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Biomedical subjects

Brian R Flay

Publications and source records attributed to Brian R Flay.

At least 19 recordsLinked to original sources
PubMed2006

A national survey of tobacco cessation programs for youths.

OBJECTIVES: We collected data on a national sample of existing community-based tobacco cessation programs for youths to understand their prevalence and overall characteristics. METHODS: We employed a 2-stage sampling design with US counties as the first-stage probability sampling units. We then used snowball sampling in selected counties to identify administrators of tobacco cessation programs for youths. We collected data on cessation programs when programs were identified. RESULTS: We profiled 591 programs in 408 counties. Programs were more numerous in urban counties; fewer programs were found in low-income counties. State-level measures of smoking prevalence and tobacco control expenditures were not associated with program availability. Most programs were multisession, school-based group programs serving 50 or fewer youths per year. Program content included cognitive-behavioral components found in adult programs along with content specific to adolescence. The median annual budget was 2000 dollars. Few programs (9%) reported only mandatory enrollment, 35% reported mixed mandatory and voluntary enrollment, and 56% reported only voluntary enrollment. CONCLUSIONS: There is considerable homogeneity among community-based tobacco cessation programs for youths. Programs are least prevalent in the types of communities for which national data show increases in youths' smoking prevalence.

Adolescent↗
PubMed2006

Predictive validity of four nicotine dependence measures in a college sample.

BACKGROUND: The present study compared the predictive and incremental validity of four commonly used dependence measures (Diagnostic and Statistical Manual-IV [DSM-IV] nicotine dependence criteria, Fagerstrom Test for Nicotine Dependence [FTND], Hooked On Nicotine Checklist [HONC], Nicotine Dependence Syndrome Scale [NDSS]) in a first year college sample reporting light smoking patterns. METHODS: Nicotine dependence measures were administered at the end of the first semester and follow-up smoking behavior (i.e. continued smoking, quantity, frequency, and length of abstinence) was assessed at the end of the first and second academic years. RESULTS: Higher levels of dependence as measured by the HONC and DSM-IV predicted smoking behavior at both follow-up assessments. While higher scores on some of the NDSS factors predicted heavier smoking behavior during follow-up assessments, higher scores on other NDSS factors predicted lighter smoking behavior. The DSM-IV, NDSS-priority, and HONC measures provided some evidence for incremental validity. Higher dependence scores on all four measures were related to shorter lengths of smoking abstinence. CONCLUSIONS: The four dependence measures were differentially related to smoking behavior outcomes in a light smoking sample. These findings suggest that nicotine dependence can predict a variety of smoking behaviors in light smokers.

Adult↗
PubMed2006

The natural history of college smoking: trajectories of daily smoking during the freshman year.

Although the initiation of cigarette use typically occurs prior to age 18, there is evidence for considerable change in smoking behavior after this age. College may be a particularly important period to study smoking because it is a time when adolescents transition into a new social context where substance use is normative. Using a longitudinal design, daily assessments of smoking were collected during the entire first year of college for a large cohort of freshman (N=496). Findings suggested a weekly cycle of smoking such that the probability of smoking was much higher on weekends (Friday and Saturday) than on remaining days of the week. In addition to this weekly cycle, there was an overall trend for smoking to decline over the course of the year. Substantial individual variability in levels of smoking was observed. These findings provide new insights into college smoking, and have implications for assessment, policy, intervention, and future directions for research.

Adolescent↗
PubMed2006

Recruitment and retention of adolescents in a smoking trajectory study: who participates and lessons learned.

Recruitment of adolescents into tobacco use research is often challenging. This study reports on the predictors of recruitment and retention in a longitudinal study of adolescent smoking behavior. In 2000, 8th and 10th grade students at 18 schools (N = 5,298) in the Chicago metropolitan area completed brief screening surveys; 1457 students (ranging from susceptible nonsmokers to regular smokers) were invited to participate in a longitudinal study, and 48.9% agreed. Chi-square analyses revealed that female and white students were more likely to participate than male and nonwhite students. Recruitment rates did not vary by parental smoking status, students' experience with smoking, or student grade. Multivariate analyses revealed that overall, gender and race were significant predictors of participation. Chi-square and multivariate analyses revealed no significant differences in retention on the demographic, smoking experience, or psychosocial variables measured. Implications of the results and study limitations are discussed.

Adolescent↗
PubMed2006

The time-varying influences of peer and family support on adolescent daily positive and negative affect.

The time-varying influences of peer and family support on adolescent daily mood were explored among youth transitioning from middle school to high school (8th to 9th grade, N = 268) as compared to youth transitioning from 10th to 11th grade (N = 240). Real-time measures of daily positive and negative affect (ecological momentary assessments) were collected via palmtop computers at baseline, 6 months, and 12 months. Participants rated 12 mood adjectives in response to 5 to 7 random prompts per day for 7 consecutive days. Perceived peer and family support were assessed via self-report. Mixed-effects regression analyses revealed significant grade by time by peer support interactions for positive and negative mood, with the younger cohort showing greater increases in the relation between peer support and affect over time than the older cohort. Family support did not interact with cohort or time.

Adolescent↗
PubMed2005

Community and school drug prevention strategy prevalence: differential effects by setting and substance.

This study used key informant interviews and student survey data in 508 U.S. communities to examine relationships between the prevalence of community and non-classroom-based school substance prevention strategies and teen substance use rates. After controlling for covariates, analyses indicated that: (1) adult-supervised after-school activities were significantly related to lower past 30-day cigarette smoking and both past 30-day alcohol use and binge drinking; (2) unsupervised after-school recreational facilities were significantly associated with both lower past 30-day cigarette smoking and current daily smoking; (3) community activities to reduce substance use were significantly related to lower binge drinking; and (4) student organizations to prevent alcohol abuse were significantly related to lower binge drinking. Communities need a broad spectrum of strategies to address variation in substance use among youth. EDITORS' STRATEGIC IMPLICATIONS: Policymakers at the school, community, state, and federal levels will benefit from knowing that after-school activities for teens typically result in reliable (though often modest) reductions in substance use in this large national sample. This is a strategy that works, but the effects are likely to vary by setting, level of supervision, substance, and program implementation.

Adolescent↗
PubMed2005

Standards of evidence: criteria for efficacy, effectiveness and dissemination.

Ever increasing demands for accountability, together with the proliferation of lists of evidence-based prevention programs and policies, led the Society for Prevention Research to charge a committee with establishing standards for identifying effective prevention programs and policies. Recognizing that interventions that are effective and ready for dissemination are a subset of effective programs and policies, and that effective programs and policies are a subset of efficacious interventions, SPR's Standards Committee developed overlapping sets of standards. We designed these Standards to assist practitioners, policy makers, and administrators to determine which interventions are efficacious, which are effective, and which are ready for dissemination. Under these Standards, an efficacious intervention will have been tested in at least two rigorous trials that (1) involved defined samples from defined populations, (2) used psychometrically sound measures and data collection procedures; (3) analyzed their data with rigorous statistical approaches; (4) showed consistent positive effects (without serious iatrogenic effects); and (5) reported at least one significant long-term follow-up. An effective intervention under these Standards will not only meet all standards for efficacious interventions, but also will have (1) manuals, appropriate training, and technical support available to allow third parties to adopt and implement the intervention; (2) been evaluated under real-world conditions in studies that included sound measurement of the level of implementation and engagement of the target audience (in both the intervention and control conditions); (3) indicated the practical importance of intervention outcome effects; and (4) clearly demonstrated to whom intervention findings can be generalized. An intervention recognized as ready for broad dissemination under these Standards will not only meet all standards for efficacious and effective interventions, but will also provide (1) evidence of the ability to "go to scale"; (2) clear cost information; and (3) monitoring and evaluation tools so that adopting agencies can monitor or evaluate how well the intervention works in their settings. Finally, the Standards Committee identified possible standards desirable for current and future areas of prevention science as the field develops. If successful, these Standards will inform efforts in the field to find prevention programs and policies that are of proven efficacy, effectiveness, or readiness for adoption and will guide prevention scientists as they seek to discover, research, and bring to the field new prevention programs and policies.

Clinical Trials as Topic↗
PubMed2005

Adolescents' smoking expectancies: psychometric properties and prediction of behavior change.

Outcome expectancies have been related to smoking behavior among adults, but less attention has been given to expectancies about smoking among adolescents at differing levels of smoking experience. The present study reports the psychometric properties and predictive validity of a brief expectancy scale across two samples of adolescents. Sample 1 (N = 349) consisted of high school students (54% female) who were regular smokers enrolled in a cessation program. Sample 2 (N = 273) consisted of 8th- and 10th-grade early experimenters (54% female) involved in a natural history study of smoking trajectories. In both samples, a principal component analysis of a 13-item expectancy scale yielded four factors (taste, weight control, boredom relief, and negative affect management), each with high internal consistency (coefficient alphas >.77) and accounting for 73% and 80% of the total variance for each sample, respectively. Expectancies were significantly higher among current smokers than among early initiators. In Sample 1, boredom relief and weight management expectancies predicted smoking status 6 months later. In Sample 2, students whose smoking increased over 18 months had higher overall expectancies at baseline compared with those who tried smoking and did not escalate. These findings support the predictive validity of expectancies in predicting escalation and cessation. Implications for the importance of expectancies in understanding adolescent smoking behavior are considered.

Adolescent↗
PubMed2005

Evaluation of the effects of the Aban Aya Youth Project in reducing violence among African American adolescent males using latent class growth mixture modeling techniques.

This study employs growth mixture modeling techniques to evaluate the preventive effects of the Aban Aya Youth Project in reducing the rate of growth of violence among African American adolescent males (N = 552). Results suggest three distinct classes of participants: high risk (34%), medium risk (54%), and low risk (12%) based on both the participants' initial violence scores and their growth of violence over time. Results further show significant effects (almost 3 times as large as the effect found in the regular one-class analysis) for the high-risk class but not for the medium- or low-risk classes.

Adolescent↗
PubMed2004

Effects of 2 prevention programs on high-risk behaviors among African American youth: a randomized trial.

OBJECTIVE: To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth. DESIGN: Cluster randomized trial. SETTING: Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998. PARTICIPANTS: Students in grades 5 through 8 and their parents and teachers. INTERVENTIONS: The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care. MAIN OUTCOME MEASURES: Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use). RESULTS: For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls. CONCLUSIONS: Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research.

Adolescent↗
PubMed2004

The healthy pursuit of self-esteem: comment on and alternative to the Crocker and Park (2004) formulation.

J. Crocker and L. E. Park (2004) proposed both (a) that the importance of self-esteem lies more in how people strive for it rather than whether it is high or low and (b) that the benefits of pursuing self-esteem are of a limited, short-term nature and are outweighed by the significant costs that entail for functioning in multiple areas. The authors review research that raises questions about the validity of each of these assumptions. They conclude that findings are more consistent with a view in which (a) high self-esteem, or at least the avoidance of low self-esteem, is an important factor contributing to overall health and well-being and (b) the pursuit of self-esteem, when directed toward adaptive ends, can be instrumental in promoting long-term outcomes that are of value to both individuals and society. They also describe an integrative theoretical framework that encompasses both of these possibilities.

Adaptation, Psychological↗
PubMed2004

Squeezing interval change from ordinal panel data: latent growth curves with ordinal outcomes.

A didactic on latent growth curve modeling for ordinal outcomes is presented. The conceptual aspects of modeling growth with ordinal variables and the notion of threshold invariance are illustrated graphically using a hypothetical example. The ordinal growth model is described in terms of 3 nested models: (a) multivariate normality of the underlying continuous latent variables (yt) and its relationship with the observed ordinal response pattern (Yt), (b) threshold invariance over time, and (c) growth model for the continuous latent variable on a common scale. Algebraic implications of the model restrictions are derived, and practical aspects of fitting ordinal growth models are discussed with the help of an empirical example and Mx script (M. C. Neale, S. M. Boker, G. Xie, & H. H. Maes, 1999). The necessary conditions for the identification of growth models with ordinal data and the methodological implications of the model of threshold invariance are discussed.

Adolescent↗
PubMed2004

Identifying and predicting adolescent smokers' developmental trajectories.

Very few studies have defined trajectories of smoking. In the present study, we modeled growth in adolescent smoking and empirically identified prototypical trajectories. We conceptualized escalation of smoking as a growth process and modeled rates of change and heterogeneity of these patterns using latent growth mixture modeling. The analysis identified six trajectories with low ambiguity about group membership (early rapid escalators, late rapid escalators, late moderate escalators, late slow escalators-smokers, stable puffers, and late slow escalators-puffers). A trajectory of quitters was not identified. We also examined predictors of the smoking trajectories. The predictors were assessed across the adolescent years and included variables related to smoking and other substance use, as well as a range of variables related to sociodemographic factors and mental health. Observed change in the pattern of predictors across age has implications for the mechanism of effect of these variables in relation to smoking trajectories, including predictors that differentiated among daily smokers, variables that may determine the trajectory (e.g., friends smoking), and variables that may result from the trajectory (e.g., marijuana use, less attachment to friends).

Adolescent↗
PubMed2004

The role of smoking intentions in predicting future smoking among youth: findings from Monitoring the Future data.

AIMS: To demonstrate that intentions predict long-term future levels of smoking, irrespective of level of past smoking experience. A growing body of research suggests that intentions about future smoking might play an important role in addition to the influence of past smoking experience on the likelihood of smoking in future. DESIGN: Using logistic regression analyses, we assessed the relationship between baseline smoking experience and a firm intention 'not to be smoking cigarettes 5 years from now' with four outcome measures of smoking at follow-up: 30-day smoking at a 3/4- and 5/6-year follow-up and current established smoking (self-described regular smokers or former smokers who had smoked in the past 30 days) at a 3/4- and 5/6-year follow-up. PARTICIPANTS: US nationally representative samples of 12th graders who responded to the Monitoring the Future (MTF) survey from the years 1976 to 1993, inclusive. For these panels, we linked stage of smoking and intentions at 12th grade to follow-up measures of smoking collected at 3/4 years after baseline and 5/6 years after baseline. FINDINGS: Analysis of 3/4-year follow-up data (weighted n = 4544) and 5/6-year follow-up data (weighted n = 3885) for both definitions of smoking outcome indicated that there was a dose-response relationship between levels of baseline smoking experience and the likelihood of future smoking. In addition, independent of baseline smoking experience, there was a statistically significant protective effect for a firm intention not to smoke in five year's time on future smoking behavior. CONCLUSIONS: The findings suggest that evaluative studies of tobacco control policies and programs might usefully employ smoking uptake categories that incorporate smoking intentions as early indicators of outcome.

Adolescent↗
PubMed2004

Violence prevention among African American adolescent males.

OBJECTIVE: To test psychosocial mediators of the effects of an intervention in reducing the rate of growth of violence among adolescents. METHOD: Five hundred and seventy-one African American adolescent males participated in this randomized trial. Multilevel modeling techniques were used to ascertain both intervention and mediated effects. RESULTS: Intervention significantly reduced rate of growth of violence and 5 social and psychological factors in the treatment group relative to the control group. Four of these social and psychological factors were found to be complete mediators between the intervention and its preventive effects. CONCLUSION: Changing psychological mediating variables is central to reducing youth violence.

Adolescent↗
PubMed2003

Long-term effects of the Positive Action program.

OBJECTIVE: To report long-term effectiveness of the Positive Action program. METHODS: Used matched-schools design and school-level achievement and disciplinary data to evaluate program effects on student performance and behavior in elementary schools. RESULTS: Participation in the Positive Action program improved student behavior, school involvement, and academic achievement at all 3 levels of schools, with the results showing a clear dose-response relationship. CONCLUSION: Results provide clear evidence that a coherent, comprehensive, and integrated program can have enduring effects in multiple domains.

Adolescent↗
PubMed2002

A finite mixture model of growth trajectories of adolescent alcohol use: predictors and consequences.

The current study sought to identify classes of growth trajectories of adolescent alcohol use and to examine the predictors and outcomes associated with the classes. Alcohol use was assessed from Grades 7 to 12 in a school-based sample. Latent growth mixture modeling was used, and results indicated 5 discrete longitudinal drinking patterns. The 2 most common drinking patterns included occasional very light drinking from Grades 7 to 12 and moderate escalation in both quantity and frequency of alcohol use. One group drank infrequently but at high levels throughout the study period. Another group exhibited rapid escalation in both quantity and frequency. The final group started at high levels of frequency and quantity in Grade 7 and showed rapid de-escalation in frequency. Emotional distress and risk taking distinguished the classes, and all classes, particularly rapid escalators, showed elevated levels of alcohol-related problems relative to occasional very light drinkers.

Adolescent↗