Is Online Partner-Seeking Associated with Increased Risk of Condomless Sex and Sexually Transmitted Infections Among Individuals Who Engage in Heterosexual Sex? A Systematic Narrative Review.

Use of Internet websites and mobile applications to meet potential romantic and sexual partners is becoming increasingly popular. While the Internet might foster better communication and sexual negotiation between partners, it can also be a deceptive environment that instigates and accelerates sexual risk-taking. Given the complexities of the Internet, it is critical to examine the association between risky sexual behaviors (RSBs) and online partner-seeking. Five databases (i.e., Google Scholar, PubMed, PsycINFO, Web of Science, and Ovid Medline) were searched for articles published before September 10, 2017, that examined the association between online partner solicitation (either for romantic and/or sexual reasons) and RSBs. Studies were eligible for inclusion if they were empirical papers published in English-language peer-reviewed journals looking at samples of online partner seekers who practice heterosexual sex (with a comparison group) and reporting either condom use or sexually transmitted infections (STIs) status, which were the two primary outcomes. A total of 25 studies met the criteria to be included in our review. Results from this literature search do not indicate a clear association between online partner-seeking and condom use or STI status. Potential moderators (i.e., age, gender, reasons for online partner solicitation, duration of Internet correspondence, and Internet modalities) that should be included in future research were identified. Sexual health prevention efforts should address methods to negotiate safe practices between sexual partners and to encourage healthy non-virtual relationships, particularly among vulnerable populations.

Patterns of Sexual Experience Among Urban Latino and African American Ninth Grade Students.

This analysis assessed patterns of sexual experience, the order in which behaviors were initiated, and associated factors, among Latino and African American ninth grade students (average age 15.2) who self-administered audio-computer-assisted surveys on netbooks in classes at 10 Los Angeles-area public high schools. Lifetime experiences with vaginal and oral sex were most common (19% and 16%, respectively); fewer reported anal sex (6%). Of the 23% reporting any sex, 91% fell into four categories: 36% reporting both oral and vaginal sex; 23% vaginal only; 18% all three; and 13% oral only. Most sexually experienced students (88%) initiated with vaginal or oral sex (46% vaginal, 33% oral, 9% both same day). No dominant pathway of sexual onset emerged for those reporting all three types of sex. We found no evidence that oral or anal sex substituted for or delayed vaginal sex. Males, those with a current partner, and those reporting multiple partners were more likely than others to report all three sexual behaviors versus vaginal only (odds ratios [ORs] 2.0, 1.5, 3.0; p = .02, .06, < .01, respectively). Although vaginal intercourse dominated their early sexual behavior, one-fifth of sexually experienced students reported anal intercourse, highlighting the need for specific prevention messages surrounding this higher-risk behavior.

Sense of coherence and tobacco use myths among adolescents as predictors of at-risk youth cigarette use.

We examined the association between a general construct of wellness beliefs, sense of coherence, and a specific measure of tobacco-related beliefs, tobacco use myths, as predictors of two smoking-related outcome measures-next year smoking expectation and last 30-day smoking. Self-report questionnaires were administered to 710 adolescents attending California continuation high schools at baseline and at 1-year follow-up between 2006 and 2008. Cross-sectionally, predictor and outcome measures were correlated. However, in longitudinal analyses, only tobacco use myths predicted change in outcome measures. We speculate that future smoking interventions among adolescents would achieve relatively efficacious outcomes by targeting specific health beliefs instead of global health beliefs. The study's limitations are noted.

The process of adoption of evidence-based tobacco use prevention programs in California schools.

Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community and organizational variables on the adoption of prevention programs via school administrators' beliefs and the organization's receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts' use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools.

Association between home availability and vegetable consumption in youth: a review.

OBJECTIVE: To systematically review literature examining the association between vegetable home availability and vegetable intake in youth. DESIGN: Articles were identified through December 2012 using a search of PubMed, PsychINFO and OVID/Medline databases, using the following keywords in varying combinations: home, environment, availability, vegetable, intake, consumption, children. Quantitative studies examining home vegetable availability and vegetable intake in children and adolescents were included. Fifteen studies were included that met inclusion criteria. SETTING: Studies were conducted in the USA (n 8), Australia (n 1), Greece (n 1), Iceland (n 1), Denmark (n 1), the UK (n 1), the Netherlands (n 1) and a combination of nine European countries (n 1). SUBJECTS: Various populations of children and adolescents were examined. RESULTS: Seven of the studies (47 %) found a positive association between vegetable availability and intake, with the others reporting null findings. There were no clear patterns of association by study design, age of subjects included, comprehensiveness of measures, or inclusion of covariates in analyses. Child report of home availability was associated with child vegetable intake (n 6, all found a positive association), while parent report of home availability was only minimally associated (n 9, one found a positive association; P=0.001 from post hoc Fisher's exact test comparing parent v. child report). CONCLUSIONS: Parent perception of availability may be closer to truth, given the parental role in food shopping and preparation. Therefore, to impact child vegetable intake, absolute availability may not be as important as child perception of vegetables in the home. Child perception of availability may be altered by level of familiarity with vegetables.

Predicting Self-Initiated Marijuana Use Cessation among Youth at Continuation High Schools.

The current article reports a large scale study of the prediction of marijuana use cessation among individuals attending alternative high schools who were regular users at baseline. Based on the Triadic Influence Theory, predictors of marijuana use cessation at 1-year follow-up were organized by type of influence (e.g., interpersonal, cultural and attitudinal, and intrapersonal) and level of influence (e.g., distal and ultimate). Among the 522 students who were past 30-day marijuana users at baseline, quitting was defined as having not used marijuana in the last 30 days at 1-year follow-up (43% of baseline users). To account for the level of influence we employed a theory-based analytic strategy, hierarchical regression. In the final multivariate model, lower level of baseline marijuana use and less of a likelihood to endorse pro-drug-use myths remained predictors of marijuana use cessation 1-year later. Implications of these findings include the need to develop cessation programs that reduce psychological dependence on marijuana use, and correct cognitive misperceptions about drug use in order to help adolescents make decisions that lead to health-promoting behaviors.

Bidirectional associations between future time perspective and substance use among continuation high-school students.

We examined whether a bidirectional, longitudinal relationship exists between future time perspective (FTP), measured with the Zimbardo Time Perspective Inventory, and any past 30-day use of alcohol, tobacco, marijuana, or hard drugs among continuation high school students (N = 1,310, mean age 16.8 years) in a large urban area. We found increased FTP to be protective against drug use for all substances except alcohol. While any baseline use of substances did not predict changes in FTP 1 year later. The discussion explores why alcohol findings may differ from other substances. Future consideration of FTP as a mediator of program effects is explored.

The Effects of Implementation Fidelity in the Towards No Drug Abuse Dissemination Trial.

PURPOSE: The current study examines the influence of contextual and provider-level factors on the implementation fidelity of a research-based substance abuse prevention program. Also, it investigates whether two provider-level factors, self-efficacy and beliefs about the value of the program, statistically moderate and mediate the effects of a provider training intervention on implementation fidelity. DESIGN/METHODOLOGY/APPROACH: Using generalized mixed-linear modeling, we examine relationships between program provider-, organizational, and community-level factors and implementation fidelity in a sample of 50 high school teachers from 43 high schools in 8 states across the U.S. Fidelity of implementation was assessed utilizing an observation procedure. FINDINGS: Implementation fidelity was negatively associated with the urbanicity of the community and the level of teachers' beliefs about the value of the program, and positively predicted by the organizational capacity of the school. Comprehensive training significantly increased teachers' self-efficacy, which resulted in an increase in implementation fidelity. RESEARCH IMPLICATIONS: School-based prevention program implementation is influenced by a variety of contextual factors occurring at multiple ecological levels. Future effectiveness and dissemination studies need to account for the complex nature of schools in analyses of implementation fidelity and outcomes. PRACTICAL IMPLICATIONS: Our findings suggest that both provider- and organizational-level factors are influential in promoting implementation fidelity. Before implementation begins, as well as throughout the implementation process, training and ongoing technical assistance should be conducted to increase teachers' skills, self-efficacy, and comfort with prevention curricula. ORIGINALITY/VALUE: The present study is one of the few to examine contextual and provider-level correlates of implementation fidelity and use mediation analyses to explore whether provider-level factors mediate the effects of a provider training intervention on implementation fidelity.

Prevention, family, and community.

The "Prevention, Family, and Community" session was chaired by Dr. Joseph Jror-Serk Cheng, who is an expert in community psychiatry and mental health policy and is superintendent of the Bali Psychiatric Center in Taipei. Dr. Shu-Lung Yang, dean of Student Affairs and Professor/Director of the Crime Research Center, National Chung Cheng University in Taiwan, served as the discussant. The two presenters were Dr. Louise Ann Rohrbach, who presented on "Prevention of Alcohol and other Drug Abuse: Science, Practice, Critical Issues, and Future Direction," and Dr. Dennis Daley, who spoke on "Family and Social Aspects of Drug Abuse: Implications for Treatment and Recovery." Dr. Rohrbach is associate professor of Preventive Medicine and director of the Master of Public Health (MPH) program at the University of Southern California (USC) Keck School of Medicine. Dr. Daley is professor of psychiatry at the University of Pittsburgh School of Medicine in Pennsylvania.

Boosting a teen substance use prevention program with motivational interviewing.

A brief motivational interviewing (MI) intervention may be a viable adjunct to school-based substance abuse prevention programs. This article describes the development and implementation of a brief MI intervention with 573 adolescents (mean age 16.8; 40.3% female, 68% Latino) enrolled in eight continuation high schools in Southern California. Study participants were assigned to the MI condition in a randomized controlled trial of Project Toward No Drug Abuse. Data are provided on dosage, topics discussed, and quality of MI determined with the Motivational Interviewing Skill Code (MISC). Results suggest that the protocol was feasible and implemented with adequate fidelity. The study's limitations are noted.

Dissemination of Project Towards No Drug Abuse (TND): findings from a survey of program adopters.

This study examines adoption and implementation decisions among organizations that purchased Project Towards No Drug Abuse from 2001 to 2004. Telephone interviews were conducted with 120 organizations nationwide. The most common reason for adopting the program was its evidence base. In schools, classroom teachers were more likely to deliver the program than other types of implementers, and in nonschool organizations, prevention specialists, and counselors were more common (p < .05). Most organizations (73%) reported that they delivered all of the program sessions. The limitations of the study, as well as the implications of the findings for future research and wide-scale prevention program dissemination, are discussed.

The Project Towards No Drug Abuse (TND) dissemination trial: implementation fidelity and immediate outcomes.

One of the important research issues in the emerging area of research on dissemination of prevention programs relates to the type and extent of training needed by program providers to prepare them to implement effective programs with fidelity. The present paper describes the immediate outcomes of a dissemination and implementation trial of Project Toward No Drug Abuse, an evidence-based prevention program for high school students. A total of 65 high schools in 14 school districts across the USA were recruited and randomly assigned to one of three experimental conditions: comprehensive implementation support for teachers, regular workshop training only, or standard care control. The comprehensive intervention was comprised of on-site coaching, web-based support, and technical assistance, in addition to the regular workshop. Students (n = 2,983) completed self-report surveys before and immediately after program implementation. Fidelity of implementation was assessed with a classroom observation procedure that focused on program process. Results indicated that relative to the controls, both intervention conditions produced effects on hypothesized program mediators, including greater gains in program-related knowledge; greater reductions in cigarette, marijuana and hard drug use intentions; and more positive changes in drug-related beliefs. There were stronger effects on implementation fidelity in the comprehensive, relative to the regular, training condition. However, seven of the ten immediate student outcome measures showed no significant differences between the two training conditions. The implications of these findings for dissemination research and practice are discussed.

The prevalence of evidence-based drug use prevention curricula in U.S. middle schools in 2005.

Since the promulgation of its Principles of Effectiveness in 1998, the Office of Safe and Drug-Free Schools of the U.S. Department of Education has promoted the use of evidence-based drug prevention programs in the nation's schools. We report the results of a survey, conducted in 2005, of a nationally representative sample of 1,721 schools with middle school grades. Respondents comprised the staff member in the school identified as most knowledgeable about the school's drug prevention programs. The total response rate was 78%. Respondents answered questions concerning which drug use prevention curricula they used, and, if they used more than one, which one they used the most frequently. Three federally-sponsored registries were used to specify which curricula were considered evidence-based. Findings from 2005 were then compared to earlier estimates based on a similar 1999 survey. We found that 42.6% of the nation's schools with middle school grades were using an evidence-based curriculum, an increase of 8% from our 1999 estimate. The two most prevalent curricula in use, at 19% each, were Life Skills Training and Project ALERT. We note, however, that only 8% of Life Skills Training users and 9% of Project ALERT users reported using those curricula the most, and that only 23% of respondents overall reported that they used an evidence-based curriculum the most. More information is needed as to why over three-quarters of the nation's schools with middle school grades continue to administer curricula that have not been identified as effective.

One-year follow-up evaluation of Project Towards No Drug Abuse (TND-4).

OBJECTIVES: This paper describes the one-year outcomes of the fourth experimental trial of Project Towards No Drug Abuse. Two theoretical content components of the program were examined to increase our understanding of the relative contribution of each to the effectiveness of the program. METHODS: High schools in Southern California (n=18) were randomly assigned to one of three conditions: cognitive perception information curriculum, cognitive perception information+behavioral skills curriculum, or standard care (control). The curricula were delivered to high school students (n=2734) by project health educators and regular classroom teachers. Program effectiveness was assessed with both dichotomous and continuous measures of 30-day substance use at baseline and one-year follow-up. RESULTS: Across all program schools, the two different curricula failed to significantly reduce dichotomous measures of substance use (cigarette, alcohol, marijuana, and hard drugs) at one-year follow-up. Both curricula exerted an effect only on the continuous measure of hard drug use, indicating a 42% (p=0.02) reduction in the number of times hard drugs were used in the last 30 days in the program groups relative to the control. CONCLUSIONS: The lack of main effects of the program on dichotomous outcomes was contrary to previous studies. An effect on an ordinal count measure of hard drug use among both intervention conditions replicates previous work and suggests that this program effect may have been due to changes in cognitive misperception of drug use rather than behavioral skill.

Prospective associations of social self-control with drug use among youth from regular and alternative high schools.

BACKGROUND: This study examined the one year prospective associations between adolescent social self-control and drug outcomes (cigarette use, alcohol use, marijuana use, hard drug use, and problem drug use) among adolescents from regular and continuation high schools. In our previous cross-sectional study, poor social self-control was found to be associated with higher drug use, controlling for 12 personality disorder categories. In this study, we attempted to find out (a) whether lack of social self-control predicted drug use one year later, and (b) whether drug use at baseline predicted social self-control one year later. METHODS: We surveyed 2081 older adolescents from 9 regular (N = 1529) and 9 continuation (alternative) (N = 552) high schools in the Los Angeles area. Data were collected at two time points in an interval of approximately 1 year. RESULTS: Past 30-day cigarette smoking, marijuana use, hard drug use, and problem drug use at baseline were found to predict lower social self-control at follow-up, controlling for baseline social self-control and demographic variables. The effect of problem drug use as a one-year predictor of social self-control was found to be moderated by school type (regular or continuation high school), such that the relationship was significant for continuation high school students only. Conversely, social self-control was found to predict past 30-day alcohol use, marijuana use, and problem drug use, controlling for baseline drug use and demographic variables. For alcohol use, marijuana use, and problem drug use outcomes, school type was not found to moderate the effects of social self-control, though an interaction effect was found regarding cigarette smoking. Social self-control was a significant predictor of cigarette use only at regular high school. CONCLUSION: The results indicate that social self-control and drug use share a reciprocal relationship. Lack of social self-control in adolescents seems to result in increased drug use, which in turn is likely to further decrease social self-control. Thus, it seems that social self-control is an alterable cognitive-behavioral attribute which can be improved through skill-based interventions in order to prevent drug use among adolescents. Policies aimed at preventing drug abuse among adolescents may benefit from institutionalizing social self-control skills training.

Six-month and one-year effects of project EX-4: a classroom-based smoking prevention and cessation intervention program.

OBJECTIVE: This study evaluated the efficacy of a version of Project EX that was adapted for implementation in the classroom context (Project EX-4). This paper reports the program outcomes based on pretest, six-month, and one-year follow-up surveys. METHODS: An 8 session classroom-based curriculum was tested with a clustered randomized controlled trial that involved a total of 1097 students in 6 program and 6 control alternative high schools. Weekly and monthly smoking was assessed at the three time points. Outcome effects were analyzed with multi-level random coefficients models. RESULTS: Students in the program condition experienced a greater reduction in weekly smoking and monthly smoking, at 6-and-12-month follow-ups. The net change varied between -5.1% and -7.6%, comparing the program condition to the control condition. CONCLUSIONS: The implementation of Project EX in a classroom setting produced decreases in smoking among students in the program, relative to those in the standard care control condition. It is likely that a classroom-based smoking prevention/cessation program can lead to lower overall smoking prevalence than a cessation program that is implemented in a school-based smoking cessation clinic format.

Short-term effects of Project EX-4: a classroom-based smoking prevention and cessation intervention program.

OBJECTIVE: Researchers continue to try to develop effective teen tobacco use prevention and cessation programs. Three previous school clinic-based studies established the efficacy of Project EX for teen smoking cessation. This fourth study adapts Project EX to the classroom context. This paper reports the findings based on pretest and posttest surveys conducted immediately prior and post-intervention. METHODS: An eight-session classroom-based curriculum was developed and tested with a randomized controlled trial that involved a total of 1097 students in six program and six control continuation high schools. Program-specific knowledge and smoking measures were assessed at both the pretest and posttest surveys, and were used to evaluate the program's effect on the immediate outcomes. The immediate outcomes effects were analyzed with multi-level random coefficients models. RESULTS: Program students provided favorable process ratings of the overall program and each session. Compared with the students in the control condition, students in the program condition showed a greater change in correct knowledge responses from pretest to posttest (beta=+5.5%, p=0.0003). Students in the program condition also experienced a greater reduction in weekly smoking (beta=-6.9%, p=0.038), and intention for smoking in the next 12 months (beta=-0.21 in 5-level scale, p=0.023). CONCLUSIONS: EX-4 immediate outcome results revealed favorable student responses to the program, increases in knowledge, and decreases in smoking relative to a standard care control condition.

Translation in tobacco and drug abuse prevention research.

The purpose of this article is to describe the translation of research on tobacco and drug abuse prevention from basic science to program development to large-scale program dissemination, and from animal to human studies. Where relevant, continuity of translation is discussed by referring to two variables that have been studied for their potential relationship to drug use risk in both animals and humans: sensation and novelty seeking and low impulse control. Review of the research indicates relatively slow translation until the early 1990s. The authors recommend several mechanisms to promote more rapid translation across types of research that encourage reciprocal rather than unidirectional transmission of knowledge to expedite the development and diffusion of more timely, targeted drug abuse prevention programs.

Factors associated with adoption of evidence-based substance use prevention curricula in US school districts.

This paper examines factors associated with the adoption of evidence-based substance use prevention curricula (EBC) in a national sample of school districts. Substance abuse prevention coordinators in public school districts (n = 1593), which were affiliated with a random sample of schools that served students in Grades 5-8, completed a written survey in 1999. Results indicated that 47.5% of districts used at least one EBC in their schools with middle school grades. Substance use prevention coordinators reported they had the greatest input in decisions about curricula. In a multivariate analysis of factors positively associated with district-level decisions to adopt evidence-based programs, significant factors included input from a state substance use prevention group, use of information disseminated by the National Institute on Drug Abuse or Center for Substance Abuse Prevention, use of local needs assessment data, consideration of research showing which curricula are effective and allocation of a greater proportion of the coordinator's time to substance use prevention activities. State and federal agencies should increase their efforts to disseminate information about evidence-based programs, targeting in particular the district substance use prevention coordinator.