Stuart Usdan

Purpose: The purpose of this study was to identify the relationship between work-related, individual, and environmental factors and self-reported standing time during the workday. Design: Cross-sectional study design. Setting: Participants were recruited from a large, public university in the southeastern United States. Measures: Data were collected through an 87-item online survey using previously validated scales that assessed workplace standing time, demographic variables, work-related psychosocial factors, and workplace environment factors. Analysis: One-way analysis of variance, Pearson correlation coefficients, and nonparametric tests were used to determine univariate relationships between standing time and independent work-related variables and demographic factors. Results: Mean standing time among the sample (n = 502) was 72.49 minutes (standard deviation = 73.48) daily. There was a significant relationship between standing time and barrier self-efficacy for standing at work...

Blacks in the USA, including black men who have sex with men (MSM), tend to have stronger religious and spiritual affiliations compared with other racial/ethnic populations. HIV and STD incidence rates continue to rise among Black MSM. Using data from the CDC Brothers y Hermanos (ByHS) project, this study examined correlations between high-risk behavior, e.g., substance use and high-risk sexual behavior (e.g., condom use history, unprotected sexual intercourse, HIV infection status, and STD infection status) religiosity, spirituality, age, among Black MSM (N = 1141). This exploratory study examined whether religiosity and spirituality were associated with high-risk behavior and high-risk sexual behavior among Black MSM. Religiosity and spirituality indices were compiled from the ByHS data. The religiosity index was significantly associated with HIV infection and use of cocaine, crack, and poppers as well as marginally associated with ecstasy use. Spirituality was significantly assoc...

Screening risky drinking college drivers is important in prevention research. This study validates existing impaired driving risk criterion by Schumacher et al. (2002) on 2,659 undergraduates where 64.8% were female, 54.3% were white, average age = 20.7 (SD=18.8). Drinking and drinking and driving were assessed by Impaired Driving Screener and readiness rulers to assess behavior change. There were 3 risk groups based on number of drinking and driving episodes in last 30 days [low= 0 (n=2122 or 79.8%); moderate=1 (n=231 or 8.7%); high=2 or more (n=306 or 11.5%)]. Most high risk students (90.5%) were monthly drinkers (intoxicated 1 or more times/month) while 65.4% and 23.8% in moderate and low groups drank monthly. High risk (42.5%) were more likely to binge drink (> 5 drinks at least twice/week) compared to moderate (10.8%) and low risk (4.2%) groups. All high and moderate risk students drove after drinking in lifetime, but so did 30% of low risk group. High risk group drove after...

HIV infection rates continue to disproportionately affect Black men who have sex with men (Black MSM) compared to other groups. Research has shown that higher rates of substance use and higher levels of depression are positively correlated with higher sexual risk behavior, and little research has examined relationships between high levels of religiosity and spirituality prevalent in Black culture and issues of substance use and depression among Black MSM. This study did just that and found a relationship between religiosity, spirituality, and risk behavior. These relationships suggest that future HIV prevention models might incorporate religiosity and spirituality to increase the efficacy of risk reduction interventions for Black MSM.

Tanzania has the highest burden of cervical cancer in East Africa. This study aims to identify perceived barriers and facilitators that influence scale-up of regional and population-level cervical cancer screening and treatment programs in Tanzania. Convenience sampling was used to select participants for this qualitative study among 35 key informants. Twenty-eight stakeholders from public-sector health facilities, academia, government, and nongovernmental organizations completed in-depth interviews, and a seven-member municipal health management team participated in a focus group discussion. The investigation identified themes related to the infrastructure of health services for cervical cancer prevention, service delivery, political will, and sociocultural influences on screening and treatment. Decentralizing service delivery, improving access to screening and treatment, increasing the number of trained health workers, and garnering political will were perceived as key facilitator...

ABSTRACT This chapter describes 2 treatment outcome studies for cocaine dependency among homeless people and presents the findings (J. Milby et al., 1996). It also describes how contingency management was used in these studies and discusses the options for technology transfer of contingency management interventions. Before describing the studies, the authors briefly review the relevant literature on homelessness and substance abuse. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Abstinence, employment, and homelessness treatment outcomes at 12-month follow-up are presented from a study comparing behavioral day treatment plus abstinence-contingent housing and work therapy with behavioral day treatment only among homeless persons who abuse crack cocaine. Within-group improvements were revealed, but group differences for drug abstinence found in J. B. Milby et al. (2000) failed to persist at 12 months. Drug use measurement and treatment termination explanations are discussed. Within- but not between-group differences were found for employment and homelessness outcomes at long-term follow-up. Research extending abstinence contingencies and continuous drug use monitoring is recommended. Questions about effectiveness of contingency management alone, role of coexisting psychiatric disorders on treatment outcome, and individualized treatment dosing are offered.

Substance use disorder diagnoses were used as a treatment outcome measure in a randomized comparison of day treatment (DT) and day treatment plus contingency management (DT+) among homeless persons with primarily crack/cocaine disorders. Participants (N = 127, DT+ = 69, DT = 58, 73.2% male, 82.7% African American) were assessed at baseline and 6-month treatment completion. Binary positive and negative diagnostic outcomes for cocaine, marijuana, and alcohol were compared by treatment group. DT+ was 2.1 times more likely to have a positive treatment outcome than DT. Concordance between diagnostic change and point and continuous abstinence outcomes were found. The use of diagnostic change can be a practical addition to drug toxicology and self-report treatment outcome measures for research and practice.

This study presents the prevalence and treatment outcome of DUAL diagnoses (psychoactive substance use disorders [PSUD] plus other nonpsychotic mental disorders) among a population of homeless persons participating in a behavioral day treatment and contingency management drug abuse treatment program. Participants were 128 persons: 76.6% male, 23.4% female; 82.2% African-American, 17.2% Caucasian. There were 46 (35.9%) PSUDs and 82 (64.1%) DUAL participants. Cocaine (96.9%) and alcohol disorders (57.8%) were most prevalent overall, and 60.2% of participants had two or more psychoactive substance use disorders. DUAL participants had significantly more alcohol disorders than PSUDs (62.2% versus 50.0%). The most prevalent mental disorders (other than substance use) for the total and DUAL samples were, respectively, mood (51.6% and 80.5%) and anxiety (35.9% and 56.1%), and 31.3% and 48.8% had more than two mental disorders. The DUAL group had more severe problems than the PSUD group at baseline in alcohol, medical condition, employment/support, and psychiatric status areas on the ASI. Both groups showed treatment improvements at 6-months follow-up with the DUAL group showing greater mean changes than the PSUD group in five of the seven ASI areas. These findings are discussed in terms of effect of dual diagnoses on treatment outcome and study limitations related to a retrospective design and select sample of nonpsychotic mental disorders.

This research explored the diffusion process of distance education in schools of public health to determine best practices in the planning and implementation of future programs. The researcher traced the diffusion process by utilizing a multiple-case study methodology using a semi-structured interview to collect the perceptions of Distance Learning Coordinators within five schools of public health and a monitor survey of each program's website to corroborate interview data. The research focused on the implementation of programs and explored why schools of public health developed distance education programs; how schools of public health restructured to facilitate development and implementation of distance education programs; and how distance education was refined to meet the needs of the schools of public health.

Excessive alcohol consumption and drinking and driving among college students are public health concerns. Online alcohol-related interventions have produced some positive outcomes in the college student populations; however, online interventions to reduce drinking and driving specifically have been neither developed nor tested. We developed an online Impaired Driving Intervention (IDI) using the Impaired Driving Assessment, a modified alcohol-specific version of timeline follow-back method of assessing behavior. This research examines: (1) the development of the IDI; (2) a pilot test of the IDI among 19 undergraduates; and (3) the refinements made to the program based on the pilot test. As a result of our pilot test, we changed the timing of our participant screening and for several program components we provided clearer instructions, including the addition of informative “pop-up” windows.

Compared to non-athletes, college athletes consume more alcohol and report higher rates of alcohol-relat ed consequences such as DUI, unsafe sexual practices, and criminal behavior. This poses major problems for the integrity of college athletics, athletic department personnel, and health educators who work to reduce destructive alcohol behaviors on campus. To understand why current alcohol education is ineffective, it is necessary to examine the ecology of this behavior. This article examines alcohol use among college athletes using the Social Ecology Model to determine what most injluences this behavior. A proposed ecological model specific to alcohol use among college athletes is discussed.

With extreme rates of binge drinking among young adults, college students continue to be a primary focus for a range of alcohol prevention efforts. Most universities are attempting to change the alcohol environment by implementing a variety of strategies to reduce heavy drinking among college students. With the exception of parental notification policies, there have been relatively few strategies utilizing the role of parents in alcohol prevention programming. Guided by the constructs of the Health Belief Model, this paper presents an exploratory study of parent-child communication as a prevention strategy to reduce heavy drinking among first-year college students. Background The highest prevalence of both binge drinking and heavy drinking in 2002 was seen among young adults ages 18-25 (SAMHSA, 2002). The rates of binge drinking among college students is nearly double the rates for high school students, which may indicate that the college environment encourages high risk drinking. Many students view heavy drinking as a rite of passage that everyone must go through in life (Waiters, Bennett, & Noto, 2000). Young adults aged 18-22 enrolled full-time in a college were more likely than their peers not enrolled full time to use alcohol, drink heavily, and binge drink (64% to 54%, respectively) (SAMHSA, 2002). Wechsler, Lee, Kuo, Seibring, Nelson, & Lee, (2002) reported 44% of college students in 2001 were classified as binge drinkers. O'Malley and Johnston (2001) reported data showing that two of five American college students can be labeled "binge drinkers," with binge drinking (heavy drinking) being defined as having five or more drinks in one sitting for a male and four for a female. Because heavy alcohol use is such a problem on college campuses, many universities have implemented a variety of programs as a means to reduce heavy drinking. Some universities are attempting to reach the entire campus via universal approaches by combating the social norms of drinking by trying to reduce the misperceptions of college drinking of students (Waiters et.al., 2000). Several schools have implemented social norms campaigns as a universal approach to promote environmental change on college campuses. The effectiveness of social norms campaigns, however, is the source of controversy among prevention specialists (Wechsler, Nelson, Lee, Seibring, Lewis, & Keeling, 2003). Another environmental approach widely adopted by universities is the implementation of substance-free alternative programming. This can be seen at schools such as Boston College and the University of North Carolina at Chapel Hill where substance free late night programs have been adopted to show college students that there are other things to do around campus other than alcohol-related activities. These late night activities also offer students who abstain from drinking the opportunity to engage in alternate activities with other students with similar interests (Higher Education Center, 2001). There are few published research studies evaluating the effectiveness of substance free alternative programming. To date, parents of college students have been largely underutilized in prevention strategies to reduce heavy drinking among college students. Rather than being proactive in preventing alcohol-related situations, involvement of parents is more often reactive through parental notification policies, which typically involve parents only after their child has undergone judiciary proceedings for violating campus or community laws or policies regarding alcohol or experienced an alcohol-related injury (Zweig and Thompson, 2001). Parents often underestimate their role in their child's life once their child has left for college (Turrisi, Wiersma, & Hughs, 2000). This probably stems from the assumption that the influence parents exert in their child's life is radically reduced when their child is away from home and at college. …

Background/Purpose: College alcohol researchers regularly examine the impact of perceived norms on alcohol consumption; however, little research has been done on the influence of attitudes, norms, and negative personal alcohol outcomes on alcohol use. The purpose of this study is to examine the relationship between alcohol use and attitudes, norms, and alcohol-related problems (ARP) in a college student sample. Methods: Paper-and-pencil surveys were administered to 910 undergraduate students (72.6% female) at a large, public university in the southeastern U.S. A backward stepwise regression analysis was conducted with average drinks per week as the dependent variable and the following independent variables: attitudes toward alcohol, descriptive norms of alcohol use and ARP, injunctive norms of alcohol use, and demographic variables of interest. Results: Respondents reported the average number of drinks they consumed per week with a mean of 6.61 drinks (s.d.=8.0). The regression mode...

College students who drink excessively often experience poor school performance, psychosocial problems, antisocial behaviors, injuries, overdoses, high-risk sexual behaviors, and other risk factors, such as alcohol-impaired driving. A concept that may be effective in alleviating both alcohol consumption and negative alcohol-related consequences are protective behavioral strategies, such as alternating alcoholic and non-alcoholic drinks. The purpose of this research was to explore the relationship between alcohol consumption, protective behavioral strategies and school performance among a sample of college students (N=406) who drank alcohol in the past 30 days. Structural equation modeling (SEM) demonstrated that alcohol consumption amount was negatively correlated with school performance, where protective drinking behaviors were positively correlated with school performance. Specifically, the less alcohol consumed and the more protective drinking behaviors a participant engaged in, ...

The misuse of prescription stimulants (MPS) is an emergent adverse health behavior among undergraduate college students. However, current research on MPS is largely atheoretical. The purpose of this study was to validate a survey to assess MPS-related theory of planned behavior (TPB) constructs (i.e. attitudes, subjective norms, and perceived behavioral control) and determine the relationship between these constructs, MPS-related risk factors (e.g. gender and class status), and current MPS (i.e. past 30 days use) among college students. Participants (N = 978, 67.8% female and 82.9% Caucasian) at a large public university in the southeastern USA completed a survey assessing MPS and MPS-related TPB constructs during fall 2010. To examine the relationship between MPS-related TPB constructs and current MPS, we conducted (1) confirmatory factor analyses to validate that our survey items assessed MPS-related TPB constructs and (2) a series of regression analyses to examine associations between MPS-related TPB constructs, potential MPS-related risk factors, and MPS in this sample. Our factor analyses indicated that the survey items assessed MPS-related TPB constructs and our multivariate logistic regression analysis indicated that perceived behavioral control was significantly associated with current MPS. In addition, analyses found that having a prescription stimulant was a protective factor against MPS when the model included MPS-related TPB variables.

Objective: This study examined the feasibility of using wireless mobile devices (MDs) to collect daily alcohol information among college students, in particular examining feasibility in the context of costs associated with the use of wireless MDs. This study reports on practical aspects of using MDs to collect alcohol data, including compliance, technical success, user preferences for completing MD-based assessments, and cost. Setting: The study took place at a large, public university in the south-eastern United States. Design: A two-group, randomized design was used. A daily assessment of alcohol use administered using wireless MDs was completed by a group of college students ( n=86) for 30 days and compared to a paper-based (PB) daily assessment of alcohol use completed by a second group of college students ( n=83) over the same time period. Results: Completion rates for the MD assessment (85.8 per cent) were comparable to the PB assessment (97.6 per cent) given the differences i...

Excessive alcohol consumption is a predominant health concern on college campuses in the United States. A stepwise multiple regression analysis was used to examine the predictive values of demographic factors in relation to alcohol subscales (Drinking Context Scale, College Alcohol Problems Scale-revised, and Social Modeling Scale) with the outcome of number of drinking days in the past 30 days among a sample (n = 224) of first-year college students. The final model predicted 37.5% of the variability in drinking days in the past month. All variables, except for race, were significantly associated with the outcome (p < .05).