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Biomedical subjects

Daniel McCaffrey

Publications and source records attributed to Daniel McCaffrey.

7 recordsLinked to original sources

Impact of a school-based dating violence prevention program among Latino teens: randomized controlled effectiveness trial.

PURPOSE: Given the high rate of dating violence between teens and associated deleterious outcomes, the need for effective prevention and early intervention programs is clear. Break the Cycle's Ending Violence curriculum, a three-class-session prevention program focused on legal issues, is evaluated here for its impact on Latino/a youth. METHODS: Tracks within large urban high schools that had at least 80% Latino/a students were randomized to immediate or delayed curriculum. Classrooms were randomly selected within tracks and individual student outcomes were assessed pre- and postintervention and six months later. RESULTS: Students in intervention classrooms showed improved knowledge, less acceptance of female-on-male aggression, and enhanced perception of the helpfulness and likelihood of seeking assistance from a number of sources immediately after the program. Improved knowledge and perceived helpfulness of an attorney were maintained six months later. There were no differences in recent abusive/fearful dating experiences or violence victimization or perpetration. CONCLUSIONS: The Ending Violence curriculum has an impact on teen norms, knowledge, and help-seeking proclivities that may aid in early intervention for dating violence among Latino/a students.

Adolescent↗

Estimating probit models with self-selected treatments.

Outcomes research often requires estimating the impact of a binary treatment on a binary outcome in a non-randomized setting, such as the effect of taking a drug on mortality. The data often come from self-selected samples, leading to a spurious correlation between the treatment and outcome when standard binary dependent variable techniques, like logit or probit, are used. Intuition suggests that a two-step procedure (analogous to two-stage least squares) might be sufficient to deal with this problem if variables are available that are correlated with the treatment choice but not the outcome. This paper demonstrates the limitations of such a two-step procedure. We show that such estimators will not generally be consistent. We conduct a Monte Carlo exercise to compare the performance of the two-step probit estimator, the two-stage least squares linear probability model estimator, and the multivariate probit. The results from this exercise argue in favour of using the multivariate probit rather than the two-step or linear probability model estimators, especially when there is more than one treatment, when the average probability of the dependent variable is close to 0 or 1, or when the data generating process is not normal. We demonstrate how these different methods perform in an empirical example examining the effect of private and public insurance coverage on the mortality of HIV+ patients.

Anti-HIV Agents↗

Socio-environmental influences on adolescents' alcohol outcome expectancies: a prospective analysis.

AIMS: To investigate the prospective influence of social influence and social bonding variables on the development of alcohol outcome expectancies among adolescents with and without drinking experience. DESIGN: Longitudinal data from students in the control schools of a field trial designed to evaluate a school-based drug prevention program. SETTING: A total of 19 middle schools in South Dakota, USA. MEASUREMENTS: An alcohol outcome expectancy scale administered to 1410 students in grades 8 and 9. After using confirmatory factor analysis (CFA) to develop an expectancies measure, multiple-group (grade 8 drinkers versus grade 8 non-drinkers) path analysis was used to model 9th grade alcohol expectancies. Grade 8 social influence and bonding variables were used as predictors, controlling for grade 8 expectancies. FINDINGS: At the bivariate level, peer and adult influences and social bonding variables were related consistently to alcohol outcome expectancies among drinkers and non-drinkers. A bivariate relationship between alcohol advertising and alcohol expectancies was found among drinkers only. In the multivariate model, greater alcohol use by important adults predicted independently increased alcohol positivity among drinkers; greater perceived approval of alcohol use by parents and peers predicted diminished perceived potency of alcohol among non-drinkers. Advertisement exposure and social bonding variables were not independent predictors of alcohol expectancies in the multivariate model. CONCLUSIONS: These findings suggest that attempts to alter adolescents' alcohol expectancies are likely to fail unless they address the influence of immediate social models on these beliefs.

Adolescent↗

Measuring developmental changes in alcohol expectancies.

The goal of this study was to measure shifts in alcohol expectancies from childhood into adolescence while controlling for changes in the psychometric properties of the instrument. One thousand nine hundred ninety-three 4th-grade and 1,632 9th-grade students from South Dakota rated the likelihood that 23 outcomes would result from alcohol use. These expectancies were modeled using a 2-factor confirmatory factor analysis. After differences in the psychometric properties of the instrument were controlled, the cohorts were distinguished by a large difference in Alcohol Positivity, with older participants viewing alcohol's effects more positively. Additionally, older participants displayed greater Alcohol Potency, believing that alcohol has a larger impact on all outcomes. There were also significant differences in the interpretation of the alcohol expectancies items across cohorts.

Adolescent↗

Prevalence of substance use among white and American Indian young adolescents in a Northern Plains state.

This article documents the prevalence of self-reported substance use among White and American Indian adolescents enrolled in seventh grade (ages 12 through 13) in 1997 in a Northern Plains state. Data were collected by self-administered questionnaire preceding adolescents' participation in a randomized field trial of Project Alert, a seventh and eighth grade substance use prevention curriculum. Rates of lifetime and past-month use of cigarettes and marijuana were higher among American Indians than among Whites of the same gender. American Indian girls exceeded American Indian boys as well as White girls and White boys on lifetime and past-month use of cigarettes and marijuana as well as alcohol and inhalants; differences on cigarette and inhalant use reached statistical significance. These findings add to the sparse literature on substance use among adolescents as young as 12 through 13 years old and underscore the importance of examining gender-specific substance use patterns early in adolescence.

Adolescent↗

Predictors of beer advertising awareness among eighth graders.

AIMS: To identify correlates of beer advertising awareness among adolescents at an age when most initiate use of alcohol. DESIGN: We conducted a cross-sectional analysis of an in-school survey about alcohol advertising. Structural equation modeling was used to test for independent predictors of a latent beer advertising awareness construct, separately among boys and girls. SETTING: Twenty middle schools in South Dakota, USA participated during their spring semester. PARTICIPANTS: A total of 1530 eighth graders. MEASUREMENTS: A latent advertisement awareness variable was derived based on recognition of six masked beer advertisements, knowledge of beer brands and knowledge of beer slogans. Tested predictors included measures of exposure to alcohol advertising in various venues, social norms regarding drinking, drinking beliefs and behavior and gender. FINDINGS: Adolescents with greater exposure to advertisements in magazines, at sporting and music events and on television were more advertisement aware than those with less exposure, as were teens who watch more TV, pay attention to beer advertisements and know adults who drink. Beer advertisement awareness was dramatically higher among boys, and was associated with drinking only among boys. CONCLUSIONS: Each of a variety of advertising venues appears to influence independently the extent to which beer advertising is incorporated into an adolescent's cognitive world. Boys are more likely to be aware of and remember beer marketing, and may be more likely to drink as a result of this awareness than girls.

Adolescent↗

The effects of primary care depression treatment on patients' clinical status and employment.

OBJECTIVE: To evaluate the effects of depression treatment in primary care on patients' clinical status and employment, over six months. DATA SOURCES/STUDY SETTING: Data are from a randomized controlled trial of quality improvement for depression that included 938 adults with depressive disorder in 46 managed primary care clinics in five states. STUDY DESIGN: Observational analysis of the effects of evidence-based depression care over six months on health outcomes and employment. Selection into treatment is accounted for using instrumental variables techniques, with randomized assignment to the quality improvement intervention as the identifying instrument. DATA COLLECTION/EXTRACTION METHODS: Patient-reported clinical status, employment, health care use, and personal characteristics; health care use and costs from claims data. PRINCIPAL FINDINGS: At six months, patients with appropriate care, compared to those without it, had lower rates of depressive disorder (24 percent versus 70 percent), better mental health-related quality of life, and higher rates of employment (72 percent versus 53 percent), each p<.05. CONCLUSIONS: Appropriate treatment for depression provided in community-based primary care substantially improves clinical and quality of life outcomes and employment.

Depressive Disorder↗