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ABSTRACTReadability studies routinely report that resources with physical activity-related content exceed the eighth-grade reading level (RL), the maximum recommended for health education resources. The objectives of this meta-analysis were to determine the extent that findings in the literature represented true differences and whether production sources differed in their average RL. Fourteen studies met the study inclusion criteria. The main analysis involved 819 print and web article resources produced by government and nongovernment sources. The average RL was greater than eighth-grade (M = 10.25, 95% CI = [9.62, 10.91], p < .001), a nearly substantial magnitude of difference (g = .75), with a substantial percentage of the observed effects representing true differences (I2 = 79.79%). No differences were observed between productions sources, Q(5) = 2.56, p = .767. Publication bias and publication date did not meaningfully affect the main findings, nor did variations in study methodology or quality. The implications of these results for kinesiology are discussed and recommendations for future research are presented.

Major advances in population health will not occur unless we translate existing knowledge into effective multicomponent interventions, implement and maintain these in communities, and develop rigorous translational research and evaluation methods to ensure continual improvement and sustainability. We discuss challenges and offer approaches to evaluation that are key for translational research stages 3 to 5 to advance optimized adoption, implementation, and maintenance of effective and replicable multicomponent strategies. The major challenges we discuss concern (a) multiple contexts of evaluation/research, (b) complexity of packages of interventions, and (c) phases of evaluation/research questions. We suggest multiple alternative research designs that maintain rigor but accommodate these challenges and highlight the need for measurement systems. Longitudinal data collection and a standardized continuous measurement system are fundamental to the evaluation and refinement of complex multicomponent interventions. To be useful to T3-T5 translational research efforts in neighborhoods and communities, such a system would include assessments of the reach, implementation, effects on immediate outcomes, and effects of the comprehensive intervention package on more distal health outcomes.

Purpose. Examine the effects of a comprehensive, school-wide social-emotional and character development program using a positive youth development perspective. Specifically, we examined a mediation mechanism whereby positive academic-related behaviors mediated the intervention effects on substance use, violence, and sexual activity.Design. Matched-pair, cluster-randomized, controlled design.Setting. Twenty (10 intervention and 10 control) racially/ethnically diverse schools in Hawaii.Subjects. Elementary-aged students (N= 1784) from grade 5.Intervention. The Positive Action program.Measures. Students self-reported their academic behaviors, together with their substance use, violence, and voluntary sexual activity; teachers rated students' academic behaviors, substance use, and violence.Analysis. Structural equation modeling.Results. Students attending intervention schools reported significantly better academic behavior (B = .273, SE = .039, p < .001) and significantly less substance use (B = –.970, SE = .292, p < .01, incidence-rate ratio [IRR] = .379), violence (B = −1.410, SE = .296, p < .001, IRR = .244), and sexual activity (B = −2.415, SE = .608, p < .001, odds ratio = .089); boys reported more negative behaviors than girls. Intervention effects on student-reported substance use, violence, and sexual activity were mediated by positive academic behavior. Teacher reports corroborated these results, with rated academic behavior partially mediating the effects of the intervention on rated negative behaviors.Conclusion. This study (1) provides evidence that adds insight into one mechanism through which a social-emotional and character development program affects negative outcomes and (2) supports social-emotional and character development and positive youth development perspectives that posit that focusing on youths' assets may reduce negative behaviors.

Hundreds of studies have tested the efficacy or effectiveness of school curriculum-based (CB) substance use prevention programs. Over the years, various researchers have also tested programs that included school curricula, but with the addition of school environment, family, mass media, or community components. The purpose of this review is to determine the extent to which adding any of these components to CB programs improves overall program effectiveness in the prevention of substance use (SU).

Objectives.This paper estimates the prevalence of exposure to and participation in a televised smoking cessation intervention targeting women with high school or less education and describes characteristics related to exposure and participation.

It is not always possible, especially in large-scale evaluation research, to ensure that random assignment will produce groups that are comparable on any number of potentially important factors. Typically, gaining comparability has been achieved only at the expense of random assignment. A method is presented that allows multivariate comparability while making only minimal restrictions on randomization. The procedure is demonstrated in the context of assigning 63 aggregated units (schools) to 28 experimental and control conditions. Good comparability of groups for all primary main effects and interactions was venfied for 15 individual variables.

Videotapes were developed to try to impact on personal level judgments of concern and risk in the context of smokeless tobacco use, a growing substance use problem in adolescents. In a within-and-between-subjects design, convincingness (i.e., dramatic portrayal) of the videotaped message (high and low) and perceived probability of consequences portrayed in the message (high and low) were manipulated. Both manipulations were done by varying presentation style of the same, accurate information. The manipulation of convincingness did not alter the impact of the message on most judgments, whereas the manipulation of probability of consequences did. Two individual difference predictors, prior use of smokeless tobacco and male sex role orientation, were also found to enhance the amount of change in personal level judgments, but these variables did not interact with the message manipulations. These results suggest that a media manipulation of probability of consequences would be more effective than a manipulation of convincingness of message on impacting adolescent judgments of concern and risk regarding the use of smokeless tobacco.

Few studies have examined the relevance of social-influence-related moderator variables in the genesis of adolescent smoking. In the present study, the interactive effects of moderator variables with social influence (peer smoking and peer approval) on adolescent smoking were examined in a sample of high school students. Potential moderator variables of the effects of social influence were self-efficacy judgments, self-esteem, perceived stress, parental supervision after school, and gender. Results demonstrated that self-efficacy judgments signficantly moderated the predictive effects of social influence on smoking tendencies. These findings are consistent with theories suggesting that certain personality or situational variables act as buffers that either protect the adolescent against social influence or make the adolescent more susceptible to such influence.

The development of a questionnaire for use in a manufacturing plant with four major cultural groups-New Zealanders of European origin, Maoris, Samoans, and Cook Islanders-is described. The problems encountered lead to practical suggestions about the nature of the questions asked, their response format, translation-retranslation problems, and administration of the questionnaire. The experience described shows that great care is needed when doing questionnaire work in the applied multicultural environment.

This study examines the effects of alcohol use prevention curricula designed to have differential impact on hypothesized mediating variables. Three curricula, one which focused on teaching individuals social pressure resistance skills, one which focused on solidifying conservative group norms, and one which had a goal of increasing student understanding of the consequences of using alcohol, were tested. Results confirm that each program had a differential effect on hypothesized mediating variables.

The present article describes an evaluation of a self-report questionnaire administered to whole classrooms of 7th graders. Using the test-retest reliability matrix (based on concepts of Cronbach [1] and Campbell and Fiske [2]), eight of nine drug-use indices appeared to have acceptable to good reliability. The three measures included in the test-retest reliability matrix provide stronger evidence for good reliability than could any single measure.

Objectives.This paper reviews the literature regarding predictors of adolescent self-initiated smoking cessation and investigates self-initiated smoking cessation among a large sample of alternative high school youth in southern California. Youth transfer to alternative schools because of academic or behavioral problems, and they are at relatively high risk for cigarette smoking.

Background.Current research on the etiology of cigarette smoking has largely focused on the identification of psychosocial predictors of tobacco onset. Few data are available on the predictors of different stages of smoking among adolescents. The present study examines the psychosocial predictors of different stages of smoking, including trial, experimental, and regular use, among high school students.

The increasing importance of high-quality evaluative research on health lifestyle change programs is established. Failure to ask the right evaluative research questions and problems of research design are identified as two major reasons for the dearth of well-controlled, interpretable evaluations in this area. Thirteen issues of research design that need to be considered if interpretable answers to evaluative research questions are to be obtained are identified and discussed. Solutions to these problems and design recommendations are offered.

This study describes the patterns and predictors of smokeless tobacco (ST) use in a large sample of urban public school students in Los Angeles and San Diego. The use of ST is more common among men than women and among Caucasians than African Americans, Hispanics, and others. Approximately 20% of the male respondents and 5% of the female respondents reported use of ST at least once, and 10.1% of male students and 3.1% of female students who had never tried ST by seventh grade started to use it by eighth grade. Among Caucasians, about 30% of boys reported trying ST at least once and 13.7% of those who had never used ST by seventh grade initiated experimentation by eighth grade. These data are used to examine the family, peer, and intrapersonal predictors of ST onset. The family risk factors for ST onset include living with a single parent, parent-child conflicts, and parental alcohol use. The peer risk factors for ST use include peer drug use and activities with friends, such as parties and participation in sports. The intrapersonal risk factors include poor grades in school, risk taking, and stress. The study also shows that those who use cigarettes, alcohol, or marijuana are at higher risk of using ST and vice versa. This study supports a problem-prone behavior perspective of ST use and cigarette smoking. We suggest that both products be targeted because the same programs are likely to apply to both products to counteract problem-prone type variables.

Asthma is the most common chronic disease in childhood. The prevalence of asthma is especially high in inner city children. The occurrence of asthma may be associated with many environmental factors, including involuntary exposure to maternal smoking.

The information-processing model of the attitude and behavior change process was critically examined and extended from six to 12 levels for a better analysis of change due to mass media campaigns. Findings from social psychology and communications research, and from evaluations of mass media health promotion programs, were reviewed to determine how source, message, channel, receiver, and destination variables affect each of the levels of change of major interest (knowledge, beliefs, attitudes, intentions and behavior). Factors found to most likely induce permanent attitude and behavior change (most important in health promotion) were: presentation and repetition over long time periods, via multiple sources, at different times (including "prime" or high-exposure times), by multiple sources, in novel and involving ways, with appeals to multiple motives, development of social support, and provisions of appropriate behavioral skills, alternatives, and reinforcement (preferably in ways that get the active participation of the audience). Suggestions for evaluation of mass media programs that take account of this complexity were advanced.

School-based prevention trials typically face large variations in school composition and levels ofpreintervention behavior. Such variations may inhibit efforts to maximize internal and external validity. This article presents a method for using school-level attributes in sample description and random assignment of schools to conditions. The utility of the archival data was examined using multivanate canonical techniques. The authors found that a small set of attributes could efficiently predict the observed school-level variations in smoking and other drug use. It is recommended that these attributes be used by other school-based studies to enhance experimen talfield studies.

Three methods of use of estimate tobacco products experimentation were examined in nineteen schools (thirteen junior high schools and six high schools). Convergent and discriminant validity of measures of student experimentation of cigarettes and smokeless tobacco were assessed using Campbell and Fiske's (1959) criteria to analyze a multitrait-multimethod correlation matrix produced by two traits (cigarettes and smokeless tobacco) and three methods (aggregated students' self-report of tobacco experimentation, school personnel prevalence estimates of student tobacco experimentation, and school outdoor refuse evidence of tobacco products). The student self-report and the school staff estimate methods demonstrated good convergent validity. The refuse method showed convergent validity with the student self-reports of smokeless tobacco only. Evidence for discriminant validity was only suggestive. It appears that the school personnel method is the most useful and economic alternative for estimating school-level tobacco experimentation.

This study evaluated the relationship between level of program implementation and change in adolescent drug use behavior in the Midwestern Prevention Project (MPP), a school- and community-based program for drug abuse prevention. Trained teachers implemented the pro gram with transition year students. Implementation was measured by teacher self-report and validated by research staff reports. Adolescent drug use was measured by student self-report; an expired air measure of smoking was used to increase the accuracy of self-reported drug use. Regression analyses were used to evaluate adherence; exposure, or amount of implementation; and reinvention. Results showed that all schools assigned to the program condition adhered to the research by implementing the program. Exposure had a significant effect on minimizing the increase in drug use from baseline to one year. Exposure also had a larger magnitude of intervention effect than experimental group assignment. Reinvention did not affect drug use. Results are discussed in terms of research assumptions about quality of program implementation, and possible school-level predictors of implementation.

The purpose of this study was to determine the degree to which the use of tobacco, alcohol, and marijuana by young adolescents can be described using a common theoretical model. Structural models were created in which psychosocial variables hierarchically predicted the use of each substance. The fit of a model in which paths from predictor variables were constrained to be equal was not inferior in any meaningful way to that of a model in which all path coefficients were freely estimated, thus suggesting that use of tobacco, alcohol, and marijuana by young adolescents may be considered to be a unitary phenomenon. A simplified model, in which these substances were combined into a single latent variable, showed a good fit. The results of these analyses suggest that it may be beneficial to consider adolescent substance use to be a unitary phenomenon.

Recent evaluations of smoking prevention programs have suggested considerable promise for curricula emphasizing resistance of social influences. The present study extends these evaluations by addressing key methodological limitations in previous work. Twenty-two matched schools were randomized to experimental and control conditions. Grade 6 students received a 6-week core curriculum, plus additional sessions through Grades 7 and 8. Questionnaires, and saliva samples to validate self-reported smoking behavior, were collected at five times over the 2-year study period. Cross-sectional and longitudinal analyses examined program impact for five levels of initial smoking experience, ranging from “never smoker” through regular, weekly smoker. Significant program effects were documented, most clearly for those having some experience with smoking before the program began and for those with smoking peer and family models. This study provides the methodologically most rigorous test to date of social influence programs for smoking prevention and documents for the first time significant effects for those at high risk for smoking.

Background.In longitudinal smoking prevention studies, a difficulty in evaluating treatment effects is understanding whether bias is associated with those who do not complete the study. This study presents the significant predictors of attrition and suggests how to reduce attrition bias in evaluating program effects.Methods.Survival analysis methods were used to assess factors associated with attrition at different time points of the study.Results.Results of the analysis indicate that those who drop out tend to be of lower academic achievement, have lower tobacco and health knowledge, and have lower social influence/resistance skills knowledge, and are more likely to be smokers and to be marijuana users. Blacks are more likely to drop out than the other ethnic groups. Gender is not a significant predictor for dropout. The dropout rates among the treatment conditions are significantly different.Conclusions.The findings of this study demonstrate that attritions in longitudinal smoking prevention studies are not at random. By considering the characteristics of dropouts, one can reduce attrition bias using available procedures and can take appropriate strategies for reducing dropout rates in future smoking prevention studies.