Participation In Prevention Activities Research Articles

Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review.

BackgroundColorectal cancer (CRC) screening programmes require high levels of participation in order to reduce mortality. To improve participation rates, it is necessary to identify the health risk factors and social inequalities associated with non-participation.MethodsA systematic review was conducted between June and September of 2019 in six databases: CINHAL, Medline, Scopus, Social Sciences Citation Index, Embase and PsycINFO. Studies assessing the relationship between health risk factors, participation in preventive activities and participation in CRC screening were included. Methodological assessment was carried out according to the Quality Assessment Tools of the National Heart, Lung and Blood Institute.ResultsA total of nine studies that analyze participation in both organized and opportunistic screening programmes using any type of screening method were finally selected. Data were mainly self-reported although in two studies medical records were also studied. We identified several variables: gender, body mass index, consultation with a doctor or a specialist, educational level, employment, health insurance, residence, ethnicity, age, marital status, income, other preventive activities, obesity, physical activity, smoking, family history of CRC and general health status.ConclusionThe scarcity of studies linking risk factors, social inequalities and participation in preventive activities for participation in screening in the same study makes it difficult to reach definitive patterns related to non-participation in CRC screening programmes. Nevertheless, being under 60, obese, smoker and sedentary have shown an association with non-participation as well as not visiting a doctor.

The prevention of drug substances abuse among schoolchildren

The drug abuse is one of the most important medical and social problems of the youth. The problems with illegal and dangerous using of psychoactive drugs of different chemical categories by schoolchildren are caused by common social and psychological risk factors. Thus, in many research studies, all drugs and solvent substances are covered by general concept of "narcotic substances". The study purpose is to develop an evidence database related to efficiency of common prevention measures and to development of sound recommendations of its management. The study included sociological survey of representative sampling of 445 schoolchildren aged from 14 to 17 years. The relationship between participation in preventive activities (factorial sign) and development of objective concepts about harm of drug abuse and possibilities of narcology (resulting sign) are studied using calculation of relative risk and its confidence interval. The study proves the positive effect of lecturing of specialists, psychological lessons and trainings, review of thematic video materials. The involvement of schoolchildren into development of agitation materials concerning healthy life-style and into reading of special literature is considered as effective in case of their implementation after target group received initial knowledge about problems of drug abuse and toxicomania. The study proved the negative effect of independent search of information about drugs in Internet, fabrication agitation materials about harm of drugs by adolescents, discussions based on opposite opinions and all forms of communication with patients with drug addiction. The necessity of widespread implementation of target advanced training of managers of preventive measures application.

Prevalence of smoking among medical and teaching staff ers

Th e article covers results of comparative analysis of prevalence and motivation for tobacco smoking, and its consequences for health state in medical and teaching staff ers, in occupations of high risk due to occupational psychoemotional burnout and stress. Polling covered 601 staff ers of governmental medical institutions managed by Health care Department of Moscow and 300 teachers of governmental educational institutions managed by Education Department of Moscow. All the examinees were tested for individual att itude to tobacco smoking (presence or absence of tobacco smoking; for smokers — number of cigarett es smoked daily; att itude to tobacco smoking among the colleagues; personal participation in preventive activities of anti-smoking organizations). Findings are that prevalence of tobacco smoking in medical staff ers in higher than among teachers. Th e authors determined priority directions of anti-smoking activities among medical and teaching staff ers.

Prevalence and Factors Associated With Injuries in Elite Spanish Volleyball

Prevalence studies have been carried out widely on elite volleyball players. However, the extent to which specific prevention strategies are used and the influence of the sport equipment on the occurrence of injuries have been sparsely investigated. To describe the prevalence of injuries sustained during 1 season in elite Spanish volleyball leagues and to investigate the association of injuries with factors such as player court position, injury mechanism, type of shoes used when playing, or participation in prevention activities. Descriptive cross-sectional epidemiology study: observational study. European elite professional volleyball. Professional volleyball players from the elite Spanish volleyball league. A self-report questionnaire assessed the presence of injury during a volleyball season. Questions included the type of injury, its anatomic location, participation in prevention strategies, shoe type, the injury mechanism, the season period, the period of leave, and the treatment received. In total, 490 players (71.2% response rate) completed and returned the questionnaire. The injury prevalence was 66.9%, and the average of injuries per player was 0.94 (0.85) (range: 0-4). Most Spanish elite volleyball players participated in prevention programs during the season (90.3%) and played volleyball with low-top shoes (83.6%), but these factors were not associated with the prevalence of injuries (P > .05). The anatomic regions with the most injuries were the ankle, knee, and shoulder; the most common types of injury were sprains, tendinopathies, and strains, usually occurring during blocking and attack actions during the in-season period. Despite most elite volleyball players participating in prevention programs, the results reveal a high injury prevalence. Further prospective research on the effectiveness of prevention strategies in elite volleyball is needed.

Działania profilaktyczne skierowane do rodziców jako forma ochrony dzieci przed krzywdzeniem na przykładnie oferty Fundacji Dajemy Dzieciom Siłę

Nie sposób przecenić wartości profilaktyki i jej efektywności w dowolnym aspekcie życia każdego człowieka. Celem niniejszego artykułu – o charakterze teoretyczno-empirycznym – jest zaprezentowanie znaczenia działań profilaktycznych skierowanych do rodziców, jako formy ochrony dzieci przed krzywdzeniem. Artykuł zawiera definicję profilaktyki, krótki zarys trendów we współczesnych działaniach prewencyjnych, opis roli rodziców w trudnym procesie wychowania i ochrony dzieci, jak również zobrazowanie poziomu wiedzy rodziców na temat profilaktyki krzywdzenia dzieci, ich oczekiwań odnośnie działań specjalistycznych, przełożenia zdobytych umiejętności na pozytywne zmiany w obrębie rodziny oraz najczęstszych przyczyn korzystania z profesjonalnej pomocy. Możliwość rozmowy, wymiany poglądów, zdobycia profesjonalnej wiedzy, wsparcia i pomocy pomaga dość szybko opanować sytuacje kryzysowe i przywrócić równowagę psychiczną rodzica, tak niezbędną w prawidłowych relacjach z dzieckiem. Zaprezentowany materiał ukazuje bezpośredni pozytywny wpływ uczestniczenia w działaniach prewencyjnych na sytuację rodzin z małymi dziećmi. Przedstawia wyniki badań empirycznych, przeprowadzonych wśród rodziców korzystających z oferty Fundacji Dajemy Dzieciom Siłę.

Factors Associated With Cancer Worry Among People Aged 50 or Older, Spain, 2012-2014.

IntroductionCancer worry varies among patients and may influence their participation in preventive activities. We tested whether sociodemographic characteristics, lifestyle, locus of control, comorbidity, and perceived health status were associated with the level of cancer worry among adults aged 50 or older.MethodsWe conducted an observational cross-sectional study of 666 adults in Spain aged 50 or older. Participants were selected by simple random sampling and asked to visit their designated health center for a personal interview. The study variables were level of cancer worry (measured by Cancer Worry Scale [CWS]), sociodemographic characteristics, lifestyle, personal history or family history of cancer, comorbidity, self-perceived health, locus of control, and social support. ResultsMore than half of participants, 58.1%, were women; mean age was 60.5 years (standard deviation [SD], 6.8 y). Measurement of the frequency and severity of cancer worry (possible scale of 6–24 points) yielded a mean CWS score of 9.3 (95% confidence interval, 9.0–9.5); 31.9% of participants reported being concerned about cancer. Scores were higher among women (9.7 [SD, 3.3]) than men (8.7 [SD, 2.7]) (P < .001) and among participants in rural settings (10.0 [SD, 3.4]) than in urban settings (9.0 [SD, 3.0]) (P < .001). Multiple linear regression showed a greater degree of cancer worry among people with personal or family history of cancer, more health problems, worse self-perceived health, and lower social support.ConclusionCancer worry is frequent among older adults, and the level of such concern is related not only to personal characteristics but also to lifestyle and health status. Further research is required to understand how contextual factors can influence cancer worry and how such concern changes behavior patterns related to cancer prevention activities.

Parents' perceptions on offspring risk and prevention of anxiety and depression: a qualitative study.

BackgroundOffspring of patients with anxiety or depression are at high risk for developing anxiety or depression. Despite the positive findings regarding effectiveness of prevention programs, recruitment for prevention activities and trials is notoriously difficult. Our randomized controlled prevention trial was terminated due to lack of patient inclusion. Research on mentally-ill parents’ perceptions of offspring’s risk and need for preventive intervention may shed light on this issue, and may enhance family participation in prevention activities and trials.MethodsQualitative data were collected through semi-structured interviews with 24 parents (patients with anxiety or depression, or their partners). An inductive content analysis of the data was performed. Five research questions were investigated regarding parents’ perceptions of anxiety, depression, and offspring risk; anxiety, depression, and parenting; the need for offspring intervention and prevention; and barriers to and experiences with participation in preventive research.ResultsParental perceptions of the impact of parental anxiety and depression on offspring greatly differed. Parents articulated concerns about children’s symptomatology, however, most parents did not perceive a direct link between parent symptoms and offspring quality of life. They experienced an influence of parental symptoms on family quality of life, but chose not to discuss that with their children in order to protect them. Parents were not well aware of the possibilities regarding professional help for offspring and preferred parent-focused rather than offspring-focused interventions such as parent psycho-education. Important barriers to participation in preventive research included parental overburden, shame and stigma, and perceived lack of necessity for intervention.ConclusionsThis study highlights the importance of educating parents in adult health care. Providing psycho-education regarding offspring risk, communication in the family, and parenting in order to increase parental knowledge and parent–child communication, and decrease guilt and shame are important first steps in motivating parents to participate in preventive treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/2050-7283-2-17) contains supplementary material, which is available to authorized users.

Integrative health care model for climacteric stage women: design of the intervention

BackgroundClimacteric stage women experience significant biological, psychological and social changes. With demographic changes being observed in the growing number of climacteric stage women in Mexico, it is important to improve their knowledge about the climacteric stage and its potential associated problems, encourage their participation in screening programs, and promote the acquisition of healthy lifestyles.At Mexican health care institutions the predominant health care model for climacteric stage women has a biomedical perspective. Medical doctors provide mostly curative services and have limited support from other health professionals. This study aims to design an integrative health care model (IHCM: bio-psycho-social, multidisciplinary and women-centered) applicable in primary care services aimed at climacteric stage women.Methods/DesignWe present the design, inclusion criteria and detailed description of an IHCM. The IHCM consists of collaborative and coordinated provision of services by a health team, which is involves a family doctor, nurse, psychologist, and the woman herself. The health team promotes the empowerment of women through individual and group counseling on the climacteric stage and health related self-care. The intervention lasts three months followed by a three-month follow-up period to evaluate the effectiveness of the model. The effectiveness of the model will be evaluated through the following aspects: health-related quality of life (HR-QoL), empowerment, self-efficacy and knowledge regarding the climacteric stage and health-related self-care activities, use of screening services, and improvement in lifestyles (regular leisure time physical activity and healthy diet).DiscussionParticipation in preventive activities should be encouraged among women in Mexico. Designing and evaluating the effectiveness of an integrative health care model for women at the climacteric stage, based on the empowerment approach and focus on health-related self-care to improve their HR-QoL is pertinent for current health conditions of this age group.Trial registrationThe study is registered at the ClinicalTrials.gov (NCT01272115).

The effect of major depression on participation in preventive health care activities

BackgroundThe objective of this study was to determine whether major depressive episodes (MDE) contribute to a lower rate of participation in three prevention activities: blood pressure checks, mammograms and Pap tests.MethodsThe data source for this study was the Canadian National Population Health Survey (NPHS), a longitudinal study that started in 1994 and has subsequently re-interviewed its participants every two years. The NPHS included a short form version of the Composite International Diagnostic Interview (CIDI-SF) to assess past year MDE and also collected data on participation in preventive activities. Initially, we examined whether respondents with MDE in a particular year were less likely to participate in screening during that same year. In order to assess whether MDE negatively altered the pattern of participation, those successfully screened at the baseline interview in 1994 were identified and divided into cohorts depending on their MDE status. Proportional hazard models were used to quantify the effect of MDE on subsequent participation in screening.ResultsNo effect of MDE on participation in the three preventive activities was identified either in the cross-sectional or longitudinal analysis. Adjustment for a set of relevant covariates did not alter this result.ConclusionWhereas MDE might be expected to reduce the frequency of participation in screening activities, no evidence for this was found in the current analysis. Since people with MDE may contact the health system more frequently, this may offset any tendency of the illness itself to reduce participation in screening.

Atod Prevention Programming in the Non-School Hours and Adolescent Substance Use

To reduce problems associated with youth substance use, Indiana developed funding streams and infrastructure to facilitate coordination of statewide prevention efforts. These prevention efforts aimed at youth include programming in the non-school hours. To examine the relationship between these efforts and youth substance abuse, students indicating participation in one or more prevention activities were compared to non-participant students. Results revealed that participating middle school students were less likely to have reported use of tobacco than their non-participating peers. Also, participation in prevention activities in the non-school hours was related to a lower likelihood of alcohol use among high school students.

Drama-based education to motivate participation in substance abuse prevention

BackgroundThe substance abuse prevention goal of the theatre production "TUNNELS" was to provide community education on substance abuse to an audience in Durham, NC and surrounding communities. The education effort intended to increase awareness and understanding of the risk and protective factors associated with alcohol and other drug use, and to promote pro-active behaviors in substance abuse prevention within the adult community. It was hypothesized that community-based education via drama would change attitudes toward alcohol and substance abuse, and increase participation in family and community activities aimed at substance abuse prevention.MethodsA focus group comprised of educators, substance abuse researchers and local substance abuse counselors developed "life stories" of users of alcohol and other drugs and a local playwright incorporated these and other experiences into a series of six vignettes. The production was publicized throughout the Durham area, and 700 adults attending the play signed a consent form and completed the pre-play survey. The participant pool was restricted to those adults who completed both the time-1 and time-2 surveys and resided within Durham and surrounding communities. Paired comparisons of mean responses were analyzed using a paired sample two-tailed t-test. A telephone survey three months after the play assessed attitudes toward substance abuse as a disease, and whether the respondents had increased their participation in prevention activities including discussions of the play with others.ResultsViewing the play increased the knowledge base of participants regarding substance abuse as a disease, even though the audience demonstrated an appreciation of risk and protective factors prior to attending the performance. In the pre-play survey, participants indicated a strong opinion that parental involvement in teen life was important, and therefore this was not increased as a result of viewing the play. It was found that the drama increased intent to participate in substance abuse prevention activities at home and in the community. Follow-up surveys performed three months after the performance indicated that participants had discussed the play with others and had increased their participation in substance abuse prevention activities, particularly regarding donations of money.ConclusionDrama incorporates a component of emotional response to the informational content, and the combination of emotion and information works together to promote individual intentions to become more involved in family and community prevention activities. This study demonstrates the efficacy of drama as a mechanism to educate and motivate. Support for this mechanism is warranted at the level of state, local community, school district, and faith-based and community organizations.

Integrated Approach for Managing Health Risks at Work—The Role of Occupational Health Nurses

Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

Psychoactive Substance Use among Young People: Findings of a Multi-Center Study in Three African Countries

This paper presents the findings of baseline assessments on psychoactive substance use that were conducted in selected sites in South Africa, Tanzania and Zambia between December 2000 and September 2001. The assessments focused on the status of substance use and prevention resources. They showed that a wide range of substances were used—especially alcohol, tobacco and painkillers—and included substances taken by injection. Usage was particularly widespread in settings where trade in substances offered a means of survival. Institutional resources for prevention of substance use were limited. The social circles within which young people lived set an example and directly encouraged substance use, particularly the use of alcohol, tobacco, and, to a lesser extent, cannabis. These findings suggest the need for policy and programs that give balanced weight to demand and supply reduction, target young people, improve young people's living conditions, and ensure youths' participation in prevention activities.

Oral cancer prevention and detection in primary healthcare

Aim To investigate current knowledge, examination habits and preventive practices of primary healthcare professionals in Scotland, with respect to oral cancer, and to determine any relevant training needs. Setting Primary care. Method Questionnaires were sent to a random sample of 357 general medical practitioners (GMPs) and 331 dental practitioners throughout Scotland. Additionally, focus group research and interviews were conducted amongst primary healthcare team members. Results Whilst 58% of dental respondents reported examining regularly for signs of oral cancer, GMPs examined patients' mouths usually in response to a complaint of soreness. The majority of GMPs (85%) and dentists (63%) indicated that they felt less than confident in detecting oral cancer, with over 70% of GMPs identifying lack of training as an important barrier. Many practitioners were unclear concerning the relative importance of the presence of potentially malignant lesions in the oral cavity. A high proportion of the GMPs indicated that they should have a major role to play in oral cancer detection (66%) but many felt strongly that this should be primarily the remit of the dental team. Conclusion The study revealed a need for continuing education programmes for primary care practitioners in oral cancer-related activities. This should aim to improve diagnostic skills and seek to increase practitioners' participation in preventive activities.

The role of primary healthcare professionals in oral cancer prevention and detection.

To investigate current knowledge, examination habits and preventive practices of primary healthcare professionals in Scotland, with respect to oral cancer, and to determine any relevant training needs. Primary care. Questionnaires were sent to a random sample of 357 general medical practitioners (GMPs) and 331 dental practitioners throughout Scotland. Additionally, focus group research and interviews were conducted amongst primary healthcare team members. Whilst 58% of dental respondents reported examining regularly for signs of oral cancer, GMPs examined patients' mouths usually in response to a complaint of soreness. The majority of GMPs (85%) and dentists (63%) indicated that they felt less than confident in detecting oral cancer, with over 70% of GMPs identifying lack of training as an important barrier. Many practitioners were unclear concerning the relative importance of the presence of potentially malignant lesions in the oral cavity. A high proportion of the GMPs indicated that they should have a major role to play in oral cancer detection (66%) but many felt strongly that this should be primarily the remit of the dental team. The study revealed a need for continuing education programmes for primary care practitioners in oral cancer-related activities. This should aim to improve diagnostic skills and seek to increase practitioners' participation in preventive activities.

HIV surveillance among injecting drug users

Injecting drug users (IDUs) should be considered a 'partially hidden population' at high risk for HIV infection. In almost all locations it should be possible to locate and conduct research with IDUs, but it will probably never be possible to enumerate or draw random samples from an IDU population. Surveillance research studies with IDUs should include risk behaviors, as surveillance of HIV infection only will not be sufficiently time sensitive, and be used to develop and refine HIV prevention programming for the population. Contacts with IDUs can be developed at multiple settings, including voluntary treatment programs, law enforcement settings, and through 'street outreach.' Each type of setting has different advantages, disadvantages and ethical concerns. HIV testing as part of surveillance also raises additional important ethical concerns. The primary risk behaviors that should be included in surveillance studies are 'sharing' of drug injection equipment, the potential for rapid partner change among risk partners, and sexual risk behavior. Additional important objectives for surveillance research include: (1) the size of the local IDU population, (2) patterns of drug use, (3) availability injection equipment, (4) participation in prevention activities, and (5) access to and use of anti-retroviral treatments. HIV incidence is an ultimate objective for surveillance research, but there are no currently available cost-efficient methods for studying HIV incidence, so estimation from indirect measurements is usually required.

Mejora de la atención prestada a víctimas de violencia doméstica. Impacto de una intervención priorizada

To evaluate the impact of a priority intervention in the care given to women who are victims of domestic violence and their children. Non-randomised intervention study. Urban health centre. Women and children living at a reception centre for families suffering domestic violence and who had clinical records opened at the health centre. Pre-intervention group (December 1997-July 1999): 36 women, 70 children. Post-intervention group (August 1999-June 2000): 35 women and 41 children.Interventions. Allocation to a single family doctor and paediatrician. Elimination of bureaucratic obstacles and prioritised care. Social/family assessment by the social worker. Preferential inclusion in programmes: Women: family planning, hepatitis B vaccination, pregnancy control, early diagnosis of breast cancer (women > 50), same for cervical cancer. Children: child health (< 5) (priority activities: psychomotor development and somatometry) and vaccinations. This intervention started in August 1999. Measurement of the impact of the intervention: bivariant analysis through Chi2 test for qualitative variables and Student's t test and U Mann-Whitney test for quantitative variables (alpha 0.05) in the pre- and post-intervention groups. Statistically significant differences in participation were detected between the pre- and post-intervention groups in the following activities: number of visits to programmes (0.49, SD 0.95; 1.01, SD 1.24, respectively), social and family assessment (83%/100%), family planning (14%/51.4%), hepatitis B vaccination (19%/48.7%), early cervical cancer diagnosis (0/25.7%), child health (33.4%/70%), vaccinations (26.34%/64%), somametric assessment (25%/100%) and psychomotor development assessment (41.6%/94%). Prioritised intervention in families that are victims of domestic violence improves their participation in preventive activities.

Citizen participation in prevention activities: Path model II

Effective, community-wide AOD prevention activities require a broad base of citizen involvement in program planning and implementation. Yet what influences an individual's decision to participate in these activities, particularly in a socially distressed community, is not well known. In a previous study, the authors developed a three-factor path model of participation. These factors were participation accessibility, the desire to participate, and knowledge about participation. The present investigation is a replication of that study with two purposes: (1) expansion of the initial findings by adding additional indicators of the model constructs, and (2) examination of the adequacy of the model for predicting participation in an economically and socially distressed community. The findings of this study were based upon random digit dialing telephone interviews of 250 residents of Chester, PA. The respondents were interviewed about their knowledge of and participation in prevention activities, their perception of the seriousness of AOD and other problems, and their demographic characteristics. Data were analyzed by multiple regression. Findings indicate that knowledge had the strongest direct effect on participation, with desire and accessibility adding important indirect effects. Overall, 34% of the variance was explained. The primary implications drawn from this study are: (1) the model, at variance with previous research by the authors, requires additional testing under a variety of social conditions and with an expansion of construct indicators; and (2) citizen participation programs in low-income neighborhoods should focus on building awareness of these programs.

Citizen participation in prevention activities: A path model

Effective, community-wide AOD prevention activities require a broad base of citizen involvement in program planning and implementation. Yet what influences an individual's decision to participate in these activities, particularly in a socially distressed community, is not well known. In a previous study, the authors developed a three-factor path model of participation. These factors were participation accessibility, the desire to participate, and knowledge about participation. The present investigation is a replication of that study with two purposes: (1) expansion of the initial findings by adding additional indicators of the model constructs, and (2) examination of the adequacy of the model for predicting participation in an economically and socially distressed community. The findings of this study were based upon random digit dialing telephone interviews of 250 residents of Chester, PA. The respondents were interviewed about their knowledge of and participation in prevention activities, their perception of the seriousness of AOD and other problems, and their demographic characteristics. Data were analyzed by multiple regression. Findings indicate that knowledge had the strongest direct effect on participation, with desire and accessibility adding important indirect effects. Overall, 34% of the variance was explained. The primary implications drawn from this study are: (1) the model, at variance with previous research by the authors, requires additional testing under a variety of social conditions and with an expansion of construct indicators; and (2) citizen participation programs in low-income neighborhoods should focus on building awareness of these programs.

Implementation effectiveness trial of a social influences smoking prevention program using schools and television

Results are reported from a quasi-experimental implementation effectiveness trial of a television and school-based smoking prevention program. The program used the social influences approach, focusing on peer, family and media influences on adolescents to become smokers, and providing grade 7 students (age 12-13) with the knowledge and skills to resist them. The evaluation allowed for assessments of: the value of coordinated television programming in increasing school, student and parent availability and acceptance of the program; the effects of program context (whether all or half of a grade cohort received the program in school) on participation and subsequent smoking behavior; and the effects of parental participation in prevention activities on subsequent student smoking. Data on availability, acceptance, participation and implementation are reported and immediate post-test and 1and 2-year follow-up results. Strong effects of television programming and context on availability, acceptance and parinstitute for Health Promotion and Disease Prevention Research, University of Southern California, 35 North Lake Avenue, Pasadena, CA 91101, USA 'Also at the Division of Health Behavior Research, Department of Preventive Medicine, School of Medicine, University of Southern California, USA 2 Also at Feeling Fine Productions and KABC-TV Los Angeles, USA 'To whom reprint requests should be sent at: Prevention Research Center, School of Public Health, University of Illinois at Chicago, PO Box 6998, Chicago, IL 60680, USA ticipation were found. Significant associations were also found between each television viewing and parental involvement and subsequent student smoking, but a lack of overall program effects on smoking outcomes limit their interpretation. Constraints on programming and research design suggest: (0 possible limitations to program effects we might reasonably expect in real-world applications of the social influences approach and (ii) the need for future true experimental efficacy trials to determine exactly what level of programming will be needed to achieve significant real-world effects.