Biomedical subjects

C W Dent

Publications and source records attributed to C W Dent.

At least 19 recordsLinked to original sources

PubMed2001

Cost-effectiveness of a school-based tobacco-use prevention program.

OBJECTIVE: To determine the cost-effectiveness of a school-based tobacco-use prevention program. DESIGN: Using data from the previously reported 2-year efficacy study of the Project Toward No Tobacco Use (TNT), we conducted a decision analysis to determine the cost-effectiveness of TNT. The benefits measured were life years (LYs) saved, quality-adjusted life years (QALYs) saved, and medical care costs saved, discounted at 3%. The costs measured were program costs. We quantified TNT's cost-effectiveness as cost per LY saved and cost per QALY saved. INTERVENTION: A 10-lesson curriculum designed to counteract social influences and misconceptions that lead to tobacco use was delivered by trained health educators to a cohort of 1234 seventh-grade students in 8 junior high schools. A 2-lesson booster session was delivered to the eighth-grade students in the second year. The efficacy evaluation was based on 770 ninth-grade students who participated in the program in the seventh and eighth grades and in both the baseline and the 2-year follow-up survey. RESULTS: Under base case assumptions, at an intervention cost of $16 403, TNT prevented an estimated 34.9 students from becoming established smokers. As a result, we could expect a saving of $13 316 per LY saved and a saving of $8482 per QALY saved. Results showed TNT to be cost saving over a reasonable range of model parameter estimates. CONCLUSIONS: The TNT is highly cost-effective compared with other widely accepted prevention interventions. School-based prevention programs of this type warrant careful consideration by policy makers and program planners.

Adolescent↗

PubMed2001

Project Towards No Drug Abuse: generalizability to a general high school sample.

OBJECTIVE: We examined the generalizability of a successful classroom-based prevention program developed for youth at alternative high schools (high risk) to youth at general high schools. METHOD: A replication of a previously tested prevention program in a general high school population was conducted with 1-year follow-up data. Classrooms within each of three schools were randomly assigned to two conditions, classroom education or standard care control. RESULTS: Statistically significant effects on alcohol and illicit drug use were achieved in this population through a 1-year period following the program, although effects were not achieved on cigarette smoking and marijuana use. CONCLUSIONS: These results suggest that this program (Project Towards No Drug Abuse) has applicability to a wide range of older teens.

Adolescent↗

PubMed2001

Self-reported high-risk locations of drug use among drug offenders.

The present study provides a detailed, multiple-choice, self-report analysis of home, work, and other public locations where drug offenders report using drugs. In addition, these settings were examined as a function of gender, ethnicity, type of drug used, and drug abuse/dependence status. The participants for the present study were 462 individuals attending drug diversion programs in southern California. The single most frequently reported location of use was the subjects' living room with a small group of friends. However, heavier users used different drugs across a greater variety of locations. Not surprisingly, drugs were used least at work (though a surprising 47% had used at work). Popular situations of drug use among drug offenders are similar to that of high-risk youth.

Adult↗

PubMed2000

The one-year prospective prediction of substance abuse and dependence among high-risk adolescents.

The present study examined 1-year prospective predictors of self-reported substance abuse and dependence among a sample of 702 youths at high risk for drug abuse from 21 southern California continuation high schools. Triadic influence theory was used as a theoretical guide. Predictors were selected as measures of triadic influence theory. Among 13 predictors, a drug use and intention index, and concern that one is or will become an addict or alcoholic, were consistently predictive of self-reported substance abuse or substance dependence 1 year later, controlling for baseline abuse or dependence status. In addition, baseline substance abuse, White ethnicity, and relatively poor prosocial coping predicted later substance dependence. Apparently, adolescents can predict their future use, and abuse or dependence status. Also, instruction in prosocial coping (e.g., seeking social support) may help inhibit the transition from substance abuse to substance dependence.

Adaptation, Psychological↗

PubMed2000

Ethnic differences in adolescent smoking prevalence in California: are multi-ethnic youth at higher risk?

OBJECTIVE: Although ethnic differences in adolescent smoking have been well documented, smoking among multi-ethnic adolescents has received little research attention. This study examined smoking prevalence and tobacco related psychosocial risk factors among multi-ethnic adolescents in California, as compared with white, African American, Asian American, and Hispanic adolescents. DESIGN: This study used a cross sectional design. Data were obtained from the independent evaluation of the California Tobacco Control, Prevention, and Education Program. SETTING: Students completed a paper-and-pencil survey in their classrooms. SUBJECTS: Data were collected from a stratified random sample of 5072 eighth grade students (age 13-14 years) in California during the 1996-97 school year. The data were weighted by school enrollment in analyses to make the estimates representative of the population of California students attending public schools. MAIN OUTCOME MEASURES: Outcome variables included self reported smoking prevalence, susceptibility to smoking, access to tobacco, and related attitudes, beliefs, and behaviours. Ethnicity was assessed with a self reported, "check all that apply" question. RESULTS: Results indicated that multi-ethnic adolescents were at higher risk than single-ethnic adolescents on several variables, including 30 day cigarette smoking prevalence, lifetime smokeless tobacco use, buying cigarettes, receiving cigarette offers, and expected friends' reaction if the respondent smoked. For several other variables (lifetime cigarette smoking prevalence, susceptibility to smoking, and number of friends who smoked), Hispanic adolescents were at higher risk than all other ethnic groups including multi-ethnic adolescents. Although susceptibility to smoking was highest among Hispanics, multi-ethnic adolescents scored significantly higher on susceptibility than the three other single-ethnic groups. CONCLUSIONS: Multi-ethnic adolescents may be at increased risk for smoking and may have easier access to cigarettes. Culturally targeted smoking prevention interventions for adolescents should address the unique social challenges faced by multi-ethnic adolescents that may increase their risk for smoking.

Adolescent↗

PubMed2000

One-year prospective prediction of drug use from stress-related variables.

Six stress-related variables, gender, age, and ethnicity were investigated as concurrent and prospective predictors of three types of drug use (cigarettes, alcohol, and illicit drug use) among 875 "high risk" adolescents. The stress-related variables were socioeconomic status, "missing" one's parent(s), family conflict, victimization, perceived stress, and stress-drug beliefs. In general, concurrent regression models indicated that those who were lower in socioeconomic status, held stress-drug beliefs favorable toward drug use, and who had been victimized in the last year were more likely to be cigarette, alcohol, or illicit drug users. Prospective regression models indicated that those who had used drugs at baseline and had been victimized in the last year were relatively likely to use drugs the next year. Significant predictors in the multivariable models accounted for between 56 and 85% of those subjects who were above the median on later drug use. Victimization is apparently a relatively important source of stress in the prediction of future drug use. Drug-use intervention implications of these results include the need to provide supportive services to those who have been victims of violent attacks on their person or property.

Adaptation, Psychological↗

PubMed2000

Group self-identification as a prospective predictor of drug use and violence in high-risk youth.

This study provides a 1-year prospective analysis of group self-identification as a predictor of adolescent drug use and violence. Youth identified with discrete groups. In most comparisons, 1 year later, a high-risk group reported greater levels of drug use and violence-related exposure than other groups, and the statistical relation between group self-identification and drug use or violence remained after baseline assessment of the drug use or violence measure was controlled for. This is the 1st study to demonstrate that group self-identification is a significant prospective predictor of drug use and other problem behaviors.

Adolescent↗

PubMed1999

Health behavior, quality of work life, and organizational effectiveness in the lumber industry.

A major incentive for work-site health promotion activities has been the promise of increased company profitability. Some critics have challenged the economic argument based on distal outcomes such as increased employee longevity and less morbidity later in life. The purpose of this study was to examine the relationships between employee health behavior, quality of work life, and proximal organizationally valued outcomes. Data were collected from a stratified random sample of employees working at Pacific Lumber Company (N = 146), the largest single-site lumber mill in California. Although employee sleep patterns predicted health care utilization and psychological well-being, for the most part employee health behaviors were not strong predictors of proximal organizational effectiveness factors. However, quality-of-work-life factors significantly predicted organizational commitment, absenteeism, and tardiness frequency. The findings suggest the value of improving the system of work in which employees are embedded as part of comprehensive work-site health promotion efforts.

California↗

PubMed1998

Prospective psychosocial, interpersonal, and behavioral predictors of handgun carrying among adolescents.

OBJECTIVES: This study identified behavioral and psychosocial/interpersonal factors in young adolescence that are associated with handgun carrying in later adolescence. METHODS: A sample of 2200 high school students was surveyed at 9th grade and again at 12th grade. RESULTS: Multivariate logistic regression analyses indicated that measures of risk-taking preference, depression, stress, temper, and drug use assessed while the students were in 9th grade were predictive of handgun carrying in 12th grade for both male and female students. CONCLUSIONS: These findings suggest the need for a comprehensive approach to prevention that focuses on both individual and interpersonal factors associated with adolescents' decision to carry a handgun.

Adolescent↗

PubMed1998

Implementation and process evaluation of a school-based drug abuse prevention program: Project Towards No Drug Abuse.

The present study provides an implementation, process, and immediate outcomes evaluation of the classroom component of Project Towards No Drug Abuse (TND). This project involves development and evaluation of a school-based drug abuse prevention curriculum for continuation high school youth, who are at relatively high risk for drug abuse. Three randomized conditions were evaluated: a standard care, classroom only, and classroom plus school-as-community. The latter condition was an enhanced school-based condition which involved outside-of-classroom meetings and activities. Implementation was high in both program conditions even though this was a higher risk context. Process evaluation data were favorable and did not vary between the two program conditions. Immediate outcomes data (knowledge) was higher in the two program conditions than in the standard care condition. Regarding the classroom program, addition of extra-classroom activities does not appear to alter the quality of delivery of the program.

Adolescent↗

PubMed1998

Reasons for quitting and smoking temptation among adolescent smokers: gender differences.

Adolescent cigarette smokers from randomly selected classrooms from 24 California and Illinois high schools were assessed regarding their interest in cessation, reasons for quitting, and smoking temptation circumstances. These data were analyzed by gender. Males and females were not found to differ in quit stage or perceived likelihood of ever quitting smoking, although males reported being somewhat more likely to have ever tried to quit in the past. The associations of reasons for quitting were not found to vary by gender in most comparisons. On the other hand, the associations of smoking temptation circumstances with gender showed that a greater percentage of females than males reported more circumstances that would make them tempted to smoke. Smoking cigarettes to regulate one's affective states, and to avoid nicotine withdrawal, may be functions of smoking that impede efforts at quitting, particularly among adolescent females.

Adolescent↗

PubMed1997

The correlates of substance abuse and dependence among adolescents at high risk for drug abuse.

Correlates of substance abuse disorders in teenagers may suggest new treatment modalities. The present article examines correlates of self-reported substance abuse and dependence among a sample of 1936 youth at high risk for drug abuse, from 21 southern California continuation high schools. Among 32 demographic, drug use, drug use intention, coping, or health attitude-related variables, gender, cigarette smoking, anger coping, depression, and addiction concern were most consistently associated with self-reported substance abuse or substance dependence. These results suggest that affect management may help facilitate the prevention or control of adolescent drug abuse.

Adaptation, Psychological↗

PubMed1997

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program.

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.

Adolescent↗

PubMed1997

The impact of a written parental consent policy on estimates from a school-based drug use survey.

The authors examine differences between mean, variance, and correlation parameter estimates derived from a full school-based sample and subsamples restricted by the provision of parental consent. A total of 1,607 students at 21 continuation high schools and 1,192 students at 3 traditional high schools completed a survey containing variables related to sociodemographics, drug use, mental health, and violence. The employment of a researcher-initiated home-telephone-call procedure substantially increased the parental response rate over a student-/school-assisted consent method. The subsamples restricted by the written consent criterion showed some small biases in estimates of sociodemographic variables but little or no biases on measures related to mental health, drug use, or violence measures. The augmentation of the written consent samples with verbally consented students reduced observed biases.

Adolescent↗

PubMed1997

Immediate impact of thirty-two drug use prevention activities among students at continuation high schools.

Those teenagers who are unable to remain in the regular school system for reasons including substance use are transferred to a continuation high school. Generic comprehensive social-influence-drug-use-prevention-activities are less likely to be effective for use with these at risk youth. Thus, both classroom and self-instruction (main mode of instruction at continuation high schools) versions of 16 activities derived from different theoretical sources were tested and ranked on immediate outcome variables. 388 students from six continuation high schools were provided with a pretest-activity-posttest "component study" protocol. The scores on perceived quality ratings were standardized and averaged to permit easy comparisons across lessons. While yielding similar knowledge changes, students who received the health educator led activity consistently reported higher scores on perceived quality. Social influence-oriented lessons, in general, were rated of relatively low perceived quality. The present approach assisted in selection of the lessons with the greatest overall immediate impact.

Adolescent↗

PubMed1997

Vulnerability to victimization, concurrent problem behaviors, and peer influence as predictors of in-school weapon carrying among high school students.

Previous research has indicated the potential relevance of three constructs in the prediction of adolescent weapon carrying, (a) general delinquency, (b) self-protection, and (c) social influence. The current study tests the independent associations between in-school weapon carrying and these three constructs. The sample consisted of 504 students from seven southern California high schools. Overall, 25% of the sample carried a weapon to school in the last year. Self-defense was the most commonly reported reason for in-school weapon carrying. The results from a simultaneous logistic regression analysis indicated increased risk of in-school weapon carrying among students who are male, who are affiliated with gangs or tagging crews, who are exposed to peers who carry weapons to school, and who feel vulnerable to being victimized. Prevention programs targeted at reducing in-school weapon carrying may benefit from a comprehensive focus that includes efforts to reduce involvement in other problem behaviors, influence norms regarding weapon carrying, and reduce actual and perceived vulnerability to victimization.

Adolescent↗

PubMed1996

Parenting style and adolescent depressive symptoms, smoking, and academic achievement: ethnic, gender, and SES differences.

This paper examines whether the relationship between parenting style and adolescent depressive symptoms, smoking, and academic grades varies according to ethnicity, gender, and socioeconomic status. Four parenting styles are distinguished, based on patterns of parent-adolescent decision making: autocratic (parents decide), authoritative (joint process but parents decide), permissive (joint process but adolescent decides), and unengaged (adolescent decides). The sample included 3993 15-year-old White, Hispanic, African-American, and Asian adolescents. Results are generally consistent with previous findings: adolescents with authoritative parents had the best outcomes and those with unengaged parents were least well adjusted, while the permissive and the autocratic styles produced intermediate results. For the most part, this pattern held across ethnic and sociodemographic subgroups. There was one exception, suggesting that the relationship between parenting styles, especially the unengaged style, and depressive symptoms may vary according to gender and ethnicity. More research is needed to replicate and explain this pattern in terms of ecological factors, cultural norms, and socialization goals and practices.

Achievement↗

PubMed1996

The correlates of addiction concern among adolescents at high risk for drug abuse.

A teenager's awareness that he or she is becoming a drug addict or alcoholic is likely to lead that youth to try to get treatment. This report examined correlates of addiction concern among a sample of youth at high risk for drug abuse. Approximately 36% of a sample of 274 students at two southern California continuation high schools perceived themselves at risk for drug or alcohol addiction. Whereas 15 of 25 demographic, drug use, social psychological, or health orientation related variables were associated with an addiction concern measure in bivariate analyses, after partialing out covariation among its correlates, three drug use indices, two items that measured the importance of health as a value, and an assertiveness measure remained significant nonredundant correlates of addiction concern. These results suggest a potential importance of both manipulation of health motivation and social skills instruction in facilitating the prevention of adolescent drug abuse.

Adolescent↗