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Comput Human Behav. Author manuscript; available in PMC 2007 March 26.
Published in final edited form as: Comput Human Behav. 1989 ; 5(2): 7993.

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Microcomputer-Based Approaches for Preventing Drug and Alcohol Abuse Among Adolescents from Ethnic-Racial Minority Backgrounds
Michael S. Moncher, Clifford A. Parms, Mario A. Orlandi, Steven P. Schinke, Samuel O. Miller, Josephine Palleja, and Mary B. Schinke Columbia University and American Health Foundation

Abstract
This study was designed to empirically assess the potential of microcomputer-based intervention with black adolescents from economically disadvantaged backgrounds. Subjects were 26, 11 through 14-year-old black females and males recruited from three boroughs in New York City. A sample task was administered via microcomputer system followed by a postintervention measurement battery. Observational measures were also employed to assess interactional variables. Subjects attitudes toward educational content in general, and toward drug and alcohol information delivery in particular, appeared to be a significant intervening variable that could alter the overall efficacy of computer-delivered interventions. Both observational and postintervention measures indicated an overall positive subject response to computer-administered instruction. In contrast, however, respondents indicated a negative response to microcomputer delivery of drug and alcohol related materials. Results of the experiment are discussed along with rationales and future research directions.

INTRODUCTION AND OVERVIEW

Recent years have witnessed a growing use of computer-assisted instruction (CAI) for a variety of purposes. As noted by Elwork and Gutkin (1985): The computerization of our society has already begun. We have little doubt that it will proceed at an ever quickening pace. The central question confronting behavioral scientists is whether we want it to occur with our input (p. 14). Studies of CAI programs find consistent increases in adolescents performance, rate of learning, and motivation (Burns & Bozeman, 1981; Hartley & Levell, 1978; Kulik, Bangert, & Williams, 1983; McCollister, Burts, Wright, & Hildreth, 1986; Menis, Synder, & BenKohav, 1980; Ragosta, 1983). CAI can provide several important instructional advantages in health education. Because it is interactive, self-directed software is intrinsically motivating. With this software, adolescents can elicit health information in areas of greatest concern. Techniques such as branching can further personalize youths learning, permitting much flexibility and considerable involvement (Anand & Ross, 1987; Bosworth, Gustafson, Hawkins, Chewning, & Day, 1983). With drug and alcohol issues, self-directed formats give youths access to potentially more objective information. Additionally, this information can be obtained confidentially, which is essential

Requests for reprints should be addressed to Michael S. Moncher, Columbia University School of Social Work, 622 West 113th Street, New York, NY 10025..

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to young people exploring current knowledge on illegal and value-laden topics (Kahn, 1987). In addition to helping youths debunk myths and learn about the substances they commonly use, the objectivity afforded by self-directed computer formats reduces the likelihood of biased information that can mar drug and alcohol prevention efforts. Interacting with self-directed computer programs may not only equip black adolescents with a repertoire of knowledge and skills around drugs and alcohol, but also may instill in young people the confidence to apply that learning. Indeed, research points to such benefits for young people in general (Robertson, Ladewig, Strickland, & Boschung 1987) and adolescents from lower socioeconomic and disadvantaged backgrounds in particular (Daron & Rich, 1981; Mervarech & Rich, 1985; Saracho, 1982). Last, the interactive computer medium may heighten black youths self-efficacy by letting them control their learning and by showing them that they can exert independent decision making about drugs, alcohol, and other personal choice behaviors. Recent research on computer-based instruction is encouraging. Watkins (1986) reported that six months after the delivery of a microcomputer-based instructional program, first-grade participants had improved math and cognitive reasoning skills relative to students who received a noncomputerized intervention. In a meta-analysis of 32 comparative studies, Kulik, Kulik, and Bangert-Drowns (1985) found that computer-assisted and computer-managed instructional programs effected higher outcome changes than traditional, noncomputerized programs. For instance, children who received computer-assisted programs, which accounted for the majority of studies examined in the meta-analysis, achieved post-intervention gains averaging .47 standard deviations, or from the 50th to the 68th percentile in outcome measurement scores. Earlier meta-analyses of microcomputer instructional interventions also showed positive effects. Chambers and Sprecher (1980) reviewed all available research on the topic and learned that computer-assisted instruction: (a) produced equal or better learning outcomes as compared to traditional instruction; (b) reduced learning time over traditional instruction; (c) improved student attitudes toward computers as a learning vehicle; and (d) promoted professionals acceptance and use of computer applications. Similarly, a meta-analysis of computer-based learning at the secondary education level by Kulik et al. (1983) found that when juxtaposed with conventional classroom instruction, computer methods resulted in greater student achievement and in reduced time for learning a topic. Despite the potential of self-directed health education, such computer-based programs are slow in coming. While presenting strong support for computer-mediated instruction in general, most research to date has not focused primarily on behaviorally oriented interventions. One such intervention, tested by Tombari, Fitzpatrick, and Childress (1985) showed significant posttest gains. In a controlled experimental design involving fifth-graders, Tombari et al. tested an intervention involving such procedures as goal setting, goal rehearsal, feedback, contingent reinforcement, schedule attenuation, and maintenance of behavior change. Each procedure was delivered and monitored by personal computer. A reversal design indicated that the intervention reduced disruptive classroom behavior and was more efficient than teachermediated intervention. Raines and Ellis (1982) reported that a computer-assisted intervention to facilitate behavior change in such areas as smoking, weight, exercise, and drinking was helpful for 92 % of all users. A program delivered on a large scope, the Staywell Lifestyle Change Program, has applied cognitive-behavioral methods to similarly effect health changes (Lau & Hall, 1983). Another computer-based health education program, the Body Awareness Resource Network (BARN) Project, has achieved a measure of success by giving the computer a personality (Hawkins, Bosworth, Chewning, Day, & Gustofson, 1985).

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The BARN projecta computer-based health promotion system for teenagers and their familieswarrants additional discussion. Longitudinal field testing following 800 subjects drawn from an original sample of 2400 adolescents provides strong evidence of the efficacy of computer-based health promotion (CBHP) (Gustafson, Bosworth, Chewning, & Hawkins, 1986). An extensive review of available health-related software indicated a paucity of material that was either interactive, integrative, or goal oriented in approach. BARN was developed to address this need. In the testing phase, a number of positive results were found. Significantly, the authors noted that: BARN reaches adolescents who, in the pretest, generally reported more risk-taking behavior (e.g. more smoking, higher rate of sexual intercourse, more serious consequences from alcohol or other drug use, etc.) than nonusers. Thus the computer may be a particularly powerful means of reaching people who are making bad health decisions (Gustafson et al., 1986, p. 9). Utilizing technological advances in health-related software design, BARN is on the leading edge of computer-based health promotion systems for young people. Its early successes indicate both the feasibility of such systems, and the potential efficacy they will achieve. The areas of learning theory, decision science, artificial intelligence, simulation, change theory, and group processes have developed models that can provide the structure of a CBHP (computer based health promotion) system. The knowledge base of health promotion has increased to the point where impressive stores of data, literature, and expertise have been developed. What must be done now is to carefully design high quality CBHP systems to help people solve their health-related behavior problems by compensating for documented human weaknesses in complex problem solving. These systems can then interface with group and individual problem solving (Gustafson et al., 1986, p. 34). While CBHP may represent immeasurable value for health education in general, comparative questions concerning delivery methodology are often raised. In this regard, Deardorff (1986) compared the relative efficacy of curricula delivered via computer, face-to-face, and written materials. Outcome data revealed a positive assessment of computerized and face-to-face formats, with the written format assessed less positively. Deardorff reported that subjects spent more time interacting with the computer than during either written or face-to-face formats. Furthermore, the study discovered a relationship between subjects time spent interacting with computer and their free recall of information presented (r = .39, p < .01). Additionally, Wise and Wise (1987), in a comparison study of computer-administered and paper-administered achievement tests with elementary school children found that, while no significant mean test score differences were noted, computer feedback stimulated state-anxiety among high mathematics achievers leading to the conclusion that additional research is needed regarding feedback as a mechanism in computer-aided instructional materials. Another study found that a computer-aided behavioral smoking cessation program was at least as effective in promoting abstinence as were traditional face-to-face methods. Perhaps of greater long-term import was the finding that all participants in this program indicated that they would not have attempted to quit smoking at this time, had there not been this program, (Schneider, 1986, p. 284). In addition to comparative educational techniques, a second lingering question for CAI and CBHP in particular has been personal or receiver variables of research subjects. Lewis and Cooney (1987) used computer-aided instruction to assess effects of differential educational styles on mathematics achievement. Locus of control and field dependence/independence
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variable measures were examined subsequent to computer-based interventions employing competitive and individualistic feedback mechanisms against a control group receiving instruction with no feedback other than that normally provided by the system. While no significant main effects were observed, it was noted that treatment conditions differentially effected performance by gender, with males progressing at a higher rate under the competitive condition and females progressing at a higher rate under the individualistic feedback condition than was observed under the competitive condition. Study results also noted that while performance was affected by condition, differences in academic locus of control were obviated by this study. Other recent studies reported in these pages have shown that, among certain groups, computerbased instrument administrations are at least as valid and reliable as are paper-pencil administrations of equivalent instruments (Harrell, Honaker, Hetu, & Oberwager, 1987; Lambert, Reagen, Rylee, & Skinner, 1987), and research is being done to isolate attitudinal variables that may be used to enhance effective software development for both instructional and testing purposes among various subject groups (Burke, Normand, & Raju, 1987; Nickell & Pinto, 1987; Rozensky, Feldman-Honor, Rasinski, Tovian, & Herz, 1986). Of particular interest, given the minority focus of our research, is a recent, well controlled study by Pulos and Fisher (1987) measuring adolescents interest in computers by attitude and socioeconomic status. School A was located in a large, urban setting. Ethnic composition was 51% black, 35% hispanic, 4% asian and 8% white. Furthermore, 41% of the families received AFDC. Computer exposure was minimal. School B was located in a suburban area, was predominantly white, and reported only 5 % of the families receiving AFDC. Further, all adolescents in school B had significant computer exposure. The instruments administered to all students were designed to measure interests in computer and other activities. In addition, open-ended questions were included to elicit student views about the characteristics of adolescents who like computers. These data were subjected to a principal components analysis in which four principal components were found including typical adolescent activities, adult-approving activities, intellectual activities, and physical activities. Component scores were calculated for each, and compared across the two school groups. The results indicated that, while in general most adolescents were indifferent to computers, there was a school difference in computer interest with students from the lower SES school showing significantly more interest than those in the middle-class school. Pulos and Fisher suggest that this difference might be due largely to the lack of computer exposure of the lower SES group. If this is so, might we not capitalize on this deficit in the service of prevention? They further suggest that computer interest was subjectively associated with more intellectual, adult approved behaviors. Perhaps this association is the basis for the low interest in computers found in this study, since many adolescents do not want to be seen as intelligent and will tend to avoid activities that may lead them to be seen as intellectual by their peers. (Pulos & Fisher, 1987, p. 35). It appears clear that persons in general do tend to respond positively to computer administered instruction. For microcomputer-based interventions to help black adolescents avoid drug and alcohol abuse, research is needed to ascertain specific attitudes of black adolescents toward computers. Given both cultural and socioeconomic differentials, it must be determined both whether this group in particular will respond to cognitive-behavioral, health related messages delivered via computer. Furthermore, responsive hardware and software configurations must be developed to tap the specific needs of black youth, thus promoting maximum response. This

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study was designed to increase empirical knowledge on computer-aided instruction for drug abuse prevention among youth from disadvantaged, ethnic-racial minority backgrounds.

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METHOD
Subjects Study subjects were 26, 11 through 14-year-old black females and males from economically disadvantaged homes located in three boroughs of New York City. Recruited through New York City Board of Education Community School District schools and from the New York Housing Authority, subjects gave their informed consent and obtained parental consent prior to study participation. Subjects understood the nature of the study and were able to withdraw from it at any time without penalty. No enticements for study involvement were offered subjects or their parents. Table 1 presents demographic characteristics of study subjects. Procedure The study was designed to empirically assess the potential of microcomputer-based intervention with black adolescents from economically disadvantaged backgrounds. Accordingly, study subjects were given a sample task via a microcomputer system, followed by a post-intervention measurement battery. Post-intervention questionnaires contained Likert scaled and open-ended items. Together, questionnaire items measured contextual and interactional variables appropriate to the microcomputer task and software. Contextual variables measured in the battery included the amount of material retained, or learned, by subjects upon completion of computer interaction. These variables covered subjects feelings about using computers respective to such factors as intimidation, mastery, enjoyment, and involvement. Interactional variables measured in the questionnaire battery included the degree to which subjects would interact with the microcomputer over time. This degree of interaction was estimated by time-interval measures of subjects eyes on microcomputer screen and their fingers on the entry pad keys. Additional measures of interactional parameters were obtained by assessments of subjects ability to follow software and instructor comments and subjects attention span in time on the computers. Other items measured subjects perceptions of the microcomputer as a receptive learning and teaching medium, subjects prior computer experience, and their current accessibility to and use of microcomputers. Computer Task Five subjects were concurrently tested, each individually operating a computer for approximately 15 minutes. Each student was assigned to a computer, and urged to observe the demonstration program running on the screen prior to attempting to use the software. In addition to the demonstration, a brief description of the learning task and basic keyboard use was presented. The description was made uniform across subjects to avoid potential confound resulting from differential explanations. As the study primarily focused on user interest in using computers, the software selection criteria centered on reduction of as many barriers to use as possible. First, given the limited duration of the interaction between student and software, the teaching technique and computer interface had to provide easy access to the material with a minimum of external guidance. In such a case, interface-generated frustrations of inexperienced users could be kept to a bare minimum. Second, the content had to represent a known knowledge category students were used to dealing with (rather than health-related content less frequently encountered).

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Against these criteria, we chose an educational package that allowed subjects to continually interact with the software in response to computer-generated questions and tasks. The software itself was a well-known geography package. The primary task was to place countries in an area map in response to the countrys name or other information about that country. The humancomputer interface employed a standard ARROW - key/ENTER control technique for moving the cursor and making selections. The primary visual nature of the software thus presented students with meager reading requirements. Additionally, the various user-selectable methods of questioning available provided interest and challenge as well as individualized levels of difficulty. Measurement Measurements of subjects were taken at two periods. During the computer task, two observers recorded data on each subjects overt interactions with the software and microcomputer. Immediately after the computer task, subjects were individually interviewed about their experience with the microcomputer and software. Observations The observational protocol required two observers, each of whom made a consecutive, minute by minute sweep of each subject (generally in cohorts of five), over a fifteen minute period. Each observer was provided with a coding sheet with the following instructions: In the top half of each box, record a (1) if the child is looking at the screen. Record a (0) if the child is not looking at the screen. In the bottom half of each box, record a (1) if the childs fingers are depressing keys. Record a (0) if the childs fingers are not depressing keys. Use of two raters provided a measure of inter-rater reliability. In addition, a facilitator was present to give the children initial instructions, and answer any questions asked during the intervention period. The observers did not interact with subjects. Posttest Interview Following subjects completion of the intervention, they were taken into an interviewing room and administered a posttest questionnaire designed to measure values on the variables described above. Each child was assured by the interviewer that the information provided was confidential and to be used only for purposes of analysis. Each subject, at the end of the interview, was encouraged to provide input regarding the computer in general, and, specifically, what could be done to make working with the machine more interesting, enjoyable, and valuable as a learning experience.

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RESULTS
Observational Data Inter-rater reliability was 88.5 % as measured across the three variables of time (15 min), eye interaction with the screen and finger interactions with the keyboard. Cell size precluded any statistical measures of significance, as no chi-square related tests could be performed. Interaction effects were observed as follows. First, the ration of overall time spent interacting as measured on either of the two interacting variables was 85.7 %. Second, subjects had both eyes and hands on the computer 85.1% of the time across the observed measurement period. Again, cell size precludes analysis of significance. Third, the ratio of eyes off the screen was 0%. Finally, the ratio of noninteraction during the fifteen minutes intervention was 1.3%.

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Responses When asked about positive reactions to computer-generated tasks, 23.1% of the participants answered with the general response, I liked everything. About one-third of the subjects (34.6 %) were more specific, indicating that they liked using the computer. Nearly one-fourth of the subjects (23.1%) mentioned a software-specific variable. An additional 11.5% of the subjects mentioned using the keyboard as an enjoyable experience (Table 2). Subjects negative reactions to computer tasks mirrored the positive responses. About 42% of the subjects found no disagreeable task aspects. Additionally, 19.2% of the participants objected only to having to stop. The more general question measuring overall interaction disagreement confirmed these results, with 57.7 % of the subjects enjoying all interaction aspects. Nearly 27 % of the adolescents singled out a bothersome software-specific variable. About 12 % of the subjects mentioned a lack of screen clarity due to the size of the display. Only three participants (11.5 %) mentioned problems with the level of difficulty, finding it either too difficult or too simplistic. All participants who mentioned the difficulty level had some previous computer experience (Table 3). Tables 4 and 5 depict subjects responses to questions regarding possible hardware, software, or process modifications that would have increased subject enjoyment. As with all communications, computer-delivered education materials are subject to variations in quality specific to those targeted for receipt of intended information. Values for specific receiver variables were obtained during posttest interviews and subsequently correlated with general reactions to the software test session. Receiver variables included gender, age, previous computer experience, familiarity with video games, and overall computer availability. Regarding previous computer experience, participants fell into three overall categories; those with no experience, those with less than one year of experience, and those with more than one year of experience. Seventy-seven point eight percent or 14 of 18 boys tested, had some previous experience (53.8% of the total sample). Over 63 %, or 5 of the 8 girls tested, had previous experience (19.2 % of the total sample), indicating differential gender effects (Table 6). In another analysis, 77.8% of the boys tested expressed enjoyment of video games, with 72.3% of them actively participating in play. By contrast, 87.5% of the girls tested expressed similar enjoyment with only 25% actively involved in their use (Table 7 and 8). When asked questions concerning the helpfulness and necessity of instructions given by the software and the interventionist, 34.6% of all participants felt that the combination of computer/ intervention instructions was adequate for overall task performance, including hardware use. Except for general responses such as the instructions helped me learn how to use the computer, the most dominant response category related to questions on aspects of keyboard use. Nearly 43 % of all subjects made mention of the keyboard, stating either that the instructions regarding its use were helpful or were needed. Participants were asked three different questions designed to determine their relative preference for computer vs. human materials delivery. Results indicate a disparity based upon the type of information to be conveyed. In response to a general question concerning preference for computer or teacher-delivered classroom work, computer delivery was the clear choice. (69.2%). When asked to choose between computer or human delivery in general, the participants split evenly (Table 9).

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In direct contrast, when asked to choose between computer or human delivery of information or counseling regarding drug or alcohol abuse, there was an 8 to 1 split in favor of human delivery, with 18 respondents (69.2 %) choosing such interventions and only 2 participants (7.7 %) preferring computer delivery. Almost 20 % of the subject had no specific preference. For all three questions, the primary reason for choosing human delivery related to the inanimate nature of a computer and its inability to understand or otherwise relate to human problems. This notion was best articulated by one subject who stated, Computer cant take drugs. (Table 10). When asked about other general factors involved in deciding upon computer or human content delivery, participants generally felt that a computer was more fun than a person. There was no agreement on whether general (nondrug or alcohol specific) information could be gained more effectively from either source. Other factors mentioned favoring either computer or human delivery preferences included I dont have to write on a computer,, I like computers,, and A computer cant yell at me (Table 11). Responses indicated a general trend towards computer use in school. Though 27.8 % of the boys (five subjects) had home access to a computer, none of the girls had such access (Table 12). Regarding types of activities most often performed on a computer, the largest response (42.9%) indicated game playing, with learning activities second (23.8%; Table 13).

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DISCUSSION
In this study, black adolescents attitudes toward educational content is general, and toward drug and alcohol information delivery in particular, appeared to be a significant intervening variable that could alter the overall efficacy of computer-delivered interventions. With reference to McGuires persuasion matrix, software designs must take into account the possible disbelief and/or suspicion of targeted subjects in the ability of the computer to exhibit the flexibility, empathy, and sensitivity requisite for understanding human problems. Consequently, research must ascertain black adolescents specific attitudes towards computers. Given both cultural and socio-economic differentials, it must be determined whether this group will respond positively to computer-delivered interventions and, if it will, how best can hardware and software be designed to promote maximum response. Further, black adolescents must have access to computer hardware. Largely due to economic maldistributions, such access is more the exception than the rule. Still, cost-cutting trends, aggressive marketing, and in-kind contributions of equipment bode well for rising numbers of microcomputers in the homes and schools of black american youth (Becker, 1984; Ingersoll & Smith, 1984). Also, as more ethnic-specific software is developed and tested, schools and organizations serving predominantly black populations may be more likely to make the requisite investments to achieve the long term economies of scale such programs should provide. Software must also be developed to provided multi-screened, comprehensive, and easily accessed information on all facets of drug and alcohol of specific interest to this cohort, as well as to deliver differentially paced, effective and age appropriate prevention interventions. Results from the present study indicate that these aspects of modular design are critical if the general trend noted towards computer enjoyment and use is to be extended to dissemination of drug and alcohol information and preventive interventions. Steps must be taken within the software design to instill a sense of confidence in the user through repetitive demonstration of
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human-like responsiveness, early in the intervention experience. This is highlighted by the reluctance of the study cohorts toward computer interactions regarding substance use, inconsistent with the overall positive attitude exhibited by the subjects about working with computers in general. The economic imperatives of software development dictate that production must meet market demand. Consequently, most instructional software is geared currently toward majority culture, middle- and upper-income americans, seldom tapping the life experience and everyday realities of ethnic-racial minority, lower income, and disadvantaged populations. To successfully develop such interactive and effective software, focus groups must be implemented in order to gather further information from the cohort regarding preferences, as well as to test efficacy of software during the development process. Areas for further research include large scale, controlled testing of computer-based vs. human skills-interventions using such newly developed software. Such studies might be longitudinal in nature and include booster sessions utilizing both changes in attitudinal factors, knowledge retention, and drug/alcohol use as the cohort reaches high school age. Finally, studies combining both human and computer-aided content delivery would provide data regarding possible synergistic or suppressor interactions. Possibly, positive correlations could have been discovered between various interview parameters and psychometric measures obtained during the test session. However, logistics of the test experience did not permit subject identification cross-linking of data. More sophisticated measurements development, significantly larger samples, and appropriate coding measures provide additional areas for further study.

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References
Anand PG, Ross SM. Using computer-assisted instruction to personalize arithmetic materials for elementary school children. Journal of Educational Psychology 1987;79(1):7278. Becker, HJ. School uses of microcomputers: Reports from a national survey. Baltimore, MD: Johns Hopkins University Center for Social Organization of Schools; 1984. Bosworth, K.; Gustafson, DH.; Hawkins, RP.; Chewning, B.; Day, T. Health Education Microcomputers. 1983 Oct. Adolescents, health education; and computers: The body awareness network (BARN); p. 59-60. Burke MJ, Normand J, Raju MS. Examinee attitudes toward computer-administered ability testing. Computers in Human Behavior 1987;3(2):95107. Burns PK, Bozeman WC. Computer-assisted instruction and mathematics achievement: Is there a relationship? Educational Technology 1981;21:3229. Chambers JA, Sprecher JA. Computer-assisted instruction: Current trends and critical issues. Communications ogrthe ACM 1980;23:332342.Daron & Rich, 1985. Daron, E.; Rich, Y. Development and validation of the Israel quality of school life scale. In: Epstein, JO., editor. The quality of school life. Lexington, MA: Lexington Books; 1981. p. 179-195. Deardorff W. Computerized health education: A comparison with traditional formats. Health Education Quarterly 1986;13:6172. [PubMed: 3957686] Elwork A, Gutkin TB. The behavioral sciences in the computer age. Computers in Human Behavior 1985;1:318. Gustafson, DH.; Bosworth, K.; Chewning, B.; Hawkins, RP. Computer-based health promotion: Combining technological advances with problem-solving techniques to effect successful health behavior changes. 1986. Unpublished manuscript. Harrell TH, Honaker LM, Hetu M, Oberwager J. Computerized vs. traditional administration of the multidimensional aptitude battery-verbal scale: An examination of reliability and validity. Computers and Human Behavior 1987;3(2):129137.

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Hartley, JR.; Levell, K. The psychological principles underlying the design of computer-based instructional systems. In: Hartley, J.; Davies, I., editors. Contributions to an educational technology. 2. London: Kogan-Page Limited; 1978. Hawkins, RP.; Bosworth, K.; Chewning, B.; Day, PM.; Gustafson, DH. Adolescents use of computerbased health information: The BARN project. In: Chen, M.; Paisley, W., editors. Children and microcomputers: research on the newest medium. 1985. p. 228-245. Ingersoll G, Smith C. Availability and growth of microcomputers in American schools. Technological Horizons in Education 1984;12:8487. Kahn LK. Effects of computer-assisted instruction on selected interaction skills related to responsible sexuality. Journal of School Health 1987;57(7):282287. [PubMed: 3312815] Kulik JA, Bangert RL, Williams GW. Effects of computer-based teaching on secondary school students. Journal of Educational Psychology 1983;75:1926. Kulik JA, Kulik CC, Bangert-Drowns R. Effectiveness of computer-based education in elementary schools. Computers in Human Behavior 1985;1:5974. Lambert ME, Reagan HA, Rylee K, Skinner JR. Equivalence of computerized and traditional MMPI administration with substance abusers. Computers in Human Behavior 1987;3(2):139143. Lau CC, Hall PP. Computer-based education design strategies for the PLATO Staywell Lifestyle Change Program. Journal of Computer-Based Instruction 1983;9 Lewis MA, Cooney JB. Attributional and performance effects of competitive and individualistic feedback in computer-assisted mathematics instruction. Computers in Human Behavior 1987;74:113. McCollister TS, Burts DC, Wright VL, Hildreth GJ. Effects of computer-assisted instruction and teacherassisted instruction on arithmetic task achievement scores of kindergarten children. Journal of Educational Research 1986;80(2):121125. Menis Y, Snyder M, Ben-Kohav E. Improving achievement by means of the computer. Educational Technology 1980;20(8) Mervarech ZR, Rich Y. Effects of computer-assisted mathematics instruction on disadvantaged pupils cognitive and affective development. Journal of Educational Research 1985;79(1) Nickell GS, Pinto JN. The computer attitude scale. Computers in Human Behavior 1987;2:301306. Pulos S, Fisher S. Adolescents interests in computers: The role of attitude and socioeconomic status. Computers in Human Behavior 1987;3(1):2936. Ragosta M. Computer-assisted instruction and compensatory education: A longitudinal analysis. Machine-Mediated Learning 1983;1(1)Raines & Ellis, 1982. Raines JR, Ellis LB. Conversational microcomputer based health risk appraised. Computers programs in Biomedicine 1982;14(2):175183. Rozensky HR, Feldman-Honor L, Rasinski K, Tovian SM, Herz GI. Paper- and-pencil versus computeradministered MMPIs: A comparison of attitudes. Computers in Human Behavior 1986;2:111116. Robertson EB, Ladewig BH, Strickland MP, Boschung MD. Enhancement of self-esteem through the use of computer-assisted instruction. Journal of Educational Research 1987;80(5):314316. Saracho ON. The effects of a computer-assisted instruction program on basic skills achievement and attitudes towards instruction of Spanish-speaking migrant children. American Educational Research Journal 1982;19:201219. Schneider SJ. Trial of an on-line behavioral smoking cessation program. Computers in Human Behavior 1986;2:277286. Tombari ML, Fitzpatrick SJ, Childress W. Using computers as contingency managers in self-monitoring interventions: A case study. Computers in Human Behavior 1985;1:7582. Watkins MW. Microcomputer-based math instruction with first-grade students. Computers in Human Behavior 1986;2:7175. Wise SL, Wise LA. Comparison of computer-administered and paper-administered achievement tests with elementary school children. Computers in Human Behavior 1987;3(1):1520.

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Table 1

Subject Demographic Characteristics

AGE GRADE Max 16 16 16 Mean 7.22 8.25 7.54 Min 5 7 5 Max 9 10 10

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N Boys Girls Total 18 8 26

% 69.2 30.8 100.0%

Mean 13.83 14.75 14.12

Min 11 12 11

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Table 2

Subjects Positive Reactions to Computer Task

Items Subjects Liked Best Items Subjects Enjoyed Most Item Software Directions Experience Other Frequency 18 3 1 2 Percent 69.3 11.5 3.8 7.7

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Item Software Using computer All tasks Keyboard

Frequency 6 9 6 3

Percent 23.1 34.6 23.1 11.5

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Table 3

Subjects Negative Reactions to Computer Task

Items Subjects Liked Least Items Subjects Disliked Most Item Software Difficulty level Nothing Other Frequency 7 3 15 1 Percent 26.9 11.5 57.7 3.8

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Item No response Having to stop Visual limitation Nothing Keyboard

Frequency 2 5 3 11 1

Percent 7.7 19.2 11.5 42.2 3.8

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Table 4

Elements to Increase Subjects Enjoyment of the Task

Elements Mentioned

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Customization Different content Alternate technique Other Nothing No response

11.5% (3) 23.1% (6) 23.1% (6) 11.5% (3) 19.2% (5) 11.5% (3)

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Table 5

Suggested Modifications to Increase Enjoyment

Item to Modify Frequency 9 6 3 3 7 2 2 1 1 Percent 34.6 23.1 11.5* 11.5* 26.9* 7.6* 7.7 3.8 3.8

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Nothing Use games More access Use joystick Content Speech Customization Software mechanics Sound (other than speech)

Note. Response categories for this question are not mutually exclusive. Two responses were recorded for each respondent when applicable. As such, percentages reflect how many respondents mentioned any single item. Asterisk items are those mentioned as the second response in addition to other items. All other responses represent the first response.

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Table 6

Subjects Prior Computer Experience

Prior Experience

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

N Boys Girls 14 5

% 77.8% 62.5%

Less than 1 year 33.3% (6) 0.0

2 or more years 44.4% (8) 62.5% (5)

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Table 7

Subjects Preference and Use of Video Game

Enjoyment of video games

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Yes Boys Girls Sample 77.8% (14) 87.5% (7) 80.8% (21)

No 22.2 (4) 12.5 (1) 19.2 (5)

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Table 8

Subjects Average Time Spent Playing Video Games, by Gender

Time Spent Using Video Games Each Week

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

None Boys Girls Total 27.8% (5) 75.0% (6) 42.3% (11)

< 15 min 11.1 % (2) 0.0% 7.7% (2)

1530 min 16.7% (3) 0.0% 11.5% (3)

12 hrs 5.6% (1) 12.5% (1) 7.7% (2)

2 + hrs 38.9% (7) 12.5% (1) 30.8% (8)

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Table 9

Subjects Preferences for Computer vs. Person Instruction

Preference Computer 42.3% (11) 65.4% (17) 7.7% (2) Person 42.3% (11) 26.9% (7) 69.2% (18) Either 7.7% (2) 7.7% (2) 19.2% (5)

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Computer/Person Computer/Classroom Computer/Counselor

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Table 10

Factors Cited as Important in Choosing Human Delivery for Drug and Alcohol Abuse Prevention Content
Factor Cited Frequency 9 2 1 8 1 1 1 4 Percent 42.3 15.4* 3.8 30.8* 3.8 3.8 3.8 15.1*

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

More knowledge (quantity) Better explanation/response Need to explain self Lack of personalism Feelings Speaking ability/limitation Self-pacing of learning Other

Note. Response categories are not mutually exclusive. Two responses were recorded for each respondent when applicable. As such, percentages reflect how many respondents mentioned any single item. Asterisk items are those mentioned as the second response in addition to other items. All other responses represent the first response.

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Moncher et al.

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Table 11

Factors Cited as Important in Choosing General Computer or Human Content Delivery

Frequency Percent 19.2 7.7 15.4 3.8 7.7 7.7

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

More fun Help More information Understanding Interpersonal interaction No reason given

5 2 4 1 2 2

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Table 12

Computer Availability
Computer Availability in Percentages and (Frequency)

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Home Boys Girls Sample 27.8% (5) 0.0% 19.2% (5)

School 83.6% (15) 75.0% (6) 80.8% (21)

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Table 13

Activities on Computer
Activities Mentioned (in Percentages)

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Item Games Learning Word processing Programming Other Nothing

Boys 43.8 18.8 12.5 12.5 0.0 12.5

Girls 40.0 40.0 0.0 0.0 20.0 0.0

Sample 42.9 23.8 9.5 9.5 4.8 9.5

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