Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation
ABSTRACT A stage-matched expert system intervention was evaluated on 4144 smokers in a two-arm randomized control trial with four follow-ups over 24 months. Smokers were recruited by random digit-dial calls, and 80.0% of the eligible smokers were enrolled. Individualized and interactive expert system computer reports were sent at 0, 3, and 6 months. The reports provided feedback on 15 variables relevant for progressing through the stages. The primary outcomes were point prevalence and prolonged abstinence rates. At 24 months, the expert system resulted in 25.6% point prevalence and 12% prolonged abstinence, which were 30% and 56% greater than the control condition. Abstinence rates at each 6-month follow-up were significantly greater in the Expert System (ES) condition than in the comparison condition with the absolute difference increasing at each follow-up. A proactive home-based stage-matched expert system smoking cessation program can produce both high participation rates and relatively high abstinence rates.
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ABSTRACT: The present longitudinal study investigates baseline assessments of static and dynamic variables, including demographic characteristics, smoking severity, and Transtheoretical Model of Behavior Change (TTM) effort variables (Decisional Balance (e.g. Pros and Cons), Situational Temptations, and Processes of Change) of relapse among individuals who were abstinent at 12-months. The study sample (N = 521) was derived from an integrated dataset of four population-based smoking cessation interventions. Several key findings included: Participants who were aged 25-44 and 45-64 (OR = .43, p = .01 and OR = .40, p = .01, respectively) compared to being aged 18-24 were less likely to relapse at follow-up. Participants in the control group were more than twice as likely to relapse (OR = 2.17, p = .00) at follow-up compared to participants in the treatment group. Participants who reported higher Habit Strength scores were more likely to relapse (OR = 1.05, p = .02). Participants who had higher scores of Reinforcement Management (OR = 1.05, p = .04) and Self-Reevaluation (OR = 1.08, p = .01) were more likely to relapse Findings add to one assumption that relapsers tend to relapse not solely due to smoking addiction severity, but due to immediate precursor factors such as emotional distress. One approach would be to provide additional expert guidance on how smokers can manage stress effectively when they enroll in treatment at any stage of change.Addictive Behaviors 03/2015; 42. · 2.44 Impact Factor
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ABSTRACT: Considerations of how gender-related factors influence smoking first appeared over 20 years ago in the work of critical and feminist scholars. This scholarship highlighted the need to consider the social and cultural context of women¿s tobacco use and the relationships between smoking and gender inequity. Parallel research on men¿s smoking and masculinities has only recently emerged with some attention being given to gender influences on men¿s tobacco use. Since that time, a multidisciplinary literature addressing women and men¿s tobacco use has spanned the social, psychological and medical sciences. To incorporate these gender-related factors into tobacco reduction and cessation interventions, our research team identified the need to clarify the current theoretical and methodological interpretations of gender within the context of tobacco research. To address this need a scoping review of the published literature was conducted focussing on tobacco reduction and cessation from the perspective of three aspects of gender: gender roles, gender identities, and gender relations. Findings of the review indicate that there is a need for greater clarity on how researchers define and conceptualize gender and its significance for tobacco control. Patterns and anomalies in the literature are described to guide the future development of interventions that are gender-sensitive and gender-specific. Three principles for including gender-related factors in tobacco reduction and cessation interventions were identified: a) the need to build upon solid conceptualizations of gender, b) the importance of including components that comprehensively address gender-related influences, and c) the importance of promoting gender equity and healthy gender norms, roles and relations.International Journal for Equity in Health 12/2014; 13(1):114. · 1.71 Impact Factor
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ABSTRACT: ReSumen El Modelo Transteórico es un modelo ampliamente utilizado para la explicación del cambio intencional, sobre todo cuando el cambio se refiere a conductas adictivas. A pesar de ello, también ha sido un modelo muy criticado, entre otros motivos por falta de validez. En este trabajo nos propusimos valorar la validez del propio modelo evaluando diferen-tes variables psicológicas distintas a los propios constructos del modelo: amplificación somatosensorial, hábitos de salud, actitudes y opiniones. La muestra estuvo compuesta por 347 estudiantes de la Universidad de Huelva. La participación fue voluntaria. Los sujetos fumadores se distribuyeron según las etapas del Modelo Transteórico de la siguiente manera: 40.0% precontempladores, 18.3% contempladores, 9,7% prepa-radores, 9.0% acción y 23.0% mantenedores. Los resultados obtenidos apoyan la validez del modelo.