CAMPUS IN TRANSITION: CHANGE IN STUDENT DRINKING AS A “DRY” CAMPUS BECOMES “WET”. Robert Turrisi1, Mark Johnson2, Dexter Taylor2, Bob Voas2, 1Pennsylvania State University, University Park, PA United States; 2Pacific Institute for Research and Evaluation, Calverton, MD United States
As the health risk and harm associated with college drinking become increasingly evident, university administrations across the country have implemented programs and policies to reduce alcohol consumption by students. One approach has limited the availability of alcohol to students by instituting “dry campus” policies that prohibit alcohol sales, possession, and consumption on campus grounds. Countervailing this, however, are economic factors associated with alcohol sales; dry universities may find that campus-owned venues cannot compete with wet off-campus venues for booking the most popular and profitable acts.
At least one university has bucked the trend of reducing alcohol availability to students by transitioning from dry to wet status. In 2000, Boise State University lifted its campuswide ban on alcohol sales so that on-campus entertainment venues could serve alcohol. The research described in this paper examined changes over time in student drinking and in perceived drinking norms at Boise State´s wet campus relative to a comparable dry campus at Portland State University. Additionally, the research examined service practices (e.g., checking IDs, serving multiple drinks) at the wet on-campus venue, as well as at two wet off-campus venues in Boise. The purpose was to test whether transitioning from a dry to wet campus would be associated with increases in student drinking and perceived drinking norms.
Our data collection involved (1) a survey of student drinking, normative beliefs, and alcohol-related problems at Boise State and Portland State Universities; (2) a survey of student attendance at the Boise State venue and the two off-campus venues (containing questions concerning alcohol consumption at these events); (3) an observational survey of alcohol-service practice at the three venues (one on-campus, two off-campus); and (4) an age 20 and younger compliance-check survey (where young-looking confederates attempted to purchase alcohol) at the three venues.
To date, analyses of these multiple data sources suggest the following three primary findings:
- There is no evidence of increased alcohol consumption or perceived drinking norms at Boise State University relative to Portland State University.
- Service practices at the wet on-campus venue were as stringent, if not more so, than at the off-campus venues.
- There is no evidence of increased attendance at events hosted by the on-campus venue. Implications of the dry-to-wet transition, including the university´s recent plans to increase alcohol service to tailgate parties outside of sporting events, are discussed.
5:00 PM – 7:00 PM
POSTER SESSION 2 AND RECEPTION
Posters are grouped by theme.
Columbia A, B, and C
POSTERS: DISSEMINATION 323
TRANSLATION OF A GROUP COGNITIVE-BEHAVIORAL PSYCHOTHERAPY DEPRESSION PREVENTION INTERVENTION INTO A PRIMARY CARE MODEL FOR COMMUNITY DISSEMINATION. Benjamin Van Voorhees1, Ellis Justin1, 1University of Chicago, Chicago, IL United States
BACKGROUND: Face-to-face Cognitive Behavior Psychotherapy (CBT) and individual Interpersonal Psychotherapy (IPT) may prevent depression in at-risk adolescents in study settings. Several barriers to dissemination of these approaches in community settings have been identified: (1) loss of fidelity, (2) poor motivation, (3) lack of cultural acceptability, and (4) high costs. The purpose of this study is to translate a depression prevention intervention from a study setting into a combined primary care/web-based model by addressing these barriers. METHODS: We employed a multidisciplinary team of investigators and 14 late adolescent evaluators (half male, half non-white) recruited from two urban primary care settings in a multi-step process of intervention translation/development: (1) initial translation by primary care physician, (2) serial fidelity reviews by a health psychologist, original source manual authors, and a practicing psychotherapist, (3) cultural review by an adolescent editor and adolescent evaluators, (4) cost review based on time of encounters and willingness to pay for intervention, and (5) revision based on this evaluation. We evaluated the translation process with regard to four outcomes related to known dissemination barriers: (1) fidelity (checklist, qualitative reviews), (2) motivation (themes), (3) cultural acceptability (themes) and (4) low potential costs (time and willingness to pay). RESULTS: The final 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 CBT (behavioral activation, counter pessimistic thinking), and Interpersonal Psychotherapy (activate social network, strengthen relationship skills), and a follow-up MI in primary care to enhance behavior change. Fidelity check list/serial reviews were satisfactory. Key motivations for participation included: (1) importance of reducing risk, (2) perceived intervention coherence/effectiveness, (3) building “resiliency”, and (4) altruism. Some of the adolescents who found the “every-day” language easy to understand suggested that the intervention was “too simple” to work (lack of cultural authority). The mean duration of the first MI was approximately 20 minutes and the second, 15 minutes. Adolescents were willing to pay a mean of $20.63 for the intervention. CONCLUSIONS: Complex preventive interventions for depression can be translated into the community settings with high fidelity and cultural acceptability using multidisciplinary teams and incorporating the opinions of potential users. The adolescents´ willingness to pay was similar to the co—payment required for the two primary care visits needed for the intervention.
BRIDGING RESEARCH TO PRACTICE AND COMMUNITY-CENTERED MODELS IN CHILD MALTREATMENT AND YOUTH VIOLENCE PREVENTION. Paul Flaspohler1, Jennifer Duffy2, Janet Saul3, Natalie Audage3, Lindsey Stillman2, Abe Wandersman2, 1Miami University, Oxford, OH United States; 2University of South Carolina, Columbia, SC United States; 3Centers for Disease Control and Prevention (CDC), Atlanta, GA United States
The purpose of this poster is to present a framework developed to understand how research, training and technical assistance and community and organizational capacity can be better integrated for more effective prevention of youth violence and child maltreatment. The development of the framework was undertaken by the Centers for Disease Control and Prevention´s Division of Violence Prevention to identify priority areas for prevention dissemination activities and priority areas for research on dissemination, capacity, and utilization. The framework was created through analysis of research-to-practice models, dissemination processes, and research on community capacity. Through a series of working groups, the framework was revised using feedback generated from content experts in community capacity, training and technical assistance, program implementation/utilization, public health, dissemination, youth violence, and child maltreatment. The framework focuses on three levels of systems: Community Prevention Systems, Prevention Research Systems, and Prevention Support Systems, as well as the dissemination activities that connect the systems. Community Prevention Systems are the realms of prevention practice (e.g., schools, community organizations). Prevention Research Systems are organizations producing research on effective prevention (e.g., universities, non-profit groups, government agencies). A third “system,” called the Prevention Support System, provides linkage between research and community systems. The framework was developed to support the dissemination of best practice processes and principles for prevention, as well as best practice programs. Processes are ways of engaging communities, assessing community needs and resources, planning programs, and matching community needs and resources with appropriate interventions (Green, 2001). Principles are defined as qualities or standards associated with effective prevention programming (e.g., principles of effective prevention, Nation et al., 2003). We suggest that systematic research on questions identified through the framework may lead to more effective ways of providing support to organizations and communities with varying levels of capacity, and more systematic ways of allocating prevention support services. The poster will present the framework and discuss lessons learned in determining priority areas for dissemination practice and research identified through the development of the framework.
TAKING SMOKING OUT OF THE SHADOW: TOBACCO CONTROL EDUCATIONAL AND TRAINING WORKSHOPS FOR RUSSIAN DOCTORS.. Olga Vikhireva1, Vladimir Levshin2, Natalia Radkevich2, Anna Kalinina1, Svetlana Shalnova1, Alexander Deev1, 1State Research Center for Preventive Medicine, Moscow, Russia; 2Cancer Research Center, Moscow, Russia
Comparing to other risk factors of chronic non-communicable diseases, smoking in Russia remains the most neglected one, in spite of its high prevalence and significant input into excessive morbidity and mortality. To improve the situation, local teams of cardiologists and oncologists launched an initiative “Tobacco Control Educational and Training Workshops for Russian Doctors”. The project has been supported with an ACS-UICC Tobacco Control Seed Grant. In 2004, there will be held five full-day workshops for interested doctors of various specialties. The progress is evaluated during successive questionnaire surveys.
Typically, the attendees are never-smokers (64%; preliminary data from the first three workshops), with equal numbers of ex- and current smokers (18%); mostly women (83%). There are doctors of various specialties (general practitioners, cardiologists, oncologists, medical managers, etc.). The quality of lectures/discussions is assessed as high. The most useful to trainees is practically oriented information on treating smokers in everyday clinical practice.
One month later, more than 80% trainees report assessing smoking status and giving cessation advice to virtually every patient. Most doctors recommend nicotine replacement therapy (84%), individual and group behavioral therapy (66% and 50%, respectively). Among difficulties faced during implementing cessation skills and knowledge into clinical work, most doctors cite low motivation of smokers (67%).
The results of all five workshops, obtained in November 2004, will be presented.
It is planned to continue the workshops, and establish a CME course on tobacco control, taking into account the comments and suggestions from the participants. An elective course on tobacco control has been implemented at the Sechenov Medical Academy, Moscow. More smoking-related issues have been included in the programs of national and local medical events (e.g., Congresses of the National Cardiology Society), discussed in medical press, on the websites, etc.
To involve Russian regions into tobacco control network, we conduct educational courses of flexible length and format not only in Moscow, but also in other Russian cities (Moscow Region, Nizhniy Novgorod, Yekaterinburg, Tomsk).
Only with active tobacco control work, it is possible to overcome the Eastern European health paradox. Motivating and teaching health professionals is the first step on this long, but inevitable way.
THE IMPORTANCE OF ENGAGEMENT AND QUALITY OF PARTICIPATION IN PARENT BEHAVIOR. Alexandra Gitter1, Robert Nix1, Bierman Karen1, 1Pennsylvania State University, University Park, PA United States
One of the most effective intervention approaches for the treatment of children´s conduct problems is parent behavior management training. Engaging families in such training on a preventive basis, however, often poses a challenge. This study will examine what factors predict engagement and the quality of participation in parent groups designed to prevent children´s conduct problems and will examine whether engagement and the quality of participation in those groups is related to change in parents´ behavior.This study will rely on data from the intervention sample of Fast Track, a multi-component program designed to prevent children´s conduct problems. This sample includes 445 families (55% minority; 31% less than high school degree; 45% unemployed; 49% single) living in Durham, Nashville, rural Pennsylvania, or Seattle. All families had a child who scored in the top decile of oppositional and aggressive behavior problems in kindergarten. When children were in first grade, groups of 5 to 7 parents met weekly at their children´s schools to learn how they could support children´s academic success and handle common behavior problems in a positive and effective manner. Ratings of parents´ engagement and quality of participation (e.g., interest in material, willingness to talk, acceptance of new ideas, and skill in implementing material) were made by group leaders; all other data were collected during annual home interviews.Preliminary analyses indicate that diverse factors such as family socioeconomic status (r=.31, p<.001), mothers´ symptoms of depression (r = -.11, p<.03), and parents´ perceptions of children´s behavior problems (r =.12, p<.02) were moderately related to parents´ engagement and the quality of their participation in parent groups, but none of those factors related to the frequency with which parents attended groups. Hierarchical linear models suggest that parents´ engagement and the quality of their participation in groups predicted their caregiving behaviors at the end of the year, controlling for pre-treatment levels of those behaviors. Parents´ engagement and the quality of their participation was related to observer ratings of parental warmth (&beta=.14, p<.01), parents´ use of physical punishment (&beta=.30, p<.001), teachers´ reports of parents´ involvement in children´s education (&beta=.26,p<.001), and interviewer ratings of parents´ insight into their child´s personality (&beta=.25,p<.001).These findings emphasize the importance of ensuring that engagement and the quality of parents´ participation in groups is high. Although necessary, it may not be sufficient to simply get parents to attend parent training groups.
CONDUCTING DISSEMINATION RESEARCH IN HIGH SCHOOLS: CHALLENGES OF `GOING TO SCALE´ WITH PROJECT TOWARDS NO DRUG ABUSE (TND). Luanne Rohrbach1, Steve Sussman1, 1University of Southern California, Alhambra, CA United States
One of the most critical issues in prevention science is how to translate research on effective prevention interventions to widespread practice. In the area of substance use prevention, efforts to disseminate research-based interventions in schools have been bolstered by recent federal policies requiring schools to implement effective prevention programs with their federal substance use prevention funds. There are many important research questions that prevention scientists need to be address in order to guide these efforts. What organizational factors positively influence the delivery of research-based programs, and how can these be enhanced? What are the most effective methods for preparing teachers to implement evidence-based prevention curricula? What kinds of interventions ensure maintenance of program delivery?
This paper will describe research on the dissemination of Project Towards No Drug Abuse (TND), an effective substance abuse prevention program that targets high school students. Supported by a grant from NIDA, the dissemination research project is comparing the relative effectiveness of a standard face-to-face training workshop and a comprehensive-implementation-support model (training workshop plus web-based support, technical assistance, and coaching for teachers as well as consultation to administrators) as modalities for preparing schools to deliver Project TND with fidelity and sustainability. Schools in both training conditions are being compared to those in a delayed-intervention control condition on measures of students´ use of tobacco, alcohol, marijuana, and other drugs. Over the course of the project, a total of 60 schools will be recruited to participate. During the first year, 18 regular and 3 alternative high schools in Los Angeles were recruited and 17 teachers in the standard and comprehensive conditions implemented the program. Data on teachers´ attitudes, program-specific knowledge, program acceptance, and background characteristics were collected via self-report surveys, and each teacher was observed by research staff during program delivery. Examples of challenges encountered when conducting a study of this type will be discussed, including communication for effective school and teacher recruitment, finding an appropriate subject area for implementation in the high school setting, handling the logistics of providing training and maintaining contact with teachers, and fostering administrative support for program implementation.
REDUCING CANCER HEALTH DISPARITIES BY DISSEMINATING EVIDENCE-BASED APPROACHES FOR ENERGY BALANCE PROMOTION. Edward Maibach1, Mary Ann Van Duyn1, Barbara Wingrove1, Tarsha McCrae1, Michael Rothschild2, 1National Cancer Institute, Bethesda, MD United States; 2University of Wisconsin-Madison, Madison, WI United States
Obesity is a serious and growing public health problem in the U.S. today, and a strong risk factor to diseases, such as type 2 diabetes, heart disease, and cancer. A number of minority and underserved populations are disproportionately affected by obesity, and obesity is a potential contributing factor to health disparities. Better dissemination of culturally appropriate evidence-based energy balance intervention approaches for obesity prevention and control is critically needed; however, this area has not been widely studied.
This symposium will explore ways to enhance dissemination of evidence-based practices by using market research to determine how these approaches can and should be promoted in and adapted to specific minority and underserved communities and settings.
Three pilot studies of market research, conducted among minority communities experiencing excess obesity across the lifecycle will be presented: low-income Hispanic women in Houston, Texas, Hmong parents and their children in Southern California, and young adult Native Hawaiians. These pilots are being performed by investigators from the NCI´s Center to Reduce Cancer Health Disparities´s Special Populations Network, which has been successful in developing and sustaining community relationships to reduce cancer health disparities in minority and underserved populations. These pilot research projects are currently underway and will be completed in early 2005.
Using common qualitative measures, presenters will highlight perceived benefits of, and barriers to, participating in (among target audience members) or offering (among intermediaries) programs consistent with the successful intervention approaches, yet more culturally appropriate. A discussant will then summarize insights and themes gleaned from the data, along with the potentials and pitfalls associated with a marketing approach.
The ultimate public health value of these pilots is in illuminating how to create culturally tailored interventions based on evidence-based approaches, and also, how to build successful and sustainable distribution channels in communities with cancer health disparities for disseminating proven obesity prevention and control interventions.
KA `AINA `IKE: ADAPTING PACE+ TO IMPROVE ENERGY BALANCE IN YOUNG ADULT NATIVE HAWAIIANS. Jamie Boyd1, 1Leeward Community College, Pearl City, HI United States
Ka `Aina 'Ike is a 3 credit college-based nutrition and lifestyle course designed to motivate Native Hawaiian adults to adopt healthy eating and physical activity behaviors. Adapted from a successful research-based intervention conducted in primary care, Ka `Aina´ Ike was modified for a college population and incorporates Hawaiian cultural values, traditional learning styles, and socio-political history, while emphasizing individualized behavioral change and group health and physical education strategies.
The study uses follow-up focus groups to elicit perceived benefits and barriers associated with motivating participants to successfully adopt and maintain healthier lifestyles. A delayed intervention design will be used to compare pre-post qualitative measures of behavioral change and biometric measures. Working collaboratively with established Native Hawaiian community partners, project findings and materials will be disseminated through their own programs to those who might most benefit from these approaches.
Results from the market research, along with the plan for how the resultant market research will be used to adapt and deliver successful energy-balance programs to the Native Hawaiian population, will be presented.
ENERGY BALANCE FEASIBILITY STUDY FOR LOW INCOME HISPANIC WOMEN. Amelie Ramirez1, Kipling Gallion2, Patricia Chalela2, 1Baylor College of Medicine, Houston, TX United States; 2Baylor College of Medicine, San Antonio, TX United States
This study is conducting formative research to assess knowledge, attitudes and behaviors about nutrition and exercise (i.e. energy balance) among low income, Hispanic women over 40 years of age in Houston, Texas. Drawing upon the evidence-base and best practices resources, several evidence-based social support intervention approaches were identified, which will form the foundation for replication of an energy balance intervention among low income Latinas.
From Houston´s “East End” barrios: 1) 144 Hispanic women are being recruited to attend focus groups to discuss energy balance and to gauge reaction to effective intervention approaches for improving healthy eating and physical activity, and 2) key informant interviews are being conducted (with representatives from several Catholic Churches, grocery distributors, mass media and other relevant community representatives in the Houston East End area) to discuss the potential for a church based energy balance intervention in this community.
These data will be reported, along with recommendations for the design, implementation and evaluation of a culturally appropriate, evidence-based intervention conducted through churches to promote energy balance among Hispanic women.
ENERGY BALANCE AND 5 A DAY PROMOTION FOR CALIFORNIAN HMONG FAMILIES. Marjorie Kagawa-Singer1, Gail Harrison2, 1UCLA School of Public Health and Asian American Studies Dept, Los Angeles, CA United States; 2University of California, Los Angeles, Los Angeles, CA United States
As part of Asian American Network for Cancer Awareness, Research and Training (AANCART), this collaborative pilot study is conducting formative research to inform the design of a community-wide campaign to promote energy balance through increased physical activity and fruit and vegetable consumption among low income Hmong parents and their children (5-14 years of age). Available data shows a growing trend of weight gain among the youth in this population.
This formative research extends similar research conducted with Chinese and Vietnamese communities in Northern and Southern California to the Hmong communities in Central and Northern California. The study is: 1) conducting eight focus groups with parents of children 5-14 years of age and with children 11-14 years of age; 2) conducting key informant interviews with professionals and leaders in the Hmong community; and 3) conducting interviews with professionals who have conducted physical activity and nutrition activities in these communities. Focus group and key informant interviews are being designed to elicit culturally relevant information about how best to adapt evidence-based community-wide campaign intervention approaches for the Hmong population. Community partners are assisting in the identification and adaptation of these evidence-based energy balance community-wide intervention approaches, and will be collaborating on the delivery of the culturally adapted program.
Salient elements, identified from this research, for adapting and disseminating an effective “5 A Day” nutrition and physical activity community-wide campaign in low income Hmong populations in California will be presented.