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Sheikhattari P, Apata J, Bleich L, Kamangar F, Assari S. Efficacy of a Smoking Cessation Program for Underserved Ethnic Minority Communities: Results of a Smoking Cessation Trial. Int J Public Health 2023; 68:1605739. [PMID: 37408795 PMCID: PMC10318133 DOI: 10.3389/ijph.2023.1605739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/06/2023] [Indexed: 07/07/2023] Open
Abstract
Objectives: Using a participatory research approach, this study reports the efficacy of the Communities Engaged and Advocating for a Smoke-free Environment (CEASE)-4 intervention offered by the local peers. Methods: CEASE-4 is a theory-based tobacco-cessation intervention, tailored to the needs of underserved populations. 842 tobacco users self-selected into: a) self-help (n = 472), b) single-session class (n = 163), and c) four-session class (n = 207). While self-help group only received educational materials, curriculum for other arms was built on the social cognitive, motivational interviewing, and trans-theoretical- frameworks. Participants could also receive nicotine replacement therapy (NRT). Outcome was self-reported smoking cessation measured 12 weeks after completion of the intervention, validated by exhaled carbon monoxide (CO) test. Results: Quit rate was statistically different across groups, with highest quit rate in four-session and lowest quit rate in self-help arm. Cessation rates at follow up (12 weeks after completion of the intervention) were 2.3% in the self-help arm, 6.1% in the single-session arm and 13.0% in the four-session arm. Conclusion: While theory-based smoking cessation services are effective for underserved populations, four-session curriculum might be superior to a single session program.
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Affiliation(s)
- Payam Sheikhattari
- Department of Behavioral Health Science, School of Community Health and Policy, Morgan State University, Baltimore, MD, United States
- Prevention Sciences Research Center, Morgan State University, Baltimore, MD, United States
| | - Jummai Apata
- Prevention Sciences Research Center, Morgan State University, Baltimore, MD, United States
| | - Lisa Bleich
- Signal Fire Consulting, Baltimore, MD, United States
| | - Farin Kamangar
- Office of Research Administration, Morgan State University, Baltimore, MD, United States
| | - Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
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2
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Bricca A, Swithenbank Z, Scott N, Treweek S, Johnston M, Black N, Hartmann-Boyce J, West R, Michie S, de Bruin M. Predictors of recruitment and retention in randomized controlled trials of behavioural smoking cessation interventions: a systematic review and meta-regression analysis. Addiction 2022; 117:299-311. [PMID: 34159677 DOI: 10.1111/add.15614] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/06/2021] [Accepted: 06/09/2021] [Indexed: 01/10/2023]
Abstract
AIM To investigate predictors of participant eligibility, recruitment and retention in behavioural randomized controlled trials (RCTs) for smoking cessation. METHOD Systematic review and pre-specified meta-regression analysis of behavioural RCTs for smoking cessation including adult (≥ 18-year-old) smokers. The pre-specified predictors were identified through a literature review and experts' consultation and included participant, trial and intervention characteristics and recruitment and retention strategies. Outcome measures included eligibility rates (proportion of people eligible for the trials), recruitment rates, retention rates and differential retention rates. RESULTS A total of 172 RCTs with 89 639 participants. Eligibility [median 57.6%; interquartile range (IQR) = 34.7-83.7], recruitment (median 66.4%; IQR = 42.7-85.2) and retention rates (median 80.5%; IQR = 68.5-89.5) varied considerably across studies. For eligibility rates, the recruitment strategy appeared not to be associated with eligibility rates. For recruitment rates, use of indirect recruitment strategies (e.g. public announcements) [odds ratio (OR) = 0.30, 95% confidence interval (CI) = 0.11-0.82] and self-help interventions (OR = 0.14, 95% CI = 0.03-0.67) were associated with lower recruitment rates. For retention rates, higher retention was seen if the sample had ongoing physical health condition/s (OR = 1.66, 95% CI = 1.04-2.63), whereas lower retention was seen amongst primarily female samples (OR = 0.83, 95% CI = 0.71-0.98) and those motivated to quit smoking (OR = 0.74, 95% CI = 0.55-0.99) when indirect recruitment methods were used (OR = 0.60, 95% CI = 0.38-0.97) and at longer follow-up assessments (OR = 0.83, 95% CI = 0.79-0.87). For differential retention, higher retention in the intervention group occurred when the intervention but not comparator group received financial incentives for smoking cessation (OR = 1.35, 95% CI = 1.02-1.77). CONCLUSIONS In randomized controlled trials of behavioural smoking cessation interventions, recruitment and retention rates appear to be higher for smoking cessation interventions that include a person-to-person rather than at-a-distance contact; male participants, smokers with chronic conditions, smokers not initially motivated to quit and shorter follow-up assessments seems to be associated with improved retention; financial incentive interventions improve retention in groups receiving them relative to comparison groups.
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Affiliation(s)
- Alessio Bricca
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark, Slagelse, Denmark
| | - Zoe Swithenbank
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Neil Scott
- Medical Statistics Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK
| | - Marie Johnston
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Nicola Black
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Technology Addiction Team, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences and National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Robert West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Marijn de Bruin
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, the Netherlands
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Martínez-Vispo C, López-Durán A, Rodríguez-Cano R, Senra C, Becoña E. Treatment completion and anxiety sensitivity effects on smoking cessation outcomes. Addict Behav 2021; 117:106856. [PMID: 33609810 DOI: 10.1016/j.addbeh.2021.106856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Treatment completion is associated with abstinence outcomes in smoking cessation interventions. Previous research has stated that anxiety sensitivity (AS) is associated with smoking-related variables and smoking-cessation outcomes. To date, research has not examined the interaction between AS and treatment completion on smoking-cessation outcomes over time. This study aims to examine the main and the interactive effects of treatment completion and AS (total score and specific dimensions) on smoking-cessation outcomes at 3-, 6-, and 12-month follow-ups. METHOD The sample consisted of 210 smokers enrolled in an eight-session smoking-cessation cognitive-behavioral treatment (62.1% women; Mage = 45.2, SD = 11.0). Participants were classified as completers (attended the eight treatment sessions) and non-completers (attended ≤ 7 sessions). Abstinence was biochemically confirmed. RESULTS Main effects indicated that completers had a higher likelihood of being abstinent over time when compared to non-completers. Regarding AS, those with greater AS-Physical Concerns had lower abstinence rates. Besides, a significant interaction between treatment completion, time and AS-Physical Concerns was found. Particularly, completers with greater AS-Physical Concerns had a higher likelihood of being abstainers than non-completers over time, while no significant differences were found for those with lower AS-Physical Concerns. CONCLUSION These data highlight the relevance of AS-Physical levels and smoking-cessation treatment completion on abstinence outcomes over time among treatment-seeking smokers.
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Affiliation(s)
- Carmela Martínez-Vispo
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain.
| | - Ana López-Durán
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain
| | - Rubén Rodríguez-Cano
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain
| | - Elisardo Becoña
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain
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4
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Alghzawi H, Trinkoff A, Zhu S, Storr C. Remission from nicotine dependence among people with severe mental illness who received help/services for tobacco/nicotine use. Int J Methods Psychiatr Res 2020; 29:1-11. [PMID: 32945054 PMCID: PMC7723218 DOI: 10.1002/mpr.1845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES A growing body of evidence supports pharmacological interventions to assist smoking cessation in people with severe mental illness (SMI); that is, lifetime major depressive disorder, bipolar disorders, or schizophrenia. Little is known about whether behavioral services are also associated with high probability of remission from nicotine dependence as compared to other types of help/services received (pharmacological, behavioral, or both). METHODS A sample of 726 American lifetime adult smokers with SMI and a history of nicotine dependence, who received help/services for tobacco/nicotine use, were identified. These data came from a limited public use dataset, the 2012-2013 NESARC-III. Survival analysis was used to compare the probability of remission from nicotine dependence and the time needed for full remission from nicotine dependence by type of help/services received for tobacco/nicotine use. RESULTS Remission was more frequent among those who received behavioral services. In addition, the average time from onset of nicotine dependence until full remission from nicotine dependence was shorter among those who received behavioral services. CONCLUSIONS The current study suggests a clinical need for behavioral interventions to promote the probability of remission from nicotine dependence among smokers with SMI. Health care providers could play a role in educating and encouraging smokers with SMI to seek and utilize behavioral services.
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Affiliation(s)
- Hamzah Alghzawi
- Department of Family and Community Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
| | - Alison Trinkoff
- Department of Family and Community Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
| | - Shijun Zhu
- Department of Organizational Systems and Adult Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
| | - Carla Storr
- Department of Family and Community Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
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5
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van Straaten B, Meerkerk GJ, van den Brand FA, Lucas P, de Wit N, Nagelhout GE. How can vulnerable groups be recruited to participate in a community-based smoking cessation program and perceptions of effective elements: A qualitative study among participants and professionals. Tob Prev Cessat 2020; 6:64. [PMID: 33241164 PMCID: PMC7682486 DOI: 10.18332/tpc/128269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/30/2020] [Accepted: 10/08/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smokers from vulnerable groups, such as smokers with a low socioeconomic position, often have more difficulty quitting smoking and often are more difficult to recruit for smoking cessation programs. It is important to know how vulnerable groups can be recruited and motivated to participate in a smoking cessation program and what participants and professionals perceive as effective elements. METHODS Qualitative interviews were performed with participants of a communitybased smoking cessation program in the Netherlands (n=18) and professionals involved in the recruitment of participants or as trainers in the community-based smoking cessation program (n=8). They were interviewed twice: once before the program had started and once after the program had ended. Interviews were semi-structured and conducted between September 2018 and February 2019. RESULTS We found that organizing the program in the neighborhood lowered the threshold to participate, that registration should be quick and easy, that an active approach is needed, and that personal contact is important. This study also showed that information sharing, social support, commitment of the trainer, and personal contact are perceived as effective elements of such a program. CONCLUSIONS This study shows that vulnerable smokers can be successfully recruited for a smoking cessation program. We recommend that such interventions include a group setting, extensive personal contact between participants and a committed trainer, and implementation of the program at a location in the neighborhood of the target group. Practical recommendations for professionals are to personally approach people multiple times if needed, to make sure that registration is quick and easy, and to fill in the registration form immediately during recruitment.
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Affiliation(s)
| | | | - Floor A van den Brand
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, the Netherlands
| | - Pamela Lucas
- Amsterdam Research Institute for Societal Innovation, Research group Urban Social Work/ Research group Poverty Interventions Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | | | - Gera E Nagelhout
- IVO Research Institute, The Hague, the Netherlands.,Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands
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Kathuria H, Koppelman E, Borrelli B, Slatore CG, Clark JA, Lasser KE, Wiener RS. Patient-Physician Discussions on Lung Cancer Screening: A Missed Teachable Moment to Promote Smoking Cessation. Nicotine Tob Res 2020; 22:431-439. [PMID: 30476209 PMCID: PMC7297104 DOI: 10.1093/ntr/nty254] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 11/21/2018] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Little is known about whether patients and physicians perceive lung cancer screening (LCS) as a teachable moment to promote smoking cessation or the degree to which physicians in "real world" settings link LCS discussions with smoking cessation counseling. We sought to characterize patient and physician perspectives of discussions about smoking cessation during LCS. METHODS We conducted a qualitative study (interviews and focus groups) with 21 physicians and 28 smokers screened in four diverse hospitals. Transcripts were analyzed for characteristics of communication about smoking cessation and LCS, the perceived effect on motivation to quit smoking, the degree to which physicians leverage LCS as a teachable moment to promote smoking cessation, and suggestions to improve patient-physician communication about smoking cessation in the context of LCS. RESULTS Patients reported that LCS made them more cognizant of the health consequences of smoking, priming them for a teachable moment. While physicians and patients both acknowledged that smoking cessation counseling was frequent, they described little connection between their discussions regarding LCS and smoking cessation counseling. Physicians identified several barriers to integrating discussions on smoking cessation and LCS. They volunteered communication strategies by which LCS could be leveraged to promote smoking cessation. CONCLUSIONS LCS highlights the harms of smoking to patients who are chronic, heavy smokers and thus may serve as a teachable moment for promoting smoking cessation. However, this opportunity is typically missed in clinical practice. IMPLICATIONS LCS highlights the harms of smoking to heavily addicted smokers. Yet both physicians and patients reported little connection between LCS and tobacco treatment discussions due to multiple barriers. On-site tobacco treatment programs and post-screening messaging tailored to the LCS results are needed to maximize the health outcomes of LCS, including smoking quit rates and longer-term smoking-related morbidity and mortality.
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Affiliation(s)
- Hasmeena Kathuria
- The Pulmonary Center, Boston University School of Medicine, Boston, MA
| | - Elisa Koppelman
- Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, Bedford, MA
- Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Belinda Borrelli
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR
| | - Jack A Clark
- Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, Bedford, MA
- Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Karen E Lasser
- Section of General Internal Medicine, Boston Medical Center, Boston, MA
- Community Health Sciences, Boston University School of Public Health, Boston, MA
| | - Renda Soylemez Wiener
- The Pulmonary Center, Boston University School of Medicine, Boston, MA
- Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, Bedford, MA
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7
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Cupertino AP, Cartujano-Barrera F, Basile Colugnati FA, Batista Formagini TD, Garcia de Siqueira Galil A, Ferreira Carvalho Banhato E, Ferreira MA, Richter KP. Web-based decision-making tool for smoking cessation (Pare de fumar conosco) among patients with chronic conditions in Brazil : one-arm feasibility study. BMJ Health Care Inform 2020; 27:e100063. [PMID: 31915181 PMCID: PMC7062353 DOI: 10.1136/bmjhci-2019-100063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/07/2019] [Accepted: 12/18/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To assess the feasibility of Pare de fumar conosco, a web-based smoking cessation decision-making tool, among patients with chronic conditions in Brazil. METHODS We recruited 85 Brazilian smokers in two clinical centres for chronic conditions to complete Pare de fumar conosco. Outcome measures included interest in using smoking cessation resources and self-reported 7-day point prevalence abstinence 12 weeks following the intervention. RESULTS The average age of participants was 54.2 years old (SD=10.5) and 77.9% had not completed high school. All participants were daily smokers and the majority smoked ≥11 cigarettes per day (63.5%). Pre-post intervention interest in using pharmacotherapy and group counselling significantly increased (82.4% vs 22.4%, p≤0.0001; and 85.9% vs 21.2%, p≤0.0001, respectively). At 12 weeks, eight participants (9.4%) reported 7-day point prevalence abstinence using intention-to-treat analysis (35.2% follow-up rate). CONCLUSION The Pare de fumar conosco smoking cessation web-based tool significantly increased interest in pharmacotherapy and behavioural counselling. Additional testing as a formal randomised clinical trial appears warranted.
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Affiliation(s)
- Ana Paula Cupertino
- Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | | | | | | | | | | | | | - Kimber P Richter
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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8
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Estreet A, Apata J, Kamangar F, Schutzman C, Buccheri J, O'Keefe AM, Wagner F, Sheikhattari P. Improving Participants' Retention in a Smoking Cessation Intervention Using a Community-based Participatory Research Approach. Int J Prev Med 2018; 8:106. [PMID: 29416835 PMCID: PMC5760842 DOI: 10.4103/ijpvm.ijpvm_303_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/17/2017] [Indexed: 01/11/2023] Open
Abstract
Background This study compares participant' sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings. Methods Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking (n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence. Results Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8). Conclusions Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners.
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Affiliation(s)
- Anthony Estreet
- Master of Social Work Program, School of Social Work, Morgan State University, Baltimore, MD, USA
| | - Jummai Apata
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA.,Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Farin Kamangar
- ASCEND Center for Biomedical Research, Morgan State University, Baltimore, MD, USA.,Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Morgan State University, Baltimore, MD, USA
| | - Christine Schutzman
- CEASE Partnership, Fusion Incorporated, Morgan State University, Baltimore, MD, USA
| | - Jane Buccheri
- CEASE Partnership, Fusion Incorporated, Morgan State University, Baltimore, MD, USA
| | - Anne-Marie O'Keefe
- Department of Health Policy and Managment, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Fernando Wagner
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Payam Sheikhattari
- Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA.,ASCEND Center for Biomedical Research, Morgan State University, Baltimore, MD, USA.,Department of Behavioral Health Sciences, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
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9
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Hanlon C, Morris T, O’Sullivan GA. Participant perceptions of an individualised physical activity anti-smoking intervention. HEALTH EDUCATION 2018. [DOI: 10.1108/he-05-2017-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore a health program comprising the individual experiences, successes and setbacks of adults in an individually tailored, community-based smoking intervention and physical activity program. The program incorporated physical activity consultation (PAC) and phone support from the well-established Quit smoking cessation program, and in partnership with Melton City Council, Victoria, Australia.
Design/methodology/approach
Expert facilitators in PAC led the intervention. The program was titled “ActivePlus” and the intervention was conducted for eight weeks. Post-program facilitator guidance continued for three weeks and follow-up on participants was conducted at week 24. Five participants continued to week 24 and were interviewed. Three case descriptions were chosen as a sample to analyse using descriptive content analysis to illustrate the range of experiences, successes and setbacks reported by these individual participants.
Findings
Smoking reduction/cessation results varied among cases, but increases in PA were sustained. Participants valued the expert support of PAC facilitators, though usage and appraisal of Quit telephone smoking cessation services was mixed. The individually tailored PAC was valued by participants, who felt it also contributed to their smoking reduction/cessation goals.
Practical implications
In future, the intervention would benefit from the same ongoing support in smoking cessation as the PAC. Practitioners should consider the benefit of including PAC in smoking cessation interventions. However, such interventions should be individually tailored and include facilitation by a PAC and a smoking cessation expert.
Originality/value
Few studies have looked at completely individualised smoking cessation interventions using PAC. The current study also addresses the recommendations of previous research to investigate the use of more intense PA intervention supported by expert PAC facilitation.
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10
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Travaglini LE, Li L, Brown CH, Bennett ME. Predictors of smoking cessation group treatment engagement among veterans with serious mental illness. Addict Behav 2017; 75:103-107. [PMID: 28728038 PMCID: PMC5616105 DOI: 10.1016/j.addbeh.2017.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 06/29/2017] [Accepted: 07/08/2017] [Indexed: 12/31/2022]
Abstract
High prevalence rates of tobacco use, particularly cigarettes, pose a serious health threat for individuals with serious mental illness (SMI), and research has demonstrated the effectiveness of pharmacotherapy and psychosocial interventions to reduce tobacco use in this group. However, few studies have considered predictors of tobacco cessation treatment engagement among individuals with SMI. The current study examined predictors of engagement in smoking cessation groups among veterans with SMI engaged in mental health services at three VA medical centers. All veterans were participating in a smoking cessation treatment study. Of 178 veterans who completed baseline assessments, 127 (83.6%) engaged in treatment, defined as attending at least three group sessions. Forty-one (N=41) predictors across five domains (demographics, psychiatric concerns, medical concerns, smoking history, and self-efficacy to quit smoking) were identified based on previous research and clinical expertise. Using backward elimination to determine a final multivariable logistic regression model, three predictors were found to be significantly related to treatment engagement: marital status (never-married individuals more likely to engage); previous engagement in group smoking cessation services; and greater severity of positive symptoms on the Brief Psychiatric Rating Scale. When included in the multivariable logistic regression model, the full model discriminates between engagers and non-engagers reasonably well (c statistic=0.73). Major considerations based on these findings are: individuals with SMI appear to be interested in smoking cessation services; and serious psychiatric symptomatology should not discourage treatment providers from encouraging engagement in smoking cessation services.
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Affiliation(s)
- Letitia E Travaglini
- VA Capital Healthcare Network Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD 21201, United States; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States.
| | - Lan Li
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States.
| | - Clayton H Brown
- VA Capital Healthcare Network Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD 21201, United States; Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, United States.
| | - Melanie E Bennett
- VA Capital Healthcare Network Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD 21201, United States; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States.
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Kathuria H, Detterbeck FC, Fathi JT, Fennig K, Gould MK, Jolicoeur DG, Land SR, Massetti GM, Mazzone PJ, Silvestri GA, Slatore CG, Smith RA, Vachani A, Zeliadt SB, Wiener RS. Stakeholder Research Priorities for Smoking Cessation Interventions within Lung Cancer Screening Programs. An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2017; 196:1202-1212. [PMID: 29090963 DOI: 10.1164/rccm.201709-1858st] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
RATIONALE Smoking cessation counseling in conjunction with low-dose computed tomography (LDCT) lung cancer screening is recommended in multiple clinical practice guidelines. The best approach for integrating effective smoking cessation interventions within this setting is unknown. OBJECTIVES To summarize evidence, identify research gaps, prioritize topics for future research, and propose standardized tools for use in conducting research on smoking cessation interventions within the LDCT lung cancer screening setting. METHODS The American Thoracic Society convened a multistakeholder committee with expertise in tobacco dependence treatment and/or LDCT screening. During an in-person meeting, evidence was reviewed, research gaps were identified, and key questions were generated for each of three research domains: (1) target population to study; (2) adaptation, development, and testing of interventions; and (3) implementation of interventions with demonstrated efficacy. We also identified standardized measures for use in conducting this research. A larger stakeholder panel then ranked research questions by perceived importance in an online survey. Final prioritization was generated hierarchically on the basis of average rank assigned. RESULTS There was little consensus on which questions within the population domain were of highest priority. Within the intervention domain, research to evaluate the effectiveness in the lung cancer screening setting of evidence-based smoking cessation interventions shown to be effective in other contexts was ranked highest. In the implementation domain, stakeholders prioritized understanding strategies to identify and overcome barriers to integrating smoking cessation in lung cancer screening settings. CONCLUSIONS This statement offers an agenda to stimulate research surrounding the integration and implementation of smoking cessation interventions with LDCT lung cancer screening.
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Wu V, Abo-Sido N, Espinola JA, Tierney CN, Tedesco KT, Sullivan AF, Camargo CA. Predictors of successful telephone follow-up in a multicenter study of infants with severe bronchiolitis. Ann Epidemiol 2017. [PMID: 28645568 DOI: 10.1016/j.annepidem.2017.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To identify the characteristics that predict successful telephone follow-up with parents of infants with severe bronchiolitis. METHODS We analyzed data from a 17-center, prospective cohort study of infants (age <1 year) hospitalized with bronchiolitis during three consecutive fall/winter seasons. Participant contact information and clinical data were collected during the index hospitalization. Parents were called at 6-month intervals (based on the child's age) after discharge to assess respiratory problems. The primary outcome was age 12-month telephone interview status. Participants were classified as unreachable after 28 days of unsuccessful attempts. RESULTS 798 of 916 children (87%) completed the age 12-month telephone interview. In unadjusted analyses, factors associated with successful follow-up included: private health insurance, annual household income $60,000 or more, and residing in the Northeast, Midwest, or West. Follow-up was less common among non-Hispanic blacks, Hispanics, and households with 3 or more children. In multivariable analyses, follow-up was more likely among parents of females, and, compared with the South, in the Northeast and Midwest (all P < .05). Compared with non-Hispanic whites, non-Hispanic blacks and Hispanics remained less likely to complete the interview as did households with 3 or more children (all P < .05). CONCLUSION Sociodemographic and geographic factors predict successful telephone follow-up, even among parents of infants with severe illness.
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Affiliation(s)
| | | | - Janice A Espinola
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Courtney N Tierney
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Ashley F Sullivan
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Carlos A Camargo
- Harvard Medical School, Boston, MA; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
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Austin AW, Pelletier R, Pilote L, Rabi DM. Factors associated with study completion in patients with premature acute coronary syndrome. PLoS One 2017; 12:e0173594. [PMID: 28301532 PMCID: PMC5354376 DOI: 10.1371/journal.pone.0173594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 02/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Factors associated with study completion in younger adults are not well understood. This study sought to describe psychosocial, clinical, and demographic features associated with completion of a study of men and women with premature acute coronary syndrome. METHODS As part of the GENdEr and Sex determInantS of cardiovascular disease: From bench to beyond-Premature Acute Coronary Syndrome (GENESIS-PRAXY) study, demographic, psychosocial, and clinical variables were assessed in 1213 patients hospitalized for acute coronary syndrome (≤ 55 years; 30% women). Patients were followed for 12 months. Dropouts withdrew from the study or were lost to follow-up after 12 months; completers were still enrolled after 12 months. RESULTS Of 1213 patients initially enrolled, 777 (64.1%) completed 12-month follow-up. Fully adjusted models suggested that being older (OR = 1.04, 95% CI [1.01, 1.06]), higher subjective social status within one's country (OR = 1.11, 95% CI [1.01, 1.22]), being free of type II diabetes, (OR = 0.66, 95% CI [0.45, 0.97]), non-smoking status (OR = 0.70, 95% CI [0.51, 0.95]) and being free of depression (OR = 1.52, 95% CI [1.11, 2.07]) were independently associated with study completion. CONCLUSIONS Recruitment/retention strategies targeting individuals who smoke, are younger, have low subjective social status within one's country, have diabetes, or have depression may improve participant follow-up in cardiovascular cohort studies.
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Affiliation(s)
- Anthony W. Austin
- Department of Social and Behavioral Sciences, University of Arkansas at Pine Bluff, Pine Bluff, Arkansas, United States of America
| | - Roxanne Pelletier
- Centre de psychologie Au fil des maux, Mont-Saint-Hilaire, Quebec, Canada
| | - Louise Pilote
- Divisions of General Internal Medicine and Clinical Epidemiology, McGill University Health Centre, Montréal, Quebec, Canada
| | - Doreen M. Rabi
- Departments of Medicine, Community Health and Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
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Courtney RJ, Clare P, Boland V, Martire KA, Bonevski B, Hall W, Siahpush M, Borland R, Doran CM, West R, Farrell M, Mattick RP. Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers. Addict Behav 2017; 64:13-20. [PMID: 27533077 DOI: 10.1016/j.addbeh.2016.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/20/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Little is known about the factors associated with retention in smoking cessation trials, especially for low-socioeconomic status (low-SES) smokers. This study examined the factors associated with retention of low-SES smokers in the Australian Financial Interventions for Smoking Cessation Among Low-Income Smokers (FISCALS) trial. DESIGN A two-group parallel block randomised open-label trial with allocation concealment. SETTING Australia. The study was conducted primarily by telephone-based interviews with nicotine replacement therapy delivered via mail. PARTICIPANTS 1047 low-SES smokers interested in quitting smoking were randomised. MEASUREMENTS Participants completed computer assisted telephone interviews (CATIs) at baseline, 2-month and 8-month follow-up. Smoking-related, substance use, mental or physical health, general psychological constructs, sociodemographic and recruitment sources association with retention at 8-month follow-up were examined using binary logistic regression. FINDINGS 946 participants (90%) completed the 2-month follow-up interview and 880 participants (84%) completed the 8-month follow-up interview. Retention at 8-months was associated with higher motivation to quit (OR: 1.15; 95% CI: 1.04, 1.27 p<0.01), more recent quit attempts (OR: 1.20; 95% CI: 1.04, 1.40 p<0.05), increasing age (OR: 1.05; 95% CI: 1.03, 1.07 p<0.01), and higher level of education (OR: 2.24; 95% CI: 1.45, 3.46 p<0.01). Lower retention at 8-months occurred for those participants recruited from posters placed in Department of Human Service Centrelink Offices (OR: 0.56; 95% CI: 0.35, 0.89, p<0.05) compared to participants recruited from Quitline services. No significant differences in retention were found for participants recruited via newspaper advertisements or word of mouth compared to Quitline services. No significant associations were found between health-related or behavioural factors and retention. CONCLUSIONS In the context of high overall retention rates from disadvantaged smokers in a randomised trial, retention was greater in those smokers with higher motivation to quit, more recent quit attempts, increased age, higher level of education and for those recruited through Quitline or newspaper advertisements.
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Affiliation(s)
- Ryan J Courtney
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia.
| | - Philip Clare
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Veronica Boland
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Kristy A Martire
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia; School of Psychology, UNSW, Australia. http://orcid.org/0000-0002-5324-0732
| | - Billie Bonevski
- School of Medicine & Public Health, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Wayne Hall
- Centre for Clinical Research, University of Queensland, Australia
| | - Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Center, United States
| | - Ron Borland
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Australia
| | - Christopher M Doran
- School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Australia
| | - Robert West
- UCL Department of Epidemiology & Public Health, University College London, UK
| | - Michael Farrell
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
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Zeng EY, Vilardaga R, Heffner JL, Mull KE, Bricker JB. Predictors of Utilization of a Novel Smoking Cessation Smartphone App. Telemed J E Health 2015; 21:998-1004. [PMID: 26171733 DOI: 10.1089/tmj.2014.0232] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Understanding the characteristics of high and low utilizers of smartphone applications (apps) for smoking cessation would inform development of more engaging and effective apps, yet no studies to date have addressed this critical question. Informed by prior research on predictors of cessation Web site utilization, this study examines the degree to which baseline demographic factors (gender, age, and education), smoking-related factors (smoking level and friends' smoking), and psychological factors (depression and anxiety) are predictive of utilization of a smartphone app for smoking cessation called SmartQuit. MATERIALS AND METHODS Data came from 98 participants randomized to SmartQuit as part of a pilot trial from March to May 2013. We used negative binomial count regressions to examine the relationship between user characteristics and utilization of the app over an 8-week treatment period. RESULTS Lower education (risk ratio [RR]=0.492; p=0.021), heavier smoking (RR=0.613; p=0.033), and depression (RR=0.958; p=0.017) prospectively predicted lower app utilization. Women (RR=0.320; p=0.022), those with lower education (RR=0.491; p=0.013), and heavier smokers (RR=0.418; p=0.039) had lower utilization of app features known to predict smoking cessation. CONCLUSIONS Many of the predictors of utilization of smoking cessation apps are the same as those of cessation Web sites. App-delivered smoking cessation treatment effectiveness could be enhanced by focusing on increasing engagement of women, those with lower education, heavy smokers, and those with current depressive symptoms.
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Affiliation(s)
- Emily Y Zeng
- 1 Department of Psychology, University of Washington , Seattle, Washington.,2 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, Washington
| | - Roger Vilardaga
- 2 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, Washington.,3 Department of Psychiatry and Behavioral Sciences, University of Washington , Seattle, Washington
| | - Jaimee L Heffner
- 2 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, Washington
| | - Kristin E Mull
- 2 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, Washington
| | - Jonathan B Bricker
- 1 Department of Psychology, University of Washington , Seattle, Washington.,2 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, Washington
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Leyro TM, Hendricks PS, Hall SM. If at first you don't succeed: characterization of smokers with late smoking abstinence onset. Addict Behav 2015; 45:34-8. [PMID: 25637886 DOI: 10.1016/j.addbeh.2015.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/24/2014] [Accepted: 01/12/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Most cigarette smoking cessation research has aimed to clarify characteristics associated with initial and sustained abstinence, with less attention paid to predictors of gaining abstinence following an initial failure. METHODS The current investigation explored pre-treatment demographic, smoking, and psychiatric characteristics related to gaining abstinence among smokers who failed to attain initial abstinence. Participants were 809 individuals enrolled in extended, 52-week, smoking cessation interventions. Of these, 287 (62.4%) failed to achieve initial abstinence. Gaining abstinence following initial abstinence failure was defined as achieving seven-day point prevalent abstinence at any post-initial abstinence assessment. RESULTS Those who gained abstinence (Gainers) were more likely to have a live-in partner (χ(2)(1, N=283)=3.8, p=.05, Cramér's V=.12), identify as Hispanic (χ(2)(1, N=281)=7.8, p<.01, Cramér's V=.17), evidence lower baseline expired breath carbon monoxide (F(1, 284)=5.7, p=.02, η(2)=.02), report less cigarette dependence (F(1, 278)=7.1, p<.01, η(2)=.03), and report past week cannabis use (χ(2)(1, N=284)=5.6, p=.02, Cramér's V=.14). A logistic regression model suggested that having a live-in partner (OR=5.14, 95% CI=1.09-3.02, p=.02) and identifying as Hispanic (OR=4.93, 95% CI=1.20-18.77, p=.03) increased the odds of gaining abstinence. DISCUSSION Having a live-in partner, Hispanic status, greater cigarette dependence, and recent cannabis use were associated with gaining abstinence. These findings provide insight into an understudied area, contributing an initial framework toward understanding gaining abstinence following initial failure.
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Affiliation(s)
- Teresa M Leyro
- Department of Psychology, Rutgers University, 53 Avenue E., Piscataway, NJ 07030, USA.
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA.
| | - Sharon M Hall
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
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Richards CM, Sharif F, Eischen S, Thomas J, Wang Q, Guo H, Luo X, Okuyemi K. Retention of Homeless Smokers in the Power to Quit Study. Nicotine Tob Res 2014; 17:1104-11. [PMID: 25301816 DOI: 10.1093/ntr/ntu210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 09/26/2014] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Concerns about retention are a major barrier to conducting studies enrolling homeless individuals. Since smoking is a major problem in homeless communities and research on effective methods of promoting smoking cessation is needed, we describe strategies used to increase retention and participant characteristics associated with retention in smoking cessation study enrolling homeless adults. METHODS The parent study was a 2-group randomized controlled trial with 26-week follow-up enrolling 430 homeless smokers from emergency shelters and transitional housing units in Minneapolis/Saint Paul, MN, USA. Multiple strategies were used to increase retention, including conducting visits at convenient locations for participants, collecting several forms of contact information from participants, using a schedule that was flexible and included frequent low-intensity visits, and providing incentives. Participant demographics as well as characteristics related to tobacco and drug use and health status were analyzed for associations with retention using univariate and multivariate analysis. RESULTS Overall retention was 75% at 26 weeks. Factors associated with increased retention included greater age; having healthcare coverage; history of multiple homeless episodes, lower stress level; and higher PHQ-9 (Patient Health Questionnaire-9) score. A history of excessive drinking and drug use were associated with decreased retention. CONCLUSIONS It is possible to successfully retain homeless individuals in a smoking cessation study if the study is designed with participants' needs in mind.
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Affiliation(s)
- Christina M Richards
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN; Program in Health Disparities Research, University of Minnesota, Minneapolis, MN
| | - Faduma Sharif
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN; Program in Health Disparities Research, University of Minnesota, Minneapolis, MN
| | - Sara Eischen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN; Program in Health Disparities Research, University of Minnesota, Minneapolis, MN
| | | | - Qi Wang
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Hongfei Guo
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Xianghua Luo
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Kolawole Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN; Program in Health Disparities Research, University of Minnesota, Minneapolis, MN; Center for Health Equity, University of Minnesota, Minneapolis, MN; Masonic Cancer Center, University of Minnesota, Minneapolis, MN;
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Benson FE, Stronks K, Willemsen MC, Bogaerts NMM, Nierkens V. Wanting to attend isn't just wanting to quit: why some disadvantaged smokers regularly attend smoking cessation behavioural therapy while others do not: a qualitative study. BMC Public Health 2014; 14:695. [PMID: 25002149 PMCID: PMC4105168 DOI: 10.1186/1471-2458-14-695] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/26/2014] [Indexed: 11/27/2022] Open
Abstract
Background Attendance of a behavioural support programme facilitates smoking cessation. Disadvantaged smokers have been shown to attend less than their more affluent peers. We need to gain in-depth insight into underlying reasons for differing attendance behaviour in disadvantaged smokers, to better address this issue. This study aims to explore the underlying motivations, barriers and social support of smokers exhibiting different patterns of attendance at a free smoking cessation behavioural support programme in a disadvantaged neighbourhood of The Netherlands. Methods In 29 smokers undertaking smoking cessation group therapy or telephone counselling in a disadvantaged neighbourhood, qualitative interviews were completed, coded and analysed. Major themes were motivations, barriers to attend and social support. Motivations and social support were analysed with reference to the self-determination theory. Results Two distinct patterns of attendance emerged: those who missed up to two sessions (“frequent attenders”), and those who missed more than two sessions (“infrequent attenders”). The groups differed in their motivations to attend, barriers to attendance, and in the level of social support they received. In comparison with the infrequent attenders, frequent attenders more often had intrinsic motivation to attend (e.g. enjoyed attending), and named more self-determined extrinsic motivations to attend, such as commitment to attendance and wanting to quit. Most of those mentioning intrinsic motivation did not mention a desire to quit as a motivation for attendance. No organizational barriers to attendance were mentioned by frequent attenders, such as misunderstandings around details of appointments. Frequent attenders experienced more social support within and outside the course. Conclusion Motivation to attend behavioural support, as distinct from motivation to quit smoking, is an important factor in attendance of smoking cessation courses in disadvantaged areas. Some focus on increasing motivation to attend may help to prevent participants missing sessions.
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Affiliation(s)
- Fiona E Benson
- Department Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
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Coutinho MT, Koinis-Mitchell D, Kopel SJ, Romero-Bosch L, Lobato D, McQuaid EL, Seifer R, Fritz GK, Canino G. Factors associated with recruitment and retention of diverse children with asthma. CHILDRENS HEALTH CARE 2014; 43:132-150. [PMID: 25013244 PMCID: PMC4084850 DOI: 10.1080/02739615.2013.837821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examines factors associated with recruitment and retention of Latino, Dominican (DR) and mainland Puerto Rican (PR), and non-Latino white (NLW) families into a pediatric asthma study. Over eleven hundred (n=1185) families were screened, and 489 (n= 174 NLW, n= 160 DR, n= 155 PR) were enrolled. Rates of recruitment by source of recruitment and rates of retention differed by ethnic group. Families whose caregiver had never married had lower odds of completing the study. The findings highlight the need for further study to examine the effectiveness of specific recruitment and retention strategies with Latino and non-Latino white families.
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Affiliation(s)
- Maria Teresa Coutinho
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Daphne Koinis-Mitchell
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sheryl J Kopel
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Lilia Romero-Bosch
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Debra Lobato
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elizabeth L McQuaid
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Ronald Seifer
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Gregory K Fritz
- Bradley/Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
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Meneses K, Azuero A, Su X, Benz R, McNees P. Predictors of attrition among rural breast cancer survivors. Res Nurs Health 2013; 37:21-31. [PMID: 24338864 DOI: 10.1002/nur.21576] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2013] [Indexed: 11/06/2022]
Abstract
Attrition can jeopardize both internal and external validity. The goal of this secondary analysis was to examine predictors of attrition using baseline data of 432 participants in the Rural Breast Cancer Survivors study. Attrition predictors were conceptualized based on demographic, social, cancer treatment, physical health, and mental health characteristics. Baseline measures were selected using this conceptualization. Bivariate tests of association, discrete-time Cox regression models and recursive partitioning techniques were used in analysis. Results showed that 100 participants (23%) dropped out by Month 12. Non-linear tree analyses showed that poor mental health and lack of health insurance were significant predictors of attrition. Findings contribute to future research efforts to reduce research attrition among rural underserved populations.
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Affiliation(s)
- Karen Meneses
- School of Nursing, University of Alabama, Birmingham, AL
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Mak KK, Ho SY, Day JR. A Review of Life-Course Familial and Lifestyle Factors of Smoking Initiation and Cessation. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0341-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gallus S, Ghislandi S, Muttarak R. Effects of the economic crisis on smoking prevalence and number of smokers in the USA. Tob Control 2013; 24:82-8. [PMID: 23956058 DOI: 10.1136/tobaccocontrol-2012-050856] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Scanty and controversial information is available on the impact of macroeconomic fluctuations on smoking behaviour. No study has quantified the effects of fiscal crises on smoking prevalence. This study aimed to investigate the effects of the 2007-2008 economic crisis on smoking prevalence and number of smokers in the USA. METHODS Using data from the repeated Behavioural Risk Factor Surveillance System (BRFSS) surveys in pre-crisis (2005-2007) and post-crisis (2009-2010) periods on a total of 1,981,607 US adults, we separated the expected (after allowance for the demographic growth of the US population, secular smoking prevalence trends and changes in sociodemographic characteristics) from the unexpected (assumed attributable to the economic crisis) changes in the number of smokers across different employment statuses. RESULTS Joinpoint regression analysis revealed no significant changes in smoking prevalence trends over the period 2005-2010. The crisis resulted in an increase in the number of smokers in the US by 0.6 million. This is largely due to an unexpected decrease of 1.7 million smokers among employed and an increase of 2.4 million smokers among unemployed individuals, whose smoking prevalence also remains extremely high in the post-crisis period (32.6%). CONCLUSIONS The 2008 financial crisis had a weak effect on smoking prevalence. The pro-cyclical relationship (ie, the crisis results in a lower number of smokers) found among the employed is offset by the counter-cyclical relationship (ie, the crisis results in a higher number of smokers) found among unemployed individuals. Public health interventions should specifically target those in unemployment, particularly in hard times.
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Affiliation(s)
- Silvano Gallus
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Simone Ghislandi
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy ECONPUBBLICA, Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy
| | - Raya Muttarak
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna Institute of Demography/Austrian Academy of Sciences, Vienna, Austria
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Participant- and study-related characteristics predicting treatment completion and study retention in an adolescent smoking cessation trial. J Adolesc Health 2011; 49:371-8. [PMID: 21939867 DOI: 10.1016/j.jadohealth.2011.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 01/22/2011] [Accepted: 01/24/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine which factors predict smoking cessation treatment completion and retention among adolescents. METHODS In a multisite, randomized, controlled trial, the efficacy of motivational interviewing was compared with structured brief advice for smoking cessation and reduction in adolescents (n = 355) aged 14-18 years (55% female, 45% black, 12% Hispanic). Treatment spanned 12 weeks, with follow-up assessments at 24 weeks. Treatment completion was defined as completion of all five counseling sessions. Study retention was defined as completing the 24-week assessment. Participant and study variables served as predictors of treatment completion and retention. RESULTS In all, 79% of participants completed all five counseling sessions and the same percent completed the 24-week assessment. Black race, precontemplation stage to cut back, and shorter length of time between the baseline assessment and the first counseling session were significantly associated with treatment completion. For every 7.5-day delay in starting treatment after the baseline visit, there was a 50% decrease in the odds of completing all five treatment sessions. Retention at 24 weeks was predicted by black race, younger age, greater maternal education, expectations of graduating college, and structured brief advice intervention. CONCLUSIONS High rates of treatment completion and study retention can be achieved in a multisession, behavioral intervention for adolescent smoking cessation. Findings suggest that treatment should begin soon after the intake session to maximize treatment completion. Enhanced efforts to retain older adolescents and youth with lower academic goals and lower family income will be important in future studies.
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Borrelli B, Hayes RB, Gregor K, Lee CS, McQuaid EL. Differences in smoking behavior and attitudes among Puerto Rican, Dominican, and non-Latino white caregivers of children with asthma. Am J Health Promot 2011; 25:S91-5. [PMID: 21510794 DOI: 10.4278/ajhp.100624-arb-214] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE No studies have examined the differences in smoking attitudes and behavior between Dominicans (DRs) and Puerto Ricans (PRs). Identification of pretreatment differences is important for cultural adaptation of evidenced-based smoking cessation treatments. DESIGN Secondary analysis. SETTING/INTERVENTION: Three home visits for asthma education and smoking cessation. SUBJECTS Caregivers who smoke and have a child with asthma: DRs (n = 30), PRs (n = 67), and non-Latino whites (n = 128; NLWs). MEASURES Baseline assessment of psychosocial variables. ANALYSES Controlled for age, education, and acculturation. RESULTS Compared with DRs, PRs were more acculturated, more nicotine dependent, less motivated and confident to quit, and identified more pros of smoking (all p < .05). Compared with NLWs, PRs were less likely to be employed, smoked fewer cigarettes per day, and had lower education, greater depressed mood, greater pros and cons of smoking, less social support, and higher child asthma morbidity (all p < .05). Compared with NLWs, DRs were less nicotine dependent, more confident to quit, and less likely to live with a smoker; reported greater cons of smoking and greater stress; and were more likely to have a household smoking ban (DRs 60% vs. NLWs 33.6%). Only 3.3% of DRs were precontemplators vs. 16.4% (PRs) and 10.9% (NLWs). CONCLUSIONS PRs appear to have more factors associated with risk of smoking treatment failure; DRs appear to have more protective factors. Examination of the role of these smoking attitudes as potential moderators and mediators of smoking behavior are needed to guide the cultural adaptation of evidenced-based treatments.
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Affiliation(s)
- Belinda Borrelli
- Centers for Behavioral and Preventive Medicine, Miriam Hospital, Brown Medical School, Providence, Rhode Island 02903, USA.
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