Stuart L. Usdan

Alcohol use and high-risk sexual behavior among collegiate women: a review of research on alcohol myopia theory.

Abstract A review of current English literature in the areas of high-risk alcohol use and sexual behavior was conducted from September 2007 to December 2008. Objective: The purpose was to specifically review studies that used alcohol myopia theory (AMT) as the theoretical perspective from which they were evaluated and analyzed. Participants: Collegiate women were the population of interest in the review. Methods: Literature was acquired through searches within the Academic Search Premier and PubMed databases using the keywords “college,” “women,” “risk,” “alcohol,” “sex,” and “alcohol myopia.” Results: Results articulate the high prevalence of negative sexual consequences related to alcohol use among college-aged women and the utility of AMT. Conclusions: Future interventions aimed at decreasing high-risk alcohol and sexual behaviors among college women should incorporate AMT. Continued theory-based research examining the relationship between alcohol use and sexual behavior is needed to inform future interventions and better understand why college women continue to consume high levels of alcohol and engage in risky sexual behaviors despite the threat of negative consequences.

Abstinent-contingent housing and treatment retention among crack-cocaine-dependent homeless persons

This study investigated Behavioral Day Treatment attendance in relation to treatment outcome among homeless persons dependent on crack-cocaine. Participants (N = 141) were 72.3% male and 82.7% African American. Days attended, activities attended, and follow-up rates over a 12-month period were positively affected by the more attractive treatment of providing immediate, rent-free, abstinent-contingent housing during a 2-month Behavioral Day Treatment program. Results replicated previous findings that abstinence is a function of treatment attendance and more treatment is associated with greater abstinence. The loss of predictive power at long-term follow-up, limitations of a retrospective design, need to identify most predictive therapeutic activity types, and potential influence of mental disorders were discussed. Analytical techniques used in this study allows for the planning, predictability, and measurement of drug abuse treatment success as a function of service utilization.

Drinking Likelihood, Alcohol Problems, and Peer Influence Among First-Year College Students

Excessive alcohol consumption is a predominant health concern on college campuses in the United States. A stepwise multiple regression analysis was used to examine the predictive values of demographic factors in relation to alcohol subscales (Drinking Context Scale, College Alcohol Problems Scale-revised, and Social Modeling Scale) with the outcome of number of drinking days in the past 30 days among a sample (n = 224) of first-year college students. The final model predicted 37.5% of the variability in drinking days in the past month. All variables, except for race, were significantly associated with the outcome (p <. 05).

Gender Differences in College Leisure Time Physical Activity: Application of the Theory of Planned Behavior and Integrated Behavioral Model

Abstract Objective: National data consistently report that males participate in leisure time physical activity (LTPA) at higher rates than females. This study expanded previous research to examine gender differences in LTPA of college students using the theory of planned behavior (TPB) by including 2 additional constructs, descriptive norm and self-efficacy, from the integrated behavioral model. Participants: Participants were college students (N = 621) from a large public university in the southeastern United States. Methods: A self-report, classroom-based assessment with validated and reliable measures of LTPA, TPB constructs, descriptive norm, self-efficacy, and demographics was conducted in fall 2009. Results: Regression analyses revealed attitude (β = .119), intention (β = .438), self-efficacy (β = .166), body mass index (BMI) (β = −.084), and sports participation (β = .081) as significantly associated with LTPA for females (R 2 = .425, p < .001), whereas intention (β = .371) was significant for males (R 2 = .202, p < .001). Conclusions: Practitioners should consider tailoring promotional materials to address these gender differences in efforts to increase LTPA participation among college students.

The feasibility of assessing alcohol use among college students using wireless mobile devices: Implications for health education and behavioural research

Objective: This study examined the feasibility of using wireless mobile devices (MDs) to collect daily alcohol information among college students, in particular examining feasibility in the context of costs associated with the use of wireless MDs. This study reports on practical aspects of using MDs to collect alcohol data, including compliance, technical success, user preferences for completing MD-based assessments, and cost. Setting: The study took place at a large, public university in the south-eastern United States. Design: A two-group, randomized design was used. A daily assessment of alcohol use administered using wireless MDs was completed by a group of college students (n=86) for 30 days and compared to a paper-based (PB) daily assessment of alcohol use completed by a second group of college students (n=83) over the same time period. Results: Completion rates for the MD assessment (85.8 per cent) were comparable to the PB assessment (97.6 per cent) given the differences in mode of administration. Participants found the MDs easy to use (83.7 per cent), easy to read (94.2 per cent), and on average liked completing the daily MD assessment (M 4.47, SD 1.16) significantly more than respondents liked completing the PB assessment (M 3.88, SD 1.08; t [164] 3.84, p < 0.001). Few participants in the MD group reported that they were uncomfortable (9.3 per cent) or nervous (2.3 per cent) completing daily assessments using the MDs. Conclusion: Results indicate that the feasibility of using MDs for data collection may be influenced by user preferences and should be tested on different health behaviours in more diverse populations.

Using handheld computers for daily alcohol assessment: Results from a pilot study

Aims: The purpose of this pilot study was to determine the feasibility and usability of daily retrospective assessments of alcohol use using handheld computers and to explore their comparability to Timeline Followback (TLFB) assessments. Methods: College student participants received a Handheld Assessment Tool (HAT) at enrolment, which surveyed alcohol consumption and contextual factors for the previous day. After 1 week of daily monitoring, participants completed a paper‐and‐pencil TLFB assessment and HAT usability scale. Results: Of the 1,800 matched data points on the HAT and TLFB, the overall level of agreement was very good (kappa = 0.80, p<0.001). The mean difference between the number of drinks per drinking days recorded using both methods was 0.19 (SD = 0.56). Participants completed HAT surveys on 87 out of 91 total possible survey days (95.6%). The HAT recorded 34 drinking days and the TLFB recorded 37 out the 91 possible days; the HAT was reported to be highly usable by all participants. Conclusion: Overall, the HAT was found to be usable and feasible and produced high adherence. Further research should validate this alcohol assessment approach and apply it to representative populations.

Pill popping problems: The non-medical use of stimulant medications in an undergraduate sample

Aims: The non-medical use of prescription stimulants (NMUPS) is an emergent health behaviour among undergraduate college students. This study examined the prevalence, primary motivations and risk factors associated with lifetime and current NMUPS among undergraduates. Methods: An anonymous survey examining the NMUPS behaviour was administered in-class to a sample of 1020 of traditional undergraduate university students. Findings: Findings indicated that 35% of students used a prescription stimulant at least once non-medically during their lifetime and 12% had done so in the previous 30 days. Results also indicated that the majority of current and lifetime non-medical users were motivated to engage in the behaviour to improve or enhance academic performance. Further, multivariate logistic regression analyses revealed that students who engaged in current or lifetime NMUPS were more likely to be non-freshmen, affiliated with a Greek organization and diagnosed with attention deficit/hyperactivity disorder (ADHD). Conclusions: Efforts to reduce college students from engaging in NMUPS would benefit by targeting specific portions of the student body. These initiatives should include information about how to address academic problems without abusing stimulant medications.

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men

ABSTRACT Objective: The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men. Participants: Participants were unvaccinated college men aged 18–26 years attending a large public university in the southeastern United States during Spring 2015. Methods: A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire. Results: The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance. Conclusions: Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.

An examination of the misuse of prescription stimulants among college students using the theory of planned behavior

The misuse of prescription stimulants (MPS) is an emergent adverse health behavior among undergraduate college students. However, current research on MPS is largely atheoretical. The purpose of this study was to validate a survey to assess MPS-related theory of planned behavior (TPB) constructs (i.e. attitudes, subjective norms, and perceived behavioral control) and determine the relationship between these constructs, MPS-related risk factors (e.g. gender and class status), and current MPS (i.e. past 30 days use) among college students. Participants (N = 978, 67.8% female and 82.9% Caucasian) at a large public university in the southeastern USA completed a survey assessing MPS and MPS-related TPB constructs during fall 2010. To examine the relationship between MPS-related TPB constructs and current MPS, we conducted (1) confirmatory factor analyses to validate that our survey items assessed MPS-related TPB constructs and (2) a series of regression analyses to examine associations between MPS-related TPB constructs, potential MPS-related risk factors, and MPS in this sample. Our factor analyses indicated that the survey items assessed MPS-related TPB constructs and our multivariate logistic regression analysis indicated that perceived behavioral control was significantly associated with current MPS. In addition, analyses found that having a prescription stimulant was a protective factor against MPS when the model included MPS-related TPB variables.

Expanding Cervical Cancer Screening and Treatment in Tanzania: Stakeholders’ Perceptions of Structural Influences on Scale-Up

UNLABELLED Tanzania has the highest burden of cervical cancer in East Africa. This study aims to identify perceived barriers and facilitators that influence scale-up of regional and population-level cervical cancer screening and treatment programs in Tanzania. Convenience sampling was used to select participants for this qualitative study among 35 key informants. Twenty-eight stakeholders from public-sector health facilities, academia, government, and nongovernmental organizations completed in-depth interviews, and a seven-member municipal health management team participated in a focus group discussion. The investigation identified themes related to the infrastructure of health services for cervical cancer prevention, service delivery, political will, and sociocultural influences on screening and treatment. Decentralizing service delivery, improving access to screening and treatment, increasing the number of trained health workers, and garnering political will were perceived as key facilitators for enhancing and initiating screening and treatment services. In conclusion, participants perceived that system-level structural factors should be addressed to expand regional and population-level service delivery of screening and treatment. IMPLICATIONS FOR PRACTICE Tanzanian women have a high burden of cervical cancer. Understanding the perceived structural factors that may influence screening coverage for cervical cancer and availability of treatment may be beneficial for program scale-up. This study showed that multiple factors contribute to the challenge of cervical cancer screening and treatment in Tanzania. In addition, it highlighted systematic developments aimed at expanding services. This study is important because the themes that emerged from the results may help inform programs that plan to improve screening and treatment in Tanzania and potentially in other areas with high burdens of cervical cancer.