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Biomedical subjects

H Severson

Publications and source records attributed to H Severson.

15 recordsLinked to original sources
PubMed1995

Adolescent health-threatening and health-enhancing behaviors: a study of word association and imagery.

PURPOSE: To examine the ways in which perceived risks and benefits relate to health-threatening and health-enhancing behaviors by adolescents. METHOD: The study used a word association methodology to explore adolescents' thoughts and affective feelings associated with five health-threatening behaviors (e.g., drinking beer, smoking cigarettes) and three health-enhancing behaviors (e.g., exercising, using a seat belt). RESULTS: Each behavior elicited a mix of positive and negative associations. Health-threatening behaviors had many positive associations in common, such as having fun, social facilitation, and physiological arousal. Health-enhancing behaviors had much less commonality in their positive associations. Patterns of negative associations were not highly similar across behaviors. The content and affective tone of the associations were closely linked to participation in health-threatening behaviors and health-enhancing behaviors. Participants in an activity were far more likely than nonparticipants to associate that activity with positive outcomes, concepts, and affect and less likely to produce outcomes, concepts, and affect and less likely to produce negative associations. CONCLUSIONS: The word association methodology provides a useful technique for exploring adolescents' cognitions and affective reactions with regard to health-related behaviors. The data provided by this method have implications for prevention and intervention programs, as well as for future research.

Adolescent↗
PubMed1995

Making the most of a teachable moment: a smokeless-tobacco cessation intervention in the dental office.

OBJECTIVES: Primary care medical clinics are good settings for smoking interventions. This study extends this strategy with a smokeless tobacco intervention delivered by dentists and dental hygienists in the course of routine dental care. METHODS: Male users of moist snuff and chewing tobacco (n = 518) were identified by questionnaire in clinic waiting rooms and then randomly assigned to either usual care or intervention. The intervention included a routine oral examination with special attention to the part of the mouth in which tobacco was kept and an explanation of the health risks of using smokeless tobacco. After receiving unequivocal advice to stop using tobacco, each patient viewed a 9-minute videotape, received a self-help manual, and was briefly counseled by the dental hygienist. RESULTS: Long-term success was defined as no smokeless tobacco use at both 3- and 12-month follow-ups, with those lost to follow-up counted as smokeless tobacco users. The intervention increased the proportion of patients who quit by about one half (12.5% vs 18.4%, P < .05). CONCLUSIONS: These results demonstrate the efficacy of a brief dental office intervention for the general population of smokeless tobacco users.

Adolescent↗
PubMed1993

A psychometric study of adolescent risk perception.

Forty-one high-school students evaluated each of 30 activities (e.g. smoking, drinking, drug use, sex) on each of 14 characteristics of perceived risk and perceived benefit. They also indicated whether they themselves engaged in the activities. Adolescents who participated in an activity perceived the risks to be smaller, better known, and more controllable than did non-participants. Participants also perceived greater benefits relative to risks, greater peer pressure to engage in the activity, and a higher rate of participation by others. Implications for theory, research, and for health education and intervention programs are discussed.

Adolescent↗
PubMed1990

The efficacy of social-influence prevention programs versus "standard care": are new initiatives needed?

This study evaluates the effects of a school-based smoking prevention program after 1 year, using school (22 middle/elementary schools, 15 high schools) as both the unit of randomization and the unit of analysis. The multigrade level (grades 6 through 9) intervention was designed to address comprehensively the social influence factors that encourage smoking. Teacher survey data indicated that treatment schools had a median of 10 classroom sessions devoted to tobacco/drug use education, 5 of which were the sessions designed for this evaluation, and control schools had also dedicated a median of 10 classroom sessions to tobacco/drug education. Thus, the study evaluated the incremental effects of the social influence intervention compared to "standard-care" curricula. Among those who reported smoking one or more cigarettes in the month prior to the intervention, there was a significant treatment effect on rate of smoking at one year, but no grade level, gender, or interaction effects. The 1-year covariate-adjusted smoking rate among pretest smokers in the treatment schools was 76.6 cigarettes per month, compared to 111.6 cigarettes per month in control schools, a 31.4% difference. These effects were not accounted for by differential subject attrition. The analyses for nonsmokers, however, showed no significant effects, and the program did not affect self-reported alcohol or marijuana use. Taken together with the results of other prevention studies, these results point to the need for the development and evaluation of new initiatives to prevent substance use.

Adolescent↗
PubMed1990

The tobacco use research program at Oregon Research Institute.

The research program at ORI deals with both adolescent and adult tobacco use and is guided by a behavioral framework which emphasizes the role of the social context in tobacco use onset, maintenance and cessation. Growing appreciation of the importance of social context variables, combined with an emerging recognition of the need for a public health rather than clinical perspective on tobacco use, have led to a focus on interventions in larger social systems such as schools, worksites, health care plans, and communities. This research requires attention to the science of behavior change at both the individual and organizational levels.

Adolescent↗
PubMed1989

An in-depth analysis of male adolescent smokeless tobacco users: interviews with users and their fathers.

Male adolescent smokeless tobacco (ST) users (N = 191) were extensively interviewed, then followed over a 6-month period with monthly telephone interviews. In addition, their fathers (N = 137) were interviewed by telephone. Based on these data, ST use appears similar to cigarette smoking with respect to onset, patterns of use, social influences, attempts to quit, and indications of addiction. Onset and continued use of ST largely occur in a social context. Parents are reportedly aware (73%) of their sons' ST use but appear tolerant. The great majority of S's (92%) believe that there is some health risk associated with ST use. Over half report noticing ST-related changes in their oral cavities, although their dentists generally had not discussed ST use with them. Over one-third of the current users report unsuccessful quit attempts. ST use appears to be part of a more general pattern of substance use, including marijuana and alcohol.

Adolescent↗
PubMed1989

Rationale for the use of passive consent in smoking prevention research: politics, policy, and pragmatics.

The empirical evaluation of school-based smoking prevention programs requires a broad sampling of subjects who are exposed to treatment or control conditions. The low base rate of ongoing smoking among young adolescents, the slow increase in smoking rates, and concerns about the representativeness of samples make it imperative that assessment of smoking and drug use include almost all students. Positive consent procedures outlined by regulations for the protection of human subjects (Department of Health and Human Services. Code of Federal Regulations, Part 46: Protection of Human Subjects. #45 CFR 46, 1983) require parental permission for minors to participate in a research project. However, those subjects who are at highest risk to smoke are least likely to have parental consent for such a project. Low participation rates and subject selection bias are serious threats to the external validity of studies that use a positive consent procedure. With passive consent, parents respond only if they wish to withhold consent; a nonresponse is interpreted as approval of their child's participation. The subject retains the right to consent or decline participation. Four criteria must be met to waive the requirement of positive parental consent. The passive consent procedure, as used in smoking prevention research, meets those criteria. Data are presented that support the use of this procedure. Research is recommended to examine how consent procedures can affect the results of prevention studies.

Adolescent↗
PubMed1989

Development and evaluation of a smokeless tobacco cessation program: a pilot study.

A multicomponent, cognitive-behavioral intervention program, offered to 25 chronic, adolescent male users of smokeless tobacco, was divided into three sessions and involved self-monitoring of smokeless tobacco use, awareness of health risks, behavioral coping strategies, frequent phone contact, and relapse prevention training. Biochemical (carbon monoxide and cotinine) verification of self-reports was obtained, information about subject and environmental characteristics collected, and a 3-month follow-up conducted. Twenty-one of the 25 subjects completed treatment; 9 participants were abstinent at the conclusion of the program, and 4 remained successful in quitting at the 3-month follow-up. Participants who did not achieve complete abstinence reported substantial reductions in smokeless tobacco use, and no increase in cigarette consumption occurred as a result of reducing or quitting use of it. Subjects successful in achieving cessation had consumed a smaller amount of smokeless tobacco at baseline and were more likely to be involved in school athletics.

Adolescent↗
PubMed1987

Do smoking prevention programs really work? Attrition and the internal and external validity of an evaluation of a refusal skills training program.

This study investigated the effects of a smoking prevention program that emphasized refusal skills training on 1730 adolescents in three high schools and six middle schools. Classes within these schools were randomly assigned to treatment or no-treatment conditions to avoid confounding schools with treatment condition. The effects of attrition on the internal and external validity of the study were examined. Although the results indicated an apparent effect of the program at the 1-year follow-up in deterring continued smoking among those who were smoking at pretest, this result may have been due to a higher rate of attrition among high-rate smokers in the treatment condition than in the control condition. Attrition also affected external validity. Across both conditions, subjects who were smoking at pretest and who were at risk to smoke were more likely to be missing at follow-up. The program did have an effect on the refusal skills of participants and the validity of this effect was not jeopardized by differential attrition.

Adolescent↗
PubMed1987

How generalizable are the effects of smoking prevention programs? Refusal skills training and parent messages in a teacher-administered program.

This study investigated both substantive and methodological issues associated with school-based smoking prevention programs. Substantive issues included the efficacy of a refusal skills training curriculum and of parent messages mailed to students' homes. Methodological issues included the effects of assigning classrooms versus entire schools to experimental conditions and determination of the effects of attrition on internal and external validity. Results revealed differential impact for different subgroups of adolescents. The refusal skills program produced lower rates of smoking than the control condition for students who were smokers at the pretreatment assessment but may have produced detrimental effects among males who were nonsmokers at pretest. The provision of parent messages did not affect outcome. Method of assignment (schools versus classrooms) failed to produce significant effects, and attrition did not affect internal validity. However, the above differential findings, as well as the impact of attrition on external validity, raise questions concerning the generalizability of smoking prevention programs.

Adolescent↗
PubMedDate not supplied

Self-initiated quitting among adolescent smokers.

OBJECTIVES: This paper reviews the literature regarding predictors of adolescent self-initiated smoking cessation and investigates self-initiated smoking cessation among a large sample of alternative high school youth in southern California. Youth transfer to alternative schools because of academic or behavioral problems, and they are at relatively high risk for cigarette smoking. METHODS: Several demographic (e.g., gender), behavioral (e.g., level of smoking), and psychosocial (e.g., risk-taking) predictors of adolescent smoking cessation were investigated. The alternative high school cohort provided a sufficient sample size of quitters (defined as no use in the past 30 days, measured after a 1-year period) to permit a prospective examination of adolescent smoking cessation. RESULTS: Although nine demographic, behavioral, or psychosocial variables discriminated among quitters and nonquitters in univariate analyses, only level of baseline smoking, smoking intention, and perceived stress were predictors in a final multivariable model. CONCLUSIONS: Based on the literature review and findings among the cohort, smoking cessation programs for adolescents should include counteraction of problem-prone attitudes, support of wellness attitudes, provision of motivation to quit strategies, and assistance with overcoming withdrawal symptoms.

Adolescent↗