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The aim of this study was to assess university students' knowledge and understanding about HPV and its association with their vaccination status and health literacy. A sample of 383 undergraduate university students between the ages of 18 and 26 were recruited between February 14 and March 22, 2018. An electronic survey was administered to assess knowledge and HPV awareness, vaccination status, and health literacy. Participants had moderate mean knowledge scores of 6.02 of a possible 11 (SD = 3.06). There was a positive association between health literacy and HPV knowledge and a statistically significant difference in knowledge scores between those who are vaccinated and unvaccinated p < 0.001. This study expanded available research on HPV vaccine and its uptake among university students and can be used to develop educational interventions. Continuous examination of HPV knowledge gaps and identifying factors that affect vaccine uptake is pivotal to increasing vaccination rates.

OBJECTIVES: Adherence to most evidence-based cancer screenings is lower among African Americans due to system- and individual-level factors that contribute to persistent disparities. Given the recommendation for low-dose computed tomography (LDCT) screening among individuals at high risk for lung cancer, we sought to describe aspects of decision-making for LDCT among African Americans and to examine associations between select components of decision-making and screening-related intentions. DESIGN: African Americans (N=119) with a long-term smoking history, aged 55 to 80 years, and without lung cancer were recruited to participate in a cross-sectional survey. We measured knowledge, awareness, decisional conflict, preferences, and values related to lung cancer screening. RESULTS: The majority of the study population was of lower socioeconomic status (67.2% had an annual income of ≤$20,000) and long-term current (79%) smokers. Participants had a median 20 pack-years smoking history. Most participants (65.8%) had not heard of LDCT and the total lung cancer screening knowledge score was M=7.1/15.0 (SD=1.8). Participants with higher scores on the importance of the pros and cons of screening expressed greater likelihood of talking with a doctor, family, and friends about screening (p’s

OBJECTIVE: The purpose of this investigation was to examine the relationships among alcohol use, driving behavior, and indicators of health among older adults. METHODS: A sample of 818 adults ages 65 and older were recruited through the state motor vehicle administration and completed an online survey. Regression models were used to assess the associations between alcohol use, driving behaviors, and 6 health indicators. RESULTS: Whereas more frequent alcohol use was associated with fewer health conditions, higher quantity alcohol use was associated with increased likelihood of having at least one health condition. Participants who drove several days a week and those who drove every day had higher perceived health status, a lower number of past-year health conditions, and a lower number of past-year health events when compared to less frequent drivers. Persons who had at least one past-year negative driving behavior or event were significantly less likely to have positive health status, had lower perceived health status, and had a higher number of past-year health conditions and events. CONCLUSIONS: High quantity alcohol use and risky driving behavior among older adults are indicative of poorer health. Continued efforts are needed to educate older adults on the relationships among alcohol use, driving behavior, and health.

OBJECTIVES. The purpose of this investigation was to determine what older adults find most concerning about driving as they age and how these concerns are related to driving skill, behaviors, and experiences. METHODS. In partnership with the Maryland Motor Vehicle Administration, a sample of 751 older adults ages 65 and older completed an online survey between October 2017 and May 2018. A content analysis was used to code open-ended responses about driver concerns, and multivariate logistic regression models were used to analyze the associations between driving concerns and driving skill, behavior, and experiences. RESULTS. Eighty-four percent of participants reported at least one driving concern, with 44% concerned about others’ driving, 34% concerned about their own driving, and 24% concerned about driving conditions. The most frequently mentioned driving concerns were other drivers in general, driving at night, visual ability and awareness, and other drivers being aggressive or reckless. Being concerned with their own driving was significantly associated with decreased perceived driving skill and increased odds of experiencing negative driving experiences in the past year. Being concerned about others’ driving was associated with increased odds of wearing a seatbelt (AOR = 2.67; 95% CI = 1.02, 7.00), having high perceived driving skills in emergency situations (AOR = 1.56; 95% CI = 1.14, 2.12), and getting in a near crash or collision in the past year (AOR = 1.50; 95% CI = 1.04, 2.18). CONCLUSIONS. Older adult drivers are frequently concerned about their own driving as well as the driving of others. Implications for future research and health practice are discussed.

OBJECTIVES: The purpose of this investigation was to compare the drinking patterns and experiences (both positive and negative) among DUI offenders who had installed an ignition interlock. The association between those experiences and interlock performance as measured by the number of times they had a lockout, was also assessed. METHODS: Over 300 DUI offenders who installed an interlocks in the State of Florida were recruited and completed an on-line survey at the beginning and end of their interlock restriction. A record of the interlock performance data from each was downloaded and used to determine how many lockouts they experienced during their interlock restriction period. Offenders were defined into two groups; successful cases (having 0 or 1 lockout) or poor performers (have 2 or more lockouts). Chi-square and binary regressions were used to assess differences between groups. RESULTS: Poor performers reported significantly more drinking and were more likely to drink in a context of emotional comfort, yet they were more likely to report positive experiences with the interlock, especially as to its ability to remind them to avoid another DUI by reducing their drinking and driving. No difference was found between these two groups for the interlock’s ability to reduce drinking. CONCLUSIONS: People with a more serious drinking pattern and who may be most at risk for recidivating may be more inclined to recognize the potential benefits of the interlock as a DUI preventive countermeasure. More research is needed to identify and influence high risk DUI offenders while on the interlock to increase its effectiveness once the interlock is removed.

Lung cancer screening via low-dose computed tomography (LDCT) has been underutilized by high-risk current and former smokers since its approval in 2013. Further, lower use of other evidence-based cancer screening tests (e.g., colorectal cancer, breast cancer) has been noted among African Americans when compared with other racial and ethnic groups. Reasons for low uptake are multilayered but include the need for consideration of patients' personal values about the screening decision. The goal of the present study was to (1) identify positive and negative factors specific to lung cancer screening via LDCT and (2) develop statements to capture values about the screening test for use in a new measure of decisional values. Key informant interviews (n = 9) identified several benefits and risks of lung cancer screening that may be important to African American smokers. Based on these interviews, a pool of items with the values statements was administered to a convenience sample of 119 African Americans [aged 55-80years, current or former smokers (who quit

to examine associations between childhood maltreatment and adulthood obesity, and mediating effects of adolescent depressive symptoms and BMI, using the U.S. National Longitudinal Study of Adolescent to Adult Health (n = 10,894). Individuals who reported sexual maltreatment were 27% more likely to be obese (BMI≥30; AOR = 1.27, 95% CI: 0.98-1.63) and 72% more likely to be extremely obese (BMI≥40) in adulthood (AOR = 1.72, 1.18-2.51) than those who did not. Individuals who reported physical maltreatment were 37% more likely to be extremely obese than those who did not (AOR = 1.37, 1.11-1.70). These relationships were true for males and females, and interaction terms by sex were not statistically significant. Adolescent depressive symptoms and BMI were statistically significant mediators between sexual and physical maltreatment and extreme obesity (p .05), and between physical maltreatment and self-rated obesity (p .05). Therefore, adolescent characteristics are mechanisms on the causal pathway between maltreatment and obesity in adulthood. Further research should explore these mechanisms.

Objective Alcohol use among older adults is a major public health concern given potentially negative effects to health and functioning in this population. Little is known about context in which alcohol use among older adults occurs, or how context of use is associated with risk behaviors. Method Invitation letters were mailed to licensed drivers 65 years and older in Maryland. A total of 825 participants completed an online survey that assessed demographic characteristics, alcohol use, social context of drinking, and driving behaviors. Results The analytic sample consisted of 604 older adult current drinkers (55% male). A factor analysis revealed three separate contexts of drinking: social facilitation, emotional comfort, and relaxation. Drinking in the context of social facilitation was associated with driving after drinking. Drinking in the context of emotional comfort was associated with getting drunk, driving after drinking, and running a stop sign or red light. Drinking in the context of relaxation was associated with traffic risk behaviors, including running a stop sign or red light and getting in a near crash or collision. Conclusions Understanding the social context of alcohol use among older adults may be useful for targeting and attempting to modify risky alcohol use and driving behaviors.

BACKGROUND: Substance use is prevalent and is associated with academic performance among adolescents. Few studies have examined the association between abstinence from all substances and academic achievement. METHODS: Data from a nationally representative sample of 9,578 twelfth graders from the 2015 Monitoring the Future survey were analyzed to examine relationships between abstinence from substance use and four academic variables: skipping school, grades, academic self-efficacy, and emotional academic engagement. Participants were categorized as lifetime non-users, former users, and past-year users based on the use of 14 substances. RESULTS: Approximately one-quarter of participants had never used cigarettes, alcohol, or other drugs during their lifetime, and 8%(wt) used at least one substance during their lifetime but not during the past year. Adjusting for demographic variables, past-year substance users had 2.71 greater odds of skipping school during the past month than lifetime non-users and 1.74 greater odds of having low grades. Lifetime non-users reported greater academic self-efficacy and emotional academic engagement than past-year users. CONCLUSIONS: Many twelfth graders have abstained from all substance use during their lifetime, and these adolescents experience better academic outcomes than their substance-using peers. Substance use prevention programs should be evaluated as a way to promote academic achievement.

Sleep disturbances can accompany alcohol use disorders during various phases of the disease. This analysis utilized a mixed methods approach to assess whether sleep-related beliefs and/or behavior of individuals who are alcohol dependent were associated with sleep quality both pre- and postdischarge from a clinical research facility providing inpatient alcohol rehabilitation treatment. Individuals with higher self-efficacy for sleep (SE-S) reported better sleep quality at both time points. Individuals with fewer dysfunctional beliefs about sleep had poorer sleep quality at both time points. Individuals with higher unhealthy sleep-related safety behaviors had poorer sleep quality at both time points. In a linear regression model, only the difference in SE-S scores from pre- to postdischarge (β = −.396, p = .01) and the postdischarge Penn Alcohol Craving Score (β = .283, p = .019) significantly predicted the change in sleep quality. Thus, those whose SE-S scores increased and those with lower postdischarge craving scores were more likely to experience a decrease on Pittsburgh Sleep Quality Index scores from pre- to postdischarge even after controlling for covariates. References to behavior or personal factors were often discussed during the qualitative interviews in tandem with the environment. Participants reported both (1) self-medicating anxiety with alcohol and (2) self-medicating the inability to fall asleep with alcohol. Given the success of behavioral sleep interventions in various populations and the unique potential contributions of mixed methods approaches to examine sleep and alcohol use, assessing sleep-related cognitions and behaviors of individuals with severe alcohol use disorders may be important in understanding sleep quality and subsequent relapse.

The purpose of this study was to determine how frequent permanent change of station moves and turnover in primary care providers are associated with continuity of care and patient satisfaction in military spouses. These domains have been studied extensively in civilian populations, but this study seeks to begin filling a gap in the literature surrounding military spouses and their experiences with the military health system.Spouses were recruited via social media to complete a brief online questionnaire to examine factors related to continuity of care and satisfaction with military health care. Results were analyzed using analysis of variance and χContinuity of care scores were significantly lower as the number of moves and providers increased. Patient satisfaction was also significantly associated with continuity. In logistic regression analyses, patient-provider relationship and health status were the only significant predictors across two measures of patient satisfaction. Respondents with higher relationship scores were nearly two times more likely to report being satisfied than those with lower scores. Qualitative results indicated that the majority of dissatisfied spouses were unhappy with their military providers, which supported quantitative findings related to patient-provider relationship.No studies have previously been conducted to determine why military health system beneficiaries are less satisfied with care than their civilian counterparts. Discontinuous care is an ongoing issue for military families, which can impact satisfaction and potentially lead to poorer health outcomes. Although the military culture may not allow for fewer relocations, these results indicate that taking steps to promote enduring, trusting relationships with primary care providers may improve patient satisfaction.

Few studies have investigated the association between the social context of cannabis use and cannabis use disorder (CUD). This longitudinal study of college students aimed to: develop a social context measure of cannabis use; examine the degree to which social context is associated with the transition from non-problematic cannabis use to CUD; and, examine the association between social context of cannabis use and depressive symptoms. The analytic sample consisted of 322 past-year cannabis users at baseline. Four distinct and internally consistent social context scales were found (i.e., social facilitation, emotional pain, sex-seeking, and peer acceptance). Persistent CUD (meeting DSM-IV criteria for CUD at baseline and twelve months later) was associated with using cannabis in social facilitation or emotional pain contexts, controlling for frequency of cannabis use and alcohol use quantity. Students with higher levels of depressive symptoms were more likely to use cannabis in an emotional pain or sex-seeking context. These findings highlight the importance of examining the social contextual factors relating to substance use among college students.

Asthma is a common chronic disease among adolescent students, and was one of the 5 most common reasons for pediatric treat-and-release for emergency department visits among 5- to 14-year-old children in 2010.1 In 2013, 26.3% of high school and 23.5% of middle school students in Maryland reported ever having been told by a doctor or nurse that they had asthma.2 Avoidance of smoking and exposure to secondhand smoke has been recommended for people with asthma,3 because persons with asthma who smoke experience higher rates of hospitalization and reduced quality of life when compared with non-smokers with asthma.4 Previous studies have found that adolescents with current asthma smoke as many or more cigarettes than adolescents without asthma.5-8 For example, adolescents reporting having had an asthma episode or attack are more likely than other adolescents to report lifetime daily cigarette use and current frequent cigarette use.5 In addition, a recent study has shown that high school students with asthma have a higher prevalence of hookah smoking than other students.9 Despite the large number of studies identifying relationships between peers, school programs, family members, and media for adolescent smokers,10-13 our understanding of the role of these factors for asthmatic adolescent smokers remains limited. Previous studies of asthmatic adolescent smoking have examined environmental smoking exposure, alcohol, communication with parents, as well as intrapersonal factors such as autonomy, depression, smoking prevalence, asthma management.6,14,15 Sex has an impact on adolescents’ school social networks including peer selection, patterning of peer ties, and peer influence making.16 Research is needed to explore whether and to what extent exposure to smoking in mass media has a similar influence on adolescent tobacco use and variations by sex.17 This study aims to determine whether exposure to mass media and school social networks’ influence are associated with current smoking status among asthmatic adolescent students by sex and if these associations vary by sex.

OBJECTIVE To examine the relationship between parental monitoring and adolescent drinking over time. METHODS Adolescents completed a baseline survey regarding their involvement with alcohol and parental monitoring. They were interviewed 12 months later, to obtain follow-up measures of drinking and involvement in alcohol-risk situations. RESULTS Highly monitored adolescents were less likely to report that they were drinking 12 months later. This relationship remained when controlling for age, gender, drinking at baseline, and being in various high-risk situations. CONCLUSIONS The longer term protective relationship between parental monitoring and alcohol involvement was demonstrated. The need to establish frequent parental monitoring is indicated.

OBJECTIVES To assess the association between parental monitoring and adolescent alcohol risk. METHODS Adolescent managed-care patients completed a survey of their involvement with alcohol and their perceptions of monitoring and other forms of parental influence. RESULTS Frequent monitoring was associated with less likelihood that adolescents had engaged in a variety of alcohol-risk behaviors or had been in a variety of risk situations. Choosing to share alcohol-related concerns with other adults and placing importance on parents' opinions were not as consistently related to alcohol risk. CONCLUSIONS The need to enhance parental monitoring as a proactive protective parental response is indicated.

OBJECTIVES: To examine the physical, social and temporal contexts of physical activity, as well as sex variations of the associations among 314 urban adolescents. METHODS: Three-day physical activity recall measured contextual information of physical activities. Logistic regressions and generalized estimating equation models examined associations among physical activity types and contexts, and sex differences. RESULTS: Active transportation was the most common physical activity. Home/neighborhood and school were the most common physical activity locations. School was the main location for organized physical activity. Boys spent more time on recreational physical activity, regardless of the social context, compared to girls. The average physical activity level was significantly lower for girls than for boys after school. CONCLUSIONS: Physical activity promotion interventions need to target physical activity environments and social contexts in a sex-specific manner. Language: en

OBJECTIVES: To determine the nature and prevalence of parental involvement with teen driving and its relationship to teen driving risk. METHODS: A statewide sample of 424 Maryland parents and their provisionally licensed teenagers were interviewed. RESULTS: Parents were unaware of the extent to which their teens had engaged in high-risk traffic events, such as being distracted by friends or driving too fast. Teens who were allowed unsupervised access to a car at least several times a week were 3 times as likely to have driven too fast than were those who had access once a month or less. The frequency of parental teaching of driving skills was not strongly related to teen risk taking. CONCLUSION: The need to increase parents' capacity to impose and enforce driving restrictions on provisionally licensed teen drivers is indicated. Language: en

In a statewide random telephone survey of 454 parents and their 14- to 19-year-old adolescents, we examined the associations between various parenting strategies and self-reported teen drinking. Less teen drinking was associated with parents' reports of checking to see if other parents would be present at teen parties, particularly among White parents. Parents' monitoring of teens' activities was associated with feelings of competence at doing so. There was, however, no difference in drinking between teens with parents who did or did not report restricting their teens due to teen misbehavior. These findings suggest that a proactive parental monitoring approach may be associated with less adolescent drinking. Prospective research is needed to clarify the causal relationship between parental monitoring, efficacy and teen alcohol-related behavior.

OBJECTIVES To establish reliability/validity of the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ). METHODS The GN-SBQ and the Fagerstrom Test for Nicotine Dependence (FTND) were completed by 100 smokers. The number of cigarettes smoked, smoking duration, and craving were obtained. RESULTS The GN-SBQ was internally consistent (Cronbach α = .82), temporally stable (r = .86), and uncorrelated with FTND. There was a significant main effect for craving, F(3, 73) = 14.68, p < .001; and the GN-SBQ was a significant predictor of craving levels (β = .476, p < .001). CONCLUSIONS The GN-SBQ shows promise as a tool for distinguishing behavioral from physical nicotine dependence.

Objective: To develop an instrument that measures the social context of hookah use among college students. Participants: A pool of 50 potential items, based on 44 in-depth interviews with regular college hookah smokers, was administered to a sample of 274 hookah users between October and December 2011. Methods: Participants were approached in hookah bars and asked to complete the survey. Results: A principle components analysis revealed 3 reliable factors: social facilitation, family/cultural influence, and alternative to smoking cigarettes and drinking. These were examined across different categories of hookah use: Weekly hookah users were more likely to smoke in a context of social facilitation than the other 2 groups. Similar effects were observed for family/cultural influence. Asians were more likely to smoke in a context of family and cultural influence than non-Asians. Conclusions: This scale has potential for identifying situation-specific contexts of hookah use that may help in designing ...

BACKGROUND: Trait aggression has been linked to alcohol-related problems among college students. However, the individual conditions underlying this association are unknown. Empirical evidence and theory suggest the importance of distress tolerance, defined as an individual's ability to withstand negative affective states, in the relationship between trait aggression and alcohol use. Therefore, the purpose of the current study was to examine whether distress tolerance moderates the relationship between trait aggression and problematic alcohol use. METHODS: Participants were 646 undergraduate students in a large university, who reported any lifetime alcohol use. The dependent variable, problematic alcohol use, was measured using the Alcohol Use Disorders Identification Test total score. The main independent variable, trait aggression, was assessed on the negative emotionality scale of the Multidimensional Personality Questionnaire, and the moderator, distress tolerance, was determined using the Distress Tolerance Scale. RESULTS: Hierarchical linear regression analyses indicated a significant interaction between trait aggression and distress tolerance in predicting problematic alcohol use, adjusting for demographic variables, regular substance use, depressive symptoms, and anxiety symptoms. Specifically, a significant positive relationship between trait aggression and problematic alcohol use was present among those with low, but not high, distress tolerance. CONCLUSIONS: Results provide evidence that college students with high levels of trait aggression are more likely to engage in problematic alcohol use if they also evidence an inability to tolerate negative affective states. Study implications are discussed, including the development of prevention and intervention programs that target distress tolerance skills. Language: en

Background: Previous research has suggested important contextual factors that can differentiate problem and nonproblem drinkers. Objectives: To evaluate the strength of the prospective association between social contexts of drinking and subsequent alcohol use disorder and drunk driving 2-3 years later. Methods: The sample consisted of 652 individuals who were originally recruited at college entry, had complete data on at least one social context subscale, met the minimum criteria for Year 1 drinking, and had nonmissing data on at least one of the outcome variables in Years 3 and/or 4. Social contexts of drinking were assessed in Year 1 by using previously validated scales measuring six different situational and motivational contexts in which alcohol is consumed. DSM-IV criteria for alcohol abuse and dependence and drunk driving were assessed annually. Results: Holding constant gender, race/ethnicity, and baseline drinking frequency, the frequency of drinking in a context of social facilitation, sex-seeking, or in a motor vehicle during Year 1 was significantly related to a greater likelihood of alcohol abuse, alcohol dependence, and drunk driving in Years 3 and/or 4. Drinking in a context of emotional pain was related to alcohol dependence and drunk driving but not to alcohol abuse. Conclusions: The Social Context of Drinking Scales have utility for identifying students who are at risk for developing alcohol-related problems. Scientific Significance: Identifying college students who might develop alcohol dependence requires an assessment of both situational and motivational factors that influence drinking, especially drinking in a motor vehicle. Language: en

An anonymous questionnaire was administered to more than 1,200 seventh to 12th grade students in four rural public schools in western New York State. The questionnaire measured alcohol use, the social contexts of drinking, and the personality trait known as "sensation seeking." A majority (57%) were drinkers, and discriminant function analyses were performed on their scores on these measures to determine if they could distinguish between different levels of alcohol use intensity, alcohol-impaired driving, and riding with an impaired driver. Results indicated social context measure were effective in distinguishing among levels on each indicant of abuse. In particular, high-intensity drinkers, impaired drivers, and riders of impaired drivers were more likely to drink in a context of social facilitation, stress control, and defiance of school and adult authority. The drinking context of peer acceptance was important only in distinguishing teen-agers who ride with drunk drivers from those who do not. Overall, the sensation seeking trait was of moderate importance in distinguishing among different alcohol abuse practices. Implications of these findings for assessment as well as school-based prevention programs are discussed.

This study investigated the potential effects of alcohol price increases on alcohol-related attitudes and perceptions of youth. Data were collected through a survey of high school students conducted after the federal excise taxes on alcohol beverages were increased in January 1991. Survey data lend support to previous research showing that higher alcohol prices contribute to lower alcohol consumption by youth, as well as to a decrease in related problems such as driving while intoxicated. Survey data also suggest that a price of around $7.50 for a six-pack of beer or a four-pack of wine coolers would discourage purchases by youth. Further studies are called for to substantiate and to expand on these findings with more diverse adolescent populations.

A series of items that measure the social context of alcohol consumption among adolescents was administered in a questionnaire survey to over 1,300 high school students. Emerging from a factor analysis were five factors which suggested that drinking occurs in the following social contexts: drinking for social facilitation where adults are not present, drinking at school or during school-related activities, drinking for stress control, drinking for conformity or to be part of a group, and drinking under parental supervision at home. Scales based on these factors appeared to be reliable, free from social desirability bias, and able to discriminate problem drinkers from nonproblem drinkers. The most important of these factors was drinking for social facilitation that is not restrained by the presence of adults. These findings reinforce the validity of examining the social context of drinking (which involves situational as well as motivational reasons for drinking) to uncover important etiological contributors of alcohol abuse in an adolescent population.

Focus group interviews were conducted with Hispanic teenagers to explore their patterns of alcohol consumption, influences on drinking and possible intervention strategies. The findings revealed that drinking and alcohol-impaired driving are common. Conviviality and social facilitation are the predominant contexts for alcohol consumption in this population. The strong influence of peers was detected where drinking to 'fit in' and be part of the crowd was observed. Parents were also noted to have influence. Some parents actively promoted drinking among their sons as it is often seen as a sign of masculinity or 'machismo'. Suggestions for effective prevention strategies included a preference for messages which vividly portray the harmful consequences of alcohol consumption and the use of testimonials from people who have suffered some form of impairment due to alcohol abuse. Teens, especially those who speak Spanish and understand the Hispanic culture, were seen as the most credible spokespersons for prevention campaigns. Language: en

Background: Alcohol-impaired driving is a major public health problem. National studies indicate that about 25% of college students have driven while intoxicated in the past month and an even greater percentage drive after drinking any alcohol and/or ride with an intoxicated driver. The purpose of this investigation was to examine the change in these various alcohol-related traffic risk behaviors as students progressed through their college experience. Methods: A cohort of 1,253 first-time first-year students attending a large, mid-Atlantic university were interviewed annually for 4 years. Repeated measures analyses were performed using generalized estimating equations to evaluate age-related changes in prevalence and frequency of each behavior (i.e., ages 19 to 22). Results: At age 19, 17%(wt) of students drove while intoxicated, 42%(wt) drove after drinking any alcohol, and 38%(wt) rode with an intoxicated driver. For all 3 driving behaviors, prevalence and frequency increased significantly at age 21. Males were more likely to engage in these behaviors than females. To understand the possible relationship of these behaviors to changes in drinking patterns, a post hoc analysis was conducted and revealed that while drinking frequency increased every year, frequency of drunkenness was stable for females, but increased for males. Conclusions: Alcohol-related traffic risk behaviors are quite common among college students and take a significant upturn when students reach the age of 21. Prevention strategies targeted to the college population are needed to prevent serious consequences of these alcohol-related traffic risk behaviors. Language: en

This study examined the association between dating violence victimization and psychosocial risk and protective factors among Latino early adolescents. An anonymous, cross-sectional, self-reported survey was administered to a convenience sample of Latino youth ( n = 322) aged 11 to 13 residing in suburban Washington, D.C. The dependent variable was physical dating violence; the independent variables included violence, substance use, emotional well-being, prosocial behaviors, and parenting practices. Multivariate logistic regression models were constructed and adjusted odds ratio and 95% confidence interval were examined. Overall, 13.5% ( n = 43) of Latino early adolescents reported being a victim of physical dating violence within the past year. The prevalence was 14.4% for girls and 12.9% for boys. Among the girls, binge drinking was the sole risk behavior associated with dating violence. Gun carrying, alcohol consumption, and having considered suicide were associated with dating violence among the boys. Physical dating violence appears to affect a small but significant proportion of Latino early adolescents and is associated with other risk behaviors. Healthy dating relationship programs are warranted for middle school youth with some tailoring to reflect gender differences in risk profiles.

Three hundred and seven nurses at a large military medical centre were sent and completed an anonymous questionnaire which measured their smoking status along with job stress, job satisfaction and social support, as well as a variety of demographic factors. Three groups of nurses were defined on the basis of their response to the smoking status questions: those who have never smoked (54%), former smokers (23%) and current smokers (22%). The results revealed that the current smokers reported significantly (P less than 0.05) more job stress, job dissatisfaction and less social support than either former smokers or those who had never smoked. Further, the former smokers reported significantly less social support, defined from a variety of perspectives, than those who had never smoked. These were not as important in predicting amount smoked (number of cigarettes per day) among the current smoker group as they were in predicting differences between the different smoking status groups. The results suggest the need to incorporate the issues of social support and to a lesser extent job stress/satisfaction issues into smoking cessation programmes aimed at this population.

An anonymous survey questionnaire was administered in school to over 1,100 White and close to 400 Black middle class, suburban high school students. The questionnaire included questions about the source of information and influence about drugs and alcohol. Results revealed that while both groups rated the mass media as their best source of information, Whites were more likely to report this than Blacks. Blacks reported more frequently than Whites that they would go to their family if they had a question about alcohol or drugs, if they thought they had a problem with and needed help with a drug problem, and would most likely believe their family if they were told that they had a problem with alcohol or drugs. Whites were more likely to use their friends for these sources of information. Results are discussed in terms of the need to empower parents to be more influential at preventing alcohol and drug abuse among adolescents and for the need to research whether middle class Black families employ in...

The evidence concerning Maryland's anti-drunk driving program, Checkpoint Strikeforce, is reviewed. To date, there is no evidence to indicate that this campaign, which involves a number of sobriety checkpoints and media activities to promote these efforts, has had any impact on public perceptions, driver behaviors, or alcohol-related motor vehicle crashes and injuries. This conclusion is drawn after examining statistics for alcohol-related crashes, police citations for impaired driving, and public perceptions of alcohol-impaired driving risk. Comparisons are also made with other states in the mid-Atlantic region, where similar campaign activities have occurred. Reasons for this failure in Maryland include insufficient levels of enforcement (e.g., too few sobriety checkpoints and vehicle contacts occurred to raise public perceptions of risk pertaining to impaired driving) and inadequate publicity surrounding this campaign. Suggestions for overcoming these problems are offered.

Introduction The purpose of this investigation was to identify beliefs, driving personality dispositions, and behaviors that distinguish self-defined aggressive drivers from non-aggressive drivers. Method Telephone surveys were used to identify self-reported aggressive drivers (n = 305) who were compared to non-aggressive drivers (n = 1,715) concerning their beliefs, driving behaviors, and self-described driving dispositions. Results Aggressive drivers, compared to non-aggressive drivers, were less concerned about speeding, aggressive driving, and cell phone use while driving, yet were more likely to have had an encounter with another aggressive driver. They were also more likely to report that they had driven when they knew they had too much to drink, yet they felt less likely that they would be stopped by the police. Conclusion Aggressive drivers display many dispositions that define them as high risk drivers and public information/motivational campaigns alone will likely be ineffective with this group of drivers. Strategies that combine visible enforcement with widespread publicity campaigns appear to be necessary.

The purpose of the investigation was to determine if parent-teen discordance for parent-imposed restrictions on driving conditions, driving rules, and the consequences for driving rule violations were related to risky teen driving. A total of 579 parents and their newly licensed teens were interviewed by telephone, 1 month after teens obtained provisional licenses. In multiple regression analyses, the degree of disagreement with parent restrictions on driving conditions and parent-imposed consequences for driving rule violations were negatively associated with a composite measure of teen risky driving. Female parents were negatively associated and male teens were positively associated with risky driving, but discordance with restricted driving conditions was the most important predictor. Discordance may reflect poor parent-teen relations or inadequate communication about parental expectations. The findings suggest that increasing parent-teen concordance on parent-imposed driving restrictions may help reduce risky teen driving.

This investigation sought to determine if Maryland’s new graduated licensing programwas associated with greater levels of parental involvement in, and restriction on, teens’ unsupervised driving. Separate samples of teens with provisional licenses were interviewed by telephone before ( n= 424) and after ( n= 600) the new program took effect. The findings indicated that teens in the new program reported significant increases in the frequency of parental driving instruction and supervised driving during the permit phase. There were no differences in amounts of instruction or supervised driving after provisional licensure. Also, teens in the new program reported greater overall amounts of parental restriction on their driving; however, few specific restrictions showed increases. Programs that encourage parents to regulate, restrict, monitor, and supervise the driving privileges of their teens during their provisional period of licensure are recommended. Graduated licensing laws and programs benefit from specific behavioral interventions targeted to, and implemented by, parents.

Objective: The purpose of this study was to determine the extent to which effects of exposure to a brief intervention designed to increase parental restrictions on teen driving privileges persisted over time. Design: A total of 658 parents and their 16 year old adolescents were recruited from a local motor vehicle administration (MVA) site as adolescents successfully tested for provisional licenses. At the MVA, parents completed written surveys about expected teen driving during the first month of provisional licensure. Afterwards, on weeks assigned as intervention, parents watched a video and were given the video and a driving agreement to take home. Both parents and teens completed follow up telephone interviews about communication, amounts, and limits on teen driving at one month (579 dyads), four months (529 dyads), and nine months (528 dyads). Results: The results indicated that both intervention parents and teens were much more likely to report using a driving agreement at each follow up during the nine month period. Significant treatment group differences persisted for communication about driving, but effects related to limits on teen driving that were evident at one month declined over time. Reports for passenger, road, and overall limits remained significant at four months; fewer were present at nine months. There were no differences in amounts of teen driving at four or nine months. Conclusions: It is possible to reach parents through brief interventions at the MVA and successfully promote increases in initial parental restrictions on teen driving with modest persistence for at least four months.

OBJECTIVES: This investigation sought to test the effectiveness of a statewide ignition interlock license restriction program for drivers with multiple alcohol-related traffic offenses. METHODS: A total of 1387 multiple offenders eligible for license reinstatement were randomly assigned to participate in an ignition interlock program (experimental group) or in the conventional postlicensing treatment program (control group). The arrest rates of these 2 groups for alcohol traffic offenses were compared for 1 year during the ignition interlock license restriction program and for 1 year after unrestricted driving privileges were returned. RESULTS: Participation in the interlock program reduced offenders' risk of committing an alcohol traffic violation within the first year by about 65%. The alcohol traffic violation rate during the first year was significantly less for participants in the interlock program (2.4%) than for those in the control group (6.7%). However, there was no statistically significant difference between these groups in the second year, after the interlock license restriction was lifted. CONCLUSIONS: Ignition interlock license restriction programs are effective at reducing recidivism among drivers with multiple alcohol offenses, at least while the restriction is in effect.

This study of more than 1,300 high school students examined gender differences in the social context of drinking associated with four alcohol problem behaviors (high intensity drinking, binge drinking, driving while intoxicated, and riding with an alcohol impaired driver). A series of analyses treated five social contexts of drinking (Social Facilitation, School Defiance, Stress Control, Peer Acceptance, and Parental Approval) as dependent variables and revealed significant multivariate interaction effects between gender and all four alcohol problem behaviors. Male problem drinkers were more likely to drink in all social contexts than female problem drinkers or non-problem drinkers of both genders. Females were no more likely to drink in the context of Stress Control than males, a finding inconsistent with some previous research. The social contexts of Social Facilitation, School Defiance, and Stress Control were the best discriminators of problem versus non-problem drinkers of both genders (although the order of importance varied by gender and specific problem behavior). Implications for designing targeted interventions are discussed.

The high risk of fire death and injury among elderly people is well documented. To be effective, fire safety education must reach older adults in the settings in which they reside: nursing homes and other long-term care institutions, board and care homes, and independent living facilities including the person's own home. Training must also be targeted at the people who are responsible for fire safety. In the case of the nursing home or board and care home, the responsible people are the staff and owners. In the case of the majority of older adults who live independently in their homes, it is either the individual or family members. These programs must also be comprehensive. A fire safety education curriculum was developed by a group of experts in a variety of related fields including fire safety, gerontology, health care industry, developmental disabilities, research, and instructional design. Older adults were included in each planning session. Based on that curriculum, workshops and workshop materials were developed for each of the three target populations: staff of health care facilities, staff and owners of board and care homes, and elderly people living independently in their homes. Materials included both print and audiovisuals. A pilot test of each workshop was conducted to test the short-term effects of the programs. Results indicated significant gains in knowledge for all groups and a significant improvement in positive attitudes toward fire safety for most participants. Measures of effects of the programs on intentions to change fire safety practices indicated a potential for change. Results also showed that the measured traits, knowledge of fire safety and attitudes toward fire safety, were relatively stable.

A national survey of cardiopulmonary resuscitation (CPR) training services for deaf individuals was conducted by contacting regional directors of the American Heart Association, the American National Red Cross, and continuing education programs for the deaf. The results revealed that very little is being done in the way of a CPR training for the deaf. The American National Red Cross appears to be more active in this area than the other two organizations. Communication barriers and lack of adequate training resources (e.g., captioned films and sign interpreters) were identified as the major reasons why so few deaf people are being given CPR instruction. Cardiopulmonary resuscitation (CPR) has been shown to be an extremely important skill for people to possess in order to reduce the chances of death in a cardiac arrest victim (Copley, Mantle, Rogers, RA¼ssel, & Rackely, 1977; Crampton, Aldrich, Stillerman, Gascho, & Miles, 1975; Eisenberg, Bergner, & Hallstrom, 1979; Stephenson, 1974). The relationship between effective CPR training and increased survival of heart attack victims has resulted in a burgeoning interest in receiving CPR instruction. In the last 10 years training efforts have spread from what was the sole province of physicians and paramedical professionals to the lay public in community programs. While the research literature is rampant with training and outcome evaluations of CPR training for the general public, the deaf population has been virtually ignored. Current estimates indicate that there are approximately 1,968,000 deaf people in this country1. This is a sizeable population to be excluded from CPR training efforts. In an innovative study by Tomasetti, Beck

Deaf college students were randomly assigned to three separate instructional conditions for a cardiopulmonary resuscitation (CPR) course. One group received the standard course presented through signed instruction. A second group received the same instruction with the addition of a captioned vidA©ocassette, "The New Pulse of Life—Revised." The third group received the standard instruction and viewed the uncaptioned vidA©ocassette, signed by an interpreter. These groups were compared with a non-deaf group who received the standard 4-hour course. The results revealed that the deaf group which viewed the uncaptioned vidA©ocassette signed by an interpreter retained a significantly greater amount of performance skills than the other groups. The prompt and effective administration of cardiopulmonary resuscitation (CPR) significantly increases a cardiac arrest victim's chances of survival (Copley, Mantle, Rogers, Russell, & Rackley, 1977; Crampton, Aldrich, Stillerman, Gascho, & Miles, 1975; Eisenberg, Bergner, & Hallstrom, 1979; Stephenson, 1974). This fact underscores the importance of training the lay public to initiate CPR before advanced cardiac care is provided in an emergency medical care facility. However, additional effort is needed to train all segments of the population, including the handicapped. This investigation focused upon the deaf segment of the handicapped population. There is little information on CPR instruction and retention ability of the deaf learner, although many studies indicate that nondeaf trainees show significant decreases in retention as early as three months following instruction (Barrick, 1977; Vanderschmidt, 1976; Vanderschmidt, Burnap, & Thwaites, 1975). A need exists to provide CPR programs for deaf individuals and to improve the retention of these abilities. The use of inadequate visual aids in CPR

Eighty dental patients were pretested with a scale measuring health locus of control and then exposed to a persuasive communication designed to manipulate their beliefs about the seriousness of periodontal disease and their susceptibility to it. The high seriousness condition increased feelings of fear, concern, and threat as well as intentions and reported compliance with recommended oral hygiene procedures. However, patient's perceived personal efficacy in performing the recommended behavior was the most important predictor of subsequent behavior. The implications of the results for Roger's protection motivation theory are discussed.

This study was designed to determine what factors might contribute to possible pregnancy and birth control usage among a sample of college women. The obtained sample was comprised of 140 college women who sought pregnancy tests at the health center at the University of Maryland. Of the 140 pregnancy tests performed 40 (28.6%) were positive. Over 40% of the women in this study were not using any type of birth control at the time of their possible pregnancy and over 15% of women whose tests proved positive had been pregnant before. The reasons given for non-use seem to reflect a tendency to deny ones sexuality. In addition over 1/3 of the non-users listed their concern over the health risks of birth control methods as a reason for non-use. Denial and health risk appear to be critical barriers for effective contraceptive usage and these issues need to be addressed in birth control education programs for this population. Not surprisingly a strong relationship was detected between sporadic or non-use of birth control and pregnancy. Also contraceptive behavior at the onset of sexual activity appears to be related consistently to use in later years. Those women who reported that they had used some method of contraception the 1st time they had intercourse were more likely to use contraception "always." Methods that supposedly had failed for those women who had positive pregnancy tests tended to be the diaphragm and the sponge. These same women were more likely to have used the diaphragm or sponge the 1st time they had intercourse. The women with negative pregnancy tests were more likely to have used condoms in both initial and subsequent sexual activity. Because lack of knowledge has not played a major role in unintended pregnancy health educators must concentrate more on the psychosocial factors of non-contraceptive use including denial and guilt over sexuality in general (particularly in women) lack of communication between the sexes a coming to terms with sexuality in general and assertiveness training.

Over 700 college students were measured with the Jenkins Activity Survey (JAS) along with eleven other personality scales in an attempt to identify the personality correlates of this scale. These eleven personality variables were analyzed to determine their contribution to a discriminant solution between extreme high scores (supposedly true Type A's) and low scores (supposedly true Type B's) as measured by the JAS. The results revealed that relative to those subjects who were classified as Type B's, those classified as Type A's exhibited significantly greater status concern, less alexithymia, more misanthropy and greater life satisfaction. Self-esteem and related self-concepts did not differ significantly between these two groups. These findings challenge the validity of this instrument as a measure of Type A trait.