Sara Veblen-Mortenson

Project Northland: outcomes of a communitywide alcohol use prevention program during early adolescence.

OBJECTIVES Project Northland is an efficacy trial with the goal of preventing or reducing alcohol use among young adolescents by using a multilevel, communitywide approach. METHODS Conducted in 24 school districts and adjacent communities in northeastern Minnesota since 1991, the intervention targets the class of 1998 (sixth-grade students in 1991) and has been implemented for 3 school years (1991 to 1994). The intervention consists of social-behavioral curricula in schools, peer leadership, parental involvement/education, and communitywide task force activities. Annual surveys of the class of 1998 measure alcohol use, tobacco use, and psychosocial factors. RESULTS At the end of 3 years, students in the intervention school districts report less onset and prevalence of alcohol use than students in the reference districts. The differences were particularly notable among those who were nonusers at baseline. CONCLUSIONS The results of Project Northland suggest that multilevel, targeted prevention programs for young adolescents are effective in reducing alcohol use.

Out and about: association of the built environment with physical activity behaviors of adolescent females.

Locational data, logged on portable GPS units and matched with accelerometer data, was used to examine associations of the built environment with physical activity and sedentary behaviors of adolescent females. In a sample of 293 adolescent females aged 15 to 18 years old in Minneapolis and San Diego, the built environment around each GPS point and its corresponding sedentary, light, and moderate-to-vigorous intensity physical activity was examined using random intercept multinomial logistic regression models. The odds of higher physical activity intensity (3-level outcome: sedentary, light, MVPA) were higher in places with parks, schools, and high population density, during weekdays, and lower in places with more roads and food outlets. Understanding the places where physical activity and sedentary behaviors occur appears to be a promising strategy to clarify relationships and inform policy aimed at increasing physical activity and reducing sedentary behaviors.

Project Northland High School Interventions: Community Action to Reduce Adolescent Alcohol Use

Project Northland is a randomized community trial initially implemented in 24 school districts and communities in northeastern Minnesota, with goals of delaying onset and reducing adolescent alcohol use using community-wide, multiyear, multiple interventions. The study targets the Class of 1998 from the 6th to 12th grades (1991-1998). The early adolescent phase of Project Northland has been completed, and reductions in the prevalence of alcohol use at the end of 8th grade were achieved. Phase II of Project Northland, targeting 11th- and 12th-grade students, uses five major strategies: (1) direct action community organizing methods to encourage citizens to reduce underage access to alcohol, (2) youth development involving high school students in youth action teams, (3) print media to support community organizing and youth action initiatives and communicate healthy norms about underage drinking (e.g., providing alcohol to minors is unacceptable), (4) parent education and involvement, and (5) a classroom-based curriculum for 11th-grade students. This article describes the background, design, implementation, and process measures of the intervention strategies for Phase II of Project Northland.

A Home-Based Prevention Program for Sixth-Grade Alcohol Use: Results from Project Northland

Project Northland is designed to prevent alcohol use among young adolescents. The project is ongoing in 24 school districts, randomly assigned to intervention or reference conditions. Multiple interventions begin with sixth graders and continue through eighth grade. The reference districts offer their standard health curricula. Evaluation consists of school surveys with the cohort (N = 2201) and telephone surveys of half their parents. This article describes the sixth-grade home-based intervention, the Slick Tracy Home Team. Findings of broad-based participation across sex, race, and risk status were documented, as well as some increases in knowledge and family communication about alcohol use.

Weight-Related Teasing in a Racially Diverse Sample of Sixth-Grade Children

Negative outcomes are associated with weight-based teasing. Among children, little research to date has explored the extent to which teasing occurs, the effects of teasing, or differences among sources of teasing. The purpose of this secondary data analysis was to assess the prevalence and frequency of weight-related teasing by peers and families in a low-income, multiracial/ethnic sample of children; to determine how bothered children were by the teasing; to evaluate whether teasing varied by overweight status and sex; and to see whether body satisfaction varied based on teasing history. In 2007, baseline data were obtained from 148 children (aged 11 to 12 years) in a classroom intervention pilot study in four public schools serving low-income communities in St Paul, MN. Participants completed a classroom survey assessing body satisfaction and weight-related teasing. Height and weight were measured. Forty percent of children reported being teased by peers and 36% reported being teased by family members about their weight. Significantly more overweight/obese children reported being teased by peers (P<0.01) and family members (P<0.05) than normal weight children. No significant differences were seen between weight status and the degree to which children were bothered by teasing. Body satisfaction was lower among children teased by family members or peers than those who were not teased (P<0.05). These results suggest that weight-related teasing is a problem for children, especially those who are overweight or obese. A better understanding is needed of the long-term effects of teasing on behavioral and psychosocial outcomes in racially/ethnically diverse samples of children.

Violence-related outcomes of the D.A.R.E. plus project.

The objectives of this study were to examine outcomes of the Minnesota D.A.R.E. Plus Project on violence-related behaviors among middle school students and mediation analyses that test how the intervention was effective in reducing physical and verbal violence. Twenty-four schools were randomly assigned to the D.A.R.E. middle school curriculum, the D.A.R.E. Plus multicomponent intervention, or control. The study cohort completed a self-report questionnaire at baseline and two follow-ups. The results showed that boys had higher rates of violence and victimization than girls. The D.A.R.E. Plus program was more effective in preventing violence among boys than among girls. It appears that the small behavioral effect that D.A.R.E. Plus did demonstrate on physical and verbal violence among boys was entirely mediated by a decrease of norms that support violence, an increase in outcome expectancies about being violence-free, and an increase in parental consequences for fighting.

An evaluation of a theatre production to encourage non-smoking among elementary age children: 2 Smart 2 Smoke

OBJECTIVE To evaluate the impact of a theatre production on smoking-related attitudes, norms, and intentions of children in grades 1–6 (aged 6–12 years). DESIGN Seventeen schools were randomly selected among 160 that were participating in the implementation of the theatre production 2 Smart 2 Smoke. Schools that participated in the theatre production after 3 December 1997 were assigned as control schools. Assignment of schools to a given date for the theatre production was a random process. Students in grades 1–6 were surveyed before and after the theatre production and associated activities. The data were examined for pretest–posttest differences and intervention-control differences. The school was the unit of analysis. SETTING Elementary schools in the Twin Cities metropolitan area. PARTICIPANTS Students in grades 1–6 in 17 elementary schools. INTERVENTION Two plays2 Smart 2 Smoke for grades 1–3 (6–8 year olds) and grades 4–6 (9–12 year olds), respectively, with follow-up activities for the classroom and home. A national theatre company performed the plays at the schools. MAIN OUTCOME MEASURES Intention to smoke in the future, normative expectations about how many people smoke, functional meanings of smoking, expected outcomes of smoking. RESULTS 10% more students reported that they would never smoke a cigarette after the theatre production. Students in grades 4–6 showed changes in the functional meanings and expected outcomes of smoking. Students in grades 1–3 showed changes in normative expectations. CONCLUSIONS Further research on the impact of live theatre productions as a smoking prevention strategy is recommended.

Influence of the Built Environment on Pedestrian Route Choices of Adolescent Girls

We examined the influence of the built environment on pedestrian route selection among adolescent girls. Portable global positioning system units, accelerometers, and travel diaries were used to identify the origin, destination, and walking routes of girls in San Diego, California, and Minneapolis, Minnesota. We completed an inventory of the built environment on every street segment to measure the characteristics of routes taken and not taken. Route-level variables covering four key conceptual built environment domains (Aesthetics, Destinations, Functionality, and Safety) were used in the analysis of route choice. Shorter distance had the strongest positive association with route choice, whereas the presence of a greenway or trail, higher safety, presence of sidewalks, and availability of destinations along a route were also consistently positively associated with route choice at both sites. The results suggest that it may be possible to encourage pedestrians to walk farther by providing high-quality and stimulating routes.

NET-Works: Linking families, communities and primary care to prevent obesity in preschool-age children.

Obesity prevention in children offers a unique window of opportunity to establish healthful eating and physical activity behaviors to maintain a healthful body weight and avoid the adverse proximal and distal long-term health consequences of obesity. Given that obesity is the result of a complex interaction between biological, behavioral, family-based, and community environmental factors, intervention at multiple levels and across multiple settings is critical for both short- and long-term effectiveness. The Minnesota NET-Works (Now Everybody Together for Amazing and Healthful Kids) study is one of four obesity prevention and/or treatment trials that are part of the Childhood Obesity Prevention and Treatment (COPTR) Consortium. The goal of the NET-Works study is to evaluate an intervention that integrates home, community, primary care and neighborhood strategies to promote healthful eating, activity patterns, and body weight among low income, racially/ethnically diverse preschool-age children. Critical to the success of this intervention is the creation of linkages among the settings to support parents in making home environment and parenting behavior changes to foster healthful child growth. Five hundred racially/ethnically diverse, two-four year old children and their parent or primary caregiver will be randomized to the multi-component intervention or to a usual care comparison group for a three-year period. This paper describes the study design, measurement and intervention protocols, and statistical analysis plan for the NET-Works trial.

Peer leadership in school and community alcohol use prevention activities

Abstract This article describes two major peer leadership components of the first phase of Project Northland, a prevention trial using multilevel community-wide strategies to prevent alcohol use and alcohol-related problems among youth. The intervention programs target Class of 1998 students, and began when they were in sixth grade. Described are (1) two peer leadership interventions implemented when the cohort was in seventh and eighth grades, (2) the students involved with the peer leadership activities, and (3) the association between involvement in peer leadership activities and tendency toward alcohol use following involvement, at the end of seventh and eighth grades. Students were elected by their classmates to lead the seventh grade alcohol use prevention curriculum. In addition, students had the opportunity to volunteer as peer leaders to plan alcohol-free activities during their seventh- and eighth-grade years. At baseline both types of peer leaders generally were lower on measures of problem beh...