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Biomedical subjects

J W Graham

Publications and source records attributed to J W Graham.

At least 37 records · Page 2Linked to original sources
PubMed1991

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↗
PubMed1991

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↗
PubMed1990

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↗
PubMed1989

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↗
PubMed1989

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↗
PubMed1989

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↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1987

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↗
PubMed1987

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↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1986

Child support awards: differentials and trends by race and marital status.

This study has analyzed data from combined 1979 and 1982 April supplements to the Current Population Survey to study differences in the award of child support by race and marital status. The following findings emerge from this study: The percentage of women with children present from an absent father who are awarded child support varies greatly by race and marital status. Among all women, nonblacks are more than twice as likely as blacks to have a child support award, and the ever-married are almost six times as likely as the never-married to have an award. Among the ever-married, currently separated women are approximately half as likely as the ever-divorced to have secured an award. The lower probability of child support awards among blacks can be attributed in part to their disproportionate membership in marital status groups with lower award probabilities. Blacks are four and one-half times as likely as nonblacks to be among the never-married and almost twice as likely to be among the currently separated. Racial differences in award probabilities exist within all marital status groups except the never-married. Among the currently separated, blacks are one-third less likely than nonblacks to have an award. Among the ever-divorced, blacks are almost one-fourth less likely than nonblacks to have an award. Among the never-married, unlike the ever-married, virtually no statistically significant socioeconomic characteristics appear to distinguish mothers who have a child support award from those who do not. Among all women, 50 to 60 percent of the gross racial differential in award rates can be explained by observed differences in such economic and demographic characteristics as marital status, educational attainment, age, place of residence, and number of children. Among the ever-married, 50 percent of the gross racial difference can be explained by these factors. Among the ever-married, the likelihood of being awarded child support at marital disruption has increased over time, but this upward trend has been different for blacks and nonblacks. Among nonblacks, the proportion of women obtaining a child support award increased 1.3 percent per year between 1960 and 1975 and then declined 0.4 percent per year since then. Among blacks, the proportion increased 0.8 percent per year between 1960 and 1975 and then accelerated to 1.6 percent per year since then.(ABSTRACT TRUNCATED AT 400 WORDS)

Black or African American↗
PubMed1985

Self-initiated smoking cessation among high school students.

The purpose of this study was to examine psychosocial predictors of self-initiated smoking cessation among high school students. Students from nine high schools were pretested using a questionnaire which assessed smoking behavior, beliefs about positive and negative consequences of smoking, moral attitudes toward smoking, normative expectations about smoking, rebelliousness, peer smoking and parent smoking. Smokers identified at pretest were reexamined three months and fifteen months later. Three variables, moral attitudes, peer smoking and positive beliefs about smoking significantly discriminated continuing smokers from quitters at the three-month posttest. Three different variables, negative beliefs about smoking, parental smoking and rebelliousness significantly discriminated between those who quit and later relapsed and those who quit and maintained their non-smoking status at the 15 month posttest. Smoking characteristics at pretest failed to discriminate either those who would quit or those who would maintain their non-smoking status. Results support the development of public information programs which encourage early cessation of smoking which feature the development of appropriate attitudes and beliefs and which foster social support.

Adolescent↗
PubMed1984

Constructing the cost of health professions education.

Pressures at the national, state, and institutional levels are forcing health professions education administrators to justify their budget requests. Because unit cost studies traditionally used by higher education have proved unsatisfactory, program constructed cost models have been developed. The advantages of the model for administrators lie in the fact that any input unit of the model can be adjusted and the effects of that adjustment can be measured against the cost per student. In times of budget restrictions, these adjustments permit administrators to model various combinations of student enrollment, faculty involvement, class size, and basic program structure to obtain the optimal education experience from available resources. The model is applied by way of example to all nonbaccalaureate dental hygiene education programs in the United States.

Costs and Cost Analysis↗