Reducing Adolescent Risk: Toward an Integrated Approach

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Edited by: Daniel Romer

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  • Part I: Adolescents as Decision Makers

    Part II: Common Pathways and Influences on Adolescent Risk Behavior

    Part III: Perspectives from Different Risk Research Traditions

    Part IV: Overarching Approaches and Recommendations for Future Research

  • Dedication

    To my daughter Adrienne and all young people making the transition to adulthood.

    Copyright

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    Acknowledgments

    The Annenberg Public Policy Center (APPC) thanks the Annenberg Foundation and the Annenberg Foundation at Sunnylands Trust for their support of the conference on which this book is based. In addition, we thank the American Academy of Political and Social Science for cosponsoring the conference with the Annenberg Adolescent Risk Communication Institute of the University of Pennsylvania. Thanks also go to the seven session leaders of the conference who helped to organize their sessions and recruit panel members: Madelyn Gould, Mark Griffiths, John Jemmott, Lloyd Johnston, Douglas Kirby, Susan Millstein, and Paul Slovic. Although we were unable to include papers from all the panelists and session leaders, their participation produced a most stimulating and exciting meeting. The many attendees from government agencies and foundations (listed in Appendix B) were not only an excellent audience but also contributed greatly to the discussions. Kenneth Bollen of the University of North Carolina also consulted with us on the design of the causal modeling discussed in Chapter 1. Thanks also go to Linda Gray for her patience and dedication to editing the volume. Finally, we thank Belkys López and Nikki Dooner for their help in bringing this volume together and the following members of the APPC staff who helped to make the conference a success: Richard Cardona, Kyle Cassidy, Joshua Gesell, Deborah Porter, Carmen Renwick, and Debra Williams.

    Preface

    In January of 2001, the Annenberg Foundation provided an endowment to the Annenberg Public Policy Center (APPC) of the University of Pennsylvania to establish the Adolescent Risk Communication Institute (ARCI). The purpose of this new center is to synthesize what is known about effective strategies to reduce adolescent risk behavior and to encourage healthy youth development. In addition, ARCI was created to encourage new research that could lead to more effective strategies for healthy adolescent development and to communicate the findings to the policy community as well as to parents, youth, and persons who care for and educate young people.

    As Kathleen Hall Jamieson, Director of the APPC, and Daniel Romer, Research Director of ARCI, considered how best to launch the new Institute, they considered it critical to recognize that the United States does not have a comprehensive youth development strategy. The schools are perhaps the most important venue for the training and development of the young. However, there has only recently been an attempt to fashion a nationwide strategy to promote the educational attainment of youth. The primary responsibility for the health and development of young people lies with the states. However, the states differ dramatically in programs and resources dedicated to young people's development and well-being. A diverse array of governmental departments take responsibility for youth development, but their programs have developed along separate paths with little common purpose.

    Despite the fractured state of programming for youth, there is increased interest in developing more comprehensive strategies. The National Governors Association (NGA) has created a Youth Policy Network that is encouraging states to look for ways to integrate their youth-related programs. Seventeen states (including New York, California, and Massachusetts) have begun this process with help from the NGA as well as other national youth-oriented organizations (Ferber, Pittman, & Marshall, 2002). These efforts are increasingly looking for ways to involve schools, state agencies, and community-based organizations in a unified strategy to encourage positive youth development. In addition, policymakers look to the research community to provide guidance regarding the most effective approaches.

    To achieve the goal of more coherent youth policy, the research community and federal agencies such as the Centers for Disease Control and Prevention and the Department of Education will be increasingly called on to identify strategies that can help states and the federal government create comprehensive programs.

    Unfortunately, research-based recommendations for healthy development are usually focused on single outcomes with few comprehensive strategies. For example, recommendations from both Healthy People (U.S. Department of Health and Human Services, 2000b) and Healthy Youth (Fleming, Towey, & Jarosik, 2001) contain a plethora of worthy objectives spanning a wide range of youth outcomes, such as reduced drug, alcohol, and cigarette use; healthier approaches to sex; and reduced reliance on violent methods of problem solving. However, each is discussed as a separate problem with separate strategies.

    Strategies to achieve healthy outcomes also rely heavily on the schools and medical providers to deliver health education programs. However, the federal government has recently embarked on a policy of increased emphasis on educational achievement to improve the academic readiness of the nation's youth. The No Child Left Behind program focuses on academic testing as early as third grade and imposes financial penalties on schools that fail to meet testing goals. Although the legislation concentrates heavily on poor and disadvantaged schools, the effects of this initiative will be felt across the educational spectrum. With this increased pressure on academic performance in schools, there will be even less room in the school day for health-related curricula. If they do not already, schools will soon lack the time in the school day to continue behavior-specific prevention curricula.

    Another common strategy is the use of mass media campaigns to reach youth and parents regarding risky behavior. We now have major campaigns to discourage cigarette smoking, illicit drug use (especially marijuana), and childbirth before marriage. However, we often see messages that seem to ignore possible effects on other risk behaviors: for example, antismoking and drug messages that model young people's suicide behavior. There is also little recognition of the well-established pathway from cigarettes and alcohol to marijuana (see Hornik, this volume).

    Despite evidence of comorbidity for major health risks, our interventions continue to be developed for single outcomes. So we asked, What do we know about interventions that might be able to reduce adolescent risk and increase resilience across behaviors?

    To answer this question, we brought experts together from seven fields to discuss the pathways to risk behavior in their domain and possible strategies to reduce multiple risks. Our risk domains included traditional ones, such as tobacco, drugs, and alcohol as well as the prevention of risky sexual behavior. But we also included some relatively understudied domains, such as suicide and gambling. Indeed, gambling has not yet been recognized as a serious health threat to youth in the United States (National Research Council, 1999). However, we thought it would be helpful to learn more about this behavior because it might serve as a test case of the temptation to “reinvent the wheel” in developing interventions for this behavior.

    Indeed, if the past is any guide, the nation's approach to preventing the risks of this behavior in youth will be to develop a new set of interventions that compete with the other programs that currently take up time in the school curriculum and in medical care settings.

    Suicide was selected not only because it is a leading cause of death among youth, but also because it is related to a range of conditions and behaviors that concern youth. Suicide is a major form of violent death that often involves firearms. It is also a major consequence of mental illness, especially depression, which is prevalent in youth and comorbid with many other adolescent risk behaviors (see Gould, this volume, and Alloy, Zhu, & Abramson, this volume). Hence, it was felt that a focus on this behavior would provide a useful lens through which to understand a range of youth behaviors that pose a serious risk to healthy youth development.

    We invited researchers who study sexual risks not only because the problem is serious but also to gain a greater understanding of comprehensive strategies that might be effective for these risks. This field is fragmented by the division between the older and more established family-planning approaches to pregnancy prevention and the newer effort to reduce exposure to sexually transmitted diseases (STDs), especially HIV. In addition, there is a major split among policymakers about the best way to encourage safer sexual behavior in youth. Welfare reform legislation has emphasized “abstinence first” programs that on their face appear to encourage behavior that can reduce both pregnancy and STDs. However, it is not clear that such a strategy can be effective for all youth at all ages, just as a “Just Say No” approach has only limited success for other risk behaviors considered normative for adults but not for youth. Hence, we invited researchers from both fields to discuss what is known about sexual risks and potential intervention strategies that lead to comprehensive interventions.

    Finally, we asked researchers who study risk perception and decision making in adolescents to review the state of the art in this field. Many intervention strategies presuppose that adolescents can be educated to make better decisions about risky activities. However, there remains considerable controversy within this field as to whether adolescents adequately perceive the risk of many harmful behaviors (e.g., tobacco use) and if they adequately integrate their understanding of risk into decisions about engaging in risky behavior. To the degree that adolescents are seen as rational actors, there is hope that they can be influenced to make adaptive decisions. At the same time, there are serious concerns that young people will become addicted, for example, to tobacco, before they adequately understand the risks of this activity.

    The list of presenters at the conference is in Appendix A. In addition to the presenters, many representatives from federal agencies and foundations attended the meeting and contributed to the discussion and proceedings. Their names and affiliations are contained in Appendix B. The papers we include in this volume contain a wealth of references to the scholarly and policy literature; these are located at the end of the book.

    Overview of Chapter Organization

    Although the conference was organized around seven risk topics, we present many of the papers written for the conference according to the common themes that connect them, irrespective of the session in which they were presented. In the first chapter, Daniel Romer presents findings from a national survey of youth conducted by ARCI to inform the conference about potential relationships between the risk behaviors discussed at the meeting. The results of this analysis indicate not only that risk behaviors are related but that interventions to reduce this comorbidity may have a large effect across a wide range of behaviors. In addition, he shows that young people are aware of the co-occurrence of risk behavior and associate much of it with popular peers. These findings suggested that the ultimate aim of the conference, to identify comprehensive approaches to risk reduction, had considerable promise. However, simply telling young people not to engage in these behaviors is unlikely to be a successful strategy. Therefore, strategies that address the reasons for the appeal of risk behavior and that provide healthier alternatives will have greater chances for success.

    Adolescents as Decision Makers

    In Part I, Section A, we focus on the papers that addressed questions surrounding adolescents as decision makers. One enduring question concerning adolescents is whether they even consider the risks of their behavior before they engage in it. James Byrnes considers this and other questions regarding adolescent decision making and emphasizes the need to consider both the risky situations that adolescents find themselves in and their capacities for making good decisions in those situations. Laurence Steinberg proposes a definition of mature decision making and questions whether adolescents can fully master these skills. Daniel Lapsley addresses the question of whether young people are subject to belief in certain fables that encourage risky behavior. He takes a more optimistic tack by observing that adolescents are often protected from certain harmful conditions, such as depression, by the belief in optimistic fables. Hence, to the degree that adolescents believe in fables at all, the effects of these beliefs need not be harmful.

    In Section B of Part I, Susan Millstein and Paul Slovic argue for the importance of affect in adolescent decision making. Millstein suggests that risk judgments may not have much influence on adolescents unless the risks reach a critical affective threshold. As a result, many risk judgments may be unrelated to behavior. Slovic explores the importance of the “affect heuristic” as a process that influences risk judgments and behaviors. Use of this heuristic encourages people to use their feelings toward a behavior rather than a reasoned analysis of risks as the basis for deciding to try the behavior. Advertising and promotion can create positive images of many risky behaviors likely to elicit favorable feelings. In addition, many of these behaviors are seen as popular and confer the appearance of adult status. As a result, young people are likely to give them a try. Unfortunately, the addictive properties of some risk behaviors can make this a hazardous strategy.

    Other authors argue forcefully that many adolescents are sensitive to risk information and will moderate their behavior in line with risk perceptions under certain conditions. Martin Fishbein argues that risk judgments do affect intentions and that one can observe this relationship if one measures risk perceptions appropriately. He presents examples of sexual behavior that illustrate this relationship. In the realm of drugs and alcohol, Lloyd Johnston discusses the role of fads and other changes in popular culture that appear to induce widespread changes in drug use despite little or no change in personality predispositions or availability of drugs. He argues that perceptions of the risks of drugs have been a powerful mediator of these changes. These wider social influences also need to be understood to design effective interventions for the prevention of risk behavior in youth. In addition, he shows that some correlates of drug use (such as lack of attachment to school) may influence a wide range of drug use tendencies. Finally, Meg Gerrard, Frederick Gibbons, and Michelle Gano argue that risk perceptions are most likely to influence the behavior of adolescents who are willing to try a new behavior (but have not yet done so) and hence who are open to information about the consequences of those behaviors.

    The authors in Section C of Part I present evidence that adolescents who approach complex decisions with more adaptive decision-making skills are more likely to make healthy choices than those whose decision-making skills are weak or simplistic. Myrna Shure reviews a long line of research that she pioneered to identify decision-making skills that can be taught in the primary grades and that lead to more adaptive behavior as children age. Kenneth Griffin argues that teaching these skills in combination with risk-specific information can be an effective strategy to insulate youth from risky peer influences. Andrew Parker and Baruch Fischhoff argue that basic decision-making skills are correlated with safer behavior across a range of risk domains, including substance use, unprotected sex, and delinquent behavior.

    Geoffrey Fong and Peter Hall discuss the importance of sensitivity to delayed effects of risk behaviors and present evidence that young people who are taught to appreciate these delays will be more likely to persist in maintaining healthy behavior. Finally, Maria LaRusso and Robert Selman argue that school social environments are powerful influences on the decision maturity of middle school youth. Schools with chaotic and arbitrary discipline policies create cynicism regarding health advice and fail to provide credible guidance for youths who face challenges negotiating decisions about risky behavior.

    Common Pathways and Influences on Adolescent Risk Behavior

    In Part II, we feature authors who focus on intervention strategies that exploit common pathways to risk behavior. In Section A of Part II, Anthony Biglan and Christine Cody review the findings of a project that synthesized what is known about multiple-problem youth. These youth follow developmental paths characterized by multiple risky behaviors, such as substance use, aggressive and antisocial behavior, and risky sexual behavior. These individuals account for a large proportion of the risk behavior engaged in by youth. However, these youth can be identified early (primarily by their aggressive tendencies in the elementary grades) and potentially helped to avoid some of the hazardous effects of their behavior. Herbert Severson, Judy Andrews, and Hill Walker also advocate early detection with the help of teachers who can be a valuable aid in identifying multiple-problem youth. Their research suggests that teachers can be trained to use objective assessment tools and that once identified, problem youth can be helped to find more adaptive ways of interacting with peers and teachers in school and other settings. Finally, Kenneth Winters, Gerald August, and Willa Leitten describe an intensive intervention currently under investigation to identify and help multiple-problem youth to avoid their likely maladaptive developmental paths.

    In Section B of Part II, two chapters provide an overview of what is known about predispositions to engage in a range of risk behaviors. Caryn Lerman, Freda Patterson, and Alexandra Shields review the latest developments in genetics regarding addictive behaviors. Although they conclude that it is unlikely that there is a single gene for addiction, several traits are likely to be inherited that predispose persons to seek experiences that are addictive. They focus on sensation seeking and impulsiveness as paradigms of such traits. They also discuss some of the ethical issues that will arise once it becomes possible to identify risk-predisposing traits in children. Lewis Donohew and his coauthors review the extensive evidence for the role of sensation seeking as a trait that predisposes young people to seek risky experiences. He focuses on the implications of this relationship for the design of persuasive messages to discourage these outlets for sensation seekers.

    Depression is a major risk factor for suicide and is itself an important mental health problem in adolescents. Lauren Alloy, Lin Zhu, and Lyn Abramson review recent research on the developmental precursors of depression and some potential interventions to prevent depression in young people. If successful, such interventions might also be able to help depressed persons overcome the need to abuse substances such as tobacco and alcohol.

    Peers and the family, the focus of Section C of Part II, are important influences on adolescent risk behavior. Joseph Rodgers discusses the role of social contagion among teens as a mechanism for the spread of risky behaviors. The same mechanisms appear to underlie the social transmission of a range of risk behaviors, including tobacco use and sexual initiation. If these transmission processes could be postponed to even a little later in development, the reductions in risk behavior initiation could be sizable. Bonita Stanton and James Burns discuss the importance of including parents in interventions because their influence through mechanisms such as parental monitoring of behavior can affect a wide range of risk behaviors, including unprotected sex, violence, and drug use.

    Mass media are an important influence on young people. In Section D of Part II, Barbara Delaney, from the Partnership for a Drug Free America, discusses the research strategies used to develop antidrug messages for the national campaigns that her organization has sponsored for over a decade. Joseph Cappella, Marco Yzer, and Martin Fishbein amplify the need to identify strong arguments that can persuade youth to avoid risk behavior and provide examples of some methods to accomplish this goal.

    Perspectives from Different Risk Research Traditions

    Part III provides perspectives on the challenges posed by several of the major risk behaviors discussed at the conference. In Section A of Part III, the first team of authors focuses on the relatively understudied behavior of problem gambling. Mark Griffiths summarizes the state of knowledge about this behavior from the perspective of the United Kingdom, where access to gambling by young people is less restricted than in the United States. As a result, it is possible to observe some of the potential abuses that greater access to gambling devices such as slot machines has on young people. This is particularly of concern because gambling restrictions in the United States have progressively been lifted to the point where access in venues such as the Internet is open to anyone. In addition, just as substance use can become addictive, there is evidence that gambling has the potential to induce the same type of dependencies on its frequent users. As we saw in the analysis of comorbidity among substance use and gambling in Chapter 1, gambling has many of the same precursors as substance use and may be able to be treated with some of the same strategies. Jeffrey Derevensky, Rina Gupta, Laurie Dickson, Karen Hardoon, and Anne-Elyse Deguire highlight the overlap in precursors and risk factors between problem gambling and other risk behaviors. They also suggest some ways of conceptualizing problem gambling within a risk-resilience framework. Marc Potenza discusses some of the potential interventions that might be tested to prevent youth addiction to gambling, and Rachel Volberg reviews some recent research concerning the prevalence of the behavior and some ways that states with fewer restrictions on gambling have attempted to shield youth from its effects.

    The sessions devoted to sexual behavior at the conference, the focus of Section B of Part III, were perhaps the most contentious regarding appropriate strategies for prevention. Douglas Kirby provides an overview of the many intervention approaches to safer sexual behavior that have been tested. He concludes that whether one focuses on abstinence or safer sex as strategies, the important factor that seems to underlie successful interventions is increasing attachment to adults and peers who foster healthy norms for youth behavior. Across a wide range of interventions, attachment to adults in prosocial activities, such as community service, seems to have lasting impact on reducing risky sexual behavior.

    Despite Kirby's optimistic assessment, the other authors find much that is problematic in current approaches to prevention in the sexual arena. Mignon Moore and Jeanne Brooks-Gunn review the research and find that programs with a comprehensive approach that includes access to contraception and information about a variety of options for sexual health are the most successful. In addition, they suggest that a focus on healthy youth development rather than on risk avoidance characterizes the successful programs. They also argue that the current emphasis on abstinence-first programs by the federal government places concerns about sexual morality above sexual health. Dennis Fortenberry argues that the emphasis on sexual risk stigmatizes a natural and important behavior in which youth will eventually be expected to engage. He argues that a middle ground in our search for effective strategies must be found that can encourage healthy regard for sex while also promoting greater safety in the way sexual relations are conducted.

    Although suicide is the third leading cause of death in youth under age 25 and the second leading cause for college students, it remains an understudied problem in prevention research. In Section C of Part III, Madelyn Gould reviews what is known about the major precursors and influences on suicide. She also notes some of the important ways in which these precursors overlap with other risk behaviors. Furthermore, because mental disorders such as depression are major risk factors, the prevention of suicide dovetails with efforts to promote mental health and to reduce the stigma of seeking help for mental disorders.

    David Brent discusses several intervention approaches for reducing adolescent suicide. He focuses on gun access as an important precursor to suicide. Nearly all the increase in youth suicide over the past 50 years has been related to increases in the use of firearms as a means of death. He discusses some ways in which removal of access to firearms for vulnerable youth may be able to save lives and avoid nonfatal injuries. Sean Joe discusses the problem of recent increases in suicide among African American youth. He argues that this phenomenon may be linked to changes in the status of African American youth that have led to greater tendencies for individuals to blame themselves rather than external conditions for failure.

    Finally, in Section D of Part III, Robert Hornik reports some findings from the national evaluation of the United States antidrug campaign. He finds that the gateway hypothesis for tobacco and alcohol use as precursors to marijuana use is still quite viable. Very few youth begin to use marijuana without first smoking cigarettes or drinking alcohol. An effective strategy for reducing marijuana initiation could be reducing cigarette smoking. Similar effects should be observed from encouraging the safer use of alcohol.

    Overarching Approaches and Recommendations for Future Research

    In Part IV, we feature some of the presenters who focused on more global strategies for risk reduction. The approach that seeks to encourage engagement in positive activities and the creation of healthy environments (positive youth development) is discussed by Brian Flay as a strategy to reduce a range of risky behaviors. He argues that for such programs to succeed, they will need to change entire social units such as schools and communities. In addition, Jodie Roth and Jeanne Brooks-Gunn review the evidence concerning community-based programs for positive youth development. Their review finds that programs that were more successful in influencing multiple risk behaviors also increased attachment to the community and instilled positive norms for healthy behavior. Finally, Ralph DiClemente, Gina Wingood, and Richard Crosby survey recent developments in multilevel approaches that seek to change not only the individual but also higher levels of social connection, such as the family and community. They argue that such interventions will have greater endurance and success than ones that focus only on individual change.

    In the last chapter, Kathleen Jamieson and Daniel Romer review the major implications of the conference proceedings for future research and policy development. They identify four major findings from the conference that should be pursued in future research to identify comprehensive intervention strategies and a unified policy for healthy youth development.

  • Appendix A: Reducing Adolescent Risk: Conference Schedule June 27–30, 2002

    Thursday, June 27, 2002
    Session 1: General Risk Perception and Behavior
    • Session Leader: Susan Millstein, University of California, San Francisco
    • James Byrnes, University of Maryland
    • Meg Gerrard, Iowa State University
    • Bonnie Halpern-Felsher, University of California, San Francisco
    • Daniel Lapsley, Ball State University
    • Andrew Parker, Virginia Tech University
    • Robert Selman, Harvard University
    • Myrna B. Shure, Drexel University
    • Laurence Steinberg, Temple University
    Session 2: Suicide
    • Session Leader: Madelyn Gould, Columbia University
    • Lauren Alloy, Temple University
    • Aaron T. Beck, University of Pennsylvania
    • Alan L. Berman, American Association of Suicidology
    • David Brent, Western Psychiatric Institute
    • Jane Gillham, University of Pennsylvania
    • Ian Gotlib, Stanford University
    • Lawrence Greenhill, Columbia University
    • Sean Joe, School of Social Work, University of Pennsylvania
    • Steve Stack, Wayne State University
    Friday, June 28, 2002
    Breakfast
    • Invited Speaker: Caryn Lerman, Director, Tobacco Research Program at the Leonard & Madlyn Abramson Family Cancer Research Institute, University of Pennsylvania
    Session 3: Gambling
    • Session Leader: Mark Griffiths, Nottingham University, United Kingdom
    • Jeffrey Derevensky, McGill University
    • Richard I. Evans, University of Houston
    • Marc Potenza, Yale University School of Medicine
    • Rachel Volberg, University of Massachusetts
    • Ken C. Winters, University of Minnesota
    Lunch
    • Invited Speaker: Aaron T. Beck, Professor Emeritus, University of Pennsylvania
    Session 4: Tobacco
    • Session Leader: Paul Slovic, University of Oregon
    • Brian Flay, University of Illinois, Chicago
    • Geoffrey Fong, University of Waterloo
    • Lyndon Haviland, The American Legacy Foundation
    • Caryn Lerman, University of Pennsylvania
    • Daniel McGoldrick, Tobacco Free Kids
    • Connie Pechmann, University of California, Irvine
    • Herbert Severson, Oregon Research Institute
    • Neil Weinstein, Rutgers University
    Session 5: Pregnancy
    • Session Leader: Douglas Kirby, Education Training Research Associates
    • Jane Brown, University of North Carolina
    • Jacqueline Darroch, Alan Guttmacher Institute
    • James Jaccard, SUNY Albany
    • Rebecca Maynard, University of Pennsylvania
    • Mignon Moore, Columbia University
    • Marisa Nightingale, The National Campaign To Prevent Teen Pregnancy
    • Joseph Rodgers, University of Oklahoma
    • Diane Scott-Jones, Boston College
    Saturday, June 29, 2002
    Session 6: HIV/STD
    • Session Leader: John Jemmott, The Annenberg School for Communication
    • Ralph DiClemente, Emory University
    • Martin Fishbein, The Annenberg School for Communication
    • Dennis Fortenberry, Indiana University
    • Loretta Jemmott, University of Pennsylvania
    • Robert Johnson, New Jersey Medical School
    • Sara Kinsman, Children's Hospital of Pennsylvania
    • Freya Sonenstein, Urban Institute
    • Bonita Stanton, West Virginia University
    • Antonia Villarruel, University of Michigan
    • Gina Wingood, Emory University
    Lunch
    • Invited Speaker: David Shaffer, Irving Phillips Professor of Child Psychology, Columbia University
    Session 7: Alcohol/Drugs
    • Session Leader: Lloyd Johnston, University of Michigan
    • Anthony Biglan, Oregon Research Institute
    • Joseph Cappella, The Annenberg School for Communication
    • Barbara Delaney, Partnership for a Drug-Free America
    • Lewis Donohew, University of Kentucky
    • Kenneth Griffin, Cornell Medical School
    • George Hacker, The Center for Science in the Public Interest
    • Robert Hornik, The Annenberg School for Communication
    • Michael Windle, University of Alabama at Birmingham

    Appendix B: Conference Attendees, June 27 – June 30, 2002

    • CARMEN ANDERSON
    • Program Officer, Children, Youth & Families
    • The Heinz Endowment
    • ELIJAH ANDERSON
    • Board of Directors
    • American Academy of Political and Social Science
    • JANET AUDRAIN
    • Assistant Professor
    • Psychiatry, University of Pennsylvania
    • DAN BARRETT
    • The Annenberg School for Communication
    • University of Pennsylvania
    • COURTNEY BENNETT
    • Program Officer
    • The David and Lucile Packard Foundation
    • TYRONE BENTLEY
    • Developmental Pediatric Fellow Children's Seashore House/C.H.O.P.
    • ALAN L. BERMAN
    • Executive Director American Association of Suicidology
    • LINDA BLOCK
    • Health Communication Specialist Centers for Disease Control
    • LISA BOLTON
    • Associate Professor of Marketing Wharton, University of Pennsylvania
    • NICOLETTE BOREK
    • Division of Mental Disorders,
    • Behavior Research and AIDS
    • National Institute of Mental Health
    • RHONDA BOYD
    • Instructor
    • University of Pennsylvania School of Medicine
    • GREG BROWN
    • Assistant Professor
    • Department of Psychiatry
    • University of Pennsylvania
    • ELAINE CASEY
    • Program Officer
    • The Pew Charitable Trusts
    • ROSE CHENEY
    • Executive Director
    • Firearm Injury Center at Penn
    • University of Pennsylvania
    • MIKE CODY
    • Professor
    • Annenberg School
    • University of Southern California
    • LINDA CROSSETT
    • Acting Chief of Research Application Branch
    • Centers for Disease Control
    • MAURA DUNFEY
    • Research & Communications Coordinator
    • Firearm Injury Center at Penn
    • University of Pennsylvania
    • JEANETTE FRIEDMAN
    • Caron Foundation
    • LYNNE HAVERKOS
    • Program Director
    • National Institute of Child Health and Human Development
    • FREDERICK HELDRING
    • Executive Director
    • American Academy of Political and Social Science
    • GREGG HENRIQUES
    • Assistant Professor
    • Department of Psychiatry
    • University of Pennsylvania
    • JUDY HERRMAN
    • University of Delaware
    • Center for Community
    • Development & Family Policy
    • NICOLE HEWITT
    • Center for Health Behavior and Communication Research
    • The Annenberg Public Policy Center University of Pennsylvania
    • JANET HSU
    • Center for Health Behavior and Communication Research
    • The Annenberg Public Policy Center
    • University of Pennsylvania
    • JOAH IANNOTTA
    • National Academy of Science
    • CAROLE JOHNSON
    • Program Officer
    • The Pew Charitable Trusts
    • LINDA KOENIG
    • Assistant Chief for Behavioral Science
    • Division of HIV/AIDS Prevention
    • Centers for Disease Control
    • KITTY KOLBERT
    • The Annenberg School for Communication
    • University of Pennsylvania
    • DEMIE KURZ
    • Codirector, Women's Studies Program
    • University of Pennsylvania
    • MARIA LARUSSO
    • Graduate School of Education
    • Harvard University
    • RAY LORION
    • Chair & Professor of Psychology in Education
    • Graduate School of Education
    • University of Pennsylvania
    • JANE MACHIN
    • Wharton, University of Pennsylvania
    • JOE MCLLHANEY
    • Director
    • The Medical Institute, Austin, TX
    • MARY ANN MEYERS
    • Board of Directors American Academy of Political and Social Science
    • LYNN MILLER
    • Professor
    • Annenberg School
    • University of Southern California
    • KLAUS NAUDÉ
    • Board of Directors
    • American Academy of Political and Social Science
    • SUSAN NEWCOMER
    • Demographic & Behavioral Sciences Branch
    • National Institute of Child Health and Human Development
    • JAMES NONNEMAKER
    • Research Economist
    • RTI International
    • FREDA PATTERSON
    • Project Manager
    • Tobacco Use Research Center
    • JANE LESLIE PEARSON
    • Chief, Preventive Interventions Programs
    • National Institute of Mental Health
    • ROBERT W. PEARSON
    • Executive Director
    • American Academy of Political and Social Science
    • JAROSLAV PELIKAN
    • Board of Directors
    • American Academy of Political and Social Science
    • WILLO PEQUEGNAT
    • Chief, Prevention Translational
    • Research Program
    • National Institute of Mental Health
    • LOUIS H. POLLAK
    • Board of Directors
    • American Academy of Political and Social Science
    • LESHAWNDRA PRICE
    • National Institute of Mental Health
    • JANE PRITZL
    • Division of Adolescent and School Health
    • Centers for Disease Control
    • KAREN REIVICH
    • University of Pennsylvania
    • KELLY SCHMITT
    • Assistant Director, Education and Research
    • Sesame Street Research
    • DON SCHWARZ
    • Associate Professor & Vice Chair of Pediatrics
    • Children's Hospital of Pennsylvania
    • MELISSA SEIDE
    • Program Manager
    • Firearm Injury Center at Penn
    • University of Pennsylvania
    • BELINDA SIMS
    • Chief, Preventive Interventions Program
    • National Institute of Mental Health
    • JANET ST. LAWRENCE
    • Chief of Behavioral Interventions & Research Branch
    • Division of STD Prevention
    • Centers for Disease Control
    • GLADYS THOMAS
    • Center Administrator, Center for Health Behavior and Communication Research
    • Annenberg Public Policy Center
    • University of Pennsylvania
    • MARCO YZER
    • The Amsterdam School of Communication Research
    • University of Amsterdam

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