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Descriptors:
Public Agencies; State Government; Financial Support; State Aid; Smoking; Health Promotion; Health Programs; Program Evaluation; Training; Role; Evaluators; Technical Writing; Reports; Information Utilization; Attitudes; Stakeholders; Accountability; Program Effectiveness; Test Construction; Scoring

Abstract:
Nearly all private, government and non-governmental organizations that receive government funding to run social or health promotion programs in the United States are required to conduct program evaluations and to report findings to the funding agency. Reports are usually due at the end of a funding cycle and they may or may not have an influence on the continuation of program funding. The final evaluation report (FER), as the end-of-funding-cycle report is often called, generally relates the intervention and evaluation results of the funding period and has a dual purpose. It is considered an element of accountability and should give the program and its stakeholders direction for the future. All too often though, this is not the case. Evaluators have voiced myriad concerns about the many issues related to reports and their usage. In their study of a random sample of American Evaluation Association members, Torres et al. (1997) found that evaluators are generally discontent about reporting and about the fact that their reports are often misused or not used at all. Evaluation reports could be a valuable instrument for moving projects forward if stakeholders and project staff would make good use of evaluation findings. The Tobacco Control Evaluation Center (TCEC) (2006) at the University of California at Davis developed scoring measures for final report writing for over 100 local tobacco control projects in California but found 2007 reports lacking in quality. In 2010, it conducted a training campaign in the hope that the projects themselves, the funding government agency and TCEC may make better use of the reports. The response to the training call was overwhelming, and comparing scores from 2007 and 2010, participating agencies made statistically significant improvements but non-participants did not. Results relating to the mode of training were inconclusive. The pre- and post-score comparison proved to be a valuable measuring tool, and the 1-day face-to-face training was a useful training mode. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Pregnancy; Language Impairments; Phonological Awareness; Child Development; Grade 1; Leisure Time; Foreign Countries; Preschool Children; Birth; Parent Background; Age Differences; Migration; Intelligence; Smoking; Television Viewing; Risk; Language Acquisition

Abstract:
Early child development is influenced by various genetic and environmental factors. This study aims to identify factors that affect the phonological awareness of preschool and first grade children. Based on a sample of 330 German-speaking children (mean age = 6.2 years) the following domains were evaluated: Parent factors, birth and pregnancy, child factors, and leisure time activities (all based on parent report). Regression analysis provided information on the relative contribution of each predictor on the explained variance. Results indicate that the variables "migration background," "child age," "child intelligence," "smoking during pregnancy," "language difficulties" (impairments of word expression, grammatical deficits, stutter), and "watching TV" have a significant influence on phonological awareness. (Contains 3 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Health Behavior; Smoking; Adolescents; Genetics; Drinking; Peer Influence; Biochemistry; Risk; Longitudinal Studies; Brain Hemisphere Functions; Guidelines; Incidence; Correlation

Abstract:
We investigate whether the serotonin transporter-linked polymorphic region ("5HTTLPR"), a gene associated with environmental sensitivity, moderates the association between smoking and drinking patterns at adolescents' schools and their corresponding risk for smoking and drinking themselves. Drawing on the school-based design of the National Longitudinal Study of Adolescent Health in conjunction with molecular genetic data for roughly 15,000 respondents (including over 2,000 sibling pairs), we show that adolescents smoke more cigarettes and consume more alcohol when attending schools with elevated rates of tobacco and alcohol use. More important, an individual's susceptibility to school-level patterns of smoking or drinking is conditional on the number of short alleles he or she has in "5HTTLPR". Overall, the findings demonstrate the utility of the differential susceptibility framework for medical sociology by suggesting that health behaviors reflect interactions between genetic factors and the prevalence of these behaviors in a person's context. (Contains 4 tables, 2 figures and 7 notes.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Child Abuse; Smoking; Adolescents; Child Welfare; Drinking; Depression (Psychology); Resilience (Psychology); Early Intervention; Caregivers; Sexual Abuse; Correlation; Symptoms (Individual Disorders); Young Adults; Welfare Services; Religion; Community Involvement; Prevention

Abstract:
Objective: It is well established that child maltreatment reflects a context of risk for multiple negative outcomes. Identifying factors that protect against negative outcomes is important for the development of strengths-based approaches that emphasize resilience, particularly for youth transitioning out of the child welfare system. The current study examined the relationship between an internal resilience measure, the Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003), and several external measures of resilience and behavioral outcomes (tobacco use and dependence, alcohol use and problems, and depression symptoms). In addition, two models of resilience were examined in the context of child maltreatment: a compensatory model and a risk-protection model. Methods: Ninety-three emerging adults (ages 18-25) who were making the transition out of child welfare completed self-report measures of child maltreatment, internal resilience (CD-RISC), external resilience (academic achievement, religious and community involvement, monitoring by caregivers, and presence of an adult mentor), alcohol and tobacco use, and depression symptoms. Results: Internal resilience was significantly associated with involvement in religion and community, and monitoring by caregivers. In addition, internal resilience was negatively associated with past year smoking and nicotine dependence, and with symptoms of depression. Hierarchical regression analyses were conducted to examine the direct and interaction effects of resilience on depression symptoms in the context of child maltreatment. When internal resilience was added to the model, it made a significant contribution to depression scores over and above child maltreatment (physical, sexual, and emotional abuse; emotional neglect). In addition, there was a significant Sexual Abuse x Resilience interaction, wherein high resilience was associated with a reduction in depression scores at higher levels of sexual abuse. Conclusions: These findings support internal resilience as both a compensatory and protective factor for depression symptoms in the context of sexual abuse among emerging adults transitioning out of child welfare. Prevention and early intervention within child welfare should include strengthening internal resilience, with continued monitoring of competencies through the transition from adolescence to emerging adulthood. (Contains 3 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Program Evaluation; Youth; State Programs; Adolescents; Advertising; Regression (Statistics); At Risk Persons; Prevention; Smoking; Telephone Surveys; Health Promotion; Health Behavior; Health Education; Public Health; Adolescent Attitudes; Program Effectiveness; Mass Media Effects; Mass Media Role

Abstract:
In 2003, the state of North Carolina (NC) implemented a multi-component initiative focused on teenage tobacco use prevention and cessation. One component of this initiative is "Tobacco.Reality.Unfiltered." ("TRU"), a tobacco prevention media campaign, aimed at NC youth aged 11-17 years. This research evaluates the first 5 years of the TRU media campaign, from 2004 to 2009, using telephone surveys of NC youth. Overall, TRU campaign awareness was moderate among youth in its first year, with awareness significantly increasing over time. The majority of youth who saw the advertisements reported that they were convincing, attention grabbing and gave good reasons not to smoke. In 2009, logistic regression models revealed awareness of the TRU advertisements was associated with decreased odds of current smoking and experimenting with cigarettes for at-risk NC youth. Results from this research may help other states to define, evaluate and modify their own media campaigns, especially within financially or politically constraining environments. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; Smoking; Family Environment; Risk; Educational Attainment; Socioeconomic Status; Low Income Groups; Health Promotion; Prevention; Health Behavior; Public Health; Program Effectiveness; Questionnaires; Predictor Variables; Statistical Analysis

Abstract:
Our objective was to assess how exposure to secondhand tobacco smoke occurs in Hungarian homes, particularly among non-smokers, and to examine the effectiveness of home smoking bans in eliminating exposure to secondhand smoke at home. In 2009, 2286 non-smokers and smokers aged 16-70 years, who were selected randomly from a nationally representative sample of 48 Hungarian settlements, completed paper-and-pencil self-administered questionnaires addressing tobacco-related attitudes, opinions and behaviors. Chi-square tests, one-way analysis of variance and multivariate logistic regression models were used to assess the effect of demographics, socio-economic characteristics and home smoking policies on the risk of exposure to secondhand tobacco smoke at home. Significantly higher risk of exposure was found among younger, lower educated and poorer people and among those having no or partial home smoking restrictions. There was a significant interaction between education level and home smoking policies: the effect of a smoking ban on exposure to secondhand tobacco smoke was stronger for the lower educated group than the higher educated group. The results suggest that Hungarians are making good progress in implementing home smoking bans, and that in the majority of population these bans are working. More can be done to promote the uptake of home smoking bans among poorer and less educated subpopulations. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; Behavior Change; Qualitative Research; Mothers; Children; Pollution; Smoking; Intervention; Outcome Measures; Barriers; Family Environment; Health Promotion; Health Behavior; Public Health; Child Health; Parent Attitudes; Program Effectiveness; Comparative Analysis; Statistical Analysis; Case Studies

Abstract:
This article explores mothers' narratives of changing home smoking behaviours after participating in an intervention (Reducing Families' Exposure to Smoking in the Home [REFRESH]) aimed at reducing families' exposure to secondhand smoke (SHS) in homes in Scotland. An analysis of qualitative findings illuminates quantitative changes in levels of SHS exposure. Prospective quantitative and qualitative data were drawn from 21 smoking mothers with at least one child under 6 years. Quantitative change was measured by home air quality, i.e. fine particulate matter less than 2.5 micrograms (PM[subscript 2.5]). These measurements guided the organization of mothers into categories of change (smoke-free home at baseline [SFB], smoke-free home at final, some change and no change [NC]). Qualitative data from 17 mothers with non-SFB were analysed thematically within and across these categories. Three comparative case studies illustrate the varying changes made, barriers to change and how mothers valued such changes. The outcomes varied post-intervention, with homes smoke-free, partially smoke-free or making NC. The changes in home smoking behaviour were incremental, yet beneficial to reducing SHS exposure, and related to the nature of the restrictions and personal circumstances in the home pre-intervention. Across all change categories, mothers valued the changes they had made and expressed an intention to increase the changes. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; Indigenous Populations; Stakeholders; Smoking; Health Personnel; Concept Mapping; Focus Groups; Cultural Relevance; Workshops; Brainstorming; Health Promotion; Prevention; Health Behavior; Behavior Change; Public Health; Community Health Services; Program Development; Interviews; Multivariate Analysis

Abstract:
Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Evidence; Risk; Smoking; Intervention; Behavior Modification; Depression (Psychology); Low Income Groups; Socioeconomic Status; Counseling; Counseling Effectiveness; Drug Therapy; Health Promotion; Prevention; Health Behavior; Behavior Change; Health Education; Public Health; Community Health Services; Health Personnel; Program Implementation; Program Effectiveness; Outcomes of Treatment; Correlation

Abstract:
Lay health advisers (LHAs) are increasingly used to deliver tobacco dependence treatment, especially with low-socioeconomic status (SES) populations. More information is needed about treatment adherence to help interpret mixed evidence of LHA intervention effectiveness. This study examined adherence to behavioral counseling and nicotine patches in an LHA intervention with 147 Ohio Appalachian female daily smokers. Participants were randomly selected from clinics and randomized to the intervention condition of a randomized controlled trial. Overall, 75.5% of participants received all seven planned LHA visits, 29.3% used patches for greater than 7 weeks and approximately half received high average ratings on participant responsiveness. Depressive symptoms and low nicotine dependence were associated with lower patch adherence while high poverty-to-income ratio was associated with high responsiveness. Compared with those with fewer visits, participants who received all visits were more likely to be abstinent (22.5 versus 2.8%, P = 0.026) or have attempted quitting (85.0 versus 47.4%, P = 0.009) at 3 months. High participant responsiveness was associated with 12-month abstinence. LHA interventions should focus on improving adherence to nicotine patches and managing depression because it is an independent risk factor for low adherence. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; Urban Areas; Adults; Motivation; Smoking; Intervention; Health Personnel; Disadvantaged Youth; Focus Groups; Slums; Peer Influence; Developing Nations; Health Promotion; Prevention; Health Behavior; Health Education; Public Health; Community Health Services; Adolescents; Adolescent Attitudes; Program Development; Predictor Variables; Social Influences

Abstract:
Project Advancing Cessation of Tobacco in Vulnerable Indian Tobacco Consuming Youth (ACTIVITY) is a community-based group randomized intervention trial focused on disadvantaged youth (aged 10-19 years) residing in 14 low-income communities (slums and resettlement colonies) in Delhi, India. This article discusses the findings of Focus Group Discussions (FGDs) conducted to inform the development and test the appropriateness of Project ACTIVITY's intervention model. The findings of the FGDs facilitated the understanding of factors contributing to increased tobacco uptake and cessation (both smoking and smokeless tobacco) among youth in this setting. Twenty-two FGDs were conducted with youth (10-19 years) and adults in two urban slums in Delhi. Key findings revealed: (i) youth and adults had limited knowledge about long-term health consequences of tobacco use; (ii) socio-environmental determinants and peer pressure were important variables influencing initiation of tobacco use; (iii) lack of motivation, support and sufficient skills hinder tobacco cessation and (iv) active involvement of community, family, religious leaders, local policy makers and health professionals is important in creating and reinforcing tobacco-free norms. The results of these FGDs aided in finalizing the intervention model for Project ACTIVITY and guided its intervention development. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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