Madeline A Dalton
Dartmouth College
Project start date: 2012-02-01
Project end date: 2017-01-31
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to Madeline A Dalton
Environmental And Family Influences On Adolescent Overweight
Madeline A Dalton, Associate Professor
Pediatricsdartmouth College
office Of Sponsored Projects
hanover, Nh 03755
Grant 5R01ES014218-04 from National Institute Of Environmental Health Sciences IRG: ZES1
Abstract: Project Summary The impact of the built environment on health in rural areas has been understudied and virtually nothing is known about the influence of the rural built environment on overweight in adolescents. Our overarching goal for this study is to examine the influence of the built environment on adolescent overweight in the predominantly rural communities of Northern New England. Our multidisciplinary team will use quantitative and qualitative methods to conduct multi-level assessments of risk factors for adolescent overweight. We will accomplish our aims by studying an established cohort of 2567 adolescents and their parents, representing 26 stable and largely rural communities in Vermont and New Hampshire. When adolescents (8-13 years of age) were first surveyed in 2002-2003, the prevalence of overweight by community ranged from 9.7% to 34.1%, indicating substantial variation at the community level. Relevant individual and family characteristics of this cohort will be assessed through three annual telephone surveys, beginning in January 2006. We will use GIS data and on-site mapping, to characterize the built environment of each community. The community level data will include assessments of recreational resources and food (including fast food) availability, as well as standard measures of density, diversity and design. We will use an ethnographic approach to assess and describe the ´culture´ surrounding physical activity and food within each of the schools attended by our cohort. The assessment of multi-level data will allow us to investigate how individual and family characteristics interact with the built environment to influence adolescent overweight. Our primary outcome will be adolescent overweight (defined as body mass index (BMI) equal to or greater than the 95th percentile of the sex-specific BMI-for-age growth curves. Intermediate outcomes will include adolescent physical activity levels and dietary intake patterns, including consumption of high fat and high calorie foods. The multi-disciplinary expertise of our investigative group and the availability of a well-established cohort ensure the feasibility, efficiency, and success of the proposed effort. Relevance Our study includes children and low SES communities, two populations targeted by RFA-04-003 because of their vulnerability. In addition, our study focuses on rural communities, meeting the expressed need for studies of rural populations. Results from this study will help to identify risk factors that could be targeted through specific interventions to prevent adolescent overweight
Keywords: adolescence (12-20), body weight, community planning, family structure /dynamics, geographic site, obesity, rural area, socioenvironment body physical activity, culture, disease /disorder proneness /risk, interdisciplinary collaboration, nutrient intake activity, socioeconomics behavioral /social science research tag, clinical research, focus group, human subject, information system, interview
Project start date: 2005-09-19
Project end date: 2010-07-31
5R01ES014218-04 (2008): $462376
5R01ES014218-03 (2007): $499685
5R01ES014218-02 (2006): $492530
1R01ES014218-01 (2005): $539456
Bupropion To Prevent Postpartum Smoking Relapse
Madeline A Dalton, Associate Professor
Dartmouth College Office Of Sponsored Projects Hanover, Nh 03755
Grant 5R21DA015103-03 from National Institute On Drug Abuse IRG: NIDA
Abstract: In this R21 grant application we propose to conduct pilot work that will lay the foundation for a randomized clinical trial of bupropion SR to prevent smoking relapse in postpartum women. Although many women quit smoking during pregnancy, up to 70 percent are smoking again within one year of delivery. Behavioral interventions designed to prevent relapse following delivery have met with only limited success. At the same time, several trials have demonstrated that bupropion SR is safe and effective in promoting cessation. However, there are no published studies evaluating the effectiveness of bupropion SR in preventing relapse during particularly vulnerable periods, such as the postpartum period. Our ultimate goal is to evaluate the effectiveness of bupropion SR in preventing relapse during the postpartum period among women who quit smoking during pregnancy and are abstinent at the time of delivery through a double-blind, placebo-controlled, randomized clinical trial. This pilot study will allow us to develop and fine tune the methodology for the trial and demonstrate our ability to enroll and follow participants. In this study, we will enroll 50 women at the time of delivery and randomly assign them to receive placebo or bupropion SR for 12 weeks. Our objectives are to a) test protocols for recruitment, sample collection, and follow-up; b) develop survey instruments; c) evaluate patient compliance; and d) estimate eligibility, participation, and retention rates for the larger trial. Patients and investigators will be blind to treatment assignment. Subjects in the treatment group will receive 300mg bupropion SR (150mg QD am for 7 days followed by 150mg BID for 11 weeks). Subjects in the control group will receive placebo following the same schedule. Both groups will receive 5 telephone-counseling sessions to encourage the maintenance of cessation in accordance with clinical practice guidelines. Patient compliance will be measured using the MEMS Track CapTM (Aprex Corporation, Union City, CA), which records each time and date the medication bottle is opened. Self-reported smoking status will be validated with a urine cotinine dipstick (<=100ng/ml) at baseline and saliva cotinine (<=30ng/ml) at 12 and 26 weeks postpartum. Data on covariates and mediating factors known to be associated with smoking cessation and relapse will be collected at baseline, week 12 and week 26 through telephone interviews. If proven effective in a follow-up randomized trial, the enrollment and implementation strategies we are testing could be utilized to implement a county or state program.
Keywords: bupropion, chemoprevention, drug screening /evaluation, human therapy evaluation, postpartum, relapse /recurrence, smoking, tobacco abuse prevention, clinical trial, counseling, drug adverse effect, drug detection, experimental design, nicotine, telecommunication, therapy compliance, tobacco abuse education, data collection, human subject, interview, patient oriented research, questionnaire
Project start date: 2002-05-01
Project end date: 2006-04-30
5R21DA015103-03 (2004): $158000
5R21DA015103-02 (2003): $158000
Preventing Teen Smoking By Restricting Movie Exposure
Madeline A Dalton, Associate Professor
Dartmouth College Office Of Sponsored Projects Hanover, Nh 03755
Grant 5R01CA094273-04 from National Cancer Institute IRG: ZCA1
Abstract: Background--The average child spends as much time viewing movies and television as he spends in school. Tobacco use is ubiquitous in movies, yet its impact on adolescent smoking has not been studied before. We hypothesize that exposure to tobacco use in movies is a causal element in the initiation of adolescent smoking. Preliminary Work-- Our 4-year study resulted in a content analysis measuring the amount and context of tobacco use in over 600 popular contemporary movies. We found tobacco depictions in 95% of the movies and brand appearances in 28%. We linked these data with responses from a cross-sectional study of over 5000 5% 8_ grade students. In a multivariate analysis, adolescent exposure to tobacco use in movies was associated with adolescent smoking and, among never smokers, it was associated with attitudes that predict future smoking. Specific Aims--The goal of this application is to better understand the relationship between viewing tobacco use in movies and adolescent smoking. To accomplish this, we plan to continue the content analysis of popular contemporary films through the year 2005 and conduct a two-year longitudinal telephone survey of a nationally representative sample of 3000 adolescents. This survey will enable us to describe adolescents exposure to tobacco use in contemporary films over time and to determine if this exposure predicts smoking uptake. Methods--Adolescents will be surveyed semiannually about their smoking status, exposure to a sample of recently released popular movies, and a number of other factors related to adolescent smoking. Each survey will contain a unique subset of movies, randomly selected from top box-office hits and video rentals released within six months prior to the survey. The primary outcome will be the transition from never smoker to experimenter. Secondary analyses will be conducted to examine whether exposure to movie tobacco use influences a t titudes among never smokers and influences experimenters to become established smokers. We will also evaluate differences in movie exposure among whites, African Americans, and Latinos. Significance-- This is the first prospective study to evaluate the public health implications of depicting tobacco use in movies. Because our study involves a nationally representative sample of U.S. adolescents, data from this survey will enable us to determine the number of cases of youth smoking in the United States that are attributable to exposure to tobacco use in popular, contemporary movies.
Keywords: mass information media, tobacco abuse prevention, attitude, racial /ethnic difference, smoking, tobacco abuse, adolescence (12-20), clinical research, human subject, middle childhood (6-11), telecommunication
Project start date: 2001-09-28
Project end date: 2007-02-28
5R01CA094273-04 (2004): $578989
5R01CA094273-03 (2003): $1218438
Movie Influence On Adolesent Smoking: A Follow-up Study
Madeline A Dalton, Associate Professor
Dartmouth College Office Of Sponsored Projects Hanover, Nh 03755
Grant 5R01CA108918-03 from National Cancer Institute IRG: ZRG1
Abstract: Background In a previous prospective study, we found that viewing smoking in movies strongly predicted smoking initiation among adolescents 10 to 14 years of age, even after adjusting for other social influences, child and parenting characteristics. We now propose to continue following this cohort of adolescents. Aims The primary aims of this study are to evaluate the effect of viewing smoking in movies on the risk of becoming an established smoker, evaluate the impact of age on the relationship between movie smoking exposure and smoking initiation, and identify child and parenting factors that may modify the association between exposure to movie smoking and adolescent smoking behavior Methods To accomplish these aims, we propose a three-year longitudinal telephone survey of the 2603 adolescents who participated in our previous prospective study. These adolescents are now 15 to 19 years of age. Participants will be surveyed annually to update their smoking status, movie exposure, and other risk factors for smoking. As in our previous study, surveys will be administered using a CATI system and each individual survey will contain a unique subset of movies, randomly selected from a larger sample of top box office hits and video rentals. Survey responses will be linked with information from a content analysis of smoking in movies to estimate an individual s exposure to movie smoking. Significance These adolescents are now at the age of highest risk for smoking uptake. The proposed follow-up is optimally timed to evaluate the influence of movies on smoking initiation in late adolescence and on established smoking. Our previous study of this cohort produced highly significant findings that catalyzed a dialogue between State Attorneys General and representatives from the motion picture industry. Results from the proposed study will extend our earlier findings by clarifying the influence of movie smoking exposure on risk of later age smoking initiation and, importantly, on progression to established smoking.
Keywords: adolescence (12-20), health behavior, mass information media, smoking, substance abuse epidemiology, tobacco abuse, disease /disorder etiology, disease /disorder onset, longitudinal human study, role model, tobacco abuse prevention, behavioral /social science research tag, clinical research, human subject, interview
Project start date: 2005-05-25
Project end date: 2010-02-28
5R01CA108918-03 (2007): $572805
3R01CA108918-02S1 (2006): $146699
Sponsored Links Excellgen http://Excellgen.com
5R01CA108918-02 (2006): $582636
Movie Influence On Adolescent Smoking: A Follow-up Study
Madeline A Dalton, Associate Professor
Dartmouth College Office Of Sponsored Projects Hanover, Nh 03755
Grant 1R01CA108918-01A1 from National Cancer Institute IRG: ZRG1
Abstract: Background In a previous prospective study, we found that viewing smoking in movies strongly predicted smoking initiation among adolescents 10 to 14 years of age, even after adjusting for other social influences, child and parenting characteristics. We now propose to continue following this cohort of adolescents. Aims The primary aims of this study are to evaluate the effect of viewing smoking in movies on the risk of becoming an established smoker, evaluate the impact of age on the relationship between movie smoking exposure and smoking initiation, and identify child and parenting factors that may modify the association between exposure to movie smoking and adolescent smoking behavior Methods To accomplish these aims, we propose a three-year longitudinal telephone survey of the 2603 adolescents who participated in our previous prospective study. These adolescents are now 15 to 19 years of age. Participants will be surveyed annually to update their smoking status, movie exposure, and other risk factors for smoking. As in our previous study, surveys will be administered using a CATI system and each individual survey will contain a unique subset of movies, randomly selected from a larger sample of top box office hits and video rentals. Survey responses will be linked with information from a content analysis of smoking in movies to estimate an individual s exposure to movie smoking. Significance These adolescents are now at the age of highest risk for smoking uptake. The proposed follow-up is optimally timed to evaluate the influence of movies on smoking initiation in late adolescence and on established smoking. Our previous study of this cohort produced highly significant findings that catalyzed a dialogue between State Attorneys General and representatives from the motion picture industry. Results from the proposed study will extend our earlier findings by clarifying the influence of movie smoking exposure on risk of later age smoking initiation and, importantly, on progression to established smoking.
Keywords: adolescence (12-20), health behavior, mass information media, smoking, substance abuse epidemiology, tobacco abuse, disease /disorder etiology, disease /disorder onset, longitudinal human study, role model, tobacco abuse prevention, behavioral /social science research tag, clinical research, human subject, interview
Project start date: 2005-05-25
Project end date: 2010-03-31
1R01CA108918-01A1 (2005): $554923
Movie Influence On Adolesent Smoking: A Follow-up Study
Madeline A Dalton, Associate Professor
Dartmouth College Office Of Sponsored Projects Hanover, Nh 03755
Grant 3R01CA108918-01A1S1 from National Cancer Institute IRG: ZRG1
Abstract: Background In a previous prospective study, we found that viewing smoking in movies strongly predicted smoking initiation among adolescents 10 to 14 years of age, even after adjusting for other social influences, child and parenting characteristics. We now propose to continue following this cohort of adolescents. Aims The primary aims of this study are to evaluate the effect of viewing smoking in movies on the risk of becoming an established smoker, evaluate the impact of age on the relationship between movie smoking exposure and smoking initiation, and identify child and parenting factors that may modify the effect of exposure to movie smoking on adolescent smoking behavior. Methods To accomplish these aims, we propose a three-year longitudinal telephone survey of the 2603 adolescents who participated in our previous prospective study. These adolescents are now 14 to 18 years of age. Participants will be surveyed annually to update their smoking status, movie exposure, and other risk factors for smoking. As in our previous study, surveys will be administered using a CATI system and each individual survey will contain a unique subset of movies, randomly selected from a larger sample of top box office hits and video rentals. Survey responses will be linked with information from a content analysis of smoking in movies to estimate an individual s exposure to movie smoking. Significance These adolescents are now at the age of highest risk for smoking uptake. The proposed follow-up is optimally timed to evaluate the impact of movies on smoking initiation in late adolescence and on established smoking. Our previous study of this cohort produced highly significant findings that catalyzed a dialogue between 28 Attorneys General and the Motion Picture Association of America (MPAA). Results from the proposed study will extend our earlier findings by clarifying the impact of movie smoking exposure on later age smoking initiation and, importantly, on progression to established smoking.
Project start date: 2005-05-25
Project end date: 2007-03-31
3R01CA108918-01A1S1 (2005): $84186