Handbook of Health Psychology

By Andrew Baum; Tracey A. Revenson et al. | Go to book overview
this now challenges the overall effectiveness of prevention programs over the last several years. Johnston et al. (1995) speculated that one reason for this increase in smoking is that smokers attractive to teenagers are once again being frequently “modeled” in the media. It is also possible that, as has been discovered in recent years, schools have been less enthusiastic about smoking prevention programs because over all, substance abuse curricula are in place with little modification of their content despite the changing face of the psychosocial influences to which adolescents are exposed. Ellickson et al. (1993) pointed out, however, that even with equivocation concerning long-term effectiveness of prevention programs, any successful delay of engaging in high risk behavior results in a lowered risk of contracting an STD, being in a car wreck, or other consequences of high risk behavior that can result in poorer health and higher treatment costs. The longer onset is delayed, the more success will be gained in avoiding illness and psychosocial effects attached to high risk behavior. If initiation can be delayed long enough, will the adolescent's high risk avoidance behavior carry over into adult decision making about health choices? If success is achieved in changing social norms, these same messages must be communicated within the community as well as in the school or social setting where adolescents may initially be exposed to the messages. Considerable evidence of the value of this is apparent as more and more institutions and communities are committed to limiting exposure of nonsmokers to smokers.Strategies for monitoring prevention programs with appropriate modification of their content over time would appear to be one major step that might be taken to address the alarming findings in the Johnston et al. (1995) report. In fact, we are currently exploring in our major longitudinal investigations the effect of high dosage prevention interventions throughout the tenure of prospective investigations. Other investigators are also responding to this problem of washing out of early effects of prevention programs in a similar manner. Future prevention research should consider:
1. Synergism among an array of health threatening behaviours.
2. Differences in frequency of patterns of use of harmfull substances among various ethnic and racial groups.
3. The need for high dosage truly long-term continual prevention interventions.
4. Promote the involvement of school, communities, and, mass media in modifying group norms and behavious (including eliminating youth targeted content in cigarette ads), so that norms and displays of models of the use of cigarettes and use of other subtances become an increasingly less effective stimulus for the initiation of such behaviours by adolescents.

ACKNOWLEDGEMENTS

This reasearch was supported in the context of the Psychology Research Training Grant 5 TI DE 138, National Institute of Dental Reasearch; the Social Psychological Deterrents of Smoking in School Project, National Heart, Lung & Blood Institute Grant 17269, through the Baylor College of Medicine National Heart & Blood Vessel Research and Demonstration Center; the Minority Adolescent Drug Use Prevention, National Institute on Drug Abuse, 1 ROl DA07024-OlA3, Richard I. Evans, principal investigator; and AIDS Prevention Among Minority Adolescents, National Institute of Child Health and Human Development, 1 RO 1 HD30638–01, Richard I. Evans, principal investigator.


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