Tobacco prevention in North Carolina public schools

The purpose of this study is to report on the extent of, and organization for, tobacco prevention education in North Carolina Public Schools. Moreover, issues for the diffusion of tobacco prevention curricula are discussed. A questionnaire examining tobacco education practices and curriculum within school districts was mailed to health education representatives in each of the North Carolina public school districts. One-hundred twenty-five usable questionnaires were returned for analysis (125/140 = 89.3%). Of the school districts responding to the survey, 101 (80.8%) reported having adopted a system-wide curriculum which includes tobacco-related instruction. Additionally, a large percentage of the school districts with an adopted curriculum were using commercially published materials (85.2%). Large tobacco producing counties in North Carolina were not significantly different than other counties in the adoption or public acceptance of school programs with a tobacco prevention component. However, school systems with an adopted, general tobacco use policy for the district were more likely to have adopted a district-wide tobacco education curriculum. Individual schools were also involved with multiple tobacco prevention curriculum and learning programs. In the sixth, seventh, and eighth grades, the sample reported using a total of twelve different programs. Many of these learning programs lacked necessary elements of effective programs. Key diffusion issues included the impact of multi-tobacco curricula use to the introduction of new and effective material, as well as the association between district-wide tobacco use policies and the adoption of curriculum.     

Importance of tobacco cessation services at higher education public institutions in Texas

While rates of tobacco use on university campuses rose over the past decade, little is known about what institutions are doing to address this rising concern. Health center directors at public institutions of higher education across the state of Texas were surveyed (n = 42) regarding the perceived importance of smoking cessation, prevalence of interventions on their campuses, and perceived success of intervening efforts. While most health center directors regarded smoking cessation as important, over half of the directors indicated that their sites did not offer tobacco cessation services of any kind. Furthermore, of those offering smoking cessation, most believed that their smoking cessation programs were only somewhat or not at all effective. Findings revealed that there is a noticeable gap between perceived importance and actual implementation of smoking cessation programs within university-based health centers. Recommendations include implementing innovative cessation methods, such as those that are Web-based and highly accessible to students.     

Reading Rites: Teaching Textwork in Graduate Education

The ability to comprehend, discuss, and use disciplinary texts is central to graduate education. Although techniques for teaching writing have been well-discussed, and even incorporated into graduate curricula, the same is not true for techniques of scholarly reading, a crucial skill that is largely untaught and which students must learn independently or through shared culture. We argue that more explicit training in reading has potential benefits for graduate student education. Drawing on thirty-six in-depth interviews with students in the social sciences, we focus on the routines of managing academic reading, necessary for accessing information for research. Graduate students develop techniques and schedules that permit them to read rapidly or carefully, to read for different academic purposes, and to make information retrievable through notating. We suggest how graduate programs might incorporate reading education into the curriculum.     

An impact evaluation of student teacher training in HIV/AIDS education in Zimbabwe

Zimbabwe introduced a nation-wide program to teach AIDS education in 1994. This paper evaluates changes in student teachers' level of knowledge about transmission, symptoms and prevention of STDs and HIV/AIDS; their attitude towards persons living with AIDS; and their sensitivity to the impact of the epidemic and to discussing and teaching about these issues. There was an increase in knowledge of HIV prevention and in teachers' ability to discuss reproductive health and sexual issues. However, as students were exposed to other HIV material outside the programme, not all of this change is due to the programme. Course attendance needed to be enforced and the curriculum needed to be updated with student participation. Peer educators and participatory techniques are needed to get students to internalise positive attitudes and behaviour. The education materials need to address the lack of female empowerment in making decisions and negotiating for safer sex.     

An Evaluative Review of Outcome Research on Universal Mental Health Promotion and Prevention Programs for Higher Education Students

Abstract

Objective: This review is the first large-scale attempt to evaluate the effectiveness of universal promotion and prevention programs for higher education students on a range of adjustment outcomes. Participants/Methods: The current review examined 83 controlled interventions involving college, graduate, and professional students, with a focus on 3 main outcomes: social and emotional skills, self-perceptions, and emotional distress. Results/Conclusions: Skill-oriented programs that included supervised practice demonstrated the strongest benefits, thus showing promise as a successful mental health promotion and preventive intervention. In comparing different intervention strategies, mindfulness training and cognitive-behavioral techniques appear to be the most effective. Furthermore, interventions conducted as a class appear to be effective, suggesting the potential for exposing higher education students to skill training through routine curricula offerings. This review offers recommendations for improving the experimental rigor of future research, and implications for enhancing campus services to optimize student success in psychosocial—and thus ultimately academic—domains.     

Evaluation of a tobacco prevention program on knowledge, attitudes, intention and behavior of tobacco use among fourth grade students--a preliminary study

This was a preliminary study to evaluate the effectiveness of a tobacco prevention program on knowledge, attitude, intention, and behavior of tobacco use among fourth-grade students in four north central Florida counties. The results suggest that the program was effective in improving students' knowledge, attitudes, and intention toward not using tobacco products. Data analysis showed that students in the education group had a greater improvement in knowledge than the comparison group. Students in the education group also improved their attitude and intention scores while the comparison group did not show any improvement. The results also indicated positive responses from the students. In addition, teachers also gave a very positive response to the program.     

Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.     

Tobacco prevention education in schools for the deaf: the faculty perspective

We report results of a survey of tobacco education practices and perspectives among faculty at four Schools for the Deaf participating in the trial of a tailored tobacco prevention curriculum. Few faculty (20.4%) included tobacco use among the three most important health problems facing their students, although 88.8% considered tobacco education to be worthwhile. Despite perceived unmet needs among their students, classroom or school-wide attention to tobacco prevention was limited. Only 13.9% reported delivering tobacco programming in the prior year, most often reporting lack of deaf-friendly curriculum and materials (60.9%), time (47.8%), and training (43.5%) as barriers to program delivery. Perceptions, attitudes, and institutional issues, including lack of tailored curriculum, were seen as contributing to the limited focus on this important health problem.     

Sexually transmitted disease services at US colleges and universities

The authors' objectives in this study were to describe the proportion of schools providing and the percentage of students with access to HIV and sexually transmitted disease (STD) education, treatment, and prevention services at 2-year and 4-year US colleges and universities. The authors mailed self-administered questionnaires to a stratified random sample (n = 910) of the 2,755 US schools with an enrollment of more than 500 students; 736 (81%) returned the survey. Four hundred seventy-four schools (60%) had a health center, representing 73% of students. Schools with a health center or housing for students were more likely to provide STD education; 52% of the schools made condoms available to students. Sixty percent of schools with health centers could test for both Chlamydia trachomatis and Neisseria gonorrhoeae, but only 67% of these schools screened women for these infections. Although most schools provided some prevention education, access to prevention, testing, and education should be increased at schools where these services are possible but not available.     

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use Among College Students

Abstract

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.     

Expertization of Everyone and the Revolt of the Client*†

American society is witnessing a dramatic explosion and dissemination of knowledge, accompanied by the increasing refusal of patients, customers, students, and other types of clients to passively receive the services of the expert in any body of knowledge or skill. There has been an expansive growth of occupational experts and a demand on the part of clients for a change in the relation. Knowledge monopolization is decreasingly possible due to the activities of mass communication and of the literate public, and clients are becoming varied in the amount of knowledge with which they turn to the expert. Thus, while the political and economic groups are increasingly depending on the expert elite for plans and programs, the members at all levels of society are demanding rights of decision making.     

Smoking cessation and relapse prevention among undergraduate students: a pilot demonstration project

The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that peers were effective facilitators. Relapse-prevention interventions, which began immediately after participants quit smoking, included 6 monthly group programs and individual meetings. Each session provided education and training in stress management, nutrition and exercise habits, managing environmental smoking triggers, and coping in social situations. After participating in the relapse-prevention programs, 63.3% of the initial quitters remained smoke free, another indication that peers were effective facilitators. The success of the program, combined with the dearth of population-specific cessation and relapse-prevention tools, suggests that college administrators and health educators should develop integrated tobacco management strategies on college campuses.     

The prevention of gambling problems in youth: a conceptual framework

Despite increased awareness of the need to begin educating young children about the potential dangers of gambling, empirical knowledge of the prevention of adolescent problem gambling and its translation into science-based prevention initiatives is scarce. This paper poses the question of whether or not the common elements of tobacco, alcohol, and illicit drug abuse prevention programs can be applied to gambling prevention. Common risk and protective factors across addictions, including gambling, appear to point to the need to develop a general model of primary, secondary, and tertiary prevention. The authors present the need for science-based prevention initiatives and describe a general adolescent risk-taking model as a basis for science-based prevention of adolescent problem gambling and other risk behaviors.     

Tobacco, depression, and lifestyle choices in the pivotal early college years

The author explored the correlates of tobacco use among 18- and 19-year-old students at a major midwestern university. A sample of 203 randomly selected freshmen and sophomore students completed a survey that included questions about tobacco use, other drug use, mental health issues, eating disorders, stress, smoking environment, and healthy lifestyles. The prevalence rate for tobacco use was 29% for the past year and 32% for the past month. Multivariate analyses suggested that students with a lifetime diagnosis of depression or treatment for depression were 7 times as likely as other students to use tobacco. In addition, marijuana and alcohol use and weekend exposure to smoke increased the likelihood of being a tobacco user. Stress and diet behaviors were found not to be significantly associated with tobacco use. Implications for health promotion among high school and college populations are drawn from the study findings.     

Evaluation of community-based AIDS education and risk reduction projects in ethnic and racial minority communities: A survey of projects funded by the U.S. public health service

The purpose of this study was to describe proposed program evaluation methods used to determine effectiveness of selected federally funded AIDS education and risk reduction interventions focused on ethnic and racial minority populations. Funding for AIDS prevention programs has grown significantly since 1985, when the first allocation of $11 million was earmarked for general AIDS prevention and education. In 1987, funds specifically targeting minority populations were set aside from AIDS prevention and education programs. Nine agencies/divisions within the Department of Health and Human Services (DHHS) were identified as having funded AIDS prevention and education projects targeted toward ethnic and racial minority populations. The grants and contracts reviewed for this study were limited to those programs receiving Federal funding through DHHS. Few programs provided information within the broader context of sex education and drug education. The modification of needle-sharing behavior among IV drug users and unprotected sex with an IV drug user were the two most frequent risk factors targeted. All 63 programs used at least one formative evaluation method. The most frequently used formative techniques were monitoring achievement of project objectives and counting the number of people participating in program activities. Forty programs counted the amount of AIDS literature distributed. Thirty-three programs conducted a baseline assessment of AIDS knowledge, and 33 programs conducted a baseline assessment of risk behaviors for HIV infection. Results from this study support the National Academy of Sciences recommendation that while summative evaluation will ultimately be valuable, it would be premature to begin developing outcome evaluation strategies at the present time. It is incumbent upon program planners and evaluators to ensure that premature program evaluations are not made in an effort to eliminate direct federal funding of minority community-based strategies to stop the spread of HIV infection.     

Student perceptions of international education and study abroad: a pilot study at York University,Canada

International student mobility has been identified as a key strategy for the internationalization of higher education. Although an institutional priority, Canada has among the lowest levels of international student mobility, with only 2% of full-time university students participating in study-abroad programs. This pilot study, conducted at a large public university in Toronto, examined the value that students place on international education, their awareness of opportunities made available by the university, their attitudes toward, perceptions of, and preferences toward study abroad, and the institutional and individual factors that influence their intent to engage in study abroad. The study found associations between students’ intent to study abroad with their perceived social and institutional support and academic hassles at the host and home institution. It identified three distinct groups within the population, those intending to study abroad, those unsure about their plans, and a third group who does not seek to pursue study abroad. In terms of applied value, the findings will inform program administrators how to customize their support services and programs to both assist interested students and attract new students that otherwise would not be interested in such an experience.     

Teacher training in norm setting approaches to drug education: a pilot study comparing standard and video-enhanced methods

Norm setting has been shown to be a crucial element of effective drug education. The purpose of this study was to examine the degree to which a videotape describing concepts and methods for establishing positive norms would enhance standard training. Participants included 35 teachers and 64 health education students who were randomly assigned to the standard training condition or the video-enhanced training. Participants completed pretest and posttest measures of beliefs, attitudes, and knowledge concerning prevention methods. Both the standard and the video-based instruction produced improved understanding of norms and norm setting prevention methods. However, the video-based instruction resulted in several notable improvements beyond what was achieved in standard instruction. Video training can be an important tool as research-based drug abuse prevention achieves wide-scale dissemination. It offers a way of standardizing training and has the potential to increase the fidelity with which prevention programs are implemented.     

Social skills, competence, and drug refusal efficacy as predictors of adolescent alcohol use

Numerous alcohol and drug abuse prevention trials have included social resistance training as a strategy for reducing early-stage adolescent alcohol use. Evaluations of these trials has shown them to be moderately effective, although the precise impact of the resistance training in comparison to other programmatic features has not been clearly identified. The current study examined the extent to which assertiveness and related social skills, personal competence (perceived cognitive mastery), and refusal efficacy predict alcohol involvement. Males were at greater risk for poor refusal skills and reported higher alcohol involvement. Cross-sectionally, youth characterized by poor social skill development reported lower refusal efficacy, lower grades, poor competence, and more alcohol use. Poor refusal efficacy was associated with more risk-taking, lower grades, less competence, and more alcohol use. Longitudinally, both poor refusal skills and risk-taking were associated with higher alcohol use. High personal competence was associated with lower alcohol use in both the eighth and tenth grades, but had no long-term effects on alcohol use. Findings highlight the close interplay between perceived competence and refusal skill efficacy, both of which should be included as essential components of school-based prevention strategies.     

A collaborative approach to nutrition education for college students

It is well established in the literature that college students have poor eating habits and that many barriers exist to achieving optimal nutrition for this busy population. Little is known about students' perceptions of this problem or suggestions for improving their dietary habits. Similarly, college health professionals need innovative approaches to nutritional education. In an effort to develop an online nutrition resource specifically geared to college students, the authors assessed the availability of Internet-based nutritional information for this population and conducted focus groups with students and health professionals to identify relevant nutrition concerns. They used concept-mapping techniques to conduct a systematic analysis of the qualitative information generated from their focus group participants. Their findings emphasize the need for targeted resources for college students and the importance of using students' suggestions in developing nutrition programs.     

College smoking policies and smoking cessation programs: results of a survey of college health center directors

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessations programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.