Alcohol and Other Drug Resistance Strategies Employed by Rural Adolescents

This study seeks to identify how rural adolescents make health decisions and utilize communication strategies to resist influence attempts in offers of alcohol, tobacco, and other drugs (ATOD). Semi-structured interviews were conducted with 113 adolescents from rural school districts to solicit information on ATOD norms, past ATOD experiences, and substance offer response episodes. Rural youths’ resistance strategies were similar to previous findings with urban adolescents – refuse, explain, avoid, and leave (the REAL typology) – while unique features of these strategies were identified including the importance of personal narratives, the articulation of a non-user identity, and being “accountable” to self and others

Designed Cultural Adaptation and Delivery Quality in Rural Substance Use Prevention: An Effectiveness Trial for the Keepin’ it REAL Curriculum

This study examined how cultural adaptation and delivery quality of the school-based intervention keepin’ it REAL (kiR) influenced adolescent substance use. The goal of the study was to compare the effectiveness of the multi-cultural, urban (non-adapted) kiR intervention, a re-grounded (adapted) rural version of the kiR intervention and control condition in a new, rural setting. A total of 39 middle schools in rural communities of two states in the USA were randomly assigned to one of three conditions (i.e., control, non-adapted urban kiR, and adapted rural kiR). Data included adolescent self-reported lifetime substance use and observers’ ratings of delivery quality from video recordings of lessons. Ratings of delivery quality were used to create four comparison groups (i.e., low/high delivery quality in non-adapted/urban kiR condition and low/high quality in adapted/rural kiR condition). Controlling for substance use in the 7th grade, findings compared 9th graders’ (N = 2781) lifetime alcohol, cigarette, marijuana, and chewing tobacco use. Mixed model analyses revealed that rural youth receiving the culturally adapted/rural curriculum reported significantly less cigarette use than rural youth in the control condition regardless of delivery quality. In the non-adapted/urban condition, youth receiving high delivery quality delivery reported less marijuana use than those receiving low delivery quality condition. However, substance use outcomes of youth receiving high and low delivery quality in the non-adapted intervention did not differ significantly from those the control group. Findings support the effectiveness of the culturally adapted/rural keepin’ it REAL curriculum for rural youth

Trends of Parent-Adolescent Drug Talk Styles in Early Adolescence

The present study seeks to understand how parents as prevention agents approach substance use prevention messages during the period of early adolescence. Students (N = 410) in a drug prevention trial completed surveys from 7th to 9th grade. Using longitudinal data, a series of latent transition analyses was conducted to identify major trends of parent–adolescent drug talk styles (i.e., never talked, situated direct, ongoing direct, situated indirect, and ongoing indirect) in control and treatment conditions. Findings demonstrate a developmental trend in drug talk styles toward a situated style of talk as youth transitioned from 7th grade to 9th grade. Findings also show that even though the drug prevention trial did not specifically target parental communication, parents in the treatment condition provide more ongoing substance use prevention messages to their adolescent children than do parents in the control condition. The present study discusses relevant developmental issues, potential intervention effects, and future research directions for communication research in substance use prevention

Filamin B Regulates Chondrocyte Proliferation and Differentiation through Cdk1 Signaling

Humans who harbor loss of function mutations in the actin-associated filamin B (FLNB) gene develop spondylocarpotarsal syndrome (SCT), a disorder characterized by dwarfism (delayed bone formation) and premature fusion of the vertebral, carpal and tarsal bones (premature differentiation). To better understand the cellular and molecular mechanisms governing these seemingly divergent processes, we generated and characterized FlnB knockdown ATDC5 cell lines. We found that FlnB knockdown led to reduced proliferation and enhanced differentiation in chondrocytes. Within the shortened growth plate of postnatal FlnB−/− mice long bone, we observed a similarly progressive decline in the number of rapidly proliferating chondrocytes and premature differentiation characterized by an enlarged prehypertrophic zone, a widened Col2a1+/Col10a1+ overlapping region, but relatively reduced hypertrophic zone length. The reduced chondrocyte proliferation and premature differentiation were, in part, attributable to enhanced G2/M phase progression, where fewer FlnB deficient ATDC5 chondrocytes resided in the G2/M phase of the cell cycle. FlnB loss reduced Cdk1 phosphorylation (an inhibitor of G2/M phase progression) and Cdk1 inhibition in chondrocytes mimicked the null FlnB, premature differentiation phenotype, through a β1-integrin receptor- Pi3k/Akt (a key regulator of chondrocyte differentiation) mediated pathway. In this context, the early prehypertrophic differentiation provides an explanation for the premature differentiation seen in this disorder, whereas the progressive decline in proliferating chondrocytes would ultimately lead to reduced chondrocyte production and shortened bone length. These findings begin to define a role for filamin proteins in directing both cell proliferation and differentiation through indirect regulation of cell cycle associated proteins

Teacher Narratives and Student Engagement Testing Narrative Engagement Theory in Drug Prevention Education

Testing narrative engagement theory, this study examines student engagement and teachers’ spontaneous narratives told in a narrative-based drug prevention curriculum. The study describes the extent to which teachers share their own narratives in a narrative-based curriculum, identifies dominant narrative elements, forms and functions, and assesses the relationships among teacher narratives, overall lesson narrative quality, and student engagement. One-hundred videotaped lessons of the keepin’ it REAL drug prevention curriculum were coded and the results supported the claim that increased narrative quality of a prevention lesson would be associated with increased student engagement. The quality of narrativity, however, varied widely. Implications of these results for narrative-based prevention interventions and narrative pedagogy are discussed

Random Assignment of Schools to Groups in the Drug Resistance Strategies Rural Project: Some New Methodological Twists

Random assignment to groups is the foundation for scientifically rigorous clinical trials. But assignment is challenging in group randomized trials when only a few units (schools) are assigned to each condition. In the DRSR project, we assigned 39 rural Pennsylvania and Ohio schools to three conditions (rural, classic, control). But even with 13 schools per condition, achieving pretest equivalence on important variables is not guaranteed. We collected data on six important school-level variables: rurality, number of grades in the school, enrollment per grade, percent white, percent receiving free/assisted lunch, and test scores. Key to our procedure was the inclusion of school-level drug use data, available for a subset of the schools. Also, key was that we handled the partial data with modern missing data techniques. We chose to create one composite stratifying variable based on the seven school-level variables available. Principal components analysis with the seven variables yielded two factors, which were averaged to form the composite inflate suppress (CIS) score which was the basis of stratification. The CIS score was broken into three strata within each state; schools were assigned at random to the three program conditions from within each stratum, within each state. Results showed that program group membership was unrelated to the CIS score, the two factors making up the CIS score, and the seven items making up the factors. Program group membership was not significantly related to pretest measures of drug use (alcohol, cigarettes, marijuana, chewing tobacco; smallest p\u3e.15), thus verifying that pretest equivalence was achieved

Parental Messages about Substance Use in Early Adolescence: Extending a Model of Drug-Talk Styles

This study extends a typology of parent-offspring drug talk styles to early adolescents and investigates associations with adolescent substance use. Data come from a self-report survey associated with a school-based, 7th grade drug prevention curriculum. Mixed-methods were used to collect data across four measurement occasions spanning 30 months. Findings highlight frequencies of various drug-talk styles over time (i.e., situated direct, ongoing direct, situated indirect, ongoing indirect, never talked), messages adolescents hear from parents, and comparisons of alcohol, cigarette, and marijuana use by drug talk style. This study advances understanding of parent-adolescent communication about substances and holds practical implications for drug prevention efforts

Describing Teacher–Student Interactions: A Qualitative Assessment of Teacher Implementation of the 7th Grade keepin’ it REAL Substance Use Intervention

Variations in the delivery of school-based substance use prevention curricula affect students\u27 acquisition of the lesson content and program outcomes. Although adaptation is sometimes viewed as a lack of fidelity, it is unclear what types of variations actually occur in the classroom. This observational study investigated teacher and student behaviors during implementation of a middle school-based drug prevention curriculum in 25 schools across two Midwestern states. Trained observers coded videos of 276 lessons, reflecting a total of 31 predominantly Caucasian teachers (10 males and 21 females) in 73 different classes. Employing qualitative coding procedures, the study provides a working typology of implementation patterns based on varying levels of teacher control and student participation. These patterns are fairly consistent across lessons and across classes of students, suggesting a teacher-driven delivery model where teachers create a set of constraints within which students vary their engagement. Findings provide a descriptive basis grounded in observation of classroom implementation that can be used to test models of implementation fidelity and quality as well as impact training and other dissemination research

From Kids, Through Kids, To Kids: Examining the Social Influence Strategies Used by Adolescents to Promote Prevention Among Peers

Recent technological advances have increased the interest and ability of lay audiences to create messages; however, the feasibility of incorporating lay multimedia messages into health campaigns has seldom been examined. Drawing on the principle of cultural grounding and narrative engagement theory, this article seeks to examine what types of messages adolescents believe are most effective in persuading their peers to resist substance use and to provide empirical data on the extent to which audience-generated intervention messages are consistent with the associated campaign philosophy and branding. Data for the current study are prevention messages created by students as part of a four-lesson substance use prevention booster program delivered to eighth-grade students in 20 rural schools in Pennsylvania and Ohio during 2010-2011. Content analysis results indicate that didactic message strategies were more common in audience-generated messages than narrative strategies, although strategy was somewhat dependent on the medium used. Two of the most common strategies that adolescents used to persuade peers not to use substances were negative consequences and identity appeals, and messages varied in the degree to which they were consistent with the theoretical underpinnings and program philosophy of the prevention campaign. Implications of the current study for understanding the social construction of substance use prevention messages among adolescents and incorporating audience-generated messages in health communication campaigns are discussed