Eleni L. Tolma

Although studies have shown that smoking is detrimental to the health of patients with systemic lupus erythematosus (SLE), studies regarding barriers and motivators for smoking cessation are lacking. The purpose of this study was to generate hypotheses regarding the barriers and motivators for smoking cessation in SLE patients. This study was based on the theoretical framework of the stages of change model. All participants met SLE classification criteria. Interviews were conducted with 16 current and 10 former smokers. Motivators included: medical reasons, readiness, and concern for others. Barriers included: enjoyment, coping mechanism, and an emotional connection. Participants were unsure of the impact of smoking on their medication and disease, and had mixed feelings regarding the impact on pain. The main motivator for cessation in this population was concern for one's health. Rheumatologists need to include disease specific harms and assess pain management strategies as part of cessation counseling.

There are significant disparities in breast cancer screening and survivorship between American Indian (AI) and non-Hispanic white women. This study aimed to identify the salient beliefs AI women from Oklahoma have on regular mammography screening, and to determine which beliefs and health- related practices are associated with past mammography screening behavior.

For adolescents, illicit drug use remains a significant public health problem. This study explored prospectively the differential effects of 17 youth assets and 5 environmental factors on drug use in adolescent males and females (Youth Asset Study – a 5‐wave longitudinal study of 1117 youth/parent pairs). Baseline analyses included 1093 youth (53% female). Mean age was 14.3 years (SD = 1.6) and the youth were 40% Non‐Hispanic White, 28% Hispanic, 24% Non‐Hispanic Black, and 9% Non‐Hispanic other. Analyses revealed that 16 assets for males and 15 for females as well as the total asset score were prospectively associated with no drug use. No environmental factors were prospectively associated with any drug use for males, and for a subset of females, only Neighborhood Support was significant. This study confirms and extends previous work regarding youth drug use by recognizing the importance of the protective effect of assets for both males and females.

BACKGROUND: Two risk behaviors, alcohol consumption and early initiation of sexual intercourse (ISI), can have devastating consequences for youth. The purpose of this study was to determine the association of school connectedness and school‐related behaviors (eg, academic performance, skipping school, getting into trouble at school) with these 2 risk behaviors.METHODS: The Youth Asset Survey (YAS) was administered to 1117 youth/parent pairs in their homes using Computer‐Assisted Personal/Self‐Interviewing (CAPI/CASI). The YAS measures 17 youth assets and risk behaviors including alcohol consumption and sexual activity.RESULTS: The mean age of the sample was 14.3 years; 53% were female; and 70% were from 2‐parent homes. Five school‐related behaviors were positively associated with no ISI. Four school‐related behaviors were positively associated with reporting no alcohol consumption in the past 30 days, including the School Connectedness asset (only among 12‐ to 13‐year‐olds), not skipping school (only among non‐Hispanic Caucasians), staying out of trouble, and paying attention.CONCLUSIONS: School is very much a part of the lives of youth and therefore the relationship they have with their school experience is important and may influence their involvement in risk behaviors. Feeling connected to school is a positive asset that can protect youth from such risky behaviors as sexual initiation and alcohol consumption.

To examine how the relationship between parental-related youth assets and youth sexual activity differed by race/ethnicity. A random sample of 976 youth and their parents living in a Midwestern city participated in the study. Multivariate logistic regression analyses were conducted for 3 major ethnic groups controlling for the other demographics. Parental monitoring had the strongest association with sexual abstinence for all 3 ethnic/racial groups. Family communication and relationship with mother were also important for white and black youth respectively. Parental youth assets, especially parental monitoring, can be important in the decision to delay sexual intercourse.

Purpose.: Food insecurity in the United States is a major public health issue. The main objective of this study was to evaluate the availability and quality of printed materials addressing food security targeted to special populations by the United States Department of Agriculture (USDA). Design.: Nutrition education resources addressing food security available from USDA websites were selected for analysis. Setting.: Not applicable. Participants.: The review team consisted of project staff (n = 6), two of who were fluent in Spanish. Method.: Selection criteria were established to identify the food-security materials, and a group of reviewers assessed the quality of each publication both quantitatively and qualitatively. A consensus meeting among the reviewers was held to make final determinations of the quality of the materials. The quantitative data analysis consisted of basic descriptive statistics. Results.: Among the 27 materials initially identified, 20 were either irrelevant or of low relevance to food security. Moreover, very few of them were intended for minority populations. The quality of most of the materials ranged from “average” to “good.” Some of the major weaknesses include readability level, lack of cultural relevance, and inadequate coverage of food insecurity. Conclusion.: Very few materials on food insecurity are of high quality. In the development of such materials, emphasis should be given to the readability level, content, and cultural relevance.

The potential of Community Involvement as a protective factor (youth asset) for eight adolescent risk behaviors was examined in this study. Cross-sectional data were collected from a randomly-selected population using in-home, in-person interviews in racially diverse inner-city neighborhoods of two Midwestern cities. Research participants were teenagers (n=1,278) and parents of the teenagers (n=1,278). Data included demographic variables; eight adolescent risk behaviors, including sexual activity, violence and the use of tobacco, alcohol and drugs. This study found youth with the Community Involvement asset were significantly (p<.05) more likely to: never have had sexual intercourse; not use tobacco or drugs; not use alcohol if living in a one-parent family; not carry a weapon, or never have been arrested. Involvement in community volunteer experiences may hold potential for strengthening youth development and prevention programs focused on reducing youth risk-taking behaviors.

This article examines the applicability of the Theory of Planned Behavior (TPB) with the addition of the selfefficacy construct in the understanding of the motivation to obtain an initial screeningmammogramamong Cypriot women. The study sample consisted of 293women aged 40 to 65 years, asymptomatic of breast cancer, and with no previous mammography experience. The study took place at the General Hospital of Nicosia in Cyprus. The results of the study provided support of the TPB with the addition of self-efficacy in an international setting. Self-efficacy was the strongest predictor of intention. Other predictors of intention included educational level, time of last clinical breast examination, and age. The study also provided some empirical support of the distinction between self-efficacy and perceived behavioral control. Researchers may want to include self-efficacy in addition to the TPB and other demographic characteristics in future applications to more fully explain behavioral outcomes.

Breast cancer is an important public health issue in Cyprus. The purpose of the study was to assess: (a) the differences in motivational beliefs between women who decided to obtain a mammogram and women who did not; and (b) which beliefs predict the decision to get a mammogram. Data were collected through face-to-face interviews from 293 women (mean age = 52) at the outpatient clinics of the General Hospital of Nicosia. Variables of interests include demographics, other preventive behaviours, and cognitions. T-tests for independent samples and multiple logistic regression were the primary analytic techniques. One hundred and eight women decided to obtain their first mammogram within the next 6 months. Deciders were more motivated to obtain a mammogram than non-deciders. Significant statistical differences were found regarding women's attitude, perceived social pressure, perceived control over environmental factors, and self-efficacy towards obtaining a mammogram. The self-efficacy beliefs as well as the physician recommendation were the most predictive factors in the decision to obtain a mammogram. In the planning of successful educational campaigns promoting breast cancer screening in Cyprus, practitioners could focus on the following: (a) enhancing self-efficacy, (b) promoting a clinical environment conducive to mammography screening, and (c) encouraging physician recommendation.