2020 design and methods of the Population Assessment of Tobacco and Health (PATH) study during the COVID-19 pandemic.

The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative, longitudinal study of the US population on tobacco use and its effects on health, collecting data annually since 2013. The COVID-19 pandemic interrupted in-person survey data collections around the world. In the USA, this included a PATH Study data collection focused on youth (13-17) and young adults (18-19) as well as other US surveys on tobacco use. Given that it was necessary to pause data collection and considering that tobacco-use behaviours could be expected to change along with pandemic-related changes in the social environment, the original design for the 2020 PATH Study data collection for youth and young adults was modified. Also, the PATH Study Adult Telephone Survey was developed to address the need for adult tobacco use monitoring in this unprecedented time. This article describes the modifications made to the 2020 PATH Study design and protocol to provide nationally representative data for youth and adults after the onset of the COVID-19 pandemic as well as the implications of these modifications for researchers.

The Gap between the Knowledge and Current Practices--A Case of Tobacco Control Programs in Croatia.

Despite the availability of numerous evidence-based smoking prevention and cessation programs, many countries are still not implementing these research-proven programs. The primary aim of this paper is to summarize the extent to which evidence-based smoking control programs have been implemented in Croatia over the last two decades. Data from the systematic reviews of the Cochrane Tobacco Addiction Group, which are readily available worldwide, were used as criteria to evaluate whether effective, evidence-based programs have been implemented in Croatia. According to our findings, the most effective behavioral and pharmacological smoking cessation interventions have thus far been underutilized in Croatia. In addition, some interventions that have been continuously implemented in Croatia--such as using self-help materials, school-based programs and the celebration of World No Tobacco Day--have only small, short-term beneficial effects according to the Cochrane reviews. However, Croatia is a party to the World health Organization Framework Convention on Tobacco Control and therefore has effective national legislation on tobacco control. Croatia should develop and implement programs that integrate the existing high-quality empirical evidence on the effectiveness of various behavioral, pharmacological, and social interventions for smoking prevention and cessation. This programming should become a part of a continuous national strategy, and should be implemented throughout all of Croatia.

Substance abuse among adolescents.

Substance use and dependence are among the most prevalent causes of adolescent morbidity and mortality in the United States. This paper provides a review of differences between adolescent and adult substance abuse, prevention and treatment approaches, and future potential directions and needs for more effective programming in the treatment of adolescent substance abuse(1) and dependence on psychoactive substances.

Physical and relational aggression as predictors of drug use: gender differences among high school students.

The present study investigated the longitudinal relationships between physical and relational aggression and later drug use, as moderated by gender. Self-reported data were gathered from 2064 high school students at pretest and 1-year post-test to test the hypotheses that (1) males would engage in more physical aggression than females, whereas females would engage in more relational aggression than males; and (2) physical aggression would be a stronger drug use predictor for males and relational aggression a stronger predictor for females. Results indicated that males reported engaging in more physical aggression than females at baseline; however, females and males reported engaging in similar rates of relational aggression. After controlling for relational aggression, baseline drug use, and demographic variables, physical aggression at baseline was found to predict alcohol use 1-year later for males but not for females. After controlling for physical aggression, baseline drug use, and demographic variables, relational aggression was found to predict cigarette use and marijuana use for females but not for males. However, relational aggression was found to predict later alcohol and hard drug equally across gender. These findings suggest that both physical and relational aggression are predictive of subsequent drug use and have important implications for violence and drug use prevention intervention efforts.

Project Towards No Drug Abuse (TND): needs assessment of a social service referral telephone program for high risk youth.

The purpose of this study was to conduct a needs assessment of a potential social service resource telephone program component among high risk youth who received the Project Towards No Drug Abuse (TND) classroom-based program (approximately 1 year earlier). Results supported youths' overwhelming receptiveness of a social service referral program. The vast majority of respondents indicated a strong desire for resource and referral information on vocational, educational, recreational, transportation, and mental health and drug counseling. Further research is needed to investigate the effectiveness of the provision of social service resource information on drug use among emerging adults.

Translation of evidence-based tobacco use prevention programming in Croatia.

Croatia faces a major threat of smoking-related health burdens given the monumental changes this newly formed country has undergone in the past 15 years because of its postcommunist democratic and economic transitions and the destructive 1991-1995 war with Serbia. This article provides information on Croatia's general background, current smoking prevalence and attitudes, and current evidence-based smoking prevention efforts. Furthermore, various cultural and contextual conditions within Croatia that facilitate or impede smoking prevention research utilization are discussed. Finally, it is concluded that new research is needed that continues to build on comprehensive research-tested multicomponent prevention initiatives utilizing school-, family-, community-, and mass media-based delivery modalities, which specifically focus on the social influences of smoking.

Fidelity of implementation in Project Towards No Drug Abuse (TND): a comparison of classroom teachers and program specialists.

This paper presents the results of an effectiveness trial of Project Towards No Drug Abuse [TND], in which we compared program delivery by regular classroom teachers and program specialists within the same high schools. Within 18 schools that were randomly assigned to the program or control conditions, health classrooms were assigned to program delivery by teachers or (outside) specialists. Classroom sessions were observed by pairs of observers to assess three domains of implementation fidelity: adherence, classroom process, and perceived student acceptance of the program. Pre- and immediate posttest survey data were collected from 2331 students. Of the four composite indexes of implementation fidelity that were examined, only one (quality of delivery) showed a difference between specialists and teachers, with marginally higher ratings of specialists (p < .10). Both teachers and program specialists achieved effects on three of the five immediate outcome measures, including program-specific knowledge, addiction concern, and social self-control. Students' posttest ratings of the program overall and the quality of program delivery failed to reveal differences between the teacher- and specialist-led classrooms. These results suggest that motivated, trained classroom teachers can implement evidence-based prevention programs with fidelity and achieve immediate effects.

Non drug use- and drug use-specific spirituality as one-year predictors of drug use among high-risk youth.

The present article explored two different dimensions of spirituality that might tap negative and positive relations with adolescent drug use over a 1-year period. Non-drug-use-specific spirituality measured how spiritual the person believes he or she is, participation in spiritual groups, and engagement in spiritual practices such as prayer, whereas drug-use-specific spirituality measured using drugs as a spiritual practice. Self-report questionnaire data were collected during 1997-1999 from a sample of 501 adolescents in 18 continuation high schools across southern California. Participants ranged in age from 14 to 19 and were 57% male, with an ethnic distribution of 34% White, 49% Latino, 5% African American, 7% Asian, and 5% other. A series of general linear model analyses were conducted to identify whether or not two different spirituality variables predict drug use (cigarettes, alcohol, marijuana, hallucinogens, and stimulants) at 1-year follow-up. After controlling for baseline drug use, non-drug-use-specific spirituality was negatively predictive of alcohol, marijuana, and stimulant use, whereas drug-use-specific spirituality failed to be found predictive of these variables one year later. Conversely, drug-use-specific spirituality was positively predictive of cigarette smoking and hallucinogen use, whereas non-drug-use spirituality failed to be found predictive of these variables. Our results provide new evidence that suggests that spirituality may have an effect on drug use among adolescents. The drug-use-specific measure of spirituality showed "risk effects" on drug use, whereas the other measure resulted in "protective effects," as found in previous research. Knowledge of the risk and protective patterns and mechanisms of spirituality may be translated into future drug use prevention intervention programs.

Translation in the health professions: converting science into action.

The systematic translation of evidence-based research findings, tools, and information into practice is critical to improving the quality of our nation's health. However, despite several decades of advances in developing medical knowledge based on high-quality empirical evidence, widespread implementation of these findings into practice in diverse applied settings has not been achieved. This article reviews definitions and conceptual models that describe the translation of research from basic discovery to real-world applications, summarizes the various issues involved in the process of translation, discusses multiple barriers, and provides recommendations to surmount these hurdles. Areas of further research in this arena are suggested. Finally, the article concludes that translational research is an important area to continue to pursue requiring long-term collaborative commitment among researchers and practitioners.

Project Towards No Drug Abuse: long-term substance use outcomes evaluation.

OBJECTIVES: This paper presents up to 5 years post-program outcomes of Project Towards No Drug Abuse (Project TND), a drug abuse prevention program conducted in South California alternative high school system during years 1994-1999. METHODS: The effects of a 9-session health motivation--social skills--decision-making curriculum were evaluated. Twenty-one schools recruited were randomly assigned to standard care (control), classroom only, or a classroom plus semester-long school-as-community component. Last 30-day use of cigarettes, alcohol, marijuana, and hard drugs were assessed at three time intervals: short-term (year 1), middle-term (years 2 or 3), and long-term (years 4 or 5). Multilevel random coefficients modeling were employed to estimate the adjusted levels of substance use. RESULTS: Among 1578 baseline subjects, follow-up data were available for 68% (year 1), 66% (years 2 or 3), and 46% (years 4 or 5) of subjects, respectively. Results revealed significant positive long-term program effects for hard drug use at year 4 or 5 for the two program interventions (P = 0.02). CONCLUSIONS: Project TND reduced hard drug use in the 46% who were successfully followed. It is the first program to demonstrate long-term self-reported behavioral effects on hard drug use among high-risk youth by using a school-based, limited-session model.

An evaluation of the fidelity of implementation of a school-based drug abuse prevention program: project toward no drug abuse (TND).

This article provides an implementation fidelity evaluation of the fourth experimental trial of Project Towards No Drug Abuse (TND). Two theoretical content components of the curriculum were examined to increase our understanding of the active ingredients of successful drug abuse prevention programs. A total of 18 senior high schools were randomly assigned by block to receive one of three conditions: cognitive perception information curriculum, cognitive perception information + behavioral skills curriculum, or standard care (control). These curricula were delivered to both regular and continuation high schools students (n=2331) by trained project health educators and regular classroom teachers. Across all program schools, the two different curricula were implemented as intended, were received favorably by students, and showed significant improvements in knowledge specific to the theoretical content being delivered. This pattern of results suggests that the experimental manipulations worked as intended, and thus, permit the attribution of future behavioral outcome differences between conditions to differences in content of Project TND material provided rather than to differences in the fidelity of delivery. Further, our findings indicate that Project TND can be implemented effectively with low and high risk youth in a general environment as well as with high risk youth in a more specialized environment.

Prediction of violence perpetration among high-risk youth.

OBJECTIVES: To prospectively examine demographic background, personality, perceived environment, and behavior as violence perpetration predictors in emerging adulthood among high-risk adolescents using problem-behavior theory as a conceptual perspective. METHODS: Self-report questionnaires were administered 5 years apart to 676 participants. RESULTS: Hard drug use, belief that hurting another's property while drunk was acceptable, and high-risk group self-identification predicted later violence perpetration independent of baseline violence perpetration. CONCLUSIONS: Consistent with problem-behavior theory, personality, perceived environment, and behavior variables, beyond baseline violent behavior, predict risk for future violence perpetration in emerging adulthood, whereas demographic background may exert indirect effects.

A review of 25 long-term adolescent tobacco and other drug use prevention program evaluations.

BACKGROUND: Although the initial effectiveness of psychosocial strategies programming in preventing smoking and other drug abuse among adolescents has been well established through literature reviews and meta-analyses, much less evidence exists for the long-term follow-up success of these interventions. The primary goal of this paper, therefore, is to summarize the effectiveness of published program evaluation studies that have followed adolescents across the transitional period between junior high and high school for a period of at least 2 years. METHODS: Studies for inclusion in this review were accessed primarily through a computerized search of Medline, Healthstar, and PsychINFO databases. Intervention studies that met five core criteria were retained for review. Two authors independently abstracted data on study characteristics, methodology, and program outcomes. RESULTS: Search results yielded 25 studies suitable for examination. The majority of these studies reported significant program effects for long-term smoking, alcohol, and marijuana outcomes, while indicating a fairly consistent magnitude of program effects. CONCLUSIONS: This review provides long-term empirical evidence of the effectiveness of social influences programs in preventing or reducing substance use for up to 15 years after completion of programming. However, this conclusion is still somewhat tenuous given the lack of significant program effects reported in several studies and the great variability that existed in the level of internal and external validity across all studies.

Alcoholic liver disease (ALD): a new domain for prevention efforts.

Alcoholic liver disease (ALD) is a leading cause of death; yet relatively little has been written about it in the health behavior research literature. This paper will describe ALD, what factors predict ALD including findings from analyses of the 1998 state of California and Los Angeles County hospital discharge data, and possible means of preventing this disease. It is hoped that new interest among health behavior researchers and practitioners will be stimulated.