Biomedical subjects

Susan T Ennett

Publications and source records attributed to Susan T Ennett.

15 recordsLinked to original sources

PubMed2006

Mechanisms through which drug, sex partner, and friendship network characteristics relate to risky needle use among high risk youth and young adults.

Drug injector social networks are a primary social space in which risky needle use behaviors associated with HIV transmission occur, but the mechanisms through which these social networks influence risky needle use are unclear. This study investigated two mechanisms, social support and social regulation, through which injection drug users' social networks might relate to risky needle use behaviors. We investigated how these mechanisms work in three types of social networks, namely, drug user, sex partner, and friendship networks. Data are from a study of HIV risk and protective behaviors of youth and young adults, ages 14-43, in the United States who were injection drug users and/or the sexual partners of users (N = 277). The three types of networks were constructed based on information respondents provided about their drug use partners, sexual partners, and friends. The networks were characterized by structural (i.e., size and density) and interactional (i.e., multiplexity and closeness) characteristics. We conducted tests for mediation using ordered probit models and multiple linear regression. In the drug networks, social regulation partially meditated the relationship between multiplexity and risky needle use (p<.10). In the sex partner networks, emotional support partially mediated the relationship between network size and risky needle use (p<.001), fully mediated the relationship between network closeness and risky needle use (p<.001), and partially mediated the relationship between multiplexity and risky needle use (p<.01). Mediators were not identified in the friendship networks. The findings demonstrate that network mechanisms explaining risky needle use differ for drug user and sex partner networks in ways consistent with the functional nature of each type of network tie.

Adolescent↗

PubMed2005

Factors associated with adoption of evidence-based substance use prevention curricula in US school districts.

This paper examines factors associated with the adoption of evidence-based substance use prevention curricula (EBC) in a national sample of school districts. Substance abuse prevention coordinators in public school districts (n = 1593), which were affiliated with a random sample of schools that served students in Grades 5-8, completed a written survey in 1999. Results indicated that 47.5% of districts used at least one EBC in their schools with middle school grades. Substance use prevention coordinators reported they had the greatest input in decisions about curricula. In a multivariate analysis of factors positively associated with district-level decisions to adopt evidence-based programs, significant factors included input from a state substance use prevention group, use of information disseminated by the National Institute on Drug Abuse or Center for Substance Abuse Prevention, use of local needs assessment data, consideration of research showing which curricula are effective and allocation of a greater proportion of the coordinator's time to substance use prevention activities. State and federal agencies should increase their efforts to disseminate information about evidence-based programs, targeting in particular the district substance use prevention coordinator.

Adolescent↗

PubMed2005

Assessing the effects of the dating violence prevention program "safe dates" using random coefficient regression modeling.

The Safe Dates Project is a randomized trial for evaluating a school-based adolescent dating violence prevention program. Five waves of data were used to examine the effects of Safe Dates over time including primary and secondary prevention effects, moderators, and mediators of program effects. Using random coefficients models, with multiple imputation of missing data, significant program effects were found at all four follow-up periods on psychological, moderate physical, and sexual dating violence perpetration and moderate physical dating violence victimization. Marginal effects were found on sexual victimization. Effects on severe physical perpetration at all four follow-up periods were moderated by prior involvement in that type of violence. Primary and secondary prevention effects were found and the program was equally effective for males and females and for whites and non-whites. Program effects were mediated by changes in dating violence norms, gender-role norms, and awareness of community services.

Adolescent↗

PubMed2005

Neighborhood influences on adolescent cigarette and alcohol use: mediating effects through parent and peer behaviors.

The influence of neighborhoods on adolescent behaviors has received increasing research attention. In the present study, we use structural equation models to specify pathways from neighborhoods to adolescent cigarette and alcohol use through parental closeness, parental monitoring, parent substance use, and peer substance use. We use a national sample with 959 adolescents 12 to 14 years of age whose residential addresses were matched with 1990 Census tracts to provide neighborhood characteristics. We found that for adolescent cigarette use low socioeconomic status (SES) neighborhoods were associated with increased parental monitoring, which was further associated with decreased adolescent cigarette use. For adolescent alcohol use, high SES neighborhoods were associated with increased parent drinking, which was further associated with increased adolescent alcohol use. Low SES neighborhoods were associated with increased parental monitoring and increased peer drinking, which were in turn associated with decreased and increased adolescent alcohol use, respectively.

Adolescent↗

PubMed2005

Parental perceptions of their preschool-aged children's oral health.

BACKGROUND: Parents have an important role in making decisions about their children's oral health. The purpose of the authors' study was to determine parental perceptions of their children's oral health status and factors correlated with these perceptions of health. METHODS: The authors analyzed data for 3,424 children (2-5 years of age) from the Third National Health and Nutrition Examination Survey. They based the dependent variable on a question asked of primary caregivers: "How would you describe the condition of [child's name]'s natural teeth?" Explanatory variables included demographic variables, dental visits, perception of child's general health, need for dental care and presence of tooth caries. RESULTS: Eighty-nine percent of parents rated their child's oral health as excellent, very good or good, and 11 percent rated it as fair or poor (mean = 2.7 on a five-point scale, with 1 being excellent and 5 being poor). Tooth caries, perceived need for dental cleaning and treatment, lower income and poorer general health perceptions were associated with poorer parental ratings. CONCLUSIONS: Actual disease and perceived need are associated significantly with parents' perceptions of their children's oral health. PRACTICE IMPLICATIONS: Understanding parents' perceptions of their children's oral health and factors that motivate these perceptions can help dentistry overcome barriers that parents encounter in accessing dental care for their children.

Child, Preschool↗

PubMed2004

Longitudinal predictors of serious physical and sexual dating violence victimization during adolescence.

BACKGROUND: This study identifies potentially modifiable risk factors for the onset of and chronic victimization from serious physical and sexual dating violence. METHODS: One thousand two hundred ninety-one 8th and 9th graders from a county in North Carolina were assessed annually for 5 and 4 years, respectively. RESULTS: For males, having been hit by an adult with the intention of harm, having low self-esteem, and having been in a physical fight with a peer predicted onset of serious physical dating violence victimization. Those variables, plus having a friend who has been a victim of dating violence, alcohol use, and being white, predicted chronic victimization for males. For females, onset of serious physical dating violence victimization was predicted by having been hit by an adult; that variable, plus living in a single-parent household, predicted chronic victimization from serious physical violence. Also for females, onset of sexual violence victimization was predicted by having a friend who has been the victim of dating violence and being depressed; those variables and gender stereotyping predicted chronic victimization from sexual dating violence. CONCLUSIONS: The findings identify high-risk groups and risk factors to target for intervention and have implications for approaches to delivering dating violence prevention programs.

Adolescent↗

PubMed2004

Students' special needs and problems as reasons for the adaptation of substance abuse prevention curricula in the nation's middle schools.

In this study we estimate the proportion of the nation's middle school teachers who have adapted substance abuse curricula in response to their students' special problems or needs. We also explore a variety of characteristics associated with schools, teachers, and the curricula implemented that are associated with adaptations made in response to the most prevalent of these student problems or needs. Study data were collected in 1999 from a representative sample of lead substance abuse prevention teachers in the nation's public and private schools. We found that 79.8% of respondents report adapting their prevention curricula in response to at least one of the dozen student problems and needs specified. The problems cited most frequently, by slightly more than half of all respondents, relate to the needs of students who are sexually active or have discipline problems. Associated most strongly with adaptations for these two reasons were teachers who were recently trained in their curricula, and substance abuse prevention lessons that could readily be integrated into the school's overall curriculum. We discuss the need for curriculum developers to recognize the frequency with which, and reasons for which, teachers are adapting their curricula, and to include appropriate optional content that addresses students' needs.

Analysis of Variance↗

PubMed2004

Effects of a tailored follow-up intervention on health behaviors, beliefs, and attitudes.

BACKGROUND: The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers. METHODS: Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled in the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program at local North Carolina health departments. During the year after the behavior change program, intervention participants were mailed six sets of computer-tailored health messages and received two computer-tailored telephone counseling sessions. Main outcomes of dietary and physical activity behaviors, beliefs, and attitudes were measured. RESULTS: Intervention participants were more likely to move forward into more advanced stages of physical activity change (p = 0.02); control participants were more likely to increase their level of dietary social support at follow-up (p = 0.05). Both groups maintained low levels of reported saturated fat and cholesterol intake at follow-up. No changes were seen in physical activity in either group. CONCLUSIONS: Mailed computer-tailored health messages and telephone counseling calls favorably modified forward physical activity stage movement but did not appreciably affect any other psychosocial or behavioral outcomes.

Attitude to Health↗

PubMed2004

Assessing the long-term effects of the Safe Dates program and a booster in preventing and reducing adolescent dating violence victimization and perpetration.

OBJECTIVES: This study determined 4-year postintervention effects of Safe Dates on dating violence, booster effects, and moderators of the program effects. METHODS: We gathered baseline data in 10 schools that were randomly allocated to a treatment condition. We collected follow-up data 1 month after the program and then yearly thereafter for 4 years. Between the 2- and 3-year follow-ups, a randomly selected half of treatment adolescents received a booster. RESULTS: Compared with controls, adolescents receiving Safe Dates reported significantly less physical, serious physical, and sexual dating violence perpetration and victimization 4 years after the program. The booster did not improve the effectiveness of Safe Dates. CONCLUSIONS: Safe Dates shows promise for preventing dating violence but the booster should not be used.

Adolescent↗

PubMed2004

Who's calling the shots? Decision-makers and the adoption of effective school-based substance use prevention curricula.

This study investigates the relative roles of school district and school-level decision-makers in the implementation of effective substance use prevention curricula. Drawing on a "Site-Based Management" approach to effective decision-making, we hypothesized that schools whose personnel played active decision-making roles would be more likely to implement effective curricula than those in which decision-making was the prerogative of school district personnel. Study data comprised 1369 questionnaires completed by a representative national sample of both district-level prevention coordinators and middle school-based lead prevention teachers. From the perspective of the lead prevention teachers, the school district-level prevention coordinator was more influential than school staff in selecting effective prevention curricula. However, we did find some support for our hypothesis from our district-level informants, who indicated that community groups and advisory committees also play a modest role in the selection of such curricula.

Adolescent↗

PubMed2003

How measures of perception from survey data lead to inconsistent regression results: evidence from adolescent and peer substance use.

In studies of peer group behavior, the direct measure of peer group behavior is often not available, and so is replaced by perceptions from survey respondents. This study shows that regression estimators are inconsistent when the correctly measured independent variable of group behavior is replaced with perceived measures from survey respondents. The inconsistency is due to three sources: projection of own behavior onto the group, rescaling the marginal effect of the group, and simple random measurement error. We discuss why each effect may cause inconsistency, derive formulas for the probability limit to quantify their effects, and illustrate with three examples of adolescent smoking and drinking.

Adolescent↗

PubMed2003

A comparison of current practice in school-based substance use prevention programs with meta-analysis findings.

The series of seminal meta-analytic studies of school-based substance use prevention program studies conducted by the late Nancy S. Tobler and colleagues concluded that programs with content focused on social influences' knowledge, drug refusal skills, and generic competency skills and that use participatory or interactive teaching strategies were more effective than programs focused on knowledge and attitudes and favoring traditional didactic instruction. The present study compared current school practice against evidence-based standards for "effective content" and "effective delivery," derived from the Tobler findings. Respondents were the lead staff who taught substance use prevention in the 1998-1999 school year in a national sample of public and private schools that included middle school grades (N = 1,795). Results indicate that most providers (62.25%) taught effective content, but few used effective delivery (17.44%), and fewer still used both effective content and delivery (14.23%). Those who taught an evidence-based program (e.g., Life Skills Training, Project ALERT), however, were more likely to implement both effective content and delivery, as were those teachers who were recently trained in substance use prevention and were comfortable using interactive teaching methods. The findings indicate that the transfer to practice of research knowledge about school-based substance use prevention programming has been limited.

Adolescent↗

PubMed2003

The principles of effectiveness: early awareness and plans for implementation in a national sample of public schools and their districts.

The US Department of Education's Principles of Effectiveness require recipients of Safe and Drug-Free Schools and Community Act funds to: a) base drug and violence prevention programs on needs assessment data, b) develop measurable program goals and objectives, c) implement programs with research evidence of effectiveness, and d) periodically evaluate programs relative to their goals and objectives. This paper reports the extent of awareness of the Principles of Effectiveness and plans for their implementation among public school districts and schools in the United States in the year following their announcement. Results showed a greater percentage of public school districts than individual schools knew about the principles and planned for implementation, but baseline levels of awareness for both districts and schools were relatively low. Schools were more likely to know about the principles when their associated school district also knew. Results suggest a need for greater communication about the principles to school districts, and in turn, a need for greater communication between district and school-level substance use prevention staff.

Child↗

PubMed2002

Comprehensiveness of substance use prevention programs in U.S. middle schools.

PURPOSE: To assess how current practice in middle school substance use prevention programs compares with seven recommended guidelines adapted from the Centers for Disease Control and Prevention guidelines for school-based tobacco use prevention programs. METHODS: Substance use prevention practice was analyzed using data from a 1999 mailed questionnaire of a nationally representative sample of 1496 public and private schools with middle school grades that reported having a substance use prevention program. Respondents answered questions about substance use prevention education and activities in the whole school and in their own classroom. Weighted prevalence estimates for the seven recommendations are presented, and multiple regression was used to analyze correlates of implementation of the recommendations. RESULTS: An estimated 64.2% of schools met four or more of the recommendations for school-based substance use prevention practice; 4.0% met all seven recommendations. Schools were most likely to report having and enforcing substance use prevention policies (84.3%) and least likely to report training teachers in substance use prevention (17.9%). More recommendations were implemented in schools that were public and had larger enrollments, greater perceived availability of resources, greater school board and parental support for substance use prevention, and had hired a school substance use prevention coordinator. CONCLUSIONS: The low prevalence of comprehensive substance use prevention programs in U.S. middle schools may limit the potential impact of school programs on the prevalence of youth substance use.

Adolescent↗

PubMed2002

Influence of a family program on adolescent smoking and drinking prevalence.

Reducing the prevalence of adolescent cigarette smoking and alcohol drinking are public health goals of the United States. Although families have strong influence on their children, few randomized studies have examined whether family-directed programs influence those behaviors in general universal populations. This paper reports findings from an evaluation of a family program that features the mailing of four booklets to adult family members with follow-up telephone calls by health educators. A national sample of adolescent-parent pairs and a randomized experimental design were used to evaluate the program. Baseline users and nonusers of those substances were considered simultaneously in analyses so that program influences on smoking and drinking prevalence could be examined. The findings suggest that the program significantly reduced the prevalence of smoking cigarettes and drinking alcohol among adolescents. These findings are discussed in the context of earlier reports of research on the family program and implications for public health.

Adolescent↗