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Goldgof GM, Mishra S, Bajaj K. Efficacy of the QuitSure App for Smoking Cessation in Adult Smokers: Cross-Sectional Web Survey. JMIR Hum Factors 2024; 11:e49519. [PMID: 38709553 PMCID: PMC11106700 DOI: 10.2196/49519] [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: 05/31/2023] [Revised: 11/28/2023] [Accepted: 02/28/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Cigarette smoking remains one of the leading causes of preventable death worldwide. A worldwide study by the World Health Organization concluded that more than 8 million people die every year from smoking, tobacco consumption, and secondhand smoke. The most effective tobacco cessation programs require personalized human intervention combined with costly pharmaceutical supplementation, making them unaffordable or inaccessible to most tobacco users. Thus, digital interventions offer a promising alternative to these traditional methods. However, the leading smartphone apps available in the market today have either not been studied in a clinical setting or are unable to match the smoking cessation success rates of their expensive offline counterparts. We would like to understand whether QuitSure, a novel smoking cessation app built by Rapidkart Online Private Limited, is able to bridge this efficacy gap and deliver affordable and effective smoking cessation at scale. OBJECTIVE Our objective was to do an initial exploration into the engagement, efficacy, and safety of QuitSure based on the self-reported experiences of its users. Outcomes measured were program completion, the effect of program completion on smoking behavior, including self-reported cessation outcomes, and negative health events from using the app. METHODS All QuitSure registered users who created their accounts on the QuitSure app between April 1, 2021, and February 28, 2022, were sent an anonymized web-based survey. The survey results were added to their engagement data on the app to evaluate the feasibility and efficacy of the app as a smoking cessation intervention. The data were analyzed using descriptive statistics (frequencies and percentages) and the χ2 test of independence. RESULTS In total, 1299 users who had completed the QuitSure program submitted the survey and satisfied the inclusion criteria of the study. Of these, 1286 participants had completed the program more than 30 days before filling out the survey, and 1040 (80.1%, 95% CI 79.1%-82.6%) of them had maintained prolonged abstinence for at least 30 days after program completion. A majority of participants (770/891, 86.4%) who were still maintaining abstinence at the time of submitting the survey did not experience any severe nicotine withdrawal symptoms, while 41.9% (373/891) experienced no mild withdrawal symptoms either. Smoking quantity prior to completing the program significantly affected quit rates (P<.001), with heavy smokers (>20 cigarettes per day) having a lower 30-day prolonged abstinence rate (relative risk=0.91; 95% CI 90.0%-96.2%) compared to lighter smokers. No additional adverse events outside of known nicotine withdrawal symptoms were reported. CONCLUSIONS The nature of web-based surveys and cohort selection allows for extensive unknown biases. However, the efficacy rates of survey respondents who completed the program were high and provide a case for further investigation in the form of randomized controlled trials on the QuitSure tobacco cessation program.
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Affiliation(s)
- Gregory M Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Shweta Mishra
- QuitSure, Rapidkart Online Private Limited, Mumbai, India
| | - Kriti Bajaj
- QuitSure, Rapidkart Online Private Limited, Mumbai, India
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Kaasgaard DM, Sørensen MK, Christiansen RB, Breum UN, Asiamah N, Friis LBT, Hjorth P. Video consultation and treatment in the community smoking cessation therapy success rates in patients with mental illness: a randomized controlled trial. Nord J Psychiatry 2024; 78:272-280. [PMID: 38385357 DOI: 10.1080/08039488.2024.2318305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Smoking is the single factor with the highest impact on reducing life expectancy of patients with mental illness. Patients experience difficulty in participating in smoking cessation programs but are concerned about the impact of tobacco on their health and finances. Smoking cessation advice via videoconferencing might be an alternative to an ordinary in-person consultation. MATERIAL AND METHOD Randomized controlled trial with follow-up at 6 months. We included patients with diagnoses of schizophrenia and affective disorder from psychiatric outpatient clinics. Intervention 1 involved daily video consultations; intervention 2 was treatment as usual. RESULTS Seventy patients were included. For both/all groups/interventions, rates of smoking cessation were 45% and predictors for a 50% reduction in smoking were antipsychotic medication load [odds ratio (OR) 0.54; p = 0.045] and number of nicotine patches (OR 1.02; p = 0.06). Predictors for a reduction in the number of cigarettes to < 10 were antipsychotic medication load (OR 0.52; p = 0.04), number of nicotine patches (OR 1.01; p = 0.02) and number of cigarettes at baseline [OR 0.95 (p = 0.09); adjusted OR 0.94 (p = 0.02)]. Patients prevented weight gain during the cessation period. CONCLUSION The smoking cessation rate was high. One of the reasons for the high cessation rate was that the intervention was carried out by highly experienced and professionally qualified staff. In addition, we used free nicotine patches to increase the patients' motivation to quit smoking. It is very important that we introduce these results into our clinical work with the patients.
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Affiliation(s)
- Didde Marie Kaasgaard
- Psychiatric Department, Mental Health Services, Region of Southern Denmark, University Hospital of Southern Denmark, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mette Knudsgaard Sørensen
- Psychiatric Department, Mental Health Services, Region of Southern Denmark, University Hospital of Southern, Odense, Denmark
| | | | | | - Nestor Asiamah
- Division of Interdisciplinary Research and Practice, School of Health and Social Care, University of Essex, Colchester, UK
- Department of Health Promotion, Africa Centre for Epidemiology, Accra, Accra North, Ghana
| | - Lone Bülow Toft Friis
- Psychiatric Department, Mental Health Services, Region of Southern Denmark, University Hospital of Southern, Odense, Denmark
| | - Peter Hjorth
- Psychiatric Department, Mental Health Services, Region of Southern Denmark, University Hospital of Southern Denmark, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Bendotti H, Lawler S, Gartner C, Ireland D, Marshall HM. Smoking Cessation Counseling in Practice: A Qualitative Analysis of Quitline Conversations in Queensland, Australia. HEALTH EDUCATION & BEHAVIOR 2024; 51:43-53. [PMID: 37846946 PMCID: PMC10785561 DOI: 10.1177/10901981231206068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques.
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Affiliation(s)
- Hollie Bendotti
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Sheleigh Lawler
- School of Public Health, The University of Queensland, Herston, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - David Ireland
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Henry M. Marshall
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
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Zhan C, Qu W, Fok MR, Jin L, Lin Y. Motivational Interviewing on Periodontal Treatment Outcomes: A Meta-Analysis. Int Dent J 2024:S0020-6539(24)00005-4. [PMID: 38307831 DOI: 10.1016/j.identj.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/16/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This systematic review investigated the clinical efficacy of motivational interviewing (MI) in improving oral hygiene and periodontal health in patients with periodontal diseases. METHODS A comprehensive literature search was conducted across various databases up to May 2023. Randomised controlled trials (RCTs) evaluating the effects of MI on periodontal conditions in patients with gingivitis, periodontitis, and peri‑implantitis were included. After data screening, a risk-of-bias assessment was performed using the Cochrane risk of bias (RoB) tool. The meta-analysis was performed using random-effects models. RESULTS Out of 2108 records screened, 7 RCTs involving 474 patients were included in the qualitative synthesis, with 6 of these studies included in the meta-analysis. Amongst these, 5 studies had a high RoB and 2 had some concerns about bias. Although individual studies reported varied results regarding the effects of MI on different periodontal indices and parameters at different time points, the pooled results revealed no significant difference in the overall effect on plaque level, bleeding on probing, and gingival inflammation between the MI and control groups. In addition, there is insufficient evidence to suggest any significant effect on attachment loss or probing depth. CONCLUSIONS The current evidence is insufficient to support the effectiveness of MI as an adjunctive intervention for improving oral hygiene and periodontal outcomes. However, these results should be interpreted with caution. Additional high-quality studies with standardised MI interventions are required to derive definite conclusions.
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Affiliation(s)
- Chaoning Zhan
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Wanting Qu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Melissa Rachel Fok
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
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Kim Y, Lee J, Lee E, Lim J, Kim Y, Lee CT, Jang SH, Paek YJ, Lee WC, Lee CW, Kim HY, Goo JM, Choi KS, Park B, Lee DH, Seo HG. Strategies to Improve Smoking Cessation for Participants in Lung Cancer Screening Program: Analysis of Factors Associated with Smoking Cessation in Korean Lung Cancer Screening Project (K-LUCAS). Cancer Res Treat 2024; 56:92-103. [PMID: 37562437 PMCID: PMC10789955 DOI: 10.4143/crt.2022.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/05/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE Smoking cessation intervention is one of the key components of successful lung cancer screening program. We investigated the effectiveness and related factors of smoking cessation services provided to the participants in a population-based lung cancer screening trial. MATERIALS AND METHODS The Korean Lung Cancer Screening Project (K-LUCAS) is a nationwide, multi-center lung cancer screening trial that evaluates the feasibility of implementing population-based lung cancer screening. All 5,144 current smokers who participated in the K-LUCAS received a mandatory smoking cessation counseling. Changes in smoking status were followed up using a telephone survey in 6 months after lung cancer screening participation. The lung cancer screening's impact on smoking cessation is analyzed by variations in the smoking cessation interventions provided in screening units. RESULTS Among 4,136 survey responders, participant's motivation to quit smoking increased by 9.4% on average after lung cancer screening. After 6 months from the initial screening, 24.3% of participants stopped smoking, and 10.6% of participants had not smoked continuously for at least 6 months after screening. Over 80% of quitters stated that participation in lung cancer screening motivated them to quit smoking. Low-cost public smoking cessation program combined with lung cancer screening increased the abstinence rates. The smokers were three times more likely to quit smoking when the smoking cessation counseling was provided simultaneously with low-dose computed tomography screening results than when provided separately. CONCLUSION A mandatory smoking cessation intervention integrated with screening result counselling by a physician after participation in lung cancer screening could be effective for increasing smoking cessation attempts.
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Affiliation(s)
- Yeol Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jaeho Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eunju Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Juntae Lim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yonghyun Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Choon-Taek Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hun Jang
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Won-Chul Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan Wha Lee
- Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea
| | - Hyae Young Kim
- Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Kui Son Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Boyoung Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Duk Hyoung Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hong Gwan Seo
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
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Kvaavik E, Weemes Grøtting M, Halkjelsvik T, van Helvoirt R, Kirkhorn IH, Bjaanes MM, Tøndel H, Sværen JT, Gripsgård H, Byrkje K, Helleve A. The effect of a smoking cessation program for patients in cancer treatment: a quasi-experimental intervention study. Acta Oncol 2023; 62:1890-1897. [PMID: 37930762 DOI: 10.1080/0284186x.2023.2277883] [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: 09/12/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Compared to non-smokers, smokers have reduced effects of cancer treatment, and increased risk of treatment-related toxicity. Quitting smoking can improve treatment effects and reduce side effects. This study reports on the potential impact of a smoking cessation program on smoking cessation rates among patients in cancer treatment. MATERIAL AND METHODS Cancer patients 18 years and older who smoked, with survival prognosis ≥12 months, not suffering dementia or other mental illness, and who were referred to cancer treatment at six Norwegian hospitals were invited to participate. The study took place from 2017 to 2020 and used a pre-test-posttest non-equivalent control group design. The intervention group received structured smoking cessation guidance based on Motivational Interviewing combined with cost-free nicotine replacement products, while the control group received standard smoking cessation treatment. Self-reported smoking status were registered at baseline and at 6 months' follow up. RESULTS 76% of patients smoked at baseline and 44% at follow-up in the intervention group, correspondingly 72% and 49% in the control group. In an analysis of differences in within-person change, the reduction in the intervention group was 13 percentage points larger (95% CI = (0.25, -0.005), p = 0.041). Adjusting for gender, age, education, labour market participation and partnership status did not attenuate the estimated effect (18 percentage point difference, 95% CI = (-0.346, -0.016), p = 0.032). Demographic factors and dropout rate differed somewhat between the groups with a higher dropout rate in the intervention group, 54% vs. 51%, respectively). CONCLUSION Offering a structured smoking cessation program based on Motivational Interviewing and cost-free nicotine replacement products to cancer patients can increase cessation rates in comparison to standard smoking cessation care.
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Affiliation(s)
- Elisabeth Kvaavik
- Department Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Maja Weemes Grøtting
- Department Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Torleif Halkjelsvik
- Department Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Rene van Helvoirt
- Hospital of Southern Norway, South-Eastern, Norway Regional Health Authority, Oslo, Norway
| | | | | | | | | | - Helga Gripsgård
- Haukeland University Hospital, Bergen Hospital Trust, Bergen, Norway
| | | | - Arnfinn Helleve
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health (NIPH), Oslo, Norway
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Barat E, Vanbergue B, Leguillon R, Chenailler C, Arrii M, Curado J, Varin R, Soubieux A. [Tobacco and surgery: A survey of health professionals' practices and knowledge. A role for the community pharmacist]. ANNALES PHARMACEUTIQUES FRANÇAISES 2023; 81:1082-1089. [PMID: 37481067 DOI: 10.1016/j.pharma.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE To evaluate the knowledge and management of preoperative smoking patients by different health professionals. METHOD We conducted a survey among surgeons, anesthesiologists, and pharmacists using questionnaires. The study included 115 pharmacists and 7 physicians. RESULTS Only 28% of pharmacists felt they had the necessary knowledge about smoking cessation before surgery and its consequences. Moreover, pharmacists were informed of the surgery less than one month before in 61% of cases, whereas physicians claimed to inform patients at least 3 months before in 57% of cases. The main reasons mentioned by the pharmacist for not informing the patient about presurgical smoking cessation were a lack of knowledge of the information to be relayed and a late knowledge of the scheduling of a surgery. Additionally, 57% of physicians stated that they never prescribed nicotine replacement products, while 42% of pharmacists felt that they never dispensed them. CONCLUSION The study provides a clear picture of the smoking pathway before surgery and highlights areas for improvement in the management of preoperative smoking patients by different health professionals.
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Affiliation(s)
- Eric Barat
- Department of Pharmacy, CHU de Rouen, 76031 Rouen cedex, France; Normandie University, UNICAEN, Inserm U1086, 14000 Caen, France.
| | | | | | | | - Marianne Arrii
- Department of Pharmacy, CHU de Rouen, 76031 Rouen cedex, France
| | - Jonathan Curado
- Department of Orthopedic, CHU de Rouen, 76031 Rouen cedex, France
| | - Rémi Varin
- Department of Pharmacy, UNIROUEN, Inserm U1234, CHU de Rouen, Normandie University, 76031 Rouen cedex, France
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Torres TK, Hamann HA, Shen M, Stone J. Empathic Communication and Implicit Bias in the Context of Cancer Among a Medical Student Sample. HEALTH COMMUNICATION 2023:1-12. [PMID: 37906434 PMCID: PMC11058116 DOI: 10.1080/10410236.2023.2272359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Oncology clinicians often miss opportunities to communicate empathy to patients. The current study examined the relationship between implicit bias (based on cancer type and ethnicity) and medical students' empathic communication in encounters with standardized patients who presented as Hispanic (lung or colorectal) individuals diagnosed with cancer. Participants (101 medical students) completed the Implicit Association Test (IAT) to measure implicit bias based on cancer type (lung v. colorectal) and ethnicity (Hispanic v. non-Hispanic White). Empathic opportunities and responses (assessed by the Empathic Communication Coding System; ECCS) were evaluated in a mock consultation (Objective Structured Clinical Examination; OSCE) focused on smoking cessation in the context of cancer. Among the 241 empathic opportunities identified across the 101 encounters (M = 2.4), 158 (65.6%) received high empathy responses from the medical students. High empathy responses were most frequently used during challenge (73.2%) and emotion (77.3%) opportunities compared to progress (45.9%) opportunities. Higher levels of implicit bias against Hispanics predicted lower odds of an empathic response from the medical student (OR = 3.24, p = .04, 95% CI = 0.09-0.95). Further work is needed to understand the relationship between implicit bias and empathic communication and inform the development of interventions.
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Affiliation(s)
- Tara K. Torres
- Department of Psychology, University of Arizona, Tucson, AZ
| | - Heidi A. Hamann
- Department of Psychology, University of Arizona, Tucson, AZ
- University of Arizona Cancer Center, Tucson, AZ
| | - Megan Shen
- Fred Hutchinson Cancer Research Institute, Seattle, WA
| | - Jeff Stone
- Department of Psychology, University of Arizona, Tucson, AZ
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Garver-Apgar CE, Morris CM, Pavlik J, Lenartz T, Hamm M. Peer-Facilitated Tobacco Cessation in a Prison Setting: A Proof of Concept Study. Tob Use Insights 2023; 16:1179173X231168511. [PMID: 37051590 PMCID: PMC10084529 DOI: 10.1177/1179173x231168511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background Despite the vast human and economic costs associated with tobacco use among U.S. inmates, smoking remains a largely ignored public health epidemic. Incarcerated individuals smoke at 3 to 4 times the rate of the general population and face tobacco-related health disparities. Purpose This paper reports results from a single arm, pre/post pilot study designed to test the feasibility and initial effectiveness of an inmate-administered group tobacco cessation intervention within a men’s pre-release program run by the Arizona Department of Corrections. Methods Corrections staff and inmate peer mentors were trained in the DIMENSIONS: Tobacco Free Program, a manualized 6-session tobacco cessation group curriculum. Group sessions used evidence-based interventions for assisting inmates develop skills to live tobacco and nicotine free. In 2019-2020, 39 men who reported tobacco use voluntarily participated in one of three cessation groups. Wilcoxen signed-rank tests evaluated changes across group sessions in frequency of tobacco use and attitudes about nicotine-free living post release. Results Most participants attended all six group sessions (79%) and made one or more quit attempts (78%). Overall, 24% of the sample reported quitting tobacco, and significant reductions in tobacco use were reported after only two sessions. Participants further reported significant positive changes in knowledge, plans, support, and confidence to live tobacco-free lives post-release. Conclusions To our knowledge, this is the first study to demonstrate that, with minimal investment, implementation of an evidence-based, peer-led tobacco free program is feasible and effective within an incarcerated population uniquely vulnerable to the burden of tobacco.
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Affiliation(s)
| | - Chad M. Morris
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jim Pavlik
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Tran DD, Davis JP, Ring C, Buch K, Fitzke RE, Pedersen ER. Informing the development of interventions for e-cigarette use and prevention of transition to cigarette smoking in young adults: A qualitative study. Prev Med Rep 2023; 35:102332. [PMID: 37519444 PMCID: PMC10382918 DOI: 10.1016/j.pmedr.2023.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023] Open
Abstract
E-cigarette use in young individuals may increase risk for cigarette smoking initiation. Over half of young adults who use e-cigarettes voiced their desire to quit e-cigarettes. Mobile-based interventions may allow for an easy-to-use platform to engage young adults in cessation services and reduce risk for cigarette uptake. To inform development of such programs, this study sought to gather information about what young adults want to see included in e-cigarette cessation interventions that also target future smoking risk. Nine online focus groups (n = 33) were conducted in July and August 2022 with young adults who either (1) currently used e-cigarettes, (2) formerly used e-cigarettes, or (3) initiated nicotine use with e-cigarettes but subsequently smoked cigarettes (dual use). Two research team members independently coded the transcripts and identified themes. A third researcher independently reviewed the coding and thematic analysis. Participants believed that mobile-based interventions should include peer support, ways to track cessation progress, education about the harms of e-cigarettes, gamification, and incentivization. They also believed that to prevent future cigarette smoking, interventions need to include education about the harms of smoking, teach refusal skills for offers to smoke, and incorporate personal anecdotes from former smokers. To increase their readiness, motivation, and self-efficacy to quit, participants who continue to use e-cigarettes reported needing effective substitutions to replace e-cigarettes, barriers to hinder their access to e-cigarettes, and social support. Findings from this study may be useful to incorporate when developing interventions designed to reduce e-cigarette use and risk of progression to smoking for young adults.
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Affiliation(s)
- Denise D. Tran
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
| | - Jordan P. Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th Street, Los Angeles, CA 90089, USA
| | - Colin Ring
- Loma Linda University School of Behavioral Health, Department of Psychology, 11130 Anderson Street, Loma Linda, CA 92354, USA
| | - Keegan Buch
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
| | - Reagan E. Fitzke
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
| | - Eric R. Pedersen
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
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Nian T, Guo K, Liu W, Deng X, Hu X, Xu M, E F, Wang Z, Song G, Yang K, Li X, Shang W. Non-pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses. BMC Med 2023; 21:378. [PMID: 37775745 PMCID: PMC10542700 DOI: 10.1186/s12916-023-03087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Although non-pharmacological smoking cessation measures have been widely used among smokers, current research evidence on the effects of smoking cessation is inconsistent and of mixed quality. Moreover, there is a lack of comprehensive evidence synthesis. This study seeks to systematically identify, describe, and evaluate the available evidence for non-pharmacological interventions in smoking populations through evidence mapping (EM), and to search for best-practice smoking cessation programs. METHODS A comprehensive search for relevant studies published from the establishment of the library to January 8, 2023, was conducted in PubMed, Web of Science, Embase, the Cochrane Library, CNKI, CBM, Wan Fang, and VIP. Two authors independently assessed eligibility and extracted data. The PRISMA statement and AMSTAR 2 tool were used to evaluate the report quality and methodology quality of systematic reviews/meta-analyses (SRs/MAs), respectively. Bubble plots were utilized to display information, such as the study population, intervention type, evidence quality, and original study sample size. RESULTS A total of 145 SRs/MAs regarding non-pharmacological interventions for smoking cessation were investigated, with 20 types of interventions identified. The most commonly used interventions were cognitive behaviour education (n = 32, 22.07%), professional counselling (n = 20, 13.79%), and non-nicotine electronic cigarettes (e-cigarettes) (n = 13, 8.97%). Among them, counselling and behavioural support can improve smoking cessation rates, but the effect varies depending on the characteristics of the support provided. These findings are consistent with previous SRs/MAs. The general population (n = 108, 74.48%) was the main cohort included in the SRs/MAs. The total score of PRISMA for the quality of the reports ranged from 8 to 27, and 13 studies (8.97%) were rated as high confidence, and nine studies (6.21%) as moderate confidence, in the AMSTAR 2 confidence rating. CONCLUSIONS The abstinence effect of cognitive behaviour education and money incentive intervention has advantages, and non-nicotine e-cigarettes appear to help some smokers transition to less harmful replacement tools. However, the methodological shortcomings of SRs/MAs should be considered. Therefore, to better guide future practice in the field of non-pharmacological smoking cessation, it is essential to improve the methodological quality of SRs and carry out high-quality randomized controlled trials (RCTs).
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Affiliation(s)
- Tao Nian
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Kangle Guo
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wendi Liu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xinxin Deng
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xiaoye Hu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
| | - Meng Xu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Fenfen E
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Ziyi Wang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Guihang Song
- Gansu Provincial Medical Security Bureau, Lanzhou, 730000, People's Republic of China
| | - Kehu Yang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Xiuxia Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wenru Shang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China.
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Collaborative Innovation Center of First Hospital, Lanzhou University, Lanzhou, 730000, People's Republic of China.
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Druckrey-Fiskaaen KT, Furulund E, Madebo T, Carlsen SEL, Fadnes LT, Lid TG. A qualitative study on people with opioid use disorders' perspectives on smoking and smoking cessation interventions. Front Psychiatry 2023; 14:1185338. [PMID: 37636821 PMCID: PMC10447904 DOI: 10.3389/fpsyt.2023.1185338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Smoking-related diseases are major contributors to disability and shorter life expectancy among opioid-dependent patients. Smoking prevalence is considerably higher for opioid-dependent persons than among the general population, and only a minority quit smoking in treatment settings. Studies show that pharmacological smoking cessation interventions have modest success rates. This study aimed to investigate patients' receiving opioid agonist therapy perspectives on factors affecting behavior and decisions related to smoking cessation, and their experiences with smoking cessation. Methods This is a qualitative study using semi-structured individual interviews. The participants were asked, among others, to elaborate on the participants' thoughts about smoking, previous attempts to quit tobacco use, and what could prompt a smoking cessation attempt. We analyzed the transcripts with systematic text condensation. The Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines were followed. Opioid-dependent patients receiving opioid agonist therapy in outpatient clinics were invited to participate using a purposive sampling method. In total, fourteen individuals participated in this study. Results We identified six themes which were: (1) reflections on how smoking affected decisions, (2) smoking and its impact on physical and mental health, (3) the economy as a motivator to stop smoking, (4) emotions, desires, and habits related to smoking, (5) knowledge of smoking, smoking cessation, and quit attempts, and (6) social factors influencing the participants' choices and activities. The participants were well informed about the consequences of smoking and had some knowledge and experience in quitting. The participants' pulmonary health was an important motivational factor for change. Withdrawal symptoms, anxiety, and fear of using other substances discouraged several from attempting to quit smoking. In contrast, social support from partners and access to meaningful activities were considered important factors for success. Few reported being offered help from health professionals to make a smoking cessation attempt. Discussion Experiencing social support, being encouraged to quit smoking, and patients' concerns for their physical health were important reasons for wanting to quit smoking. Smoking cessation interventions based on patient preferences and on the behavior change wheel may enable a higher success rate among patients receiving opioid agonist therapy.
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Affiliation(s)
- Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Einar Furulund
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Tesfaye Madebo
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Siv-Elin Leirvåg Carlsen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Lars T. Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Torgeir Gilje Lid
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
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Farver-Vestergaard I, Hjorth P, Pisinger C, Larsen PV, Løkke A. A survey exploring the practices of smoking cessation support among hospital-based healthcare providers. BMC Health Serv Res 2023; 23:645. [PMID: 37328757 DOI: 10.1186/s12913-023-09657-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/06/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Hospital visits constitute a 'window of opportunity' for initiating smoking cessation attempts, and healthcare providers (HCPs) play an important role in supporting patients to stop smoking. Yet, the current practices of supporting smoking cessation in the hospital setting are largely unexplored. The aim of this study was to explore practices of smoking cessation support among hospital-based HCPs. METHODS HCPs working in a large hospital in the secondary care sector completed an online, cross-sectional survey, including sociodemographic and work-related factors as well as 21 questions assessing practices of smoking cessation support based on the "five As" framework. Descriptive statistics were computed, and predictors of HCPs giving patients advice to stop smoking were explored using logistic regression analysis. RESULTS All employees (N = 3998) in the hospital received a survey link; 1645 (41.1%) HCPs with daily patient contact completed the survey. Smoking cessation support in the hospital setting was limited with regard to assessment of smoking; providing information and advice; planning and referral for further support; and follow-up on smoking cessation attempts. Almost half (44.8%) of participating HCPs with daily patient contact never or rarely advise their patients to stop smoking. Physicians were more likely than nurses to advice patients to stop smoking, and HCPs in outpatient clinics were more likely to give advice than inpatient clinic HCPs. CONCLUSION Smoking cessation support is very limited in the hospital-based healthcare setting. This is problematic, as hospital visits can be windows of opportunity to help patients change their health behaviour. An intensified focus on the implementation of hospital-based smoking cessation support is needed.
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Affiliation(s)
- Ingeborg Farver-Vestergaard
- Department of Medicine, Lillebaelt Hospital, Beriderbakken 4, Vejle, 7100, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Peter Hjorth
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Psychiatric Hospital, Region of Southern Denmark, Vejle, Denmark
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Capital Region of Denmark, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
- Danish Heart Foundation, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Pia Veldt Larsen
- Mental Health Services, Region of Southern Denmark, Vejle, Denmark
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Beriderbakken 4, Vejle, 7100, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Albasheer O, Alhazmi AH, Alharbi A, Makeen AM, Alqassim AY, Al-Musawa HI, Alabah AE, Alhazmi AK, Khormi NA, Hamzi YA, Sharhah EYA, Salami RM, Alshareef M, Suwaydi H, Elkhobby A. Effectiveness and determinants of smoking cessation in the Saudi Arabian Region of Jazan: A cross-sectional study. Tob Induc Dis 2023; 21:06. [PMID: 36721860 PMCID: PMC9865635 DOI: 10.18332/tid/156842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/27/2022] [Accepted: 11/23/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Smoking cessation has significant health benefits. The purpose of this study is to assess the efficacy and related factors of smoking cessation therapies in the Jazan Region of Saudi Arabia. METHODS This is a cross-sectional study that took place at smoking cessation clinics in primary healthcare centers between January 2019 and January 2020. RESULTS This study enrolled a total of 103 people. The success rate for quitting smoking was 36% at three months, with a 13% relapse rate at six months. Age (p=0.017), occupation (p=0.046), daily cigarette intake (p=0.015), and number of visits (p=0.001) were all found to be significant determinants of smoking cessation. In the multivariate analysis, only the number of visits increased the likelihood to quit smoking (AOR=0.31; 95% CI: 0.15-0.63). Self-efficacy was cited as the primary reason for quitting smoking by 71% of the participants, whereas family support, smoking cessation therapies, and friends' support were cited as predictive variables by 18%, 10%, and 1% of the participants, respectively. CONCLUSIONS Smokers who received the smoking cessation intervention package were three times more likely to succeed in giving up smoking when compared to those who received the routine service. Regular follow-up during smoking cessation interventions significantly enhanced the quit rate. It is recommended that pharmacotherapy strategies and intense therapy performed face-to-face with a cessation counselor be combined to improve the quit rate.
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Affiliation(s)
- Osama Albasheer
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Abdulaziz H. Alhazmi
- Emerging and Epidemic Infectious Diseases Research Unit, Medical Research Center, Jazan University, Jazan City, Saudi Arabia,Microbiology and Parasitology Department, College of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Abdullah Alharbi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Anwar M. Makeen
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Ahmad Y. Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | | | - Amjad E. Alabah
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | | | - Nawaf A. Khormi
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Yazeed A. Hamzi
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | | | | | - Mohammed Alshareef
- Family Medicine and Primary Health Care, Ministry of Health, Jazan City, Saudi Arabia
| | - Hassan Suwaydi
- Family Medicine and Primary Health Care, Ministry of Health, Jazan City, Saudi Arabia
| | - Ahmed Elkhobby
- Family Medicine and Primary Health Care, Ministry of Health, Jazan City, Saudi Arabia
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Kopylova OV, Ershova AI, Yaltonsky VM, Sirota NA, Drapkina OM. Motivational counseling in the prevention of the development and progression of cardiovascular diseases. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2023. [DOI: 10.15829/1728-8800-2022-3455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Despite significant progress in the development of novel methods for the prevention and treatment of cardiovascular diseases, their prevalence remains high, which is largely due to low adherence of patients to drug and non-drug preventive interventions. Motivational counseling (MC) is a unique technology that makes it possible to activate the patient’s desire to change their behavior towards a healthy one. The review presents an analysis of the literature on MC technology and the possibilities of its application in cardiology practice. Research data show the effectiveness of MC in improving the nutrition profile, physical activity, weight loss, smoking cessation, control of glycated hemoglobin in patients with diabetes, improving outcomes in patients with heart failure, increasing adherence to therapy, etc. Conducting MC using telemedicine technologies seems promising. The training of specialists is of paramount importance, since the effectiveness of this type of counseling largely depends on the accuracy of the consultant’s adherence to the essence and technologies of MC.
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Affiliation(s)
- O. V. Kopylova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. I. Ershova
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. M. Yaltonsky
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - N. A. Sirota
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Suh S, Cho N, Jeoung S, An H. Developing a Psychological Intervention for Decreasing Bedtime Procrastination: The BED-PRO Study. Behav Sleep Med 2022; 20:659-673. [PMID: 34524942 DOI: 10.1080/15402002.2021.1979004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Bedtime Procrastination (BP) is defined as the behavior of going to bed later than intended, without having external reasons for doing so. Previous studies have shown that BP has a negative effect on sleep and health, emphasizing the need to develop interventions to decrease BP. This intervention development study is a proof-of-concept study for a psychological intervention designed for decreasing bedtime procrastination, namely BED-PRO. MATERIAL AND METHOD The intervention was developed based on behavioral modification principles and motivational interviewing techniques. The final intervention was a weekly three-session intervention, with one additional booster call. Twenty individuals with high BP participated in the study, and data was collected for pre- and post-intervention, and one-month follow-up. Individuals completed the Bedtime Procrastination Scale, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire, Insomnia Severity Index, and a sleep diary. RESULT Significant changes were found for BPS scores, bedtime procrastination duration (Δ51 mins, 63.8% reduction compared to baseline), wake after sleep onset, sleep efficiency and feeling refreshed upon awakening measured by sleep diaries following the intervention. In addition, changes in BPS, ISI, and ESS scores, wake after sleep onset, sleep efficiency and feeling refreshed upon awakening were maintained or continued to improve at 1-month follow-up. CONCLUSION This study verified the feasibility and acceptability of the BED-PRO intervention and the potential for being the first intervention to target bedtime procrastination. Considering the research about negative implications of BP, we expect that this intervention could be a step forward in considering BP as a serious health behavior.
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Affiliation(s)
- Sooyeon Suh
- Department of Psychology, Sungshin University, Seoul, Republic of Korea
| | - Nayoung Cho
- Department of Psychology, Sungshin University, Seoul, Republic of Korea
| | - Sonhye Jeoung
- Department of Psychology, Sungshin University, Seoul, Republic of Korea
| | - Hyeyoung An
- Department of Psychology, Sungshin University, Seoul, Republic of Korea
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Petit B, Dornier A, Meille V, Demina A, Trojak B. Non-invasive brain stimulation for smoking cessation: a systematic review and meta-analysis. Addiction 2022; 117:2768-2779. [PMID: 35470522 DOI: 10.1111/add.15889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 03/15/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS Non-invasive brain stimulation (NIBS) methods have showed promising results for the treatment of tobacco use disorder, but little is known about the efficacy of NIBS on sustained tobacco abstinence. We aimed to assess its effectiveness for long-term smoking cessation. METHODS Systematic review and meta-analysis of randomized controlled trials (RCT). PubMed, Cochrane library, Embase, PsycINFO and clinical trials registries were systematically searched for relevant studies up to May 2021. Relevant studies included adult smokers seeking smoking cessation, included in an RCT using NIBS [specifically repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)], and with follow-up of more than 4 weeks. There were no restrictions on location. Abstinence rates in the active NIBS groups were compared with abstinence rates in sham NIBS or in usual treatment groups, from 4 weeks to 12 months following the quit attempt. Smoking abstinence was measured on an intention-to-treat basis and we used risk ratios (RRs) as measures of effect size. RESULTS Seven studies were included (n = 699 patients). In all included studies, the control groups were receiving sham NIBS and only data from 3 to 6 months were analysable. By pooling the seven included studies, the RR of sustained abstinence of any form of NIBS relative to sham NIBS was 2.39 [95% confidence interval (CI) = 1.26-4.55; I2 = 40%]. Subgroup analyses found that the RR was even higher when excitatory rTMS was used on the left dorsolateral prefrontal cortex (RR = 4.34; 95% CI = 1.69-11.18; I2 = 0%) or when using deep rTMS targeting the lateral prefrontal cortex and insula bilaterally (RR = 4.64; 95% CI = 1.61-13.39; I2 = 0%). A high risk of bias was found in four included studies. We also determined, using grades of recommendation, assessment, development and evaluation, that overall there was a low level of confidence in the results. CONCLUSION Non-invasive brain stimulation (NIBS) may improve smoking abstinence rates from 3 to 6 months after quitting smoking, compared with sham NIBS or usual treatment.
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Affiliation(s)
- Benjamin Petit
- Department of Addictology, University Hospital of Dijon, Dijon, France
| | - Alexandre Dornier
- Department of Addictology, University Hospital of Dijon, Dijon, France
| | - Vincent Meille
- Department of Addictology, University Hospital of Dijon, Dijon, France
| | - Anastasia Demina
- Department of Addictology, University Hospital of Dijon, Dijon, France
| | - Benoit Trojak
- Department of Addictology, University Hospital of Dijon, Dijon, France.,University of Burgundy, Cognition, Action et Plasticité Sensorimotrice, Dijon, France
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Resnicow K, Delacroix E, Chen G, Austin S, Stoffel E, Hanson EN, Gerido LH, Kaphingst KA, Yashar BM, Marvin M, Griggs JJ, Cragun D. Motivational interviewing for genetic counseling: A unified framework for persuasive and equipoise conversations. J Genet Couns 2022; 31:1020-1031. [PMID: 35906848 PMCID: PMC9796431 DOI: 10.1002/jgc4.1609] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/31/2022] [Accepted: 06/12/2022] [Indexed: 01/01/2023]
Abstract
Genetic counselors (GCs) have traditionally been trained to adopt a position of equipoise or clinical neutrality. They provide information, answer questions, address barriers, and engage in shared decision-making, but generally, they do not prescribe a genetic test. Historically, GCs have generally been trained not to persuade the ambivalent or resistant patient. More recently, however, there has been discussion regarding when a greater degree of persuasion or directionality may be appropriate within genetic counseling (GC) and what role MI may play in this process. The role for "persuasive GC" is based on the premise that some genetic tests provide actionable information that would clearly benefit patients and families by impacting treatment or surveillance. For other tests, the benefits are less clear as they do not directly impact patient care or the benefits may be more subjective in nature, driven by patient values or psychological needs. For the former, we propose that GCs may adopt a more persuasive clinical approach while for the latter, a more traditional equipoise stance may be more appropriate. We suggest that motivational interviewing (MI) could serve as a unifying counseling model that allows GCs to handle both persuasive and equipoise encounters. For clearly beneficial tests, while directional, the MI encounter can still be non-directive, autonomy-supportive, and patient-centered. MI can also be adapted for equipoise situations, for example, placing less emphasis on eliciting and strengthening change talk as that is more a behavior change strategy than a shared decision-making strategy. The core principles and strategies of MI, such as autonomy support, evocation, open questions, reflective listening, and affirmation would apply to both persuasive and equipoise encounters. Key issues that merit discussion include how best to train GCs both during their initial and post-graduate education.
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Affiliation(s)
- Ken Resnicow
- University of Michigan School of Public HealthAnn ArborMichiganUSA
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
| | - Emerson Delacroix
- University of Michigan School of Public HealthAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborMichiganUSA
| | - Gabriela Chen
- University of Michigan School of Public HealthAnn ArborMichiganUSA
- Genetic Counseling Graduate Training Program, Department of Human GeneticsUniversity of MichiganAnn ArborMichiganUSA
| | - Sarah Austin
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
| | - Elena Stoffel
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborMichiganUSA
| | - Erika N. Hanson
- Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborMichiganUSA
| | | | - Kimberly A. Kaphingst
- Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA
- Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Beverly M. Yashar
- Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborMichiganUSA
- Genetic Counseling Graduate Training Program, Department of Human GeneticsUniversity of MichiganAnn ArborMichiganUSA
| | - Monica Marvin
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborMichiganUSA
- Genetic Counseling Graduate Training Program, Department of Human GeneticsUniversity of MichiganAnn ArborMichiganUSA
| | - Jennifer J. Griggs
- University of Michigan School of Public HealthAnn ArborMichiganUSA
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborMichiganUSA
| | - Deborah Cragun
- University of South Florida, College of Public HealthTampaFloridaUSA
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Znyk M, Wężyk-Caba I, Kaleta D. The Frequency of Tobacco Smoking and E-Cigarettes Use among Primary Health Care Patients-The Association between Anti-Tobacco Interventions and Smoking in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11584. [PMID: 36141847 PMCID: PMC9517004 DOI: 10.3390/ijerph191811584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to assess the prevalence of smoking and e-cigarette use among primary care patients during the COVID-19 pandemic and to assess the frequency of minimal anti-tobacco interventions by family doctors. A cross-sectional study was conducted from January 2020 to December 2021 encompassing 896 patients over 18 years of age who used primary health care in the city of Lodz, Poland. In total, 21.2% of the respondents were smokers, 11.6% were e-cigarette users, and 7.3% dual users. In addition, 68.4% of smokers had been asked about smoking, while 62.9% of non-smokers and 33.7% of smokers were advised to quit smoking; furthermore, 71.1% of e-cigarette users and 72.3% of dual users were asked about tobacco use, and 17.3% and 21.5%, respectively, had been advised to quit smoking. Multivariate logistic regression analysis found men and alcohol users to receive more minimal anti-tobacco advice than women and non-alcohol users (OR = 1.46; p < 0.05 and OR = 1.45; p < 0.05), socio-demographic and health correlates did not increase the chances of obtaining minimal anti-tobacco interventions among smokers. People with a medium level of education had a higher chance of receiving minimal anti-tobacco intervention from their family doctor when using e-cigarettes and when they were dual users (OR = 2.06; p < 0.05 and OR = 2.51; p < 0.05). Smokers were less likely to receive minimal anti-tobacco interventions than reported in previous studies. Measures should be implemented to increase the minimum interventions provided by GPs in their daily work among all patients, not only those who use tobacco. Non-smokers should be encouraged to abstain.
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Tsemach R, Enden‐Izhaki A, Amit Aharon A. Intervention training of urology healthcare staff to counsel acute care inpatients on smoking cessation: An evaluation study. Nurs Open 2022; 10:828-837. [PMID: 36059078 PMCID: PMC9834151 DOI: 10.1002/nop2.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 07/24/2022] [Accepted: 08/22/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To evaluate the differences, following intervention training, in the knowledge, attitudes, role perception, self-capacity and intention of urology staff to counsel inpatients on smoking cessation. DESIGN A descriptive evaluation study of intervention training in counselling on smoking cessation. The study was designed following guidance by the Medical Research Council. METHODS The evaluation was based on a closed-end questionnaire with four time-point measurements from May 2018-December 2019 (N = 29 at each time-point). A repeated measure within-subjects ANOVA was conducted to explore the variance in participants' attitudes, role perception, self-capacity and intention to counsel patients regarding smoking cessation. Eta squared and Bonferroni post hoc tests were used to interpret the results. RESULTS No change was observed in the research variables after theoretical science-based learning of the smoking hazards and the benefits of cessation. A statistically significant difference was found following procedural knowledge based on training, practical experience and skill development.
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Affiliation(s)
- Ronit Tsemach
- Urology DepartmentTel Aviv Sourasky Medical CenterTel AvivIsrael,Nursing Department, Steyer School of Health Professions, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Anat Enden‐Izhaki
- Macabi Health ServicesSecretary of the Israel Medical Association for Smoking Prevention and CessationTel AvivIsrael
| | - Anat Amit Aharon
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
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21
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Domlyn AM, Crowder C, Eisenson H, Pollak KI, Davis JM, Calhoun PS, Wilson SM. Implementation mapping for tobacco cessation in a federally qualified health center. Front Public Health 2022; 10:908646. [PMID: 36117603 PMCID: PMC9478793 DOI: 10.3389/fpubh.2022.908646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/04/2022] [Indexed: 01/22/2023] Open
Abstract
Background Implementation mapping (IM) is a promising five-step method for guiding planning, execution, and maintenance of an innovation. Case examples are valuable for implementation practitioners to understand considerations for applying IM. This pilot study aimed to determine the feasibility of using IM within a federally qualified health center (FQHC) with limited funds and a 1-year timeline. Methods An urban FQHC partnered with an academic team to employ IM for implementing a computerized strategy of tobacco cessation: the 5A's (Ask, Advise, Assess, Assist, Arrange). Each step of IM was supplemented with theory-driven methods and frameworks. Data collection included surveys and interviews with clinic staff, analyzed via rapid data analysis. Results Medical assistants and clinicians were identified as primary implementers of the 5A's intervention. Salient determinants of change included the perceived compatibility and relative priority of 5A's. Performance objectives and change objectives were derived to address these determinants, along with a suite of implementation strategies. Despite indicators of adoptability and acceptability of the 5A's, reductions in willingness to adopt the implementation package occurred over time and the intervention was not adopted by the FQHC within the study timeframe. This is likely due to the strain of the COVID-19 pandemic altering health clinic priorities. Conclusions Administratively, the five IM steps are feasible to conduct with FQHC staff within 1 year. However, this study did not obtain its intended outcomes. Lessons learned include the importance of re-assessing barriers over time and ensuring a longer timeframe to observe implementation outcomes.
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Affiliation(s)
- Ariel M. Domlyn
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States
| | | | - Howard Eisenson
- Lincoln Community Health Center, Durham, NC, United States
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States
| | - Kathryn I. Pollak
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
- Duke Cancer Institute, Duke University Health System, Durham, NC, United States
| | - James M. Davis
- Duke Cancer Institute, Duke University Health System, Durham, NC, United States
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Patrick S. Calhoun
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States
- Duke Cancer Institute, Duke University Health System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Sarah M. Wilson
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
- Duke Cancer Institute, Duke University Health System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
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22
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Willemse E, Walters BH, Springvloet L, Bommelé J, Willemsen MC. “If the social circle is engaged, more pregnant women will successfully quit smoking”: a qualitative study of the experiences of midwives in the Netherlands with smoking cessation care. BMC Health Serv Res 2022; 22:1106. [PMID: 36045362 PMCID: PMC9429426 DOI: 10.1186/s12913-022-08472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background If smoking is common within a pregnant woman’s social circle, she is more likely to smoke and her chances of succeeding in quitting smoking are reduced. It is therefore important to encourage smoking cessation in a pregnant woman’s social circle. Midwives are ideally positioned to help pregnant women and members of their social circle quit smoking but there is currently little knowledge about if and how midwives approach smoking cessation with pregnant women’s social circles. Methods In 2017 and 2018, semi-structured interviews were conducted with 14 birth care providers in the Netherlands. Interviews were inductively coded; data were analyzed thematically. Results In the interviews, midwives reported that they don’t commonly provide smoking cessation support to members of pregnant women’s social circles. The respondents noted that they primarily focused on mothers and weren’t always convinced that advising the partners, family, and friends of pregnant women to quit smoking was their responsibility. Data from the interviews revealed that barriers to giving advice to the social circle included a lack of a trusting relationship with the social circle, concerns about raising the topic and giving unwanted advice on cessation to members of the social circle and a lack of opportunity to discuss smoking. Conclusions Midwives in the Netherlands were reluctant to actively provide smoking cessation advice to the social circle of pregnant women. To overcome barriers to addressing cessation to the social circle, educational programs or new modules for existing programs could be used to improve skills related to discussing smoking. Clear guidelines and protocols on the role of midwives in providing cessation support to the social circle could help midwives overcome ambivalence that they might have. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08472-7.
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Druckrey-Fiskaaen KT, Furulund E, Daltveit JT, Vold JH, Lid TG, Madebo T, Fadnes LT. Integration of smoking cessation into standard treatment for patients receiving opioid agonist therapy who are smoking tobacco: protocol for a randomised controlled trial (ATLAS4LAR). Trials 2022; 23:663. [PMID: 35978355 PMCID: PMC9382815 DOI: 10.1186/s13063-022-06560-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND About 85% of patients receiving opioid agonist therapy (OAT) for opioid dependence are smoking tobacco. Although smoke-related pulmonary diseases are significant contributors to morbidity and mortality, few smoking cessation interventions are evaluated within this group, and few OAT patients are offered smoking cessation as an integrated part of their addiction treatment. This study protocol describes an integrated smoking cessation intervention aimed at patients receiving OAT and smoking tobacco. METHODS This is a multicentre, randomised controlled clinical trial that will recruit 266 daily tobacco smoking patients receiving OAT in OAT outpatient clinics in Bergen and Stavanger, Norway. The patients randomised for the intervention arm will be offered smoking cessation therapy consisting of weekly brief behavioural interventions and prescription-free nicotine replacement products. In the control arm, patients will receive standard care without any added interventions related to smoking cessation. The smoking cessation intervention includes psychoeducational techniques with components from motivational interviewing, and nicotine replacement products such as nicotine lozenges, patches, and chewing gum. The duration of the intervention is 16 weeks, with the option of extending it by a further 8 weeks. The main outcomes are measured at 16 weeks after initiation of the intervention, and sustained effects are evaluated 1 year after intervention initiation. The primary outcome is smoking cessation verified by carbon monoxide (CO) levels or at least a 50% reduction in the number of cigarettes smoked. Secondary outcomes are changes in psychological well-being, biochemical inflammation markers, changes in physical health, quality of life, and fatigue. DISCUSSION Integration of other treatments to standard OAT care improves adherence and completion rates providing another rationale for integrated smoking cessation treatment. Thus, if integrated smoking cessation treatment is superior to standard care, this trial provides important information on further scale-up. TRIAL REGISTRATION ClinicalTrials.gov NCT05290025. Registered on 22 March 2022.
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Affiliation(s)
- Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Einar Furulund
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Jan Tore Daltveit
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Torgeir Gilje Lid
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Tesfaye Madebo
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Patient experiences with tobacco use during substance use disorder treatment and early recovery: a mixed method analysis of phone interview responses. J Addict Dis 2022:1-7. [PMID: 35930400 DOI: 10.1080/10550887.2022.2103352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Tobacco use and related mortality remain disproportionately high among individuals with substance use disorders (SUDs). Though engagement in tobacco cessation interventions is associated with improved long-term recovery, many individuals in SUD treatment do not participate. The goal of the present study was to better understand patient views regarding tobacco use/cessation during residential SUD treatment, in order to decrease barriers for this vulnerable population. This study utilized a cross-sectional design and mixed methods analysis. Following discharge from residential SUD treatment, individuals who reported any use of tobacco were invited to participate in a brief phone interview. Forty-one of the 60 who were reached (68%) agreed to participate. Responses were quantified for analysis when appropriate, and descriptive statistics were calculated for quantitative data. Thematic analysis was used to analyze qualitative responses. Most respondents (83%) reported that tobacco cessation was an important goal and were open to tobacco cessation treatment. The vast majority (85%) did not think tobacco use interfered with their recovery from other SUDs. Respondents noted the socially-reinforcing nature of tobacco use in treatment, and indicated a desire for increased access to cessation services. Results suggest increased patient education and changes to treatment center tobacco policies may assist individuals recovering from SUD with tobacco cessation.
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25
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He L, Basar E, Wiers RW, Antheunis ML, Krahmer E. Can chatbots help to motivate smoking cessation? A study on the effectiveness of motivational interviewing on engagement and therapeutic alliance. BMC Public Health 2022; 22:726. [PMID: 35413887 PMCID: PMC9003955 DOI: 10.1186/s12889-022-13115-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/25/2022] [Indexed: 12/30/2022] Open
Abstract
Background Cigarette smoking poses a major threat to public health. While cessation support provided by healthcare professionals is effective, its use remains low. Chatbots have the potential to serve as a useful addition. The objective of this study is to explore the possibility of using a motivational interviewing style chatbot to enhance engagement, therapeutic alliance, and perceived empathy in the context of smoking cessation. Methods A preregistered web-based experiment was conducted in which smokers (n = 153) were randomly assigned to either the motivational interviewing (MI)-style chatbot condition (n = 78) or the neutral chatbot condition (n = 75) and interacted with the chatbot in two sessions. In the assessment session, typical intake questions in smoking cessation interventions were administered by the chatbot, such as smoking history, nicotine dependence level, and intention to quit. In the feedback session, the chatbot provided personalized normative feedback and discussed with participants potential reasons to quit. Engagement with the chatbot, therapeutic alliance, and perceived empathy were the primary outcomes and were assessed after both sessions. Secondary outcomes were motivation to quit and perceived communication competence and were assessed after the two sessions. Results No significant effects of the experimental manipulation (MI-style or neutral chatbot) were found on engagement, therapeutic alliance, or perceived empathy. A significant increase in therapeutic alliance over two sessions emerged in both conditions, with participants reporting significantly increased motivation to quit. The chatbot was perceived as highly competent, and communication competence was positively associated with engagement, therapeutic alliance, and perceived empathy. Conclusion The results of this preregistered study suggest that talking with a chatbot about smoking cessation can help to motivate smokers to quit and that the effect of conversation has the potential to build up over time. We did not find support for an extra motivating effect of the MI-style chatbot, for which we discuss possible reasons. These findings highlight the promise of using chatbots to motivate smoking cessation. Implications for future research are discussed.
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Affiliation(s)
- Linwei He
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Erkan Basar
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology, and Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Marjolijn L Antheunis
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands
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Lutala P, Muula A. Brief behaviour change counselling in non-communicable diseases in Mangochi, Southern Malawi: a hypothetical acceptability study. Pilot Feasibility Stud 2022; 8:69. [PMID: 35331326 PMCID: PMC8944110 DOI: 10.1186/s40814-022-01032-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Brief behaviour change counselling (BBCC) approaches have shown some potential in reversing and/or decreasing the effects of behavioural risk factors (harmful alcohol, smoking, physical inactivity and unhealthy diets). However, BBCC is new in Malawi. Thus, we explored the acceptability of brief behaviour change counselling using 5 As and a guiding style from motivational interviewing (BBCC + 5 As + GS) among health providers, policy-makers and patients living with noncommunicable diseases (NCDs) in the Mangochi district located in Malawi. METHODS An exploratory qualitative cross-sectional study used purposive sampling to select 44 respondents. We conducted group discussions with five focus groups that included patients. We also carried out nine key-informant interviews with healthcare providers and policy-makers. Data were managed and organized with Atlas.ti. cloud and analysed using the thematic framework approach. FINDINGS Several themes, categories, and their subcategories emerged from the interviews. Participants perceived the introduction and delivery of BBCC + 5As + GS in Mangochi as smooth. However, they predicted a few challenges such as time and space to conduct the intervention, cultural bottlenecks caused by low education level, age differences between healthcare providers and patients, low provider- to- patient ratio and high provider turnover. For this method to be adopted, a simplified format is deemed necessary to improve effectiveness with patients. This technique can only be sustained if training opportunities are provided and if positive testimonies are given by beneficiaries. Incorporation of a continuous quality improvement cycle targeting challenges must be part of the intervention. Participants perceived that BBCC will contribute to developing the listening ability of healthcare providers. This would help in providing personalized and cost-effective care relevant to Mangochi. The participants also perceived that BBCC + 5As + GS will be affordable, credible and useful. CONCLUSION We found a high acceptability rate of BBCC among stakeholders in NCDs clinics in Mangochi. There are a number of areas where BBCC + 5As + GS could be improved to increase the acceptability. Accordingly, a study of feasibility and preliminary efficacy is warranted to determine other prerequisites for the implementation of a large-scale trial using this BBCC+ 5 As + GS, and to fully understand the implementation requirements of a full trial in Mangochi.
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Affiliation(s)
- Prosper Lutala
- School of Public Health & Family Medicine, College of Medicine, University of Malawi, Zomba, Malawi. .,NCDs-Brite Consortium, College of Medicine, University of Malawi, Zomba, Malawi. .,Africa Centre of Excellence in Public Health and Herbal Medicine (ACEPHEM), Zomba, Malawi. .,College of Medicine Mangochi Campus, P.O. Box 431, Mangochi, Malawi.
| | - Adamson Muula
- School of Public Health & Family Medicine, College of Medicine, University of Malawi, Zomba, Malawi.,Africa Centre of Excellence in Public Health and Herbal Medicine (ACEPHEM), Zomba, Malawi
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“Quit Cold Turkey”: Effects of a Quit-and-Win Smoking Cessation Challenge Offered at Christmas on Abstinence, Daily Cigarette Intake, and Cravings. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00780-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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28
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Mathur S, Conway DI, Macpherson LMD, Ross AJ. Systematic overview of systematic reviews and clinical guidelines: assessment and prevention of behavioural risk factors associated with oral cancer to inform dental professionals in primary care dental practices. Evid Based Dent 2022:10.1038/s41432-022-0235-1. [PMID: 35256757 DOI: 10.1038/s41432-022-0235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
Aims/objectives Tobacco and alcohol are recognised as the major modifiable risk factors for oral cancer, the incidence of which is rising globally and predicted to increase. This paper aimed to: 1) appraise and synthesise best practice evidence for assessing the major behavioural risk factors for oral cancer and delivering behaviour change interventions (for example, advice, counselling, signposting/referral to preventive services); and 2) assess appropriateness for implementation by dental professionals in primary care.Methods A systematic overview was undertaken of systematic reviews and international clinical guidelines. This involved: systematically searching and collating the international literature on assessing oral cancer risk and delivering preventive interventions within primary care; quality appraising and assessing the risk of bias using validated tools; synthesising the evidence for best practice; and assessing application of key findings to the dental setting.Results and conclusions There is clear evidence for the effectiveness of a 'brief', in-person, motivational intervention for sustained tobacco abstinence or reduced alcohol consumption, following risk factor assessment. Evidence for combined behavioural interventions is lacking. There is no firm conclusion with regards to optimal duration of brief interventions (range 5-20 minutes). For tobacco users, longer (10-20 minutes) and intensive (more than 20 minutes, with follow-up visits) interventions are more effective in increasing quit rates compared to no intervention; very brief (less than five minutes) interventions in a single session show comparable effectiveness to the longer/more intensive interventions. For alcohol users, 10-15-minute multi-contact interventions were most effective, compared to no intervention or very brief (less than five minutes) intervention or intensive intervention; brief interventions of five-minute duration were equally effective. There is limited direct evidence from the dental practice setting (one high-quality systematic review relating to tobacco prevention and none relating to alcohol). Thus, very brief, or brief advice of up to five minutes, should be trialled for tobacco and alcohol respectively in a dental practice setting, after risk assessment tailored to patient motivational status. Exploring delivery by the dental team is supported, as effectiveness was generally independent of primary care provider.
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Affiliation(s)
- Sweta Mathur
- Kaiser Permanente Centre for Health Research, Portland, OR, USA.
| | - David I Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
| | | | - Alastair J Ross
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
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Gunasekeran D, Chew AMK, Chandrasekar E, Rajendram P, Kandarpa V, Rajendram M, Chia A, Smith H, Leong CK. The impact and applications of social media platforms for public health responses before and during COVID-19. J Med Internet Res 2022; 24:e33680. [PMID: 35129456 PMCID: PMC9004624 DOI: 10.2196/33680] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/27/2022] [Accepted: 02/04/2022] [Indexed: 12/21/2022] Open
Abstract
Background Social media platforms have numerous potential benefits and drawbacks on public health, which have been described in the literature. The COVID-19 pandemic has exposed our limited knowledge regarding the potential health impact of these platforms, which have been detrimental to public health responses in many regions. Objective This review aims to highlight a brief history of social media in health care and report its potential negative and positive public health impacts, which have been characterized in the literature. Methods We searched electronic bibliographic databases including PubMed, including Medline and Institute of Electrical and Electronics Engineers Xplore, from December 10, 2015, to December 10, 2020. We screened the title and abstracts and selected relevant reports for review of full text and reference lists. These were analyzed thematically and consolidated into applications of social media platforms for public health. Results The positive and negative impact of social media platforms on public health are catalogued on the basis of recent research in this report. These findings are discussed in the context of improving future public health responses and incorporating other emerging digital technology domains such as artificial intelligence. However, there is a need for more research with pragmatic methodology that evaluates the impact of specific digital interventions to inform future health policy. Conclusions Recent research has highlighted the potential negative impact of social media platforms on population health, as well as potentially useful applications for public health communication, monitoring, and predictions. More research is needed to objectively investigate measures to mitigate against its negative impact while harnessing effective applications for the benefit of public health.
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Affiliation(s)
| | | | | | | | | | - Mallika Rajendram
- National University of Singapore (NUS), 10 Medical Drive, Singapore, SG
| | - Audrey Chia
- National University of Singapore (NUS), 10 Medical Drive, Singapore, SG
| | - Helen Smith
- Lee Kong Chian School of Medicine (LKCMedicine), Singapore, SG
| | - Choon Kit Leong
- National University of Singapore (NUS), 10 Medical Drive, Singapore, SG.,Mission Medical Clinic, Singapore, SG
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30
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de Frel DL, Janssen VR, Meijer E, Atsma DE. Optimizing Smoking Cessation Counseling in a University Hospital: Results and Pitfalls. FRONTIERS IN HEALTH SERVICES 2022; 2:882964. [PMID: 36925867 PMCID: PMC10012747 DOI: 10.3389/frhs.2022.882964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022]
Abstract
Background Healthcare professionals (HPs) can play a substantial role in smoking cessation counseling (SCC) but in practice often skip this task due to time constraints. This study evaluates the implementation of the rapid Ask-Advise-Connect (AAC) method in a University hospital setting. Methods This mixed methods pre-post interventional study was performed at the Cardiology department of a University hospital and consisted of (1) a quantitative assessment of patient smoking registration and HP connection rates to external SCC from the Electronic Medical Record, (2) semi-structured interviews with 10 HPs to assess their attitudes toward AAC, and (3) a blended intervention aimed to implement AAC. The blended intervention consisted of face-to-face and online AAC psychoeducation for HPs followed-up with motivational messages on their smart pagers over a period of 6 weeks. Results In total, 48,321 patient registrations and 67 HPs were included. Before AAC implementation, HPs assessed smoking status in 74.0% of patients and connected 9.3% of identified smokers with SCC. Post intervention, these percentages did not increase (73.2%, p = 0.20; and 10.9%, p = 0.18, respectively). Nonetheless, the vast majority (90%) of HPs feel it is important to discuss patient smoking, and view it as their duty to do so. Main barriers to AAC reported by HPs were forgetfulness and time pressure. Conclusion This study shows that this AAC intervention does not increase Asking after smoking status or Connection of patients to SCC in a University Hospital. However, HPs hold positive attitudes toward AAC. A better understanding of the mechanisms required for optimizing HPs practice behavior is needed.
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Affiliation(s)
- Daan L de Frel
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Veronica R Janssen
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Eline Meijer
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Douwe E Atsma
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Association Arts en Leefstijl (Physician and Lifestyle), Utrecht, Netherlands
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31
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Dai S, Chan MHM, Kam RKT, Li AM, Au CT, Chan KCC. Monthly Motivational Interview Counseling and Nicotine Replacement Therapy for Smoking Parents of Pediatric Patients: A Randomized Controlled Trial. Front Pediatr 2022; 10:798351. [PMID: 35498786 PMCID: PMC9045057 DOI: 10.3389/fped.2022.798351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/14/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Parental smoking is the dominant source of passive smoke exposure in the pediatric population. The current randomized controlled trial (RCT) study aimed to evaluate the effectiveness of a multi-component smoking reduction intervention in parental smoking reduction and children's environmental tobacco smoke exposure reduction in clinical settings. METHODS A single-blinded, 6-month randomized controlled trial recruited smoking parents (N = 210) of children who attended the pediatric wards or clinics at the Prince of Wales Hospital. Participants allocated to the intervention group (n = 105) received monthly motivational interviews on smoking reduction with emphasis on health hazards related to children's passive smoke exposure, 8-week nicotine replacement therapy, and referral to smoking cessation service if the parents preferred. The control group (n = 105) received simple verbal advice on smoking cessation. Primary outcomes were parental urine cotinine validated and self-reported ≥50% smoking reduction rates at 6 months. RESULTS Smoking parents in the intervention group had significantly more biochemically validated ≥50% smoking reduction than the control: 27.1 vs. 10.0% (OR = 3.34, 95% CI: 1.16-9.62, P = 0.02). The rate of self-reported ≥50% smoking reduction was also significantly higher in the intervention group than the control: 51.9 vs. 20.2% (OR = 4.40, 95% CI: 2.38-8.12, P < 0.001). For secondary outcomes, the rate of parental self-reported smoking cessation was higher in the intervention arm: 10.5 vs. 1.0% (OR = 12.17, 95% CI: 1.54-96.07, P < 0.001), however, no differences were detected in biochemically validated cessation and changes in children's passive smoke exposure between the groups. CONCLUSION Monthly smoking reduction counseling together with nicotine replacement therapy is more effective than simple verbal cessation advice in the smoking reduction for parents of pediatric patients. However, this study did not demonstrate differences in smoking cessation or reduction in children's passive smoke exposure with a 6-month follow-up. Achievement of a smoke-free environment remains challenging. TRIAL REGISTRATION Clinicaltrials.gov, identifier: NCT03879889.
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Affiliation(s)
- Siyu Dai
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China
| | - Michael Ho Ming Chan
- Department of Chemical Pathology, Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China
| | - Richard Kin Ting Kam
- Department of Chemical Pathology, Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China
| | - Albert Martin Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chun Ting Au
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kate Ching-Ching Chan
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Osinibi M, Lawton A, Bossley C, Gupta A. Promoting smoking cessation in the paediatric respiratory clinic. Eur J Pediatr 2022; 181:2863-2865. [PMID: 35412093 PMCID: PMC9192386 DOI: 10.1007/s00431-022-04453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
UNLABELLED Exposure to tobacco smoke is harmful to children and young people (CYP). There is, to our knowledge, no published evidence quantifying the success of smoking cessation interventions targeted at both CYP and their parents or guardians in paediatric respiratory clinics. We offered 102 participants smoking cessation advice, using motivational interviewing and exhaled carbon monoxide measurements to help them quit smoking. In total, 16 of 102 participants quit smoking, with 4 lost to follow-up. A further 40 participants cut down on how much they smoked. CONCLUSION Formal screening questions on smoking and the provision of smoking cessation advice should form a regular part of all respiratory clinics where CYP and their parents are seen. Simple smoking cessation interventions can lead to reduced smoking in this population. WHAT IS KNOWN • Tobacco smoking is strongly associated with significant morbidity and mortality. • Adolescents with chronic respiratory diseases may themselves smoke, or may have parents who do so. WHAT IS NEW • Smoking cessation interventions are well received in paediatric respiratory clinic by patients and their families. • Simple smoking cessation interventions can help young people and their parents to stop smoking or cut down on smoking.
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Affiliation(s)
| | | | | | - Atul Gupta
- Respiratory Paediatrics, Kingʼs College Hospital NHS Foundation Trust, Denmark Hill, London, UK
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Effective psychological therapies to improve lifestyle behaviors in (pre)pregnant women: A systematic review. Prev Med Rep 2021; 24:101631. [PMID: 34976684 PMCID: PMC8683997 DOI: 10.1016/j.pmedr.2021.101631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/22/2021] [Accepted: 11/06/2021] [Indexed: 12/02/2022] Open
Abstract
Poor lifestyle behaviors impact (pre)pregnant women by affecting pregnancy outcomes and offspring health. This systematic review provides an overview of psychological therapies to support lifestyle behavior changes among (pre)pregnant women. Scientific databases were searched from their inception to 20 December 2020 for studies investigating the effects of psychological therapies on improvements in lifestyle behaviors. Studies were eligible if they included (pre)pregnant women, examined the effects of a psychological therapy on at least one lifestyle behavior and used a control group receiving usual pregnancy care or a non-psychological intervention. Lifestyle behaviors of interest were dietary intake, physical activity, smoking, alcohol consumption, drug use, body weight loss and body weight gain during pregnancy. Pregnancy complications were included as outcome measures. Motivational interviewing (MI) (n = 21), cognitive behavioral therapy (CBT) (n = 8), incentive-based contingency management (IBCM) (n = 9), mindfulness (n = 1) and hypnosis (n = 1) were investigated as lifestyle behavior interventions. The findings revealed that MI was effective in reducing (self-reported) smoking and alcohol consumption and restricting gestational weight gain (GWG). CBT was only studied as an intervention to restrict GWG and the results predominantly confirmed its effectiveness. IBCM showed the strongest effect on reducing smoking and substance use. The studies using hypnosis or mindfulness to reduce smoking or restrict GWG, respectively, showed no associations. The use of psychological therapies to improve lifestyle behaviors among (pre)pregnant women is new and the scientific proof is promising. Before wide implementation is legitimated, more evidence is needed on the consequences of lifestyle change for pregnancy outcomes.
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Jin X, Kinner SA, Hopkins R, Stockings E, Courtney RJ, Shakeshaft A, Petrie D, Dobbins T, Puljevic C, Chang S, Dolan K. A randomised controlled trial of motivational interview for relapse prevention after release from smoke-free prisons in Australia. Int J Prison Health 2021. [DOI: 10.1108/ijph-01-2020-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.
Design/methodology/approach
This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.
Findings
From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).
Research limitations/implications
A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.
Originality/value
This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.
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Løchting I, Hagen R, Monsen CK, Grotle M, Storheim K, Aanesen F, Øiestad BE, Eik H, Bagøien G. Fidelity of a Motivational Interviewing Intervention for Improving Return to Work for People with Musculoskeletal Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910324. [PMID: 34639624 PMCID: PMC8507704 DOI: 10.3390/ijerph181910324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
The objective of this study was to conduct a fidelity evaluation of a motivational interviewing (MI) intervention delivered by social insurance caseworkers, in a three-arm randomized controlled trial (RCT) for improving return to work for people on sick leave with musculoskeletal disorders. The caseworkers received six days of MI training, including an intervention manual prior to the trial onset, as well as supervision throughout the trial. The caseworkers recorded 21 MI sessions at regular intervals during the trial. An independent MI analysis center scored the recordings using the MI treatment integrity code (MITI 4). In addition, three experienced MI trainers assessed the adherence to the MI intervention manual on a 1–4 Likert scale and MI competence. Total MITI 4 mean scores were at beginning proficiency levels for two components (global technical, mean 3.0; SD 0.6 and the reflections/questions ratio, mean 1.1; SD 0.2) and under beginning proficiency for two components (global relational, mean 3.2; SD 0.7 and complex question, mean 34.0; SD 21.2). The MI trainers’ assessment showed similar results. The mean adherence score for the MI sessions was 2.96 (SD 0.9). Despite delivering a thorough course and supervision package, most of the caseworkers did not reach proficiency levels of good MI competence during the study. The fidelity evaluation showed that a large amount of training, supervision and practice is needed for caseworkers to become competent MI providers. When planning to implement MI, it is important that thorough consideration is given regarding the resources and the time needed to train caseworkers to provide MI in a social insurance setting.
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Affiliation(s)
- Ida Løchting
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, 0424 Oslo, Norway; (M.G.); (K.S.)
- Correspondence: ; Tel.: +47-9183-2700
| | - Roger Hagen
- Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway;
- Department of Psychology, Norwegian University of Science and Technology, P.O. Box 8900, 7491 Trondheim, Norway
- Research Institute, Modum Bad, P.O. Box 33, 3370 Vikersund, Norway
| | - Christine K. Monsen
- Division of Mental Health & Addiction, Vestfold Hospital Trust, P.O. Box 2168, 3103 Tønsberg, Norway;
| | - Margreth Grotle
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, 0424 Oslo, Norway; (M.G.); (K.S.)
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Kjersti Storheim
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, 0424 Oslo, Norway; (M.G.); (K.S.)
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Fiona Aanesen
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Britt Elin Øiestad
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Hedda Eik
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Gunnhild Bagøien
- Nidelv Community Mental Health Centre, Department of Mental Health, Trondheim University Hospital, P.O. Box 3250, 7006 Trondheim, Norway;
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Khafagy GM, Mahmoud MM, Soliman SSA. Effect of Patient Empowerment Model on Smoking Cessation: Randomized Controlled Trial. Korean J Fam Med 2021; 42:369-375. [PMID: 34607412 PMCID: PMC8490173 DOI: 10.4082/kjfm.20.0212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/24/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation. METHODS This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period. RESULTS The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2-4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups. CONCLUSION Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.
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Affiliation(s)
- Ghada M. Khafagy
- Departments of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mervat M. Mahmoud
- Departments of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Saeed S. A. Soliman
- Departments of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Mohamed R, Bullen C, Hairi FM, Nordin ASA. A systematic review of group therapy programs for smoking cessation in Asian countries. Tob Induc Dis 2021; 19:63. [PMID: 34413718 PMCID: PMC8336625 DOI: 10.18332/tid/140089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. METHODS The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: ‘smoking’, ‘cigarette’, ‘tobacco’, ‘nicotine’, ‘group therapy’ and ‘cessation’ (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. RESULTS A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. CONCLUSIONS Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.
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Affiliation(s)
- Rashidi Mohamed
- Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Bangi, Malaysia
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,University of Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
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Thornberry A, Garcia TJ, Peck J, Sefcik E. Occupational Health Nurses' Self-Efficacy in Implementing Smoking Cessation Interventions for Workers: A Manufacturing Company Quality Improvement Project. Workplace Health Saf 2021; 70:63-72. [PMID: 34338092 DOI: 10.1177/21650799211022991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Effective smoking cessation interventions (SCIs) are urgently needed for the working population where smoking continues at high rates. Occupational health nurses (OHNs) could be effective in providing SCI, but self-efficacy was found to be a major barrier. The purpose of this study was to improve the delivery of SCI to those who smoke in the workplace and to explore nurse self-efficacy. METHODS Pretest and posttest were conducted on two groups, OHNs (n = 5) and smokers (n = 11) working at U.S. manufacturing facilities. OHNs were trained on motivational interviewing (MI) techniques who then recruited smokers to help them practice their newly acquired skills. The two groups were measured by Likert-type scale for OHN self-efficacy and smoker level of change toward quitting. FINDINGS Paired t-tests detected statistically significant differences in OHN's preintervention and postintervention self-efficacy scores, t(4) = -4.46, p < .001,; d = 2.92) and smokers' preintervention and postintervention stage of change toward quitting scores, t(10) = -9.07, p < .001,; d = 2.09), suggesting that the training and MI intervention were effective in increasing OHN self-efficacy and smokers' motivation to change. CONCLUSION/APPLICATION TO PRACTICE This quality improvement (QI) project indicated smokers can be successfully recruited and counseled using MI techniques, while simultaneously improving OHN self-efficacy toward helping patients. Theory-based applications brought OHNs and smokers together in a new paradigm resulting in positive changes for both. Secondary findings in the reverse nurse-patient role revealed success in an innovative recruitment method for smoking cessation.
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Dobber J, Snaterse M, Latour C, Peters R, Ter Riet G, Scholte Op Reimer W, de Haan L, van Meijel B. Active Ingredients and Mechanisms of Change in Motivational Interviewing for Smoking Cessation in Patients With Coronary Artery Disease: A Mixed Methods Study. Front Psychol 2021; 12:599203. [PMID: 34239470 PMCID: PMC8258345 DOI: 10.3389/fpsyg.2021.599203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background: For patients with coronary artery disease (CAD), smoking is an important risk factor for the recurrence of a cardiovascular event. Motivational interviewing (MI) may increase the motivation of the smokers to stop smoking. Data on MI for smoking cessation in patients with CAD are limited, and the active ingredients and working mechanisms of MI in smoking cessation are largely unknown. Therefore, this study was designed to explore active ingredients and working mechanisms of MI for smoking cessation in smokers with CAD, shortly after a cardiovascular event. Methods: We conducted a qualitative multiple case study of 24 patients with CAD who participated in a randomized trial on lifestyle change. One hundred and nine audio-recorded MI sessions were coded with a combination of the sequential code for observing process exchanges (SCOPE) and the motivational interviewing skill code (MISC). The analysis of the cases consisted of three phases: single case analysis, cross-case analysis, and cross-case synthesis. In a quantitative sequential analysis, we calculated the transition probabilities between the use of MI techniques by the coaches and the subsequent patient statements concerning smoking cessation. Results: In 12 cases, we observed ingredients that appeared to activate the mechanisms of change. Active ingredients were compositions of behaviors of the coaches (e.g., supporting self-efficacy and supporting autonomy) and patient reactions (e.g., in-depth self-exploration and change talk), interacting over large parts of an MI session. The composition of active ingredients differed among cases, as the patient process and the MI-coaching strategy differed. Particularly, change talk and self-efficacy appeared to stimulate the mechanisms of change “arguing oneself into change” and “increasing self-efficacy/confidence.” Conclusion: Harnessing active ingredients that target the mechanisms of change “increasing self-efficacy” and “arguing oneself into change” is a good MI strategy for smoking cessation, because it addresses the ambivalence of a patient toward his/her ability to quit, while, after the actual cessation, maintaining the feeling of urgency to persist in not smoking in the patient.
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Affiliation(s)
- Jos Dobber
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Marjolein Snaterse
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Corine Latour
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ron Peters
- Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands
| | - Gerben Ter Riet
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands
| | - Wilma Scholte Op Reimer
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands
| | - Lieuwe de Haan
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - Berno van Meijel
- Inholland University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Centers, Department of Psychiatry, VU Medical Center, Public Health Research Institute (APH), Amsterdam, Netherlands.,Parnassia Psychiatric Institute, The Hague, Netherlands
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Martin-Lujan F, Basora-Gallisa J, Villalobos F, Martin-Vergara N, Aparicio-Llopis E, Pascual-Palacios I, Santigosa-Ayala A, Catalin RE, Rey-Reñones C, Solà R. Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study. J Epidemiol Community Health 2021; 75:1001-1009. [PMID: 33883199 PMCID: PMC8458052 DOI: 10.1136/jech-2020-216219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/10/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
Objective This 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results. Design Randomised, parallel, controlled, multicentre clinical trial. Setting This study involved 12 primary healthcare centres (Tarragona, Spain). Participants Active smokers aged 35–70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters. Main outcome Prolonged abstinence (12 months) validated by expired-CO testing. Results Spirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04). Conclusions In active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare. Trial registration number NCT01194596.
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Affiliation(s)
- Francisco Martin-Lujan
- Direcció d'Atenció Primària, Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain .,Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - Josep Basora-Gallisa
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - Felipe Villalobos
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain
| | - Nuria Martin-Vergara
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain
| | | | | | - Antoni Santigosa-Ayala
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain.,Institut Català de la Salut, Sant Salvador Primary Health-Care Centre, Tarragona, Spain
| | - Roxana-Elena Catalin
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,Institut Català de la Salut, Bonavista-La Canonja Primary Health-Care Centre, Tarragona, Spain
| | - Cristina Rey-Reñones
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - Rosa Solà
- Hospital Universitari Sant Joan de Reus, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Functional Nutrition, Oxidation and Cardiovascular Disease (NFOC-SALUT) group, Universitat Rovira i Virgili, Reus, Spain
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Hejjaji V, Khetan A, Hughes JW, Gupta P, Jones PG, Ahmed A, Mohan SKM, Josephson RA. A combined community health worker and text messagingbased intervention for smoking cessation in India: Project MUKTI - A mixed methods study. Tob Prev Cessat 2021; 7:23. [PMID: 33791445 PMCID: PMC8005919 DOI: 10.18332/tpc/132469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/26/2020] [Accepted: 01/15/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We sought to evaluate the effectiveness of a community health worker (CHW) led smoking cessation intervention, supplemented by text messages, and tailored to an individual’s readiness to quit. METHODS We conducted a cluster randomized controlled trial (April 2018–August 2019) in adult smokers residing in a semi-urban region of India. Participants in the intervention arm received CHW-led home visits and had the option of choosing to receive regular text messages. The dose and content of CHW counseling and text messages were tailored to the participant’s readiness to quit. The control group received brief education only. Primary outcome was biochemically verified smoking cessation at the end of 12 months. Both intention-to-treat and as-treated analyses were performed. RESULTS A total of 238 (mean age 43±12.3 years, male 96.2%) participants were enrolled; 151 (64%) in the intervention arm and 83 (35.4%) in the control arm. At 12 months, 31 (20.5%) participants in the intervention arm and 9 (10.8%) in the control arm quit smoking (absolute risk difference=9.7%; RR=1.69; 95% CI: 0.04–71.33, p=0.74). In the as-treated analysis, 17 (36.9%) of the 46 participants who received optimal dose of the intervention quit smoking. CONCLUSIONS CHW-led home-based counseling, supplemented by regular text messages, led to an increase in quit rates for smoking, especially among those exposed to a higher dose of the intervention. However, the difference in cessation rates was not statistically significant. Future studies should consider testing mobile application-based multimedia messaging with larger populations, as a supplement to CHW-based counseling.
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Affiliation(s)
- Vittal Hejjaji
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, University of Missouri Kansas City, Kansas, United States
| | - Aditya Khetan
- Department of Cardiovascular Medicine, McMaster University Medical Center, Hamilton, Canada
| | - Joel W Hughes
- Department of Psychology, Kent State University, Kent, United States
| | - Prashant Gupta
- Department of Psychology, All India Institute of Medical Sciences, New Delhi, India
| | - Philip G Jones
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, University of Missouri Kansas City, Kansas, United States
| | - Asma Ahmed
- Department of Surgery, Ramaiah Medical College, Bangalore, India
| | - Sri Krishna Madan Mohan
- Department of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center - Case Western Reserve University, Cleveland, United States
| | - Richard A Josephson
- Department of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center - Case Western Reserve University, Cleveland, United States
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Ho RKS, Fok PWY, Chan HCH. Pattern and determinants of alcohol and tobacco co-use and its relationship with smoking cessation in Hong Kong. Tob Prev Cessat 2021; 7:21. [PMID: 33778215 PMCID: PMC7989697 DOI: 10.18332/tpc/132288] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/23/2020] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Alcohol and tobacco are often used together. Studies have shown that some biological factors contribute to the concurrent use of alcohol and nicotine. There have been comparatively few studies that document the concurrent prevalence and correlates of alcohol and tobacco use among adults. A better understanding of the smokers who also drink is needed to help them to quit smoking. METHODS A retrospective case review study on smokers who voluntarily joined our service in 2014-2017 was conducted. Characteristics of tobacco users only, and alcohol and tobacco co-users were reviewed. The quit rate of smoking related to alcohol use was analyzed. Participants were contacted by phone at week 26 and 52 to ascertain smoking status and abstinence. RESULTS There were 4602 alcohol and tobacco co-users and 2732 tobacco only users. Co-users had higher education level and better income than tobacco only users. In all, 52.24% of co-users were aged 21-40 years. For the alcohol users, their mean AUDIT score was only 6.17 (SD: 5.67). Multivariate analysis showed that age and gender were associated with co-use while high personal income had lower odds of co-use. Quit rate decreased as the AUDIT score increased. Those who had binge drinking more than once a month had lower quit rate compared with binge drinking less than once a month at week 26 (34.2% vs 43.19%, p<0.0001). CONCLUSIONS Alcohol and tobacco co-users should acknowledge alcohol-tobacco interactions to reduce alcohol use and prevent smoking relapse. Healthcare providers should screen for alcohol use in smoking cessation interventions.
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Affiliation(s)
- Raymond K. S. Ho
- Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation, Hong Kong
| | - Patrick W. Y. Fok
- Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation, Hong Kong
| | - Helen C. H. Chan
- Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation, Hong Kong
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Shen X, Xiao S, Liu R, Tong G, Liu T, Wang D. Personalized hypertension management based on serial assessment and telemedicine (PHMA): a cluster randomize controlled trial protocol in Anhui, China. BMC Cardiovasc Disord 2021; 21:135. [PMID: 33711941 PMCID: PMC7953659 DOI: 10.1186/s12872-021-01943-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite tremendous investment worldwide, hypertension treatment and control rates remain low. The complexity and long-term dynamics of influencing factors make personalized management inevitable and challenging. This protocol describes Personalized Hypertension Management in Anhui, China (PHMA), a project that uses a package of innovative approaches in tailoring interventions to individual patient's dynamic complications and contexts. METHODS/DESIGN PHMA strives to reduce hypertension harms by eight "objective behaviors" (e.g., self-monitoring and reporting, healthy diet, physical exercise/activities). These objective behaviors are promoted through five intervention measures: support for self- monitoring, supervised machine communications, daily education or reminder messages, weekly blood pressure notification, and quarterly signed feedback. PHMA uses ten categories and over 300 variables in selecting and refining intervention procedures and content for individual patients. Efficacy of the intervention package is evaluated using a cluster randomized controlled trial design involving a total of 60 site communities and 3352 hypertension patients. Primary measure for the evaluation is systolic and diastolic blood pressure; while secondary evaluation measures include quality of life (EQ5D-5L), occurrence of hypertension-related complications (such as cerebral hemorrhage, coronary heart disease, myocardial or cerebral infarction), healthcare utilization and scores of objective behaviors. DISCUSSION PHMA uses novel, low cost and sustainable approaches to tailor interventions to the dynamic conditions and contexts of individual patients. Unlike contemporary approaches to hypertension management which are mainly population based, each participant patient in PHMA applies a unique intervention package and all messages, feedbacks and other materials sent out to individual patients are different from each other. PHMA is the first project that adopts comprehensive tailoring and if proved effective, it should have important implications for future research, practice and policy-making. Trial registration ISRCTN10999269. July 17, 2020; https://doi.org/10.1186/ISRCTN10999269 .
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Affiliation(s)
- Xingrong Shen
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
| | - Siyi Xiao
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
| | - Rong Liu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
| | - Guixian Tong
- The First Affiliated Hospital of USTC, 17 Lujiang Road, Hefei, China
| | - Tongzhu Liu
- The First Affiliated Hospital of USTC, 17 Lujiang Road, Hefei, China
| | - Debin Wang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
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Rebora P, Spedale V, Occhino G, Luciani M, Alvaro R, Vellone E, Riegel B, Ausili D. Effectiveness of motivational interviewing on anxiety, depression, sleep quality and quality of life in heart failure patients: secondary analysis of the MOTIVATE-HF randomized controlled trial. Qual Life Res 2021; 30:1939-1949. [PMID: 33616815 PMCID: PMC8233269 DOI: 10.1007/s11136-021-02788-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
Purpose Anxiety, depression, poor sleep quality and lower quality of life (QOL) are associated with worse outcomes in heart failure (HF) patients. Motivational interview (MI) has been effective in different patient populations to promote self-care. However, its effect on anxiety, depression, sleep quality and QOL in HF patients is unknown. The aim of this study was to evaluate the effect of MI on anxiety, depression, sleep quality and QOL over 12 months from the intervention. Methods This was a planned, secondary outcome analysis of the MOTIVATE-HF study, a three-arm randomized controlled trial (1:1:1) evaluating the effect of MI in improving self-care in HF patients. In Arm 1, the patient received MI, while in Arm 2, the patient and the caregiver received MI. Arm 3, the control group, received standard treatment. Endpoints were evaluated with the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), the 12-Item Short-Form Health Survey (SF-12) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) every three months for one year. Results We enrolled and randomized 510 HF patient and caregiver dyads (155 dyads in Arm 1, 177 dyads in Arm 2, and 178 dyads in Arm 3). A total of 238 HF patients and 235 caregivers completed the 12-month trial. No significant changes were seen in anxiety, depression and sleep quality over time among the three study arms, but disease-specific QOL improved in the intervention groups, especially in Arm 2. Conclusion Clinicians may want to include both patients and caregivers when providing MI interventions. Further research is needed to investigate the required intensity of MI to be effective on sleep quality, anxiety and depression (ClinicalTrials.gov Identifier: NCT02894502). Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02788-3).
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Affiliation(s)
- Paola Rebora
- Department of Medicine and Surgery, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Valentina Spedale
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Giuseppe Occhino
- Biostatistics and Bioimaging Centre, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104-4217 USA
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano - Bicocca, Via Cadore 48, 20900 Monza, Italy
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Marler JD, Fujii CA, Galanko JA, Balbierz DJ, Utley DS. Durability of Abstinence After Completing a Comprehensive Digital Smoking Cessation Program Incorporating a Mobile App, Breath Sensor, and Coaching: Cohort Study. J Med Internet Res 2021; 23:e25578. [PMID: 33482628 PMCID: PMC7920755 DOI: 10.2196/25578] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/11/2021] [Accepted: 01/21/2021] [Indexed: 01/07/2023] Open
Abstract
Background Despite decreasing prevalence over the last several decades, cigarette smoking remains the leading cause of preventable death and disease, underscoring the need for innovative, effective solutions. Pivot is a novel, inclusive smoking cessation program designed for smokers along the entire spectrum of readiness to quit. Pivot leverages proven methods and technological advancements, including a personal portable breath carbon monoxide sensor, smartphone app, and in-app text-based coaching. We previously reported outcomes from the end of active Pivot program participation in 319 adult smokers. Herein, we report longer-term follow up in this cohort. Objective The aim of this study was to assess and report participant outcomes 3 months after completion of Pivot, including smoking behavior, quit rates, continuous abstinence rates and durability, and predictors of abstinence. Methods This prospective remote cohort study included US-based cigarette smokers aged 18 to 65 years who smoked ≥5 cigarettes per day (CPD). Three months after completion of active participation in Pivot, final follow-up data were collected via an online questionnaire. Outcomes included smoking behavior (CPD and quit attempts), self-reported quit rates (7- and 30-day point prevalence abstinence [PPA]), and continuous abstinence rates (proportion who achieved uninterrupted abstinence) and duration. Exploratory regression analyses were performed to identify baseline characteristics associated with achievement of 7-day PPA, 30-day PPA, and continuous abstinence. Results A total of 319 participants completed onboarding (intention-to-treat [ITT]); 288/319 participants (90.3%) completed follow up (completers) at a mean of 7.2 (SD 1.2) months after onboarding. At final follow up, CPD were reduced by 52.6% (SE 2.1; P<.001) among all 319 participants, and most completers (152/288, 52.8%) reduced their CPD by at least 50%. Overall, most completers (232/288, 80.6%) made at least one quit attempt. Quit rates increased after the end of Pivot; using ITT analyses, 35.4% (113/319) achieved 7-day PPA and 31.3% (100/319) achieved 30-day PPA at final follow up compared with 32.0% (102/319) and 27.6% (88/319), respectively, at the end of the Pivot program. Continuous abstinence was achieved in about a quarter of those who onboarded (76/319, 23.8%) and in most who reported 30-day PPA at the end of Pivot (76/88, 86.4%), with a mean abstinence duration of 5.8 (SD 0.6) months. In exploratory regression analyses, lower baseline CPD, more positive baseline attitudes reflecting higher self-efficacy (higher confidence to quit and lower perceived difficulty of quitting), and higher education were associated with achieving abstinence. Conclusions This study provides the first longer-term outcomes of the Pivot smoking cessation program. At final follow up, quit rates increased and continuous abstinence was favorable; the majority who achieved abstinence at the end of Pivot sustained abstinence throughout follow up. Decreases in CPD persisted and most participants made a quit attempt. Overall, final follow-up outcomes were stable or improved when compared to previous outcomes from the end of the program. These findings validate earlier results, and suggest that Pivot is an effective and durable solution for smoking cessation. Trial Registration ClinicalTrials.gov NCT03295643; https://clinicaltrials.gov/ct2/show/NCT03295643
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Affiliation(s)
| | | | - Joseph A Galanko
- Biostatistics Core for the Center for Gastrointestinal Biology and Disease and the Clinical Nutrition Research Center, Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Ale BM, Amahowe F, Nganda MM, Danwang C, Wakaba NN, Almuwallad A, Ale FBG, Sanoussi A, Abdullahi SH, Bigna JJ. Global burden of active smoking among people living with HIV on antiretroviral therapy: a systematic review and meta-analysis. Infect Dis Poverty 2021; 10:12. [PMID: 33579391 PMCID: PMC7881452 DOI: 10.1186/s40249-021-00799-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background Although the high burden of both active smoking and human immunodeficiency virus (HIV) is clearly known, the relationship between them is still not well characterized. Therefore, we estimated the global prevalence of active smoking in people living with HIV (PLHIV) on antiretroviral therapy (ART) and investigated the association between exposure to active smoking and risk for suboptimal adherence to ART. Main text: We searched PubMed, Embase, and Web of Science to identify articles published until September 19, 2019. Eligible studies reported the prevalence of active smoking in PLHIV on ART or investigated the association between active smoking and ART adherence; or enough data to compute these estimates. We used a random-effects model to pool data and quantified heterogeneity (I2). The global prevalence of active smoking was 36.1% (95% CI: 33.7–37.2; 329 prevalence data; 462 104 participants) with substantial heterogeneity. The prevalence increased with level of country income; from 10.1% (95% CI: 6.8–14.1) in low-income to 45.2% (95% CI: 42.7–47.7) in high-income countries; P < 0.0001. With regards to the Joint United Nations Programme on HIV/AIDS (UNAIDS) regions, the prevalence was higher in West and Central Europe and North America 45.4% (42.7–48.1) and lowest in the two UNAIDS regions of sub-Saharan Africa: Eastern and Southern Africa 10.7% (95% CI: 7.8–14.0) and West and Central Africa 4.4% (2.9–6.3); P < 0.0001. Globally, we estimated that there were 4 110 669 PLHIV on ART who were active smokers, among which the highest number was from Eastern and Southern Africa (35.9%) followed by Asia and the Pacific (25.9%). Active smoking was significantly associated with suboptimal ART adherence: pooled odds ratio 1.57 (95% CI: 1.37–1.80; I2 = 56.8%; 19 studies; 48 450 participants); even after considering adjusted estimates: 1.67 (95% CI: 1.39–2.01; I2 = 53.0%; 14 studies). Conclusions This study suggests a high prevalence of active smoking in PLHIV on ART and an association between active smoking and ART suboptimal adherence. As such, healthcare providers and policy makers should focus on adopting and implementing tobacco harm reduction strategies in HIV care, especially in sub-Saharan Africa known as epicenter of HIV pandemic with highest number of active tobacco smoking among PLHIV on ART. ![]()
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Affiliation(s)
| | | | - Motto Malea Nganda
- Department of Clinical Science and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Célestin Danwang
- Epidemiology and Biostatistics Unit, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | | | - Ateeq Almuwallad
- Applied Medical Sciences College, Jazan University, Jazan, Saudi Arabia.,Center for Trauma Science, Queen Mary University of London, London, UK
| | | | - Alamou Sanoussi
- Transition Support Program Department, Advocate Good Samaritan Hospital, Downers Grove, IL, USA
| | | | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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Staras SAS, Richardson E, Merlo LJ, Bian J, Thompson LA, Krieger JL, Gurka MJ, Sanders AH, Shenkman EA. A feasibility trial of parent HPV vaccine reminders and phone-based motivational interviewing. BMC Public Health 2021; 21:109. [PMID: 33422047 PMCID: PMC7797089 DOI: 10.1186/s12889-020-10132-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/25/2020] [Indexed: 11/28/2022] Open
Abstract
Background We assessed the feasibility and acceptability of a sequential approach of parent-targeted HPV vaccine reminders and phone-based Motivation Interviewing (MI). Methods In 2016, we selected all 11- to 12-year-old boys and girls seen in one clinic whose vaccine records did not include the HPV vaccine (n=286). By gender, we individually randomized parents of adolescents to an interactive text message (74 girls and 45 boys), postcard reminder (46 boys and no girls because of previously demonstrated efficacy), or standard care group (75 girls and 46 boys). Reminders were sent with medical director permission and a HIPAA waiver. Two months after reminders, among the adolescents whose vaccine records still did not include the HPV vaccine, we selected a gender-stratified random sample of 20 parents for phone-based MI. We assessed the percentage of deliverable messages, the percentage of parents’ responding to the interactive text message, parent acceptability of receiving a text message, and MI parent responsiveness and interviewer competence (MI Treatment Integrity Coding system). Results Nearly all messages were deliverable (98% of postcards and 74% of text messages). Six of the 88 parents (7%) receiving text messages scheduled an appointment through our interactive system. The acceptability survey response rate was 37% (38/102). Respondents were favorable toward vaccine reminders for all parents (82%). Among 20 sampled parents, 17 were reached by phone of whom 7 completed MI, 4 had or were getting the HPV vaccine for their child, and 5 expressed disinterest. Across the 7 MI calls, the interviewer was rated 100% MI adherent and scored an average 4.19 rating for Global Spirit. Conclusion Without providing explicit consent to receive vaccine-related messages, parents nonetheless found postcards and interactive text messages acceptable. Centralizing MI to phone calls with trained staff was acceptable to parents and resulted in highly MI-adherent interviews. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10132-6.
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Affiliation(s)
- Stephanie A S Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA. .,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Eric Richardson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Lisa J Merlo
- The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA.,Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Lindsay A Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA.,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Janice L Krieger
- Department of Advertising, College of Journalism and Communication, University of Florida, Gainesville, FL, USA
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ashley H Sanders
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA
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Körkel J. Treating patients with multiple substance use in accordance with their personal treatment goals: a new paradigm for addiction treatment. DRUGS AND ALCOHOL TODAY 2021. [DOI: 10.1108/dat-10-2020-0065] [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
This paper aims to present the theoretical foundation and practical approach of “open-target addiction treatment” (OTAT). Traditional treatment programmes are usually-oriented towards fixed predefined goals (abstinence, reduced consumption and harm reduction) and often focus on one substance only (e.g. alcohol). However, as a rule, people who use drugs consume several substances and sometimes additionally exhibit behavioural addictions. For many of these addictions, there is more or less motivation for change, but commonly it is not abstinence as a consistent goal. The paradigm of OTAT systematically considers multi-substance use, expects high readiness to change and is aware that commonly clients lack the willingness to abstain permanently.
Design/methodology/approach
The theory and practice of OTAT involve three components, namely, first, to create a systematic inventory of all psychoactive substances consumed and addictive behaviours performed, second, to clarify, which substance-related change goals clients pursue and third, to choose adequate treatment options matching the substance-specific goals of the clients. Furthermore, OTAT includes didactic tools to support working along with these three steps (e.g. a set of cards to gain an overview over the psychoactive substances used and addictive behaviours performed).
Findings
The systematic implementation of OTAT requires fundamentally different concepts about addiction and its treatment, specific competencies of the staff and a corresponding portfolio of interventions within the treatment facilities.
Research limitations/implications
Future research should focus more on patients’ goal preferences and their impact on their willingness to take up treatment and its outcomes.
Practical implications
To implement OTAT treatment, institutions have to undergo a systematic process of team and organizational development.
Social implications
OTAT has the potential to reduce the treatment gap and to serve severely addicted individuals in a more comprehensive way.
Originality/value
The OTAT approach has not been described in the addiction treatment literature so far.
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Mical R, Martin-Velez J, Blackstone T, Derouin A. Vaccine Hesitancy in Rural Pediatric Primary Care. J Pediatr Health Care 2021; 35:16-22. [PMID: 33010996 PMCID: PMC7527836 DOI: 10.1016/j.pedhc.2020.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 11/29/2022]
Abstract
Vaccine hesitancy (VH) is a pervasive issue resulting in the delay or refusal of vaccines, which are known to protect against life-threatening diseases. The purpose of this quality improvement project was to determine if early identification of VH using the Parent Attitudes about Childhood Vaccines survey and targeted interventions would decrease VH scores. Of the 70 total participants, 11 participants were VH in the preintervention survey group; of those, nine (81.8%) were not VH in the postintervention survey group, and two (18.2%) remained VH (p = .004) after the intervention. Routine screening for VH using the Parent Attitudes about Childhood Vaccines survey and implementing interventions successfully decreased VH scores and improved vaccine compliance.
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Riordan P, Davis M. Anxiety and psychological management of heart disease and heart surgery. HANDBOOK OF CLINICAL NEUROLOGY 2021; 177:393-408. [PMID: 33632455 DOI: 10.1016/b978-0-12-819814-8.00026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Anxiety is associated with many forms and facets of heart disease, and, by extension, neurologic manifestations of heart disease. Despite its seeming self-evidence, anxiety is challenging to consistently define, measure, and operationalize in the context of medical research. Various diagnostic nosologies have been defined and refined over time, but anxiety is also a universal human experience that may be "normal" in many circumstances, particularly in the face of major medical issues. For these and other reasons, the research on anxiety and heart disease is mixed, incomplete, and often characterized by challenging questions of causality. Nonetheless, a broad body of literature has established clear connections between anxiety and vascular risk factors, cardiac disease, and cardiac surgery. These relationships are often intuitive, with research suggesting, for example, that chronic activation of the sympathetic nervous system is associated with increased risk of heart disease. However, they are sometimes complexly reciprocal or even surprising (e.g., with high-anxiety individuals found to have better outcomes in some cardiac conditions by virtue of seeking evaluation and treatment earlier). This chapter reviews the construct of anxiety and its complexities, its associations with heart disease, and the established treatments for anxiety, concluding with questions about anxiety, heart disease, and their optimal management that still need to be answered.
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Affiliation(s)
- Patrick Riordan
- Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, United States.
| | - Matthew Davis
- Mental Health Service Line, Edward Hines Jr. VA Hospital, Hines, IL, United States
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