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This study investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. The research was based on secondary analysis of data from the Study of Marriage, Family, and Life Quality with a sample of 128 people who completed an infertility-related stress instrument at all three measurement intervals (1988, 1999, and 1990). Self-esteem and perceived health were associated with stress at the study baseline, importance of a biological family and extent of spousal support associated with stress at the 12-month follow-up, and factors pertaining to infertility treatment (number of treatments, relationship with physicians) associated with stress at the 24-month follow-up. Self-esteem was the only psychosocial factor associated with change in stress over the course of treatment. Social workers and health care professionals should be sensitive to the emotional experiences of couples during infertility treatment. Identifying factors explaining stress, or that may be targets for intervention, has significance for social workers in health care and other settings. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To identify factors associated with cigarette smoking in the 6th-grade through 10th-grade youth population of Sarasota County, Florida. METHODS: A closed-ended, quantitative survey was completed by 2004 youth and used to extract population-specific data on the correlates of cigarette use. RESULTS: A range of factors influence cigarette use including self-efficacy to refuse offers of cigarettes, perceived emotional benefits, and perceived maternal disapproval of smoking. CONCLUSIONS: Results underscore the need for multiple-component interventions. This study is unique in that it represents population-specific research in which community partners are using the findings to develop community-specific prevention marketing interventions. [ABSTRACT FROM AUTHOR]

Although youth involvement in health promotion efforts is not a new concept, projects that actively involve youths in planning research, collecting data, and making research design decisions are rare. This article describes the evaluation process and outcomes for a youth-directed data collection initiative. Eleven youth researchers conducted 112 personal in-depth interviews and 22 focus groups involving 206 youths in 5th through 12th grade. Youth researchers felt confident they could conduct focus groups and in-depth interviews and staff ratings of youths' effectiveness in moderating focus groups indicated they were successful in carrying out the qualitative research. [ABSTRACT FROM AUTHOR]

Objectives: To develop and evaluate a new community-based social marketing (CBPM) model. Methods: CBPM is being piloted to prevent the initiation of smoking and alcohol consumption among middle-school students. The project's impact on behavioral outcomes and the community's ability to use CBPM to solve public health problems are being evaluated. Results: Commu nity members have demonstrated an unexpected level of interest in learning CBPM and applying its principles to program planning. Conclusions: Community control of the social marketing process has the potential to enhance program integration into existing community structures, making them more effective and sustainable. [ABSTRACT FROM AUTHOR]

Objective: To introduce audience-segmentation techniques to health educators and health behavior researchers. Methods: Provide a comparison between nonmarketing and marketing approaches to developing health behavior change strategies and reviews some of the most commonly used techniques for audience-segmentation analysis. Results: The determinants of the breast cancer screening among women in Florida are used to illustrate the use of CHAID for segmentation analysis. Conclusions: Audiencesegmentation techniques enabled us to discover the unique characteristics of population segments with very high need and to focus intervention resources in a manner that is likely to maximize intervention impact. [ABSTRACT FROM AUTHOR]

Objective: To describe the application of the social marketing approach to promoting breast cancer screening services. Methods: The Florida Cares for Women project is used to illustrate to the social marketing plan based on the concept of the 4 Ps, product, place, price, and promotion. Results: The 6 phases of social marketing are discussed with specific project examples: (a) initial planning, (b) formative (consumer) research, (c) strategy development, (d) campaign development, (e) implementation, and (f) evaluation. Conclusion: Using a social marketing approach, a campaign was developed to promote breast cancer screening services in Florida. [ABSTRACT FROM AUTHOR]

Objective: To examine ADHD symptom persistence and factors associated with elevated symptom counts in a diverse, longitudinal community-based sample., Method: Parents reported demographics and completed a diagnostic interview repeatedly over a 6-year period. At Time 1, 481 interviews were completed about children (5-13 years); all participants were invited to four annual follow-up interviews, and 379 (79%) completed at least one. Inattentive (IA) and hyperactive-impulsive (HI) symptom counts were modeled with logistic quantile regression, while accounting for study design complexities., Results: The prevalence of seven IA symptoms remained stable from early childhood through late adolescence. The prevalence of eight HI symptoms decreased by more than half over time. After demographic adjustment, the upper quartile of HI symptom counts decreased with age (p < .01). High HI symptom counts persisted more among those with high IA symptom counts (p = .05)., Conclusion: This study further characterizes and provides insights into ADHD symptom trajectory through adolescence., (© The Author(s) 2014.)

Social disparities in the receipt of contraceptive services were assessed among a sample of 2,031 sexually experienced adolescent females 15 to 18 years of age using secondary data from the National Longitudinal Study of Adolescent Health (Add Health). Findings revealed no social disparities in receipt of contraceptive services; rather, adolescent females who had a parent with less than a high school degree were more likely to receive contraceptive services. Adolescents' individual characteristics, including perceptions of maternal disapproval of sexual activity and use of contraceptives, barriers in access to and use of birth control, health needs, and enabling resources were significantly associated with their receipt of contraceptive services. Neighborhood characteristics were not significantly associated with adolescents' receipt of services in this study.

Objective: To examine associations between parental limits on soft drinks and purchasing soft drinks from school vending machines and consuming soft drinks among middle school students., Design: Secondary analysis of cross-sectional data from the middle school Youth Risk Behavior Survey., Setting: Eight public middle schools in central Kentucky., Participants: All sixth- through eighth-grade students in 7 schools and all eighth-grade students in 1 school (n = 4,049)., Variables Measured: Self-reported parental limits on soft drink intake, school vending machine soft drink purchases, soft drink consumption, and control variables., Analysis: Chi-square and binary logistic regression analyses., Results: Compared to students with no parental limits on soft drink consumption, students with the strictest limits were less likely to purchase soft drinks from school vending machines and consume soft drinks; conversely, students with minor parental limitations were more likely to consume soft drinks. The odds of consuming soft drinks were nearly 4 times greater when students purchased soft drinks from school vending machines than when they did not., Conclusions and Implications: Further research may enhance understanding of the influence of varying degrees of parental limitations. Efforts to reduce children's soft drink consumption may be augmented by policies limiting soft drink purchases in schools., (Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.)

This article describes the application and refinement of community-based prevention marketing (CBPM), an example of community-based participatory research that blends social marketing theories and techniques and community organization principles to guide voluntary health behavior change. The Florida Prevention Research Center has worked with a community coalition in Sarasota County, Florida to define locally important health problems and issues and to develop responsive health-promotion interventions. The CBPM framework has evolved as academic and community-based researchers have gained experience applying it. Community boards can use marketing principles to design evidence-based strategies for addressing local public health concerns. Based on 6 years of experience with the "Believe in All Your Possibilities" program, lessons learned that have led to revision and improvement of the CBPM framework are described.

Background and Objectives: Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design., Methods: The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance., Results: This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation., Conclusion: Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Objective: The purpose of this study was to (a) describe the timing of maltreatment recurrence and (b) measure associations between child demographics and characteristics of initial reports with recurrent maltreatment., Method: Using administrative data from the Florida Department of Children and Families, case histories of 189,375 children with an initial maltreatment report in 1998 or 1999 were examined using event history techniques, also known as survival analysis, to assess the relationship between predictor variables and the likelihood and timing of recurrence. Specifically, data were analyzed using descriptive and multivariate analytic methods, including life-table analysis and logistic regression analysis., Results: Over 26% of the sample had a maltreatment recurrence during the 2-year follow-up period, and the risk of recurrence was greatest in the first 4 months after the initial incident. Results also suggest the presence of unique associations between recurrence and a child's race/ethnicity and age, as well as indication level, maltreatment type, and service disposition as specified in the initial report., Conclusions: Results indicate that recurrent reports are more likely for young and White children whose first report resulted in a substantiation of neglect and the provision of in-home preventive services. This research highlights the importance of further investigating the relationship between chronic maltreatment and other influential variables.

Alcohol consumption by youth can produce negative health outcomes. This study identified correlates of lifetime alcohol use, recent alcohol use, and binge drinking among youth in sixth through 10th grade (n = 2,004) in Sarasota County, Fla. Results from a closed-ended, quantitative survey acknowledged a range of personal, social, and environmental influences. Breadth of these influences supports a need for multifaceted, community-based interventions for effective prevention of youth alcohol use. This study was unique because it represents population-specific research in which community partners are using the findings to develop community-specific social marketing interventions to prevent underage drinking and promote alternative behaviors.

This study explored and compared the role of self esteem, stress and social support in maintenance or improvement in physical and psychosocial functioning over 12 months in older men and women with cardiovascular disease. Data from 502 adults over 60 years of age showed that self esteem and stress were both significantly associated with functioning when demographic and clinical factors were controlled. Men were significantly more likely than women to maintain or improve in functioning. Self esteem, stress, compliance with medication regimens, and marital status were significantly associated with maintenance or improvement of functioning among women. Only age and stress were significantly associated with maintenance or improvement in functioning among men. Findings indicated that: (1) stress and self esteem were stronger predictors of functioning, especially among women, than demographic and clinical factors; and (2) women in the highest quartile of the self esteem distribution were approximately five times as likely to maintain or improve their functioning as women in the lowest quartile.

Objective: The associations of prior DSM-III-R disorders with probability and timing of subsequent divorce were examined., Method: The data came from the part II subsample (N=5,877) of the National Comorbidity Survey. The respondents completed a structured diagnostic interview that retrospectively dated age at onset of each of 14 lifetime DSM-III-R disorders and recorded ages at first marriage and divorce. These data were used to estimate survival models describing the relationships between prior disorders and subsequent divorce. In addition, simulations were used to estimate the number of years spent out of marriage because of these causal relationships in the total U.S. population., Results: Prior psychiatric disorders were associated with a substantially higher risk of divorce. The simulations suggested that the effects of these associations in the U.S. population in the survey's age range are approximately 23 million lost years of marriage among men and 48 million lost years of marriage among women., Conclusions: Psychiatric disorders have a number of adverse consequences for those who suffer from them and for their families and communities. The results reported here suggest that an increase in the number of people who divorce and a decrease in the number of years of marriage in the population may be among them. The debate over whether society can afford to provide universal treatment for psychiatric disorders needs to take these costs into consideration.

While studies of psychopathology have begun to consider social consequences of psychiatric disorders during the past decade, marriage has received little attention, despite evidence that it influences life quality. The present paper examines the effects of clinically significant psychiatric disorders on the probability and timing of first marriage and whether the relationships between psychiatric disorders and marriage differ by type of disorder, gender, and birth cohort. Psychiatric disorders are found to have substantial effects on entry into first marriage. These effects are the same for men and women across all cohorts. Individual psychiatric disorders have similar effects on entry into first marriage. Psychiatric disorders are positively associated with early first marriage, which is strongly related to adverse consequences, and negatively associated with on-time and late first marriage, which are related to benefits such as financial security and social support. These results highlight the importance of early interventions for psychiatric disorders-if not for the purposes of primary prevention, then for the purposes of preventing the cumulation of adversities that occur secondarily through early marriage.