Linda Dusenbury

Smoking prevention among urban minority youth: assessing effects on outcome and mediating variables.

We tested the effectiveness of a social resistance/competence enhancement approach to smoking prevention among predominantly Hispanic seventh graders (N = 3,153) from 47 New York City schools. After blocking on school type (public and parochial) and ethnic composition (percent Hispanic), schools were randomly assigned either to receive the 15-session prevention program or to serve as no-contact controls. Using the school as the unit of analysis, significant program effects were found for cigarette smoking, normative expectations concerning peer and adult smoking, smoking prevalence knowledge, social acceptability knowledge, and knowledge of smoking consequences. Using structural modeling techniques, a significant relation was found between the normative expectation and knowledge variables affected by the intervention and posttest smoking, suggesting that changes on these variables mediated the impact of the intervention on cigarette smoking. This study extends the results of previous prevention research and demonstrates the generalizability of this approach to predominantly Hispanic urban minority students.

A skills training approach to smoking prevention among hispanic youth

The present study was designed to test the feasibility, acceptability, and effectiveness of a 15-session smoking prevention intervention with a predominantly hispanic (74%) sample of seventh-grade students (N=471) in eight urban schools in the New York area. The smoking prevention curriculum teaches social resistance skills within the context of a broader intervention promoting general personal and social competence and was implemented in this study by regular classroom teachers. Results of logistic regression analyses provided preliminary evidence of the efficacy of this type of smoking prevention strategy with urban minority youth when implemented with a reasonable degree of fidelity. The significance of these findings is that they provide support for the generalizability of an approach previously found to be effective with white middle-class populations to a predominantly hispanic inner-city population.

CORRELATES AND PREDICTORS OF SMOKING AMONG BLACK ADOLESCENTS

Little is known about the etiology of cigarette smoking among minority populations. This study examines the correlates and predictors of smoking among inner-city black seventh graders (N = 608). Enhanced self-reports of cigarette smoking were collected along with data concerning demographic, social, and psychological factors hypothesized to promote smoking initiation. Results indicate that social environmental factors, such as the smoking status of friends and siblings, and individual factors, such as refusal assertiveness, general assertiveness, and age are predictive of current smoking. Similarly, the smoking status of friends, attitudes concerning the harmful effects of smoking, and low self-esteem concerning schools are predictive of behavioral intention to smoke in the future. Overall, the factors that were the most salient predictors of smoking for the black adolescents in this study are generally congruent with the existing literature for other populations.

Pursuing the course from research to practice.

Diffusion of Innovation Theory describes the typical course by which innovations become standard practice. Research-based prevention programs are one such innovation. These programs have passed through the early phases of diffusion—innovation development and adoption by progressive schools that seek out innovations. With one quarter of the nations schools having adopted a research-based program, the field is currently in the early majority phase of diffusion. If the patterns of normal diffusion hold true, this phase is likely to be characterized by emerging tensions between program developers and adopting schools. There are several concerns that require attention from researchers and practitioners. Practitioners need to develop their capacity to implement programs with fidelity and to adapt programs appropriately to meet their circumstance. Program developers need to simplify and redesign programs to make them appealing and useful to teachers. Operational capacity to fulfill orders and provide training needs to be developed.

Family-Based Drug Abuse Prevention Programs: A Review

Key elements of promising family-based drug abuse prevention strategies include: (1) program content based on proven prevention theory and research; (2) comprehensive approaches that begin early, extend across the life span, address multiple risk and protective factors, and generalize across settings; (3) developmentally appropriate material; (4) sensitivity to the culture and community; (5) sufficient dosage and follow-up; (6) use of interactive teaching techniques; (7) training for prevention program providers; and (8) evaluation to know that the intervention had the desired effect on behavior. In addition, an issue with major implications for prevention is how to reach the broadest possible audience or those who may most benefit from prevention services.

Social influence predictors of alcohol use among New York Latino youth

We examined demographic and social influence predictors of adolescent drinking among New York City Latino adolescents, including specific Latino subgroups (i.e., Puerto Rican, Dominican, Colombian, and Ecuadorian). Sixth- and seventh-grade students (N = 3129) who identified themselves as Latino or Hispanic on the survey questionnaire comprised our Latino sample. The survey included self-reported frequency of alcohol use, demographic items, and measures of social influences for drinking. Logistic-regression analyses revealed that social influences (how many friends drink, attitudes of parents and friends toward respondents drinking) are strong predictors of current drinking (defined as drinking at least once a month) for the overall sample of Latino youth, as well as for Puerto Rican youth and Dominican youth. Findings are discussed in terms of their implications for prevention.

All Stars Plus: A Competence and Motivation Enhancement Approach to Prevention.

All Stars Core is a school‐based drug abuse prevention program for 11 to 14 year olds from the United States. It focuses on five qualities that protect children from drug use: viewing drug use as uncommon and unacceptable to the peer group (norms); viewing drug use as interfering with future goals; commitment to avoid drug use; positive attention from parents; and feeling accepted at school. All Star Plus was recently developed with the goal of expanding the Core program to include the development of three competencies: goal setting, decision making, and skills to resist peer pressure resistance. Students either received All Stars Core, All Stars Plus, or were assigned to the non‐treated control group. Both programs outperformed the control group; however, All Stars Plus was more effective in preventing drug use than All Stars Core. All Stars Plus was found to reduce alcohol use, drunkenness, cigarette smoking, marijuana use, and inhalant use. The Plus program appeared to have achieved these outcomes by improving norms, increasing persistence in pursuing goals, and by increasing attention from parents.

Measuring Quality of Delivery in a Substance Use Prevention Program.

The purpose of this study was to develop and validate an observation measure designed to capture teachers’ use of interactive teaching skills within the delivery of the All Stars substance use prevention program. Coders counted the number of times teachers praised and encouraged students, accepted and used students’ ideas, asked questions, self-disclosed personal anecdotes, and corrected student misbehavior. These teacher behaviors loaded on three factors: classroom management, acknowledgment, and student-centered methods. Classroom management was negatively related to student engagement. Acknowledgment was negatively related to students’ normative beliefs. Student-centered methods were positively related to student idealism and normative beliefs, and marginally predicted decreases in student marijuana use. Editors’ Strategic Implications: The authors provide a promising approach to studying pedagogical prevention approaches, and they also link teaching processes to student outcomes. This study of program delivery should be of general interest (i.e., not limited to substance use prevention) to practitioners and researchers.

Three-Year Trajectory of Teachers’ Fidelity to a Drug Prevention Curriculum

Little is known about the trajectories over time of classroom teachers’ fidelity to drug prevention curricula. Using the “Concerns-Based Adoption Model” (C-BAM) as a theoretical framework, we hypothesized that teachers’ fidelity would improve with repetition. Participants comprised 23 middle school teachers who videotaped their administration of three entire iterations of the All Stars curriculum. Investigators coded two key curriculum lessons, specifically assessing the proportion of activities of each lesson teachers attempted and whether they omitted, added, or changed prescribed content, or delivered it using new methods. Study findings provided only partial support for the C-BAM model. Considerable variability in teachers’ performance over time was noted, suggesting that their progression over time may be nonlinear and dynamic, and quite possibly a function of their classroom and school contexts. There was also evidence that, by their third iteration of All Stars, teachers tended to regress toward the baseline mean. That is, the implementation quality of those that started out with high levels of fidelity tended to degrade, while those that started out with very low fidelity to the curriculum tended to improve. Study findings suggest the need for ongoing training and technical assistance, as well as “just in time” messages delivered electronically; but it is also possible that some prevention curricula may impose unrealistic expectations or burdens on teachers’ abilities and classroom time.

Smokeless tobacco use among adolescents: correlates and concurrent predictors.

Seventh grade students (N = 1539) from three regions of New York State were surveyed to determine the prevalence of smokeless tobacco use and its relationship to seven background variables, 13 substance use variables, and 19 psychosocial variables. Significant correlations with smokeless tobacco use were found within each of these variable domains. Concurrent predictors for each domain were determined using logistic regression analysis. The resulting three models were combined in a stepwise fashion in an effort to determine the most complete prediction model. The final model indicated that individuals at the highest risk for using smokeless tobacco were rural males who had smoked more than four cigarettes in their lifetime, were more heavily involved with alcohol, had a lower degree of assertiveness and social anxiety, and had reported eating as a coping response. Implications for prevention are discussed.