Alfred McAlister - US grants

community; mass information media; tobacco abuse prevention;

The project will demonstrate and analyze the effect of mass media and community organization and training to reduce cigarette smoking in specific low income population near the Mexican border in South Texas. Smoking rates are relatively high among men in this group and, if current trends continue, rates of smoking-related cancer may increase relative to populations in which smoking rates among men have decreased. The investigators will construct a partially-randomized, longitudinal, quasi-experimental design involving residents of eight selected locations where adults (18-64yrs.) in approximately 3,500 households and approximately 18,000 students (14-18 yrs.) in ten senior high school will be invited to participate in the research program. In all locations, cigarette smoking and variables related to cigarette smoking will be measured over a five-year period in household interviews of adults from randomly sampled census blocks and class-room surveys of students from senior-high-schools. In sub-samples, two or three biochemical tests will be employed to supplement self-reports of smoking. Three of the study locations will provide control or comparison for assessing program effects in four other study locations where different media/community activities will be conducted for smoking prevention/cessation. One location will serve as a control for the first two years before experimental programs to reduce smoking are introduced there. Three levels of experimental activity will be established sequentially in different locations and/or blocks or neighborhoods within locations: (1) Mass media program only; (2) Media and direct community organization and training to increase encouragement and reinforcement for responses specifically related to smoking cessation/prevention; (3) Media and community organization as above, with establishment of additional systems for more general social support for stress-coping. The different experimental methods will be based on theoretical principles from the behavioral sciences and will also be designed to correspond to meaningful policy option for local and regional planners. All program activities will be integrated into existing public health service structures though local authority and with active participation of the study communities to demonstrste effective material and services that can be feasibly continued and adopted by other public health agencies.

Mexican Americans; neoplasm /cancer education; cancer risk; nutrition aspect of cancer; alcoholism /alcohol abuse prevention; community health services; tobacco abuse prevention;

Mexican Americans; neoplasm /cancer education; cancer risk; nutrition aspect of cancer; alcoholism /alcohol abuse prevention; tobacco abuse prevention; community health services; nutrition related tag;

A comprehensive program of pre and postdoctoral education and training is proposed to provide professional preparation in the application of behavioral sciences to cancer prevention and control. In year-1, two pre and two postdoctoral positions are requested; while in years 2, 3, 4 and 5, four pre and four postdoctoral positions will be enrolled. Predoctoral students will complete a curriculum of classroom instruction in cancer epidemiology, behavioral science, health promotion and research methodology, and will be placed in research training positions. Postdoctoral fellows, some of whom will complete M.P.H. degrees during training, will attend selected classes and seminars, and be placed in research settings where they can gain experience appropriate to their interests and career goals. In both pre and postdoctoral education the experience includes: (1) advanced study of theories of behavior and behavior change; (2) development of methodological skills; and (3) acquisition of practical experience in carrying out cancer prevention and control studies in a variety of real world settings. The core training faculty is involved in a wide range of studies, largely supported by the National Cancer Institute (NIH and CDC awards for the current year's direct costs total $2,709,685), which provide high-level opportunities for skills development in research methodology, program planning and implementation and dissemination of new approaches to cancer prevention and control.. This cancer education proposal is an expansion and enhancement of our present postdoctoral program and will focus on both pre and postdoctoral education for the use of behavioral sciences in cancer prevention and control across diverse settings for public action. If the proposed education grant is awarded, it will replace the training grant (presently in its final year). We place an emphasis on the education of minorities and women, particularly Hispanics who receive training in connection with community studies of Mexican-American populations. A total of seven African-American and Hispanic students/fellows have been previously or currently involved in training activities, including three recently enrolled in predoctoral education. Of four minority trainees who have completed education and training programs in the Center for Health Promotion Research and Development, three have taken academic research positions and shown impressive initial accomplishments in obtaining support for original programs of independent research.

Mexican Americans; neoplasm /cancer education; cancer risk; nutrition aspect of cancer; alcoholism /alcohol abuse prevention; tobacco abuse prevention; community health services; nutrition related tag;

Moral disengagement is the process through which people can inflict suffering on others with a clear conscience. Numerous studies have validated this concept and recent research has shown that moral disengagement can be measured and that these measures can predict youth violence and delinquency. Pilot studies have shown that peer modeling and education can reduce moral disengagement and intolerance and that those reductions may prevent intergroup aggression and increase opposition to military violence. Based upon these preliminary studies, the investigators will develop and then qualitatively and quantitatively pretest a comprehensive set of instruments to measure the moral disengagement processes that influence seven individual and collective forms of violence among diverse groups of urban youth (high school students ages 14-15 in Houston, Texas). School- and media community-based instruction and education materials will also be developed to provide peer modeling and education promoting moral engagement (ie, resistance to moral disengagement). Then two, successive randomized nine-month school- community-level experiments will be conducted with two treatment and two comparison schools and approximately 3,000 research participants. This experiment will determine whether the instruction and education decreased moral disengagement and whether those reductions resulted in reduced rates of reported violent and delinquent behavior and behavioral intentions and in lower levels of reported victimization by violence in various forms.

More than 26,000 people die each year as a result of tobacco use in Texas. To lessen the health burden of tobacco, innovative and intensive interventions are urgently needed. The tobacco suit settlement in Texas has led to an allocation of approximately $10 million/yr. for state-level tobacco control. To match per-capita expenditures that have appeared to influence behavior in other major state initiatives, the funds will be concentrated in media, community and policy activities for a single region, involving approximately one-fifth of the state population and forming a "natural" quasi-experimental design. The University of Texas School of Public Health, the Baylor College of Medicine and the Texas Department of Health (TDH) will evaluate these regional activities and investigate their processes and effects in the three major cultural groups in Texas (Anglo-, Hispanic- and African-American). Data sources will include annual telephone surveys of adults (approx. 10,000 year/with 2,200 smokers), biannual surveys of secondary school students (n=15,000/2 years), surveys of physicians, other providers, schools, other organizations and key individuals, media content tracking and other qualitative and quantitative studies to document and evaluate the implementation of media, community and policy activities. In the quasi-experimental regional studies, trends in adult and youth prevalence and related factors will be compared in statewide and regional groups. Tobacco use cessation effects in the intensive regions will be evaluated through comparative panel studies. In an experimental study limited to randomly selected panel participants, some smokers and their families will receive mail-telephone contacts from peer outreach workers to increase exposure and response to media and community activities. The research designs employed in these studies will allow us to answer questions about the effects of different intensive regional interventions on tobacco use prevalence and smoking cessation and the processes and qualitative factors that are associated with the success or failure of different interventions in different ethnic and SES groups. To enhance the quality of intensive regional activities supported by the settlement funds, technical assistance will be provided through training workshops for TDH and its partners and contractors, focusing on effective multi-cultural action and the use of innovative media, community and policy interventions to address specific theoretical variables related to cessation and prevention. A publicity and peer modeling campaign will be conducted to promote individual behavior change and organizational program and policy innovation. This regional project within Texas is designed to gather evidence of effects of anti-smoking expenditures and to provide capacity development to justify later funding of similarly intensive tobacco control activities for the entire state.