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College Women’s HPV Vaccine Decision Narratives

Drawing on 38 in-depth qualitative interviews with college women and college health clinicians, we collected human papillomavirus (HPV) vaccine decision narratives to identify the implicit and explicit values underlying HPV vaccine decision making. Narratives of vaccine acceptance and resistance were identified. Vaccine acceptance narratives consisted of four themes: supportive family messages, explicit health care provider endorsement, peer descriptive norms reducing stigma of vaccination, and disease framing (e.g., cancer, HPV) shaping vaccine benefit perceptions. Vaccine resistance narratives consisted of five themes: skepticism of vaccine safety, invoking alternative prevention strategies, articulating stigmatizing HPV messages, overcoming self-efficacy barriers (e.g., cost, availability, time, and fear of parental disclosure), and delay strategies. Common to all decision narratives was that relationship status framed college women’s perceptions of HPV susceptibility. Theoretical and practical implications for designing HPV vaccine messages aimed at college-aged women are discussed.

Understanding Real-World Implementation Quality and “Active Ingredients” of PBIS

Programs delivered in the “real world” often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the “real-world” implementation quality of PBIS and to take a first step toward identifying the components of PBIS that “matter most” for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral during the 2007–2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three “active ingredients” of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in “real-world” settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy.

Primary Familial Brain Calcification

Primary familial brain calcification (PFBC) is a neurodegenerative disease with characteristic calcium deposits in the basal ganglia and other brain regions. The disease usually presents as a combination of abnormal movements, cognitive and psychiatric manifestations, clinically indistinguishable from other adult-onset neurodegenerative disorders. The differential diagnosis must be established with genetic and nongenetic disorders that can also lead to calcium deposits in encephalic structures. In the past years PFBC causal mutations have been discovered in genes related to calcium phosphate homeostasis (SLC20A2, XPR1) and in genes involved with endothelial function and integrity (PDGFB, PDGFRB). The most frequently mutated gene is SLC20A2, where mutations can affect any domain of the protein. There is no clearcut relationship between the specific mutation/gene, onset age, neuroimaging pattern, and severity of clinical manifestations. The discovery of the genetic basis of PFBC provides not only a diagnostic tool, but also an insight into the pathomechanisms and potential therapeutic trials for this rare disease.

A Review of Elementary School-Based Substance Use Prevention Programs: Identifying Program Attributes:

This article takes a systematic approach to reviewing substance use prevention programs introduced in elementary school (K-6th grade). Previous studies evaluating such programs among elementary school students showed mixed effects on subsequent substance use and related psychosocial factors. Thirty published evaluation studies of 24 elementary school-based substance use prevention programs were reviewed. The study selection criteria included searching for program evaluations from 1980 to 2008. Among 27 evaluation studies that examined program effects on substance use, 56% (n = 15) found significant decreases. In addition, programs most often demonstrated effects on increasing negative substance use attitudes, increasing knowledge, decreasing perceptions of prevalence rates (i.e., descriptive norms), and improving resistance skills. These results have implications for the appropriateness and value of introducing substance use prevention programs to youth in elementary school.

Mapping as a visual health communication tool: promises and dilemmas.

In the era of evidence-based public health promotion and planning, the use of maps as a form of evidence to communicate about the multiple determinants of cancer is on the rise. Geographic information systems and mapping technologies make future proliferation of this strategy likely. Yet disease maps as a communication form remain largely unexamined. This content analysis considers the presence of multivariate information, credibility cues, and the communication function of publicly accessible maps for cancer control activities. Thirty-six state comprehensive cancer control plans were publicly available in July 2005 and were reviewed for the presence of maps. Fourteen of the 36 state cancer plans (39%) contained map images (N = 59 static maps). A continuum of map interactivity was observed, with 10 states having interactive mapping tools available to query and map cancer information. Four states had both cancer plans with map images and interactive mapping tools available to the public on their Web sites. Of the 14 state cancer plans that depicted map images, two displayed multivariate data in a single map. Nine of the 10 states with interactive mapping capability offered the option to display multivariate health risk messages. The most frequent content category mapped was cancer incidence and mortality, with stage at diagnosis infrequently available. The most frequent communication function served by the maps reviewed was redundancy, as maps repeated information contained in textual forms. The social and ethical implications for communicating about cancer through the use of visual geographic representations are discussed.

Familias con Voz: Community Survey Results from an Intimate Partner Violence (IPV) Prevention Project with Migrant Workers

The Migrant Clinicians Network’s Familias con Voz (Families with a Voice) project aims to train migrant men and women to become intimate partner violence (IPV) peer educators in their communities. In preparation for implementing educational activities, a community survey was conducted with 298 participants in three Texas border counties. Verbal abuse, such as name calling, was the most frequent type of violence reported. Men perceived anger as a cause of partner violence significantly more than women. Only 22% of respondents reported knowing of a shelter they could turn to for help. Surprisingly, a majority of participants cited “seeking help from the police” when asked about ways to decrease partner violence. Survey results offer insight into developing effective intervention programs by capturing the intended audiences’ beliefs and attitudes. Additionally, survey results reveal possible strategies for how to tackle IPV in U.S.-Mexico border migrant farmworker communities.

Using Geographic Information Systems to Promote Community Involvement in Comprehensive Cancer Control

Geographic information systems (GIS) for cancer control present an innovative approach to health communication for comprehensive cancer control (CCC) planning. The ability to spatially depict multivariate views of cancer incidence, treatment site locations, transportation routes, and even environmental exposures within a map represents opportunities to involve communities in novel ways with cancer control. Communities may be involved strategically and/or as a goal in planning efforts. The experiences and perceptions of a near census of U.S. CCC program managers (N = 49) were examined to gain their insights about the compatibility of GIS mapping for CCC, the target audiences to be reached with maps as a CCC message, and relative advantages of this technology in its diffusion. Analysis includes a quantitative assessment of interviews and qualitative statements to illustrate these issues. Results suggest that GIS use for cancer control has the potential to build community capacity and social capital for communities as a way to reduce the cancer burden.

Assessment of Training Needs and Preferences for Geographic Information Systems (GIS) Mapping in State Comprehensive Cancer-Control Programs

Geographic information systems (GIS) mapping technologies have potential to advance public health promotion by mapping regional differences in attributes (e.g., disease burden, environmental exposures, access to health care services) to suggest priorities for public health interventions. Training in GIS for comprehensive cancer control (CCC) has been overlooked. State CCC programs’ GIS training needs were assessed by interviewing 49 state CCC directors. A majority perceived a need for GIS training, slightly more than half of state CCC programs had access to geocoded data, and the majority of programs did not require continuing education credits of their staff. CCC directors perceived judging maps and realizing their limitations as important skills and identified epidemiologists, CCC staff, public health officials, policy makers, and cancer coalition members as training audiences. They preferred in-class training sessions that last a few hours to a day. Lessons learned are shared to develop training programs with translatable GIS skills for CCC.

Drug prevention in elementary schools: an introduction to the special issue.

addresses several variationson a theme, namely: what is the state of drug prevention programming in ournation’s elementary schools? There is now abundant evidence to suggest thatpre-adolescents, or “tweens” as they have been called (Pasch, Perry, Stigler,& Komro, 2008), are already beginning to experiment with alcohol and othersubstances by the time they are 12 or 13. The most recent statistics availablefrom the household-based National Survey on Drug Use and Health suggest thatas of 2007 about 3.5% of the nation’s 12 and 13 year olds were current drinkers,and 1.5% were “binge” or heavy drinkers (Substance Abuse and Mental HealthServices Administration [SAMHSA], 2008). Statistics derived from other stateand national data sets indicate that about 4.1% of 6th graders report current(i.e., 30-day) alcohol use. Thisfinding, Donovan (2007) points out, isremarkablyconsistent across several state and regional surveys. As suggested by a survey ofa large national convenience sample that was conducted by PRIDE in 2001-02,students between the 5th and 6th grade enter a critical developmental timeperiodduringwhichtheirannualuseofbeer,winecoolers,andliquordoubles(Donovan,Leech, Zucker, Loveland-Cherry, Jester, Fitzgerald, et al., 2004). By contrast,prevalenceratesofexperimentalalcoholusebetween4thand5thgradearestatic.

Contextualizing Single Parent–Preadolescent Drug Use Talks

This article aims to examine parent–child drug talks specific to African American single mothers and their preadolescent children who live in a inner city neighborhood. Thirty-two single mothers participated in 1-hr individual interviews describing how they communicated with their preadolescent (8–12 years old) about drug use. Three areas were addressed: why drug talks occur, how drug talks take place, and the content of these talks. The interviews revealed that parent–child drug talks were culturally and communally driven, taking place out of necessity, incorporating real life situations as evidence of drug use outcomes, and occurring quite frequently with open communication regarding drug use. The implications are discussed related to the design of parent–child communication strategies in preadolescent drug use prevention.