American Journal of Health Behavior

To identify factors associated with cigarette smoking in the 6th-grade through 10th-grade youth population of Sarasota County, Florida. A closed-ended, quantitative survey was completed by 2004 youth and used to extract population-specific data on the correlates of cigarette use. A range of factors influence cigarette use including self-efficacy to refuse offers of cigarettes, perceived emotional benefits, and perceived maternal disapproval of smoking. 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.

To examine adolescent tobacco use among members of the South-Eastern Europe (SEE) Health Network using data from the Global Youth Tobacco Survey (GYTS). Nationally representative samples were drawn from students in grades associated with youth aged 13 to 15 in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, the Former Yugoslavian Republic of Macedonia, Montenegro, Republic of Moldova, Romania, and Serbia. Current cigarette smoking rates among students ranged from 5.6% to 33.1%. Current use of tobacco products other than cigarettes ranged from 3.6% to 10.2%. If effective programs are not developed, implemented, and enforced, morbidity and mortality attributed to tobacco use will surely increase.

To obtain and discuss in-depth information on health care use in Asian Americans (AAs). Nineteen focus groups were conducted in 174 adults from 13 AA communities in Montgomery County, Maryland. MAX QDA software was used to analyze qualitative data. Financial, physical, communication, and cultural attitudes were 4 major barriers to accessing health care. Underrepresented communities reported unique additional barriers, such as lack of screening opportunities and interpretation services due to lack of resources in the communities. Future studies, public health policy, and funding resources should consider including underrepresented AA subgroups and reflect their needs.

To identify factors associated with successful neighborhood mobilization to prevent teen pregnancy using a positive youth development approach. A multiple case study was conducted on 5 neighborhood partnerships using in-person interviews with key informants, observation of meetings, and review of existing documents. Competent staff, strong sense of community, support of key organizations, shared leadership, effective group process, and a perceived need for the initiative influenced level of mobilization. Organizing neighborhoods around teen pregnancy prevention, even using a youth development approach, is challenging but can be accomplished when the right constellation of factors is in place.

To examine whether theories and/or models are used in interventions geared towards improving health-related outcomes for individuals with limited literacy skills. Intervention studies (n=52) published between 1980 and 2009 that met inclusion criteria were reviewed to assess the topic addressed, type of theory and/or model used, and the extent of theory use. Twenty-one (40.4%) interventions were based on a theory or model. Most of those 21 interventions were either "informed by" (n=15, 71.4%) or "applied" (n=4, 19.1%) theory whereas 2 (9.5%) "tested" theory. Most low-literacy intervention research is not based on any educational, behavioral, or social science theory or model.

To understand changes in cigarette-brand choice by adolescents in the context of demographic differences and advertising. Data from 3 nationally representative cross-sectional surveys of adolescents were analyzed. Marlboro, Camel, and Newport brand cigarettes accounted for over 80% of the cigarettes usually bought by adolescents in 1989, 1993, and 1996. Between 1989 and 1996, Marlboro and Camel market shares changed little, whereas preference for Newport doubled among white and Hispanic adolescents. Brand preference among adolescents has been steadily concentrated among 3 brands. More attention may need to be focused on mentholated brands given the increase in Newport's market share.

To examine the feasibility of using a composite index of smoking behaviors to analyze adolescent smoking. A secondary analysis of data from 10 annual surveys (1991-2000), from 566,467 Indiana students in grades 6 through 12. A composite index was calculated, and differences between index scores were analyzed using 1-way ANOVA, Tukey's post hoc tests, and 2-way moving averages. Index scores increased before 1997 and decreased after 1976, with greater change among 7th through 10th graders. The 2-way moving average comparison of a composite index, used with prevalence-based trend analyses, provides a more complete picture of changes in adolescent cigarette smoking.

To examine the prevalence and trend of inhalant use among Indiana public school students. The Alcohol, Tobacco, and Other Drug Use among Indiana Children and Adolescents surveys conducted annually between 1991 and 2004 were reanalyzed using 2-way moving average, Poisson regression, and ANOVA tests. The prevalence had increased during 1991- 1997, decreased during 1997- 2002, and increased again since 2003. Poisson model estimated an average annual decrease rate of 5.6%. The intensity of inhalant use had also decreased. More males and Hispanics use inhalants. Inhalant use needs to be addressed in drug prevention programs.

To determine trends and sexual risk behaviors associated with anal intercourse among college women over an 8-year period. A sexual activity questionnaire was used to collect data from 813 students enrolled in a women's health course. Thirty-two percent of the women had engaged in anal intercourse, and this measure was consistent across time. Women who had engaged in anal intercourse were significantly younger at first intercourse and had a greater lifetime number of partners and more reported STIs. This study underscores the importance of expanding our understanding of sexual behaviors of college women and openly addressing anal intercourse as a part of the sexual repertoire of college women.

To determine the extent of coverage of tobacco topics, as compared to coverage of health and nonhealth topics, in "general interest" and "health" magazines. Lead articles and fillers published from 1996 through 1999 in 9 widely circulated magazines were studied. Less than 1% of all articles and fillers on health topics focused on tobacco topics. A smaller proportion of tobacco articles and fillers, as compared to other health topics, was published in health magazines than in general interest magazines. Tobacco is covered less, compared to other health topics, especially in health magazines, than its importance warrants as a threat to health.

To examine the current-period cost of treating 4 major smoking-related diseases: lung cancer, chronic obstructive pulmonary disease, ischemic heart disease, and cerebrovascular disease. Analyses are based on the MarketScan database, a medical claims database from large employers. We found that total expenditures to treat ischemic heart disease were highest, followed by those to treat chronic obstructive pulmonary disease (COPD). When median expenditures per claim and disease severity were considered, lung cancer was the most expensive condition to treat and ischemic heart disease the least expensive. Median treatment expenditures increased as the severity of disease increased. Treating smoking-related diseases is costly in the current-period and over a lifetime.

To determine the magnitude and causes of unintentional burn injuries attributed to hot objects or substances among children aged birth to 4 years in the United States. Data were obtained from the National Hospital Ambulatory Medical Care System. Annually, 78,000 infants and toddlers were treated in ambulatory care settings for injuries due to contact with a hot object or substance. Hot foods, curling irons, or clothing irons were the main causes of burns. Due to the varied causes of burns, a combination of health education and product design interventions are likely necessary to prevent these injuries.

To evaluate the accountability of osteoporosis information available in selected mass-circulating women's magazines (n=8) and a sample of newspapers (n=2). Osteoporosis articles (n=132) were assessed for sources of information used, incidence/prevalence statistics, risks factors, and prevention measures. Expert sources were highlighted in the majority of articles, whereas incidence/ prevalence statistics were described in less than half of the articles. Risk factors and prevention measures were outlined in most articles; however, much of the information presented was ambiguous and incomplete. It appears that the reporting of osteoporosis in women's magazines and newspapers is not entirely balanced; thus, future coverage should provide greater detail when reporting risks and preventive measures.

To investigate the association of current smoking with body mass index (BMI) and perceived body weight among high school students in the United States. We analyzed data from the 1999-2005 Youth Risk Behavior Survey. Perceived body weight and BMI were associated with adolescents' current smoking. Adjusted odds ratios of current smoking for overweight and at-risk-of-overweight BMI groups continued to increase over the entire survey years. The more recent the cohort, the stronger the link of current smoking with BMI and perceived body weight. The relationship between body weight and current smoking strengthened over time.

To examine dental visits among smoking and nonsmoking adults in a nationally representative sample. Logistic regression analysis was performed, using a sample of 15,250 US adults from the Medical Expenditure Panel Survey Household Component 2000. Current smokers were less likely to report dental visits (32.9%) than were nonsmokers (45.0%) during 2000. Differences were statistically significant even after accounting for other predictors of dental care use. Efforts to optimize the oral health of smokers and reduce serious oral diseases may benefit from addressing this lower use of dental services among smokers.

This presentation was the introduction of Herbert H. Severson the 2006 American Academy of Health Behavior Research Laureate presented in Carmel, CA, March 5-8, 2006 by Steve Sussman.

To examine associations between menthol cigarette smoking and nicotine dependence, quit attempts, and physical and mental health. Data were drawn from the 2007 Florida Behavioral Risk Factor Surveillance System (BRFSS) and a follow-up survey among current smokers (N = 3396). Univariate and multivariate logistic regression analyses were conducted. In multivariate analyses, menthol cigarette smoking was associated with women, African American and Hispanic race/ethnicity, and greater mental distress. Women, racial/ethnic minorities, and individuals reporting a greater frequency of mental distress are more likely to smoke menthol versus nonmenthol cigarettes. Implications for public health policy and cessation interventions are discussed.

To explore the relationship between health-related quality of life (HRQOL) and nicotine dependence in a representative sample of 3560 Florida smokers. Data from the 2007 Behavioral Risk Factor Surveillance System-Florida Tobacco Callback Survey were used. Logistic regression models were conducted to identify factors independently associated with HRQOL measures. Greater nicotine dependence was associated with poor/fair self-rated health, 1-29 days of poor physical health, and poor mental health, and inactivity in the past 30 days. The consequences of long-term smoking, and thus nicotine dependence, may not be confined to traditional morbidity measures but may include poor perceived health and overall well-being.

To understand vendor perspectives regarding changes made in 2009 to the Special Supplemental Nutrition Program for Women, Infant, and Children (WIC) food package. Fifty-two in-depth, qualitative interviews with owners or managers of small stores in 8 urban areas across 7 states conducted 6-12 months after the changes. Store owners experienced implementation challenges, but felt the changes increased the number of customers, sales, and profits. This research provides vendor perspectives on the 2009 WIC policy changes and may enhance policy implementation directed at increasing healthy food availability, particularly in urban communities.

To examine the relationships of religious involvement and affiliation with health behavior and conditions. A survey (n = 3014) conducted for the Nashville REACH 2010 project included questions about religious affiliation and practice as well as health behaviors and conditions. Bivariate analyses indicated negative associations between religious involvement and health, along with differences between religious affiliations/groups. This relationship changed, however, after controlling for demographic differences and individual differences in religious involvement. Religious groups share not only beliefs, but also socioeconomic, ethnic, and cultural similarities that must be taken into account in research examining religion and health.

To investigate the psychometric properties of the BMSLSS among 522 college students. Internal consistency reliability explored scale reliability, factor analysis explored construct validity, known-groups validity was assessed by use of items from the National College Youth Risk Behavior Survey and Harvard National Survey of Alcohol Use, and criterion-related validity was explored through analyses with the CDC's Health-Related Quality of Life Scale. Acceptable internal consistency reliability, construct, known-groups, and criterion-related validity were established. These findings offer preliminary support for the BMSLSS; it could serve as part of comprehensive evaluations of subjective QOL for program evaluation and/or policy purposes among college students.