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Current Projects
The Prevention Connection: Integrating Substance Abuse Prevention and Health Promotion
During the last 20 years, approaches to the prevention of drug abuse have become more numerous and scientifically sophisticated. However, the development and implementation of prevention training programs has not kept pace with the considerable advances made in prevention science and applications. Nowhere is this dearth of training programs more evident than in the training of workplace health professionals to deliver advanced prevention training to working adults. In this Phase II SBIR project, a substance abuse prevention training program was developed specifically for health promotion and wellness practitioners, with a focus on workplace-oriented health promotion practitioners. The web-based training program uses an interactive, multi-media approach. The prevention training program focuses on training health promotion professionals to successfully integrate substance abuse prevention materials and messages into standard, popular health promotion programs without losing the impact of the program on the target health behavior (i.e., nutrition or stress management). The program also provides information to help health promotion professionals understand why it is important to integrate substance abuse prevention and health promotion and presents the business case for substance abuse prevention. In addition, Prevention Connection provides an in-depth look at the leading substance abuse prevention models and theories and includes descriptions of innovative workplace prevention programs and facts about drugs and their effects. The program was tested with members of the Worksite Health Promotion Division of the American College of Sports Medicine.
Parent Power - Raising Safe and Drug-Free Kids
Substance abuse among adolescents continues at intolerably high levels. Research indicates that parents can provide a powerful, positive influence over their children through warm, authoritative family management; strong attachments; positive parental modeling; and less permissive attitudes. The evidence argues convincingly for prevention programs directed specifically at parents. The workplace is an underutilized resource for targeting parents. Although prevention programs for parents exist, very few consider the adolescent’s stage of development, and fewer still provide parents with opportunities for individual learning, behavior modeling, and vicarious learning using interactive, multi-media technology. Finally, few exist that provide these opportunities for parents at their convenience.

The objective of the research was to develop and test a web-based adolescent substance abuse prevention program for parents. The program is designed to raise parents' self-efficacy to make positive changes in their children's lives. This multimedia program helps increase parental skills in: 1) maintaining healthy communication in general and specifically talking to kids about substance use; 2) using positive and constructive family management styles; and 3) setting clear, consistent, and developmentally appropriate limits on adolescent behavior. Details on adolescent development and interactive sessions, separated into specific stages of adolescent development, are also included. In addition, the Parent Power program provides general information on adolescent substance use, specific information on drugs and their short- and long-term effects, and the signs and symptoms of substance use. Two additional program components include: 1) the Safety Zone, which provides information on other high risk behaviors and conditions such as sexual behavior, risky driving, violence, and depression; and 2) Parents and Teens Together, which provides on-line activities for parents and teens to do together. Parents can also find links other resources available on the Internet.

Stress And Mood Management
Stress, depression and other mental health disorders are prevalent, disabling conditions that have substantial effects on the health and productivity of the work force. Although effective approaches to the prevention and treatment of these problems are available, a large proportion of the work force – perhaps a majority of those afflicted – do not seek interventions for their problems, largely because of the stigma attached to the mental disorders, coupled with a lack of exposure to available interventions.

The goal of this project, funded by the National Institute of Mental Health, is to develop and test an interactive, multi-media web-based stress and mood management program for the workplace. By presenting topics of depression, anxiety and substance abuse within a program of stress management – a relatively non-stigmatized topic – working adults can acquire the necessary awareness, skills and motivation to prevent or seek treatment for these costly disorders. In Phase I, a prototype stress and mood management program (focusing primarily on the Stress Management module) was developed. The prototype program was tested in focus groups of working adults, and interviews were conducted with human resource managers and workplace health professionals to assess the feasibility and commercial viability of the program. Phase II includes the full development and field test of the program.

Health Connection
Most heavy drinkers and users of illicit drugs are working adults, yet few workplaces provide substance abuse prevention messages and materials to their work forces. Although research has shown that substance abuse prevention material is effective when integrated into workplace health promotion programs, this approach requires prevention materials (e.g., print and video) to be inserted into traditional instructor-led seminars. In order to greatly expand the reach and impact of workplace substance abuse prevention, this project includes the development of a web-based health promotion program for the work force that has substance abuse prevention material woven throughout the content. With such a program, employees who access a given health promotion topic (e.g., stress management, fitness, etc.) will also be presented with substance abuse prevention material that is related to the particular health promotion topic. Just as important, the completed Health Connection will contain the four most popular health promotion programs – Stress Management, Nutrition/Weight Management, Fitness, and Smoking Cessation – all on the Web. In Phase I, a prototype health promotion/substance abuse prevention program was constructed and pilot-tested. In Phase II, The Health Connection program will be completed and field-tested in a randomized design at a worksite. It is expected that The Health Connection will both improve health practices and reduce substance abuse in a significant proportion of the work force.
Web-Based Diabetes Prevention Program For The Workplace
Type 2 diabetes, a costly and debilitating disease, has reached epidemic proportions in the U.S. Risk is strongly associated with factors related to lifestyle behaviors. Individualized, interactive, multimedia interventions aimed specifically at primary prevention and early detection of Type 2 diabetes hold great promise, yet are generally lacking in the workplace and elsewhere. The Internet currently falls short of its potential to deliver a sophisticated behavior change program aimed at Type 2 diabetes prevention, detection and control.

The purpose of this project is to develop and test an innovative, web-based multimedia program aimed at working adults at risk for Type 2 diabetes and designed to reduce or ameliorate modifiable risk factors through health-related behavior change. The program, entitled, Turning Point, is based on a well-tested health behavior change model, which is firmly rooted in social learning and health behavior change theories.

Phase I includes the development of the final structure and content of the program and prototype testing with experts and focus groups drawn from the target audience. Phase II includes the completion of the program and a rigorous field-test with the target audience.

Parents' Guide To Child Nutrition And Health
Five of the leading causes of death in the U.S. can be linked to diet and exercise. Evidence indicates that lifelong dietary patterns are typically established early and recent studies show positive associations between childhood diet and later cancers. However, children’s diets often do not meet the minimum recommended requirements and many children do not engage in sufficient physical activity. Parents can have a major impact on their children’s eating and exercise practices. Unfortunately, many parents lack the awareness, motivation and/or skills to ensure that their children are practicing healthful eating and exercise habits.

The objective of this project is to develop and test a multimedia program for parents designed to promote healthful child dietary and exercise practices and reduce children’s risk of cancer and other chronic diseases. Phase I includes the development of the preliminary structure and content of the program, prototype development, and focus group testing with parents. Phase II involves the full development of the program and an evaluation of program effectiveness through a rigorous field test with parents.

A Web-Based Program On Youth Mental Health For Parents
Emotional problems in youth are a common and serious health concern. Research indicates that depression in adolescence is increasing and may be starting earlier in life. Interventions designed to give parents the information and skills necessary to recognize and intervene when emotional problems are detected hold great promise. Individuals and health organizations have begun to mobilize and share information for families with children who suffer from mental disorders via the world-wide-web. Despite this progress, most of the websites currently addressing adolescent depression or anxiety fall short in this effort.

The purpose of this project is to develop and test an innovative web-based multimedia program aimed at parents and designed to prevent mental health problems in youth. The program will incorporate interesting audio and visual segments and provide scientifically sound information that is accessible to parents from varying educational backgrounds. In Phase I, the final structure and content of the program were developed and a prototype was tested with focus groups of parents. Phase II includes the completion of the program modules and field testing the program with working parents in a pretest/posttest randomized design.

Substance Abuse Education Website For Primary Care
Results from the National Household Survey on Drug Abuse indicate that in 2001 nearly 16 million Americans 12 years of age and older were current illicit drug users, over 45 million engaged in binge drinking in the previous month, and nearly 13 million were heavy alcohol drinkers. Chemical dependence, including nicotine, alcohol, prescription drugs, and illicit drugs, is one of the leading cause of morbidity and mortality in the United States. Medical professionals in primary care like family medicine, internal medicine, pediatrics, and, in some cases, gynecology who routinely provide preventive health care and rely on routine screening to detect diseases and promote wellness are in a unique position to detect risky substance use and substance use disorders in their earliest stages. However, few medical professionals routinely perform substance use screening and interventions. Indeed, Healthy People 2000: National Health and Disease Objectives for Reducing Alcohol and Other Drug Problems specifically established a goal for the year 2000 to “Increase to at least 75 percent the proportion of primary care providers who screen for alcohol and other drug use problems. The American Medical Association currently recommends that physicians screen all patients for alcohol and other drug abuse and the American Nurses Association supports the role of professional nurses, in all settings, to assess for substance abuse problems.

Given the wide support for the screening of alcohol and other drug abuse in primary care settings, it is unusual to note that very little such screening is actually conducted. Indeed, research indicates that 41%-94% of primary care physicians fail to recognize substance abuse in their outpatient population. The lack of adequate training in the detection and treatment of substance use and the fact that substance use is generally considered a mental health problem and not a medical problem are two barriers to the routine assessment of substance use by primary care practitioners. The goal of this project is to create a technologically innovative, multifaceted, web-based training program for primary care physicians, nurses and nurse practitioners that will serve two purposes. First, the program will provide a comprehensive training course for nurses and physicians in which they can receive continuing education and continuing medical education credit. In addition, based on feedback from the usability tests, specific elements of the program will be available for physicians and nurses in practice. In Phase I, a prototype program, entitled Primary Care Connection, was developed and pilot tested (including a usability test) with physicians, nurses, and nurse practitioners. In addition, ISA surveyed physicians and nurses regarding their screening practices and the barriers to substance use screening in primary care settings. Phase II includes the full program development and testing with groups of primary care professionals.

A Web-Based Program To Prevent Prescription Drug Abuse
Prescription medications are an effective way to bring improvements in the health of numerous individuals, however, many patients fail to receive proper education and counseling prior to the initiation and during the course of a pharmaceutical treatment. Critical to this issue is the fact that medications such as tranquilizers, sedatives, analgesics, and stimulants have the potential for abuse and may lead to drug misuse, dependence, and addiction if not administered and managed properly. Data from National Household Survey on Drug Abuse indicated that the misuse and abuse of prescription medications is on the rise. While drug abuse affects many Americans, the National Institute on Drug Abuse recently noted that there appears to be increased concern for older adults, adolescents, and women.

The purpose of the project is to develop and test an innovative web-based educational program designed to prevent prescription drug abuse among working women. The program contains important information on the safe use of medications with abuse potential and on alternatives to taking medications. Phase I includes the development and focus group testing of the prototype structure and Phase II involves the full development and field test of the program and preparation for marketing.

Web-Based Alcohol Abuse Prevention For College Students
College is a time when a large proportion of young people engage in heavy and binge drinking, putting themselves at risk for a variety of health and safety problems. The proposed effort will develop and test a web-based multi-media alcohol abuse prevention program aimed at college students, with specific paths for freshmen. The program will have an overall stress management/well-being focus and will also include sections addressing sexual health and safety. A major section of the program will be devoted to alcohol abuse prevention, and alcohol abuse prevention material will be interwoven throughout the other sections.

Phase I involves the preliminary structure and content development and pilot-testing with focus groups of college students drawn from two universities. Phase II involves full program development and rigorous field testing with college students as well as preparations for marketing.

Community Based Study Of Creating Lasting Family Connections And Stress Management
This project combines a CSAP model program, Creating Lasting Family Connections (CLFC) with a program integrating substance abuse prevention into stress management (The Stress Management Connection). The quasi-experimental evaluation includes pre, post, and follow-up surveys. The goal of the project is to assess the effectiveness of implementing the combined program in a community-based setting as opposed to faith-based (CLFC) or workplace-based (Stress Management) settings where the programs have been previous been implemented. The project is a collaboration between ISA and the Prevention Unit of the Fairfax County (Virginia) Community Services Board. The CLFC program includes separate modules for parents and youth, as well as combined parent/youth sessions. The program covers parenting practices, parent-child communication, and substance abuse prevention. The Stress Management Connection targets parents and focuses on positive stress management techniques. Three cohorts of families are being used to maximize sample sizes and the power of the study. Survey data are being collected from parents and youth at three times: (1) before they receive program services (pre-intervention), (2) shortly after they complete the sessions, which will be roughly six months after the pre-intervention data collection (post-intervention), and (3) roughly six months later (follow-up). Multivariate statistical analyses are being used to evaluate program effectiveness.