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Biomedical subjects

C L Perry

Publications and source records attributed to C L Perry.

At least 19 recordsLinked to original sources
PubMed1992

Results from a statewide approach to adolescent tobacco use prevention.

BACKGROUND: The 1985 Minnesota Legislature established guidelines for school-based tobacco-use prevention programming and provided financial incentives to school districts to encourage them to adopt a broad range of preventive measures. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project was funded by the National Cancer Institute in 1986 to evaluate the Minnesota initiative through two parallel studies. METHODS: The Four Group Comparison Study was a prospective study of 48 school "units" which were randomly assigned to one of four conditions in 1987. Baseline observations were taken in the sixth grade in 1987, interventions were delivered in the seventh grade, and follow-up observations were taken in the seventh, eighth, and ninth grades. The Four Group Comparison Study was designed to evaluate the three middle-school interventions that were most widely adopted by Minnesota school districts as a result of the 1985 legislation. The Two State Comparison Study was a serial cross-sectional study of representative districts in Minnesota and Wisconsin. Annual surveys of ninth graders were conducted from 1986-1990. The Two State Comparison Study was designed to determine whether tobacco-use patterns changed in Minnesota relative to Wisconsin following the Minnesota legislation. RESULTS: The prospective study indicated that none of the interventions was more effective in reducing adolescent tobacco use compared with a randomized control group. The serial cross-sectional study revealed that there was a modest net decline in Minnesota relative to Wisconsin from 1986 to 1990, but that it was within the range of chance variation. CONCLUSIONS: Taken together, these results indicate that this legislative initiative was insufficient to reduce adolescent tobacco use statewide during the 5-year study period. Together with results from other recent studies, they suggest that even more intensive efforts may be required to effect widespread reductions in adolescent tobacco use.

Adolescent↗
PubMed1992

Models for effective prevention.

The social influence models do provide some optimism for primary prevention efforts. Prevention programs appear most effective when 1) the target behavior of the intervention has received increasing societal disapproval (such as cigarette smoking), 2) multiple years of behavioral health education are planned, and 3) community-wide involvement or mass media complement a school-based peer-led program (45,46). Short-term programs and those involving alcohol use have had less favorable outcomes. Future research in primary prevention should address concerns of high-risk groups and high-risk countries, such as lower income populations in the United States or countries that have large adolescent homeless populations. The utilization of adolescent leaders for program dissemination might be particularly critical in these settings. A second major and global concern should focus upon alcohol use and alcohol-related problems. In many communities adolescent alcohol use is normative and even adult supported. Thus, young people are getting quite inconsistent messages on alcohol from their schools, from TV, from peers, and from parents. This inconsistency may translate into many tragic and avoidable deaths for young people. Clearly, in the area of alcohol-related problems, community-wide involvement may be necessary. A third direction for prevention research should involve issues of norms, access, and enforcement including policy interventions, such as involve the availability of cigarette vending machines or the ease of under-age buying or levels of taxation. These methods affect adolescents more acutely since their financial resources, for the most part, are more limited. These policy level methods also signify to adolescents what adults consider appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Communitywide smoking prevention: long-term outcomes of the Minnesota Heart Health Program and the Class of 1989 Study.

OBJECTIVES: The Class of 1989 Study is part of the Minnesota Heart Health Program (MHHP), a populationwide research and demonstration project designed to reduce cardiovascular disease in three educated communities from 1980 to 1993. This paper describes an intensive, school-based behavioral intervention on cigarette smoking, comparing long-term outcomes in one of the intervention communities with those in a matched reference community. METHODS: Beginning in sixth grade (1983), seven annual waves of cohort and cross-sectional behavioral measurements were taken from one MHHP intervention community and its matched pair. All students in each community were eligible to participate (baseline n = 2401). Self-reported data collected at each period described prevalence and intensity of cigarette smoking. RESULTS: There were no differences at baseline for either weekly smoking prevalence or intensity of smoking. Throughout the follow-up period, however, smoking rates as determined by these measures were significantly lower in the intervention community: 14.6% of students were weekly smokers at the end of high school compared with 24.1% in the reference community. CONCLUSIONS: These results suggest that multiple intervention components such as behavioral education in schools, booster programs to sustain training, and complementary communitywide strategies may all be needed for lasting reductions in adolescent tobacco use.

Adolescent↗
PubMed1991

The Minnesota Heart Health Program. Education for youth and parents.

Within the Minnesota Heart Health Program, all schools have participated in these programs and most have been incorporated as part of the regular school curriculum. The involvement of parents in youth programs has been challenging, but we view it as essential to making significant changes. Further, a program with appropriate underlying behavioral theory and community involvement can be successful. Such efforts seem critical to primary prevention of cardiovascular disease risk and subsequent disease in a culture where these diseases are common.

Adolescent↗
PubMed1991

Etiology of drinking and driving among adolescents: implications for primary prevention.

A prospective study was conducted to investigate what factors are predictive of self-reported drinking and driving (DD) among adolescents. The study employs a theoretical framework taken from Problem Behavior Theory; environmental, personality, and behavioral factors are explored for their predictability of DD. A cohort of 1482 high school students completed a written survey in spring of 1986 and again in fall of 1986. The findings confirm that Problem Behavior Theory provides a useful theoretical framework with which to identify etiological factors predictive of DD among adolescents. Identified personality, perceived environmental, behavioral, and demographic factors accounted for approximately 50% of the reported variance in DD at baseline. The same factors accounted for approximately 40% percent of the variance in follow-up DD and were predictive both among the students who did not drink and drive at baseline (incidence cases), and among those students who did drink and drive at baseline (continuation versus discontinuation of the behavior). Based on these etiological data, we recommend that school-based, peer-led educational prevention programs be designed to reach young adolescents prior to the age at which a driver's license is obtained. We further recommend that the programs be broad-based and consider DD within the larger context of drinking and driving related behaviors and traffic safety in general.

Adolescent↗
PubMed1991

A cross-cultural pilot study on alcohol education and young people.

Alcohol use has become normative for adolescents in most developed and developing countries, with serious health implications. In response to this problem, the World Health Organization convened a group of investigators in 1985 from centres in four countries--Australia, Chile, Norway and Swaziland--to participate in a pilot study on the efficacy of the social influences approach in school-based alcohol education. The goal of the educational programme was to delay onset and minimize involvement of alcohol use among 13-14 year-old adolescents. 25 schools in the 4 countries, representing middle- and lower-class populations, were randomly assigned to peer-led education, teacher-led education or a control condition. The programme focused on the social and environmental influences to drink alcohol, and skills to resist those influences. It consisted of 5 lessons over 2 months. Baseline and post-test data measured alcohol-use knowledge, attitudes, skills and friends' drinking patterns. Data were collected immediately prior to and 2 months following the educational programme. The data converge on the finding that peer-led education appears to be efficacious in reducing alcohol use across a variety of settings and cultures.

Adolescent↗
PubMed1990

Evaluating the statewide dissemination of smoking prevention curricula: factors in teacher compliance.

As part of a larger study to evaluate the impact of a state-levied tax increase on tobacco products and the allocation of funds for smoking education, 81 schools were assigned randomly to one of four recommended smoking prevention programs for adolescents. The four programs differed in amount of program structure and extent of teacher training required. A one-session observation was made of 106 teachers in the 81 schools to assess the percentage of time allocated to recommended activities--those based on the social influences model. Data suggest an explicit curriculum with designed activities and face-to-face teacher training results in greater compliance to prescribed program components.

Adolescent↗
PubMed1990

United States: perspectives in school health.

An overview is presented of school health programs being conducted in the U.S. as well as the U.S. education system. Major health problems of youth are identified and initiatives to improve the health of school-aged youth are reviewed. With the start of the new decade, it will be important to use and disseminate the findings from ongoing school health programs and research projects, to address the growing social issues for children and adolescents that directly affect their physical health, and to broaden the scope of school health to include issues of psychological or mental health, issues related to social competencies, dysfunctional family lives, or major life events.

Adolescent↗
PubMed1990

School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH).

The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multisite intervention research study that builds on significant progress made in school health education research in the 1980s. The study has three phases: Phase I deals with study design, intervention, and measurement development, Phase II involves the main trial in 96 schools in four states, and Phase III focuses on analysis. The intervention program targets third-fifth grade students and focuses on multiple cardiovascular health behaviors, including eating habits, physical activity, and cigarette smoking. Classroom curricula, school environmental change, and family involvement programs are developed for each grade level and behavioral focus. This paper describes Phase II of CATCH with a rationale for cardiovascular health promotion with youth. The process of change that appears to be necessary for school-based health promotion and that will be tested in CATCH are presented as a framework to guide these efforts.

Adolescent↗
PubMed1990

Parent involvement in cigarette smoking prevention: two pilot evaluations of the "Unpuffables Program".

Efforts to prevent the onset of cigarette smoking with young adolescents have been primarily successful in delaying onset, particularly with classroom curricula that emphasize social competencies. Maintenance of these reductions has been difficult to sustain into later adolescence, suggesting the need for programs to complement and supplement curricula. Since one group of adolescents more difficult to influence are those whose parents smoke, parental involvement in smoking prevention may be a powerful enhancer. This paper describes the "Unpuffables Program," an activity package program around smoking, for preadolescents and their parents. Two pilot evaluation studies in Minnesota and Massachusetts focus on the feasibility of and receptivity to the "Unpuffables Program." High awareness and participation rates were found in both settings. The program appears to provide an opportunity for smoking to be discussed at home, motivating smokers to consider cessation, and reinforcing nonsmoking parents' attitudes and behaviors.

Adult↗
PubMed1989

Parent education in youth-directed nutrition interventions.

Since parents play a pivotal role in helping their children to implement eating pattern changes, interest in parent education in youth-directed nutrition interventions is likely to increase along with heightened interest in primary prevention. Previous experience indicates, however, that it may be difficult to recruit and sustain parent involvement. This article describes an evaluation of the effect on parents of two youth-directed interventions with a parent component, a classroom curriculum called Hearty Heart and Friends and a mailed-home, parent-taught approach called Hearty Heart Home Team. Using incentives, a participation rate of 85.6% was achieved in Hearty Heart Home Team. This parent-taught intervention had significantly greater impact on parent than did the school-only curriculum in the following areas: knowledge about diet and heart disease; attitudes of efficacy, intention, outcome expectation and modeling; and parent-child communication and child involvement in food or nutrition-related issues in the home. In addition, the parent-taught approach influenced foods present in the home as evidenced by Home Team groups having significantly more encouraged foods and more positive choices in six scores on a shelf inventory measure conducted by in-home interviewers.

Child↗
PubMed1989

Synthesis of cardiovascular behavioral research for youth health promotion.

The National Heart, Lung, and Blood Institute (NHLBI) has funded school and family-based research studies for more than a decade. The scientific background for focusing on the major cardiovascular health behaviors with youth is reviewed, as well as the importance of the components in the school health program as a framework for the multiple considerations in school health research. A synthesis of 10 NHLBI funded studies is presented including the sociodemographic characteristics of study populations, study designs, interventions, measures, and results. The studies address single or multiple behaviors, elementary and high school age groups, and multiple ethnic/racial groups, and test various combinations of curriculum, parental involvement, and environmental changes (including school food service).

Adolescent↗
PubMed1989

Parent involvement with children's health promotion: a one-year follow-up of the Minnesota home team.

This study compares the long-term outcomes of a school-based program to an equivalent home-based program with 2250 third-grade students in 31 urban schools in Minnesota and North Dakota in order to detect changes in dietary fat and sodium consumption. The school-based program, The Adventures of Hearty Heart and Friends, involved 15 sessions over five weeks in the third-grade classrooms. The home-based program, the Hearty Heart Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial, and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six percent of the parents participated in the Home Team and 71% (almost 1000 families) completed the five-week course. Students in the home-based program reported more behavior change at posttest, had reduced the total fat, saturated fat, and monounsaturated fat in their diets and increased their complex carbohydrate consumption. The changes derived from the dietary recall data did not maintain after one year. The data converge to suggest the feasibility and importance of parental involvement for initiating health behavior changes with children of this age.

Child↗
PubMed1989

WHO Collaborative Study on Alcohol Education and Young People: outcomes of a four-country pilot study.

In 1985 the Division of Mental Health, World Health Organization, Geneva, convened a group of investigators from centers in four countries--Australia, Chile, Norway, Swaziland--to participate in a pilot study on the efficacy of school-based alcohol education. The goal of the educational program was to delay onset and minimize involvement of alcohol use among 13- to 14-year-old adolescents. Twenty-five schools in the four countries, representing middle- and lower-class populations, were randomly assigned to peer-led education, teacher-led education, or a control condition. The educational program was derived from social-psychological theory and etiological research on adolescent alcohol use. The program focused on the social and environmental influences to drink alcohol and skills to resist those influences. It consisted of five lessons over 2 months. Baseline and posttest data measured alcohol use knowledge, attitudes, skills, and friends' drinking patterns. Data were collected immediately prior to and 2 months following the educational program. The data converge on the finding that peer-led education appears to be efficacious in reducing alcohol use across a variety of settings and cultures.

Adolescent↗
PubMed1989

Prevention of alcohol use and abuse in adolescence: teacher- vs peer-led intervention.

The use of peer leaders as facilitators for smoking and alcohol abuse prevention with adolescents is one component of recently successful programs. Peer leaders are unique in their abilities to influence peer group behavior because they are members of the peer group, are credible role models and disseminators of social information, and utilize the same language as their peers. Peer leaders can be trained to modify environmental, personality, and behavioral factors that are predictive of alcohol use among adolescents, and become a viable alternative to teachers and adult leaders. The WHO Collaborative Study on Alcohol Education and Young People compared a peer-led alcohol educational program to a teacher-led program to no program in 25 schools in Australia, Chile, Norway, and Swaziland. The educational program emphasized refusal skills for alcohol use among 8th and 9th graders in the four countries. The peer-led educational program appears to be efficacious in reducing adolescent involvement with alcohol across a variety of settings, economies, and cultures. Peer leadership may be a particularly promising approach to prevention, theoretically and empirically.

Adolescent↗
PubMed1988

A statewide approach to adolescent tobacco-use prevention: the Minnesota-Wisconsin Adolescent Tobacco-Use Research Project.

Adolescent smoking rates remain high and the use of smokeless tobacco is increasing, especially among males. Despite this continuing public health problem and the recent development of more effective prevention programs, few adolescents now participate in such programs at school. Recent legislation in Minnesota established guidelines for tobacco-use prevention programming and provides financial incentives to school districts to use more effective methods. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project has implemented an evaluation design that will provide data on the efficacy of this statewide approach to the prevention of tobacco use among adolescents. This article describes the current state of tobacco-use prevention programming in Minnesota schools, current efforts to improve on that record, and the research design set up to evaluate these strategies.

Adolescent↗