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New this Month - December 2006
Holder, H. D. (2006). What is to be made of racial and
gender differences in substance use, and what should communities do about
it? In W. R. Miller & K. M. Carroll (Eds.), Rethinking substance abuse:
What the science shows, and what we should do about it (pp. 153-165).
New York: Guilford Press.
Nygaard, P. (2006). Focus on secondary prevention: Implications
of a study on intervention in social networks. Substance Use & Misuse,
41(13), 1719-1733.
Screening and brief intervention (SBI) as a method within secondary prevention
of alcohol use-related problems has experienced enormous attention and
interest over the past 20 years. Initial results were very promising and
great effort was put into designing screening instruments and developing
different kinds of interventions. However, at the same time, the approach
has generated problems in its own right. Some of these problems relate
to standardization of instruments and some to criteria of inclusion into
samples; others relate to the focus on the individual drinking style independent
from social influences. In light of these problems, it is necessary to
elaborate on the theoretical foundation, as well as on the methods used
in SBI. This article introduces a method for intervening in social networks
with important implications for SBI. By putting emphasis on the motivational
part of SBI and including social networks in the field of intervention,
it may be assumed that the approach will produce better results than heretofore.
The results from a Danish qualitative study on intervening into the social
network of social drinkers are presented. This study was carried out between
1991 and 1999 and involved 13 adult Danes between 35 and 45 years of age.
They all had a weekly alcohol consumption of 120 to 360 g of pure alcohol
and they all considered themselves to be social drinkers. The results
of this study show that enhanced awareness of the person's own drinking,
as well as that of peers, may influence decisions about specific drinking
situations. These findings and the perspectives for SBI are discussed.
Recommendations for further research are also presented.
Randolph, K. A., Gerend, M. A., & Miller, B. A. (2006).
Measuring alcohol expectancies in youth. Journal of Youth and Adolescence,
35(6), 939-948.
Beliefs about the consequences of using alcohol, alcohol expectancies,
are powerful predictors of underage drinking. The Alcohol Expectancies
Questionnaire-Adolescent form (AEQ-A) has been widely used to measure
expectancies in youth. Despite its broad use, the factor structure of
the AEQ-A has not been firmly established. It is also not known whether
it assesses similar constructs (i.e., measurement invariance) between
boys and girls. This article reports on a confirmatory factor analysis
(CFA) of a shortened version of the AEQ-A with 310 youth, ages 10-16,
to determine whether a two factor, positive and negative expectancy structure
held for this sample and to test measurement invariance across gender.
The results support evidence of a 2-factor, positive and negative structure
for the abbreviated version of the AEQ-A and show that it assesses equivalent
alcohol expectancy constructs among males and females. These findings
have important implications for cognitive based approaches to alcohol
prevention.
Hill, C. E., Crook-Lyon, R. E., Hess, S. A., Goates-Jones, M.,
Roffman, M., Stahl, J., Sim, W., & Johnson, M. (2006). Prediction
of session process and outcome in the Hill Dream Model: Contributions
of client characteristics and the process of the three stages. Dreaming,
16(3), 159-185.
Forty-two therapists trained in the C. E. Hill dream model (1996, 2004a)
conducted single dream sessions with 157 volunteer clients. Clients who
profited most from dream sessions had poor initial functioning on the
problem reflected in the dream, positive attitudes toward dreams, salient
dreams, low initial insight into the dream, and poor initial action ideas
related to the dream. When initial stages of the session were evaluated
positively, later stages were also evaluated positively. Process (therapist
competence/adherence and client involvement) was positively related to
session outcome. Perspective also influenced the findings, such that clients',
therapists', and judges' perceptions of process related to their own,
but not others', evaluations of process and session outcome. Implications
of findings for dream work and research are presented.
Lawrence, B. A., Miller, T. R., & Maxim, L. D. (2006).
Recent research on recreational boating accidents and the contribution
of boating under the influence: Summary of results. Washington, D.C.:
U.S. Coast Guard.
The United States Coast Guard (USCG) has the legal responsibility to collect,
analyze, and publish recreational boating accident data and statistical
information for the fifty states, five U.S. territories, and the District
of Columbia. Boating accident statistics are compiled and used for many
purposes, such as: identifying trends; characterizing accident causes;
assessing the contributions of operator error, mechanical malfunctions,
and environmental factors; and evaluating the possible benefits of government
initiatives (e.g., boater education, legislation/regulation, and boat
construction standards) to reduce the risks associated with recreational
boating activity. Complete and accurate accident data are essential for
these purposes. This summary of some recent research looks at recreational
boating accidents and the contribution of boating under the influence.
Levy, D. T., Ross, H., Powell, L., Bauer, J. E., & Lee, H.
R. (2007). The role of public policies in reducing smoking prevalence
and deaths caused by smoking in Arizona: Results from the Arizona Tobacco
Policy Simulation Model. Journal of Public Health Management and Practice,
13(1), 59-67.
Arizona was one of the first few states to implement a comprehensive tobacco
control program. The effect of that program is examined using a computer-simulation
model (SimSmoke) developed for the purposes of evaluation, planning, and
justifying policies. This approach assesses the impact to date of tobacco
control policies on smoking prevalence and generates predictions about
the effects of tobacco control policies on past and future smoking prevalence
and associated future premature mortality. SimSmoke estimates indicate
that tobacco control policies reduced smoking rates in Arizona by about
20 percent over the period 1993-2002. A previous CDC study obtains similar
effects, but does not net out the effects of individual policies. SimSmoke
attributes much of the reduction, about 61 percent, to price increases
and attributes 38 percent of the overall effect to media policies, leaving
only a small percentage of the smoking reductions attributed to quitlines,
youth access policies, and the weak clean air laws. Tobacco control policies
implemented as comprehensive strategies have significantly affected smoking
rates in Arizona, which leads to large reductions in deaths attributable
to smoking. It will be important to maintain these efforts over time to
reduce or keep smoking prevalence down and to minimize smoking-attributable
deaths.
Ross, H., Powell, L. M., Bauer, J. E., Levy, D. T., Peck, R. M.,
& Lee, H. R. (2006). Community-based youth tobacco control
interventions: cost effectiveness of the full court press project. Applied
Health Economics and Health Policy, 5(3), 167-176.
BACKGROUND: We evaluated the impact of a community-based tobacco control
project that was implemented in the city of Tucson, Arizona, USA, between
1996 and 2001. AIM: The project's goal was to reduce the prevalence of
youth smoking through change in social norms at schools and in communities
and workplaces. As is often the case, these community-based health promotion
interventions were implemented in conjunction with other broader programmes,
in this case implemented on the state level. METHOD: Taking into account
state level interventions as well as changes in sociodemographic and economic
environment over the course of the project (e.g. increases in cigarette
prices), we measure the net effect of the intervention in terms of the
number of people who quit or did not initiate smoking and by the discounted
life-years gained. To establish the value of investing into community-based
intervention, we calculated the real discounted cost per quit and per
life-year gained of $US3789 and $US3942, respectively. These compare favourably
with the real cost per quit of $US4270 when implementing the 1996 US Clinical
Practice Guideline for smoking cessation but exceed the real cost of $US2923
per discounted life-year gained when following the guideline. RESULTS:
A sensitivity analysis that assumed 5% programme persistence (i.e. 5%
of the programme's impact would last forever in the absence of future
funding for the programme), one-third would relapse and that one-third
of those who quit may have quit smoking even without the programme, suggested
a lower cost per discounted life-year saved of $US3476. The cost effectiveness
of this project compares favourably with other tobacco control interventions.
CONCLUSION: Despite its relatively small target group, this community-based
intervention was cost effective.
Miller, T. R., Levy, D. T., Cohen, M. A., & Cox, K. L.
(2006). Costs of alcohol and drug-involved crime. Prevention Science,
7(4), 333-342.
A large proportion of violent and property crimes involve alcohol or other
drugs (AOD). AOD use only causes some of these crimes. This paper estimates
the costs of AOD-involved and AOD-attributable crimes. Crime counts are
from government statistics adjusted for underreporting. The AOD-involved
portion of crime costs is estimated from inmate surveys on alcohol and
illicit drug use at the time of the crime. The costs and AOD-attributable
portion of AOD-involved crimes come from published studies. They include
tangible medical, mental health, property loss, future earnings, public
services, adjudication, and sanctioning costs, as well as the value of
pain and suffering. An estimated 5.4 million violent crimes and 8 million
property crimes involved AOD use in 1999. Those AOD-involved crimes cost
society over $6.5 billion in medical and mental health care and almost
$65 billion in other tangible expenses (in 1999 dollars). If the value
of pain, suffering, and lost quality of life is added, AOD-involved crime
costs totaled $205 billion. Violent crimes accounted for more than 85%
of the costs. Roughly estimated, crimes attributable to alcohol cost $84
billion, more than 2 times the $38 billion attributable to drugs. Although
American media-news and entertainment-dwell on the links between drugs
and crime, alcohol-attributable crime costs are double drug-attributable
ones. Effective efforts to reduce the abuse of alcohol and illicit drugs
should reduce costs associated with crime.
Corso, P., Finkelstein, E., Miller, T., Fiebelkorn, I., &
Zaloshnja, E. (2006). Incidence and lifetime costs of injuries
in the United States. Injury Prevention, 12(4), 212-218.
Background: Standardized methodologies for assessing economic burden of
injury at the national or international level do not exist. Objective:
To measure national incidence, medical costs, and productivity losses
of medically treated injuries using the most recent data available in
the United States, as a case study for similarly developed countries undertaking
economic burden analyses. Method: The authors combined several data sets
to estimate the incidence of fatal and non-fatal injuries in 2000. They
computed unit medical and productivity costs and multiplied these costs
by corresponding incidence estimates to yield total lifetime costs of
injuries occurring in 2000. Main outcome measures: Incidence, medical
costs, productivity losses, and total costs for injuries stratified by
age group, sex, and mechanism. Results: More than 50 million Americans
experienced a medically treated injury in 2000, resulting in lifetime
costs of $406 billion; $80 billion for medical treatment and $326 billion
for lost productivity. Males had a 20% higher rate of injury than females.
Injuries resulting from falls or being struck by/against an object accounted
for more than 44% of injuries. The rate of medically treated injuries
declined by 15% from 1985 to 2000 in the US. For those aged 0-44, the
incidence rate of injuries declined by more than 20%; while persons aged
75 and older experienced a 20% increase. Conclusions: These national burden
estimates provide unequivocal evidence of the large health and financial
burden of injuries. This study can serve as a template for other countries
or be used in intercountry comparisons.
Peters, R., Jr., Kelder, S. H., Prokhorov, A. V., Agurcia, C.
A., Yacoubian, G. S., Jr., & Essien, E. J. (2006). Beliefs
regarding cigarette use, motivations to quit, and perceptions on cessation
programs among minority adolescent cigarette smokers. Journal of Adolescent
Health, 39(5), 754-757.
To gain a better understanding of minority smoking cessation interventions,
our study used a qualitative approach to investigate smoking uptake beliefs
regarding cigarette use, motivations to quit, and perceptions on cessation
programs among 65 minority high school students who were current smokers.
Yacoubian, G. S., & Cone, E. J. (2006). A comparison
between the Intercept Oral Fluid Collection Device® and urinalysis
among Baltimore City probationers. Journal of Criminal Justice, 34(4),
413-424.
Abstract: Few studies compared oral fluid (OF) analysis to laboratory
urinalysis (UA) in real-world criminal justice environments, and no studies
had collected survey data, from either specimen providers or specimen
collectors, about the overall OF collection experience. In the most comprehensive
toxicological comparison study conducted to date, urine and OF specimens
were collected from a sample of 223 adult probationers in Baltimore City,
Maryland, between March and May 2004. In addition, probationers and probation
staff were surveyed about the OF collection experience. With confirmed
UA as the reference standard, the Intercept Oral Specimen Collection Device®
(Intercept) was 100 percent sensitive and 99 percent specific for benzodiazepines,
92 percent sensitive and 96 percent specific for cocaine, 77 percent sensitive
and 96 percent specific for opiates, 39 percent sensitive and 98 percent
specific for marijuana, and 75 percent sensitive and 91 percent specific
for the detection of at least one drug. Seventy-two percent of the probationers
and 88 percent of the probation staff rated the Intercept experience better
than the collection of urine specimens. Implications for criminal justice
policy and research are discussed.
Hallfors, D., Cho, H., Sanchez, V., Khatapoush, S., Kim, H. M.,
& Bauer, D. (2006). Efficacy vs effectiveness trial results
of an indicated "Model" Substance Abuse Program: Implications
for public health. American Journal of Public Health, 96(12), 2254-2259.
OBJECTIVES: The US Department of Education requires schools to choose
substance abuse and violence prevention programs that meet standards of
effectiveness. The Substance Abuse and Mental Health Services Agency certifies
"model" programs that meet this standard. We compared findings
from a large, multisite effectiveness trial of 1 model program to its
efficacy trial findings, upon which the certification was based. METHODS:
1370 high-risk youths were randomized to experimental or control groups
across 9 high schools in 2 large urban school districts. We used intent-to-treat
and on-treatment approaches to examine baseline equivalence, attrition,
and group differences in outcomes at the end of the program and at a 6-month
follow-up. RESULTS: Positive efficacy trial findings were not replicated
in the effectiveness trial. All main effects were either null or worse
for the experimental than for the control group. CONCLUSIONS: These findings
suggest that small efficacy trials conducted by developers provide insufficient
evidence of effectiveness. Federal agencies and public health scientists
must work together to raise the standards of evidence and ensure that
data from new trials are incorporated into ongoing assessments of program
effects.
Hallfors, D. D., Iritani, B. J., Miller, W. C., & Bauer, D.
J. (2007). Sexual and drug behavior patterns and HIV and STD
racial disparities: the need for new directions. American Journal of Public
Health, 97(1), 125-132.
OBJECTIVES: We used nationally representative data to examine whether
individuals' sexual and drug behavior patterns account for racial disparities
in sexually transmitted disease (STD) and HIV prevalence. METHODS: Data
were derived from wave III of the National Longitudinal Study of Adolescent
Health. Participants were aged 18 to 26 years old; analyses were limited
to non-Hispanic Blacks and Whites. Theory and cluster analyses yielded
16 unique behavior patterns. Bivariate analyses compared STD and HIV prevalences
for each behavior pattern, by race. Logistic regression analyses examined
within-pattern race effects before and after control for covariates. RESULTS:
Unadjusted odds of STD and HIV infection were significantly higher among
Blacks than among Whites for 11 of the risk behavior patterns assessed.
Across behavior patterns, covariates had little effect on reducing race
odds ratios. CONCLUSIONS: White young adults in the United States are
at elevated STD and HIV risk when they engage in high-risk behaviors.
Black young adults, however, are at high risk even when their behaviors
are normative. Factors other than individual risk behaviors and covariates
appear to account for racial disparities, indicating the need for population-level
interventions.
Iritani, B. J., Ford, C. A., Miller, W. C., Hallfors, D. D., &
Halpern, C. T. (2006). Comparison of self-reported and test-identified
chlamydial infections among young adults in the United States of America.
Sexual Health, 3(4), 245-251.
Background: Many studies rely on respondent reports of prior diagnosed
sexually transmissible infections (STIs), but these self reports are likely
to under-estimate infection prevalence. The extent of bias from using
self-reported STI data, and whether bias varies by sex and race, is largely
unknown. This gap is addressed using a large, nationally representative
sample. Methods: Cross-sectional analyses of Wave III of the National
Longitudinal Study of Adolescent Health. Participants were 18-26 years
old (n = 12 359). Estimates of the prevalence of chlamydial infection
based on self-reported diagnoses in the past year were compared with actual
prevalence based on nucleic acid amplification testing (NAAT) at the time
of data collection. Ratios of test-identified prevalence to self-reported
diagnosis prevalence were calculated by sex and race/ethnicity groups.
Larger ratios indicate greater extent of self reports under-estimating
infection prevalence. Results: About 4.2% of the sample had a current
NAAT-identified chlamydial infection, but only 3.0% reported having been
diagnosed with chlamydia in the past year, yielding a ratio of 1.43. The
ratio of test-identified infection prevalence to prevalence identified
from self-reported diagnoses was larger among men than women (2.07 versus
1.14, P < 0.05). Among men, the ratio was larger among non-Hispanic
blacks (2.40) compared with non-Hispanic whites (1.07, P < 0.05). Conclusions:
Use of self-reported diagnoses under-estimates chlamydial infection prevalence,
particularly among men, and among non-Hispanic black men. Reliance on
self-reported STIs may consequently lead to biased conclusions, particularly
for these groups. Use of biological testing for STIs in research studies
is recommended.
Thomas, S. (2006). The Difference "Difference"
Makes: Women and Leadership/The Difference Women Make: The Policy Impact
of Women in Congress. Signs: Journal of Women in Culture & Society,
31(4), 1160-1163.
The article reviews two books "The Difference Difference Makes: Women
and Leadership," edited by Deborah L. Rhode and "The Difference
Women Make: The Policy Impact of Women in Congress," by Michele L.
Swers.
Thomas, S., Rickert, L., & Cannon, C. (2006). The
meaning, status, and future of reproductive autonomy: The case of alcohol
use during pregnancy. UCLA Women's Law Journal, 15(1), 1-46.
In this article, we have sought to expand our understanding of reproductive
freedom in two ways. First, we investigated the extent to which state
legislatures have pursued paths leading toward either reproductive autonomy
or reproductive restraint with respect to alcohol use during pregnancy
and what the trend suggests for the future. Our results indicate that
while states have enacted a greater number of facilitation than inhibition
provisions, the numbers tell only part of the story. The types of facilitation
enactments generally do not provide intervention and treatment for women
in need. Moreover, the severity of the inhibition enactments, however
small in number, compromise women's reproductive freedom. Second, using
the political science literature on women officeholders as a foundation,
we asked whether the proportion of women in legislatures across the nation
is positively correlated with adoption of provisions supporting reproductive
autonomy. The answer to that question is an unqualified yes. Thus, one
strategy to reverse losses of reproductive freedom is for supporters of
these goals to work not only to bring more women into politics, but to
work strategically to increase proportions of women in legislatures especially
in key legislatures.
Mastropieri, M. A., Scruggs, T. E., Norland, J. J., Berkeley,
S., McDuffie, K., Tornquist, E. H., & Connors, N. (2006).
Differentiated curriculum enhancement in inclusive middle school science:
Effects on classroom and high-stakes tests. Journal of Special Education,
40(3), 130-137.
This investigation compared quantitative outcomes associated with classwide
peer tutoring using differentiated hands-on activities vs. teacher-directed
instruction for students with mild disabilities in inclusive 8th-grade
science classes. Thirteen classes of 213 students (109 males; 104 females),
of whom 44 were classified with disabilities, participated in 12-week
sessions in a randomized field trial design. Experimental classes received
units of differentiated, peer-mediated, hands-on instruction, while control
classes received traditional science instruction. Results indicate that
collaborative hands-on activities statistically facilitate learning of
middle school science content on posttests and on state high-stakes tests
for all students and that students enjoyed using the activities. Implications
for practice indicate use of supplemental peer mediated hands-on activities
may provide necessary review and practice for students with disabilities.
Future research would help uncover additional critical instructional variables.
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