D. Lynne Kaltreider

Results of an Independent Evaluation of Project ALERT Delivered in Schools by Cooperative Extension

Reported are results of an independent effectiveness study of the Project ALERT drug prevention program implemented in eight Pennsylvania middle schools by outside program leaders employed by Cooperative Extension. In this randomized, 2-cohort longitudinal evaluation, 1,649 seventh-grade students completed a pretest and four waves of posttests over the 2-year program and 1-year follow-up. Project ALERTs effectiveness was tested through a 3-level hierarchical linear model. Analyses failed to yield any positive effects for substance use or mediators for use in the adult or teen-assisted delivery of the curriculum. An extensive set of additional analyses detected no differential program effects by student risk level, gender, school, or level of implementation quality. Potential explanations for outcomes relative to Project ALERTs original effectiveness trial are discussed, as well as implications for future research, including the need to conduct independent effectiveness studies of previously validated programs in a variety of contexts.

Drug prevention in a community setting: A longitudinal study of the relative effectiveness of a three-year primary prevention program in boys & girls clubs across the nation

Tested the effectiveness of a youth drug prevention program in a community setting. Boys & Girls Clubs of Americas Stay SMART program, adapted from a school-based personal and social competence drug prevention program, was offered, with and without a 2-year booster program, to 13-year-old members of Boys & Girls Clubs. Over 27 months, (a) 5 Boys & Girls Clubs offered the Stay SMART program, (b) 5 Boys & Girls Clubs offered the Stay SMART program with the booster programs, and (c) 4 Boys & Girls Clubs served as a control group. The Stay SMART program alone and the Stay SMART program with the booster programs showed effects for marijuana-related behavior, cigarette-related behavior, alcohol-related behavior, overall drug-related behavior, and knowledge concerning drug use. The Stay SMART program with the booster programs produced additional effects for alcohol attitudes and marijuana attitudes after each year of booster programs. Results suggest that a school-based personal and social competence program can be adapted effectively to a community setting and that booster programs might enhance program effects. Implications for alternative community models of prevention are discussed.

Profile of Urinary Incontinent Elderly in Long-Term Care Institutions

This article presents a profile of incontinent elderly in long‐term care institutions. One hundred thirty‐three frail elderly women were recruited from seven nursing homes in central Pennsylvania for a three‐year clinical trial to test the effectiveness of a behavioral therapy on urinary incontinence. All of the patients had more than one medical diagnosis. Eighty percent had cardiorespiratory conditions; the most prevalent diagnoses were cardiovascular diseases. Eighty percent had one or more neurological diseases, including “organic brain syndrome”(47%) and senile dementia (30%); 44% had arthritis/rheumatism. Half of the patients showed severe cognitive impairment; only 12% showed no cognitive impairment. Sixty‐three percent were totally dependent; 68% used wheelchairs, 61% were chairbound; 50% had impairments in vision, one‐third in hearing, and 14% in speech. Normal bladder capacity, absence of detrusor instability, and satisfactory bladder emptying, as evidenced by low residual urines, was found in 41% of the patients, suggesting that incontinence in this elderly group may not be a primary bladder problem, but rather that mental and physical disabilities may be a more important underlying cause of incontinence in these patients. An important finding in this study is that 34% of the patients had detrusor instability. It is theoretically possible that pharmacologic therapy with anticholinergic agents or imipramine could improve incontinence in this group. Five percent were found to have large residual urine volumes in association with high‐capacity bladders suggesting overflow incontinence as the cause of their daily leakage. Pelvic relaxation and stress leakage was far less common in this elderly group of nursing home patients than in young and middle‐aged women.

A 27-Month Evaluation of a Sexual Activity Prevention Program in Boys & Girls Clubs across the Nation

This study evaluated an abstinence-only sexual activity prevention programs part of multifocus program Stay SMART also aimed at preventing drug use among Boys & Girls Club youths. No effects were observed for virgins. Desired effects for sexual behavior and attitudes toward sexual activity were found for nonvirgins who participated in only stay SMART. No effects were found for nonvirgins who participated in stay SMART followed by a two-year booster program. (authors)

Involving Parents of High-Risk Youth in Drug Prevention A Three-Year Longitudinal Study in Boys & Girls Clubs

The study evaluated the incremental effect of a 3-year drug prevention program for high-risk early adolescents, combined with monthly youth activities and parent involvement (Family Advocacy Network [FAN] Club group) relative to: (a) the 3-year drug prevention program with monthly youth activities but without parent involvement (Prevention Plus Youth Activities group), (b) the 3-year drug prevention program alone (Prevention Only group), and (c) no program (Control group). Results showed positive effects for the FAN Club group for alcohol refusal, marijuana refusal cigarette refusal and marijuana attitudes. The Prevention Plus Youth Activities group and the Prevention Only group held fairly constant on those four variables. The Control group showed a decrease in reported ability to refuse alcohol, marijuana, and cigarettes; an increase in favorable attitudes toward marijuana use; and the least knwledge of the groups. Implications for youth organization prevention programs with parent involvement are discussed

Boys & girls clubs and school collaborations: A longitudinal study of a multicomponent substance abuse prevention program for high‐risk elementary school children

This study tested the effectiveness of a multicomponent after-school substance abuse prevention program for high-risk second- and third-grade children implemented collaboratively by Boys & Girls Clubs and their local schools. The 2-year program was designed to reduce risk factors predictive of later substance abuse, and to enhance protective factors shown to buffer risk. Results showed positive effects on program childrens personal competency skills including (1) refusing wrongdoing; (2) solving peer and school problems; (3) showing courteousness to teachers and other school personnel; and (4) behaving ethically. For the most part, the program also had positive effects on childrens feelings toward school and grades in spelling. Results suggest that youth-serving organizations and schools can collaboratively implement multicomponent interventions that provide protective factors that may buffer high-risk elementary school children from the multiple risks in their lives for future drug abuse.

The ISQ-P Tool Measuring Stress Associated with Incontinence

1. ISQ-P is a useful tool in measuring psychological stress associated with urinary incontinence. 2. ISQ-P can be used in conjunction with bladder training programs. 3. Patients with urinary incontinence show depressive symptoms, have somatic concerns regarding urinary incontinence, and exhibit a feeling of shame.

The Cost-Effectiveness of DISPOSABLE VERSUS REUSABLE DIAPERS A Controlled Experiment in a Nursing Home

Because caring for incontinent elderly in nursing homes is so time-consuming and costly, this topic is of interest to nursing home administrators. A comparison of disposable products with reusable cloth diapers suggests that the disposable product used in the controlled study could save nursing homes approximately

Urinary Incontinence : Nursing Home Staff Reaction Toward Residents

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Beyond the Schools: Strategies for Implementing Successful Drug Prevention Programs in Community Youth-Serving Organizations

248 per year per person. Although product costs were similar, the cost savings on laundry favored the disposable product. The study found the disposable product superior to the cloth reusable diaper after the skin condition of the participants was measured.