Marc T. Braverman

Predicting Repetition of Suicide Attempt: A Prospective Study of 50 Suicide Attempters

The purpose of this study was to identify risk factors for repetition of suicide attempt by means of a prospective design. Fifty suicide attempters were interviewed shortly after their attempt and then 18 months later. During this time period, eight persons had repeated their suicide attempt. Logistic regression analyses showed that low self-appraised problem-solving capacity and general self-efficacy predicted repetition of attempt. No significant effects were found from depression, hopelessness or self-esteem. Moreover, self-appraised problem-solving capacity and self-efficacy retained their predictive power even when controlling for sex, age, previous suicide attempt, suicide intention and medical risk. The single most important predictor of repeated suicide attempt was found to be low self-efficacy; a change of one standard deviation yielded an odds ratio of 3.7.

The Importance of Social Interaction: A New Perspective on Social Epidemiology, Social Risk Factors, and Health

Social epidemiology research has provided persuasive evidence of the link between the social environment—especially socioeconomic status—and health outcomes, but has failed to identify underlying mechanisms that might account for the association. The research may have been limited to date by its reliance on traditional epidemiological methods that emphasize a search for specific causal factor-disease relationships. It is time to take the research evidence and recast it to find practical solutions. We argue that the human development perspective supplies a framework for understanding the critical interaction between elements of social environment and health: Analyzing the social epidemiological research from this perspective can help to explain why and how the most potent factor, socioeconomic status, affects health outcomes. Equally important, this alternative perspective also presents health education practice implications.

Curtailing Tobacco Use Among Youth: Evaluation of Project 4-Health

This article reports the development and evaluation of Project 4-Health, a theory-driven, research-based program to prevent tobacco use among youth enrolled in 4-H clubs throughout California. Additional goals were to involve youth in discouraging others’tobacco use and to develop youth leadership for tobacco control. To assess program effectiveness, 72 clubs were matched and randomly assigned to the program or control condition. Of 1,853 eligible club members, 88.6% completed the pretest. Of these, 79.5% completed a posttest 4 months after conclusion of program delivery, and 77.6% completed a second posttest 2 years later. Short-term effects were found on 7 of 24 outcome measures, indicating changes in knowledge, attitudes, and behavioral intention, but not in social influence variables or behaviors. No long-term effects were observed. Discussion considers how the challenges of designing, delivering, and evaluating the intervention influenced results and implications for preventing tobacco use through community-based youth groups.

Negotiating Measurement: Methodological and Interpersonal Considerations in the Choice and Interpretation of Instruments.

Sound evaluation planning requires numerous decisions about how constructs in a program theory will be translated into measures and instruments that produce evaluation data. This article, the first in a dialogue exchange, examines how decisions about measurement are (and should be) made, especially in the context of small-scale local program settings. Rigorous measurement strategies will increase the credibility of a study’s conclusions, but they usually entail various kinds of costs. In making measurement decisions, evaluators must establish standards for strength of evidence that a given measure produces, weigh alternative measurement options, and communicate carefully with clients and other stakeholders about the measurement requirements in a given evaluation.

Negative Life Events in Childhood, Psychological Problems and Suicide Attempts in Adulthood: A Matched Case-Control Study

The purpose of the study was to investigate relations between childhood negative life events (parental loss, parental mental illness and parental abuse), adult psychological problems (depression, hopelessness, low self-esteem, low self-appraised problem-solving capacity, and alcohol problems) and suicidal behavior. A matched case control design was applied (total N =321). Risk of suicide attempt was found to be related to childhood negative life events as well as to psychological problems of adulthood. Moreover, the effects of childhood events were found to be partially mediated through the psychological problems, and gender-specific risk pathways were identified. For men, the central pathway involved parental mental illness during childhood and low self-esteem in adulthood. For women, childhood abuse, adulthood depression and alcohol problems appeared to constitute central factors. Additionally, effects were found for previous suicide attempts.

Stress reduction in child-abusing families : global and specific measures

This study compared in-home treatment to traditional county services for their ability to reduce stress in child-abusing families. 47 families who were at risk for having at least one child removed from the home for child abuse were referred to Families First for an intensive 6-wk., in-home therapy program. A comparison group of 29 families who were also at risk for having at least one child removed for abuse received traditional county services but no in-home therapy. Stress scores used were derived from a factor analysis of the Family Inventory of Life Events and Changes (FILE) that had identified 10 stress factors. The stress data were analyzed by a series of 2 × 2 analyses of variance, group and time being the independent variables and the stress factors the dependent variables. Total stress was significantly reduced over time for both groups, and several specific stress factors were also significantly reduced over time. In secondary analyses, 2 × 3 (group by time) analyses identified interactions for total stress and three of the individual stress factors. In-home treatment was effective in reducing stress, but traditional services were also effective. Some possible explanations were discussed. A major finding was that, by including analyses using the specific stress factors (rather than just the Total Stress score), a much richer understanding of the role stress plays in abusive families is provided. It was concluded that, although global stress may be reduced by different methods, some specific types of stress are more likely to be reduced than others.

Supportive of a smoke-free campus but opposed to a 100% tobacco-free campus: Identification of predictors among university students, faculty, and staff

Many universities are adopting campus tobacco policies, but little research has explored factors influencing the choice between the policy options of smoke-free versus 100% tobacco-free. Students, faculty, and staff at a U.S. state university participated in a web-based survey in 2013, approximately one year after adoption of a smoke-free policy. Respondents who expressed support for the policy were included in an analysis to examine their opinions regarding a 100% tobacco-free policy. The samples included 4138 students and 1582 faculty/staff. Bivariate analyses and multivariate logistic regression were used to identify predictors of opposition to a tobacco-free campus. Independent variables included strength of support for a smoke-free campus, past-month tobacco use (cigarettes, smokeless tobacco, e-cigarettes, non-cigarette combustible tobacco products), campus exposure to secondhand smoke, perceptions of tobacco-related behaviors and norms, and demographics. Of these supporters of a smoke-free campus, 14.3% of students and 10.2% of faculty/staff were opposed to a tobacco-free campus. In the multivariate analyses, in both samples, smokeless tobacco use predicted opposition while smoke-free policy support and female gender predicted support. In addition, among students, current or former cigarette smoking and non-cigarette combustible tobacco use predicted opposition; international student status and secondhand smoke exposure predicted support. Among faculty/staff, age over 55 predicted support. Future research should examine why current and former smokers might oppose policies restricting non-combustible tobacco products, even when they support smoke-free policies. In policy planning, campus administrators should communicate actual tobacco usage levels. International students who do not use tobacco may be a source of policy support.

Daily Smoking and Subjective Health Complaints in Adolescence

Introduction: Using data from the Health Behaviour in School-aged Children survey, this study used a repeated cross-sectional design to examine associations between daily smoking, gender, and self-reported health complaints in five cohorts of adolescents over a 16-year period. Methods: Data were from nationally representative cohorts of 15-year-old youth in Norway in 1993/1994, 1997/1998, 2001/2002, 2005/2006, and 2009/2010 (n total = 7761). Dependent variables were psychological, somatic, and total health complaints. A mixed GLM model examined main and interaction effects of smoking (daily, intermittent, nonsmoking), year, and gender in predicting complaints. Time periods were segmented to compare trends across smoking groups in specific periods. Results: Prevalence of daily smoking declined from 15.5% (1993/1994) to 6.0% (2009/2010). All health complaint scores were significantly higher for smokers and for girls (vs. boys). Smoking status by year interactions were significant for all complaint variables during the period of sharpest decline of daily smoking prevalence (2001/2002–2005/2006), with daily smokers experiencing increases in health complaints while intermittent and nonsmokers did not. Smoking status by gender interactions were significant for all health complaint variables, indicating that the main effect for gender (females higher) was even stronger among smokers compared with nonsmokers. Using year as unit of analysis, the size of mean differences between daily smokers and intermittent/nonsmokers in total complaints was significantly negatively correlated with daily smoking prevalence (−.963, n = 5, p < .01). Conclusions: As prevalence of daily smoking declined, daily smokers reported higher levels of complaints, suggesting increasing health problems within this group. Girls who smoke daily had particularly elevated levels of complaints. Implications: This study indicates that the relationship between daily smoking and concurrent health symptomatology in adolescents is changing over time, with higher levels of health complaints reported as overall smoking prevalence declines. To our knowledge, this finding has not previously been reported. If youth are smoking to cope with distress, pain, or other health concerns, tobacco control objectives will be increasingly difficult to achieve with adolescents. Levels of health complaints are particularly high among girls who are daily smokers. The findings suggest that restrictive measures and persuasive communications may not be sufficient tobacco prevention strategies for adolescent populations. Young smokers may need counseling and support.

Performance Measurement and Performance Indicators: A Literature Review and a Proposed Model for Practical Adoption

Performance measurement systems (PMSs) are developed and implemented to support the accomplishment of objectives of an organization or organizational initiative. PMSs are structured to enable monitoring of performance. This monitoring is accomplished through the identification of areas of concern and success, with the ultimate goals of developing organizational capabilities and enhancing organizational learning. This article reviews the literature on performance measurement and its implementation, and proposes a model to guide the development and implementation of PMSs. The article concludes with a consideration of the broader implications of PMSs and provides recommendations for future research in PMSs with regard to human resource development.

Can Healthy Recipes Change Eating Behaviors? The Food Hero Social Marketing Campaign Recipe Project Experience and Evaluation

In 2012, Americans spent approximately 42% of their household food budget eating away fromhome, a factor linked to reduced fruit andvegetable (FV) intake. Conversely, when individuals andfamiliesprepare foodathome, they have higher diet quality, including FV intake. Researchers recommend that efforts toencouragehealthyeatingfocus onpromotinghome foodpreparationand offering FV in multiple food environments (eg, home, schools, and work). The Oregon State University Extension Service developed the Food Hero social marketing campaign to increase FV consumption of Oregon residents eligible for Supplemental Nutrition Assistance Program (SNAP). Per the 2015 Dietary Guidelines for Americans, a central aim of Food Hero is to reach target families using a socioecological framework that includes multiple elements of society. A major component of the campaign is its ongoing recipe project. The Food Hero social marketing campaign began in 2009, whereas recipe development has been ongoing since the inception of the Oregon Expanded Food and Nutrition Education Program in the late 1960s. The FV-focused recipe project strategically formulates and shares recipes to help families and foodser-