Alcohol use of African Americans and Whites from ages 9-20: descriptive results from a longitudinal study.

African American and White youth (N = 405) were assessed annually for 8 years, providing alcohol use data spanning from ages 9-20 years. Alcohol use increased with age, as did binge drinking, drunkenness, peer alcohol use, and ease of obtaining alcohol. At younger ages, the usual alcoholic drink was wine; other drinks were preferred at older ages. Fewer African Americans than Whites reported alcohol use, binge drinking, drunkenness, peer alcohol use, and encouragement of alcohol. These results support and extend previous findings and suggest that contextual influences may help explain alcohol use differences and similarities between African American and White youth.

Development and correlates of alcohol use from ages 13-20.

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.

A measurement model of youth physical activity using pedometer and self, parent, and peer reports.

BACKGROUND: Because no single measure is able to accurately assess all types of physical activity (PA), some researchers advocate use of multiple methods and multiple informants to measure PA. However, little research has tested the validity of proxy reports of youth PA. PURPOSE: The current study determined whether peer, parent, and self-reports reflects a latent measure of youth PA. As a test of construct validity, pedometer data were included in the model and covaried with the second-order target youth PA factor to determine the relationship between the youth PA factor and an objective measure of PA. METHOD: Participants included 291 target youth (ages 10, 12, or 14 years), a peer, and a parent of each target child (N = 873). Each participant reported about target children's vigorous PA during the past 7 days, days of PA in a typical week, and PA compared to others the same age and sex. Pedometers recorded the average number of steps taken per day by target youth over 7 days. RESULTS: Analyses indicated an acceptable fit of the model to the data, as all variables loaded significantly on their respective factors, and all factors had significant loadings on the higher-order target PA factor. A moderate correlation was observed between the higher-order youth PA factor and the pedometer measure. CONCLUSION: Combining multiple reports of youth PA has the potential to yield a more comprehensive measure of youth PA but may not be practical for all studies.

Women, economic hardship and the path of survival: HIV/AIDS risk behavior among women receiving HIV/AIDS treatment in Uganda.

The results are presented from a 2005 survey of 377 women in four HIV/AIDS treatment programs in Uganda. The aim of the study was to explore women's economic hardships and the association with four sexual risk behaviors: whether a woman was sexually active in the last 12 months, whether a condom was used during the last sex act, whether she reported having had a sexual partner in the last six months who she suspected had multiple partners and report of forced, coercive or survival sex in the last six months. Few women were sexually active (34%), likely due to the high proportion of widows (49%). Married women were likely to report forced, coercive or survival sex (35%). Eighty-four percent of women reported condom used at last sex act. Forced, coercive or survival sex was associated with number of meals missed per week (AOR=1.125, 95% CI 1.11, 1.587, p<0.05). Sex with a partner in the last six months who a woman suspected had multiple partners was also associated with number of missed meals per week (AOR=2.080, 95% CI 1.084, 3.992). Currently women in Ugandan antiretroviral therapy programs are not likely to be sexually active, except for married women. Many women need to find food and other support, which may put them at risk of forced, coercive or survival sex due to dependency on men.

The ABC's of LGM: An Introductory Guide to Latent Variable Growth Curve Modeling.

In recent years, we have witnessed an increase in the complexity of theoretical models that attempt to explain behavior from both contextual and developmental perspectives. This increase in the complexity of our theoretical propositions regarding behavior parallels recent methodological advances for the analysis of change.These new analysis techniques have fundamentally altered how we conceptualize and study change. Researchers have begun to identify larger frameworks to integrate our knowledge regarding the analysis of change. One such framework is latent growth modeling, perhaps the most important and influential statistical revolution to have recently occurred in the social and behavioral sciences. This paper presents a basic introduction to a latent growth modeling approach for analyzing repeated measures data. Included is the specification and interpretation of the growth factors, primary extensions such as the analysis of growth in multiple populations, and structural models including both precursors of growth, and subsequent outcomes hypothesized to be influenced by the growth functions.

Use of a Local Worker Survey as a Source of Neighborhood Information.

Researchers increasingly recognize the potential influence of the neighborhood environment on individual health and social behavior. To examine these influences, it is important to use varying measures and sources of neighborhood characteristics. Though neighborhood residents are often surveyed, the perceptions of neighborhood workers have been largely ignored. The current study documents procedures and findings from two longitudinal studies in which workers in 60 neighborhoods were surveyed about neighborhood social cohesion and social control (collective efficacy), and neighborhood problems. Results indicated that workers within neighborhoods were more homogeneous in their views of neighborhood collective efficacy and neighborhood problems than were workers across neighborhoods. In addition, workers' perceptions of their neighborhoods were similar to the perceptions of neighborhood residents, but also provided unique information. Overall, this study demonstrates the viability and usefulness of local workers as an additional source of neighborhood information.

Reliability of pedometer data in samples of youth and older women.

BACKGROUND: Pedometers offer researchers a convenient and inexpensive tool for objective measurement of physical activity. However, many unanswered questions remain about expected values for steps/day for different populations, sources of variation in the data, and reliability of pedometer measurements. METHODS: This study documented and compared mean steps/day, demographic predictors of steps/day, and pedometer reliability in two longitudinal investigations, one involving a population-based youth sample (N = 367) and the other targeting postmenopausal women with type 2 diabetes (N = 270). Individuals were asked to wear pedometers (Yamax model SW-701) at the waist for 7 days and record steps/per day. They were also asked to record daily physical activities, duration, and perceived intensity (1 = low/light, 2 = medium/moderate, 3 = high/hard) for the same 7 days. In addition, survey data regarding usual physical activity was collected. Analyses of variance (ANOVA) were conducted to determine whether there were significant differences in pedometer results according to sex, age, and body mass index. Repeated measures ANOVAs were used to examine potential differences in results among differing numbers of days. RESULTS: Mean steps/day were 10,365 steps in the youth sample and 4,352 steps in the sample of older women. Girls took significantly fewer steps than boys, older women took fewer steps than younger women, and both youth and women with greater body mass took fewer steps than those with lower body mass. Reliability coefficients of .80 or greater were obtained with 5 or more days of data collection in the youth sample and 2 or more days in the sample of older women. Youth and older women were more active on weekdays than on weekends. Low but significant associations were found between step counts and self-report measures of physical activity in both samples. CONCLUSION: Mean steps/day and reliability estimates in the two samples were generally consistent with previously published studies of pedometer use. Based on these two studies, unsealed pedometers were found to offer an easy-to-use and cost-effective objective measure of physical activity in both youth and older adult populations.

A cohort-sequential latent growth model of physical activity from ages 12 to 17 years.

BACKGROUND: Despite serious public health implications of decreased physical activity during adolescence, few longitudinal studies have been conducted to determine the trajectory and important correlates of physical activity change during this period. PURPOSE: This study examines change in physical activity from ages 12 to 17 years and the influences of personal, family, peer, and demographic factors on activity patterns. METHODS: Data were from 371 youth. The sample was 50.1% female, 76% White, 12% African American, 4% Hispanic, 2% Asian, 2% American Indian, and 4% other or mixed races. Mean age was 12.05 years (SD = 1.63) at Time 1. Multivariate latent growth curve modeling (LGM), a cohort-sequential design, and a multiple-group design by sex were employed. RESULTS: Youth physical activity declined significantly from ages 12 to 17. Boys had higher initial levels of physical activity than girls. Efficacy to overcome barriers, physically active friends, and friend social support all played roles in reducing the decline in physical activity. Early maturing boys, although more physically active initially, experienced a greater decline in physical activity compared to later maturing boys. CONCLUSIONS: These findings encourage further research on the etiology and development of youth physical activity using procedures such as LGM to better understand the risk and protective factors associated with youth physical activity decline.

Retention of African-American and White youth in a longitudinal substance use study.

The current investigation discusses successful strategies used to retain N = 405 African-American and White target youth in a longitudinal, non-intervention study focused on alcohol and other drug use. Ninety-one percent of youth remained in the study for all 4 years, including 87% of African-Americans and 96% of Whites. In a logistic regression model incorporating age, ethnicity, income, sex, parent/guardian marital status, parent alcohol use, and family cohesion, only sex significantly predicted retention, with girls being more likely to remain in the study compared with boys, although ethnicity neared significance.

Alcohol use from ages 9 to 16: A cohort-sequential latent growth model.

This study examined alcohol use from pre-adolescence to mid-adolescence and determined the influence of hypothesized covariates on changes in alcohol use rates during this developmental period. The sample comprised 405 randomly recruited youth from three age cohorts (9, 11, and 13 years), assessed annually for 4 years. Youth were 48.4% female, 50.4% African-American, and 49.6% White. A cohort-sequential latent growth model was employed which modeled alcohol use (use versus non-use) from ages 9 to 16 years, accounting for demographic variables of gender, race, parent marital status, and family economic status. Covariates of alcohol use included parent alcohol use, family alcohol problems, family cohesion, parent supervision, peer deviance, peer alcohol use, and peer encouragement of alcohol use. Results showed that proportions of alcohol users increased steadily from ages 9 to 16 years. Significant covariates were found on the intercept and slope. Being female and higher levels of parent alcohol use were associated with higher initial rates of alcohol use, whereas greater friends' encouragement of alcohol use was related to lower initial rates of alcohol use (intercept). Alternatively, more peer deviance and friends' encouragement of alcohol use was related to an increase in alcohol use rates from ages 9 to 16 years (slope), as was being White and from a single-parent family.

Sources and types of social support in youth physical activity.

This study examines the influence of sources and types of social support on youth physical activity. The sample comprised 372 youth (mean age=12.05 years, SD=1.63). Youth were 76% White and 50.3% female. The annual household income for the sample was 20% under $30,000; 30% $30,000-$49,999; 25% $50,000-$69,999; 13% $70,000-$89,999; and 12% $90,000 and above. Results revealed that friends who support and watch youth engage in activities are significantly and positively related to youth physical activity. Significant correlations existed among the type factors. Future research should examine the sources and nature of support and the mechanisms through which social support influences youth physical activity.

A multilevel approach to youth physical activity research.

Social environment factors are hypothesized to interact with individual-level factors to influence youth physical activity. Multilevel analytic approaches are ideal for examining the influence of the social environment on youth physical activity as they allow examination of research questions across multiple contexts and levels ( e.g., individual, family, and neighborhood levels).

The PHLAME firefighters' study: feasibility and findings.

OBJECTIVE: To assess efficacy of 2 worksite health promotion interventions. METHODS: Randomly assign 3 fire stations to (a) team-based curriculum, (b) individual counselor meetings, and (c) control. RESULTS: Both interventions were feasible and acceptable, and they resulted in significant reductions in LDL cholesterol. The team approach significantly increased coworker cohesion, personal exercise habits, and coworkers' healthy behaviors. The one-on-one strategy significantly increased dietary self-monitoring, decreased fat intake, and reduced depressed feelings. CONCLUSIONS: Although both interventions promoted healthy behaviors, specific outcomes differed and reflected their conceptual underpinnings. The team-based curriculum is innovative and may enlist influences not accessed with individual formats.

Telephone Recruitment of a Random Stratified Youth Sample for a Physical Activity Study.

It is important that studies on youth health behavior obtain sufficiently large representative samples so that power is adequate and results are generalizable. Few researchers, however, have documented procedures and methods for recruitment of a random stratified youth sample for studies on health-related behavior, specifically physical activity. This study describes the recruitment methods used to attain a stratified sample of 360 target youth (male and female from 10-, 12-, and 14-year old cohorts), and a parent of each child, representing families in 58 different neighborhoods. A peer of each target youth was also invited to participate. Recruitment was conducted primarily by telephone, using computer-assisted telephone interviewing (CATI) software. Approximately 38% of calls resulted in person contact, of which about 98% of families did not qualify. Of those qualified, about 68% agreed to participate. The telephone recruitment was supplemented by door-to-door recruitment in selected neighborhoods. The average cost of telephone recruitment was approximately $99 per family. Advantages and limitations of the recruitment method are discussed.

Understanding intention to undergo colonoscopy among intermediate-risk siblings of colorectal cancer patients: a test of a mediational model.

BACKGROUND: There is a need for research to identify factors influencing intentions to undergo colorectal cancer (CRC) screening among family members at risk for CRC. This study tested a mediational model primarily guided by Ronis' elaboration of the Health Belief Model in predicting intention to have colorectal cancer screening among siblings of individuals diagnosed with colorectal cancer prior to age 56 years. METHODS: Data were collected from 534 siblings of individuals diagnosed with CRC. A baseline survey was administered by telephone. Measures included perceived susceptibility, CRC severity, physician and family support for CRC screening, cancer-specific distress, the closeness of the relationship with the affected sibling, and future intention to have a colonoscopy. Participant age, gender, and number of prior colonoscopies, as well as the stage of the affected patient's cancer and time from the patient's diagnosis to the interview, were controlled for in the analyses. RESULTS: The proposed model was not a good fit to the data. A respecified model was fit to the data. In this model, physician support, family support, and sibling closeness were significantly associated with both perceived benefits and barriers. Perceived severity was associated with barriers. Benefits and barriers, as well as cancer-specific distress, were directly associated with colonoscopy intentions. Results were consistent with a mediational role for benefits and barriers in the associations of sibling closeness and with a mediational role for barriers in the association between perceived severity and colonoscopy intentions. Family and physician support impacted intentions both directly and indirectly through effects on benefits and barriers. Perceived risk was not associated with benefits, barriers, or colonoscopy intentions. CONCLUSION: Intervention efforts to increase colonoscopy intentions may benefit from targeting family influences, particularly the affected proband in the family, as well as physician influence, cancer-related distress, perceived CRC severity, and perceived benefits and barriers to colonoscopy.

A multilevel contextual model of neighborhood collective efficacy.

Different data sources were used to examine hypothesized relations among neighborhood-, family-, and individual-level variables, and perceptions of neighborhood collective efficacy. Data were from 1,105 individuals (56% female, 42% African American, and 58% White) nested within 55 neighborhoods and 392 families, analyzed within a multilevel design using a 3-level model. At the neighborhood level, the study examined relations between Census, police, and neighborhood representative indicators. At the family level, the model examined the influence of marital status and family income. At the individual level, gender and age were examined. Results indicated that age at the individual level, marital status at the family level, and poverty and perceived gang activity at the neighborhood level predicted levels of neighborhood collective efficacy. The study illustrated significant variation across neighborhoods and families, and demonstrates the utility of combining different sources of neighborhood data to examine relations of interest within a multilevel framework.

Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME).

The Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME) study evaluates the efficacy of two intervention strategies for improving nutrition and physical activity practices in fire fighters: a team-centered program and a one-on-one format targeting the individual. PHLAME compares these two behavior change models (the team-based versus the one-on-one approaches) against a usual-care control group. As a group, fire fighters have a concentration of the same harmful behaviors and health risks commonly afflicting the US population. Fire fighters have a unique work structure which is ideal for a team-centered model of behavior change. This strategy, based on Social Learning Theory, focuses on a team of fire fighters who work together on the same shift. If this team-centered model proves successful, it could provide a cost-effective method to impact behavior, and be disseminated among fire bureaus and in other team settings. The one-on-one intervention incorporates the Transtheoretical Model of behavior change, uses Motivational Interviewing for its counseling strategy and could be used in the more typical provider-client clinic setting. Findings from PHLAME will provide information about the process and outcomes of these models' ability to achieve health behavior change.

Relations between youth antisocial and prosocial activities.

This study examines relations among antisocial and prosocial activities for boys and girls aged 10, 12, and 14 years. Antisocial activities included substance use and other deviant behaviors. Prosocial activities included physical activity, organized sports, organized nonsport activities, volunteer and religious activities. Household income and single-parent vs. two-parent family status were included as covariates. The sample comprised 356 youth (mean age = 12.06 years, 50% female, 73% White). A six-group (Age x Gender) multiple-sample structural equation model was employed to determine the existence of latent factors (substance use, deviant behaviors, prosocial activities) and relations among variables. Results showed a positive relationship among prosocial behaviors, and between substance use and other deviant behaviors. Organized sport and days of physical activity were inversely related to substance use. Higher income and living in a two-parent family were associated with less substance use and deviant behavior. There was little variation by gender and age.

A multilevel analysis of neighborhood context and youth alcohol and drug problems.

Various sources of data were used to examine hypothesized relations among neighborhood variables and youth alcohol and drug problems. Family members (N = 1186) were from 55 neighborhoods: 57% female, 41% African American, and 59% White. Data were clustered by neighborhood and analyzed within a multilevel design. At the neighborhood level, the study examined relations among poverty, stores selling alcohol, neighborhood social cohesion, neighborhood problems with youth alcohol and drug use, and drug and alcohol arrests. At the individual level, gender, ethnicity, adult versus child status, neighborhood social cohesion, and neighborhood problems were examined. Results indicated that more stores sold alcohol in higher poverty neighborhoods, which was associated with less social cohesion. Lower social cohesion was related to greater perceived neighborhood problems with youth alcohol and drug use, which was positively related to neighborhood youth drug and alcohol arrests. The study showed significant variation across neighborhoods and demonstrates the utility of combining different sources of neighborhood data to examine relations of interest.