Conducting ecologically valid prevention research: recruiting and retaining a "whole village" in multimethod, multiagent studies

Relating Facial Trustworthiness to Antisocial Behavior in Adolescent and Adult Men

Here, we investigate how facial trustworthiness-a socially influential appearance variable-interrelates with antisocial behavior across adolescence and middle adulthood. Specifically, adolescents who look untrustworthy may be treated with suspicion, leading to antisocial behavior through expectancy effects. Alternatively, early antisocial behaviors may promote an untrustworthy appearance over time (Dorian Gray effect). We tested these expectancy and Dorian Gray effects in a longitudinal study that followed 206 at-risk boys (90% White) from ages 13-38 years. Parallel process piecewise growth models indicated that facial trustworthiness (assessed from photographs taken prospectively) declined during adolescence and then stabilized in adulthood. Consistent with expectancy effects, initial levels of facial trustworthiness were positively related to increases in antisocial behavior during adolescence and also during adulthood. Additionally, higher initial levels of antisocial behavior predicted relative decreases in facial trustworthiness across adolescence. Adolescent boys' facial appearance may therefore both encourage and reflect antisocial behavior over time.

Intergenerational associations in onset of cannabis use during adolescence: A data synthesis approach

The present study examined associations between parents' and their children's ages of onset of cannabis use using a data synthesis methodology to pool data from 3 similarly designed intergenerational studies. Regarding age of first use of cannabis, prospective data were collected at one or more assessments from early to late adolescence in each generation. The extent to which parent and offspring gender separately or jointly moderated intergenerational effects was examined. Data were harmonized from studies originating in the states of Washington (Bailey, Hill, Epstein, Steeger, & Hawkins, 2018), New York (Thornberry, Henry, Krohn, Lizotte, & Nadel, 2018), and Oregon (Capaldi, Kerr, & Tiberio, 2018) when the parents were in late childhood to early adolescence; analyses concerned 1,081 parents and their children from 971 unique families. Parents' and their children's age of cannabis use onset during adolescence were modeled using discrete-time survival analysis techniques. Although data were successfully synthesized across the studies, the primary hypothesis was not supported: parents' earlier age of first cannabis use during adolescence was not significantly associated with earlier onset of cannabis use in the offspring generation. Rather, parents' histories of any cannabis use in adolescence-regardless of timing-were linked with increased risk for early onset cannabis use by their children compared to parents with no history of use during adolescence. There were no significant parent, child, or parent-by-child gender moderation effects. Thus, prevention of adolescent onset of cannabis in one generation may have prevention benefits for the next. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Men's misuse of prescription opioids from early to middle adulthood: An examination of developmental and concurrent prediction models

OBJECTIVE

The prevalence of misuse of prescription opioids across adulthood and the associations of such misuse with symptoms of psychopathology and use of other substances were examined for an at-risk community sample of men.

METHOD

For a longitudinal study of boys (N = 206) followed to adulthood, misuse of prescription opioids was assessed on 13 occasions from ages 20-21 years to 37-38 years. Prediction of misuse was examined from prospectively assessed risk factors in 3 models: (a) parental substance use during the men's adolescence; (b) the men's own risk behaviors in adolescence-delinquent behavior, depressive symptoms, and use of tobacco, alcohol, marijuana, and opioids; and (c) within- and between-individual effects of the men's risk behaviors during adulthood.

RESULTS

Opioid misuse was reported by 29% of men. After accounting for effects of age and considered individually, parent marijuana use and all of the adolescent and adult risk factors (except adolescent depressive symptoms) were significant between-individual predictors of opioid misuse. Furthermore, within-individual prediction was significant for adult delinquency and alcohol use after accounting for increases in opioid misuse with age. When risk factors were tested simultaneously, men's adult delinquency and use of marijuana and tobacco remained significant between-individual predictors, whereas no parental or adolescent risk factors remained significant in these models.

CONCLUSION

Both adolescent and adult risk factors were examined that predicted adult opioid misuse. Preventing adolescent problem behavior and using such histories to inform screening for misuse risk in adulthood may reduce the burden of the opioid crisis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Prospective Associations Between Boys' Substance Use and Problem Behavior Histories and Their Facial Trustworthiness in Adulthood

Introduction: People whose faces look untrustworthy tend to receive harsher social evaluations, including more severe criminal sentences. Yet little is known about how much facial trustworthiness reflects individuals' behavioral histories. We examined whether adolescent histories of delinquency and substance use predict strangers' perceptions of young men's facial trustworthiness.

Methods: Boys (n = 206) recruited from schools with higher juvenile crime rates were assessed repeatedly from ages 10–24 years, including arrest records and self-reported delinquency and substance use. Coders blind to the study's purpose rated participants' facial trustworthiness from photographs taken at ages 14 and 24; parent-reported childhood family income and coder ratings of attractiveness and positive affect at age 24 were considered as controls.

Results: Facial trustworthiness at age 24 (but not age 14) negatively correlated with all measures of problem behavior. Yet, self-reported tobacco use occasions from ages 12–23 had the strongest association with facial trustworthiness at age 24, a relation that persisted when controlling for arrests and delinquency from ages 12–23, other substance use, family income, ratings of age-24 positive facial affect, attractiveness, and age-14 facial trustworthiness (β = −.29, 95% CI [−.42, −.15], p < .001).

Discussion: Although boys' early facial trustworthiness did not relate to their later problem behavior, men with histories of more delinquency and tobacco use appeared less facially trustworthy as adults. Appearance-related biases may have forensic and healthcare implications for young men. Additionally, prevention efforts could leverage information about the early impacts of tobacco use on appearance.

Pathways to Preventing Substance Use Among Youth in Foster Care

Substance use problems are highly prevalent among youth in foster care. Such problems in adolescence have long-lasting implications for subsequent adjustment throughout adulthood and even across generations. Although several programs have demonstrated positive results in reducing substance use in at-risk youth, few studies have systemically examined how such programs work for foster youth and whether they are effective for both genders. This study examined the efficacy of KEEP SAFE, a family-based and skill-focused program designed to prevent substance use and other related health risking behaviors among youth in foster care. We hypothesized that improving the caregiver-youth relationship would lead to later reductions in youths' involvement with deviant peers, which subsequently would lead to less substance use, and that this mechanism would work comparably for both genders. A sample of 259 youth (154 girls, ages 11-17 years) in foster care and their caregivers participated in a randomized controlled trial and was followed for 18 months post-baseline. Results indicated that the intervention significantly reduced substance use in foster youth at 18 months post-baseline and that the intervention influenced substance use through two processes: youths' improved quality of relationships with caregivers at 6 months post-baseline and fewer associations with deviant peers at 12 months post-baseline. This suggests that these two processes may be fruitful immediate targets in substance use prevention programs for foster youth. We also found little gender differences in direct and mediating effects of the intervention, suggesting KEEP SAFE may be effective for both genders in foster care.

Assessing Associations in Substance Use across Three Generations: From Grandparents to Sons and from Sons to Their Children

The Three Generational Study (3GS) began in the early 90s and involves the third generation (G3) offspring of second generation (G2) fathers who were originally recruited in 1984 as part of the Oregon Youth Study (OYS) in mid childhood (ages 9-10 years) along with their first- generation (G1) parents. As boys, the G2 fathers lived in higher delinquency neighborhoods of a medium-sized Pacific Northwestern United States city. The OYS-3GS examines questions concerning socially mediated intergenerational transmission versus discontinuity (or moderation) of antisocial behavior, substance use, and related problem behaviors. Questions address influences of the grandparents, or Generation 1 (G1), on their sons in G2 and in turn of these sons and their partners on their own children in G3. In this article, we present an overview of the study design-and underlying theory-related to general and outcome-specific transmission pathways. We then summarize key issues and findings to date related to the current main focus of the study regarding intergenerational associations in substance use.

Middle Childhood Antecedents to Progressions in Male Adolescent Substance Use

Initiation of substance use before the age of 15 to 16 is a distinct risk factor for a variety of mental health problems and eventual drug abuse. Using multimethod, multi-agent measures of child, family, and peer antecedents at age 9 to 10, we studied the longitudinal effects in an at-risk sample of 206 boys. Event history analysis was used to examine the antecedents to patterned alcohol and tobacco use as well as experimentation with marijuana between ages 11 and 16. Univariate models revealed that at Grade 4, most constructs were prognostic of boys’ early substance use. Multivariate event history models clarified the risk and protective structure associated with tobacco, alcohol, and marijuana use. The level of intercorrelation among the predictor variables, however, suggested that family, peer, and child characteristics were inextricably connected within an ecology of development. A structural equation prediction model suggested a higher order construct, “childhood risk structure. ”

Effects of prenatal substance exposure on neurocognitive correlates of inhibitory control success and failure

Adolescents with prenatal substance (drug and alcohol) exposure exhibit inhibitory control (IC) deficits and aberrations in associated neural function. Nearly all research to date examines exposure to individual substances, and a minimal amount is known about the effects of heterogeneous exposure-which is more representative of population exposure levels. Using functional magnetic resonance imaging (fMRI), we investigated IC (Go/NoGo) in heterogeneously exposed (n = 7) vs. control (n = 7) at-risk adolescents (ages 13-17). The fMRI results indicated multiple IC processing differences consistent with a more immature developmental profile for exposed adolescents (Exposed  >  Nonexposed: NoGo > Go: right ventrolateral prefrontal cortex, right cuneus, and left inferior parietal lobe; NoGo > false alarm: occipital lobe; Go > false alarm: right anterior prefrontal cortex). Simple effects suggest exposed adolescents exhibited exaggerated correct trial but decreased incorrect trial activation. Results provide initial evidence that prenatal exposure across substances creates similar patterns of atypical brain activation to IC success and failure.

Heterogeneity in men's marijuana use in the 20s: adolescent antecedents and consequences in the 30s

Adolescent psychopathology is commonly connected to marijuana use. How changes in these adolescent antecedents and in adolescent marijuana use are connected to patterns of marijuana use in the 20s is little understood. Another issue not clearly understood is psychopathology in the 30s as predicted by marijuana use in the 20s. This study sought to examine these two issues and the associations with marijuana disorder diagnoses using a longitudinal data set of 205 men with essentially annual reports. Individual psychopathology and family characteristics from the men's adolescence were used to predict their patterns of marijuana use across their 20s, and aspects of the men's psychopathology in their mid-30s were predicted from these patterns. Three patterns of marijuana use in the 20s were identified using growth mixture modeling and were associated with diagnoses of marijuana disorders at age 26 years. Parental marijuana use predicted chronic use for the men in adulthood. Patterns of marijuana use in the 20s predicted antisocial behavior and deviant peer association at age 36 years (controlling for adolescent levels of the outcomes by residualization). These findings indicate that differential patterns of marijuana use in early adulthood are associated with psychopathology toward midlife.

Influences on Boys' Marijuana Use in High School: A Two-Part Random Intercept Growth Model

This study examined differences in predictors of marijuana use versus quantity of marijuana use across the high school years, using annual assessments from the Oregon Youth Study (OYS) and a two-part model for semicontinuous data. The OYS is a community sample of at-risk boys followed from age 10 years. In order to capture dynamic prediction effects, change scores of predictors, as well as baseline scores, were included. Baseline predictors predominantly showed associations with the intercepts but not with the slopes of growth models. Change scores for parental monitoring, peer substance use, and antisocial behavior and deviant associations were associated with both parts of the model. Findings highlight the importance of looking at marijuana use compared to quantity of marijuana use.

Reaching everyone: Promoting the inclusion of youth with disabilities in evaluating foster care outcomes

Efforts to evaluate foster care outcomes must avoid systematic exclusion of particular groups. Although often unrecognized as such, youth with disabilities are highly overrepresented in the U.S. foster care system, and yet youth with some disabilities, including those with intellectual, serious emotional, and physical impairments may be underrepresented in research and evaluation studies evaluating foster care outcomes. The recruitment and retention of youth with various disabilities in such studies can be impeded by under-identification of disability and relatively high placement and school mobility. Furthermore, youth with various disabilities may experience more disappointing outcomes than foster youth overall, underscoring the importance of including these youth in outcome tracking efforts. This is especially relevant given the recent implementation of the National Youth in Transition Database (NYTD), which requires that state child welfare agencies gather baseline information about youth in foster care at age 17, and then survey outcomes at 19 and 21. To promote the full participation of foster youth with disabilities in such outcome evaluation, this paper describes successful strategies for identifying and retaining participants that were used in three separate longitudinal intervention studies. These strategies include the systematic recruitment of foster youth by special education status, and creative use of validated tracking and retention strategies incorporating minor accommodations as needed.

Recruitment and retention of Latino immigrant families in prevention research

The development and testing of culturally competent interventions relies on the recruitment and retention of ethnic minority populations. Minority immigrants are a population of keen interest given their widespread growth, needs, and contributions to communities in which they settle, and particularly recent immigrants from Mexico and Central and South American countries. However, recruitment and retention strategies for entirely immigrant samples are rarely discussed in the literature. The current article describes lessons learned from two family-focused longitudinal prevention research studies of Latino immigrants in Oregon-the Adolescent Latino Acculturation Study (ALAS) and the Latino Youth and Family Empowerment Project-II (LYFE-II). Social, legal, economic, and political contexts are considered that shape Latino immigrants' experiences in their home countries as well as in the United States. The implications of these contexts for effective recruitment and retention strategies are discussed.

ENROLLING AND ENGAGING HIGH-RISK YOUTH AND FAMILIES IN COMMUNITY-BASED, BRIEF INTERVENTION SERVICES

Increasing interest has been shown in Brief Interventions for troubled persons, including those with substance abuse problems. Most of the published literature on this topic has focused on adults, and on the efficacy of these interventions. Few of these studies have examined the critical issues of enrollment and engagement in Brief Intervention services. The present paper seeks to address the shortcomings in the current literature by reporting on our experiences implementing NIDA funded, Brief Intervention projects involving truant and diversion program youth.

Increasing participation in prevention research: strategies for youths, parents, and schools

TOPIC

Subject participation is a critical concern for clinicians and researchers involved in prevention programs, especially for intensive interventions that require randomized assignment and lengthy youth and parent involvement.

PURPOSE

This article describes details of an integrated approach used to recruit and retain at-risk high school youths, their parents, and high schools to two different comprehensive, "indicated" prevention programs.

SOURCES USED

Parent and youth recruitment and retention data for the two studies is provided in support of the approach described. A coordinated, multilevel approach, organized around cross-cutting issues, is described in detail as a response to the challenges of including vulnerable populations in intervention research.

CONCLUSION

Methods are relevant to nurse clinicians who deliver prevention programs, and are important to clinical research that relies upon adequate participation in research programs.

Growth in alcohol use in at-risk adolescent boys: two-part random effects prediction models

BACKGROUND

Alcohol use frequently onsets and shows rapid growth during the adolescent years, but few studies have examined growth in two indicators, namely in use and in volume given use, with prediction from key risk factors measured across the adolescent years.

METHODS

Based on a dynamic developmental systems framework, we predicted that the general risk pathway associated with the development of antisocial behavior (namely poor parental practices and antisocial behavior/deviant peer association) would be associated with both indicators of use in Grade 6. Specific proximal social influences, namely alcohol use by parents and peers, were also hypothesized, with growth in peer use of alcohol expected to be predictive of growth. Predictors were assessed by youth, parent, and teacher reports, with alcohol use and volume assessed yearly by youth self-reports. Models were tested separately for the 3-year middle school period and the 4-year high school period. Hypotheses were tested for the Oregon Youth Study sample of approximately 200 at-risk boys.

RESULTS

Findings indicated that alcohol use by both parents and peers were associated with initial levels of alcohol use and volume, but increases in peer use predicted growth in these indicators. Parental monitoring showed a protective effect on growth in volume in high school.

CONCLUSION

Alcohol use by members of the adolescent's social network is critical to initiation of use, and peer use is critical to growth. With these predictors specific to alcohol use in the model, none of the general risk factors for antisocial behavior were significant.

Use of coercive sexual tactics across 10 years in at-risk young men: developmental patterns and co-occurring problematic dating behaviors

Men's use of two coercive sexual tactics was tracked over 10 years in a sample of at-risk young men (N = 201). Patterns were identified for each tactic. For the tactic using drugs or alcohol to go further sexually, non-coercers (63%) and coercers (37%) were identified. For the tactic of going further sexually after the woman said "no," three patterns were identified-noncoercers (10%), low-level coercers who used the tactic five times or less over 10 years (42%), and high level coercers who used the tactic more than five times over 10 years (48%). The associations between coercive tactics and two dating behaviors-physical aggression toward a partner and risky sexual behaviors-were examined using multilevel linear modeling. For both coercive tactics, main effects and interaction effects with time occurred for physical aggression toward a partner. The most coercive men perpetrated the most physical aggression toward a partner between ages 18 and 22 years, but sexual coercion was unrelated to partner abuse between ages 22 and 27 years. Results suggest men vary in their use of coercive sexual tactics over time and the frequency of coercion varies based on tactic. Preliminary evidence suggests the use of coercive sexual tactics is associated with physical aggression toward a partner but not risky sexual behaviors, though the strength of the association varies over time.

Intergenerational transmission of internalising and externalising behaviours across three generations: gender-specific pathways

BACKGROUND

Few studies have examined gender-specific pathways in the intergenerational transmission of internalising and externalising behaviours across three generations.

AIM

The current study considered both parental figures' internalising and externalising symptoms simultaneously and tested path models of the transmission of internalising and externalising symptoms from Generation 1 (G1) to Generation 2 (G2) and from G2 to Generation 3 (G3) by focusing on gender-specific pathways.

METHOD

The study used data from the Oregon Youth Study of 206 young men and two associated studies of their intimate partners (Couples Study) and children (Three-Generational Study) over 20 years.

RESULTS

Findings indicated that, in general, mothers' internalising behaviour showed robust influence on offspring's internalising symptoms across three generations, regardless of gender of the child. G2 men's externalising behaviour was further predicted by G1 mothers' internalising as well as externalising behaviour, albeit the latter was only marginally significant. G3 girls' internalising and externalising behaviour was predicted by their fathers' corresponding behaviour. Overall, fathers' influence on their sons was limited.

CONCLUSION

The findings shed important light on potential gender-specific mechanisms of intergenerational transmission of internalising and externalising behaviour.

Der Einfluss von Anreizen auf die Rekrutierung von Eltern und auf die Effektivität eines präventiven Elterntrainings

Zusammenfassung. Theoretischer Hintergrund: Es gibt kaum theoretische Modelle darüber, wie Eltern am besten für die Teilnahme an Präventionsangeboten zu gewinnen wären. Fragestellung: Wirken sich unterschiedliche Anreize auf die Teilnahme an einem kognitiv-behavioralen Elterntraining aus? Haben die Anreize Auswirkung auf die Wirksamkeit des Programms? Methode: Hundertsiebenundneunzig Eltern aus 15 Kindertagesstätten in sozial benachteiligten Stadtgebieten nahmen an dem Training teil, nachdem ihre Kita randomisiert einer der vier nachfolgenden Bedingungen zugewiesen wurde: Training einzeln/unbezahlt, Training einzeln/bezahlt, Training in Gruppe/unbezahlt, Training in Gruppe/bezahlt. Ergebnisse: Es zeigte sich, dass (1) das Elterntraining auch in einer sozial benachteiligten Umgebung deutliche Effekte hervorrief, und (2) die beiden Anreizbedingungen auf Teilnahme und Wirksamkeit differenziell Einfluss nahmen. Während Bezahlung (nicht so das Setting) die Teilnahmebereitschaft von Eltern deutlich erhöhte, wirkte sich das Setting auf die Wirksamkeit aus: Im Einzeltraining veränderte sich das Erziehungsverhalten stärker als im Gruppentraining. In allen anderen untersuchten Bereichen gab es keine Unterschiede in der Wirksamkeit in Abhängigkeit von den Rekrutierungsstrategien. Schlussfolgerung: Diese Ergebnisse unterstützen die Empfehlung, Eltern aus sozial benachteiligten Gebieten für die Teilnahme an präventiven Programmen zu bezahlen, da (1) ein größerer Teil der fokussierten Population erreicht wird und (2) die Bezahlung keine nachteilige Auswirkung auf die kurzfristige Effektivität zeigt.

Early development of delinquency within divorced families: evaluating a randomized preventive intervention trial

This paper reports on an experimental test of coercion theory early onset model of delinquency. Results are from the Oregon Divorce Study-II, a randomized preventive intervention trial with a sample of 238 recently separated mothers and their sons in early elementary school. The objective was to experimentally manipulate parenting variables hypothesized to influence development of delinquent behaviors. Multiple-method assessment spanned 36 months. Because the intervention focused on parent training, we expected that any intervention effects on changes in child outcomes would be mediated by hypothesized intervening mechanisms. Linear growth models showed significantly greater reduction in boys' delinquency and deviant peer affiliation in the experimental group relative to the controls. Subsequent models using no method overlap in constructs demonstrated that the intervention effect on delinquency operated through growth in parenting and reduction in deviant peer affiliation.

Developmental trajectories of offending: validation and prediction to young adult alcohol use, drug use, and depressive symptoms

This longitudinal study extended previous work of Wiesner and Capaldi by examining the validity of differing offending pathways and the prediction from the pathways to substance use and depressive symptoms for 204 young men. Findings from this study indicated good external validity of the offending trajectories. Further, substance use and depressive symptoms in young adulthood (i.e., ages 23-24 through 25-26 years) varied depending on different trajectories of offending from early adolescence to young adulthood (i.e., ages 12-13 through 23-24 years), even after controlling for antisocial propensity, parental criminality, demographic factors, and prior levels of each outcome. Specifically, chronic high-level offenders had higher levels of depressive symptoms and engaged more often in drug use compared with very rare, decreasing low-level, and decreasing high-level offenders. Chronic low-level offenders, in contrast, displayed fewer systematic differences compared with the two decreasing offender groups and the chronic high-level offenders. The findings supported the contention that varying courses of offending may have plausible causal effects on young adult outcomes beyond the effects of an underlying propensity for crime.

Overcoming recruitment challenges in construction safety intervention research

BACKGROUND

Recruiting workers in small construction companies and securing their participation in voluntary safety programs or safety research poses unique challenges. Worker turnover and worksite changes contribute to difficulties in locating and enrolling participants. Economic pressures and time demands potentially threaten ongoing participation.

METHODS

Six simulation exercises designed to reduce back and fall injuries in small construction companies were developed based on data from focus groups of workers and company owners. Working with a workers' compensation insurer, we had access to owner-operators of general, heavy, and special trade construction companies reporting less than $10,000 in payroll expenses. Recruitment methods included a participation incentive, mailed invitations followed by phone contacts, and follow-up reminders.

RESULTS

Despite using recruitment methods recommended in the literature, participation rates were low over a 2-year intervention period. Because of these difficulties, factors affecting participation or nonparticipation became an additional research focus. Owners' perceptions of already having a good safety record and of the time demands of participation were the most commonly cited reasons for not participating.

CONCLUSIONS

Literature on recruitment emphasizes processes and procedures under investigator control rather than understanding potential participants' judgments about the adequacy of their existing practices and the potential benefits of intervention participation relative to potential time and productivity trade-offs. Greater attention to such judgments may enhance recruitment and participation in under-studied and difficult to access populations.

The role of adolescent friends, romantic partners, and siblings in the emergence of the adult antisocial lifestyle

This study investigated the contribution of social processes in boys' adolescent relationships in 3 key domains--same-sex friends, cross-sex romantic partners, and younger siblings--to continued association with delinquent peers in young adulthood and, therefore, to continuance of an antisocial lifestyle. It was hypothesized that levels of negative interaction and antisocial talk observed during problem-solving discussions would be associated across the 3 domains. The influences of negative interactions and antisocial talk in the adolescent relationships on young-adult delinquent peer association were compared in 2 mediational models. It was posited that antisocial talk would be more predictive of continued association with delinquent peers than would negative interactions. Hypotheses were tested on an at-risk sample of young men (the Oregon Youth Study). Findings were generally in keeping with the hypotheses.

Challenges to improving the impact of worksite cancer prevention programs: comparing reach, enrollment, and attrition using active versus passive recruitment strategies

OBJECTIVE

The impact of worksite intervention studies is maximized when reach and enrollment are high and attrition is low. Differences in reach, enrollment, and retention were investigated by comparing 2 different employee recruitment methods for a home-based cancer-prevention intervention study.

METHODS

Twenty-two worksites (N = 10,014 employees) chose either active or passive methods to recruit employees into a home-based intervention study. Reach (e.g., number of employees who gave permission to be called at home), Enrollment (e.g., number of employees who joined the home intervention study), and Attrition (e.g., number who did not complete the 12- and 24-month follow-ups) were determined. Analysis at the cluster level assessed differences between worksites that selected active (n = 12) versus passive (n = 10) recruitment methods on key outcomes of interest. Employees recruited by passive methods had significantly higher reach (74.5% vs. 24.4% for active) but significantly lower enrollment (41% vs. 78%) and retention (54% vs. 70%) rates (all ps < .0001). Passive methods also successfully enrolled a more diverse, high-risk employee sample. Passive (vs. active) recruitment methods hold advantages for increased reach and the ability to retain a more representative employee sample. Implications of these results for the design of future worksite studies that involve multilevel recruitment methods are discussed.

Heterosexual risk behaviors in at-risk young men from early adolescence to young adulthood: prevalence, prediction, and association with STD contraction

Health-compromising lifestyles involve stable patterns of behavior and are associated with high-risk social environments and accelerated developmental trajectories. Developmentally, antisocial behavior is associated with such lifestyles. Mediational models predicting a measure of lifetime average sexual risk behavior assessed over a 10-year period (from ages 13-14 to 22-23 years) were examined for a sample of at-risk young men. The measure included years of abstinence from intercourse as well as levels of 3 key heterosexual indicators of risk: frequency of intercourse, number of intercourse partners, and condom use. Predictors included lifetime average measures of contextual, family, and peer process variables and individual behaviors. In addition, similar models for prediction of STD contraction were assessed. A younger age of onset of intercourse was associated with higher numbers of intercourse partners after onset. As hypothesized, findings indicated mediational associations of socioeconomic status, parental monitoring, deviant-peer association, antisocial behavior, and substance use in the prediction of sexual risk behavior. Lower condom use also predicted STD contraction.

Physical aggression in a community sample of at-risk young couples: gender comparisons for high frequency, injury, and fear

The associations of frequent physical aggression, injury, and fear were examined for a community-based sample of at-risk young couples who were dating, cohabiting, or married. It was hypothesized that frequent physical aggression toward a partner, in the range of shelter samples, is largely caused by antisocial behavior and mutual couple conflict and, thus, that there would be greater similarity across genders in such behavior than has previously been supposed. It was also predicted that levels of injury and fear would be higher in women but that some men would experience these impacts. Findings indicated similarity across genders both in the prevalence of frequent aggression and in its association with antisocial behavior. Furthermore, such aggression was likely to be bidirectional in couples. Contrary to the hypothesis of the study, rates of injury and fear for the women were not significantly higher than for the men.

Description and immediate impacts of a preventive intervention for conduct problems

A population-based randomized intervention trial for the prevention of conduct problems (i.e., oppositional defiant disorder and conduct disorder) is described. The LIFT (Linking the Interests of Families and Teachers) intervention was designed for all first- and fifth-grade elementary school boys and girls and their families living in at-risk neighborhoods characterized by high rates of juvenile delinquency. The 10-week intervention strategy was carefully targeted at proximal and malleable antecedents in three social domains that were identified by a developmental model of conduct problems. From 12 elementary schools, 671 first and fifth graders and their families participated either in the theory-based universal preventive intervention or in a control condition. The intervention consisted of parent training, a classroom-based social skills program, a playground behavioral program, and systematic communication between teachers and parents. A multiple measure assessment strategy was used to evaluate participant satisfaction and participation, fidelity of implementation, and the immediate impacts of the program on targeted antecedents.

The analysis of intervention change in children and families: methodological and conceptual issues embedded in intervention studies

This article provides an overview of methodological and conceptual issues underlying the assessment of change during psychotherapy with children and families. Three central considerations are discussed: (1) What changes do we measure? (2) When do we measure change? (3) How do we measure change? The difficulties with the traditional methods of assessing change are highlighted, and suggestions for a new paradigm that calls for expansion of the nomological network relevant to the analysis of change, as well as the inclusion of more assessment points and more reliable and valid measures of the change process, are presented. Illustrations of key points are provided from the Adolescent Transitions Program, a theoretically based intervention program targeting high-risk youth.

A prospective validation study of inclination, belief, and context predictors of family-focused prevention involvement

Prior research by the authors tested a model of factors influencing parent inclination to participate in parenting interventions. Family context, belief, attitude, and inclination to participate variables from this model were used to predict the actual participation of 1,121 families in assessment and intervention activities of a family-focused preventive intervention research project. Invitations to the project assessment and intervention components were, respectively, about 6 months and 10 months following the initiation of a telephone survey collecting predictor variable data. Logistic regression analyses examining each predictor individually showed that a number of family context, belief, attitude, and inclination variables were predictive of project participation. Subsequently, multiple logistic regressions were conducted, entering variables by blocks corresponding to theoretical model components. These analyses showed that prospectively stated inclination to participate in a parenting intervention and level of education were consistently significant predictors of both assessment participation and intervention enrollment. Implications for both research and practice are discussed.

Challenges in defining and developing the field of rural mental disorder preventive intervention research

An overview of selected issues and challenges in defining and developing the field of rural preventive intervention research is presented. One fundamental challenge is to clarify the distinguishing characteristics of prevention science in rural contexts. Other challenges are evident in the need to address: the lack of consensus on conceptual and methodological approaches to this field, limited empirical study to date, the tremendous diversity of rural populations, and inconsistencies in the usage of the term "rural". This article suggests the organization of a work group to formulate and implement a clear research agenda. In addition, several general questions are discussed that, if addressed, might serve to better define and further develop the field. These questions concern the implications of multiple approaches to prevention science in rural contexts, the classification of rural populations, the functional relevance of rural residence in the etiology of specific disorders, the application of extant etiological models to interventions designed specifically for rural populations, the conduct of rural area prevention needs assessments, the development of models for collaboration between intervention researchers and rural community stakeholders, and strategies to engage rural residents in preventive interventions.

Prevention research in rural communities: overview and concluding comments

This paper provides an overview of the challenges that confront researchers in rural settings, synthesizing the manuscripts in this special issue of The American Journal of Community Psychology. Researchers typically focus on issues of research design, measurement, and data analyses. However, when applied research is conducted in rural settings, greater time and attention are required to identify how the research can be conducted successfully. In this overview of the challenges that confront researchers in rural contexts, qualitative differences between rural and urban environments are described with particular attention to their implications for the conduct of rural research. Finally, theoretical and research topics that can better inform future rural research efforts are discussed.