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Beltsville, MD, United States

Holder H.,Pacific Institute for Research and Evaluation

Prevention research concerning alcohol, tobacco and other drugs faces a number of challenges as the scientific foundation is strengthened for the future. Seven issues which the prevention research field should address are discussed: lack of transparency in analyses of prevention program outcomes, lack of disclosure of copyright and potential for profit/income during publication, post-hoc outcome variable selection and reporting only outcomes which show positive and statistical significance at any follow-up point, tendency to evaluate statistical significance only rather than practical significance as well, problem of selection bias in terms of selecting subjects and limited generalizability, the need for confirmation of outcomes in which only self-report data are used and selection of appropriate statistical distributions in conducting significance testing. In order to establish a solid scientific base for alcohol, tobacco and drug prevention, this paper calls for discussions, disclosures and debates about the above issues (and others) as essential. In summary, the best approach is always transparency. © 2009 Society for the Study of Addiction. Source

Miller T.R.,Pacific Institute for Research and Evaluation
Prevention Science

Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on three more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8 %, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996–2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development; increase breast-feeding; and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand. © 2015, Society for Prevention Research. Source

Cunradi C.B.,Pacific Institute for Research and Evaluation
International Journal of Environmental Research and Public Health

Indices of heavy drinking have consistently been linked with increased risk for intimate partner violence (IPV) among couples in the general household population. Because IPV is a 'private' event, most IPV research has focused on individual-level risk factors, but current social ecological theory suggests that alcohol outlets can act with neighborhood conditions to increase risks for IPV. This paper reviews the theoretical and empirical literatures relevant to identifying specific social mechanisms linking IPV to alcohol use in community settings, and discusses three social mechanisms relevant to these effects: greater numbers of alcohol outlets within a neighborhood may (1) be a sign of loosened normative constraints against violence; (2) promote problem alcohol use among at-risk couples, and; (3) provide environments where groups of persons at risk for IPV may form and mutually reinforce IPV-related attitudes, norms, and problem behaviors. Understanding these mechanisms is of critical public health importance for developing environmental strategies aimed at prevention of IPV, such as changes in zoning, community action and education, and policing. © 2010 by the authors. Source

Freisthler B.,University of California at Los Angeles | Gruenewald P.J.,Pacific Institute for Research and Evaluation
Alcoholism: Clinical and Experimental Research

Background: Despite well-known associations between heavy drinking and child physical abuse, little is known about specific risks related to drinking different amounts of alcohol in different drinking venues. This study uses a context-specific dose-response model to examine how drinking in various venues (e.g., at bars or parties) is related to physically abusive parenting practices while controlling for individual and psychosocial characteristics. Methods: Data were collected via a telephone survey of parents in 50 cities in California, resulting in 2,163 respondents who reported drinking in the past year. Child physical abuse and corporal punishment were measured using the Conflict Tactics Scale, Parent-Child version. Drinking behaviors were measured using continued drinking measures. Data were analyzed using zero-inflated Poisson models. Results: Drinking at homes, parties, or bars more frequently was related to greater frequencies of physically abusive parenting practices. The use of greater amounts of alcohol in association with drinking at bars appeared to increase risks of corporal punishment, a dose-response effect. Dose-response relationships were not found for drinking at homes or parties or drinking at bars for physical abuse nor for drinking at home and parties for corporal punishment. Conclusions: Frequencies of using drinking venues, particularly bars and home or parties, are associated with greater use of abusive parenting practices. These findings suggest that a parent's routine drinking activities place children at different risks of being physically abused. They also suggest that interventions that take into account parents' alcohol use at drinking venues are an important avenue for secondary prevention efforts. © 2012 by the Research Society on Alcoholism. Source

Fell J.C.,Pacific Institute for Research and Evaluation
Traffic Injury Prevention

Objective: This analysis is an update of a Traffic Tech published by the National Highway Traffic Safety Administration (NHTSA) in March 1992. Drivers with prior driving-while-intoxicated (DWI) convictions are overrepresented in fatal crashes and the relative risk of fatal crash involvement is greater for these repeat DWI offenders. Methods: Although it is estimated that 2.1 percent of licensed drivers had a prior arrest for DWI within the past 3 years in 2010, 8.0 percent of intoxicated drivers (blood alcohol concentration [BAC] ≥ 0.08 g/dL) involved in fatal crashes had at least one prior DWI conviction in the past 3 years during that same year. Results: Drivers with prior DWI convictions are overrepresented in fatal crashes by a factor of 1.62 or are 62 percent more likely to be in a fatal crash. Similarly, drivers with prior DWI convictions are also overrepresented as drinking drivers in fatal crashes: those with low BACs (0.01-0.07) by a factor of 2.38 and those with high BACs (0.08+) by a factor of 3.81. Conclusion: Though repeat DWI offenders are at a substantially higher risk of fatal crash involvement, the vast majority of intoxicated drivers in fatal crashes do not have a DWI conviction in the past 3 years (11 out of 12) according to the Fatality Analysis Reporting System records for the year 2010. © 2014 Copyright Taylor & Francis Group, LLC. Source

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