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Kowitt SD, Finan LJ, Lipperman-Kreda S. Objective and perceived measures of tobacco marketing are uniquely associated with cigar use. Tob Control 2023; 32:428-434. [PMID: 34615738 PMCID: PMC9444056 DOI: 10.1136/tobaccocontrol-2021-056601] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/28/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Few studies have examined associations between perceived and objective exposure to tobacco marketing and cigar use, which is the second most commonly used tobacco product by youth. METHODS We used Geographic Ecological Momentary Assessment data over 14 days from youth aged 16-20 years (n=83 participants, n=948 observations; 34% past month users of any tobacco product) in eight city areas in California. Tobacco outlets in study cities were visited by trained observers to record outlet Global Positioning System (GPS) point locations and outdoor tobacco marketing. We assessed daily perceived exposure to tobacco marketing within participants' activity spaces; daily objective exposure to tobacco outlets with outdoor marketing within 50 m of activity space polylines (number of outlets and time spent near outlets) and daily cigar use excluding and including blunts. RESULTS Controlling for demographics and baseline tobacco use, results from mixed logistic regression models showed that greater perceived exposure to tobacco marketing was positively associated with higher odds of cigar use each day, excluding blunts (adjusted odds ratios (aOR): 2.00; 95% CI 1.03 to 3.87) and including blunts (aOR: 1.87; 95% CI 1.26 to 2.77). Also, exposure to a greater number of tobacco outlets with outdoor marketing was associated with higher odds of cigar use each day, excluding blunts (aOR: 1.34; 95% CI 1.01 to 1.78), but not including blunts. CONCLUSIONS Tobacco control efforts should consider both perceived and objective exposure to tobacco marketing and unique associations with blunt use to prevent cigar use.
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Affiliation(s)
- Sarah D Kowitt
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura J Finan
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
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2
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Marks LC, Hund AM, Finan LJ, Kannass KN, Hesson-McInnis MS. Understanding academic readiness for kindergarten: The interactive role of emotion knowledge and teacher-child closeness. J Exp Child Psychol 2023; 227:105585. [PMID: 36423440 DOI: 10.1016/j.jecp.2022.105585] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/23/2022]
Abstract
One goal of this study was to test the role of emotion knowledge and teacher-child closeness and conflict in predicting academic readiness for kindergarten over and above demographic factors and executive functioning skills (especially inhibitory control) known to predict readiness. Another goal was to test teacher-child closeness as a moderator of the association between emotion knowledge or executive functioning and academic readiness. A total of 141 4- and 5-year-old children completed emotion knowledge, academic readiness, and inhibitory control measures. Preschool teachers reported their perceived relationship closeness and conflict with individual students. Accounting for child age in months, family income, and inhibitory control, emotion knowledge and teacher-child closeness were positively associated with academic readiness. Teacher-child closeness moderated the relationship between emotion knowledge and academic readiness, suggesting that teacher-child closeness may be especially important in promoting academic readiness for preschool students with low emotion knowledge.
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3
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Su-Russell C, Finan LJ. Siblings as ethnic-racial socialization agents: A call for research. New Dir Child Adolesc Dev 2022; 2022:91-105. [PMID: 35921501 DOI: 10.1002/cad.20476] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Research illustrating the adverse impact of discrimination and the increasing ethnic and racial diversity in the United States has resulted in a substantial body of work examining risk and protective factors for marginalized and ethnic and racial minority individuals. One factor that has received considerable attention over the past several decades is ethnic-racial socialization (ERS). Extant empirical research on ERS has heavily focused on parents, especially mothers, as socialization agents. What is noticeably missing from this literature is the potentially important roles of siblings as salient ERS agents. After briefly illustrating the focus of past research on parents as ERS agents, we review the theoretical justification for studying siblings in the ERS process and the very limited research on siblings' role in ERS-related processes. We close with a discussion of the important considerations for future researchers investigating sibling ERS.
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Affiliation(s)
- Chang Su-Russell
- Human Development and Family Science, Illinois State University, Normal, Illinois, USA
| | - Laura J Finan
- Psychology, Illinois State University, Normal, Illinois, USA
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4
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Lipperman-Kreda S, Islam S, Wharton K, Finan LJ, Kowitt SD. Youth tobacco and cannabis use and co-use: Associations with daily exposure to tobacco marketing within activity spaces and by travel patterns. Addict Behav 2022; 126:107202. [PMID: 34864435 PMCID: PMC8751225 DOI: 10.1016/j.addbeh.2021.107202] [Citation(s) in RCA: 5] [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: 06/21/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND We investigated youth daily activity spaces, travel patterns, exposure to tobacco retail marketing, and tobacco and cannabis use and co-use. METHODS Data included 1,060 daily assessments from 100 participants (16-20 years old) in 8 California cities. Using GPS-enabled smartphones with a survey application, youth completed brief daily surveys, and location coordinates were obtained at one-minute intervals. Tobacco outlets in study cities were visited by observers to record outlet GPS point locations and data concerning tobacco marketing. Tobacco outlet addresses and GPS location coordinates were geocoded. Activity spaces were constructed by joining sequential location points. Measures included the number of outlets with outdoor tobacco marketing within 50 m of activity space polylines and the amount of time participants were within 50 m of these outlets each day. Participants also reported tobacco and cannabis use and whether they saw tobacco ads by their neighborhood, school, workplace, and anywhere else each day. Additionally each day they reported how much time they traveled by different modes of transportation, with parents/guardians, and with friends. RESULTS In mixed effects multinomial regression models, perceived exposure to tobacco marketing was associated with co-use of tobacco and cannabis on a given day (RRR = 1.66, p < 0.05). Although perceived exposure to tobacco marketing was not associated with tobacco use only, moderation analysis indicated that the likelihood of tobacco use was greater among youth who walked/biked/skated more (RRR = 5.22, p < 0.05). CONCLUSION Perceived exposure to tobacco marketing contributes to youth tobacco and cannabis use or co-use, especially for those who travel by walking/biking/skating.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue Suite 601, Berkeley, CA, USA.
| | - Sabrina Islam
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue Suite 601, Berkeley, CA, USA; School of Public Health, University of California at Berkeley, 2121 Berkeley Way, Berkeley, CA, USA
| | - Kristina Wharton
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue Suite 601, Berkeley, CA, USA; School of Public Health, University of California at Berkeley, 2121 Berkeley Way, Berkeley, CA, USA
| | - Laura J Finan
- Department of Psychology, Illinois State University, IL, USA
| | - Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Finan LJ, Ellis M, Solka J, Jasinski L, Ohannessian CM. Longitudinal and bidirectional associations between family conflict and adolescents' e-cigarette use. J Adolesc 2022; 94:92-96. [PMID: 35353405 DOI: 10.1002/jad.12007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This study examined potential longitudinal and bidirectional relationships between family conflict and adolescent e-cigarette use, and whether gender moderated these associations. METHODS Adolescents (NT1 = 1334; Mage = 13.11, SD = 0.82; 52% female; 50% White) from the United States completed surveys in the spring of 2016 and again in the fall of 2017. RESULTS Logistic regression analyses indicated that after controlling for previous e-cigarette use, family conflict was positively associated with a greater likelihood of e-cigarette use 6 months later. Results from multiple regression analyses indicated that after controlling for previous family conflict, e-cigarette use was associated with increases in later family conflict, particularly for girls. CONCLUSIONS Study findings highlight reducing family conflict and supporting family functioning as a possible intervention target for adolescent e-cigarette use, a major public health problem.
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Affiliation(s)
- Laura J Finan
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Miranda Ellis
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Jake Solka
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Luke Jasinski
- Department of Psychology, Illinois State University, Normal, Illinois, USA
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Finan LJ, Linden-Carmichael AN, Adams AR, Youngquist A, Lipperman-Kreda S, Mello ZR. Time Perspective and Substance Use: An Examination Across Three Adolescent Samples. Addict Res Theory 2021; 30:112-118. [PMID: 35340990 PMCID: PMC8942381 DOI: 10.1080/16066359.2021.1948537] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 06/03/2021] [Accepted: 06/23/2021] [Indexed: 06/14/2023]
Abstract
Time perspective is conceptualized as a multidimensional construct that assesses individuals' feelings and thoughts about the past, present, and future. The current study examined relationships between feelings (time attitudes) and thoughts (time orientation) about time and substance use behaviors across three adolescent samples. Participants included a high-risk sample of adjudicated youth (N=124; M age =15.54, SD=1.69; 51.61% female) and two general population school samples (N=777; M age =15.82, SD=1.23; 53.41% female; N=1873; M age =15.87, SD=1.28; 52.22% female). Cross-sectional survey data were collected from samples in schools during 2010, 2016, and 2011, respectively. Poisson and negative binomial regression analyses indicated that overall, more positive feelings about time were associated with fewer substances used and, conversely, more negative feelings about time were associated with more substances used. These findings were particularly salient for participants with stronger positive and negative feelings toward the past and present time periods. Further, across the three samples, adolescents with a balanced time orientation (i.e., equal emphasis on all three time periods) generally reported less substance use than individuals who emphasized only one or two time periods. Findings highlight relationships between time perspective dimensions and substance use across diverse samples and illustrate opportunities for adapting time perspective-based substance use interventions for adolescents.
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Finan LJ, Lipperman-Kreda S, Grube JW, Balassone A, Kaner E. Alcohol Marketing and Adolescent and Young Adult Alcohol Use Behaviors: A Systematic Review of Cross-Sectional Studies. J Stud Alcohol Drugs Suppl 2021. [PMID: 32079561 PMCID: PMC7063997 DOI: 10.15288/jsads.2020.s19.42] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults. Method: Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion. Results: Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples’ alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples. Conclusions: Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples’ alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.
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Affiliation(s)
- Laura J Finan
- Department of Psychology, Illinois State University, Normal, Illinois
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Joel W Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
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Finan LJ, Lipperman-Kreda S. Changes in Drinking Contexts over the Night Course: Concurrent and Lagged Associations with Adolescents' Nightly Alcohol Use. Alcohol Clin Exp Res 2020; 44:2611-2617. [PMID: 33067817 DOI: 10.1111/acer.14486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/16/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Examining underage drinking contexts can advance the field of adolescent substance use prevention by supporting and informing interventions that can target adolescents in specific contexts. The current study examines how concurrent and lagged situational (i.e., alcohol availability and adult supervision), social (i.e., the number of people and presence of friends), and location (i.e., home vs other location) context characteristics change risks for alcohol use over the night course. METHODS Text messages with links to online surveys were used to collect ecological momentary assessment (EMA) data over 2 weekends from adolescents in California. Data were collected using adolescents' personal cell phones early and late in the evening and the following morning. Analyses were limited to adolescents with at least 1 drinking occasion during EMA (N = 58; Mage = 16.64, SD = 0.74; 48% female; 83% White). RESULTS Drinking earlier in the evening was positively associated with continued drinking over the night course. Context characteristics were found to play important concurrent and lagged roles in increasing the likelihood of alcohol use over evening hours. CONCLUSIONS Findings indicated substantive concurrent and lagged social, situational, and location-based contextual effects on adolescent alcohol use over the course of an evening. Importantly, context characteristics were differentially associated with alcohol use over the course of the evening. The fact that these contextual factors are modifiable suggests that the use of prevention strategies delivered to adolescents throughout the evening may reduce adolescents' drinking and related problems over the evening hours.
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Affiliation(s)
- Laura J Finan
- From the, Department of Psychology, (LJF), Illinois State University, Normal, Illinois, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, (SL-K), Pacific Institute for Research and Evaluation, Berkeley, California, USA
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Zhang L, Finan LJ, Bersamin M, Fisher DA, Paschall MJ. Sexual Orientation-Based Alcohol, Tobacco, and Other Drug Use Disparities: The Protective Role of School-Based Health Centers. Youth Soc 2020; 52:1153-1173. [PMID: 34321700 PMCID: PMC8315521 DOI: 10.1177/0044118x19851892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study investigated whether the presence of school-based health centers (SBHCs) was associated with six substance use behaviors among sexual minority youth (SMY) and their heterosexual peers. Data from the 2015 Oregon Healthy Teens Survey, including 13,608 11th graders in 137 schools (26 with SBHCs) were used in the current study. Multilevel logistic regression analyses were performed. Results revealed significant SBHC by SMY status interactions indicating a relatively lower likelihood of past 30-day alcohol use (23%), binge drinking (43%), use of e-cigarettes (22%), marijuana (44%), and unprescribed prescription drugs (28%) among SMY in SBHC schools compared with non-SMY at SBHC schools. Furthermore, SMY in SBHC schools reported lower likelihood of aforementioned substance use behaviors than SMY attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY in SBHC and non-SBHC schools. Findings from this study suggest SBHCs may help to mitigate substance use disparities among marginalized populations, such as SMY.
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Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation, Chapel Hill, NC, USA
| | - Laura J. Finan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Melina Bersamin
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
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Lipperman-Kreda S, Finan LJ, Kowitt SD, Grube JW, Abadi M, Balassone A, Kaner E. Youth daily exposure to tobacco outlets and cigarette smoking behaviors: does exposure within activity space matter? Addiction 2020; 115:1728-1735. [PMID: 32032445 PMCID: PMC7415501 DOI: 10.1111/add.15001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/10/2019] [Revised: 12/09/2019] [Accepted: 01/31/2020] [Indexed: 11/28/2022]
Abstract
AIMS To examine whether daily exposure to tobacco outlets within activity spaces is associated with cigarette smoking and with the number of cigarettes smoked by youth that day. DESIGN The study used geographic ecological momentary assessment (GEMA) data that combined daily surveys with ecological momentary assessment of global positioning systems (GPS) using geographic information systems (GIS) to allow for real-time data collection of participants' environments and behaviors. SETTING Eight mid-sized California (USA) city areas. PARTICIPANTS The analytical sample included 1065 days, which were clustered within 100 smoker and non-smoker participants (aged 16-20 years, 60% female). MEASUREMENTS Any cigarette smoking and number of cigarettes smoked on a given day, the number of tobacco outlets within 100 m of activity space polylines each day, the number of minutes participants spent within 100 m of tobacco outlets each day and demographic characteristics (age, sex, race/ethnicity and perceived socio-economic status). FINDINGS Controlling for demographic characteristics, the findings of multi-level mixed effects logistic models were inconclusive, whether or not the number of tobacco outlets within 100 m of youths' activity space polylines or the number of minutes spent within 100 m of tobacco outlets were associated with whether the participant smoked cigarettes on a given day [odds ratio (OR) = 1.05, P = 0.24; OR = 0.99, P = 0.81, respectively]. However, in multi-level zero-inflated negative binomial models, the risk of smoking an additional cigarette on a given day increased with each additional tobacco outlet [incidence rate ratio (IRR) = 1.04, P < 0.05] and each additional minute spent within 100 m of tobacco outlets (IRR = 1.01, P < 0.001) each day. CONCLUSIONS Among young people in urban California, differences in day-to-day exposure to tobacco outlets within activity spaces does not seem to be significantly associated with whether a person smokes a cigarette on a given day, but higher exposure to tobacco outlets appears to be positively associated with the number of cigarettes smoked on that day.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704,Correspondence should be addressed to Sharon Lipperman-Kreda, Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704,
| | - Laura J. Finan
- Department of Psychology, Illinois State University, Campus Box 4620, Normal, IL 61790-4620
| | - Sarah D. Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joel W. Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Melissa Abadi
- Pacific Institute for Research and Evaluation, One Riverfront Plaza, Suite 2100, 401 West Main Street, Louisville, KY 40202
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
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11
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Finan LJ, Moon J, Kaur M, Gard D, Mello ZR. Trepidation and time: an examination of anxiety and thoughts and feelings about the past, present, and future among adolescents. Applied Developmental Science 2020. [DOI: 10.1080/10888691.2020.1778476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Finan LJ, Lipperman-Kreda S, Grube JW, Balassone A, Kaner E. Alcohol Marketing and Adolescent and Young Adult Alcohol Use Behaviors: A Systematic Review of Cross-Sectional Studies. J Stud Alcohol Drugs Suppl 2020; Sup 19:42-56. [PMID: 32079561 PMCID: PMC7063997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/10/2019] [Indexed: 03/29/2024] Open
Abstract
OBJECTIVE This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults. METHOD Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion. RESULTS Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples' alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples. CONCLUSIONS Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples' alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.
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Affiliation(s)
- Laura J. Finan
- Department of Psychology, Illinois State University, Normal, Illinois
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Joel W. Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
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13
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Zhang L, Finan LJ, Bersamin M, Fisher DA. Sexual Orientation-Based Depression and Suicidality Health Disparities: The Protective Role of School-Based Health Centers. J Res Adolesc 2020; 30 Suppl 1:134-142. [PMID: 30230104 PMCID: PMC6430702 DOI: 10.1111/jora.12454] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study's purpose was to examine whether school-based health centers (SBHCs) support mental health indicators among sexual minority youth (SMY). Data came from the 2015 Oregon Healthy Teens Survey with 13,608 11th graders in 137 public high schools in Oregon. Regression results revealed significant SBHC by SMY status interactions indicating relative reductions in likelihood of depressive episodes (30%), suicidal ideation (34%), and suicide attempts (43%) among SMY in schools with SBHCs. SMY students in SBHC schools reported lower likelihood of a past-year depressive episode, suicidal ideation, and suicide attempt versus those attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY by SBHC status. SBHCs may help reduce mental health disparities among SMY, a marginalized, underserved population.
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Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation
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Abstract
Background. Despite a growing trend in community-based research, studies investigating the influence of multi-level community factors on individual-level outcomes remain relatively sparse. Objective. The current study aimed to extend this literature by investigating the association between community disadvantage measured at the community level, and adolescents' substance use over time. Additionally, this study also investigated the influence of parental support and community belonging on this association. Methods. Data were drawn from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health data set. Using a multi-level modeling approach, we tested the association between community disadvantage and substance use during adolescence. Second, to determine if this association held longitudinally, we examined the influence of community disadvantage on substance use over time, into young adulthood. Lastly, we tested the moderating effects of parental support and community belonging on the association between community disadvantage and substance use during adolescence and young adulthood. Results. Findings suggested that individuals experiencing the greatest disadvantage were less likely to engage in substance use in comparison to those experiencing the greatest advantage. Conclusions/Importance. Differential effects of parental support and community belonging on community disadvantage and substance use were also found. Implications of these findings are discussed.
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Affiliation(s)
- Mellissa S Gordon
- College of Education and Human Development, University of Delaware, Newark, Delaware, USA
| | - Beth S Russell
- Department of Human Development and Family Studies, University of Connecticut, Storrs, Connecticut, USA
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15
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Finan LJ, Ohannessian CM, Gordon MS. Trajectories of depressive symptoms from adolescence to emerging adulthood: The influence of parents, peers, and siblings. Dev Psychol 2018; 54:1555-1567. [PMID: 30047776 DOI: 10.1037/dev0000543] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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] [Indexed: 12/13/2022]
Abstract
The primary purpose of this study was to examine whether social relationship factors are associated with trajectories of depressive symptoms from adolescence into emerging adulthood. Specifically, adolescent-parent communication with mothers and fathers, peer support, and sibling warmth and hostility were examined in relation to depressive symptoms for girls and boys. Adolescents (N = 372; Mage = 16.09; SD = .69; 55% female) from the Mid-Atlantic United States completed surveys in the spring of 2007, 2008, and 2009 and again in the fall of 2014 when they were emerging adults. Growth curve modeling results suggested that communication with mothers and fathers and peer support predicted lower levels of depressive symptoms in adolescence for girls. For boys, peer support predicted lower whereas sibling hostility predicted higher levels of depressive symptoms in adolescence. Further, adolescent-mother communication for girls and adolescent-father communication for boys predicted the decline in depressive symptoms into emerging adulthood. Both sibling warmth and hostility for girls, whereas only sibling hostility for boys, predicted less steep declines in depressive symptoms over time. Findings draw attention to differences in experiences with depressive symptoms by sex and the importance of social relationship factors in the lives of adolescents and emerging adults. Implications for intervention and prevention are discussed. (PsycINFO Database Record
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Affiliation(s)
| | | | - Mellissa S Gordon
- Department of Human Development Family Studies, University of Delaware
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Lipperman-Kreda S, Finan LJ, Grube JW. Social and situational characteristics associated with adolescents' drinking at party and non-party events. Addict Behav 2018; 83:148-153. [PMID: 29249280 DOI: 10.1016/j.addbeh.2017.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 12/02/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
We investigated social and situational characteristics associated with adolescents' drinking at party and non-party events and whether these associations vary by party location (homes versus other locations). Ecological momentary assessment data were obtained over two weekends from 149 adolescents in California (46% female, M age=16.4years), using smartphone surveys administered early and late in the evening and the following morning. We assessed whether, where, and with whom adolescents drank alcohol. Social contexts with more people (RRR=1.05, p≤0.005) and with mixed gender composition (RRR=3.15, p≤0.05) were positively associated with increased risks of alcohol use at parties, but not at non-party events. Conversely, social contexts with friends were positively associated with alcohol use at non-party events (RRR=4.32, p≤0.005), but not at parties. Perceived access to alcohol was associated with increased risks for alcohol use at both party and non-party events, but the association was stronger for alcohol use at parties than non-parties (RRR=1.85, p<0.005 versus 4.01, p≤0.005). Additional analyses showed that contexts with mixed gender composition were positively associated with alcohol use at parties not in homes (RRR=11.29, p≤0.05), and perceptions of getting caught by parents or police were negatively associated with non-party alcohol use in homes (RRR=0.57, p≤0.005). This study identified social-ecological contexts of underage drinking parties, which are high risk settings for heavier drinking and other alcohol-related problems. Findings can inform context-based interventions to target these high-risk settings, whether at homes or other locations.
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Moore RS, Gilder DA, Grube JW, Lee JP, Geisler JA, Friese B, Calac DJ, Finan LJ, Ehlers CL. Prevention of Underage Drinking on California Indian Reservations Using Individual- and Community-Level Approaches. Am J Public Health 2018; 108:1035-1041. [PMID: 29927644 DOI: 10.2105/ajph.2018.304447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate combined individual- and community-level interventions to reduce underage drinking by American Indian/Alaska Native (AI/AN) youths on rural California Indian reservations. METHODS Individual-level interventions included brief motivational interviewing and psychoeducation for Tribal youths. Community-level interventions included community mobilization and awareness activities, as well as restricting alcohol sales to minors. To test effects, we compared 7 waves of California Healthy Kids Survey data (2002-2015) for 9th- and 11th-grade AI/AN and non-AI/AN students in intervention area schools with California AI/AN students outside the intervention area (n = 617, n = 33 469, and n = 976, respectively). RESULTS Pre- to postintervention mean past 30-day drinking frequency declined among current drinkers in the intervention group (8.4-6.3 days) relative to comparison groups. Similarly, heavy episodic drinking frequency among current drinkers declined in the intervention group (7.0-4.8 days) versus the comparison groups. CONCLUSIONS This study documented significant, sustained past 30-day drinking or heavy episodic drinking frequency reductions among AI/AN 9th- and 11th-grade current drinkers in rural California Indian reservation communities exposed to multilevel interventions. Public Health Implications. Multilevel community-partnered interventions can effectively reduce underage alcohol use in this population.
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Affiliation(s)
- Roland S Moore
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - David A Gilder
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Joel W Grube
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Juliet P Lee
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Jennifer A Geisler
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Bettina Friese
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Daniel J Calac
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Laura J Finan
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
| | - Cindy L Ehlers
- Roland S. Moore, Joel W. Grube, Juliet P. Lee, Bettina Friese, and Laura J. Finan are with Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. David A. Gilder and Cindy L. Ehlers are with the Scripps Research Institute, La Jolla, CA. Jennifer A. Geisler was with and Daniel J. Calac is with the Southern California Tribal Health Center
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Finan LJ, Simpson E, Schulz J, Ohannessian CM. Parental Problem Drinking and Emerging Adult Problem Behavior: The Moderating Role of Parental Support. J Child Fam Stud 2018; 27:1175-1185. [PMID: 29713136 PMCID: PMC5921927] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examined the relationship between parental problem drinking (maternal and paternal) and emerging adult problem behaviors (alcohol use, drug use, and antisocial behavior). In addition, the moderating role of parental support (maternal and paternal) was explored. Data were drawn from a nationally representative sample of emerging adults (N = 600; Mage = 20.00, SD = 1.42; 50% women; 62% White). Results from regression analyses of survey data indicated that both maternal problem drinking and maternal support moderated the relationship between paternal problem drinking and emerging adult alcohol use. For drug use, there was a three-way interaction between paternal problem drinking, maternal problem drinking, and maternal support. The relationship between paternal problem drinking and drug use only was significant for those who reported high maternal problem drinking and low maternal support. For antisocial behavior, there were positive relationships between paternal problem drinking and antisocial behavior and between maternal problem drinking and antisocial behavior in contexts of varying levels of parental support. Findings highlight the potential for parental support to both buffer and enhance the adverse influence of parental problem drinking across varied contexts.
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Affiliation(s)
- Laura J Finan
- Prevention Research Center, University of California, Berkeley, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, , 510-883-5703
| | - Emily Simpson
- University of Connecticut and Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106.
| | - Jessica Schulz
- Rutgers University, Camden, 311 N. Fifth Street, Camden, NJ 08102,
| | - Christine McCauley Ohannessian
- University of Connecticut School of Medicine and Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106,
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Abstract
OBJECTIVE We conducted meta-analyses of studies that investigated the associations between tobacco outlet density around homes and schools and adolescents' past-month cigarette smoking. DATA SOURCES Systematic literature searches of eight databases were carried out in February 2017. Searches were not limited by date, language, country or peer-reviewed status. STUDY SELECTION After screening for quality, studies that examined the relationship between tobacco outlet density and adolescents' past-month smoking were selected for inclusion. DATA EXTRACTION Two investigators screened study abstracts and full texts and independently extracted data. Consensus was reached at each stage. DATA SYNTHESIS Random-effects meta-analyses were conducted on 11 studies that provided 13 effect sizes. Results showed that there was a significant association between tobacco outlet density around homes and adolescents' past-month smoking behaviour, with an overall effect size of OR=1.08 (95% CI 1.04 to 1.13; P<0.001; I2=0%). For density around schools, the association was not statistically significant (OR=1.01, 95% CI 0.98 to 1.03; P=0.53; I2=39%). CONCLUSIONS These findings suggest that exposure to tobacco outlets near home environments may be important for understanding adolescents' past-month smoking. Restricting access to tobacco outlets and controlling the number of outlets in residential areas may be an effective preventive strategy to help reduce adolescents' smoking.
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Affiliation(s)
- Laura J Finan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California, USA
| | - Melissa Abadi
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, Kentucky, USA
| | - Joel W Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California, USA
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California, USA
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California, USA
| | - Andrew Gaidus
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California, USA
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Abstract
The objective of the current study was to explore demographic, financial, and psychosocial barriers associated with the use/non-use of reproductive health (RH) services. The sample included 212 college students (60 % female) aged 18-19 from a Northern California public university. In October, 2014, students took an on-line survey with questions on knowledge, access, barriers, and use of different RH services and settings. Findings indicated that college students were more likely to visit a primary care setting and/or school-based setting for their RH care. Sexual intercourse was the strongest correlate of having received RH care in the past year, followed by gender, social disapproval, and knowledge of available services. Analyses stratified by gender found a similar pattern among females. However, the only significant predictor among males was knowledge of available services. These finding highlight universities as uniquely positioned to reduce perceived barriers to accessing RH services by making use of technology, promoting health and wellness centers, and providing/adding sexual and reproductive information to general education classes.
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Affiliation(s)
- Melina Bersamin
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612, USA
| | - Deborah A Fisher
- Pacific Institute for Research and Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD, 20705, USA
| | - Arik V Marcell
- Department of Pediatrics, Johns Hopkins University, 200 N. Wolfe Street, Room 2062, Baltimore, MD, 21287, USA
| | - Laura J Finan
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612, USA.
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Abstract
OBJECTIVE The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. METHODS AND PARTICIPANTS Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). RESULTS Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. CONCLUSIONS Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.
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Affiliation(s)
- Melina Bersamin
- Prevention Research Center, Pacific Institute for Research and Evaluation
| | | | | | - Laura J. Finan
- Correspondence concerning this article should be addressed to Laura Finan, Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, California, 94612, USA. Phone: 510-883-5703,
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Mello ZR, Walker EB, Finan LJ, Stiasny A, Wiggers ICS, McBroom KA, Worrell FC. Time perspective, psychological outcomes, and risky behavior among runaway adolescents. Applied Developmental Science 2017. [DOI: 10.1080/10888691.2016.1276455] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Finan LJ, Schulz J, Gordon MS, Ohannessian CM. Parental problem drinking and adolescent externalizing behaviors: The mediating role of family functioning. J Adolesc 2015; 43:100-10. [PMID: 26073673 PMCID: PMC4516616 DOI: 10.1016/j.adolescence.2015.05.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [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: 11/03/2014] [Revised: 04/08/2015] [Accepted: 05/01/2015] [Indexed: 11/24/2022]
Abstract
This study explored relationships among parental problem drinking, family functioning, and adolescent externalizing behaviors. The unique effects of maternal and paternal drinking were examined separately for girls and boys. The sample included 14-19 year old U.S. adolescents (Mage = 16.15; SD = .75; 52.5% female) and their parents. Participants completed surveys in the spring of 2007 and 2008. Structural equation modeling was used to conduct path analysis models. Results showed the distinctive and adverse effects of parental problem drinking on adolescent alcohol use, drug use, rule breaking, and aggressive behavior over time. Findings also highlighted the indirect and mediating roles of family functioning. For both girls and boys, family cohesion mediated the relationship between parental problem drinking and adolescent externalizing behaviors. For girls, adolescent-father communication predicted increased externalizing behaviors over time. These findings draw attention to the importance of exploring adolescent and parent gender when examining parental problem drinking, family functioning, and externalizing behaviors.
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Affiliation(s)
- Laura J Finan
- University of Delaware, Human Development Family Studies, 120 Alison Hall West, Newark, DE 19716, United States.
| | - Jessica Schulz
- University of Delaware, Human Development Family Studies, 120 Alison Hall West, Newark, DE 19716, United States.
| | - Mellissa S Gordon
- University of Delaware, Human Development Family Studies, 120 Alison Hall West, Newark, DE 19716, United States.
| | - Christine McCauley Ohannessian
- University of Connecticut School of Medicine, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, United States.
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Ohannessian CM, Finan LJ, Schulz J, Hesselbrock V. A Long-Term Longitudinal Examination of the Effect of Early Onset of Alcohol and Drug Use on Later Alcohol Abuse. Subst Abus 2015; 36:440-4. [PMID: 25671782 DOI: 10.1080/08897077.2014.989353] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Early onset of alcohol use has been linked to later alcohol problems in adulthood. Currently, it is not clear whether early onset of marijuana and tobacco use similarly predicts alcohol problems. Moreover, most studies examining the effect of early substance use onset on later problems only have followed youth into their early 20s. Therefore, the primary goal of this study was to examine whether early onset of alcohol, marijuana, and tobacco use predicts alcohol problems beyond the transition to adulthood. METHODS The sample included 225 15-19-year-old youth (60% girls; 62% Caucasian) who were surveyed in three time periods: 1993-1998 (Time 1), 1998-2003 (Time 2), and 2003-2007 (Time 3). Participants reported their age of onset for regular drinking, tobacco use, and marijuana use. At each time of measurement, they also completed surveys relating to their alcohol use and abuse. RESULTS Participants with an earlier age of onset of drinking regularly scored higher on the Michigan Alcoholism Screening Test (MAST) and drank more frequently to get high and drunk throughout their 20s. Tobacco use onset and marijuana use onset were not associated with later alcohol use or abuse. CONCLUSIONS Results from this study suggest that the relationship between the onset of substance use and later substance abuse may be substance specific. Of note, early onset of regular drinking was associated with alcohol problems during adulthood, underscoring the importance of delaying the onset of regular alcohol use among youth.
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Affiliation(s)
- Christine McCauley Ohannessian
- a Children's Center for Community Research , Connecticut Children's Medical Center , Hartford , Connecticut , USA.,b University of Connecticut School of Medicine , Farmington , Connecticut , USA
| | | | | | - Victor Hesselbrock
- b University of Connecticut School of Medicine , Farmington , Connecticut , USA
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