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Biomedical subjects

B G Simons-Morton

Publications and source records attributed to B G Simons-Morton.

At least 19 recordsLinked to original sources

Persistence of effects of a brief intervention on parental restrictions of teen driving privileges.

OBJECTIVE: The purpose of this study was to determine the extent to which effects of exposure to a brief intervention designed to increase parental restrictions on teen driving privileges persisted over time. DESIGN: A total of 658 parents and their 16 year old adolescents were recruited from a local motor vehicle administration (MVA) site as adolescents successfully tested for provisional licenses. At the MVA, parents completed written surveys about expected teen driving during the first month of provisional licensure. Afterwards, on weeks assigned as intervention, parents watched a video and were given the video and a driving agreement to take home. Both parents and teens completed follow up telephone interviews about communication, amounts, and limits on teen driving at one month (579 dyads), four months (529 dyads), and nine months (528 dyads). RESULTS: The results indicated that both intervention parents and teens were much more likely to report using a driving agreement at each follow up during the nine month period. Significant treatment group differences persisted for communication about driving, but effects related to limits on teen driving that were evident at one month declined over time. Reports for passenger, road, and overall limits remained significant at four months; fewer were present at nine months. There were no differences in amounts of teen driving at four or nine months. CONCLUSIONS: It is possible to reach parents through brief interventions at the MVA and successfully promote increases in initial parental restrictions on teen driving with modest persistence for at least four months.

Accidents, Traffic↗

Promoting parental management of teen driving.

OBJECTIVE: Parenting may be an important protective factor against teen driving risk; however, parents do not limit teen driving as much as might be expected. The Checkpoint Program was designed to promote parental management of teen driving through the use of staged persuasive communications. METHODS: Parent-teen dyads (n = 452) were recruited when teens received learner's permits and interviewed over the telephone at baseline, licensure, and three months post-licensure. After baseline, families were randomized to either the intervention group that received persuasive communications or to the comparison group that received general information about driving safety. RESULTS: Both parents and teens in the intervention group reported significantly greater limits on teen driving at licensure and three months post-licensure. In multivariate analyses, intervention and baseline driving expectations had significant effects on driving limits at licensure. Intervention and driving limits established at licensure were associated with three month driving limits. CONCLUSION: The findings indicate that exposure to the Checkpoints Program increased parental limits on teen driving.

Accidents, Traffic↗

Acceptability of the Checkpoints Parent-Teen Driving Agreement: pilot test.

BACKGROUND: Parent-teen driving agreements are potentially important tools to facilitate parental management of teen driving and reduce adolescent driving risk. The Checkpoints Parent-Teen Driving Agreement (Checkpoints P-TDA) was designed so that parents could initially impose strict limitations on teen driving in high-risk driving conditions (e.g., at night and with teen passengers) and gradually increase driving privileges over time as teens demonstrate responsible driving behavior. METHODS: To assess the acceptability of the format and content of the Checkpoints P-TDA, it was pilot tested with a convenience sample of 47 families recruited as their teens tested for a driver's license at five private driving schools in Connecticut. Family members were interviewed at the driving schools about potential limits on teen driving, asked to use the driving agreement, and re-interviewed within 3 months about acceptability of the driving agreement and initial driving limits placed on teens. RESULTS: Most families (38 of 47) used and liked the agreement. In addition, most parents placed the recommended strict initial limits on teen driving related to driving unsupervised at night, with teen passengers, and on high-speed roads. Moreover, parents reported placing more strict limits on their teens' driving than they originally intended. CONCLUSIONS: The results showed promise for the acceptability of the Checkpoints P-TDA, which will be tested statewide.

Accidents, Traffic↗

Prevalence and predictors of immunization among inner-city infants: a birth cohort study.

CONTEXT: Although the proportion of US children who are appropriately immunized increased dramatically in the past decade, rates remain suboptimal among low-income, inner-city youth. Timely initiation of immunization is an important predictor of immunization status later in childhood; however, prospective studies identifying predictors of initiation are lacking. OBJECTIVES: The objectives of this study were to: 1) describe immunization patterns in a cohort of infants born to predominantly low-income, inner-city mothers; 2) identify determinants, as measured at birth, of immunization status at 3 and 7 months of age; and 3) identify determinants of continuation of immunization among those who initiate immunization by 3 months of age. DESIGN: Prospective, birth cohort study. METHODS: Maternal/infant dyads were systematically selected from 3 District of Columbia hospitals between August 1995 and September 1996. Three hundred sixty-nine mothers were interviewed shortly after delivery, at 3 to 7 months postpartum, and at 7 to 12 months postpartum. Medical records were reviewed at all reported sites of care for 324 (88%) infants. Vaccinations assessed included diphtheria, tetanus, and pertussis; polio; and Haemophilus influenzae type B. Multivariate logistic regression analyses were used to determine factors associated with immunization status of infants at 3 and 7 months of age. RESULTS: At 3 months of age, 75% of infants were up-to-date (UTD) versus only 41% at 7 months. In adjusted analyses, baseline factors associated with being UTD at 3 months included enrollment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during pregnancy, intention to breastfeed, and presence of the infant's grandmother in the household. Infants were less likely to be UTD if their mothers perceived higher barriers to immunization. Baseline factors associated with being UTD at 7 months included lower birth order and maternal employment. Among the subset of infants who were UTD at 3 months, only 53% remained UTD at 7 months. Factors measured at the first follow-up interview that were associated with continuation of immunization at 7 months included maternal employment and lower perceived barriers. CONCLUSIONS: Immunization rates during the first 7 months of life were low in this inner-city population. Factors associated with immunization status that are potentially amenable to change included perceived barriers to immunization and enrollment in WIC during pregnancy.

Adult↗

Student-school bonding and adolescent problem behavior.

Adolescent problem behavior, including substance use, school misconduct and delinquency, is a national concern. Implicit in the concept of middle school is the recognition that students who develop positive social bonds with their school are more likely to perform well academically, and refrain from misconduct and other antisocial behavior. However, little scientific attention has been given to the complex interactions between middle school students and the school environment. Prior to implementing a middle school problem behavior prevention program we conducted a survey in the seven middle schools in one US school district. Out of 4668 grade 6-8 students enrolled, 4263 (91.3%) completed the survey. Student-school bonding was positively correlated with school adjustment (r = 0.49) and perceived school climate (r = 0.77), but inversely correlated with problem behavior (r = -0.39 to -0.43). Problem behavior was significantly higher (P < 0.001) among males than females and among students in higher grades. Conversely, school bonding, climate and adjustment were significantly higher (P < 0.001) among females than males, but declined significantly from one grade to the next. The data support the conclusion that school bonding is associated with problem behavior. We describe the development of a multiple-component intervention in middle schools designed to increase student-school bonding and prevent problem behavior.

Adolescent↗

Health communication in the prevention of alcohol, tobacco, and drug use.

Research on substance abuse prevention programs indicates that effectiveness is greater when multiple intervention approaches that address the specific vocabulary, perceptions, and values of the target population are employed. The field of health communication provides unique perspectives on media that can be applied to increase the salience and effectiveness of substance abuse prevention programs. Well-designed and well-delivered health communications have the capacity for reaching remote audiences, changing health attitudes and behavior, shaping social norms, changing the way health issues are portrayed by the popular media, and influencing decisions about legislation and policies. Health communication approaches are generally employed within the broad context of health promotion programs, along with education, community development, empowerment, and social change approaches. This article describes the role of health communication in substance abuse prevention, reviews major conceptualizations of health communication, and introduces the unique features of the four articles included in this special section of Health Education & Behavior.

Adolescent↗

Physical activity in a multiethnic population of third graders in four states.

OBJECTIVES: This research assessed the amount of daily physical activity in a multiethnic sample of US third-grade students. METHODS: Physical activity interviews were conducted with 2410 third graders from 96 schools in four states. Blood pressure, cholesterol, body mass index, timed run for distance, physical-activity self-efficacy, and perceived support for physical activity were also assessed. RESULTS: Students reported a daily average of 89.9 minutes of moderate to vigorous physical activity, 34.7 minutes of vigorous activity, and 120.4 minutes of sedentary behavior; however, 36.6% obtained less than 60 minutes of moderate to vigorous physical activity daily, and 12.8% reported less than 30 minutes. Boys reported more physical and sedentary activity than girls; White children reported more activity than Black or Hispanic children; California children reported the most activity and Louisiana children the least. Geographic location, male gender, lower cholesterol, higher perceived efficacy in physical activity, and higher social support were associated with more physical activity. CONCLUSIONS: Average reported activity met the Year 2000 objectives; however, many students reported less than recommended amounts of activity. These findings support the need for health promotion programs that increase the number of physically active children.

Analysis of Variance↗

Evaluation of a local designated driver and responsible server program to prevent drinking and driving.

Point of purchase interventions by beverage alcohol servers provide one promising approach to preventing drinking and driving and many communities now support such programs. To evaluate the impact of a designated driver and responsible server program in Houston, we assessed server training courses, observed and interviewed servers and patrons at five establishments participating in the program, and reviewed the distribution of vouchers awarded for a safe ride home by taxi. The training course for alcoholic beverage servers produced significant improvements in the participants' perceptions about their role in preventing drunk driving. In five participating establishments 15.6 percent of servers wore buttons announcing the establishment's participation in the program; immediately after retraining 26.6 percent wore the buttons. Of the eligible patrons in these establishments 6.6 percent actually participated in the designated driver program. The program provided an average of 0.7 safe ride home vouchers per establishment per month. In one additional establishment an experiment was conducted in which servers always announced the designated driver program to patrons, but no increase in the prevalence of designated drivers occurred.

Accidents, Traffic↗

Evaluation of health education programs: current assessment and future directions.

Recently there has been an increase in the different types of strategies used in health education interventions, including an emphasis on broadening programs focused on individual behavior change to include larger units of practice. There has also been an increasing critique of the traditional physical science paradigm for evaluating the multiple dimensions inherent in many interventions. Additionally, there is a growing recognition of the importance of involving multiple stakeholders in designing, implementing, and evaluating interventions. Each of these factors carries specific evaluation challenges. With the overall aim of strengthening the evaluation of health education programs, this article aims to (a) present conceptual and technical design issues and options, (b) describe different approaches to evaluation, (c) highlight evaluation approaches that have been effective, (d) critique the limitations of traditional evaluation approaches, (e) examine promising approaches and implications for future evaluations, and (f) provide recommendations for evaluation designs, data collection methods, roles, responsibilities, and principles for evaluating interventions.

Forecasting↗

Creating capacity: establishing a health education research agenda for special populations.

On Day 2 of the joint CDC/SOPHE conference on Creating Capacity: Establishing a Research Agenda for Health Education, the participants were asked to identify research needs or special issues in working with children and adolescents, the elderly, women, men, and underserved groups. This article presents the priority research areas across subgroups identified by the participants. The cross-group priorities are followed by research recommendations for each subgroup.

Adolescent↗

Adolescent drinking and driving: etiology and interpretation.

In the adolescent population, drinking and driving is an important cause of injury, disability and premature death. A literature review of the demographics and etiology of drinking and drinking/driving reveals: 1) which subgroups of the adolescent population are more likely to drink and drink/drive; 2) where and why adolescents drink and drink/drive; 3) peer and family issues associated with adolescent drinking and drinking/driving; and 4) adolescent expectancies and perceived efficacies associated with drinking and drinking/driving. A discussion of the role of theory and the use of etiologic data in intervention research precedes an overview of several types of school-based alcohol-prevention programs and recommendations for more theory based interventions.

Accidents, Traffic↗

Observed levels of elementary and middle school children's physical activity during physical education classes.

BACKGROUND: The benefits of childhood physical activity include fitness, weight control, and exercise habits that may carry over into adulthood. School physical education is the primary program responsible for training the nation's youth to be physically active and national objectives call for students to be engaged in moderate-to-vigorous physical activity at least 50% of class time. The purpose of this study was to determine through systematic observation in a regional sample of elementary and middle schools the amount of moderate-to-vigorous physical activity students obtain during physical education classes. METHODS: Twenty elementary schools and 7 middle schools were randomly sampled from the 355 elementary schools and 117 middle schools in the 20 school districts in Harris County, Texas. In addition, 9 elementary and 6 middle schools that were identified as having excellent physical education programs were sampled purposively to provide a comparison. Seven systematic observations of student's physical activity were conducted during physical education in each school. RESULTS: The average moderate-to-vigorous physical activity in the randomly selected elementary schools was 8.6%, significantly less (P < 0.05) than for the randomly selected middle schools (16.1%) or for the comparison elementary schools (20.6%) and middle schools (24.0%). CONCLUSIONS: The average amount of physical activity observed in this regional sample of schools was less than the estimated national average of 27% and far less than the national recommendation calling for a minimum of 50%.

Adolescent↗

The physical activity of fifth-grade students during physical education classes.

One hundred fifty-seven fifth-grade students in 20 of the 355 elementary schools in one Texas county were systematically observed during physical education classes. On average, the students spent 8.5% of class time in moderate to vigorous physical activity, 23.3% in minimal activity, and 68.1% in sedentary activity. None of the schools averaged 20% of class time in moderate to vigorous physical activity. The levels of physical activity observed are substantially lower than the levels called for in national health objectives.

Child↗