John R. Ureda

Explanations of ethnic and gender differences in youth smoking: A multi-site, qualitative investigation

Two of the most powerful predictors of adolescent smoking are ethnicity and gender, but little research has focused on understanding how these factors play a role in adolescent smoking. This paper reports results from a qualitative, multi-site investigation of explanations for ethnic and gender differences in cigarette smoking with five ethnic groups: whites, African-Americans, Hispanics, Native Americans, and Asian-American/Pacific Islanders. Across 11 states, we conducted 178 focus groups with a total of 1175 adolescents. The groups explored such major research themes as reasons for smoking and not smoking; images of smoking and smokers; messages youth receive about smoking and not smoking; and the social context of smoking. We synthesized data from the focus groups through multiple cross-site collaborations and discussions, with an emphasis on identifying consistent themes across a majority of groups and sites. Striking differences emerged across ethnic and gender sub-groups in reasons for not smoking. African-American females in particular viewed not smoking as a positive identity marker. Asian-American/Pacific Islander females similarly reported strong mandates not to smoke. Youths perceptions of family messages about smoking also varied by ethnicity and gender, with African-American, Hispanic, and Asian-American/Pacific Islander youth consistently reporting strong, clear anti-smoking messages from family. These findings, notable in their consistency across geographic regions, may shed light on the discrepant prevalence of smoking across ethnic and gender groups.

Examining the Theory of Planned Behavior and the Construct of Self-Efficacy to Predict Mammography Intention:

This article examines the applicability of the Theory of Planned Behavior (TPB) with the addition of the selfefficacy construct in the understanding of the motivation to obtain an initial screeningmammogramamong Cypriot women. The study sample consisted of 293women aged 40 to 65 years, asymptomatic of breast cancer, and with no previous mammography experience. The study took place at the General Hospital of Nicosia in Cyprus. The results of the study provided support of the TPB with the addition of self-efficacy in an international setting. Self-efficacy was the strongest predictor of intention. Other predictors of intention included educational level, time of last clinical breast examination, and age. The study also provided some empirical support of the distinction between self-efficacy and perceived behavioral control. Researchers may want to include self-efficacy in addition to the TPB and other demographic characteristics in future applications to more fully explain behavioral outcomes.

Cognitive motivations associated with screening mammography in Cyprus

BACKGROUND This study examined the relationship between cognitive motivations, demographic characteristics, related preventive health behaviors, and intention to obtain a first screening mammogram among Greek Cypriot women. METHODS This cross-sectional study took place at the outpatient clinics of the General Hospital of Nicosia during the fall of 1999. The participants were 293 women asymptomatic of breast cancer and with no previous mammographic experience. The Theory of Planned Behavior in conjunction with the construct of self-efficacy was used in the development of the questionnaire. The assessment also included demographic information, practice of other preventive health behaviors, and knowledge of breast cancer screening. RESULTS Self-efficacy was the most significant determinant of initial screening mammography, followed by normative beliefs associated with the physician, family and close friends, and perceived behavioral control beliefs related to barriers to obtaining a mammogram. Educational level, time of last clinical breast examination, and status of breast self-examination were also strongly implicated in the explanation of initial screening mammography. CONCLUSIONS Insights into specific salient motivational cognitions and certain demographic characteristics or related preventive health behaviors are crucial to the development and implementation of effective intervention strategies.

An Exploration of Family Influences on Smoking among Ethnically Diverse Adolescents

In an attempt to better understand mechanisms throughwhich families might influence adolescent smoking, focus group data collected as part of a larger study of ethnic and gender differences in teen smoking were analyzed for family-related themes. Across six sites, 132 focus groups were conducted with African American, American Indian, Hispanic, Asian/Pacific Islander, and White youth. Similarities across race/ethnicity were evident in the content of antismoking messages and the feeling among youth that theywould get in trouble with their parents if caught smoking. African American and Asian/Pacific Islander youth appeared more concerned about their parents thinking less of them if they smoked than were youth from other racial/ethnic groups. White and American Indian youth were more likely to discuss that their parents felt it was their own decision as to whether or not to smoke than were the other groups.

Specific Motivations of Milk Consumption among Pregnant Women Enrolled in or Eligible for WIC

Abstract To identify motivational determinants of milk consumption, a major source of prenatal calcium intake, 180 pregnant women drawn from two prenatal clinics in South Carolina were surveyed. Most of them were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC Program). The Theory of Planned Behavior was used to design an instrument assessing attitudinal, subjective normative, and perceived control beliefs toward consuming milk. Motivational beliefs explaining milk consumption were first explored using univariate regression (p

Who's driving? college students' choices of transportation home after drinking.

Legal and educational interventions have not had a significant impact in reducing alcohol use among college students. The purpose of this study was to determine the frequency at which students placed themselves “at-risk” for alcohol-related traffic fatalities, either by driving while alcohol impaired or riding with an alcohol-impaired driver. On a given weekend night, 18% (n = 60) of students surveyed placed themselves at risk of being involved in an alcohol-related traffic fatality. Two-thirds of the “at-risk” subjects reported returning home with an alcohol-impaired driver. Recommendations are made for strengthening prevention efforts.Legal and educational interventions have not had a significant impact in reducing alcohol use among college students. The purpose of this study was to determine the frequency at which students placed themselves “at-risk” for alcohol-related traffic fatalities, either by driving while alcohol impaired or riding with an alcohol-impaired driver. On a given weekend night, 18% (n = 60) of students surveyed placed themselves at risk of being involved in an alcohol-related traffic fatality. Two-thirds of the “at-risk” subjects reported returning home with an alcohol-impaired driver. Recommendations are made for strengthening prevention efforts.

Community Intervention Creating Opportunities and Support for Cancer Control Behaviors

Much of the potential for reducing cancer mortality is dependent on the adoption of new behavioral patterns. Such changes demand application of the behavioral‐social sciences. A shift from univariate reductionist models of causation toward multivariate systems models is needed. Decisions (and behavior) are the focus of much of the behavioral‐social sciences. Determinants of decisions are delimited by controlling systems. Health care is only one of many possible influences on controlling systems, and its influence is only marginal for the behavior of the general public. Thus, community interventions that address multiple determinants within controlling systems are needed to influence most behaviors. Belief saliency hierarchies appear to psychologically mediate controlling systems. Changes in these saliency hierarchies lead to changes in behaviors. Person‐valued beliefs, social‐valued beliefs, and feasibility beliefs serve as the informational basis for the hierarchies. Needs activation is a primary means by which hierarchies shift. Changing environmental cues and signals also impart such shifts. Experience, persuasive communication, and value extracted from the environment also change hierarchies. Needs activation, community presence, persuasive communication, facilitation, inhibition, and experience‐based interventions are discussed for tobacco use control, dietary change, and breast and cervical cancer screening behavior. Emphasis is given to how the health care system can become a part of the controlling system that influences community behavior. Issues concerning successful implementation of community education programs are raised.