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K Smolkowski

Publications and source records attributed to K Smolkowski.

9 recordsLinked to original sources

A randomised controlled trial of a community intervention to prevent adolescent tobacco use.

OBJECTIVE: Experimental evaluation of comprehensive community wide programme to prevent adolescent tobacco use. DESIGN: Eight pairs of small Oregon communities (population 1700 to 13 500) were randomly assigned to receive a school based prevention programme or the school based programme plus a community programme. Effects were assessed through five annual surveys (time 1-5) of seventh and ninth grade (ages 12-15 years) students. INTERVENTION: The community programme included: (a) media advocacy, (b) youth anti-tobacco activities, (c) family communications about tobacco use, and (d) reduction of youth access to tobacco. MAIN OUTCOME MEASURE: The prevalence of self reported smoking and smokeless tobacco use in the week before assessment. RESULTS: The community programme had significant effects on the prevalence of weekly cigarette use at times 2 and 5 and the effect approached significance at time 4. An effect on the slope of prevalence across time points was evident only when time 2 data points were eliminated from the analysis. The intervention affected the prevalence of smokeless tobacco among grade 9 boys at time 2. There were also significant effects on the slope of alcohol use among ninth graders and the quadratic slope of marijuana for all students. CONCLUSION: The results suggest that comprehensive community wide interventions can improve on the preventive effect of school based tobacco prevention programmes and that effective tobacco prevention may prevent other substance use.

Adolescent↗

The value of the Parenting Scale for measuring the discipline practices of parents of middle school children.

The psychometric properties of the Parenting Scale (Arnold, O'Leary, Wolff, and Acker, 1993), a 30-item instrument originally developed to assess the discipline practices of parents of preschool children, were examined for parents of middle school students. Subjects were 298 parents of middle school student identified as at-risk for problem behavior. An exploratory factor analysis identified two factors labeled 'Overreactivity' and 'Laxness', closely resembling two of the factors found by Arnold et al., but each of these factors contained only six items. Confirmatory factor analyses, using data from the first two assessments, replicated this factor structure. The factors were significantly correlated with measures of parents' behavior, with scales from the child Behavior Checklist and Parent Daily Reports, and with the Beck Depression Inventory. The Laxness factor was less robust than the Overreactivity factor.

Adolescent↗

Development of adolescent problem behavior.

The developmental model of adolescent antisocial behavior advanced by Patterson and colleagues (e.g., Patterson, Reid, & Dishion, 1992) appears to generalize the development of a diverse set of problem behaviors. Structural equation modeling methods were applied to 18-month longitudinal data from 523 adolescents. The problem behavior construct included substance use, antisocial behavior, academic failure, and risky sexual behavior. Families with high levels of conflict were less likely to have high levels of parent-child involvement. Such family conditions resulted in less adequate parental monitoring of adolescent behavior, making associations with deviant peers more likely. Poor parental monitoring and associations with deviant peers were strong predictors of engagement in problem behavior. These constructs accounted for 46% of the variance in problem behavior. Although association with deviant peers was the most proximal social influence on problem behavior, parental monitoring and family factors (conflict and involvement) were key parenting practices that influenced this developmental process.

Achievement↗

The effectiveness of a parenting skills program for parents of middle school students in small communities.

This study provides evidence of the effectiveness of behaviorally based parenting skills classes provided by carefully trained and supervised group leaders who were not mental health clinicians. A program for parents of at-risk middle school students was evaluated in a randomized controlled trial in 8 small Oregon communities. Parents (N = 303) were randomly assigned to immediate treatment or a wait-list condition. Data were analyzed using latent growth modeling. Participation in the program led to significant improvements in problem-solving interactions as indicated by parent reports and a Taped Situations Test. Parents' over-reactivity and laxness toward their children's behavior were reduced and their feelings toward their children improved significantly as a function of treatment. Parent-reported child antisocial behavior was also reduced.

Adolescent↗

Peer and parental influences on adolescent tobacco use.

Longitudinal models of the development of adolescent smoking and smokeless tobacco (ST) use were tested for a sample of 643 adolescents, age 14 to 17. The sample was assessed at three time points. Smoking, smokeless tobacco, and other problem behaviors formed a single problem behavior factor. Structural equation modeling indicated that inadequate parental monitoring and association with deviant peers at Time 2 predicted tobacco use at Time 3. When parental and peer smoking at Time 2 were added to the model, each accounted for significant variance in predicting Time 3 smoking, but inadequate parental monitoring and association with deviant peers still accounted for some of the variance in Time 3 smoking. In predicting boys' smokeless tobacco use, monitoring at Time 2 predicted smokeless tobacco use, but only when parental approval of ST use was not included. Fathers approval of ST use at Time 2 predicted ST use at Time 3, while maternal disapproval predicted its use.

Adolescent↗

Does sexual coercion play a role in the high-risk sexual behavior of adolescent and young adult women?

Sexual coercion and its relationship to high-risk sexual behavior were examined in five samples of young women. Sample 1 (N = 22) consisted of sexually active adolescents aged 15 to 19. Samples 2 (N = 206) and 3 (N = 70) were recruited from among patients at three sexually transmitted disease clinics. Sample 4 (N = 51) consisted of young homeless women living on the street in a large city. Sample 5 (N = 51) was recruited from among young women on a college campus. Across all samples, 44.4% of women indicated that they had been forced into some form of sexual activity against their will. Self-reports of sexually coercive experiences were consistently related to risky sexual behavior. It appears that many young women are coerced into engaging in high-risk sexual behavior. This implies the need for greater attention to male coercive sexual behavior and women's skills for coping with such behavior.

Adolescent↗

The social context for risky sexual behavior among adolescents.

This study supports a model of adolescents' risky sexual behavior in which this behavior is seen as a product of the same peer and family factors which influence a wide range of problem behaviors. The Patterson et al. (1992) model of peer and parental factors associated with adolescents' sexual risk-taking behavior was tested on three independent samples of adolescents, ages 14 through 18. Adolescents whose peers were reported to engage in diverse problem behaviors were more likely to engage in risky sexual behavior. Poor parental monitoring and parent-child coercive interactions were associated having deviant peers, and poor parental monitoring also had a direct relationship to risky sexual behavior. Family involvement was associated with fewer parent-child coercive interactions. Less availability of parental figures in the family was directly associated with risky sexual behavior and was also associated with poorer parental monitoring.

Adolescent↗

Mathematical modeling of epidemic syphilis transmission. Implications for syphilis control programs.

BACKGROUND AND OBJECTIVES: The past 10 years' wave of syphilis epidemics has challenged syphilis control programs. Although apparently connected to drugs-for-sex trading of crack cocaine, the genesis and resolution of these epidemics is poorly understood. GOALS OF THE STUDY: The goals of this study were to develop a mathematical model of epidemic syphilis transmission based on empiric data, to stimulate and ascertain behavioral and sociologic features necessary to produce epidemic transmission, and to explore mechanisms leading to resolution of epidemic transmission. STUDY DESIGN: The study used multi-compartment iterative computer simulation using empirically derived input data. RESULTS: Epidemic transmission resulted from adding a small core group of individuals with very high levels of partner exchange (300-400 partners per year) to a population with levels of partner exchange seen in the general population. Epidemic resolution could result from immunity or subtle changes in the size or partner exchange rate of the core group. CONCLUSION: There is a need for sexually transmitted disease control programs to reevaluate their approach to prevention and control of epidemic syphilis in light of data on transmission dynamics.

Adolescent↗