRODUCTIVITY MANAGEMENT TO ENHANCE WORKFORCE PRODUCTIVITY. Kate Neufeld1, Marcie Birk1, Carlla Jones1, 1US Army Center for Health Promotion and Preventive Medicine, APG, MD United States
Using Health and Productivity Management to Enhance Workforce Productivity
Healthy “human capital” is a critical business and military force asset for the 21st century. Health and Productivity Management (HPM) is a new field that maximizes the value of human capital by emphasizing the vital relationship of employee health to workplace productivity and corporate performance. HPM is a valuable strategy to increase worker productivity while on the job.
This poster will provide a general overview of HPM; introduce the HPM approach to improving performance on the job from better health by integrating wellness and prevention; chronic disease management; occupational health and safety; disability management; and overall organizational health; and present data gathered from the Work Limitations Questionnaire, a validated survey developed by the Health Institute of New England Medical Center, to measure the impact of chronic health problems on job performance and work productivity among employed individuals.
HPM is a valuable model used by employers to increase on-the-job productivity, manage rising health care costs, and improve employee retention. This model has been implemented in a variety of business and industry settings, as is being considered in the U.S. military, as well. HPM is an especially valuable tool to increase overall organizational output and productivity as resources shrink.
ADDRESSING SUBSTANCE USE MEDIATORS THROUGH A PEER LEADERSHIP PROGRAM: A CURRICULUM MAPPING PROCESS. Sharon Rose Powell1, Sherry Barr1, Valerie Johnson2, Robert Pandina2, John Kalafat2, 1Princeton Center for Leadership Training, Princeton, NJ United States; 2Rutgers, The State University of New Jersey, Piscataway, NJ United States
Making the transition to high school is a particularly significant and challenging turning point for adolescents. Many key developmental changes may occur during this transition, including the decisions related to substance use behavior. The Peer Group Connection (PGC) program was developed 25 years ago to help ease the transition into high school and provide peer support and team mentoring to adolescents at a critical period in their development. PGC is a peer leadership and freshmen transition initiative that trains junior or senior high school students to work in co-leader teams as group discussion leaders and positive role models for their freshmen peers. Peer leaders facilitate 30 weekly discussions with freshmen about common issues facing high school students.
By using older, trained peers to facilitate discussions and conduct other peer group activities with freshmen, a special bond and rapport is formed among students to help them navigate the daily pressures of transitioning into high school. We believe that the connections that students make have a lasting effect on their social adjustment to high school and their decisions about active participation in other high school activities in and outside of school.
In the fall of 2003, practitioners and researchers from the NIDA-funded Rutgers Transdisciplinary Prevention Research Center initiated an update of the PGC peer leadership curriculum. Curriculum development was informed by 25 years of field work, information gleaned from focus groups, input from psychologists, teachers and students, and research findings that link important risk and protective factors to the development of substance use problems.
The PGC curriculum uses an activity-based model to set a context for discussion before students participate in engaging, hands-on games or simulations about various topics. Following each activity, students reflect on their learning and share insights gained from active participation. Using a mapping process, program components were matched to both the transitional challenges that are faced by students in their movement from the middle to high school environment as well as to important mediating risk and protective factors associated with drug abuse among adolescents. The mapping process was utilized to ensure that weekly sessions address the following mediators: school attachment, achievement orientation, peer acceptance, stress and time management, social competence, coping skills, expectancies related to substance use, sensation seeking, impulsivity and decision making. In this presentation, we will describe the mapping process and show how the curriculum addresses the challenges of transitioning from middle to high school.
EXAMINING CLOSENESS TO PARENTS, FAMILY STRUCTURE AND PARENTAL SMOKING AS PREDICTORS OF SMOKING STATUS AMONG MIDDLE SCHOOL AND HIGH SCHOOL ADOLESCENTS. Diane Wilson1, Patricia Obando1, Donna McClish1, Melanie Bean1, Karen Mitchell1, Elizabeth Fries1, 1Virginia Commonwealth University, Richmond, VA United States
Background:Close parent-child relationships have been shown to be protective against addictive behaviors including smoking. Yet, more youth live in single parent households today than ever before which may mediate closeness to parents. This study examined closeness to parents, family structure, and smoking in parents/siblings to predict smoking among middle and high school Virginia adolescents.
Methods: Baseline survey data from 19,431 middle school (MS) and 5800 high school (HS) students participating in youth prevention/cessation programs in Virginia were used in these analyses. Using multivariate regression models, we tested the effects of closeness to parents, family structure, parental and sibling smoking, time spent with parents, comfort communicating problems with parents, frequency of eating dinner with parents, gender, and ethnicity on smoking status in MS and HS adolescents.
Results: Twenty-six percent of HS and 7% of MS students reported being current smokers. Among HS students, students spending more time with parents (p<.001) and eating dinner with parents > 3x/week (p<.001) were significantly less likely to report current smoking. Among MS students, sibling smoking (p=.002) not being close to mother (p=.032) or father (p=.007), and not being comfortable talking with parents about problems (p=.002) were significant predictors of smoking. Spending time with parents (p<.001) and eating dinner with parents (p=.018) were also significantly protective against smoking in MS students. Ethnicity, but not gender, was also a significant predictor of smoking in both HS (p<.001) and MS (p<.001) regression models. Neither family structure, reported family closeness nor smoking status of the parents were significantly associated with current smoking among youth in multivariate models.
Conclusions: Spending time with parents through communication and eating dinner were stronger predictors of not currently smoking in youth than living in a 2-parent versus 1-parent household or smoking status of the parents in both MS and HS youth. In addition, among MS students, having a sibling that smoked, and not being close to either a mother or a father significantly predicted smoking in youth. New models of intervention with greater emphasis on family involvement will be important towards reducing teen smoking rates among both Middle School and High School students in the US.
INDIVIDUAL MOTIVATION AND PARENTAL INFLUENCE ON ADOLESCENTS' EXPERIENCES OF INTEREST IN THE FREE TIME CONTEXT: A LONGITUDINAL EXAMINATION. Erin Sharp1, Linda Caldwell1, Ty Ridenour1, 1Pennsylvania State University, University Park, PA United States
Adolescents spend a large amount of time in discretionary leisure. Compared to other contexts, leisure offers a distinctive opportunity for positive youth development to occur. However, some adolescents report high levels of boredom in their free time. If adolescents are bored and not engaged in interesting experiences in their leisure, it not only limits growth opportunities, but has also been linked to increased delinquency and substance use. This study utilizes longitudinal data to investigate the roles of individual motivation and parent level variables on experiences of interest in adolescent free time.
Participants were 369 students (53% male) in grade 7 (W1), 8 (W2), and 9 (W3), and made up the control group for a study testing the effects of the TimeWise leisure intervention. Adolescents completed a survey that included items measuring the following concepts: parental knowledge (e.g. My parents know where I go and what I do after school), parental control (My parents have too much control over my free time), amotivation (I don´t know why I do my free time activities, and I don´t really care), self-regulated motivation (I do what I do in my free time to develop skills that I can use later in life), and interest (e.g. My free time activities are very interesting to me).
SEM (LISREL 8.51) was used to test the relations between the predictors and the outcome at each time point, to test mediation between the parenting variables and adolescent motivation, and to examine the invariance of these relations across time. Results supported adolescent amotivation as a robust predictor of interest at each time point. Self-regulated motivation was also a robust predictor at W1 and W2, but not at W3. Further analyses suggest that W1 and W2 self-regulated motivation are critical for experiences of interest at W3. Results indicate that amotivation and self-regulated motivation mediate the relationship between parental knowledge and interest. Interestingly, parental control only had a significant impact of adolescent amotivation, but not self-regulated motivation. Parental control had a significant, negative, direct impact on adolescents´ experience of interest in free time across time.
Results indicate that both individual motivation and parenting play a role in adolescent´s experiences of interest in free time. Parental knowledge of free time enhances adolescent motivation, while parental control negatively impacts motivation and experiences of interest. Findings will be discussed for their implications on family and individual level interventions, and the importance of developmental timing of intervention efforts.