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This article presents the findings of a 2-year-long quasi-experimental study of post-release engagement and recidivism for youth with disabilities. The effects of specialized Reentry Intervention and Support for Engagement (RISE) for youth with disabilities were compared with two other groups: (a) youth with disabilities who received traditional special education services, and (b) youth without disabilities who received traditional general education services in a juvenile correctional facility. Regardless of group, participants who were engaged in the community 30 days post-release were more likely to be engaged at 120 days and less likely to recidivate than nonengaged participants. However, compared with the two other groups, participants who received RISE services were more likely to be engaged in the community at 120 days post-release and have significantly lower rates of recidivism. We conclude our study by examining limitations, suggestions, implications for practice and policy, and future research.

Interest in the pathways young people take from high school to early adulthood indicates that participation in early employment and postsecondary education facilitates long-term independence, agency, and career stability (Eliason et al., 2015; Shanahan et al., 2002). Although many adolescents with disabilities do not participate in these early adult experiences at rates commensurate with their normative peers, the overall structure, timing, and persistence of these patterns is not well understood. The current study analyzes data from the National Longitudinal Transition Study 2 (NLTS2) to explore patterns of emerging adult engagement in employment and/or postsecondary school among young adults with high-incidence disabilities across three early adult time points (20 to 25 years old) as well as adolescent precursors to these patterns. The sample was comprised exclusively of youth with disabilities (i.e., learning disabilities, emotional disturbance, and intellectual disability), 32% of participants were students of color, and 23% were from families living below the federal poverty line. Results suggested 3 patterns of adult engagement: dynamically engaged (15%), primarily employed (51%), and primarily unengaged (34%). Student race and disability type were associated with these patterns as were individual skills (e.g., reading, mathematics & social skills), family characteristics (i.e., parent expectations), and school experiences (i.e., peer relationships, extracurricular activities) gathered during high school. These findings shed new light on the patterns of early employment and postsecondary participation among emerging adults with disabilities as well as adolescent predictors of these patterns.

The purpose of the current study was to develop a multi-indicator construct of economic hardship among adolescents with disabilities (N = 9,230) participating in the National Longitudinal Transition Study-2, the largest, most comprehensive investigation of adolescents with disabilities ever conducted. Five theoretically relevant indicators (i.e., family income, head-of-household education, head-of-household employment, participation in social programs, and lack of resources) contributed to the formation of an economic hardship latent construct. Scores on this factor were validated through associations with demographic, tangible-resource, school, and family factors. The implications of these findings for continued efforts to understand and respond to economic hardship among adolescents with disabilities are discussed.

Justice-involved youth have a high risk of reoffending after release, indicating the need for evidence-based reentry programming. This paper presents the results of a two-year post-release non-randomized comparison study. The study examined the impact of enhanced transition programming, delivered through Reentry Intervention and Support for Engagement by Integrating Technology (RISE-IT), on recidivism by comparing two groups, youth who received enhanced vs. traditional transition services in a secure care facility. Enhanced services included: enhanced reception, assessment & classification, transition planning, vocational preparation, merging two worlds curriculum, and 30-day aftercare support. Results indicate that youth who received enhanced services through RISE-IT had significantly lower rates of recidivism. Limitations and implications for practice, as well as future research, are discussed. [ABSTRACT FROM AUTHOR]

Objective: Test whether a group-delivered dissonance-based transdiagnostic eating disorder treatment, Body Project Treatment (BPT), produces greater reductions in eating disorder symptoms and higher abstinence from eating disorder behaviors and remittance from eating disorder diagnoses than group-delivered transdiagnostic interpersonal psychotherapy (IPT). Method: Women with a range of eating disorders (N = 73) were randomized to 8-week group-implemented BPT or IPT and completed surveys and masked diagnostic interviews at pretest, posttest, and 6-month follow-up. Results: Participants randomized to BPT versus IPT showed significantly greater reductions in eating disorder symptoms (d = −.75), pursuit of the thin ideal (d = −.87), anxiety symptoms (d = −.76), and social impairment (d = −.59) through 6-month follow-up. By end of treatment, participants randomized to the BPT versus IPT did not significantly differ on abstinence from binge eating and purging (49% vs. 40%, respectively) or remittance from eating disorder diagnoses (54% vs. 40%, respectively). Participants randomized to BPT versus IPT did not differ significantly in average session attendance (5.8 vs. 6.9, respectively) or average homework assignments completed (4.6 vs. 5.6, respectively). The within-condition reductions in eating disorder symptoms for BPT did not significantly differ when implemented in person versus via synchronous video telepsychiatry (d = −1.39 vs. −1.09, respectively), though these effects should be considered preliminary because of the small cell sizes. Conclusions: The evidence that BPT produces greater reductions in eating disorder symptoms, pursuit of the thin ideal, anxiety symptoms, and social impairment than IPT is encouraging because it provides some assurance that the effects are present equating for the effects of expectancies, demand characteristics, and nonspecific factors. What is the public health significance of this article?: This study provides evidence that a novel dissonance-based transdiagnostic eating disorder treatment produced greater reductions in eating disorder symptoms, pursuit of the thin ideal, anxiety symptoms, and social impairment relative to group-delivered transdiagnostic interpersonal psychotherapy. To our knowledge, this is the first transdiagnostic eating disorder treatment to significantly outperform an alternative active treatment through 6-month follow-up. [ABSTRACT FROM AUTHOR]

This study examined the viability of a brief, parent-reported strengths and needs assessment as the first step in a multiple-gating approach to proactive positive behavior support for families. The "Positive Family Support--Strengths and Needs Assessment" (PFS-SaNA) was designed to collaboratively engage parents early in the school year in a home-school coordinated Positive Family Support (PFS) system. In this study, we evaluated the reliability and validity of the PFS-SaNA in the context of public middle schools. Findings suggest that the 14-item, unidimensional PFS-SaNA shows convergent validity with teacher ratings of risk. It can be easily and cost-effectively used by school personnel when parents register their children for school at the beginning of each school year.

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming. [ABSTRACT FROM AUTHOR]

Background: This study tested whether the dissonance-based Body Project eating disorder prevention program reduced onset of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) over long-term follow-up. Methods: Data were combined from three prevention trials that targeted young women at high-risk for eating disorders (N = 1092; M age = 19.3). Participants were randomized to Body Project groups led by peer educators or expressive writing/educational controls and completed masked diagnostic interviews over 2- to 4-year follow-ups. Logistic regressions tested whether onset of each eating disorder over follow-up differed between Body Project and control participants. Results: Peer-led Body Project groups produced a 46% reduction in onset of subthreshold/threshold BN and a 62% reduction in onset of PD relative to controls over follow-up. Rates of onset of subthreshold/threshold AN and BED did not significantly differ between peer-led Body Project participants and control participants. Conclusions: Results support the dissemination of the peer-led Body Project for reducing future onset of BN and PD. This study and recent research suggest that thin-ideal internalization, the risk factor for eating disorders targeted in the Body Project , may be more relevant for predicting onset of BN and PD compared to AN and BED. Findings support the development of a version of the Body Project aimed to reduce risk factors that have predicted future onset of all four types of eating disorders (e.g. overvaluation of weight/shape, fear of weight gain), which may more effectively prevent all eating disorder types. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the unique contributions of a comprehensive set of predictors and the most salient predictors of school dropout among a nationally representative sample of students with learning disabilities (LD). A comprehensive set of theoretically and empirically relevant factors was selected for examination. Analyses were conducted to explore the unique contribution and relative importance of these factors in predicting dropout. Results indicated that the most salient predictors of school dropout included a set of malleable individual (grades, and engagement in high-risk behaviors), family (parent expectations), and school (quality of students' relationship with teachers and peers) factors. The findings validate multicomponent dropout prevention and intervention models for this population while at the same time illuminating specific key components that appear to be of particular importance in school dropout among students with LD.

Background: Alcohol use disorder (AUD) is an etiologically and clinically heterogeneous condition. Accumulating evidence suggests that persons with lifetime histories of comorbid AUD and non-alcohol substance use disorder (DRUG) constitute an important subgroup of AUD. This study evaluated the distinctiveness of the comorbid AUD/DRUG behavioral phenotype in a community sample with respect to risk factors, AUD course features, and outcome variables assessed at age 30. Contrast groups included persons with histories of AUD only, DRUG only, and neither AUD nor DRUG. Methods: This research utilized a prospective study design with an age-based cohort (n = 732). Participants completed four comprehensive diagnostic evaluations during the high-risk periods of adolescence, emerging adulthood, and young adulthood. Results: The comorbid AUD/DRUG group was distinguished from the AUD only group by risk factors, AUD course features, and outcomes. Group differences in outcomes were also explained by overall substance use disorder (SUD) severity. Persons with AUD/DRUG comorbidity were indistinguishable from those with DRUG only histories with respect to risk factors and outcomes but demonstrated greater overall SUD severity. Persons with AUD only were indistinguishable from those with neither AUD nor DRUG histories in risk factor endorsements and were mostly similar in outcomes. Conclusions: Findings collectively suggest that young adults with histories of AUD only and those with comorbid AUD/DRUG are drawn from dissimilar populations. Similarities between the AUD only group with those absent AUD or DRUG histories are likely related to the former group's developmentally limited AUD course accompanied by relatively few or short-lived alcohol-related problems. [ABSTRACT FROM AUTHOR]

A secondary analysis was conducted of the National Longitudinal Transition Study-2 to examine (a) main effects of parents' school and postschool outcome expectations on the actual outcomes achieved, (b) demographic moderators, and (c) adolescent autonomy as a mediator of parent expectations and outcomes. Parent expectations were found to significantly predict study outcomes. Moderator analysis indicated that disability type moderated the relationship between parent expectations and outcomes. Meditational analyses indicated that autonomy did not mediate the relationship between parent expectations and study outcomes. However, parent expectations significantly predicted levels of autonomy, and autonomy predicted a number of postschool outcomes. Together, these findings suggest a need for interventions that support and foster positive parent expectations and parental supports to promote autonomy development. Additional research is needed on the mechanisms by which parent expectations and autonomy affect the outcomes of adolescents with disabilities. (Contains 6 tables.)

This study examined alcohol use development from ages 13-20 years. The sample comprised 256 youth (50.4% female; 51.2% White, 48.8% African American) assessed annually for 6 years. A cohort-sequential latent growth model was used to model categorical alcohol use (non-use vs. use). Covariates included gender, race, income, parent marital status, risk taking, spiritual beliefs, parent alcohol use, family alcohol problems, family cohesion, friends' alcohol use, and normative peer use. The alcohol use trajectory increased steadily with age. Risk taking, friends' alcohol use, and normative peer use were positively associated with higher initial rates of alcohol use. Initial parent alcohol use and positive change in parents' and friends' alcohol use over time were related to an increase in alcohol use from ages 13-20 years. (Contains 2 tables and 2 figures.)

Objective: To evaluate the effects of a brief group cognitive-behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up. Method: In this indicated prevention trial, 341 at-risk youths were randomized to a group CB intervention, group supportive expressive intervention, CB bibliotherapy, or educational brochure control condition. Results: Significantly greater reductions in depressive symptoms were shown by group CB participants relative to brochure control participants by 1-year follow-up and bibliotherapy participants by 1- and 2-year follow-up but not relative to supportive expressive participants. Supportive expressive participants showed greater symptom reduction than CB bibliotherapy participants did at 2-year follow-up. Risk for onset of major or minor depression over the 2-year follow-up was significantly lower for group CB participants (14%; odds ratio = 2.2) and CB bibliotherapy participants (3%; odds ratio = 8.1) than for brochure controls (23%). Conclusions: Results indicate that this group CB intervention reduces initial symptoms and risk for future depressive episodes, although both supportive expressive therapy and CB bibliotherapy also produce intervention effects that persist long term. Indeed, CB bibliotherapy emerged as the least expensive method of reducing risk for future episodes of depression. (Contains 3 tables, 1 footnote and 2 figures.)

Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB bibliotherapy, or assessment-only control condition. Results: The group CB intervention reduced depressive symptoms and negative cognitions and increased pleasant activities. Change in these mediators predicted change in depression, and intervention effects became weaker controlling for change in the mediators; yet, change in depression appeared typically to occur before change in the mediators. The supportive expressive intervention reduced depressive symptoms but affected only 1 of 2 mediators (emotional expression but not loneliness). Change in emotional expression did not correlate with change in depression, and change in depression usually occurred before change in the mediators. Bibliotherapy did not significantly affect depressive symptoms or the ostensive mediators (negative cognitions and pleasant activities), and change in depression usually occurred before change in the mediators. Conclusion: Results imply that this procedure provides a sensitive test of mediation but yielded limited support for the hypothesized mediators, suggesting that nonspecific factors may play an important mediational role. (Contains 4 tables and 3 footnotes.)

Juvenile offenders are costly to our society in terms of the monetary and social expenditures from the legal system, victims' person costs, and incarceration. The re-entry and community reintegration outcomes for formerly incarcerated youth with a disabling condition are bleak compared to peers without disabilities. In this study, we examined the factors--both static and intervention-related--that reduce recidivism rates for project participants possessing a mental health and/or special education diagnosis and were served by a facility-to-community re-entry intervention. Our sample was comprised of a total of 320 youth formerly incarcerated who received project services between August of 1999 through June of 2004. Project services include a transition specialist whose role is service coordination to youth from the facility to the community. Kaplan-Meier survival functions were calculated for participants on the outcome measure of the rates of recidivism. Additionally, Cox regression modeling was used to identify factors for the prediction of time to recidivate. Our findings indicate that the intervention may contribute to reduced recidivism rates but that a set of static demographic and pre-incarceration risks contribute more to the prediction of recidivism than community adjustment factors (e.g., employment or enrollment). With these findings, the intervention seems promising yet it remains unclear about which programmatic features contribute to reduced recidivism rates. Implications for research and practice are shared.

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater reductions in depressive symptoms than did supportive-expressive, bibliotherapy, and assessment-only participants at posttest, though only the difference compared with assessment controls was significant at 6-month follow-up. CB participants showed significantly greater improvements in social adjustment and reductions in substance use at posttest and 6-month follow-up than did participants in all 3 other conditions. Supportive-expressive and bibliotherapy participants showed greater reductions in depressive symptoms than did assessment-only controls at certain follow-up assessments but produced no effects for social adjustment and substance use. CB, supportive-expressive, and bibliotherapy participants showed a significantly lower risk for major depression onset over the 6-month follow-up than did assessment-only controls. The evidence that this brief CB intervention reduced risk for future depression onset and outperformed alternative interventions for certain ecologically important outcomes suggests that this intervention may have clinical utility. (Contains 2 figures and 2 tables.)

Objective: College students are at particularly high risk for mental health problems, such as eating disorders, which are associated with functional impairment, distress, and morbidity, but barriers limit implementation of evidence-based interventions at colleges. We evaluated the effectiveness and implementation quality of a peer educator (PE) delivered eating disorder prevention program (the Body Project [BP]), which has a broad evidence-based using a train-the-trainer (TTT) approach and experimentally evaluated three levels of implementation support. Method: We recruited 63 colleges with peer educator programs and randomly assigned them to (a) receive a 2-day TTT training in which peer educators were trained to implement the Body Project and supervisors were taught how to train future peer educators (TTT), (b) TTT training plus a technical assistance (TA) workshop (TTT + TA), or (c) TTT plus the TA workshop and quality assurance (QA) consultations over 1-year (TTT + TA + QA). Colleges recruited undergraduates (N = 1,387, 98% female, 55% White) to complete Body Project groups. Results: There were no significant differences across condition for attendance, adherence, competence, and reach, though nonsignificant trends suggested some benefit of TTT + TA + QA relative to TTT for adherence and competence (ds =.40 and.30). Adding TA and QA to TTT was associated with significantly larger reductions in risk factors and eating disorder symptoms. Conclusions: Results suggest that the Body Project can be effectively implemented at colleges using peer educators and a TTT approach and that adding TA and QA resulted in significantly larger improvements in outcomes for group participants, and marginally higher adherence and competence. What is the public health significance of this article?: This study evaluated the effectiveness and implementation quality of an evidence-based peer educator delivered eating disorder prevention program using a train-the-trainer approach and experimentally evaluated three levels of implementation support. Results suggest that this prevention program can be effectively implemented on college campuses using peer educators and a train-the-trainer approach and that the addition of technical assistance and quality assurance resulted in significantly larger improvements in outcomes for group participants and marginally higher intervention adherence and competence by peer educators. [ABSTRACT FROM AUTHOR]

BackgroundNonspecific low back pain (NLBP) is the diagnosis for individuals with back pain that has no underlying medical cause (eg, tumor, infection, fracture, herniated disc, spinal stenosis). The American College of Physicians (ACP) and American Pain Society (APS) recommend multidisciplinary treatments for NLBP that lasts more than 4 weeks. This approach, however, is impractical for many physicians to implement, and relatively few providers offer NLBP treatment that meets the joint ACP-APS guidelines. ObjectiveThis study evaluated the efficacy of a mobile-Web intervention called “FitBack” to help users implement self-tailored strategies to manage and prevent NLBP occurrences. MethodsA total of 597 adults were recruited, screened, consented, and assessed online at baseline, at 2 months (T2), and at 4 months (T3). After baseline assessments, participants were randomized into three groups: FitBack intervention, alternative care group that received 8 emails urging participants to link to six Internet resources for NLBP, and control group. The FitBack group also received weekly email reminder prompts for 8 weeks plus emails to do assessments. The control group was only contacted to do assessments. ResultsUsers of the FitBack program showed greater improvement compared to the control group in every comparison of the critical physical, behavioral, and worksite outcome measures at 4-month follow-up. In addition, users of the FitBack program performed better than the alternative care group on current back pain, behavioral, and worksite outcomes at 4-month follow-up. For example, subjects in the control group were 1.7 times more likely to report current back pain than subjects in the FitBack group; subjects in the alternative care group were 1.6 times more likely to report current back pain at 4-month follow-up. Further, the users of the FitBack program showed greater improvement compared to both the control and alternative care groups at 4-month follow-up on patient activation, constructs of the Theory of Planned Behavior, and attitudes toward pain. ConclusionsThis research demonstrated that a theoretically based stand-alone mobile-Web intervention that tailors content to users’ preferences and interests can be an effective tool in self-management of low back pain. When viewed from the RE-AIM perspective (ie, reach, efficacy/effectiveness, adoption, implementation fidelity, and maintenance), this study supports the notion that there is considerable value in this type of intervention as a potentially cost-effective tool that can reach large numbers of people. The results are promising considering that the FitBack intervention was neither supported by professional caregivers nor integrated within a health promotion campaign, which might have provided additional support for participants. Still, more research is needed on how self-guided mobile-Web interventions will be used over time and to understand factors associated with continuing user engagement. Trial RegistrationClinicaltrials.gov NCT01950091; http://clinicaltrials.gov/ct2/show/NCT01950091 (Archived by WebCite at http://www.webcitation.org/6TwZucX77).

Objective: Identify implementation factors, including intervention, facilitator, participant, and college factors, that were associated with larger reductions in eating disorder symptoms for undergraduates who completed a dissonance-based eating disorder prevention program delivered by peer educators in an implementation support trial. The goal was to determine how to maximize the effects of this prevention program in future implementation efforts. Method: We recruited 63 universities with peer educator programs and randomly assigned them to three levels of implementation support for delivery of an evidence-based eating disorder prevention program (the Body Project). The present report investigated whether several intervention, facilitator, participant, and college characteristics were associated with the magnitude of reductions in eating disorder symptoms among 1,387 undergraduates who completed the Body Project. Results: Significantly greater reductions in eating disorder symptoms were found for the four-session versus two-session version of the Body Project (d = −.36), when Body Project groups were delivered virtually versus in-person (d = −.22), when observation-based supervision was provided to peer educators during intervention implementation versus when it was not (d = −.15), and for larger versus smaller universities (d = −.24). Although effects were small, the additive effect was medium (d = −.50). Conclusions: Results suggest that if the goal is to optimize the effects of the Body Project, peer educator programs at universities should implement the full four-session version of the prevention program that contains all of the dissonance-inducing activities and home exercises, implement this prevention program virtually, and provide supervision to facilitators implementing this prevention program. What is the public health significance of this article?: Using data from an implementation support study in which peer educators at 63 universities delivered a dissonance-based eating disorder prevention program to 1,387 undergraduates, we sought to identify intervention, facilitator, participant, and university factors that correlated with larger intervention effects. Greater reductions in eating disorder symptoms were observed for undergraduates who completed the full four-session version of this prevention program versus the abbreviated two-session version, when this prevention program was delivered virtually versus in-person, when supervision was provided to peer educators during implementation, and for larger versus smaller universities. Although each effect was small, the additive effects were medium and results provide guidance regarding how to optimize the effectiveness of this eating disorder prevention program when implemented by peer educators at universities. [ABSTRACT FROM AUTHOR]

In recent years, the value of science, technology, engineering, and math (STEM) education has grown exponentially. The need for activities that facilitate motivation to learn STEM for middle and high school students is well-documented. Although there is a paucity of research on the intersection of STEM and service-learning, identification of activities that have the potential to increase motivation in STEM and civic awareness is important. The purpose of this descriptive study is to discuss the novel GoSTEM! model, an extension of a community-based program, GoBabyGo!, which modifies ride-on cars (ROCs) for young children with mobility and developmental disabilities. Twenty-one middle and high school students participated in the camp culminating in a product of service, five GoBabyGo! modified ROCs, for distribution into the community. Participants reported their experience and responses were coded for themes. Results indicated that engaging in the modification process facilitated engagement in STEM learning paired with enthusiasm for providing a service to the community. Families who received a modified ROC were also interviewed and identified a variety of benefits for their child. Utilizing real-world implementation of building modified ROCs for children with disabilities provides a novel way to promote STEM learning. [ABSTRACT FROM AUTHOR]

BackgroundPhysical activity (PA) for older adults has well-documented physical and cognitive benefits, but most seniors do not meet recommended guidelines for PA, and interventions are lacking. ObjectivesThis study evaluated the efficacy of a 12-week Internet intervention to help sedentary older adults over 55 years of age adopt and maintain an exercise regimen. MethodsA total of 368 sedentary men and women (M=60.3; SD 4.9) were recruited, screened, and assessed online. They were randomized into treatment and control groups and assessed at pretest, at 12 weeks, and at 6 months. After treatment group participants rated their fitness level, activity goals, and barriers to exercise, the Internet intervention program helped them select exercise activities in the areas of endurance, flexibility, strengthening, and balance enhancement. They returned to the program weekly for automated video and text support and education, with the option to change or increase their exercise plan. The program also included ongoing problem solving to overcome user-identified barriers to exercise. ResultsThe multivariate model indicated significant treatment effects at posttest (P=.001; large effect size) and at 6 months (P=.001; medium effect size). At posttest, intervention participation showed significant improvement on 13 of 14 outcome measures compared to the control participants. At 6 months, treatment participants maintained large gains compared to the control participants on all 14 outcome measures. ConclusionsThese results suggest that an online PA program has the potential to positively impact the physical activity of sedentary older adult participants. More research is needed to replicate the study results, which were based on self-report measures. Research is also needed on intervention effects with older populations.

Background Smoking cessation remains a significant public health problem. Innovative interventions that use the Internet have begun to emerge that offer great promise in reaching large numbers of participants and encouraging widespread behavior change. To date, the relatively few controlled trials of Web-based smoking cessation programs have been limited by short follow-up intervals. Objective We describe the 6-month follow-up results of a randomized controlled trial in which participants recruited online were randomly assigned to either a Web-based smoking cessation program (Quit Smoking Network; QSN) or a Web-based exercise enhancement program (Active Lives) adapted somewhat to encourage smoking cessation. Methods The study was a two-arm randomized controlled trial that compared two Web-based smoking cessation programs: (1) the QSN intervention condition presented cognitive-behavioral strategies, and (2) the Active Lives control condition provided participants with guidance in developing a physical activity program to assist them with quitting. The QSN condition provided smoking cessation information and behavior change strategies while the Active Lives condition provided participants with physical activity recommendations and goal setting. The QSN condition was designed to be more engaging (eg, it included multimedia components) and to present much greater content than is typically found in smoking cessation programs. Results Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments. While participants in the QSN intervention condition spent more time than controls visiting the online program, the median number of 1.0 visit in each condition and the substantial attrition (60.8% at the 6-month follow-up) indicate that participants were not as engaged as we had expected. Conclusions Contrary to our hypothesis, our test of two Web-based smoking cessation conditions, an intervention and an attention placebo control, failed to show differences at 3- and 6-month assessments. We explored possible reasons for this finding, including limited engagement of participants and simplifying program content and architecture. Future research needs to address methods to improve participant engagement in online smoking cessation programs. Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits. Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention.

Objective: Knowledge of factors that predict alcohol use disorder (AUD) recurrence or the subsequent switching to a different substance use disorder (SUD) after initial AUD recovery is especially crucial for preventive efforts that seek to alter life courses dominated by problematic substance use. This study evaluated whether the proportions (or densities) of first-degree relatives with AUD and non-alcohol substance use disorder (NASUD) histories predicted AUD recurrence or a new NASUD onset in a family member (i.e., proband) following initial AUD episode recovery.Method: This research is based on a prospective and multigenerational data set collected as part of the Oregon Adolescent Depression Project (OADP). The initial proband cohort was selected randomly from nine high schools in western Oregon. The sample for this research consisted of OADP probands with histories of AUD who recovered from their first AUD episode by age 30 (n = 244). Lifetime SUD histories were also assessed for first-degree adult relatives of probands (n = 790).Results: In unadjusted and partially adjusted analyses, family densities of AUD predicted AUD recurrence among probands, and family densities of NASUDs predicted the onset of a new NASUD following first-episode AUD recovery. In fully adjusted analyses, the effect for AUD family histories on proband AUD recurrence remained, whereas the effect for family NASUD histories on new NASUD emergence was not maintained.Conclusions: Family SUD histories have predictive relevance for the course of AUD following initial recovery as well as some specificity for the type of SUD recurrence subsequently experienced. [ABSTRACT FROM AUTHOR]