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Sheffer CE. Tobacco quitlines: Opportunities for innovation to increase reach and effectiveness. Prev Med 2022; 165:107319. [PMID: 36283486 DOI: 10.1016/j.ypmed.2022.107319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022]
Abstract
The largest tobacco treatment network in North America, Tobacco Quitlines are an effective population-based approach to increase tobacco cessation; however, overall reach has decreased significantly in the past decade. A new generation of innovations responsive to evolving shifts in communication preferences, supported by research, and focused on increasing the impact of services have the potential to reinvigorate this network. The goal of this narrative review was to identify opportunities for innovation in Quitline service delivery, synthesize evidence for these opportunities, and identify gaps in the research. Innovation was defined as significant shift in current practice by utilizing novel theoretical concepts, approaches, methodologies, or interventions. The Experimental Medicine Approach informed the identification of gaps in the research. The specific domains were selected by reviewing previous reviews, commentaries, calls for action, and a recent report on promising practices. Evidence was garnered primarily from systematic reviews. Opportunities included automated and interactive digital therapeutics, novel health communications for stigma-free media campaigns, methods to increase access to nicotine replacement therapies, novel treatment options and combinations, and methods to promote engagement with digital therapeutics. Research topics that cross multiple domains include the consideration of theoretical frameworks, the identification of therapeutic targets and mechanisms of action, and the development of adapted approaches to address specific challenges and cultural responsivity. Finally, an examination is needed to understand how to improve the speed with which innovations are developed and implemented in this network.
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Affiliation(s)
- Christine E Sheffer
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm & Carlton, Buffalo, NY 14263, United States of America.
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2
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Kidwell KM, Reiter-Purtill J, Decker K, Howarth T, Doland F, Zeller MH. Stress and eating responses in adolescent females predisposed to obesity: A pilot and feasibility study. Appetite 2022; 179:106308. [PMID: 36100044 DOI: 10.1016/j.appet.2022.106308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/09/2022] [Accepted: 09/07/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To explore how chronic stress, reactivity to acute stress, and obesogenic eating are linked in adolescent females predisposed to obesity. METHODS Participants included 21 adolescent females (mage = 14.57 years) and their biological mothers with obesity (body mass index [BMI] ≥ 30 kg/m2). The pilot and feasibility study involved adolescent self-report of chronic stress, an acute stress-induction paradigm (Trier Social Stress Task, TSST), salivary cortisol collection to assess stress reactivity, and both subjective (self-report) and objective (snack buffet) measures of obesogenic eating. RESULTS Adolescent females reporting high chronic stress were significantly more likely to engage in self-reported emotional and external eating and to have higher food cravings (p's < .05) compared to adolescents with low chronic stress. Effect size estimates suggested a blunting effect of cortisol in the high chronic stress group. Blunted cortisol reactivity significantly predicted higher self-reported food cravings for the high chronic stress group (p = .04). Associations among chronic stress, cortisol, and self-reported and objective obesogenic eating reflected medium to large effect sizes. CONCLUSIONS This study built on limited extant research on stress and eating to demonstrate that chronic stress was associated with self-reported obesogenic eating patterns in adolescent females predisposed to obesity. Different patterns of cortisol reactivity and eating emerged depending on chronic stress group (low versus high). Understanding these eating patterns in the context of chronic stress can inform interventions to reduce obesity risks in adolescence.
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Affiliation(s)
- Katherine M Kidwell
- Division of Behavioral Medicine Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244, USA.
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Kristina Decker
- Division of Behavioral Medicine Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Taylor Howarth
- Division of Behavioral Medicine Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Faye Doland
- Division of Behavioral Medicine Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Meg H Zeller
- Division of Behavioral Medicine Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
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Baldwin AS, Lamb CL, Geary BA, Mitchell AD, Kouros CD, Levens S, Martin LE. Testing and Optimizing Guided Thinking Tasks to Promote Physical Activity: Protocol for a Randomized Factorial Trial (Preprint). JMIR Res Protoc 2022; 11:e40908. [PMID: 36074550 PMCID: PMC9501674 DOI: 10.2196/40908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration International Registered Report Identifier (IRRID)
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Affiliation(s)
- Austin S Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Colin L Lamb
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Bree A Geary
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Alexis D Mitchell
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Chrystyna D Kouros
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Sara Levens
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Laura E Martin
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
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Louvardi M, Chrousos GP, Darviri C. The Effect of Stress Management Techniques on Persons with Addictive Behaviors: a Systematic Review. Mater Sociomed 2021; 33:213-218. [PMID: 34759780 PMCID: PMC8563055 DOI: 10.5455/msm.2021.33.213-218] [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: 07/25/2021] [Accepted: 09/26/2021] [Indexed: 11/03/2022] Open
Abstract
Background According to the current state of knowledge, addictions are often developed as a maladaptive coping response to elevated stress levels. Stress management has a beneficial effect on various mental health problems. Yet, there is no strong evidence concerning the effect of stress management on stress levels of individuals with addictive behaviors, although such an effect might benefit their addictive symptoms. Objective To investigate the effect of stress management on stress levels of persons with addictive behaviors. Methods A systematic review of the literature was carried out on Biomed Central, PubMed, Scopus and Web of Science searching for relevant trials investigating the effect of stress management techniques, specifically of Progressive Muscle Relaxation (PMR), Autogenic Training (AT) and Guided Imagery (GI), on stress levels of individuals with addictive behaviors. In order to be included, the studies had to be randomized trials using an intervention and a non-intervention or a placebo control group, to apply PMR, GI or AT, to include a sample with addictive behaviors, to be published in English, to involve a baseline and at least one subsequent measurement, to be published in peer-review journals and to measure stress through instruments or biochemical assessments. The trials' quality was assessed by the use of the Jadad Scale. Results A total of four studies met the inclusion criteria and were further analyzed. The findings indicated that PMR might lead to a reduction of stress levels, while no such evidence is found concerning GI and AT. The quality of all trials was low. Conclusion Progressive Muscle Relaxation and GI might have a divergent effect on persons with addictive behaviors. Yet, the low number of the studies and their poor quality debars drawing reliable conclusions for potential beneficial effects.
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Affiliation(s)
- Maya Louvardi
- Postgraduate Course "Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- Postgraduate Course "Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Course "Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Gordon JS, Sbarra D, Armin J, Pace TWW, Gniady C, Barraza Y. Use of a Guided Imagery Mobile App (See Me Serene) to Reduce COVID-19-Related Stress: Pilot Feasibility Study. JMIR Form Res 2021; 5:e32353. [PMID: 34546941 PMCID: PMC8491644 DOI: 10.2196/32353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 12/13/2022] Open
Abstract
Background The SARS-CoV-2 pandemic has led to concerns about mental health resulting from regional and national lockdowns, social isolation, job loss, and concern about disease exposure. Objective We describe results of the pilot feasibility study of the See Me Serene mHealth app. The app provides users with immersive, vivid, nature experiences to reduce stress and anxiety related to COVID-19 and other isolation. The goals of the study were to develop the See Me Serene app and test the feasibility and acceptability of study procedures, and explore the potential impact of the app on stress and anxiety. Methods We developed and tested the See Me Serene app and our study procedures for feasibility, and gathered preliminary data with a goal of 100 participants. The research was conducted in 2 phases: (1) development and internal testing of the app; and (2) feasibility and pilot testing with participants recruited online through earned media (eg, news stories), presentations at a university campus, and social media (eg, online sharing of earned media and presentations). The feasibility study employed a mixed methods, within-subjects, pre-/posttest design. At baseline and 30-day follow-up, we assessed stress-related variables via validated self-report measures and saliva samples for determination of cortisol concentrations. Results We met or surpassed all our feasibility benchmarks for recruitment (101 participants recruited), retention (91% [90/99] of 30-day assessment completed), and data collection (99 participants completed all baseline data; 85% [84/99] of salivary cortisol samples returned). Participants adhered to the intervention. On average, participants listened to 48.2 audio files over 30 days or approximately 1.6 audio files per day. Participants were satisfied with the app, with 87% (78/90) rating the app as helpful in dealing with stress and anxiety. The app showed the potential to reduce stress, anxiety, loneliness, and worry. We did not find significant differences (P=.41) in cortisol levels over time. Our findings suggest that future research is warranted to test the efficacy of the See Me Serene app with a representative, diverse sample. Conclusions There is a need for evidence-based and easily disseminable stress-reduction interventions. See Me Serene is a feasible intervention and has the potential to reduce stress related to COVID-19 and other forms of social isolation. More research on See Me Serene is warranted.
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Affiliation(s)
- Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - David Sbarra
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Julie Armin
- Department of Family and Community of Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Thaddeus W W Pace
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - Chris Gniady
- Department of Computer Science, University of Arizona, Tucson, AZ, United States
| | - Yessenya Barraza
- College of Nursing, University of Arizona, Tucson, AZ, United States
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Giacobbi P, Symons Downs D, Haggerty T, Pidhorskyi S, Long DL, Clemmer M, Steinman SA, Olfert MD, Kinnamon K, Rao N, Staggs H, Adjeroh D. Feasibility and Acceptability of Guided Imagery to Sequentially Address Multiple Health Behaviors During Pregnancy. J Midwifery Womens Health 2021; 66:664-670. [PMID: 34510697 DOI: 10.1111/jmwh.13251] [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: 07/13/2020] [Revised: 03/26/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Pregnancy presents health challenges related to well-being, physical activity, dietary regulation, and body image. There is evidence to support the use of guided imagery to address these concerns during pregnancy. The purpose of this study was to analyze the use and short-term outcomes of a multiple-behavior guided imagery intervention delivered through a mobile health (mHealth) application for pregnant women. METHODS A single-arm, 5-week feasibility trial was conducted, and participants were instructed to listen to an audio file every day for 35 days on an mHealth application. Measurements included ongoing assessments of the participants' use of the guided imagery audio files and pre- and post-test measures of depression, anxiety, stress, physical activity, food cravings, and body image. Postintervention qualitative interviews were conducted to assess whether participants would continue to use guided imagery. RESULTS Fifty-eight participants (mean age, 28.5 years) were enrolled from January to June of 2018. Cloud analytics data showed an average of 4.96 audio downloads per week with the Sleep and Relaxation file being the most widely used (mean weekly usage, 5.67) and reported favorite during follow-up interviews. Paired-sample t tests from pre- to post-test showed significant reductions in depression, anxiety, and stress, increased physical activity, and sedentary behavior along with some changes in body image. DISCUSSION Future scalable guided imagery interventions are justified to test for efficacy. Guided imagery may also be delivered in person by health care providers or by using widely available technologies.
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Affiliation(s)
- Peter Giacobbi
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia.,Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Danielle Symons Downs
- Department of Kinesiology, College of Health and Human Development, Penn State University, State College, Pennsylvania.,Department of Obstetrics and Gynecology, College of Health and Human Development, Penn State University, State College, Pennsylvania
| | - Treah Haggerty
- Department of Family Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Stanislav Pidhorskyi
- Lane Department of Computer Science and Electrical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia
| | - D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama Birmingham, Birmingham, Alabama
| | - Melanie Clemmer
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Shari A Steinman
- Department of Psychology, College of Liberal Arts and Sciences, West Virginia University, Morgantown, West Virginia
| | - Melissa D Olfert
- Department of Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, West Virginia
| | - Kelsey Kinnamon
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia
| | - Neel Rao
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia
| | - Hannah Staggs
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia
| | - Donald Adjeroh
- Lane Department of Computer Science and Electrical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia
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Classical Introspection Revisited: Implications of Research on Visual Imagery for the Functions of Pristine Inner Experience as Apprehended by Descriptive Experience Sampling. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00176-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Armin JS, Nair U, Giacobbi P, Povis G, Barraza Y, Gordon JS. Developing a Guided Imagery Telephone-Based Tobacco Cessation Program for a Randomized Controlled Trial. Tob Use Insights 2020; 13:1179173X20949267. [PMID: 32922107 PMCID: PMC7446272 DOI: 10.1177/1179173x20949267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/14/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIMS Guided imagery is an evidence-based, multi-sensory, cognitive process that can be used to increase motivation and achieve a desired behavior. Quitlines are effective, standard care approaches for tobacco cessation; however, utilization of quitlines is low. Using guided imagery-based interventions for smoking cessation may appeal to smokers who do not utilize traditional quitline services. This paper reports the development of program materials for a randomized controlled feasibility trial of a guided imagery-based smoking cessation intervention. The objective of the formative work was to ensure that program materials are inclusive of groups that are less likely to use quitlines, including men and racial/ethnic minority tobacco users. METHODS A three-phase process was used to complete formative assessment: (1) integration of evidence-based cessation practices into program development; (2) iterative small group interviews (N = 46) to modify the program; and (3) pilot-testing the coaching protocol and study process among a small sample of smokers (N = 5). RESULTS The Community Advisory Board and project consultants offered input on program content and study recruitment based on their knowledge of minority communities with whom they conduct outreach. Small group interview participants included members of underserved quitline populations (52.37% non-white; 55.56% men). Only 28.26% of participants had prior experience with guided imagery, but others described the use of similar mindfulness and meditation practices. Participant feedback was incorporated into program materials and protocols. DISCUSSION Iteratively collected feedback and pilot testing influenced program content and delivery and informed study processes for a randomized controlled feasibility trial of a telephone-delivered, guided imagery-based intervention.
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Affiliation(s)
- Julie S Armin
- Department of Family & Community Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Uma Nair
- Department of Family & Community Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Peter Giacobbi
- College of Physical Activity and Sport Sciences and School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Gayle Povis
- The University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Tucson AZ, USA
| | - Yessenya Barraza
- The University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Tucson AZ, USA
| | - Judith S Gordon
- College of Nursing, The University of Arizona, Tucson, AZ, USA
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Gordon JS, Giacobbi P, Armin JS, Nair US, Bell ML, Povis G. Testing the feasibility of a guided imagery tobacco cessation intervention delivered by a telephone quitline: Study protocol for a randomized controlled feasibility trial. Contemp Clin Trials Commun 2019; 16:100437. [PMID: 31508532 PMCID: PMC6727006 DOI: 10.1016/j.conctc.2019.100437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/07/2019] [Accepted: 08/21/2019] [Indexed: 11/03/2022] Open
Abstract
Background Guided imagery (GI) is an evidence-based method that uses the imagination to practice and achieve a desired outcome. Little research has focused on how GI can be delivered to smokers using remote or virtual methods, such as a telephone-based intervention. Telephone-based services for tobacco cessation (quitlines) have emerged as standard of care for tobacco cessation. However, quitlines reach only a small fraction of smokers, and men and racial/ethnic minorities are less likely to use quitlines than majority women. GI has the potential to attract under-served minority groups as well as smokers who are looking for an alternative approach to cessation. The present study is designed to test the feasibility and potential impact of a GI tobacco cessation intervention delivered by telephone. This study compares the GI intervention with a standard behavioral (SB) intervention. Methods Participants (N = 100) are randomized to either the GI (intervention) or SB (control) condition. Each condition features a 6-week intervention in which participants work with coaches to quit tobacco. Primary outcomes are feasibility related (recruitment, retention, adherence), and secondary outcomes include cessation at 6 months post-intervention (7-day and 30-day abstinence). Discussion A GI intervention delivered via quitline would allow for scalability and dissemination, potentially reaching a more representative group of smokers. Results from this study will determine the feasibility of delivering the GI intervention, and describe the reach of the intervention to under-represented tobacco users. If successful, our study results will guide the design and conduct of a future efficacy trial.
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Affiliation(s)
| | - Peter Giacobbi
- West Virginia University, Social and Behavioral Sciences, School of Public Health, USA
| | - Julie S Armin
- University of Arizona, Department of Family and Community Medicine, USA
| | - Uma S Nair
- University of Arizona, Mel and Enid Zuckerman College of Public Health, USA
| | - Melanie L Bell
- University of Arizona, Mel and Enid Zuckerman College of Public Health, USA
| | - Gayle Povis
- University of Arizona, College of Nursing, USA
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