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Biomedical subjects

A McAlister

Publications and source records attributed to A McAlister.

At least 19 recordsLinked to original sources
PubMed2004

Minors' tobacco possession law violations and intentions to smoke: implications for tobacco control.

OBJECTIVES: To test: (1) whether citation under the Minors in Possession (MIP) law, vicarious citation (knowing someone who was cited), and threat of driving licence suspension are associated with decreased intentions to smoke next year; and (2) whether the policy is differentially enforced. SUBJECTS: 28,249 white, Hispanic, and African American students in grades 6-12 (11-18 years old) participated in the study. METHOD: The 86 item anonymous Texas Youth Tobacco Survey was completed by students attending 37 schools in 14 east and central Texas communities. RESULTS: Hierarchical linear modelling showed that MIP citation was unrelated to the future smoking intentions of most youth. However, there was a negative association between citation and smoking intentions for ever daily smoking youth at four schools. Threat of licence suspension was associated with a lower likelihood of future smoking intentions among ever daily smoking youth and vicarious citation did not deter youth from future smoking. African American and Hispanic youth had a higher probability of being cited than their peers. CONCLUSIONS: Threat of driving licence suspension has the intended effect upon youth who are/were committed smokers and MIP citation has the intended effect upon committed smokers at only four schools. However, differential enforcement of the law based on ethnicity may be occurring. Before drawing firm conclusions, current findings must be replicated with longitudinal data to determine the consequences of citation on subsequent tobacco use.

Adolescent↗
PubMed2001

Randomized controlled trial of two cigarette quit programmes in coronary care patients after acute myocardial infarction.

BACKGROUND: Tobacco cessation after acute myocardial infarction (AMI) substantially improves outcome but how effective individual programmes are needs to be established. To date, few studies have examined this factor. AIMS: To assess the outcome of two smoking cessation programmes after AMI. METHODS: One hundred and ninety-eight current smokers admitted to coronary care with an AMI participated in a randomized controlled study comparing two outpatient tobacco interventions, the Stanford Heart Attack Staying Free (SF) programme and a Usual Care (UC) programme. RESULTS: Log-rank analyses revealed that patients in the SF programme were retained longer (P < 0.001) and had higher cotinine validated abstinence rates (P < 0.001) compared with patients in the UC programme. Twelve months after intervention, 39% of the SF programme compared with 2% of the UC programme demonstrated cotinine validated tobacco cessation, representing a significant reduced relapse rate in the SF programme (chi2, P< 0.001). CONCLUSIONS: The SF smoking cessation programme initiated in hospital can significantly reduce smoking rates at 12 months after myocardial infarction. Although superior to the UC quit programme, Australian outcomes were lower than the American programme originators' published outcomes.

Adult↗
PubMed2001

Cigarette smoking behavior among US Latino men and women from different countries of origin.

OBJECTIVES: This study sought to compare smoking behavior among Latino men and women from different countries of origin. METHODS: A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. RESULTS: A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [CI] = 23.7, 26.3) than among women (12.1%, 95% CI = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% CI = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35). High ac culturation was associated with more smoking in women (OR = 1.12, 95% CI = 1.00-1.25) and less smoking in men (OR = 0.86, 95% CI = 0.78-0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. CONCLUSIONS: Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex.

Acculturation↗
PubMed2001

Attitudes towards war, killing, and punishment of children among young people in Estonia, Finland, Romania, the Russian Federation, and the USA.

OBJECTIVE: To study the cultural differences in moral disengagement, which lends support to attitudes used to justify violence. METHODS: We carried out classroom surveys of a total of 3122 students in the USA (Houston, TX, and Washington, DC) and in four European countries--Estonia (Tartu), Finland (Helsinki), Romania (Satu Mare) and the Russian Federation (St Petersburg). Data were also taken from a random sample telephone survey of 341 young adults (aged 18-35 years) in Texas, USA. Ten distinct groups were studied. Seven questions were common to all the surveys, using identical statements about the participants' agreement with attitudes relating to war, diplomacy, killing, and the punishment of children. FINDINGS: The US students were more likely than those in Europe to agree with the following statements: "War is necessary" (20% vs 9%), "A person has the right to kill to defend property" (54% vs 17%), and "Physical punishment is necessary for children" (27% vs 10%). Justification of war and killing was less common among females than males in all groups; other differences within the US groups and the European groups were smaller than the differences between the US and European groups. CONCLUSION: The results confirm the gap between the US and European groups in moral disengagement attitudes and tendencies that could lead to deadly violence.

Adolescent↗
PubMed2000

International quit and win 1996: standardized evaluation in selected campaign countries.

BACKGROUND: Quit and Win '96 recruited 70,000 smokers in 25 countries. The participants tried to abstain from smoking for at least 4 weeks. All participating countries followed the jointly agreed rules. Half of the countries implemented the campaign nationally and half, regionally. METHODS: A 1-year follow-up study was conducted in the participating countries. The aim of this study was to provide a standardized evaluation based on data from eight European campaign sites. Three measures were used to evaluate the effectiveness of the campaigns. The first measure was the participation rate, which is the proportion of participants among the smoking population targeted in each site. The second measure was a cautious estimate for the continuous 1-year abstinence rate, which is the proportion of abstainers among the follow-up sample regarding all non-respondents as relapsed. Third was the measure of the population impact, which is the efficacy of the intervention multiplied by its reach, where the efficacy equals the abstinence rate and the reach equals the participation rate. RESULTS: The participation rates varied from 0.1 to 2%, being highest in North Karelia, Finland, and Pitka;auranta, Russia. The abstinence rates varied from 12 to 35%, being highest in Hungary, Ukraine, and Russia, where the prevalence of smoking is also relatively high. The population impacts varied from 0.02 to 0.5%, being highest in Pitka;auranta, where both the reach and the efficacy of the Quit and Win were relatively high. CONCLUSIONS: There was great variation in effectiveness, with population impact being affected more by participation rate than abstinence rate. Quit and Win contests are feasible interventions in diverse European populations. To improve the effectiveness, future campaigns should increase the reach of the intervention.

Adult↗
PubMed2000

Social networks and cancer screening in four U.S. Hispanic groups.

BACKGROUND: Evidence shows that social relationships play an important role in health and health behavior. We examined the relationship between social networks and cancer screening among four U.S. Hispanic groups. METHODS: We used telephone surveys to collect data in eight U.S. regions that have concentrations of diverse Hispanic-origin populations. We interviewed 8903 Hispanic adults, for a response rate of 83%; analysis was restricted to the 2383 women aged > or =40. As a measure of social integration, we formed a social network index from items on the number of close relatives and friends, frequency of contact, and church membership. We used logistic regression to estimate the effects of social integration on screening, adjusting for sociodemographic factors. RESULTS: Among Mexican, Cuban, and Central-American women, the effect of social integration on mammography screening was slight. The odds ratios (OR) per unit change in social integration category ranged from 1.16 to 1.22 with confidence intervals (CI) that overlapped with the null. For Pap smear screening, the effect was strongest among Mexican-American women (OR=1.44, 95% CI=1.21 to 1.72), but also evident among Central-American women (OR=1.22, 95% CI=0.72 to 2.06) and Cuban women (OR = 1.25, 95% CI = 0.81 to 1.93). Among Puerto Rican women, social integration had no effect on either mammography (OR=1.03) or Pap smear screening (OR=1.08). CONCLUSIONS: Independent of socioeconomic factors, social integration appears to influence cancer screening participation of Hispanic women. The modest effect is not universal across Hispanic groups and was stronger for Pap smear than for mammography screening behavior. Researchers should recognize Hispanic group differences in social network characteristics and the potential of social networks to change screening behavior.

Adult↗
PubMed2000

Outcome evaluation of a multi-component violence-prevention program for middle schools: the Students for Peace project.

This study evaluated the effect of Students for Peace, a multi-component violence-prevention intervention, on reducing aggressive behaviors among students of eight middle schools randomly assigned into intervention or control conditions. The intervention, based on Social Cognitive Theory, included the formation of a School Health Promotion Council, training of peer mediators and peer helpers, training of teachers in conflict resolution, a violence-prevention curriculum, and newsletters for parents. All students were evaluated in the spring of 1994, 1995 and 1996 (approximately 9000 students per evaluation). Sixth graders in 1994 were followed through seventh grade in 1995 or eighth grade in 1996 or both (n = 2246). Cohort and cross-sectional evaluations indicated little to no intervention effect in reducing aggressive behaviors, fights at school, injuries due to fighting, missing classes because of feeling unsafe at school or being threatened to be hurt. For all variables, the strongest predictors of violence in eighth grade were violence in sixth grade and low academic performance. Although ideal and frequently recommended, the holistic approach to prevention in schools in which teachers, administrators and staff model peaceful conflict resolution is difficult to implement, and, in this case, proved ineffective. The Students for Peace experience suggests that interventions begin prior to middle school, explore social environmental intervention strategies, and involve parents and community members.

Adolescent↗
PubMed2000

Breast cancer screening in regional Hispanic populations.

Although Hispanics' use of breast cancer screening services has been investigated, to date there have been no published studies of distinct Hispanic populations in different areas of the country. Using the diverse populations and sites involved in the National Hispanic Leadership Initiative on Cancer 'En Acción', this study examines ethno-regional differences in breast cancer screening rates among these groups and explores the correlates of screening participation. Data collected through telephone surveys were analyzed for women 40 years of age and older (n = 2082). After controlling for demographic variables traditionally related to breast cancer screening rates, it was found that ethno-regional differences in breast cancer screening practices clearly persisted. In addition to traditional demographic factors, other variables evidently underlie differences in Hispanics' utilization of breast cancer screening services. These variables may be cultural and should be investigated in future research. Meanwhile, researchers should not refer to the 'Hispanic' population at large without identifying, addressing and clarifying the ethno-regional characteristics of their samples.

Adult↗
PubMed1999

REACT theory-based intervention to reduce treatment-seeking delay for acute myocardial infarction. Rapid Early Action for Coronary Treatment.

Coronary heart disease (CHD) remains the leading cause of mortality in the U.S. Innovations in reperfusion therapies can potentially reduce CHD morbidity and mortality associated with acute myocardial infarction (AMI) when treatment is initiated within the first few hours of symptom onset. However, delay in seeking treatment for AMI is unacceptably lengthy, resulting in most patients being ineligible for reperfusion therapies. The Rapid Early Action for Coronary Treatment (REACT) Trial is a four-year, 20-community, randomized trial to design and test the effectiveness of a multi-component intervention to reduce patient delay for hospital care-seeking for AMI symptoms. This manuscript describes the development and content of the theoretically-based REACT intervention and summarizes: (1) the research literature used to inform the intervention; (2) the behavioral theories used to guide the development, implementation, and evaluation of the intervention; (3) the formative research undertaken to understand better decision-making processes as well as barriers and facilitators to seeking medical care as perceived by AMI patients, their families, and medical professionals; (4) the intervention design issues that were addressed; (5) the synthesis of data sources in developing the core message content; (6) the conceptualization for determining the intervention target audiences and associated intervention components and strategies, their integration with guiding theoretical approaches and implementation theories for the study, and a description of major intervention materials developed to implement the intervention; and (7) the focus of the outcome, impact, and process measurement based on the intervention components and theories on which they were developed.

Female↗
PubMed1998

Fifteen-year follow-up of smoking prevention effects in the North Karelia youth project.

OBJECTIVES: This study evaluated the long-term effects of a school- and community-based smoking prevention program in Finland. METHODS: Four intervention schools from North Karelia and two control schools from another province were chosen for the evaluation. Students who received the intervention were taught to resist social pressures to smoke. The program began in 1978 with seventh-grade students and ran through 1980, with a 15-year follow-up. In North Karelia, a community-based smoking cessation program for adults was also carried out. RESULTS: Mean lifetime cigarette consumption was 22% lower among program subjects than among control subjects. Smoking and prevalence were lower up to the age of 21. CONCLUSIONS: Long-term smoking prevention effects can be achieved if a school-based program using a social influence model is combined with community and mass media interventions.

Adolescent↗
PubMed1997

Developing a media- and school-based program for substance abuse prevention among Hispanic youth: a case study of Mirame!/Look at me!

Mirame!/Look at Me! is a substance abuse prevention program for low-income Mexican American youth 9 to 13 years of age. The theory-driven curriculum, developed for mass distribution via a satellite television network, features social models who demonstrate cognitive-behavioral skills and display conservative norms regarding substance abuse. An 18-session curriculum contains 5-minute videos that are assigned to be followed by discussion and social reinforcement from a teacher or volunteer. This case study reports the program development process and experiences in the initial dissemination of the program through national networks for schools and cable television subscribers.

Adolescent↗
PubMed1996

Health care in Kazakstan.

Faced with major economic difficulties in the wake of political upheaval, Kazakstan is striving to strengthen its health care system, not only materially but also through the adoption of enlightened approaches by professionals and of beneficial lifestyles by the public at large.

Community Health Services↗
PubMed1995

Violence prevention in middle schools: a pilot evaluation.

PURPOSE: To evaluate the effect of a violence prevention curriculum and of trained peer leaders on self-reported aggressive behaviors, knowledge about violence and conflict-resolution skills, self-efficacy, and attitudes among 223 6th graders. METHODS: The effect of two intervention groups (violence prevention curriculum taught by the teacher with or without the assistance of trained peer leaders) and one control group were compared. Ten 6th grade classes (four control and six intervention classes) of four middle schools participated in the study. Students were evaluated before and shortly after the implementation of the curriculum, as well as 3 months later. RESULTS: The intervention reduced self-reported aggressive behaviors among boys, but this reduction was significant only in two of the six intervention classes. Both interventions had an overall significant effect on increasing knowledge about violence and skills to reduce violence. After the intervention, students also developed a more negative attitude toward responding violently when provoked. Attitude change was stronger among students from the teacher plus peer leader group. No intervention effect was observed on self-efficacy nor on attitudes toward skills to reduce violence. Changes were not maintained over time. CONCLUSIONS: Results emphasize the need for continuous and comprehensive interventions, follow-up evaluations, and careful selection of peer leaders. Aggressive behaviors, not knowledge alone, should be used as the main dependent variable.

Adolescent↗
PubMed1995

Relationship between safe sex and acculturation into the gay subculture.

There is some evidence, although conflicting, to suggest that socialization or acculturation into the gay community is associated with lower levels of unsafe sex. We attempted to determine the relationship between acculturation and sexual safety. We examined data from 282 men (from the Dallas AIDS Community Demonstration Project) who had sex with men and were not in a monogamous relationship to determine the associations between safer sex and indices of acculturation. The indices of acculturation included regular reading of local and national gay newspapers and magazines, and belonging to an organization for gay men. The data indicated that there were significant relationships between acculturation, talking to sexual partners about HIV risk reduction and sexual identity, and the dependent variable of frequency of condom use for anal sex. A regression equation indicated that 21% of the variance of anal condom use was predicted by these variables. These data suggest that acculturation into the gay community is associated with safer sexual behaviour, and we discuss the implications of these data for using role models and normative beliefs in HIV prevention programmes.

Adult↗
PubMed1995

Targeting Hispanic populations: future research and prevention strategies.

Minority populations face a wide variety of economic, institutional, and cultural barriers to health care. These barriers and low levels of education and income pose significant challenges for health professionals in developing cancer research and prevention-control strategies. It is suggested that specific segments of Hispanic populations fit the model of an underdeveloped country in the intermediate stage of epidemiological transition. Since noncommunicable diseases have not yet fully emerged in some of these Hispanic population segments, the opportunity exists to apply primordial prevention strategies. Such campaigns would focus on dissuading members of these populations from adopting negative health behaviors while promoting positive lifestyle choices. Optimal programs would increase cancer screening participation and discourage risk behaviors through community-oriented, population-based interventions. Future directions in prevention and control efforts for minority populations should include expanded health insurance coverage, improved access to health care, greater emphasis on minority recruitment in health care fields, focused epidemiologic and clinical research, and identification and replication of effective components within existing prevention-control programs.

Delivery of Health Care↗
PubMed1995

Community level cancer control in a Texas barrio: Part I--Theoretical basis, implementation, and process evaluation.

A theory-based program that used peer modeling and a network of peer communicators to promote breast and cervical cancer screening was designed and implemented in a barrio of San Antonio with a population of approximately 25,000 adult women. The implementation process was evaluated and documented through field notes, archival documents, content analyses, interviews, surveys, etc. Over a 21-month period, a total of 156 new stories and a network for distribution of more than 80,000 print pieces carried messages about positive role models who were receiving Pap smears and mammograms. A group of 85 volunteers were recruited to promote screening; these volunteers reached 2000-3000 women each month with personal contacts in which cancer screening was encouraged. A small group of volunteers offered particularly intensive assistance to their peers, e.g., helping them to make and keep appointments for screening examinations. The theoretical communication model for the program, which maximizes audience and community participation as sources and channels for messages, was well suited for the cross-cultural application presented here.

Adult↗
PubMed1992

Substance use among Hispanic and non-Hispanic adolescents.

This study compared lifetime prevalence data on substance use with demographic and psychosocial variables among 2,821 Hispanic and non-Hispanic white students from two Southwestern cities. Study findings revealed that ethnic-racial background factors were not the strongest predictors of substance use. Rather, when the analyses accounted for school grades and for maternal education, non-Hispanic youth had higher lifetime substance use rates than Hispanic youth. Study findings suggest that preventive intervention and treatment efforts for substance abuse problems among adolescents should consider sociodemographic risk factors as well as ethnic-racial factors.

Adolescent↗