%0 Journal Article %J Prev Sci %D 2014 %T A framework for testing and promoting expanded dissemination of promising preventive interventions that are being implemented in community settings. %A Mason, W A %A Fleming, Charles B %A Thompson, Ronald W %A Haggerty, Kevin P %A Snyder, James J %K Diffusion of Innovation %K Evidence-Based Medicine %K Female %K Health Promotion %K Humans %K Male %K Preventive Health Services %K Program Development %K Registries %K United States %X

Many evidence-based preventive interventions have been developed in recent years, but few are widely used. With the current focus on efficacy trials, widespread dissemination and implementation of evidence-based interventions are often afterthoughts. One potential strategy for reversing this trend is to find a promising program with a strong delivery vehicle in place and improve and test the program's efficacy through rigorous evaluation. If the program is supported by evidence, the dissemination vehicle is already in place and potentially can be expanded. This strategy has been used infrequently and has met with limited success to date, in part, because the field lacks a framework for guiding such research. To address this gap, we outline a framework for moving promising preventive interventions that are currently being implemented in community settings through a process of rigorous testing and, if needed, program modification in order to promote expanded dissemination. The framework is guided by RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) (Glasgow et al., Am J Publ Health 89:1322-1327, 1999), which focuses attention on external as well as internal validity in program tests, and is illustrated with examples. Challenges, such as responding to negative and null results, and opportunities inherent in the framework are discussed.

%B Prev Sci %V 15 %P 674-83 %8 2014 Oct %G eng %N 5 %R 10.1007/s11121-013-0409-3 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Changes in self-control problems and attention problems during middle school predict alcohol, tobacco, and marijuana use during high school. %A King, Kevin M %A Fleming, Charles B %A Monahan, Kathryn C %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Alcohol Drinking %K Attention %K Child %K Disruptive, Impulse Control, and Conduct Disorders %K Female %K Humans %K Internal-External Control %K Longitudinal Studies %K Male %K Models, Psychological %K Self Concept %K Smoking %X

Although deficits in impulse control have been linked to adolescent use of alcohol and illicit drugs, less attention has been given to variability in change in impulse control across adolescence and whether this variability may be a signal of risk for early substance use. The goals of the current study were to examine growth in two aspects of impulse control, self-control problems and attention problems, across middle adolescence, and to test the prospective effects of level and change in these variables on levels and change over time in substance use. Data are from a community sample of 955 adolescents interviewed (along with their parents and teachers) annually from 6th to 11th grade. Results indicated that greater self-control problems and attentional problems in the 6th grade and increases in these problems over time were associated with higher levels of substance use at 11th grade. Our results suggest that modeling change over time enhances the understanding of how impulse control influences the development of substance use.

%B Psychol Addict Behav %V 25 %P 69-79 %8 2011 Mar %G eng %N 1 %R 10.1037/a0021958 %0 Journal Article %J Vaccine %D 2011 %T HPV vaccination among a community sample of young adult women. %A Manhart, Lisa E %A Burgess-Hull, Albert J %A Fleming, Charles B %A Bailey, Jennifer A %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Demography %K Educational Status %K Female %K Health Knowledge, Attitudes, Practice %K Humans %K Interviews as Topic %K Longitudinal Studies %K Male %K Papillomavirus Infections %K Papillomavirus Vaccines %K Patient Acceptance of Health Care %K Smoking %K United States %K Vaccination %K Washington %K Young Adult %X

OBJECTIVES: Despite the high efficacy of the human papillomavirus (HPV) vaccine, uptake has been slow and little data on psychosocial barriers to vaccination exist.

METHODS: A community sample of 428 women enrolled in a longitudinal study of social development in the Seattle WA metropolitan area were interviewed about HPV vaccine status, attitudes, and barriers to HPV vaccination in spring 2008 or 2009 at ∼age 22.

RESULTS: Nineteen percent of women had initiated vaccination, 10% had completed the series, and ∼40% of unvaccinated women intended to get vaccinated. Peer approval was associated with vaccine initiation (adjusted prevalence ratio (APR) 2.1; 95% confidence interval 1.4-3.2) and intention to vaccinate (APR 1.4; 1.1-1.9). Belief the vaccine is <75% effective was associated with less initiation (APR 0.6; 0.4-0.9) or intention to vaccinate (APR 0.5; 0.4-0.7). Vaccine initiation was also less likely among cigarette smokers and illegal drug users, whereas intention to vaccinate was more common among women currently attending school or with >5 lifetime sex partners, but less common among women perceiving low susceptibility to HPV (APR 0.6; 0.5-0.9).

CONCLUSIONS: HPV vaccination uptake was low in this community sample of young adult women. Increasing awareness of susceptibility to HPV and the high efficacy of the vaccine, along with peer interventions to increase acceptability, may be most effective.

%B Vaccine %V 29 %P 5238-44 %8 2011 Jul 18 %G eng %N 32 %R 10.1016/j.vaccine.2011.05.024 %0 Journal Article %J Addict Behav %D 2011 %T Is nonmedical prescription opiate use a unique form of illicit drug use? %A Catalano, Richard F %A White, Helene R %A Fleming, Charles B %A Haggerty, Kevin P %K Adolescent %K Analgesics, Opioid %K Drug Prescriptions %K Female %K Humans %K Longitudinal Studies %K Male %K Northwestern United States %K Risk Factors %K Self Medication %K Substance-Related Disorders %K Young Adult %X

Nonmedical prescription opiate (NMPO) use is of great concern because of its high addiction potential, cognitive impairment effects, and other adverse consequences (e.g., hormonal and immune system effects, hyperalgesia and overdose). Due to the combination of drugs used by those who are NMPO users, it is difficult to isolate the negative effects of NMPO use from the effects of other legal and illicit drugs. Based on a stage model of substance use, this study tested whether NMPO use represents a unique form of illicit drug use among emerging adults and whether there are unique consequences of early NMPO use. We used longitudinal data from 912 emerging adults from the Raising Healthy Children study who were interviewed at least annually from the first or second grade through age 21. The findings indicated that almost all NMPO users have also used marijuana and a large majority has also used other drugs, such as cocaine and ecstasy. In addition, more frequent users of NMPOs are also more frequent users of other drugs. Except for violent behavior, NMPO use explained little unique variance in negative outcomes of use (e.g., drug use disorder, mood disorder, nonproductive behavior, poor health, and property crime) beyond that explained by other illicit drug use. Future studies examining the predictors or consequences of NMPO use and nonmedical use of other prescription drugs need to consider use within the context of other drug use.

%B Addict Behav %V 36 %P 79-86 %8 2011 Jan-Feb %G eng %N 1-2 %R 10.1016/j.addbeh.2010.08.028 %0 Journal Article %J J Youth Adolesc %D 2010 %T Identifying trajectories of adolescents' depressive phenomena: an examination of early risk factors. %A Mazza, James J %A Fleming, Charles B %A Abbott, Robert D %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Antisocial Personality Disorder %K Attention Deficit Disorder with Hyperactivity %K Depression %K Female %K Humans %K Male %K Parents %K Risk Factors %K Sex Factors %K Socioeconomic Factors %K Stress, Psychological %K Surveys and Questionnaires %X

Few studies have examined risk factors of childhood and early adolescent depressive symptomatology trajectories. This study examined self-report depressive symptomatology across a 6-year time period from 2nd to 8th grade to identify latent groups of individuals with similar patterns of depressive phenomena in a sample of 951 children (440 girls, 511 boys). Analyses, using semiparametric group modeling (SGM), identified 5 trajectory groups for girls and boys: low depressed stables, low depressed risers, mildly depressed stables, moderately depressed changers, and moderately depressed risers. Individual risk factors, with the exception of shy/withdrawn behavior, were significantly different across trajectory group membership for boys and girls, as was low-income status for boys. Boys in the low depressed and mildly depressed stable trajectory groups had significantly higher levels of antisocial behavior, attention problems, and lower social competency compared to girls in similar groups. These results suggest that universal prevention programs implemented in early elementary school that target selected risk factors may be helpful in reducing future adolescent mental health problems, specifically depressive symptomatology.

%B J Youth Adolesc %V 39 %P 579-93 %8 2010 Jun %G eng %N 6 %R 10.1007/s10964-009-9406-z %0 Journal Article %J J Stud Alcohol Drugs %D 2010 %T Romantic relationship status changes and substance use among 18- to 20-year-olds. %A Fleming, Charles B %A White, Helene R %A Oesterle, Sabrina %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Age Factors %K Depression %K Female %K Humans %K Interpersonal Relations %K Longitudinal Studies %K Male %K Marriage %K Sexual Partners %K Single Person %K Substance-Related Disorders %K Young Adult %X

OBJECTIVE: Changes in romantic relationship status are common in emerging adulthood and may be linked to changes in substance use. This study tested the hypothesis that entry into relationships or transitioning to a more committed status leads to decreases in substance use and that dissolution of relationships or transitioning to a less committed status results in increases in substance use.

METHOD: Data were from a community sample of 939 individuals. Substance use (heavy drinking, marijuana use, and cigarette smoking) and relationship status (single, in a romantic relationship but not cohabiting, cohabiting, or married) were assessed at the beginning and end of three 6-month intervals between the ages of 18 and 20 years. Models were estimated to assess the association between transitions in relationship status and substance use, adjusting for prior levels of use.

RESULTS: There were increases in heavy drinking, marijuana use, and cigarette smoking associated with dissolution of a romantic relationship, as well as increases in marijuana use and cigarette smoking associated with switching partners within a 6-month interval. Mediation analyses found some support for increases in both depressive symptoms and exposure to substance-using peers partially accounting for these associations. Decreases in substance use were not found for individuals entering into a new relationship or transitioning to a more committed relationship status. In fact, cigarette smoking increased among those who went from being single to being in a romantic relationship compared with those whose relationship status did not change.

CONCLUSIONS: Emerging adults who experience dissolution of romantic relationships or quickly move from one relationship to another experience increased substance use. Both depressive symptoms and changes in peer environments may partially account for these changes in use.

%B J Stud Alcohol Drugs %V 71 %P 847-56 %8 2010 Nov %G eng %N 6 %0 Journal Article %J J Health Soc Behav %D 2010 %T Romantic relationships and substance use in early adulthood: an examination of the influences of relationship type, partner substance use, and relationship quality. %A Fleming, Charles B %A White, Helene R %A Catalano, Richard F %K Adolescent %K Courtship %K Data Collection %K Female %K Humans %K Longitudinal Studies %K Male %K Substance-Related Disorders %K Young Adult %X

This study used longitudinal data from 909 young adults to examine associations between substance use and the status and quality of romantic relationships. Heavy alcohol use, marijuana use, and cigarette smoking, as well as relationship status, relationship quality, partner substance use, and other salient life circumstances were assessed at four time points in the two years after high school. Marriage, cohabiting relationships, and noncohabiting dating relationships were associated with reductions in heavy drinking and marijuana use relative to non-dating, after adjusting for adolescent substance use; marriage compared to not dating was associated with reductions in cigarette smoking. For those in romantic relationships, partner substance use moderated the associations between relationship quality and substance use for heavy drinking and for marijuana use, supporting the hypothesis derived from the Social Development Model that the protective effect of stronger social bonds depends on the use patterns of the partner to whom an individual is bonded.

%B J Health Soc Behav %V 51 %P 153-67 %8 2010 Jun %G eng %N 2