Nicole R. Morgan

Changes in Eating and Physical Activity Behaviors Across Seven Semesters of College Living On or Off Campus Matters

The transition from adolescence to adulthood is an important period for establishing behavioral patterns that affect long-term health and chronic disease risk. Nelson and colleagues speculated that developmental changes and changes in living situation may play an important role in the nutrition and physical activity behaviors of college students. Data from the University Life Study, a longitudinal study of college students that includes web-based surveys administered 14 consecutive days each semester, were used to examine fruit, vegetable, and sugared soda consumption, physical activity, and sedentary activity behaviors across seven semesters. Estimates for each semester were calculated to determine the frequency with which students consumed fruits, vegetables, and sugared soda, engaged in moderate to vigorous physical activity, and engaged in sedentary activities. Four models, estimated with HLM 6.04, were used to predict changes in these behaviors across the seven semesters. Living on or off campus was included to determine if this explained additional variance. Results indicated that few college students consumed fruits and vegetables or exercised at optimal levels during the seven semesters surveyed. Daily fruit and vegetable consumption and daily physical activity declined significantly from the first to the seventh semester. For both of these findings, living off campus exacerbated the problem. Average number of hours of sedentary behaviors declined over time, as did number of days on which at least one sugared soda was consumed. Living location did not explain additional variance in these positive trends. Implications for policy, practice, and future research are discussed.

Protective Effects of Parent-College Student Communication during the First Semester of College.

Abstract Objective: Recent studies suggest that parents maintain influence as their adolescents transition into college. Advances in communication technology make frequent communication between parents and college students easy and affordable. This study examines the protective effect of parent–college student communication on student drinking behaviors, estimated peak blood alcohol concentration (eBAC), and serious negative consequences of drinking. Participants: Participants were 746 first-year, first-time, full-time students at a large university in the United States Methods: Participants completed a baseline and 14 daily Web-based surveys. Results: The amount of time spent communicating with parents on weekend days predicted the number of drinks consumed, heavy drinking, and peak eBAC, consistent with a protective within-person effect. No association between communication and serious negative consequences was observed. Conclusions: Encouraging parents to communicate with their college students, particularly on weekend days, could be a relatively simple, easily implemented protective process to reduce dangerous drinking behaviors.

State Patty's Day: College Student Drinking and Local Crime Increased on a Student-constructed Holiday

College student alcohol consumption is a major concern, and is known to increase during the celebration of special events. This study examined a student-constructed holiday, State Patty’s Day, at a university with a dominant drinking culture using three sources of data—coded data from Facebook groups, daily web surveys from first-year students (N = 227, 51% male, age 18 to 20; 27.3% Hispanic/Latino; of non-Hispanic/Latino, 26.9% of sample European American/White, 19.4% Asian American/Hawaiian/Pacific Islander, 15.9% African American/Black, 10.6% more than one race), and criminal offense data from police records. Results indicated that messages about State Patty’s Day on Facebook focused on drinking and social aspects of the holiday, such as the social context of drinking, a sense of belonging to a larger community, and the social norms of drinking. These messages were rarely about consequences and rarely negative. On State Patty’s Day, 51% of students consumed alcohol, compared to 29% across other sampled weekend days. Students consumed more drinks (M = 8.2 [SD = 5.3] drinks per State Patty’s Day drinker) and were more likely to engage in heavy drinking on State Patty’s Day, after controlling for gender, drinking motives, and weekend, demonstrating the event-specific spike in heavy drinking associated with this holiday. The impact of this student-constructed holiday went beyond individual drinking behavior; alcohol-specific and other crime also peaked on State Patty’s Day and the day after. Event-specific prevention strategies may be particularly important in addressing these spontaneous, quickly-constructed, and dynamic events.

Common components analysis: An adapted approach for evaluating programs

Common Components Analysis (CCA) summarizes the results of program evaluations that utilize randomized control trials and have demonstrated effectiveness in improving their intended outcome(s) into their key elements. This area of research has integrated and modified the existing CCA approach to provide a means of evaluating components of programs without a solid evidence-base, across a variety of target outcomes. This adapted CCA approach (a) captures a variety of similar program characteristics to increase the quality of the comparison within components; (b) identifies components from four primary areas (i.e., content, process, barrier reduction, and sustainability) within specific programming domains (e.g., vocation, social); and (c) proposes future directions to test the extent to which the common components are associated with changes in intended program outcomes (e.g., employment, job retention). The purpose of this paper is to discuss the feasibility of this adapted CCA approach. To illustrate the utility of this technique, researchers used CCA with two popular employment programs that target successful Veteran reintegration but have limited program evaluation - Hire Heroes USA and Hire Our Heroes. This adapted CCA could be applied to longitudinal research designs to identify all utilized programs and the most promising components of these programs as they relate to changes in outcomes.

College Students’ Perceptions of the Links Between Alcohol Use and Sexual Experiences

Alcohol use is associated with impaired decision making and unwanted sexual outcomes, but emerging adults generally perceive the co-occurrence of alcohol use and sexual behavior positively. The current study examined perceived links between alcohol use and sexual experiences. Data were from 279 college students using stratified random sampling with replacement (56% female, 25% Hispanic/Latino, 22% African American, 28% Asian American/Pacific Islander, and 51% European American; M = 19.95 [0.43] years old). We coded participants’ responses to an open-ended question about how their alcohol use and sexual feelings were related. Students generally perceived that alcohol is facilitative of sex or has no effect. The most common responses were that alcohol leads to arousal and disinhibition. Almost no students mentioned alcohol’s impact on contraceptive use or sexual assault. Results differed by gender, prior sexual behavior, and heavy drinking. We interpret results in light of alcohol myopia theory and discuss implications for prevention.

A novel approach for evaluating programs designed to serve military veterans: Using an adapted common components analysis

Evaluators are challenged to keep pace with the vast array of Veteran support programs operating in the United States, resulting in a situation in which many programs lack any evidence of impact. Due to this lack of evidence, there is no efficient way to suggest which programs are most effective in helping Veterans in need of support. One potential solution to this dilemma is to reconceptualize program evaluation, by moving away from evaluating programs individually to evaluating what is common across programs. The Common Components Analysis (CCA) is one such technique that aggregates findings from programs that have undergone rigorous evaluation at the level of program components (e.g., content, process, barrier reduction). Given that many Veteran programs lack outcome evidence from rigorous studies, an adaptation to CCA is needed. This report examines cross-sectional data from a pilot study using an adapted CCA across five domains of well-being (i.e., employment, education, legal/financial/housing, mental/physical health, and social/personal relationships). The purpose of this preliminary study is to determine the feasibility of eliciting program nominations and program components from Veterans via an online survey. When coupled with a longitudinal research design, this adaptation to CCA will allow for stronger causal claims about the expected impact of different program components within and across a variety of domains.

Treating PTSD in active duty service members using cognitive processing therapy or prolonged exposure therapy: Examining everyday practice at a military outpatient clinic

ABSTRACT The Institute of Medicine has stressed the need for evaluations of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) among active duty service members (AD) using a variety of evaluation approaches (Institute of Medicine, 2012). The current study examined the clinical files of 134 service members who completed treatment for PTSD using either prolonged exposure (PE) or cognitive processing therapy at an outpatient clinic. At the completion of each session, therapists made a clinical rating as to whether or not the session was protocol adherent. The total number of treatment sessions and the proportion of sessions rated as being protocol adherent were calculated. Multi-level models estimated the change in patient PTSD and other psychological symptoms over time as a function of clinician-rated protocol adherence and total number of sessions. Approximately 65% of clinic encounters were rated by therapists as being protocol adherent. Significant reductions in PTSD and psychological symptoms were associated with protocol adherence, and this was particularly true for patients who began treatment above clinical thresholds for both PTSD and other psychological symptoms. However, as the number of sessions increased, the impact of protocol adherence was attenuated. Patient characteristics, including gender, ethnicity, and co-morbidity for other psychiatric disorders were not related to symptom change trajectories over time. These findings suggest that protocol adherence and efficiency in delivery of EBTs for the treatment of PTSD with AD is critical.

Spouse and Family Functioning Before and After a Marine’s Suicide: Comparisons to Deaths by Accident and in Combat

The impact of service member suicides on families is not well understood. Civilian studies have demonstrated that family survivors of suicide deaths experience complicated grief, feel guilt and shame, and often do not receive sufficient social support. In this exploratory study, spouse survivors of Marines who died by suicide (N = 17), accident (N = 19), and in combat (N = 34) retrospectively reported on their immediate pre- and postmortem and current personal and family functioning. Nonparametric analyses revealed that several between-group differences existed. Observation of the means suggested that the spouses and families of Marines who died by suicide exhibited significantly poorer pre- and postmortem functioning compared with those whose spouses died in combat. Specific challenges included low family cohesion, high family conflict, perceived stigma, and shame. There were no differences in current spouse or family functioning, and there was weak evidence for posttraumatic growth among surviving spouses of those dying by suicide. These results should be considered preliminary and interpreted with caution given several methodological challenges.