TRANSDISCIPLINARY TRAINING FOR PREDOCTORAL BEHAVIORAL SCIENTISTS
Melbourne F Hovell, Professor & Director
San Diego State University, 5250 Campanile Dr, San Diego, Ca 92182
Grant 5T32GM084896-03 from National Institute Of General Medical Sciences
Abstract: Behavioral factors contribute significantly to and often interact with biological factors to influence health and disease. While behavioral and biological/biomedical sciences have historically operated independently, health promotion and disease prevention cannot be fully realized without multidisciplinary efforts. The joint doctoral program (JDP) in Public Health offered by San Diego State University´s Graduate School of Public Health and the University of California-San Diego´s School of Medicine is an ideal setting for training future investigators who may bridge these disciplines. Two behavioral and two biomedical scientists will direct the program. An executive committee will select fellows for funding and assign them to appropriate mentors. Advisory committees comprised of behavioral and biological/biomedical faculty will oversee fellows´ training. Faculty from several behavioral and biological/biomedical departments at both institutions will participate. Research expertise areas include but are not limited to diet & exercise; infectious & chronic disease epidemiology & prevention; tobacco exposure & control; substance abuse & addiction; gene-environment interactions; prenatal & perinatal teratology; and ethnicity & health. Each year, up to 5 new predoctoral public health students who are interested in integrating biological/biomedical science training in their behavioral science program of study will be offered 3 years of T32 support. Ideal T32 candidates will enter with a Master´s in Public Health or related field and have a limited background in biology/biomedicine and a stated interest in obtaining additional training in these areas. Based on fellows´ interests, individualized programs of study will include the JDP curriculum with added coursework in related biological/biomedical concepts & methodologies; rotations in behavioral- & biological/biomedical-focused research labs; training in the conduct of ethical research; and a teaching component. Our goal is to produce scientists who are versed in behavioral and biological/biomedical science and are prepared to conduct ethical multidisciplinary research. Relevance The Institute of Medicine has recognized that the understanding, control, and prevention of morbidity require multidisciplinary research and public health promotion systems. This training program will equip behavioral scientists with the biological/biomedical background necessary to work collaboratively with biomedical investigators to prevent and control disease in populations
Keywords: Behavioral; Scientist; Training; pre-doc; pre-doctoral; predoc; predoctoral
Project start date: 2008-07-01
Project end date: 2013-06-30
Budget start date: 1-JUL-2010
Budget end date: 30-JUN-2011
PFA/PA: PAR-06-503
5T32GM084896-03 (2010): $131250
Sponsored Links Excellgen http://Excellgen.com
TRANSDISCIPLINARY TRAINING FOR PREDOCTORAL BEHAVIORAL SCIENTISTS
Melbourne F Hovell, Professor & Director
San Diego State University, 5250 Campanile Dr, San Diego, Ca 92182
Grant 5T32GM084896-02 from National Institute Of General Medical Sciences
Abstract: Behavioral factors contribute significantly to and often interact with biological factors to influence health and disease. While behavioral and biological/biomedical sciences have historically operated independently, health promotion and disease prevention cannot be fully realized without multidisciplinary efforts. The joint doctoral program (JDP) in Public Health offered by San Diego State University´s Graduate School of Public Health and the University of California-San Diego´s School of Medicine is an ideal setting for training future investigators who may bridge these disciplines. Two behavioral and two biomedical scientists will direct the program. An executive committee will select fellows for funding and assign them to appropriate mentors. Advisory committees comprised of behavioral and biological/biomedical faculty will oversee fellows´ training. Faculty from several behavioral and biological/biomedical departments at both institutions will participate. Research expertise areas include but are not limited to diet & exercise; infectious & chronic disease epidemiology & prevention; tobacco exposure & control; substance abuse & addiction; gene-environment interactions; prenatal & perinatal teratology; and ethnicity & health. Each year, up to 5 new predoctoral public health students who are interested in integrating biological/biomedical science training in their behavioral science program of study will be offered 3 years of T32 support. Ideal T32 candidates will enter with a Master´s in Public Health or related field and have a limited background in biology/biomedicine and a stated interest in obtaining additional training in these areas. Based on fellows´ interests, individualized programs of study will include the JDP curriculum with added coursework in related biological/biomedical concepts & methodologies; rotations in behavioral- & biological/biomedical-focused research labs; training in the conduct of ethical research; and a teaching component. Our goal is to produce scientists who are versed in behavioral and biological/biomedical science and are prepared to conduct ethical multidisciplinary research. Relevance The Institute of Medicine has recognized that the understanding, control, and prevention of morbidity require multidisciplinary research and public health promotion systems. This training program will equip behavioral scientists with the biological/biomedical background necessary to work collaboratively with biomedical investigators to prevent and control disease in populations
Keywords: Behavioral; Scientist; Training; pre-doc; pre-doctoral; predoc; predoctoral
Project start date: 2008-07-01
Project end date: 2013-06-30
Budget start date: 1-JUL-2009
Budget end date: 30-JUN-2010
PFA/PA: PAR-06-503
5T32GM084896-02 (2009): $130368
Grants awarded to Melbourne F Hovell
Promoting Adherence To TB Regimens In High-Risk Youth
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HL068595-05 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: Tuberculosis (TB) was responsible for almost one billion deaths in the 20th century. It is epidemic in the developing world and immigrants introduce TB to developed nations. TB control requires treatment for LTBI and active disease, as well as adherence to medical regimens. We propose to determine the effectiveness of a public health model of LTBI control among high-risk adolescents. The integration of behavioral science, medical services, parent instruction, assistance from schools and clinics, all coordinated by the County Health Department, is based on recommendations from CDC. The effectiveness of this system is dependent, in part, on patients adherence. The proposed study will demonstrate a public health program for TB control among PPD+ adolescents and conduct a controlled trial of peer counseling plus parent education for adherence to INH. We will test these procedures with high-risk adolescents, from Latino, Asian, and foreign-born populations, for whom latent TB is epidemic. High school students will be screened and 300 PPD+ male and female youth (13-18 yrs.) will be assigned at random to either usual medical care plus non-directed (attention control) counseling, or to usual medical care plus peer adherence counseling and parent instructions to support adherence. Parents of eligible youth will be provided instruction about TB, their child s risk, and preventive treatment. Parents of youth assigned to the peer counseling condition will obtain additional instruction to use contingency management to support their child s adherence to INH. Clinic personnel will receive continuing medical education (CME) related to TB. The primary specific aims are 1) to determine whether peer counseling increases adherence to prescribed INH medication relative to controls and 2) to determine the cost and cost effectiveness of the intervention. We will determine if training increases parents and professionals knowledge of TB control and we will explore possible determinants of adherence to INH. Reported adherence (number of pills taken/month), pill counts and electronic dispenser measures will be verified by monthly impromptu urine assays. Multivariate statistical tests will be used to determine possible mediators/moderators and other predictors of adherence over 12 months. The assessment of both outcomes and relative costs will inform the effectiveness and practicality of a larger scale TB prevention program for high-risk youth in San Diego and other regions where TB is epidemic.
Keywords: adolescence (12-20), communicable disease control, counseling, health care model, therapy compliance, tuberculosis, behavior modification, child rearing, cost effectiveness, health disparity, human therapy evaluation, isoniazid, outcomes research, parent offspring interaction, respiratory disorder chemotherapy, social support network, behavioral /social science research tag, clinical research, health services research tag, human subject
Project start date: 2003-09-15
Project end date: 2008-08-31
5R01HL068595-05 (2007): $770041
5R01HL068595-04 (2006): $778108
3R01HL068595-02S1 (2005): $10748
3R01HL068595-02S2 (2005): $10860
3R01HL068595-03S1 (2005): $26279
5R01HL068595-03 (2005): $916903
5R01HL068595-02 (2004): $822417
1R01HL068595-01A2 (2003): $868916
TEACHING YOUTH SOCIAL SKILLS--AN AIDS PREVENTION TRIAL
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HD025021-05 from National Institute Of Child Health And Human Development IRG: SRC
Abstract: This study will test behavioral programs designed to reduce adolescents "unsafe" sexual behavior. Behavioral rehearsal procedures that emphasize social skills and decision-making will be compared to didactic sex education and a "no-training" control. We believe the social skills training will be more effective for teaching skills to resist peer pressure for "unsafe" sexual behavior and, thereby, reduce the consequent risks of AIDS and other sexually transmitted diseases (STDs). This analysis also will assess the extent to which trained youth influence their friends knowledge and social skills, as an estimate of the "diffusion" of effects on peer pressure/support of responsible sexual development. A Public Health model will be demonstrated by training youth recruited from community medical clinics. A randomized clinical trail (stratified for Hispanic, Anglo, and gender) design will be used. Three hundred youth from 14-16 yrs. and two friends (600 additional youth, nested within the primary sample) will be divided into three groups one experimental, one usual-training control and one no-training control. Youth assigned to the experimental group will receive 8 weeks of training. A professional instructor and a specially trained peer assistant will use behavioral rehearsal techniques, including video models, role- playing and corrective feedback, to establish target social and decision-making skills. Youth will be taught how to say "no" (abstain from sex), how to request a partner to use a condom, how to select safe sexual partners, etc. The immediate and long term consequences of their social/sexual behavior will be reviewed to establish establish decision-making skills. Usual training controls will be taught only the biological processes of reproduction and the natural history of STDs and explained the most important risk factors involved; no-training controls will receive only the scheduled measures. They will not be taught specific social skills, nor will behavioral rehearsal be employed. The differential effects of training will be measured for the primary sample of 300 youth and 600 friends. Measures of knowledge, affective reactions and social skills will be obtained immediately prior to instruction, post instruction, at 3, 6, 12 and 18 months. Knowledge, affective reactions and sexual experience (e.g. intercourse) will be measured in private one-to-one interviews. Social skills will be measured by direct observation of role-played tests. These techniques may provide youth with the skills to avoid AIDS infection, and other STDS.
Keywords: AIDS education /prevention, adolescence (12-20), behavioral medicine, education evaluation /planning, peer group, sex education, social behavior, social conformity, condom, decision making, disease prevention /control, health behavior, role, sexually transmitted disease, social support network, Hispanic American, caucasian American, human subject, sex difference, videotape /videodisc
Project start date: 1988-09-01
Project end date: 1994-11-30
5R01HD025021-05 (1993): $215314
CLINICIAN PROMOTION OF HEALTHY DIET AND ACTIVITY TO REDUCE OBESITY AMONG ADOLESCE
Melbourne F Hovell, Professor & Director
San Diego State University, 5250 Campanile Dr, San Diego, Ca 92182
Grant 5R01CA138192-02 from National Cancer Institute
Abstract: This study will test a 24-month multi-component intervention designed to increase physical activity, reduce sedentary practices and promote healthy diets among preteens who obtain orthodontia care. The intervention is based on the Behavioral Ecological Model (BEM), where interacting physiological, environmental, and cultural contingencies select behavior. This study will require five years to recruit 50 orthodontist offices, and 2100 youth, and implement an office-wide intervention for promoting healthy diet and physical activity among 8-13 yr old youth. Our primary aims are to detect a differential change in diet, physical activity and BMI in our experimental group compared to the tobacco prevention control group; to observe differential effects of the intervention between low vs. high SES; and similarly for males vs. females; to validate our primary outcome variables by contrasting them with a "gold standard"; and determine the degree to which family and peer encouragement for sedentary and high caloric diet at baseline increases the relative effect of the orthodontist intervention. Offices will be assigned at random to condition producing a 2 (experimental group) by 2 strata (low vs. high SES) by 2 strata (male vs. female) by 4 (repeated measures) experimental design. Those in the experimental condition will be exposed to the office-wide intervention for diet and activity; those in the control condition will be exposed to an office-wide intervention for tobacco prevention. The intervention will consist of training of orthodontists and office staff to provide appropriate social prompts, reinforcement and counseling, and modification of the offices to provide supportive physical and social resources for their patients and parents. Measures of diet, physical activity, body composition, tobacco use, fitness and family and peer encouragement will occur at baseline, 12, 24, and 36 months. Differential change over time will be analyzed using Random Effects Multivariate modeling. Analyses will include control for office cluster effects and multivariate models will include analyses of hypothetical main effects, experimental group by time interactions, and moderating effects by inclusion of interaction terms for susceptibility by experimental condition and other possible moderators. Relevance If successful, this study may inform policies that would promote all specialists (physicians, general dentists) to deliver brief counseling for diet and physical activity. Doing so might yield the cumulative exposure necessary to effect and sustain change in a large proportion of the preteen population. If successful, this study may inform policies that would promote all specialists (physicians, general dentists) to deliver brief counseling for diet and physical activity. Doing so might yield the cumulative exposure necessary to effect and sustain change in a large proportion of the preteen population
Keywords: Adolescent; Adolescent Youth; Au element; BMI percentile; BMI z-score; Behavior; Behavioral; Behavioral Model; Body Composition; Body mass index; Caring; Community Trial; Control Groups; Counseling; DXA; Dental; Dentists; Diet; Diet good; Dose; Dual-Energy X-Ray Absorptiometry; Eating; Epidemiologic Research; Epidemiologic Studies; Epidemiological Studies; Epidemiology Research; Experimental Designs; Family; Family member; Female; Food Intake; Friends; Gender; Gold; Healthy diet; Incidence; Intervention; Intervention Strategies; Life Style; Lifestyle; Measures; Mediating; Mexican; Modeling; Models, Statistical; Modification; Obesity; Orthodontic; Outcome; Parents; Participant; Patients; Physical activity; Physicians; Physiologic; Physiological; Pilot Projects; Policies; Population; Predisposition; Preventive Intervention; Probabilistic Models; Procedures; Psychological reinforcement; Quality Control; Quetelet index; Randomized; Recruitment Activity; Reinforcement; Reinforcement (Psychology); Relative; Relative (related person); Reporting; Research Resources; Resources; Smoking; Specialist; Statistical Models; Susceptibility; Testing; Time; Tobacco; Tobacco Consumption; Tobacco use; Training; Video Games; Visit; Writing; X-Ray Absorptiometry, Dual-Energy; Youth; Youth 10-21; adiposity; base; cohort; control trial; corpulence; corpulency; corpulentia; fitness; intervention design; intervention effect; interventional strategy; juvenile; juvenile human; male; member; obese; obese people; obese person; obese population; peer; pilot study; preadolescence; preteen; prevent; preventing; preventional intervention strategy; primary outcome; public health relevance; randomisation; randomization; randomly assigned; recruit; sedentary; social; therapy design; tobacco prevention; tobacco use prevention; treatment design
Relevance: If successful, this study may inform policies that would promote all specialists (physicians, general dentists) to deliver brief counseling for diet and physical activity. Doing so might yield the cumulative exposure necessary to effect and sustain change in a large proportion of the preteen population
Project start date: 2009-03-01
Project end date: 2014-01-31
Budget start date: 1-FEB-2010
Budget end date: 31-JAN-2011
PFA/PA: PA-07-070
5R01CA138192-02 (2010): $814822
Sponsored Links Excellgen http://Excellgen.com
3R01CA138192-02S1 (2010): $15797
3R01CA138192-01A2S1 (2009): $158561
HEALTHY CHILDREN AND HEALTHY FAMILIES PROGRAM
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HD037749-05 from National Institute Of Child Health And Human Development IRG: ZHD1
Abstract: This study is designed to determine whether parent training is an effective means of increasing children~s consumption of a high calcium diet and increase their strength and aerobic exercise in order to prevent osteoporosis as adults. Sedentary children (N = 180) with a history of low calcium intake and a family history of osteoporosis will be recruited sequentially. Males and females form different racial/ ethnic backgrounds will be included. One child/family will see as the unit of random assignment A 2 X 2 X 7 random assignment, repeated measures, design will be employed. Children and their parents will be divided into two groups. The experimental group will receive educational and support services for diet and exercise change in the target child (N = 90) . Each of these conditions will be divided again at random into two subgroups one ( N = 45) will obtain parent-training concerning the target topic (i.e. Safety or diet and exercise); the second group (N=45) will obtain the same instruction plus episodic coaching. Training will require 12 weekly classes and will emphasize principle of behavior and contingency management techniques. Coaching procedures will be provided over 9 months and will assist parents with problem-solving in order to refine and maintain parenting skills. Measures will be obtained seven times, prior to parent-training, at the end of parent training ( at 3 months) , and repeatedly through the coaching and one year follow up period. Outcome measures will include 24 hour recall estimates of change in diet., and change in physical activity. These will be validated by objective outcome measures, including 5Rm strength and , VO2 max fitness measures. Using stat of the art DXA scans, total bone calcium, bone density and specific site bone density will be obtained. Body composition and skeletal age also will be assessed by DXA Generalized estimating equations will be employed to estimate main effects covariates, and interactions to test study hypothesis. Exploratory analyses will include assessment of hypothetical processes, such as parenting practices and child/parent interactions (based on objective video tape measures as mediating variables in achieving changes in bone density . Results will inform clinical and educational prevention of osteoporosis in male and female from different racial/ethnic backgrounds at risk of osteoporosis as adults.
Keywords: bone density, child rearing, dietary calcium, disease /disorder prevention /control, education evaluation /planning, exercise, health behavior, health education, osteoporosis, adolescence (12-20), body composition, longitudinal human study, middle childhood (6-11), parent offspring interaction, behavioral /social science research tag, clinical research, human subject, nutrition related tag
Project start date: 1999-05-01
Project end date: 2005-04-30
5R01HD037749-05 (2003): $457759
5R01HD037749-04 (2002): $515195
3R01HD037749-03S1 (2001): $43636
5R01HD037749-03 (2001): $583758
3R01HD037749-02S1 (2000): $42498
5R01HD037749-02 (2000): $609094
INCREASING EXERCISE IN HISPANIC WOMEN
Melbourne F Hovell, Professor And Director
Graduate School Of Public Health (gsph)san Diego State University
5250 Campanile Dr
san Diego, Ca 92182
Grant 5R18HL052704-05 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: This study is a continuation of a recently completed community demonstration and education trial (R18) funded by NHLBI. Almost no research has been done on preventive/physical activity intervention for low SES Latino women, who were at high risk for a sedentary lifestyle, obesity, diabetes and life stress related to poverty-important CVD risk factors. The purpose of this proposal is to evaluate long-term maintenance of physical activity and fitness, to assess the effects of post-training incentives on maintenance, of physical activity and fitness, to assess the effects of post-training incentives on maintenance, and to assess the degree of generalization of activity from mothers to husbands and children. Finally, this study will include cost/benefit analyses of the training and maintenance interventions for low-income Latina families. We have completed a controlled trial of the 6-month physical activity intervention, which showed significant improvement in physical fitness, physical activity, exercise/nutrition knowledge, and BMI, relative to an alternative treatment control (home safety training). Based on the successful recruitment of 179 low-income, Spanish speaking Latinas, we plan an 18-month follow-up which will allow us to compare the effects of the 6-month training intervention alone vs. two different maintenance interventions (contingent vs. non-contingent post-training incentives) in the first 6 months of follow-up. Assessment will include maximal exercise testing, anthropometrics, blood pressure, blood lipids, glucose, insulin, and physical activity measures. Participant´s spouses will be evaluated on blood pressure, BMI, and physical activity. One randomly selected child age 7-18 from each family will be evaluated on weight for height and physical activity. Spouses´ and children´s physical activity will be assessed by wearing an electronic activity monitor during the non- sleep period for 7 days, supplement4ed with culturally tailored, age- appropriate interview measures of physical activity. Interviews will be used to connect information on important determinants (modeling and parental support) of exercise maintenance to conduct secondary analyses of mediating variables of behavior change critical to advance theory for more effective interventions. Results will inform CVD interventions and related health policy for low-income high risk Latinas, an emerging population
Keywords: Hispanic American, behavior modification, body physical activity, cardiovascular disorder prevention, exercise, female, health service demonstration project blood pressure, body composition, cholesterol, dietary lipid, health care cost /financing, longitudinal human study, low income, quality of life, social support network adolescence (12-18), behavioral /social science research tag, clinical research, health services research tag, human subject, middle childhood (6-11), nutrition related tag, women`s health
Project start date: 1996-07-15
Project end date: 2002-12-31
5R18HL052704-05 (2001): $156428
Sponsored Links Excellgen http://Excellgen.com
2R18HL052704-04 (2000): $448122
3R18HL052704-04S2 (2000): $20322
3R18HL052704-04S3 (2000): $22792
3R18HL052704-04S1 (2000): $20322
Environmental Tobacco Smoke Reduction In Preteens
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HL066307-05 from National Heart, Lung, And Blood Institute IRG: ZRG1
Abstract: This revised proposal is based on reviewers advice and updated pilot data. Parent counseling reduced children s ETS exposure in our previous studies. This study will determine if interventions directed to preteens alone can reduce ETS exposure. Our original pilot study showed that counseling reduced preteen s ETS exposure. New analyses showed that counseling reduced exposure to preteens in our NIH asthma study. A third pilot showed that counseling plus feedback and incentives reduced preteens ETS exposure. Based on these results, we decreased the number of counseling sessions to 10, liberalized inclusion criteria, and added recruitment sources to assure feasibility. This trial will determine the effects of counseling+feedback vs. counseling+ feedback+incentives on ETS exposure and susceptibility to smoking among high-risk preteens. 300 youth 9-12 years old, including African-American, Latino, Anglo, and other racial/ethnic groups, will be recruited. Preteens must be nonsmokers who are exposed to ETS in their home. Youth will be recruited sequentially and assigned to usual education, counseling plus cotinine feedback, or counseling, cotinine feedback and incentives. Outcome measures will be obtained prior to intervention, at 2, 4, 6, 12, and 18 months. Urine samples will be analyzed for cotinine using highly sensitive (detection limit .05 ng/ml) and reliable procedures as employed by CDC (ID-LC/MS/MS). The same measures will be used for cotinine feedback. Repeated measures analyses of differential exposure to ETS will be employed. Mixed effect regression (REML) and GEE models will be used for outcome analyses. Exploratory analyses will address questions about the environmental and social determinants of tobacco use and ETS exposure based on our Behavioral Ecological Model. We also will explore the feasibility of conducting a genetic study of tobacco addiction, and we will collect personnel and other cost data from which later cost/utility analyses can be computed. With increased fidelity, additional recruitment sources, and our past successful ETS studies, we are confident that this trial will be completed successfully and contribute to ETS exposure reduction and possibly smoking prevention in high-risk youth.
Keywords: counseling, middle childhood (6-11), passive smoking, reinforcer, tobacco abuse prevention, behavioral genetics, disease /disorder proneness /risk, disulfide bond, environmental exposure, gene environment interaction, longitudinal human study, mechanical stress, nicotine, outcomes research, protein structure function, psychological model, smoking, tobacco abuse education, behavioral /social science research tag, clinical research, human subject, interview, urinalysis
Project start date: 2003-02-01
Project end date: 2009-01-31
5R01HL066307-05 (2007): $703857
5R01HL066307-04 (2006): $770230
5R01HL066307-03 (2005): $792738
5R01HL066307-02 (2004): $789892
1R01HL066307-01A2 (2003): $752998
PROMOTING ADHERENCE TO TB REGIMENS IN LATINO ADOLESCENTS
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HL055738-05 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: The project proposes to test a public health model of screening, preventive INH treatment, and adherence counseling plus medical education of primary care clinicians to enhance their skills and attention to TB control. The investigators will test a behavioral adherence intervention for Latino adolescents with latent disease and a medical education program designed to enhance primary care (community clinic) practitioners treatment of active and latent TB infection. To extend the proposed model to most community clinic settings, the investigators propose to demonstrate outcome effectiveness as well as cost effectiveness in relation to the costs of failing to control latent TB in this population. Public school adolescents will be screened and 300 PPD positive male and female Latino youth (13-18 years) will be assigned at random to either usual medical treatment, usual medical treatment plus non-directed (attention control) counseling, or medical care plus behavioral adherence counseling. Concurrently participating clinic personnel will receive training in TB control. The primary specific aims are to determine whether behavioral counseling increases clinic attendance and adherence to prescribed INH medication relative to controls, and to determine if training increases professionals knowledge and practice of TB screening and control treatment. Pill count and reported estimates of adherence will be verified by random urine assays. Repeated measures analyses will be used to assess the effects of professional training. Exploratory analyses will identify correlates of adherence, and cost effectiveness analyses will assess the relative costs of screening and treatment compared to the costs of not controlling TB.
Keywords: Hispanic American, adolescence (12-18), communicable disease control, human therapy evaluation, mass screening, respiratory disorder chemotherapy, therapy compliance, tuberculosis, behavioral medicine, counseling, health care cost /financing, health care model, health care service utilization, health education, public health, training, behavioral /social science research tag, human subject, urinalysis
Project start date: 1995-09-30
Project end date: 2001-08-31
5R01HL055738-05 (1999): $448158
Sponsored Links Excellgen http://Excellgen.com
PROMOTING ADHERENCE--TB REGIMENS IN LATINO ADOLESCENTS
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 3R01HL055738-04S1 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: The project proposes to test a public health model of screening, preventive INH treatment, and adherence counseling plus medical education of primary care clinicians to enhance their skills and attention to TB control. The investigators will test a behavioral adherence intervention for Latino adolescents with latent disease and a medical education program designed to enhance primary care (community clinic) practitioners treatment of active and latent TB infection. To extend the proposed model to most community clinic settings, the investigators propose to demonstrate outcome effectiveness as well as cost effectiveness in relation to the costs of failing to control latent TB in this population. Public school adolescents will be screened and 300 PPD positive male and female Latino youth (13-18 years) will be assigned at random to either usual medical treatment, usual medical treatment plus non-directed (attention control) counseling, or medical care plus behavioral adherence counseling. Concurrently participating clinic personnel will receive training in TB control. The primary specific aims are to determine whether behavioral counseling increases clinic attendance and adherence to prescribed INH medication relative to controls, and to determine if training increases professionals knowledge and practice of TB screening and control treatment. Pill count and reported estimates of adherence will be verified by random urine assays. Repeated measures analyses will be used to assess the effects of professional training. Exploratory analyses will identify correlates of adherence, and cost effectiveness analyses will assess the relative costs of screening and treatment compared to the costs of not controlling TB.
Keywords: Hispanic American, adolescence (12-18), communicable disease control, human therapy evaluation, mass screening, respiratory disorder chemotherapy, therapy compliance, tuberculosis, behavioral medicine, counseling, health care cost /financing, health care model, health care service utilization, health education, public health, training, behavioral /social science research tag, human subject, urinalysis
Project start date: 1995-09-30
Project end date: 2000-08-31
3R01HL055738-04S1 (1998): $20746
PROMOTING ADHERENCE TO TB REGIMENS IN LATINO ADOLESCENTS
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HL055738-04 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: The project proposes to test a public health model of screening, preventive INH treatment, and adherence counseling plus medical education of primary care clinicians to enhance their skills and attention to TB control. The investigators will test a behavioral adherence intervention for Latino adolescents with latent disease and a medical education program designed to enhance primary care (community clinic) practitioners treatment of active and latent TB infection. To extend the proposed model to most community clinic settings, the investigators propose to demonstrate outcome effectiveness as well as cost effectiveness in relation to the costs of failing to control latent TB in this population. Public school adolescents will be screened and 300 PPD positive male and female Latino youth (13-18 years) will be assigned at random to either usual medical treatment, usual medical treatment plus non-directed (attention control) counseling, or medical care plus behavioral adherence counseling. Concurrently participating clinic personnel will receive training in TB control. The primary specific aims are to determine whether behavioral counseling increases clinic attendance and adherence to prescribed INH medication relative to controls, and to determine if training increases professionals knowledge and practice of TB screening and control treatment. Pill count and reported estimates of adherence will be verified by random urine assays. Repeated measures analyses will be used to assess the effects of professional training. Exploratory analyses will identify correlates of adherence, and cost effectiveness analyses will assess the relative costs of screening and treatment compared to the costs of not controlling TB.
Keywords: Hispanic American, adolescence (12-18), communicable disease control, human therapy evaluation, mass screening, respiratory disorder chemotherapy, therapy compliance, tuberculosis, behavioral medicine, counseling, health care cost /financing, health care model, health care service utilization, health education, public health, training, behavioral /social science research tag, human subject, urinalysis
Project start date: 1995-09-30
Project end date: 2000-08-31
5R01HL055738-04 (1998): $549609
5R01HL055738-03 (1997): $711587
3R01HL055738-05S1 (1999): $66877
3R01HL055738-04S2 (1998): $35743
TEACHING YOUTH SOCIAL SKILLS--AN AIDS PREVENTION TRIAL
Melbourne F Hovell, Professor And Director
San Diego State University
5250 Campanile Dr
san Diego, Ca 92182
Grant 2R01HD025021-06A1 from National Institute Of Child Health And Human Development IRG: ARRF
Abstract: The goal of Project STARRT was to increase adolescents´ understanding of AIDS risks and test a preventive intervention to decrease risk behaviors for pregnancy, STDs and AIDS. A social skills training program was developed to impart peer-resistance skills for drug and sexual practices among 440 Latino and Anglo youth, and to determine the degree of dissemination of skills to friends. The random assignment design and objective measures of skills made it possible to assess the role of social network interactions on AIDS risk practices. The experimental training resulted in a four-fold increase in social skills levels, and evidence of dissemination of skills between trained youth and their friends was observed. In addition, correlates of social skills and risk behaviors supported our conceptual model of adolescent sexual behavior. This competitive renewal proposes to follow these youth through four years post training. At which time they will be 18 to 23 years of age. The majority will be sexually active and many will have over 5 years of sexual experience. This follow-up will require 18 months of continued support and will enable the assessment of the durability of training effects as well as exploration of the social determinants of risk practices. Planned analysis will contribute to the understanding of AIDS risk during the period of life when approximately 20% of all HIV infections are established, and for under-served populations in the case of Latinos. The proposed competitive continuation of Project STARRT will take advantage of existing reliable measures, trained staff, data collection facilities and a comprehensive data set on a cohort demonstrated as retainable for additional measures. These pre-existing factors make such an extension an efficient means of collecting longitudinal data from early adolescence through early adulthood for Latino and Anglo youth. The following specific aims will be achieved during the proposed 18-month continuation period 1. to recruit at least 85% of the initial cohort to a 48-month follow-up interview of risk behavior and disease status; 2. to determine the differential effects of the social skills training, usual sex education and no-training on risk practices and outcomes at 48 months; 3. to explore the relationship between changes in hypothesized determinants of sexual behavior and changes in sexual behaviors
Keywords: AIDS, AIDS education /prevention, adolescence (12-20), human immunodeficiency virus, sex education, social behavior condom, decision making, disease prevention /control, drug addiction prevention, health behavior, peer group, sex behavior, sexually transmitted disease, social conformity, social support network Hispanic American, caucasian American, human subject
Project start date: 1988-09-01
Project end date: 1995-09-30
2R01HD025021-06A1 (1994): $205054
NINOS SANOS--REDUCING ETS EXPOSURE IN LATINO ASTHMATICS
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HL052835-04 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: Overall this investigation will contribute to the NHLBI goal to reduce tobacco-related morbidity of under-served low SES Latino children with asthma. Our primary specific aims are 1) to determine the differential effectiveness of behavioral counseling for reduction of ETS exposure in asthmatic Latino children compared to children who receive only general asthma management education; 2) to validate Latino parent-reported smoke exposure measures using CDC s repeated urine cotinine biological assay; 3) to determine the change in asthma management knowledge, and change in reported home asthma management procedures compared to pre-education. Secondary aims are 4) to determine the degree to which smoking parents reduce or quit smoking as a result of ETS reduction counseling; 5) to explore the correlates of change in ETS exposure; 6) to develop a satisfactory field measure of asthma severity; and 7) to explore the differences in asthma severity between groups and to explore possible predictors of asthma severity. Two hundred families will be recruited from four large community medical clinics in San Diego County, each located in the most densely populated Latino neighborhoods. Families will receive asthma management education after which they will be assigned at random (stratified by clinic) to two groups control or behavioral counseling to reduce ETS exposure. Counseling will include contingency contracting and problem solving negotiations. Bicultural, bilingual, Latina counselors and research staff will tailor the intervention and measurement procedures to be compatible with the Latino culture and to provide counseling and interviews in Spanish or English, as requested by the families. Measures will be obtained repeatedly over 13 months at pre- intervention and 4 times post-intervention. Measures will include a biological estimate of ETS exposure and parent-reported measures of ETS exposure. Both biological and parent report measures will be used as dependent variables. The repeated biological measure will estimate validity for the parent-reported exposure. Repeated measures statistical models will be used to determine significant differences within and between groups for both ETS exposure measures and parent smoking rates. Changes in knowledge and asthma management practices will be assessed using paired t-tests. Hierarchial multiple regression analyses will be used to explore correlates of ETS exposure, asthma severity, and general health. This study will provide a model for delivering preventive medical care to an under-served low SES minority population, which will contribute to the prevention and control of tobacco related morbidity. If successful, this study will set the stage for clinical trials needed to determine the possible reduction in asthma morbidity to be derived from reduced ETS exposure. This proposal is a revision based on feedback from all study sections.
Keywords: Hispanic American, asthma, disease /disorder prevention /control, health behavior, human therapy evaluation, passive smoking, adolescence (12-18), behavioral medicine, child (0-11), counseling, family, low income, prognosis, tobacco abuse education, tobacco abuse prevention, behavioral /social science research tag, clinical research, drug testing, human subject
Project start date: 1996-06-01
Project end date: 2001-05-31
5R01HL052835-04 (1999): $596836
5R01HL052835-03 (1998): $799985
5R01HL052835-02 (1997): $776013
3R01HL052835-03S1 (1998): $9204
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PROJECT ANDALE--INCREASING EXERCISE IN HISPANIC WOMEN
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 5R01HL052704-03 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: Latino women are at high risk for cardiovascular (CVD) and other chronic diseases, in part, due to sedentary lifestyle, obesity, and poor fitness. Few studies assess long-term physical activity, fewer observe maintenance and none have demonstrated effective procedures for sustaining exercise. Only one study has demonstrated increased moderate exercise and none has demonstrated maintenance of physical activity among Latino women. Theoretically-based procedures (shaping, contingency management, relapse prevention, and social reinforcement) hypothesized as necessary to maintain physical activity have not yet been tested experimentally. The purpose of this study is to determine the differential effectiveness of a culturally tailored program to shape and maintain moderate intensity physical activity and to improve cardiorespiratory fitness among low SES sedentary Latino women. 210 Latinas will be assigned at random to one of 3 groups 1 six month physical activity intervention, 1 physical activity plus maintenance intervention, and 1 safety education control. Exercise training will emphasize walking. Bilingual exercise leaders, aided by peer models from the community, will use shaping procedures to establish daily walking in participants. In the maintenance program, family incentives will reinforce transfer to community exercise and will be used to establish positive feedback loops to promote activity within the family. Peer led community exercise sessions, and community activism will also be used to establish social networks which will reinforce sustained physical activity. Program support will be faded out as naturally occurring social support for Community exercise is established. Four (baseline, post- intervention, post-maintenance, follow-up), repeated measures over 24 months will assess fitness (VO2max), physical activity (PAR), and CVD risk factors. Theoretically important mediating variables, such as self- efficacy, social support, stage of change for exercise, decisional balance, and home exercise environment will be explored. Repeated measures analyses will be used to determine significant differences among groups, time and group by time main effects. This study is the first to attempt to engineer maintenance of physical activity among minority women. Results will inform interventions targeted to Latino women and will provide a model to be used to sustain physical activity and reduce the risk of cardiovascular and other diseases. If effective, this analysis will also serve as a model for designing programs to sustain physical activity in the increasingly sedentary general population.
Keywords: Hispanic American, cardiovascular disorder prevention, culture, disease /disorder proneness /risk, exercise, female, human therapy evaluation, behavior modification, body physical activity, respiratory airway volume, social model, socioeconomics, clinical research, human subject
Project start date: 1996-07-15
Project end date: 2000-01-19
5R01HL052704-03 (1998): $584583
5R01HL052704-02 (1997): $632916
TRANSDISCIPLINARY TRAINING FOR PREDOCTORAL BEHAVIORAL SCIENTISTS
Melbourne F Hovell, Professor & Director
San Diego State University, 5250 Campanile Dr, San Diego, Ca 92182
Grant 3T32GM084896-02S1 from National Institute Of General Medical Sciences
Abstract: Behavioral factors contribute significantly to and often interact with biological factors to influence health and disease. While behavioral and biological/biomedical sciences have historically operated independently, health promotion and disease prevention cannot be fully realized without multidisciplinary efforts. The joint doctoral program (JDP) in Public Health offered by San Diego State University´s Graduate School of Public Health and the University of California-San Diego´s School of Medicine is an ideal setting for training future investigators who may bridge these disciplines. Two behavioral and two biomedical scientists will direct the program. An executive committee will select fellows for funding and assign them to appropriate mentors. Advisory committees comprised of behavioral and biological/biomedical faculty will oversee fellows´ training. Faculty from several behavioral and biological/biomedical departments at both institutions will participate. Research expertise areas include but are not limited to diet & exercise; infectious & chronic disease epidemiology & prevention; tobacco exposure & control; substance abuse & addiction; gene-environment interactions; prenatal & perinatal teratology; and ethnicity & health. Each year, up to 5 new predoctoral public health students who are interested in integrating biological/biomedical science training in their behavioral science program of study will be offered 3 years of T32 support. Ideal T32 candidates will enter with a Master´s in Public Health or related field and have a limited background in biology/biomedicine and a stated interest in obtaining additional training in these areas. Based on fellows´ interests, individualized programs of study will include the JDP curriculum with added coursework in related biological/biomedical concepts & methodologies; rotations in behavioral- & biological/biomedical-focused research labs; training in the conduct of ethical research; and a teaching component. Our goal is to produce scientists who are versed in behavioral and biological/biomedical science and are prepared to conduct ethical multidisciplinary research. Relevance The Institute of Medicine has recognized that the understanding, control, and prevention of morbidity require multidisciplinary research and public health promotion systems. This training program will equip behavioral scientists with the biological/biomedical background necessary to work collaboratively with biomedical investigators to prevent and control disease in populations
Keywords: Behavioral; Scientist; Training; pre-doc; pre-doctoral; predoc; predoctoral
Project start date: 2009-09-01
Project end date: 2011-08-31
Budget start date: 1-SEP-2009
Budget end date: 31-AUG-2011
PFA/PA: PAR-06-503
3T32GM084896-02S1 (2009): $130368
1T32GM084896-01 (2008): $97114
Melbourne F Hovell
San Diego State University
Project start date: 2009-03-01
Project end date: 2015-01-31
Environmental Tobacco Smoke Reduction In Preteens
Melbourne F Hovell, Professor And Director
San Diego State University 5250 Campanile Dr San Diego, Ca 92182
Grant 3R01HL066307-04S1 from National Heart, Lung, And Blood Institute IRG: ZRG1
Project start date: 2003-02-01
Project end date: 2008-01-31
3R01HL066307-04S1 (2007): $4174
3R01HL066307-05S2 (2007): $41663
3R01HL066307-01A2S1 (2003): $21345
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