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Biomedical subjects

R Spoth

Publications and source records attributed to R Spoth.

At least 19 recordsLinked to original sources
PubMed2001

Rural-urban differences in the distribution of parent-reported risk factors for substance use among young adolescents.

PURPOSE: We examined rural-urban differences in cumulative risk for youth substance use. A recent report [National Center on Addiction and Substance Abuse (CASA) 2000] found that the rural-urban distribution of substance use and known risk factors for substance use differed; in many cases rural youth showed higher levels of use, as well as higher levels of risk factors. The current investigation, while not directly examining substance use, further examined rural-urban differences in the distribution of risk factors for youth substance use, based on information from parent reports. METHOD: Study 1 data were collected from a random sample of Midwestern parents (n = 339) with a young adolescent between the ages of 11 and 13 years. Study 2 data were collected from a second sample of Midwestern parents (n = 593). RESULTS: Analyses of rural-urban comparisons demonstrated higher levels of cumulative risk among rural youth. An evaluation of the sensitivity of the analysis to rural-urban classification schemes indicated that the findings were robust, but that there was some minor variation in rural-urban differences by classification scheme. IMPLICATIONS: Results contribute to an explanation of findings from earlier reports of rural-urban differences in substance use, and suggest directions for future research on rural-urban distributions of youth risk factors.

Adolescent↗
PubMed2001

Preparing for the drug free years: session-specific effects of a universal parent-training intervention with rural families.

Like their urban counterparts, adolescents from rural areas are at risk for health and behavior problems, including alcohol and other drug use. This study tested the effects on parenting practices of specific sessions of a parent-training intervention, Preparing for the Drug Free Years, designed to prevent adolescent substance abuse and other problem behaviors. Two hundred and nine rural families were randomly assigned to an intervention or a wait-list control condition. Analyses of covariance comparing adjusted posttest scores revealed that parents in the intervention condition reported significant improvements in parenting behaviors targeted by specific intervention sessions when compared with controls. Effects were most pronounced among mothers. No significant effects were found for nontargeted parenting behaviors, and targeted behaviors were most improved among parents attending relevant program sessions. These results strengthen the internal validity of the study and increase the plausibility that reported improvements were due to the intervention.

Adolescent↗
PubMed2000

Effects of the "Preparing for the Drug Free Years" curriculum on growth in alcohol use and risk for alcohol use in early adolescence.

Preparing for the Drug-Free Years (PDFY) is a curriculum designed to help parents learn skills to consistently communicate clear norms against adolescent substance use, effectively and proactively manage their families, reduce family conflict, and help their children learn skills to resist antisocial peer influences. This study examined the effects of PDFY on the trajectories of these factors, as well as on the trajectory of alcohol use from early to mid adolescence. The sample consisted of 424 rural families of sixth graders from schools randomly assigned to an intervention or a control condition. Data were collected from both parents and students at pretest, posttest, and 1-, 2- and 3 1/2-year follow-ups. Latent growth models were examined. PDFY significantly reduced the growth of alcohol use and improved parent norms regarding adolescent alcohol use over time. Implications for prevention and evaluation are discussed.

Adaptation, Psychological↗
PubMed2000

Modeling factors influencing enrollment in family-focused preventive intervention research.

The reported study tests an extension of a previously supported model of family context and health belief predictors of parental inclination to enroll in preventive interventions. The extended model addresses limitations in the prior investigation; it examines the role of intervention-related beliefs and inclinations on actual enrollment in a skills training intervention research project. Model testing was conducted with a sample of 635 parents of 6th graders who completed a prospective participation factor survey and were recruited for an intervention research project 6 months later. The model fit was strong and all but one of the primary hypothesized effects were supported. Notably, both stated inclination to enroll in an intervention and in the research project had significant positive effects on actual project enrollment occurring 6 months later. Perceived intervention benefits and barriers had significant effects on both types of stated inclination to enroll. Examination of modification indices for the model suggested an additional path linking educational attainment with actual enrollment.

Adult↗
PubMed1999

Engaging families in longitudinal preventive intervention research: discrete-time survival analysis of socioeconomic and social-emotional risk factors.

This study examined whether family risk factors predicted attrition in a prevention research project that incorporated procedures to increase retention in assessment and intervention activities. Analyses used data from 667 rural families collected over 4 waves and consisted of (a) young adolescent and parent reports of internalizing and externalizing problems, (b) observer ratings of distress in parent-child interactions, and (c) family socioeconomic status (SES). Analyses failed to identify any risk factors as significant predictors of intervention participation. Only SES was found to be significant as a predictor of assessment attrition. This SES result appeared to reflect an association between lower educational attainment and an increased likelihood of attrition.

Adult↗
PubMed1999

Assessing a public health approach to delay onset and progression of adolescent substance use: latent transition and log-linear analyses of longitudinal family preventive intervention outcomes.

This study examined the effects of the Iowa Strengthening Families Program (ISFP) and the Preparing for the Drug-Free Years program (PDFY) on young adolescent transitions from nonuse of substances to initiation and progression of substance use. Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents. Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses. Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up. Also at this follow-up, the PDFY showed effects on delayed progression of use among those previously reporting initiation.

Adolescent↗
PubMed1999

Modeling long-term parent outcomes of two universal family-focused preventive interventions: one-year follow-up results.

The present investigation extended prior work by R. Spoth, C. Redmond, and C. Shin (1998). These researchers reported findings that 2 universal family-focused preventive intervention programs each had direct effects on a proximal parenting outcome (intervention-targeted parenting behaviors) and indirect effects on 2 global and distal outcomes (parent-child affective quality and general child management) at posttesting. A replication of the previously tested parenting outcome model was conducted with 1-year follow-up data and procedures identical to those used in the earlier study. Results of the present study (N = 404 families) indicate that statistically significant effects on parenting outcomes were sustained through a 1-year period following the posttest.

Adolescent↗
PubMed1999

Alcohol initiation outcomes of universal family-focused preventive interventions: one- and two-year follow-ups of a controlled study.

OBJECTIVE: This article summarizes the literature on alcohol initiation outcomes of universal family interventions and examines the long-term effects of the Iowa Strengthening Families Program (ISFP) on these outcomes. METHOD: A longitudinal, controlled efficacy study of the ISFP was conducted with 446 families from 22 rural school districts in a Midwestern state. Alcohol initiation behaviors were measured by a four-item index (Alcohol Initiation Index [AII]), with low scores representing a lower level of alcohol initiation. The AII was examined using mixed-model analyses of covariance. Relative reduction rates for individual initiation behaviors and initiation differences among higher- and lower-dosage intervention groups were calculated. RESULTS: AII scores were significantly lower among intervention group adolescents than among control group adolescents at 1- and 2-year follow-up assessments. Relative-reduction rate differences between intervention and control groups on specific alcohol initiation behaviors (e.g., onset of drinking without parental permission, onset of drunkenness) ranged from approximately 30% to 60%. Dosage-related initiation differences were evident only at the 1-year follow-up. CONCLUSIONS: Studies indicating the public health benefits of universal interventions that delay the initiation of alcohol use also underscore the importance of the current line of investigation. All effect sizes and relative reduction rates of specific alcohol initiation behaviors suggest the practical significance of the findings. The gap in the prevention outcome knowledge base in this area of investigation could be filled with more rigorous universal family-focused intervention studies that address a wide range of implementation and methodological issues.

Adolescent↗
PubMed1998

Direct and indirect latent-variable parenting outcomes of two universal family-focused preventive interventions: extending a public health-oriented research base.

Recent literature underscores the need for studies of family-based preventive interventions oriented toward public health objectives. This article illustrates a program evaluation approach for the study of family intervention outcomes in general populations. Thirty-three rural schools were randomly assigned to 1 of 3 conditions: the Preparing for the Drug-Free Years Program (PDFY), the Iowa Strengthening Families Program (ISFP), and a minimal-contact control group. Self-report and observational data collected from 523 families were used to develop measurement models of 3 latent parenting constructs that included measurement method effects. Analyses were conducted to ensure initial and attrition-related group equivalencies and to assess school effects. Structural equation models of the hypothesized sequence of direct and indirect effects for both PDFY and ISFP were then fit to the data. All hypothesized effects were significant for both interventions. The discussion addresses the potential public health benefits of evaluation research on universal preventive interventions.

Adolescent↗
PubMed1998

Risk moderation of parent and child outcomes in a preventive intervention: a test and replication.

Family risk-related variations in proximal parent and young adolescent outcomes of a universal family-focused preventive intervention were examined using a cumulative index of risk incorporating sociodemographic characteristics and social-emotional adjustment measures. Results of an initial investigation involving 209 families of young adolescents suggested that intervention efficacy was largely unrelated to cumulative family risk. These findings were replicated with a second sample of 428 families. Implications for future intervention applications and outcome research are discussed.

Adolescent↗
PubMed1997

Challenges in defining and developing the field of rural mental disorder preventive intervention research.

An overview of selected issues and challenges in defining and developing the field of rural preventive intervention research is presented. One fundamental challenge is to clarify the distinguishing characteristics of prevention science in rural contexts. Other challenges are evident in the need to address: the lack of consensus on conceptual and methodological approaches to this field, limited empirical study to date, the tremendous diversity of rural populations, and inconsistencies in the usage of the term "rural". This article suggests the organization of a work group to formulate and implement a clear research agenda. In addition, several general questions are discussed that, if addressed, might serve to better define and further develop the field. These questions concern the implications of multiple approaches to prevention science in rural contexts, the classification of rural populations, the functional relevance of rural residence in the etiology of specific disorders, the application of extant etiological models to interventions designed specifically for rural populations, the conduct of rural area prevention needs assessments, the development of models for collaboration between intervention researchers and rural community stakeholders, and strategies to engage rural residents in preventive interventions.

Community Mental Health Services↗
PubMed1997

Applying readily accessible graphical techniques to assess curvilinear relationships and detect outliers. The case of protective family processes.

The purpose of this article is to use data from a study of protective family processes to illustrate how readily accessible graphical techniques can supplement correlation and regression analyses. Graphical techniques can help to (a) better understand family process data from a descriptive standpoint, (b) minimize erroneous statistical conclusions, and (c) clarify theoretically important relationships among variables. Following a brief description of the substantive area selected for illustration of the graphical techniques, data from a study employing multimethod measurement procedures (N = 146) are employed to illustrate two graphical technique applications in the analysis of a predictor (marital quality) of a study outcome variable (parent-child affective quality). Instructions for the application of relevant procedures in SAS and SPSS statistical packages are provided.

Child↗
PubMed1996

Protective factors and young adolescent tendency to abstain from alcohol use: a model using two waves of intervention study data.

Two waves of data from a family-focused preventive intervention project were used to test a model of the influence of protective factors on young adolescents' tendency toward alcohol abstinence. Prior theoretical and empirical work guided the specification of hypothesized effects of the protective factors affectional relationship with parents, affiliation with prosocial peers, and mastery-esteem on tendency toward alcohol abstinence. The tested model controlled for preintervention measures and included specified interrelations of protective factors across time. Structural equation analysis indicated that the model fit the data. Two of the hypothesized cross-time effects, however, were not supported.

Adolescent↗
PubMed1993

Consumer-focused data collection in prevention program evaluation. Rationale and illustrations.

This article presents a rationale for consumer-focused data collection at multiple points in the process of prevention program evaluation. Recommended procedures include data collection on consumer responses to various recruitment strategies and consumer preferences for specific program delivery features. Following the general rationale for use of these procedures, a summary description of their relationship with existing approaches to program evaluation is presented. Finally, illustrations of consumer-focused data collection procedures applied during several phases of an ongoing program evaluation project are provided.

Consumer Behavior↗
PubMed1993

An alternative method for sample size determination in substance misuse prevention research.

There is considerable evidence that social science researchers often fail to adequately address statistical power and related sample size issues. This tendency has been particularly salient in substance misuse prevention research. Although failure to carefully address statistical power and sample size issues most frequently results in studies lacking statistical power, other problems can also occur. For example, sample size determination in controlled studies which focus on rates of substance initiation and similar measures require close consideration of baseline rates indicated by these measures. Otherwise, when conventional procedures for sample size determination are utilized, samples in these studies can exceed the size necessary for predesignated levels of power. This article presents a simple alternative to conventional procedures for sample size determination which can be applied to controlled study of substance initiation and similar outcomes.

Alcoholism↗
PubMed1991

Smoking cessation program preferences associated with stage of quitting.

The purpose of this article is to report results from three exploratory studies which examined smoker preferences for cessation program attributes associated with stage of quitting. Study 1 was a telephone survey of 205 randomly selected smokers, in "precontemplative," "contemplative," and "ready-for-action" stages of quitting, who were queried about their preference for a wide variety of cessation program attributes. Study 2 entailed a computer-assisted telephone interview of 218 smokers in the same three stages of quitting. Interview data were used for multiattribute utility analysis of (a) preference for specific program attributes, selected partially on the basis of Study 1 results; and (b) preference for six different types of cessation programs, evaluated through computer simulations. Study 3 replicated Study 2 procedures using a smaller mall intercept sample which allowed in-person interviews and the use of display materials. Results suggested that there are limited but potentially significant differences among smokers in the three stages concerning program attribute preferences (e.g., use of self-help vs. facilitator-led programs, inclusion of relaxation techniques, quitting cold turkey, strategies for gaining social support). Nonetheless, there were no statistically significant differences among the three subgroups in level of preference for the six types of programs evaluated. Implications of these preliminary results are discussed.

Adult↗
PubMed1983

Differential stress reduction: preliminary application to an alcohol-abusing population.

This study applied a differential stress reduction paradigm to an alcoholic population. The paradigm was tested by designing stress management procedures to match alcoholics' locus of control. Subjects were 55 participants in an alcohol dependency treatment program at a Veterans Administration Medical Center. Three-channel assessment of general anxiety with seven separate measures was conducted; data were collected at pretesting, posttesting, and at an 8-week follow-up. A two-factor design was used, incorporating multivariate analyses of covariance. Findings supported the hypothesis that matching the treatment control orientation with trainee locus of control enhances outcome. Results also showed a significant difference in outcome between types of locus of control, with internal locus of control subjects performing better. There were no significant differences in the treatment group comparisons.

Adult↗