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Biomedical subjects

A T Butchart

Publications and source records attributed to A T Butchart.

11 recordsLinked to original sources
PubMed1993

Assessment of adolescent refusal skills in an alcohol misuse prevention study.

Although many substance abuse prevention programs seek to enhance the ability of adolescents to refuse offers of alcohol and other drugs, few report assessments of refusal skill ability or its relationship to substance use. This report describes a procedure to assess the ability of adolescents to refuse the offer of a beer, and presents the findings of those assessments as well as their relationships to alcohol misuse prevention knowledge, susceptibility to peer pressure, internal health locus of control, self-esteem, and alcohol use and misuse. A one-third random sample (n = 1012) of 10th graders participating in a longitudinal evaluation of an alcohol misuse prevention curriculum was assessed individually. Students rated their own refusals, which were also rated by trained female and male raters. The results indicated that adolescents refuse the offer of a beer only somewhat convincingly. Those adolescents with better refusal skills had higher levels of alcohol misuse prevention knowledge, especially regarding resisting pressures to use alcohol and the application of knowledge of typical alcohol-related situations. They also reported less susceptibility to peer pressure, greater internal health locus of control and self-esteem, and less alcohol use and misuse. The results provide support for teaching refusal skills in substance abuse prevention programs and for assessing refusal skills in the evaluation of such programs.

Adolescent↗
PubMed1993

Structural equation model tests of patterns of family interaction, peer alcohol use, and intrapersonal predictors of adolescent alcohol use and misuse.

A survey of 1,340 students in grades six through twelve was conducted to test, in the context of structural equation models, the predictive validity of a theoretical model of antecedents of adolescent alcohol use and misuse. Constructs including parents' alcohol use, older siblings alcohol use, parents' approval of students alcohol use, older sibling approval of students alcohol use, peer use and approval of alcohol use (PUA), parental nurturance, parental permissiveness, child's grade in school, susceptibility to peer pressure (SPP), and deviant self-image, were included. The final iterations of the models accounted for more than half of the variance in both alcohol use and alcohol misuse. In a standardized solution, the two largest direct effects on both adolescent alcohol use and misuse were from SPP and PUA. When a seven item measure of SPP, including three items specific to alcohol use was used, the SPP latent variable accounted for a somewhat greater percentage of the variance in adolescent alcohol use and misuse than did the latent variable of PUA. When the three alcohol-specific items were deleted from SPP, however, PUA accounted for more variance than SPP. Other predictors, including parental behaviors, proved to be significant when their indirect effects were evaluated. Models predicting alcohol use and alcohol misuse were similar. SPP, PUA, and other significant predictors should be included in future models predicting adolescent alcohol use and misuse, as well as in future interventions targeting these behaviors. Longitudinal studies should be used to test these findings. Evaluation of prevention should include examination of possible interactions of these predictors with each other and with subject subgroup classifications.

Adolescent↗
PubMed1992

An elementary school-based alcohol misuse prevention program: a follow-up evaluation.

An alcohol misuse prevention study (AMPS) curriculum for fifth- and sixth-grade students was developed, implemented and evaluated with over 5,000 students. The AMPS program emphasized social pressures resistance training, focusing on the immediate effects of alcohol, risks of alcohol misuse and social pressures to misuse alcohol. Schools were randomly assigned to curriculum, curriculum plus booster or control groups with half of each group pretested and all posttested. Measures focused on susceptibility to peer pressure, internal health locus of control, understanding of the curriculum material, alcohol use and alcohol misuse. After 26 months, there was a significant treatment by occasion interaction on internal health locus of control (sixth grade). A significant treatment by occasion interaction effect was also found with respect to curriculum measures in both grades. There was no significant treatment by occasion interactions with respect to alcohol use or misuse when the groups as a whole were considered. When subgroup analyses based on type of prior drinking experience were conducted, however, significant program effects on alcohol misuse were found among sixth-grade students who had experienced unsupervised as well as supervised drinking prior to the prevention program.

Alcohol Drinking↗
PubMed1989

Differential effectiveness of an elementary school-based alcohol misuse prevention program.

An elementary school social skills/peer pressure resistance curriculum for the prevention of alcohol misuse was developed, implemented, and evaluated. Schools were randomly assigned to curriculum and control groups, with half of each group pretested prior to intervention and all students posttested two months, 14 months, and 26 months following intervention. Students in grade five at the beginning of the study were randomly assigned to treatment, treatment plus booster, and control conditions. Students in grade six were randomly assigned to treatment and control conditions. Three way repeated measures analyses of covariance (treatment condition by type of prior drinking experience by occasion) were conducted for each grade level on indices of "frequency/quantity of alcohol use" and "total alcohol misuse." Results indicated the intervention was effective in reducing the rate of increase of alcohol use and misuse among grade six students who entered the study with prior unsupervised as well as supervised alcohol use. After corrections for intraclass correlations on the dependent variables, the significant finding regarding the alcohol misuse variable was maintained.

Alcoholism↗
PubMed1989

Pretest and treatment effects in an elementary school-based alcohol misuse prevention program.

Forty-nine schools (N = 5,680 fifth and sixth grade students) were assigned to pretest/treatment, pretest/no treatment, no pretest/treatment, and no pretest/no treatment conditions in the context of an alcohol misuse prevention study. At the first posttest, five months after the pretest and two months after the intervention, the effects of the pretest and of the intervention were examined. The analyses showed that failure to correct for the design effect due to clustering within schools resulted in the overestimation of the significance of treatment and pretest effects. After correction for the design effect, a significant treatment effect in the hypothesized direction was found with respect to students' awareness of the content of the curriculum. As hypothesized, significant treatment effects on the alcohol use and misuse measures had not yet developed but are expected to occur at subsequent posttest occasions. Significant pretest effects were found for indices measuring trouble with peers resulting from students' alcohol use, students' internal health locus of control, and their perceptions of adults as a locus of control for their health. Two of the three pretest effects were in the direction that would be hypothesized if the pretest were providing the same impetus as the intervention. Implications of these findings for school-based substance abuse prevention programs are discussed.

Child↗
PubMed1989

A covariance structure model test of antecedents of adolescent alcohol misuse and a prevention effort.

As part of an alcohol misuse prevention evaluation, questionnaires were administered to 4,157 junior high school students to determine levels of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem. A conceptual model of the antecedents of adolescent alcohol misuse and the effectiveness of a prevention effort was tested using covariance structure modeling techniques. The factor loadings for the model were all moderate to high, indicating that the observed variables served well as measurement instruments for the latent variables. The hypothesized structural relationships among the latent variables of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem were supported by the data. The full model explained 45 percent of the variance in alcohol misuse in the analysis based on the total sample. The direct effect of the intervention on alcohol misuse was small but significant in the hypothesized direction. The direct effects of the intervention on susceptibility to peer pressure and internal health locus of control were not significant. The model was tested separately for groups of students who had high versus low scores on susceptibility to peer pressure in order to test the interaction between susceptibility to peer pressure and exposure to peer use and misuse of alcohol. The percentage of variance accounted for in alcohol misuse did not increase upon testing the model separately for students who had high versus low scores on susceptibility to peer pressure. Observed differences in the significance of the parameter estimates between the high and low susceptibility to peer pressure groups suggest that different approaches to the design and evaluation of substance abuse prevention programs may be necessary for different subgroups of students.

Alcoholism↗
PubMed1987

Susceptibility to peer pressure, self-esteem, and health locus of control as correlates of adolescent substance abuse.

As part of a school-based alcohol misuse prevention study, questionnaires were administered to 2,589 fifth and sixth grade students to determine levels of use of alcohol, marijuana, and cigarettes, intentions to use these substances, and problems resulting from alcohol misuse. The questionnaire also included 45 items concerning susceptibility to peer pressure, self-esteem, and health locus of control. These 45 items were factor analyzed separately for two groups formed by random assignment. Six factors were identified which were both internally consistent and replicable, and indices were constructed. The indices measuring susceptibility to peer pressure, self-esteem, and internal health locus of control were significantly and negatively correlated with most of the substance use, misuse, and intention items, and an external health locus of control index was not significantly related to most of the substance use, misuse, and intention items. The "Susceptibility to Peer Pressure" index correlated more highly with the adolescent substance use, misuse, and intention items than the self-esteem or the health locus of control indices, and it had the highest alpha coefficient. Implications for the design of school-based substance abuse prevention programs are discussed.

Adolescent↗
PubMed1987

Elementary school-based prevention of adolescent alcohol misuse.

The literature on the prevention of alcohol misuse and other substance abuse shows that most prevention program efforts to date have not been successful. Some possible reasons for this lack of success are discussed, and a recent, promising approach to the problem is outlined. An example of that approach, the Alcohol Misuse Prevention Study (AMPS), is described and early findings are presented. Conceptual and methodological issues considered in the design, implementation and evaluation of AMPS are discussed as examples of the planning which must go into a well-designed alcohol misuse prevention program. Issues now being raised in the evaluation of AMPS are presented with their implications for future prevention programs.

Alcoholism↗
PubMedDate not supplied

Psychometric properties of component and global measures of structured interview assessed type A behavior in a population sample.

Structured interview (SI) assessments of global and component Type A behavior were conducted in a general population sample of 903 respondents. Correlations among all the measures were positive and significant. A factor analysis revealed that the common component variance was explained by a single underlying factor. Interrater reliabilities were approximately 0.5 to 0.7 for the individual components and 0.8 for both the SI global Type A and a second global measure that was assigned independently by assessors who did the component scoring. Prediction of the SI-assessed global measure from the components accounted for 56% of the variance, and prediction of the second global measure from the components accounted for about 83% of the variance. Implications of the psychometric properties of the SI component and global measures of Type A behavior for future research are discussed.

Humans↗
PubMedDate not supplied

Environmental correlates of adolescent substance use and misuse: implications for prevention programs.

The research in the areas of peer, family and community environmental effects on adolescent substance use and misuse clearly and consistently shows that peer substance use behavior is the primary predictor of adolescent alcohol use. Peer norms, however, are more important in the prediction of adolescent alcohol misuse. Parental norms and monitoring are secondary to the peer variables, but still of significance in the prediction of adolescent alcohol use and misuse. The intrapersonal construct of susceptibility to peer pressure is as important as the peer and parent variables in the prediction of both alcohol use and misuse in adolescence.

Adolescent↗