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Biomedical subjects

N Maccoby

Publications and source records attributed to N Maccoby.

At least 19 recordsLinked to original sources

Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project.

To test whether communitywide health education can reduce stroke and coronary heart disease, we compared two treatment cities (N = 122,800) and two control cities (N = 197,500) for changes in knowledge of risk factors, blood pressure, plasma cholesterol level, smoking rate, body weight, and resting pulse rate. Treatment cities received a 5-year, low-cost, comprehensive program using social learning theory, a communication-behavior change model, community organization principles, and social marketing methods that resulted in about 26 hours of exposure to multichannel and multifactor education. Risk factors were assessed in representative cohort and cross-sectional surveys at baseline and in three later surveys. After 30 to 64 months of education, significant net reductions in community averages favoring treatment occurred in plasma cholesterol level (2%), blood pressure (4%), resting pulse rate (3%), and smoking rate (13%) of the cohort sample. These risk factor changes resulted in important decreases in composite total mortality risk scores (15%) and coronary heart disease risk scores (16%). Thus, such low-cost programs can have an impact on risk factors in broad population groups.

Adult↗

Psychosocial predictors of physical activity in adolescents.

Regular physical activity consistently demonstrates an inverse relationship with coronary heart disease and has positive effects on quality of life and other psychological variables. Despite the benefits of exercise, many youth and adults maintain a sedentary lifestyle. Interventions are needed, particularly with youth, to increase levels of physical activity. A better understanding of the psychosocial predictors of physical activity will aid in structuring these interventions. Longitudinal data from a cohort of 743 10th-grade students from the control condition of the Stanford Adolescent Heart Health Program were analyzed. Regression analysis indicated that psychosocial variables were significantly related to physical activity after controlling for baseline levels of physical activity and BMI. Associations with physical activity were found for intention to exercise, self-efficacy, stress, and direct social influence. The designers of future interventions should consider including program components that target these variables.

Adolescent↗

Social influences approach to smoking prevention: the effects of videotape delivery with and without same-age peer leader participation.

This study tested the hypothesis that cigarette smoking adoption among adolescents could be suppressed by providing school-based videotape instruction for resisting social influences to smoke. The utilization of same-age peer leaders was also varied to test whether their participation in the classroom would enhance program effects. Seventh grade students (N = 540) from one junior high school in Southern California were randomly assigned by classrooms (N = 15) to: (a) videotape instruction, (b) videotape instruction plus peer leader involvement, or (c) survey-only. Seventh grade students (N = 234) in a second junior high school served as a measurement-only control. Assessments were conducted at the beginning and end of the academic year. Results revealed a marked suppression in the onset of both experimental and regular smoking among those students exposed to the pressure resistance training with peer leader involvement. Pressure resistance training without peer leader involvement produced a more variable and less powerful effect on students' smoking behavior. Data collected on students' use of alcohol and marijuana revealed a generalized suppression effect, albeit weaker than for tobacco, among those students exposed to the social resistance training with peer leader involvement. Results provide further encouraging support for the use of peer-led pressure resistance training in preventing adolescent drug use.

Adolescent↗

Communication and health education research: potential sources for education for prevention of drug use.

Studies conducted by the Stanford Center for Research in Disease Prevention have been carried out over the last 15 years. These studies indicate that, with systematic planning by interdisciplinary research teams, field research projects, based on appropriate theory, can be mounted successfully both at the community level and in schools for the study of adolescents and for adolescent children. Both final and interim results are for the most part encouraging. While all of the research reported here applies to health problems completely different from AIDS, some useful suggestions may emerge. For one thing, in both AIDS prevention and chronic disease prevention, the most effective measures to be taken appear to be behavioral. The research reported here is almost exclusively concerned with developing and testing methods for assisting people to change their behavior in ways that are likely to promote health and reduce risk of disease. They involve education at a community level and in schools. Perhaps education for AIDS prevention can follow similar lines with some success. Recently, several studies have been directed toward the prevention of drug abuse habits being formed by schoolchildren. A 1984 Rand Corporation report summarizes a number of relevant studies and describes models that have been applied (Polich et al. 1984). These programs are aimed at nonuser adolescents who otherwise might become users. It depicts four stages of experimental use of drugs: (1) nonuse--never tried drugs, (2) experimental or episodic use, (3) regular or frequent use, and finally (4) heavy use. Primary prevention is aimed at the early stages of use. The methods used are essentially those described above. Students need to be able to identify pressures to begin usage, especially from peers. They then need to know the dangers and problems arising from drug use. Next, and crucially, they need to develop skills to resist such pressures and practice using the skills in the presence of such pressure. Role-play situations can help in this process. Project Star at the University of Southern California (not yet published) has recently completed a large-scale seventh grade study in Los Angeles junior high schools. They found the following social approaches worked best in the prevention of drug abuse behavior. These approaches promoted group identification, explained the nature of peer pressure, clarified the misinformation on the prevalence of drug use among peers, made clear the consequences of drug use, and used role-playing techniques to teach resistance skills.(ABSTRACT TRUNCATED AT 400 WORDS)

California↗

Cigarette advertisements in magazines: evidence for a differential focus on women's and youth magazines.

Cigarette advertisements in eight popular magazines from 1960 to 1985 were examined. The magazines were selected to represent different market segments, particularly women and youth. Across all eight magazines, the average number of cigarette ads per issue increased substantially following the 1971 television ban on cigarette ads. Moreover, beginning in the late 1960s and early 1970s, proportionately more ads were placed in women's and youth-oriented magazines than in magazines which targeted other population segments. These data suggest that the tobacco industry may have responded to decreases in the number of smokers and the per capita consumption of cigarettes with an enterprising attempt to recruit new smokers-particularly young people and women.

Adolescent↗

Perspectives on adolescent substance use. A defined population study.

We asked 1447 tenth graders to complete a survey on physical activity, nutrition, stress, and substance use and to undergo basic physical assessments. In a multiple regression analysis, increased level of substance use by both boys and girls was most strongly predicted by friends' marijuana use. For boys, this was followed by perceived safety of cigarette smoking; poor school performance; parents' education; and use of diet pills, laxatives, or diuretics for weight control, accounting for 44% of the overall variation in substance use. For girls, friends' marijuana use was followed by poor school performance; self-induced vomiting for weight control; perceived safety of cigarette smoking; use of diet pills, laxatives, or diuretics for weight control; parents' education; perceived adult attitudes about cigarettes; and nonuse of seat belts, accounting for 53% of the overall variance. Separate multiple regression analyses for each substance produced similar results. The homogeneity of the study population precluded ethnic comparisons. These findings suggest that for many purposes substance use may be considered a single behavior regardless of the specific substance(s) used and that substance use may exist as part of a syndrome of adolescent problem behaviors. In addition, the potent influence of perceived social environment suggests that a social influence resistance model may represent the most successful preventive strategy.

Adolescent↗

Mediated smoking cessation programs in the Stanford Five-City Project.

Two mediated smoking cessation programs were subjected to a field evaluation. The Quit Kit is a printed self-help package, and "Calling It Quits" consists of five segments which were aired on the local television news. A sample of 239 persons requested the Quit Kit and were followed. At the 2-month and 12-month follow-ups, respectively, 13.6% and 17.9% of those surveyed reported abstinence. Results indicate the potential of mediated interventions.

Adult↗

The Stanford Five-City Project: design and methods.

The Stanford Five-City Project is a large experimental field study of community health education for the prevention of cardiovascular disease. It will provide data on fundamental questions in cardiovascular disease epidemiology, communication, health education, behavior change, and community organization, and will also test the ability of a potentially cost-effective program to prevent cardiovascular disease at the community level. This paper describes the purposes, hypotheses, design, and methods of the Five-City Project as a reference for future papers describing results. It is hypothesized that a 20% decrease in cardiovascular disease risk will lead to a significant decline in cardiovascular disease event rates in two treatment communities compared with three reference communities as a result of a six-year intervention program of community-wide health education and organization. Risk factor change will be assessed through four surveys of independent samples and in a repeatedly surveyed cohort. Cardiovascular disease event rates will be assessed through continuous community surveillance of fatal and nonfatal myocardial infarction and stroke.

Adolescent↗

Long-term follow-up of a pilot project on smoking prevention with adolescents.

Seventh graders (N = 353) in one junior high school received an experimental smoking prevention program aimed at teaching students to resist the social pressures to smoke cigarettes. Seventh graders (N = 217) in another school served as controls. Teams of high-school students trained in basic behavior change skills led seven classroom sessions of instruction in counter-arguing during the school year. Significant differences were found between groups in reported smoking at a 9-month posttest. Results were maintained at 21- and 33-month follow-ups.

Adolescent↗

Does dietary health education reach only the privileged? The Stanford Three Community Study.

The relationship of selected social factors to diet, weight and plasma cholesterol was studied in one control and two treatment towns before and after a 3-year, bilingual, mass-media health education program. Spanish-speaking persons reported higher dietary cholesterol and saturated fat than English-speaking participants at baseline, and this remained true after adjusting for the confounding influence of socioeconomic status (SES). Obesity was also more prevalent in Spanish-language and low-SES groups, but plasma cholesterol was not related to these sociodemographic factors. Over the 3 years of the education program, all groups reported 20-40% decreases in dietary cholesterol and saturated fat. These decreases were as large in low-SES groups as in high-SES groups; Spanish-speaking participants reported significantly greater decreases in dietary saturated fat (p = 0.02). Weight change was not related to either SES or language group, but change in plasma cholesterol was marginally more favorable in Spanish-speaking subjects (p = 0.06).

Adult↗

Pilot study of smoking, alcohol and drug abuse prevention.

A longitudinal pilot study gathered data on the onset and prevention of smoking, alcohol, and drug abuse among 526 students from two junior-high-schools in California. Over two school years, students who were trained to resist social pressures toward tobacco, alcohol, and drug use began smoking at less than one-half the rate of those who did not receive special training. Frequent alcohol and marijuana use was also less prevalent among the students who received such training.

Adolescent↗