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Li J, Rico A, Brener N, Roberts A, Mpofu J, Underwood M. Comparison of Paper-and-Pencil Versus Tablet Administration of the 2021 National Youth Risk Behavior Survey (YRBS). J Adolesc Health 2024; 74:814-819. [PMID: 38069937 DOI: 10.1016/j.jadohealth.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/07/2023] [Accepted: 10/28/2023] [Indexed: 03/24/2024]
Abstract
PURPOSE As part of efforts to modernize the Youth Risk Behavior Surveillance System, the national Youth Risk Behavior Survey (YRBS) is moving from paper-and-pencil instrument (PAPI) administration to electronic administration using tablets. This study aimed to examine differences in demographic characteristics and the reporting of health behaviors and experiences between the PAPI- and tablet-administered 2021 national YRBS questionnaire. METHODS High school students (grades 9-12) in classrooms from 57 schools participating in the 2021 national YRBS were assigned randomly to complete the survey using PAPI (n = 4,684 students) or using tablets (n = 3,645 students). Eighty-nine behavior and experience items were examined to compare the missingness in reporting and the prevalence estimation (i.e., proportions) by administration mode. RESULTS Demographic characteristics (sex, race/ethnicity, grade, and sexual identity) did not differ by mode (PAPI vs. tablet). For the majority (93.2%, 83 out of 89) of YRBS behavior and experience items, mode was not significantly associated with the reported proportions, adjusting for sex, race/ethnicity, grade, and sexual identity. However, 30 out of 89 (33.7%) items showed significant variation in missingness by mode; 10 items had higher missingness with PAPI administration while 20 had higher missingness with tablet administration. DISCUSSION Survey administration mode was not significantly associated with behavior and experience reporting among high school students. More research is needed to understand differential patterns of missingness by mode. Aligning with Centers for Disease Control and Prevention's Public Health Data Modernization Initiative, findings from this study provide evidence to support electronic survey administration for the national YRBS, particularly using tablet data collection.
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Affiliation(s)
- Jingjing Li
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Adriana Rico
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nancy Brener
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jonetta Mpofu
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mike Underwood
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Harrell MB, Chen B, Clendennen SL, Sumbe A, Case KR, Wilkinson AV, Loukas A, Perry CL. Longitudinal trajectories of E-cigarette use among adolescents: A 5-year, multiple cohort study of vaping with and without marijuana. Prev Med 2021; 150:106670. [PMID: 34087321 PMCID: PMC8316299 DOI: 10.1016/j.ypmed.2021.106670] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
E-cigarette use harms adolescent health, yet it continues to escalate rapidly among teens nationwide. This longitudinal study sought to identify and differentiate between developmental trajectories of past 30-day e-cigarette use with and without marijuana (i.e., liquid THC) across adolescence (11-19 years old). Three population-based cohorts of adolescents (n = 3907; N = 461,069) living in major metropolitan areas of Texas (Houston, Dallas-Ft. Worth, San Antonio, Austin) completed up to 9 Waves of an e-cigarette use survey, from 2014 to 2019. Growth curve models (GCMs) were used to identify average trajectories of past 30-day e-cigarette use, by cohort. Growth mixture models (GMMs) were used to investigate developmental patterns in these trajectories, by cohort. Sociodemographic differences in trajectories were also investigated. Stable trajectories of e-cigarette use with and without marijuana were identified, from 11 through 19 years of age. Trajectories varied by age of onset; frequency and escalation in use; and substance used. With one exception, all trajectories of e-cigarette use escalated with age. Moreover, age of onset and progression in use were positively related. The most problematic trajectories, corresponding to more frequent use, were observed among the younger cohorts compared to the oldest. Primary prevention is critical. Interventions to prevent the onset and progression in e-cigarette use among teens must begin early (e.g., in middle school) and be sustained throughout adolescence.
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Affiliation(s)
- Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America.
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Stephanie L Clendennen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Aslesha Sumbe
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Kathleen R Case
- UT Health San Antonio, Center for Research to Advance Community Health, San Antonio, TX, United States of America
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Alexandra Loukas
- Health Behavior and Health Education in the Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, United States of America
| | - Cheryl L Perry
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
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Barnes C, McCrabb S, Stacey F, Nathan N, Yoong SL, Grady A, Sutherland R, Hodder R, Innes-Hughes C, Davies M, Wolfenden L. Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review. Transl Behav Med 2021; 11:1365-1410. [PMID: 34080618 PMCID: PMC8320878 DOI: 10.1093/tbm/ibab037] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although best practice recommendations exist regarding school-based healthy eating and physical activity policies, practices, and programs, research indicates that implementation is poor. As the field of implementation science is rapidly evolving, an update of the recent review of strategies to improve the implementation of healthy eating and physical activity interventions in schools published in the Cochrane Library in 2017 was required. The primary aim of this review was to examine the effectiveness of strategies that aim to improve the implementation of school-based policies, practices, or programs to address child diet, physical activity, or obesity. A systematic review of articles published between August 31, 2016 and April 10, 2019 utilizing Cochrane methodology was conducted. In addition to the 22 studies included in the original review, eight further studies were identified as eligible. The 30 studies sought to improve the implementation of healthy eating (n = 16), physical activity (n = 11), or both healthy eating and physical activity (n = 3). The narrative synthesis indicated that effect sizes of strategies to improve implementation were highly variable across studies. For example, among 10 studies reporting the proportion of schools implementing a targeted policy, practice, or program versus a minimal or usual practice control, the median unadjusted effect size was 16.2%, ranging from -0.2% to 66.6%. Findings provide some evidence to support the effectiveness of strategies in enhancing the nutritional quality of foods served at schools, the implementation of canteen policies, and the time scheduled for physical education.
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Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Sam McCrabb
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Fiona Stacey
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Alice Grady
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Rebecca Hodder
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | | | - Marc Davies
- New South Wales Office of Preventive Health, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
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Mitchell KR, Purcell C, Forsyth R, Barry S, Hunter R, Simpson SA, McDaid L, Elliot L, McCann M, Wetherall K, Broccatelli C, Bailey JV, Moore L. A peer-led intervention to promote sexual health in secondary schools: the STASH feasibility study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Young people report higher levels of unsafe sex and have higher rates of sexually transmitted infections than any other age group. Schools are well placed to facilitate early intervention, but more effective approaches are required. Peer-led approaches can augment school-based education, but often fail to capitalise on mechanisms of social influence. The potential of using social media in sexual health has not been tested in school settings.
Objectives
Finalise the design of the Sexually Transmitted infections And Sexual Health (STASH) intervention; assess the recruitment and retention of peer supporters, and acceptability to participants and stakeholders; assess the fidelity and reach, in addition to the barriers to and facilitators of, implementation; refine programme theory; understand the potential of social media; determine design parameters for a future randomised controlled trial, including economic evaluation; and establish whether or not progression criteria were met.
Design
This was a feasibility study comprising intervention development and refinement of the STASH pilot and non-randomised feasibility trial in six schools. Control data were provided by students in the year above the intervention group.
Setting
Secondary schools in Scotland.
Participants
Students aged 14–16 years, teachers and intervention delivery partners.
Interventions
The STASH intervention was adapted from A Stop Smoking In Schools Trial (ASSIST) (an effective peer-led smoking intervention). Based on diffusion of innovation theory, the STASH study involves peer nomination to identify the most influential students, with the aim of recruiting and training 15% of the year group as peer supporters. The peer supporters deliver sexual health messages to friends in their year group via conversations and use of Facebook (www.facebook.com; Facebook, Inc., Menlo Park, CA, USA) to share varied content from a curated set of web-based resources. Peer supporters are given support themselves via follow-up sessions and via trainer membership of Facebook groups.
Main outcome measures
The primary outcome was whether or not progression criteria were met in relation to intervention acceptability and feasibility. The study also piloted indicative primary outcomes for a full-scale evaluation.
Data sources
Peer supporter questionnaire; observations of activities; interviews with trainers, teachers, peer supporters and students; monitoring log of peer supporter activities (including on Facebook and meeting attendance); questionnaire to control year group (baseline characteristics, social networks, mediators and sexual health outcomes); baseline and follow-up questionnaire (approximately 6 months later) for intervention year group.
Results
A total of 104 students were trained as peer supporters (just over half of those nominated for the role by their peers). Role retention was very high (97%). Of 611 students completing the follow-up questionnaire, 58% reported exposure to STASH study activities. Intervention acceptability was high among students and stakeholders. Activities were delivered with good fidelity. The peer supporters were active, representative of their year group and well connected within their social network. Carefully managed social media use by peer supporters augmented conversations. A primary outcome of ‘always safer sex’ was identified, measured as no sex or always condom use for vaginal or anal sex in the last 6 months. The intervention cost £42 per student. Six progression criteria were met. A seventh criterion (regarding uptake of role by peer supporters) was not.
Limitations
Small feasibility study that cannot comment on effectiveness.
Conclusions
The STASH intervention is feasible and acceptable within the context of Scottish secondary schools. The results support continuation to a full-scale evaluation.
Future work
Small-scale improvements to the intervention, refinement to programme theory and funding sought for full-scale evaluation.
Trial registration
Current Controlled Trials ISRCTN97369178.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kirstin R Mitchell
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Carrie Purcell
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ross Forsyth
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sarah Barry
- Department of Mathematics and Statistics, Strathclyde University, Glasgow, UK
| | - Rachael Hunter
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Sharon A Simpson
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Lisa McDaid
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Lawrie Elliot
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Mark McCann
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kirsty Wetherall
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Chiara Broccatelli
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Julia V Bailey
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Laurence Moore
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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5
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Perry CL, Creamer MR, Chaffee BW, Unger JB, Sutfin EL, Kong G, Shang C, Clendennen SL, Krishnan-Sarin S, Pentz MA. Research on Youth and Young Adult Tobacco Use, 2013-2018, From the Food and Drug Administration-National Institutes of Health Tobacco Centers of Regulatory Science. Nicotine Tob Res 2020; 22:1063-1076. [PMID: 31127298 PMCID: PMC7457341 DOI: 10.1093/ntr/ntz059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
Abstract
The Tobacco Regulatory Science Program is a collaborative research effort between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). In 2013, the NIH funded 14 Tobacco Centers of Regulatory Science (TCORS), which serve as partners in establishing research, training, and professional development programs to guide FDA. Each of the fourteen TCORS, and two other NIH-funded research programs, the Center for the Evaluation of Nicotine in Cigarettes (CENIC) and the Consortium on Methods Evaluating Tobacco (COMET), pursued specific research themes relevant to FDA's priorities. A key mandate for FDA is to reduce tobacco use among young people. This article is a review of the peer-reviewed research, including published and in-press manuscripts, from the TCORS, CENIC, and COMET, which provides specific data or other findings on youth (ages 10-18 years) and/or young adults (ages 18-34 years), from 2013 to 2018. Citations of all TCORS, CENIC, and COMET articles from September 2013 to December 2017 were collected by the TCORS coordinating center, the Center for Evaluation and Coordination of Training and Research. Additional citations up to April 30, 2018 were requested from the principal investigators. A scoring rubric was developed and implemented to assess study type, primary theme, and FDA priority area addressed by each article. The major subareas and findings from each priority area are presented. There were 766 articles in total, with 258 (34%) focusing on youth and/or young adults. Findings relevant to FDA from this review concern impact analysis, toxicity, health effects, addiction, marketing influences, communications, and behavior. IMPLICATIONS The Tobacco Centers of Regulatory Science, CENIC, and COMET have had a high output of scientific articles since 2013. These Centers are unique in that the FDA supports science specifically to guide future regulatory actions. The 258 articles that have focused on youth and/or young adults are providing data for regulatory actions by the FDA related to the key priority areas such as the addictiveness of non-cigarette products, the effects of exposure to electronic cigarette marketing on initiation and cessation, and the impact of flavored products on youth and young adult tobacco use. Future regulations to reduce tobacco use will be guided by the cumulative evidence. These Centers are one innovative mechanism to promote important outcomes to advance tobacco regulatory science.
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Affiliation(s)
- Cheryl L Perry
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | - MeLisa R Creamer
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Jennifer B Unger
- Keck School of Medicine,University of Southern California, Los Angeles, CA
| | | | | | - Ce Shang
- Oklahoma Tobacco Research Center, Stephenson Cancer Center
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Stephanie L Clendennen
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Mary Ann Pentz
- Keck School of Medicine,University of Southern California, Los Angeles, CA
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Carey FR, Rogers SM, Cohn EA, Harrell MB, Wilkinson AV, Perry CL. Understanding susceptibility to e-cigarettes: A comprehensive model of risk factors that influence the transition from non-susceptible to susceptible among e-cigarette naïve adolescents. Addict Behav 2019; 91:68-74. [PMID: 30241775 DOI: 10.1016/j.addbeh.2018.09.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
The primary objective of this study was to identify risk factors associated with becoming susceptible to e-cigarette use over the course of a year among e-cigarette-naive adolescents considering a comprehensive model of risk factors (risk perceptions, social influences and norms, affective risk factors, and other behavioral risk factors). Data came from the Texas Adolescent Tobacco and Marketing Surveillance system (TATAMS), a longitudinal cohort study of students who were in the 6th, 8th, and 10th grades (n = 3907) during the 2014-2015 academic year. Weighted generalized linear mixed models assessed multiple predictors' associated with the transition to susceptibility to e-cigarettes at 12 months. Among 6th graders, family influence, use of other substances, and positive affect were important. Adolescents transitioning from 8th grade to high school presented the greatest number of risk factors (e.g., social and normative influences). Only sensation seeking increased the risk of susceptibility to e-cigarettes among 10th graders. Overall, by grade level, incidence of susceptibility to e-cigarettes at 12 months did not vary, but risk factor profiles varied substantially.
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Carey FR, Wilkinson AV, Harrell MB, Cohn EA, Perry CL. Measurement and predictive value of susceptibility to cigarettes, e-cigarettes, cigars, and hookah among Texas adolescents. Addict Behav Rep 2018; 8:95-101. [PMID: 30140729 PMCID: PMC6104349 DOI: 10.1016/j.abrep.2018.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/03/2018] [Accepted: 08/16/2018] [Indexed: 01/05/2023] Open
Abstract
Susceptibility to cigarette smoking, defined as the lack of a firm commitment not to smoke in the future, begins in childhood and is a phase in the transition from never to ever use of cigarettes. While a consistent and validated predictor of cigarette use, little research has assessed whether the susceptibility construct applies equally well across other tobacco products. Baseline data were collected in 2014–2015 from a representative sample of (n = 2844) middle and high school students in five counties surrounding the four largest cities in Texas, (49% female and mean age 13.13 years, with subsequent waves at 6, 12, and 18 months. Confirmatory factor analysis examined the appropriateness of a three-item susceptibility measure (product-specific curiosity, intention to use, and peer influence) across product types and ethnic groups (Hispanic versus non-Hispanic). Logistic regression examined whether product specific susceptibility at baseline predicted future product initiation. At baseline, 11.5%, 17.0%, 17.4% and 29.4%, of adolescent never users were susceptible to cigars, cigarettes, hookah and e-cigarettes, respectively; significantly more Hispanic than non-Hispanic adolescents were susceptible to e-cigarettes (32.4% versus 26%, p < 0.01) and cigarettes (19.9% versus 13.9%, p < 0.05). Product-specific items were significantly and consistently associated with the respective underlying susceptibility product construct and across ethnic groups (p < 0.001 for all). Susceptibility to e-cigarettes (AOR = 2.28–6.64) or any combustible product (cigarettes, hookah, cigars; AOR = 3.38–5.20) significantly predicted subsequent ever use. This study confirms the appropriateness of the susceptibility construct across four tobacco product types and ethnic groups, and the utility of susceptibility in predicting future product use among adolescents. Susceptibility to e-cigarettes and combustible tobacco products is robustly measured by the same three product-specific items Product-specific susceptibility constructs predicted use of respective tobacco products at 6, 12, and 18 months post-baseline Susceptibility to e-cigarettes and combustible tobacco products can be measured reliably in Hispanic and non-Hispanic youth
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Affiliation(s)
- Felicia R Carey
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston, School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701, United States of America
| | - Anna V Wilkinson
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston, School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701, United States of America
| | - Melissa B Harrell
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston, School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701, United States of America
| | - Elisabeth A Cohn
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston, School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701, United States of America
| | - Cheryl L Perry
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston, School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701, United States of America
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Pasch KE, Nicksic NE, Opara SC, Jackson C, Harrell MB, Perry CL. Recall of Point-of-Sale Marketing Predicts Cigar and E-Cigarette Use Among Texas Youth. Nicotine Tob Res 2018; 20:962-969. [PMID: 29069425 PMCID: PMC6037067 DOI: 10.1093/ntr/ntx237] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Indexed: 11/14/2022]
Abstract
Introduction While research has documented associations between recall of point-of-sale (POS) tobacco marketing and youth tobacco use, much of the research is cross-sectional and focused on cigarettes. The present longitudinal study examined recall of tobacco marketing at the POS and multiple types of tobacco use 6 months later. Methods The Texas Adolescent Tobacco Advertising and Marketing Surveillance System (TATAMS) is a large-scale, representative study of 6th, 8th, and 10th graders in 79 middle and high schools in five counties in Texas. Weighted logistic regression examined associations between recall of tobacco advertisements and products on display at baseline and ever use, current use, and susceptibility to use for cigarette, e-cigarette, cigar, and smokeless products 6 months later. Results Students' recall of signs marketing e-cigarettes at baseline predicted ever e-cigarette use and increased susceptibility to use e-cigarettes at follow-up, across all store types. Recall of e-cigarette displays only predicted susceptibility to use e-cigarettes at follow-up, across all store types. Both recall of signs marketing cigars and cigar product displays predicted current and ever cigar smoking and increased susceptibility to smoking cigars at follow-up, across all store types. Recall of cigarette and smokeless product marketing and displays was not associated with tobacco use measures. Conclusion The POS environment continues to be an important influence on youth tobacco use. Restrictions on POS marketing, particularly around schools, are warranted. Implications Cross-sectional studies have shown that exposure to POS cigarette marketing is associated with use of cigarettes among youth, though longitudinal evidence of the same is sparse and mixed. Cross-sectional studies have found that recall of cigars, smokeless product, and e-cigarette tobacco marketing at POS is associated with curiosity about tobacco use or intentions to use tobacco among youth, but limited longitudinal research has been conducted. Findings from the present longitudinal study suggest that recall of tobacco marketing at retail POS predicts ever use of e-cigarettes and cigars, current use of cigars, and susceptibility to cigar and e-cigarette use among youth.
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Affiliation(s)
- Keryn E Pasch
- Department of Kinesiology and Health Education, University of Texas at Austin, USA
| | - Nicole E Nicksic
- Department of Epidemiology, Human Genetics, and Environmental Sciences
| | - Samuel C Opara
- Department of Epidemiology, Human Genetics, and Environmental Sciences
| | - Christian Jackson
- Department of Epidemiology, Human Genetics, and Environmental Sciences
| | - Melissa B Harrell
- Department of Epidemiology, Human Genetics, and Environmental Sciences
| | - Cheryl L Perry
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, USA
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9
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School Policy, Administrator Perceptions, and Student E-cigarette Use. HEALTH BEHAVIOR AND POLICY REVIEW 2018; 5:72-82. [PMID: 30854404 DOI: 10.14485/hbpr.5.4.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objective In this study, we investigated the relationship between school e-cigarette policy and e-cigarette use among students. Secondarily, we examined whether this relationship varied by administrator perceptions about e-cigarette use being "an issue." Methods Data were utilized from written school policies, a school tobacco surveillance study of 2755 students (N = 310,412), and administrator interviews in 54 Texas schools. Results When administrators perceived e-cigarettes as an issue, the odds of ever e-cigarette use, susceptibility to use e-cigarettes, and perceived peer use of e-cigarettes were 0.20-0.54 times lower for students attending schools that had an e-cigarette policy compared to those without a policy (p < .05). Conclusion The impact of school policies on student e-cigarette use behavior is positive if policies are strongly implemented.
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Abstract
Objective We examined the impact of e-cigarette advertising on e-cigarette use behaviors among youth over time. Methods At baseline, 3907 students participated in a youth tobacco surveillance study from 2014-2015 and 2488 students completed a 6-month follow-up. Weighted logistic regression models investigated the recall of e-cigarette advertisements (TV/radio/billboards/retail/Internet) as a risk factor for e-cigarette perceived harm, use, and susceptibility. Results The odds of ever e-cigarette use was 3 times higher (AOR=2.99; 95% CI, 1.50-5.97) at 6-month follow-up among e-cigarette never-users who recalled e-cigarette advertisements in retail stores at baseline, compared to those who did not. Likewise, the odds of current e-cigarette use and susceptibility to e-cigarette use at 6-month follow-up were 2.03 (95% CI, 1.11-3.72) and 1.77 (95% CI, 1.20-2.61), respectively. Additionally, recall of e-cigarette advertisements on the Internet at baseline was significantly related to current use (AOR=2.17; 95% CI, 1.05-4.48) and susceptibility to use e-cigarettes (AOR=1.72;95% CI, 1.15-2.58) at 6-month follow-up. Conclusions Recall of e-cigarette advertisements at point-of-sale and on the Internet was significantly associated with adolescent e-cigarette susceptibility and use, which supports the need to minimize adolescent exposure to these advertisements.
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11
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Mantey DS, Harrell MB, Case K, Crook B, Kelder SH, Perry CL. Subjective experiences at first use of cigarette, e-cigarettes, hookah, and cigar products among Texas adolescents. Drug Alcohol Depend 2017; 173:10-16. [PMID: 28182981 PMCID: PMC5432196 DOI: 10.1016/j.drugalcdep.2016.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/06/2016] [Accepted: 12/10/2016] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Subjective experiences ("SEs") at first cigarette use have been thoroughly examined; however, limited research has examined SEs at first use of non-cigarette products. This study addresses this gap in the literature. METHODS Cross-sectional data from 6th, 8th and 10th grade students in four metropolitan areas of Texas (n=3907/N=461,069). Nausea, coughing, relaxation, rush/buzz, and dizziness at first use were assessed for cigarettes, e-cigarettes, hookah, and cigar products. Chi-square analyses examined differences in the prevalence of first use SEs by product. Weighted multiple logistic regression analyses examined the association of SEs and current product use. Covariates were grade, gender, race/ethnicity, and current other tobacco product use. RESULTS Exploratory factor analysis of SEs determined differing factor structures across tobacco products. For example, the following items loaded onto the positive SE factor: 1) relaxation, rush, and dizziness for cigarettes, and 2) relaxation and rush for e-cigarettes, hookah, and cigar products. Prevalence of negative SEs (coughing and nausea) were higher for cigarette and cigar products compared to e-cigarettes and hookah. Positive SEs for cigarettes were associated with increased odds of current cigarette use (AOR=1.51); similarly positive SEs for cigars were associated with increased odds of current cigar use (AOR=2.11). Feeling nauseous at first use of cigars was associated with decreased odds of current cigar use (AOR=0.18). No SEs were associated with current e-cigarette or hookah use. CONCLUSIONS Subjective experiences at first use differ by tobacco product. Longitudinal studies are needed to examine temporal relationships between SEs at first use and sustained tobacco use.
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Affiliation(s)
- Dale S Mantey
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA.
| | - Melissa B Harrell
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Kathleen Case
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Brittani Crook
- Center for Health Communication Affiliated Fellow, Moody College of Communication, University of Texas at Austin,300 W. Dean Keeton St., Austin, TX 78712, USA
| | - Steven H Kelder
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Cheryl L Perry
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
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12
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Abstract
Objectives To provide a full methodological description of the design of the wave I and II (6-month follow-up) surveys of the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS), a longitudinal surveillance study of 6th, 8th, and 10th grade students who attended schools in Bexar, Dallas, Tarrant, Harris, or Travis counties, where the 4 largest cities in Texas (San Antonio, Dallas, Fort Worth, Houston, and Austin, respectively) are located. Methods TATAMS used a complex probability design, yielding representative estimates of these students in these counties during the 2014-2015 academic year. Weighted prevalence of the use of tobacco products, drugs and alcohol in wave I, and the percent of: (i) bias, (ii) relative bias, and (iii) relative bias ratio, between waves I and II are estimated. Results The wave I sample included 79 schools and 3,907 students. The prevalence of current cigarette, e-cigarette and hookah use at wave I was 3.5%, 7.4%, and 2.5%, respectively. Small biases, mostly less than 3.5%, were observed for nonrespondents in wave II. Conclusions Even with adaptions to the sampling methodology, the resulting sample adequately represents the target population. Results from TATAMS will have important implications for future tobacco policy in Texas and federal regulation.
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13
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Harrell M, Weaver S, Loukas A, Creamer M, Marti C, Jackson C, Heath J, Nayak P, Perry C, Pechacek T, Eriksen M. Flavored e-cigarette use: Characterizing youth, young adult, and adult users. Prev Med Rep 2017; 5:33-40. [PMID: 27896041 PMCID: PMC5121224 DOI: 10.1016/j.pmedr.2016.11.001] [Citation(s) in RCA: 195] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/26/2016] [Accepted: 11/06/2016] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study is to investigate how the use of flavored e-cigarettes varies between youth (12-17 years old), young adults (18-29 years old), and older adults (30 + years old). Cross-sectional surveys of school-going youth (n = 3907) and young adult college students (n = 5482) in Texas, and young adults and older adults (n = 6051) nationwide were administered in 2014-2015. Proportions and 95% confidence intervals were used to describe the percentage of e-cigarette use at initiation and in the past 30 days that was flavored, among current e-cigarette users. Chi-square tests were applied to examine differences by combustible tobacco product use and demographic factors. Most e-cigarette users said their first and "usual" e-cigarettes were flavored. At initiation, the majority of Texas school-going youth (98%), Texas young adult college students (95%), and young adults (71.2%) nationwide said their first e-cigarettes were flavored to taste like something other than tobacco, compared to 44.1% of older adults nationwide. Fruit and candy flavors predominated for all groups; and, for youth, flavors were an especially salient reason to use e-cigarettes. Among adults, the use of tobacco flavor at initiation was common among dual users (e-cigarettes + combustible tobacco), while other flavors were more common among former cigarette smokers (P = 0.03). Restricting the range of e-cigarette flavors (e.g., eliminating sweet flavors, like fruit and candy) may benefit youth and young adult prevention efforts. However, it is unclear what impact this change would have on adult smoking cessation.
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Affiliation(s)
- M.B. Harrell
- UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - S.R. Weaver
- Georgia State University Tobacco Center of Regulatory Science & Division of Epidemiology & Biostatistics, School of Public Health, Georgia State University, 33 Gilmer Street SE, Atlanta, GA 30303, USA
| | - A. Loukas
- Department of Kinesiology & Health Education, University of Texas at Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712-1415, USA
| | - M. Creamer
- UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - C.N. Marti
- Department of Kinesiology & Health Education, University of Texas at Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712-1415, USA
| | - C.D. Jackson
- UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - J.W. Heath
- Georgia State University Tobacco Center of Regulatory Science, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA
| | - P. Nayak
- Georgia State University Tobacco Center of Regulatory Science, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA
| | - C.L. Perry
- UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - T.F. Pechacek
- Georgia State University Tobacco Center of Regulatory Science & Division of Health Management & Policy, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA
| | - M.P. Eriksen
- Georgia State University Tobacco Center of Regulatory Science & Division of Health Management & Policy, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA
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