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Biomedical subjects

Thomas W Valente

Publications and source records attributed to Thomas W Valente.

At least 19 recordsLinked to original sources
PubMed2006

Perceived peer influence and peer selection on adolescent smoking.

Despite advances in tobacco control, adolescent smoking remains a problem. The smoking status of friends is one of the highest correlates with adolescent smoking. This homophily (commonality of friends based on a given attribute) may be due to either peer pressure, where adolescents adopt the smoking behaviors of their friends, or peer selection, where adolescents choose friends based on their smoking status. This study used structural equation modeling to test a model of peer influence and peer selection on ever smoking by adolescents. The primary analysis of the model did not reach significance, but post hoc analyses did result in a model with good fit. Results indicated that both peer influence and peer selection were occurring, and that peer influence was more salient in the population than was peer selection. Implications of these results for tobacco prevention programs are discussed.

Adolescent↗
PubMed2006

The interaction of curriculum type and implementation method on 1-year smoking outcomes in a school-based prevention program.

Studies have shown that the effectiveness of programs or curricula may depend in part on who delivers the material. In adolescent health education programs, peer leaders are often recruited to implement programs because they are more persuasive to other adolescents than adults. Teachers also systematically vary how groups are constructed in school-based health education programs. This study compared the effects of three leader and group selection methods within the context of two tobacco prevention programs. Eight schools received a social influences program (Chips) and eight received a program with a multicultural emphasis (Flavor). Within these 16 schools 84 classrooms consisting of 1486 students were randomly assigned to one of three leader and group creation conditions: (i) leaders defined as those who received the most nominations by students and groups created randomly (random group), (ii) same as (i) but groups created by assigning students to the leaders they nominated (network), and (iii) leaders and groups created by teachers (teacher). One year follow-up data showed that main effects of the curriculum and network assignments were non-significant on smoking initiation when entered alone. Interaction terms of curriculum and assignment methods, however, were significant such that the network and teacher conditions were less effective than the random group condition with Chips, and more effective than random group condition with Flavor. These data show that school-based prevention programs should be evaluated in light of who implements the program. Even a peer-led program will be differentially effective based on how leaders are selected and how groups are formed, and this effect may be curriculum dependent.

Child↗
PubMed2006

Peer influences on adolescent cigarette smoking: a theoretical review of the literature.

This article reviews several classes of theories to elucidate the relationship between adolescent cigarette smoking and friends' cigarette smoking. Perceived influence theories hinge upon an adolescent's perception of friends' smoking behavior. External influence theories are those in which friends' smoking behavior overtly influences adolescent smoking. Group level theories examine how differences at the level of subculture, gender, and race/ethnicity influence the relationship under study. Network theories are also discussed. A model integrating relevant theories into a longitudinal model representing friend influences on adolescent smoking is presented, along with implications of the results presented for adolescent tobacco prevention programs.

Adolescent↗
PubMed2006

Diffusion of innovations and network segmentation: the part played by people in promoting health.

OBJECTIVE: The objective of this study was to describe how diffusion of innovations theory can integrate mass media, interpersonal communication, and social network analysis. These principles can be used to implement and tailor data-based health promotion activities. GOAL: The goal of this study was to develop a model for using and incorporating interpersonal communication into health promotion programs designed to encourage behaviors that reduce the spread of sexually transmitted diseases (STDs)/HIV. STUDY DESIGN: The authors conducted a review of selected studies that exemplify how diffusion of innovations theory has applied interpersonal communication to promote STD/HIV preventive health behaviors. RESULTS: Few studies have incorporated interpersonal communication as an intervention strategy to encourage STD/HIV preventive behavior. Interventions that have used interpersonal communication have observed successes in health promotion and increases in safer sex behaviors. CONCLUSIONS: This study shows that social network analysis can be used to design more appropriate and perhaps more effective health promotion programs.

Communication↗
PubMed2006

Translation in the health professions: converting science into action.

The systematic translation of evidence-based research findings, tools, and information into practice is critical to improving the quality of our nation's health. However, despite several decades of advances in developing medical knowledge based on high-quality empirical evidence, widespread implementation of these findings into practice in diverse applied settings has not been achieved. This article reviews definitions and conceptual models that describe the translation of research from basic discovery to real-world applications, summarizes the various issues involved in the process of translation, discusses multiple barriers, and provides recommendations to surmount these hurdles. Areas of further research in this arena are suggested. Finally, the article concludes that translational research is an important area to continue to pursue requiring long-term collaborative commitment among researchers and practitioners.

Biomedical Research↗
PubMed2006

Type II translation: transporting prevention interventions from research to real-world settings.

This article summarizes research on Type II translation of prevention interventions aimed at enhancing the adoption of effective programs and practices in communities. The primary goal of Type II translation is to institutionalize evidence-based programs, products, and services. First, the authors describe theoretical frameworks that are useful to guide Type II translation research. Second, research on prevention program implementation, including fidelity of implementation and factors that are associated with successful program implementation, is summarized. The authors describe interventions designed to enhance the dissemination of preventive interventions in community and public health settings. Third, they describe strategies used by prevention program developers who have taken programs to scale. Fourth, they present a case example of Project Towards No Drug Abuse (TND), an empirically validated high school-based substance abuse prevention program. They describe ongoing research on the dissemination of Project TND. Finally, they provide suggestions for future Type II translation research.

Behavior↗
PubMed2006

Promoting breastfeeding in Bolivia: do social networks add to the predictive value of traditional socioeconomic characteristics?

This study tested whether the prediction of health-related knowledge (correct breastfeeding practices in this case) could be improved by including information about the composition of an individual's personal network above and beyond that predicted by his/her socioeconomic or demographic characteristics. Few studies have tested the predictive value of social networks, especially for population-based studies, despite an increased use of social networks in the past few years in several fields of health research, especially in research relating to prevention of HIV/AIDS and design of HIV/AIDS programmes. Promotion of breastfeeding practices that enhance child survival is important in Bolivia because of high infant morbidity and mortality in the country. Data on a cross-sectional urban probability sample of 2,354 women and men aged 15-49 years were collected from seven urban areas in Bolivia. Model building and the log likelihood ratio criteria were used for assessing the significance of variables in a logistic model. Results showed that the network variables added significantly (p < 0.05 for knowledge of breastfeeding only with no other liquids and for knowledge of breastfeeding only with no solids p < 0.01) to the predictive power of the socioeconomic variables. These results may also hold for other health research areas, increasingly using social network analysis, such as that of HIV/AIDS.

Adolescent↗
PubMed2005

Do popular students smoke? The association between popularity and smoking among middle school students.

BACKGROUND: Several studies have shown an association between popularity and behavior, indicating that popular people tend to reflect the norms of their group. Among adolescents, it has been hypothesized that popular students are more likely to smoke, especially in schools with high smoking prevalence. METHODS: Data were collected on friendship patterns and smoking from 1,486 sixth and seventh graders in 16 middle schools in southern California. Susceptibility to smoke was measured as not stating a commitment not to smoke in the future, and smoking as ever taken a puff or smoked a whole cigarette. We measured popularity as the number of times a student was chosen as a friend. Multivariate logistic regression was used to correlate popularity with susceptibility to smoke and smoking at follow-up controlling for baseline outcomes, demographic characteristics, and clustering within schools. RESULTS: Popularity was associated with increased susceptibility to smoke (Adjusted Odds Ratio [AOR] = 5.64, p < .001) and smoking (AOR = 5.09, p < .05) over the 1-year interval between surveys. Although the association was strongest for non-White boys, we did not find evidence of interactions between popularity and gender or ethnicity. CONCLUSIONS: Popular middle school students were more likely to become smokers compared to their less popular peers. Although there seems some difference in the association by gender and ethnicity, the evidence does not suggest subgroup effects in this population. Implications for the study of adolescent smoking and prevention programming are discussed.

Adolescent↗
PubMed2005

Impact of sexual networks on risk for gonorrhea and chlamydia among low-income urban African American adolescents.

OBJECTIVE: To determine whether African American adolescents, whose recent sex partners reported having another sex partner, are at increased risk for exposure to genital chlamydial infection or gonorrhea. STUDY DESIGN: A household sample of low-income urban African American adolescents 14 to 19 years of age, up to two of their close friends, and their sex partners were interviewed and tested for gonorrhea and chlamydial infection. RESULTS: Thirty-four of 145 adolescents had at least one recent sex partner infected with Neisseria gonorrhoeae and/or Chlamydia trachomatis. The adjusted model showed that adolescents, whose recent sex partners reported having another sex partner, were more likely to have a recent sex partner with gonorrhea and/or chlamydial infection. CONCLUSION: In addition to individual factors, network factors may explain why African American adolescents are at increased risk for exposure to sexually transmitted infections (STIs). Multi-level community-based interventions may need to address network factors along with personal behaviors in order to prevent STIs among low-income urban African American adolescents.

Adolescent↗
PubMed2005

Intergenerational transfers of resources between older persons and extended kin in Taiwan and the Philippines.

This study examines the extent to which older generations actively exchange resources with extended kin in Taiwan and the Philippines. It is critical to understand the position of older generations in the family, because population ageing and declines in family size spur concerns about the tenacity of family support. This research builds upon previous studies that have predominantly focused on parent-child relationships alone or on support received by older parents. Social-network measures are used to estimate overall levels of transfers of resources across generations, and the prevalence and patterns of pathways that link generations and types of kin. Our findings show that the availability of kin is similar in both settings but that transfer activity in the Philippines appears more broadly distributed across family relations, especially siblings, while in Taiwan transfers are more concentrated among lineal kin. These results confirm the importance and diversity of extended kin in systems of family support.

Data Collection↗
PubMed2005

The selection of family planning discussion partners in Nepal.

There is growing evidence that the information women receive about family planning from their social network is influential in their decisions to use a contraceptive method. Less is known, however, regarding the role individuals play in constructing their social network and, thereby, determining the nature of its influence. This study examined the criteria women use to select their family planning discussion partners and the individual-level factors that promote the addition of a contraceptive user to one's discussion network. Sociometric data were collected in November 1997 and February 1999 from all currently married women aged 15 to 49 years in three villages of Dang District in the Mid-Western Region of Nepal (panel N = 281). Preference for women from one's ethnic group and the strategic selection of contraceptive users was observed. Contraceptive use and attitudes toward family planning were both positively associated with the addition of a contraceptive user to one's discussion network, suggesting that women seek contraceptive users to confirm their existing beliefs and behaviors. Understanding the dynamics of social network formation can assist programs to better utilize the behavior change potential of peer networks.

Adolescent↗
PubMed2004

Characteristics of opinion leaders in substance abuse treatment agencies.

OBJECTIVE: This study was part of a larger effort to test the effectiveness of technology transfer approaches related to evidence-based treatment of co-occurring substance abuse and mental health disorders. Specifically, this study examined characteristics of "opinion leaders" as technology transfer agents. METHOD: A network analysis was conducted within four large substance abuse treatment agencies to identify individuals that other counselors sought out for consultation on co-occurring issues. The identified opinion leaders were then compared with other counselors on demographic variables, education and experience, and attitudes and knowledge about working with individuals with co-occurring disorders. RESULTS: The analyses demonstrate that opinion leaders differed from other counselors in competency-related characteristics including more postgraduate education, relevant professional credentials, and years of experience in mental health treatment. They also had greater knowledge of the dynamics and treatment of co-occurring disorders as well as a greater willingness and confidence in working with such clients. CONCLUSION: These results suggest that opinion leaders are used within agencies for information and consultation regarding treatment issues. Therefore, opinion leaders may provide an important vehicle for dissemination and adoption of evidence-based treatment practices in community treatment settings.

Adult↗
PubMed2004

Using social networks to understand and prevent substance use: a transdisciplinary perspective.

We review findings from research on smoking, alcohol, and other drug use, which show that the network approaCh is instructive for understanding social influences on substance use. A hypothetical network is used throughout to illustrate different network findings and provide a short glossary of terms. We then describe how network analysis can be used to design more effective prevention programs and to monitor and evaluate these programs. The article closes with a discussion of the inherent transdisciplinarity of social network analysis.

Biomedical Research↗
PubMed2003

Using network analysis to understand community-based programs: a case study from highland Madagascar.

CONTEXT: Programs using community-based distribution (CBD) of family planning services have had mixed success in Sub-Saharan Africa. Knowledge about why these programs succeed or fail is limited. METHODS: In 1999, a total of 159 women and men of reproductive age were interviewed in a village in highland Madagascar with an active community-based family planning program. Network analysis informed by chi-square tests and multiple regression analysis was used to test whether respondents' communication with CBD agents and the location of their discussion partners were associated with their knowledge and use of family planning. RESULTS: The CBD agents were highly central in the village's family planning network; 35% of women and 19% of men directly communicated with a CBD agent about family planning or were indirectly linked to an agent. Knowledge of family planning was associated with having either a direct or an indirect link to a CBD agent; use of a modern method was associated with discussing family planning only with someone outside the village (odds ratio, 12.6) or with discussing it in the village and communicating directly with a CBD agent (10.8). CONCLUSIONS: Network analysis can improve the understanding of community-based program functioning by providing a way to examine who receives information from and is influenced by CBD agents.

Adolescent↗
PubMed2003

Effects of a social-network method for group assignment strategies on peer-led tobacco prevention programs in schools.

OBJECTIVES: Our study tested the effectiveness of network methods for identifying opinion leaders and for constructing groups. METHODS: Three conditions-random, teacher, and network--ere randomly assigned to 84 6th-grade classrooms within 16 schools. Pre- and postcurriculum data on mediators of tobacco use were collected from 1961 students. Peer leaders in the network condition were identified by student nominations, and those leaders were matched with the students who nominated them. RESULTS: Students in the network condition relative to the random condition liked the prevention program more and had improved attitudes (beta = -0.06; P <.01), improved self-efficacy (beta = -0.10; P <.001), and decreased intention to smoke (adjusted odds ratio [OR] = 0.46; 95% confidence interval [CI] = 0.38, 0.55). CONCLUSIONS: The network method was the most effective way to structure the program. Future programs may refine this technique and use it in other settings.

Child↗
PubMed2002

The adoption of ablation therapy for Barrett's esophagus: a cohort study of gastroenterologists.

OBJECTIVES: Although ablation therapy may be useful in the treatment of Barrett's esophagus. evidence of effectiveness is scarce, and little is known about current utilization of ablation. We aimed to determine whether the use of ablation was increasing in a cohort of gastroenterologists, and to identify physician beliefs and characteristics associated with ablation use. METHODS: We surveyed a national sample of gastroenterologists about ablation use, with an 18-month follow-up. The self-administered instrument included questions about demographic characteristics, attitudes about ablation therapy, and prior experience with ablation. Case scenarios were also included. We used logistic regression to identify factors associated with the use of ablation in patients with Barrett's esophagus. RESULTS: Two hundred seventy-nine (50.3% of those eligible) responded to the baseline survey. Few agreed that ablation lowers the risk of adenocarcinoma (15%) or is supported by the medical literature (19%). However, 25% of respondents reportedly had used ablation at baseline, and this increased to 36% in the follow-up survey (p = 0.0003). The use of ablation was significantly associated with physician age greater than 54 yr (odds ratio [OR] = 2.77, 95% CI = 1.04-7.37) and the belief that ablation was used by colleagues (OR = 13.27, 95% CI = 4.44-39.64) or decreases medical costs (OR = 5.07, 95% CI = 1.00-25.74). CONCLUSIONS: Although few gastroenterologists agreed that ablation is effective, a significant proportion had adopted its use. There was a significant increase in ablation use during our study period, and the characteristic that was most strongly associated with ablation use was the belief that colleagues used it.

Adult↗