1
|
Dearfield CT, Ulfers M, Horn K, Bernat DH. Resident Support for the Federally Mandated Smoke-Free Rule in Public Housing: 2018-2022. Int J Environ Res Public Health 2024; 21:102. [PMID: 38248565 PMCID: PMC10815862 DOI: 10.3390/ijerph21010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
This study examines support for the Department of Housing and Urban Development's (HUD) mandatory smoke-free rule up to four years post-rule among smokers and non-smokers. A repeated cross-sectional design was used where District of Columbia public housing residents aged 18+ (n = 529) completed surveys during three time points: July 2018 (pre-rule), November 2018-March 2020 (post-rule), and September 2020-December 2022 (post-rule + COVID-19). Full support for the rule was indicated by agreeing that smoking should not be allowed in all indoor locations and within 25 feet of buildings. Descriptive statistics showed significant differences in support across time for smokers (5.3%, 30.7%, and 22.5%, respectively) and similar support across time for nonsmokers (48.2%, 52.2%, and 40.0%, respectively). In unstratified regression analysis, pre-rule support was lower than when the rule was in effect (aOR = 0.47, 95% CI = 0.25, 0.90), and tobacco users were less likely to support the rule (aOR = 0.34, 95% CI = 0.23, 0.50). Stratified logistic regression results showed that pre-rule support was lower among smokers compared to post-rule support (aOR = 0.14, 95% CI = 0.03, 0.59); support among nonsmokers did not vary by time. Findings overall indicate low support for the smoke-free rule up to 4 years post-implementation. Engaging residents with the rule and promoting health and well-being may further enhance policy effectiveness and acceptance.
Collapse
Affiliation(s)
- Craig T. Dearfield
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (M.U.); (D.H.B.)
| | - Margaret Ulfers
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (M.U.); (D.H.B.)
| | - Kimberly Horn
- Department of Population Health Sciences, Virginia Tech-Carilion Fralin Biomedical Research Institute, Roanoke, VA 24016, USA;
| | - Debra H. Bernat
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (M.U.); (D.H.B.)
| |
Collapse
|
2
|
Dearfield CT, Choi K, Vivino A, Horn K, Ahluwalia JS, Crandell I, Bernat EM, Bernat DH. Are excluding e-cigarettes a loophole in the smokefree public housing rule? Prev Med Rep 2023; 31:102069. [PMID: 36483578 PMCID: PMC9722475 DOI: 10.1016/j.pmedr.2022.102069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
The U.S. Department of Housing and Urban Development (HUD) required all Public Housing Authorities to become smokefree in July 2018, following an 18-month implementation period that began February 2017. The HUD rule included all combustible tobacco products; e-cigarettes were not included. This purpose of this study is to characterize e-cigarette use overall and initiation after the implementation of the smokefree rule among tobacco users living in public housing. Data were collected from 396 adult (18+ years) current tobacco users at the time of rule implementation residing in the District of Columbia Housing Authority between July 2018 and November 2021. Measures include e-cigarette use, age of initiation, reasons for e-cigarette use, e-cigarette use susceptibility (among non-users), and sociodemographic characteristics. Descriptive and crosstab statistics were calculated to characterize e-cigarette use. Nearly-one-quarter of tobacco users reported lifetime use of e-cigarettes (24 %, n = 95) and 4.8 % (n = 19) indicated past 30-day e-cigarette use. Of the lifetime users, twenty-two (23.2 %) initiated their use after the smoke-free rule went into effect, with only two of those residents indicating they did so because of the rule. Of those who never used an e-cigarette, 23.5 % (n = 70) indicated being curious about e-cigarettes and 10.7 % (n = 40) said they may use e-cigarettes in the next year. Results indicate low use of e-cigarette products and low uptake due to the rule. Few tobacco users who never used e-cigarettes indicated intentions to use. Results suggest that omitting e-cigarettes from the HUD rule has not led to significant use of these products in this sample.
Collapse
Affiliation(s)
- Craig T. Dearfield
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, United States
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, United States
| | - Anthony Vivino
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, United States
| | - Kimberly Horn
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, United States
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Legorreta Cancer Center, Brown University, Providence, RI, United States
| | - Ian Crandell
- Virginia Tech-Center for Biostatistics and Health Data Sciences, Roanoke, VA, United States
| | | | - Debra H. Bernat
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, United States
| |
Collapse
|
3
|
Dearfield CT, Horn K, Crandell I, Bernat DH. Behavioural intentions in response to a potential menthol cigarette sales ban: a survey examining smokers in Washington, DC public housing. BMJ Open 2022; 12:e059821. [PMID: 35831050 PMCID: PMC9280868 DOI: 10.1136/bmjopen-2021-059821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Local, national and international policies are being proposed to ban the sale of menthol-flavoured tobacco products. With more bans being implemented, it is increasingly important to understand reactions to these bans among smokers of low socioeconomic status. This study examined public housing residents' behavioural intentions if menthol-flavoured cigarettes were no longer sold. SETTING 15 District of Columbia Housing Authority properties between March 2019 and March 2021. PARTICIPANTS 221 District of Columbia Housing Authority residents ages 18-80 years who reported smoking menthol cigarettes (83.3% African-American/black). PRIMARY AND SECONDARY OUTCOMES Cigarette quitting and switching intentions due to a hypothetical menthol-flavoured cigarette sales ban. RESULTS Nearly one-half (48.0%) of residents said they intended to quit cigarette use if menthol-flavoured products were no longer sold, while 27.2% were unsure if they would quit, and 24.9% reported they would not quit. Older residents (OR 0.94 per year, 95% CI 0.91 to 0.97), senior/disabled building versus family building residents (OR 0.50, 95% CI 0.25 to 0.97), those who smoked within 30 min of waking (OR 0.48, 95% CI 0.23 to 0.98) and daily smokers (OR 0.42, 95% CI 0.21 to 0.84) had lower odds of reporting quit intentions associated with a menthol ban. Of those not intending to quit, 40.7% reported they would switch to non-menthol cigarettes, 20.4% to another non-menthol product, 13.0% to menthol e-cigarettes and 20.4% to another menthol product. CONCLUSIONS Results suggest banning the sale of menthol-flavoured products has the potential to impact cigarette smoking cessation. Nearly three-quarters of smokers in public housing indicated a possibility of quitting smoking because of a menthol cigarette ban. Bans that include all flavours in all tobacco products may be most effective for facilitating overall tobacco cessation.
Collapse
Affiliation(s)
- Craig T Dearfield
- Epidemiology, The George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
| | - Kimberly Horn
- Department of Population Health Sciences, Virginia Tech-Carilion Fralin Biomedical Research Institute, Roanoke, Virginia, USA
| | - Ian Crandell
- Department of Statistics, Center for Biostatistics and Health Data Science, Virginia Polytechnic Institute and State University, Roanoke, Virginia, USA
| | - Debra H Bernat
- Epidemiology, The George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
| |
Collapse
|
4
|
Horn K, Dearfield CT, Beth Johnson S, Krost K, Rincon Gallardo Patino S, Gray T, Crandell I, Bernat DH. Smoking cessation intentions and attempts one year after the federally mandated smoke-free housing rule. Prev Med Rep 2021; 24:101600. [PMID: 34976657 PMCID: PMC8683937 DOI: 10.1016/j.pmedr.2021.101600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 12/15/2022] Open
Abstract
The present study examines public housing residents' smoking cessation intentions, expectancies, and attempts one year after implementation of the Department of Housing and Urban Development's mandatory smoke-free rule in public housing. The sample includes 233 cigarette smokers, ages 18-80, who reside in the District of Columbia Housing Authority. Data collection occurred between March and August 2019. Descriptive statistics, chi-square, and Wilcoxon two-sample test analyses assessed smoking cessation intentions, expectancies, and attempts across resident demographics and characteristics. Findings showed 17.2% of residents reported not thinking about quitting, 39.1% reported thinking about quitting, and 48.6% reported thinking about quitting specifically because of the rule. Residents ages 60-80 were more likely to consider quitting because of the rule, compared to residents ages 18-59. Of those thinking of quitting, 58.6% were sure they could quit if they tried. Those thinking of quitting due to the rule (62.0%) were more likely to have made at least one quit attempt in the past 3 months than those i not attributinging thinking of quitting to the rule. Res Residents trying to quit reported an average of 2.7 attempts in the last 3 months;; most perceived evidence-based cessation supports as not helpful. A A majority reported thinking about quitting and attempting to quit but continuing to smoke, indicating a significant gap between intent to quit and successfully quitting. Results suggest that the rule positively influenced smoking behaviors. However, additional interventions are needed to assist public housing residents with successfully quitting smoking.
Collapse
Affiliation(s)
- Kimberly Horn
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, USA
| | - Craig T. Dearfield
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, USA
| | - Sallie Beth Johnson
- Radford University Carilion, Department of Public Health and Healthcare Leadership, Roanoke, VA, USA
- Virginia Tech Carilion, Department of Family and Community Medicine, Roanoke, VA, USA
| | - Kevin Krost
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, USA
| | | | - Tiffany Gray
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, USA
| | - Ian Crandell
- Virginia Tech-Center for Biostatistics and Health Data Sciences, Roanoke, VA, USA
| | - Debra H. Bernat
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, USA
| |
Collapse
|
5
|
Dearfield CT, Chen-Sankey JC, McNeel TS, Bernat DH, Choi K. E-cigarette initiation predicts subsequent academic performance among youth: Results from the PATH Study. Prev Med 2021; 153:106781. [PMID: 34487749 PMCID: PMC8595658 DOI: 10.1016/j.ypmed.2021.106781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/19/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
Research shows cigarette smoking is associated with lower academic performance among youth. This study examines how initiating e-cigarette use is associated with subsequent academic performance. Data from Waves 2-4 youth and parent surveys of the Population Assessment of Tobacco and Health (PATH) Study were analyzed. Youth (12-15 years old) who reported never using any tobacco products at Wave 2 were included in the analysis (n = 4960). Initiation of e-cigarettes and cigarettes was assessed at Wave 3. Weighted multivariable linear regression models were tested to assess the association between e-cigarette and cigarette initiation at Wave 3 and academic performance at Wave 4, controlling for covariates at Wave 2. At Wave 3, 4.3% and 1.9% of youth initiated e-cigarette and cigarette use, respectively. Youth who initiated e-cigarette use at Wave 3 had lower academic performance at Wave 4, compared to those who did not initiate e-cigarette use (adjusted regression coefficient [ARC] -0.22, 95% confidence interval [CI] -0.43, -0.02). Initiating cigarettes was also associated with lower academic performance (ARC -0.51, 95% CI -0.84, -0.18). Results indicate that e-cigarette use initiation is associated with lower subsequent academic performance, independent from the association between cigarette use initiation and lower academic performance among U.S. youth. Future research needs to examine whether preventing youth e-cigarette and cigarette use can lead to improvement in academic performance.
Collapse
Affiliation(s)
- Craig T Dearfield
- The George Washington University, Washington, DC, United States of America.
| | - Julia C Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, United States of America
| | - Timothy S McNeel
- Information Management Services, Inc., Rockville, MD, United States of America
| | - Debra H Bernat
- The George Washington University, Washington, DC, United States of America
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, United States of America
| |
Collapse
|
6
|
Berg CJ, Yang YT, Pratt-Chapman ML, Douglas Evans W, Cupertino AP, Horn K, Bernat DH, Abroms LC, Tercyak KP. Campus tobacco control policies and cessation interventions in college students: a commentary calling for research and action to address tobacco-related health disparities. Transl Behav Med 2021; 11:1030-1036. [PMID: 32893870 PMCID: PMC8075612 DOI: 10.1093/tbm/ibaa083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tobacco-related health disparities (TRHDs) have a significant impact on population health in the USA. Effectively preventing and controlling TRHDs among young adult populations require multiple prevention and cessation points, including within college/university contexts. This commentary addresses current campus tobacco control policies and cessation interventions for U.S. college students, with an emphasis on TRHDs and opportunities for research and research translation to reduce these disparities. This commentary is informed by literature published between 2010 and 2020 regarding (a) prevalence and impact of campus tobacco control policies; and/or (b) behavioral outcomes from cessation interventions for young adults attending colleges. Despite a doubling of college campuses adopting tobacco-free policies from 2012 to 2017, roughly two-thirds continue to operate without such policies. Few policies address alternative tobacco products (e.g., e-cigarettes, cigars/cigarillos, and hookah), and communication about and enforcement of existing policies is extremely limited. A broad range of cessation intervention strategies have targeted individuals in this age group, but with little focus on TRHDs and limited intervention dissemination. Importantly, college students representing populations at risk for TRHDs (e.g., racial/ethnic/sexual/gender minorities, low socioeconomic status) are less likely to be exposed to strong tobacco control policies or supports for cessation. There are untapped opportunities for behavioral medicine approaches to reduce TRHDs in college settings. Research findings regarding multilevel (policy, community-level, and individual-level) interventions must be translated to policy/practice in order to address tobacco use, particularly among vulnerable college student populations.
Collapse
Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC USA
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - Y Tony Yang
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
- Center for Health Policy and Media Engagement, School of Nursing, George Washington University, Washington, DC, USA
| | - Mandi L Pratt-Chapman
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - W Douglas Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC USA
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - Ana-Paula Cupertino
- Department of Public Health Sciences, Wilmot Cancer Institute, Community Outreach, Engagement, and Disparities Research, University of Rochester, Rochester, NY, USA
| | - Kimberly Horn
- Department of Population Health Sciences, Virginia Tech-Carilion Fralin Biomedical Research Institute, Virginia Tech, Blacksburg, VA, USA
| | - Debra H Bernat
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC USA
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - Kenneth P Tercyak
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|
7
|
Bernat DH, Choi K. Differences in Cigarette Use and the Tobacco Environment Among Youth Living in Metropolitan and Nonmetropolitan Areas. J Rural Health 2018; 34:80-87. [PMID: 27443961 PMCID: PMC5585066 DOI: 10.1111/jrh.12194] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine cigarette use and the tobacco-related environment among adolescents living in metropolitan and nonmetropolitan areas. METHODS Data from adolescents ages 14-17 that completed the 2012 Florida Youth Tobacco Survey were analyzed (n = 40,746). This includes a representative sample of middle and high school students throughout the state. RESULTS Nonmetropolitan adolescents were more likely than metropolitan adolescents to report lifetime smoking, past 30-day smoking, daily smoking, initiating smoking at younger ages, having smoked a greater number of cigarettes in their lifetime and in the past 30 days, friend acceptance of adult smoking, a parent offering them a cigarette, living with a smoker, and that smoking was allowed in their home. Nonmetropolitan adolescents were also more likely to have seen tobacco ads the last time they visited convenience marts, gas stations, grocery stores, and big box stores, and flavored tobacco products or ads for them. These differences persisted after controlling for demographics. CONCLUSIONS The present results suggest vast differences in smoking behavior among nonmetropolitan and metropolitan adolescents and that targeting social and environmental factors may be beneficial for reducing tobacco disparities among nonmetropolitan adolescents.
Collapse
Affiliation(s)
- Debra H Bernat
- Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
8
|
Erickson P, Gardner LD, Loffredo CA, St George DM, Bowman ED, Deepak J, Mitchell K, Meaney CL, Langenberg P, Bernat DH, Amr S, Ryan BM. Racial and Ethnic Differences in the Relationship between Aspirin Use and Non-Small Cell Lung Cancer Risk and Survival. Cancer Epidemiol Biomarkers Prev 2018; 27:1518-1526. [PMID: 30171037 DOI: 10.1158/1055-9965.epi-18-0366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/25/2018] [Accepted: 08/22/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND African Americans (AA) experience higher incidence and mortality of lung cancer as compared with European Americans (EA). Inflammation is associated with lung cancer, many aspects of which differ between AA and EA. We investigated whether use, frequency, and duration of the anti-inflammatory drug aspirin were associated with lung cancer risk and survival, separately among AA and EA populations. METHODS Using data from the Maryland Non-Small Cell Lung Cancer (NSCLC) Case-Control Study (1,220 cases [404 AA and 816 EA] and 1,634 controls [1,004 EA and 630 AA]), we estimated the adjusted odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) of the associations between aspirin use and NSCLC risk and survival, respectively. RESULTS Any aspirin use (OR: 0.66; 95% CI, 0.49-0.89), daily use of ≥ 1 tablet (OR: 0.68; 95% CI, 0.50-0.90), and use for ≥ 3 years (OR: 0.61; 95% CI, 0.44-0.85) was associated with lower NSCLC risk only among men, even after adjustment for covariates including body mass index and global genetic ancestry. These variables were also associated with improved survival, but only among AA (HR: 0.64; 95% CI, 0.46-0.91; HR: 0.61; 95% CI, 0.42-0.90; and HR: 0.60; 95% CI, 0.39-0.92, respectively). Tylenol and other NSAIDs were either associated with elevated or no NSCLC risk. CONCLUSIONS Aspirin use is associated with lower risk of NSCLC among men and improved survival among AA. IMPACT Preventive regular aspirin use could be considered among men and AA.
Collapse
Affiliation(s)
- Patricia Erickson
- George Washington University, Washington, District of Columbia
- Laboratory of Human Carcinogenesis, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Lisa D Gardner
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Christopher A Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia
| | - Diane Marie St George
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Elise D Bowman
- Laboratory of Human Carcinogenesis, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Janaki Deepak
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Khadijah Mitchell
- Laboratory of Human Carcinogenesis, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Claire L Meaney
- Laboratory of Human Carcinogenesis, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Patricia Langenberg
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Debra H Bernat
- George Washington University, Washington, District of Columbia
| | - Sania Amr
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
- Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Bríd M Ryan
- Laboratory of Human Carcinogenesis, Center for Cancer Research, NCI, NIH, Bethesda, Maryland.
| |
Collapse
|
9
|
Abstract
This article discusses the first study to assess public opinion of alcohol policies in Puerto Rico. In 2001, a telephone survey of 514 adults on the island assessed levels of support for 20 alcohol control policies covering five domains: (a) raising alcohol taxes, (b) restricting alcohol consumption in public places, (c) punishing adult providers of alcohol, (d) restricting youth access to alcohol, and (e) restricting marketing of alcohol. Results show high-level support for all alcohol policies, especially for restrictions on alcohol consumption in public places (93% to 95% support) and increases in alcohol taxes earmarked for alcohol treatment, prevention, and education (92% support). Multiple regression analyses reveal older respondents, compared to younger respondents, and respondents reporting lower levels of alcohol consumption were more supportive of alcohol control policies. Results demonstrate a willingness in Puerto Rico to consider public policy solutions to social and health problems associated with drinking.
Collapse
Affiliation(s)
| | | | | | - Mary Jo Vázquez
- Center for Enforcing Underage Drinking Laws, Pacific Institute for Research and Evaluation
| | | |
Collapse
|
10
|
Bernat DH, Lenk KM, Nelson TF, Winters KC, Toomey TL. College law enforcement and security department responses to alcohol-related incidents: a national study. Alcohol Clin Exp Res 2014; 38:2253-9. [PMID: 25040722 DOI: 10.1111/acer.12490] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 04/24/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Campus police and security personnel are often the first to respond to alcohol-related incidents on campus. The purpose of this study is to examine how campus law enforcement and security respond to alcohol-related incidents, and how consequences and communication differ based on characteristics of the incident. METHODS Directors of campus police/security from 343 colleges across the United States completed a survey regarding usual practice following serious, underage, and less serious alcohol incidents on and off campus. RESULTS Campus law enforcement and security most commonly reported contacting campus officials. A minority reported issuing citations and referring students to the health center. Enforcement actions were more commonly reported for serious and underage incidents than for less serious incidents. Large (vs. small) colleges, public (vs. private) colleges, and those located in small (vs. large) towns more consistently reported taking actions against drinkers. CONCLUSIONS Understanding how campus police and security respond to alcohol-related incidents is essential for reducing alcohol-related problems on college campuses.
Collapse
Affiliation(s)
- Debra H Bernat
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland
| | | | | | | | | |
Collapse
|
11
|
Bernat DH, Gerend MA, Chevallier K, Zimmerman MA, Bauermeister JA. Characteristics associated with initiation of the human papillomavirus vaccine among a national sample of male and female young adults. J Adolesc Health 2013; 53:630-6. [PMID: 24138764 PMCID: PMC3845491 DOI: 10.1016/j.jadohealth.2013.07.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 07/30/2013] [Accepted: 07/30/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine rates of human papillomavirus vaccine initiation, and characteristics associated with initiation, among a national sample of male and female young adults. METHODS Participants (n = 3,448; 48% female) were recruited using a Web-based, respondent-driven sampling strategy and completed a Web-based survey between October and December 2010. RESULTS A total of 45% of females and 4% of males initiated the vaccine. Females who were younger, never married, were in school, attended religious services less than once a month, were sexually active, and reported a greater number of lifetime sex partners, and who had been tested for human immunodeficiency virus were more likely to report initiation. Males who were African-American, attended religious services less than once a month, and reported a greater number of sex partners in their lifetime, and who had been tested for human immunodeficiency virus were more likely to report initiation. CONCLUSIONS Factors associated with human papillomavirus vaccine initiation may differ for males and females. Further research with larger samples of males is needed to fully understand characteristics associated with male initiation. Regardless of gender, however, most young adults who have not initiated sexual activity have not received the vaccine. Further research is needed to examine how to increase vaccination rates among this population, because they may benefit most from vaccination.
Collapse
Affiliation(s)
- Debra H. Bernat
- Corresponding Author, Debra H. Bernat, 1115 West Call Street, P.O. Box 3064300, Tallahassee, FL 32306-4300, Tel: 850.645.9223, Fax: 850.645.1773,
| | - Mary A. Gerend
- Medical Humanities & Social Sciences, College of Medicine, Florida State University
| | | | | | | |
Collapse
|
12
|
Klein EG, Bernat DH, Lenk KM, Forster JL. Nondaily smoking patterns in young adulthood. Addict Behav 2013; 38:2267-72. [PMID: 23583831 DOI: 10.1016/j.addbeh.2013.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 01/04/2013] [Accepted: 03/11/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Many young adult smokers routinely smoke less than daily. Prospective, longitudinal data are needed to describe and predict the influences on smoking patterns among nondaily young adult smokers. METHODS Latent class growth analysis was used to examine developmental trajectories and predictors of nondaily cigarette smoking among young adults aged 18 to 21 in the Upper Midwestern United States. RESULTS There were three distinct groups of nondaily smokers during young adulthood (n=519). College status, previous quit attempts, attitudes toward the meanings of cigarettes, and situational factors influencing smoking were significant predictors of group membership. CONCLUSIONS Nondaily smoking in young adulthood may result in several discrete patterns of smoking between age 18 and 21. Predictors that differentiate smoking trajectories may be useful to promote cessation or reduction in young adult smoking.
Collapse
|
13
|
Bernat DH, Maldonado-Molina M, Hyland A, Wagenaar AC. Effects of smoke-free laws on alcohol-related car crashes in California and New York: time series analyses from 1982 to 2008. Am J Public Health 2012; 103:214-20. [PMID: 23237160 DOI: 10.2105/ajph.2012.300906] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We examined effects of New York and California's statewide smoke-free restaurant and bar policies on alcohol-related car crash fatalities. We used an interrupted time-series design from 1982 to 2008, with 312 monthly observations, to examine the effect of each state's law on single-vehicle-nighttime crashes and crashes involving a driver with a blood alcohol concentration of 0.08 grams per deciliter or greater. Implementation of New York and California's statewide smoke-free policies was not associated with alcohol-related car crash fatalities. Additionally, analyses showed no effect of New York's smoke-free policy on alcohol-related car crash fatalities in communities along the Pennsylvania-New York border. Statewide smoke-free restaurant and bar laws do not appear to affect rates of alcohol-related car crashes.
Collapse
Affiliation(s)
- Debra H Bernat
- College of Medicine, Florida State University, Tallahassee, FL 32306, USA.
| | | | | | | |
Collapse
|
14
|
Bernat DH, Choi K, Erickson DJ, Lenk KM, Forster JL. Minnesota's comprehensive statewide smokefree law: short-term effects on young adults. Am J Prev Med 2012; 43:S156-62. [PMID: 23079212 PMCID: PMC3481548 DOI: 10.1016/j.amepre.2012.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/20/2012] [Accepted: 07/26/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Young adults have the highest rate of smoking among any age group. PURPOSE The purpose of this study is to assess the short-term effects of Minnesota's comprehensive statewide smokefree law on young adult smoking perceptions and behavior. METHODS Telephone surveys were conducted before and up to 18 months after Minnesota's statewide smokefree law went into effect on October 1, 2007 (data analyzed 2010-2011). Participants included young adults from a population-based cohort in Minnesota (n=1458) and from five other upper Midwest states that serve as a comparison (n=248). Differences in perceptions and smoking behavior were examined between Minnesota participants who lived with and without a local smokefree law prior to Minnesota's statewide law, and participants who lived in the comparison states. RESULTS The majority of youth in Minnesota were aware of the smoking restrictions in restaurants and bars following the law. After implementation of the law, Minnesota participants who previously lived without a local law (versus comparison) were more likely to perceive fewer adult and peer smokers and less likely to report leaving social events early because it was too smoky. No changes in smoking behaviors were observed before and after the law. Minnesota participants, however, who lived without a prior law (versus participants with a prior law) were more likely to attribute a quit attempt after the law to smoking restrictions in restaurant and bars. CONCLUSIONS Results suggest that Minnesota's law has changed perceptions of the tobacco environment. Longer-term follow-up may be needed to observe changes in smoking behavior.
Collapse
Affiliation(s)
- Debra H Bernat
- Medical Humanities and Social Sciences, College of Medicine, Florida State University, Tallahassee, Florida 32306-4300, USA.
| | | | | | | | | |
Collapse
|
15
|
Bernat DH, Oakes JM, Pettingell SL, Resnick M. Risk and direct protective factors for youth violence: results from the National Longitudinal Study of Adolescent Health. Am J Prev Med 2012; 43:S57-66. [PMID: 22789958 DOI: 10.1016/j.amepre.2012.04.023] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 04/23/2012] [Accepted: 04/26/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The majority of studies on youth violence have focused on factors that increase the risk for youth violence. PURPOSE To assess whether determinants of violence operate as risk factors, direct protective factors, or both during adolescence and young adulthood. METHODS Data from participants in the National Longitudinal Study of Adolescent Health, aged 13 years at Wave 1, were analyzed. Individual, family, school, peer, and community factors during adolescence (Wave 1 [1995]; age 13 years) were examined as predictors of violence involvement during adolescence (Wave 2 [1996]; age 14 years) and in young adulthood (Wave 3 [2001-2002]; ages 18-20 years). RESULTS Twelve percent of participants aged 14 years and 8% of participants aged 18-20 years reported serious violence involvement during the past 12 months. Bivariate analyses revealed risk and direct protective factors for violence at both time points. Risk for violence at age 14 years was increased by earlier attention-deficit hyperactivity disorder (ADHD) symptoms, low school connectedness, low grade-point average, and high peer delinquency. Direct protective factors for youth violence at age 14 years included low ADHD symptoms, low emotional distress, high educational aspirations, and high grade-point averages. Bivariate analyses showed a lower risk of violence among youth aged 18-20 years who reported low peer delinquency at age 13 years. Multiple logistic regression analyses predicting violence involvement showed direct protective effects for low ADHD symptoms and low emotional distress at age 14 years, and a direct protective effect for low peer delinquency at ages 18-20 years, after controlling for demographic characteristics. CONCLUSIONS Findings suggest that violence involvement remains difficult to predict but indicate the importance of assessing both risk and direct protective factors for understanding violent behavior.
Collapse
Affiliation(s)
- Debra H Bernat
- Department of Medical Humanities and Social Sciences, Florida State University, Tallahassee, Florida, USA
| | | | | | | |
Collapse
|
16
|
Abstract
PURPOSE Smoking restrictions in recreational settings are established to promote anti-smoking norms and reduce exposure to secondhand smoke. Outdoor smoke-free policies are increasing, yet little is known about the perceptions of such restrictions. METHODS Data were collected from a population-based sample of young adults (n=2289) in upper Midwestern United States. Cross-sectional multivariate logistic regression was used to assess predictors of the perceived difficulty to smoke in outdoor park areas. RESULTS Living in an area with a smoke-free park policy was associated with a 1.4 times higher odds of perceiving difficulty to smoke compared to those living in an area without such a policy, after controlling for past month smoking, physical activity, age, and gender. Both smokers and non-smokers living in an area with a smoke-free park policy had higher odds of perceiving difficulty to smoking in park areas (OR=1.6 and 1.3 respectively) compared to smokers and non-smokers living in areas without such policies. CONCLUSION Banning smoking in park areas was associated with a heightened perception of difficulty in smoking for young adult smokers and non-smokers.
Collapse
Affiliation(s)
- Elizabeth G Klein
- Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
| | | | | |
Collapse
|
17
|
Goldade K, Choi K, Bernat DH, Klein EG, Okuyemi KS, Forster J. Multilevel predictors of smoking initiation among adolescents: findings from the Minnesota Adolescent Community Cohort (MACC) study. Prev Med 2012; 54:242-6. [PMID: 22245269 PMCID: PMC3319284 DOI: 10.1016/j.ypmed.2011.12.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 12/20/2011] [Accepted: 12/29/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To understand how factors at multiple levels of influence impact adolescent smoking initiation. METHOD Data from the Minnesota Adolescent Community Cohort, a population-based cohort, were analyzed. Adolescents were recruited from randomly selected geopolitical units (GPUs) in Minnesota at ages 12 to 13 (n=1953), and were surveyed every six months (2000-2006) until 18. The association between baseline social factors and smoking initiation was analyzed using logistic regression. Linear regression was used to analyze predictors and age of initiation among smokers (n=603). RESULTS Higher proportion of 15-16 year-olds who smoke at the area-level (GPU) was associated with younger initiation (15.47 vs 15.87, p<.05). Higher proportion of the population employed and higher median household income were associated with older initiation (15.90 vs. 15.56 p<.05). Parent education, living with parents or siblings who smoke, living in homes that allow smoking, and having friends who smoke at baseline were associated with smoking initiation or younger initiation (p<.05). Participants whose parents had less than a high school education were 1.6 times more likely than those with college educated parents to have smoked at least a whole cigarette (CI=1.06, 2.26). CONCLUSION Factors at multiple levels of influence effect adolescent smoking initiation. Smoking by older age peers and lower SES predicts earlier smoking.
Collapse
Affiliation(s)
- Kate Goldade
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St. SE, Suite 166, Minneapolis, MN 55414 USA, Ph. 612-625-5474 Fax. 612-626-6782
| | - Kelvin Choi
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 Second Street South, Suite 300, Minneapolis, MN 55454, USA
| | - Debra H. Bernat
- Department of Medical Humanities & Social Sciences, College of Medicine, Florida State University, 1115 West Call Street, P.O. Box 3064300, Tallahassee, FL 32306-4300 USA
| | - Elizabeth G. Klein
- Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, 174 W 18 Avenue, Columbus, OH 43210 USA
| | - Kolawole S. Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Minneapolis, MN 55414 USA
| | - Jean Forster
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. Second St., Suite 300, Minneapolis, MN 55454 USA
| |
Collapse
|
18
|
Fabian LEA, Bernat DH, Lenk KM, Shi Q, Forster JL. Smoke-free laws in bars and restaurants: does support among teens and young adults change after a statewide smoke-free law? Public Health Rep 2011; 126:669-76. [PMID: 21886327 DOI: 10.1177/003335491112600509] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We assessed changes in levels of support for smoke-free bars and restaurants among teens and young adults before and after implementation of a statewide smoke-free law. METHODS We measured support for smoke-free bars and restaurants among teens and young adults aged 16-24 years living in Minnesota (n=2,785) and five comparison states (n=404), up to 12 months before and up to six months after Minnesota's smoke-free law went into effect in October 2007. We compared changes in support among three subgroups-Minnesota participants who lived with a previous local smoke-free law, Minnesota participants who did not live with a previous local smoke-free law, and participants from the comparison states-before and after Minnesota's statewide smoke-free law went into effect. RESULTS Support for smoke-free restaurants and bars among participants in Minnesota and comparison states increased after Minnesota's smoke-free law went into effect. Minnesotans, both those living with and without a previous local smoke-free law, showed similar increases in support for smoke-free restaurants as participants in comparison states. However, Minnesotans living without a previous local law showed larger increases in support for smoke-free bars than both those in comparison states and those living in Minnesota with a previous local smoke-free law. CONCLUSIONS Our study employed a more robust design than similar studies and focused on the teen and young adult population. Our results will help advocates and policy makers demonstrate how public support for smoke-free laws increases following smoke-free legislation, particularly among those who were not previously living with a local smoke-free law.
Collapse
Affiliation(s)
- Lindsey E A Fabian
- University of Minnesota, Division of Epidemiology & Community Health, Minneapolis, MN, USA.
| | | | | | | | | |
Collapse
|
19
|
Lagus KA, Bernat DH, Bearinger LH, Resnick MD, Eisenberg ME. Parental perspectives on sources of sex information for young people. J Adolesc Health 2011; 49:87-9. [PMID: 21700163 DOI: 10.1016/j.jadohealth.2010.10.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 10/04/2010] [Accepted: 10/21/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine parental perspectives toward sources of sex information. METHODS Interviews were conducted with 1605 parents. RESULTS Most parents indicated that youth should receive information from their parents; however, in reality, believe they obtain most of their information from friends and the media. CONCLUSION Nearly all parents want young people to receive information about sex from their parents.
Collapse
Affiliation(s)
- Kathryn Allen Lagus
- Center for Adolescent Nursing, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | | | | |
Collapse
|
20
|
Sieving RE, Bernat DH, Resnick MD, Oliphant J, Pettingell S, Plowman S, Skay C. A Clinic-Based Youth Development Program to Reduce Sexual Risk Behaviors Among Adolescent Girls. Health Promot Pract 2011; 13:462-71. [DOI: 10.1177/1524839910386011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Multifaceted, sustained efforts are needed to reduce early pregnancy and sexually transmitted diseases among high-risk adolescents. An important area for research is testing youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful and few efforts have rigorously evaluated a dual approach of building protective factors while addressing risk. This article presents findings from a pilot study of Prime Time, a clinic-based youth development intervention to reduce sexual risk behaviors among girls at risk for early pregnancy. Girls aged 13 to 17 years meeting specified risk criteria were assigned to Prime Time treatment groups. The Prime Time intervention included a combination of case management services and peer leadership groups. Participants completed self-report surveys at baseline, 12 and 18 months following enrollment. At 12 months, the intervention group reported significantly fewer sexual partners than the control group. At 18 months, the intervention group reported significantly more consistent condom use with trends toward more consistent hormonal and dual method use. Dose-response analyses suggested that relatively high levels of exposure to a youth development intervention were needed to change contraceptive use behaviors among adolescents at risk for early pregnancy. Given promising findings, further testing of the Prime Time intervention is warranted.
Collapse
Affiliation(s)
| | - Debra H. Bernat
- Florida State University College of Medicine, Tallahassee, FL, USA
| | | | | | | | | | - Carol Skay
- University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
21
|
Bernat DH, Erickson DJ, Shi Q, Fabian LE, Forster JL. Short-term effects of a comprehensive, statewide smokefree law on perceived opportunities to smoke. Am J Prev Med 2010; 39:S23-9. [PMID: 21074673 PMCID: PMC3062471 DOI: 10.1016/j.amepre.2010.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 08/12/2010] [Accepted: 08/24/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND The goal of this study was to assess the effects of Minnesota's comprehensive, statewide smokefree law on young adults' perceived opportunities to smoke in restaurants and bars. PURPOSE Differential effects of the law were examined for those living with and without previous local smokefree ordinances. METHODS Telephone surveys were conducted 6-12 months prior, 0-6 months prior, and 0-6 months after Minnesota's statewide smokefree law went into effect. Participants included young adults from a population-based cohort in Minnesota (n = 1446) and from four other Upper Midwest states that serve as a comparison (n = 238). RESULTS A greater proportion of Minnesota participants (regardless of previous law) reported it was very hard for an adult to find a place to smoke in both restaurants and bars/clubs after the statewide law, compared to the comparison group. Effects were greater among Minnesota participants who did not live with a local smokefree ordinance previously. CONCLUSIONS Within 6 months of Minnesota's statewide smokefree law, Minnesota young adults, even those who lived with a prior local smoking ordinance, believed it was more difficult for adults to find a place to smoke in restaurants and bars/clubs. Changing perceived opportunities to smoke in the state may be an initial step in changing social norms and smoking behaviors. These results suggest that statewide smokefree laws may provide additional barriers to smoking, beyond those obtained through local ordinances.
Collapse
Affiliation(s)
- Debra H Bernat
- Department of Medical Humanities and Social Sciences, College of Medicine, Florida State University, Tallahassee, Florida, USA.
| | | | | | | | | |
Collapse
|
22
|
Bernat DH, Harpin SB, Eisenberg ME, Bearinger LH, Resnick MD. Parental support for the human papillomavirus vaccine. J Adolesc Health 2009; 45:525-7. [PMID: 19837360 DOI: 10.1016/j.jadohealth.2009.04.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 04/18/2009] [Accepted: 04/22/2009] [Indexed: 11/19/2022]
Abstract
This study examined support for the human papillomavirus (HPV) vaccine among a representative sample of Minnesota parents after approval from the U.S. Food and Drug Administration. Support for the vaccine was high; 87% supported its use. Although individual characteristics predicted support, support was high across subgroups with two-thirds or more of parents supporting the vaccine.
Collapse
Affiliation(s)
- Debra H Bernat
- Center for Adolescent Nursing, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
| | | | | | | | | |
Collapse
|
23
|
Abstract
BACKGROUND Increasing correct and consistent condom use among sexually active adolescents continues to be a critical public health goal, with schools serving as key agents for achieving this goal through sexuality education and condom use provision. This research aims to describe the views of parents regarding school-based condom distribution and education programs, and examines how these views differ across demographic groups. METHODS Parents of school-age children in Minnesota were surveyed in telephone interviews (N = 1605; 63% participation) regarding their beliefs about condom availability and education. Chi-square tests of significance were used to detect differences in agreement with each statement for 10 demographic and personal characteristics. RESULTS A majority of respondents held supportive views about condom availability and education programs. Strongest support centered on statements in the survey about teenagers needing information about condoms (86%) and showing actual condoms during classroom lessons (77%). Approximately two thirds of the parents agreed that school-based instruction about condoms should be "allowed" at the high school level (65%), and one fifth (21%) believed that this type of education should be "required." Support for condom availability and education programs differed significantly according to certain personal characteristics, with less supportive views from self-identified Born Again Christians and politically conservative parents. CONCLUSIONS Public discourse regarding school-based sexuality education should include the viewpoints of parents of school-aged children as key stakeholders. Parents' perspectives provide unique and critical insights that school administrators and educators should consider as they develop educational and programmatic offerings regarding condoms.
Collapse
Affiliation(s)
- Marla E Eisenberg
- Division of Adolescent Health and Medicine, Department of Pediatrics, School of Medicine, University of Minnesota, 717 Delaware St. SE, 3rd floor, Minneapolis, MN 55414, USA.
| | | | | | | |
Collapse
|
24
|
Abstract
This study investigates symptom presentation and school functioning in a nonclinical sample of children with social phobia (SP). Forty-five children with SP were identified via school-wide screenings and follow-up diagnostic interviews. Analyses examined types and intensity of fears, number of social situations avoided, interpersonal relationships, and classroom functioning. To identify characteristics unique to social phobic children, children with SP (n = 45) were compared to anxious children without SP (n = 56) on the above variables. Comorbidity in children with SP and factors associated with SP severity were also evaluated. Compared to anxious children without SP, children with SP feared and avoided a significantly greater number of social situations. In addition, they were significantly more likely to have trouble with making friends and to prefer being alone rather than with peers. All children with SP met criteria for at least one comorbid disorder. Significant factors explaining child-reported severity of SP were number of social situations avoided and intensity of fears. Greater severity of SP was significantly associated with poorer social skills, poorer leadership skills, greater attention difficulties, and greater learning problems in the classroom. It is important to understand the symptom presentation of SP so that children with SP are identified early and effective interventions are instituted. This is especially critical given the impact of SP on school functioning.
Collapse
Affiliation(s)
- Gail A Bernstein
- Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55454, USA.
| | | | | | | |
Collapse
|
25
|
Bernat DH, Lazovich D, Forster JL, Oakes JM, Chen V. Area-level variation in adolescent smoking. Prev Chronic Dis 2009; 6:A42. [PMID: 19288985 PMCID: PMC2687848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The purpose of this study is to 1) examine the variability in the prevalence of adolescent smoking in 60 geographic areas of Minnesota and 2) assess how variability in area-level smoking prevalence is associated with area-level sociodemographic characteristics. METHODS Smoking data were collected from 3,636 adolescents residing in 60 areas of the state of Minnesota. Area-level characteristics were obtained from the 2000 US Census. Coefficient of variation was calculated to assess variability in smoking prevalence across areas, and mean smoking prevalence was compared above and below the median for each area-level characteristic. RESULTS Substantial variation was found in adolescent smoking prevalence rates. Across the 60 areas, the percentage of adolescents that ever smoked varied from 13% to 53%, and the percentage of adolescents that smoked in the past 30 days ranged from 3% to 19%. Mean lifetime smoking prevalence was higher in areas with a higher percentage of residents with less than a high school education, a lower percentage of residents living in an urban area, lower median housing value and a lower median household income, a higher percentage of residents aged 16 years or older who were unemployed, and a higher percentage of residents with an income-to-poverty ratio less than 1.5. Similar results were found for past 30-day smoking prevalence among girls; however, no area-level characteristics were significantly associated with past 30-day smoking prevalence among boys. CONCLUSION Results suggest that area-level characteristics may play an important role in adolescent smoking, particularly for girls.
Collapse
|
26
|
Layne AE, Bernat DH, Victor AM, Bernstein GA. Generalized anxiety disorder in a nonclinical sample of children: symptom presentation and predictors of impairment. J Anxiety Disord 2009; 23:283-9. [PMID: 18815006 PMCID: PMC3353806 DOI: 10.1016/j.janxdis.2008.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Revised: 08/05/2008] [Accepted: 08/05/2008] [Indexed: 10/21/2022]
Abstract
Presentation of generalized anxiety disorder (GAD) in a nonclinical sample of children (7-11 years old) and factors that predict overall impairment were examined. Symptom presentation was compared in children with GAD (n=49) and anxious children without GAD (n=42). Children with GAD endorsed significantly more worries, greater intensity of worries, and more DSM-IV associated symptoms than anxious children without GAD. Eighty-six percent of children with GAD had a comorbid diagnosis with 4% having a depressive disorder. Number of associated symptoms was most predictive of GAD impairment based on child perspective and intensity of worry was most predictive based on clinician perspective. Overall, findings from the current study are consistent with reports based on clinical samples. The DSM-IV-TR criteria for GAD were supported, with the exception that children with GAD typically present with several associated symptoms, rather than only one.
Collapse
Affiliation(s)
- Ann E. Layne
- Division of Child & Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Debra H. Bernat
- University of Minnesota School of Nursing, Minneapolis, MN, United States
| | - Andrea M. Victor
- Division of Child & Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States,Corresponding author at: F256/2B West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States. Tel.: +1 612 273 9711; fax: +1 612 273 9779. (A.M. Victor)
| | - Gail A. Bernstein
- Division of Child & Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| |
Collapse
|
27
|
Abstract
We interviewed 732 smokers (from five US upper Midwestern states) via telephone in 2006 to examine young adult smoking patterns. We first defined two groups of intermittent smokers-low (who smoked for 1-14 days in the past 30 days) and high (who smoked for 15-29 days in the past 30 days), and then analyzed differences between these two groups and daily smokers. Low intermittent smokers were much less likely to consider themselves smokers, feel addicted, or smoke with friends than high intermittent smokers. Daily smokers were more likely to feel addicted and have trouble quitting smoking than high intermittent smokers. Implications, limitations, and ideas for future studies will be discussed.
Collapse
Affiliation(s)
- Kathleen M Lenk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
| | | | | | | | | |
Collapse
|
28
|
Bernat DH, Erickson DJ, Widome R, Perry CL, Forster JL. Adolescent smoking trajectories: results from a population-based cohort study. J Adolesc Health 2008; 43:334-40. [PMID: 18809130 PMCID: PMC2743902 DOI: 10.1016/j.jadohealth.2008.02.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Revised: 01/11/2008] [Accepted: 02/19/2008] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify distinct smoking trajectories during adolescence and assess how smoking-related factors relate to trajectory membership. METHODS The sample includes 3637 youth from across the state of Minnesota. Measures include tobacco use, smoking behaviors of parents and friends, youth smoking-related attitudes and beliefs, and home smoking policies. A cohort-sequential design was used to identify smoking trajectories, including five cohorts of youth (ages 12-16) followed for 3 years. RESULTS Six distinct trajectories of tobacco use were found: nonsmokers (54%), triers (17%), occasional users (10%), early established (7%), late established (8%), and decliners (4%). Several factors were associated with increased likelihood of being in a smoking trajectory group (vs. the nonsmoking group): parental smoking, friend smoking, greater perceptions of the number of adults and teenagers who smoke, and higher functional meaning of tobacco use. In contrast, higher perceived difficulty smoking in public places, negative perceptions of the tobacco industry, and home smoking policies were associated with less likelihood of being in one of the smoking trajectories (vs. the nonsmoking trajectory). CONCLUSIONS Adolescents exhibit diverse patterns of smoking during adolescence and tobacco-related influences were strong predictors of trajectory membership.
Collapse
Affiliation(s)
- Debra H Bernat
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA.
| | | | | | | | | |
Collapse
|
29
|
Eisenberg ME, Bernat DH, Bearinger LH, Resnick MD. Support for comprehensive sexuality education: perspectives from parents of school-age youth. J Adolesc Health 2008; 42:352-9. [PMID: 18346660 DOI: 10.1016/j.jadohealth.2007.09.019] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Revised: 09/17/2007] [Accepted: 09/21/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE Controversy about school-based sexuality education in public schools has continued over the past decade, despite mounting evidence that comprehensive sexuality education effectively promotes sexual health and that parents support these programs in public schools. The present study replicates and expands upon previous findings regarding public views on school-based sexuality education. METHODS One thousand six hundred five parents of school-age children in Minnesota responded to telephone surveys in 2006-2007 (63% participation rate), including items regarding general sexuality education, 12 specific topics, the grade level at which each should be taught, and attitudes toward sexuality education. RESULTS The large majority of parents supported teaching about both abstinence and contraception (comprehensive sexuality education [CSE]; 89.3%), and support was high across all demographic categories of parents. All specific sexuality education topics received majority support (63.4%-98.6%), even those often viewed as controversial. Parents believed most topics should first be taught during the middle school years. Parents held slightly more favorable views on the effectiveness of CSE compared to abstinence-only education, and these views were strongly associated with support for CSE (odds ratio [OR](CSE) = 14.3; OR(abstinence) = 0.11). CONCLUSIONS This study highlights a mismatch between parents' expressed opinions and preferences, and actual sexuality education content as currently taught in the majority of public schools. In light of broad parental support for education that emphasizes multiple strategies for prevention of pregnancy and sexually transmitted infections (including abstinence), parents should be encouraged to express their opinions on sexuality education to teachers, administrators, and school boards regarding the importance of including a variety of topics and beginning instruction during middle school years or earlier.
Collapse
Affiliation(s)
- Marla E Eisenberg
- Healthy Youth Development Prevention Research Center, Division of Adolescent Health and Medicine, Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
| | | | | | | |
Collapse
|
30
|
Forster JL, Widome R, Bernat DH. Policy interventions and surveillance as strategies to prevent tobacco use in adolescents and young adults. Am J Prev Med 2007; 33:S335-9. [PMID: 18021908 DOI: 10.1016/j.amepre.2007.09.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 08/03/2007] [Accepted: 09/19/2007] [Indexed: 11/28/2022]
Abstract
Tobacco-policy interventions are designed to change the environment with the ultimate goal of preventing young people from beginning to smoke or reducing the likelihood that they will accelerate and solidify their smoking patterns. Several studies show that smoking bans in the home, at school, at work, and in the community are associated with less progression to smoking, less consolidation of experimental into regular smoking, and more quitting among adolescents and young adults. Randomized community trials and cohort studies support an association between enforcement of youth access laws against businesses and lower adolescent smoking rates. Several decades of studies provide evidence that increasing cigarette price through excise taxes reduces smoking among adolescents and young adults, who are particularly price-sensitive. Ongoing surveillance of tobacco-use behaviors in adolescents and young adults is essential for monitoring smoking patterns and evaluating tobacco policies.
Collapse
Affiliation(s)
- Jean L Forster
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA.
| | | | | |
Collapse
|
31
|
Bernat DH, August GJ, Hektner JM, Bloomquist ML. The Early Risers Preventive Intervention: Testing for Six-year Outcomes and Mediational Processes. J Abnorm Child Psychol 2007; 35:605-17. [PMID: 17333359 DOI: 10.1007/s10802-007-9116-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Accepted: 02/12/2007] [Indexed: 11/28/2022]
Abstract
We examined effects of the Early Risers "Skills for Success" early-age-targeted prevention program on serious conduct problems following 5 years of continuous intervention and one year of follow-up. We also examined if intervention effects on proximally-targeted variables found after 3 years mediated intervention effects on conduct problems found after 6 years. Participants included 151 at-risk children (106 males and 45 females) followed from first through sixth-grade, from 23 semi-rural schools in Minnesota. After 6 years, program children showed fewer oppositional defiant disorder (ODD) symptoms than control children. Program children did not significantly differ from controls on number of conduct disorder (CD) symptoms, DSM-IV diagnoses of ODD and CD, or drug use involvement. Results of the mediation analysis indicated that fewer ODD symptoms among program youth after 6 years were partially mediated by social skills and effective discipline. The study provides support for the early-starter model of conduct problems development that provides the framework for the Early Risers intervention. The study's implications for prevention and limitations are discussed.
Collapse
Affiliation(s)
- Debra H Bernat
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
| | | | | | | |
Collapse
|
32
|
Victor AM, Bernat DH, Bernstein GA, Layne AE. Effects of parent and family characteristics on treatment outcome of anxious children. J Anxiety Disord 2007; 21:835-48. [PMID: 17161582 PMCID: PMC2442036 DOI: 10.1016/j.janxdis.2006.11.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 11/13/2006] [Accepted: 11/18/2006] [Indexed: 11/30/2022]
Abstract
This study examines relations between family functioning, parenting stress, parental psychopathology, and treatment outcome. Participants included 61 children (ages 7-11 years) with features or diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia. Treatment conditions included group cognitive behavioral therapy (CBT) and no-treatment control. Higher family cohesion at baseline was associated with significantly greater decreases in child anxiety at posttreatment for participants who received CBT, while no association was found for the no-treatment control participants. Parenting stress and parental psychopathology were not associated with treatment outcome for either condition. Post hoc analyses examining relations between family cohesion, parenting stress, and parental psychopathology showed that parents from families low in cohesion reported significantly higher levels of parenting stress and psychopathology compared to parents from families high in cohesion. These results will facilitate development and implementation of effective interventions with anxious children.
Collapse
Affiliation(s)
- Andrea M Victor
- Division of Child & Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
| | | | | | | |
Collapse
|
33
|
Bernat DH, Dunsmuir WTM, Wagenaar AC. Effects of lowering the legal BAC to 0.08 on single-vehicle-nighttime fatal traffic crashes in 19 jurisdictions. Accid Anal Prev 2004; 36:1089-1097. [PMID: 15350886 DOI: 10.1016/j.aap.2004.04.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2003] [Revised: 10/01/2003] [Accepted: 04/07/2004] [Indexed: 05/24/2023]
Abstract
BACKGROUND In the past few decades, numerous policies, including those that lower legal blood alcohol concentration limits, have been enacted to reduce alcohol-impaired driving. In the US, 41 states and the District of Columbia have enacted 0.08 per se laws, which specify that if a driver's BAC is at or above 0.08, a violation has occurred even if the driver does not show signs of intoxication. OBJECTIVE We examined effects of lowering the blood alcohol concentration limit to 0.08 per se on fatal traffic crashes in 18 states and the District of Columbia, and whether effects of the law varied by state or by baseline rates of fatal traffic crashes. METHOD Data on fatal traffic crashes were obtained from the Fatality Analysis Reporting System, including all states that enacted 0.08 per se prior to 2001 in the contiguous United States. Effects of the 0.08 law were examined in each state separately, and the overall effect across states was examined using a mixed-model Poisson regression on single-vehicle-nighttime fatal traffic crashes. RESULTS State-specific analyses showed that fatal traffic crashes significantly decreased in three of the 19 states following the introduction of the 0.08 law, prior to adjusting for potential confounders. The mixed-model regression showed a statistically significant 5.2% reduction in single-vehicle-nighttime fatal traffic crashes associated with the 0.08 law across all states, after adjusting for administrative license revocation, the number of Friday and Saturday nights in a month, and trends in all other types of fatal traffic crashes. Findings indicate that the effect of the 0.08 law does not vary significantly by state or baseline rate of fatal traffic crashes in a state, and no significant statistical interaction exists between 0.08 and administrative license revocation policy effects.
Collapse
Affiliation(s)
- Debra H Bernat
- Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454-1015, USA
| | | | | |
Collapse
|