Mary Ann Pentz

The mediational role of neurocognition in the behavioral outcomes of a social-emotional prevention program in elementary school students: effects of the PATHS Curriculum.

Neuropsychology is one field that holds promise in the construction of comprehensive, developmental models for the promotion of social competence and prevention of problem behavior. Neuropsychological models of behavior suggest that childrens neurological functioning affects the regulation of strong emotions, as well as performance in social, cognitive, and behavioral spheres. The current study examines the underlying neurocognitive conceptual theory of action of one social-emotional development program. Hypothesized was that inhibitory control and verbal fluency would mediate the relationship between program condition and teacher-reported externalizing and internalizing behavior problems. Participants were 318 regular education students enrolled in the second or third grade. A series of regression analyses provided empirical support for (a) the effectiveness of the PATHS Curriculum in promoting inhibitory control and verbal fluency and (b) a partial mediating role for inhibitory control in the relation between prevention condition and behavioral outcomes. Implications are that programs designed to promote social and emotional development should consider comprehensive models that attend to neurocognitive functioning and development. Lack of consideration of neurocognitive pathways to the promotion of social competence may ignore important mechanisms through which prevention affects youth outcomes. Furthermore, the findings suggest that developers of social-emotional preventions should design curricula to explicitly promote the developmental integration of executive functioning, verbal processing, and emotional awareness. Doing so may enhance prevention outcomes particularly if those preventions are implemented during a time of peak neurocognitive development

A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning

Smart growth is an approach to urban planning that provides a framework for making community development decisions. Despite its growing use, it is not known whether smart growth can impact physical activity. This review utilizes existing built environment research on factors that have been used in smart growth planning to determine whether they are associated with physical activity or body mass. Searching the MEDLINE, Psycinfo and Web‐of‐Knowledge databases, 204 articles were identified for descriptive review, and 44 for a more in‐depth review of studies that evaluated four or more smart growth planning principles. Five smart growth factors (diverse housing types, mixed land use, housing density, compact development patterns and levels of open space) were associated with increased levels of physical activity, primarily walking. Associations with other forms of physical activity were less common. Results varied by gender and method of environmental assessment. Body mass was largely unaffected. This review suggests that several features of the built environment associated with smart growth planning may promote important forms of physical activity. Future smart growth community planning could focus more directly on health, and future research should explore whether combinations or a critical mass of smart growth features is associated with better population health outcomes.

Translation in the Health Professions Converting Science into Action

The systematic translation of evidence-based research findings, tools, and information into practice is critical to improving the quality of our nation’s health. However, despite several decades of advances in developing medical knowledge based on high-quality empirical evidence, widespread implementation of these findings into practice in diverse applied settings has not been achieved. This article reviews definitions and conceptual models that describe the translation of research from basic discovery to real-world applications, summarizes the various issues involved in the process of translation, discusses multiple barriers, and provides recommendations to surmount these hurdles. Areas of further research in this arena are suggested. Finally, the article concludes that translational research is an important area to continue to pursue requiring long-term collaborative commitment among researchers and practitioners.

Effects of Program Implementation on Adolescent Drug Use Behavior The Midwestern Prevention Project (MPP)

This study evaluated the relationship between level of program implementation and change in adolescent drug use behavior in the Midwestern Prevention Project (MPP), a school- and community-based program for drug abuse prevention. Trained teachers implemented the pro gram with transition year students. Implementation was measured by teacher self-report and validated by research staff reports. Adolescent drug use was measured by student self-report; an expired air measure of smoking was used to increase the accuracy of self-reported drug use. Regression analyses were used to evaluate adherence; exposure, or amount of implementation; and reinvention. Results showed that all schools assigned to the program condition adhered to the research by implementing the program. Exposure had a significant effect on minimizing the increase in drug use from baseline to one year. Exposure also had a larger magnitude of intervention effect than experimental group assignment. Reinvention did not affect drug use. Results are discussed in terms of research assumptions about quality of program implementation, and possible school-level predictors of implementation.

Parallel developmental trajectories of sensation seeking and regular substance use in adolescents.

This study applied piecewise latent growth modeling to longitudinal survey data from 2 different samples of adolescents (N=1,002 and N=1,206) to examine the hypothesis that development of sensation seeking in middle school would predict development of substance use (cigarettes, alcohol, and marijuana) in middle school and high school. Results showed that sensation seeking had strong predictive value for both concurrent and distal marijuana and alcohol use in both samples; however, initial level of sensation seeking predicted initial level of cigarette use during high school in 1 sample only. White participants scored consistently higher on both initial level and rate of increase in sensation seeking than did participants of other ethnicities. Advantages of this methodology are discussed in the context of substance use research.

Identifying Trajectories of Adolescent Smoking: An Application of Latent Growth Mixture Modeling

The goal of the current study was to identify discrete longitudinal patterns of change in adolescent smoking using latent growth mixture modeling. Five distinct longitudinal patterns were identified. A group of early rapid escalators was characterized by early escalation (at age 13) that rapidly increased to heavy smoking. A pattern characterized by occasional puffing up until age 15, at which time smoking escalated to moderate levels was also identified (late moderate escalators). Another group included adolescents who, after age 15, began to escalate slowly in their smoking to light (0.5 cigarettes per month) levels (late slow escalators). Finally, a group of stable light smokers (those who smoked 1-2 cigarettes per month) and a group of stable puffers (those who smoked only a few puffs per month) were also identified. The stable puffer group was the largest group and represented 25% of smokers.

The power of policy: the relationship of smoking policy to adolescent smoking.

This study examined the effects of smoking policy on 4,807 adolescents in 23 schools over a two-county area in California. Amounts and prevalence rates of adolescent smoking were measured with a self-report survey and a biochemical measure; school smoking policy was measured with two independent surveys of school staff. Policy effects were evaluated with multiple and logistic regression analyses controlling for school-level socioeconomic status and environmental support for teaching and administration. Of the 23 schools, 100 percent had a formal written and regularly enforced policy component restricting student smoking on school grounds, 94 percent restricted students leaving school grounds, 65 percent restricted smoking near school grounds, and 57 percent had a smoking prevention education plan. Schools with policies having all four versus less than four components, high versus low emphasis on prevention, and a low versus high emphasis on cessation reported lower amounts of smoking in the last week and in the last 24 hours. Punitive consequences of policy violation had no effect. Results were compared to school staff observations of adolescent smoking, and school archival records of student smoking violations in the last year. Results suggest that school smoking policy is associated with decreased amounts of smoking in adolescents.

A study of community design, greenness and physical activity in children using satellite, GPS and accelerometer data

This study examined relationships between greenness exposure and free-living physical activity behavior of children in smart growth and conventionally designed communities. Normalized Difference Vegetation Index (NDVI) was used to quantify childrens (n=208) greenness exposure at 30-s epoch accelerometer and GPS data points. A generalized linear mixed model with a kernel density smoothing term for addressing spatial autocorrelation was fit to analyze residential neighborhood activity data. Excluding activity at home and during school-hours, an epoch-level analysis found momentary greenness exposure was positively associated with the likelihood of contemporaneous moderate-to-vigorous physical activity (MVPA). This association was stronger for smart growth residents who experienced a 39% increase in odds of MVPA for a 10th to 90th percentile increase in exposure to greenness (OR=1.39, 95% CI 1.36-1.44). An individual-level analysis found children who experienced >20 min of daily exposure to greener spaces (>90th percentile) engaged in nearly 5 times the daily rate of MVPA of children with nearly zero daily exposure to greener spaces (95% CI 3.09-7.20).

Addressing core challenges for the next generation of type 2 translation research and systems: the translation science to population impact (TSci Impact) framework.

Evidence-based preventive interventions developed over the past two decades represent great potential for enhancing public health and well-being. Research confirming the limited extent to which these interventions have been broadly and effectively implemented, however, indicates much progress is needed to achieve population-level impact. In part, progress requires Type 2 translation research that investigates the complex processes and systems through which evidence-based interventions are adopted, implemented, and sustained on a large scale, with a strong orientation toward devising empirically-driven strategies for increasing their population impact. In this article, we address two core challenges to the advancement of T2 translation research: (1) building infrastructure and capacity to support systems-oriented scaling up of evidence-based interventions, with well-integrated practice-oriented T2 research, and (2) developing an agenda and improving research methods for advancing T2 translation science. We also summarize a heuristic “Translation Science to Population Impact (TSci Impact) Framework.” It articulates key considerations in addressing the core challenges, with three components that represent: (1) four phases of translation functions to be investigated (pre-adoption, adoption, implementation, and sustainability); (2) the multiple contexts in which translation occurs, ranging from community to national levels; and (3) necessary practice and research infrastructure supports. Discussion of the framework addresses the critical roles of practitioner–scientist partnerships and networks, governmental agencies and policies at all levels, plus financing partnerships and structures, all required for both infrastructure development and advances in the science. The article concludes with two sets of recommended action steps that could provide impetus for advancing the next generation of T2 translation science and, in turn, potentially enhance the health and well-being of subsequent generations of youth and families.

Adolescent to Emerging Adulthood Smoking Trajectories: When Do Smoking Trajectories Diverge, and Do They Predict Early Adulthood Nicotine Dependence?

This study evaluated the adolescent tobacco-use trajectories that predict nicotine dependence in early adulthood and when these trajectories start to diverge. As part of a follow-up to a large prevention trial, the present study evaluated 1,017 individuals from early adolescence (age 12) to early adulthood (age 28). Participants were recruited from eight middle schools in Kansas City, Missouri. Students were entering 6th grade or 7th grade at baseline. Smoking was evaluated at baseline, 6 months, at annual follow-ups through high school, and every 18 months thereafter until age 28. The study goals were to determine (a) whether distinct weekly tobacco-use trajectories could be identified between early adolescence and emerging adulthood (ages 12-24); (b) when during development these trajectories diverged; and (c) which trajectories could predict nicotine dependence in early adulthood (ages 26-28). A four-trajectory mixed model (abstainers, low users, late stable users, and early stable users) demonstrated the best fit to the data. Membership in increasingly high-use trajectories placed participants at greater relative risk for becoming nicotine dependent than did membership in lower-use trajectories. General linear models showed greater weekly cigarette consumption for early stable users as early as the first wave of data collection (age 12) and significant differences among all other trajectories by age 15. The findings support the implementation of smoking prevention programs early in middle or junior high school and suggest that adolescents who are already smoking at least two cigarettes per week by age 12 may benefit from additional addiction prevention efforts.