Mario A. Orlandi

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.

School-based health promotion: Substance abuse and sexual behavior

Abstract As the limitations of curative medicine have become increasingly apparent and epidemiologic studies have established the linkage between lifestyle and disease, health promotion interventions have been developed to address public health problems in a proactive manner. The school has become a natural locus of health promotion efforts. School-based health promotion efforts have utilized several different strategies including information dissemination efforts, fear-arousal tactics, modifying normative expectations, and both problem-specific and generic skills training approaches. This paper focuses on two health areas that include several major public health problems and which have received considerable attention during the past decade: substance abuse (cigarette smoking, alcohol abuse, and illicit drug abuse) and sexual behavior (AIDS, sexually transmitted diseases, and unwanted pregnancy). School-based health promotion approaches to these problems have evolved in a largely separate yet parallel manner. These problems appear to have strikingly similar etiologies and may be prevented using similar intervention strategies. Information dissemination approaches have been consistently found to be of limited effectiveness. Interventions targeting social and psychological factors are the most promising. Research concerning sexual behavior has generally lagged behind that of substance abuse prevention. It is argued that careful consideration should be given to the application of strategies found effective in preventing substance abuse to the prevention of AIDS, STDs, and unwanted pregnancy.

A Self-Help Smoking Cessation Program for Inner-City African Americans: Results from the Harlem Health Connection Project

The authors develop and test a culturally sensitive, low-intensity smoking cessation intervention for low-socioeconomic African Americans. African American adult smokers were randomly assigned to receive either a multicomponent smoking cessation intervention comprising a printed guide, a video, and a telephone booster call or health education materials not directly addressing tobacco use. The results of the study were mixed. Although no significant effects were observed for the entire treatment cohort, the results of post hoc analyses suggest that culturally sensitive self-help smoking cessation materials plus a single phone contact can produce short-term cessation rates similar to those reported for majority populations. This conclusion should be tempered by the low completion rate for the booster call and several design limitations of the study.

Assessing the Utility of the Drug Abuse Screening Test in the Workplace

The purpose of this study was to determine the utility and assess the psychometric properties of the Drug Abuse Screening Test (DAST) in a sample of persons receiving services from an employee assistance program (EAP). Study participants (N = 176) were union members, including identified drug users and nonusers. As in other studies, the DAST was found to have a high internal consistency, test-retest reliability, and item-total scale correlation. Also consistent with previous reports, factor analysis identified 5 factors. The multifactor solution of the DAST underscores the importance of measuring and assessing substance use along a continuum of early recognition to its more advanced stages. DAST scores were correlated with family, financial status, job performance, mental health problems, and alcohol abuse. Study findings lend support to the DAST as a practical screening tool for use by human resource workers who provide services for substance-using individuals who are receiving services in an EAP setting.

Smoking Prevalence in Harlem, New York.

Cigarette smoking and its physiologic sequelae differ considerably among African-Americans, whites, and Hispanics? 4 Among adolescents and young adults, smoking rates are lower among African-Americans than among whites or Hispanics. 2,5 Among persons aged 35 and older, however, African-Americans have the highest rates. 2 The higher smoking rates among African-Pmaerican adults may be related to lower quit rates 6,7 and later initiation, s Black-white differences in adult smoking and consequent mortality appear greater for men thanfor women 1,3,4 and are largely attributable to socioeconomicg12 and psychologic ~’m4 factors, rather than race per se. l°,l~-2] Reducing smoking among low-income African-Americans is a national health priority. ~2

Intervention effects on youth tobacco use in the community intervention trial (COMMIT)

The Community Intervention Trial for Smoking Cessation (COMMIT) was an intervention trial funded by the National Cancer Institute to evaluate the effects of a multi-component, community based smoking control intervention on cessation in adult smokers.1,2 The primary (adult) outcomes of this trial have been published elsewhere.3,4 In this letter we test the hypothesis that a comprehensive, community based intervention aimed at adult smokers would have an ancillary impact on the prevalence of youth smoking. The COMMIT intervention5 included youth oriented activities directed toward four principle areas: school based education programmes, smoking policies in schools, legislative activities related to youth smoking, and participation by students and teachers in other COMMIT activities. The evaluation …

Substance use among hispanic and non-Hispanic adolescents

This study compared lifetime prevalence data on substance use with demographic and psychosocial variables among 2,821 Hispanic and non-Hispanic white students from two Southwestern cities. Study findings revealed that ethnic-racial background factors were not the strongest predictors of substance use. Rather, when the analyses accounted for school grades and for maternal education, non-Hispanic youth had higher lifetime substance use rates than Hispanic youth. Study findings suggest that preventive intervention and treatment efforts for substance abuse problems among adolescents should consider sociodemographic risk factors as well as ethnic-racial factors.

Smoking and Health Promotion: Obstacles and Opportunities

Tobacco in its various forms has been recognized for centuries to have an adverse effect on human health. From King James to Shakespeare, from Sommering to Abbe, from Mueller to the definitive studies in the 1950s, historical comments, clinical observations, epidemiological studies, and laboratory experiments have demonstrated that the use of tobacco— whether by smoking, snuffing, or chewing—is detrimental to human health by significantly contributing to excess disability, disease, and death (Abbe, 1915; Doll and Hill, 1956; Hammond and Horn, 1958; Hoffman, 1929; IARC, 1986; James, 1604; Kennaway and Kennaway, 1947; Levin, Goldstein, and Gerhardt, 1950; Mueller, 1939; Ochsner and DeBakey, 1941; Soemmering, 1795; Wynder and Graham, 1950; Wynder and Hoffmann, 1967; Wynder and Stellman, 1977).

Smoking Control Interventions for Special Populations: Beyond Cultural Sensitivity

Overall, cigarette consumption is on the decline. Between 1964 and 1987, the prevalence of smoking among adults decreased from 40% to 29% and it has been estimated that half of all living adults who ever smoked have quit.1 Nonetheless, smoking is currently responsible for more than one out of every six deaths in the United States and is considered the most significant preventable cause of death in society today.