Handbook of Program Development for Health Behavior Research & Practice

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Edited by: Steve Sussman

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  • Part I: Rationale for a Handbook of Program Development

    Part II: The Connection between Theory and Activity Pooling

    Part III: Perceived Efficacy Methods

    Part IV: Immediate-Impact Methods and Program Construction

    Part V: Tying Immediate-Outcomes Measures to Longer-Term Outcomes and Conclusions

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    Foreword

    In the broad sweep of social and behavioral science applications in medicine, public health, and health promotion, the sciences are maturing rapidly, the applications are progressing more fitfully, but the health results are panning out with frustrating inconsistency. In this volume, Dr. Sussman and his collaborators have tried to put their collective fingers on the link in this chain that seems to have been the weakest—the link between the science and its most appropriate application to ensure the best result. The reason this link is weak has much to do with the variability of the targets—the populations and their circumstances. These circumstances include the particular population's health needs and resources that biomedical scientists and epidemi-ologists would have us analyze. They also include their cultural traditions that anthropologists would have us understand, their socioeconomic conditions that sociologists and economists would have us appreciate, and the contingencies of their behavior that psychologists would have us consider. In short, the program development link in the theory- and evidence-based planning-to-evaluation chain is an interchangeable link, depending on the delineation of a population and its circumstances.

    Science, in this context, refers to the combination of theory, evidence from past applications of the theory, and methods for data collection and analysis appropriate to the particular population, its health issues, and its cultural, socioeconomic, and psychological circumstances. To bring these elements of science to bear on the program development link between planning and evaluation, Sussman et al. offer a more intricate chain made up of six smaller links to repair the weak link of program development. They provide a theoretical and practical rationale for the attention to each of these six steps in program development, theory, and research that underpins the step. Also, for each step, they provide a case study that illustrates the application of the step in a real-world population and health problem. They also invite commentary from recognized theorist-researcher-practitioners in the health field who have dealt with some success with that step or aspect of the program development process.

    When all these six steps are added to what they consider a paralyzing array of planning and evaluation processes, many practitioners will react with some diffidence if not resistance. The editors and authors of this book retain a refreshing appreciation of the practicalities of applying theory-based and evidence-based program development methods in real time. They suggest (or recognize the need for) shortcuts, resources, and rule-of-thumb methods to get the essential information required to make professional judgments in the absence of complete information. As these methods and rules of thumb become codified, we may hope for readily retrievable instruments and computer software that will help the practitioner apply them more efficiently.

    This book promises to strengthen that weak link between planning and evaluation, offering relevant theory and methods for matching appropriate interventions with the specific needs and circumstances of populations. If practitioners will incorporate these methods into their planning process, they will add credibility and effectiveness to their programs. If researchers will concentrate some of their evaluation efforts to this phase of the planning process, the larger good will be served by the improved guidance available to practitioners, who now must depend heavily on their ability to sort intervention fads and fashions from evidence-based matching of interventions to populations and circumstances.

    Lawrence W.Green

    Preface

    Health behavior program development refers to what goes into the construction of a health behavior program from the point at which it is conceived to the point at which the program is built and ready for a trial. A careful search of alternative texts and journals reveals that there is no one source that is dedicated to presentation of research or practice in this arena. In fact, no forum for consensual systematization of health program development methods exists in health behavior research or practice. Yet, health program development is essential to changing health research and practice needs. As the social climate changes, new approaches to changing health behavior often need development. Program development work also is needed to determine the appropriate constituents of a program for a new population that differs in lifestyle characteristics or risk. Modifications also may be needed in a program as applied to different levels of implementation (e.g., community-wide coalitions vs. clinics).

    This volume justifies the importance of engaging in a scientific and systematic practice of health behavior program development. It identifies means to overcome obstacles to development of this arena and offers a consensual model to guide development of programming. This model is referred to as the six-step “program development chain model.” This model provides a comprehensive road map (see Table 1.1). It serves as a guide to the creation of new program development methods and evaluation (research) and development of programs based on a compilation of methods and evaluation techniques presented in this text (practice). One goal of this book is to speak to the breadth of health behavior research and practice when describing previous or future needed program development work. Thus, each of the 13 substantive chapters in this text presents examples from two or more health areas. A wide variety of techniques are presented. In addition, case study information is presented in 7 chapters to demonstrate the use of these techniques in action. Many technical terms are introduced in this text. These terms are bolded on their first occurrence to assist in recognition and acquisition of critical material. In all, this handbook provides 20 chapters of detailed and useful information, making it the most complete text of its kind.

    The audience for this handbook includes researchers, teachers, public health practitioners/clinicians, students, and policymakers. Persons in the academic community will be very interested in this compendium because it definitely fills a research gap. This work could serve as the basis of some courses in methodology (e.g., design courses, program development courses that as of yet do not exist), as well as provide a needed avenue of investigation.

    County health department personnel generally are provided funds to evaluate immediate outcomes. Thus, county health department and other health agency managers and evaluators across different health arenas may hold great interest in this handbook. Those who engage in health program development work at health maintenance organizations, public health departments, or industry will be very interested in using methods presented here. Those policymakers who must decide which data to trust also will be potential readers. Of course, some material, such as meta-analysis, is suited primarily for the research community. However, an attempt was made to place much of this material in a framework that can be understood by educated laypeople. Some practitioners may wish to engage in their own systematic reviews of previous empirical studies, and this text will help them in that endeavor. Because its orientation is methodological, this volume will have international application.

    The handbook consists of five parts. The first part provides a justification for the field and consists of three chapters. Chapter 1 provides the history and rationale for engaging in health behavior program development. Chapter 2 presents a case study that shows how to apply the six-step program development model presented in Chapter 1 to the arena of mass media smoking prevention efforts. Chapter 3 presents the hurdles to engaging in program development and how to surmount those hurdles.

    The second part of the handbook presents the connection between theory and pooling intervention activities together. The fourth chapter of the text, the first in this part, provides an explanation of the use of theory in program development. Next comes Chapter 5, a second case study, which presents the use of a novel instance of theory—implicit cognition—for drug abuse and driving-under-the-influence (DUI) prevention. Next, Chapter 6 presents the use of assessment studies to fill in gaps in theory regarding what leads to health-related behavior. Assessment studies also can help suggest plausible activities to alter health-related behavior. Chapter 7 discusses many issues and resources relevant to pooling information about prior interventions. Chapter 8, a third case study, provides an example of pooling information for teen pregnancy and sexually transmitted disease (STD) prevention.

    TABLE 1.1 The Six-Step Program Development Chain Model

    The third part of the handbook presents perceived efficacy (i.e., concept evaluation) methods of activity selection. Chapter 9 provides a review of numerous verbal methods of selecting potentially useful activities. Chapter 10, the fourth case study, provides an example of the collection and use of verbal perceived efficacy information (use of focus groups for teen smoking cessation). Next, Chapter 11 provides a review of numerous paper-and-pencil methods of selecting potentially useful activities. Chapter 12, the fifth case study, provides an example of a paper-and-pencil perceived efficacy study (use of theme studies for teen smoking cessation).

    The fourth part of the handbook presents immediate-impact studies of activities and program creation. Chapter 13 discusses the main type of immediate-impact study of individual activities or sessions—the use of component studies. Chapter 14, the sixth case study, provides an example of the use of component studies for teen smoking cessation. Chapter 15 discusses issues relevant to sequencing of programming—that is, programs over the life span, sessions in a single program, and activities in a single session. Chapter 16 then discusses use of the pilot study, which tests a full program. Chapter 17, the seventh case study, presents an example of the use of pilot testing for teen drug abuse prevention.

    Finally, the fifth part of the handbook discusses finding immediate-outcome measures that will predict longer-term outcome measures and discusses future issues to consider in this arena of health behavior program development. Chapters 18 and 19 present the use of meta-analysis and mediation analysis, respectively, to identify good programming and immediate-outcome measures. Finally, Chapter 20 summarizes the text, suggests mediator and moderator measures that might be most important in health behavior programming, and indicates future issues to attend to by researchers and practitioners.

    One interesting aspect of this volume is the inclusion of the seven case studies, which provide practical guidelines on addressing relevant aspects of program development. These case studies provide useful information for discussion, research, and application. A second valuable aspect of this handbook is the inclusion of commentaries at the end of each substantive chapter that is not a case study. Sixteen commentaries are included. These commentaries extend the chapters; that is, they provide additional considerations for researchers and practitioners in the field of health behavior research and practice, as expressed by several leaders in the field. It is our shared vision that this text will become a standard resource for persons in our field in the years to come.

    Acknowledgments

    There are a lot of people to thank for helping put together a text of this magnitude. First, I would like to thank several persons at Sage Publications for their efforts. Dan Ruth guided me in the development of the text, and C. Deborah Laughton helped bring the text to a safe landing with the assistance of Eileen Carr, Diana Axelsen, Gillian Dickens, and Janelle LeMaster. Sage maintains a strong and positive interest in bridging important new frontiers in health behavior research and practice. Second, I would like to thank my private grammarian, Susan Perry, now a well-respected book author, for helping to smooth out the chapter bumps. Third, I would like to thank the University of Southern California (particularly Andy Johnson, Malcolm Pike, and Leslie Bernstein), National Institute on Drug Abuse (particularly Larry Seitz and Bill Bukoski), and California Tobacco-Related Disease Research Program (particularly Larry Gruder and Phil Gardiner) for giving me the support and flexibility to complete the editing on this test. Fourth, I would like to thank reviewer Dan Romer, Bill Bukowski, Andrew Baum, and Bruce L. Levin for their suggestions. Fifth, I would like to thank all the book authors and commentary writers for their input. All of these persons are leaders in their fields and have shown great collaborative spirit in development of the text. Some of these persons greatly influenced the shape of my own career, for which I will always be grateful (e.g., Howard Leventhal, Brian Flay, and Richard Evans). Sixth, I would like to thank my wife, Rotchana, and my children, Guang and Evan, for their love and support at home, which helped make the completion of the text a balanced process. Finally, I would like to thank the reader looking through this text, considering its contexts, and engaging in a grand, shared scheme—to improve dramatically the development and outcomes of health behavior programs

    SteveSussmanUniversity of Southern California
  • Author Index

    About the Contributors

    David G. Altman, Ph.D., is Professor of Public Health Sciences at the Wake Forest University School of Medicine. Before arriving at Wake Forest University in 1994, he spent 10 years at the Stanford Center for Research in Disease Prevention, Stanford University School of Medicine. He has conducted a variety of studies in the general area of community health promotion. He is a past president of Stop Teenage Addiction to Tobacco (STAT) and serves as National Program Director of the Robert Wood Johnson Foundation Substance Abuse Policy Research Program. In 1997, he was selected as a Fellow of the W. K. Kellogg Foundation National Leadership Program. He is a Fellow of the American Psychological Association and the Society of Behavioral Medicine (SBM) and a member of the American Public Health Association, Council on Epidemiology and Prevention of the American Heart Association, and the Society of Public Health Education. He received his doctorate in social ecology from the University of California, Irvine, in 1984.

    Susan L. Ames, M.A., is a research assistant and predoctoral student at the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, University of Southern California. Her research interests include implicit cognition and substance use in high-risk populations, impact of memory on addictive behaviors, developing prediction models of substance use, prevention and harm reduction of addictive behaviors, and psychosocial correlates of drug use and other risk behaviors. She received an M.A. in Psychology from California State University, Los Angeles, in 1994.

    M. Douglas Anglin, Ph.D., is involved in more than 50 federal-, state-, and county-funded research projects dealing with multiple aspects of drug abuse, including prevalence estimation, needs assessment, and resource allocation; the evaluation of community treatment and other interventions for drug abusers; HIV/AIDS epidemiology and high-risk behavior in drug users; and social policy analysis. He has served as an adviser for a number of organizations, including the Los Angeles County Alcohol and Drug Programs Administration, the California State Department of Alcohol and Drug Programs, the California Department of Corrections, the Federal Bureau of Prisons, the Office of National Drug Control Policy, the National Institute on Drug Abuse, the Center for Substance Abuse Treatment, and the National Association of State Alcohol and Drug Abuse Directors. Among his current activities, Dr. Anglin is Director of the UCLA Drug Abuse Research Center (Neuropsychiatric Institute). He received his doctorate in social psychology from the University of California, Los Angeles, in 1980.

    Guadalupe X. Ayala, M.A., is an evaluation and data manager on several NIH-funded research projects with a focus on Latino health. She received her master's degree in psychology from California State University, San Marcos in 1995 and is pursuing a doctoral degree in clinical psychology/behavioral medicine at SDSU-UCSD. She has more than 7 years of experience in the health research field, including 5 years working with Spanish-dominant populations. Her research experiences have been in the area of health promotion with Latinas, treatment compliance among cardiovascular patients, instrument development, acculturation and intergenerational issues, theory development, and nutrition assessment.

    Kris Bosworth, Ph.D., is a faculty member in the College of Education at the University of Arizona, where she holds the Smith Endowed Chair in Substance Abuse Education. She has been involved in prevention research for more than 20 years, with a focus on development, implementation, and evaluation of theory-based interventions for middle schools. A hallmark of her research is the appropriate use of technology as a tool for delivery of prevention interventions. Previously, she has held positions as Associate Research Scientist at the University of Wisconsin–Madison Center for Health Systems Research and Analysis, Associate Professor and Director at the Center for Adolescent Studies at Indiana University, and Visiting Scientist at the Centers for Disease Control and Prevention's Youth Violence Prevention Team. She received her doctorate of education in the Department of Continuing Adult and Vocational Education, School of Education, at the University of Wisconsin–Madison in 1988.

    Brian Colwell, Ph.D., CHES, is Associate Professor in the Department of Social and Behavioral Health at the Texas A&M School of Rural Public Health. Prior to that, he was Associate Professor of Health Education at Texas A&M University. He is actively involved in research and service related to improving school health education and reducing adolescent risk behaviors. He is the codeveloper, with Dr. Dennis Smith, of the Adolescent Tobacco Use Awareness and Cessation Program that is used by the state of Texas. He is a member of the Board of Directors of the Texas Division of the American Cancer Society. He earned his doctorate in health behavior at Indiana University in 1992.

    Gerald C. Davison, Ph.D., has been on the University of Southern California faculty since 1979 as Professor of Psychology. From 1979 to 1984, he was Director of Clinical Training and, from 1984 to 1990, department chair. From 1994 to 1996, he served as interim dean of the Annenberg School for Communication. His research interests are in cognitive assessment and cognitive behavior therapy, with particular focus on the application of his articulated thoughts in a simulated situations paradigm to a variety of emotional/behavior phenomena, including anxiety, depression, Type A behavior, borderline hypertension, safer sexual behavior, and dating violence. He received his doctorate in psychology from Stanford University in 1965.

    Clyde W. Dent, Ph.D., is Associate Professor of Research in the Department of Preventive Medicine and the Institute for Health Promotion and Disease Prevention Research at the University of Southern California. His interests include evaluation of drug abuse prevention programs, especially as pertaining to Hispanic populations. He received his doctorate in psychology from the University of North Carolina in 1984.

    Stewart I. Donaldson, Ph.D., is Associate Professor of Psychology and Organizational Behavior at the School of Organizational and Behavioral Sciences, Claremont Graduate University. He currently serves as co-chair of the Theory-Driven Evaluation and Program Theory Topical Interest Group of the American Evaluation Association. He is principal investigator on several program development and evaluation research grants, including the evaluation of the California Wellness Foundation's $20 million Work & Health Initiative. His interests include theory-driven program design and evaluation, substance abuse prevention, and worksite health promotion, including employee assistance programming. He received his doctorate in psychology from the Claremont Graduate University in 1991.

    Carol N. D'Onofrio, Dr.P.H., is Professor Emerita at the School of Public Health, University of California, Berkeley; Adjunct Research Scientist at the Northern California Cancer Center; and freelance consultant. Her work concentrates on the development and evaluation of public health programs for vulnerable populations, including youth, ethnic minority groups, people with disabilities, the poor, and the sick. Her research focuses on tobacco use prevention, breast and cervical cancer screening, and, more recently, the needs of cancer patients and the delivery of health services in managed care environments. She also has conducted research on survey methodology. She is past president of the Society for Public Health Education and has served on the Governing Council and the Program Development Board of the American Public Health Association. She received her doctorate in public health from the University of California, Berkeley, in 1973.

    Ronald S. Drabman, Ph.D., is Professor of Psychiatry and Human Behavior and Director of the clinical psychology training programs at UMC. His interests include all aspects of child behavior. He has published in the areas of child behavior modification and the effects of television violence and behavioral pediatrics. His research has been supported by several grants from NIMH. He is a fellow of the APA (Divisions 12 and 25). He served as finance chairperson and on the publications board of Behavior Therapy. Currently, he is an associate editor of Behavior Therapy and secretary-treasurer of AABT. He has been executive secretary of the Mississippi State Board of Psychological Examiners and associate editor of the Journal of Applied Behavior Analysis. The program he directs received the first annual outstanding training program award from AABT. He received his doctorate from the State University of New York at Stony Brook in 1972.

    David Duncan, Dr.P.H., is Senior Study Director in the Substance Abuse Research Group, at Westat, an employee-owned research corporation that performs contract research primarily for the federal government. He has extensive experience as a researcher, administrator, and academic in the areas of substance abuse, public health, and health education. His interdisciplinary doctorate in behavioral science, epidemiology, biostatistics, and program evaluation was awarded in 1976 by the University of Texas at Houston.

    John P. Elder, Ph.D., is Professor and Head of the Division of Health Promotion at San Diego State University in the Graduate School of Public Health. His research has included smoking prevention and tobacco control, heart health nutrition in the Latino community, and international child survival programs. He has published 190 articles and chapters as well as three books. He received an M.P.H. degree from Boston University and a Ph.D. in Psychology from West Virginia University.

    Jill English, Ph.D., is Assistant Professor of Health Science at California State University, Fullerton. She has been working in the area of health education curriculum development, implementation, and evaluation for the past 15 years. In addition, she had conducted research in drug prevention programs, provided technical assistance throughout the nation in the field of drug prevention, and taught health education in schools. Her interests are in the areas of curriculum development and school health. She graduated from the University of Southern California in 1988 with a doctorate in education.

    Richard I. Evans, Ph.D., is Distinguished Professor in the Department of Psychology at the University of Houston and Director of the Social Psychology Program and the Social Psychology/Behavioral Medicine Research Group. He was the principal author of the “U.S. Surgeon General's Report on Smoking in Children and Adolescents”; he pioneered the social influence conceptualizations on prevention of smoking and other health risk behaviors, which generated the social inoculation model that encompasses resistance skills training and other prevention strategies; and he contributed the technique for increasing the validity of self-reports of risky health behaviors. He directs the NSF–supported Oral/Visual History Project, which includes videotaped dialogues and books reflecting those dialogues with the world's notable psychologists. His interests include social influence processes, measurement of smoking behavior, and social inoculation models for tobacco, alcohol, and HIV prevention. He graduated from Michigan State University in 1950 with a doctorate in social psychology.

    Brian R. Flay, D.Phil., is Professor of Public Health at the University of Illinois-Chicago, and Director of the Health Research and Policy Centers, a cluster of university-wide centers focusing on health behavior, health promotion and disease prevention, health in the elderly, health services, and public policy. He continues his research on smoking and drug abuse etiology and prevention, as well as AIDS and violence prevention. He received his doctorate in social psychology from Waikato University in New Zealand in 1976. After receiving postdoctoral training in evaluation research and social psychology at Northwestern University (Evanston, Illinois) under a Fulbright/Hays Fellowship, he started research on smoking prevention at the University of Waterloo (Ontario, Canada). In 1987, he moved to the University of Illinois at Chicago to start the Prevention Research Center in the School of Public Health. In 1993, he was recognized by the Research Council of the American School Health Association for outstanding research.

    Shirley M. Glynn, Ph.D., is Clinical Research Psychologist at the West Los Angeles VA Medical Center and Associate Research Psychologist in the Department of Psychiatry and Behavioral Sciences at UCLA. She received her Ph.D. in clinical/social psychology in 1985 from the University of Illinois in Chicago. After completing her clinical internship at Camarillo, California, State Hospital, she accepted a position as the psychologist on the Clinical Research Unit at the UCLA NPI&H Clinical Research Center for the Study of Schizophrenia at Camarillo State Hospital. In 1987, she joined the Research Service at the West Los Angeles VA Medical Center to conduct clinical trials of psychosocial interventions for serious psychiatric disorders. She has published extensively in the areas of schizophrenia, posttraumatic stress disorder, behavioral interventions, and family treatment. She is a licensed psychologist in California and, in addition to her research interests, has a small private practice.

    Lawrence W. Green, Dr.P.H., is Distinguished Fellow/Visiting Scientist in the Office on Smoking and Health at the Centers for Disease Control and Prevention (CDC). From 1991 to 1999, he was Director of the Institute of Health Promotion Research and Professor of Health Care and Epidemiology at the University of British Columbia. He served as the first director of the U.S. Office of Disease Prevention and Health Promotion. That office coordinated the first “Surgeon General's Report on Health Promoion and Disease Prevention” and the “1990 Objectives for the Nation.” His honors include the Award of Excellence and the Distinguished Career Award, American Public Health Association; the Jacques Perisot Medal of the International Union for Health Promotion and Education; the Distinguished Fellow Award of the Society for Public Health Education; the Presidential Citation, Scholar Award, and Distinguished Service Award of the Association for the Advancement of Health Education; and Honorary Fellow of the American School Health Association. He received his degree in public health at the University of California at Berkeley in 1968.

    Stephen L. Hamann, M.P.H., Ed.D., is Assistant Dean for Medical Education in the Faculty of Medicine at Rangsit University, and he is founder of the Tobacco Control Policy Research Network in Thailand (http://www.ash.or.th). Subareas of particular focus include program implementation and evaluation research and practice, evidence-based medicine, and tobacco cessation and control among the populace in Thailand. He received his doctorate in education from the University of Hawaii at Honolulu in 1992. He previously received his M.P.H. from the University of Illinois at Chicago in 1976.

    William B. Hansen, Ph.D., is President of Tanglewood Research. He has written numerous curricula for school-based prevention, including Project SMART, Project STAR, and All Stars. He has authored more than 80 articles in scientific journals. He has served on the faculty at the University of California at Los Angeles (1978–1984), the University of Southern California (1980–1989), and Bowman Gray School of Medicine (1989–1996). Groups that have relied on him for advice about prevention include the U.S. Congress' Office of Technology Assessment, the U.S. Department of Education, the National Institute on Drug Abuse, the Center for Substance Abuse Prevention, the United Nations, and the U.S. Information Agency. He received his doctorate in psychology from the University of Houston in 1978.

    Jack E. Henningfield, Ph.D., is Vice President, Research and Health Policy, Pinney Associates, Bethesda, Maryland, and Associate Professor of Behavioral Biology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore. He has conducted research on the effects of a wide range of psychoactive drugs on animals and humans, with a continuous emphasis on the validity and generality of the methods and measures used. His interests in obesity research have led to approximately 300 publications in the archival literature. He received his doctorate in Experimental Psychology with a psychopharmacology emphasis from the University of Minnesota in 1977.

    Beth Rachael Hoffman, B.A., has been a teaching assistant and predoctoral student at the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, University of Southern California, since 1998. Her research interests include the effects of culture, ethnicity, and socioeconomic status on high-risk behaviors, particularly drug use and sexual practices, in adolescents. She received her degree in Psychology from the University of Maryland, Baltimore County in 1998.

    C. Anderson Johnson, Ph.D., is the Sidney Garfield Professor in the Department of Preventive Medicine and Director of the Institute for Health Promotion and Disease Prevention Research at the University of Southern California. He has more than 30 years of experience in health behavior research, including school-based and community-based prevention trials. He currently is overseeing components of the Independent Evaluation of the California Tobacco Control Program. Recently, he became Director of one of the NIC-sponsored TTURC centers, which involves collaboration with the Department of Public Health in Wuhan, China, to develop and deliver smoking prevention programs to Chinese adolescents. His interests include the etiology of health-related lifestyles and approaches to the prevention of behavioral risks for disease, including drug abuse, nutritional practices, physical exercise, and communication strategies. He received his doctorate in Psychology from Duke University in 1974.

    Valerie Johnson, Ph.D., is Associate Professor of Sociology with the Center of Alcohol Studies at Rutgers University. Currently, she is a coinvestigator on a longitudinal study, funded by the National Institute on Drug Abuse, on vulnerability to drug abuse as well as a principal investigator on a study funded by the National Institute on Alcoholism and Alcohol Abuse on familial transmission of alcohol and related problems. Her research focuses primarily on the etiology, familial transmission, and consequences of alcohol and drug use, especially among adolescents and young adults, as well as evaluation research. She received her doctorate in Sociology from Rutgers University in 1985.

    Jeffrey L. Kibler, Ph.D., is a postdoctoral fellow specializing in clinical psychology and behavioral medicine at the University of Mississippi Medical Center. He is currently examining the role of cognitive, emotional, and physiological factors in posttraumatic stress disorder and depression. He received his doctorate in 1999 from the University of Miami, specializing in clinical health psychology. His doctoral dissertation focused on pain perception in Type 1 diabetes mellitus. His research interests include behavioral, psychological, and physiological markers for cardiovascular disease and psychophysiological bases for pain, psychopathology, and sleep disorders.

    Elizabeth A. Klonoff, Ph.D., is Professor of Psychology and Co-Director of Clinical Training in the University of California-San Diego/San Diego State University Joint Doctoral Program in Clinical Psychology, and Executive Director of the Behavioral Health Institute at San Diego State University. From 1988–2000, she was Professor of Psychology and executive director of the Behavioral Health Institute at California State University–San Bernardino. Her research focuses on smoking among and the health behavior of ethnic minorities, women, and children. She is a Fellow in the American Psychological Association Divisions 35 (Women) and 45 (Ethnic Minorities). She received her doctorate in clinical psychology from the University of Oregon in 1977.

    Hope Landrine, Ph.D., is Research Professor at California State University–San Diego State University Joint Docoral Program in Clinical Psychology, and R & D Director of the Behavioral Health Institute at San Diego State University. She was Associate Professor of Psychology at California State University–San Bernardino from 1986 to 1992, and Senior Research Scientist at Los Angeles County Public Health Foundation from 1993 to 2000. Her research focuses on smoking among and the health behavior of ethnic minorities and the health behavior of ethnic minorities, women, and children. She received her doctorate in clinical psychology from the University of Rhode Island in 1983, postdoctoral training in social psychology at Stanford University, and postdoctoral training in cancer control as a National Cancer Institute Fellow at the University of Southern California Medical School. She is a Fellow in the American Psychological Association, Divisions 9 (Social Issues), 35 (Women), and 45 (Ethnic Minorities).

    Howard Leventhal, Ph.D., is the Board of Governor's Professor of Health Psychology at Rutgers University. He was former chair of the Department of Psychology at the University of Wisconsin–Madison. He was president of the Division of Health Psychology (38) of the American Psychological Association (1996–1997). He has served as chair of the Behavioral Medicine Study Section of NIH. Among other activities, he currently is a member of the advisory board of the Research Institute for Psychology and Health (at Lieden, Utrecht, and Tilburg). His theoretical and empirical contributions, in more than 200 articles and book chapters, span the fields of the emotions, illness behavior, and illness attribution, including patient compliance with treatment regimens, interventions to minimize pain, strategies for smoking intervention and prevention, and strategies to control hypertension. He has been recently inducted into the National Academy of Science Institute of Medicine. He received his doctorate in Psychology from the University of North Carolina in 1956.

    Kara Lichtman, B.A., is Project Manager for Project EX, a motivation-enhanced adolescent tobacco cessation study funded by the Tobacco-Related Disease Research Program of California. Over the past 2 years, she has obtained broad experience in the field of curriculum development research. As program specialist, her responsibilities have included curriculum development and implementation as well as data collection, management, and analysis. Project EX has become the most effective experimental teen tobacco use cessation trial to date.

    Douglas Longshore, Ph.D., is Associate Research Sociologist and Associate Director at the UCLA Drug Abuse Research Center and also is Associate Behavioral Scientist at RAND, Santa Monica, California. He has been a research associate and project manager in the Studies and Evaluation Department of System Development Corporation, Santa Monica, California. He also has worked as a social science analyst and project manager in the Program Evaluation and Methodology Division of the U.S. General Accounting Office, Washington, D.C. He received his doctorate in Sociology from University of California, Los Angeles, in 1981.

    Michael Lynskey, Ph.D., 1997, is a lecturer in the National Drug and Alcohol Research Centre at the University of New South Wales in Sydney, Australia, and is working in a number of areas, including the etiology of illicit drug use and drug-related harm, the comorbidity of substance use and mental health problems, and the prevention of substance-related harm. He received his doctorate in Psychology from Otago University in 1996. Between 1991 and 1997, he worked at the Christchurch Health and Development Study, a longitudinal study of 1,265 children born in Christchurch (New Zealand) who have been studied from birth to the age 18.

    David P. MacKinnon, Ph.D., is Professor in the Psychology Department at Arizona State University, Tempe. His interests include statistical methods in prevention research and health psychology, such as investigation of mediation effects and information processing of warning labels. He received his doctorate in psychology from the University of California, Los Angeles, in 1986.

    Stan Maes, Ph.D., is Professor of Health Psychology at Leiden University, the Netherlands. He received his doctorate in psychology and educational sciences from Gent State University (Belgium) in 1976. He served on the Faculty of Psychology and Educational Sciences at Gent State University from 1971 to 1973, at Antwerp University on the Medical Faculty from 1973 to 1981, and at Tilburg University (the Netherlands) from 1981 to 1990, where he became the first chair in this discipline outside of the United States. He was cofounder and the first president of the European Health Psychology Society (1986–1992), president of the Health Psychology Division of the International Association of Applied Psychology (1990–1994), and, since 1998, president of the International Society on Health Psychology Research. He is a member of the editorial board of eight journals in the field of health psychology. He has published more than 150 scientific publications, including 5 books, in various languages, concerning health promotion in school and work settings, doctor-patient communication, and psychological aspects of and interventions with chronic disease patients.

    Suzanne M. McMurphy, Ph.D., is Assistant Professor at the University of New Hampshire in the Department of Social Work. From 1988 to 1990, she was a Fulbright Scholar in Sweden, after which she remained working with the Swedish National Council for Crime Prevention and the Swedish Ministry of Justice through 1993. After returning to the United States, she has continued to collaborate internationally on substance abuse and criminal justice issues. Most recently, she has worked with the BIOMED project in the Netherlands, developing instruments on evaluating substance abuse treatment programs within Europe. She is currently the principal investigator of a number of evaluation projects, including an NIJ-sponsored evaluation of substance abuse treatment programs in the New Hampshire Department of Corrections. She received her doctorate in social policy from Bryn Mawr College in 1993.

    Kim T. Mueser, Ph.D., is a licensed clinical psychologist and Professor in the Departments of Psychiatry and Community and Family Medicine at the Dartmouth Medical School in Hanover, New Hampshire. He completed his psychology internship, training at Camarillo State Hospital, California, in 1985. He was on the faculty of the Psychiatry Department at the Medical College of Pennsylvania in Philadelphia from 1985 until 1994. His clinical and research interests include research on the treatment of persons with severe mental illness and substance use disorders (“dually diagnosed” clients), family treatment and social skills training for severe mental illness, and other aspects of psychiatric rehabilitation. He has lectured widely on psychiatric rehabilitation and has published more than 100 articles in refereed journals and numerous books. He received his doctorate in clinical psychology from the University of Illinois at Chicago in 1984.

    Elahe Nezami, Ph.D., is Research Assistant Professor and Director of the undergraduate program in the Department of Preventive Medicine. She completed a 3-year postdoctoral fellowship, funded by the National Cancer Institute. Her research interests include tobacco use prevention and cessation, cross-cultural interpretation of mental health measures, and international health. She received her doctorate in psychology from the University of Southern California in 1993.

    Starr Niego, Ph.D., is a developmental psychologist who specializes in designing, implementing, and evaluating education and health promotion programs, particularly for at-risk youth. She is a Senior Research Associate at Sociometrics, where she is Project Director for the Program Archive on Sexuality, Health, and Adolescence (PASHA), a collection of effective teen pregnancy and STD/HIV/AIDS prevention programs. She received her doctorate in psychology from the Department of Human Development and Family Studies at Cornell University in 1995.

    Robert J. Pandina, Ph.D., is a developmental neuropsychologist with specialty training in experimental and clinical psychopharmacology. His current research, which focuses on understanding the biopsychosocial origins and consequences of alcohol and drug use, abuse, and dependence, emphasizes a life span developmental perspective and employs longitudinal methodology. Other areas of expertise include mechanisms of drug action, development and assessment of prevention and treatment interventions, drug testing in the workplace, and forensic psychology. He is Director of the Rutgers University Center of Alcohol Studies, the principal investigator of the National Institute on Drug Abuse–funded Health and Human Development Laboratory, and Professor of Psychology in the Graduate School of Applied and Professional Psychology at Rutgers. He received his doctorate in psychology from the University of Vermont in 1973.

    Mary Ann Pentz, Ph.D., is Professor of Preventive Medicine at the Institute for Health Promotion and Disease Prevention Research at the University of Southern California. She has chaired the NIDA Epidemiology and Prevention Studies section and has served on advisory boards for the Robert Wood Johnson Foundation and OSAP in the area of community substance abuse prevention. Her interests include community approaches to substance abuse prevention, policy effects on drug abuse, and stress prevention. She received her doctorate in psychology from Syracuse University in 1978.

    Brian Perrochet, B.A., is an independent writer and editor specializing in social sciences and medical research. He has worked with researchers from the UCLA Drug Abuse Research Center since 1989. He was lead editor of a collection of comprehensive articles on drug abuse and its consequences among pregnant and parenting women in California (published as a special volume of the Journal of Psychoactive Drugs). He is the founding editor of Futures in Drug Abuse Research, the quarterly newsletter and Web site serving the 44 research training programs funded by the National Institute on Drug Abuse since 1995.

    James Peterson, Ph.D., has been Vice President of Sociometrics Corporation since 1996. He has directed the Data Resources Program of the National Institute of Justice, the Outreach Demonstration Evaluation project for the Social Security Administration, and the evaluation of the Option for Pre-Teens program. Previously, he served as study director at Temple University's Institute for Survey Research. There, he directed more than 20 studies, focusing primarily on research on drug use, fertility, and child development. He currently is directing the Contextual Data Archive and the American Family Data Center projects, among others. He received his doctorate in sociology from the University of Chicago in 1972.

    Rick Petosa, Ph.D., is Associate Professor in the Department of Health Behavior and Health Promotion in the School of Public Health at The Ohio State University. He is the author of 55 journal articles and 59 research presentations on the design, implementation, and evaluation of health behavior change programs. He has served as principal investigator on school-based interventions funded by the W. T. Grant Foundation and the American Heart Association. Currently, he is an evaluation consultant on a project designed to disseminate an empirically based curriculum for HIV prevention. Also, over the past 4 years, he has completed several investigations related to physical activity among youth, adults, and postretirement adults. He received his doctorate in health education and behavioral science from Southern Illinois University in 1980.

    Pekka Puska, M.D., M.Pol.Sc., Ph.D., is Professor and Director of the Department of Epidemiology and Health Promotion at the National Public Health Institute of Finland. He also is Director of the Division of Health and Chronic Diseases for the National Public Health Institute of Finland and Deputy to the Director General of the National Public Health Institute of Finland. He has been a member of the World Health Organization (WHO) permanent panel of experts on cardiovascular diseases from 1978 to the present, and he was given the WHO Annual Health Education Award in 1990. He also was a member of the Finnish National Parliament from 1987 to 1991. He has more than 400 publications in the fields of public health, epidemiology, disease prevention, and health promotion. He received his M.Pol.Sc. and doctorate in medicine from the University of Turku in 1968 and 1971 and his doctorate in Public Health from the University of Kuopio in 1974.

    Louise Ann Rohrbach, Ph.D., M.P.H., is Research Assistant Professor in the Department of Preventive Medicine at the University of Southern California. Her research interests include theory-based program evaluation, development and evaluation of school- and community-based tobacco control and substance abuse prevention programs, diffusion of effective prevention programs, and gender differences in adolescent substance abuse. She received her doctorate in Health Behavior Research from the Department of Preventive Medicine at the University of Southern California in 1989. She received her master's in public health from the University of California, Los Angeles in 1980.

    Herbert H. Severson, Ph.D., is Associate Professor of Counseling Psychology at the University of Oregon–Eugene and is Senior Research Scientist at the Oregon Research Institute (formerly its director). He has been Professor of Psychology at the University of Northern Colorado and University of Oregon. He has been a contributing author to three surgeon general reports and coauthor of the Institute of Medicine report, “Growing Up Tobacco Free.” His interests include the importance of substance abuse cessation programming for adolescents and treatment of aggressive behavior in adolescents. He has more than 80 publications. He received his doctorate in psychology from the University of Wisconsin–Madison in 1973.

    Thomas R. Simon, Ph.D., is a behavioral scientist with the Division of Violence Prevention in the National center for Injury Prevention and Control of the Centers for Disease Control and Prevention (CDC). His current research is focused on understanding risk and protective factors for violence and suicide. He serves as a scientific advisor on several CDC-funded longitudinal evaluations of violence and suicide prevention programs. He also conducted program development and evaluation research in the areas of adolescent tobacco use and substance abuse. He received his Ph.D. in preventive medicine at the University of Southern California in 1996.

    Edward G. Singleton, Ph.D., is Visiting Research Scholar-in-Residence at the Howard University Center for Drug Abuse Research in Washington, D.C. From 1991 to 1994, he was a Senior Fellow for the National Institute on Drug Abuse (NIDA) Intramural Research Program. He has been a Maryland-licensed psychologist since 1986, and a Diplomate Board-Certified Forensic Examiner since 1996. He was awarded status as a Diplomate by the American Board of Psychological Specialties in June 1997. Other honors include the NIDA Director's Award of Merit for Exemplary Achievements as part of the Historically Black Colleges and Universities (HBCU) Task Force (1994) and the 1998 Lonnie E. Mitchell Award for Outstanding Contributions to Research, Prevention, and Treatment of Alcohol and Drug Addiction. Research interests are psychometric applications to substance abuse research. He received a doctorate in Psychology from Howard University in 1985.

    Dennis W. Smith, Ph.D., is Chair of the Department of Health and Human Performance, University of Houston, Texas. He received his doctorate in health education from The Ohio State University in 1985. From 1987 to 1990, he held a postdoctoral appointment at the Universities of North Carolina at Greensboro and Chapel Hill working on an NCI-funded project on tobacco curriculum diffusion in schools. He has won numerous awards, including Outstanding Leadership in Comprehensive School Health Education and Cancer Prevention, American Cancer Society, Texas Division, Inc., 1996–1997, and he was elected Fellow by the American School Health Association in 1994.

    Alan W. Stacy, Ph.D., is Research Associate Professor at the University of Southern California, Department of Preventive Medicine, and Research Psychologist in the Department of Psychology at the University of California, Los Angeles. He has published numerous articles on cognitive processes in health behavior (including alcohol, tobacco, and other drug use), and HIV-related and diet behavior. He has been the principal or coprincipal investigator on a number of federally funded projects on the etiology of alcohol and other drug use, on prevention of tobacco and other drug use in adolescents, and on effects of alcohol advertising. His main theoretical focus is on understanding how associations in memory influence health behavior implicitly, without one's conscious deliberations of the pros and cons of alternative activities. He received his doctorate in psychology from the University of California at Riverside in 1986.

    Gordon P. Street, Ph.D., is a research instructor specializing in biostatistics and clinical research at the Center for Treatment and Study of Anxiety at MCP/Hahnemann University in Philadelphia. He graduated in June 1998 from the California School of Professional Psychology in San Diego, where his research explored the application of a scientific approach to the professional practice of psychology. In one study, he found that counselors-in-training were more likely to display confirmation bias within an interviewing task when encouraged to use an intuitive approach than when encouraged to use a scientific approach. He is currently involved in research into the course and treatment of posttraumatic stress disorder and social phobia.

    Alan N. Sussman, Ph.D., is Adjunct Professor, Daley College and College of Lake County, Department of Social Sciences and Humanities and Department of Communication Skills. He has served on the faculty of Departments of Philosophy in the United States (including Indiana University, Northwest; State University of New York, College at Buffalo) and abroad (Universities of Calabar, Ghana, Sierra Leone, Zimbabwe) over the past 35 years. He has published several articles pertaining to philosophy of mind, logic, and philosophy of science in journals, including the Journal of Philosophy. Sub-areas of particular focus are in the areas of epistemology, metaphysics, the philosophy of language, and theory development. He received his doctorate in philosophy from the University of Chicago in 1974.

    Steve Sussman, Ph.D., is Professor in the Department of Preventive Medicine and Institute for Health Promotion and Disease Prevention Research at the University of Southern California. He served on a clinical psychology residency at Jackson Veterans Administration and University of Mississippi Medical Centers. He has published more than 160 articles, chapters, or books in the area of drug abuse prevention and cessation. He was the principal investigator of the Project Towards No Tobacco Use (TNT), a tobacco use prevention project that is recognized by CDC, NIDA, CSAP, the California Department of Education, and Sociometrics, Inc. as a model program. Sub-areas of particular focus are prediction of tobacco and other drug use, school-based tobacco and other drug abuse prevention and cessation (e.g., Project TND, indicated drug abuse prevention; Project EX, teen tobacco use cessation), other research with high-risk populations, and an emphasis on the use of program development methods. He received his doctorate in psychology from the University of Illinois at Chicago in 1984.

    Nancy S. Tobler, Ph.D., has held a joint associate professorship in the Schools of Social Welfare and Public Health, Department of Biometry and Statistics, from the State University of New York at Albany. Her research interests include the use of quantitative and qualitative methods in the systematic integration of research-based evaluations of adolescent substance abuse prevention programs. Her previous experiences included work as a science teacher and as a therapist in sexual abuse prevention. She was principal evaluator on a Center for Substance Abuse Prevention High Risk Youth grant. Her meta-analytic work, as well as other works, has been published in numerous peer-reviewed journals, and she has been a frequent invited speaker at national conferences. She received her doctorate in Social Welfare from the School of Social Welfare, State University of New York at Albany.

    Jennifer B. Unger, Ph.D., is Research Assistant Professor in the Department of Preventive Medicine. She currently is overseeing a portion of the evaluation of the California Tobacco Control Program, a statewide education, community, and media effort. She also is a coprincipal investigator of the newly funded NCI TTURC grant. She has conducted research on the psychosocial predictors of health behaviors such as physical activity, substance use, unprotected sex, and needle sharing. She is especially interested in the role of social networks in determining health behaviors and health outcomes. She received her doctorate in health behavior research from the Department of Preventive Medicine at the University of Southern California in 1996.

    Thomas Ashby Wills, Ph.D., is Associate Professor in the Health Psychology Training Program, conducted jointly by the Ferkauf Graduate School of Psychology and the Albert Einstein College of Medicine. He is a Fellow of the American Psychological Association Divisions 8 and 38 (social and health psychology). His research interests include social support and health, stress and coping processes, and adolescent substance abuse. Currently, he is conducting a cohort study on the role of temperament processes in adolescent substance use escalation. He received his doctorate in Psychology from the University of Oregon–Eugene in 1974. He received postdoctoral training in epidemiology at the Columbia University School of Public Health.

    John K. Worden, Ph.D., has served in the Office of Health Promotion Research in the College of Medicine at the University of Vermont, reaching the rank of Research Professor in 1991. Since 1979, he has developed and evaluated community-based health promotion interventions. One of these interventions was a smoking prevention program funded by the National Cancer Institute, comprising an intensive mass media campaign designed for youth in Grades 5 through 10 along with a school program. For this project, Dr. Worden and colleagues received the C. Everett Koop National Health Award in 1996 and the Best Paper Award, Health Education and Behavior, from Sage Publications in 1997. Dr. Worden and colleagues also have developed and evaluated community-based and mass media interventions to promote breast cancer screening, help young adults quit smoking, and prevent alcohol use by adolescents. He received his doctorate in Mass Communication from Syracuse University in 1971.


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