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Biomedical subjects

J W Graham

Publications and source records attributed to J W Graham.

At least 19 recordsLinked to original sources

Resistance-skills training and onset of alcohol use: evidence for beneficial and potentially harmful effects in public schools and in private Catholic schools.

Recent research suggests that the success of social influence prevention programs is due to enhancing an adolescent's ability to resist passive social pressure (e.g., social modeling and overestimation of peer use), and is not due to teaching refusal skills for combating active social pressure (i.e., alcohol and drug offers). Using 4 waves of longitudinal data (collected in the 5th, 6th, 7th, and 8th grades) from 11,995 students participating in the Adolescent Alcohol Prevention Trial, resistance-skills training was found to be an effective strategy for preventing the onset of alcohol use when program assumptions were met. However, a counterproductive effect was found for adolescents attending public school who received a resistance training only condition.

Adolescent

Changes in the relationship between child support payments and educational attainment of offspring, 1979-1988.

We examine changes over the 1980s in the effect of child support payments on the educational attainment of children age 16 to 19 in the United States, and why child support has a stronger impact than other sources of income. We use 1979 and 1988 Current Population Survey data, covering a period when improvements in enforcement should have increased the proportion of reluctant fathers paying support. We hypothesize and find that the positive effect of child support on education diminished somewhat over this period, both absolutely and in relation to other income.

Adolescent

Testing the generalizability of intervening mechanism theories: understanding the effects of adolescent drug use prevention interventions.

Outcome research has shown that drug prevention programs based on theories of social influence often prevent the onset of adolescent drug use. However, little is known empirically about the processes through which they have their effects. The purpose of the present study was to evaluate intervening mechanism theories of two program models for preventing the onset of adolescent drug use. Analyses based on a total of 3077 fifth graders participating in the Adolescent Alcohol Prevention Trial revealed that both normative education and resistance training activated the causal processes they targeted. While beliefs about prevalence and acceptability significantly mediated the effects of normative education on subsequent adolescent drug use, resistance skills did not significantly predict subsequent drug use. More impressively, this pattern of results was virtually the same across sex, ethnicity, context (public versus private school students), drugs (alcohol, cigarettes, and marijuana) and levels of risk and was durable across time. These findings strongly suggest that successful social influence-based prevention programs may be driven primarily by their ability to foster social norms that reduce an adolescent's social motivation to begin using alcohol, cigarettes, and marijuana.

Adolescent

Preventing alcohol, marijuana, and cigarette use among adolescents: peer pressure resistance training versus establishing conservative norms.

BACKGROUND: Two strategies for preventing the onset of alcohol abuse, and marijuana and cigarette use were tested in junior high schools in Los Angeles and Orange Counties, California. The first strategy taught skills to refuse substance use offers. The second strategy corrected erroneous normative perceptions about prevalence and acceptability of use among peers and established conservative groups norms regarding use. METHODS: Four experimental conditions were created by randomly assigning schools to receive (a) neither of the experimental curricula (placebo comparison), (b) resistance skill training alone, (c) normative education alone, or (d) both resistance skill training and normative education. Students were pretested prior to the program and post-tested 1 year following delivery of the program. RESULTS: There were main effects of normative education for summary measures of alcohol (P = 0.0011), marijuana (P = 0.0096), and cigarette smoking (P = 0.0311). All individual dichotomous measures of alcohol, marijuana, and tobacco use indicated significant reductions in onset attributable to normative education. There were no significant main effects of resistance skill training. CONCLUSION: These results suggest that establishing conservative norms is an effective strategy for preventing substance use.

Adolescent

Modeling transitions in latent stage-sequential processes: a substance use prevention example.

This article illustrates the use of latent transition analysis (LTA), a methodology for testing stage-sequential models of individual growth. LTA is an outgrowth of latent class theory and is a particular type of latent Markov model emphasizing the use of multiple manifest indicators. LTA is used to compare the fit of two models of early adolescent substance use onset and to assess the effects of a school-based substance use prevention program on Ss measured in 7th grade and again in 8th grade. Several interesting findings emerged. First, a model of substance use onset including both alcohol and tobacco use as possible starting points fit better than a model that included alcohol use as the only starting point. Second, Ss who had tried tobacco but not alcohol in in 7th grade seemed to be on an accelerated onset trajectory. Third, the normative education prevention program was generally successful, except for the students who had tried only tobacco in 7th grade.

Age Factors

Social influence processes affecting adolescent substance use.

Social influence is central to models of adolescent substance use. Nonetheless, researchers fail to delineate the various forms of social influence. A framework that distinguishes between active (explicit drug offers) and passive (social modeling and overestimation of friends' use) social pressure was tested. The effect of these processes on alcohol and cigarette use was examined with 526 seventh graders taking part in an alcohol prevention program. Hierarchical regression analyses demonstrated that pretest measures of alcohol use, offers, modeling, and overestimation each accounted for unique variance in posttest alcohol use. Similar results were obtained for cigarette smoking. The general model was not significantly different for boys and girls, or for prior users and prior nonusers, supporting the generalizability of the framework. Implications for intervention programs are discussed.

Adolescent

Program integrity as a moderator of prevention program effectiveness: results for fifth-grade students in the adolescent alcohol prevention trial.

This study reports the results of a test of the quality of program delivery (program integrity) as a variable that may moderate the effectiveness of alcohol prevention programs. Two theory-based programs, Resistance Training and Normative Education, were delivered to fifth-grade students who were then tested on program relevant mediating variables. Resistance Training was found to improve students' knowledge of peer pressure resistance strategies, their performance on a behavioral assessment of peer pressure resistance skills and the manifestation of their future intentions to drink alcohol. Normative Education was found to improve students' perceptions of a conservative norm regarding alcohol use, facilitated their belief that refusing unwanted offers to drink alcohol could be easily accomplished and reduced their perceptions of the prevalence of alcohol use. Program integrity was measured by program specialists who taught the programs to students and by trained observers. Ratings of program integrity were found to significantly moderate outcomes for three of seven mediating variables. Affected were knowledge of peer pressure resistance strategies, behavioral pressure resistance skills and perceived self-efficacy. These results suggest that the quality of program delivery and reception may play an important moderating function on prevention program effectiveness.

Adolescent

Drug use prevention programs, gender, and ethnicity: evaluation of three seventh-grade Project SMART cohorts.

One-year follow-up data from three seventh-grade cohorts of Project SMART were examined to assess the effects of two social psychology-based programs within each of six subgroups: males, females, Asians, blacks, Hispanics, and whites. The three cohorts (total N = 5,070) were those receiving curriculum or serving as controls as seventh-graders in 1982-1983, 1983-1984, and 1984-1985 school years. The outcome measures used were composite indices based on lifetime and recent use items for cigarettes, alcohol, and marijuana. The major analysis was ANCOVA on classroom means for the composite indices at post-test, using pretest classroom means for the indices as a covariate. The results showed clear prevention effects for females but not for males. Overall prevention effects were strongest for cigarette smoking, but were also evident for alcohol. Significant sex by program interactions, showing differential program effects for males and females, were found for cigarettes and marijuana, but not for alcohol. There was a nonsignificant trend suggesting that the programs were most effective for Asians and least effective for whites.

Adolescent

Evidence for two paths of alcohol use onset in adolescents.

Research is needed to identify risk factors specifically associated with the development of substance abuse. The current study explored the possibility that adolescents classified as having a problem behavior prone orientation (Type II) are predisposed to more rapid alcohol use onset compared to more normally socialized (Type I) adolescents. It was hypothesized that both types of adolescents would increase their alcohol use over time, but that problem behavior prone adolescents would increase their rates of alcohol consumption more rapidly than would normally socialized adolescents. Using ANCOVA (with baseline alcohol use as a covariate) and t tests (examining only nondrinkers at baseline), the hypotheses were strongly supported. Both Type I and Type II adolescents significantly increased their alcohol use over a one-year period. Type II adolescents, in comparison to Type I adolescents, had significantly higher alcohol use. The greater alcohol use among Type II adolescents was attributed to their problem behavior prone orientation. The findings suggest the existence of two different developmental pathways of alcohol use onset, one initiated by normally socialized adolescents and the other by adolescents with a problem behavior prone orientation. Future alcohol abuse prevention programs may benefit from tailored intervention strategies which take into account population specific risk factors.

Adolescent

Social environment and adjustment after laryngectomy.

The relationship between social environmental variables and psychological, physical, and speech dysfunction after laryngectomy surgery was examined. The relationships between these categories of dysfunction and the following three social environmental factors were examined: (1) acceptance and emotional support from family and friends; (2) disease-specific support from peers who have had the same surgical intervention and from professionals; and (3) socioeconomic status (SES). Data were collected from 60 total laryngectomy patients an average of 24.3 months after surgery. The type of support provided was different for each source of support, family-friend or peer-professional. Interpersonal support from family and friends was strongly associated with psychosocial and physical dysfunction but had a weaker association with speech adjustment. Diseases-specific support from speech therapists and other laryngectomees was a weaker predictor of dysfunction but a stronger predictor of communication adaptation. SES was not predictive of dysfunction or communication adaptation. Thus different sources of social support can make specific contributions to minimizing physical and psychosocial dysfunction and acquiring skills to overcome the limitations imposed by the surgery.

Adaptation, Psychological

Activity involvement, risk-taking, demographic variables, and other drug use: prediction of trying smokeless tobacco.

Four activity participation variables (clubs, sports, church, and parties); two indices of "risk-taking" (preference for risk-taking, getting into trouble at school); three demographic variables (sex, ethnic group, socioeconomic status); and two drug use variables (trial of cigarettes and alcohol) were examined as correlates and prospective predictors of trial of smokeless tobacco in two cohorts of seventh graders in urban Los Angeles. The data were analyzed separately for males and females. Cross-sectional logistic regression analyses indicated that correlates of trying smokeless tobacco among the seventh-grade cohorts or among these same cohorts in the eighth grade (considering those persons who had not tried smokeless tobacco in seventh grade) generally included being white, trying cigarettes, risk-taking, and attending parties. Prospective logistic regression analyses with data from subjects who had not tried smokeless tobacco in the seventh grade indicated that predictors of subsequent trial of it generally included only being white and having tried cigarettes. Sports participation predicted onset only in one cohort of female subjects but not in males. Some activities that have been proposed as being predictive of smokeless tobacco use (e.g., sports participation) are generally irrelevant for a large sample of young adolescents in urban Los Angeles. White male cigarette smokers, regardless of the activities they have engaged in, are most likely to try smokeless tobacco.

Adolescent

Affective and social influences approaches to the prevention of multiple substance abuse among seventh grade students: results from project SMART.

Two drug abuse prevention curricula were tested to determine their efficacy in preventing the onset of tobacco, alcohol, and marijuana use among adolescents. The first program focused on prevention through social pressure resistance training. The second featured affective education approaches to prevention. Curricula were tested on seventh grade students. Subjects were pretested just prior to the program and were post-tested at 12 and 24 months. Post-test analyses indicated that the social program delivered to seventh grade subjects was effective in delaying the onset of tobacco, alcohol, and marijuana use. No preventive effect of the affective education program was observed. By the final post-test, classrooms that had received the affective program had significantly more drug use than controls.

Adaptation, Psychological

The impact of the differences in the decline of dental school applicants in the United States and Canada.

The number of individuals writing the Canadian Dental Association Dental Aptitude Test and the American Dental Association Dental Admissions Test for the first time is used as a measure of the number of new additions to the dental school applicant pool in each of the past 15 years. Dramatic changes have occurred during that period. Comparisons are made and similarities noted between the situations in the United States and Canada. A discussion of the probable causes of the differences highlights the changing government programs in the two countries, the perceptions of potential applicants, and the attitudes of members of the dental profession. Some suggestions for future action are proposed.

Canada

The consistency of peer and parent influences on tobacco, alcohol, and marijuana use among young adolescents.

The purpose of this study was to determine the degree to which the use of tobacco, alcohol, and marijuana by young adolescents can be described using a common theoretical model. Structural models were created in which psychosocial variables hierarchically predicted the use of each substance. The fit of a model in which paths from predictor variables were constrained to be equal was not inferior in any meaningful way to that of a model in which all path coefficients were freely estimated, thus suggesting that use of tobacco, alcohol, and marijuana by young adolescents may be considered to be a unitary phenomenon. A simplified model, in which these substances were combined into a single latent variable, showed a good fit. The results of these analyses suggest that it may be beneficial to consider adolescent substance use to be a unitary phenomenon.

Adolescent

Path model of multidimensional compliance with cancer therapy.

Patients newly diagnosed with hematologic malignancies were followed for a 6-month treatment period to assess compliance with three regimen requirements for cancer therapy: anti-neoplastic medication self-administered intermittently, supportive medication self-administered daily, and monthly clinic appointments. The effect on compliance of three intervention "packages" (some combination of education, shaping of pill-taking behavior, and home restructuring) and the extent that patient satisfaction, knowledge, and uncertainty about illness-related events mediated the effects of the interventions were also examined. Blood levels of the drugs and self-report measures indicated that compliance with daily pill taking was higher for each intervention group compared to a control group. Similar results were obtained for compliance with clinic appointments. No improvement in intermittent self-medication was found. Although each intervention package increased patient knowledge and satisfaction, path analyses demonstrated that knowledge did not affect any aspect of compliance, whereas satisfaction was associated with increased appointment keeping only. Daily pill taking was influenced directly by the behavioral components of the interventions. Uncertainty did not influence compliance but was associated with depression, which was negatively correlated with intermittent self-medication.

Administration, Oral

High-school smoking prevention: results of a three-year longitudinal study.

This study compared two strategies for preventing cigarette smoking among high-school students. One strategy emphasized social-pressure resistance skills, while the other focused on education about health concerns which are relevant to high-school students. Additionally, the use of same-age peer leaders and the use of familiar models in media presentations were investigated. The results suggest that social-influences resistance training was efficacious in reducing transitions to higher use by those who had previously experimented with cigarettes. Health education was most effective in preventing initial experimentation among those who had not smoked prior to the beginning of the study. Neither program was effective in limiting transitions among those who had gone beyond the experimental stage of smoking, and neither had any effect on encouraging cessation. There were no differences which could be attributed to peer leaders or to familiar media models. During later adolescence, a combined health education and social skills training approach is advocated. It is suggested that while there are some gains by implementing programs during late adolescence, prevention programs targeted at younger students may be more effective generally.

Adolescent

Role of health locus of control beliefs and expectations of treatment efficacy in adjustment to cancer.

We examined the effects of health locus of control beliefs (self-, doctor, and chance control) and expectations of treatment efficacy on short-term psychological adjustment in a sample of newly diagnosed cancer patients. The role of these beliefs and expectations in moderating the relation between (perceived and actual) disease severity and depression was also examined. The data were collected within one week of diagnosis. The relation between perceptions of disease severity and depression was weaker for those who believed that they could personally control their health and for those who held positive expectations about the effects of complying with medical treatment. Similar patterns were found when disease severity was defined in terms of prognosis for survival. Strong negative correlations between self-control/treatment expectations and depression were found for those who perceived that their illness was very severe. The results for chance and doctor control were less consistent. The stability of health control beliefs and treatment expectations over the course of a serious long-term illness is discussed.

Adaptation, Psychological